2014-05-14T09:32:27-05:00 2013-06-30 861065772 Deloitte Tax LLP 250 East Fifth Street Suite 1900 Cincinnati OH 45202 990 2012-07-01 910349750 Our Lady of Lourdes Hospital at Pasco OURL 5095477704 520 North 4th Avenue Pasco WA 993012568 Frank R Becker 5095462282 2014-05-13 1 Rebecca Lyons P01487105 5137847100 2014-05-15 2012 2015-11-30 17:44:51Z Lourdes Health Network John Serle 520 North 4th Avenue Pasco WA 993012568 103766591 0 0928 X www.lourdeshealth.net X 1920 WA Respond to the healthcare needs of the Mid-Columbia area in a Christian spirit. 13 13 913 167 346525 341298 721530 256709 109179571 102106610 714348 868805 787936 137999 111403385 103370123 250463 254749 0 0 57114336 57787513 0 0 0 54236296 44445494 111601095 102487756 -197710 882367 71828166 72806536 28131375 28970017 43696791 43836519 X The mission of Our Lady of Lourdes Hospital at Pasco is an extension of the healing ministry of Jesus. We are called to serve our community, our patients, their loved ones and our co-workers with respect, compassion and care. We respond to the health care needs in a Christian spirit. We strive for excellence in all we do. Our Catholic health ministry is dedicated to spiritually centered, holistic care, which sustains and improves the health of individuals and communities. In furtherance of its mission and in an effort to reduce the government's financial burden, Our Lady of Lourdes Hospital at Pasco provides essential health care services, such as inpatient acute care, emergency and ambulatory services, behavioral health care, and outpatient clinics as well as community services. 0 1 41052490 46692296 Our Lady of Lourdes Hospital at Pasco provides a substantial portion of its services to the elderly and poor. During the fiscal year ending June 30, 2013, approximately 34% of the value of services rendered were to elderly patients under the Medicare program and approximately 19% of services were provided to patients who were deemed indigent under state, county, or Hospital guidelines. In the spirit of principles adopted by Ascension Health, Our Lady of Lourdes Hospital at Pasco has taken proactive steps to address those issues that will affect the accessibility, the financing, and the delivery of healthcare to all persons especially the uninsured, the underinsured, and the underserved. During the fiscal year ending June 30, 2013, the estimated cost of services provided to the elderly, the uninsured, and the underinsured totaled $8,333,668, including $2,149,652 cost for charity care and $1,385,235 in bad debts attributable to the uninsured and underinsured, $808,443 in services to the general community, and $4,582,354 in unpaid cost of public programs. 10864735 254749 12357336 Community benefits are programs or activities that provide treatment and/or promote health and healing as a response to identified community needs. In efforts to promote healthy living, Our Lady of Lourdes Hospital at Pasco has made available the following programs to the community: physical fitness activities, community health programs, medical education, cancer screening programs, support groups and educational classes, CPR and first aid classes, health screening, flu shot clinic, nutrition and weight loss management. 37856270 43056978 Our Lady of Lourdes Hospital at Pasco provides the following inpatient and outpatient medical services to the community: emergency care services, flight care, laboratory services, orthopedic services, pain management, primary care physicians, radiology services, rehabilitation services, sleep studies, maternity, physical therapy, occupational therapy, speech therapy, respiratory therapy, surgery, pediatrics, imaging, inpatient and outpatient alcohol and substance abuse, and inpatient and outpatient behavioral health services. Some of these services, such as rehab therapies, primary care physicians, behavioral health and maternity operate at a loss in order to ensure that all services are available to meet community health care needs. During the fiscal year ending June 30, 2013, Our Lady of Lourdes Hospital at Pasco treated 2,623 inpatient adults and children in the community for a total of 12,956 patient days of service. Our Lady of Lourdes Hospital at Pasco also provided services to 239,644 outpatients, including 2,055 outpatient surgical patients, 21,925 emergency room visits, 7,554 behavioral health and rehab therapy visits and 138,143 clinic and urgent care visits. 89773495 1 1 0 1 0 0 0 0 0 0 1 0 0 1 1 1 0 1 0 0 0 0 0 0 0 0 1 1 1 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 1 1 1 0 0 1 210 0 1 913 1 1 1 0 0 0 0 0 0 0 0 0 X 13 13 0 0 0 0 1 1 1 1 1 0 0 1 1 1 1 1 1 1 1 1 1 X Roberta Wittorf 5095423044 520 North 4th Avenue Pasco WA 993012568 X Ernest Parra 1.00 0.00 X X 0 0 0 Bart Gallant 1.00 0.00 X X 0 0 0 Charles Graves 1.00 0.00 X X 0 0 0 Sr Mary Williams 1.00 0.00 X X 0 0 0 Greg Garcia 1.00 0.00 X X 0 0 0 Dr Laurie Evans 1.00 0.00 X 0 0 0 Julie Killian 1.00 0.00 X 0 0 0 Sr Ann Patricia O'Connor 1.00 0.00 X 0 0 0 Sr Adrienne Clare Pereira 1.00 0.00 X 0 0 0 Jeff Petersen 1.00 0.00 X 0 0 0 Dr Venkataraman Sambasivan 1.00 0.00 X 0 0 0 Randy Shoop 1.00 0.00 X 0 0 0 Sr Mary Catherine Siminski 1.00 0.00 X 0 0 0 John Serle 48.00 2.00 X 754461 0 46707 Frank Becker 48.00 2.00 X 351178 0 55515 Sr Esther Polacci Sch O 50.00 0.00 X 0 0 0 Barbara Blood 50.00 0.00 X 174708 0 7972 Denise Clapp 50.00 0.00 X 151731 0 16163 Barbara Mead 50.00 0.00 X 251024 0 25149 James I Bucher MD 50.00 0.00 X 396147 0 15363 Michael J Hannan MD 50.00 0.00 X 416577 0 33960 James T Go MD 50.00 0.00 X 373994 0 20755 Benjamin D Pe MD 50.00 0.00 X 392586 0 36979 John Michael Roach MD 50.00 0.00 X 472352 0 33495 3734758 0 292058 86 0 1 0 Tri Cities Laboratory LLC 110 West Cliff Avenue Spokane WA 99204 Laboratory Services 2785672 Northwest Emergency Physicians Inc PO Box 634850 Cincinnati OH 452634850 Emergency Physicians 2451227 Specialized Physicals 1365 Beet Road Walla Walla WA 99362 Physician Services 824003 TriMedx LLC PO Box 636129 Cincinnati OH 452636129 Equipment Servicing 607328 Nuance Communications 1 Wayside Road Burlington MA 01803 Technology Services 526615 16 160592 96117 2822 256709 Net Patient Services 621990 54651037 54651037 Medicare Patient Rev. 621990 28593934 28593934 Medicaid Patient Rev. 621990 18098362 18098362 763277 763277 102106610 859323 859323 287018 335639 -48621 -48621 -48621 70311 60829 9482 9482 9482 Cafeteria and Vending 722212 294640 294640 Pharmacy 446110 76597 76597 Inv in Uncon. Entities 523000 -284619 346525 -631144 100002 100002 186620 103370123 102106610 346525 660279 254749 254749 1683102 558136 1124966 42932604 38973098 3959506 2422583 2155576 267007 7654216 6620096 1034120 3095008 2724891 370117 217741 456888 -239147 219624 219624 185054 185054 21557 21557 6505142 4994872 1510270 706585 706585 732238 700154 32084 4617570 4045453 572117 3526059 3366512 159547 308908 243269 65639 425013 372517 52496 3099235 2713632 385603 311178 272623 38555 Medical & Food Supplies 13117398 13046286 71112 Professional Fees 5167187 5105142 62045 Other Minor Equipment 430126 407076 23050 Dues and Subscriptions 179530 76109 103421 4675349 2686416 1988933 102487756 89773495 12714261 0 7029773 69257 16286677 13796186 1432341 1543678 1358330 1479935 27269571 8560826 20747390 18708745 54880 217375 1940889 24701400 35267846 71828166 72806536 11707147 11604904 213233 577658 16210995 16787455 28131375 28970017 X 43636732 43765978 60059 70541 0 43696791 43836519 71828166 72806536 X 882367 499637 -1242276 X 0 1 X 1 0 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 0 0 0 0 0 0 0 0 1 21557 21557 0 Explanation of Lobbying Activities: Part II-B, Line 1: Lobbying expenses represent the portion of dues paid to national and state hospital associations that are specially allocable to lobbying. Our Lady of Lourdes Hospital at Pasco 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. 1334397 1334397 16550724 4587597 11963127 758154 323942 434212 7576891 3649287 3927604 1049405 1049405 18708745 Interest in Investment held by Ascension Health Alliance 24762553 Investments in Tri-Cities Cancer Center 5239898 Investments in Tri-Cities Lab. 2185744 Deferred Compensation Asset 1824175 Third Party Receivables 1012490 Investment in BLT, LLC 114289 Other Miscellaneous Receivables 71185 Physician Guarantees Asset 57512 35267846 Intercompany Debt to Ascension Health Alliance 12190557 Deferred Compensation Liability 1824175 Estimated Settlement to Third Party Payors 1354823 Other Long-Term Debt 1109242 Self Insurance Liability 308658 16787455 X Description of Uncertain Tax Positions Under FIN 48: Part X, Line 2: From the consolidated audited financial statements of Our Lady of Lourdes Hospital at Pasco d/b/a Lourdes Health Network ("Health Network"): The member health care entities of the Health Network 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 Network 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. 1 1 X 1 X 1 X 1 1 1 0 1 1 2149652 2149652 0.02080 34323936 29741582 4582354 0.04440 36473588 29741582 6732006 0.06520 146000 146000 0.00140 201521 201521 0.00200 2552073 2037095 514978 0.00500 91944 91944 0.00090 2991538 2037095 954443 0.00930 39465126 31778677 7686449 0.07450 2150 2150 0.00000 45391 45391 0.00040 788 788 0.00000 48329 48329 0.00040 0 1385235 16316196 17403414 -1087218 X 1 1 2 1 Lourdes Medical Center

520 North 4th Avenue Pasco WA 99301

www.lourdeshealth.net X X X X A 2 Lourdes Counseling Center

1175 Carondelet Drive Richland WA 99352

www.lourdeshealth.net X Behavioral Health Services A Facility Reporting Group - A 1 X X X X X X X X X 12 1 1 1 X X X X X X 0 0 1 1 200.000000000000 1 300.000000000000 1 X X X X X X 1 1 X X 1 0 1 X 0 0 10 Lourdes Columbia Point

112 Columbia Point Drive Suite 103 Richland WA 99352

Physician Clinic Lourdes Surgical Associates

1200 N 14th Avenue Suite 400 Pasco WA 99301

Surgical Services Lourdes Women's Health at 14th Avenue

1200 N 14th Avenue Suite 255 Pasco WA 99301

Women's Health Care (Closed October 2013) Lourdes Ear Nose and Throat Assoc

1200 N 14th Avenue Suite 220 Pasco WA 99301

Ear, Nose and Throat Care Lourdes Family Health Center

650 S Columbia Avenue Connell WA 99326

Family Health Care Clinic Lourdes Urgent Care

5304 N Road 68 Pasco WA 99301

Urgent Care Clinic Lourdes Occupational Hlth & Phys Med

9915 Sandifur Parkway Pasco WA 99301

Occupational Health and Physical Medicine Lourdes Riverview Medical Group

4403 W Court Street Suite B Pasco WA 99301

Physician Clinic Lourdes West Pasco

7425 Wrigley Drive Pasco WA 99301

Women's Hlth, Family Med., Pediatrics, Gastroenterology & Diagnostic Imaging Lourdes Cullum House

208 Cullum Avenue Richland WA 99352

Behavioral Health Residential Support 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-to-charge ratio that addresses all patient segments (for example: inpatient, outpatient, emergency room, private insurance, Medicaid, Medicare, uninsured, or self-pay). The best available data was used to calculate the amounts reported in the table. Part I, Line 7g: The organization has not included costs attributable to a physician clinic as part of subsidized health services. Part II: Lourdes Health Network ("Lourdes") provided the following community building activities:- CHILDHOOD OBESITY - To support healthy activities and prevention of childhood obesity, Lourdes sponsored three fun runs in local schools, provided "healthy snack" education to three local schools, and sponsored America on the Move through the YMCA. Without the support of Lourdes, the schools and organizations would not have been able to offer these activities that are designed to help young children learn healthy habits. Lourdes also supports many youth sports activities, such as Kennewick Youth Baseball, little league basketball teams and soccer teams to further our work to encourage children to be active.- PRENATAL OUTREACH - Lourdes provides free prenatal classes to anyone in the community, regardless of hospital of delivery. Classes include: Prenatal education in English and Spanish, Infant CPR classes, and refresher courses. In addition, a postpartum clinic is available free of charge for any new mother and baby post discharge. A positive educational program is also provided to high-risk teen mothers via the New Horizons High School and the Pasco School District. This program provides self esteem, parenting skills, and pre and post natal education.- COMMUNITY EDUCATION - For 95 years, Lourdes has been active providing community education throughout the region. A few examples: - Lourdes Health Network Nutritional Counselors are guest speakers at nursing homes, assisted living facilities, schools, volunteer groups and churches presenting healthy eating and diabetes prevention information provided by Lourdes, but at no cost to attendees. - Lourdes Health Network's Infection Control nurse actively educated children in schools and the community at many community events about proper hand washing and flu prevention at no cost to attendees and funded by Lourdes. In addition, Lourdes spearheaded an internal and external hand washing campaign and provided the largest community event - the Benton Franklin Fair and Rodeo - with posters, hand wipes, and hand sanitizers. - Dr. Benjamin Pe, Lourdes board certified child psychiatrist, provides educational sessions to local elementary schools about signs and symptoms of childhood mental illness provided by Lourdes at no cost to the school district. - Blood Drives - Lourdes works in close partnership with the Red Cross and promotes and hosts blood drives in many of our facilities. Having an adequate community blood supply is essential to our community's health. Lourdes is proud to offer these blood drives at no cost to participants or to the Red Cross. - Scholarships - Lourdes Auxiliary provides outstanding local students wanting to enter the healthcare field with $1,500 scholarships to pursue their education. This is one way that we can contribute to fighting the healthcare worker shortage and further the education of our community's brightest students. Part III, Line 4: The organization is a part of the Our Lady of Lourdes Hospital at Pasco consolidated audit. The footnote that references bad debt expense in the June 30, 2013 consolidated audit is as follows: 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 allowance for doubtful accounts based upon historical write-off experience by payer 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 Network 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 Network's policies.The methodology for determining the allowance for doubtful accounts and related write-offs on uninsured patient accounts has remained consistent with the prior year. During fiscal 2013, the Health Network brought substantially all of the patient billing functions in-house. This change resulted in a substantial improvement in patient accounts receivable collection efforts in 2013. The Health Network has not experienced material changes in write-off trends and has not materially changed its charity care policy since June 30, 2012.The organization's share of bad debt expense in 2012 was $3,477,722 atcharges ($1,385,235 at cost). 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 has a written debt collection policy that also includes a provision on the collection practices to be followed for patients who are known to qualify for charity care or financial assistance. If a patient qualifies for charity or financial assistance certain collection practices do not apply. Part VI, Line 2: Lourdes Health Network ("Lourdes") is a collaborative community partner. During year ended June 30, 2013, Lourdes collaborated with Benton-Franklin Community Health Alliance, Kadlec Regional Medical Center, Kennewick General Hospital, PMH Medical Center, Group Health Cooperative, the Benton-Franklin Health District, and many other key partners and time contributors to complete the Community Health Needs Assessment for Benton and Franklin Counties ("CHNA"). Through data and community perception, a CHNA is a systematic examination of the health status within a given population to help identify key problems and assets in a community. The CHNA highlights the findings through a culmination of our health status, community themes and strengths, forces of change, and local public health systems. A complete copy of the organizations CHNA can be accessed at http://www.bfcha.org/. Part VI, Line 3: Financial counselors are trained to discuss our financial assistance policy and assist those needing assistance with the application. In addition, they have knowledge of other assistance programs that patients may qualify for and assist patients in finding that information. During the pre-registration, registration, admission and discharge processes, Lourdes attempts to identify patients who may be eligible for charity or discounted care via the charity care policy. A financial counselor is provided to all patients. Lourdes charity care policy is posted in all admitting areas, the emergency room and the information desk with information about our financial assistance program and how to access it if needed. On the website is the full application available for download as well as information about the policy. A written summary and contact information is provided in all communications with patients regarding bills and account status. Part VI, Line 4: Lourdes Health Network ("Lourdes") primarily serves those residing in Franklin and Benton Counties. Lourdes offers the only acute hospital in Franklin County and provides a clinic in North Franklin County. Lourdes also offers the region's only inpatient mental health hospital in Benton & Franklin Counties. In fiscal year ending June 30, 2013, Lourdes Health Network provided more than $8.9 million calculated using CHA guidelines in charity and uncompensated care to members of our community. The demographic makeup of the community we serves is as follows:FRANKLIN COUNTY - Total Population (Est. as of July 2012) - 85,845- 69.6% are high school educated or above - Median Household Income - $51,770- 21.5% of individuals below poverty level - 51.0% Hispanic or LatinoBENTON COUNTY- Total Population (Est. as of July 2012) - 182,398- 88.9% are high school educated or above- Median Household Income - $60,300- 12.9% of individuals below poverty level- 18.5% Hispanic or LatinoThe Health Status of the Mid-Columbia region trends with the health of the nation. However, our area has a higher prevalence of childhood obesity and diabetes, which then adds to other issues, such as heart disease and stroke. Other areas rated unfavorable compared to peer counties include:- Births to women under 18- Births to unmarried women- No care in first trimester- Mortality- Homicide- Lung Cancer- Stroke- Suicide- Colon CancerLourdes Health Network works diligently to provide healthy lifestyle education to the community in multiple ways such as a community newsletter, a web-based health information library, community events and educational forums and formalized relationships with schools. Part VI, Line 5: Our Lady of Lourdes Hospital at Pasco ("Lourdes") seeks to improve the physical, mental, social, and spiritual health status of its surrounding community. In addition to providing health care services to all individuals who require medical attention, Our Lady of Lourdes Hospital at Pasco has developed programs to help achieve its mission. Lourdes has provided significant support in the form of job shadow hours for classes at a local college, an employment service, and other organizations with the purpose of creating new employment opportunities for members of the community. Lourdes has also participated in other community-building coalitions in an effort to address health and safety concerns in the community.Lourdes allows educated staff with specific expertise to provide community education. For instance, the Infection Control nurse provides hand hygiene education to schools, at community events, and to teachers. Lourdes' board-certified child psychiatrist provides education to local teachers about signs and symptoms of children's common mental health issues. Certified dieticians provide education to school children and through the YMCA about healthy after-school snacks and overall healthy eating habits. It is estimated that over 2,000 school children and staff have attended sessions in the last year. Partnership with City of Pasco for Pasco Safety Improvements - Lourdes Medical Center is located on 4th Avenue in Pasco. 4th Avenue is a major arterial with 4 lanes of traffic. There have been several deaths and many injuries as people attempt to cross 4th Avenue to enter the hospital. As a proactive community leader, Lourdes has partnered with the City on a safety assessment and plan to improve 4th Avenue. This partnership included a monetary donation to the City for the assessment. The safety of our community and our patients is of utmost concern for Lourdes. - Other Non-profits: American Cancer Society, American Diabetes Association, American Red Cross, Boys and Girls Clubs, YMCA. Part VI, Line 6: Our Lady of Lourdes Hospital at Pasco, d/b/a Lourdes Health Network ("Health Network") is a member of Ascension Health. In December 2011, Ascension Health Alliance became the sole corporate member and parent organization of Ascension Health, a Catholic, national health system consisting primarily of not-for-profit 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 Health Alliance serves as the member or shareholder of various other subsidiaries. Ascension Health Alliance, its subsidiaries, and the Health Ministries are referred to collectively from time to time hereafter as the System.Ascension Health Alliance is sponsored by Ascension Health Ministries, a Public Juridic Person. The Participating Entities of Ascension Health Ministries are the Daughters of Charity of St. Vincent de Paul in the United States, St. Louise Province, the Congregation of St. Joseph, theCongregation of the Sisters of St. Joseph of Carondelet, the Congregation of Alexian Brothers of the Immaculate Conception Province American Province and the Sisters of Sorrowful Mother of the Third Order of St. Francis of Assisi US/Caribbean Province.Our Lady of Lourdes Hospital at Pasco d/b/a Lourdes Health Network, located in Pasco Washington, is a not-for-profit acute care hospital. The Health Network consists of two separately licensed not-for-profit health care providers and a foundation: Lourdes Medical Center ("MedicalCenter") located in Pasco, Washington; Lourdes Counseling Center ("Counseling Center") in Richland, Washington; and Lourdes Foundation ("Foundation"). The Medical Center and Counseling Center provide inpatient, outpatient and emergency care services for the residents ofPasco and its surrounding communities. Admitting physicians are primarily practitioners in the local area. The Foundation supports the Medical Center and the Counseling Center. The Health Network 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 System directs its governance and management activities toward strong, vibrant, Catholic Health Ministries united in service and healing and dedicates its resources to spiritually centered care which sustains and improves the health of the individuals and communities it serves. Inaccordance with the System's mission of service to those persons living in poverty and other vulnerable persons, each Health Ministry accepts patients regardless of their ability to pay. The System uses four categories to identify the resources utilized for the care of persons living in poverty and community benefit programs:- Traditional charity care includes the cost of services provided to persons who cannot afford 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 living in poverty and community benefit programs. The cost of providing care to 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).The amount of traditional charity care provided, determined on the basis of cost, was approximately $2,091 and $1,747 for the years ended June 30, 2013 and 2012, respectively. The amount of unpaid cost of public programs, cost of other programs for persons living in poverty and other vulnerable persons, and community benefit cost are reported in the accompanying other information. Reports Filed With States Part VI, Line 7 WA OUR LADY OF LOURDES HOSPITAL AT PASCOCOMMUNITY BENEFIT REPORTFOR THE YEAR ENDED JUNE 30, 2013This report illustrates the significant degree to which Our Lady of Lourdes Hospital at Pasco (dba and referred to throughout this document as Lourdes Health Network) contributes to the positive health status of the communities it serves. As a member of Ascension Health, the nation's largest not-for-profit healthcare system, Lourdes Health Network continues to build and strengthen sustainable collaborative efforts that benefit the health of individuals, families, and society as a whole. The goal of Lourdes Health Network is to perpetuate the healing mission of Jesus. Lourdes Health Network furthers this goal through delivery of patient services at the beginning of life, the end of life and each step in between with care to the elderly and indigent, patient education and health awareness programs for the community. Our concern for all human life and dignity of each person leads the organization to provide medical and mental health services to all people in the community without regard to the patient's race, creed, national origin, economic status, or ability to pay in a compassionate spirit. In order to portray the full breadth of our contribution, our community benefit information is described below: ORGANIZATIONAL COMMITMENT TO PROVIDING COMMUNITY BENEFITLourdes Health Network consists of Lourdes Medical Center, a 25-bed Acute Critical Access Hospital with an additional 10-bed inpatient rehabilitation unit and Lourdes Counseling Center, a stand alone 32-bed Psychiatric Hospital offering both inpatient and outpatient behavioral health services and a network of physician clinics caring for families in Southeastern Washington.In June of 2013, Lourdes Health Network's Volunteer Board of Directors approved the Community Health Improvement Plan based on community needs as identified in the Community Health Needs Assessment. Areas of focus for Lourdes Health Network include but are not limited to obesity and behavioral health. Lourdes Health Network primarily serves the Benton & Franklin Counties of Washington State an area with a population of nearly 250,000 total population. Our Lady of Lourdes Hospital at Pasco seeks to improve the physical, mental, social and spiritual health status of its surrounding community. In addition to providing health care services to all individuals who require medical attention, Lourdes Health Network has developed the following programs to help achieve its mission:EXPANDING AWARENESS, EDUCATION, AND HEALTH PROMOTIONLourdes Health Network believes that it is essential to educate people regarding the types of behavior that improve their chances of living a healthy life. Lourdes Health Network has invested significantly in unique, top quality health education and materials relating to first aid, health and wellness and more in order to accomplish its goals.BodyWorks - Lourdes Health Network provides, at no charge, children struggling with obesity a course called BodyWorks. This five week, five session program is designed to help children and their entire family make healthier nutrition choices. Registered dieticians work directly with them and also provide coaching for grocery shopping. Lourdes Health Network also offers a series called, "Lunch and Learn" free and open to anyone on various health care topics monthly. Medical Education - Lourdes Health Network believes in order to provide the best health care to the community, its clinical personnel must receive ongoing medical education. Healthcare professionals are therefore encouraged to attend the "Lunch and Learn" sessions provided onsite. In addition, Lourdes Health Network provides healthcare professionals education in the following job specific areas on a routine basis:- BLS = Basic Life Support (i.e. cardiopulmonary resuscitation CPR)- ACLS = Advance Cardiac Life Support- TNCC = Trauma Nurse Core Curriculum- PALS = Pediatric Advanced Life Support- STABLE = Advanced Neonatal Resuscitation- Advanced Rehab Documentation and FIM scoring- Advanced Solution Wound Care- CPT Coding E/M Documentation guidelines- Emergency Severity index: 5 level triage- PICC Line Insertion class- Prophylaxis and Management of Asthma- Radiation Safety Training- SBAR Communication- Providing Holistic, Reverent CareIn the spirit of principles adopted by Ascension Health, Lourdes Health Network has taken proactive steps to address those issues that will affect accessibility, the financing, and the delivery of healthcare to all persons, especially the uninsured, underinsured, and the underserved. During the fiscal year ending June 30, 2013, the estimated unreimbursed cost of services provided to the elderly, uninsured, and underinsured totaled $8,333,668 with an additional $2,149,652 in charity care delivered.Lourdes Medical Center provides a substantial portion of its services to the elderly and poor. During the fiscal year ending June 30, 2013, approximately 34% of the values of services rendered were to elderly patients under the Medicare program, and approximately 19% of the services were provided to patients who were deemed indigent under state guidelines (Medicaid).Lourdes Counseling Center also provides a substantial portion of its services to the elderly and poor. During the fiscal year ending June 30, 2013, approximately 22% of the values of its services rendered were to elderly patients under the Medicare program, and approximately 46% of the services were provided to patients who were deemed indigent under state guidelines (Medicaid).LOURDES MEDICAL CENTER- Operates an emergency room that is open to all persons regardless of ability to pay; - Has an open medical staff with privileges available to all qualified physicians in the area; - Has a volunteer-based governing body in which independent persons representative of the community comprise a majority;- Engages in the training and education of health care professionals; and- Participates in Medicaid, Medicare, CHAMPUS, Tricare, and/or other government-sponsored health care programs.PATIENT SERVICESLourdes Health Network provides the following in-patient and out-patient medical services to the community:- ICU- Acute Care- Chemical Dependency and Rehabilitation- Physical Rehabilitation- Surgery- Same-Day Surgery- Gastroenterology Lab- Laboratory- Diagnostic Imaging- Diagnostic Therapeutic- Adult and Child Psychiatry- Renal- Emergency- Clinic Services (Occupational Health, Primary Care, Pediatrics, Gastroenterology, Urgent Care, Pediatric Urgent Care, OB/GYN, ENT, Urology, Neurology, Pulmonology, General Surgery, and Internal Medicine)- Ambulatory- Sleep Lab- Ear, Nose and Throat- Therapies (Physical, Occupational, and Speech)- Diabetic & Nutritional Education and Counseling- Inpatient Adult Psychiatric- Outpatient Counseling and Behavioral Health Treatment- Intensive Outpatient Behavioral Health- Supported Living Programs for Behavioral Health- PATH Program for the Homeless PopulationSome of the services listed above operate at a loss in order to ensure that all services are available to meet community health care needs, such as the PATH Program.During the fiscal year ending June 30, 2013, Lourdes Health Network treated 2,623 adults and children in the community for a total of 12,956 patient days of service. The Medical Center also provided services to 239,644 outpatients, including 2,055 outpatient surgery patients, 21,925 emergency room visits, 7,554 behavioral health and rehab therapy visits, and 138,143 clinic and urgent care visits.FINANCIAL INFORMATIONThe financial information presented below was prepared in accordance with the Catholic Health Association's (CHA) community benefit reporting guidelines. These guidelines recommend the following:- Report care of the poor at cost, not charges.- Do not include bad debt, contractual allowances, and quick pay discounts as part of care of the poor expense.- Do not count Medicare shortfall as a community benefit.- Report the net expense for community benefit services, i.e., the total community benefit expense minus any associated revenue from patients, payers, and other external sources.The CHA reporting guidelines reflect a conservative approach to reporting quantifiable community benefit. The goal of the reporting guidelines is to produce community benefit financial reports that reflect true costs and that describe community benefit activities that increase access to health care and improve community health. For fiscal year ended June 30, 20131. Care of the poor (at cost) = $2,149,6522. Government sponsored health care (net expense) = $4,582,354(unpaid cost of public indigent care programs includes Medicaid, SCHIP, other safety net programs; does not include Medicare shortfall)3. Community Benefit Programs (net expense) = $808,4434. Bad debt (at cost) = $1,385,235 Part V, Line 8 Facility Reporting Group A See below Facility 1 -- Lourdes Medical Center Part V, Section B, line 3: Throughout the assessment process members of the steering committee provided specific presentations in their field of expertise. The steering committee learned about previous assessments, current health statistics, the economy, spirituality, and many other topics relevant to understanding the sub-populations and health trends of the community. In addition, WSU-Tri-Cities students assisted the steering committee by presenting assessments on six population groups: uninsured elementary students, middle school adolescents, young adults with mental illness, agricultural workers, the Hanford workforce, and seniors aged 65+. Two Masters of Public Health (MPH) students helped with compiling data and statistical analysis. Students from Columbia Basin College helped conduct a community oral health survey. Facility 1 -- Lourdes Medical Center Part V, Section B, line 4: The assessment and report were compiled through collaboration between the Benton-Franklin Community Health Alliance, Kadlec Regional Medical Center, Kennewick General Hospital, Lourdes Health Network, PMH Medical Center, Group Health Cooperative, the Benton-Franklin Health District, and many other key partners and time contributors. For a complete list of entities included in the Community Health Needs Assessment see:http://www.lourdeshealth.net/assets-lhn/pdf/brochures/CHNA-2013-Executive- Summary.pdf Facility 1 -- Lourdes Medical Center Part V, Section B, line 7: Lourdes Medical Center does not intend to address the following community health needs identifited in the Community Health Needs Assessment: - Affordability while we continue to contain costs and maintain our generous charity care policy, we will not specifically address this need as the issue is much larger and difficult to address. - Lack of Insurance we will not directly address this issue as many of those without health insurance will have health insurance with the Affordable Care Act. Facility 1 -- Lourdes Medical Center Part V, Section B, line 14g: Signs are posted in emergency rooms, in waiting rooms, and at the admissions offices to notify patients that the hospital has a financial assistance policy. In addition, every billing statement and the Hospital's website include information regarding the financial assistance policy. The policy is provided at the request of the patient. Facility 1 -- Lourdes Medical Center Part V, Section B, line 18e: Question 18 is more appropriately answered as not applicable as the Billing and Collections Policy of Our Lady of Lourdes Hospital at Pasco does not allow a hospital to engage in extraordinary collection actions before the organization made reasonable efforts to determine whether the individual is eligible for assistance under the financial assistance policy. Reasonable efforts taken include but are not limited to:- Notifying individuals of the financial assistance policy on admission- Notifying individuals of the financial assistance policy prior to discharge- Notifying individuals of the financial assistance policy incommunications with the patients regarding the patients' bills- Documenting its determination of whether patients were eligible forfinancial assistance under the hospital facility's financial assistancepolicy Facility 2 -- Lourdes Counseling Center Part V, Section B, line 3: Throughout the assessment process members of the steering committee provided specific presentations in their field of expertise. The steering committee learned about previous assessments, current health statistics, the economy, spirituality, and many other topics relevant to understanding the sub-populations and health trends of the community. In addition, WSU-Tri-Cities students assisted the steering committee by presenting assessments on six population groups: uninsured elementary students, middle school adolescents, young adults with mental illness, agricultural workers, the Hanford workforce, and seniors aged 65+. Two Masters of Public Health (MPH) students helped with compiling data and statistical analysis. Students from Columbia Basin College helped conduct a community oral health survey. Facility 2 -- Lourdes Counseling Center Part V, Section B, line 4: The assessment and report were compiled through collaboration between the Benton-Franklin Community Health Alliance, Kadlec Regional Medical Center, Kennewick General Hospital, Lourdes Health Network, PMH Medical Center, Group Health Cooperative, the Benton-Franklin Health District, and many other key partners and time contributors. For a complete list of entities included in the Community Health Needs Assessment see:http://www.lourdeshealth.net/assets-lhn/pdf/brochures/CHNA-2013-Executive- Summary.pdf Facility 2 -- Lourdes Counseling Center Part V, Section B, line 7: Lourdes Counseling Center does not intend to address the following community health needs identifited in the Community Health Needs Assessment: - Affordability while we continue to contain costs and maintain our generous charity care policy, we will not specifically address this need as the issue is much larger and difficult to address. - Lack of Insurance we will not directly address this issue as many of those without health insurance will have health insurance with the Affordable Care Act. Facility 2 -- Lourdes Counseling Center Part V, Section B, line 14g: Signs are posted in emergency rooms, in waiting rooms, and at the admissions offices to notify patients that the hospital has a financial assistance policy. In addition, every billing statement and the Hospital's website include information regarding the financial assistance policy. The policy is provided at the request of the patient. Facility 2 -- Lourdes Counseling Center Part V, Section B, line 18e: Question 18 is more appropriately answered as not applicable as the Billing and Collections Policy of Our Lady of Lourdes Hospital at Pasco does not allow a hospital to engage in extraordinary collection actions before the organization made reasonable efforts to determine whether the individual is eligible for assistance under the financial assistance policy. Reasonable efforts taken include but are not limited to:- Notifying individuals of the financial assistance policy on admission- Notifying individuals of the financial assistance policy prior to discharge- Notifying individuals of the financial assistance policy incommunications with the patients regarding the patients' bills- Documenting its determination of whether patients were eligible forfinancial assistance under the hospital facility's financial assistancepolicy 1 Lourdes Foundation 520 North 4th Avenue Pasco WA 99301 911528577 Section 501(c)(3) 200393 General Support Washington State University Foundation 255 E Main St Suite 301 Pullman WA 991641925 911075542 Section 501(c)(3) 30000 Tri Cities Nursing Partnership Support 2 0 Procedure for Monitoring Grants in the U.S.: Part I, Line 2: Schedule I, Part I, Line 2: Our Lady of Lourdes Hospital at Pasco provided donations to Lourdes Foundation to assist in daily operations. Lourdes Foundation's operations are closely monitored through shared leadership and goverance to ensure monies given are used as intended. In addition, Our Lady of Lourdes Hospital at Pasco donated to Benton Franklin Community Health Alliance in support of its access to care goals in the local community. The use of these funds is monitored through access to care successes and break throughs in the community. X X X 1 1 X X X X 0 1 0 0 0 0 0 0 0 John Serle 303718 0 367750 0 82993 0 22004 0 24703 0 801168 0 0 0 Frank Becker 207333 0 82756 0 61089 0 31000 0 24515 0 406693 0 18435 0 Barbara Blood 153987 0 20611 0 110 0 0 0 7972 0 182680 0 0 0 Denise Clapp 136110 0 8479 0 7142 0 6080 0 10083 0 167894 0 0 0 Barbara Mead 183946 0 28718 0 38360 0 15009 0 10140 0 276173 0 0 0 James I Bucher MD 394771 0 0 0 1376 0 0 0 15363 0 411510 0 0 0 Michael J Hannan MD 396389 0 0 0 20188 0 12500 0 21460 0 450537 0 0 0 James T Go MD 346777 0 19409 0 7808 0 0 0 20755 0 394749 0 0 0 Benjamin D Pe MD 207298 0 157888 0 27400 0 12500 0 24479 0 429565 0 0 0 John Michael Roach MD 6700 0 448549 0 17103 0 12500 0 20995 0 505847 0 0 0 Part I, Line 1a An officer is allowed to receive companion travel reimbursement for one companion on two business trips. The companion fees are reimbursable according to the standard travel reimbursement policy. These reimbursements are considered taxable income to the officer and are included in taxable wages. Gross up payments are made to all employees of Our Lady of Lourdes Hospital at Pasco for gifts received from the employer such as Christmas gift cards and special recognition awards. An officer receives payments for tax preparation services. These reimbursements are considered taxable income to the officer and are included in taxable wages. 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, are entirely dependent on 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 not guarantee that these executives will evere receive any benefit under the program. Any amount ultimately paid under the program to executive is reported as compensation on Form 990, Schedule J, Part II, Column B in the year paid. The following individual receive payment from the supplemental nonqualified retirement plan in the amount as noted: Frank Becker - $18,435 The following individuals made contributions to the supplemental nonqualified retirement plan in the amounts as noted: John Serle - $17,004 Frank Becker - $26,000 Barbara Mead - $10,400 Changes in Program Services Form 990, Part III, line 3 During fiscal year ending June 30, 2013, Our Lady of Lourdes Hospital at Pasco discontinued its labor/delivery and nursery service lines and closed its Connell clinic location. Form 990, Part VI, Section A, line 6 Our Lady of Lourdes Hospital at Pasco has a single corporate member, Ascension Health. Form 990, Part VI, Section A, line 7a Our Lady of Lourdes Hospital at Pasco has a single corporate member, Ascension Health, who has the ability to elect members to the governing body of Our Lady of Lourdes Hospital at Pasco. Form 990, Part VI, Section A, line 7b Ascension Health has designed a system authority matrix which assigns authority for key decisions that are necessary in the operation of the system. Specific areas that are identified in the authority matrix are: new organizations & major transactions; governing documents; appointments/removals; evaluation; debt limits; strategic & financial plans; assets; system policies & procedures. These areas are subject to certain levels of approval by Ascension per the system authority matrix. 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. 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 The organization regulary and consistently monitors and enforces compliance with the conflict of interest policy in that any director, principal officer, or member of a committee with governing board delegated powers, who has a direct or indirect financial interest, must disclose the existence of the financial interest and be given the opportunity to disclose all material facts to the directors and members of the committees with governing board delegated powers considering the proposed transaction or arrangement. The remaining individuals on the governing board or committee will decide if conflicts of interest exist. Each director, principal officer and member of a committee with governing board delegated powers annually signs a statement which affirms such person has received a copy of the conflict of interest policy, has read and understands the policy, has agreed to comply with the policy, and understands that the organization is charitable and in order to maintain its federal tax exemption it must engage primarily in activities which accomplish its tax-exempt purpose. Form 990, Part VI, Section B, line 15 In determing the compensation of the organization's CEO, the process included a review and approval by independent persons, comparability data, and contemporaneous substantiation of the deliberation and decision. The Audit Committee reviewed and approved the compensation. In the review of the compensation, the CEO was compared to individuals at other hospitals 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. The individual was not present when his compensation was decided. In determining the compensation of other officers of the organization, the process included a review and approval by independent persons, comparability data, and contemporaneous substatntion of the deliberation and decision. The Audit Committee reviewed and approved the compensation. In the review of the compensation, the other officers of the organization were compared to individuals at other hospitals 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 A: Sister Esther Polacci is paid directly from LA Province of the Sisters of St. Joseph Carondelet. Changes in Net Assets or Fund Balances: Form 990, Part XI, line 9: Transfer to Sponsor -106,175. Transfer to Affiliates -1,132,056. Release from Restriction -4,045. 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 Lourdes Foundation 520 North 4th Avenue Pasco WA 99301 911528577 Fundraising WA Section 501(c)(3) Schedule A, Line 11a Our Lady of Lourdes Hospital at Pasco 1 Physicians of Pasco Condominiums Assoc 520 North 4th Avenue Pasco WA 99301 453691641 Property Management WA Lourdes Health Network C -72943 4267 0.78540 1 0 1 1 0 0 0 0 0 0 0 0 0 0 0 0 1 1 1 1 Lourdes Foundation B 200393 Actual Amount Paid Lourdes Foundation C 160592 Actual Amount Paid Lourdes Foundation Q 81214 Actual Amount Paid Ascension Health P 10045882 Actual Amount Paid Ascension Health R 860807 Actual Amount Paid Ascension Health S 501542 Actual Amount Paid