2015-05-14T08:54:12-05:00 2014-06-30 861065772 Deloitte Tax LLP 250 East Fifth Street Suite 1900 Cincinnati OH 45202 990 2013-07-01 260479484 St Luke's-St Vincent's Healthcare Inc STLU 9044506001 4205 Belfort Road No 4015 Jacksonville FL 32216 Kimberly Hodgkinson CFO - Health System 9043087300 2015-05-14 1 Rebecca Lyons P01487105 5137847100 2013 2016-02-25 16:41:14Z St Vincent's Medical Center Southside Moody L Chisholm 1 Shircliff Way Jacksonville FL 32204 182578253 0 0928 X www.jaxhealth.com X 2007 FL Spiritually centered care which sustains & improves the health of the community. 12 11 1170 124 0 0 3157398 38122 173334831 177989075 1882279 3358571 1343914 1094659 179718422 182480427 0 0 0 0 59075055 53849843 0 0 0 104800622 102685544 163875677 156535387 15842745 25945040 201505467 163805201 162679132 132851821 38826335 30953380 St. Vincent's Health System, Inc. is a not-for-profit, philanthropic organization established in 1982 that is committed to enhancing the current and future healthcare needs of Jacksonville and the surrounding area. 0 0 148654927 176704859 Please refer to Schedule H for the Community Benefit Report. 343312 1284216 Exempt Affiliate Rent. 0 148998239 1 1 0 0 0 0 0 0 0 0 1 0 0 1 1 1 0 1 0 0 0 0 0 0 0 0 1 1 0 0 1 0 0 0 0 0 0 0 1 0 0 0 0 0 1 1 1 0 0 1 0 0 1 1170 1 0 0 0 0 0 0 0 0 0 0 X 12 11 1 0 0 0 1 1 1 1 1 0 0 1 1 1 1 1 1 0 0 0 X Herb Kaminsky 9044506001 4205 Belfort Road Suite 4030 Jacksonville FL 32216 X Sidney S Simmons II Chairman 3.00 3.00 X X 0 0 0 C Daniel Rice Chairman (end 6/14) 3.00 3.00 X X 0 0 0 David G Kulik Vice Chairman 1.00 1.00 X X 0 0 0 Richard Mullaney Secretary/Treasurer 1.00 1.00 X X 0 0 0 Ricardo Morales Jr Secretary/Treasurer 1.00 1.00 X X 0 0 0 Paul J Chappano MD Member 1.00 1.00 X 0 0 0 Gary R Chartrand Member 1.00 1.00 X 0 0 0 Carla Harris Member 1.00 1.00 X 0 0 0 Richard Jones Member 1.00 1.00 X 0 0 0 Sr Nancy Murphy DC Member 1.00 1.00 X 0 0 0 Sr Elyse Staab DC Member 1.00 1.00 X 0 0 0 Moody Chisholm President/CEO, Ex-Officio 40.00 40.00 X X 0 1617338 90819 Kimberly Hodgkinson CFO (start 1/14) 40.00 40.00 X 0 424813 77309 Mark Doyle CFO (end 9/13) 40.00 0.00 X 0 128182 0 Donnie Romine Jr COO/President - Riverside 40.00 40.00 X 0 508876 81728 Karen F Darnell VP/Chief Ambulatory Service Officer 40.00 40.00 X 0 356217 85105 Janice G Lipsky Sr. VP HR/OD/CHRO 40.00 40.00 X 0 297156 89170 John Meyer Sr. VP Strategic Planning 40.00 40.00 X 0 266210 34964 Jeffrey Middlebrooks General Counsel 40.00 40.00 X 0 340685 48102 Kyle Sanders President - Southside 40.00 0.00 X 0 402103 57895 Lorraine M Keith COO/CNO - St. Luke's 40.00 0.00 X 252439 0 57840 Steve Nauman Interim CMO 40.00 40.00 X 0 393892 0 Charles Griffey CRNA 40.00 0.00 X 135275 0 41140 Jason Waszak Pharmacist 40.00 0.00 X 139011 0 35311 Rebecca Goldwasser CRNA 40.00 0.00 X 150087 0 18167 Jeffery Scarmack Pharmacist 40.00 0.00 X 141161 0 30166 Jill Wenzel CRNA 40.00 0.00 X 127508 0 31073 Phil C Perry Former CMO (end 4/14) 40.00 40.00 X 0 149428 31140 945481 4884900 809929 62 1 1 0 68 38122 38122 Net Patient Revenue 621990 102189326 102189326 Medicare/Medicaid 621990 72653819 72653819 ARRA Revenue 900099 1796784 1796784 Exempt Affiliates Rent 532000 1284216 1284216 64930 64930 177989075 3358549 3358549 407443 95516 311927 311927 311927 22 0 22 22 22 77832 2310 75522 75522 Cafeteria Sales 722320 707210 707210 707210 182480427 177989075 0 4453230 310279 297868 12411 43606299 41692946 1913353 6543247 6255344 287903 3390018 3240857 149161 65440 65440 13464285 11846398 1617887 39759 39759 286046 257441 28605 137063 116504 20559 7102185 6816481 285704 28843 21632 7211 25025 18769 6256 3675202 3564945 110257 7951604 7713055 238549 1651103 1651103 Medical Supplies 37516383 37346410 169973 Corporate Services 15905520 13519692 2385828 Professional Med. Fees 12370859 12370859 Equipment Rent/Maint. 1252625 1178764 73861 1213602 1049412 164190 156535387 148998239 7537148 0 4083 6600 29219697 29641197 3365862 3496168 110564 254612 160916880 74603854 89856070 86313026 1406203 1403357 2787387 5137327 74755601 37552914 201505467 163805201 12252559 11795959 150426573 121055862 162679132 132851821 X 37420132 29550023 1406203 1403357 0 38826335 30953380 201505467 163805201 X 25945040 -2846 -33815149 X 0 1 X 1 0 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 1 Part II-B, Line 1: St. Luke's-St. Vincent's Healthcare, Inc. had lobbying expenses related to the portion of dues paid to national and state hospital addociations that are specifically allocable to lobbying. However, St. Luke's-St. Vincent's Healthcare, Inc. was not able to determine the amount. St. Luke's-St. Vincent's Healthcare, 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. 14487081 14487081 70346892 18089382 52257510 55989295 48023443 7965852 20093612 8491029 11602583 86313026 Interest in Investments Held by Ascension Health Alliance 32305708 Third Party Settlements 3784148 Other Long Term Assets 1463058 37552914 Intercompany Debt with Ascension Health Alliance 114234365 Pension and Other Post Retirement Liabilities 5243760 Self-Insurance Liabilities - NonCurrent 914395 Other 305530 Estimated Third-Party Payor Settlements 240518 Intercompany Payables 117294 121055862 X Part X, Line 2: From the consolidated financial statements of St. Vincent's Health System, Inc. (which include the activity of St. Luke's-St. Vincent's Healthcare, Inc.): The member health care entities of the Health Ministry are primarily tax-exempt organizations under Internal Revenue Code Section 501(c)(3) or 501(c)(2), and their related income is exempt from federal income tax under Section 501(a). The Health Ministry has three taxable corporations, CPS, First Coast, and SVPE. These entities file U.S. and Florida income tax returns. The Health Ministry 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. At June 30, 2014, the Health Ministry's taxable corporations had net operating loss carryforwards of approximately $49,865,000, which will expire beginning in 2015 through 2025. Deferred taxes have been provided for these amounts, resulting in a net deferred tax asset of approximately $19,447,000 and $16,460,000 at June 30, 2014 and 2013. A full valuation allowance has been provided at both June 30, 2014 and 2013, to offset the deferred tax asset since the Health Ministry has determined that it is more likely than not that the benefit of the net operating loss carryforwards will not be realized in future years. 1 1 X 1 X 1 X 1 1 1 0 1 1 6140183 6140183 0.03920 12986762 3829275 9157487 0.05850 19126945 3829275 15297670 0.09770 146824 146824 0.00090 133593 133593 0.00090 280417 280417 0.00180 19407362 3829275 15578087 0.09950 8285 8285 0.00010 8285 8285 0.00010 0 10650972 1835124 69137131 68279623 857508 X 1 1 1 1 St Luke's-St Vincent's Healthcare 4205 Belfort Road Suite 4030 Jacksonville FL 32216 www.jaxhealth.com 4494 X X X St Luke's-St Vincent's Healthcare Inc 1 1 X X X X X X X X X 12 1 1 1 X See Part V, Facility Information X See Part V, Facility Information X X X X X X X X X 0 0 1 1 200.000000000000 1 400.000000000000 1 X X X X X X X X 1 1 X X 1 0 X X X X 1 X X 0 0 St. Luke's-St. Vincent's Healthcare, Inc. Part V, Section B, Line 3: Nine hospitals [Southern Baptist Hospital of Florida, Inc. (Baptist Medical Center Jacksonville, Baptist Medical Center South, Wolfson Children's Hospital), Baptist Medical Center of the Beaches, Inc., Baptist Medical Center of Nassau, Inc., Mayo Clinic, St. Vincent's Medical Center Riverside, St. Vincent's Medical Center Southside and UF Health)]. Four Departments of Health (Florida Departments of Health for Clay County, Duval County, St. John's County and Nassau County) convened with the Health Planning Council of Northeast Florida to facilitate the CHNA. Each hospital agreed on its respective targeted communities. St. Vincent's was tasked with analyzing internal hospital census, existing community benefit programs, as well as secondary data collection. A community health survey was developed and administered to a broad varied range of residents living in the targeted five-county community. The survey contained questions regarding perceived quality of life and health of the community, barriers to health care, use of health care needs and demographic information. The survey included participants from Clay, Duval, Nassau and St. John's Counties. The internet panel method was used in order to reach the largest possible number of qualified respondents. Focus groups and round table discussions were another method used to take into account input from the persons who represent the broad interest of community served. The roundtable discussions allowed for the identification of the needs and priorities of participants who have the knowledge and expertise to inform the research. Representatives from Clay, Duval, Nassau, Putnam and St. Johns Counties gave their input on multiple dimensions of their communities, including the built environment, local economy, barriers to access and motivation for healthy living. For the secondary research, public health related data was gathered from five counties. Each County Health Department provided an assessment that determined public health priorities for the next three to five years. The partnership's CHNA reflects the priorities identified in the health department assessments and its corresponding health improvement plan. St. Luke's-St. Vincent's Healthcare, Inc. Part V, Section B, Line 4: The other hospital facilities with which the reporting hospital facility conducted its CHNA, include:- Baptist Medical Center Jacksonville - Duval County- Baptist Medical Center Beaches - Duval County (specially, Atlantic, Neptune and Jacksonville Beaches)- Baptist Medical Center Nassau - Nassau County - Baptist Medical Center South - Duval County and Northern St. Johns County- Brooks Rehabilitation - Duval County and St. Johns County- Mayo Clinic - Duval County- St. Vincent's Medical Center Riverside - Duval County, Clay County and Putnam County- St. Vincent's Medical Center Southside - Duval County- Shands Jacksonville Medical Center - Duval County- Wolfson Children's Hospital - Duval County St. Luke's-St. Vincent's Healthcare, Inc. Part V, Section B, Line 5d: The CHNA of the hospital facility can be located at the following web address: http://www.jaxhealth.com/about-us/community-health-needs-assessment/Part V, Section B, Line 5b:St. Luke's-St. Vincent's Healthcare CHNA was also posted on the Health Communities Institute's website: http://assets.thehcn.net/content/sites/hpcnef/2012_CHNA_REPORT_FINAL.pdf St. Luke's-St. Vincent's Healthcare, Inc. Part V, Section B, Line 7: One of the top priority risk factors identified in the community health assessment-Built Environment-will not be addressed directly by hospital-led initiatives. The community health survey showed that many residents in the hospital service areas do not have pedestrian paths or grocery stores in their neighborhood. Walk-ability and ease of access to grocery stores can be major barriers to regular participation in physical activity and access to fresh fruits and vegetables. That said, none of the participating hospital partners are in a position to directly impact these issues. However, all of the partners are committed to improving the health and wellness of our communities, and fully support local government and wellness coalitions in their efforts to positively impact these issues.Transportation effects access to care, particularly among the low-income and medically-underserved populations. Other local organizations such as the Area Agency on Aging, Council on Aging and local transportation systems are already working to address transportation needs in the area. Therefore, the participating partners will not directly address this issue with any new initiatives. St. Luke's-St. Vincent's Healthcare, Inc. Part V, Section B, Line 14g: A summary of the financial assistance policy is posted on the hospital facility's website, emergency rooms or waiting rooms, admission offices, and available upon request. St. Luke's-St. Vincent's Healthcare, Inc. Part V, Section B, Line 20d: The self-pay discount is calculated based upon the highest paying payor that represents greater than 3% of gross revenue. Part I, Line 7: The cost of providing charity care, means tested government programs, and community benefit programs is estimated using internal cost data, and is calculated in compliance with Catholic Health Association ("CHA") guidelines. The organization uses a cost accounting system that addresses all patient segments. The best available data was used to calculate the amounts reported in the table.St. Vincent's Medical Center Southside (SVMCS) posts information about availability of charity care in its emergency room and admissions areas. Referrals for charity care are made by the financial specialist, patient accounting personnel, social work personnel, collection agency personnel, physicians and community members. All patients potentially eligible for charity care status are screened by the financial specialist/collection representatives for assistance through federal, state, county and other social service programs. The financial specialists/collection representatives work collaboratively with other health care members to explore alternative financial resources for the patients. The Charity Care Policy is available to patients upon request and provided the patient does not qualify for any funded program. Medicaid patients upon exhaustion of benefits will automatically qualify for charity care allowance as long as they remain eligible for Medicaid.Patients will be denied charity based on non-compliance with attempts to obtain insurance for eligibility coverage through other programs (i.e. Medicaid-eligible individuals who have failed to keep required appointments with their case worker). Patients should be screened prior to sending to Florida Department of Children and Family Services to determine if they qualify for Medicaid. Patients can be selected for presumptive charity care by using an electronic screening process. Patients may also be referred to St. Vincent's community outreach programs for continuing care.Information about the Charity Care Policy is included in the patient bills indicating financial assistance is available along with information about contacting St. Vincent's HealthCare to seek assistance. We do not provide the "criteria" within the bills themselves. Any uninsured patient or patient requesting assistance is referred to a patient financial advocate to assist with resolving the bill with the Hospital. This process includes assisting the patient with filing an application for any government sponsored health care program. All patient financial services areas maintain a list of available translators for any non-English speaking patients. There are all bi-lingual associates in the patient financial services department and are available as needed to assist with non-English speaking patients.All registration staff is trained and responsible for completing an initial financial assistance screening application that is used for assessing the patient's family financial situation. The financial assistance screening application is then forwarded to a patient financial advocate who will review and assist the patient with the process.The collection agencies used by St. Vincent's Southside are required to follow St. Vincent's HealthCare's policies regarding patient notification about the availability of financial assistance. Those patients who indicate an inability to pay for their services are referred back to the hospital to apply for charity care. In addition to this process, open accounts are routinely screened using computer software tools for potential charity care qualified patients. Any patient with family income less that 200% of Federal Poverty Guidelines will qualify for 100% Charity Care write-off. Part II, Community Building Activities: St. Vincent's HealthCare has been part of Jacksonville for over 95 years. St. Vincent's Medical Center Southside has been part of the system for over five years. It has welcomed the sick and vulnerable to its doors. In its Mission Statement, St. Vincent's Southside proclaims that it provides care to all, but with special attention to the poor and vulnerable. This is the emphasis it employs in its Community Building Programs. It uses multiple tools to determine community need including data collection from the Health Planning Council, Agency for Healthcare Administration, county health departments, The Florida Department of Health, live estimates via Thompson Reuters, inpatient and outpatient utilization rates and state inpatient/outpatient data allows St. Vincent's to participate in the following programs:Cash support for the Jacksonville Area Chamber of Commerce and the Clay County Chamber of Commerce: The Chambers' objectives are to drive business in the region with emphasis on initiatives for the un/under employed in the area through their Career Academies and Youth Summer Initiatives. St. Vincent's Medical Center Southside supports preparation for all members of the community for entering and remaining in the workforce. This is especially important in an area with over 10.5% unemployment.Cash support for organizations such as the Boys and Girls Club: The Boselli Foundation and Community Connections, these organizations are devoted to assisting young people into becoming educated and active members of the community. Each of these organizations works with low income at risk students; students as identified by zip codes with the lowest incomes. These are the children who are the most likely to drop out of school and society. Through their various programs they ensure that children are safe after school and in an environment that fosters learning.The Boselli Foundation and The Boys and Girls Clubs work with children, especially those from low income areas to realize their potential through established programs. They provide afterschool mentoring and academic enrichment programs to engage and sustain children in developing in the joys of learning. They promote a safe environment for children, providing structure and creating trust. Community Connections provides housing for the homeless. They work to provide safe, clean housing for children and parents, as well as social programs to support families reestablishing themselves as productive members of society. Among the programs offered are child care, career training, and family counseling services. These services provide children stability to continue their education during times of insecurity and crisis within the family structure. Part III, Line 2: St. Luke's-St. Vincent's Healthcare, Inc.'s bad debt allowance percentage is based on the weighted average of six twelve-to-seventeen month historical periods. The percentage is calculated monthly and analyzed for large variances. Part III, Line 3: St. Luke's-St. Vincent's Healthcare, Inc. isolates bad debts for patients who have no insurance from the patient accounting records and calculates the cost of those services in a similar manner to how charity cost is calculated, using RCC's times the charges written off. Part III, Line 4: From the consolidated audited financial statements of St. Vincent's Health System and subsidiaries (which include the activity of St. Luke's-St. Vincent's Healthcare):The provision for doubtful accounts is based upon management's assessment of expected net collections considering economic conditions, historical experience, trends in health care 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 Health Ministry 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 Ascension Health. Accounts receivable are written off after collection efforts have been followed in accordance with the Health Ministry's policies. Part III, Line 8: Ascension Health and related health ministries follow 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. Part III, Line 9b: The organization does have a written debt collection policy and Carity Care Policy (financial assistance). Patients without insurance are interviewed face-to-face to determine if they qualify for any third party payers or governmental programs. Patient statements contain messages requesting the patients to contact the organization should they need assistance with their debt. Patients that do not request assistance or provide the information necessary to qualify for financial assistance will follow a routing collection methodology. Part VI, Line 2: St. Vincent's Medical Center Southside uses multiple tools to determine community need. It has conducted a formal Community Health Needs Assessment, and has begun its implementation plan. A copy is available for download on the company's website http://www.jaxhealth.com/about-us/community-health-needs-assessment/ Currently the following tools are used: data from the Health Planning Council, Agency for Healthcare Administration, county health departments, The Florida Department of Health, live estimates via Thomson Reuters, Inpatient and outpatient utilization rates, and State Inpatient/Outpatient discharge data. Part VI, Line 3: St. Vincent's Southside posts information about availability of charity care in its emergency room and admissions areas. Referrals for charity care are made by Financial Specialists, Patient Accounting personnel, social work personnel, collection agency personnel, physicians and community members. All patients potentially eligible for charity care status are screened by the Financial Specialists/Collection representatives for assistance through federal, state, county and other social service programs. The Financial Specialists/Collection representatives work collaboratively with other health care members to explore alternative financial resources for the patients. The Charity Care Policy is available to patients upon request and provided the patient does not qualify for any funded program. Medicaid patients upon exhaustion of benefits will automatically qualify for charity care allowance as long as they remain eligible for Medicaid.The Hospital Outreach Eligibility Program (HOPE) was created to improve access to health care. Information about the program is available, not only at St. Vincent's Medical Center Southside but also in physician offices, on the website, on the medical clinic vans, and at various locations throughout the community. HOPE staff works to provide this service to the entire community, not just patients likely to use St. Vincent's HealthCare. Staff participates in neighborhood and community-wide enrollment fairs and health screenings in which, not only are patients who come to SVMCS screened, but persons throughout the community are screened to determine eligibility for insurance. Programs for which HOPE staff works diligently to enroll include Medicaid, Florida KidCare, charity programs, other state and federally funded programs including Medicare, COBRA, and HCRA. Patients will be denied charity based on non-compliance with attempts to obtain insurance for eligibility coverage though other programs (i.e. Medicaid-eligible individuals who have failed to keep required appointments with their case worker). Patients should be screened prior to sending to Florida Department of Children and Family Services to determine if they qualify for Medicaid. Patients can be selected for presumptive charity care by using an electronic screening process. Information about the Charity Care Policy is included in the patient bills indicating financial assistance is available and information about contacting the Hospital to seek assistance. We do not provide the criteria within the bills themselves. Any uninsured patient or patient requesting assistance is referred to a patient financial advocate to assist with resolving the bill with the Hospital. This process includes assisting the patient with filing an application for any government sponsored health care program. All patient financial services areas maintain a list of available translators for any non-English speaking patients. There are all bi-lingual associates in the patient financial services department and are available as needed to assist with non-English speaking patients.All registration staff is trained and responsible for completing an initial financial assistance screening application that is used for assessing the patient's family's financial situation. The financial assistance screening application is then forwarded to a patient financial advocate who will review and assist the patient with the process. The collection agencies used by St. Vincent's HealthCare are required to follow St. Vincent's policies regarding patient notification about the availability of financial assistance. Those patients who indicate an inability to pay for their services are referred back to the Hospital to apply for charity care. In addition to this process, open accounts are routinely screened using computer software tools for potential charity care qualified patients. Any patient with family income less that 200% of Federal Poverty Guidelines will qualify for 100% charity care write-off. Part VI, Line 4: St. Vincent's HealthCare looks at the community it serves in two ways. On a regional level, five counties fall into the overall planning region: Duval, Clay, Nassau, Baker, and St. John's. On a more narrow level, 75% of the primary service area is reviewed by zip code, which is comprised of approximately 90,000 inpatient cases.The zip codes on which St. Vincent's Southside focuses in Duval County, Jacksonville are: 32207, 32208, 32210, 32211, 32216, 32217, 32218, 32223, 32224, 32225, 32244, 32246, 32250, 32256, 32257 and 32258; in St. John's County, Florida are: 32082 and 32259.The facilities within the area are:- Baptist Medical Center, an acute care not-for-profit facility in Jacksonville with 676 beds; - Baptist Medical Center Beaches, an acute care not-for-profit facility in Jacksonville Beach with 146 beds; - Baptist Medical Center Nassau, an acute care not-for-profit facility in Fernandina Beach with 54 beds; - Baptist Medical Center South, an acute care not-for-profit facility in Jacksonville with 225 beds;- Ed Fraser Hospital, an acute care not-for-profit facility in MacClenny with 25 beds; - Flagler Hospital, an acute care not-for-profit facility in St. Augustine with 302 beds; - Kindred Hospital North Florida, an acute care for-profit facility in Green Cove Springs with 80 beds;- Mayo Clinic Jacksonville, an academic not-for-profit facility in Jacksonville with 249 beds; - Memorial Hospital Jacksonville, an acute care for-profit facility in Jacksonville with 425 beds; - Orange Park Medical Center, an acute care for-profit facility in Orange Park with 297 beds; - Riverpoint Behavioral Health, Jacksonville a psychiatric for-profit facility in Jacksonville with 93 beds; - St. Vincent's Medical Center Riverside, an acute care not-for-profit facility in Jacksonville with 528 beds; - Shands Jacksonville Medical Center, an acute care not-for-profit facility in Jacksonville with 695 beds; - Specialty Hospital Jacksonville, an acute care for-profit facility in Jacksonville with 107 beds; - St. Luke's Hospital, an acute care not-for-profit facility in Jacksonville with 311 beds; - Ten Broeck Jacksonville, Wekiva Springs an acute care for-profit facility in Jacksonville with 68 beds.Various metrics are reviewed when establishing community outreach programs. The following are examples of the data St. Vincent's collects when determining regional and community needs:- St. Vincent's HealthCare compares county population by race against the state. St. Vincent's also compares population by race in each of the zip codes. The findings from the comparison indicate that of the approximately 1,400,000 persons in the region the significant racial breakdowns are 66% white, 22% African American, and 6% Hispanic. The percentage of non-English speaking populations in the 2000 census in the region was 0.1%.- St. Vincent's Medical Center Southside compares the Jacksonville Metropolitan Statistical Area (MSA) in average household income against the federal poverty percentage finding that in the five county area household incomes ranged from almost $90,000 in St. John's County to $54,000 in Baker County. The percentage of persons below the Federal Poverty Rate ranged from a low of 7.9% in St. John's County to a high of 15.3% in Baker County. The Florida average was 13.3%.Florida chart tables which are provided by the Florida Department of Health, Office of Planning, Evaluation and Data Analysis are utilized to determine Behavioral Risk Factors (BRFSS) and Chronic disease prevalence in the region. By reviewing FL charts, County Profiles and BRFSS data, along with internal volume and financial data, St. Vincent's Southside is able to determine areas of need and chronic disease prevalence in relation to behavioral risk factors. The analysis below is an example of the data often compiled from the resources mentioned above. Analysis of Baker County:Baker County demonstrates the least favorable situation with comparison to the other counties in the state with regards to the following diseases: CAD (deaths), stroke (deaths and hospitalizations), lung cancer (death and smoking rate), prostate cancer (death), skin cancer (death) and diabetes (death, hospitalization and percentage of adults with diabetes). This county has the least favorable situation in comparison to all counties on the following measures in the Behavioral Risk Factors (BRFSS) Data: percentage of adults who meet vigorous physical activity recommendations, percentage of adults who engage in no leisure-time physical activity, percentage of adults who eat at least 5 servings of fruits and vegetables a day, and the percentage of adults who are obese.Analysis of Duval County:Duval County demonstrates the least favorable situation in comparison to the other counties in the state with regards to the following diseases: stroke (death and hospitalizations), heart failure (hospitalizations from congestive heart failure), breast and prostate cancers (deaths), cervical cancer (percentage of women 18 years of age and older who received a pap test in the past year), CLRD (asthma hospitalizations), and diabetes (death, hospitalization and amputation). On the Behavioral Risk Factors (BRFSS) data Duval has one measure in the least favorable situation which is the percentage of adults who meet moderate physical activity recommendations.Uninsured population in the region: Analysis Health Care Safety Net for Uninsured Persons:The parent company's, St. Vincent's HealthCare (SVHC), website provides information and phone numbers for patients whose incomes are 200% below the federal poverty level. Financial counselors are available to decide whether a patient qualifies for charity care. Patients who do not have insurance are eligible for discounts on their bill when they agree to a payment plan; this service is also provided by the financial counselors. The SVHC website, jaxhealth.com, contains a wealth of information on services which St. Vincent's Medical Center Southside (SVMCS) provides to the less fortunate. SVMCS has an active Mobile Health Outreach Mission (MHOM). This mission provides free medical services to the residents of Northeast Florida, who are un-served and underserved. This mission mainly sees migrant/rural farm workers and their families and also poor inner city families in the following counties: Clay, Duval, Nassau, Putnam, St. John's and Volusia. A mobile health unit consists of a physician, nurse practitioner, emergency medical technician and social worker assist to assist in providing care. Examples of care provided to this population are: immunizations, health screenings, physicals, laboratory, diagnostic testing, dental care, case management, health education and dispensing of free medication. MHOM case management works with patients in need to gain access to services or specialist not provided by their mobile clinics. Patients are connected with appropriate resources for follow up care. St. Vincent's Medical Center Southside provides several programs to address the needs of under privileged children and mothers. One is the School Nurse Program, which places nurses in schools serving disadvantaged children. These nurses are often the only direct access some of these children have to health care. The Seton Center for Women and Children was established to ensure that as many poor expectant mothers as is possible get proper prenatal care. However, the Center cares for mothers and babies of all incomes. The Center provides information to expectant parents on childbirth, breastfeeding and new infant care giving. It also offers infant health screening which includes a full assessment and examination of the baby and examination of the mother.Care Management manages the Good Samaritan Fund to help those less fortunate by providing support beyond the excellent medical care provided at St. Vincent's HealthCare. Many of St. Vincent's patients need financial assistance with prescription medications, funeral expenses and other critical needs. The Good Samaritan Fund pays for these items for patients who have no other assistance available to them. Part VI, Line 5: St. Vincent's Medical Center Southside (formerly St. Luke's Hospital) is the oldest private hospital in the state of Florida. During its 138 years of operation the facility has been in five locations and has been its current locale since the mid-1980s. St. Luke's joined St. Vincent's HealthCare in 2008. Like its other St. Vincent's HealthCare sibling St. Vincent's Medical Center Riverside, St. Vincent's Medical Center Southside welcomes the sick and vulnerable to its doors. In its Mission Statement, St. Vincent's proclaims that it provides care to all, but with special attention to the poor and vulnerable. This is the emphasis St. Vincent's Medical Center Southside uses in its community benefit programs.St. Vincent's Southside has a medical staff open to all qualified physicians in the Northeast Florida area. The majority of the dedicated members of the Board of Directors of parent organization, St. Vincent's HealthCare, are persons who live and work in the Jacksonville area and who, by virtue of their continuous service to the community, are acutely aware of the social and health needs of the Northeast Florida region. These individuals along with the members of the medical staff are committed to the Mission Statement and its call to provide high quality healthcare for all who come to its doors.With cash and in-kind contributions, St. Vincent's Medical Center Southside and, in some instances, in partnership with other organizations is able to offer a variety of opportunities which are no or low cost to the community. St. Vincent's does this as part of its mission to provide care for all, especially the poor and vulnerable of the community.The St. Vincent's HealthCare's website, www.jaxhealth.com, is an encyclopedia with wellness tools for the community to gain information to live a healthier lifestyle. St. Vincent's Medical Center Southside promotes regular radio programming presented by healthcare professionals promoting prevention and wellness. It sponsors the Parish Nurse Program which is in 70 congregations in Northeast Florida. This program empowers congregations to care for themselves with health and wellness initiatives trained by RNs. Through cash contributions St. Vincent's Southside has supported the Medical Clinic of the I.M. Sulzbacher Homeless Center; emergency pregnancy services; Catholic Charities; summer camp for special children for the Diocese of St. Augustine; ICARE, a social justice advocacy collaboration of area clergy; Northeast Florida Health Planning Council; the American Cancer Society; the Cancer Society; WeCare Jacksonville; The Way Free Medical Clinic in Green Cove Springs, FL; the Florida Bioethics Network; Brooks College of Health at the University of North Florida and many other organizations whose mission is compatible with St. Vincent's Medical Center Southside.The Good Samaritan Fund of St. Vincent's disbursed approximately $232,000 to 2,500 patients in financial need. These services included medications, clothing, short-term residential and burial expenses. Part VI, Line 6: St. Vincent's Health System, Inc. and subsidiaries (the "Health Ministry") is a member of Ascension Health. In December 2011, Ascension Health Alliance, doing business as Ascension, became 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 health care facilities, or Health Ministries, located in 23 of the United States and the District of Columbia. In addition to serving as the sole corporate member of Ascension Health, Ascension serves as the member or shareholder of various other subsidiaries. Ascension, its subsidiaries, and the Health Ministries are referred to collectively from time to time hereafter as the "System".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 American Province, and the Sisters of the Sorrowful Mother of the Third Order of St. Francis of Assisi U.S./Caribbean Province.St. Vincent's Southside is a wholly owned subsidiary of St. Vincent's Health System, Inc. (SVHS), which is a member of Ascension Health. Ascension Health is a Catholic, national health system consisting primarily of nonprofit corporations that own and operate local health care facilities, or Health Ministries, located in 20 of the United States and the District of Columbia. Ascension Health is sponsored by the Northeast, Southeast, East Central, and West Central Provinces of the Daughters of Charity of St. Vincent de Paul, the Congregation of St. Joseph, and the Sisters of St. Joseph of Carondelet (CSJ). The Health Ministry, located in Jacksonville, Florida, is a nonprofit acute care hospital. The Health Ministry provides inpatient, outpatient, and emergency care services for the residents of Northeast Florida and Southern Georgia. Admitting physicians are primarily practitioners in the local area. The Health Ministry is related to Ascension Health's other sponsored organizations through common control. Substantially all expenses of Ascension Health are related to providing health care services.The Health Ministry includes the following subsidiaries:- St. Vincent's Medical Center, Inc. ("Riverside") a nonprofit, acute care medical center. Riverside provides inpatient, outpatient, and emergency care services. Admitting physicians are primarily practitioners in the local area.- St. Luke'sSt. Vincent's Health, Inc. ("Southside") a nonprofit, acute care medical center. Southside provides inpatient, outpatient, and emergency care services. Admitting physicians are primarily practitioners in the local area.- St. Vincent's Medical Center, Inc. Clay County ("Clay County") a nonprofit, acute care medical center. Clay County provides inpatient, outpatient, and emergency care services. Admitting physicians are primarily practitioners in the local area. Clay County began operations in October 2013.- St. Catherines Laboure Manor, Inc. ("Nursing Home") a nonprofit, skilled nursing facility.- St. Vincent's Ambulatory Care, Inc. ("Ambulatory Care") a nonprofit, specialty physician practice that provides neurosurgery, neurology, and cardiology services.- St. Vincent's Foundation, Inc. ("Foundation") a nonprofit organization that supports the activities of the acute facilities and the Nursing Home through various fund raising activities.- St. Vincent's Physician Enterprise, Inc. ("SVPE") a taxable entity that provides primary care services.- First Coast Primary Care, Inc. ("First Coast") a taxable entity that provides primary care services.- Consolidated Pharmacy Services, Inc. ("CPS") a taxable entity that provides retail pharmaceutical services and ambulance transportation services.Mission:Ascension Health 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 Ascension Health'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. Ascension Health 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 health care 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 who are poor and community benefit programs. The cost of providing care of persons living in poverty and community benefit programs is estimated using internal cost data and is calculated in compliance with guidelines established by both the Catholic Health Association (CHA) and the Internal Revenue Service (IRS).Additional affiliates and members of the St. Vincent's Health System include: St. Vincent's Medical Center, Inc., St. Catherines Laboure Manor, Inc., St. Vincent's Ambulatory Care, Inc., First Coast Primary Care, Inc., St. Vincent's Physician Enterprise Inc., Consolidated Pharmacy Services, Inc. and St. Vincent's Foundation, Inc., St. Vincent's Medical Center Clay County, Inc. 1 1 0 0 0 0 0 0 0 Moody Chisholm President/CEO, Ex-Officio 0 598917 0 936973 0 81448 0 51820 0 38999 0 1708157 0 0 Kimberly Hodgkinson CFO (start 1/14) 0 341831 0 56917 0 26065 0 35315 0 41994 0 502122 0 0 Donnie Romine Jr COO/President - Riverside 0 409829 0 99017 0 30 0 51953 0 29775 0 590604 0 0 Karen F Darnell VP/Chief Ambulatory Service Officer 0 289980 0 44242 0 21995 0 50138 0 34967 0 441322 0 0 Janice G Lipsky Sr. VP HR/OD/CHRO 0 246182 0 34217 0 16757 0 48098 0 41072 0 386326 0 0 John Meyer Sr. VP Strategic Planning 0 230088 0 34892 0 1230 0 23264 0 11700 0 301174 0 0 Jeffrey Middlebrooks General Counsel 0 294353 0 45462 0 870 0 25415 0 22687 0 388787 0 0 Kyle Sanders President - Southside 0 306596 0 95477 0 30 0 25676 0 32219 0 459998 0 0 Lorraine M Keith COO/CNO - St. Luke's 215495 0 27352 0 9592 0 29794 0 28046 0 310279 0 0 0 Steve Nauman Interim CMO 0 393892 0 0 0 0 0 0 0 0 0 393892 0 0 Charles Griffey CRNA 135245 0 0 0 30 0 23000 0 18140 0 176415 0 0 0 Jason Waszak Pharmacist 137286 0 1695 0 30 0 13871 0 21440 0 174322 0 0 0 Rebecca Goldwasser CRNA 150057 0 0 0 30 0 0 0 18167 0 168254 0 0 0 Jeffery Scarmack Pharmacist 138636 0 2495 0 30 0 11347 0 18819 0 171327 0 0 0 Jill Wenzel CRNA 127478 0 0 0 30 0 20805 0 10268 0 158581 0 0 0 Phil C Perry Former CMO (end 4/14) 0 123555 0 0 0 25873 0 17782 0 13358 0 180568 0 0 Part I, Line 3 Ascension Health, a related organization of St. Luke's-St. Vincent's Healthcare, Inc. uses the following to establish the compensation of the organization's CEO: - Compensation Committee, - Independent Compensation Consultant, - Compensation Survey or Study, and - Approval by the Board or Compensation Committee. Part I, Line 4a, Severance Payments: Mark Doyle - $120,625 Part I, Line 4b: 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 executives is reported as compensation on Form 990 Schedule J, Part II, Column B in the year paid. The following individual received a payout from Ascension Health's nonqualified retirement plan in the amount as noted: Kimberly Hodgkinson - $2,527 North Florida Anesthesia See Part V 270235 See Part V 0 Schedule L, Part IV: Business Transactions Involving Interested Persons:a) Name: North Florida Anesthesia Consultantsb) Relationship between Interested Person and Organization: North Florida Anesthesia Consultants is more than 35% owned by a board member of St. Luke's-St. Vincent's Healthcare, Inc. c) Amount of Transaction: $270,235d) Description of the Transaction: North Florida Anesthesia Consultants provide goods and services to St. Luke's-St. Vincent's Healthcare, Inc. Form 990, Part VI, Section A, line 2 Many of the persons listed on Part VII have a "business relationship" with each other by virtue of employment by related St. Vincent's Health System, Inc. entities. Form 990, Part VI, Section A, line 6 St. Luke's-St. Vincent's Healthcare has a single corporate member, St. Vincent's Health System, Inc. Form 990, Part VI, Section A, line 7a St. Luke's-St. Vincent's Healthcare has a single corporate member, St. Vincent's Health System, Inc., who has the ability to elect members to the governing body of St. Luke's-St. Vincent's Healthcare. Form 990, Part VI, Section A, line 7b All decisions that have a material impact to St. Luke's-St. Vincent's Healthcare financial information or corporation as a whole are subject to approval by its sole corporate member, St. Vincent's Health System, Inc. Form 990, Part VI, Section B, line 11 Management, including certain officers, works diligently to complete the Form 990 and attached schedules in a thorough manner. Management presents the Form to the Board, or a designated committee, to review. Prior to filing the return, all Board Members are provided the Form 990 and management team members are available to answer any Board Members' questions. Form 990, Part VI, Section B, line 12c Officers, directors or trustees, and key employees are required to complete a Conflict of Interest Attestation Statement at the time of hiring or when their service begins. Annually, the Corporate Responsibility Officer sends the Conflict of Interest Policy and Attestation Statement to all officers, directors or trustees, and key employees for completion and return within two weeks. Three separate mailings are sent out with two week deadlines to receive a maximum response. The responses from the returned Attestation Statement are organized in a spreadsheet and are carefully reviewed by the Corporate Responsibility Officer, the Chief Legal Officer, and the Chief Executive Officer. A full report is presented to the Audit Committee and any potential conflicts of interest are handled by the committee in an appropriate manner. Form 990, Part VI, Section B, line 15 In determining the compensation of the organization's CEO, the process, performed by Ascension Health, a related organization of St. Luke's-St. Vincent's Healthcare, 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 CEO was compared to individuals at other organizations in the area who hold the same title. During the review and approval of the compensation, documentation of the decision was recorded in the committee minutes. The individual was not present when his compensation was decided. In determining the compensation of other officers and key employees of the organization, the process, performed by St. Vincent's Health System, Inc., a related organization of St. Luke's-St. Vincent's Healthcare, 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 other officers and key employees were compared to individuals at other organizations in the area who hold the same title. During the review and approval of the compensation, documentation of the decision was recorded in the board minutes. Form 990, Part VI, Section C, line 19 The organization will provide any documents open to public inspection upon request. Form 990, Part VII, Section B: 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 Ascension Health (EIN: 31-1662309). Expenses are allocated to and reimbursed by the filing organization to Ascension Health. As such, the organization has not reported independent contractors paid on Form 990, Part VII, Section B. Form 990, Part XI, line 9: Unrestricted Deferred Pension Cost Adm by Ascension Health -1,132,416. Transfer to Affiliates -32,682,733. Ascension Health Alliance pO Box 45998 St Louis MO 631455998 453358926 National Health System MO Section 501(c)(3) Schedule A, Line 11a N/A 0 Ascension Health PO Box 45998 St Louis MO 63145 311662309 National Health System MO Section 501(c)(3) Schedule A, Line 11a Ascension Health Alliance 0 St Vincent's Health System Inc 4205 Belfort Road Suite 4030 Jacksonville FL 32216 593650609 Parent Entity FL Section 501(c)(3) Schedule A, Line 11b Ascension Health 0 St Vincent's Medical Center Inc 4205 Belfort Road Suite 4030 Jacksonville FL 32216 590624449 Hospital FL Section 501(c)(3) Schedule A, Line 3 St Vincent's Health System Inc 1 St Vincent's Ambulatory Care Inc 4205 Belfort Road Suite 4030 Jacksonville FL 32216 592292041 Physician Practice FL Section 501(c)(3) Schedule A, Line 9 St Vincent's Health System Inc 1 St Vincent's Foundation Inc 4205 Belfort Road Suite 4030 Jacksonville FL 32216 592219923 Fund Raising FL Section 501(c)(3) Schedule A, Line 7 St Vincent's Health System Inc 1 St Catherines Laboure Manor Inc 4205 Belfort Road Suite 4030 Jacksonville FL 32216 591878316 Nursing Home FL Section 501(c)(3) Schedule A, Line 3 St Vincent's Health System Inc 1 St Vincent's Medical Center Clay County Inc 1580 Branan Field Road Middleburg FL 32068 461523194 Hospital FL Section 501(c)(3) Schedule A, Line 3 St Vincent's Health System Inc 1 Consolidated Pharmacy Services Inc 4205 Belfort Road Suite 4030 Jacksonville FL 32216 593398033 Retail Pharmacy & Patient Transport FL N/A C 0 Advanced Patient Transportation Inc 4205 Belfort Road Suite 4030 Jacksonville FL 32216 593381444 Transport Services FL N/A C 0 Seton Pharmacies 4205 Belfort Road Suite 4030 Jacksonville FL 32216 593001427 Retail Pharmacy FL N/A C 0 First Coast Primary Care 4205 Belfort Road Suite 4030 Jacksonville FL 32216 205746243 Primary Care FL N/A C 0 Family Medicine Condominium Association Inc 1 Shircliff Way Jacksonville FL 32204 261983355 Condominium Association FL N/A C 0 St Vincent's Physician Enterprise Inc 4205 Belfort Road Suite 4030 Jacksonville FL 32216 271927603 Primary Care FL N/A C 0 0 0 1 0 0 0 0 0 1 0 0 0 1 0 0 0 0 0 1 St Vincent's Health System Inc I 383584 FMV St Vincent's Ambulatory Care Inc I 634678 FMV St Vincent's Medical Center Inc I 144407 FMV St Vincent's Health System Inc M 8641076 FMV First Coast Primary Care Inc S 168602 FMV St Catherines Laboure Manor Inc S 361014 FMV St Vincent's Health System Inc S 51384240 FMV St Vincent's Ambulatory Care Inc S 1493566 FMV St Vincent's Physician Enterprise Inc S 164737 FMV Ascension Health S 10177837 FMV St Vincent's Foundation Inc S 186982 FMV St Vincent's Medical Center Inc S 5671758 FMV St Vincent's Medical Center Clay County Inc S 400504 FMV