2016-05-16T15:09:46-05:00 2015-06-30 861065772 Deloitte Tax LLP 250 East Fifth Street Suite 1900 Cincinnati OH 45202 990 2014-07-01 621869474 Saint Thomas Midtown Hospital SAIN 6152845555 4220 Harding Road Nashville TN 37205 Lisa Davis CFO-Saint Thomas Health 2016-05-16 true Meghann Ackley P01399136 5137847100 2014 2016-08-17 19:52:53Z Karen Springer 4220 Harding Road Nashville TN 37205 451756119 false 0928 X www.sths.com/midtown X 1941 TN Our Catholic Ministry is dedicated to spiritually centered, holistic care. 18 15 2191 189 0 0 868322 250340 391044216 419191388 -8938 4054506 15909262 15512369 407812862 439008603 897755 1259256 0 0 115568898 116002310 0 0 0 251671854 273563529 368138507 390825095 39674355 48183508 184862653 186905260 293943633 300549057 -109080980 -113643797 Rooted in the loving ministry of Jesus as healer, we commit ourselves to serving all persons with special attention to those who are poor and vulnerable. Our Catholic health ministry is dedicated to spiritually centered, holistic care, which sustains and improves the health of individuals and communities. We are advocates for a compassionate and just society through our actions and our words. false false 357952197 1259256 437567491 SAINT THOMAS MIDTOWN HOSPITAL PROVIDES A WIDE VARIETY OF INPATIENT AND OUTPATIENT CARDIAC, ORTHOPEDIC, NEUROSCIENCES, WOMEN'S HEALTH, AND CANCER SERVICES. DURING THE FISCAL YEAR ENDING JUNE 30, 2015, SAINT THOMAS MIDTOWN HOSPITAL RECOGNIZED $389M FROM SURGERIES, $95M FROM LABOR & DELIVERY, AND $66M FROM EMERGENCIES DEPARTMENT SERVICES. ALSO, SAINT THOMAS MIDTOWN HOSPITAL PROVIDES A SUBSTANTIAL PORTION OF ITS SERVICES TO THE ELDERLY AND POOR. DURING THE FISCAL YEAR ENDING JUNE 30, 2015, 29% OF THE VALUE OF SERVICES RENDERED WAS TO ELDERLY PATIENTS UNDER THE MEDICARE PROGRAM, AND APPROXIMATELY 10% OF THE VALUE OF THE SERVICES WAS PROVIDED TO PATIENTS WHO WERE DEEMED INDIGENT UNDER STATE, COUNTY, OR SAINT THOMAS MIDTOWN HOSPITAL GUIDELINES. SEE SCHEDULE H FOR SUPPLEMENTAL INFORMATION ON COMMUNITY BENEFIT. 357952197 true true false true false false false false false true true false false false true true false true false false false false false false false false true true true false true false false false false false false false false false false false false false true true true false false true 0 0 2191 true false false false false false false false false false false X 18 15 true false false false true true true true true false false true true true true true true false false true true X Lisa Davis 6152846826 2000 Church Street Nashville TN 37236 MICHAEL SCHATZLEIN MD CHAIRMAN & CEO STHE 1.00 47.50 X X 0 2667403 40277 CRAIG POLKOW VICE CHAIRMAN & CFO STHE 1.00 46.00 X X 0 623498 35900 ANTHONY HEARD VICE CHAIRMAN 1.00 8.00 X X 0 0 0 KAREN SPRINGER SEC/TREASURER & COO STHE 1.00 44.00 X X 0 805412 18943 PATRICK R SHEPHERD SECRETARY 1.00 8.00 X X 0 0 0 LEE MOSS TREASURER 1.00 9.00 X X 0 0 0 CLARK BAKER CHAIRMAN 1.00 8.00 X X 0 0 0 SAMAR ALI BOARD MEMBER 1.00 8.00 X 0 0 0 WILLIAM ANDERSON BOARD MEMBER 1.00 8.00 X 0 0 0 DELL CROSSLIN BOARD MEMBER 1.00 8.00 X 0 0 0 MARK PETERS MD BOARD MEMBER 1.00 8.00 X 0 0 0 STEVE SCHWAB MD BOARD MEMBER 1.00 8.00 X 0 0 0 SCOTT STANDARD MD BOARD MEMBER 1.00 8.00 X 0 0 0 SISTER DINAH WHITE DC BOARD MEMBER 1.00 8.00 X 0 0 0 BRIAN WILCOX MD BOARD MEMBER 1.00 8.00 X 0 0 0 JOHN JAY WILLIAMS MD BOARD MEMBER 1.00 8.00 X 0 0 0 EMIL HASSAN BOARD MEMBER 1.00 8.00 X 0 0 0 MARK PEACOCK MD BOARD MEMBER 1.00 8.00 X 0 0 0 PAMELA HESS CFO STW/STM 20.00 20.00 X 0 356154 31004 BERNARD SHERRY PRES/CEO STW/STM 20.00 21.00 X 0 744322 38595 DON KING COO STW/STM 20.00 20.00 X 0 393151 32874 JENNIFER ELLIOTT CNO 20.00 20.00 X 292717 0 25874 JAMES BURNS MD PHYSICIAN 40.00 0 X 365268 0 24468 NEIL JHAMB MD PHYSICIAN 40.00 0 X 367156 0 24829 RENE LIM MD PHYSICIAN 40.00 0 X 376742 0 25774 NAVED MOHYUDDIN MD PHYSICIAN 40.00 0 X 386907 0 29359 GEOFFREY SMALLWOOD MD CHIEF MEDICAL OFFICER 40.00 0 X 452615 0 26851 RENEE KESSLER FORMER COO 0.00 0 X 341028 0 27874 WESLEY LITTRELL FORMER SEC/TREAS 0.00 0.00 X 0 355904 0 ALAN STRAUSS FORMER EVP/CFO 85.00 X 0 1184936 19005 2582433 7130780 401627 83 true true false 0 X 250340 250340 Net Patient Service Revenue 621990 414747954 414747954 Ancillary Revenue 621400 1538575 1538575 Rental Income 900099 2868153 2868153 Pharmacy Revenue 446110 36706 36706 0 0 0 0 419191388 7654616 12649896 -4995280 0 -4995280 -4995280 4152126 97620 0 4054506 4054506 4054506 Provider Tax 621990 14837456 14837456 Cafeteria/Vending Reve 722320 2131546 2131546 Meaningful Use 900099 3201870 3201870 336777 336777 0 0 20507649 439008603 437567491 0 1190772 X 1259256 1259256 292717 263445 29272 341028 341028 94170236 84753212 9417024 1856377 1670739 185638 12617484 11355735 1261749 6724468 6052022 672446 72993837 62044762 10949075 9743 9743 46303253 41672928 4630325 0 28869 25982 2887 227282 204554 22728 247981 223183 24798 7292868 6563581 729287 58730 52857 5873 60090 54081 6009 7544599 6790139 754460 17764415 15987974 1776441 1526409 1373768 152641 Medical Supplies 80850081 80850081 Minor Equipment 1259588 1133630 125958 Maintenance & Repair 458339 412505 45834 Provider Tax 32333451 32333451 4603994 2874312 1729682 0 390825095 357952197 32872898 0 2326 1912 46026800 43871957 0 0 5336567 5567449 1402204 1422954 440147849 317909248 116877207 122238601 0 938221 815102 6497112 3967782 7782216 9019503 184862653 186905260 22353031 24884886 2719715 442624 268870887 275221547 293943633 300549057 X -109080980 -113643797 -109080980 -113643797 184862653 186905260 X 48183508 -52746325 X false true X true false X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED false false false false false false false false true 9254 9254 false Schedule C, Part II-B, Line 1 DETAILED DESCRIPTION OF THE LOBBYING ACTIVITY LOBBYING EXPENSES REPRESENT THE PORTION OF DUES PAID TO NATIONAL AND STATE HOSPITAL ASSOCIATIONS THAT ARE SPECIFICALLY ALLOCABLE TO LOBBYING. SAINT THOMAS MIDTOWN HOSPITAL DOES NOT PARTICIPATE IN OR INTERVENE IN (INCLUDING THE PUBLICHING OR DISTRIBUTING OF STATEMENTS) ANY POLITICAL CAMPAIGN ON BEHALF OF (OR IN OPPOSITION TO) ANY CANDIDATE FOR PUBLIC OFFICE. 547548 652 17883 12244 553839 457351 542 94297 4642 547548 258652 150943 58940 11184 457351 278117 260 -10597 9128 258652 255655 275 42030 19843 278117 0.5597 0.4403 false true true 9957112 9957112 276597370 203741204 72856166 995526 590515 405011 131429969 110907543 20522426 21167872 2669986 18497886 122238601 Est Settlements to Third Party Payors 9850629 Self-Insurance Liability 3706974 AH Savings Plan Liability 1180440 Physician Guarantee Liability 2894269 Intercompany Payables 14333577 Intercompany Debt to Ascension Health 238184853 Pension and Other Post Retirement Liab 4368129 Misc. NonCurrent Liabilities 702676 275221547 X Schedule D, Part V, Line 4 Intended uses of endowment funds THE ENDOWMENT FUNDS ARE HELD BY SAINT THOMAS HEALTH FOUNDATIONS. THE ENDOWMENT FUNDS ARE SPECIFICALLY DESIGNATED POOLS OF ASSETS HELD AND INVESTED BY THE FOUNDATION TO PROVIDE LONG-TERM GROWTH, INTEREST AND DIVIDENDS. ONLY THE INCOME FROM AN ENDOWMENT FUND IS USED. Schedule D, Part X, Line 2 FIN 48 (ASC 740) footnote From the consolidated audited financial statements of Ascension Health Alliance and its member organizations ("The System") which include the activity of Saint Thomas Midtown Hospital: The System accounts for uncertainty in income tax provisions by applying a recognition threshold and measurement attribute for financial statement recognition and measurement of a tax position taken or expected to be taken in a tax return. The System has determined that no material unrecognized tax benefits or liabilities exist as of June 30, 2015. true true X true X true X true true true false true true 14041350 0 14041350 0.0359 75801229 60297259 15503970 0.0397 0 0 0 0.0 0 0 89842579 60297259 29545320 0.0756 1286057 377337 908720 0.0023 1125812 586028 539784 0.0014 16442 0 16442 0.0000 0 0 0 0.0 0 1397478 0 1397478 0.0036 0 0 3825789 963365 2862424 0.0073 0 0 93668368 61260624 32407744 0.0829 24167 24167 0.0001 0 0.0 0 0.0 0 0.0 0 0.0 49160 49160 0.0001 0 0.0 0 0.0 0 0.0 0 0 73327 0 73327 0.0002 false 12671563 1276026 80532597 87906600 -7374003 X true true 1 1 Saint Thomas Midtown Hospital 2000 Church Street Nashville TN 37203 https://www.sths.com/midtown 0000000032 X X X Saint Thomas Midtown Hospital 1 false false true X X X X X X X X X 12 true true true true X http://www.sthealth.com/about-us/mission-integration/community/community-health-needs-assessment X true 12 true http://www.sthealth.com/about-us/mission-integration/community/community-health-needs-assessment false false true X 2.0 3.0 X X X X true true X X X true X https://www.sths.com/Pages/Patients-and-Visitors/Financial-Assistance.aspx X https://www.sths.com/Pages/Patients-and-Visitors/Financial-Assistance.aspx X https://www.sths.com/Pages/Patients-and-Visitors/Financial-Assistance.aspx X X X X true false X X X X true X false false Schedule H, Part V, Section B, Line 5 Facility , 1 Facility , 1 - Saint Thomas Midtown Hospital. Input was received from individuals and groups who represented broad interests of the community through a community phone survey, interviews with community representatives and leaders, and a review of findings at a community health working summit. The CHNA process received input from those with special knowledge of or expertise in public health. The CHNA workgroup included those with experience in health policy advocacy, care of the un- and underinsured and public health training. The workgroup consulted with the local health department and social services departments, who provided input and resources for the CHNA. Stratasan was contracted as a consultant to provide coordination and analysis of a random community survey and facilitated a working community health summit to identify and prioritize health needs. For complete description of CHNA methodology and listing of individuals and organizations that provided input, please review the Hospital's CHNA online at: http://www.sthealth.com/about-us/mission-integration/community/community-health-needs-assessment Schedule H, Part V, Section B, Line 6a Facility , 1 Facility , 1 - Saint Thomas Midtown Hospital. The JUNE 30, 2013 CHNA was conducted jointly with Saint Thomas Midtown Hospital, Saint Thomas Hospital for Specialty Surgery, Saint Thomas West Hospital, and Saint Thomas Health system representatives, in consultation with the Metro Nashville Public Health Department. Schedule H, Part V, Section B, Line 6b Facility , 1 Facility , 1 - Saint Thomas Midtown Hospital. The JUNE 30, 2013 CHNA was conducted jointly with Saint Thomas Midtown Hospital, Saint Thomas Hospital for Specialty Surgery, Saint Thomas West Hospital, and Saint Thomas Health system representatives, in consultation with the Metro Nashville Public Health Department. Schedule H, Part V, Section B, Line 11 Facility , 1 Facility , 1 - Saint Thomas Midtown Hospital. The implementation strategy may be found at: https://www.sths.com/Pages/Community/Community-Health-Needs-Assessment.aspx ST Midtown provided the following programs and donations during the tax year to address the CHNA priority needs identified: Need: Access to Care Programs: Medical Mission at Home; Charity Care Post Discharge Donation: STH Safety Net Primary Care Clinics; Faith Family Medical Center; Hospital Hospitality House; Medical Missions Around the World; Project Cure; Room in the Inn; Linen Svc for Ronald McDonald House; Tennessee Justice Center Need: Health Education & Practical Application Programs: Health Professions Education; Medical Library Donation: Faith Family Medical Center; New Beginnings Need: Mental & Dental Health Programs: Middle TN Oral Health Coalition Donation: Hope Smiles; Interfaith Dental Clinic; Christian Women's Job Corp; Hope Clinic for Women; Preston Taylor Ministries; Sexual Assault Center Need: Wellness/Obesity/Food Programs: Breastfeeding Outreach Donation: Nurses for Newborns; Boys & Girls Club of Middle TN; Catholic Charities; The Little Pantry That Could Need: Exercise & Safety Donation: Nashville Downtown Partnership - Bicycle Program Need: Economy/Poverty Donations: Charity Burials Saint Thomas Health provided the following programs and donations during the tax year to address the CHNA priority needs identified: Need: Access to Care Programs: Charity Care Post Discharge Dispensary of Hope - Distribution Center; Dispensary of Hope Charitable Pharmacies; Medical Missions at Home; Mobile Mammography; Safety Net Primary Care Clinics; Telemedicine - Stroke Evaluation Need: Health Education & Practical Application Programs: Health Professions Education - CME Conferences; Health Professions Education - GME; Medical Library Donation: United Way Need: Mental & Dental Health Programs: Behavioral Health expansion in Hickman County, Community Collaboration, project evaluation Donation: Hope Smiles Need: Wellness/Obesity/Food Donation: The Governor's Foundation for Health and Wellness; Habitat for Humanity Need: Exercise & Safety Donation: The Governor's Foundation for Health and Wellness Schedule H, Part V, Section B, Line 13 Facility , 1 Facility , 1 - Saint Thomas Midtown Hospital. We use presumptive scoring to identify charity accounts. Schedule H, Part V, Section B, Line 22 Facility , 1 Facility , 1 - Saint Thomas Midtown Hospital. The State of Tennessee legislates that billings cannot exceed 175% cost to charge on most recent Joint Annual Report. 1 Schedule H, Part I, Line 6b Community Benefit Report Saint Thomas Midtown Hospital is included in the consolidated community benefit report prepared by Saint Thomas Health. Schedule H, Part VI, Line 2 NEEDS ASSESSMENT - Part 2 Saint Thomas Health supports a variety of efforts and continues to work in collaboration with other community agencies to address the health and well-being of our community, especially the poor and vulnerable, including restricted cash donations to outside organizations, in-kind donation of employee time/services to outside organizations and representation on community/non-profit boards and committees which work to improve the health and quality of life of the communities we serve. As a system, STH supports a variety of efforts specifically aimed at providing services for persons who are poor and improving the health of the community. For example, in fiscal year 2015: Continuing Medical Education: STH offers a variety of online accredited continuing medical education courses. Additionally, in-person seminars on various health topics are offered. The courses are open to all physicians and health professionals. During FY15, 16 educational courses/seminars were offered with total attendance of 682. (Community Health Need: Health Education and Access to Care) Graduate Medical Education: STH and its Affiliates serves as training sites for University of Tennessee, Meharry Medical College and Vanderbilt University medical residents. In fiscal year 2015, 93 medical residents received graduate medical education training at a Saint Thomas Health site. (Community Health Need: Health Education and Access to Care) Medical Missions at Home: STH organized three mission-at-home events, one in Davidson County, one in Hickman County, and one in Rutherford County, held within a low income community. Volunteers from all of STH entities participated, and community volunteer providers offered health screenings, referrals, consultations, dental care, eye exams, glasses, health education, and a health ministry presence to persons who otherwise have limited access to health care. In FY15, these events served 1,202 community members who had a total of 3,868 health care encounters. (Community Health Need: Access to Care) Saint Thomas Medical Partners Family Health Centers: The mission of STMP network of family health clinics is to serve the community by providing health care to all ages regardless of insurance or financial resources. Staffed by licensed medical professions, for those who do not have insurance, fees are based on a sliding scale using federal poverty guidelines. In addition, private insurance, Medicare and TennCare are accepted. STH operates 5 primary care safety-net clinics that provided 54,955 patient encounters for 16,803 patients in fiscal year 2015. The clinics are committed to providing high-quality primary care to the uninsured and underinsured and serve the Davidson, Hickman, and Rutherford County communities. Acute medical care is provided usually on the same day and patients with chronic illnesses are seen routinely. The clinics offer a broad range of women's health care. For patients struggling with mental health issues, a Psychiatric Nurse Practitioner and licensed social worker provide one-on-one counseling and group therapy sessions. The clinics utilize the services of the Dispensary of Hope to provide convenient access to free and reduced-cost medications. Social workers and trained nurses also help patients request free medications through the Patient Assistance Program Referral Services. The clinics work to ensure access to specialty services by linking patients to other resources within the community. The South and West Clinics offer additional services: Clinica Nueva Vida - a comprehensive prenatal care program for uninsured, low income Hispanic women in Greater Nashville; and The Healthy Lifestyles Program - a program for adults with type 2 diabetes or pre-diabetes utilizing group and individual nutritional counseling, along with cooking and exercise classes, combined with medical monitoring. ST Midtown, ST Rutherford, and ST West provide financial support to the health centers. (Community Health Need: Access to Care) Our Mission in Motion: The mobile mammography outreach program is designed to increase access to high quality screening mammography for all women with special attention to the poor and vulnerable in Middle Tennessee. The program provides screening mammograms in collaboration with local employers, communities, and safety net clinics, reducing the barrier of transportation and inability to afford time away from work. Screening mammograms are available to the uninsured. When indicated, Our Mission in Motion works with women to connect them to follow up care. It is the goal of the program to improve the compliance rates for screening mammography, thus decreasing the late stage detections of Breast Cancer for women in Middle Tennessee. In fiscal year 2015, 2,983 screening were performed, with 405 women receiving their first mammography. (Community Health Need: Access to Care and Wellness) Schedule H, Part VI, Line 2 NEEDS ASSESSMENT - PART 3 Advocacy for Health: STH helped to form the Safety Net Consortium of Middle Tennessee to address the needs of the uninsured residents of Middle Tennessee. Saint Thomas Health Foundation serves as the legal and fiduciary agent to the Consortium. The Board of Directors that governs the Consortium is comprised of health care providers and local business leaders who serve the poor and uninsured. STH actively advocates for healthcare access and coverage for all persons through ongoing meeting with elected officials and sponsorship of community events and presentations to increase awareness and educate the public regarding healthcare reform and access. STH Senior Leaders participate as active board members of non-profit organizations whose mission is aligned with community health improvement. Additionally, STH has a local county health council representative member on each of the three counties: Davidson, Hickman, and Rutherford. (Community Health Needs: Access to Care) Dispensary of Hope: Since 2003, Dispensary of Hope has been distributing medication from manufacturers, distributors, and healthcare providers to federally-qualified health centers, free and charitable clinics and pharmacies serving the poor and uninsured. The Dispensary of Hope currently serves over 65 communities nationwide. All access sites are not-for-profit facilities legally authorized to dispense medications. The Dispensary of Hope offers two programs in which access sites can participate. In fiscal year 2015, there were approximately 96,700 patient encounters with 245,240 prescriptions filled. The Instant Access Program had 58 participating sites and the Diabetic Supply Program had 42 participating sites. The Dispensary of Hope distributed $29,926,672 worth of medications through the Instant Access program (valued at the industry standard "average wholesale price") and $123,201 worth of diabetic supplies (valued at the price charged to access sites). (Community Health Need: Access to Care and Wellness) Dispensary of Hope Charitable Pharmacy: Since 2006, Dispensary of Hope Pharmacy provides medication assistance for uninsured and underinsured individuals who are experiencing financial hardship. In fiscal year 2015, 25,398 prescriptions were filled, with 13,301 total patient encounters at the Saint Thomas West Hospital location. The pharmacy located in Rutherford County dispensed 29,413 prescriptions with a total of 9,876 patient encounters. A third pharmacy was opened on the Saint Thomas Midtown Hospital campus in October 2014. During FY 15, 6,064 prescriptions were filled, with 2,742 patient encounters. (Community Health Need: Access to Care and Wellness) Camp Bluebird: STH is a founding partner and primary supporter of Camp Bluebird and draws volunteers from Saint Thomas Health, the community and other community hospitals. Camp Bluebird was the first camp in the Middle Tennessee area designed for adult cancer patients. For three days and two nights volunteers provide adult campers with education, support and encouragement in living life after a cancer diagnosis. Camp is held each Spring and Fall with an average of 100 to 110 cancer patients participating in fiscal year 2015. (Community Health Need: Health Education and Wellness). Schedule H, Part VI, Line 5 PROMOTION OF COMMUNITY HEALTH - PART 2 Community Benefit Cash and In-Kind Contributions: ST Midtown supports a variety of efforts and continues to work in collaboration with other community agencies to address the health and well-being of our community, especially the poor and vulnerable, including: The hospital has provided access to its conference rooms at no charge to some community organizations whose programs align with its mission. American Red Cross: ST Midtown hosts frequent blood drives in conjunction with the local American Red Cross. (Community Health Need: Access to Care) Boys & Girls Club of Middle Tennessee: ST West and ST Midtown provide funds to support its work to improve health through the Triple Play program. (Community Health Need: Obesity, Health Education, and Access to Healthy Food) Catholic Charities: Both ST West and ST Midtown Hospitals provide funds to support its work as the lead agency at the United Ways' South Nashville Family Resource Center to provide health education, access to healthy food and mental health services. This center is located next to one of STH safety net clinics. (Community Health Need: Wellness, Mental Health, Health Education and Access to Care) Christian Women's Job Corp of Middle Tennessee: ST West and ST Midtown Hospitals provide funds to support its mission to empower individuals to break harmful cycles caused by poverty by providing education, mentoring and resources. Programs offered include GED test preparation, Life and Job Skills, and Conversational English Classes. (Community Health Need: Mental Health) Faith Family Medical Center: ST Midtown provides a building located on the hospital campus at no cost, for a primary care medical clinic which addresses the holistic health needs of the uninsured working poor. (Community Health Need: Access to Care and Health Education) Faith Family Medical Center: ST West and ST Midtown Hospitals provide support for its health education program Journey to Health, a comprehensive program aimed to reduce risk factors for obesity and chronic disease. (Community Health Need: Health Education) Fannie Battle Day Home for Children: ST West and ST Midtown Hospitals provide support for the implementation of the Sparks physical activity program at the center and to provide more fresh fruits and vegetables during meals and snacks. (Community Health Need: Health Education and Access to Healthy Food) Hope Clinic for Women: ST West and Midtown provides funds to support its mission to equip women, men and families to make healthy choices with unplanned pregnancies, prevention, pregnancy loss and postpartum depression, through its Prenatal & Parenting Education and their Mentoring and professional counseling programs and health care for women. (Community Health Need: Mental Health, Health Education, and Access to Care) Hope Smiles: ST West and ST Midtown Hospitals provide funds to support its mission to provide a safety net for dental care in the West Nashville area and to support its participation in the health systems three Medical Missions at Home events. (Community Health Need: Oral Health) Schedule H, Part VI, Line 5 PROMOTION OF COMMUNITY HEALTH - PART 3 Hospital Hospitality House of Nashville: ST West and ST Midtown Hospitals provide funds to support families basic needs, lodging, meals and supportive care, during time of extended medical treatment. (Community Health Need: Access to Care) Nashville Downtown Partnership: ST Midtown sponsors the B-cycle station on Church Street near the hospital. This shared bike program is implemented to increase active transportation and is aligned with Healthy People 2020 goals. (Community Health Need: Physical Activity and Wellness) New Beginnings: ST West and ST Midtown provide funds to support its healthy lifestyle program for low-income women. The program uses physical fitness training, nutrition and health education, along with life coaching to improve overall health and well-being. (Community Health Need: Health Education and Wellness) Interfaith Dental Clinic: ST Midtown and ST West Hospitals provide funds to support its mission to provide oral health care and oral health education for uninsured, low-income working people, their families and the elderly. (Community Health Need: Oral Health and Health Education) Nurses for Newborns: ST Midtown and ST Rutherford provide funds to support its mission to provide a safety net for families most at-risk, to help prevent infant mortality, child abuse and neglect through in-home nursing visits (up to 2 years) which provide healthcare, education and positive parenting skills. Additionally, they work closely with Nurses for Newborns to promote a visit with a Nurses for Newborn representative for families prior to going home so that a relationship may be developed to ensure an easy transition. Various members of Saint Thomas Health staff have served on the Nurses for Newborns board. (Community Health Need: Wellness, Health Education, and Mental Health) Preston Taylor Ministries: ST West and ST Midtown Hospitals provide funds to support its mission to empower children and youth to reach their potential through the Preston Taylor Ministries one-on-one mentoring programs. (Community Health Need: Mental Health and Wellness) Room In The Inn: Both ST West and ST Midtown Hospitals provide funds to support its mission of support for persons experiencing homelessness. The funds are restricted to holistic support of homeless individuals who have experienced a recent hospitalization and who would benefit from a transitional supportive living environment, including navigation of the health care system and obtaining necessary mental health services. (Community Health Need: Access to Care) Sexual Assault Center: ST West, ST Midtown, and ST Rutherford provide funds to support their mission to provide healing for those affected by sexual assault and end sexual violence. The funds are restricted to provide treatment and mental health support to low-income clients. (Community Health Need: Mental Health and Access to Care) Shared Linen services for Ronald McDonald House and Room In The Inn - Both ST Midtown and ST West Hospitals participate in cost sharing of linen expenses for two area non-profits, one which addresses needs of the homeless and one addressing temporary housing for families of hospitalized families. (Community Health Need: Access to Care) Tennessee Justice Center (TJC): ST Midtown, ST Rutherford, and ST West work together with TJC to improve access to care through providing enrollment assistance and training. The hospitals also provide financial support to TJC for this collaborative work. (Community Health Need: Access to Care) The Little Pantry That Could: ST West and ST Midtown Hospitals provide funds to support their mission to provide healthy food and nutrition education to the underserved in West Nashville. Funds are restricted to support for acquiring healthy food items and nutritional education for the poor and vulnerable. (Community Health Need: Access to Healthy Food) Schedule H, Part I, Line 7 Costing Methodology used to calculate financial assistance The cost of providing charity care, means tested government programs, and community benefit programs is estimated using internal cost data, and is calculated in compliance with Catholic Health Association ("CHA") guidelines. The organization uses a cost accounting system that addresses all patient segments (for example: inpatient, outpatient, emergency room, private insurance, Medicaid, Medicare, uninsured, or self pay). The best available data was used to calculate the amounts reported in the table. Schedule H, Part II Community Building Activities Social determinates are the conditions of communities within which people live that affect their health and well-being and include housing, crime, poverty, education, discrimination, and others. Addressing the social determinates of health through community building is an important component in improving the contributing factors that determine the health of the community. ST Midtown supports a variety of efforts and continues to work in collaboration with other community agencies to address the health and well-being of our community, especially the poor and vulnerable, including representation on community/non-profit boards and committees which work to improve the health and address its social determinates. Schedule H, Part III, Line 4 Bad debt expense - financial statement footnote The provision for doubtful accounts is based upon management's assessment of expected net collections considering economic conditions, historical experience, trends in healthcare coverage, and other collection indicators. Periodically throughout the year, management assesses the adequacy of the allowance for doubtful accounts based upon historical write-off experience by payor category, including those amounts not covered by insurance. The results of this review are then used to make any modifications to the provision for doubtful accounts to establish an appropriate allowance for doubtful accounts. After satisfaction of amounts due from insurance and reasonable efforts to collect from the patient have been exhausted, the System follows established guidelines for placing certain past-due patient balances with collection agencies, subject to the terms of certain restrictions on collection efforts as determined by the System. Accounts receivable are written off after collection efforts have been followed in accordance with the System's policies. Schedule H, Part III, Line 8 Community benefit & methodology for determining medicare costs Saint Thomas Midtown Hospital follows the Catholic Health Association (CHA) guidelines for determining community benefit. CHA community benefit reporting guidelines suggest that Medicare shortfall is not treated as community benefit. Schedule H, Part III, Line 9b Collection practices for patients eligible for financial assistance The organization has a written debt collection policy that also includes a provision on the collection practices to be followed for patients who are known to qualify for charity care or financial assistance. If a patient qualifies for charity or financial assistance certain collection practices do not apply. Schedule H, Part V, Section B, Line 16a FAP website - Saint Thomas Midtown Hospital: Line 16a URL: https://www.sths.com/Pages/Patients-and-Visitors/Financial-Assistance.aspx; Schedule H, Part V, Section B, Line 16b FAP Application website - Saint Thomas Midtown Hospital: Line 16b URL: https://www.sths.com/Pages/Patients-and-Visitors/Financial-Assistance.aspx; Schedule H, Part V, Section B, Line 16c FAP plain language summary website - Saint Thomas Midtown Hospital: Line 16c URL: https://www.sths.com/Pages/Patients-and-Visitors/Financial-Assistance.aspx; Schedule H, Part VI, Line 2 Needs assessment Community Health Needs Assessment (CHNA) is conducted every three years, with the most recent conducted in fiscal year 2013. The CHNA was conducted jointly as noted above. The objectives of the CHNA and subsequent hospital specific implementation strategies were: 1. Provide an unbiased comprehensive assessment of Davidson County's health needs and assets; 2. Use the CHNA to prioritize the Saint Thomas Health Community Benefit Program strategy and 3. Fulfill Internal Revenue Service regulations related to 501(c)(3) non-profit hospital status for federal income taxes. For complete description of CHNA methodology, identification of priority needs, and findings, please review the Hospital's CHNA online at: https://www.sths.com/Pages/Community/Community-Health-Needs-Assessment.aspx In addition to the reported CHNA, the organization, Saint Thomas Health (STH), assesses the health needs of the communities it serves through representation on local health councils and non-profits addressing the needs of the underserved. Saint Thomas Midtown Hospital, established in 1918, is a 683-bed hospital in Nashville, Tennessee. It provides emergency room services and comprehensive inpatient and outpatient care, including obstetrical services and a Level III neonatal intensive care unit. The Hospital is part of Saint Thomas Health. Saint Thomas Health (STH) is Middle Tennessee's faith-based, not-for-profit health care system united as one healing community. Saint Thomas Health is focused on transforming the healthcare experience and helping people live healthier lives, with special attention to the poor and vulnerable. The regional health system included, in FY15, five (5) hospitals: Saint Thomas Hospital for Spinal Surgery, Saint Thomas Midtown Hospital and Saint Thomas West Hospital in Nashville, Saint Thomas Rutherford Hospital in Murfreesboro, and Saint Thomas Hickman Hospital in Centerville. A comprehensive network of affiliated joint ventures, medical practices, clinics and rehabilitation facilities complements the hospital services. Saint Thomas Health is a member of Ascension, a Catholic organization that is the largest not-for-profit health system in the United States. Saint Thomas Health is committed to providing care to the communities it serves with attention to the poor and vulnerable. STH's mission provides a strong foundation and guidance for its work as a caring ministry of healing, including its commitment to community service and to provide access to quality healthcare for all. The STH Mission, Vision and Values are the key factors influencing their approach and commitment to addressing community health needs through their community benefit activity. Ascension Health's Socially Just Wage and Benefits Policy, established in 2001, applies to all of the Ascension Health Ministry, including subsidiary entities and to contractual third-party vendor relationships. Saint Thomas Health and Ascension are committed to providing a livable wage to employees. Minimum wage was raised to $11/hour during FY15. Catholic Social Teaching recognizes that each individual has a fundamental right to share in the fruits of her or his labor and to have basic needs met, including access to healthcare. An essential component of the Socially Just Wage Policy is the employer subsidization of the cost of healthcare insurance for lower-paid associates. This employer subsidy, combined with the minimum hourly wage rate, will provide affected associates with a decent standard of living and affordable access to healthcare. (Community Health Need: Access to Care and Wellness) Schedule H, Part VI, Line 3 Patient education of eligibility for assistance Education of eligibility for assistance at Saint Thomas Midtown Hospital ("ST Midtown") begins at registration with signage displayed at all registration points notifying patients that we have a Financial Assistance Program, as well as contact information for the patient to use should they need assistance. Brochures containing this information are also available for patients at all registration points. Saint Thomas Midtown Hospital's registration associates discuss the estimated balance that will be due with both insured and self-pay patients. Should the associate identify that the patient may need assistance with that balance he/she will provide the patient with a Financial Assistance Application and help them complete it, if needed. All self-pay and underinsured patients are screened by Saint Thomas Midtown Hospital for alternative coverage including Medicaid, SSI/SSD, Cobra, student coverage, and crime victims' compensation. If no alternative is identified then an associate will work with the patient to complete a Financial Assistance Application. Also, contact information is listed on Saint Thomas Midtown Hospital billing statements for the patient to use in the event they need assistance with their balances. Collections associates have been trained to offer patients a Financial Assistance application if needed by the patient. Saint Thomas Midtown Hospital works with third party collection vendors who are required to follow the Hospital's Financial Assistance Policy. Third party vendors are also used to perform "charity scoring", a process that screens incomplete Financial Assistance applications to qualify patients for presumptive charity. A plain language summary of the Financial Assistance Policy and Application can be found on our website at https://www.sths.com/Pages/Patients-and-Visitors/Financial-Assistance.aspx. Schedule H, Part VI, Line 4 Community information Located in Nashville, Tennessee, Saint Thomas Midtown Hospital (ST Midtown), primarily serves residents of Davidson County and adjacent surrounding counties in Middle Tennessee. In calendar year 2014, over 80% of emergency room cases and over half of inpatients originated within the county. ST Midtown served over 26,715 inpatients, including 4,957 newborns. Davidson County is one of 95 counties within the state of Tennessee and is located in the Middle Tennessee region. Tennessee is located in the Southeastern region of the United States. Davidson County has urban, suburban and rural areas and encompasses 504 square miles, having a population density of 1243.3 persons per square mile. United States Census Quick Facts for 2014 indicates a population of 668,347 estimates. Community Demographic highlights include: 51.7% Female; 65.8% White; 28.1% African American; 7.0% Persons under 5 years; 10.9% Persons 65 years and over; 86.4% High school graduate or higher (% persons age 25+, 2009-2013); 23.3 minutes, mean travel time to work (2009-2013); $28,467 per capita money income in the past 12 months (2009-2013); $47,335 median household income (2009-2013); and 18.5% persons below poverty level (2009-2013). American Fact Finder, American Community Survey (2010-2012, 3 year estimate) notes, 16.7 of residents and 7.4% of children (ages 0-17), 22.1% ages 18-64, 1.3% 65 years and older, and 23.1% ages 19-25 in Davidson County were uninsured. According to the Tennessee Department of Health's Joint Annual Report of Hospitals, 2013, Davidson County has 15 hospitals: 10 General and Specialty Hospitals with a combined 3,221 staffed beds (3,772 licensed beds); One Mental Health Hospital with 195 staffed beds out of 300 licensed beds; and 4 Long Term hospitals with 202 staffed beds out of 210 licensed beds. There are areas designated as medically underserved within Davidson County. For a complete description of the community demographics and selection for CHNA purposes, please review the Hospital's CHNA online at: https://www.sths.com/Pages/Community/Community-Health-Needs-Assessment.aspx Schedule H, Part VI, Line 5 Promotion of community health The Saint Thomas Health's governing body is comprised of persons representing diverse aspects and interests of the community. Many members of the Saint Thomas Health governing body reside in the organization's primary service area; who are neither employees nor independent contractors of the organization, nor family members thereof. Medical Staff: The organization extends medical staff privileges to all qualified physicians in its community for some or all of its departments or specialties. Patient care: ST Midtown operates an emergency room open to all persons, regardless of ability to pay. The hospital participates in Medicaid, Medicare, TennCare, CHAMPUS, Tricare, and other government sponsored health care programs. ST Midtown provides financial assistance, both full and partial adjustments, to those who cannot afford to pay (both insured and uninsured). Saint Thomas Health Foundation: Patients and families of ST Midtown, ST Hickman, and ST West have access to the Irene and Melvin Lewis, Transplant, Mandy Moore, Francis Gluck and Healthing Outreach Fund which assists patients who are financially unable to provide for needed medical-related expenditures. There is also a fund available to all employees of Saint Thomas Health who are experiencing hardship. This fund, the Sister Juliana Beurlein Employee Financial Assistance Fund offered system-wide over $110,035 in assistance in FY2015. STH Senior Leaders and associates participate as active board members of non-profit organizations whose mission aligns with community health improvement and addresses social determinates of health. Medical Library: Medical Libraries are located on the campuses of Saint Thomas Midtown Hospital and Saint Thomas West Hospital. Librarians offer assistance in researching health information. Assistance is available to the broader community regardless of where medical care is obtained. In fiscal year 2015, librarians assisted 205 individuals, researching 212 topics. (Community Health Need: Health Education) Building Families Together - Breastfeeding Outreach: Beginning in February 2015, ST Midtown offers breastfeeding outreach through open-door times available to all community members provided by Certified Lactation Consultants. The service is available to all pregnant and breastfeeding mothers, infants and support persons in Davidson County regardless of delivery hospital. This outreach program is working to improve the breastfeeding rates for the community, therefore reducing maternal morbidity and improving infant health. Initially open two (2) days per week/ four (4) hours per day, Monthly attendance has grown from 17 to 100 per month. Hours of the program have been increased in FY16 to accommodate community demand. To date, the exclusive breastfeeding rate for the attendees of the program is >80%. (Community Health Need: Wellness and Health Education) Dispensary of Hope Charitable Pharmacy: Since 2006, Dispensary of Hope Pharmacy provides medication assistance for uninsured and underinsured individuals who are experiencing financial hardship. In fiscal year 2015, a third pharmacy was opened on the Saint Thomas Midtown Hospital campus in October 2014. During FY15, 6,064 prescriptions were filled, with 2,742 patient encounters. (Community Health Need: Access to Care and Wellness) Health Professions Education: ST Midtown serves as a clinical site for students attending many of the area nursing and allied health schools. An average of 41 students per month had clinical training at the hospital in fiscal year 2015, with more than 13,000 hours of clinical instruction on the hospital campus during the year. (Community Health Need: Health Education and Access to Care) Schedule H, Part VI, Line 6 Affiliated health care system Ascension Health Alliance, d/b/a Ascension (Ascension), is a Missouri nonprofit corporation formed on September 13, 2011. Ascension is the sole corporate member and parent organization of Ascension Health, a Catholic national health system consisting primarily of nonprofit corporation that own and operate local healthcare facilities, or Health Ministries, located in 23 of the United States and the District of Columbia. Ascension is sponsored by Ascension Sponsor, a Public Juridic Person. The Participating Entities of Ascension Sponsor are the Daughters of Charity of St. Vincent de Paul, St. Louise Province; the Congregation of St. Joseph; the Congregation of the Sisters of St. Joseph of Carondelet; the Congregation of Alexian Brothers of the Immaculate Conception Province, Inc. - American Province; and the Sisters of the Sorrowful Mother of the Third Order of St. Francis of Assisi - US/Caribbean Province. Mission: The System directs its governance and management activities toward strong, vibrant, Catholic Health Ministries united in service and healing, and dedicates its resources to spiritually centered care which sustains and improves the health of the individuals and communities it serves. In accordance with the System's mission of service to those persons living in poverty and other vulnerable persons, each Health Ministry accepts patients regardless of their ability to pay. The System uses four categories to identify the resources utilized for the care of persons living in poverty and community benefit programs: -Traditional charity care includes the cost of services provided to persons who cannot afford healthcare because of inadequate resources and/or who are uninsured or underinsured. -Unpaid cost of public programs, excluding Medicare, represents the unpaid cost of services provided to persons covered by public programs for persons living in poverty and other vulnerable persons. -Cost of other programs for persons living in poverty and other vulnerable persons includes unreimbursed costs of programs intentionally designed to serve the persons living in poverty and other vulnerable persons of the community, including substance abusers, the homeless, victims of child abuse, and persons with acquired immune deficiency syndrome. -Community benefit consists of the unreimbursed costs of community benefit programs and services for the general community, not solely for the persons living in poverty, including health promotion and education, health clinics and screenings, and medical research. Discounts are provided to all uninsured patients, including those with the means to pay. Discounts provided to those patients who did not qualify for assistance under charity care guidelines are not included in the cost of providing care of persons living in poverty and other community benefit programs. The cost of providing care to persons living in poverty and other community benefit programs is estimated by reducing charges forgone by a factor derived from the ratio of each entity's total operating expenses to the entity's billed charges for patient care. Certain costs such as graduate medical education and certain other activities are excluded from total operating expenses for purposes of this computation. THE AMOUNT OF TRADITIONAL CHARITY CARE PROVIDED, DETERMINED ON THE BASIS OF COST, WAS $527,386 AND $580,606 FOR THE YEARS ENDED JUNE 30, 2015 AND 2014, RESPECTIVELY. true BOYS AND GIRLS CLUBS OF MIDDLE TENNESSEE 1704 Charlotte Ave STE 200 Nashville TN 37203 620540402 501(c)(3) 10000 0 To support the Triple Play Program at the Preston Taylor Center in order to address the priority health need of wellness, obesity, healthy food, and health education to improve the health of children and families in the area served by Saint Thomas Midtown. ROOM IN THE INN 705 Drexel Street Nashville TN 37203 620811413 501(c)(3) 25000 0 Provide funds to support persons experiencing homelessness. CATHOLIC CHARITIES 30 White Bridge RD Nashville TN 37205 620679520 501(c)(3) 26000 0 To assist in providing increased access to healthy food, health education, and mental health services to underprivileged in the community. FAITH FAMILY MEDICAL 326 21ST AVE N Nashville TN 37203 621816811 501(c)(3) 10000 0 To support the health education program, Journey to Health FANNIE BATTLE DAY HOME FOR CHILDREN 108 CHAPEL AVE Nashville TN 37206 620476290 501(c)(3) 10000 0 To implement the Sparks physical activity program and provide fresh fruits and vegetables during meals and snacks HOPE SMILES 115 PENN WARREN DR STE 300-301 Brentwood TN 37027 260829468 501(c)(3) 35000 0 Providing the needed primary dental services to needy individuals in the community INTERFAITH DENTAL CLINIC 1721 PATTERSON ST Nashville TN 37203 621567615 501(c)(3) 21666 0 Providing the needed dental care services to needy individuals in the community NURSES FOR NEWBORNS FOUNDATION 50 VANTAGE WAY STE 101 Nashville TN 37228 431601329 501(c)(3) 55000 0 Assisting in providing the needed community health care support services to vulnerable infants and their families in the community SILOAM FAMILY HEALTH CENTER 820 GALE LN Nashville TN 37204 581867940 501(c)(3) 7265 0 To support the care of patients and work of Siloam Family Health Center TENNESSEE JUSTICE CENTER INC 301 CHARLOTTE AVE Nashville TN 37201 621630417 501(c)(3) 10000 0 To provide enrollment assistance and training THE NEW BEGINNINGS CENTER 509 CRAIGHEAD ST STE 100 Nashville TN 37204 900751722 501(c)(3) 12500 0 Enrollment and program follow-up of low-income women, from the Berry Hill Area in Davidson County, Tennessee, into the New Beginnings program VISITATION HOSPITAL FOUNDATION PO BOX 210270 Nashville TN 37221 621774851 501(c)(3) 6666 0 To be used in the Nurse Midwife Program at the Visitation Clinic in Haiti SAINT THOMAS NETWORK 4220 Harding Rd Nashville TN 37205 621868848 501(c)(3) 1000739 0 Support of the Family Health Center SHARED HOSPITAL SERVICES CORPORATION 641 Mainstream Dr Nashville TN 37228 621035855 22996 0 To pay for laundry services provided at the Ronald McDonald House and the Room in the Inn. 13 1 Schedule I, Part I, Line 2 Description Of Procedure For Monitoring Use Of Grant Funds Organizations requesting grants are asked to submit a request in writing which identifies the community health need the grant will be addressing, along with goals and objectives. Requests are reviewed by the Saint Thomas Health Community Health & Benefit Committee prior to approval. Awarded grantees are asked to submit a report of program/event activities. It is requested the report include demographic summary of population benefited and achieved objectives and impact on health. The reports are reviewed by the Community Health & Benefit Team in a broad manner upon receipt, but will be more thoroughly scrutinized if the grant recipient comes back to ask for a renewal or another grant. Schedule I, Part I, Line 2 Procedures for monitoring use of grant funds. Organizations requesting grants are asked to submit a request in writing which identifies the community health need the grant will be addressing, along with goals and objectives. Requests are reviewed by the Saint Thomas Health Community Health & Benefit Committee prior to approval. Awarded grantees are asked to submit a report of program/event activities. It is requested the report include demographic summary of population benefited and achieved objectives and impact on health. The reports are reviewed by the Community Health & Benefit Team in a broad manner upon receipt, but will be more thoroughly scrutinized if the grant recipient comes back to ask for a renewal or another grant. true true false false false false false false false MICHAEL SCHATZLEIN MD CHAIRMAN & CEO STHE 0 932454 0 1561904 0 173045 0 7800 0 32477 0 2707680 0 0 CRAIG POLKOW VICE CHAIRMAN & CFO STHE 0 452362 0 162978 0 8158 0 13000 0 22900 0 659398 0 0 KAREN SPRINGER SEC/TREASURER & COO STHE 0 590000 0 209037 0 6375 0 13000 0 5943 0 824355 0 0 RENEE KESSLER FORMER COO 152651 0 77679 0 110698 0 11116 0 16758 0 368902 0 0 0 WESLEY LITTRELL FORMER SEC/TREAS 0 0 0 0 0 355904 0 0 0 0 0 355904 0 0 ALAN STRAUSS FORMER EVP/CFO 0 506768 0 535825 0 142343 0 7800 0 11205 0 1203941 0 0 PAMELA HESS CFO STW/STM 0 278450 0 76403 0 1301 0 15600 0 15404 0 387158 0 0 BERNARD SHERRY PRES/CEO STW/STM 0 516266 0 185263 0 42793 0 16900 0 21695 0 782917 0 0 DON KING COO STW/STM 0 307659 0 84044 0 1448 0 13000 0 19874 0 426025 0 0 JENNIFER ELLIOTT CNO 229575 0 62181 0 961 0 7800 0 18074 0 318591 0 0 0 JAMES BURNS MD PHYSICIAN 356522 0 8510 0 236 0 7551 0 16917 0 389736 0 0 0 NEIL JHAMB MD PHYSICIAN 366922 0 0 0 234 0 7800 0 17029 0 391985 0 0 0 RENE LIM MD PHYSICIAN 367935 0 8510 0 297 0 7475 0 18299 0 402516 0 0 0 NAVED MOHYUDDIN MD PHYSICIAN 380597 0 6010 0 300 0 7733 0 21626 0 416266 0 0 0 GEOFFREY SMALLWOOD MD CHIEF MEDICAL OFFICER 351327 0 94198 0 7090 0 7800 0 19051 0 479466 0 0 0 Schedule J, Part II Explanation of Compensation A portion of the compensation paid to Michael Schatzlein, MD is for services provided to other Ascension Health Alliance related organizations. Schedule J, Part II Explanation of Compensation THE 2014 COMPENSATION AMOUNTS SHOWN FOR ALAN STRAUSS WERE PAID BY A RELATED ORGANIZATION FOR HIS SERVICES AS THE CFO OF THE RELATED ORGANIZATION. Schedule J, Part I, Line 3 Arrangement used to establish the top management official's compensation Ascension Health, a related organization of Saint Thomas Midtown Hospital uses the following to establish the compensation of the organization's CEO: - Compensation Committee - Independent Compensation Consultant - Compensation Survey or Study - Approval by the Board or Compensation Committee Schedule J, Part I, Line 4a Severance or change-of-control payment The following individuals received severance payments in the amount noted: Renee Kessler $95,975 Wesley Littrell $355,904 Schedule J, Part I, Line 4b Supplemental nonqualified retirement plan ELIGIBLE EXECUTIVES PARTICIPATE IN A PROGRAM THAT PROVIDES FOR SUPPLEMENTAL RETIREMENT BENEFITS. THE PAYMENT OF BENEFITS UNDER THE PROGRAM, IF ANY, IS ENTIRELY DEPENDENT UPON THE FACTS AND CIRCUMSTANCES UNDER WHICH THE EXECUTIVE TERMINATES EMPLOYMENT WITH THE ORGANIZATION. BENEFITS UNDER THE PROGRAM ARE UNFUNDED AND NON-VESTED. DUE TO THE SUBSTANTIAL RISK OF FORFEITURE PROVISION, THERE IS NO GUARANTEE THAT THESE EXECUTIVES WILL EVER RECEIVE ANY BENEFIT UNDER THE PROGRAM. ANY AMOUNT ULTIMATELY PAID UNDER THE PROGRAM TO THE EXECUTIVE IS REPORTED AS COMPENSATION ON FORM 990, SCHEDULE J, PART II, COLUMN B IN THE YEAR PAID. THERE WERE NO PAYMENTS MADE FROM THE SUPPLEMENTAL NONQUALIFIED RETIREMENT PLAN. Form 990, Part IV, Line 20b Explanation of Financial Statements The activity of Saint Thomas Midtown Hospital ("STMH") is reported in the consolidated financial statements of Ascension Health Alliance. No individual audit of STMH is completed. Therefore, the attached audited financial statements are of Ascension Health Alliance and Affiliates, which include the activity of STMH. Form 990, Part VI, Line 2 RELATIONSHIPS MANY OF THE PERSONS LISTED ON PART VII HAVE A "BUSINESS RELATIONSHIP" WITH EACH OTHER BY VIRTUE OF SITTING ON RELATED SAINT THOMAS HEALTH ENTITY BOARDS. Form 990, Part VI, Line 15 PART VI, LINE 15 IN DETERMINING THE COMPENSATION OF THE ORGANIZATION'S CEO, THE PROCESS, PERFORMED BY ASCENSION HEALTH, A RELATED ORGANIZATION OF SAINT THOMAS MIDTOWN HOSPITAL, INCLUDED A REVIEW AND APPROVAL BY INDEPENDENT PERSONS, COMPARABILITY DATA AND CONTEMPORANEOUS SUBSTANTIATION OF THE DELIBERATION AND DECISION. THE COMPENSATION COMMITTEE REVIEWED AND APPROVED THE COMPENSATION. IN THE REVIEW OF THE COMPENSATION, THE CEO WAS COMPARED TO INDIVIDUALS AT OTHER ORGANIZATIONS IN THE AREA WHO HOLD THE SAME TITLE. DURING THE REVIEW AND APPROVAL OF THE COMPENSATION, DOCUMENTATION OF THE DECISION WAS RECORDED IN THE COMMITTEE MINUTES. THE INDIVIDUAL WAS NOT PRESENT WHEN HIS COMPENSATION WAS DECIDED. IN DETERMINING THE COMPENSATION OF OTHER OFFICERS OR KEY EMPLOYEES OF THE ORGANIZATION, THE PROCESS, PERFORMED BY SAINT THOMAS HEALTH, A RELATED ORGANIZATION, INCLUDED A REVIEW AND APPROVAL BY INDEPENDENT PERSONS, COMPARABILITY DATA, AND CONTEMPORANEOUS SUBSTANTIATION OF THE DELIBERATION AND DECISION. THE AUDIT COMMITTEE REVIEWED AND APPROVED THE COMPENSATION. IN THE REVIEW OF THE COMPENSATION, 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 THE BOARD MINUTES. Form 990, Part VI, Line 6 Classes of members or stockholders Saint Thomas Midtown Hospital has a single corporate member, Saint Thomas Health. Form 990, Part VI, Line 7a Members or stockholders electing members of governing body Saint Thomas Midtown Hospital has a single corporate member, Saint Thomas Health, who has the ability to elect members to the governing body of the Saint Thomas Midtown Hospital. Form 990, Part VI, Line 7b Decisions requiring approval by members or stockholders All decisions that have a material impact to Saint Thomas Midtown Hospital financial information or corporation as a whole are subject to approval by its sole corporate member, Saint Thomas Health. Ascension Health, the sole corporate member of Saint Thomas Health, has designated a system authority matrix which assigns authority for key decisions that are necessary in the operation of the system. Specific areas that are identified in the authority matrix are: new organizations & major transactions; governing documents; appointments/removals; evaluation; debt limits; strategic & financial plans; assets; system policies & procedures. These areas are subject to certain levels of approval by Ascension per the system authority matrix. Form 990, Part VI, Line 11b Review of form 990 by governing body Management, including certain officers, works diligently to complete the Form 990 and attached schedules in a thorough manner. Prior to filing the return, all Board Members are provided the Form 990 and management team members are available to answer any Board Members' questions. Form 990, Part VI, Line 12c Conflict of interest policy The organization regularly and consistently monitors and enforces compliance with the conflict of interest policy in that any director, principal officer, or member of a committee with governing board delegated powers, who has a direct or indirect financial interest, must disclose the existence of the financial interest and be given the opportunity to disclose all material facts to the directors and members of the committees with governing board delegated powers considering the proposed transaction or arrangement. The remaining individuals on the governing board or committee will decide if conflicts of interest exist. Each director, principal officer and member of a committee with governing board delegated powers annually signs a statement which affirms such person has received a copy of the conflict of interest policy, and understands that the organization is charitable and in order to maintain its federal tax exemption it must engage primarily in activities which accomplish its tax-exempt purpose. Form 990, Part VI, Line 19 Required documents available to the public The organization will provide any documents open to public inspection upon request. Form 990, Part VII, Section B, Line 1 Independent Contractor Reporting Compensation of independent contractors is paid by and reported on the Form 1096, Annual Summary and Transmittal of U.S. Information Returns, of Ascension Health EIN 31-1662309. Expenses are allocated to and reimbursed by the filing organization to Ascension Health. As such, the organization has not reported independent contractors paid on Form 990, Part VII, Section B. Form 990, Part VIII, Line 11d Other Miscellaneous Revenue Conference Revenue - Total Revenue: 4225, Related or Exempt Function Revenue: 4225, Unrelated Business Revenue: , Revenue Excluded from Tax Under Sections 512, 513, or 514: ; Lactation Boutique Revenue - Total Revenue: 146096, Related or Exempt Function Revenue: 146096, Unrelated Business Revenue: , Revenue Excluded from Tax Under Sections 512, 513, or 514: ; Seminar Revenue - Total Revenue: 117031, Related or Exempt Function Revenue: 117031, Unrelated Business Revenue: , Revenue Excluded from Tax Under Sections 512, 513, or 514: ; Other Misc Revenue - Total Revenue: 69425, Related or Exempt Function Revenue: 69425, Unrelated Business Revenue: , Revenue Excluded from Tax Under Sections 512, 513, or 514: ; Form 990, Part IX, Line 11g Other Fees Purchased Services - Total Expense: 38246634, Program Service Expense: 34421971, Management and General Expenses: 3824663, Fundraising Expenses: ; Consulting Fees - Total Expense: 90631, Program Service Expense: 81568, Management and General Expenses: 9063, Fundraising Expenses: ; Medical Directors - Total Expense: 529157, Program Service Expense: 476241, Management and General Expenses: 52916, Fundraising Expenses: ; Physician Contracted Services - Total Expense: 4131839, Program Service Expense: 3718655, Management and General Expenses: 413184, Fundraising Expenses: ; Physician Guarantee - Total Expense: 2379962, Program Service Expense: 2141966, Management and General Expenses: 237996, Fundraising Expenses: ; Physician Recruitment Fees - Total Expense: 72431, Program Service Expense: 65188, Management and General Expenses: 7243, Fundraising Expenses: ; Other Professional Fees - Total Expense: 852599, Program Service Expense: 767339, Management and General Expenses: 85260, Fundraising Expenses: ; - Total Expense: , Program Service Expense: , Management and General Expenses: , Fundraising Expenses: ; - Total Expense: , Program Service Expense: , Management and General Expenses: , Fundraising Expenses: ; - Total Expense: , Program Service Expense: , Management and General Expenses: , Fundraising Expenses: ; Form 990, Part XI, Line 9 Other changes in net assets or fund balances Deferred Pension Cost - -4681568; Transfer to/from affiliates - -48064757; ASCENSION HEALTH ALLIANCE 4600 EDMUNSON ROAD ST LOUIS MO 63134 453358926 NATIONAL HEALTH SYSTEM MO 501(c)(3 Type I NA false ASCENSION HEALTH PO BOX 45998 ST LOUIS MO 63145 311662309 NATIONAL HEALTH SYSTEM MO 501(c)(3 Type I ASCENSION HEALTH ALLIANCE false SAINT THOMAS HEALTH 4220 HARDING ROAD NASHVILLE TN 37205 581716804 SYSTEM PARENT TN 501(c)(3 Type III-FI ASCENSION HEALTH false SAINT THOMAS WEST HOSPITAL 4220 HARDING ROAD NASHVILLE TN 37205 620347580 HOSPITAL TN 501(c)(3 3 SAINT THOMAS HEALTH true SAINT THOMAS NETWORK 4220 HARDING ROAD NASHVILLE TN 37205 621284994 HEALTH INVESTMENT ENTITY TN 501(c)(3 9 SAINT THOMAS HEALTH true SAINT THOMAS HEALTH FOUNDATIONS PO BOX 380 NASHVILLE TN 37202 581663055 OPERATES FOUNDATION TN 501(c)(3 7 SAINT THOMAS NETWORK true COVENANT CARE INC 102 WOODMONT BLVD SUITE 800 NASHVILLE TN 37205 621695737 INACTIVE TN 501(c)(3 Type I SAINT THOMAS NETWORK true SAINT THOMAS RUTHERFORD HOSPITAL 1700 MEDICAL CENTER PARKWAY MURFREESBORO TN 37219 620475842 HOSPITAL TN 501(c)(3 3 SAINT THOMAS HEALTH true SAINT THOMAS RUTHERFORD FOUNDATION 1700 MEDICAL CENTER PARKWAY MURFREESBORO TN 37219 621167917 FOUNDATION TN 501(c)(3 Type I SAINT THOMAS RUTHERFORD HOSPITAL true BAPTIST HOSPITAL FOUNDATION OF NASHVILLE INC 2000 CHURCH STREET NASHVILLE TN 37236 581861378 INACTIVE TN 501(c)(3 Type I SAINT THOMAS MIDTOWN HOSPITAL true BAPTIST HEALTH CARE AFFILIATES 2000 CHURCH STREET NASHVILLE TN 37236 581509251 COMMUNITY HEALTH PROMOTION TN 501(c)(3 Type I SAINT THOMAS NETWORK true SAINT THOMAS MEDICAL PARTNERS 2000 CHURCH STREET NASHVILLE TN 37236 621529858 HEALTHCARE PROVIDER TN 501(c)(3 3 SAINT THOMAS NETWORK true SAINT THOMAS HICKMAN HOSPITAL 135 EAST SWAN STREET CENTERVILLE TN 37033 581737573 HOSPITAL TN 501(c)(3 3 BAPTIST HEALTH CARE AFFILIATES INC true SAINT THOMAS HOME CARE 135 EAST SWAN STREET CENTERVILLE TN 37033 621836937 HOME HEALTH CARE TN 501(c)(3 9 SAINT THOMAS HICKMAN HOSPITAL true BAPTIST WOMENS HEALTH CENTER LLC 1900 CHURCH STREET SUITE 300 NASHVILLE TN 37203 621772195 OWNS AND OPERATES SPECIALTY HOSPITAL TN NA N/A MIDDLE TENNESSEE AMBULATORY SURGERY CENTER LP 500 N HIGHLAND AVE MURFREESBORO TN 37130 OPERATES OUTPATIENT SURGERY CENTER TN NA N/A ST THOMAS RESEARCH INSTITUTE LLC CARDIOLOGY SERIES 102 WOODMONT BOULEVARD NASHVILLE TN 37205 264591782 CARDIOLOGY RESEARCH TN NA N/A STHS SLEEP CENTER LLC 102 WOODMONT BOULEVARD SUITE 800 NASHVILLE TN 37205 203664894 OPERATES A SLEEP CENTER TN NA N/A BAPTIST SURGERY CENTER LP 1900 CHURCH STREET SUITE 300 NASHVILLE TN 37203 OPERATES OUTPATIENT SURGERY CENTER TN NA N/A MIDDLE TENNESSEE IMAGING LLC 400 N HIGHLAND AVENUE MURFREESBORO TN 37219 010570490 DIAGNOSTIC IMAGING CENTER TN NA N/A RADS OF AMERICA LLC PO BOX 249 GOODLETTSVILLE TN 370700249 203664894 AMBULATORY SURGERY CENTER TN NA N/A MURFREESBORO DIAGNOSTIC IMAGING LLC 400 N HIGHLAND AVENUE MURFREESBORO TN 37219 200291952 DIAGNOSTIC IMAGING CENTER TN NA N/A SOVA INC 102 WOODMONT BOULEVARD SUITE 700 NASHVILLE TN 37205 261319638 HEALTH SERVICES TN NA C Corporation false BAPTIST HEALTH CARE VENTURES INC 2000 CHURCH STREET NASHVILLE TN 37236 620469214 HOLDING COMPANY TN SAINT THOMAS MIDTOWN HOSPITAL C Corporation 952000 0 1 true MISSIONPOINT HEALTH PARTNERS 102 WOODMONT BOULEVARD SUITE 700 NASHVILLE TN 37205 452958482 ACCOUNTABLE CARE ORGANIZATION TN NA C Corporation false true true true false false false false false false true false false false false false false false true true Baptist Health Care Affiliates Inc S 3336000 Actual Amount Paid Saint Thomas Medical Partners S 3390945 Actual Amount Paid Saint Thomas Hickman Hospital R 227539 Actual Amount Paid Saint Thomas Rutherford Hospital S 330611 Actual Amount Paid Saint Thomas Health S 370577026 Actual Amount Paid Saint Thomas West Hospital R 442980611 Actual Amount Paid Saint Thomas Health S 16262439 Actual Amount Paid BAPTIST HEALTH CARE AFFILIATES INC R 61325 Actual Amount Paid Saint Thomas Network B 1000739 Actual Amount Paid STHS Sleep Center R 52125 Actual Amount Paid Saint Thomas Health S 228349 Actual Amount Paid Saint Thomas Health Foundation C 250340 Actual Amount Paid Ascension Health Alliance S 78231 Actual Amount Paid Ascension Health S 3566863 Actual Amount Paid