2016-05-16T12:00:25-05:00 2015-06-30 470617373 Catholic Health Initiatives 198 Inverness Drive West Englewood CO 80112 990 2014-07-01 930391614 St Anthony Hospital STAN 5412783220 2801 St Anthony Way Pendleton OR 97801 Harold Geller President 2016-05-16 true Angela Lea P01051055 3032989100 2014 2016-08-17 19:52:53Z Harold Geller 2801 St Anthony Way Pendleton OR 97801 67849032 false 0928 X www.sahpendleton.org X 1901 OR St. Anthony Hospital was founded in 1901 by the Sisters of St. Francis to provide comprehensive health care to everyone in this rural community of Eastern Oregon, regardless of ability to pay or social status. 13 9 426 40 269343 153161 1387100 177196 61237444 66255683 6055572 705438 503890 650798 69184006 67789115 72800 1194726 0 0 26982980 26983932 0 0 0 38359545 34284313 65415325 62462971 3768681 5326144 123777663 122032945 14604692 9482785 109172971 112550160 SEE SCHEDULE O. false false 54598090 1194726 66255683 SEE SCHEDULE H 54598090 true true false true false false false false false false true true false false true true false true false false false false false false false false true true true true true false false false false false false false false false false false false false true true true false false true 0 0 426 true true true false false false false false false false false false X 13 9 false false false false true true true true true false false true true true true true true false true false OR X Harold Geller 5412783220 2801 St Anthony Way Pendleton OR 97801 ROBERT BLANC Chairman 3.00 0 X X 0 0 0 BRENT FIFE Treasurer 3.00 0 X X 0 0 0 Tim Hawkins Vice Chair 3.00 0 X X 0 0 0 BETH O'HANLON Secretary 3.00 0 X X 0 0 0 Harold Geller President / TRUSTEE 3.00 0.00 X X 0 295929 59499 SR MARIE-MONICA BORDEN TRUSTEE 3.00 1.00 X 0 0 0 MICHAEL BRUNSMAN Physician 40.00 0 X 313303 0 52002 L REYBURN COLLIS Trustee 3.00 1.00 X 0 0 0 Marion Green Trustee 4.00 1.00 X 0 0 0 JOHN MCBEE MD Trustee/physician 3.00 0 X 165615 0 0 PATRICIA WINN Trustee 3.00 0 X 0 0 0 Donald Benschoter Trustee 3.00 0 X 0 0 0 June mohrland Trustee 3.00 0 X 25039 0 99 JIM SCHLENKER Former CFO 39.00 1.00 X 217435 0 40969 Scot Attridge VP - Operational Finance 40.00 0 X 0 0 0 GLORIA LARSON VP Patient Care 40.00 0 X 181895 0 39021 WILLIAM BELL MD Physician 40.00 0 X 637728 0 53492 GABRIEL GARTON CRNA 40.00 0 X 213326 0 40515 JOHN POZAR CRNA 40.00 0 X 204005 0 41824 NANCY BROWN CRNA 40.00 0 X 228092 0 40741 Amber Pederson CRNA 40.00 0 X 215939 0 25636 2402377 295929 393798 35 false true false INLAND NW HEALTH SERVICES PO BOX 469 SPOKANE WA 992100469 INFORMATION MANAGEMENT 1815209 NW DEMOLITION & DISMANTLING 422 SW 6TH STREET PENDLETON OR 97801 CONSTRUCTION SERVICES 1358012 INTERPATH LABORATORY PO BOX 1208 PENDLETON OR 97801 CLINICAL LAB SERVICES 852928 SELLEN CONSTRUCTION COMPANY 227 WESTLAKE AVE N SEATTLE WA 98109 CONSTRUCTION SERVICES 636166 NORTHWEST EMERGENCY PHYSICIANS PO BOX 634850 CINCINNATI OH 452634850 PHYSICIAN SERVICES 505764 21 X 0 0 0 174997 0 2199 0 177196 Patient Services 900099 66253826 66253826 0 0 Rental Income 900099 1857 1857 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 66255683 556533 0 118246 438287 0 0 0 0 0 0 0 0 28970 0 59917 0 -30947 0 -30947 0 0 -30947 160517 -11612 0 0 160517 -11612 148905 0 0 148905 0 0 0 0 0 0 0 0 0 0 0 0 51915 0 51915 0 0 51915 Cafeteria 722100 417314 0 0 417314 Services Sold 900099 126600 0 73091 53509 Pharmacy Services 446110 44880 0 44880 0 41036 0 33126 7910 629830 67789115 66255683 269343 1086893 X 20000 20000 1174726 1174726 796168 353488 442680 20503016 18780662 1722354 1034295 930863 103432 3132847 2897545 235302 1517606 1274426 243180 108137 108137 7928 7928 8987571 8214533 773038 0 98347 98347 1196880 893479 303401 2814272 1295380 1518892 1999988 1708891 291097 198083 96358 101725 190314 386 189928 149542 149542 1399999 1399999 4850307 4623903 226404 273365 271648 1717 Medical Supplies 6868730 6868730 Bad debts 2453026 2453026 Repairs and maintenance 1046387 1046387 Unrelated Business Taxes 97320 97320 1544117 1544117 0 0 62462971 54598090 7864881 0 12454 0 3205393 5012739 10067609 10695519 0 0 0 1627207 1504085 1750598 2274615 137864 143753 123597764 41837930 86306887 81759834 0 19476421 20642400 0 1193230 0 123777663 122032945 5042487 7111982 0 0 9562205 2370803 14604692 9482785 X 109162418 112545198 10553 4962 109172971 112550160 123777663 122032945 X 5326144 -23 -1948932 X false true X true false X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED false false false false false true 7928 false false false 7928 false Schedule C, Part II-B, Line 1 DETAILED DESCRIPTION OF THE LOBBYING ACTIVITY LINE 1F) THE PORTION OF ORGANIZATION DUES THAT ARE RELATED TO LOBBYING ARE AS FOLLOWS: AMERICAN HOSPITAL ASSOCIATION - $1,016, CATHOLIC HEALTH ASSOCIATION - $317, OREGON ASSOCIATION OF HOSPITALS AND HEALTH SYSTEMS - $6,595. 1875719 1875719 84279285 25137122 59142163 31505 4726 26779 36574165 16029544 20544621 837090 666538 170552 81759834 CHI-OIP 20642400 F 20642400 34400 environmental remediation liability intercompany payable 1062005 other liabilities 1084093 CHI Debt Management Program Accrued Expenses 190305 2370803 X Schedule D, Part X, Line 2 FIN 48 (ASC 740) footnote St. Anthony Hospital'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 false true true 1945 553296 553296 0.0092 2159 3255993 3237083 18910 0.0003 0 0.0 0 4104 3809289 3237083 572206 0.0095 23 20602 408976 2500 406476 0.0068 7 273 302690 302690 0.0050 0 0.0 0 0.0 4 6753 266961 266961 0.0044 34 27628 978627 2500 976127 0.0163 34 31732 4787916 3239583 1548333 0.0258 0 0.0 1 300 11905 11905 0.0002 5 1201 64109 64109 0.0011 0 0.0 1 41 1594 1594 0.0000 5 760 35665 15000 20665 0.0003 0 0.0 0 0.0 0 0.0 12 2302 113273 15000 98273 0.0016 true 2453026 0 15942334 16052447 -110113 X true true EASTERN OREGON CONTINUOUS CARE ORGANIZATION PROVIDE MANAGED CARE UNDER THE ACA 0.1 0.0 0.0 1 1 St Anthony Hospital http://www.sahpendleton.org/ 14-0034 X X X X St Anthony Hospital 1 false false true X X X X X X X X X 12 true true true true X http://www.sahpendleton.org/ X true 13 false true false true X X X X X true true X X X X true X http://www.sahpendleton.org/patient-financial-assistance.html X http://www.sahpendleton.org/patient-financial-assistance.html X http://www.sahpendleton.org/patient-financial-assistance.html 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 - St. Anthony Hospital. The workgroup had meetings, focus groups and community surveys. The following organizations made up the community work group: Blue Mountain Community College Cancer Community renewal Partnership CAPECO Clearview Medication Commission on Children and Family Domestic Violence Services, Inc. Eastern Oregon Alcoholism Foundation Foster Grandparents/Senior Companions Good Shepherd Health Systems Head Start of Umatilla and Morrow Counties Healthy Communities Coalition Lifeways Mental Health Services Mirasol Family health Center Oregon Child Development Coalition Oregon Department of Human Services Pendleton Ministerial Fellowship Milton-Freewater School District Pioneer Relief Nursery Salvation Army St. Anthony Hospital St. Mary Medical Center Umatilla County Emergency Management Umatilla County Public Health United Way Yellowhawk Tribal Health Center A strategic planning work group representing the broad interests of the community then began the process of surveying the data to determine the priorities of community health needs. This group included the following members: Genni Lehnert-Beers (MPH) - Umatilla County PHD Brian Williams - Yakima Valley Farm Workers Clinic (Mirasol) Janet Jones - Umatilla County Public Health Department Lindsay Holmes - Lifeways (Mental Health) Cristina Cuevas - Lifeways (Mental Health) Michael Gregory - Lifeways (Mental Health) Rod Harwood - St. Anthony Hospital Mark Ettesvold - Good Shepherd Health Systems Karen Cook - Yellowhawk Tribal Clinic Dolores Jimerson - Yellowhawk Tribal Clinic Susan Leathers - Providence St. Mary Medical Center Harvey Crowder - Walla Walla County Public Health Department Juli Gregory - Good Shepherd Health Systems Schedule H, Part V, Section B, Line 6a Facility , 1 Facility , 1 - St. Anthony Hospital. Good Shephard Health Systems Marison-Yakima Valley Farm worker Clinic Yellowhawk Tribal Clinic Providence St. Mary Medical Center Walla Walla General Hospital Schedule H, Part V, Section B, Line 6b Facility , 1 Facility , 1 - St. Anthony Hospital. Lifeways Mental Health Services, Umatilla County Public Health Department, Walla Walla County Public Health Department Schedule H, Part V, Section B, Line 11 Facility , 1 Facility , 1 - St. Anthony Hospital. Programs and Services Provided by St. Anthony Hospital to address needs identified in the Community health needs assessment: Nutrition & Dietary Services- Registered Dietitian provides nutrition and dietary education to address this need of the community by educating on diets for various chronic health conditions. She provides presentations, workshops or informal seminar to agencies/businesses/organizations that do not have people trained in nutrition on staff. One of the classes that is taught is Heart Healthy Eating. These are offered both at the hospital or offsite at other agencies, businesses or organizations. Key Health Priority (Obesity, Diabetes) Diabetes Services- Certified Diabetes Educator provides individual and group diabetes self-management education and support group. The Diabetes Group Education is a four part series offered several times throughout the year. It is designed to empower participants to take charge of their diabetes. Each session lasts about 2 hours and builds on the information from the previous session. The sessions cover many of the basic concepts one needs to know as it relates to diabetes such as defining diabetes, target blood glucose levels, high and low blood sugars, and developing a personal support network. They engages participants in a more detailed discussion about the connection between food and diabetes, and the importance of healthy eating as it relates to managing diabetes. There is discussion about the importance of monitoring blood glucose, managing high and low blood glucose, and how to use the results from monitoring to help better manage diabetes. It also covers some more complex concepts related to diabetes including the natural course of diabetes, the many medicine options that exist for people with diabetes today, what insulin is and how it works, long-term complications associated with diabetes, and the ABCs (A1C, Blood Pressure, and Cholesterol). Key Health Priority (Obesity, Diabetes) The hospital provides health club facilities (Roundup Athletic Club) that offers health club classes, workout equipment and health coaches that provide Fusion & Biometric Weight Loss support. The club provides Adopt a School health & fitness for 5th grade students. Key Health Priority (Obesity, Diabetes) Schedule H, Part V, Section B, Line 13 Facility , 1 Facility , 1 - St. Anthony Hospital. HUD low income guidelines used. 8 St Anthony Home Care & Hospice 1703 SE Court Avenue Pendleton OR 97801 home care and hospice St Anthony We Care Clinic 1312 SW 2nd Street Pendleton OR 97801 Medical Clinic St Anthony Pediatric Clinic 1514 SE Court Avenue Pendleton OR 97801 Outpatient Clinic St Anthony Hospital Cardiology Clinic 2801 St Anthony Way Pendleton OR 97801 medical clinic specializing in heart injuries and disease. St Anthony Outpatient Physical Therapy 1425 Southgate Pendleton OR 97801 outpatient clinic St Anthony Orthopedic Clinic 1600 SE Court Place Pendleton OR 97801 Physician clinic St anthony Womens Clinic 2801 St Anthony Way Pendleton OR 97801 Clinic for women who are pregnant or have GYN issues St Anthony Internal Medicine Clinic 2801 St Anthony Way Pendleton OR 97801 Clinic specializing in internal medicine Schedule H, Part VI Lines 2,4 & 5: Needs Assessment, Community Information, and Promotion of Health Community Needs Assessment The community health assessment was cross-sectional in nature and included a written survey of adults within Umatilla County. From the beginning, community leaders were actively engaged in the planning process and helped define the content, scope, and sequence of the study. Active engagement of community members throughout the planning process is regarded as an important step in completing a valid needs assessment. The adult survey instrument was designed and pilot tested for this study. The survey was then distributed in a manner designed to create reliable results. There are limitations associated with any survey, so the results should be used with caution. Health Needs of Community The health needs of Umatilla County that were examined by the needs assessment include but are not limited to: health status, health care coverage, health care access, cardiovascular health, cancer, diabetes, arthritis, asthma, weight control, tobacco use, alcohol use, substance abuse, women's health, men's health, preventive health screenings & behaviors, sexual behavior and pregnancy outcomes, quality of life and safety, social context, mental health and suicide, oral health, parenting, American Indian healthcare access, coverage and utilization, American Indian chronic disease and prevention, American Indian quality of life and safety. Survey Findings Lack of health care coverage, tobacco use, drug use, multiple sexual partners, binge drinking, lack of male and female health screenings and lack of routine dental care were all prevalent issues among those Umatilla County adults with incomes less than $25,000. The chronic disease prevalence among Umatilla County adults with incomes less than $25,000 were: high blood cholesterol (34%), high blood pressure (33%), arthritis (29%), asthma (21%) and diabetes (10%). The percentage of adults either overweight or obese was also found to be high in Umatilla County. 32% were found to be obese and 35% overweight. Schedule H, Part I, Line 6a Community Benefit Report ST. ANTHONY HOSPITAL PREPARES ITS OWN ANNUAL WRITTEN COMMUNITY BENEFIT REPORT. ITS COMMUNITY BENEFIT REPORT IS NOT CONTAINED IN THAT OF A RELATED ORGANIZATION. Schedule H, Part VI Lines 2,4 & 5: Needs Assessment, Community Information, and Promotion of Health Community Information Service is delivered primarily to residences of Pendleton (16,612) and the surrounding area of Umatilla County with a population of 75,889. It also serves a secondary service area of over 44,586 residents in Union, Morrow and Grant counties. These counties are primarily made of rural agricultural communities in Northeastern Oregon. Umatilla County vast majority of the population is Caucasian, with Hispanics making up most of the minority population at around 24%. According to the US Census data that is a 4% increase from 2009 to 2010. SAH also serves a significant Native American population of just over 3,000 who reside on the reservation of the Confederated Tribes of the Umatilla, Cayuse and Walla Walla. The city of Pendleton shares a boarder with this reservation, which has the designation of being medically underserved. The medium age of the county is 34.6 and the medium household income is $47,693. That is down from 2009 when it was $49,839. The average salary for jobs in the county is $33,641(2009). The unemployment rate is 7.6% (Nov 2011). The percentage of residents living in poverty in 2009 is 16.4%. QUALITATIVE DESCRIPTION OF COMMUNITY BENEFIT Community Outreach for the Poor Pharmacy Indigent Care Program SAH provides prescription medications to persons who do not have the means to purchase them. Provisions of these medications helps the recipients to recover more quickly from their illnesses better manage chronic conditions and avoid costly hospitalizations. In fiscal year, 2013 prescription drugs valued at $7,164 were provided to 165 individuals Care Rides SAH collaborates with the City of Pendleton by paying $2,135 for one quarter of the cost of transportation for low-income patients in the community. This is to help ensure that this population has easy access to health care. Without it over five thousand rides would have not been provided and many may have hesitated addressing their needs in a timely manner, increasing the cost of care for all. Salvation Army Meals SAH helps provide meals weekly for the poor at the Salvation Army. The demand for this service continues to increase. This year the hospital provided almost ten percent mores meals over the prior year. Over 6,537 meals were served. This was at a cost of $248,693. St. Anthony Hospital continues to work collaboratively with our community to provide support during these difficult economic times. Tonya's House Tonya's House provides support to homeless teenage girls. They provide food, shelter, clothing, mental health, tutoring, transport to appointments and health care. SAH supports this service through donations and volunteer hours valued at $4,221. These girls would have nowhere else in this community to go if this service was not provided. Many of them come from unhealthy home environments where their lives are very much at risk because of domestic violence and/or substance abuse. Over 600 girls' needs were served. Pioneer Relief Nursery SAH provides supplies, utilities and free space for Pioneer Relief Nursery. The nursery provides respite childcare and training to parents who have challenges with childcare; which is a chronic unmet need. Its goal is to prevent child abuse and neglect in Umatilla County through intensive family support. They address the cycle of child abuse and neglect by providing therapeutic early childhood classrooms, parenting education, planned respite and comprehensive family support. PRN utilizes research-based strategies to help families build skills to cope with the stresses of raising children in families with risk factors such as poverty, substance abuse, domestic violence and isolation. Project Community Connect SAH is a part of a Coalition called A Home for Hope. Its mission is to twofold. One is to help those who are homeless or on the verge of homelessness connect with federal, state and local services. Second, is to work together to end homelessness in our community in ten-year time. St. Anthony Hospital, on its part provided volunteers, meals, and flu shots. Community Outreach for the Broader Community Hospice Care St. Anthony Hospice, as a part of its care of the terminally ill and their families, provides training and support of hospice volunteers. It also provides bereavement follow up and grief support groups for those grieving the loss of a loved one. This last year 370 individuals were served at a cost of $1,167. Flu Shot Clinic SAH provides flu shots free to the public each fall. This year over 2,135 people were served at a cost to the hospital of $10,103. This service helps prevent possible flu epidemics, which could lead to compromised health problems and or death. Childbirth Class Series SAH provide five-week series, offered six times a year. These classes cover all kinds of issues surrounding childbirth including breathing techniques, pain management, vaginal birth, and cesarean birth. They can help prepare parents for many aspects of childbirth: for the changes that pregnancy brings, for labor and delivery, and for parenting once your baby is born. These are the only classes of this kind offered in the area. Participants often come from outside the immediate area to take the classes. This last year over 1,040 people were served. Domestic Violence Services This is a private non-profit agency. It provides emergency services to victims of domestic violence and sexual assault. Its mission is to work toward ending this type of violence within the community. SAH supports this service through donations and volunteer hours. Last year 222 adults and children were provided food and shelter. This service also provided crisis calls, counseling and education. Collaborative Efforts to Improve Community Health School Based Health Center We collaborate with the local school district in providing access to health care in the school setting. SAH provides the salary and for a full-time nurse practitioner who provides support for the high school and middle school clinic. The hospital also supports the clinic's advisory committee with membership representation and space for their meetings to take place. The services provided are what would be found in a local pediatrician's office or family practice office. Services include the diagnosis and treatment (including prescriptions) for acute and chronic illnesses. It also provides the treatment of and injuries, immunizations, sport physicals and well-child checks. In essence, SBHCs bring the medical clinic into the school so school staff can refer students immediately for the care they need regardless of their ability to pay. Plus, they miss less class time! The total cost is $68,683. Over 2,310 services were through this program this year. Ninety-nine percent of the students are able to be seen and treated without being referred to their Primary Care Physician. The lack of availability of the nurse practitioner would hinder the ability to address health concerns early, before they become critical or chronic leading to poor school attendance. Schedule H, Part VI Lines 2,4 & 5: Needs Assessment, Community Information, and Promotion of Health Athletic Trainer SAH supports the athletic programs of both Blue Mountain Community College and Pendleton High School by providing an athletic trainer for their athletes. This service supports the promotion of healthier life styles, quicker access to health care and the prevention of server injuries. Without SAH support for this service these institutions would either have to limit their athletic programs they offer or jeopardize the health of the athletes. Breast Cancer Fund/Cancer Renewal Project These programs help address an important unmet need of those who battle with breast cancer. The Breast Cancer Fund helps support women who are being treated for breast cancer. Its main purpose is to provide immediate emergency relief money to breast cancer patients with emergent and/or special needs; such as mastectomy products and transportation assistance. The Cancer Renewal Project helps support survivors of cancer by offering them services that help in their recovery. These services include yoga, exercise classes and messages. SAH helps these programs by supporting the fundraising event "Tough Enough to Wear Pink," with both volunteer support and cash donations. One hundred forty-three women with breast cancer have benefited from these in this last year. Health Professions Education Health Care Professionals Training This past year we assisted in the training and education of future health care professionals. We do this to help address the need for better heath care access in rural communities. We subsidized the salary of a nurse educator for the Blue Mountain Nursing Program as well as providing a clinical cite and supervision for its nursing students. In addition, we provided a clinical site and supervision for students of a number of other health professions education programs: OHSU Nursing, LBCC Diagnostic Imaging and Pacific University Pharmacy. This ensures the availability of health care professionals our rural community. Cancer Conference St. Anthony Hospital sponsors this monthly conference. It is an essential forum to provide multidisciplinary consultative services for patients, as well as to offer education to physicians and allied health professionals. This is the only forum of this kind in the area. Schedule H, Part I, Line 3c Eligibility criteria for free or discounted care When Catholic Health Initiatives (the ultimate parent organization to St. Anthony Hospital) 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. St. Anthony Hospital 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 7g Subsidized Health Services There are no physician clinics included in subsidized health services. Schedule H, Part I, Line 7 Bad Debt Expense excluded from financial assistance calculation 2453026 Schedule H, Part I, Line 7 Costing Methodology used to calculate financial assistance A COST ACCOUNTING SYSTEM WAS NOT USED TO COMPUTE AMOUNTS IN THE TABLE. RATHER, COSTS IN THE TABLE WERE COMPUTED USING THE ORGANIZATION'S COST-TO-CHARGE RATIO. THE COST-TO-CHARGE RATIO COVERS ALL PATIENT SEGMENTS. THE COST-TO-CHARGE RATIO FOR THE YEAR ENDING 6/30/2015 WAS COMPUTED USING THE FOLLOWING FORMULA: OPERATING EXPENSE (BEFORE RESTRUCTURING, IMPAIRMENT AND OTHER LOSSES) DIVIDED BY GROSS PATIENT REVENUE. BASED ON THAT FORMULA, $57,680,390/$122,495,788 RESULTS IN A 47.1% COST-TO-CHARGE RATIO. Schedule H, Part II Community Building Activities Community Building Activities St. Anthony Hospital is very active in community building and leadership activities. SAH sees this as an essential part of its community benefit activities. They may not necessarily be seen as healthcare related, but since almost 90% of what causes individuals to need healthcare is life style related the hospital sees its involvement in these activities key to promoting healthy communities. The programs that hospital supports focus on the support and collaboration with community groups and organizations that seek to address identified needs in the community such as affordable healthcare, nurturing healthy activities that help prevent obesity and diabetes, and participation in coalitions that seek to address the needs of the homeless, housing and job shortages. Umatilla County Community Health Partnership St. Anthony Hospital is an active member of this county wide coalition. The purpose of the coalition is as follows: (1) Complete a Comprehensive County-Wide Community Health Assessment and Report; (2) Collaboratively work with the Partners to develop a 3-Year strategic plan based on the assessment. (3) Participate in the Healthy Communities Partnership in a coordinated effort to address community health needs Pendleton Progress Board Pendleton, like many communities, has been hit hard during this economic downturn. Hundreds of individuals have lost their jobs and with it their ability to pay for basic needs such as healthcare. This is reflected both in the results of the community needs assessment and in the continued demands on the hospital's charity care. For this reason, St. Anthony Hospital has several members of the Hospital Leadership participating on the Pendleton Progress Board. The Progress Board works on an advisory capacity to the City Mayor. They are committed to making the community an enjoyable and rewarding place to live and work. This includes retention and recruitment of business employers and addressing the community's housing shortage. Community Service Groups Service groups provide a variety of support to the Pendleton Community and surrounding area. This includes education, support groups, scholarships, healthcare and leadership training. Many of the groups St. Anthony sponsors and collaborates with in the service they provide. For others, the support for them comes by providing space and complementary meals for their meetings. In a small community like Pendleton, resources are limited. SAH support of these groups helps the health of whole community as a whole and nurture future collaborative work. Schedule H, Part III, Line 2 Bad debt expense - methodology used to estimate amount ST. ANTHONY HOSPITAL FOLLOWS CATHOLIC HEALTH INITIATIVES POLICY IN OFFERING A SELF-PAY DISCOUNT OF 26%. BAD DEBT IS ESTIMATED USING THE CROWE HORWATH REVENUE CYCLE ANALYTICS ON A MONTHLY BASIS. Schedule H, Part III, Line 3 Bad Debt Expense Methodology ST. ANTHONY HOSPITAL USES THE CROWE HORWARTH REVENE CYCLE ANALYTICS PROGRAM WHICH USES CURRENT AND HISTORICAL AR TO PROJECT CURRENT CONTRACUAL ALLOWANCES AND BAD DEBT. NO BAD DEBT IS INCLUDED AS A COMMUNITY BENEFIT. ST. ANTHONY HOSPITAL 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 The amount reported on the Schedule H, Part III, lines 2 and 3 are the same amounts reported for bad debt in the financial statements given corporate monthly. Please refer to the financial statement footnote below for information regarding the methodology used to determine and report bad debt expense. St. Anthony Hospital does not issue separate company audited financial statements. However, the organization is included in the consolidated financial statements of Catholic Health Initiatives. The consolidated footnote reads as follows: "The provision for bad debts is based upon management's assessment of historical and expected net collections, taking into consideration historical business and economic conditions, trends in health care coverage and other collection indicators. Management routinely assesses the adequacy of the allowances for uncollectible accounts based upon historical write-off experience by payor category. The results of these reviews are used to modify, as necessary, the provision for bad debts and to establish appropriate allowances for uncollectible net patient accounts receivable. After satisfaction of amounts due from insurance, CHI follows established guidelines for placing certain patient balances with collection agencies, subject to the terms of certain restrictions on collection efforts as determined by each facility. In accordance with Accounting Standards Update (ASU) No. 2011-07, Presentation and Disclosure of Patient Services Revenue, Provision for Bad Debts, and Allowances for Doubtful Accounts for Certain Health Entities, the provision for bad debts is presented on the consolidated statement of operations as a deduction from patient services revenues (net of contractual allowances and discounts) since CHI accepts and treats all patients without regard to the ability to pay." Schedule H, Part III, Line 8 Community benefit & methodology for determining medicare costs ST. ANTHONY HOSPITAL IS DESIGNATED AS A CRITICAL ACCESS HOSPITAL (CAH). CAHS ARE RURAL COMMUNITY HOSPITALS THAT ARE CERTIFIED TO RECEIVE COST-BASED REIMBURSEMENT FROM MEDICARE. THE REIMBURSEMENTS THAT CAHS RECEIVE ARE INTENDED TO IMPROVE THEIR FINANCIAL PERFORMANCE AND THEREBY REDUCE HOSPITAL CLOSURES. CAHS ARE CERTIFIED UNDER A DIFFERENT SET OF MEDICARE CONDITIONS OF PARTICIPATION (COP). SHORTFALLS ARE CREATED WHEN A FACILITY RECEIVES PAYMENT THAT IS LESS THAN THE COST OF CARING FOR PROGRAM BENEFICIARIES. SHORTFALLS ARE BASED ON COSTS, NOT CHARGES. ST. ANTHONY HOSPITAL, DUE TO ITS DESIGNATION AS A CAH, WOULD NORMALLY RECEIVE FULL COST-BASED REIMBURSEMENT FOR MEDICARE PURPOSES, BUT DUE TO A SEQUESTRATION REDUCTION THAT IS NOT FULLY THE CASE. ST. ANTHONY HOSPITAL, IN FY 15 EXPERIENCED A SHORTFALL OF $110,113 IN MEDICARE COSTS. 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: $15,942,387 Total Medicare costs: $16,052,516 Surplus or Shortfall $ (110,129) St. Anthony Hospital believes that excluding Medicare losses from community benefit makes the overall community benefit report more credible for these reasons: Unlike subsidized areas such as burn units or behavioral-health services, Medicare is not a differentiating feature of tax-exempt health care organizations. In fact, for-profit hospitals focus on attracting patients with Medicare coverage, especially in the case of well-paid services that include cardiac and orthopedics. Significant effort and resources are devoted to ensuring that hospitals are reimbursed appropriately by the Medicare program. The Medicare Payment Advisory Commission (MedPAC), an independent Congressional agency, carefully studies Medicare payment and the access to care that Medicare beneficiaries receive. The commission recommends payment adjustments to Congress accordingly. Though Medicare losses are not included by Catholic hospitals as community benefit, the Catholic Health Association guidelines allow hospitals to count as community benefit some programs that specifically serve the Medicare population. For instance, if hospitals operate programs for patients with Medicare benefits that respond to identified community needs, generate losses for the hospital, and meet other criteria, these programs can be included in the CHA framework in Category C as "subsidized health services." Medicare losses are different from Medicaid losses, which are counted in the CHA community benefit framework, because Medicaid reimbursements generally do not receive the level of attention paid to Medicare reimbursement. Medicaid payment is largely driven by what states can afford to pay, and is typically substantially less than what Medicare pays. Schedule H, Part III, Line 9b Collection practices for patients eligible for financial assistance St. Anthony Hospital's debt collection policy provides that St. Anthony Hospital 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 St. Anthony Hospital community assistance policy. After having been turned over to a third-party collection agent, any patient account that is subsequently determined to meet the St. Anthony Hospital community assistance policy is required to be returned immediately by the third-party collection agent to St. Anthony Hospital for appropriate follow-up. St. Anthony Hospital 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 - St. Anthony Hospital: Line 16a URL: http://www.sahpendleton.org/patient-financial-assistance.html; Schedule H, Part V, Section B, Line 16b FAP Application website - St. Anthony Hospital: Line 16b URL: http://www.sahpendleton.org/patient-financial-assistance.html; Schedule H, Part V, Section B, Line 16c FAP plain language summary website - St. Anthony Hospital: Line 16c URL: http://www.sahpendleton.org/patient-financial-assistance.html; Schedule H, Part VI, Line 3 Patient education of eligibility for assistance St Anthony Hospital includes information concerning its financial assistance policy on its website. In addition, St Anthony Hospital 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 St Anthony Hospital outpatient facilities. In addition, St Anthony Hospital 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 St Anthony Hospital'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. St Anthony Hospital 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. St Anthony Hospital'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 St. Anthony Hospital, 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. St. Anthony Hospital operates with its wholly owned affiliates and community partners, along with its fundraising arm, the St. Anthony Hospital Foundation, to serve the health care needs of the Pendleton, Oregon and surrounding communities. Schedule H, Part VI, Line 7 State filing of community benefit report OR true Blue Mountain Community College PO Box 100 Pendleton OR 97801 930506536 115(1) 20000 College Programs 1 0 Financial Assistance 1945 0 1174726 Book Financial Assistance Schedule I, Part I, Line 2 Description Of Procedure For Monitoring Use Of Grant Funds THESE ARE DONATIONS DEEMED TO BE MADE BY HOSPITAL ADMINISTRATION WITH THE BACKING OF THE BOARD OF DIRECTORS. EACH DONATION IS BROUGHT TO THE ATTENTION OF THE BOARD PRIOR TO BEING DISPENSED. THE ORGANIZATION DOES NOT MONITOR THE USE OF GRANT FUNDS AFTER THEY ARE GRANTED. Schedule I, Part III Financial Assistance St Anthony Hospital 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. THESE ARE DONATIONS DEEMED TO BE MADE BY HOSPITAL ADMINISTRATION WITH THE BACKING OF THE BOARD OF DIRECTORS. EACH DONATION IS BROUGHT TO THE ATTENTION OF THE BOARD PRIOR TO BEING DISPENSED. THE ORGANIZATION DOES NOT MONITOR THE USE OF GRANT FUNDS AFTER THEY ARE GRANTED. false true false false false false false true false Harold Geller President / TRUSTEE 0 231682 0 40658 0 23589 0 38994 0 20505 0 355428 0 0 MICHAEL BRUNSMAN Physician 308742 0 0 0 4561 0 28562 0 23440 0 365305 0 0 0 JOHN MCBEE MD Trustee/physician 165615 0 0 0 0 0 0 0 0 0 165615 0 0 0 JIM SCHLENKER Former CFO 188013 0 28804 0 618 0 18489 0 22480 0 258404 0 0 0 GLORIA LARSON VP Patient Care 156356 0 23837 0 1702 0 24073 0 14948 0 220916 0 0 0 WILLIAM BELL MD Physician 632184 0 0 0 5544 0 30052 0 23440 0 691220 0 0 0 GABRIEL GARTON CRNA 213168 0 0 0 158 0 17995 0 22520 0 253841 0 0 0 JOHN POZAR CRNA 203735 0 0 0 270 0 22125 0 19699 0 245829 0 0 0 NANCY BROWN CRNA 227287 0 0 0 805 0 25653 0 15088 0 268833 0 0 0 Amber Pederson CRNA 215781 0 0 0 158 0 5888 0 19748 0 241575 0 0 0 Schedule J, Part I, Line 4a SEVERANCE OR CHANGE-OF-CONTROL PAYMENTS 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. NO REPORTABLE INDIVIDUALS RECEIVED SEVERANCE PAYMENTS FROM THE FILING ORGANIZATION OR A RELATED ORGANIZATION DURING THE 2014 CALENDAR YEAR. Schedule J, Part I, Line 3 Arrangement used to establish the top management official's compensation Compensation for the top management official is generally established and paid by Catholic Health Initiatives (CHI), a related organization. CHI uses the following to establish the top management official's compensation: (1) Compensation Committee; (2) Independent Compensation Consultant; (3) Written Employment Contracts; (4) Compensation Survey or Study; (5) Approval by the Board or Compensation Committee. Schedule J, Part I, Line 4b Supplemental nonqualified retirement plan During the 2014 calendar year Catholic Health Initiatives (CHI), a related organization, maintained a supplemental non-qualified deferred compensation plan for MBO CEOs and other CHI employees at the level of Senior Vice President and above. The following reportable individuals were eligible to participate in that plan: HAROLD GELLER During 2014 the following contributions were made by CHI to the deferred compensation plan: HAROLD GELLER $21,152 Schedule J, Part I, Line 7 Non-fixed payments Some physicians receive incentive compensation payments that are based on a percentage of net collected revenue from services performed by that physician specifically. Form 990, Part III, Line 1 MISSION MISSION. THE MISSION OF THE CORPORATION IS TO NURTURE THE HEALING MINISTRY OF THE CHURCH, SUPPORTED BY EDUCATION AND RESEARCH. FIDELITY TO THE GOSPEL URGES THE CORPORATION TO EMPHASIZE HUMAN DIGNITY AND SOCIAL JUSTICE AS IT CREATES HEALTHIER COMMUNITIES. THE CORPORATION, SPONSORED BY A LAY-RELIGIOUS PARTNERSHIP, CALLS OTHER CATHOLIC SPONSORS AND SYSTEMS TO UNITE TO ENSURE THE FUTURE OF CATHOLIC HEALTH CARE. TO FULFILL THIS MISSION, THE CORPORATION, AS A VALUES-BASED ORGANIZATION, WILL ASSURE THE INTEGRITY OF THE MINISTRY IN BOTH CURRENT AND DEVELOPING ORGANIZATIONS AND ACTIVITIES; RESEARCH AND DEVELOP NEW MINISTRIES THAT INTEGRATE HEALTH, EDUCATION, PASTORAL, AND SOCIAL SERVICES; PROMOTE LEADERSHIP DEVELOPMENT AND FORMATION FOR MINISTRY THROUGHOUT THE ENTIRE ORGANIZATION; ADVOCATE FOR SYSTEMIC CHANGES WITH SPECIFIC CONCERN FOR PERSONS WHO ARE POOR, ALIENATED, AND UNDERSERVED; AND STEWARD RESOURCES BY GENERAL OVERSIGHT OF THE ENTIRE ORGANIZATION. Form 990, Part VI, Line 15a PROCESS FOR DETERMINING CEOS 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 18, 2014. In addition, in December 2009, Hay Group completed a comprehensive review of all positions at the level of vice president and above 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 1a Delegate broad authority to a committee Pursuant to Section 8.6 of the Bylaws of St. Anthony Hospital, the Executive Committee is composed of the board chair, the board vice chair, the President and CEO, and at least one (1) member of the Sisters of St. Francis of Philadelphia each of whom shall serve as an ex officio voting member of the Executive Committee. Each individual appointed to the Executive Committee shall serve for a term of one year or until his or her successor is duly appointed by the Board of Directors. The Executive Committee shall consist of only directors of the Corporation. Pursuant to Section 8.1 of the Corporation's bylaws, committees, such as the executive committee, that are granted the authority to act on behalf of the board of directors may include only directors of the corporation. Further, pursuant to Section 8.6 of the Corporation's bylaws, the executive committee has and may exercise such powers as may be delegated to it by the board of directors. The Executive Committee also possesses the power to transact routine business of the corporation in the interim period between regularly scheduled meetings of the board of directors. Form 990, Part VI, Line 6 Classes of members or stockholders THE SOLE CORPORATE MEMBER OF ST. ANTHONY HOSPITAL IS CATHOLIC HEALTH INITIATIVES (CHI), A COLORADO NON-PROFIT CORPORATION. Form 990, Part VI, Line 7a Members or stockholders electing members of governing body According to the organization's bylaws, directors shall be appointed or refused by the corporate member. The corporate member may appoint one or more individuals to the board of directors, and may at any time remove, with or without cause, any member of the board of directors. According to the organization's bylaws, directors of the corporation shall be appointed by the corporate member no later than June 30 of each year. The names and qualifications of each individual accepted by the board of directors shall be submitted to the corporate member, who shall appoint or refuse each nominee in accordance with the corporate member's bylaws and with endorsement of the senior vice president of operations. The corporate member may unilaterally appoint one or more individuals to the board of directors should the board fail to furnish the corporate member with a list of individuals qualified to serve on the board of directors of the corporation. Form 990, Part VI, Line 7b Decisions requiring approval by members or stockholders THE ORGANIZATION'S CORPORATE MEMBER IS CATHOLIC HEALTH INITIATIVES ("CHI"). PURSUANT TO SECTION 5.4.1 OF THE ORGANIZATION'S BYLAWS, THE CORPORATE MEMBER SHALL HAVE THE SPECIFIC RIGHTS SET FORTH IN THE GOVERNANCE MATRIX. PURSUANT TO THE GOVERNANCE MATRIX THE FOLLOWING RIGHTS ARE RESERVED TO THE CHI BOARD DIRECTLY OR THROUGH POWERS DELEGATED TO THE CHI CHIEF EXECUTIVE OFFICER: *SUBSTANTIAL CHANGE IN THE MISSION OR PHILOSOPHY OF ST. ANTHONY HOSPITAL *AMENDMENT OF THE CORPORATE DOCUMENTS OF ST. ANTHONY HOSPITAL *APPROVE MEMBERS OF ST. ANTHONY HOSPITAL'S BOARD *REMOVAL OF A MEMBER OF THE GOVERNING BODY OF ST. ANTHONY HOSPITAL *APPROVAL OF ISSUANCE OF DEBT BY ST. ANTHONY HOSPITAL *APPROVAL OF PARTICIPATION OF ST. ANTHONY HOSPITAL IN A JOINT VENTURE *APPROVAL OF FORMATION OF A NEW CORPORATION BY ST. ANTHONY HOSPITAL *APPROVAL OF A MERGER INVOLVING ST. ANTHONY HOSPITAL *APPROVAL OF THE SALE OF ALL OR SUBSTANTIALLY ALL OF THE ASSETS OF ST. ANTHONY HOSPITAL *TO REQUIRE THE TRANSFER OF ASSETS BY ST. ANTHONY HOSPITAL TO CHI TO ACCOMPLISH CHI'S GOALS AND OBJECTIVES, AND TO SATISFY CHI DEBTS. *ADOPTION OF LONG RANGE AND STRATEGIC PLANS FOR ST. ANTHONY HOSPITAL PURSUANT TO SECTION 5.5.2 OF THE ORGANIZATION'S BYLAWS, CHI MAY, IN EXERCISE OF ITS APPROVAL POWERS, GRANT OR WITHHOLD APPROVAL IN WHOLE OR IN PART, OR MAY, IN ITS COMPLETE DISCRETION, AFTER CONSULTATION WITH THE BOARD AND THE PRESIDENT AND CHIEF EXECUTIVE OFFICER OF THE ORGANIZATION, RECOMMEND SUCH OTHER OR DIFFERENT ACTIONS AS IT DEEMS APPROPRIATE. Form 990, Part VI, Line 11b Review of form 990 by governing body ONCE THE RETURN IS PREPARED, THE RETURN IS REVIEWED BY THE CEO. A COPY OF THE RETURN WILL BE PROVIDED TO THE ST. ANTHONY BOARD BEFORE THE RETURN IS FILED. SUBSEQUENT TO REVIEW BY THE CEO THE TAX DEPARTMENT FILES THE RETURN WITH THE APPROPRIATE FEDERAL AND STATE AGENCIES, MAKING ANY NON-SUBSTANTIVE CHANGES NECESSARY TO EFFECT E-FILING. ANY SUCH CHANGES ARE NOT RE-SUBMITTED TO THE CEO. Form 990, Part VI, Line 12c Conflict of interest policy Catholic Health Initiatives ("CHI") has a Conflicts of Interest ("COI") policy in place to maintain the integrity of all of its activities. The policy applies to CHI Board of Stewardship Trustees and members of its committees; all board and board committee members of CHI Entities; all CHI employees; all CHI physicians (both employed and non-employed) and all physician administrators and leaders; advanced practice clinicians (both employed and non-employed); and all CHI research personnel (both employed and non-employed). Disclosure, review and management of perceived, potential or actual conflicts of interest are accomplished through a defined COI disclosure process. Each person has a general ongoing obligation to promptly and fully report to his/her direct manager, supervisor, medical staff office, board or board committee chair any situation or circumstance that may create a conflict of interest. The person must report the actual or potential conflict as soon as she/he becomes aware of it. In any situation where the person may be in doubt, a full disclosure should be made to permit an impartial and objective determination. In addition to the general ongoing obligation, there are initial disclosure obligations. The board, board committee members, and new employees are required to make disclosures at the time of their initial hiring/appointment. All non-employed, credentialed or contracted physicians are required to make disclosures at the time of their credentialing and during any subsequent reappointment or recredentialing. All researchers are required to make disclosures upon consideration of affiliation with a research sponsor. In addition to the general ongoing and initial disclosure obligations, there is an annual disclosure obligation. All corporate officers, board and board committee members, employees at the level of manager and above, researchers, supply chain employees, employed physicians, physician administrators and leaders, and employed advanced practice clinicians must complete a new conflict of interest disclosure annually. Disclosures of perceived, potential or actual conflicts involving financial interests are forwarded to the Conflicts of Interest Review Committee ("C-CIRC") or Legal Services Group for review depending on the position of the person involved. The C-CIRC reviews COI questionnaires containing disclosures of perceived or possible conflicts for employees at a level of manager or above, supply chain employees, researchers and physicians, physician administrators and leaders, and advanced practice clinicians (both employed and non-employed). In the determination of a conflict, a COI management plan will be developed for that person. With respect to those audiences for which the C-CIRC has review responsibility, the C-CIRC will facilitate development of any such conflict of interest management plan in collaboration with local CRP staff. A designated CHI Entity staff will be responsible for monitoring the COI management plan and for documenting monitoring activities. At its sole discretion, a CHI Entity may reject a Person's request to enter into the relationship in question, or require the relationship be sufficiently altered to avoid a potential COI. If the C-CIRC determines that there is a potential or actual conflict of interest that does not currently have appropriate controls to address the conflict of interest, it may recommend that the disclosing person be allowed to participate in the activity or transaction subject to restrictions as outlined in the COI management plan. If a Person does not agree with a determination made by the C-CIRC, its interpretation of the Policy or Addenda, or seeks an exemption or exception, the following steps should be followed. The Employee disputing the review decision, interpretation of the Policy, or seeking exemption or exception must present the matter to the Employee's immediate direct manager or supervisor for review and determination. If the Employee and the manager do not agree with the review decision, interpretation of the Policy, or seek exemption or exception, the manager shall consult with the manager's Vice President (or higher if the manager is a Vice President) to reach a determination. If the matter remains unresolved, it shall be referred to the CHI Vice President of Human Resources and the CHI Corporate Responsibility Officer. If they are unable to reach agreement, the matter shall be referred to the CHI General Counsel, whose decision shall be final. Reviews and determinations involving board and board committee members and corporate officers will be the responsibility of the board, board executive committee, or board chair, with guidance from the Legal Services Group (LSG). Annual COI disclosures of all trustee and corporate officers will be reviewed by the CHI Senior Vice President, Legal Services, and General Counsel or his or her designee who will report potential conflicts to the applicable Board Chair. The Board Chair or designee shall make such further investigation of any conflict of interest disclosures as he or she may deem appropriate. If the conflict involves the Board Chair, the Vice Chair will assume the Chair's role. Based on review and evaluation of the relevant facts and circumstances, the Board Chair will make an initial determination as to whether a conflict of interest exists and whether, pursuant to the COI Policy, review and approval or other action by the Board is required. A written record of the Board Chair's determination, including relevant facts and circumstances, will be made. The Board Chair shall then make an appropriate report to the Executive Committee of the Board concerning such review, evaluation and determination. If a difference of opinion exists between the Board Chair and another Trustee as to whether the facts and circumstances of a given situation constitute a conflict of interest or whether Board review and approval or other action is required within the COI Policy, the matter shall be submitted to the Board's Executive Committee, which shall make a final determination as to the matter presented. Such determination, including relevant facts and circumstances, will be reflected in the Executive Committee minutes and will be reported to the Board. When any conflict of interest is considered by the board, the trustee or corporate officer, as appropriate, must disclose all of the material facts to the Board. The trustee shall not vote and the trustee or corporate officer shall not use his or her personal influence on the matter. The trustee or corporate officer shall be excused from the meeting during discussion and vote on the conflict of interest. In reviewing such transactions between CHI or CHI Entities and vendors or other contractors who are, or are affiliated with, Trustees or Corporate Officers, the Board will act as it would in reviewing transactions with unrelated third parties. The transaction is not be approved unless the Board determines that the transaction is fair to CHI or the CHI Entity. The Board must approve the transaction by a majority of the Trustees on the Board, without counting the vote of any individual who has an interest in the transaction. All determinations of conflicts of interest are reported as required by law, regulations, and CHI policy. Form 990, Part VI, Line 15b Process to establish compensation of other employees ST. ANTHONY HOSPITAL UTILIZES MARKET COMPENSATION RANGES FROM MARKET SURVEYS, COMPARABILITY STUDIES AND BOARD APPROVAL TO SET EXECUTIVE COMPENSATION UNDER THE ORGANIZATION'S COMPENSATION PHILOSOPHY. SPECIAL CONSIDERATION IS MADE FOR HIGH PERFORMERS AND THOSE WITH SPECIALIZED SKILLS OR EXPERIENCE. THIS PROCESS IS USED NOT ONLY FOR NEW HIRES BUT FOR ANNUAL MARKET ADJUSTMENTS AS WELL. THE PROCESS AND DECISIONS ARE DOCUMENTED IN EACH EMPLOYEE'S FILE IN HUMAN RESOURCES. St. Anthony Hospital used the Milliman NW executive survey in FY 2014 to make sure senior Executive pay was in line with the Regional Market. Form 990, Part VI, Line 19 Required documents available to the public THE ORGANIZATION'S GOVERNING DOCUMENTS AND THE CONFLICT OF INTEREST POLICY ARE AVAILABLE TO THE PUBLIC UPON REQUEST. THE ORGANIZATION'S FINANCIAL STATEMENTS ARE INCLUDED IN CATHOLIC HEALTH INITIATIVES' CONSOLIDATED AUDITED FINANCIAL STATEMENTS THAT ARE AVAILABLE AT WWW.CATHOLICHEALTHINIT.ORG OR AT WWW.DACBOND.COM. Form 990, Part VIII, Line 11d Other Miscellaneous Revenue Other Miscellaneous Revenue - Total Revenue: 41036, Related or Exempt Function Revenue: , Unrelated Business Revenue: 33126, Revenue Excluded from Tax Under Sections 512, 513, or 514: 7910; Form 990, Part IX, Line 11g Other Fees Other Fees for Services - Total Expense: 2798331, Program Service Expense: 2025293, Management and General Expenses: 773038, Fundraising Expenses: ; Consulting - Total Expense: 56590, Program Service Expense: 56590, Management and General Expenses: , Fundraising Expenses: ; Contract Services - Total Expense: 3992845, Program Service Expense: 3992845, Management and General Expenses: , Fundraising Expenses: ; Contract Labor - Total Expense: 2139805, Program Service Expense: 2139805, Management and General Expenses: , Fundraising Expenses: ; Form 990, Part XI, Line 9 Other changes in net assets or fund balances Capital Resource Contribution - -1198932; Reversal of prior period government grant - -750000; 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