2016-05-15T00:02:01-05:00 2015-06-30 861065772 DELOITTE TAX LLP 250 EAST FIFTH STREET SUITE 1900 CINCINNATI OH 45202 990 2014-07-01 731440267 Jane Phillips Nowata Hospital Inc JANE 9182733102 237 South Locust Nowata OK 74048 Lex Anderson SVP/CFO SJHS 2016-05-14 true MEGHANN ACKLEY P01399136 5137847100 2014 2016-08-17 19:52:53Z Jane Phillips Nowata Health Center Mike Moore 237 South Locust Nowata OK 74048 4149454 false X HTTP://WWW.STJOHNHEALTHSYSTEM.COM X 1946 OK Providing medical excellence and compassionate care to all who need it. 13 11 47 13 0 0 27216 9756 3959370 4136501 586 -5594 10261 3124 3997433 4143787 0 1070 0 0 2552555 2539777 0 0 0 1247280 1492371 3799835 4033218 197598 110569 3926794 4972895 138749 1092281 3788045 3880614 Continue the healing ministry of Jesus Christ by providing medical excellence and compassionate care to all who need it with a special emphasis for the poor and powerless. false false 3157463 1070 4137626 JANE PHILLIPS NOWATA HOSPITAL, INC. ("THE HOSPITAL") IS A MEDICARE DESIGNATED CRITICAL ACCESS HOSPITAL THAT PROVIDES MEDICAL SERVICES TO THE RESIDENTS OF NOWATA AND NORTHEASTERN OKLAHOMA. THE HOSPITAL OPERATES A 24-HOUR EMERGENCY DEPARTMENT AND A VARIETY OF OTHER HEALTH CARE SERVICES AND IS AN AFFILIATE OF JANE PHILLIPS. AS SUCH, IT IS PART OF ST. JOHN HEALTH SYSTEM, INC. ("ST. JOHN"). ST. JOHN, IS A WHOLLY OWNED SUBSIDIARY OF NON-PROFIT ASCENSION HEALTH. ST. JOHN AND AFFILIATES OWN AND OPERATE A COMPREHENSIVE TERTIARY HEALTH CARE DELIVERY SYSTEM WHICH PROVIDES A FULL SPECTRUM OF HEALTH-RELATED SERVICES THROUGHOUT NORTHEASTERN OKLAHOMA. ST. JOHN, HEADQUARTERED IN TULSA, OKLAHOMA, CONDUCTS ITS OPERATIONS THROUGH SEVERAL WHOLLY-OWNED OR WHOLLY-CONTROLLED SUBSIDIARIES, INCLUDING: ST. JOHN MEDICAL CENTER, INC. (THE "MEDICAL CENTER"), ST. JOHN SAPULPA, INC. ("ST. JOHN SAPULPA"), JANE PHILLIPS MEMORIAL MEDICAL CENTER ("JANE PHILLIPS"), UTICA SERVICES, INC. ("UTICA"), (CONTINUED ON SCHEDULE O) 3157463 true false false true false false false false false false true false false true true true false true false false false false false false false false true true false false true false false false false false false false false false false false false false true true true false false true 0 0 47 true false false false false false false false false false false X 13 11 true false false false true true true true true false false true true true true true true false false false OK X Lex Anderson 9187442740 1923 South Utica Avenue Tulsa OK 741046502 MIKE MOORE PRESIDENT AND CEO 0.40 40.00 X X 0 267400 19750 DAVID J PYNN PRESIDENT & CEO SJHS 0.40 42.20 X X 0 1572179 37529 JOHN B KANE CHAIRPERSON 0.20 0.20 X 0 0 0 CHARLES BOWERMAN VICE CHAIRPERSON 1.40 1.40 X 0 0 0 JEAN BLOOMFIELD DIRECTOR 0.20 0.20 X 0 0 0 GLENN BONNER DIRECTOR 0.70 0.70 X 0 0 0 STAN DEFEHR MD DIRECTOR 0.50 0.50 X 0 0 0 MARK HEADLEY DIRECTOR 1.20 1.20 X 0 0 0 ROBERT KANE DIRECTOR 0.70 0.70 X 0 0 0 DAVID KING DIRECTOR 1.40 1.40 X 0 0 0 MERL LINDSTROM DIRECTOR 1.40 1.40 X 0 0 0 H MICHAEL MAY DIRECTOR 0.50 0.50 X 0 0 0 DAVID SIGMON DIRECTOR 0.70 1.40 X 0 0 0 DAVID STIRE PRESIDENT & COO (END 12/14) 0.10 40.00 X 0 464490 20965 LEX ANDERSON TREASURER/SENIOR VP & SJHS CFO 0.40 52.00 X 0 776293 14350 KEVIN STECK SECRETARY/CORPORATE RESPONSIBILITY OFFICER 0.40 45.80 X 0 347139 1358 JAMES BRASEL VP/CFO (START 11/14) 0.40 40.60 X 0 135674 76621 DEBRA ROBNETT-BELL PHYSICIAN'S ASSISTANT 40.00 0 X 137411 0 7658 VICKY USHER RN 40.00 0 X 102197 0 5956 JEFFREY L GIBSON MD ER PHYSICIAN 40.00 0 X 100990 0 35669 CHARLES ANDERSON FORMER OFFICER (END 6/14) 0.00 0.00 X 0 616798 20914 340598 4179973 240770 3 true true false 0 X 0 0 0 0 9756 0 0 9756 Net Patient Revenue 621990 4136501 4136501 0 0 0 0 0 0 4136501 73 0 0 73 0 0 0 0 0 5667 0 -5667 -5667 0 0 -5667 NON-PRESCRIPTION SALES 900099 1125 1125 0 0 1999 0 0 1999 3124 4143787 4137626 0 -3595 X 1070 1070 2092207 1832357 259850 0 74556 36036 38520 0 222789 191144 31645 0 150225 132193 18032 0 7160 0 7160 0 570 0 570 0 439683 402540 37143 0 11601 0 11601 0 21620 210 21410 0 69252 65659 3593 0 14997 12854 2143 0 437533 58119 379414 0 12277 0 12277 0 Supplies 314516 314516 0 0 Equipment Rental 71928 37377 34551 0 Repairs & Maintenance 34581 34581 0 0 Food 31637 29469 2168 0 25016 9338 15678 0 4033218 3157463 875755 0 250394 214946 0 0 0 0 558228 898743 0 0 0 0 0 69201 65755 10920 0 2283713 560220 1817221 1723493 0 0 0 0 929124 760322 291706 1309636 3926794 4972895 138749 108397 0 0 0 0 0 0 0 0 0 0 0 0 0 0 983884 138749 1092281 X 3788045 3880614 0 0 0 0 0 0 0 0 0 0 3788045 3880614 3926794 4972895 110569 0 0 0 -18000 0 X false true X true false X false false false false false false false false true 570 570 false Schedule C, Part II-B, Line 1 DETAILED DESCRIPTION OF THE LOBBYING ACTIVITY LOBBYING EXPENSES REPRESENT THE PORTION OF DUES PAID TO NATIONAL AND STATE HOSPITAL ASSOCIATIONS THAT IS SPECIFICALLY ALLOCABLE TO LOBBYING. JANE PHILLIPS NOWATA HOSPITAL, INC. DOES NOT PARTICIPATE IN OR INTERVENE IN (INCLUDING THE PUBLISHING OR DISTRIBUTING OF STATEMENTS) ANY POLITICAL CAMPAIGN ON BEHALF OF (OR IN OPPOSITION TO) ANY CANDIDATE FOR PUBLIC OFFICE. 170000 170000 1868427 428589 1439838 205286 121631 83655 40000 10000 30000 1723493 CIP Other Assets Due From Network 420456 Other receivables 882315 Other miscellaneous assets 6865 1309636 Estimated settlements - Third party payor 983884 983884 X 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 Jane Phillips Nowata Hospital, Inc.: The System accounts for uncertainty in income tax positions by applying a recognition threshold and measurement attribute for financial statement recognition and measurement of a tax position taken or expected to be taken in a tax return. The System has determined that no material unrecognized tax benefits or liabilities exist as of June 30, 2015. true true X true X 0 true X true true true false true true 72906 0 72906 0.0181 395965 153239 242726 0.0602 0 0.0 0 0 468871 153239 315632 0.0783 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0 0 0 0 0.0 0 0 468871 153239 315632 0.0783 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0 0 0 0 0.0 false 554734 0 2573099 2414776 158323 X true true 1 1 Jane Phillips Nowata Health Center 237 South Locust Nowata OK 74084 http://www.stjohnhealthsystem.com/ 2187 X X X Jane Phillips Nowata Health Center 1 false false true X X X X X X X X X 12 true true true true X http://www.stjohnhealthsystem.com/about/community-health-needs-assessment X true 12 true http://www.stjohnhealthsystem.com/about/community-health-needs-assessment false false true X 3.0 3.0 X X X X true true X X X true X http://www.stjohnhealthsystem.com/media/file/1826/Financial_Assistance_Form.pdf X X X X X true X false X X X X true X false false Schedule H, Part V, Section B, Line 5 Facility , 1 Facility , 1 - Jane Phillips Nowata Health Center. The Tulsa County Health Department led the completion of the Community Health Needs Assessment. The determination of priority needs was based on research findings, and priorities were developed in collaboration with many other stakeholders, including other hospitals, community service agencies, state and local leaders, interested philanthropists, universities and associated medical schools, and other parties, including public health experts and representatives of the communities served. In addition, the Tulsa County Health Department's research included randomly selected households for one on one interviews and some "county resident" focus groups. St. John sits on a Pathways to Health Steering Committee and Working Group to coordinate and direct community health activities in the service area. Schedule H, Part V, Section B, Line 6a Facility , 1 Facility , 1 - Jane Phillips Nowata Health Center. The other hospital facilities with which the reporting Hospital facility conducted its CHNA, include: - St. John Medical Center, Inc. (Tulsa) - St. John Broken Arrow, Inc. - St. John Sapulpa, Inc. - Jane Phillips Memorial Medical Center (Bartlesville) - Owasso Medical Facility, Inc. Schedule H, Part V, Section B, Line 6b Facility , 1 Facility , 1 - JANE PHILLIPS NOWATA HEALTH CENTER. The other organizations other than hospital facilities with which the reporting hospital facility conducted its CHNA, include: - Tulsa County Health Department - The Chapman Trusts - George Kaiser Family Foundation Schedule H, Part V, Section B, Line 11 Facility , 1 Facility , 1 - JANE PHILLIPS NOWATA HEALTH CENTER. USING THE CHNA COMPLETED IN 2013, the St. John System DEVELOPED, ADOPTED, AND WORKED ON EXECUTING A 2014-2016 IMPLEMENTATION STRATEGY TO ADDRESS THE COMMUNITY HEALTH NEEDS IDENTIFIED IN THE COMMUNITY-WIDE COMMUNITY HEALTH NEEDS ASSESSMENT. MANY OF THESE ARE DONE IN COLLABORATION WITH INDIVIDUALS REPRESENTING INTERESTS OF THE COMMUNITY AND/OR IN SUPPORT OF COMMUNITY BASED PROGRAMS. IN TOTAL FOR THIS FISCAL YEAR ENDING JUNE 2015, THE ST. JOHN SYSTEM PARTICIPATED IN OVER 100 COMMUNITY EVENTS. EACH YEAR A BUDGET IS ESTABLISHED FOR THIS PURPOSE AND IS EXCEEDED THROUGH IDENTIFICATION OF ADDITIONAL COMMUNITY REQUESTS. UPON COMPLETION OF THE ASSESSMENT WITH INPUT FROM LOCAL PUBLIC HEALTH OFFICIALS AND OTHER LEADERS, JANE PHILLIPS NOWATA HOSPITAL, INC. has IDENTIFIED AND HAS CONTINUED TO COLLABORATIVELY WORK TOWARD ADDRESSING THE FOLLOWING PRIORITY NEEDS AS A HOSPITAL WITHIN A LARGER HEALTH SYSTEM AND THROUGH SUPPORTING THE NEEDS IDENTIFIED FOR A COMMUNITY-WIDE PLAN: 1. DIET, INACTIVITY, AND OBESITY - ACTIVE PARTICIPATON BY SEVERAL ASSOCIATES IN THE COMMUNITY WIDE COALITION, "PATHWAYS TO HEALTH," WHICH SUPPORTS THE TULSA HEALTH DEPARTMENT (THD) AND COMMUNITY PARTNERS OF THD; DURING 2015, PATHWAYS TO HEALTH COMMUNITY FOUNDATION SET OBESITY PREVENTION AS ITS PRIMARY FOCUS. - The St. John System Supports HEALTH PROMOTION WALKS INCLUDING: AMERICAN CANCER SOCIETY'S RELAY FOR LIFE, AMERICAN HEART AND AMERICAN STROKE ASSOCIATIONS' HEART WALK, SUSAN G. KOMEN - RACE FOR A CURE, AND MARCH OF DIMES WALK. - ST. JOHN FOOD AND NUTRITION SERVICES COLOR CODE HEALTHY MENU ITEMS. - The St. John System BEGAN PARTICIPATION IN ASCENSION HEALTH'S "SMART HEALTH" WELLNESS PROGRAM INITIATIVES - FIRST FOCUSING ON OUR OWN ASSOCIATES AND SUBSEQUENTLY TAKING LESSONS LEARNED TO THE BROADER COMMUNITY. THIS WAS A Multi-year INITIATIVE THAT BEGAN IN FY 2014. - THE COMMUNITY IS CURRENTLY UNDERGOING AN UPDATED COMMUNITY HEALTH NEEDS ASSESSMENT WITH SUPPORT FROM THE COUNTY HEALTH DEPARTMENT TO DETERMINE IF POSITIVE CHANGES HAVE BEEN REALIZED. 2. MENTAL HEALTH, SUBSTANCE ABUSE, TOBACCO USE - AS A HEALTHCARE PROVIDER OF EMERGENCY AND ACUTE HOSPITAL AND RELATED SERVICES, THE HOSPITAL SEES THE DIRECT AND OFTEN DEVASTATING EFFECTS OF ALCOHOL AND DRUG ABUSE, AS WELL AS TOBACCO USE, ON A DAILY BASIS. MANY, IF NOT MOST, OF THE PATIENTS WHO PRESENT TO THE SYSTEM IN ACUTE CRISIS FROM ALCOHOL AND ABUSE - WHETHER FROM INJURY OR OVERDOSE (OR BOTH) - ALSO HAVE UNDERLYING ACUTE OR CHRONIC MENTAL HEALTH CONDITIONS AND NEEDS. THE HEALTH SYSTEM IS EXPLORING HOW VIRTUAL TECHNOLOGY MIGHT BE USED TO SUPPORT HOSPITALS IN PROVIDING BETTER ACCESS TO PATIENTS FOR MENTAL HEALTH SERVICES. - PROCESS OUTCOMES ARE MEASURED FOR MENTAL HEALTH AND TOBACCO USE SCREENING THROUGH BOTH THE COMPREHENSIVE PRIMARY CARE PROGRAM AND THE MEDICARE SHARED SAVINGS PROGRAM IN WHICH ST. JOHN HOSPITALS AND EMPLOYED ST. JOHN PHYSICIANS PARTICIPATE. SINCE THESE PROGRAMS WERE IN THEIR EARLY STAGES, WE DID NOT HAVE OUTCOMES REPORTED BY THE END OF THE FISCAL YEAR. THROUGH THESE PROGRAMS, WE ARE NOW ABLE TO TRACK THE VOLUME OF PATIENTS WHO RECEIVE COUNSELING AND REFERRALS. - EACH HOSPITAL MAINTAINS ONGOING PATIENT EDUCATION RELATED TO SMOKING; MATERIALS ARE PROVIDED TO PATIENTS AND REFERRALS ARE MADE TO THE STATE OF OKLAHOMA TOBACCO HELP LINE. - PATIENTS IDENTIFIED AT JANE PHILLIPS NOWATA HOSPITAL, INC. ARE REFERRED TO A HOSPITAL OUTPATIENT DEPARTMENT AT JANE PHILLIPS MEMORIAL MEDICAL CENTER, WHERE DRUG AND ALCOHOL COUNSELING IS PROVIDED. PATIENTS FROM ANY OF OUR HOSPITALS AND CLINICS MAY BE REFERRED TO THIS SERVICE WHICH HAS A CONVENIENT, ACCESSIBLE LOCATION. REFERRALS ARE ALSO MADE TO AREA AGENCIES. - THE COMMUNITY IS CURRENTLY UNDERGOING AN UPDATED COMMUNITY HEALTH NEEDS ASSESSMENT WITH SUPPORT FROM THE COUNTY HEALTH DEPARTMENT TO DETERMINE IF POSITIVE CHANGES HAVE BEEN REALIZED. 3. CHRONIC DISEASE MANAGEMENT - EMPLOYED PHYSICIANS OF THE HEALTH SYSTEM ALSO PARTICIPATE IN COMPREHENSIVE PRIMARY CARE WHICH FOCUSES ON A MEDICAL HOME MODEL IN CARE FOR HIGH RISK PATIENTS WITH CHRONIC CONDITIONS. - THE COMMUNITY IS CURRENTLY UNDERGOING AN UPDATED COMMUNITY HEALTH NEEDS ASSESSMENT WITH SUPPORT FROM THE COUNTY HEALTH DEPARTMENT TO DETERMINE IF POSITIVE CHANGES HAVE BEEN REALIZED. 4. ACCESS TO SERVICES - ACCESS TO SERVICES IN OKLAHOMA IS A SIGNIFICANT CHALLENGE DUE TO THE LIMITED AVAILABILITY OF PRIMARY CARE PHYSICIANS. THE COMMUNITY IS CURRENTLY UNDERGOING AN UPDATED COMMUNITY HEALTH NEEDS ASSESSMENT WITH SUPPORT FROM THE COUNTY HEALTH DEPARTMENT AND THE ST. JOHN SYSTEM TO DETERMINE IF POSITIVE CHANGES HAVE BEEN REALIZED RELATED TO THE FOLLOWING IMPLEMENTATION INITIATIVES AND TO REFINE PRIORITY NEEDS IDENTIFIED IN THE 2013 ASSESSMENTS: - SAFETY NET AND EMERGENCY SERVICES - DIRECT CARE FOR THE POOR AND VULNERABLE - MEDICAL ACCESS PROGRAM - MEDICAL EDUCATION NEEDS NOT BEING ADDRESSED JANE PHILLIPS NOWATA HOSPITAL, INC. AND The ST. JOHN SYSTEM ADDRESSED ALL OF THE PRIORITY NEEDS RECOMMENDED BY THE COMMUNITY-WIDE COMMUNITY HEALTH NEEDS ASSESSMENT. HOWEVER, "OBESITY" WAS GROUPED WITH "POOR DIET AND INACTIVITY," AND "TOBACCO USE" WAS GROUPED WITH "ALCOHOL/DRUG USE" AND RENAMED "MENTAL HEALTH, SUBSTANCE ABUSE, TOBACCO USE." Schedule H, Part V, Section B, Line 16 Facility , 1 Facility , 1 - JANE PHILLIPS NOWATA HEALTH CENTER. Signs are posted in waiting rooms and at the admissions offices to notify patients that the Hospital has a financial assistance policy. In addition, every billing statement, the Hospital's website, and admission packets include information regarding the financial assistance policy. The policy is provided at the request of the patient. Schedule H, Part V, Section B, Line 22 Facility , 1 Facility , 1 - Jane Phillips Nowata Health Center. Jane Phillips Nowata Hospital, Inc. provides a 30% discount on gross charges and a 15% prompt pay discount to all uninsured patients. Patients who are determined to be eligible for financial assistance receive an additional charity care discount equal to 100% of the remaining amount due. 0 Schedule H, Part I, Line 6a NAME OF THE RELATED ORG THAT PREPARED COMMUNITY BENEFIT REPORT THE HOSPITAL IS A WHOLLY-OWNED (WHOLLY-SPONSORED) SUBSIDIARY OF ST. JOHN HEALTH SYSTEM, INC. - EIN 73-1215174 ("SJHS"). SJHS PREPARED A CONSOLIDATED COMMUNITY BENEFIT REPORT FOR THE CONSOLIDATED ORGANIZATION FOR THIS TAX YEAR. THE REPORT IS MADE AVAILABLE ON DEMAND AND IS REFERENCED BY THE ORGANIZATION IN A NUMBER OF PUBLIC MEETINGS AND COMMUNITY OUTREACH ACTIVITIES. Schedule H, Part II DESCRIBE HOW BUILDING ACTIVITIES PROMOTE THE HEALTH OF THE COMMUNITY - PART 2 Health Care that is Safe: St. John is striving to become a "high reliability" organization. High reliability means that we will be exceptionally consistent in accomplishing goals and avoiding catastrophic errors in everything we do in providing health care services. This means reducing medical errors by providing our clinicians and our patients with decision support tools to ensure the care provided is consistently based on sound scientific evidence of effectiveness. Physicians and nurses are leading our quality efforts. Among our clinical areas of focus for improvement are goals to reduce hospital acquired conditions and hospital readmissions. Some specific areas of clinical focus include reducing: - Adverse Drug Events (ADE), - Catheter Urinary Tract Infections (CAUTI), - Central Line Blood Stream Infections (CLABSI), - Surgical Site Infections (SSI), - Ventilator Associated Pneumonia (VAP), - Injuries from Falls and Immobility, - Obstetrical Adverse Events, - Pressure Ulcers, and - Venous Thromboembolism (VTE). Healthcare that Leaves No One Behind: We will continue to advocate for state and federal public policy that recognizes the inherent value of all members of society and provides support systems and adequate funding sources to ensure all of those among us have access to the health care they need. This includes providing affordable access to health care for everyone in the United States in a financially sustainable way. Our Enabling Strengths: We will use our enabling strengths to achieve our mission and vision. Those strengths include: a model community of inspired people working to provide our services and achieve our mission; empowering knowledge - clinical and business information systems that provide our associates actionable, timely data and information upon which they can make informed decisions; the creation of trusted partnerships with external partners to expand our capabilities, complement our service offerings and fulfill our mission; and achieve vital presence in the communities we serve. This vital presence contemplates creation and continuation of important safety net services, world-class centers of clinical excellence and creation of medical homes that promote each individual's participation in their own health and well-being and which create and sustain the infrastructure for promoting healthy communities. Schedule H, Part II DESCRIBE HOW BUILDING ACTIVITIES PROMOTE THE HEALTH OF THE COMMUNITY - PART 3 Our Point of View: Health care delivery and financing in the United States must change. The cost of the current system relative to the value that communities and individuals are receiving is not sustainable. In order to meet the health care needs and contribute to economic vitality of communities, with special attention to the poor and vulnerable, health care providers must fundamentally reconfigure delivery systems, care processes and cost structures. Delivering safe, high-quality care that is low cost with an exceptional patient experience will increasingly require providers to have a strong regional presence, integrated physician relationships and capabilities across the care continuum. Sustaining the St. John mission into the future will require a more continuous, dynamic relationship with those we serve and the ability to share risk with healthcare purchasers, as opportunities for inpatient growth or commercial rate increases will be limited. The movement to manage health of defined populations demands massive transformational change. This requires rapid assessment, assembly and deployment of the necessary capabilities. We believe the St. John System is well positioned to lead this transformation. Community Needs Assessment: The St. John System and each St. John Hospital have completed a Community Health Needs Assessment to help us identify the priorities for the limited resources we have to address community need. We partnered with the Tulsa County Health Department, other public and private health care, AND educational and community service organizations throughout the service area to complete the assessments and we are now working to enhance our response to the identified needs. Additional information will be forthcoming about our specific future responses to our assessment of community need. Community Benefit: The community benefit provided by the St. John System includes: uncompensated care for the poor, support for the education of medical professionals, provision of subsidized health services, support for other community organizations, initiatives to improve community health, and medical research to be some of the key areas of focus for providing community benefit. The St. John System does not include amounts recorded as bad debt; shortfalls in the difference between payment for and cost of service to Medicare beneficiaries; payment of property, sales, use, income, payroll, and other taxes OR; considerable economic value provided to the local communities in which we operate as components of community benefit. Schedule H, Part II DESCRIBE HOW BUILDING ACTIVITIES PROMOTE THE HEALTH OF THE COMMUNITY - PART 4 Care for the Poor: "Care for the Poor" (which includes the estimated cost of services provided to patients who qualify for financial assistance (charity) and the uncompensated cost of care provided to Medicaid beneficiaries) is the largest financial category of community benefit. Support for graduate and allied health medical education is the second largest. St. John provides discounts of at least 30% to all uninsured patients and additional discounts of at least 15% to uninsured patients who make the agreed upon timely payments for services they receive. All uninsured individuals living in households with incomes at or below 300% of the federal poverty limit qualify for free care for medically necessary services. Insured patients and others who are faced with financially catastrophic medical bills are also eligible for and encouraged to seek financial assistance. Consistent with our mission and values, St. John has created programs to seek out better ways to serve the uninsured and the vulnerable members of our society. With generous financial support from donors, including the Chapman trusts and with guidance and counsel from many partners in our community, St. John has created the Medical Access Program ("MAP") to try to increase and improve access to medical care for segments of the uninsured population. Beginning more than five years ago, MAP continues to grow and expand each year. MAP has brought together a network of primary care providers that provides free clinics and other services to uninsured and low income individuals throughout Tulsa. Key elements of MAP include: - Expansion of free primary care by providing direct financial support to other organizations in the community providing access to free primary care, - Operation of Rockford Medical Clinic. The Rockford Clinic is a free primary care medical home for a segment of the uninsured population that meet certain criteria for participation, - Provision of free diagnostic imaging, including CT, MRI, ultrasound, mammography and basic x-ray for patients who meet criteria, - Access to free specialty services through a network of participating clinics and physician partners and through the facilities and physicians of the St. John System, and - Access to free or reduced cost prescription medications. MAP has limited resources but continues to expand the scope of its services each year, routinely spending at least $5 million per year in donated and St. John funds. Schedule H, Part II DESCRIBE HOW BUILDING ACTIVITIES PROMOTE THE HEALTH OF THE COMMUNITY - PART 5 Support for Medical Education: St. John Medical Center, Inc. is a primary teaching hospital for The University of Oklahoma's Tulsa College of Community Medicine residency programs for internal medicine and general surgery and is the primary teaching hospital for the "In His Image" ("IHI") family medicine residency program. St. John works as a founding member of the Tulsa Medical Education Foundation providing financial support for The University of Oklahoma ("OU") residency programs. St. John also provides additional direct support to both OU and IHI residency programs and also provides direct support for a number of nursing education and allied health professional education programs. Other Community Benefit: St. John provides subsidized health services focused on certain emergency services and on post-acute senior services. Each St. John Hospital provides vital emergency medical services in its community. St. John Medical Center, Inc. services as one of only three trauma centers in Oklahoma, Oklahoma's first and only certified comprehensive stroke center, and a tertiary referral center for the entire state of Oklahoma and portions of Missouri, Arkansas, Kansas and Texas. The associates, physicians and facilities of the St. John System provide services to thousands of patients every day. Among the services provided annually are: - More than 54,000 annual inpatient and observation admissions, - More than 166,000 emergency department patient visits, - More than 3,000 births, - More than 28,000 inpatient and outpatient surgeries, - Thousands of other outpatient visits, - More than 510,000 physician office and urgent care clinic visits, - More than 8.1 million laboratory tests. Summary: The thousands of associates, physicians and volunteers that make up St. John Health System, Inc. touch the lives of thousands of patients every day and millions of patients every year. As we seek to transform health care in Oklahoma and the UNITED STATES, St. John is challenged by many factors including: lack of public resources in Oklahoma that are devoted to both care for the poor, health care infrastructure and medical education; competition from investor-owned health care facilities that do not share St. John's mission of service and emphasis on service to the poor and powerless but which seek to gain market share in commercially insured patients; poor economic and health care demographic factors contributing to generally poor health status and high rates of poverty and uninsurance in Oklahoma; and payment for values. Schedule H, Part I, Line 7 Costing Methodology used to calculate financial assistance Costs were determined using a cost to charge ratio derived from Worksheet 2, Patient Care Cost to Charges. Schedule H, Part II Community Building Activities Community Benefit Report: St. John Health System, Inc.'s (the "St. John System" or "St. John") mission is to improve the health status of the individuals who live in the communities we serve with a special emphasis on the poor and vulnerable among us; faithful to the teaching of Jesus Christ and the values of our Sponsors and the Catholic Church. Our promise to our patients and to our communities is to provide medical excellence and compassionate care. We strive to provide healthcare that works, healthcare that is safe and healthcare that leaves no one behind. To meet this mission, the St. John System has operated since the 1920's; growing from a fledgling community hospital, in what was then the southern edge of Tulsa, Oklahoma, to an integrated health care delivery system serving Northeastern Oklahoma and surrounding states. The St. John System includes: thousands of associates, employed physicians and advanced practice providers, hundreds more independent physicians and dozens of volunteers. They serve patients in six owned hospitals operating nearly 800 beds; several senior nursing and housing facilities; dozens of physician offices, clinics and urgent care centers; a reference laboratory; and partnerships and ventures that include a health insurance company, several ambulatory surgery centers and other health care activities. Together, our associates, physicians and volunteers touch the lives of thousands of patients every day, including the poor and the vulnerable. The St. John System is committed to continue the legacy of health care excellence and service started by our original founders and sponsors, the Sisters of the Sorrowful Mother, by continuing to provide vital services to the communities with continued emphasis on service to the poor and powerless. Our Mission and Values: Our mission of service and our Catholic values compel us to fulfill our promise of medical excellence and compassionate care to all who need our services, with a special emphasis on service to the poor and the powerless. We will do this by providing: health care that works; health care that is safe; and health care that leaves no one behind. We will endeavor to establish trusted relationships with our patients over their entire lives; seeking to improve their health and working to heal their minds and bodies when afflicted by injury or illness. Health Care that Works: Our vision calls us to ensure that service is committed to the health and well-being of our communities and that it responds to the needs of individuals throughout their lives. Healthcare that Works includes establishing a trusted relationship between each patient and their health care professionals so that they receive the care they need, including preventative care, when they need it and in a manner that meets their service expectations. We expect our patients to be actively involved in their own health care - participating in informed decisions that will strive to make them healthier. Health care that works assumes that the care provided is person-centered and based on the best available medical evidence, reliably delivered. Becoming truly person-centered requires shifts in focus from traditional models of health care to build an effective and trusted relationship with each patient over their lifetime across the continuum of care - emphasizing prevention and wellness, disease management, and a medical home that promotes a spiritually-centered, holistic approach to supporting a person's health and well-being. Health care that works strives to make sure the value of the care received is exceptional but at an acceptable economic cost - both to the individual and to society. Schedule H, Part III, Line 2 Bad debt expense - methodology used to estimate amount Accounts are written off to bad debt after all internal collection efforts have been exhausted. Attempts to resolve these outstanding balances can include, but are not limited to, statements being sent, phone calls, and letters being sent. Account follow up protocol is based on personal pay balance size owed. Schedule H, Part III, Line 3 Bad Debt Expense Methodology Jane Phillips Nowata Hospital, Inc. has a very robust financial assistance program; therefore, no estimate is made for bad debt attributed to financial assistance eligible patients. Schedule H, Part III, Line 4 Bad debt expense - financial statement footnote From the consolidated audited financial statements of ASCENSION HEALTH ALLIANCE, which include the activity of Jane Phillips Nowata Hospital, Inc.: The provision for doubtful accounts is based upon management's assessment of expected net collections considering historical experience, economic conditions, trends in healthcare coverage, and other collection indicators. Periodically throughout the year, management assesses the adequacy of the allowance for doubtful accounts based upon historical write-off experience by payor category, including those amounts not covered by insurance. The results of this review are then used to make any modifications to the provision for doubtful accounts to establish an appropriate allowance for doubtful accounts. 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. The methodology for determining the allowance for doubtful accounts and related write-offs on uninsured patient accounts has remained consistent with the prior year. Schedule H, Part III, Line 8 Community benefit & methodology for determining medicare costs Jane Phillips Nowata Hospital, Inc. 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 CARE or financial assistance, certain collection practices do not apply. Schedule H, Part V, Section B, Line 16b FAP Application website - Jane Phillips Nowata Health Center: Line 16b URL: http://www.stjohnhealthsystem.com/media/file/1826/Financial_Assistance_Form.pdf; Schedule H, Part VI, Line 2 Needs assessment The Hospital conducted a Community Health Needs Assessment jointly with its parent entity - St. John Health System, Inc. ("SJHS"). SJHS participates in ongoing community-based needs assessments. Some of the most significant recent activity includes commissioning of a Community Health Needs Assessment and a plan for improving community health care conducted by the Tulsa County Health Department. It was released in 2013. The 2013 assessment has been posted to the Hospital and Health System websites: http://www.stjohnhealthsystem.com/jane-phillips/patients/payment-for-services. Many major community health care service organizations participated in these studies. In addition to the above, SJHS through its subsidiary, St. John Medical Center, Inc., has established a Medical Access Program ("MAP") that is attempting to improve and expand access to health care services to the most vulnerable members of the Tulsa community. All SJHS Tulsa Hospitals including St. John Medical Center, Inc. (Tulsa), Owasso Medical Facility, Inc., St. John Sapulpa, Inc., and St. John Broken Arrow, Inc. participate in this initiative. This program is overseen by representatives of St. John, the George Kaiser Family Foundation, trustees of the Chapman trusts and The University of Oklahoma Tulsa School of Community Medicine. The MAP program includes participation of other health care providers including Good Samaritan clinics, Day Center for the Homeless, Community Health Connections FQHC, Morton Health FQHC, and a network of volunteer physician providers and other organizations. The MAP program regularly receives input from all of these organizations on needed services in the community which helps to prioritize the limited resources available to address community needs. Schedule H, Part VI, Line 3 Patient education of eligibility for assistance The Hospital has a team of financial counselors who, prior to discharge, attempt to visit in person with all uninsured inpatients and all inpatients likely to qualify for medical indigency to explain our financial assistance policies and help guide them through the process of applying for financial assistance. We also attempt to meet with the families of all Medicaid beneficiaries or individuals who we believe could potentially qualify for Medicaid to help them apply for coverage. The Hospital mentions the existence of the Financial Assistance Policy and provides a phone number to call: on its website, in admitting materials, on all invoices for services sent to patients, and in other ways. Schedule H, Part VI, Line 4 Community information As described above the Hospital is part of St. John Health System, Inc. ("SJHS"). Although SJHS provides a full spectrum of health related services throughout Northeastern Oklahoma, its tertiary operations and a large part of its other services are concentrated in the Tulsa Metropolitan Statistical Area (the "Tulsa MSA"). According to the 2010 Census, the State of Oklahoma had a resident population of 3,751,351 persons compared to 3,450,654 persons in 2000. This is an 8.7% increase. The U.S. Census Bureau estimated that in 2009, 13.5% of the Oklahoma resident population was eligible for Medicare, compared to 14.7% in 2000. Tulsa County, Oklahoma and the counties that make up the Tulsa MSA, according to the 2010 Census, had populations of 603,403 and 1,006,460, respectively. This compares to populations of 563,299 and 803,235 persons, respectively in 2000, and represents population growth of 7.1% and 25.5%, respectively. The data shows that the counties in the Tulsa MSA that surround Tulsa County grew much faster from 2000 to 2010. At the same time, the population within Tulsa County shifted away from the city of Tulsa and to suburbs such as Owasso and Broken Arrow. The cities of Broken Arrow and Owasso were two of the fastest growing communities in Oklahoma between 2000 and 2010. The population of the city of Owasso grew 56% to 28,915 from 2000 to 2010 and the population of the city of Broken Arrow grew 32% to 98,850 from 2000 to 2010. Wagoner County (southeast of Tulsa) and Rogers County (northeast of Tulsa) showed the two highest population growth rates from 2000 to 2010. Every county in the 8 county Tulsa MSA except Pawnee County grew in population from 2000 to 2010. Washington County, directly north of Tulsa County, which includes the city of Bartlesville (and Jane Phillips Memorial Medical Center), also grew in population from 2000 to 2010. When the population of Washington County is added to the population of Tulsa County, the 2010 combined population was 1,059,436. There is significant disparity in the general health of populations within the service area depending upon where an individual lives and to what socioeconomic and ethnic group they belong. Citizens who reside in "North" Tulsa and in some areas of "East" and "West" Tulsa generally have poorer health and shorter life spans than individuals who live in "South" Tulsa. Members of minority groups (many of whom reside in the geographic areas described above) share these same health characteristics. It has been demonstrated that these individuals have less access to regular health care services, including specialty care, and many seek even their primary care in hospital emergency rooms, including all of the SJHS Hospitals. Some significant minority groups in the Hospital's and SJHS's principal service area include Native Americans, Hispanics and African Americans. Each of these groups share common socioeconomic challenges making them more likely to be poor and be uninsured for health care. Each of these groups has unique ethnic health risk factors that contribute to health status that is generally poorer than their White counterparts. However, even among the White population in the Hospital's service area, there is significant adverse health care status. In general, Oklahoma (including the Hospital's service area) ranks near the bottom in many if not most measures of health status in the UNITED STATES. There are high rates of smoking, diabetes, obesity, upper respiratory illness, chronic heart conditions and many other factors. There are high rates of uninsured and underinsured individuals and families in the communities and geographies served by the Hospital, which create many challenges in meeting the demand for basic services and in improving the health status of the population. Schedule H, Part VI, Line 5 Promotion of community health St. John is a growing integrated delivery system that serves Northeastern Oklahoma and the surrounding area. It has grown significantly in recent years, with increasing revenues from outpatient and physician professional services, as well as other post-acute services. Acute care services are provided on six hospital campuses that are owned by St. John. The owned hospitals are St. John Medical Center, Inc. (the tertiary center in Tulsa, Oklahoma), Jane Phillips Memorial Medical Center in Bartlesville, St. John Owasso in Owasso, Oklahoma, St. John Broken Arrow, Inc., this Hospital, and St. John Sapulpa, Inc., a critical access hospital in Sapulpa, Oklahoma. Acute care services are also provided at two additional rural critical access hospitals which are managed by Jane Phillips. Diagnostic services and certain acute care services are also provided in a variety of free standing (including hospital-based) settings. The St. John System now includes hundreds of employed physicians and "mid-level providers", and several urgent care clinics, as well as retirement and skilled nursing facilities, including some targeted specifically to serve low-income and physically disabled individuals and other health care providers. St. John is attempting to promote community health in several ways. Most of the affiliated primary care physicians have or are establishing "medical home" models of care that are attempting to improve health status of their patients by better emphasizing preventive care and health screening and by better management of chronic disease. This includes participation in the Medicare Comprehensive Primary Care Initiative. The affiliated primary care physicians utilize a sophisticated electronic medical record that helps provide real time information to make it easier to manage patients' care. The Hospital and the other hospitals in the System have invested heavily in clinical information systems and electronic medical records to better manage patient care during each episode of acute care. St. John is investing in new systems of care to provide better coordination of care between all the different providers responsible for portions of each patient's care, with an emphasis on prevention, screening and coordination of chronic care. The Hospital and SJHS have invested in tertiary services that are needed by the community. Examples of which include development of Oklahoma's only ACS Level II Trauma Center (the highest accredited center in Tulsa), Northeastern Oklahoma's only JCAHO-accredited stroke center, neonatal intensive care, sophisticated medical technology including all-digital diagnostic radiology, cyberknife and other forms of radiation therapy, DaVinci robotic surgery, an endovascular operating suite, orthopedic and neurosurgical centers of excellence, sophisticated cardiovascular care that emphasizes rapid and effective intervention for heart attack victims and preventive care for those with chronic heart conditions. The Hospital has an open medical staff and has community, religious and physician representatives serving on its board. SJHS has created and is continuing to create systems and policies to promote better coordination of care and allocation of resources throughout the System. The Hospital participates in many community-wide health screening and health education events, as well as hosting many such events that are open to the public. The Hospital and SJHS continue to invest in medical education to support the expansion of physicians, nurses and allied health professionals that will serve current and future generations of patients in the service area. The Hospital participates in SJHS's coordinated effort to assess community need collaboratively with other interested parties in the community and to allocate capital and human resources to address the needs of the entire service area. Finally as one of only two major tax-exempt health systems in our service area, St. John reinvests 100% of any profits generated into new or expanded services for the community. Schedule H, Part VI, Line 6 Affiliated health care system ST. JOHN Health System, Inc., HEADQUARTERED IN TULSA, OKLAHOMA, AND WITH FACILITIES LOCATED THROUGHOUT NORTHEASTERN OKLAHOMA, IS AN OKLAHOMA NONPROFIT HEALTH SYSTEM. IT OWNS AND OPERATES AN INTEGRATED TERTIARY HEALTH CARE DELIVERY SYSTEM THAT PROVIDES SERVICES PRIMARILY IN NORTHEASTERN OKLAHOMA. ST. JOHN HEALTH SYSTEM, INC. AND ITS SUBSIDIARIES, AFFILIATES, AND EMPLOYED AND AFFILIATED PHYSICIANS, PROVIDE HEALTH CARE SERVICES FOR PATIENTS OF ALL AGES ACROSS A BROAD CONTINUUM OF CARE, FROM PHYSICIAN PRIMARY CARE AND SPECIALTY SERVICES TO AMBULATORY AND INPATIENT ACUTE AND POST-ACUTE SERVICES, AND INCLUDING SENIOR NURSING AND SENIOR LIVING SERVICES. THE HEALTH MINISTRY IS RELATED TO ASCENSION HEALTH'S OTHER SPONSORED ORGANIZATIONS THROUGH COMMON CONTROL. SUBSTANTIALLY ALL EXPENSES OF THE HEALTH MINISTRY ARE RELATED TO PROVIDING HEALTH CARE SERVICES. Ascension Health Alliance, d/b/a Ascension (Ascension), is a Missouri nonprofit corporation formed on September 13, 2011. Ascension is the sole corporate member and parent organization of Ascension Health, a Catholic national health system consisting primarily of nonprofit corporations that own and operate local healthcare facilities, or Health Ministries, located in 23 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. false true false false false false false true false CHARLES ANDERSON FORMER OFFICER (END 6/14) 0 475182 0 73045 0 68571 0 0 0 20914 0 637712 0 43827 MIKE MOORE PRESIDENT AND CEO 0 177228 0 26002 0 64169 0 0 0 19750 0 287150 0 46848 DAVID J PYNN PRESIDENT & CEO SJHS 0 804787 0 589299 0 178093 0 7800 0 29729 0 1609708 0 127917 DAVID STIRE PRESIDENT & COO (END 12/14) 0 306691 0 52963 0 104836 0 0 0 20965 0 485455 0 86247 LEX ANDERSON TREASURER/SENIOR VP & SJHS CFO 0 525210 0 102804 0 148280 0 0 0 14350 0 790643 0 122183 KEVIN STECK SECRETARY/CORPORATE RESPONSIBILITY OFFICER 0 238780 0 34840 0 73519 0 0 0 1358 0 348496 0 61648 JAMES BRASEL VP/CFO (START 11/14) 0 124204 0 11415 0 55 0 2621 0 74000 0 212294 0 0 Schedule J, Part I, Line 3 COMPENSATION ASCENSION HEALTH, AN AFFILIATE ORGANIZATION OF JANE PHILLIPS NOWATA HOSPITAL, INC., USES THE FOLLOWING METHODS TO ESTABLISH THE COMPENSATION OF THE ORGANIZATION'S PRESIDENT & CEO: - COMPENSATION COMMITTEE - INDEPENDENT COMPENSATION CONSULTANT - COMPENSATION SURVEY OR STUDY - APPROVAL BY THE BOARD OR COMPENSATION COMMITTEE Schedule J, Part I, Line 4b Supplemental nonqualified retirement plan Eligible executives participate in 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. The following individuals received current year distributions of: Mike Moore - $46,848 Lex Anderson - $122,183 Kevin Steck - $61,648 Charles Anderson - $43,827 David J Pynn - $127,917 David Stire - $86,247 Schedule J, Part I, Line 7 Non-fixed payments St. John Health System, Inc. is the controlling member organization of an integrated healthcare system ("System"). The System has established an executive accountability and financial incentive plan that encourages the executives' participation in the significant improvements of the quality, financial, growth, and human resource related operations of the Organization. Eligibility is triggered when the System meets certain earnings targets; however, payments received under the plan are not based on the earnings of the Organization. Executives receive points under a plan scoring system for meeting their predetermined goals. The points are then entered into the plan formula to determine the executives' incentive compensation. Maximum payments under the financial incentive plan are 30% percent of base pay for most executives. Form 990, Part III, Line 4a Program Service Description - Part 1 ST. JOHN VILLAS, INC. ("ST. JOHN VILLAS"), OWASSO MEDICAL FACILITY, INC. ("ST. JOHN OWASSO"), ST. JOHN HEALTH SYSTEM FOUNDATION, INC. ("ST. JOHN FOUNDATION"), ST. JOHN BUILDING CORPORATION ("SJBC"), ST. JOHN BROKEN ARROW, INC. ("ST. JOHN BROKEN ARROW"), AND JANE PHILLIPS NOWATA HOSPITAL, INC. ("JP NOWATA"). ST. JOHN, THESE SUBSIDIARIES, AND ALL OTHER SUBSIDIARIES UNDER ST. JOHN'S DIRECT OR INDIRECT CONTROL OR OWNERSHIP ARE REFERRED TO HEREIN AS "THE ST. JOHN SYSTEM". THE ST. JOHN SYSTEM SUPPORTS THE PURPOSE AND ACTIVITIES OF ASCENSION HEALTH AND BOTH ST. JOHN'S AND ASCENSION HEALTH'S POWERS MUST BE EXERCISED IN ACCORDANCE WITH THE TEACHINGS, TRADITIONS AND CANON LAW OF THE ROMAN CATHOLIC CHURCH AND THE ETHICAL AND RELIGIOUS DIRECTIVES FOR CATHOLIC HEALTH FACILITIES PROMULGATED BY THE NATIONAL CONFERENCE OF CATHOLIC BISHOPS OF THE UNITED STATES CATHOLIC CONFERENCE. MISSION AND VALUES: AS A CATHOLIC HEALTHCARE ORGANIZATION, ST. JOHN CARRIES ON THE MISSION OF ITS SPONSORS, THROUGH ASCENSION HEALTH, OF CONTINUING THE HEALING MINISTRY OF JESUS CHRIST. IT ASPIRES TO PROVIDE HEALTH CARE THAT WORKS, HEALTH CARE THAT IS SAFE, AND HEALTH CARE THAT LEAVES NO ONE BEHIND, WITH A PROMISE TO OUR PATIENTS AND THE COMMUNITIES WE SERVE OF PROVIDING MEDICAL EXCELLENCE AND COMPASSIONATE CARE. IT OPERATES IN CONFORMANCE WITH "THE ETHICAL AND RELIGIOUS DIRECTIVES FOR CATHOLIC HEALTH FACILITIES." FAITHFUL TO THE SPONSORSHIP MISSION, PHILOSOPHY AND VALUES, ST. JOHN'S MISSION IS TO PROVIDE HEALTHCARE AND RELATED MINISTRIES FOR THE PEOPLE SERVED, ESPECIALLY THE SICK, THE POOR AND THE POWERLESS. THE BOARD OF DIRECTORS, MANAGEMENT AND EMPLOYEES OF ST. JOHN ARE GUIDED IN THEIR DAY-TO-DAY ACTIONS AND INTERACTIONS WITH THOSE WHO SERVE AND WHO ARE SERVED BY THE VALUES OF SERVICE TO THE POOR, WISDOM, REVERENCE, CREATIVITY, DEDICATION AND INTEGRITY. ST. JOHN AND THE HOSPITAL COLLABORATE WITH OTHER INDIVIDUALS AND INSTITUTIONS IN THE VARIOUS COMMUNITIES SERVED TO ASCERTAIN COMMUNITY NEEDS AND PROVIDE A BROAD RANGE OF SERVICES ALONG THE HEALTHCARE CONTINUUM TO HELP MEET THOSE NEEDS. PROGRAMS AND SERVICES INCLUDE PREVENTIVE, DIAGNOSTIC, THERAPEUTIC AND REHABILITATIVE PROGRAMS, INCLUDING AN EMPHASIS ON HEALTH PROMOTION AND DISEASE PREVENTION. ST. JOHN ALSO ADVOCATES FOR PUBLIC POLICIES WHICH ADVANCE A HEALTHY AND JUST SOCIETY. ST. JOHN WORKS WITH LOCAL, STATE AND NATIONAL LEADERS AND ORGANIZATIONS TO BRING ABOUT A HEALTHCARE DELIVERY SYSTEM THAT PROVIDES DIGNIFIED ACCESS TO AND AFFORDABLE, HIGH QUALITY HEALTHCARE FOR ALL PERSONS. COMMUNITY NEEDS ASSESSMENT: Form 990, Part III, Line 4a PROGRAM SERVICE DESCRIPTION - PART 2 EACH OWNED HOSPITAL IN THE ST. JOHN SYSTEM HAS COMPLETED A COMMUNITY HEALTH NEEDS ASSESSMENT AND IMPLEMENTATION PLAN. THESE HAVE BEEN POSTED TO EACH HOSPITAL'S WEBSITE AND ALSO THE HEALTH SYSTEM WEBSITE. ST. JOHN CONTINUES TO LOOK FOR WAYS TO MEET UNMET COMMUNITY NEEDS IN A SUSTAINABLE AND COLLABORATIVE WAY WITH OTHER ORGANIZATIONS TO BUILD HEALTHIER COMMUNITIES. THE ST. JOHN SYSTEM SERVES A DIVERSE REPRESENTATION OF HEALTH DISPARITIES IN ONE OF THE LOWEST RANKED STATES IN THE UNITED STATES FOR HEALTH STATUS (46TH IN 2014). WITHIN THE STATE OF OKLAHOMA, COUNTIES SERVED RANK FROM 17TH OUT OF 77 TO 63RD OUT OF 77. NOWATA IS RANKED 32ND OUT OF 77 COUNTIES IN OKLAHOMA FOR HEALTH STATUS. NOWATA IS WORSE THAN THE OKLAHOMA AVERAGE FOR ADULT SMOKING, OBESITY, ACCESS TO EXERCISE OPPORTUNITIES, RATE OF UNINSURED, AND ACCESS TO PRIMARY CARE AND MENTAL HEALTH PROVIDERS. USING THE CHNA COMPLETED IN 2013, THE ST. JOHN SYSTEM DEVELOPED, ADOPTED, AND WORKED ON EXECUTING A 2014-2016 IMPLEMENTATION STRATEGY TO ADDRESS THE COMMUNITY HEALTH NEEDS IDENTIFIED IN THE COMMUNITY-WIDE COMMUNITY HEALTH NEEDS ASSESSMENT. MANY OF THESE ARE DONE IN COLLABORATION WITH INDIVIDUALS REPRESENTING INTERESTS OF THE COMMUNITY AND/OR IN SUPPORT OF COMMUNITY BASED PROGRAMS. IN TOTAL FOR THIS FISCAL YEAR ENDING JUNE 2015, THE ST. JOHN SYSTEM PARTICIPATED IN OVER 100 COMMUNITY EVENTS. EACH YEAR A BUDGET IS ESTABLISHED FOR THIS PURPOSE AND IS EXCEEDED THROUGH IDENTIFICATION OF ADDITIONAL COMMUNITY REQUESTS. UPON COMPLETION OF THE ASSESSMENT WITH INPUT FROM LOCAL PUBLIC HEALTH OFFICIALS AND OTHER LEADERS, JANE PHILLIPS NOWATA HOSPITAL, INC. IDENTIFIED AND HAS CONTINUED TO COLLABORATIVELY WORK TOWARD ADDRESSING THE FOLLOWING PRIORITY NEEDS AS A HOSPITAL WITHIN A LARGER HEALTH SYSTEM AND THROUGH SUPPORTING THE NEEDS IDENTIFIED FOR A COMMUNITY-WIDE PLAN: 1. DIET, INACTIVITY, AND OBESITY - ACTIVE PARTICIPATON BY SEVERAL ASSOCIATES IN THE COMMUNITY WIDE COALITION, "PATHWAYS TO HEALTH," WHICH SUPPORTS THE TULSA HEALTH DEPARTMENT (THD) AND COMMUNITY PARTNERS OF THD; DURING 2015, PATHWAYS TO HEALTH COMMUNITY FOUNDATION SET OBESITY PREVENTION AS ITS PRIMARY FOCUS. Form 990, Part III, Line 4a PROGRAM SERVICE DESCRIPTION - PART 3 - THE ST. JOHN SYSTEM SUPPORTS HEALTH PROMOTION WALKS INCLUDING: AMERICAN CANCER SOCIETY'S RELAY FOR LIFE, AMERICAN HEART AND AMERICAN STROKE ASSOCIATIONS' HEART WALK, SUSAN G. KOMEN - RACE FOR A CURE, AND MARCH OF DIMES WALK. - ST. JOHN FOOD AND NUTRITION SERVICES COLOR CODE HEALTHY MENU ITEMS. - THE ST. JOHN SYSTEM BEGAN PARTICIPATION IN ASCENSION HEALTH'S "SMART HEALTH" WELLNESS PROGRAM INITIATIVES - FIRST FOCUSING ON OUR OWN ASSOCIATES AND SUBSEQUENTLY TAKING LESSONS LEARNED TO THE BROADER COMMUNITY. THIS WAS A MULTI-YEAR INITIATIVE THAT BEGAN IN FY 2014. - THE COMMUNITY IS CURRENTLY UNDERGOING AN UPDATED COMMUNITY HEALTH NEEDS ASSESSMENT WITH SUPPORT FROM THE COUNTY HEALTH DEPARTMENT TO DETERMINE IF POSITIVE CHANGES HAVE BEEN REALIZED. 2. MENTAL HEALTH, SUBSTANCE ABUSE, TOBACCO USE - AS A HEALTHCARE PROVIDER OF EMERGENCY AND ACUTE HOSPITAL AND RELATED SERVICES, THE HOSPITAL SEES THE DIRECT AND OFTEN DEVASTATING EFFECTS OF ALCOHOL AND DRUG ABUSE, AS WELL AS TOBACCO USE, ON A DAILY BASIS. MANY, IF NOT MOST, OF THE PATIENTS WHO PRESENT TO THE SYSTEM IN ACUTE CRISIS FROM ALCOHOL AND ABUSE - WHETHER FROM INJURY OR OVERDOSE (OR BOTH) - ALSO HAVE UNDERLYING ACUTE OR CHRONIC MENTAL HEALTH CONDITIONS AND NEEDS. THE ST. JOHN SYSTEM IS EXPLORING HOW VIRTUAL TECHNOLOGY MIGHT BE USED TO SUPPORT HOSPITALS IN PROVIDING BETTER ACCESS TO PATIENTS FOR MENTAL HEALTH SERVICES. - PROCESS OUTCOMES ARE MEASURED FOR MENTAL HEALTH AND TOBACCO USE SCREENING THROUGH BOTH THE COMPREHENSIVE PRIMARY CARE PROGRAM AND THE MEDICARE SHARED SAVINGS PROGRAM IN WHICH THE ST. JOHN SYSTEM AND EMPLOYED ST. JOHN PHYSICIANS PARTICIPATE. SINCE THESE PROGRAMS WERE IN THEIR EARLY STAGES, WE DID NOT HAVE OUTCOMES REPORTED BY THE END OF THE FISCAL YEAR. THROUGH THESE PROGRAMS, WE ARE NOW ABLE TO TRACK THE VOLUME OF PATIENTS WHO RECEIVE COUNSELING AND REFERRALS. - EACH HOSPITAL MAINTAINS ONGOING PATIENT EDUCATION RELATED TO SMOKING; MATERIALS ARE PROVIDED TO PATIENTS AND REFERRALS ARE MADE TO THE STATE OF OKLAHOMA TOBACCO HELP LINE. Form 990, Part III, Line 4a PROGRAM SERVICE DESCRIPTION - PART 4 - PATIENTS IDENTIFIED AT JANE PHILLIPS NOWATA HOSPITAL, INC. ARE REFERRED TO A HOSPITAL OUTPATIENT DEPARTMENT AT JANE PHILLIPS MEMORIAL MEDICAL CENTER, WHERE DRUG AND ALCOHOL COUNSELING IS PROVIDED. PATIENTS FROM ANY OF OUR HOSPITALS AND CLINICS MAY BE REFERRED TO THIS SERVICE WHICH HAS A CONVENIENT, ACCESSIBLE LOCATION. REFERRALS ARE ALSO MADE TO AREA AGENCIES. - THE COMMUNITY IS CURRENTLY UNDERGOING AN UPDATED COMMUNITY HEALTH NEEDS ASSESSMENT WITH SUPPORT FROM THE COUNTY HEALTH DEPARTMENT TO DETERMINE IF POSITIVE CHANGES HAVE BEEN REALIZED. 3. CHRONIC DISEASE MANAGEMENT - EMPLOYED PHYSICIANS OF THE ST. JOHN SYSTEM ALSO PARTICIPATE IN COMPREHENSIVE PRIMARY CARE WHICH FOCUSES ON A MEDICAL HOME MODEL IN CARE FOR HIGH RISK PATIENTS WITH CHRONIC CONDITIONS. - THE COMMUNITY IS CURRENTLY UNDERGOING AN UPDATED COMMUNITY HEALTH NEEDS ASSESSMENT WITH SUPPORT FROM THE COUNTY HEALTH DEPARTMENT TO DETERMINE IF POSITIVE CHANGES HAVE BEEN REALIZED. 4. ACCESS TO SERVICES ACCESS TO SERVICES IN OKLAHOMA IS A SIGNIFICANT CHALLENGE DUE TO THE LIMITED AVAILABILITY OF PRIMARY CARE PHYSICIANS. THE COMMUNITY IS CURRENTLY UNDERGOING AN UPDATED COMMUNITY HEALTH NEEDS ASSESSMENT WITH SUPPORT FROM THE COUNTY HEALTH DEPARTMENT AND THE ST. JOHN SYSTEM TO DETERMINE IF POSITIVE CHANGES HAVE BEEN REALIZED RELATED TO THE FOLLOWING IMPLEMENTATION INITIATIVES AND TO REFINE PRIORITY NEEDS IDENTIFIED IN THE 2013 ASSESSMENTS: - SAFETY NET AND EMERGENCY SERVICES (DESCRIBED BELOW) - DIRECT CARE FOR THE POOR AND VULNERABLE (DESCRIBED BELOW) - MEDICAL ACCESS PROGRAM (DESCRIBED BELOW) - MEDICAL EDUCATION (DESCRIBED BELOW) Form 990, Part III, Line 4a PROGRAM SERVICE DESCRIPTION - PART 5 NEEDS NOT BEING ADDRESSED: JANE PHILLIPS NOWATA HOSPITAL, INC. AND THE ST. JOHN SYSTEM ADDRESSED ALL OF THE PRIORITY NEEDS RECOMMENDED BY THE COMMUNITY-WIDE COMMUNITY HEALTH NEEDS ASSESSMENT. HOWEVER, "OBESITY" WAS GROUPED WITH "POOR DIET AND INACTIVITY," AND "TOBACCO USE" WAS GROUPED WITH "ALCOHOL/DRUG USE" AND RENAMED "MENTAL HEALTH, SUBSTANCE ABUSE, TOBACCO USE." GOVERNANCE: THE ADMINISTRATIVE POWERS OF JANE PHILLIPS NOWATA HOSPITAL, INC. ARE VESTED IN ITS BOARD OF DIRECTORS, WHICH CONTROLS AND MANAGES THE PROPERTIES, AFFAIRS AND FUNDS OF THE HOSPITAL, SUBJECT TO RESERVATION OF CERTAIN POWERS BY THE ST. JOHN SYSTEM. THE BOARD MEETS WHEN NEEDED AND IT WORKS IN CONCERT WITH, AND WHEN APPROPRIATE, UNDER THE DIRECTION OF THE ST. JOHN HEALTH SYSTEM, INC. BOARD. THE BOARD REVIEWS AND APPROVES THE COMMUNITY HEALTH NEEDS ASSESSMENT AND RECOMMENDED IMPLEMENTATION INITIATIVES. COMMUNITY BENEFIT: IN MEASURING AND REPORTING QUANTIFIABLE COMMUNITY BENEFIT, THE ST. JOHN SYSTEM FOLLOWS GUIDELINES PROMULGATED BY THE CATHOLIC HEALTH ASSOCIATION OF THE UNITED STATES AND ENDORSED BY OTHER ORGANIZATIONS. UNCOMPENSATED CARE AND OTHER ELEMENTS OF COMMUNITY BENEFIT ARE MEASURED AT THE UNREIMBURSED ESTIMATED COST OF SERVICES OR RESOURCES PROVIDED. SAFETY NET AND EMERGENCY SERVICES (SUBPART A OF ACCESS TO SERVICES): AS A CRITICAL ACCESS HOSPITAL, JANE PHILLIPS NOWATA HOSPITAL, INC. IS AN INTEGRAL PART OF THE MISSION OF SERVICE AND THE CONTINUUM OF MEDICAL CARE PROVIDED BY THE ST. JOHN SYSTEM. THE ST. JOHN SYSTEM SERVES AS AN IMPORTANT SAFETY NET PROVIDER OF A BROAD CONTINUUM OF HEALTH CARE SERVICES TO THE CITIZENS OF NORTHEASTERN OKLAHOMA AND THE SURROUNDING REGION. EACH OF ITS SIX MAIN HOSPITALS OPERATES A FULL-SERVICE, 24-HOUR, 365-DAY EMERGENCY ROOM PROVIDING BOTH URGENT AND EMERGENCY CARE TO ALL INDIVIDUALS, REGARDLESS OF THEIR ABILITY TO PAY. Form 990, Part III, Line 4a PROGRAM SERVICE DESCRIPTION - PART 6 PATIENTS SEEN IN THE ST. JOHN SYSTEM FOR THE FISCAL YEAR ENDED JUNE 30, 2015: TOTAL DISCHARGES (EXCLUDING NORMAL NEWBORNS) - 38,586 TOTAL OBSERVATION DAYS - 15,413 COMBINED DISCHARGES AND OBSERVATION DAYS - 53,999 TOTAL PATIENT DAYS (EXCL. NORMAL NEWBORN AND OBSERVATIONS) - 179,945 BIRTHS - 3,279 EMERGENCY ROOM VISITS - 166,705 SELECTED OUTPATIENT VISITS (EXCL. ER & ONE DAY SURGERIES) - 342,529 INPATIENT SURGICAL CASES - 11,659 OUTPATIENT SURGICAL CASES - 17,248 PHYSICIAN OFFICE PATIENT VISITS - 448,349 URGENT CARE CLINIC PATIENT VISITS - 61,970 COMBINED PHYSICIAN OFFICE AND URGENT CARE VISITS - 510,319 TOTAL LABORATORY PROCEDURES (INCL. HOSPITAL & REFERENCE LABS) - 8,171,752 DIRECT CARE FOR THE POOR AND VULNERABLE (SUBPART B OF ACCESS TO SERVICES): THE ST. JOHN SYSTEM CONSIDERS CARE FOR THE POOR TO BE AN ESSENTIAL PART OF ITS MISSION OF SERVICE TO THE COMMUNITY. THE TOTAL COST OF CARE FOR THE POOR INCLUDES THE COST OF CHARITY CARE, THE UNREIMBURSED COST OF SERVICES TO MEDICAID BENEFICIARIES (TOGETHER REFERRED TO AS "UNCOMPENSATED CARE FOR THE POOR") AND THE COST OF SPECIAL PROGRAMS OR OTHER ACTIVITIES SPECIFICALLY TARGETED TO INCREASE ACCESS TO CARE OR PROVIDE OTHER SERVICES TO THE POOR. "CARE FOR THE POOR" INCLUDES THE ESTIMATED COST OF CARE CLASSIFIED AS CHARITY CARE PLUS THE ESTIMATED EXCESS OF THE COST OF SERVICES PROVIDED TO MEDICAID BENEFICIARIES OVER THE PAYMENTS RECEIVED FROM MEDICAID. "CARE FOR THE POOR" DOES NOT INCLUDE THE COST OF SERVICES CLASSIFIED AND WRITTEN OFF AS BAD DEBTS OR THE EXCESS OF THE COST OF SERVICES PROVIDED TO MEDICARE BENEFICIARIES OVER THE PAYMENTS RECEIVED FROM MEDICARE. CHARITY AND UNCOMPENSATED CARE: Form 990, Part III, Line 4a PROGRAM SERVICE DESCRIPTION - PART 7 THE ST. JOHN SYSTEM'S HOSPITALS, SENIOR-CARE AND OTHER FACILITIES PROVIDE SERVICES WITHOUT REGARD TO A PATIENT'S ABILITY TO PAY. IN FY15, THE ST. JOHN SYSTEM HOSPITALS PROVIDED A DISCOUNT OF AT LEAST 30% OF BILLED CHARGES TO ALL UNINSURED PATIENTS. UNINSURED PATIENTS ALSO COULD QUALIFY FOR AN ADDITIONAL 15% PROMPT PAY DISCOUNT. IN ADDITION TO THESE AUTOMATIC DISCOUNTS, PATIENTS CAN APPLY FOR FINANCIAL ASSISTANCE UP TO AND INCLUDING FREE CARE. THE DETERMINATION OF THE PATIENT'S QUALIFICATION FOR FINANCIAL ASSISTANCE IS BASED ON AN OBJECTIVE DETERMINATION OF THE PATIENT'S FINANCIAL RESOURCES AND ABILITY TO PAY. IN GENERAL, ALL UNINSURED PATIENTS WITH HOUSEHOLD INCOMES OF LESS THAN 300% OF THE FEDERAL POVERTY GUIDELINES QUALIFY FOR FREE OR SUBSTANTIALLY DISCOUNTED CARE. OTHER ENTITIES IN THE ST. JOHN SYSTEM ALSO PROVIDE CHARITY CARE BASED ON INDIVIDUAL DETERMINATIONS OF NEED. MANAGEMENT FOR THE ST. JOHN SYSTEM BELIEVES THAT ALL OF ITS BILLING AND COLLECTION POLICIES AND PROCEDURES COMPLY WITH IRS GUIDELINES AND DIRECTIVES. OTHER COMMUNITY BENEFIT AND OUTREACH ACTIVITIES: THE ST. JOHN SYSTEM AND JANE PHILLIPS NOWATA HOSPITAL, INC. PROVIDE OTHER FORMS OF COMMUNITY BENEFIT IN THE FORM OF FREE, OR REDUCED-CHARGE EDUCATIONAL SEMINARS FOR THE GENERAL PUBLIC ON WIDE RANGING TOPICS FROM PRENATAL CARE TO CHRONIC DISEASE MANAGEMENT. JANE PHILLIPS NOWATA HOSPITAL, INC. PARTICIPATES IN COMMUNITY-WIDE HEALTH SCREENING EVENTS, BLOOD DONATION DRIVES, AND A NUMBER OF OTHER OUTREACH ACTIVITIES TO IMPROVE THE HEALTH STATUS OF THE RESIDENTS OF NORTHEASTERN OKLAHOMA AND THE SURROUNDING AREA. ACCESS TO HEALTH INSURANCE COVERAGE: BETWEEN SEPTEMBER 2014 AND FEBRUARY 2015, ST. JOHN ENGAGED A TOTAL OF 772 INDIVIDUALS IN DISCUSSIONS ABOUT THE HEALTH INSURANCE MARKETPLACE AND REFERRED THEM TO ENROLLMENT ASSISTANCE. - OF THOSE 772 INDIVIDUALS, 643 WERE ENGAGED IN DISCUSSIONS ABOUT THE ENROLLMENT PROCESS DURING ONE OF OUR HEALTH MINISTRY'S 24 ONSITE OR COMMUNITY OUTREACH EVENTS HELD BETWEEN SEPTEMBER 2014 AND FEBRUARY 2015. THESE CONSUMERS WERE ALSO INFORMED ABOUT ST. JOHN HEALTH SYSTEM INC.'S FINANCIAL ASSISTANCE PROGRAM. - THE REMAINING 129 CONSUMERS WHO WERE SEEKING INFORMATION ABOUT THE MARKETPLACE SPOKE TO OUR HEALTH MINISTRY'S CONTRACTED CERTIFIED APPLICATION COUNSELORS WITH MIDLAND GROUP OVER THE PHONE ABOUT THE ENROLLMENT PROCESS. IF THE CALLER DID NOT SCHEDULE AN ENROLLMENT ASSISTANCE APPOINTMENT, THEY WERE EITHER INQUIRING ABOUT WHAT PLANS ST. JOHN HEALTH SYSTEM, INC. TAKES, WHETHER THEY QUALIFIED FOR A TAX CREDIT, OR ASKED ABOUT GENERAL INFORMATION, BUT DID NOT WANT TO SET UP AN APPOINTMENT AT THAT TIME. Form 990, Part III, Line 4a PROGRAM SERVICE DESCRIPTION - PART 8 - THE ST. JOHN SYSTEM'S CONTRACTED CERTIFIED APPLICATION COUNSELORS, THROUGH MIDLAND GROUP, ASSISTED 40 CONSUMERS WITH NAVIGATION ACTIVITIES DURING THE ENROLLMENT PERIOD. - THE ST. JOHN SYSTEM PRODUCED AND DISTRIBUTED EDUCATIONAL SIGNAGE, FLIERS, AND CARDS TO 119 LOCATIONS WITHIN THE HEALTH SYSTEM (INCLUDING: SPECIALTY CLINICS - ST. JOHN CLINIC, SOME NURSING FLOORS AT THE MEDICAL CENTER, PATIENT ADMISSIONS AND FINANCIAL COUNSELING AT ALL HOSPITALS, INPATIENT AND OUTPATIENT SPECIALTY DEPARTMENTS AT ALL HOSPITALS, HOSPITAL EMERGENCY DEPARTMENTS, AND MAIN LOBBY AND HIGH TRAFFIC AREAS WITHIN ALL HOSPITALS). THESE MATERIALS ALSO INFORMED CONSUMERS ABOUT ST. JOHN HEALTH SYSTEM INC.'S FINANCIAL ASSISTANCE PROGRAM. OTHER PROGRAM SERVICE ACCOMPLISHMENTS: AS PREVIOUSLY DISCUSSED, THE ST. JOHN SYSTEM IS ORGANIZED AND OPERATED TO PROVIDE MEDICAL EXCELLENCE AND COMPASSIONATE CARE TO THE CITIZENS OF NORTHEASTERN OKLAHOMA, WITH A SPECIAL PREFERENCE FOR THE POOR AND DISADVANTAGED. SUMMARY: THE ST. JOHN SYSTEM'S ROLE AS ONE OF THE SIGNIFICANT SAFETY-NET HEALTH CARE PROVIDERS FOR THE REGION CONTINUES TO GROW IN PROMINENCE. THE ST. JOHN SYSTEM REINVESTS 100% OF ANY PROFITS DERIVED INTO NEW AND EXPANDED SERVICES TO THE COMMUNITY. THE ST. JOHN SYSTEM IS VERY PROUD OF ITS HISTORY OF SERVICE TO THE COMMUNITY AND VIEWS ITS RESPONSIBILITY TO CONTINUE TO PROVIDE MEDICAL SERVICES TO EVERYONE, ESPECIALLY THE POOR AND DISADVANTAGED, VERY SERIOUSLY. AS THE ST. JOHN SYSTEM CONTINUES TO FACE GROWING FINANCIAL CHALLENGES, IT BECOMES INCREASINGLY DIFFICULT TO SUSTAIN OUR MISSION OF SERVICE. NEVERTHELESS, WE BELIEVE THAT THE QUANTIFIABLE COMMUNITY BENEFIT, AS WELL AS THE MANY OTHER AREAS OF SERVICE PROVIDED BY THE ST. JOHN SYSTEM AND JANE PHILLIPS NOWATA HOSPITAL, INC., CONTINUE A SOUND RECORD OF STEWARDSHIP AND A SIGNIFICANT CONTRIBUTION TO THE WELL-BEING OF BOTH THE COLLECTIVE COMMUNITIES AND THE INDIVIDUALS WITHIN THOSE COMMUNITIES WE SERVE. JANE PHILLIPS NOWATA HOSPITAL, INC. IS AN IMPORTANT PART OF ST. JOHN HEALTH SYSTEM, INC. Form 990, Part IV, Line 20b EXPLANATION OF FINANCIAL STATEMENTS THE ACTIVITY OF JANE PHILLIPS NOWATA HOSPITAL, INC. (JPNH) IS REPORTED IN THE CONSOLIDATED FINANCIAL STATEMENTS OF ASCENSION HEALTH ALLIANCE. NO INDIVIDUAL AUDIT OF JPNH IS COMPLETED. THEREFORE, THE ATTACHED AUDITED FINANCIAL STATEMENTS ARE OF ASCENSION HEALTH ALLIANCE AND AFFILIATES, WHICH INCLUDE THE ACTIVITY OF JPNH. Form 990, Part V, Line 2a Statements Regarding Other IRS Filings and Tax Compliance The salaries reflected on Form 990 were all reported on Form 941, Employer's Quarterly Federal Tax Return of Jane Phillips Memorial Medical Center (JPMMC). These salaries were reimbursed to JPMMC by the filing organization and were included in the number of employees on JPMMC's calendar year 2014 Form W-3. The number of employees reported on Part V, Line 2a of Form 990 by the filing organization represents the number of employees providing services to the filing organization during calendar year 2014. Form 990, Part VI, Line 2 FAMILY/BUSINESS RELATIONSHIPS AMONGST INTERESTED PERSONS MANY OF THE PERSONS LISTED ON PART VII HAVE A "BUSINESS RELATIONSHIP" WITH EACH OTHER BY VIRTUE OF EMPLOYMENT BY ST. JOHN HEALTH SYSTEM, INC. RELATED ENTITIES. ROBERT KANE, DIRECTOR, AND JOHN B. KANE, DIRECTOR, HAVE A FAMILY RELATIONSHIP. Form 990, Part VI, Line 15b PROCESS FOR DETERMINING COMPENSATION OF OTHER OFFICERS COMPENSATION FOR OTHER OFFICERS IN ST. JOHN HEALTH SYSTEM, INC. (SJHS), OF WHICH JANE PHILLIPS NOWATA HOSPITAL, INC. IS A PART, IS ANALYZED BY AN INDEPENDENT HEALTH CARE CONSULTING FIRM. THE ANALYSIS INCLUDES A FAIR MARKET VALUE ASSESSMENT AND ESTABLISHMENT OF A RANGE FOR EACH POSITION BASED ON RESEARCH OF COMPARABLE HEALTH CARE SYSTEMS OF SIMILAR SIZE. THE REPORT AND RECOMMENDED COMPENSATION LEVELS FOR EACH EXECUTIVE MANAGEMENT POSITION IS REVIEWED AND APPROVED BY THE EXECUTIVE COMPENSATION COMMITTEE OF THE SJHS BOARD OF DIRECTORS. Form 990, Part VI, Line 15a PROCEDURE FOR DETERMINING THE COMPENSATION OF THE CEO In determining compensation of the organization's PRESIDENT & CEO, the process, performed by Ascension Health, a related organization of St. John Nowata Hospital, Inc., included a review and approval by independent persons, comparability data, and contemporaneous substantiation of the deliberation and decision. The compensation committee reviewed and approved the compensation. In the review of the compensation, the PRESIDENT & 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 was recorded in the compensation committee minutes. The individual was not present when his compensation was decided. Form 990, Part VI, Line 6 Classes of members or stockholders JANE PHILLIPS NOWATA HOSPITAL, INC. HAS A SINGLE CORPORATE MEMBER, JANE PHILLIPS MEMORIAL MEDICAL CENTER. Form 990, Part VI, Line 7a Members or stockholders electing members of governing body JANE PHILLIPS NOWATA HOSPITAL, INC. HAS A SINGLE CORPORATE MEMBER, JANE PHILLIPS MEMORIAL MEDICAL CENTER, WHO HAS THE ABILITY TO ELECT MEMBERS TO THE GOVERNING BODY OF JANE PHILLIPS NOWATA HOSPITAL, INC. Form 990, Part VI, Line 7b Decisions requiring approval by members or stockholders All decisions that have a material impact to Jane Phillips Nowata Hospital, Inc. financial information or corporation as a whole are subject to approval by its sole corporate member, Jane Phillips Memorial Medical Center. Ascension Health, the sole corporate member of St. John Health System, Inc., 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 and major transactions; governing documents; appointments/removals; evaluations; debt limits; strategic and financial plans; assets; and system policies and procedures. These areas are subject to certain levels of approval by Ascension Health per the system authority matrix. Form 990, Part VI, Line 11b Review of form 990 by governing body Jane Phillips Nowata Hospital, Inc. (JP Nowata) is an affiliate of St. John Health System, Inc. (SJHS). SJHS has hired a third party preparer experienced in the preparation of Form 990 to assist in the preparation of the return. The Vice President/Chief Financial Officer and Controller of SJHS will work closely with the paid preparer in gathering the information for the return and will perform the initial detailed review of the return. A copy of the return will be provided to all voting Board Members of the filing Organization prior to filing. Form 990, Part VI, Line 12c Conflict of interest policy At every fiscal year end, St. John Health System, Inc. (SJHS) distributes a copy of the current Conflict of Interest Policy and Procedure Bulletin, together with an explanation and questionnaire to the members of the Board of Directors, administrative officers and key employees of SJHS, its subsidiaries and affiliates, including Jane Phillips Nowata Hospital, Inc. The Board Members, administrative officers and key employees of SJHS, its subsidiaries and affiliates must complete the questionnaire and return it to the designated SJHS official within two weeks of receipt. Completed questionnaires are reviewed and summarized by the Vice President, Corporate Compliance and Integrity, or his/her designee. That individual then presents the questionnaire results to the heads of each hospital for further provision to the various boards' Audit and Compliance Committees. The Audit and Compliance Committees, as appropriate, submit a confidential report to their Board Chairman summarizing the questionnaire results. The Board Chairman, as appropriate, may review with the Executive Committee the responses to the questionnaire results. Members of a committee with governing board delegated powers annually sign a statement which affirms such person has received a copy of the Conflict of Interest Policy, has read and understands the Policy, has agreed to comply with the Policy, and understands that the Organization is charitable and, in order to maintain its federal tax exemption, IT must engage primarily in activities which accomplish its tax-exempt purpose. Form 990, Part VI, Line 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 2 Independent Contractor Reporting: Compensation of independent contractors is paid by and reported on Form 1096, Annual Summary and Transmittal of U.S. Information Returns, of Jane Phillips Memorial Medical Center, EIN 73-0606129. Expenses are allocated to and reimbursed by the filing organization to Jane Phillips Memorial Medical Center. 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 MISC INCOME - Total Revenue: 1999, Related or Exempt Function Revenue: 0, Unrelated Business Revenue: 0, Revenue Excluded from Tax Under Sections 512, 513, or 514: 1999; Form 990, Part IX, Line 11g Other Fees LAB SERVICES - Total Expense: 165106, Program Service Expense: 165106, Management and General Expenses: , Fundraising Expenses: ; Purchased Services - Total Expense: 139155, Program Service Expense: 104833, Management and General Expenses: 34322, Fundraising Expenses: ; CONTRACTED SERVICES - Total Expense: 121464, Program Service Expense: 119909, Management and General Expenses: 1555, Fundraising Expenses: ; Professional Services - Total Expense: 13958, Program Service Expense: 12692, Management and General Expenses: 1266, Fundraising Expenses: ; ASCENSION HEALTH ALLIANCE PO BOX 45998 ST LOUIS MO 631455998 453358926 NATIONAL HEALTH SYSTEM MO 501(c)(3 Type I NA false ASCENSION HEALTH PO BOX 45998 ST LOUIS MO 63135 311662309 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