2016-06-27T14:46:34-05:00 2015-08-31 861065772 Deloitte Tax LLP 191 Peachtree Street Suite 2000 Atlanta GA 303031749 990 2014-09-01 582504530 St Francis Hospital Inc STFR 8642551000 One St Francis Drive Greenville SC 296013955 Ronnie Hyatt Treasurer/CFO-BSSFHS 8642551000 2016-06-27 1 John W Sadoff Jr P00540589 4042201500 2014 2016-12-15 16:53:06Z Craig McCoy One St Francis Drive Greenville SC 296013955 535349603 0 0928 X www.stfrancishealth.org X 1932 SC Provides acute care hospital services. 16 12 3122 276 383080 100678 2071495 6578895 523881812 520082580 1683123 1037624 6697513 7650504 534333943 535349603 761338 667113 0 0 178279723 185922290 0 0 0 295053523 284575559 474094584 471164962 60239359 64184641 751113199 833542850 323990832 351217372 427122367 482325478 X The mission is to bring compassion to health care and to be good help to those in need, especially those who are poor and dying. As a system of caregivers, we commit ourselves to help bring people and communities to health and wholeness. 0 0 439681651 667113 522412913 Bon Secours St. Francis Health System (BSSFHS) primarily serves Greenville County, which is comprised of approximately 483,000 (in 2014) residents with a 18% population increase over the last decade. 16% (in 2013) of residents in Greenville County are in households that fall below the federal poverty guidelines. Currently, 16 % of Greenville County residents are considered medically uninsured. Two specific populations with large growth rates in the county are the senior population, with a 45% growth of residents 60 and older from 2000 to 2014, and the Hispanic population, with an estimated growth of over 147% over the past decade. The three leading causes of death for Greenville County are cancer, cardiovascular disease and accidents. See Community benefit information in Sch H. The Community Benefit Report is available on the SFH website. 439681651 1 1 0 1 0 0 0 0 0 0 1 0 0 0 1 1 0 1 0 0 0 0 0 0 0 0 1 1 1 0 1 0 0 0 0 0 0 1 0 1 0 0 0 1 1 1 1 0 0 1 301 0 1 3122 1 1 1 0 0 0 0 0 0 0 0 0 X 16 12 0 0 0 0 1 1 1 1 1 0 0 1 1 1 1 1 1 0 1 1 0 X Ronnie Hyatt 8642551000 One St Francis Drive Greenville SC 296053955 X Katherine Arbuckle Board Member (Jan-Aug) 2.00 0.50 X 0 0 0 Charlton Armstrong III MD Board Member 2.00 0.00 X 0 0 0 Brother Peter Campbell CFX Board Member (Sep-Dec) 2.00 0.50 X 0 0 0 John Castile Board Member (Sep-Dec) 2.00 0.00 X 0 0 0 Richard Davis Board Member 2.00 0.00 X 0 0 0 Mills Gallivan Board Member (Jan-Aug) 2.00 0.00 X 0 0 0 Gregory Haselden Board Member 2.00 0.00 X 0 0 0 Camilla Hertwig Chairman 3.00 0.50 X X 0 0 0 Henry Horowitz Board Member 2.00 0.00 X 0 0 0 Fletcher Kirkland Jr Board Member 2.00 0.50 X 0 0 0 Joanie Martin Board Member 2.00 0.00 X 0 0 0 William Masters Board Member (Sep-Feb) 2.00 0.00 X 0 0 0 Craig McCoy CEO (Jun-Aug) 36.00 14.00 X X 0 0 0 Wayne McDonald MD Board Member 2.00 0.50 X 0 0 0 Thomas Morris PhD President 3.00 47.00 X X 0 436432 59475 Mark Nantz CEO (Sep-Jun) 25.00 25.00 X X 0 898579 117360 Jeffrey Oak PhD Board Member 2.00 48.00 X 0 498999 69248 Linton Puckett Board Member 2.00 0.00 X 0 0 0 Joseph Sullivan Board Member 2.00 0.00 X 0 0 0 Angela Webb Board Member 2.00 0.00 X 0 0 0 Daniel Duggan COO 36.00 14.00 X 0 437442 34303 Irene Holcombe Secretary 50.00 0.00 X 86654 0 15237 Ronnie Hyatt Treasurer/CFO-BSSFHS 36.00 14.00 X 587104 0 33508 Teresa Ficicchy EVP - CNO 50.00 0.00 X 338090 0 27002 Rose Leo VP - Surgical Services 50.00 0.00 X 231639 0 30335 Anselmo Nunez CEO - BSMG 0.10 49.90 X 501615 0 17601 Joseph Hartzog Emergency Physician 50.00 0.00 X 473070 0 36983 Bruce Bourdon Emergency Physician 50.00 0.00 X 421264 0 39030 Thomas Watts Emergency Physician 50.00 0.00 X 418728 0 10926 Daniel Wetenhall Emergency Physician 50.00 0.00 X 382495 0 37849 3440659 2271452 528857 171 0 1 0 Spartanburg Regional Med Center 101 East Wood Street Spartanburg SC 29303 Oncology Clinical Services 1140770 Sleepworks LLC 556 Hall Road Thomasville GA 31757 Sleep Studies 1045235 Simione Healthcare Consultants LLC 4130 Whitney Ave Hamden CT 06518 Consulting 884850 Invivo Molecular Imaging LLC PO Box 787442 Philadelphia PA 191787442 Imaging Services 636324 Upstate Carolina Radiology PA PO Box 27049 Greenville SC 29616 Radiology Readings 505356 23 6042495 536400 2334747 6578895 Patient Service Rev. 622110 520082580 520082580 520082580 696524 696524 944138 39219 0 0 944138 39219 983357 3377 979980 327680 13420 0 0 327680 13420 341100 341100 Supplies - Rebates 900099 1763324 1763324 Regency Hospital 900099 1176356 1176356 Clin Trials/Drug Res 561499 1100653 1100653 2626814 53324 379703 2193787 6667147 535349603 522412913 383080 5974715 667113 667113 1237883 1114095 123788 145986120 131387508 14598612 5246840 4722156 524684 21969198 19772278 2196920 11482249 10334024 1148225 1233401 1110061 123340 12001 10801 1200 24402 21962 2440 12384701 12384701 3367907 3031116 336791 3565278 3208750 356528 11993684 10794316 1199368 13494798 12145318 1349480 1070918 963826 107092 316862 285176 31686 6932060 6932060 20862128 18775915 2086213 1934648 1741183 193465 Medical Supplies 108883385 108883385 Purchased Services 36728442 33055598 3672844 Bad Debt Expense 27464598 27464598 BSHSI Mgmt Allocation 20764549 18688094 2076455 13541797 12187617 1354180 471164962 439681651 31483311 0 30398 14897 359783064 443651400 71552925 69630732 13923912 13674165 982737 1748945 341951355 154237693 183635840 187713662 21827681 21960567 83640996 79474208 15735646 15674274 751113199 833542850 44444130 35803648 274521 279546702 315139203 323990832 351217372 X 427122367 482325478 427122367 482325478 751113199 833542850 X 64184641 -380013 -8601517 X 0 1 X 1 0 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 0 0 0 0 0 0 0 0 1 24402 24402 0 Part II-B, Line 1: The filing organization maintains memberships to various professional healthcare associations. Portions of their membership dues are used for lobbying activities. The lobbying portion of such dues is included on line 1i. 13362169 13362169 177400384 54332170 123068214 1510018 848070 661948 144665391 95217661 49447730 5013393 3839792 1173601 187713662 Due to BSHSI 289827206 Hospice House Liability 7920278 HPL/GL Liability 7852938 Due to Affiliates 4131912 Patient Balances 2698677 FIN 47 Liability 917512 Deferred Rent 636424 Due to Medicare 457472 Misc A/P 272340 Third Party Settlements 217584 Other Misc Liabilities 206860 315139203 X Part X, Line 2: Schedule D, Part X, Line 2 requires that the organization provide the text of the footnote to the organization's financial statements that reports the organization's liability for uncertain tax positions under ASC 740. ASC 740 addresses the accounting for uncertainty in income taxes recognized in an entity's financial statements and prescribes a threshold of more-likely-than-not for recognition and derecognition of tax positions taken or expected to be taken in a tax return. The adoption of ASC 740 by BSHSI on September 1, 2007 did not have a material impact on BSHSI's consolidated financial statements. As the organization does not conduct a separate audit of its financial statements, below is the related statement from the Bon Secours Health System, Inc. consolidated audited financial statements: The System and most of its subsidiaries (including certain joint venture entities) are exempt from federal income taxes under Section 501(c)(3) of the Internal Revenue Code of 1986, as amended. The system accounts for uncertain tax positions in accordance with ASC Topic 740. The System's taxable subsidiaries have approximately $84,748 and $61,513 of net operating loss carryforwards as of August 31, 2015 and 2014, respectively, which expire in varying periods through 2035 and are available to offset future taxable income. The System's deferred tax assets are fully reserved at August 31, 2015 and 2014 as the System considers it more likely than not that these amounts will not be recognized. Any changes to the valuation allowance on the deferred tax asset are reflected in the year of the change. 1 1 X 1 X 0 1 1 0 1 1 7906625 0 7906625 0.01780 32218826 28954733 3264093 0.00740 40125451 28954733 11170718 0.02520 24 150829 3529998 0 3529998 0.00800 2 1922 406163 0 406163 0.00090 1 22 2098 0 2098 0.00000 4 1219 679190 105945 573245 0.00130 31 153992 4617449 105945 4511504 0.01020 31 153992 44742900 29060678 15682222 0.03540 0 0 0 0 0 0 0 0 5 2701 379558 0 379558 0.00090 2 257 28483 0 28483 0.00010 1 22 290 0 290 0.00000 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 8 2980 408331 408331 0.00100 1 27464598 0 128329732 141007822 -12678090 X 1 1 1 Upstate Surgery Center Ambulatory Surgery Center 0.58090 0.00000 0.11360 2 1 St Francis Hospital - Downtown One St Francis Drive Greenville SC 296013955 http://www.stfrancishealth.org HTL-0794 X X X X X A 2 St Francis Hospital - Eastside 125 Commonwealth Drive Greenville SC 296154812 http://www.stfrancishealth.org HTL-0793 X X X X A Facility Reporting Group - A 0 0 1 X X X X X X X X X 12 1 1 0 1 X http://www.stfrancishealth.org X 1 12 0 1 0 1 X 200.000000000000 X 1 1 X X X 1 X http://www.stfrancishealth.org X X X X X 1 X 1 X X X X X 1 X 0 0 Form 990, Schedule H, Part V, Section B, Line 14: The Community Service Adjustment was based on the average amounts paid by our insurance companies. Part V, Section B Facility Reporting Group A Facility Reporting Group A consists of: - Facility 1: St. Francis Hospital - Downtown, - Facility 2: St. Francis Hospital - Eastside Facility Reporting Group - A Part V, Section B, line 5: BSSFHS took into account input from persons who represented the community through a county-wide telephone survey, with an over-sampling of low income households. Focus groups were organized to capture perspectives from individuals that represent the chronically ill. Participants included representatives from Taylors Free Medical Clinic, The Greenville Free Medical Clinic, BSSF-Downtown, Faces and Voices of Recovery (substance abuse recovery program), Carolina Centers for Behavioral Health, community residents suffering from chronic disease, AID Upstate, the Greenville County Medical Society, New Horizon Family Health Services, Cancer Society of Greenville, Greenville County EMS and SCDHEC. These focus groups generated insightful perspective on the struggles and strengths of individuals experience in managing a chronic disease in Greenville County. Representatives also discussed common traits and characteristics of the current populations they serve. Expert Interviews were conducted using the NPHPSP (National Public Health Performance Standards Program) Local Public Health System Performance (LPHSA) assessment instrument. This instrument evaluated responses from key experts in the community, measuring how well Greenville County provides the 10 Essential Public Health Services. A series of 8 group interviews were conducted. Those with special knowledge in public health were consulted throughout the CHNA process. They included Natalie Dougherty (BSSFHS), Lillie Hall (SC Department of Health and Environment Control), and Dr. Alicia Powers (Health Sciences professor, Furman University). Facility Reporting Group - A Part V, Section B, line 6a: The Hospital facility's CHNA was conducted in conjunction with Greenville Health System. Facility Reporting Group - A Part V, Section B, line 11: Identified needs through the CHNA that could not be addressed through BSSFHS were asthma, mental health, alcohol/substance abuse, current technology to manage and communicate population health data to the public, and public health policy development. These needs could not be addressed by BSSFHS either because limited resources and infrastructure to address issue, or there are current community organizations that already exist to mitigate the need. Bon Secours St. Francis Developed a three-year comprehensive plan to address those needs that are within the hospital's capacity. Leveraging community resources, and building off current capabilities among staff and programs, Bon Secours St. Francis is a addressing four major priorities of the community: chronic disease prevention, oral health, access to quality health care services, and population-based health data management and evaluation through carefully devised goals and objective. Facility Reporting Group - A Part V, Section B, line 13h: The facility approved free care for patients at or below 200% of the FPL. For patients above 200% of the FPL we utilize a sliding scale with no cap. Facility Reporting Group - A Part V, Section B, line 16b website: http://www.stfrancishealth.org Facility Reporting Group - A Part V, Section B, line 16i: Information regarding the FAP is available on our websites and brochures are available at the time of registration. We have on site Counselors who can assist the patients. We have eligibility vendors who work with the patients and our statements indicate we have an FAP. Facility Reporting Group - A Part V, Section B, line 22d: Bon Secours offers 75% discounts to all self pay patients in the following markets: Virginia, South Carolina and Kentucky. We also offer an 80% discount to our patients in out New York Market. 22 St Francis Outpatient Center 3 St Francis Drive Greenville SC 29601 Outpatient Services St Francis ES Outpatient Lab 135 Commonwealth Dr Suite 255 Greenville SC 29615 Outpatient Lab St Francis Rehab 131 Commonwealth Drive Suite 200 Greenville SC 29615 Outpatient Rehab-Physical, Occupational, Speech, Massage Therapy St Francis Outpatient Rehab 120 Summer Street Greenville SC 29601 Outpatient Rehab St Francis Physical Therapy 712 Congaree Road Greenville SC 29607 Outpatient Rehab St Francis Powdersville Rehab 3407 Hwy 153 Piemont SC 29673 Outpatient Rehab St Francis Physical Therapy 209 Patewood Dr Ste 100 Greenville SC 29615 Outpatient Rehab St Francis Homecare 10 Patewood Drive Ste 300 Greenville SC 29615 Homecare Offices McCall Hospice House 1836 West Georgia Rd Simpsonville SC 29680 Hospice St Francis Sleep Disorder Center 3 St Francis Drive Ste 340 Greenville SC 29601 Sleep Disorder Center St Francis Wound Healing Center 131 Commonwealth Drive Suite 200 Greenville SC 29615 Wound Care Rehab Central Registration & Lab 2 Innovation Dr Ste 110 Greenville SC 29607 Registration and Lab Healthy Self Cardiovascular Rehab 2 Innovation Dr Ste 200 Greenville SC 29607 Cardiac/Pulmonary/Vascular Fitness/Diabetes Care Sleep Lab 2 Innovation Dr Ste 340 Greenville SC 29607 Sleep Lab Sports Medicine & Workwell Admin 135 Commonwealth Dr Suite 250 Greenville SC 29615 Workwell and Sports Admin Offices Workwell Occupational Health 135 Commonwealth Dr Suite 120 Greenville SC 29615 Occupational Health/Employee Health Early Detection & Renewal 2 Innovation Dr Ste 350 Greenville SC 29607 Diagnositcs & Early Detection Center Sports & Exe Medi & Phy Therapy 2 Innovation Dr Ste 250 Greenville SC 29607 Sports and Exercise Medicine & Physical Therapy Nu-Life 2 Innovation Dr Ste 330 Greenville SC 29607 Executive Physicals Community Education 2 Innovation Dr Ste 100 Greenville SC 29607 Classroom St Francis Pearlie Harris Breast Ctr 131 Commonwealth Drive Suite 220 Greenville SC 29615 Breast Cancer Treatment Facility St Francis Millennium Cancer Center 104 Innovation Dr Greenville SC 29607 Cancer Facility Part I, Line 3c: For patients with income above 200% of the FPG, the organization utilizes a sliding scale with no cap. Part I, Line 7: Part I, line 7a: Charity Care at cost is computed by applying a cost-to-charge ratio to the aggregate charity adjustments recorded in the general ledger. Part I, line 7b: Unreimbursed Medicaid is computed by determining the cost of Medicaid services supplied less payments received for these services. To determine the cost of Medicaid services provided, a cost-to-charge ratio is applied to traditional and managed Medicaid gross charges captured in the patient accounting system and general ledger. Payments include payments for individual claims, payments from the Medicaid program paid outside the claim process (such as medical education payments) and expected or actual cost report settlements.Part I, line 7b(f): Prior to 2006, Medicaid in the state of South Carolina was reimbursed to hospitals on a fixed prospective basis (fixed rates not directly related to costs). For years 2006 - 2012, the State reimbursed Hospitals on a cost basis (actual costs to provide services). This reimbursement resulted in the hospitals receiving payments close to their costs. Starting is 2013 the State changed reimbursement methodologies to a fixed rate prospective basis (fixed rates not directly related to costs). For the first year the rates state wide were set to approximate the hospital's cost to provide service. For the subsequent years the fixed rate will be adjusted by a state wide inflationary factor and not related to an individual hospitals cost. For 2013 the Hospital's unreimbursed Medicaid percentage for St. Francis Hospital, Inc. is fairly consistent with those of other hospitals in the state.Part I, line 7c: Unreimbursed costs from other means-tested government programs are computed by applying a cost-to-charge ratio to the total charges to patients covered under these programs. The charges are identified by the financial class assigned to the patient. For Part I, Line 7 a-c computations: The cost-to-charge ratio is derived using the suggested computation in Worksheet 2, Ratio of Patient Care Cost-to-Charges. Operating expenses and Gross patient charges are taken from the general ledger. Expenses for nonpatient care activities recorded in operating expenses are approximated as directly equaling other operating revenue, assuming these activities do not provide profit. Part I, line 7e: Community health improvement services and community benefit operations are accumulated throughout the year and reported at actual cost in a software program that specifically addresses this purpose.Part I, line 7f: Health professions education cost is determined as the direct and indirect cost of qualifying education activities as traditionally reported in columns 21-24 on Worksheet B of the Medicare cost report as a Medical Education program, nursing school or other allied health program. Part I, Ln 7 Col(f): Bad debt expense included in Part IX; line 25 and excluded from the "percent of total expense" calculation is: $27,464,598. Part I, Libe 3b: For patients with income above 200% of the FPG, the organization utilizes a sliding scale with no cap. Part II, Community Building Activities: The Bon Secours' Building Healthy Communities Initiative was created in 2008 to lead efforts towards building healthier communities in which each Bon Secours facility serves. Using a multi-level process of community engagement, grassroots advocacy, and strategic partnerships with public or private organizations and individuals, the Bon Secours St. Francis Healthy Community Initiative works to strengthen the assets of the community while identifying needs to ultimately improve the overall health of community residents. The Bon Secours St. Francis Healthy Community Initiative seeks to leverage our health care resources, outreach services and programs, clinical expertise, and relationships to best target the sources of poor health rather than just address the symptoms. Part III, Line 2: Bad debt expense on the general ledger includes: 1) actual write offs of discounted gross charges where it is determined an uninsured patient can pay and does not pay; and 2) the estimated write offs for uninsured patient accounts with outstanding balances after discount. Estimates are based on historical collection rates.When an uninsured patient is billed for patient care services, the charges are automatically discounted and the patient is requested to only pay the amount after discount. The discount is recorded as an adjustment to gross revenue and is not recorded in bad debt expense. If the balance after discount is not paid or not paid in full, the unpaid amount will be written off to bad debt expense. When a patient remits a payment on an account that has already been written off to bad debt expense, the payment is recorded as a recovery of bad debt, which reduces bad debt expense. Part III, Line 3: The organization does not report an estimate for the portion of bad debt expense that may have been likely to qualify for financial assistance under the hospital's charity care policy. The organization takes the position that ample opportunity and assistance is provided to the patient to qualify under the financial assistance policy. If sufficient information is not provided, the organization must assume the patient does not qualify. Part III, Line 4: Please see Footnote "(2d) Accounts Receivable, net" discussing "accounts receivable" on pages 11-12 in the attached BSHSI consolidated audited financial statements ("AFS"). "Allowance for uncollectible accounts" is discussed in the second paragraph in Footnote "(10) Net Patient Service Revenue" on page 45 of the attached AFS. There is not a separate "bad debt expense" footnote in the AFS. Part III, Line 8: Medicare allowable costs reflected in Part III come directly from the facility's Medicare cost report. The cost report segregates the total facility actual expenses into costs for support departments, clinical departments (routine and ancillary) and nonreimburseable departments. The cost report uses appropriate statistical bases to "step down" support costs to allowable clinical and nonreimburseable departments. The charges for clinical departments are matched to the total cost for these departments for a cost-to-charge ratio. Medicare-specific allowable costs for in- and outpatient ancillary departments are computed by applying the department-specific cost-to-charge ratio to the Medicare program charges by department. For routine departments, a per diem total cost is computed and applied to Medicare program days for the Medicare routine program cost.The organization feels the total shortfall of Medicare reimbursement compared to computed Medicare allowable costs should be treated as community benefit. The hospital improves access to patient care by providing services regardless of a patient's ability to pay or the hospital's ability to receive full cost reimbursement for services. The hospital also relieves the government of a financial burden when it provides care to publically insured patients where reimbursement is less than cost of providing the service.In addition to the costs reported above, the organization incurred additional costs relating to medicare support that are not includable in the Medicare Cost Report in the amount of: $2,359,825. Part III, Line 9b: The hospital has a written policy that describes collection practices applying to patients that qualify for charity care or financial assistance. If full assistance is approved, no collection efforts are pursued on that patient's account(s). If partial assistance is provided, the patient is responsible for the adjusted account balance and collection efforts will follow the established practices for all patients where a self-pay balance exists. Collection efforts are not pursued on any pending FAP account.Specific criteria exist for how much financial assistance, partial or total, will be provided to the patient based on the assessed need. Criteria is based on Federal Poverty Guidelines and is reviewed and updated annually. Once a patient has been deemed eligible for the Patient Financial Assistance Program (FAP), the patient is notified by letter within 60 days after receipt of the application and supporting documentation. The patient retains eligibility for a period of twelve months from the date of the application. This eligibility is signaled to hospital admissions, billing and collection staff by the assignment of a specific financial class with accompanying eligibility dates. At the end of those twelve months, the patient is responsible for reapplying for FAP eligibility. Part VI, Line 2: BSSFHS conducted a comprehensive needs assessment over the course of 18 months, and released it in 2013. The CHNA process included a community telephone survey, secondary data analysis, and focus groups. This was completed with input provided by those with public health knowledge. Additional groups were well-captured through this document, including individuals representing the broad interests of the community, persons with special knowledge of the medically underserved, low-income, minority, and chronic disease populations. This CHNA process will be conducted every three years, with the next CHNA to be released in 2016. Part VI, Line 3: Patient financial assistance policy is communicated to patients verbally upon scheduling, registration, visible postings of the policy in common areas throughout the hospital, brochures and on Bon Secours website. In addition, patient statements request that patients apply for financial assistance, if needed, once any patient financial obligation is determined.Bon Secours is committed to ensuring access to health care services for all. As a health care provider, Bon Secours treats all patients, whether insured, underinsured or uninsured, with dignity, respect and compassion throughout admission, delivery of services, discharge and billing and collection processes. Bon Secours addresses the needs of the uninsured by providing free or reduced fees on hospital services, community outreach efforts to assist with enrollment in Medicaid and other medical coverage programs, including free community-based preventive and primary care services. Bon Secours proactively screens to identify individuals and their families who may qualify for federal, state or local health insurance programs or the Bon Secours Patient Financial Assistance Program ("FAP") and assist the potential eligible patients through the qualification process. Potentially eligible patients that do not qualify for a federal or state health insurance program are referred to the Financial Assistance Coordinator located in Patient Financial Services for assistance in completing the documentation required to establish FAP eligibility. Patients are responsible for providing the information necessary to complete the documentation. The FAP aids uninsured and underinsured patients who do not qualify for government-sponsored health insurance and who communicate their inability to pay for their medical care. The FAP provides 100% financial assistance to uninsured patients with annual family incomes at or below 200% of the Federal Poverty Guidelines ("FPG"), A sliding scale assistance policy is afforded patients that exceed the income guidelines for 100% assistance. Sliding scale assistance is provided to patients and progressively declines in proportion to the patient's higher income level. Additionally, all uninsured (i.e. self pay) patients are given a reduction to the amount of the full charges for medically necessary services through a community service adjustment ("CSA"). The CSA is market adjusted and based on the payment discount received by other health care payers doing business in the community. For these patients, the FAP also sets a maximum annual family payment liability to ensure that no family suffers a catastrophic financial burden to receive necessary health care services. Based on research conducted by the Tax Foundation, a non partisan tax research group based in Washington DC, the maximum annual family liability is based on a sliding scale determined by the family income and size. In addition, a variety of other potential payment options are available. Bon Secours is dedicated to meeting the needs of non-English speaking patients by having on-site Spanish translators, and other language translation services. In addition, Bon Secours employs a telephone language service which assists in meeting any language needs that arise. The translation services are offered to non-English speaking patients from admission to discharge, including the financial process. Part VI, Line 4: Bon Secours St. Francis Health System primarily serves Greenville County, which is comprised of approximately 474,266 residents. Greenville County is the largest county in the state and one of the fastest growing, with a 5% estimated growth rate in just three years (U.S. Census), Five year estimates show that the median household income for Greenville County ($49,022) was higher than the median income of South Carolina ($44,779). Five year estimates also indicate that 15.8% of people living in Greenville County receive incomes that are below the federal poverty level. This is a decline from the previously reported estimate of 18.6% in 2011. Nonetheless, 23.9% of children under the age of 18 are estimated to live in poverty, an increase of 2.9% since 2011, Five year estimates also reveal that 16.5% (75,159) of Greenville County adults are uninsured and 8.6% of children under 18 currently have no health insurance coverage. Part VI, Line 5: BSSFHS has an open medical staff with privileges available to all qualified physicians. BSSFHS operates an emergency room at both of its hospitals which provide services 24 hours a day, seven days a week to ensure access to needed emergency care for all persons. In 2015, the health system was driven by the Bon Secours mission to serve the community by the leadership of a governing board that included sixteen members, thirteen of whom are representative of the community. BSSFHS supports several community programs through the Bon Secours mission to be "good help to those in need." As part of this mission, BSSFHS provides dedicated staff and services with the sole purpose of measuring needs, engaging partners, and addressing the needs of the community. Below gives examples of this commitment. Access to Oral Health Care Program The BSSFHS Oral Health Services program provides access to oral health care through an integrated service partnership providing a mutually beneficial relationship between businesses, funding agencies, a dental hygiene training program, and a college of dentistry. The St. Francis Mobile Dental Unit provides the opportunity to reach out to outlying portions of the county and reach populations that face multiple barriers to care, including transportation. The fixed sites at the Greenville Free Medical Clinic and the New Horizon Family Dental Care ensure that a range of comprehensive oral health services are available in the community on a sliding fee scale or at no cost for the underserved. During Fiscal Year 2014-2015 3,656 children and adults have received education and services through the Oral Health Program.Care for Families and ChildrenAnnually, BSSFHS provides each family with a 4-year-old kindergarten student residing in Greenville County a self-care manual/resource for accessing appropriate health care in Greenville. The self-care guides are purchased from the American Institute of Preventive Medicine (Health at Home ) explains common medical issues and provides a decision tree for how to care for the problem at home and how and when to seek appropriate medical care. On average, this health literacy project, "A Healthy You," documents nearly 50% of families able to avoid one or more visits to the doctor in the past 6 months because of the Health at Home book. In addition, over 60% of families specify that Health at Home books helped them decide when to see a doctor, and thought that the Health at Home books saved them money on medical or health care in the past 6 months.Finally, the Center for Developmental Services (CDS) is a local organization that ensures children with special developmental needs and their families are linked with appropriate interventions in a comfortable, convenient and organized manner; parents, siblings, and caregivers are supported throughout their time in the service delivery system. BSSFHS financially supports the Bilingual Support and Hispanic Outreach programs administered by CDS. This program assists thousands of Spanish-speaking families in making certain their children with developmental delays and disabilities receive services in a culturally respective and understandable way. Additionally, BSSFHS unveiled a new, state-of-the-art bilingual kiosk in the CDS waiting area. This kiosk links Spanish speaking families to on-line health resources and information that might not otherwise be available in Spanish. On average, 120 health-related sites are visited each month and approximately 1,400 families utilized the kiosk CDS services. The kiosk also offers Spanish-language take-home health materials and a telephone is made available to link individuals to United Way's 211 system, Greenville County's comprehensive source for community health and human service assistance. Community OutreachCommunity Wellness (CW) is made up of a team of three nurses and two social workers, who bring their expansive experience to the community. Clients are treated holistically -- mind, body, and spirit. By fostering trusting relationships with community members, the health outreach team helps transform hurt into hope, promotes and defends human dignity, and fosters a healing and caring environment. CW provides the most vulnerable members of the community with opportunities to improve their health and quality of life, focusing on reaching those who are underserved and uninsured. Staff assist individuals and families with navigating the healthcare system and accessing community resources, including health education, personal safety, and basic life skills. Clients are able to establish a patient-primary care provider relationship, improve overall health, reduce unnecessary emergency department admissions, and decrease readmission to the healthcare system. CW assists clients with finding basic needs such as affordable health care, medications, medical supplies, transportation, and food/clothing. Additionally, CW provided individual and group presentations, screenings, and written literature in addition to annual flu clinics. In 2015, CW reached over 2,300 individuals with their needs, and directed them to the most appropriate places of care. Part VI, Line 6: Bon Secours Health System, Inc., a Maryland nonprofit, nonstock membership corporation (BSHSI), and all of the other entities that are controlled directly or indirectly by Bon Secours, Inc, a Maryland nonprofit, nonstock membership corporation (BSI) are described collectively as the System. BSI, which is the sole corporate member of BSHSI, has no healthcare operations. The System was organized in June 1983 to fulfill the healthcare mission of the United States Province of the Congregation of the Sisters of Bon Secours of Paris, a congregation of religious women of the Roman Catholic Church founded in France in 1824. The System's activities are in the states of New York, Pennsylvania, Maryland, Virginia, Kentucky, South Carolina, and Florida, each referred to as a local system. The Ministry of BSHSI aids those in need, particularly those who are sick and dying, by offering services that include but are not limited to acute inpatient, outpatient, pastoral, palliative, home health, nursing home, rehabilitative, primary and secondary care and assisted living without regard to race, religion, color, gender, age, marital status, national origin, sexual orientation, or disability. BSHSI's vision to bring about the holistic health of the communities it serves is implemented through its Strategic Quality Plan which provides focus in five goal areas for the current three year period (2013-2015). One of those goals was to bring our communities to wholeness. To accomplish this, two key strategies are to: - Improve Health Locally and Globally- Build Partnerships for Population Health As a member of the Catholic health ministry and a member of Bon Secours Health System, Inc. (BSHSI), this organization and it's related entities are called to continue the healing ministry of Jesus. We exist to benefit the people living in the communities it serves. Through all of the services offered to the community, the mission is "to bring compassion to health care and to be good help to those in need, especially those who are poor and dying. As a System of caregivers, we commit ourselves to help bring people and communities to health and wholeness as part of the healing ministry of Jesus Christ and the Catholic Church." This organization and related organizations share the BSHSI Vision. "Inspired by the healing ministry of Jesus Christ and the charism of Bon Secours, Bon Secours Health System will be recognized for its leadership in justice, transforming the communities in which we serve and work into places of health and hope, and being a prophetic voice for systemic US health reform and a more humane world." Please see Schedule R for listings of the related organizations. Part VI, Line 7, Reports Filed With States SC 1 Bon Secours - St Francis Health System Foundation Inc One St Francis Drive Greenville SC 29601 260012031 501(c)(3) 667113 Cost of administrative services provided to the Foundation 1 0 Part I, Line 2: The organization complies with Bon Secours Health System, Inc.'s system-wide financial and accounting policies. Contributions are generally made as reimbursements for funds spent. In such cases, the donee/grantee organization must provide documentation to the filing organization before funds are approved for disbursement. 0 1 0 0 0 0 0 0 0 Thomas Morris PhD President 0 297010 0 95892 0 43530 0 39792 0 19683 0 495907 0 16418 Mark Nantz CEO (Sep-Jun) 0 619520 0 178094 0 100965 0 94520 0 22840 0 1015939 0 46250 Jeffrey Oak PhD Board Member 0 324325 0 104778 0 69896 0 41319 0 27929 0 568247 0 24935 Daniel Duggan COO 0 319223 0 45334 0 72885 0 15600 0 18703 0 471745 0 18206 Ronnie Hyatt Treasurer/CFO-BSSFHS 343822 0 46077 0 197205 0 15600 0 17908 0 620612 0 82875 0 Teresa Ficicchy EVP - CNO 258752 0 34805 0 44533 0 15600 0 11402 0 365092 0 0 0 Rose Leo VP - Surgical Services 188317 0 20786 0 22536 0 12680 0 17655 0 261974 0 0 0 Anselmo Nunez CEO - BSMG 377117 0 106368 0 18130 0 2203 0 15398 0 519216 0 0 0 Joseph Hartzog Emergency Physician 470660 0 0 0 2410 0 10882 0 26101 0 510053 0 0 0 Bruce Bourdon Emergency Physician 419077 0 0 0 2187 0 10909 0 28121 0 460294 0 0 0 Thomas Watts Emergency Physician 417819 0 0 0 909 0 10717 0 209 0 429654 0 0 0 Daniel Wetenhall Emergency Physician 379185 0 0 0 3310 0 10588 0 27261 0 420344 0 0 0 Part I, Line 3 Bon Secours Health System, Inc., a related organization of the filing organization uses the following to establish the compensation of the organization's CEO/Executive Director: Compensation Committee Independent Compensation Consultant Written Employment Contract Compensation Survey or Study Approval by the Board or Compensation Committee Part I, Line 4b The filing organization participates in a BSHSI sponsored executive retirement program that allows for deposits into additional retirement plans and available only to key employees. The 457F plan is a non-qualified plan and is subject to a minimum three-year service requirement before vesting on deposits made into this plan. Individuals that received a distribution include: Thomas Morris, PhD, $20,852; Mark Nantz, $57,876; Jeff Oak, PhD, $27,989; Ronnie Hyatt, $136,535; Daniel Duggan, $20,658. Katie Hertwig Daughter-in-law of Board Member Camilla Hertwig 127394 Employment 0 Krista Coben Daughter of COO Daniel Duggan 42632 Employment 0 Kyle Duggan Son of COO Daniel Duggan 56574 Employment 0 Meagan Duggan Daughter-in-law of COO Daniel Duggan 59384 Employment 0 X 1 2334747 Cost or selling price Other: 0 0 0 0 0 0 Part I, Column (b): The amount reported in Column (b) refers to the number of contributions. Form 990, Part VI, Section A, line 6 Bon Secours Health System, Inc. is the sole member of Bon Secours St. Francis Health System, Inc., which in turn is the sole member of St. Francis Hospital, Inc. Form 990, Part VI, Section A, line 7a The governing body of St. Francis Hospital, Inc. is appointed by its member Bon Secours St. Francis Health System, Inc. and subject to approval by Bon Secours Health System, Inc. Form 990, Part VI, Section A, line 7b Certain authorities of St. Francis Hospital, Inc. are reserved to its member or to Bon Secours Health System, Inc. Form 990, Part VI, Section B, line 11 The process the organization uses to review the Form 990 consists of a review by the local system's audit and compliance board-committee and providing the form to the local system board of directors to allow for a thorough review by both before the filing date. The local system's audit and compliance committee and board of directors have reviewed the Form 990, scheduled time on meeting agendas, and asked questions regarding the Form 990 before the return is filed. Form 990, Part VI, Section B, line 12c The organization regularly and consistently monitors compliance with the conflict of interest policy. On an annual basis, all persons subject to the policy, including all officers, directors and key employees are required to make certain disclosures. These include disclosures related to certain personal, financial and organizational relationships that may present a conflict, or the appearance of a conflict of interest with the organization. All disclosures go through a three-part review process: (1) disclosures are reviewed first by the corporate responsibility officer (CRO); (2) a governance team comprised of the CEO, board president, board chair, CRO, and the BSHSI CRO participate in a second review of all disclosures during which recommendations are made as to the resolution of any conflicts or potential conflicts. Depending on the facts and circumstances, resolutions may include ongoing disclosure, recusal or removal of the conflict; and (3) all disclosures and recommendations are reviewed by a board committee (audit and compliance committee reviews the disclosures of management and the governance committee reviews the disclosures of the board and board committee members). Form 990, Part VI, Section B, line 15b The compensation committee of the board of Bon Secours Health System, Inc. (BSHSI) engages in a comprehensive process for the oversight and management of remuneration for executive employees and disqualified parties of BSHSI. The compensation committee consists of a group of independent board members and engages an independent external compensation consultant to ensure they receive appropriate analysis of market and follow the practices necessary to obtain full compliance with the IRS' rebuttable presumption of reasonableness. The committee establishes and maintains a compensation philosophy; reviews pay practices against local, regional and national healthcare organizations and approves all remunerative decisions for this group of individuals. The committee reviews and receives assurances that all levels of pay within the organization are reasonable based on performance and validates incentives are met. These decisions are documented in the BSHSI board of directors and compensation committee minutes. Compensation Process Other Officers/Key Employees: For those key employees and highest paid employees that are not reviewed by the BSHSI compensation committee, the process included a review and approval by independent persons, comparability data, and contemporaneous substantiation of the deliberation and decision. In the review, the other officers or key employees of the organization were compared to other hospitals' employees in the area that hold the same title. During the review and approval of the compensation, documentation of the decision was recorded in human resources. Form 990, Part VI, Section C, line 19 The filing organization makes all documents available to the general public upon request. Form 990, Part VII - Additional Disclosure: Board Member positions are generally voluntary in nature. Compensated employees of the filing organization and other related organizations who also hold board positions are compensated only in relation to their employment and do not receive additional compensation for their board responsibilities. Form 990, Part XI, line 9: Principal Payments to BSHSI -2,163,262. Transfers to Affiliates -4,166,788. Swaps Allocation to BSHSI -2,271,468. Rounding 1. Physicians' Surgery Center at St Francis LLC One St Francis Drive Greenville SC 29601 No Activity SC 0 0 St Francis Hospital Inc Bon Secours Health System Inc 1505 Marriottsville Road Marriottsville MD 21104 521301088 Parent Org. - Management Services MD 501(c)(3) Line 11c, III-FI Bon Secours Inc 0 Bon Secours St Francis Health System Inc One St Francis Drive Greenville SC 29601 582504528 Local System Parent Org. SC 501(c)(3) Line 11c, III-FI Bon Secours Health System Inc 0 Bon Secours - St Francis Health System Foundation Inc One St Francis Drive Greenville SC 29601 260012031 Grant Making Foundation SC 501(c)(3) Line 7 St Francis Hospital Inc 1 St Francis Physician Services One St Francis Drive Greenville SC 29601 134290167 Physician Services SC 501(c)(3) Line 9 Bon Secours St Francis Health System Inc 0 Upstate Surgery Center One St Francis Drive Greenville SC 296013955 562186977 Ambulatory Surgery Center SC St Francis Hospital Inc Related 256907 1016099 0 0 0.58090 Optimum Health Network Inc One St Francis Drive Greenville SC 29601 570973524 Healthcare Services SC Bon Secours St Francis Health System Inc C 1.00000 1 0 1 1 0 0 0 0 0 0 1 0 1 1 0 0 1 1 1 1 Bon Secours - St Francis Health System Foundation Inc C 2507708 Actual Bon Secours - St Francis Health System Foundation Inc B 667113 Actual Upstate Surgery Center S 141002 Actual Upstate Surgery Center L 72587 Cost