2015-05-13T14:00:39-05:00 2014-06-30 CROWE HORWATH LLP 225 WEST WACKER DRIVE SUITE 2600 CHICAGO IL 606061224 990 2013-07-01 371137724 HOSPITAL SISTERS HEALTH SYSTEM HEALTH CARE PLAN TRUST FUND HOSP 2175234747 4936 LAVERNA ROAD Springfield IL 62707 MICHAEL W COTTRELL CFO 2015-04-03 true JOHN V WOODHULL P01305268 3128997000 2013 2016-02-25 16:41:14Z MICHAEL W COTTRELL 4936 LAVERNA ROAD Springfield IL 62707 169481139 false 0928 X WWW.HSHS.ORG X 1983 IL TO REVEAL AND EMBODY CHRIST'S HEALING LOVE FOR ALL PEOPLE THROUGH A HEALTH CARE MINISTRY. 0 0 0 0 0 0 0 0 138491583 136177007 1886921 3412411 751 0 140379255 139589418 0 0 129827244 131067599 0 0 0 0 0 8193153 10250024 138020397 141317623 2358858 -1728205 61576615 67947106 36042488 40411975 25534127 27535131 TO REVEAL AND EMBODY CHRIST'S HEALING LOVE FOR ALL PEOPLE THROUGH A HEALTH CARE MINISTRY. false false HOSPITAL SISTERS HEALTH SYSTEM HEALTH CARE PLAN TRUST FUND PROVIDES PAYMENTS FOR HOSPITAL CARE, OTHER MEDICAL CARE AND RELATED ADMINISTRATIVE COSTS AS AN EMPLOYMENT BENEFIT TO EMPLOYEES OF THE EXEMPT HOSPITAL AND HEALTH CARE ORGANIZATIONS AFFILIATED WITH HOSPITAL SISTERS HEALTH SYSTEM. false false false false false false false false false false false false false true true false true false false false false false false false false false false false false false false false false false false false false false false true true false false false true 0 0 0 false false false false false false X 0 0 false false false false false true true false false false false true false false false false false false X MICHAEL W COTTRELL 2175234747 4936 LAVERNA ROAD SPRINGFIELD IL 62707 X JP MORGAN CHASE BANK NA TRUSTEE 5.00 0 X 0 0 0 0 0 0 0 false false false BLUECROSS BLUESHIELD OF ILLINOIS 25551 NETWORK PLACE CHICAGO IL 606731255 TPA FOR MEDICAL PLAN 4397984 DEAN HEALTH PLAN 1277 DEMING WAY MADISON WI 53717 TPA FOR MEDICAL PLAN 2544656 VOYA SERVICE CENTER 2000 21ST AVE NW MINOT ND 58703 REINSURANCE PREMIUMS 1876195 CIGNA ROUTE C3 FIN HARTFORD CT 06152 TPA FOR DENTAL PLAN 346237 HEALTHWAYS INC PO BOX 116718 ATLANTA GA 303687180 MISCELLANEOUS EMPLOYEE BENEFIT 320000 5 0 0 0 0 0 0 0 0 HEALTH INSURANCE FEES 525100 136177007 136177007 0 0 0 0 0 0 0 0 136177007 1050554 1050554 0 0 0 0 0 32253578 29891721 2361857 0 2361857 2361857 0 0 0 0 0 0 0 0 0 0 0 139589418 136177007 0 3412411 0 0 0 131067599 0 0 0 0 0 0 0 15474 7400 0 0 161307 215664 0 21842 0 0 0 0 0 0 0 0 0 0 ADMIN EXPENSE HEALTH 6792681 REINSURANCE PREMIUMS 1876195 CLAIMS MANAGEMENT 149959 ADMIN EXPENSE DENTAL 346237 663265 141317623 0 0 0 18963850 18005721 824 10055 0 0 0 0 0 0 0 0 40314220 47455124 0 0 0 0 2297721 2476206 61576615 67947106 11810715 17958187 0 0 24231773 22453788 36042488 40411975 X 25534127 27535131 25534127 27535131 61576615 67947106 -1728205 3729209 0 X false true X true false 0 0 0 0 0 0 0 SECURITIES PAYABLE 259980 UNEARNED PREMIUMS 3114187 RESERVE FOR CONTINGENCIES 10418000 CLAIMS PAYABLE 8661621 22453788 X Schedule D, Part X, Line 2, FIN 48 (ASC 740) footnote HSHS AND THE FOUNDATION ARE ILLINOIS NOT FOR PROFIT ORGANIZATIONS AS DESCRIBED IN SECTION 501(C) (3) OF THE INTERNAL REVENUE CODE (THE CODE) AND ARE EXEMPT FROM FEDERAL INCOME TAXES ON RELATED INCOME PURSUANT TO SECTION 501(A) OF THE CODE. DEFERRED TAX ASSETS AND LIABILITIES ARE RECOGNIZED FOR THE FUTURE TAX CONSEQUENCES ATTRIBUTABLE TO DIFFERENCES BETWEEN THE CONSOLIDATED FINANCIAL STATEMENT CARRYING AMOUNTS OF EXISTING ASSETS AND LIABILITIES AND THEIR RESPECTIVE TAX BASIS AND OPERATING LOSS AND TAX CREDIT CARRYFORWARDS. DEFERRED TAX ASSETS AND LIABILITIES ARE MEASURED USING THE ENACTED TAX RATES EXPECTED TO APPLY TO TAXABLE INCOME IN THE YEARS IN WHICH THOSE TEMPORARY DIFFERENCES ARE EXPECTED TO BE RECOVERED OR SETTLED. THE EFFECT ON DEFERRED TAX ASSETS AND LIABILITIES OF A CHANGE IN TAX RATES IS RECOGNIZED IN INCOME IN THE PERIOD THAT INCLUDES THE ENACTMENT DATE. IN ASSESSING THE REALIZABILITY OF DEFERRED TAX ASSETS, MANAGEMENT CONSIDERS WHETHER IT IS MORE LIKELY THAN NOT THAT SOME PORTION OR ALL OF THE DEFERRED TAX ASSETS WILL NOT BE REALIZED. THE ULTIMATE REALIZATION OF DEFERRED TAX ASSETS IS DEPENDENT UPON THE GENERATION OF FUTURE TAXABLE INCOME DURING THE PERIODS IN WHICH THOSE TEMPORARY DIFFERENCES BECOME DEDUCTIBLE. MANAGEMENT CONSIDERS PROJECTED FUTURE TAXABLE INCOME AND TAX PLANNING STRATEGIES IN MAKING THIS ASSESSMENT. BASED UPON THE LEVEL OF HISTORICAL TAXABLE LOSSES AND PROJECTIONS FOR FUTURE TAXABLE LOSSES OVER THE PERIODS FOR WHICH THE DEFERRED TAX ASSETS ARE DEDUCTIBLE, MANAGEMENT BELIEVES IT IS MORE LIKELY THAN NOT THAT KIARA, INC. WILL NOT REALIZE THE MAJORITY OF THE BENEFITS OF THESE DEDUCTIBLE DIFFERENCES. THE DEFERRED TAX ASSETS ATTRIBUTABLE TO THE NET OPERATING LOSS CARRYFORWARDS NOT REALIZED AS OF JUNE 30, 2014 AND 2013 HAVE BEEN FULLY RESERVED IN THE ACCOMPANYING CONSOLIDATED FINANCIAL STATEMENTS DUE TO THE UNCERTAINTY OF REALIZATION. HSHS RECOGNIZES THE TAX BENEFIT FROM AN UNCERTAIN TAX POSITION ONLY IF IT IS MORE LIKELY THAN NOT THAT THE TAX POSITION WILL BE SUSTAINED ON EXAMINATION BY THE TAXING AUTHORITIES, BASED ON THE TECHNICAL MERITS OF THE POSITION. AS OF JUNE 30, 2014 AND 2013, HSHS DOES NOT HAVE ANY LIABILITIES FOR UNRECOGNIZED TAX BENEFITS. Form 990, Part VI, Sec A, Line 7a, Members or stockholders electing members of governing body THE SENIOR GOVERNING BODY OF HSHS HEALTH CARE PLAN TRUST FUND (THE "TRUST") IS HOSPITAL SISTERS HEALTH SYSTEM ("HSHS"), AN ILLINOIS NOT FOR PROFIT CORPORATION EXEMPT FROM FEDERAL TAXATION UNDER SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE. THE TRUST DOES NOT HAVE A BOARD OF DIRECTORS. Form 990, Part VI, Sec A, Line 7b, Decisions requiring approval by members or stockholders MEMBER RESERVED POWERS RESPONSIBILITY FOR THE POLICY AND OPERATIONS OF HSHS HEALTH CARE PLAN TRUST FUND (THE "TRUST") IS VESTED IN HOSPITAL SISTERS HEALTH SYSTEM ("HSHS"), AN ILLINOIS NOT FOR PROFIT CORPORATION EXEMPT FROM FEDERAL TAXATION UNDER SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE. THE TRUST OPERATES IN ACCORDANCE WITH THE HOSPITAL SISTERS HEALTH SYSTEM HEALTH CARE TRUST AGREEMENT, DATED DECEMBER 8, 2008 ("AGREEMENT"). PURSUANT TO THE AGREEMENT, HOSPITAL SISTERS HEALTH SYSTEM, AN ILLINOIS NOT FOR PROFIT CORPORATION EXEMPT FROM FEDERAL TAXATION UNDER SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE ("HSHS") APPOINTS THE TRUSTEE, A BANK WHICH HOLDS, INVESTS, AND DISBURSES FUNDS FROM THE TRUST FUND; AND THE PLAN ADMINSISTRATOR, WHO IS A FIDUCIARY WHO CONTROLS AND MANAGES THE OPERATION AND ADMINISTRATION OF THE HEALTH CARE PLAN, AND APPOINTS THE INVESTMENT ADVISOR, WHO DIRECTS THE INVESTMENT OF THE TRUST FUND. HSHS AND THE TRUSTEE, PLAN ADMINISTRATOR, AND INVESTMENT ADVISOR ARE OBLIGATED TO PERFORM IN ACCORDANCE WITH THE AGREEMENT. Form 990, Part VI, Sec A, Line 8a, Documentation of meetings held by governing body THE SENIOR GOVERNING BODY OF HSHS HEALTH CARE PLAN TRUST FUND (THE "TRUST") IS HOSPITAL SISTERS HEALTH SYSTEM ("HSHS"), AN ILLINOIS NOT FOR PROFIT CORPORATION EXEMPT FROM FEDERAL TAXATION UNDER SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE. THE TRUST DOES NOT HAVE A BOARD OF DIRECTORS, OR COMMITTEE THEREOF, BY WHICH MEETINGS ARE HELD. Form 990, Part VI, Sec A, Line 8b, Documentation of meetings held by committees of governing body PLEASE SEE NARRATIVE FOR FORM 990, PART VI, SECTION B, LINE 8A. Form 990, Part VI, Sec B, Line 11b, Review of form 990 by governing body RESPONSIBILITY FOR THE POLICY AND OPERATIONS OF HSHS HEALTH CARE PLAN TRUST FUND (THE "TRUST") IS VESTED IN HOSPITAL SISTERS HEALTH SYSTEM ("HSHS"), AN ILLINOIS NOT FOR PROFIT CORPORATION EXEMPT FROM FEDERAL TAXATION UNDER SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE. HSHS EMPLOYS CROWE HORWATH TO ASSIST IN THE OVERALL PREPARATION, REVIEW AND ELECTRONIC SUBMISSION OF THE FORM 990. CROWE HORWATH PROVIDES GUIDANCE IN IDENTIFYING CRITICAL ERRORS IN THE RETURN SUBMISSION, AND FEEDBACK ON QUANTITATIVE AND QUALITATIVE RESPONSES. ADDITIONALLY, HSHS' CFO PERFORMS A THOROUGH REVIEW OF THE RETURN, AND REVIEWS IT WITH THE CEO, AND/OR SENIOR LEADERS, BEFORE PRESENTING IT IN ITS ENTIRETY TO HSHS' BOARD FOR QUESTIONING AND REVIEW PRIOR TO THE RETURN'S SIGNING AND SUBMISSION TO THE IRS. FORM 990, PART VI, LINE 13, WHISTLEBLOWER POLICY PROVISIONS WITHIN THE CORPORATE COMPLIANCE PROGRAM AND CONFLICT OF INTEREST POLICY PROVIDE PROTECTIONS FOR WHISTLEBLOWER TYPE ACTIVITIES. FORM 990, PART VI, LINE 15, PROCESS USED TO ESTABLISH COMPENSATION THE TRUST DOES NOT HAVE COMPENSATED EMPLOYEES; THEREFORE, LINES 15A AND 15B HAVE BEEN ANSWERED "NO" IN ACCORDANCE WITH THE FORM 990 INSTRUCTIONS Form 990, Part VI, Sec C, Line 19, Required documents available to the public BOARD-APPROVED FINANCIAL STATEMENTS ARE MADE AVAILABLE TO THE PUBLIC UPON REQUEST. THE TRUST FOLLOWS THE DOCUMENTS AND POLICIES OF HOSPITAL SISTERS HEALTH SYSTEM ("HSHS"), AN ILLINOIS NOT FOR PROFIT CORPORATION EXEMPT FROM FEDERAL TAXATION UNDER SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE. THESE POLICIES AND THE TRUST'S GOVERNING PLAN DOCUMENTS ARE NOT MADE AVAILABLE TO THE GENERAL PUBLIC AT THIS TIME. FORM 990, PART X, LINE 11, POOLED INVESTMENT ACCOUNT THE ORGANIZATION'S CASH RESERVES ARE INVESTED IN A POOLED INVESTMENT ACCOUNT. PARTICIPATION IN THE POOLED FUND IS LIMITED TO THE 501(C)(3) HOSPITALS AND RELATED HEALTH SERVICES ORGANIZATIONS SPONSORSED BY HSHS. THE POOLED ACCOUNT CONSISTS OF CASH, EQUITY AND DEBT SECURITIES THAT ARE PUBLICLY TRADED. IN ACCORDANCE WITH THE PROVISIONS OF SFAS NO. 124 "ACCOUNTING FOR CERTAIN INVESTMENTS HELD BY NOT-FOR-PROFIT ORGANIZATIONS," INVESTMENTS IN EQUITY SECURITIES WITH READILY DETERMINABLE VALUES, AND ALL INVESTMENTS IN DEBT SECURITIES ARE REPORTED AT FAIR VALUE ON THE BALANCE SHEET. INCOME, REALIZED AND UNREALIZED GAINS AND LOSSES ARE NOT IDENTIFIED TO THE PARTICIPANTS. SCHEDULE O, AFFILIATED HEALTH SYSTEM DISCLOSURE HSHS HEALTH CARE PLAN TRUST FUND IS AN AFFILIATE OF HOSPITAL SISTERS HEALTH SYSTEM (HSHS), A HEALTH CARE MINISTRY THAT INCLUDES 13 HOSPITALS, NUMEROUS COMMUNITY-BASED HEALTH CENTERS AND CLINICS, AND HUNDREDS OF PHYSICIAN PARTNERS ACROSS ILLINOIS AND WISCONSIN. THE MISSION OF HSHS IS "TO REVEAL AND EMBODY CHRIST'S HEALING LOVE FOR ALL PEOPLE THROUGH OUR HIGH QUALITY FRANCISCAN HEALTH CARE MINISTRY." WE LIVE OUR MISSION BY PROVIDING HOLISTIC HEALING TO ALL WHO SEEK OUR CARE, AS WELL AS THROUGH COMMUNITY BENEFIT. WORKING COLLABORATIVELY WITH OTHERS IN THE COMMUNITIES WE SERVE, OUR COMMUNITY BENEFIT INITIATIVES ARE STRATEGICALLY AND SUCCESSFULLY EXPANDING ACCESS TO CARE, IMPROVING THE HEALTH STATUS OF RESIDENTS, AND FURTHERING MEDICAL EDUCATION AND KNOWLEDGE. IN FY2014, OUR 13 HOSPITALS RESPONDED TO NEEDS IDENTIFIED IN EACH OF THEIR COMMUNITY HEALTH NEEDS ASSESSMENTS (CHNAS) COMPLETED IN FY2012. THE INFORMATION GATHERED FROM THESE ASSESSMENTS WAS USED TO DEVELOP NEW AND ENHANCE EXISTING COMMUNITY BENEFIT PROGRAMS AND SERVICES THAT BEST ADDRESSED COMMUNITY NEEDS. INCLUDED AMONG THE MANY PRIORITY NEEDS IDENTIFIED IN OUR CHNAS WERE CHRONIC DISEASE PREVENTION AND MANAGEMENT, OBESITY, ADEQUATE FOOD AND NUTRITION, MENTAL HEALTH, AND ACCESS TO HEALTH CARE SERVICES. HSHS HOSPITALS ARE PROACTIVELY ADDRESSING THESE AND OTHER NEEDS THROUGH PATIENT, PROVIDER AND COMMUNITY EDUCATION, PREVENTATIVE SCREENINGS, SELF-MANAGEMENT CLASSES, AND NEW OR ENHANCED CLINICAL SERVICES. ACROSS HSHS, WE COLLECTIVELY PROVIDED $174.0 MILLION IN COMMUNITY BENEFIT (OR 9.3% OF TOTAL HOSPITAL EXPENSES) IN FY2014. INCLUDED IN THIS AMOUNT WAS $39.9 MILLION PROVIDED FOR FINANCIAL ASSISTANCE (I.E. CHARITY CARE) AND $95.8 MILLION FOR UNREIMBURSED CARE PROVIDED UNDER THE MEDICAID PROGRAM. IN ADDITION, HSHS HOSPITALS COMMITTED SIGNIFICANT RESOURCES TO CARE FOR MEDICARE PATIENTS. THE COST OF PROVIDING SERVICES TO PRIMARILY ELDERLY BENEFICIARIES OF THE MEDICARE PROGRAM - IN EXCESS OF GOVERNMENTAL AND MANAGED CARE CONTRACT PAYMENTS - WAS $175.2 MILLION. HSHS HOSPITALS ALSO RECORDED $94.2 MILLION IN UNCOLLECTIBLE ACCOUNTS. WHILE THE LATTER TWO AMOUNTS ARE NOT COUNTED AS COMMUNITY BENEFIT, THEY NONETHELESS REFLECT OUR COMMITMENT TO ALL PERSONS IN NEED OF CARE. IN ADDITION TO THE DOLLARS INVESTED IN OUR COMMUNITY BENEFIT PROGRAMS, HSHS ALSO CONTINUES TO REINVEST ANY SURPLUS REVENUE FROM OPERATIONS AND INVESTMENTS INTO NEW MEDICAL TECHNOLOGY, FACILITY INFRASTRUCTURE AND HEALTH CARE SERVICES IN OUR COMMUNITIES. BY DOING SO, WE ENSURE WE ARE ABLE TO MEET THE ONGOING DEMAND FOR HIGH QUALITY, EFFICIENT AND EASILY ACCESSIBLE HEALTH CARE. RECOGNIZING THAT THE HEALTH CARE DELIVERY MODEL IN THE UNITED STATES IS EVOLVING, HSHS REMAINS FOCUSED ON IMPLEMENTING OUR CARE INTEGRATION STRATEGY. CARE INTEGRATION COORDINATES THE DELIVERY OF CARE AROUND THE NEEDS OF EACH PATIENT. DURING FY2014, WE MADE SIGNIFICANT PROGRESS WITH THIS STRATEGY AS WE FURTHER IMPLEMENTED INTEROPERABLE HEALTH INFORMATION TECHNOLOGIES, EXPANDED THE NUMBER OF MEDICAL HOMES, AND STRENGTHENED OUR ALIGNMENT WITH PHYSICIANS. GREATER ACCESS TO CARE AS A FRANCISCAN HEALTH CARE MINISTRY, HSHS IS DEEPLY COMMITTED TO SERVING THOSE WHO ARE MOST IN NEED. WE NOT ONLY PROVIDE CARE TO EVERY PATIENT WHO WALKS THROUGH OUR DOORS, BUT ALSO REACH OUT BEYOND THE WALLS OF OUR HOSPITALS AND CLINICS TO CARE FOR THOSE IN OUR COMMUNITIES. OUR EFFORTS TO ENSURE RESIDENTS IN THE COMMUNITIES WE SERVE RECEIVE THE RIGHT CARE AT THE RIGHT TIME IN THE RIGHT SETTING OFTEN INVOLVE PARTNERING WITH OTHERS TO ACHIEVE THIS GOAL. ACROSS OUR TWO-STATE SYSTEM, THERE ARE NUMEROUS EXAMPLES OF HSHS COLLABORATING WITH OTHER ORGANIZATIONS TO ENHANCE ACCESS TO CARE FOR THOSE IN NEED. IN FY2014, HSHS AND OUR 13 HOSPITALS INVESTED A CONSIDERABLE AMOUNT OF COMMUNITY BENEFIT RESOURCES TO EDUCATE THE UNINSURED ABOUT HISTORIC NEW OPPORTUNITIES TO ENROLL IN AFFORDABLE HEALTH CARE COVERAGE AND TO FACILITATE THE ENROLLMENT PROCESS. STUDIES HAVE SHOWN THAT PEOPLE WITHOUT INSURANCE COVERAGE ARE MORE LIKELY THAN THEIR INSURED COUNTERPARTS TO POSTPONE CARE AND TO DEVELOP MORE SEVERE AND EXPENSIVE CONDITIONS. IT IS FOR THIS REASON THAT THE CATHOLIC CHURCH, CATHOLIC HEALTH CARE AND HSHS HAVE LONG PROMOTED "COVERAGE AND ACCESS FOR ALL." HSHS AND OUR 13 HOSPITALS IN PARTNERSHIP WITH LOCAL HEALTH DEPARTMENTS, SOCIAL SERVICE AGENCIES AND OTHER HEALTH CARE PROVIDERS PLAYED A VITAL ROLE IN EDUCATING ELIGIBLE PEOPLE IN THEIR LOCAL COMMUNITIES, IN REFERRING PEOPLE TO CERTIFIED APPLICATION COUNSELORS AND/OR IN ENROLLING THEM IN THE HEALTH INSURANCE EXCHANGES OR IN SECURING COVERAGE THROUGH MEDICAID EXPANSION. OF THE EIGHT STATES WITH THE HIGHEST CONCENTRATION OF UNINSURED, ILLINOIS WAS AMONG 25 STATES THAT MOVED TOWARD MEDICAID EXPANSION UNDER THE AFFORDABLE CARE ACT. WITH THE SUPPORT OF ST. MARY'S HOSPITAL MEDICAL CENTER AND ST. VINCENT HOSPITAL IN GREEN BAY, WISCONSIN, THE NEW COMMUNITY CLINIC DENTAL PROGRAM ON THE CAMPUS OF NORTHEAST WISCONSIN (NEW) TECHNICAL COLLEGE WAS ABLE TO PURCHASE EQUIPMENT TO ENABLE LOCAL ORAL SURGEONS TO PROVIDE CARE (ON A VOLUNTEER BASIS) AT THE CLINIC - THE SITE THAT ST. MARY'S AND ST. VINCENT HOSPITALS HELPED TO ESTABLISH IN 2013. ANNUALLY, THE CLINIC PROVIDES DENTAL SERVICES TO APPROXIMATELY 6,000 LOW-INCOME AND UNINSURED PERSONS INCLUDING THE HOMELESS IN BROWN COUNTY. ST. FRANCIS HOSPITAL IN LITCHFIELD, ILLINOIS PARTNERED WITH LEWIS & CLARK COMMUNITY COLLEGE AND LOCAL DENTAL PROVIDERS TO BRING THE COLLEGE'S MOBILE DENTAL HEALTH UNIT TO THE LITCHFIELD AREA; THE UNIT PROVIDES EXAMS AND SCREENINGS, X-RAYS AND HYGIENE TO THOSE IN NEED. IN WESTERN WISCONSIN, A PARTNERSHIP BETWEEN ST. JOSEPH'S HOSPITAL IN CHIPPEWA FALLS, THE CHIPPEWA HEALTH IMPROVEMENT PARTNERSHIP (CHIP), LE PHILLIPS-LIBERTAS TREATMENT CENTER AND THE OPEN DOOR CLINIC (A FREE CLINIC SUPPORTED BY ST. JOSEPH'S HOSPITAL AND CHIP) WAS DEVELOPED IN FY2014 TO PROVIDE FREE BEHAVIORAL HEALTH SERVICES TO ELIGIBLE PATIENTS OF THE OPEN DOOR CLINIC. THIS INITIATIVE IS IN DIRECT RESPONSE TO THE IDENTIFIED NEED TO PROVIDE BETTER ACCESS TO MENTAL HEALTH SERVICES FOR THOSE WITHOUT INSURANCE COVERAGE. IN FY2014, 105 REFERRALS WERE MADE FROM THE OPEN DOOR CLINIC TO LE PHILLIPS-LIBERTAS TREATMENT CENTER. IN TOTAL, 950 VISITS WERE PROVIDED TO REFERRED PATIENTS INCLUDING INITIAL INTAKE AND FOLLOW UP THERAPY SESSIONS - MENTAL HEALTH SERVICES THAT WOULD NOT HAVE BEEN RECEIVED HAD THE PROGRAM NOT BEEN DEVELOPED AND IMPLEMENTED. IN SOUTHEAST ILLINOIS, AREA RESIDENTS CAN GET HELP FILLING A PRESCRIPTION THROUGH THE LONG-TERM COLLABORATION BETWEEN ST. ANTHONY'S MEMORIAL HOSPITAL IN EFFINGHAM AND CATHOLIC CHARITIES. IN FY2014, ST. ANTHONY'S HELPED UNDERWRITE THE COST OF PRESCRIPTION MEDICATIONS FOR 311 RESIDENTS, A 10% INCREASE OVER FY2013. ST. ANTHONY'S AND CATHOLIC CHARITIES BELIEVE THAT NO ONE SHOULD BE WITHOUT PRESCRIBED MEDICATIONS BECAUSE OF INABILITY TO PAY. IN SOUTHWEST ILLINOIS, ST. JOSEPH'S HOSPITAL IN HIGHLAND ENHANCED THEIR OFFERINGS TO THEIR SENIOR POPULATION BASED ON THEIR CHNA. "SENIOR RENEWAL" IS AN OUTPATIENT COUNSELING PROGRAM FOR SENIOR ADULTS WHO MAY BE FACING EMOTIONAL AND PHYSICAL PROBLEMS UNIQUE TO THE AGING PROCESS SUCH AS FEELINGS OF LONELINESS, ISOLATION AND ANXIETY. CLIENTS RECEIVE AN INTENSIVE LEVEL OF TREATMENT WITHOUT INPATIENT HOSPITALIZATION THROUGH COUNSELING STRATEGIES AND EDUCATION. IN ADDITION, ST. JOSEPH'S HOSPITAL IN COLLABORATION WITH THE ILLINOIS DEPARTMENT OF INSURANCE PARTICIPATES IN THE SENIOR HEALTH INSURANCE PROGRAM (SHIP), A FREE HEALTH INSURANCE COUNSELING SERVICE FOR MEDICARE BENEFICIARIES AND THEIR CAREGIVERS. IN ADDITION TO PROGRAMS DESIGNED TO INCREASE ACCESS TO CARE, HSHS MAKES SURE THAT THOSE WHO NEED FINANCIAL ASSISTANCE RECEIVE IT. HSHS'S FINANCIAL ASSISTANCE (CHARITY CARE) POLICY WAS MODIFIED EFFECTIVE JANUARY 1, 2014 TO OFFER A 25% SELF-PAY DISCOUNT TO ALL PATIENTS WHO REGISTER WITHOUT INSURANCE. HSHS FINANCIAL ASSISTANCE PROGRAMS HAVE A SLIDING SCALE, IN SOME INSTANCES PROVIDING UP TO A 55% REDUCTION OFF BILLED CHARGES IF AN UNINSURED PATIENT'S FAMILY INCOME LEVEL IS DETERMINED TO BE ABOVE 500% BUT EQUAL TO OUR LESS THAN 600% OF THE CURRENT FEDERAL POVERTY GUIDELINES. ALL CHARGES ARE WAIVED FOR PATIENTS BELOW 200% OF THE FEDERAL POVERTY LEVELS. COUNSELORS ARE AVAILABLE IN OUR HOSPITALS TO EXPLAIN OUR FINANCIAL ASSISTANCE POLICY TO PATIENTS, PROVIDE THEM WITH ASSISTANCE IN FILLING OUT A SIMPLE APPLICATION FORM, OR HELP THEM ENROLL IN PUBLICLY FUNDED HEALTH CARE PROGRAMS. SCHEDULE O, AFFILIATED HEALTH SYSTEM DISCLOSURE (CONTINUED) BETTER COMMUNITY HEALTH AS PART OF OUR MISSION TO EMBODY CHRIST'S HEALING LOVE, WE UNDERSTAND THAT WE HAVE A RESPONSIBILITY TO IMPROVE THE OVERALL QUALITY OF LIFE IN OUR COMMUNITIES BY SUPPORTING INITIATIVES THAT PROMOTE HEALTH AND WELLNESS. WE RECOGNIZE WE ARE MOST SUCCESSFUL WHEN WE WORK TOGETHER WITH A WIDE ARRAY OF PUBLIC AND PRIVATE ORGANIZATIONS THAT SHARE OUR COMMITMENT TO IMPROVING LIVES. BY DOING SO, WE MAXIMIZE OUR EFFORTS AND REDUCE THE DUPLICATION OF SERVICES. HSHS HOSPITALS ALSO UNDERSTAND WE NEED TO LISTEN CLOSELY TO THE RESIDENTS OF THE COMMUNITIES WE SERVE TO ENSURE THE HEALTH CARE NEEDS OF ALL ARE BEING MET. TO THAT END, EACH OF OUR 13 HOSPITALS COMPLETED COMMUNITY HEALTH NEEDS ASSESSMENTS (CHNA) DURING FY2012. THE INFORMATION GATHERED FROM THESE ASSESSMENTS IS BEING USED TO HELP US DEVELOP NEW, AND ENHANCE EXISTING, PROGRAMS AND SERVICES THAT BEST ADDRESS THE NEEDS OF THE COMMUNITY. SEVERAL PRIORITY NEEDS WERE IDENTIFIED IN THE CHNAS INCLUDING METABOLIC AND CARDIOVASCULAR DISEASE MANAGEMENT, ADEQUATE FOOD AND NUTRITION, AND MENTAL HEALTH. HSHS HOSPITALS ARE ADDRESSING THESE AND OTHER NEEDS BY PROACTIVELY OFFERING EDUCATIONAL OPPORTUNITIES, PREVENTATIVE SCREENINGS, AND NEW OR ENHANCED CLINICAL SERVICES. IN MANY CASES, THE HOSPITALS COLLABORATE WITH OTHER COMMUNITY ORGANIZATIONS TO ADDRESS IDENTIFIED NEEDS. IN PARTNERSHIP WITH THE SANGAMON COUNTY HEALTH DEPARTMENT AND LOCAL FARMERS, ST. JOHN'S HOSPITAL IN SPRINGFIELD, ILLINOIS TOOK A LEAD ROLE IN BRINGING A FARMERS MARKET TO THE EAST SIDE OF SPRINGFIELD. THE EAST SIDE FARMERS MARKET (ESFM) ADDRESSES THREE COMMUNITY NEEDS: CHILDHOOD OBESITY, CHILDHOOD POVERTY (26% OF CHILDREN IN SANGAMON COUNTY LIVE IN POVERTY VS. 18% IN THE STATE) AND PROVIDING FRESH PRODUCE TO PERSONS LIVING IN A KNOWN "FOOD DESERT." OVER THE LAST THREE SUMMERS (JUNE - OCTOBER), ESFM HAS SERVED 3,074 FAMILIES. WIC CLIENTS, SENIOR CITIZENS AND DISABLED PERSONS HAVE ESPECIALLY BENEFITTED DUE TO ESFM BEING OFFERED ON THE SAME DAY AS WIC EDUCATION CLASSES, AND THE CLOSE PROXIMITY OF PARKING TO VENDORS. IN ADDITION, THE FARMERS CREATED A "DRIVE THROUGH" TO MAKE SHOPPING EASIER FOR SENIORS AND DISABLED PERSONS. ST. MARY'S HOSPITAL IN STREATOR, ILLINOIS TEAMED UP WITH THE STREATOR YMCA TO OFFER A 12-WEEK WEIGHT LOSS PROGRAM - HEALTHY YOU - TO MOTIVATE MORE THAN 300 PARTICIPANTS, 80% OF WHOM WERE RETURNING PARTICIPANTS FROM FY2013, TO LOSE WEIGHT AND MAINTAIN A HEALTHY LIFESTYLE. THE PROGRAM INCLUDED AEROBICS CLASSES, COOKING CLASSES, AND A MAINTENANCE PROGRAM TO ENCOURAGE PARTICIPANTS TO WEIGH IN MONTHLY. SURVEYS WERE COLLECTED AT REGISTRATION TO QUANTIFY PROGRESS FOR REPEAT PARTICIPANTS - 53% STATED THEY WERE ABLE TO MAINTAIN THEIR WEIGHT LOSS AND 74% WERE ABLE TO CONTINUE TO LOSE WEIGHT. IN FY2014, HEALTHY YOU PARTICIPANTS COLLECTIVELY LOST 2,853 POUNDS OR 4.42% OF TOTAL BODY WEIGHT. IN FY2014, ST. MARY'S HOSPITAL IN DECATUR, ILLINOIS PARTNERED WITH LOCAL PROVIDERS TO PROMOTE THE LEARN MORE, BREATHE BETTER CAMPAIGN IN COORDINATION WITH THE NATIONAL HEART, LUNG AND BLOOD INSTITUTE TO EDUCATE THE COMMUNITY ABOUT COPD AND OTHER BREATHING ISSUES AND TO PROMOTE BEHAVIORS THAT IMPROVE HEALTH. BREATHING ISSUES ARE PREVALENT IN THE DECATUR AREA DUE TO THE CONCENTRATION OF MANUFACTURING AND POOR AIR QUALITY. ST. MARY'S HAS RESEARCHED AND COMPILED ADMISSIONS DATA RELATED TO COPD AND HAS INCREASED PATIENT, PROVIDER AND COMMUNITY EDUCATION TO BETTER COORDINATE CARE ACROSS THE CONTINUUM FOR BETTER PATIENT OUTCOMES. IN ADDITION, ST. MARY'S HOSPITAL'S MODEL FOR COPD CORE MEASURES HAS BEEN SHARED AT NATIONAL BEST PRACTICES SEMINARS TO BENEFIT OTHER COMMUNITIES. ACCORDING TO THE NATIONAL ASSESSMENT OF ADULT LITERACY, ONLY 12% OF ADULTS HAVE "PROFICIENT" HEALTH LITERACY, I.E. NINE OUT OF 10 ADULTS LACK THE SKILLS NEEDED TO MANAGE THEIR HEALTH. HEALTH LITERACY WAS IDENTIFIED IN THE CHNA COMPLETED BY ST. NICHOLAS HOSPITAL IN SHEBOYGAN AND THE DEPARTMENT OF PUBLIC HEALTH IN FY2012. IN TURN, ST. NICHOLAS HOSPITAL SPONSORED A SYMPOSIUM FOR HEALTH CARE PROVIDERS AND SOCIAL SERVICES ORGANIZATIONS AND A COMMUNITY-WIDE CME FOR ALL SHEBOYGAN PHYSICIANS AS WELL AS STAFF TRAINING AS FIRST STEPS IN ADDRESSING THE HEALTH LITERACY NEEDS OF THE SHEBOYGAN COMMUNITY IN FY2013. IN FY2014, THE HEALTHY SHEBOYGAN COUNTY 2020 HEALTH LITERACY COMMITTEE HOSTED FIVE FOCUS GROUPS (HISPANIC, HMONG, LOW-INCOME, SENIOR CITIZENS AND YOUNG ADULTS) AND AN EXECUTIVE BRIEFING FOR HEALTH CARE LEADERS TO SHARE THE RESULTS OF THE COMMUNITY SURVEY AND FOCUS GROUPS. WITH THE SUPPORT OF ST. NICHOLAS HOSPITAL, A HEALTH LITERACY COMMUNITY AWARENESS CAMPAIGN IS BEING DEVELOPED. SACRED HEART HOSPITAL IN EAU CLAIRE, WISCONSIN ADDRESSED THE NEED FOR MENTAL AND BEHAVIORAL HEALTH SERVICES THROUGH THE HEALING PLACE. FREE GRIEF AND HOLISTIC SUPPORT SERVICES SUCH AS ONE ON ONE COUNSELING, WORKSHOPS AND PRESENTATIONS ARE PROVIDED FOR INDIVIDUALS AND FAMILIES DEALING WITH LOSS AND MAJOR LIFE TRANSITIONS DUE TO MILITARY SERVICE, ILLNESS, DEATH, DIVORCE, ETC. EXPANDED MEDICAL KNOWLEDGE HSHS WORKS TO ADVANCE MEDICAL KNOWLEDGE BY SUPPORTING RESEARCH INITIATIVES AND EDUCATIONAL OPPORTUNITIES. IN FY2014, HSHS HOSPITALS AND AFFILIATED PHYSICIAN GROUPS CONTRIBUTED MORE THAN $18.5 MILLION TOWARD RESEARCH AND EDUCATION. HIGHLIGHTS OF THIS COMMITMENT INCLUDE SUBSIDIZING MEDICAL SCHOOL RESIDENCY PROGRAMS, OFFERING ONGOING MEDICAL EDUCATION TO PHYSICIANS AND CLINICIANS, AND PROVIDING JOB SHADOWING PROGRAMS FOR HIGH SCHOOL STUDENTS. ANOTHER EXAMPLE OF THIS COMMITMENT INCLUDES ST. JOHN'S COLLEGE OF NURSING IN SPRINGFIELD, ILLINOIS, WHICH OFFERS THE LAST TWO YEARS OF THE BACCALAUREATE DEGREE IN NURSING, AS WELL AS CONTINUING EDUCATION PROGRAMS FOR NURSES AND HEALTH PROFESSIONALS. ST. JOHN'S COLLEGE HAS BEEN CITED AS THE OLDEST CATHOLIC HOSPITAL-BASED SCHOOL OF NURSING IN THE UNITED STATES. FOUNDED IN 1886, THE COLLEGE HAS REMAINED DEDICATED THROUGHOUT ITS RICH HISTORY TO THE EDUCATION OF PROFESSIONAL NURSES WHOSE PRACTICE EXEMPLIFIES EXCELLENCE IN AN INTEGRATED HEALTH CARE SYSTEM. THE COLLEGE IS ALSO HELPING TO ADDRESS THE SHORTAGE OF PRIMARY CARE PROFESSIONALS IN DOWNSTATE ILLINOIS. ST. ELIZABETH'S HOSPITAL IN BELLEVILLE, ILLINOIS PROVIDED CLINICAL EDUCATION IN NURSING, RADIOLOGY, SURGERY, RESPIRATORY, DIETARY, PHYSICAL AND OCCUPATIONAL THERAPY, PHARMACY AND BEHAVIORAL HEALTH TO 637 AREA COMMUNITY COLLEGE AND UNIVERSITY STUDENTS. THIS MENTORING IS VALUED AT MORE THAN $440,000. IN ADDITION, TO ADDRESS A SHORTAGE OF PRIMARY CARE FAMILY PRACTICE DOCTORS IN ST. CLAIR COUNTY, ST. ELIZABETH'S SUBSIDIZED THE ST. LOUIS UNIVERSITY FAMILY MEDICINE RESIDENCY PROGRAM, A UNIQUE MERGER OF A COMMUNITY-BASED SETTING, AN ACADEMIC CENTER AND A MILITARY-BASED RESIDENCY. CLINICAL EDUCATION SITES INCLUDED ST. ELIZABETH'S HOSPITAL, CARDINAL GLENNON CHILDREN'S HOSPITAL, AREA PHYSICIANS' OFFICES AND SCOTT AIR FORCE BASE OUTPATIENT CLINICS. ALSO IN SOUTHERN ILLINOIS, ST. JOSEPH'S HOSPITAL IN BREESE, HOSTED MEMBERS OF THE HEALTH OCCUPATIONS STUDENTS OF AMERICA ONSITE TO LEARN ABOUT JOB OPPORTUNITIES IN HEALTH CARE FROM HEALTH CARE PROFESSIONALS; ST. JOSEPH'S HOSPITAL WAS RECENTLY RECOGNIZED BY THE ILLINOIS PRINCIPALS ASSOCIATION - KASKASKIA REGION FOR SPONSORING THE PROGRAM FOR MORE THAN 30 YEARS. ST. JOSEPH'S HOSPITAL ALSO PROVIDES CLINICAL EXPERIENCE FOR KASKASKIA COLLEGE STUDENTS ENROLLED IN THE NURSING, PHYSICAL THERAPY AND RADIOLOGY PROGRAMS. PHARMACY STUDENTS HAVE ALSO COMPLETED THEIR CLINICAL TRAINING AT ST. JOSEPH'S HOSPITAL. HIGHER LEVEL OF CARE HSHS COMMUNITY BENEFIT INITIATIVES ARE A VITAL PART OF OUR OVERALL MISSION. WE BELIEVE THAT THROUGH OUR WORK TO CREATE GREATER ACCESS TO CARE, BETTER COMMUNITY HEALTH, AND EXPANDED MEDICAL KNOWLEDGE, WE MADE A POSITIVE DIFFERENCE IN THE LIVES OF TENS OF THOUSANDS OF PEOPLE IN ILLINOIS AND WISCONSIN IN FY2014. HOSPITAL SISTERS HEALTH SYSTEM'S COMMITMENT TO COMMUNITY BENEFIT STEMS FROM THE FRANCISCAN AND CATHOLIC VALUES SHARED BY OUR 14,000 COLLEAGUES ACROSS WISCONSIN AND ILLINOIS. CATHOLIC HEALTH CARE IS COMMITTED TO PROMOTING AND DEFENDING HUMAN DIGNITY, CARING FOR PERSONS LIVING IN POVERTY AND OTHER VULNERABLE POPULATIONS, AND PROMOTING THE COMMON GOOD. WE REMAIN DEDICATED TO CONTINUOUSLY IMPROVE COMMUNITY HEALTH THROUGH OUR STRATEGIC, WELL-DEFINED COMMUNITY BENEFIT INITIATIVES SO THAT WE CAN HELP MORE PEOPLE LIVE HEALTHIER LIVES. 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EFFECTIVE ON THE ACQUISITION DATE, CMH BECAME A CATHOLIC ENTITY AND THE HOSPITAL NAME WAS CHANGED TO ST. CLARE MEMORIAL HOSPITAL, INC. PREVIOUS TO THE ACQUISITION, TWO HSSI AFFILIATES HELD A COMBINED 24% MINORITY INTEREST IN CMH. REVISED GOVERNING DOCUMENTS ARE CONSISTENT WITH HSHS POLICIES APPLICABLE TO AFFILIATES. HSSI WILL RETAIN CERTAIN RESERVE POWERS OVER ST. CLARE MEMORIAL HOSPITAL, INC. CONSISTENT WITH OTHER HSSI SUBSIDIARIES PART V, LINE 2, SCHEDULE R, PART V, LINE 2 TRANSACTIONS LISTED ON SCHEDULE R, PART V, LINE 1 ARE BETWEEN RELATED 501(C)(3) ENTITIES AND ACCORDINGLY ARE NOT REQUIRED TO BE REPORTED ON SCHEDULE R, PART V, LINE 2.