2017-05-15T21:04:52-05:00 2016-06-30 861065772 Deloitte Tax LLP 111 Monument Circle Suite 4200 Indianapolis IN 462045108 990 2015-07-01 350869065 ST MARY'S HEALTH INC STMA 8124854178 3700 WASHINGTON AVENUE EVANSVILLE IN 47750 JOHN L ZABROWSKI III CFO 2017-05-15 true Shawna M Jimenez P01222873 3174648600 2015 2021-01-29 14:40:06Z DAN PAROD 3700 WASHINGTON AVENUE EVANSVILLE IN 47750 528766935 false 0928 X WWW.STMARYS.ORG X 1941 IN DEDICATED TO SPIRITUALLY CENTERED CARE, WHICH IMPROVES THE HEALTH OF INDIVIDUALS AND COMMUNITIES. 18 14 3541 329 241857 -262887 22152002 1660484 469119871 495020543 16491630 4324915 66997900 26733953 574761403 527739895 65593542 0 0 174397893 188844743 0 781297 282061410 244889338 522052845 433734081 52708558 94005814 829695793 870479825 251245692 215394142 578450101 655085683 DEDICATED TO SPIRITUALLY CENTERED CARE, WHICH IMPROVES THE HEALTH OF INDIVIDUALS AND COMMUNITIES. false false 248635465 519599087 ST. MARY'S HEALTH, INC. (SMH) PROVIDES INPATIENT AND OUTPATIENT MEDICAL SERVICES SERVING VANDERBURGH AND CONTIGUOUS COUNTIES AND PROVIDING SERVICES WITHOUT REGARD TO PATIENT RACE, CREED, NATIONAL ORIGIN, ECONOMIC STATUS, OR ABILITY TO PAY. DURING FISCAL YEAR 2016, SMH TREATED 17,469 INPATIENTS IN THE COMMUNITY FOR A TOTAL OF 81,394 PATIENT DAYS OF SERVICE. SMH ALSO PROVIDED SERVICES TO 403,174 OUTPATIENTS, INCLUDING 4,509 INPATIENT SURGERY PATIENTS, 51,649 EMERGENCY ROOM VISITS, 2,023 PHYSICIAN OFFICE VISITS, AND 28,764 CLINIC VISITS. SEE SCHEDULE H FOR A NON-EXHAUSTIVE LIST OF COMMUNITY BENEFIT PROGRAMS AND DESCRIPTIONS. 49831502 SMH PROVIDES A SUBSTANTIAL PORTION OF ITS CORE HEALTH SERVICES TO THE POOR, UNINSURED, OR UNDERINSURED AND HAS PROACTIVELY TAKEN STEPS TO ADDRESS ACCESSIBILITY, AND THE FINANCING, AND DELIVERY OF HEALTHCARE TO THE UNDERSERVED. DURING THE FISCAL YEAR ENDING JUNE 30, 2016, THE UNREIMBURSED COST OF FREE OR DISCOUNTED SERVICES PROVIDED TO PATIENTS WHO ARE DEEMED INDIGENT UNDER STATE, COUNTY, OR HOSPITAL GUIDELINES WAS $49,831,502, WHICH INCLUDED $11,490,461 OF TRADITIONAL FINANCIAL ASSISTANCE AND $38,341,041 IN UNPAID COSTS OF CARE FOR THOSE QUALIFYING FOR MEDICAID OR OTHER PUBLIC PROGRAMS FOR THE POOR. SEE SCHEDULE H FOR A NON-EXHAUSTIVE LIST OF COMMUNITY BENEFIT PROGRAMS AND DESCRIPTIONS. 1494223 IN ADDITION TO CORE MEDICAL SERVICES, SMH AND COMMUNITY PARTNERS ASSESS COMMUNITY ASSETS AND NEEDS AND WORK TOGETHER TO ADDRESS ISSUES IMPACTING HEALTH AND QUALITY OF LIFE, WITH SPECIAL EMPHASIS ON THE POOR AND VULNERABLE. IN FISCAL YEAR 2016, SMH PROVIDED $1,494,223 IN UNBILLED SERVICES TO THE POOR AND TO THE BROADER COMMUNITY. (WHEN COMBINED WITH THE COSTS OF FREE OR DISCOUNTED SERVICES FOR THE POOR LISTED IN LINE 4B, SMH PROVIDED A TOTAL COMMUNITY BENEFIT OF $51,325,725 IN FISCAL YEAR 2016.) SMH SERVES AND SUPPORTS ITS COMMUNITY THROUGH SUCH PROGRAMS AS SUPPORT GROUPS, PUBLIC HEALTH SCREENINGS, AND NUTRITION COUNSELING. SEE SCHEDULE H FOR A NON-EXHAUSTIVE LIST OF COMMUNITY BENEFIT PROGRAMS AND DESCRIPTIONS. 299961190 true true false true false false false false false false true false false true true true false true false false false false false false false false true true false false true false false false false false false true false true false false false true true true true false false true 310 0 true 3541 true true true false false false false false false false false false false X 18 14 true false false false true true true true true false false true true true true true true false true true true IN X JOHN L ZABROWSKI III 8124854178 3700 WASHINGTON AVENUE EVANSVILLE IN 47750 KEITH JEWELL CEO/PRESIDENT 60.0 5.6 X X 783468 0 52981 LAURENCE STEENBERG CHAIR 1.0 2.0 X X 0 0 0 TRUDY STOCK TREASURER 1.0 2.0 X X 0 0 0 SUSAN HARDWICK VICE CHAIR 1.0 2.0 X X 0 0 0 PHILLIP L STIVER MD SECRETARY 1.0 2.0 X X 0 0 0 RITA EYKAMP BOARD MEMBER 1.0 2.3 X 0 0 0 MICHAEL R HINTON BOARD MEMBER 1.0 2.2 X 0 0 0 SHARON KAZEE BOARD MEMBER 1.0 2.0 X 0 0 0 JOSEPH O MURDOCK BOARD MEMBER 1.0 42.0 X 0 590385 42598 SALLY RIDEOUT BOARD MEMBER 1.0 2.0 X 0 0 0 KARL SASH MD BOARD MEMBER 2.0 55.0 X 12227 484919 65992 SISTER SHARON RICHARDT BOARD MEMBER 1.0 2.0 X 0 0 0 JAMES SANDGREN BOARD MEMBER 1.0 2.0 X 0 0 0 BRIAN SCHYMIK MD BOARD MEMBER 1.0 2.0 X 0 0 0 JEFFERY WOLF BOARD MEMBER 1.0 2.0 X 0 0 0 NADINE COUDRET BOARD MEMBER 1.0 2.0 X 0 0 0 LYNN JOHNSON BOARD MEMBER 1.0 1.0 X 0 0 0 TERRY KEATING BOARD MEMBER 1.0 1.0 X 0 0 0 TRICIA BAIRD MD CHIEF CLINICAL INTEGRATION OFFICER 30.0 30.0 X 178418 164335 33073 DARCY ELLISON SR VP/CNO 60.0 0 X 378884 0 57502 WILLIAM MILLIKAN JR MD CEO, MEDICAL GROUP 60.0 1.0 X 465713 0 42047 HEIDI DUNNIWAY MD REGIONAL CMO (start 2/2016) 60.0 0 X 0 0 0 GWEN SANDEFUR EVP/COO (thru 8/2015) 60.0 1.0 X 227697 0 22256 JOHN L ZABROWSKI III CFO 60.0 0 X 324533 0 32308 JOHN GREANEY VP, AMBULATORY/CONSUMER HEALTH & FOUNDATION 55.0 0 X 227346 0 38445 KATHY HALL VP, REGIONAL ADMINISTRATOR 55.0 1.0 X 238740 0 44771 SUZETTE HERSHMAN VP, MEDICAL GROUP 55.0 2.0 X 244918 0 28205 VERNON MAAS MD VP, MEDICAL AFFAIRS (thru 6/2016) 55.0 0 X 338736 0 68505 MIKE WHITMORE VP, CLINICAL SUPPORT & ANCILLARY SERVICES 55.0 0 X 243474 0 23020 janice ERNest VP, CARDIOVASCULAR & SYSTEM SUPPORT 55.0 0 X 242528 0 56875 MICHAEL KLUEH VP/CRO (THRU 2/2016) 55.0 0 X 223759 0 42076 ALIREZA KHAKBAZNEJAD MD PHYSICIAN 55.0 0 X 540257 0 61686 LUISSA KIPRONO MD PHYSICIAN 55.0 0 X 580283 0 36100 CHARLES LACKEY MD PHYSICIAN 55.0 0 X 511302 0 51481 NURAHMED MOHAMMED MD PHYSICIAN 55.0 0 X 529816 0 48438 DALE YINGLING MD PHYSICIAN 55.0 0 X 554131 0 46805 6846230 1239639 895164 132 false true false mid america laboratories PO Box 19163 INDIANAPOLIS IN 46219 Laboratory Services 12850303 ANESTHESIOLOGY GROUP ASSOCIATES PC PO Box 5348 EVANSVILLE IN 47716 Physician Services 3621278 EVANSVILLE SURGICAL ASSOCIATES INC 520 Mary Street EVANSVILLE IN 47710 Physician Services 2374028 MEDICAL STAFFING SOLUTIONS LLC 8601 N Kentucky Ave EVANSVILLE IN 47725 Physician Services 1245646 RAY HAASE LLC 1025 Reis Avenue EVANSVILLE IN 47711 Construction Services 1054403 30 X 1584794 11376 64314 1272968 1660484 OUTPATIENT SERVICE REV 621110 257674454 257674454 INPATIENT SERVICE REV 621110 237346089 237346089 0 0 0 0 495020543 3896244 3896244 734773 462848 271925 0 271925 271925 992863 564192 0 428671 428671 428671 ADMINISTRATIVE SERVICES FOR MEMBER ENTITIES 900099 6074631 6074631 INCOME FROM K-1'S 900099 8032758 8032758 APOTHECARY 446110 5342907 5342907 7011732 4699577 241857 2070298 26462028 527739895 519599087 241857 6238467 4656545 4656545 144019389 112353643 31409382 256364 187941 163227 24342 372 30381568 23261491 7067000 53077 9599300 7279903 2302786 16611 1327995 1326198 1797 931150 17274 911520 2356 657705 657705 4131 4131 1649599 171374 1443909 34316 2918025 58586 2854713 4726 5563406 633473 4868646 61287 23613549 401949 23201162 10438 9703465 3782203 5920962 300 797842 327076 353281 117485 323639 200318 118120 5201 4137277 3143061 994216 14534950 6414471 8120479 2301184 1746886 552577 1721 PURCHASED SERVICES 76101056 57833593 18100798 166665 MEDICAL SUPPLIES 56126075 56126075 PROVIDER TAX EXPENSE 14116347 14116347 COST OF GOODS SOLD 8061676 8061676 22020267 16658713 5311176 50378 433734081 299961190 132991594 781297 12661768 11241992 71142877 77453059 0 0 620386 568646 7684516 7942925 913207 1158694 351650215 269307419 78544553 82342796 0 6282003 8005350 6153143 4583331 645693340 677183032 829695793 870479825 32983939 32291440 125002 37504 218136751 183065198 251245692 215394142 X 578450101 655085683 578450101 655085683 829695793 870479825 X 94005814 -19555625 2185393 X false true X true false X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED false false false false false false false false true 4131 4131 false Schedule C, Part II-B, Line 1 DETAILED DESCRIPTION OF THE LOBBYING ACTIVITY LOBBYING EXPENSES REPRESENT THE PORTION OF DUES PAID TO NATIONAL AND STATE HOSPITAL ASSOCIATIONS THAT IS SPECIFICALLY ALLOCABLE TO LOBBYING. ST. MARY'S HEALTH, INC. DOES NOT PARTICIPATE IN OR INTERVENE IN (INCLUDING THE PUBLISHING OR DISTRIBUTING OR STATEMENTS) ANY POLITICAL CAMPAIGN ON BEHALF OF (OR IN OPPOSITION TO) ANY CANDIDATE FOR PUBLIC OFFICE. Schedule C, Part II-B, Line 1 DETAILED DESCRIPTION OF THE LOBBYING ACTIVITY LOBBYING EXPENSES REPRESENT THE PORTION OF DUES PAID TO NATIONAL AND STATE HOSPITAL ASSOCIATIONS THAT IS SPECIFICALLY ALLOCABLE TO LOBBYING. ST. MARY'S HEALTH, INC. DOES NOT PARTICIPATE IN OR INTERVENE IN (INCLUDING THE PUBLISHING OR DISTRIBUTING OR STATEMENTS) ANY POLITICAL CAMPAIGN ON BEHALF OF (OR IN OPPOSITION TO) ANY CANDIDATE FOR PUBLIC OFFICE. 7736792 7736792 116729766 77258103 39471663 12371416 7380146 4991270 214812241 184669170 30143071 82342796 OTHER RECEIVABLES 6460994 DEFERRED COMPENsATION ASSET 4927628 ESTIMATED SETTLEMENTS FROM THIRD PARTIES 98686 PHYSICIAN GUARANTEES ASSET 7348251 OTHER CURRENT ASSETS 231968 INTEREST IN INVESTMENTS HELD BY ASCENSION HEALTH ALLIANCE 653732030 OTHER LONG TERM ASSETS INTERCOMPANY RECEIVABLES 4383475 677183032 DEFERRED COMPENSATION 4927628 SELF INSURANCE LIABILITY 1991296 ESTIMATED SETTLEMENT LIABILITY 7779568 AH SAVINGS LIABILITY 1819047 VALUATION ALLOWANCE DEFERRED RENT PAYABLE 334384 PHYSICIAN GUARANTEE LIABILITY 7348251 INTERCOMPANY DEBT WITH ASCENSION HEALTH ALLIANCE 131954375 PENSION PLAN LIABILITY 15692806 IBNR CAPITATION CLAIMS INTERCOMPANY PAYABLES 11217843 183065198 X Schedule D, Part X, Line 2 FIN 48 (ASC 740) footnote THE SYSTEM ACCOUNTS FOR UNCERTAINTY IN INCOME TAX POSITIONS BY APPLYING A RECOGNITION THRESHOLD AND MEASUREMENT ATTRIBUTE FOR FINANCIAL STATEMENT RECOGNITION AND MEASUREMENT OF A TAX POSITION TAKEN OR EXPECTED TO BE TAKEN IN A TAX RETURN. THE SYSTEM HAS DETERMINED THAT NO MATERIAL UNRECOGNIZED TAX BENEFITS OR LIABILITIES EXIST AS OF JUNE 30, 2016. true true X true X true X true true false true true 11490461 11490461 0.0265 81307222 42966181 38341041 0.0884 0 0.0 0 0 92797683 42966181 49831502 0.1149 20 10587 521595 521595 0.0012 3 4216 546102 546102 0.0013 0 0.0 0 0.0 6 25524 426526 426526 0.0010 29 40327 1494223 0 1494223 0.0034 29 40327 94291906 42966181 51325725 0.1183 1 5 1000 1000 0.0000 1 1300 14500 14500 0.0000 1 1262 15111 15111 0.0000 1 331 3005 3005 0.0000 1 1 34 34 0.0000 1 150 1500 1500 0.0000 0 0.0 1 139 16420 3800 12620 0.0000 0 0.0 7 3188 51570 3800 47770 0.0001 false 3955097 395510 150440145 122817149 27622996 X true true 1 1 ST MARY'S HEALTH INC 3700 WASHINGTON AVENUE EVANSVILLE IN 47750 WWW.STMARYS.ORG/SMLOCATION 14-005089-1 X X X X X ST MARY'S HEALTH INC 1 false false true X X X X X X X X X 15 true true true true X http://www.stmarys.org/about-us/chna/ X http://www.healthyswin.org X true 15 true http://www.stmarys.org/about-us/chna/ false false true X 200.0 300.0 X true true X X true X http://www.stmarys.org/patients-visitors/financial-assistance/ X http://www.stmarys.org/patients-visitors/financial-assistance/ X http://www.stmarys.org/patients-visitors/financial-assistance/ X X X X X true X false X X X X true X false false Schedule H, Part V, Section B, Line 5 Facility , 1 Facility , 1 - ST. MARY'S HEALTH, INC.. IN CONDUCTING ITS CHNA, THE HOSPITAL FACILITY CONDUCTED INTERVIEWS AND FOCUS GROUPS WITH COMMUNITY MEMBERS WHO HAVE A FUNDAMENTAL UNDERSTANDING OF VANDERBURGH COUNTY'S HEALTH NEEDS AND REPRESENT THE BROAD INTERESTS OF THE COMMUNITY. NINE KEY INFORMANT INTERVIEWS AND 10 FOCUS GROUP DISCUSSIONS PROVIDED INPUT ON THE COUNTY'S HEALTH CHALLENGES, THE SUB-POPULATIONS MOST IN NEED, AND EXISTING RESOURCES FOR COUNTY RESIDENTS. IN TOTAL, 84 INDIVIDUALS PARTICIPATED IN PRIMARY DATA COLLECTION TO PROVIDE COMMUNITY INPUT. Schedule H, Part V, Section B, Line 6a Facility , 1 Facility , 1 - ST. MARY'S HEALTH, INC.. THE OTHER HOSPITAL FACILITIES WITH WHICH THE REPORTING HOSPITAL FACILITY CONDUCTED ITS CHNA INCLUDES ST. MARY'S WARRICK HOSPITAL, INC. AND DEACONESS HEALTH SYSTEM. Schedule H, Part V, Section B, Line 6b Facility , 1 Facility , 1 - ST. MARY'S HEALTH, INC.. THE OTHER NON-HOSPITAL ORGANIZATIONS WITH WHICH THE REPORTING HOSPITAL FACILITY CONDUCTED ITS CHNA INCLUDES ECHO COMMUNITY HEALTH CARE, UNITED WAY OF SOUTHWESTERN INDIANA, VANDERBURGH COUNTY HEALTH DEPARTMENT, AND WELBORN BAPTIST FOUNDATION. Schedule H, Part V, Section B, Line 11 Facility , 1 Facility , 1 - ST. MARY'S HEALTH, INC.. USING THE CHNA COMPLETED IN FISCAL YEAR 2016, THE HOSPITAL DEVELOPED, ADOPTED, AND WORKED ON EXECUTING A 2017-2019 COMMUNITY WIDE IMPLEMENTATION STRATEGY TO ADDRESS PRIORITY COMMUNITY HEALTH NEEDS. THE ORGANIZATION IS WORKING TO ADDRESS THE FOLLOWING NEEDS: 1. IMPROVE THE OVERALL BEHAVIORAL HEALTH OF VANDERBURGH COUNTY BY: -SUPPORTING OPPORTUNITIES TO EDUCATE AND INCREASE ACCESS FOR MENTAL HEALTH AND SUBSTANCE ABUSE. -JOINING A GROUP OF LOCAL AGENCIES AND ORGANIZATIONS THAT MEET ON A REGULAR BASIS AS WELL AS SUB-COMMITTEES FOR SUBSTANCE ABUSE, MENTAL HEALTH ASSET MAPPING AND THE YOUTH MENTAL HEALTH FIRST AID GRANT. -INCREASING AWARENESS OF SUICIDE THROUGH COMMUNITY OUTREACH AND RESOURCES FOR ASSISTANCE THROUGH A FOCUSED EFFORT EDUCATION ON WHAT TO DO IF SOMEONE IS IN A PSYCHIATRIC CRISIS. -INCREASING AWARENESS THROUGH MARKETING IN "YOUR HEALTH" MAGAZINE. -IMPROVING ACCESS FOR MENTAL HEALTH SERVICES. 2. REDUCE THE PERCENTAGE OF ADULTS AGED 20 AND OLDER WHO ARE OBESE BY: -IMPLEMENTING A COMMUNITY-WIDE CAMPAIGN THAT INTEGRATES EDUCATION AND OPPORTUNITIES FOR MORE ACTIVE MOVEMENT AND ACCESS TO HEALTH FOODS. -OFFERING FREE DIABETES AND PRE-DIABETES EDUCATION CLASSES TO THE PUBLIC. -PROVIDING RESOURCES TO TEACHERS FOR HEALTHY EATING. -PARTICIPATING IN LOCAL COMMUNITY INITIATIVES TO MAXIMIZE RESOURCES AND SUPPORT OBESITY PREVENTION EFFORTS. 3. REDUCE INFANT MORTALITY IN THE FIRST YEAR OF LIFE BY: -MEETING REGULARLY WITH THE FETAL INFANT MORTALITY REVIEW, VANDERBURGH COUNTY HEALTH DEPARTMENT, CHILD ABUSE TASK FORCE AND OTHER LOCAL HEALTH SYSTEMS. -PROMOTING TOBACCO CESSATION WHICH RESULTS IN HEALTHIER MOTHERS AND BABIES. -PROMOTING THE POWER OF PARENTING PROGRAM, A UNIQUE PROGRAM FOR YOUNG PARENT. THE HOSPITAL FACILITY'S CHNA IDENTIFIED SUBSTANCE ABUSE, DIABETES, SOCIAL ENVIRONMENT, IMMUNIZATIONS AND INFECTIOUS DISEASE, AND PREVENTION AND SAFETY AS NEEDS TO THE COMMUNITY. THE HOSPITAL FACILITY DID NOT TAKE ACTION TO ADDRESS THESE NEEDS AS IT HAS LIMITED FINANCIAL AND OTHER RESOURCES. NO ACTIONS WERE TAKEN DURING FISCAL YEAR 2016 TOWARDS ADDRESSING THE PRIORTY COMMUNITY HEALTH NEEDS IDENTIFIED AS THE CHNA WAS NOT ADOPTED UNTIL THE END OF THE TAX YEAR. USING THE CHNA COMPLETED IN FISCAL YEAR 2013, THE HOSPITAL HAD MANY IMPLEMENTATION SUCCESSES DURING FISCAL YEAR 2016. THE HOSPITAL HAD 80 IMPLEMENTATION TACTICS, AND AMONG THE SUCCESSUL ONES WERE: -Promotion of QuitNowIndiana.com to patients as well as DrugFree.org and exceeding the goal of 100 clicks to each site from the stmarys.org website. - Child Abuse - Vanderburgh and Warrick both had a total number of substantiated Physical and Sexual Abuse cases below the FY16 goal. For Vanderburgh, the percentage of substantiated cases for all three typEs of abuse (Neglect, Physical and Sexual) are below or meeting the goal for FY16. For Warrick, the percentage of substantiated cases for Physical and Sexual abuse are below or meeting the goal for FY16. - Healthy Lives Fitness Center - Memberships made FREE to all St. Mary's Health associates and those connected to the health system through Medexcel, Touchpoint, AIS, TriMedx, Mission Point and MACL. - Joslin Diabetes Program - St. Mary's Joslin Diabetes program is now offered FREE of charge to the community as of March 1, 2016 and has seen an increase in individual visits as well as number of referring physicians. Schedule H, Part V, Section B, Line 22 Facility , 1 Facility , 1 - ST. MARY'S HEALTH, INC.. THE DISCOUNT WAS DETERMINED BY REVIEWING THE LOWEST DISCOUNT PROVIDED TO MANAGED CARE PAYERS THAT COMPRISE AT LEAST 3% OF OUR VOLUME WITH AN ADDED PROMPT PAY DISCOUNT TO THE HIGHEST PAID DISCOUNT PROVIDED TO OUR MANAGED CARE PAYERS. 28 ST MARY'S SURGICARE 300 CIRCLE FRONT DRIVE EVANSVILLE IN 47715 GENERAL SURGICAL CENTER ST MARY'S SURGICARE 1125 PROFESSIONAL BLVD EVANSVILLE IN 47714 GENERAL SURGICAL CENTER ST MARY'S REHAB 3900 WASHINGTON AVENUE EVANSVILLE IN 47714 INPATIENT REHAB CENTER ST MARY'S BREAST CENTER 100 EPWORTH CROSSING SUITE B100 NEWBURGH IN 47630 MAMMOGRAPHY St Mary's Infusion Center 3900 WASHINGTON AVENUE EVANSVILLE IN 47714 Infusion services ST MARY'S URGENT CARE EPWORTH 100 EPWORTH CROSSING SUITE B100 NEWBURGH IN 47630 MULTI SERVICE OUTPATIENT FACILITY WOUND CARE CLINIC 3801 BELLEMEADE AVENUE EVANSVILLE IN 47714 WOUND CARE ST MARY'S MATERNAL-FETAL MEDICINE 3700 WASHINGTON AVENUE SUITE 2100A EVANSVILLE IN 47750 OBSTETRICS/GYNECOLOGY ST MARY'S OUTPATIENT REHAB 1144 WASHINGTON SQUARE EVANSVILLE IN 47715 OUTPATIENT REHAB CLINIC ST MARY'S FOR CHILDREN 3900 WASHINGTON AVENUE EVANSVILLE IN 47714 CHILDREN'S HEALTH FACILITY ST MARY'S CONVENIENT CARE WEST 5320 WESTON ROAD EVANSVILLE IN 47712 MULTI SERVICE OUTPATIENT FACILITY ST MARY'S DME 100 Epworth Crossing Suite A001 NEWBURGH IN 47630 DME ST MARY'S NORTHBROOK 3838 N FIRST AVENUE EVANSVILLE IN 47710 IMAGING SERVICES/RADIOLOGY ST MARY'S DME 6840 Logan Dr Ste E EVANSVILLE IN 47715 DME ST MARY'S OCCUPATIONAL MEDICINE CLINIC 2330 LYNCH ROAD EVANSVILLE IN 47711 OCCUPATIONAL MEDICINE CLINIC ST MARY'S URGENT CARE BOONVILLE 3277 LIBERTY BLVD BOONVILLE IN 47601 MULTI SERVICE OUTPATIENT FACILITY ST MARY'S NORTH POINTE REHAB 2300 LYNCH ROAD EVANSVILLE IN 47711 OUTPATIENT REHAB CLINIC ST MARY'S WARRICK EMERGENCY MEDICAL SERVICES 415 S 4th Street Boonville IN 47601 EMS ST MARY'S WARRICK EMERGENCY MEDICAL SERVICES 540 S State St Newburgh IN 47630 EMS ST MARY'S DME 2345 W Franklin Street Suite 102 EVANSVILLE IN 47712 DME ST MARY'S IMAGING AND LAB 1138 WASHINGTON SQUARE EVANSVILLE IN 47715 IMAGING SERVICES/RADIOLOGY ST MARY'S WARRICK EMERGENCY MEDICAL SERVICES 510 N State St Chandler IN 47610 EMS ST MARY'S WEST SIDE X-RAY 2345 W FRANKLIN STREET EVANSVILLE IN 47712 IMAGING SERVICES/RADIOLOGY ST MARY'S WARRICK EMERGENCY MEDICAL SERVICES 5266 Old State Rd 66 Newburgh IN 47630 EMS ST MARY'S WARRICK EMERGENCY MEDICAL SERVICES 333 Peach Street Lynnville IN 47619 EMS ST MARY'S WEIGHT MANAGEMENT CENTER 950 S KENMORE EVANSVILLE IN 47714 WEIGHT MANAGEMENT FACILITY JOSLIN DIABETES CENTER 3801 BELLEMEADE AVENUE EVANSVILLE IN 47714 DIABETES SERVICE CENTER ST MARY'S HEART INSTITUTE 3700 WASHINGTON AVENUE EVANSVILLE IN 47714 SPECIALITY CARE FACILITY ST MARY'S PRE-PROCEDURE CLINIC 1140 WASHINGTON AVENUE EVANSVILLE IN 47714 Pre-Surgery testing facility COMMUNITY BENEFIT REPORT AS A MEMBER OF ASCENSION HEALTH, THE NATION'S LARGEST CATHOLIC HEALTHCARE SYSTEM, ST. MARY'S HEALTH, INC. CONTINUES TO BUILD AND STRENGTHEN SUSTAINABLE COLLABORATIVE EFFORTS THAT BENEFIT THE HEALTH OF INDIVIDUALS, FAMILIES, AND SOCIETY AS A WHOLE. THE GOAL OF ST. MARY'S HEALTH, INC. IS TO PERPETUATE THE HEALING MISSION OF THE CHURCH. ST. MARY'S HEALTH, INC. FURTHERS THIS GOAL THROUGH DELIVERY OF PATIENT SERVICES, CARE TO THE ELDERLY AND INDIGENT, PATIENT EDUCATION AND HEALTH AWARENESS PROGRAMS FOR THE COMMUNITY, AND MEDICAL RESEARCH. OUR CONCERN FOR ALL HUMAN LIFE AND DIGNITY OF EACH PERSON LEADS THE ORGANIZATION TO PROVIDE MEDICAL SERVICES TO ALL PEOPLE IN THE COMMUNITY WITHOUT REGARD TO THE PATIENT'S RACE, CREED, NATIONAL ORIGIN, ECONOMIC STATUS, OR ABILITY TO PAY. IN ORDER TO PORTRAY THE FULL BREADTH OF OUR CONTRIBUTION, OUR COMMUNITY BENEFIT INFORMATION IS DESCRIBED BELOW: ORGANIZATIONAL COMMITMENT TO PROVIDING COMMUNITY BENEFIT ST. MARY'S HEALTH, INC. IS A 494-BED ACUTE CARE HOSPITAL. ST. MARY'S HEALTH, INC. SERVICES THE TRI-STATE AREA AROUND SOUTHERN INDIANA, INCLUDING SOUTHEASTERN ILLINOIS, AND NORTHWESTERN KENTUCKY. ST. MARY'S HEALTH, INC. SEEKS TO IMPROVE THE PHYSICAL, MENTAL, SOCIAL AND SPIRITUAL HEALTH STATUS OF ITS SURROUNDING COMMUNITY. ST. MARY'S HEALTH, INC. PROVIDES SIGNIFICANT RESOURCES ONLINE FOR PUBLIC USE AND EDUCATION AT WWW.STMARYS.ORG. SUCH ITEMS INCLUDE INFORMATION ON ALLERGIES, ASTHMA, BACK PAIN, CANCER, DIABETES, HEART DISEASE, KIDNEY DISEASE, MEN'S HEALTH, ORTHOPEDIC HEALTH, MENTAL HEALTH, PARENTING, PATIENT SAFETY, PREGNANCY, SENIOR HEALTH, STRESS, STROKE, WEIGHT MANAGEMENT AND WOMEN'S HEALTH. PLEASE VISIT WWW.STMARYS.ORG FOR A FULL LIST OF SERVICES. Schedule H, Part I, Line 3c FREE AND DISCOUNTED CARE DETERMINATION THE ORGANIZATION PROVIDES MEDICALLY NECESSARY CARE TO ALL PATIENTS, REGARDLESS OF RACE, COLOR, CREED, ETHNIC ORIGIN, GENDER, DISABILITY, OR ECONOMIC STATUS. THE HOSPITAL USES A PERCENTAGE OF FEDERAL POVERTY LEVEL (FPL) TO DETERMINE FREE AND DISCOUNTED CARE. AT A MINIMUM, PATIENTS WITH INCOME LESS THAN OR EQUAL TO 200% OF THE FPL, WHICH MAY BE ADJUSTED FOR COST OF LIVING UTILIZING THE LOCAL WAGE INDEX COMPARED TO THE NATIONAL WAGE INDEX, WILL BE ELIGIBLE FOR 100% CHARITY CARE WRITE OFF OF CHARGES FOR SERVICES THAT HAVE BEEN PROVIDED TO THEM. ALSO, AT A MINIMUM, PATIENTS WITH INCOMES ABOVE 200% OF THE FPL BUT NOT EXCEEDING 300% OF THE FPL, SUBJECT TO ADJUSTMENTS FOR COST OF LIVING UTILIZING THE LOCAL WAGE INDEX COMPARED TO NATIONAL WAGE INDEX, WILL RECEIVE A DISCOUNT ON THE SERVICES PROVIDED TO THEM. Schedule H, Part I, Line 7 Costing Methodology used to calculate financial assistance THE COST OF PROVIDING CHARITY CARE, MEANS TESTED GOVERNMENT PROGRAMS, AND COMMUNITY BENEFIT PROGRAMS IS ESTIMATED USING INTERNAL COST DATA, AND IS CALCULATED IN COMPLIANCE WITH CATHOLIC HEALTH ASSOCIATION ("CHA") GUIDELINES. THE ORGANIZATION USES A COST ACCOUNTING SYSTEM THAT ADDRESSES ALL PATIENT SEGMENTS (FOR EXAMPLE, INPATIENT, OUTPATIENT, EMERGENCY ROOM, PRIVATE INSURANCE, MEDICAID, MEDICARE, UNINSURED, OR SELF PAY). THE BEST AVAILABLE DATA WAS USED TO CALCULATE THE AMOUNTS REPORTED IN THE TABLE FOR THE INFORMATION IN THE TABLE, A COST-TO-CHARGE RATIO WAS CALCULATED AND APPLIED. Schedule H, Part II Community Building Activities ST. MARY'S HEALTH, INC. PROMOTES THE HEALTH OF THE COMMUNITIES IT SERVES THROUGH COMMUNITY BUILDING BY PARTICIPATING AND SITTING ON VARIOUS BOARDS OF OTHER AGENCIES IN THE AREA. SOME OF THE AGENCIES THAT ST. MARY'S HEALTH, INC. WORKS WITH INCLUDE 4C OF SOUTHERN INDIANA, CHAMBER OF COMMERCE, CHILD ABUSE TASK FORCE, COMMUNITY ALLIANCE FOUNDATION, EASTER SEALS, THE RONALD MCDONALD HOUSE, BOYS & GIRLS CLUB, UNITED WAY, JUNIOR ACHIEVEMENT AND OTHER. Schedule H, Part III, Line 2 Bad debt expense - methodology used to estimate amount AFTER SATISFACTION OF AMOUNTS DUE FROM INSURANCE AND REASONABLE EFFORTS TO COLLECT FROM THE PATIENT HAVE BEEN EXHAUSTED, THE CORPORATION FOLLOWS ESTABLISHED GUIDELINES FOR PLACING CERTAIN PAST-DUE PATIENT BALANCES WITHIN COLLECTION AGENCIES, SUBJECT TO THE TERMS OF CERTAIN RESTRICTIONS ON COLLECTION EFFORTS AS DETERMINED BY ASCENSION HEALTH. ACCOUNTS RECEIVABLE ARE WRITTEN OFF AFTER COLLECTION EFFORTS HAVE BEEN FOLLOWED, IN ACCORDANCE WITH THE CORPORATION'S POLICIES. AFTER APPLYING THE COST-TO CHARGE RATIO, THE SHARE OF THE BAD DEBT EXPENSE IN FISCAL YEAR 2016 WAS $15,485,892 AT CHARGES ($3,955,097 AT COST). Schedule H, Part III, Line 3 Bad Debt Expense Methodology THE PROVISION FOR DOUBTFUL ACCOUNTS IS BASED UPON MANAGEMENT'S ASSESSMENT OF EXPECTED NET COLLECTIONS CONSIDERING HISTORICAL EXPERIENCE, ECONOMIC CONDITIONS, TRENDS IN HEALTHCARE COVERAGE, AND OTHER COLLECTION INDICATORS. PERIODICALLY THROUGHOUT THE YEAR, MANAGEMENT ASSESSES THE ADEQUACY OF THE ALLOWANCE FOR DOUBTFUL ACCOUNTS BASED UPON HISTORICAL WRITE-OFF EXPERIENCE BY PAYOR CATEGORY, INCLUDING THOSE AMOUNTS NOT COVERED BY INSURANCE. THE RESULTS OF THIS REVIEW ARE THEN USED TO MAKE ANY MODIFICATIONS TO THE PROVISION FOR DOUBTFUL ACCOUNTS TO ESTABLISH AN APPROPRIATE ALLOWANCE FOR DOUBTFUL ACCOUNTS. Schedule H, Part III, Line 4 Bad debt expense - financial statement footnote THE ORGANIZATION IS A PART OF THE ASCENSION HEALTH ALLIANCE'S CONSOLIDATED AUDIT IN WHICH THE FOOTNOTE THAT DISCUSSES THE BAD DEBT EXPENSE IS LOCATED ON PAGE 18. Schedule H, Part III, Line 8 Community benefit & methodology for determining medicare costs A COST TO CHARGE RATIO IS APPLIED TO THE ORGANIZATION'S MEDICARE EXPENSE TO DETERMINE THE MEDICARE ALLOWABLE COSTS REPORTED IN THE ORGANIZATION'S MEDICARE COST REPORT. ASCENSION HEALTH AND RELATED HEALTH MINISTRIES FOLLOW THE CATHOLIC HEALTH ASSOCIATION ("CHA") GUIDELINES FOR DETERMINING COMMUNITY BENEFIT. CHA COMMUNITY BENEFIT REPORTING GUIDELINES SUGGEST THAT MEDICARE SHORTFALL IS NOT TREATED AS A COMMUNITY BENEFIT. Schedule H, Part III, Line 9b Collection practices for patients eligible for financial assistance THE ORGANIZATION HAS A WRITTEN DEBT COLLECTION POLICY THAT ALSO INCLUDES A PROVISION ON THE COLLECTION PRACTICES TO BE FOLLOWED FOR PATIENTS WHO ARE KNOWN TO QUALIFY FOR CHARITY CARE OR FINANCIAL ASSISTANCE. IF A PATIENT QUALIFIES FOR CHARITY OR FINANCIAL ASSISTANCE CERTAIN COLLECTION PRACTICES DO NOT APPLY AND THE FINANCIAL ASSISTANCE PROGRAM IS FOLLOWED. Schedule H, Part V, Section B, Line 16a FAP website - ST. MARY'S HEALTH, INC.: Line 16a URL: http://www.stmarys.org/patients-visitors/financial-assistance/; Schedule H, Part V, Section B, Line 16b FAP Application website - ST. MARY'S HEALTH, INC.: Line 16b URL: http://www.stmarys.org/patients-visitors/financial-assistance/; Schedule H, Part V, Section B, Line 16c FAP plain language summary website - ST. MARY'S HEALTH, INC.: Line 16c URL: http://www.stmarys.org/patients-visitors/financial-assistance/; Schedule H, Part VI, Line 2 Needs assessment COMMUNITIES ARE DYNAMIC SYSTEMS IN WHICH MULTIPLE FACTORS INTERACT TO IMPACT QUALITY OF LIFE AND HEALTH STATUS. AS PART OF THE ST. MARY'S HEALTH SYSTEM, THE GOAL OF ST. MARY'S HEALTH, INC. IS TO WORK WITH ITS COMMUNITY TO CONDUCT AN ASSESSMENT AT LEAST EVERY THREE YEARS. ASSESSMENTS MAY INCLUDE PRIMARY SURVEY DATA, SECONDARY DATA, FOCUS GROUP INPUT, COMMUNITY LEADERS' SURVEY AND OTHER DATA. RESULTS ARE MADE AVAILABLE TO ORGANIZATIONS AND INDIVIDUALS THROUGHOUT THE COMMUNITY. THESE NEEDS ASSESSMENTS ARE ALSO UTILIZED IN CREATING THE HOSPITAL'S INTEGRATED STRATEGIC FINANCIAL AND OPERATIONAL PLAN. TO THAT END, ST. MARY'S HEALTH, INC. HAS BROUGHT TOGETHER A COMMUNITY ROUNDTABLE WITH THE PURPOSE OF DETERMINING THE RESOURCES AND NEEDS, PRIORITIZING ACTION AND WORKING IN PARTNERSHIP TO ADDRESS IDENTIFIED CHALLENGES WITHIN A DESIGNATED AREA SURROUNDING THE HOSPITAL. ST. MARY'S HEALTH, INC. ALSO IDENTIFIES COMMUNITY HEALTH NEEDS BY EMPLOYING OTHER PUBLIC AGENCY NEEDS ASSESSMENTS SUCH AS WELBORN BAPTIST FOUNDATION AND THE UNITED WAY. Schedule H, Part VI, Line 3 Patient education of eligibility for assistance ST. MARY'S HEALTH, INC. COMMUNICATES WITH PATIENTS IN MULTIPLE WAYS TO ENSURE THAT THOSE WHO ARE BILLED FOR SERVICES ARE AWARE OF THE HOSPITAL'S CHARITY CARE PROGRAM AS WELL AS THEIR POTENTIAL ELIGIBILITY FOR LOCAL, STATE OR FEDERAL PROGRAMS. SIGNS ARE PROMINENTLY POSTED IN EACH SERVICE AREA. IN ADDITION, THE HOSPITAL EMPLOYS FINANCIAL COUNSELORS, HEALTH ACCESS WORKERS, AND ENROLLMENT SPECIALISTS WHO CONSULT WITH PATIENTS ABOUT THEIR ELIGIBILITY FOR FINANCIAL ASSISTANCE PROGRAMS AND HELP PATIENTS IN APPLYING FOR ANY PUBLIC PROGRAMS FOR WHICH THEY MAY QUALIFY. ALL SELF-PAY PATIENTS RECEIVE A 15% DISCOUNT OFF THE TOP ON ALL CHARGES BEFORE STATEMENTS ARE MAILED. Schedule H, Part VI, Line 4 Community information ST. MARY'S HEALTH, INC. IS LOCATED IN EVANSVILLE, INDIANA AND SERVES VANDERBURGH AND CONTIGUOUS COUNTIES IN SOUTHERN INDIANA AND NORTH CENTRAL KENTUCKY. THE PRIMARY SERVICE AREA IS DEFINED AS VANDERBURGH, WARRICK, SPENCER, AND POSEY COUNTIES. THE POPULATION FOR THE PRIMARY SERVICE AREA WAS 289,496 IN 2016. ALSO THE MEDIAN INCOME FOR THE PRIMARY SERVICE AREA WAS $55,725 FOR 2016 WITH 15% OF CHILDREN BELOW POVERTY LEVEL. Schedule H, Part VI, Line 5 Promotion of community health TO PROVIDE THE HIGHEST QUALITY HEALTHCARE TO ALL PERSONS IN THE COMMUNITY, AND IN KEEPING WITH ITS NOT FOR-PROFIT STATUS, ST. MARY'S HEALTH, INC.: - DELIVERS PATIENT SERVICES, INCLUDING EMERGENCY DEPARTMENT SERVICES AND URGENT CARE SITES, TO ALL INDIVIDUALS REQUIRING HEALTHCARE, WITHOUT REGARD TO PATIENT RACE, ETHNICITY, ECONOMIC STATUS, INSURANCE STATUS OR ABILITY TO PAY - MAINTAINS AN OPEN MEDICAL STAFF THAT ALLOWS CREDENTIALED PHYSICIANS TO PRACTICE AT ITS FACILITIES - TRAINS AND EDUCATES HEALTH CARE PROFESSIONALS - PARTICIPATES IN GOVERNMENT SPONSORED PROGRAMS SUCH AS MEDICAID AND MEDICARE TO PROVIDE TO THE POOR AND ELDERLY. APPLICATION EVENTS ARE HELD AS WELL AS FOLLOW UP ASSISTANCE FOR INSURANCE - HEALTH ACCESS ADVOCATES ("HAA") ARE COMMUNITY BASED STAFF WHOSE PRIMARY ROLE IS TO SIGN CHILDREN UP FOR HOOSIER HEALTHCARE INSURANCE. THEY CAN DO THIS BY ASSISTING FAMILIES IN APPLYING FOR HOOSIER HEALTHCARE INSURANCE HERE IN THE OFFICE, IN THE COMMUNITY, OR AT THE PATIENT'S HOME. DURING THIS PROCESS, THEY CAN ALSO ASSIST FAMILIES WITH BASIC NEEDS SUCH AS FOOD, SHELTER AND CLOTHING. THE ADVOCATES CAN ALSO ASSIST ADULTS WITH APPLYING FOR MEDICAID, HEALTHY INDIANA PLAN, AND OTHER RESOURCES SUCH AS PHARMACEUTICAL APPLICATIONS FOR THOSE WHO QUALIFY. HAA WILL AT TIMES TRANSPORT PATIENTS TO NECESSARY APPOINTMENTS. ADDITIONALLY, HAA PROVIDES ASSISTANCE TO THE LATINO POPULATION BY PROVIDING A BI LINGUAL ASSOCIATE. THIS ASSOCIATE SPEARHEADS A CERTIFIED MEDICAL INTERPRETER TRAINING PROGRAM THROUGH THE BRIDGING THE GAP PROGRAM - IS GOVERNED BY A BOARD IN WHICH INDEPENDENT COMMUNITY MEMBERS COMPRISE A MAJORITY - CONDUCTS COMMUNITY HEALTH NEEDS ASSESSMENTS AND HOLDS MEMBERSHIP ON OTHER PUBLIC AGENCY BOARDS TO ENHANCE WELL BEING OF THE COMMUNITY IN PARTNERSHIP PROGRAMS - PROVIDES DENTAL SERVICES FOR PRIMARY SERVICE AREA WITH MOBILE DENTAL FOR KIDS CLINIC - NUTRITION COUNSELING IS PROVIDED TO THE COMMUNITY AND SPECIFICALLY AREA SCHOOLS AND YOUTH GROUPS, SUCH AS FOOD PYRAMID PROGRAMS, STAFF HEALTH FAIR, ETC. - COMPLIMENTARY THERAPIES INCLUDING MASSAGES, YOGA CLASSES, STRESS REDUCTION CLASSES AT HOPE RESOURCE CENTER FOR CANCER PATIENTS AND SURVIVORS - MALL WALKING PROGRAMS AND MONTHLY BLOOD PRESSURE SCREENINGS AT LOCAL MALL - CHRISTMAS PROGRAMS FOR THE POOR: GREAT EXPECTATIONS. AREA FAMILIES ARE IDENTIFIED FROM LOCAL GROUPS SUCH AS UNITED WAY, CHURCHES, AND THE SCHOOL SYSTEMS, AS NEEDING ASSISTANCE WITH CHRISTMAS. ASSOCIATES OF ST. MARY'S GIVE MONIES, FOOD, CLOTHING, TOYS, ETC. TO FAMILIES IN NEED EACH YEAR. - AUTISM VISIT WITH SANTA - WNIN KIDS DAY - MOBILE DENTAL CLINIC - CPR CLASSES GIVEN AT LOCAL DAYCARES AND SCHOOLS - JOSLIN AND DIABETIC FOOT CLINIC - LECTURES, CLASSES, EXERCISE INSERVICES - SAFESITTERS EDUCATION FOR TEENAGERS PREPARING TO TAKE CARE OF YOUNG CHILDREN, TODDLERS, AND INFANTS - ST. MARY'S NIGHTS AT CHILDREN'S MUSEUM OF EVANSVILLE - YOUTH FIRST RETREATS - AMERICAN RED CROSS BLOOD DRIVES - AMBULANCE, REHAB, AND MISC. BILLINGS PAID FOR PATIENTS - PATIENT CARE FOR NON PROFIT ECHO CLINIC - TRANSPORTATION SERVICES FOR PATIENTS AND FAMILIES - MEAL TICKETS FOR PATIENT FAMILIES Schedule H, Part VI, Line 6 Affiliated health care system As part of St. Mary's Health System, St. Mary's Health, INc. is a member of Ascension Health Alliance ("The System"). Ascension Health Alliance d/b/a Ascension (Ascension), is a Missouri nonprofit corporation formed on September 13, 2011. Ascension is the sole corporate member and parent organization of Ascension Health, a Catholic national health system consisting primarily of nonprofit corporations that own and operate local healthcare facilities, or Health Ministries, located in 23 of the United States and the District of Columbia. SPONSORSHIP: ASCENSION IS SPONSORED BY ASCENSION SPONSOR, A PUBLIC JURIDIC PERSON. THE PARTICIPATING ENTITIES OF ASCENSION SPONSOR ARE THE DAUGHTERS OF CHARITY OF ST. VINCENT DE PAUL, ST. LOUISE PROVINCE; THE CONGREGATION OF ST. JOSEPH; THE CONGREGATION OF THE SISTERS OF ST. JOSEPH OF CARONDELET; THE CONGREGATION OF ALEXIAN BROTHERS OF THE IMMACULATE CONCEPTION PROVINCE INC. - AMERICAN PROVINCE; AND THE SISTERS OF THE SORROWFUL MOTHER OF THE THIRD ORDER OF ST. FRANCIS OF ASSISI - US/CARIBBEAN PROVINCE. MISSION: THE SYSTEM DIRECTS ITS GOVERNANCE AND MANAGEMENT ACTIVITIES TOWARD STRONG, VIBRANT, CATHOLIC HEALTH MINISTRIES UNITED IN SERVICE AND HEALING, AND DEDICATES ITS RESOURCES TO SPIRITUALLY CENTERED CARE WHICH SUSTAINS AND IMPROVES THE HEALTH OF THE INDIVIDUALS AND COMMUNITIES IT SERVES. IN ACCORDANCE WITH THE SYSTEM'S MISSION OF SERVICE TO THOSE PERSONS LIVING IN POVERTY AND OTHER VULNERABLE PERSONS, EACH HEALTH MINISTRY ACCEPTS PATIENTS REGARDLESS OF THEIR ABILITY TO PAY. THE SYSTEM USES FOUR CATEGORIES TO IDENTIFY THE RESOURCES UTILIZED FOR THE CARE OF PERSONS LIVING IN POVERTY AND COMMUNITY BENEFIT PROGRAMS: - TRADITIONAL CHARITY CARE INCLUDES THE COST OF SERVICES PROVIDED TO PERSONS WHO CANNOT AFFORD HEALTHCARE BECAUSE OF INADEQUATE RESOURCES AND/OR WHO ARE UNINSURED OR UNDERINSURED. - UNPAID COST OF PUBLIC PROGRAMS, EXCLUDING MEDICARE, REPRESENTS THE UNPAID COST OF SERVICES PROVIDED TO PERSONS COVERED BY PUBLIC PROGRAMS FOR PERSONS LIVING IN POVERTY AND OTHER VULNERABLE PERSONS. - COST OF OTHER PROGRAMS FOR PERSONS LIVING IN POVERTY AND OTHER VULNERABLE PERSONS INCLUDES UNREIMBURSED COSTS OF PROGRAMS INTENTIONALLY DESIGNED TO SERVE THE PERSONS LIVING IN POVERTY AND OTHER VULNERABLE PERSONS OF THE COMMUNITY, INCLUDING SUBSTANCE ABUSERS, THE HOMELESS, VICTIMS OF CHILD ABUSE, AND PERSONS WITH ACQUIRED IMMUNE DEFICIENCY SYNDROME. - COMMUNITY BENEFIT CONSISTS OF THE UNREIMBURSED COSTS OF COMMUNITY BENEFIT PROGRAMS AND SERVICES FOR THE GENERAL COMMUNITY, NOT SOLELY FOR THE PERSONS LIVING IN POVERTY, INCLUDING HEALTH PROMOTION AND EDUCATION, HEALTH CLINICS AND SCREENINGS, AND MEDICAL RESEARCH. DISCOUNTS ARE PROVIDED TO ALL UNINSURED PATIENTS, INCLUDING THOSE WITH THE MEANS TO PAY. DISCOUNTS PROVIDED TO THOSE PATIENTS WHO DID NOT QUALIFY FOR ASSISTANCE UNDER CHARITY CARE GUIDELINES ARE NOT INCLUDED IN THE COST OF PROVIDING CARE OF PERSONS LIVING IN POVERTY AND OTHER COMMUNITY BENEFIT PROGRAMS. THE COST OF PROVIDING CARE TO PERSONS LIVING IN POVERTY AND OTHER COMMUNITY BENEFIT PROGRAMS IS ESTIMATED BY REDUCING CHARGES FORGONE BY A FACTOR DERIVED FROM THE RATIO OF EACH ENTITY'S TOTAL OPERATING EXPENSES TO THE ENTITY'S BILLED CHARGES FOR PATIENT CARE. false true false false false false false false false KEITH JEWELL CEO/PRESIDENT 490240 0 287459 0 5770 0 33812 0 19169 0 836450 0 0 0 JOSEPH O MURDOCK BOARD MEMBER 0 385269 0 148207 0 56909 0 9275 0 33323 0 632983 0 0 KARL SASH MD BOARD MEMBER 12227 292235 0 136981 0 55704 322 27589 0 38081 12548 550590 0 54512 TRICIA BAIRD MD CHIEF CLINICAL INTEGRATION OFFICER 150778 149543 27500 2915 140 11877 12195 10907 4597 5374 195211 180616 0 0 DARCY ELLISON SR VP/CNO 252178 0 72638 0 54068 0 30916 0 26586 0 436387 0 52050 0 WILLIAM MILLIKAN JR MD CEO, MEDICAL GROUP 365655 0 96263 0 3795 0 13250 0 28797 0 507760 0 0 0 GWEN SANDEFUR EVP/COO (thru 8/2015) 227118 0 0 0 579 0 1000 0 21256 0 249952 0 0 0 JOHN L ZABROWSKI III CFO 257129 0 67127 0 276 0 21928 0 10380 0 356841 0 0 0 JOHN GREANEY VP, AMBULATORY/CONSUMER HEALTH & FOUNDATION 180773 0 46382 0 192 0 10551 0 27894 0 265791 0 0 0 KATHY HALL VP, REGIONAL ADMINISTRATOR 185089 0 52859 0 792 0 15280 0 29490 0 283510 0 0 0 SUZETTE HERSHMAN VP, MEDICAL GROUP 196140 0 48490 0 288 0 14650 0 13555 0 273123 0 0 0 VERNON MAAS MD VP, MEDICAL AFFAIRS (thru 6/2016) 230476 0 67072 0 41188 0 37803 0 30702 0 407240 0 39991 0 MIKE WHITMORE VP, CLINICAL SUPPORT & ANCILLARY SERVICES 194918 0 47787 0 768 0 16009 0 7011 0 266494 0 0 0 janice ERNest VP, CARDIOVASCULAR & SYSTEM SUPPORT 192147 0 49135 0 1246 0 14976 0 41899 0 299403 0 0 0 MICHAEL KLUEH VP/CRO (THRU 2/2016) 168953 0 44654 0 10152 0 12314 0 29762 0 265835 0 9041 0 ALIREZA KHAKBAZNEJAD MD PHYSICIAN 384407 0 120169 0 35681 0 28038 0 33648 0 601943 0 35158 0 LUISSA KIPRONO MD PHYSICIAN 449027 0 0 0 131256 0 13250 0 22850 0 616383 0 0 0 CHARLES LACKEY MD PHYSICIAN 473122 0 0 0 38180 0 24259 0 27222 0 562783 0 37579 0 NURAHMED MOHAMMED MD PHYSICIAN 352219 0 170152 0 7446 0 23797 0 24641 0 578254 0 0 0 DALE YINGLING MD PHYSICIAN 541356 0 0 0 12775 0 13250 0 33555 0 600936 0 0 0 Schedule J, Part I, Line 3 Arrangement used to establish the top management official's compensation ASCENSION HEALTH, A RELATED ORGANIZATION OF ST. MARY'S HEALTH, INC., USES THE FOLLOWING TO ESTABLISH THE COMPENSATION OF THE ORGANIZATION'S CEO/EXECUTIVE DIRECTOR: COMPENSATION COMMITTEE INDEPENDENT COMPENSATION CONSULTANT COMPENSATION SURVEY OR STUDY APPROVAL BY THE BOARD OR COMPENSATION COMMITTEE Schedule J, Part I, Line 4b Supplemental nonqualified retirement plan ELIGIBLE EXECUTIVES PARTICIPATE IN VARIOUS NON-QUALIFIED DEFERRED COMPENSATION PLANS ORGANIZED UNDER CODE SECTION 457(F). THE EXACT PURPOSE OF EACH PLAN VARIES, BUT THEY INCLUDE: COMPENSATION LIMITATION MAKE-UP PLANS, VOLUNTARY DEFERRAL PLANS, DEFERRAL OF A PORTION OF INCENTIVE BONUS TYPE PLANS, ETC. ANY AMOUNT ULTIMATELY PAID UNDER THE PROGRAM TO THE EXECUTIVE IS REPORTED AS COMPENSATION ON FORM 990, SCHEDULE J, PART II, COLUMN B IN THE YEAR PAID. THE FOLLOWING INDIVIDUALS RECEIVED CURRENT YEAR DISTRIBUTIONS OF: KARL SASH, MD $54,512 DARCY ELLISON $52,050 VERNON MAAS, MD $39,991 ALIREZA KHAKBAZNEJAD, MD $35,158 CHARLES LACKEY, MD $37,579 Michael Klueh $9,041 CAROL ACKERMAN SISTER-IN-LAW OF DARCY ELLISON 45351 CAROL ACKERMAN IS AN EMPLOYEE OF ST. MARY'S HEALTH, INC. AND RECEIVES COMPENSATION FROM THE ORGANIZATION false KIMBERLY WHITMORE WIFE OF MIKE WHITMORE 55988 KIMBERLY WHITMORE IS AN EMPLOYEE OF ST. MARY'S HEALTH, INC. AND RECEIVES COMPENSATION FROM THE ORGANIZATION false TRACY NEELEY SISTER OF KEITH JEWELL 72711 TRACY NEELEY IS AN EMPLOYEE OF ST. MARY'S HEALTH, INC. AND RECEIVES COMPENSATION FROM THE ORGANIZATION false STEPHANY STANTON SISTER OF SUZETTE HERSHMAN 133533 STEPHANY STANTON IS AN EMPLOYEE OF ST. MARY'S HEALTH, INC. AND RECEIVES COMPENSATION FROM THE ORGANIZATION false ANN SCHYMIK WIFE OF DR. BRIAN SCHYMIK 31642 ANN SCHYMIK IS AN EMPLOYEE OF ST. MARY'S HEALTH, INC. AND RECEIVES COMPENSATION FROM THE ORGANIZATION false X 2 672632 Market value X EQUIPMENT 3 215639 Market value X LAND/BUILDING IMPROVEMENTS 2 384697 Market value 0 false false false Schedule M, Part I Explanations of reporting method for number of contributions Cars and other vehicles - THE NUMBERS IN COLUMN (B) REFER TO THE NUMBER OF CONTRIBUTIONS. Other - EQUIPMENT THE NUMBERS IN COLUMN (B) REFER TO THE NUMBER OF CONTRIBUTIONS. Other - LAND/BUILDING IMPROVEMENTS THE NUMBERS IN COLUMN (B) REFER TO THE NUMBER OF CONTRIBUTIONS. Form 990, Part IV, Line 24a PART IV, LINE 24A ST. MARY'S HEALTH, INC. IS A HEALTH FACILITY THAT IS PART OF THE ASCENSION HEALTH SYSTEM. ASCENSION HEALTH IS THE BORROWER FOR TAX-EXEMPT HOSPITAL REVENUE BONDS. ST. MARY'S HEALTH, INC. HOLDS AN INTERCOMPANY NOTE PAYABLE WITH ASCENSION HEALTH, AND THIS INFORMATION IS REPORTED ON THE BALANCE SHEET. Form 990, Part IV, Line 20b AUDITED FINANCIAL STATEMENTS THE ACTIVITY OF ST. MARY'S HEALTH, INC. IS REPORTED IN THE CONSOLIDATED FINANCIAL STATEMENTS OF ASCENSION HEALTH ALLIANCE. NO INDIVIDUAL AUDIT OF ST. MARY'S HEALTH, INC. IS COMPLETED. THEREFORE, THE ATTACHED AUDITED FINANCIAL STATEMENTS ARE OF ASCENSION HEALTH ALLIANCE AND AFFILIATES, WHICH INCLUDE THE ACTIVITY OF ST. MARY'S HEALTH, INC. Form 990, Part VI, Line 15a PART VI, LINE 15 IN DETERMINING THE COMPENSATION OF THE ORGANIZATION'S CEO, THE PROCESS, PERFORMED BY ASCENSION HEALTH, A RELATED ORGANIZATION OF ST. MARY'S HEALTH, INC., INCLUDED A REVIEW AND APPROVAL BY INDEPENDENT PERSONS, COMPARABILITY DATA AND CONTEMPORANEOUS SUBSTANTIATION OF THE DELIBERATION AND DECISION. THE COMPENSATION COMMITTEE REVIEWED AND APPROVED THE COMPENSATION. IN THE REVIEW OF THE COMPENSATION, THE CEO WAS COMPARED TO INDIVIDUALS AT OTHER ORGANIZATIONS IN THE AREA WHO HOLD THE SAME TITLE. DURING THE REVIEW AND APPROVAL OF THE COMPENSATION, DOCUMENTATION OF THE DECISION WAS RECORDED IN THE COMMITTEE MINUTES. THE INDIVIDUAL WAS NOT PRESENT WHEN THEIR COMPENSATION WAS DECIDED. Form 990, Part VI, Line 16b PART VI, LINE 16B ST. MARY'S HEALTH, INC. AND SUBSIDIARIES (ST. MARY'S) JOINT VENTURE OPERATING AGREEMENTS ARE NEGOTIATED WITH OTHER MEMBERS OF THE JOINT VENTURE TO ENSURE THAT ADEQUATE SAFEGUARDS ARE IN PLACE TO PROTECT ST. MARY'S EXEMPT STATUS. EACH AGREEMENT CONTAINS SPECIFIC LANGUAGE RELATED TO THE PROVISION OF HEALTH CARE SERVICES WITH A FOCUS ON COMMUNITY HEALTH BENEFIT AND MUST FOLLOW A FORMAL REVIEW PROCESS PRIOR TO CONTRACT EXECUTION. ST. MARY'S CONTINUALLY ENSURES THAT ITS EXEMPT STATUS IS PROTECTED BY ACTIVELY PARTICIPATING IN THE GOVERNANCE OF ALL ST. MARY'S JOINT VENTURES. Form 990, Part VI, Line 2 Family/business relationships amongst interested persons TRUDY STOCK AND KEITH JEWELL - Business relationship, TRUDY STOCK AND JAMES SANDGREN - Business relationship, KEITH JEWELL AND JAMES SANDGREN - Business relationship, JAMES SANDGREN AND JEFFERY WOLF - Business relationship Form 990, Part VI, Line 6 Classes of members or stockholders ST. MARY'S HEALTH, INC. HAS A SINGLE CORPORATE MEMBER, ST.VINCENT HEALTH, INC. Form 990, Part VI, Line 7a Members or stockholders electing members of governing body ST. MARY'S HEALTH, INC. HAS A SINGLE CORPORATE MEMBER, ST.VINCENT HEALTH, INC. WHO HAS THE ABILITY TO ELECT MEMBERS TO THE GOVERNING BODY OF ST. MARY'S HEALTH, INC. Form 990, Part VI, Line 7b Decisions requiring approval by members or stockholders ALL DECISIONS THAT HAVE A MATERIAL IMPACT TO ST. MARY'S HEALTH, INC.'S FINANCIAL INFORMATION OR CORPORATION AS A WHOLE ARE SUBJECT TO APPROVAL BY ITS SOLE CORPORATE MEMBER, ST.VINCENT HEALTH, INC. Form 990, Part VI, Line 11b Review of form 990 by governing body UPON RECEIVING DIRECTION FROM ITS TAX PREPARER, THE FORM 990 IS PROVIDED TO THE ST. MARY'S HEALTH, INC.'S GOVERNING BODY VIA A SECURE WEB-BASED PORTAL. THE GOVERNING BODY WILL REVIEW THE FORM 990 PRIOR TO THE FILING DATE AND ASK ANY QUESTIONS REGARDING THE FORM 990. ANY QUESTIONS AND RESPONSES WILL BE POSTED TO THE WEB-BASED PORTAL BEFORE THE RETURN IS FILED. ALL QUESTIONS AND RESPONSES WILL BE REVIEWED AND DISCLOSED IN THE MEETING MINUTES OF THE NEXT BOARD MEETING FOLLOWING THE REVIEW OF THE FORM 990. Form 990, Part VI, Line 12c Conflict of interest policy THE ORGANIZATION REGULARLY AND CONSISTENTLY MONITORS AND ENFORCES COMPLIANCE WITH THE CONFLICT OF INTEREST POLICY IN THAT ANY DIRECTOR, PRINCIPAL OFFICER, OR MEMBER OF A COMMITTEE WITH GOVERNING BOARD DELEGATED POWERS, WHO HAS A DIRECT OR INDIRECT FINANCIAL INTEREST, MUST DISCLOSE THE EXISTENCE OF THE FINANCIAL INTEREST AND BE GIVEN THE OPPORTUNITY TO DISCLOSE ALL MATERIAL FACTS TO THE DIRECTORS AND MEMBERS OF THE COMMITTEES WITH GOVERNING BOARD DELEGATED POWERS CONSIDERING THE PROPOSED TRANSACTION OR ARRANGEMENT. THE REMAINING INDIVIDUALS ON THE GOVERNING BOARD OR COMMITTEE WILL DECIDE IF CONFLICTS OF INTEREST EXIST. EACH DIRECTOR, PRINCIPAL OFFICER AND MEMBER OF A COMMITTEE WITH GOVERNING BOARD DELEGATED POWERS ANNUALLY SIGNS A STATEMENT WHICH AFFIRMS SUCH PERSON HAS RECEIVED A COPY OF THE CONFLICTS OF INTEREST POLICY, HAS READ AND UNDERSTANDS THE POLICY, HAS AGREED TO COMPLY WITH THE POLICY, AND UNDERSTANDS THAT THE ORGANIZATION IS CHARITABLE AND IN ORDER TO MAINTAIN ITS FEDERAL TAX EXEMPTION IT MUST ENGAGE PRIMARILY IN ACTIVITIES WHICH ACCOMPLISH ITS TAX-EXEMPT PURPOSE Form 990, Part VI, Line 15b Process to establish compensation of other employees COMPENSATION DETERMINATIONS OF ST. MARY'S HEALTH, INC.'S OTHER OFFICERS OR KEY EMPLOYEES ARE MADE BY ST. MARY'S HEALTH, INC.'S MANAGEMENT. IN DETERMINING COMPENSATION OF OTHER OFFICERS OR KEY EMPLOYEES OF THE ORGANIZATION, THE PROCESS INCLUDED A REVIEW AND APPROVAL BY INDEPENDENT PERSONS, COMPARABILITY DATA, AND CONTEMPORANEOUS SUBSTANTIATION OF THE DELIBERATION AND DECISION. IN THE REVIEW OF THE COMPENSATION, THE OTHER OFFICERS OR KEY EMPLOYEES OF THE ORGANIZATION WERE COMPARED TO THE OTHER HOSPITALS' EMPLOYEES IN THE AREA THAT HOLD THE SAME POSITION. Form 990, Part VI, Line 19 Required documents available to the public THE ORGANIZATION WILL PROVIDE ANY DOCUMENTS OPEN TO PUBLIC INSPECTION UPON REQUEST. Form 990, Part VIII, Line 11d Other Miscellaneous Revenue DIETARY REVENUE - Total Revenue: 1749614, Related or Exempt Function Revenue: , Unrelated Business Revenue: 114249, Revenue Excluded from Tax Under Sections 512, 513, or 514: 1635365; LAB SERVICES - Total Revenue: 317798, Related or Exempt Function Revenue: , Unrelated Business Revenue: 114550, Revenue Excluded from Tax Under Sections 512, 513, or 514: 203248; ALL OTHER REVENUE - Total Revenue: 3539110, Related or Exempt Function Revenue: 3294367, Unrelated Business Revenue: 13058, Revenue Excluded from Tax Under Sections 512, 513, or 514: 231685; GOVERNMENT INCENTIVES - Total Revenue: 1405210, Related or Exempt Function Revenue: 1405210, Unrelated Business Revenue: , Revenue Excluded from Tax Under Sections 512, 513, or 514: ; Form 990, Part XI, Line 9 Other changes in net assets or fund balances FAS 158 PENSION - -14773317; NET ASSET TRANSFER WITH RELATED ENTITIES - 15867895; Book to Tax Difference in Joint Ventures - 1090815; 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