2016-05-13T15:27:38-05:00 2015-06-30 470617373 Catholic Health Initiatives 198 Inverness Drive West Englewood CO 80112 990 2014-07-01 611293786 University Medical Center Inc UNIV 5025623621 250 E LIBERTY ST Louisville KY 40202 KENNETH MARSHALL President 2016-05-12 true MARK STOCKI P00642127 3032989100 2014 2016-08-17 19:52:53Z X University of Louisville Hospital Kenneth Marshall 250 E LIBERTY ST Louisville KY 40202 576430416 false X www.kentuckyonehealth.org/universityoflouisvillehospital X 1995 KY TO PROVIDE PATIENT CARE TO OUR COMMUNITY AND TO SERVE AS A MAJOR TEACHING HOSPITAL FOR EDUCATION AND TRAINING IN MEDICINE, DENTISTRY, NURSING, AND ALLIED HEALTH PROFESSIONS. 7 7 258 500 6351 1449 53823 26820 498237250 543110389 548623 -117441 26722812 33410648 525562508 576430416 182194 13142381 0 0 160012826 145145127 0 0 0 335889486 364465955 496084506 522753463 29478002 53676953 424670418 483186223 172454416 177293268 252216002 305892955 TO PROVIDE PATIENT CARE TO OUR COMMUNITY AND TO SERVE AS A MAJOR TEACHING HOSPITAL FOR EDUCATION AND TRAINING IN MEDICINE, DENTISTRY, NURSING, AND ALLIED HEALTH PROFESSIONS. false false 438947265 13142381 543104038 UNIVERSITY MEDICAL CENTER OPERATES THE UNIVERSITY OF LOUISVILLE HOSPITAL, WHICH IS A TEACHING FACILITY HOSPITAL DESIGNATED AS A REGIONAL TRAUMA CENTER AND PROVIDES CARE TO THE MEDICALLY NEEDY REGARDLESS OF THEIR ABILITY TO PAY. SEE SCHEDULE H FOR ADDITIONAL INFORMATION. 438947265 true true false true false false false false false false true false false false true true false true false false false false false false false false true true true true true true false false false false false true false false false false false false false false false false false false false true 0 0 258 true true true false false false false false false false false false X 7 7 false false false false false false false true true false false false true true true true true false true true false KY X ROBERT STELTENPOHL 5025874961 200 Abraham Flexner Way Louisville KY 40202 JOAN COLEMAN CHAIR 1.00 0 X X 0 0 0 GERARD J ANDERSON VICE CHAIR 1.00 0 X X 0 0 0 Laurence Benz DPT MBA OCS DIRECTOR 1.00 0 X 0 0 0 Sharmila Makhija MD Director 1.00 0 X 0 0 0 MARCIA HERN EDD cns rn DIRECTOR 1.00 0 X 0 0 0 KELLY M MCMASTERS MD PHD DIRECTOR 1.00 0 X 0 0 0 PHILLIP BOND DIRECTOR 1.00 0 X 0 0 0 MARTHA NEAL COOKE DIRECTOR 1.00 0 X 0 0 0 TONI GANZEL MD DIRECTOR 1.00 0 X 0 0 0 CHARLIE JOHNSON DIRECTOR 1.00 0 X 0 0 0 DEBRA M Murphy DIRECTOR 1.00 0 X 0 0 0 SANDY METTS SnoWDEN DIRECTOR 1.00 0 X 0 0 0 LINDY STREET DIRECTOR 1.00 0 X 0 0 0 SEAN FRANCIS DIRECTOR 1.00 0 X 0 0 0 HARLAN SANDS DIRECTOR 1.00 0 X 0 0 0 JAMES H TAYLOR MD PHD CEO 50.00 0 X 443488 0 110872 KENNETH MARSHALL President 50.00 0 X 443527 0 58819 NORMA RACINE SECRETARY 40.00 0 X 96943 0 6222 FRANCES E SMITH NURSE DIRECTOR 40.00 0.00 X 148096 0 37024 KAREN A NUTGRASS HR PAYROLL MANAGER 40.00 0.00 X 116476 0 29119 PAULINE HAYES CLINICAL MANAGER 40.00 0.00 X 111035 0 27759 CYNTHIA ECKERT CLINICAL MANAGER 40.00 0.00 X 109149 0 27287 Lisa Wright Clinical Manager 40.00 0 X 101691 0 25423 1570405 0 322525 6 true true true CONIFER HEALTH SOLUTIONS 1500 S DOUGLAS ROAD ANAHEIM CA 92806 ADMIN SERVICES 9178560 MORRISON MANAGEMENT SPECIAL 5801 PEACHTREE DUNWOODY ROAD ATLANTA GA 30342 FOOD SERVICES 5650684 CROTHALL HEALTHCARE INC 13028 COLLECTION CENTER DRIVE CHICAGO IL 60693 ENVIRONMENTAL SERVICES 5538499 Louisville Cyberknife LLC PO Box 6600 Newport Beach CA 92658 cancer treatment 3402000 Varian Medical Systems Inc 660 N McCarthy Blvd Milpitas CA 95035 equipment maintenance 3165219 66 X 0 0 0 0 0 26820 0 26820 Patient Services 900099 538428623 538422272 6351 0 Meaningful Use 900099 3203762 3203762 0 0 Intercompany Transactions 900099 1478004 1478004 0 0 0 0 0 0 0 0 0 0 0 0 0 543110389 160893 0 0 160893 0 0 0 0 0 0 0 0 217880 0 0 0 217880 0 217880 0 0 217880 0 -278334 0 0 0 -278334 -278334 0 0 -278334 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 Pharmacy Services 446110 29716292 0 0 29716292 Education 611710 135093 0 0 135093 Parking Lot 812930 125768 0 0 125768 3215615 0 0 3215615 33192768 576430416 543104038 6351 33293207 X 62349 62349 13080032 13080032 116657831 104575479 12082352 5607114 4884949 722165 14096651 12281080 1815571 8783531 7652261 1131270 1073823 1073823 19190 19190 30204 30204 111486003 56784029 54701974 0 7050 30 7020 8239364 7484440 754924 4761183 3294887 1466296 9805788 9470976 334812 131313 82528 48785 13616 11578 2038 7446223 7446223 6123546 6123546 24060054 23813098 246956 3245272 3245272 Medical Supplies 114924288 114924288 Bad debts 40468287 40468287 Intercompany Allocations 17328768 17328768 State Provider Tax 7247579 7247579 8054404 8054404 0 0 522753463 438947265 83806198 0 104022 60907 78846162 150757288 67036982 68724325 0 0 1333000 1333000 1115614 1067360 9664932 11806182 3350453 2593507 213924068 54724371 166267387 159199697 32257145 32154231 0 0 53178005 53178005 11516716 2311721 424670418 483186223 32633229 22107814 5769115 43882634 2116084 430742 0 66290809 64856227 65645179 46015851 172454416 177293268 X 252216002 305892955 252216002 305892955 424670418 483186223 53676953 0 X false true X true true true X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED false false false false false true 30204 false false false 30204 false Schedule C, Part II-B, Line 1 DETAILED DESCRIPTION OF THE LOBBYING ACTIVITY The portion of organization dues that are related to lobbying are as follows: American Hospital Association - $4,718 Catholic Health Association - $1,474 Kentucky Hospital Association - $24,012 66855675 7738813 59116862 68261208 16056837 52204371 61067763 30584034 30483729 17739422 344687 17394735 159199697 Intercompany Payables 36250956 Self-Insurance Reserves and Claims 3285727 Unclaimed Property 1960 Environmental Remediation Liability 279868 Miscellaneous 3041904 Accrued Contracts 3155436 46015851 X Schedule D, Part X, Line 2 FIN 48 (ASC 740) footnote University Medical Center's financial information is included in the consolidated audited financial statements of Catholic Health Initiatives (CHI), a related organization. CHI's FIN 48 (ASC 740) footnote for the year ended June 30, 2015, reads as follows: "CHI is a tax-exempt Colorado corporation and has been granted an exemption from federal income tax under Section 501(c)(3) of the Internal Revenue Code. CHI owns certain taxable subsidiaries and engages in certain activities that are unrelated to its exempt purpose and therefore subject to income tax. Management reviews its tax positions annually and has determined that there are no material uncertain tax positions that require recognition in the accompanying consolidated financial statements. true true X false false true true true false true true 8898 9201736 6561142 2640594 0.0055 126390245 93784900 32605345 0.0676 0 0.0 0 8898 135591981 100346042 35245939 0.0731 7 6924 622810 622810 0.0013 2 136 95083361 45722471 49360890 0.1023 1 570 132 132 0.0000 0 0.0 1 253487 253487 0.0005 11 7630 95959790 45722471 50237319 0.1042 11 16528 231551771 146068513 85483258 0.1772 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 1 59 804 804 0.0000 0 0.0 0 0.0 0 0.0 1 59 804 0 804 0.0000 true 40468287 0 97145713 81289725 15855988 X true true 1 1 University of Louisville Hospital www.kentuckyonehealth.org/universityoflouisvillehospital 100220 X X X X X University of Louisville Hospital 1 false false true X X X X X X X X 12 true true true true X http://www.kentuckyonehealth.org/documents/University%20of%20Louisville%20CHNA.pdf X true 12 true http://www.kentuckyonehealth.org/documents/ULH%20Implementation%20Strategy.pdf false false true X X X X X true true X X X true X www.kentuckyonehealth.org/financialassistance X www.kentuckyonehealth.org/financialassistance X X X true X false X X X X true X false false Schedule H, Part V, Section B, Line 5 Facility , 1 Facility , 1 - University of Louisville Hospital. ULH | JGBCC is part of KentuckyOne Health which collaborated with the Louisville Metro Department of Public Health and Wellness (LMDPHW), the Kentucky Hospital Association and other Louisville area hospitals to conduct the Community Health Needs Assessment. Other hospital systems that participated included: Baptist Hospital East, Norton Healthcare and Jewish Hospital. Four community forums were held in March 2012 at sites in each quadrant of Jefferson County. Members of the general public were asked to complete a survey on their perceptions of the city's health care needs. The data gained from these forums was utilized to inform the entire process. A fifth forum was conducted by LMDPHW Director Dr. LaQuandra Nesbitt on March 29, 2012 at the Greater Louisville Medical Society tailored to gather input from community leaders, physicians and other health professionals. It was attended by 40 individuals representing a wide array of expertise including Bill Wagner, Executive Director of the Family Health Centers, Inc., Jay Davidson, Executive Director of The Healing Place, and leaders from an array of health and human service agencies that serve low-income and minority populations. Schedule H, Part V, Section B, Line 6a Facility , 1 Facility , 1 - University of Louisville Hospital. University Medical Center conducted its CHNA with Baptist Hospital East, Norton Healthcare and Jewish Hospital. Schedule H, Part V, Section B, Line 6b Facility , 1 Facility , 1 - University of Louisville Hospital. University Medical Center conducted its CHNA with the Louisville Metro Department of Public Health and Wellness (LMDPHW) and the Kentucky Hospital Association. Schedule H, Part V, Section B, Line 11 Facility , 1 Facility , 1 - University of Louisville Hospital. The most recent Community Health needs assessment identified adult smoking, healthy eating and active living, chronic disease prevention and management as community needs. To address adult smoking, the University of Louisville Hospital is working to Increase the number of people who receive smoking intervention with the following strategies: A. Continue to partner with KCP (Kentucky Cancer Program) to offer free Cooper Clayton Method smoking cessation classes to the community. B. Increase the number of participants in smoking cessation classes by registering residents at health fairs, the Kentucky State Fair, and other community outreach events. C. Partner with University of Louisville faculty to research the effectiveness of smoking bans in our community with the goal of expanding evidence-based smoking reduction programs to other communities. To support Healthy Eating and Active Living the University of Louisville Hospital is working to increase community knowledge of the importance of healthy eating in vulnerable neighborhoods through the following Strategies: A. Partner with the Urban League to support new grocery store 'First Choice' and Walgreens Fresh Food store located in West Louisville by offering a cooking fair to educate the population about the benefits of healthy eating habits. B. Enhance relationship with the Harriet B. Porter Culinary Institute and Sullivan University to promote the Healthy Kitchen initiative to train "Kitchen Ministries" to encourage healthier eating. To address the need of Chronic Diseases Prevention and Management, the University of Louisville Hospital is working to Provide education, screenings, and assessments with the goal of increasing stroke risk awareness through the following strategies: A.Provide stroke staff to provide screenings at community events (e.g. National Stroke Association health fair, Kentucky State Fair) to include glucose checks, cholesterol checks, blood pressure and body fat analysis. B. Provide health departments and family health centers and local retail establishments with educational materials on stroke prevention to increase awareness of risk factors. The Hospital is also partnering with the community to promote improved health status and reduce readmissions through the 'Right at Home' pilot program, using the following Strategies: A.Continue 'Right at Home' pilot program in providing support to Congestive Heart Failure patients who are discharged from ULH | JGBCC who are deemed a high risk for readmission, in an effort to improve their ability to self-manage their condition at home. This free program includes medication boxes, scales and support from Right at Home employee to ensure that individuals can properly care for themselves. B. Expand the 'Right at Home' Program to serve discharge population beyond Congestive Heart Failure patients. The Hospital is also increasing the number of patients who receive community-based diabetic education through the following Strategies: A. Partner with Family Health Centers (Federally Qualified Health Centers), Park DuValle Community Health Center and Bellarmine University's Diabetes Education Program to explore the feasibility of implementing a collaborative case management program to better serve the needs of these patients in the appropriate community-based setting. B. ULH Stroke partnering with LMPHW on diabetes program at ULH. Classes will be available for the community to attend. Needs Not Addressed Some issues identified through the community health needs assessment have not been addressed in this plan. The ULH | JGBCC CHNA Planning Team considered the levels to which some needs were already being addressed in the service area. The following outlines how some of the needs identified in the assessment are addressed by others or in different ways. Low Birthweight/Premature Birth University of Louisville Hospital is addressing risky lifestlyes which can lead to low birthweight/premature births. ULH will defer additional services for this need to be addressed through Kosair Children's Hospital, Baptist Health and Norton Healthcare. Mental or Emotional Health Addiction/Substance Abuse Excessive Drinking University of Louisville Hospital currently addresses mental health as we care for those patients with chronic conditions. ULH will defer the services for this need to be addressed within KentuckyOne Health through Our Lady of Peace. In addition, Seven Counties Services, the area's community mental health service, also has the expertise and resources to focus in these areas. Schedule H, Part V, Section B, Line 13 Facility , 1 Facility , 1 - University of Louisville Hospital. HUD Low Income guidelines used. 0 Schedule H, Part V, Section B Financial Assistance Policy In addition to University Medical Center's Financial Assistance Policy, assistance is provided to economically disadvantaged patients at the university hospital by the Quality Care Charity Trust (QCCT). The purpose of the Trust is to manage government funds received and to disburse such funds to UMC for providing hospital care services to economically disadvantaged patients through the University of Louisville Hospital (Hospital). As set forth in the Revised Quality and Charity Care Trust Agreement, the funds available to the Trust from government sources are determined annually, and the Trust disburses these funds to UMC monthly in the amount of one-twelfth of the total funds determined to be available. The Trust is funded by the Louisville Metro Government and the Commonwealth of Kentucky. After the entire amount of funding available to the Trust has been exhausted, as discussed above, UMC is committed to continue to provide medically necessary Hospital Care, to the extent facilities are available, to all Indigent and Medically Needy individuals at its own expense. Schedule H, Part VI Lines 2, 4 & 5 Organization's Mission, Vision, and Tax-Exempt Purpose KentuckyOne Health, the largest and most comprehensive health system in the Commonwealth, has more than 200 locations including hospitals, physician groups, clinics, primary care centers, specialty institutes and home health agencies in Kentucky and southern Indiana. KentuckyOne Health is dedicated to bringing wellness, healing and hope to all, including the underserved. The system is made up of the former Jewish Hospital & St. Mary's HealthCare and Saint Joseph Health System, along with the University of Louisville Hospital and James Graham Brown Cancer Center. KentuckyOne Health is proud of and strengthened by its Catholic, Jewish and academic heritages. KentuckyOne Health was formed when two major Kentucky health care organizations came together in early 2012. KentuckyOne Health combines the Jewish and Catholic heritages of the two former systems- Jewish Hospital & St. Mary's HealthCare and Saint Joseph Health System. In late 2012, the organization formed a partnership with the University of Louisville Hospital | James Graham Brown Cancer Center. The nonprofit system is committed to improving the health of Kentuckians by integrating medical research, education, technology and health care services wherever patients receive care. An 18-member volunteer Board of Directors governs KentuckyOne health, its facilities and operations, with this mission: to bring wellness, healing, and hope to all. Our vision is to: * serve with a spirit of innovation and collaboration * transform health care delivery * partner to create healthy communities * advocate for a just health system University of Louisville Hospital (ULH) operates a 24-hour emergency department 365 days per year, which is open to all individuals regardless of ability to pay. ULH has open medical staff, participates in Medicare and Medicaid, and has an active charity care program. ULH is also the state's first Level 1 Trauma Center. University of Louisville Hospital, a 404-licensed-bed facility, is the leading academic medical center in the area and offers the benefits of the latest research, equipment and expertise. It is also home to the region's only Level 1 Adult Trauma Center and adult burn unit. The hospital is also the first nationally accredited Comprehensive Stroke Center in Kentucky. Rooted in nearly two centuries of service to the community, University Hospital has a rich history of providing extraordinary patient care and conducting leading-edge research. Today, the organization's direct tie to the UofL Health Sciences Center attracts millions of research dollars to improve health care and educate physicians. This high level of achievement offers patients unmatched access to innovative and specialized treatment options that are unavailable elsewhere in the region. The James Graham Brown Cancer Center opened in 1981 with the purpose of addressing the exceptionally high cancer rates experienced by the people of Kentucky. Its mission is to relieve Kentuckians' disproportionate burden of pain and suffering caused by this disease, through state-of-the-art clinical, research, education and outreach programs. During the past 30 years, the Brown Cancer Center has also become home to some of the best cancer scientists and physicians in the world. The James Graham Brown Cancer Center is a national leader in the provision of multidisciplinary cancer care, in which patients benefit (medically and practically) from a team of physicians and caregivers from every applicable field working together to plan, coordinate and provide care. ULH | JGBCC has long been on the leading edge of developments and accolades in key service areas: * First Trauma Center in the Nation * First Certified Primary Stroke Center in Kentucky * First to achieve American Heart Association "Stroke Honor Roll" in Kentucky * First Nationally Accredited Comprehensive Stroke Center in Kentucky * First Level IV Epilepsy Center in Kentucky * First Nationally Accredited Breast Center in Kentucky * First Nationally Accredited Radiation Oncology Program in Louisville * First to provide true multidisciplinary cancer care in Kentucky * First and only Blood and Marrow Transplantation Program in Louisville * First and only statewide education leader in Kangaroo Care ULH is committed to the provision of the highest quality patient- and family-centered care regardless of economic status. The hospital and cancer center provided more than $91 million of charity care in 2011, representing just part of $158 million in community benefit programs that year. ULH is the largest provider of charity care in Kentucky. Schedule H, Part VI Lines 2, 4 & 5 Community Benefit Approach Geographic Area Louisville is a major city-the largest in the state of Kentucky and the county seat of Jefferson County. As of 2010, the Louisville metropolitan area (MSA) had a population of 1,307,647 ranking it 42nd in size nationally. The metro area includes Louisville-Jefferson County and 12 surrounding counties, eight in Kentucky and four in Southern Indiana. Louisville is southeasterly situated along the border between Kentucky and Indiana, the Ohio River, in north-central Kentucky at the Falls of the Ohio. The Louisville metropolitan area is often referred to as Kentuckiana because it includes counties in Southern Indiana. A community is defined as the geographic area from which a significant number of the patients utilizing hospital services reside. While the community health needs assessment considers other types of healthcare providers, hospitals are the single largest provider of acute care services. For this reason, the utilization of hospital services provides the clearest definition of the community. ULH is located in downtown Louisville and serves a population that faces challenges that no other provider in Kentucky experiences. The ULH CHNA population is Jefferson County, but the areas that provide the most inpatient discharges are located in the downtown, western and southern parts of the county. These areas have more African-Americans, increased poverty and unemployment, increased drinking, violence and sexually transmitted infections which are characteristics that serve to separate it from not only the rest of Kentucky, but also the remainder of the county. With these structural challenges, the population that ULH serves is more likely to have poorer outcomes and a greater likelihood that they will not have the financial means to properly utilize the healthcare services provided in their community. Demographics of Constituents in Community Served According to the 2010 census, 26% of the community is between the ages of 35 and 54 and 20% of the population is between 0-14 years old. The ethnicity breakdown is 68% white, 23% black, and 5% Hispanic. In total, the population breakdown for the community shows a higher percentage of black residents compared to the state of Kentucky and the United States. A review of specific zip code areas shows a relatively large percentage of black residents in several zip codes representing the highest discharges from Jewish Hospital. Median household incomes range from $25,000-$50,000. The average annual resident unemployment rates for counties in Jewish Hospital's defined community have risen in recent years. These counties have rates are similar to Kentucky's state average, which is slightly less favorable than national averages. In Jefferson County, residents obtain a bachelor's degree or higher at rates greater than state and national averages; in Bullitt County the rate is just 11.1percent, about half the state average. The overall population is projected to increase slightly over a five-year period from577, 204 in 2013 to 595,540, a 3.2 percent increase. However, the people who utilize health care services the most, those ages 65 years and over, are projected to increase 16.7 percent, from 77,983 to 91,003. The projected change to the composition of the total community of males and females is projected to remain approximately the same over the five-year period. Community Benefit Process During 2012, a community health needs assessment (CHNA) was conducted to support the mission of enhancing the health of people in the communities served, to comply with the Patient Protection and Affordable Care Act of 2010 and federal tax-exemption requirements, and to identify health needs of the community to help prioritize the allocation of hospital resources to meet those needs. Based on current literature and other guidance from the Treasury and IRS, the following steps were completed as part of the community health needs assessment: 1. The "community" served was defined utilizing inpatient data on patient origin. 2. Population demographics and socioeconomic characteristics of the community were gathered and reported using various sources. The health status of the community was then reviewed. Information on the leading causes of death and morbidity was analyzed in conjunction with health outcomes and factors reported for the community by CountyHealthrankings.org. Health factors with significant opportunity for improvement were noted. 3. An inventory of health care facilities and resources was prepared. 4. Through a collaborative process conducted by the Louisville Metro Department of Public Health & Wellness(LMDPHW), the Kentucky Hospital Association and Louisville area hospitals, community input was obtained through a series of four public forums held across the county, and an additional forum for community leaders and medical professionals, and through an online survey. Schedule H, Part VI Lines 2, 4 & 5 Information gathered in the steps above was analyzed and reviewed to identify health issues of uninsured persons, low-income persons, minority groups and the community as a whole. Health needs were prioritized utilizing a method that weighs: 1) the size of the problem; 2) the seriousness of the problem; 3) the impact of the problem on vulnerable populations; 4) how important the problem is to the community; 5) prevalence of common themes; 6) how closely the need aligns with the strategies and strengths of the hospital and KentuckyOne Health; and 7) an evaluation of existing hospital programs responding to the identified need. Information gaps were identified during the prioritization process and reported. Summary of Assessment Findings After the CHNA was completed, the aforementioned facilities entered into a dialogue with other key community partners, including the LMDPHW, to discuss the results of the evaluation and select health priorities. Participants were given the opportunity to revise rankings and debate issues until a consensus was reached on a composite ranking of health issues. The process identified the following issues with scores of 14 or more (on a scale of 28): * Access and Health Care Disparities is very broad in that it addresses characteristics such as insurance status, income/poverty, educational attainment, crime rates, location of health care services and providers, etc. all of which impact the health status of a community. Our assessment of the community identified that all of these factors are present negatively compared to national standards in the community we serve and warrants consideration under our Community Health Needs Assessment. * Access to Primary Care impacts the health status of the community through lack of management of chronic conditions and lack of efficient and effective access to preventive care. Our assessment identified a shortage of primary care physicians in our community and an even greater shortage of primary care practices in the areas of Jefferson County served by ULH * Chronic Diseases impact the health and health care cost of our community because lack of appropriate management leads to preventable deaths, preventable hospitalizations and increased health care costs. * Leading Causes of Death in our community include heart disease, lower respiratory disease, cancer, chronic lower respiratory disease, unintentional /trauma related injuries, etc. This is important to the health of our community because if these conditions can be prevented and/or managed we have the ability to save the lives of these individuals in our community. * Risky Lifestyles was identified as an issue in our assessment of the community. Jefferson County has very high rates of alcohol and drug abuse, tobacco use, obesity, concentration of fast food restaurants, etc. These issues not only drive up health care costs, but they also impact the overall health and wellbeing of the individuals in our community. * Psychiatric, Emotional and Substance Abuse Disorders were identified as issues for our CHNA Community due to the lack of resources available to this community and the high socioeconomic impact from untreated populations. * Prematurity and Low Birth Weight babies was identified in our report as issues. Jefferson County has a higher percentage of babies born below 2500 grams than the rest of the state and the nation and has a higher preterm pregnancy rate as well. This is an issue because prematurity and low birth weight are linked to long-term health and developmental issues throughout the individual's life. * These needs were then mapped to the health improvement efforts of the Mayor's Healthy Hometown Movement in order to increase collaborative efforts to have the greatest opportunity for measurable, collective impact. Community Benefit Process for the Future In accordance with the Patient Protection and Affordable Care Act of 2010 and in order to honor its commitment to the community, KentuckyOne Health is repeating this coordinated approach with the Louisville Metro Department of Public Health and Wellness and other area hospital systems to survey the community as part of the community health needs assessment for 2015. A report due in 2016 will capture these current community sentiments and guide community benefit work in FY2017-2019 through an implementation strategy. This implementation strategy will build upon the previous CHNA published in 2013 that guided community benefit work in FY2014-2016. Qualitative Description of Community Benefit These hospitals promote the community's health by responding to the four major pillars of community benefit activities: improving access, enhancing community health, advancing medical knowledge, and reducing government burden of care. Community Outreach for the Poor They provide additional access to health care services in underserved areas of Jefferson County. ULH works to relieve the government's burden by caring for the indigent in Jefferson County. ULH has also provided staff and financial support to the Harambee Clinic, a nurse-run clinic that provides additional access to health care services in underserved areas of Jefferson County. ULH also works to enhance the health of the community through violence prevention interventions, health fairs in underserved areas, and community collaboration with other nonprofits to address the issues around hospital super-utilizers, among other initiatives. Community Outreach for the Broader Community Most community outreach is open to the public, which serves the broader community. One initiative that simultaneously improves access to healthcare and promotes health living is Walk with a Doc, which is free, open to the public, and held in three separate geographic locations in the Louisville market. KentuckyOne Health completely absorbs the cost of this program, including fees and allocating staff time in order to provide this benefit to the whole community. Health Professions Education As teaching hospitals, they work to advance medical knowledge for many different specializations of health professionals. In FY2014, this included, but was not limited to, providing education to: medical students, physician residents and fellows, nursing students, pharmacy residents, mental health professionals, physical and occupational therapists, and laboratory technicians. This was done in collaboration with the University of Louisville, the University of Kentucky, Spalding University, Galen College of Nursing, Bellarmine University, and Jefferson Community and Technical College, among others. Community Building Activities The hospitals also work to enhance the health of the community through violence prevention interventions, health fairs in underserved areas, and community collaboration with other nonprofits to address the issues around hospital super-utilizers, among other initiatives. All hospitals also donate supplies to Supplies Overseas. Collaborating partners for community building activities include, but are not limited to: Jefferson County Public Schools, Louisville Metro government, Food Literacy Project, Walk with a Doc, University of Louisville, PACT in Action, and the Center for Women and Families, among others. List of Services University of Louisville Hospital * Cancer care-James Graham Brown Cancer Center * Epilepsy center * Heart care * Lung care * Pain management care * Palliative care * Pharmacy * Psychiatric services * Radiology and diagnostic imaging * Regional clinical care * Robotic surgery * Stroke center * Sleep care * Trauma center * Women's care Schedule H, Part I, Line 3c Eligibility criteria for free or discounted care When Catholic Health Initiatives (the ultimate parent organization to University Medical Center, Inc.) established its financial assistance policy it was determined that establishing a household income scale based on the HUD very low income guidelines more accurately reflects the socioeconomic dispersions among urban and rural communities in 18 states served by CHI hospitals and health care facilities. In comparing HUD guidelines to the Federal Poverty Guidelines (FPG), we find that on average HUD guidelines compute to approximately 200% to 250% (and sometimes 300%) of FPG. University Medical Center, Inc.bases its financial assistance eligibility on HUD's 130% of Very Low Income Guidelines based on geography, and affords the uninsured and underinsured the ability to obtain financial assistance write-offs, based on a sliding scale, ranging from 25%-100% of charges. An individual's income under the HUD guidelines is a significant factor in determining eligibility for financial assistance. However, in determining whether to extend discounted or free care to a patient, the patient's assets may also be taken into consideration. For example, a patient suffering a catastrophic illness may have a reasonable level of income, but a low level of liquid assets such that the payment of medical bills would be seriously detrimental to the patient's basic financial (and ultimately physical) well-being and survival. Such a patient may be extended discounted or free care based upon the facts and circumstances. Schedule H, Part I, Line 6a Community benefit report prepared by related organization KentuckyOne Health, Inc. Schedule H, Part I, Line 7 Bad Debt Expense excluded from financial assistance calculation 40468287 Schedule H, Part I, Line 7 Costing Methodology used to calculate financial assistance AMOUNTS REPORTED ON SCHEDULE H, PART I, LINE 7 ARE DETERMINED BY MULTIPLYING REVENUE BY THE COST TO CHARGE RATIO CALULATED FROM WORKSHEET 2. Schedule H, Part III, Line 2 Bad debt expense - methodology used to estimate amount Costing methodology for amounts reported on line 2 is determined using the organization's cost/charge ratio of 14.94%. When discounts are extended to self-pay patients, these patient account discounts are recorded as a reduction in revenue, not as bad debt expense. Schedule H, Part III, Line 3 Bad Debt Expense Methodology University Medical Center, Inc. does not believe that any portion of bad debt expense could reasonably be attributed to patients who qualify for financial assistance since amounts due from those individuals' accounts will be reclassified from bad debt expense to charity care within 30 days following the date that the patient is determined to qualify for charity care. Schedule H, Part III, Line 4 Bad debt expense - financial statement footnote University Medical Center, Inc. does not issue separate company audited financial statements. However, the organization is included in the consolidated financial statements of Catholic Health Initiatives. The consolidated footnote reads as follows: "The provision for bad debts is based upon management's assessment of historical and expected net collections, taking into consideration historical business and economic conditions, trends in health care coverage, and other collection indicators. Management routinely assesses the adequacy of the allowance for uncollectible accounts based upon historical write-off experience by payor category. The results of these reviews are used to modify, as necessary, the provision for bad debts and to establish appropriate allowances for uncollectible net patient accounts receivable. After satisfaction of amounts due from insurance, CHI follows established guidelines for placing certain balances with collection agencies, subject to the terms of certain restrictions on collection efforts as determined by each facility. The provision for bad debts is presented on the consolidated statements of operations as a deduction from patient services revenues (net of contractual allowances and discounts) since CHI accepts and treats substantially all patients without regard to the ability to pay." Schedule H, Part III, Line 8 Community benefit & methodology for determining medicare costs Using essentially the same Medicare cost report principles as to the allocation of general services costs and "apportionment" methods, the "CHI Workbook" calculates a payers' gross allowable costs by service (so as to facilitate a corresponding comparison between gross allowable costs and ultimate payments received). The term "gross allowable costs" means costs before any deductibles or co-insurance are subtracted. University Medical Center, Inc.'s ultimate reimbursement will be reduced by any applicable copayment/ deductible. Where Medicare is the secondary insurer, amounts due from the insured's primary payer were not subtracted from Medicare allowable costs because the amounts are typically immaterial. Although not presented on the Medicare cost report, in order to facilitate a more accurate understanding of the "true" cost of services (for "shortfall" purposes) the CHI Workbook allows a health care facility not to offset costs that Medicare considers to be non-allowable, but for which the facility can legitimately argue are related to the care of the facility's patients. In addition, although not reportable on the Medicare cost report, the CHI workbook includes the cost of services that are paid via a set fee-schedule rather than being reimbursed based on costs (e.g. outpatient clinical laboratory). Finally, the CHI Workbook allows a facility to include other health care services performed by a separate facility (such as a physician practice) that are maintained on separate books and records (as opposed to the main facility's books and records which has its costs of service included within a cost report). True costs of Medicare computed using this methodology: Total Medicare Revenue: $97,145,713 Total Medicare costs: $81,289,725 Surplus or Shortfall $15,855,988 Schedule H, Part III, Line 9b Collection practices for patients eligible for financial assistance University Medical Center, Inc.'s debt collection policy provides that University Medical Center, Inc. will perform a reasonable review of each inpatient account prior to turning an account over to a third-party collection agent and prior to instituting any legal action for non-payment, to assure that the patient and patient guarantor are not eligible for any assistance program (e.g. Medicaid) and do not qualify for coverage through University Medical Center, Inc. community assistance policy. After having been turned over to a third-party collection agent, any patient account that is subsequently determined to meet the University Medical Center, Inc. community assistance policy is required to be returned immediately by the third-party collection agent to University Medical Center, Inc. for appropriate follow-up. University Medical Center, Inc. requires its third-party collection agents to include a message on all statements indicating that if a patient or patient guarantor meets certain stipulated income requirements, the patient or patient guarantor may be eligible for financial assistance. All of Catholic Health Initiatives' hospitals' contracts with third party collection agencies include the following standards: * Neither CHI hospitals nor their collection agencies will request bench or arrest warrants as a result of non-payment; * Neither CHI hospitals nor their collection agencies will seek liens that would require the sale or foreclosure of a primary residence; and * No Catholic Health Initiatives' collection agency may seek court action without hospital approval. Finally, collection agencies are trained on the Catholic Health Initiatives Mission, Core Values and Standard of Conduct to make sure all patients are treated with dignity and respect. Schedule H, Part V, Section B, Line 16a FAP website - University of Louisville Hospital: Line 16a URL: www.kentuckyonehealth.org/financialassistance; Schedule H, Part V, Section B, Line 16b FAP Application website - University of Louisville Hospital: Line 16b URL: www.kentuckyonehealth.org/financialassistance; Schedule H, Part VI, Line 3 Patient education of eligibility for assistance University Medical Center, Inc. includes information concerning its financial assistance policy on its website. In addition, University Medical Center, Inc. prominently displays its financial assistance policy in both English and Spanish in obvious locations throughout the hospitals, including the emergency rooms and other patient intake areas, as well as in University Medical Center, Inc. outpatient facilities. In addition, University Medical Center, Inc. registration clerks are trained to provide consultation to those who have no insurance or potentially inadequate insurance concerning their financial options including application for Medicaid and for financial assistance under University Medical Center, Inc.'s financial assistance policy. Upon registration (and once all EMTALA requirements are met), patients who are identified as uninsured (and not covered by Medicare or Medicaid) are provided with a packet of information that addresses the financial assistance policy and procedures including an application for assistance. University Medical Center's registration clerks read the organization's medical assistance policy to those who appear to be incapable of reading, and provide translators for non English-speaking individuals. University Medical Center's staff will also assist the patient/guarantor with applying for other available coverage (such as Medicaid), if necessary. Counselors assist Medicare eligible patients in enrollment by providing referrals to the appropriate government agencies. Schedule H, Part VI, Line 6 Affiliated health care system University Medical Center, Inc., along with its affiliated outpatient facilities, are part of Catholic Health Initiatives. Catholic Health Initiatives (CHI) is a national faith-based nonprofit health care organization with headquarters in Englewood, Colorado. CHI's exempt purpose is to serve as an integral part of its national system of hospitals and other charitable entities, which are described as market-based organizations, or MBOs. An MBO is a direct provider of care or services within a defined market area that may be an integrated health system and/or a stand-alone hospital or other facility or service provider. CHI serves as the parent corporation of its MBOs which are comprised of 101 hospitals, including four academic medical centers, and 30 critical access facilities; community health service organizations; accredited nursing colleges; home health agencies; and other facilities that span the inpatient and outpatient continuum of care. Together, these facilities provided $981 million in charity care and community benefit in the 2015 fiscal year, including services for the poor, free clinics, education and research. CHI provides strategic planning and management services as well as centralized "shared services" for the MBOs. The provision of centralized management and shared services - including areas such as accounting, human resources, payroll and supply chain -- provides economies of scale and purchasing power to the MBOs. The cost savings achieved through CHI's centralization enable MBOs to dedicate additional resources to high-quality health care and community outreach services to the most vulnerable members of our society. University Medical Center, Inc. operates with its wholly owned affiliates and community partners to serve the health care needs of the Louisville, Kentucky communities. Schedule H, Part VI, Line 7 State filing of community benefit report KY true St Catharine College 310 Zavier Campus Bardstown KY 40004 610956809 501(c)(3) 60000 General Support 1 0 Financial Assistance 8898 13080032 book Financial Assistance Schedule I, Part I, Line 2 Description Of Procedure For Monitoring Use Of Grant Funds DESCRIPTION OF ORGANIZATION'S PROCEDURES FOR MONITORING THE USE OF GRANTS ACTIVITIES THAT SUPPORT UNIVERSITY MEDICAL CENTER'S (UMC) MISSION, FUNDRAISING EVENTS WITH CLOSE RELATIONSHIP TO UMC CLINICAL PROGRAMS, REQUESTS THAT PROVIDE POSITIVE PUBLIC AWARENESS OF UMC, ACTIVITIES THAT ADDRESS AND PROMOTE HEALTH IMPROVEMENT INITIATIVE. UMC WILL NOT CONTRIBUTE TO: FOR-PROFIT ORGANIZATIONS, INDIVIDUALS, POLITICAL CAMPAIGNS/PARTIES, GROUPS THAT DISCRIMINATE ON THE BASIS OF AGE, RACE, SEX OR NATIONAL ORIGIN, ACTIVITIES THAT DO NOT ADVANCE UMC'S MISSION. UMC'S ANNUAL BUDGET WILL BE DETERMINED BY THE SENIOR VICE PRESIDENT AND COO AND MAINTAINED IN THE EXECUTIVE OFFICE'S BUDGET. ACCOUNTING WILL NOT PROCESS ANY PAYMENTS FOR CONTRIBUTIONS TO SPONSORSHIPS UNLESS THEY HAVE BEEN APPROVED BY THE SENIOR VICE PRESIDENT AND COO OR PRESIDENT AND CEO. REQUESTS WILL BE ENTERED, TRACKED AND RETAINED FOR PREPARING THE COMMUNITY BENEFIT REPORT. A DESIGNATED EMPLOYEE WILL INFORM REQUESTOR OF APPROVAL/DENIAL. CHECK REQUESTS WITH THE PRESIDENT AND CEO'S OR SENIOR VICE PRESIDENT AND COO'S APPROVAL WILL BE FORWARDED TO ACCOUNTING FOR PAYMENT. Schedule I, Part III Financial Assistance University Medical Center, Inc. RECOGNIZES THE RIGHT TO QUALITY HEALTHCARE REGARDLESS OF AGE, SEX, RACE, RELIGION, NATIONAL ORIGIN, OR ABILITY TO PAY. BUSINESS OFFICE STAFF HELPS PATIENTS SEEK LOCAL, STATE, AND FEDERAL REIMBURSEMENT AT NO CHARGE WHEN NO OTHER SOURCE OF PAYMENT IS AVAILABLE. CHARITY CARE IS PROVIDED TO PATIENTS WITH DEMONSTRATED INABILITY TO PAY FOR MEDICALLY NECESSARY SERVICES. THESE FUNDS ARE DIRECTLY USED TO OFFSET THE PATIENTS' ACCOUNTS RECEIVABLE. Schedule I, Part I, Line 2 Procedures for monitoring use of grant funds. DESCRIPTION OF ORGANIZATION'S PROCEDURES FOR MONITORING THE USE OF GRANTS ACTIVITIES THAT SUPPORT UNIVERSITY MEDICAL CENTER'S (UMC) MISSION, FUNDRAISING EVENTS WITH CLOSE RELATIONSHIP TO UMC CLINICAL PROGRAMS, REQUESTS THAT PROVIDE POSITIVE PUBLIC AWARENESS OF UMC, ACTIVITIES THAT ADDRESS AND PROMOTE HEALTH IMPROVEMENT INITIATIVE. UMC WILL NOT CONTRIBUTE TO: FOR-PROFIT ORGANIZATIONS, INDIVIDUALS, POLITICAL CAMPAIGNS/PARTIES, GROUPS THAT DISCRIMINATE ON THE BASIS OF AGE, RACE, SEX OR NATIONAL ORIGIN, ACTIVITIES THAT DO NOT ADVANCE UMC'S MISSION. UMC'S ANNUAL BUDGET WILL BE DETERMINED BY THE SENIOR VICE PRESIDENT AND COO AND MAINTAINED IN THE EXECUTIVE OFFICE'S BUDGET. ACCOUNTING WILL NOT PROCESS ANY PAYMENTS FOR CONTRIBUTIONS TO SPONSORSHIPS UNLESS THEY HAVE BEEN APPROVED BY THE SENIOR VICE PRESIDENT AND COO OR PRESIDENT AND CEO. REQUESTS WILL BE ENTERED, TRACKED AND RETAINED FOR PREPARING THE COMMUNITY BENEFIT REPORT. A DESIGNATED EMPLOYEE WILL INFORM REQUESTOR OF APPROVAL/DENIAL. CHECK REQUESTS WITH THE PRESIDENT AND CEO'S OR SENIOR VICE PRESIDENT AND COO'S APPROVAL WILL BE FORWARDED TO ACCOUNTING FOR PAYMENT. true true false false false false false false false JAMES H TAYLOR MD PHD CEO 443488 0 0 0 0 0 0 0 110872 0 554360 0 0 0 KENNETH MARSHALL President 385875 0 34320 0 23332 0 38453 0 20366 0 502346 0 0 0 NORMA RACINE SECRETARY 36340 0 0 0 60603 0 0 0 6222 0 103165 0 0 0 FRANCES E SMITH NURSE DIRECTOR 148096 0 0 0 0 0 0 0 37024 0 185120 0 0 0 Schedule J, Part I, Line 3 Arrangement used to establish the top management official's compensation Compensation for the top management official was established and paid by Catholic Health Initiatives (CHI), a related organization. CHI used the following to establish the top management official's compensation: (1) Compensation Committee; (2) Independent Compensation Consultant; (3) Written Employment Contracts; (4) Compensation Survey or Study; (5) Approval by the Board or Compensation Committee. Schedule J, Part I, Line 4a Severance or change-of-control payment Post-termination payments are addressed in executive employment agreements for Catholic Health Initiatives (CHI) and related organizations' employees at the level of Vice President and above, including the MBO CEOs. These employment agreements require that in order for the executive to receive post-termination payments, these individuals must execute a general release and settlement agreement. Post-termination payment arrangements are periodically reviewed for overall reasonableness in light of the executive's overall compensation package. The following reportable individuals received severance payments from Catholic Health Initiatives (a Related Organization) during the 2014 calendar year, and these severance payments were included in the individual's W-2 income and reportable compensation on Schedule J: Norma Racine - $51,060 Schedule J, Part I, Line 4b Supplemental nonqualified retirement plan During the 2014 calendar year Catholic Health Initiatives (CHI), a related organization, maintained a supplemental non-qualified deferred compensation plan for MBO CEOs/Presidents and other CHI employees at the level of Senior Vice President and above. The following reportable individuals were eligible to participate in that plan: Kenneth Marshall During 2014 the following contributions were made by CHI to the deferred compensation plan: Kenneth Marshall - $34,932 UNIVERSITY MEDICAL CENTER, INC. MAINTAINS A SPLIT DOLLAR SERP PlAN AND NON-QUALIFIED DEFERRED COMPENSATION PLAN FOR CERTAIN EXECUTIVES. Schedule J, Part II COMPENSATION FROM AN UNRELATED ORGANIZATION OR INDIVIDUAL NAME - KENNETH MARSHALL, COMPENSATION FROM UNRELATED ORGANIZATION - 502345.520000, NAME OF UNRELATED ORGANIZATION - CATHOLIC HEALTH INITIATIVES, TYPE OF COMPENSATION - WAGES AND BENEFITS Schedule J, Part II COMPENSATION FROM AN UNRELATED ORGANIZATION OR INDIVIDUAL NAME - NORMA RACINE, COMPENSATION FROM UNRELATED ORGANIZATION - 103165.000000, NAME OF UNRELATED ORGANIZATION - KENTUCKYONE HEALTH, INC., TYPE OF COMPENSATION - WAGES AND BENEFITS A LOUISVILLEJEFFERSON COUNTY METRO GOVERNMENT 320049006 2008-09-05 16000000 SEE SCHEDULE K, PART VI false false false A 15569276 0 16118030 0 0 0 0 0 0 16118030 0 0 2009 false false true true A false false false false 0.0 false false true A false true false false false false true A true -1 LOUISVILLE/JEFFERSON COUNTY METRO GOVERNMENT 2008 PART I, LINE F: MASTER LEASE AND SUBLEASE AGREEMENT (UNIVERSITY MEDICAL CENTER, INC. D/B/A UNIVERSITY OF LOUISVILLE HOUSING PROJECT) ESSENTIAL USE OF MEDICAL EQUIPMENT WITH DEPRECIABLE LIFE OF 5 OR 7 YEARS, AS CONFIRMED BY THE AMERICAN HOSPITAL ASSOCIATION'S GUIDE FOR DEPRECIABLE LIFE, AND/OR OTHER ESSENTIAL USE MEDICAL EQUIPMENT APPROVED BY THE LESSOR. PART II, LINE 3: TOTAL PROCEEDS OF ISSUE: $16,118,030 INCLUDES INVESTMENT EARNINGS PART III, LINE 7: DOES THE BOND ISSUE MEET THE PRIVATE SECURITY OR PAYMENT TEST? UMC MONITORS THE PRIVATE BUSINESS USE PERCENTAGE FOR EACH BOND ISSUE, AND THEREFORE, HAS NOT CALCULATED THE AMOUNT OF PRIVATE PAYMENTS. BECAUSE UMC HAS NOT CALCULATED THE AMOUNT OF PRIVATE PAYMENTS, SOLELY FOR SCHEDULE K REPORTING PURPOSES, WE HAVE ASSUMED THAT THE PRIVATE PAYMENT TEST HAS NOT BEEN MET. Jim Taylor FORMER CEO LIFE INSURANCE X 1333000 1333000 false true true 1333000 Form 990, Part VI, Line 15a Process to determine top management official compensation The organization's top management official's compensation is paid by Catholic Health Initiatives (CHI), a related organization. CHI has a defined compensation philosophy. Both the executive and non-executive compensation structures and ranges are reviewed annually in comparison to market data. CHI uses The Hay Group as the independent third party to assess executive compensation programs and to ensure the reasonableness of actual salaries and total compensation packages. Compensation of the senior most executives is reviewed annually. The Hay Group reviews both cash and total compensation for overall reasonableness, for adherence to CHI's compensation philosophy, and for comparability to the not-for-profit healthcare market. This independent review is delivered by Hay Group to the HR committee of the CHI Board of Stewardship Trustees annually at their September meeting and minutes are shared with the full board at the December meeting. The last review was September 14, 2015. In addition, Hay Group completed a comprehensive review of all positions at the level of vice president and above in the fall of 2014 to determine and validate appropriate compensation levels. These levels have been reviewed annually since and revised based on market data, where applicable. Form 990, Part VI, Line 11b Review of form 990 by governing body No review was or will be conducted. Form 990, Part VI, Line 12c Conflict of interest policy IT IS THE POLICY OF THE HOSPITAL THAT AN INTERESTED PERSON WHO KNOWS THAT HE OR SHE HAS AN ACTUAL OR APPARENT CONFLICT OF INTEREST SHALL DISCLOSE IT PROMPTLY AND FULLY TO ALL NECESSARY PARTIES WHENEVER IT OCCURS. INTERESTED PERSONS ARE: A. VOTING MEMBERS OF THE HOSPITAL'S BOARD OF DIRECTORS AND VOTING MEMBERS OF COMMITTEES THAT EXERCISE BOARD-DELEGATED AUTHORITY. B. OFFICERS OF THE HOSPITAL ELECTED OR APPROVED BY THE BOARD OF DIRECTORS. C. A "CONTROLLED ENTITY" IN WHICH AT LEAST 35% OF THE CONTROL OR BENEFICIAL INTEREST IS HELD BY ANY ONE OR COMBINATION OF INDIVIDUALS DESCRIBED IN A AND B. AN INTERESTED PERSON MUST DISCLOSE THE EXISTENCE AND NATURE OF HIS OR HER KNOWN INTEREST IN A PROPOSED TRANSACTION TO THE DIRECTORS AND MEMBERS OF COMMITTEES WITH BOARD DELEGATED POWERS CONSIDERING THE TRANSACTION OR ARRANGEMENT. WHEN A CONFLICT OF INTEREST IS DECLARED, THE CHAIRPERSON OF THE BOARD OR COMMITTEE SHALL APPOINT A DISINTERESTED PERSON OR COMMITTEE TO INVESTIGATE THE PROPOSED TRANSACTION. THE INTERESTED PERSON SHALL LEAVE THE MEETING AND THE VOTE ON ANY TRANSACTIONS INVOLVING THE CONFLICT OF INTEREST. THE MINUTES OF THE BOARD WILL CONTAIN THE NAMES OF THE PERSONS WHO DISCLOSE OR OTHERWISE WERE FOUND TO HAVE INTEREST IN CONNECTION WITH A CONFLICT OF INTEREST, THE NATURE OF THE INTEREST AND ANY ACTION TAKEN TO DETERMINE THE CONFLICT. Form 990, Part VI, Line 15b Process to establish compensation of other employees For all Executive Directors, Top Management Officials, Officers and Key Employees, the following process is used: 1) HUMAN RESOURCES (HR) HAS AN INDEPENDENT COMPANY DO A COMPARISON OF LIKE POSITIONS WITHIN THE COMMUNITY AND COME UP WITH A RANGE. THEY PREPARE A PROPOSAL THAT IS SUBMITTED TO HR FOR REVIEW. 2) A SALARY IS DETERMINED WITHIN THAT RANGE BASED ON YEARS OF SERVICE, EDUCATION AND OTHER FACTORS, SUCH AS ADDITIONAL RESPONSIBILITIES. HR PREPARES A PROPOSAL TO SUBMIT TO THE CEO. 3) THE PROPOSAL, CONTAINING THE POSITION, RANGE AND FINAL COMPENSATION IS TURNED OVER TO THE CEO FOR REVIEW. 4) AFTER REVIEW, THE CEO TAKES THE PROPOSAL INFORMATION AND PRESENTS IT TO THE FINANCE COMMITTEE. 5) THE FINANCE COMMITTEE DECIDES AND VOTES ON THE COMPENSATION. Form 990, Part VI, Line 19 Required documents available to the public The governing documents, conflict of interest policy and financial statements are available upon request. Form 990, Part VIII, Line 11d Other Miscellaneous Revenue Other Miscellaneous Revenue - Total Revenue: 3215615, Related or Exempt Function Revenue: , Unrelated Business Revenue: , Revenue Excluded from Tax Under Sections 512, 513, or 514: 3215615; Form 990, Part IX, Line 11g Other Fees Other Fees for Services - Total Expense: XXX-XX-XXXX, Program Service Expense: 56784029, Management and General Expenses: 54701974, Fundraising Expenses: ;