2017-05-15T16:01:07-05:00 2016-06-30 350921680 CROWE HORWATH LLP 750 N ST PAUL SUITE 850 DALLAS TX 75201 990 2015-07-01 611293786 University Medical Center Inc UNIV 5025623621 250 E LIBERTY ST 500 Louisville KY 40202 ROBERT STELTENPOHL VP-FINANCE 2017-05-15 true JACKIE COBURN P00244301 3032989100 2015 2021-01-29 14:40:06Z University of Louisville Hospital ROBERT STELTENPOHL 250 E LIBERTY ST Louisville KY 40202 615129385 false X www.kentuckyonehealth.org/university-of-louisville-hospital X 1995 KY TO PROVIDE PATIENT CARE TO OUR COMMUNITY AND TO SERVE AS A MAJOR TEACHING HOSPITAL FOR EDUCATION AND TRAINING IN MEDICINE, DENTISTRY, NURSING, AND ALLIED HEALTH PROFESSIONS. 7 7 268 500 10322 3993 26820 788779 543110389 587044033 -117441 3567731 33410648 23728842 576430416 615129385 13142381 16707988 0 145145127 145870384 0 0 364465955 414808085 522753463 577386457 53676953 37742928 483186223 517524055 177293268 175339705 305892955 342184350 TO PROVIDE PATIENT CARE TO OUR COMMUNITY AND TO SERVE AS A MAJOR TEACHING HOSPITAL FOR EDUCATION AND TRAINING IN MEDICINE, DENTISTRY, NURSING, AND ALLIED HEALTH PROFESSIONS. false false 489679206 16707988 587038431 UNIVERSITY MEDICAL CENTER OPERATES THE UNIVERSITY OF LOUISVILLE HOSPITAL, WHICH IS A TEACHING FACILITY HOSPITAL DESIGNATED AS A REGIONAL TRAUMA CENTER AND PROVIDES CARE TO THE MEDICALLY NEEDY REGARDLESS OF THEIR ABILITY TO PAY. SEE SCHEDULE H FOR ADDITIONAL INFORMATION. 489679206 true true false true false false false false false false true true false false true true false true false false true true false false false false true true false true true false false false true false false false false false false false false false false false false false true 0 0 268 true true true false false false false false false false false false X 7 7 false false false false false false false true true false false false true true true true true false true true false KY X Colleen Holton 5025874961 200 Abraham Flexner Way Louisville KY 40202 MARCIA HERN EDD cns rn VICE CHAIR 1.0 0 X X 0 0 0 JOAN COLEMAN DIRECTOR / INTERIM CEO 1.0 0 X X 0 0 0 GERARD J ANDERSON CHAIR 1.0 0 X X 0 0 0 Laurence Benz DPT MBA OCS DIRECTOR 1.0 0 X 0 0 0 TONI GANZEL MD DIRECTOR 1.0 0 X 0 0 0 SEAN FRANCIS DIRECTOR 1.0 0 X 0 0 0 HARLAN SANDS DIRECTOR 1.0 0 X 0 0 0 JAMES H TAYLOR MD PHD CEO (Partial Year) 50.0 0 X 423395 0 105849 KENNETH MARSHALL President 50.0 0 X 580978 0 64421 NANCY BOWLES VP-ONCOLOGY ADMIN SERVICE LINE 40.0 0 X 171506 0 8835 FRANCES E SMITH NURSE DIRECTOR 40.0 0.0 X 139922 0 34831 PAULINE HAYES CLINICAL MANAGER 40.0 0.0 X 111790 0 27948 CYNTHIA ECKERT CLINICAL MANAGER 40.0 0.0 X 110819 0 27705 Lisa Wright Clinical Manager 40.0 0 X 113382 0 28346 1651792 0 297935 5 false true false CROTHALL HEALTHCARE INC 13028 COLLECTION CENTER DRIVE CHICAGO IL 60693 ENVIRONMENTAL SERVICES 5641758 Louisville Cyberknife LLC PO Box 6600 Newport Beach CA 92658 cancer treatment 4641000 Wehr Constructors Inc 2517 Plantside Dr Box 32185 Louisville KY 40299 Construction 3816004 INTUITIVE SURGICAL INC 1020 Kifer Road Sunnyvale CA 94086 Surgical Systems 3274910 MORRISON MANAGEMENT SPECIAL 5801 PEACHTREE DUNWOODY ROAD ATLANTA GA 30342 FOOD SERVICES 2362677 39 X 781622 616 6541 788779 Patient Services 900099 583184587 583184587 Meaningful Use 900099 1178287 1178287 Intercompany Transactions 900099 1478004 1478004 Laboratory Services 621500 1203155 1197553 5602 0 0 0 0 587044033 1915805 4720 1911085 149693 149693 0 149693 149693 1651926 1651926 0 1651926 1651926 Pharmacy Services 446110 20140569 20140569 Education 611710 16555 16555 Parking Lot 812930 86387 86387 3335638 0 0 3335638 23579149 615129385 587038431 10322 27291853 X 6134 6134 16378396 16378396 323458 323458 529244 529244 117037871 105390588 11647283 5640564 4914091 726473 13718947 11952022 1766925 8943758 7791852 1151906 1223500 1223500 17000 17000 25179 25179 125790728 64069965 61720763 0 9671057 8784955 886102 13897656 9617611 4280045 9561014 9234560 326454 114514 71970 42544 24767 21060 3707 5980029 5980029 2519890 2519890 23146512 22908933 237579 3122547 3122547 Medical Supplies 119663424 119663424 Bad debts 64213443 64213443 Intercompany Allocations 21814936 21814936 State Provider Tax 7249119 7249119 6772770 6772770 0 0 577386457 489679206 87707251 0 60907 711198 150757288 133019679 68724325 93612181 1333000 1333000 0 0 1067360 1019105 11806182 11535350 2593507 1316563 224785565 77870884 159199697 146914681 32154231 1993242 0 71344034 0 53178005 53178005 2311721 1547017 483186223 517524055 22107814 32572683 43882634 65386246 430742 0 0 64856227 63591227 46015851 13789549 177293268 175339705 X 305892955 342184350 305892955 342184350 483186223 517524055 37742928 -1451533 0 X false true X true true true X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED false false false false false true 25179 false false false 25179 false Schedule C, Part II-B, Line 1 DETAILED DESCRIPTION OF THE LOBBYING ACTIVITY The portion of organization dues that are related to lobbying are as follows: American Hospital Association - $4,178 Kentucky Hospital Association - $21,001 Schedule C, Part II-B, Line 1 DETAILED DESCRIPTION OF THE LOBBYING ACTIVITY The portion of organization dues that are related to lobbying are as follows: American Hospital Association - $4,178 Kentucky Hospital Association - $21,001 70347911 11151575 59196336 69146787 23364510 45782277 71875124 42859966 29015158 13415743 494833 12920910 146914681 CHI OIP 71344034 F 71344034 Intercompany Payables 1852836 Self-Insurance Reserves and Claims 2120797 Unclaimed Property 1960 Environmental Remediation Liability 291063 Miscellaneous Accrued Contracts 9522893 13789549 X Schedule D, Part X, Line 2 FIN 48 (ASC 740) footnote University Medical Center's financial information is included in the consolidated audited financial statements of Catholic Health Initiatives (CHI), a related organization. CHI's FIN 48 (ASC 740) footnote for the year ended June 30, 2016, reads as follows: "CHI is a tax-exempt Colorado corporation and has been granted an exemption from federal income tax under Section 501(c)(3) of the Internal Revenue Code. CHI owns certain taxable subsidiaries and engages in certain activities that are unrelated to its exempt purpose and therefore subject to income tax. Management reviews its tax positions annually and has determined that there are no material uncertain tax positions that require recognition in the accompanying consolidated financial statements." true Sub-Saharan Africa 0 0 Grantmaking 323458 0 0 0 0 0 0 323458 0 323458 Sub-Saharan Africa Operational Support 0 N/A 323458 Equipment & Supplies Book 1 0 true false true false false false Schedule F, Part I, Line 2 Procedures for monitoring use of grant funds GRANTS ARE PROVIDED TO SUPPORT THE CHARITABLE MISSION OF GRANTEE GANIZATIONS AND CAN BE USED IN ANY WAY TO FURTHER THEIR EXEMPT PURPOSE. Schedule F, Part I, Line 2 PROCEDURES FOR MONITORING USE OF GRANT FUNDS GRANTS ARE PROVIDED TO SUPPORT THE CHARITABLE MISSION OF GRANTEE GANIZATIONS AND CAN BE USED IN ANY WAY TO FURTHER THEIR EXEMPT PURPOSE. true true X false false true true true false true true 9656743 14388948 0 0.0 129985430 103428224 26557206 0.0518 0 0.0 0 0 139642173 117817172 26557206 0.0518 7 8993 1501864 4929 1496935 0.0029 4 173 130028752 87410770 42617982 0.0830 0 0 0.0 1 157324 157324 0.0003 3 5397100 5397100 0.0105 15 9166 137085040 87415699 49669341 0.0968 15 9166 276727213 205232871 76226547 0.1485 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 1 2288 2288 0.0000 1 8584 8584 0.0000 0 0.0 0 0.0 2 0 10872 0 10872 0.0000 true 64213443 0 93320500 91253344 2067156 X true true 1 1 University of Louisville Hospital 530 S Jackson Street Louisville KY 40202 www.kentuckyonehealth.org/university-of-louisville-hospital 100220 X X X X X University of Louisville Hospital 1 false false true X X X X X X X X X 15 true false false true X www.kentuckyonehealth.org/2017-2019-university-of-louisville-hospital-chna X true 15 true www.kentuckyonehealth.org/2017-2019-university-of-louisville-hospital-chna false false true X X X X X true true X X X true X www.kentuckyonehealth.org/university-of-louisville-hospital-financial-assistance X www.kentuckyonehealth.org/university-of-louisville-hospital-financial-assistance X www.kentuckyonehealth.org/university-of-louisville-hospital-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 - University of Louisville Hospital. Primary data from the community served by the hospital was solicited by the KentuckyOne Health Louisville hospitals (including University of Louisville Hospital), Norton Healthcare, Baptist Health Kentucky and the Louisville Metro Department of Public Health and Wellness between April 2015 and September 2015. These organizations shared a Survey Monkey link with councils, workgroups, patients, county government and community members to solicit feedback about perception of health and safety in the community. Two surveys-a community survey and a physician/health care provider survey- were circulated widely. Primary data collection was completed in conjunction with the LMDPHW. The LMDPHW staff provided survey analysis and distributed the surveys internally to their staff teams. Michael Spine, Senior Vice President, Strategy and Business Development for KentuckyOne Health, provided feedback for this report in the form of prioritizing 13 health needs for each KentuckyOne Health hospital, including University of Louisville Hospital in January 2016. Mr. Spine considered county level data in conjunction with each measure's potential link to KentuckyOne Health's strategic alignment and the likelihood of building sustainable strategies to address those efforts related to each health need. Soliciting Mr. Spine's input satisfies the CHI requirement for a representative from KentuckyOne Health's regional strategy and business development department to be engaged in the CHNA process. Schedule H, Part V, Section B, Line 11 Facility , 1 Facility , 1 - University of Louisville Hospital. The most recent Community Health needs assessment identified tobacco use, diet and exercise, alcohol and drug abuse, access to care and community safety as community needs. To address alcohol and drug use, the University of Louisville Hospital is working to address the mental health issues that can underlie substance abuse with the following strategies: A. Continue to support legislation allowing the Kentucky Harm Reduction Coalition to dispense Naloxone. B. Leverage expertise in mental health to increase access to mental health services via telehealth programs that allow KentuckyOne Health staff to operate programs in communities that do not have sufficient mental health services to serve need. C. Pursue various private, state, and federal funding for programs to address mental health needs that can underlie substance abuse. To address tobacco use, the University of Louisville Hospital is implementing a system-wide approach, through the following Strategies: A. Advocate for legislation that would prohibit smoking in indoor workplaces and public places, including restaurants, bars, and hotels. B. Include advocacy for increasing the cigarette tax on 2017 legislative priorities agenda. C. Advocate requiring insurance companies to pay for evidence-based smoking cessation treatments. D. Create Health in All Policies and Practices (HiAPP) document for guidance on the health implications of organizational decisions in order to improve population health and health equity. To address community safety, the University of Louisville Hospital is focusing on the following strategy: A. Improve response to victims of human trafficking by: 1. Improving recognition of signs of victims. 2. Providing referrals to victims identified in the hospital setting. B. Advocate for a funding for a staff-supported structure of the statewide trauma system, which currently operates on volunteers and donations. C. Pursue various private, state, and federal funding for programs to promote community safety. To address diet and exercise, the University of Louisville Hospital is focusing on the following strategy: A. Begin discussions with Commissioner of Agriculture to discuss feasibility of having hospitals participate in Kentucky Proud Program to have local food used in hospital foodservice and available for resale in hospitals. B. Support legislation to provide tax and other incentives for the creation of wellness programs enabling businesses to educate and encourage employees to engage in healthy lifestyles and obtain preventative care. C. Advocate for initiatives that address the risk factors that lead to obesity and chronic diseases in children. D. Annually, identify a minimum of one opportunity to support and implement initiatives to support the CHI healthy food and wellness initiative. To address access to care, the University of Louisville Hospital is focusing on the following strategy: A. With the understanding that providing culturally-competent care will encourage the community to be more comfortable accessing care, we will create mass education for employees on culturally-competent care to provide the foundation to address health care disparities. B. Provide access to healthcare for the employees at various area companies. This includes providing a variety of preventative screenings and treatment on-site, with some sites having physician and nurse practitioner coverage on-site as well. C. Advocate for Kentucky's expanded Medicaid program for individuals with annual incomes up to 138% of the federal poverty level. D. Develop three-five year plan to increase capacity by optimizing bed utilization and using staff most efficiently. Includes developing plan for using advanced practitioners more extensively. Schedule H, Part V, Section B, Line 13 Facility , 1 Facility , 1 - University of Louisville Hospital. When Catholic Health Initiatives (the ultimate parent organization to University Medical Center, Inc.) established its financial assistance policy it was determined that establishing a household income scale based on the HUD very low income guidelines more accurately reflects the socioeconomic dispersions among urban and rural communities in 18 states served by CHI hospitals and health care facilities. In comparing HUD guidelines to the Federal Poverty Guidelines (FPG), we find that on average HUD guidelines compute to approximately 200% to 250% (and sometimes 300%) of FPG. University Medical Center, Inc. bases its financial assistance eligibility on HUD's 130% of Very Low Income Guidelines based on geography, and affords the uninsured and underinsured the ability to obtain financial assistance write-offs, based on a sliding scale, ranging from 25%-100% of charges. Schedule H, Part V, Section B, Line 22 Facility , 1 Facility , 1 - University Medical Center, Inc.. THE ORGANIZATION WILL NOT CHARGE INDIVIDUALS WHO ARE ELIGIBLE FOR FINANCIAL ASSISTANCE MORE THAN AMOUNTS GENERALLY BILLED TO THOSE WHO HAVE INSURANCE. 0 Schedule H, Part VI Lines 2, 4 & 5 and Part II Organization's Mission, Vision, and Tax-Exempt Purpose KentuckyOne Health, the largest and most comprehensive health system in the Commonwealth, has more than 200 locations including hospitals, physician groups, clinics, primary care centers, specialty institutes and home health agencies in Kentucky and southern Indiana. KentuckyOne Health is dedicated to bringing wellness, healing and hope to all, including the underserved. The system is made up of the former Jewish Hospital & St. Mary's HealthCare and Saint Joseph Health System, along with the University of Louisville Hospital and James Graham Brown Cancer Center. KentuckyOne Health is proud of and strengthened by its Catholic, Jewish and academic heritages. KentuckyOne Health was formed when two major Kentucky health care organizations came together in early 2012. KentuckyOne Health combines the Jewish and Catholic heritages of the two former systems- Jewish Hospital & St. Mary's HealthCare and Saint Joseph Health System. In late 2012, the organization formed a partnership with the University of Louisville Hospital | James Graham Brown Cancer Center. The nonprofit system is committed to improving the health of Kentuckians by integrating medical research, education, technology and health care services wherever patients receive care. An 18-member volunteer Board of Directors governs KentuckyOne health, its facilities and operations, with this mission: to bring wellness, healing, and hope to all. Our vision is to: * serve with a spirit of innovation and collaboration * transform health care delivery * partner to create healthy communities * advocate for a just health system University of Louisville Hospital (ULH) operates a 24-hour emergency department 365 days per year, which is open to all individuals regardless of ability to pay. ULH has open medical staff, participates in Medicare and Medicaid, and has an active charity care program. ULH is also the state's first Level 1 Trauma Center. University of Louisville Hospital, a 404-licensed-bed facility, is the leading academic medical center in the area and offers the benefits of the latest research, equipment and expertise. It is also home to the region's only Level 1 Adult Trauma Center and adult burn unit. The hospital is also the first nationally accredited Comprehensive Stroke Center in Kentucky. Rooted in nearly two centuries of service to the community, University Hospital has a rich history of providing extraordinary patient care and conducting leading-edge research. Today, the organization's direct tie to the UofL Health Sciences Center attracts millions of research dollars to improve health care and educate physicians. This high level of achievement offers patients unmatched access to innovative and specialized treatment options that are unavailable elsewhere in the region. The James Graham Brown Cancer Center opened in 1981 with the purpose of addressing the exceptionally high cancer rates experienced by the people of Kentucky. Its mission is to relieve Kentuckians' disproportionate burden of pain and suffering caused by this disease, through state-of-the-art clinical, research, education and outreach programs. During the past 30 years, the Brown Cancer Center has also become home to some of the best cancer scientists and physicians in the world. The James Graham Brown Cancer Center is a national leader in the provision of multidisciplinary cancer care, in which patients benefit (medically and practically) from a team of physicians and caregivers from every applicable field working together to plan, coordinate and provide care. ULH | JGBCC has long been on the leading edge of developments and accolades in key service areas: * First Trauma Center in the Nation * First Certified Primary Stroke Center in Kentucky * First to achieve American Heart Association "Stroke Honor Roll" in Kentucky * First Nationally Accredited Comprehensive Stroke Center in Kentucky * First Level IV Epilepsy Center in Kentucky * First Nationally Accredited Breast Center in Kentucky * First Nationally Accredited Radiation Oncology Program in Louisville * First to provide true multidisciplinary cancer care in Kentucky * First and only Blood and Marrow Transplantation Program in Louisville * First and only statewide education leader in Kangaroo Care ULH is committed to the provision of the highest quality patient- and family-centered care regardless of economic status. The hospital and cancer center provided more than $91 million of charity care in 2011, representing just part of $158 million in community benefit programs that year. ULH is the largest provider of charity care in Kentucky. Schedule H, Part VI Lines 2, 4 & 5 and Part II Community Benefit Approach Geographic Area Louisville is a major city-the largest in the state of Kentucky and the county seat of Jefferson County. As of 2010, the Louisville metropolitan area (MSA) had a population of 1,307,647 ranking it 42nd in size nationally. The metro area includes Louisville-Jefferson County and 12 surrounding counties, eight in Kentucky and four in Southern Indiana. Louisville is southeasterly situated along the border between Kentucky and Indiana, the Ohio River, in north-central Kentucky at the Falls of the Ohio. The Louisville metropolitan area is often referred to as Kentuckiana because it includes counties in Southern Indiana. A community is defined as the geographic area from which a significant number of the patients utilizing hospital services reside. While the community health needs assessment considers other types of healthcare providers, hospitals are the single largest provider of acute care services. For this reason, the utilization of hospital services provides the clearest definition of the community. ULH is located in downtown Louisville and serves a population that faces challenges that no other provider in Kentucky experiences. The ULH CHNA population is Jefferson County, but the areas that provide the most inpatient discharges are located in the downtown, western and southern parts of the county. These areas have more African-Americans, increased poverty and unemployment, increased drinking, violence and sexually transmitted infections which are characteristics that serve to separate it from not only the rest of Kentucky, but also the remainder of the county. With these structural challenges, the population that ULH serves is more likely to have poorer outcomes and a greater likelihood that they will not have the financial means to properly utilize the healthcare services provided in their community. Demographics of Constituents in Community Served According to the 2010 census, 26% of the community is between the ages of 35 and 54 and 20% of the population is between 0-14 years old. The ethnicity breakdown is 68% white, 23% black, and 5% Hispanic. In total, the population breakdown for the community shows a higher percentage of black residents compared to the state of Kentucky and the United States. A review of specific zip code areas shows a relatively large percentage of black residents in several zip codes representing the highest discharges from Jewish Hospital. Median household incomes range from $25,000-$50,000. The average annual resident unemployment rates for counties in Jewish Hospital's defined community have risen in recent years. These counties have rates are similar to Kentucky's state average, which is slightly less favorable than national averages. In Jefferson County, residents obtain a bachelor's degree or higher at rates greater than state and national averages; in Bullitt County the rate is just 11.1percent, about half the state average. The overall population is projected to increase slightly over a five-year period from577, 204 in 2013 to 595,540, a 3.2 percent increase. However, the people who utilize health care services the most, those ages 65 years and over, are projected to increase 16.7 percent, from 77,983 to 91,003. The projected change to the composition of the total community of males and females is projected to remain approximately the same over the five-year period. Community Benefit Process During 2012, a community health needs assessment (CHNA) was conducted to support the mission of enhancing the health of people in the communities served, to comply with the Patient Protection and Affordable Care Act of 2010 and federal tax-exemption requirements, and to identify health needs of the community to help prioritize the allocation of hospital resources to meet those needs. Based on current literature and other guidance from the Treasury and IRS, the following steps were completed as part of the community health needs assessment: 1. The "community" served was defined utilizing inpatient data on patient origin. 2. Population demographics and socioeconomic characteristics of the community were gathered and reported using various sources. The health status of the community was then reviewed. Information on the leading causes of death and morbidity was analyzed in conjunction with health outcomes and factors reported for the community by CountyHealthrankings.org. Health factors with significant opportunity for improvement were noted. 3. An inventory of health care facilities and resources was prepared. 4. Through a collaborative process conducted by the Louisville Metro Department of Public Health & Wellness(LMDPHW), the Kentucky Hospital Association and Louisville area hospitals, community input was obtained through a series of four public forums held across the county, and an additional forum for community leaders and medical professionals, and through an online survey. Schedule H, Part VI Lines 2, 4 & 5 and Part II Information gathered in the steps above was analyzed and reviewed to identify health issues of uninsured persons, low-income persons, minority groups and the community as a whole. Health needs were prioritized utilizing a method that weighs: 1) the size of the problem; 2) the seriousness of the problem; 3) the impact of the problem on vulnerable populations; 4) how important the problem is to the community; 5) prevalence of common themes; 6) how closely the need aligns with the strategies and strengths of the hospital and KentuckyOne Health; and 7) an evaluation of existing hospital programs responding to the identified need. Information gaps were identified during the prioritization process and reported. Summary of Assessment Findings After the CHNA was completed, the aforementioned facilities entered into a dialogue with other key community partners, including the LMDPHW, to discuss the results of the evaluation and select health priorities. Participants were given the opportunity to revise rankings and debate issues until a consensus was reached on a composite ranking of health issues. The process identified the following issues with scores of 14 or more (on a scale of 28): * Access and Health Care Disparities is very broad in that it addresses characteristics such as insurance status, income/poverty, educational attainment, crime rates, location of health care services and providers, etc. all of which impact the health status of a community. Our assessment of the community identified that all of these factors are present negatively compared to national standards in the community we serve and warrants consideration under our Community Health Needs Assessment. * Access to Primary Care impacts the health status of the community through lack of management of chronic conditions and lack of efficient and effective access to preventive care. Our assessment identified a shortage of primary care physicians in our community and an even greater shortage of primary care practices in the areas of Jefferson County served by ULH * Chronic Diseases impact the health and health care cost of our community because lack of appropriate management leads to preventable deaths, preventable hospitalizations and increased health care costs. * Leading Causes of Death in our community include heart disease, lower respiratory disease, cancer, chronic lower respiratory disease, unintentional /trauma related injuries, etc. This is important to the health of our community because if these conditions can be prevented and/or managed we have the ability to save the lives of these individuals in our community. * Risky Lifestyles was identified as an issue in our assessment of the community. Jefferson County has very high rates of alcohol and drug abuse, tobacco use, obesity, concentration of fast food restaurants, etc. These issues not only drive up health care costs, but they also impact the overall health and wellbeing of the individuals in our community. * Psychiatric, Emotional and Substance Abuse Disorders were identified as issues for our CHNA Community due to the lack of resources available to this community and the high socioeconomic impact from untreated populations. * Prematurity and Low Birth Weight babies was identified in our report as issues. Jefferson County has a higher percentage of babies born below 2500 grams than the rest of the state and the nation and has a higher preterm pregnancy rate as well. This is an issue because prematurity and low birth weight are linked to long-term health and developmental issues throughout the individual's life. * These needs were then mapped to the health improvement efforts of the Mayor's Healthy Hometown Movement in order to increase collaborative efforts to have the greatest opportunity for measurable, collective impact. Community Benefit Process for the Future In accordance with the Patient Protection and Affordable Care Act of 2010 and in order to honor its commitment to the community, KentuckyOne Health is repeating this coordinated approach with the Louisville Metro Department of Public Health and Wellness and other area hospital systems to survey the community as part of the community health needs assessment for 2015. A report due in 2016 will capture these current community sentiments and guide community benefit work in FY2017-2019 through an implementation strategy. This implementation strategy will build upon the previous CHNA published in 2013 that guided community benefit work in FY2014-2016. Qualitative Description of Community Benefit These hospitals promote the community's health by responding to the four major pillars of community benefit activities: improving access, enhancing community health, advancing medical knowledge, and reducing government burden of care. Community Outreach for the Poor They provide additional access to health care services in underserved areas of Jefferson County. ULH works to relieve the government's burden by caring for the indigent in Jefferson County. ULH has also provided staff and financial support to the Harambee Clinic, a nurse-run clinic that provides additional access to health care services in underserved areas of Jefferson County. ULH also works to enhance the health of the community through violence prevention interventions, health fairs in underserved areas, and community collaboration with other nonprofits to address the issues around hospital super-utilizers, among other initiatives. Community Outreach for the Broader Community Most community outreach is open to the public, which serves the broader community. One initiative that simultaneously improves access to healthcare and promotes health living is Walk with a Doc, which is free, open to the public, and held in three separate geographic locations in the Louisville market. KentuckyOne Health completely absorbs the cost of this program, including fees and allocating staff time in order to provide this benefit to the whole community. Health Professions Education As teaching hospitals, they work to advance medical knowledge for many different specializations of health professionals. In FY2014, this included, but was not limited to, providing education to: medical students, physician residents and fellows, nursing students, pharmacy residents, mental health professionals, physical and occupational therapists, and laboratory technicians. This was done in collaboration with the University of Louisville, the University of Kentucky, Spalding University, Galen College of Nursing, Bellarmine University, and Jefferson Community and Technical College, among others. Community Building Activities The hospitals also work to enhance the health of the community through violence prevention interventions, health fairs in underserved areas, and community collaboration with other nonprofits to address the issues around hospital super-utilizers, among other initiatives. All hospitals also donate supplies to Supplies Overseas. Collaborating partners for community building activities include, but are not limited to: Jefferson County Public Schools, Louisville Metro government, Food Literacy Project, Walk with a Doc, University of Louisville, PACT in Action, and the Center for Women and Families, among others. List of Services University of Louisville Hospital * Cancer care-James Graham Brown Cancer Center * Epilepsy center * Heart care * Lung care * Pain management care * Palliative care * Pharmacy * Psychiatric services * Radiology and diagnostic imaging * Regional clinical care * Robotic surgery * Stroke center * Sleep care * Trauma center * Women's care Schedule H, Part I, Line 3c Eligibility criteria for free or discounted care When Catholic Health Initiatives (the ultimate parent organization to University Medical Center, Inc.) established its financial assistance policy it was determined that establishing a household income scale based on the HUD very low income guidelines more accurately reflects the socioeconomic dispersions among urban and rural communities in 18 states served by CHI hospitals and health care facilities. In comparing HUD guidelines to the Federal Poverty Guidelines (FPG), we find that on average HUD guidelines compute to approximately 200% to 250% (and sometimes 300%) of FPG. University Medical Center, Inc. bases its financial assistance eligibility on HUD's 130% of Very Low Income Guidelines based on geography, and affords the uninsured and underinsured the ability to obtain financial assistance write-offs, based on a sliding scale, ranging from 25%-100% of charges. An individual's income under the HUD guidelines is a significant factor in determining eligibility for financial assistance. However, in determining whether to extend discounted or free care to a patient, the patient's assets may also be taken into consideration. For example, a patient suffering a catastrophic illness may have a reasonable level of income, but a low level of liquid assets such that the payment of medical bills would be seriously detrimental to the patient's basic financial (and ultimately physical) well-being and survival. Such a patient may be extended discounted or free care based upon the facts and circumstances. Schedule H, Part I, Line 6a Community benefit report prepared by related organization University Medical Center, INc. is included in a community benefit report prepared by KentuckyOne Health, Inc. Schedule H, Part I, Line 7 Bad Debt Expense excluded from financial assistance calculation 64213443 Schedule H, Part I, Line 7 Costing Methodology used to calculate financial assistance AMOUNTS REPORTED ON SCHEDULE H, PART I, LINE 7 ARE DETERMINED BY MULTIPLYING REVENUE BY THE COST TO CHARGE RATIO CALULATED FROM WORKSHEET 2. Schedule H, Part III, Line 2 Bad debt expense - methodology used to estimate amount THE ORGANIZATION HAS REPORTED BAD DEBT EXPENSE AT GROSS CHARGES WRITTEN OFF. THE ORGANIZATION'S BAD DEBT EXPENSE REPRESENTS AMOUNTS BILLED TO PATIENTS THAT WAS DEEMED UNCOLLECTIBLE AND DOES NOT INCLUDE ANY CHARGES THAT WERE ULTIMATELY REIMBURSED OR DISCOUNTED. PATIENT DISCOUNTS ARE RECORDED IN CONTRACTUAL ALLOWANCE OR FINANCIAL ASSISTANCE, AS APPROPRIATE, AS AN OFFSET TO GROSS REVENUE AND ARE NOT INCLUDED IN BAD DEBT EXPENSE. Schedule H, Part III, Line 3 Bad Debt Expense Methodology University Medical Center, Inc. does not believe that any portion of bad debt expense could reasonably be attributed to patients who qualify for financial assistance since amounts due from those individuals' accounts will be reclassified from bad debt expense to charity care within 30 days following the date that the patient is determined to qualify for charity care. Schedule H, Part III, Line 4 Bad debt expense - financial statement footnote University Medical Center, Inc. does not issue separate company audited financial statements. However, the organization is included in the consolidated financial statements of Catholic Health Initiatives. The consolidated footnote reads as follows: "The provision for bad debts is based upon management's assessment of historical and expected net collections, taking into consideration historical business and economic conditions, trends in health care coverage, and other collection indicators. Management routinely assesses the adequacy of the allowances for uncollectible accounts based upon historical write-off experience by payor category. The results of these reviews are used to modify, as necessary, the provision for bad debts and to establish appropriate allowances for uncollectible net patient accounts receivable. After satisfaction of amounts due from insurance, CHI follows established guidelines for placing certain patient balances with collection agencies, subject to the terms of certain restrictions on collection efforts as determined by each facility. The provision for bad debts is presented on the consolidated statement of operations as a deduction from patient services revenues (net of contractual allowances and discounts) since CHI accepts and treats all patients without regard to the ability to pay." Schedule H, Part III, Line 8 Community benefit & methodology for determining medicare costs Using essentially the same Medicare cost report principles as to the allocation of general services costs and "apportionment" methods, the "CHI Workbook" calculates a payers' gross allowable costs by service (so as to facilitate a corresponding comparison between gross allowable costs and ultimate payments received). The term "gross allowable costs" means costs before any deductibles or co-insurance are subtracted. University Medical Center, Inc.'s ultimate reimbursement will be reduced by any applicable copayment/ deductible. Where Medicare is the secondary insurer, amounts due from the insured's primary payer were not subtracted from Medicare allowable costs because the amounts are typically immaterial. University Medical Center, Inc. believes that excluding Medicare losses from community benefit makes the overall community benefit report more credible for these reasons: Unlike subsidized areas such as burn units or behavioral-health services, Medicare is not a differentiating feature of tax-exempt health care organizations. In fact, for-profit hospitals focus on attracting patients with Medicare coverage, especially in the case of well-paid services that include cardiac and orthopedics. Significant effort and resources are devoted to ensuring that hospitals are reimbursed appropriately by the Medicare program. The Medicare Payment Advisory Commission (MedPAC), an independent Congressional agency, carefully studies Medicare payment and the access to care that Medicare beneficiaries receive. The commission recommends payment adjustments to Congress accordingly. Though Medicare losses are not included by Catholic hospitals as community benefit, the Catholic Health Association guidelines allow hospitals to count as community benefit some programs that specifically serve the Medicare population. For instance, if hospitals operate programs for patients with Medicare benefits that respond to identified community needs, generate losses for the hospital, and meet other criteria, these programs can be included in the CHA framework in Category C as "subsidized health services." Medicare losses are different from Medicaid losses, which are counted in the CHA community benefit framework, because Medicaid reimbursements generally do not receive the level of attention paid to Medicare reimbursement. Medicaid payment is largely driven by what states can afford to pay, and is typically substantially less than what Medicare pays. Schedule H, Part III, Line 9b Collection practices for patients eligible for financial assistance University Medical Center, Inc.'s debt collection policy provides that University Medical Center, Inc. will perform a reasonable review of each inpatient account prior to turning an account over to a third-party collection agent and prior to instituting any legal action for non-payment, to assure that the patient and patient guarantor are not eligible for any assistance program (e.g. Medicaid) and do not qualify for coverage through University Medical Center, Inc. community assistance policy. After having been turned over to a third-party collection agent, any patient account that is subsequently determined to meet the University Medical Center, Inc. community assistance policy is required to be returned immediately by the third-party collection agent to University Medical Center, Inc. for appropriate follow-up. University Medical Center, Inc. requires its third-party collection agents to include a message on all statements indicating that if a patient or patient guarantor meets certain stipulated income requirements, the patient or patient guarantor may be eligible for financial assistance. All of Catholic Health Initiatives' hospitals' contracts with third party collection agencies include the following standards: * Neither CHI hospitals nor their collection agencies will request bench or arrest warrants as a result of non-payment; * Neither CHI hospitals nor their collection agencies will seek liens that would require the sale or foreclosure of a primary residence; and * No Catholic Health Initiatives' collection agency may seek court action without hospital approval. Finally, collection agencies are trained on the Catholic Health Initiatives Mission, Core Values and Standard of Conduct to make sure all patients are treated with dignity and respect. Schedule H, Part V, Section B, Line 16a FAP website - University of Louisville Hospital: Line 16a URL: www.kentuckyonehealth.org/university-of-louisville-hospital-financial-assistance; Schedule H, Part V, Section B, Line 16b FAP Application website - University of Louisville Hospital: Line 16b URL: www.kentuckyonehealth.org/university-of-louisville-hospital-financial-assistance; Schedule H, Part V, Section B, Line 16c FAP plain language summary website - University of Louisville Hospital: Line 16c URL: www.kentuckyonehealth.org/university-of-louisville-hospital-financial-assistance; Schedule H, Part VI, Line 3 Patient education of eligibility for assistance University Medical Center, Inc. includes information concerning its financial assistance policy on its website. In addition, University Medical Center, Inc. prominently displays its financial assistance policy in both English and Spanish in obvious locations throughout the hospitals, including the emergency rooms and other patient intake areas, as well as in University Medical Center, Inc. outpatient facilities. In addition, University Medical Center, Inc. registration clerks are trained to provide consultation to those who have no insurance or potentially inadequate insurance concerning their financial options including application for Medicaid and for financial assistance under University Medical Center, Inc.'s financial assistance policy. Upon registration (and once all EMTALA requirements are met), patients who are identified as uninsured (and not covered by Medicare or Medicaid) are provided with a packet of information that addresses the financial assistance policy and procedures including an application for assistance. University Medical Center's registration clerks read the organization's medical assistance policy to those who appear to be incapable of reading, and provide translators for non English-speaking individuals. University Medical Center's staff will also assist the patient/guarantor with applying for other available coverage (such as Medicaid), if necessary. Counselors assist Medicare eligible patients in enrollment by providing referrals to the appropriate government agencies. Schedule H, Part VI, Line 6 Affiliated health care system University Medical Center, Inc., along with its affiliated outpatient facilities, are part of Catholic Health Initiatives. Catholic Health Initiatives (CHI) is a national faith-based nonprofit health care organization with headquarters in Englewood, Colorado. CHI's exempt purpose is to serve as an integral part of its national system of hospitals and other charitable entities, which are described as market-based organizations, or MBOs. An MBO is a direct provider of care or services within a defined market area that may be an integrated health system and/or a stand-alone hospital or other facility or service provider. CHI serves as the parent corporation of its MBOs which are comprised of 104 hospitals, including four academic medical centers, and 30 critical access facilities; community health service organizations; accredited nursing colleges; home health agencies; and other facilities that span the inpatient and outpatient continuum of care. Together, these facilities provided $1.1 billion in financial assistance and community benefit in the 2016 fiscal year, including services for the poor, free clinics, education and research. CHI provides strategic planning and management services as well as centralized "shared services" for the MBOs. The provision of centralized management and shared services - including areas such as accounting, human resources, payroll and supply chain -- provides economies of scale and purchasing power to the MBOs. The cost savings achieved through CHI's centralization enable MBOs to dedicate additional resources to high-quality health care and community outreach services to the most vulnerable members of our society. University Medical Center, Inc. operates with its wholly owned affiliates and community partners to serve the health care needs of the Louisville, Kentucky communities. Schedule H, Part VI, Line 7 State filing of community benefit report KY true Financial Assistance 1432 0 16378396 Book Financial Assistance Schedule I, Part I, Line 2 Procedures for monitoring use of grant funds. UNIVERSITY MEDICAL CENTER, INC. RECOGNIZES THE RIGHT TO QUALITY HEALTHCARE REGARDLESS OF AGE, SEX, RACE, RELIGION, NATIONAL ORIGIN, OR ABILITY TO PAY. BUSINESS OFFICE STAFF HELPS PATIENTS SEEK LOCAL, STATE, AND FEDERAL REIMBURSEMENT AT NO CHARGE WHEN NO OTHER SOURCE OF PAYMENT IS AVAILABLE. CHARITY CARE IS PROVIDED TO PATIENTS WITH DEMONSTRATED INABILITY TO PAY FOR MEDICALLY NECESSARY SERVICES. THESE FUNDS ARE DIRECTLY USED TO OFFSET THE PATIENTS' ACCOUNTS RECEIVABLE. false true false false false false false false false JAMES H TAYLOR MD PHD CEO (Partial Year) 394354 0 0 0 29041 0 0 0 105849 0 529244 0 0 0 KENNETH MARSHALL President 396342 0 126813 0 57823 0 51305 0 13116 0 645399 0 0 0 NANCY BOWLES VP-ONCOLOGY ADMIN SERVICE LINE 155698 0 6225 0 9583 0 8023 0 812 0 180341 0 0 0 FRANCES E SMITH NURSE DIRECTOR 138195 0 0 0 1727 0 0 0 34831 0 174753 0 0 0 Schedule J, Part I, Line 3 Arrangement used to establish the top management official's compensation Compensation for the top management official was established and paid by Catholic Health Initiatives (CHI), a related organization. CHI used the following to establish the top management official's compensation: (1) Compensation Committee; (2) Independent Compensation Consultant; (3) Written Employment Contracts; (4) Compensation Survey or Study; (5) Approval by the Board or Compensation Committee. Schedule J, Part I, Line 4b Supplemental nonqualified retirement plan During the 2015 calendar year Catholic Health Initiatives (CHI), a related organization, maintained a supplemental non-qualified deferred compensation plan for MBO CEOs/Presidents and other CHI employees at the level of Senior Vice President and above. The following reportable individuals were eligible to participate in that plan: Kenneth Marshall During 2015 the following contributions were made by CHI to the deferred compensation plan: Kenneth Marshall - $34,932 Schedule J, Part II COMPENSATION FROM AN UNRELATED ORGANIZATION OR INDIVIDUAL NAME - KENNETH MARSHALL, COMPENSATION FROM UNRELATED ORGANIZATION - 645399.000000, NAME OF UNRELATED ORGANIZATION - CATHOLIC HEALTH INITIATIVES, TYPE OF COMPENSATION - WAGES AND BENEFITS Schedule J, Part II COMPENSATION FROM AN UNRELATED ORGANIZATION OR INDIVIDUAL NAME - NANCY BOWLES, COMPENSATION FROM UNRELATED ORGANIZATION - 180341.000000, NAME OF UNRELATED ORGANIZATION - KENTUCKYONE HEALTH, INC, TYPE OF COMPENSATION - WAGES AND BENEFITS Jim Taylor CEO (PARTIAL YEAR) LIFE INSURANCE X 1333000 1333000 false true true 1333000 Form 990, Part VI, Line 16b Joint venture written policy University Medical Center has not formally adopted a written policy or written procedure regarding joint ventures. However CHI's system-wide joint venture model operating agreement incorporates controls over the venture sufficient to ensure that (1) the exempt organization at all times retains control over the venture sufficient to ensure that the partnership furthers the exempt purpose of the organization; (2) in any partnership in which the exempt organization is a partner, achievement of exempt purposes is prioritized over maximization of profits for the partners; (3) the partnership does not engage in any activities that would jeopardize the exempt organization's exemption; (4) returns of capital, allocations, and distributions must be made in proportion to the partners' respective ownership interests; and (5) all contracts entered into by the partnership with the exempt organization must be at arm's-length, with prices set at fair market value. Any joint venture agreements that do not conform to the model agreement are generally reviewed by counsel. Form 990, Part VI, Line 15a COMPENSATION OF TOP MANAGEMENT OFFICIAL The organization's top management official's compensation is paid by Catholic Health Initiatives (CHI), a related organization. CHI has a defined compensation philosophy. Both the executive and non-executive compensation structures and ranges are reviewed annually in comparison to market data. CHI uses The Korn Ferry Hay Group as the independent third party to assess executive compensation programs and to ensure the reasonableness of actual salaries and total compensation packages. Compensation of the senior most executives is reviewed annually. The Korn Ferry Hay Group reviews both cash and total compensation for overall reasonableness, for adherence to CHI's compensation philosophy, and for comparability to the not-for-profit healthcare market. This independent review is delivered by Korn Ferry Hay Group to the HR committee of the CHI Board of Stewardship Trustees annually at their September meeting and minutes are shared with the full board at the December meeting. The last review was September 13, 2016. In addition, Korn Ferry Hay Group completed a comprehensive review of all positions at the level of vice president and above in the fall of 2014 to determine and validate appropriate compensation levels. These levels have been reviewed annually since and revised based on market data, where applicable. Form 990, Part VI, Line 11b Review of form 990 by governing body After review by the organization's finance department, the tax department files the return with the appropriate federal and state agencies, making any non-substantive changes necessary to effect e-filing. Form 990, Part VI, Line 12c Conflict of interest policy IT IS THE POLICY OF THE HOSPITAL THAT AN INTERESTED PERSON WHO KNOWS THAT HE OR SHE HAS AN ACTUAL OR APPARENT CONFLICT OF INTEREST SHALL DISCLOSE IT PROMPTLY AND FULLY TO ALL NECESSARY PARTIES WHENEVER IT OCCURS. INTERESTED PERSONS ARE: A. VOTING MEMBERS OF THE HOSPITAL'S BOARD OF DIRECTORS AND VOTING MEMBERS OF COMMITTEES THAT EXERCISE BOARD-DELEGATED AUTHORITY. B. OFFICERS OF THE HOSPITAL ELECTED OR APPROVED BY THE BOARD OF DIRECTORS. C. A "CONTROLLED ENTITY" IN WHICH AT LEAST 35% OF THE CONTROL OR BENEFICIAL INTEREST IS HELD BY ANY ONE OR COMBINATION OF INDIVIDUALS DESCRIBED IN A AND B. AN INTERESTED PERSON MUST DISCLOSE THE EXISTENCE AND NATURE OF HIS OR HER KNOWN INTEREST IN A PROPOSED TRANSACTION TO THE DIRECTORS AND MEMBERS OF COMMITTEES WITH BOARD DELEGATED POWERS CONSIDERING THE TRANSACTION OR ARRANGEMENT. WHEN A CONFLICT OF INTEREST IS DECLARED, THE CHAIRPERSON OF THE BOARD OR COMMITTEE SHALL APPOINT A DISINTERESTED PERSON OR COMMITTEE TO INVESTIGATE THE PROPOSED TRANSACTION. THE INTERESTED PERSON SHALL LEAVE THE MEETING AND THE VOTE ON ANY TRANSACTIONS INVOLVING THE CONFLICT OF INTEREST. THE MINUTES OF THE BOARD WILL CONTAIN THE NAMES OF THE PERSONS WHO DISCLOSE OR OTHERWISE WERE FOUND TO HAVE INTEREST IN CONNECTION WITH A CONFLICT OF INTEREST, THE NATURE OF THE INTEREST AND ANY ACTION TAKEN TO DETERMINE THE CONFLICT. Form 990, Part VI, Line 15b Process to establish compensation of other employees For all Executive Directors, Top Management Officials, Officers and Key Employees, the following process is used: 1) HUMAN RESOURCES (HR) HAS AN INDEPENDENT COMPANY DO A COMPARISON OF LIKE POSITIONS WITHIN THE COMMUNITY AND COME UP WITH A RANGE. THEY PREPARE A PROPOSAL THAT IS SUBMITTED TO HR FOR REVIEW. 2) A SALARY IS DETERMINED WITHIN THAT RANGE BASED ON YEARS OF SERVICE, EDUCATION AND OTHER FACTORS, SUCH AS ADDITIONAL RESPONSIBILITIES. HR PREPARES A PROPOSAL TO SUBMIT TO THE CEO. 3) THE PROPOSAL, CONTAINING THE POSITION, RANGE AND FINAL COMPENSATION IS TURNED OVER TO THE CEO FOR REVIEW. 4) AFTER REVIEW, THE CEO TAKES THE PROPOSAL INFORMATION AND PRESENTS IT TO THE FINANCE COMMITTEE. 5) THE FINANCE COMMITTEE DECIDES AND VOTES ON THE COMPENSATION. Form 990, Part VI, Line 19 Required documents available to the public The organization's financial statements, conflict of interest policy and governing documents are available to the public upon request. The organization's financial statements are included in Catholic Health Initiatives' consolidated audited financial statements that are available at www.catholichealthinitiatives.org or at www.DACBOND.org. Form 990, Part VIII, Line 11d Other Miscellaneous Revenue Micellaneous Revenue - Total Revenue: 3335638, Related or Exempt Function Revenue: , Unrelated Business Revenue: , Revenue Excluded from Tax Under Sections 512, 513, or 514: 3335638; Form 990, Part IX, Line 11g Other Fees Other Fees for Services - Total Expense: XXX-XX-XXXX, Program Service Expense: 64069965, Management and General Expenses: 61720763, Fundraising Expenses: ;