2014-05-15T08:57:19-05:00 2013-06-30 861065772 Deloitte Tax LLP 250 East Fifth Street Suite 1900 Cincinnati OH 45202 990 2012-07-01 630288864 St Vincent's Birmingham STVI 2059397000 810 St Vincents Drive Birmingham AL 35205 David Cauble 2059397000 2014-05-15 1 Rebecca Lyons P01487105 5137847100 2014-05-08 2012 2015-11-30 17:44:51Z John O'Neil 810 St Vincents Drive Birmingham AL 35205 388897278 0 0928 X www.stvhs.com X 1898 AL Provides essential health care services as well as community services. 14 13 2538 73 368779 -47546 708826 704533 377650651 372485852 3110244 2940282 17143555 10413958 398613276 386544625 345569 330874 0 0 121880313 117956898 0 0 0 229075893 229592477 351301775 347880249 47311501 38664376 497777253 546565119 187948569 195994188 309828684 350570931 X Rooted in the loving ministry of Jesus as healer, we commit ourselves to serving all persons with special attention to those who are poor and vulnerable. Our Catholic health ministry is dedicated to spirtually centered, holistic care which sustains and improves the health of individuals and communities. We are advocates for a compassionate and just society through our actions and our words. 0 0 312946069 330874 375174918 The hospital is dedicated to spiritually centered, holistic care that sustains and improves the health of the individuals and communities. It furthers this goal through delivery of patient services, care to the elderly and indigent, patient education and health awareness programs for the community. For detailed information on the Hospital's program services accomplishments and statistical data, see Schedule H. 312946069 1 1 0 1 0 0 0 0 0 0 1 0 0 1 1 0 0 1 0 0 0 0 0 0 0 0 1 1 1 0 1 0 0 0 0 0 1 1 0 0 0 0 0 0 1 1 1 0 0 1 X 0 0 2538 1 1 1 0 0 0 0 0 0 0 0 0 X 14 13 0 0 0 0 1 1 1 1 0 0 0 1 1 1 1 1 0 1 1 1 1 X David Cauble 2059397079 810 St Vincents Drive Birmingham AL 35205 Robert Barnett 2.00 4.00 X X 0 0 0 Kent J Graeve 2.00 4.00 X X 0 0 0 Douglas B Nunnelley 0.50 2.00 X X 0 0 0 James D Davis 2.00 4.00 X X 0 0 0 Marc E Bloomston MD 0.50 2.00 X 0 0 0 Tina N Corr 0.50 2.00 X 0 0 0 Sr Mary Elizabeth Cullen DC 0.50 2.00 X 0 0 0 Norman B Davis end 1012 0.50 2.00 X 0 0 0 Morton Goldfarb MDend 313 0.50 2.00 X 0 0 0 Benny M LaRussa Jr 0.50 2.00 X 0 0 0 William H McClanahanJr MD 0.50 2.00 X 0 0 0 Willie H Parker 0.50 2.00 X 0 0 0 Daniel F Sansone 0.50 2.00 X 0 0 0 Zeke Smith start 712 0.50 2.00 X 0 0 0 Stan Starnes 0.50 2.00 X 0 0 0 John D O'Neil 20.00 30.00 X X 0 1900939 24085 David A Cauble 20.00 30.00 X 0 602305 25894 Vicki L Briggs 20.00 30.00 X 0 638819 19928 Nan M Priest 20.00 30.00 X 0 489675 22934 Gregory L James 20.00 30.00 X 0 577576 16746 Carol A Maietta 20.00 30.00 X 0 331083 16998 William A Davis 49.00 1.00 X 512508 0 25421 Christopher L Moore 50.00 0.00 X 309202 0 24024 Janith Gannon 50.00 0.00 X 169028 0 8567 Brian K Mader 50.00 0.00 X 198040 0 21048 Lydia E Esty 50.00 0.00 X 173974 0 14273 Sam A Faircloth 50.00 0.00 X 181147 0 20866 Roger Lee Quinn 50.00 0.00 X 172279 0 16056 Dianne W Norris 50.00 0.00 X 169805 0 16082 Neeysa C Biddle end 611 0.00 0.00 X 0 143177 0 1885983 4683574 272922 8 1 1 0 TriMedx LLC PO Box 636129 Cincinnati OH 452636129 Medical Equipment 6882520 Morrison Management Specialists PO Box 102289 Atlanta GA 303682289 Dietary Services 6822608 Touchpoint Support Services 4721 Morrison Drive Suite 300 Mobile AL 36609 Dietary & Environmental Services 4177314 Star Electrical Contractors 205 20th Avenue South Birmingham AL 35205 Electrical Work 1446119 Crothall Services Group 200 16th Street South Birmingham AL 352331600 Environmental Services 1363203 33 594529 67346 42658 704533 Net Patient Revenue 621990 370989333 370845731 143602 Investment - JV's 621990 1013253 1013253 Lab Revenue 621990 483266 258089 225177 372485852 2895257 2895257 199631 91470 108161 108161 108161 69916 24891 45025 45025 45025 4018497 2236292 1782205 1782205 ARRA Funds 900099 3680668 3680668 Parking Revenue 812930 1504835 1504835 Child Care Center 900099 280244 280244 3057845 3057845 8523592 386544625 375174918 368779 10296395 330874 330874 901032 810929 90103 97034624 87331161 9703463 2199398 1979458 219940 10611853 9550668 1061185 7209991 6488992 720999 752351 677116 75235 15601 15601 28358479 25522631 2835848 37181 33463 3718 1545273 1390746 154527 16112446 14501201 1611245 10714726 9643253 1071473 55423 49881 5542 36371 32734 3637 4115176 3703658 411518 18790697 16911627 1879070 731300 658170 73130 Medical Supplies 87812148 79030933 8781215 Corporate Allocation 29372148 26434933 2937215 Provider Tax 17139629 15425666 1713963 Medical/Surgical Rental 4310521 3879469 431052 9693007 8542905 1150102 347880249 312946069 34934180 0 278908 68088 38788876 47412118 5184979 6867264 490526 698516 496902296 311505220 195131381 185397076 2030030 2276751 300450 645846 255572103 303199460 497777253 546565119 7537879 20620959 27664 513277 180383026 174859952 187948569 195994188 X 309626448 350400557 202236 170374 0 309828684 350570931 497777253 546565119 X 38664376 2260111 -182240 X 0 1 X 1 0 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 0 0 0 0 0 0 0 0 1 15601 15601 0 Part IV, Supplemental Information: Part II-B, Line 1(i), Other Lobbying Activities: Lobbying expenses represent the portion of dues paid to national and state hospital associations that is specifically allocable to lobbying. St. Vincent's Birmingham 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. 1 8790157 8790157 205766194 89065040 116701154 6181759 4978209 1203550 274335105 217461971 56873134 1829081 1829081 185397076 Intercompany Receivables 234908979 Interest in Investment Held by Ascension Health Alliance 54729029 Other Long-Term Investments 11663911 Other Receivables 1017241 Other Long-Term Assets 709926 Restricted Assets 170374 303199460 Intercompany Debt to Ascension Health 117525751 Other Non-Current Liability 47295303 Estimated Third Party Payables 6036686 Patient AR Credit Balances 3368774 Physician Guarantee Liability 397382 Post Retirement Benefits 156910 Other Current Liabilities 79146 174859952 1 1 X 1 X 1 X 1 1 1 0 1 1 7252604 7252604 0.02080 26745080 16092197 10652883 0.03060 33997684 16092197 17905487 0.05140 22 12225 677452 252 677200 0.00190 5 361 619378 295919 323459 0.00090 3 4822 25220 9975 15245 0.00000 2 5 163852 163852 0.00050 7 1500 288911 288911 0.00080 39 18913 1774813 306146 1468667 0.00410 39 18913 35772497 16398343 19374154 0.05550 2 824 824 0.00000 5 4310 7287 7287 0.00000 2 8200 8138 8138 0.00000 9 12510 16249 16249 0 12497777 132210517 137837428 -5626911 X 1 1 1 1 St Vincent's Birmingham

810 St Vincents Drive Birmingham AL 35205

http://www.stvhs.com/birmingham/ X X X St Vincent's Birmingham 1 1 X X X X X X X X 12 1 0 1 X X X X X X X 1 0 1 1 200.000000000000 1 300.000000000000 1 X X X X 1 1 X X X X 1 0 1 X 0 0 1 Access to Care Network

810 St Vincents Drive POB 1-Ste 105 Birmingham AL 35205

Medical Clinic 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 costing accounting system 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. For the information in the table, a cost-to-charge ratio were calculated and applied. Part I, Line 7g: The organization employs its physicians at physician clinics, so the associated costs and charges relating to those physician services are included in all relevant categories in Part I. Part II: St. Vincent's Health System provided the following community building activities in FY 2013:St. Vincent's Health System has taken the lead in creating a Community Health Care Provider Coalition that meets every other month to collaborate, coordinate and educate each other and the community about important health issues and resources. This group includes hospitals, mental health providers, non-profit clinics, local health department, and other service providers.St. Vincent's Heart Day - A System-wide initiative with its main goal to assist individuals to access heart tests at an affordable cost if they would otherwise be unable to access such services. Heart assessment tests (valued at $350) are made available for a low fee of $40. Follow up by Dial-A-Nurse is offered to those who need additional testing. Dial-A-Nurse - Registered nurses are available during normal business hours to answer health information inquiries. They are able to triage callers who express symptoms and give basic information about health conditions. St. Vincent's Christmas Store - A Christmas program in partnership with Catholic Center of Concern and King's Home that works to provide families who have experienced an emergency with Christmas items as well as health information. The program provides a toy, winter coat, food box with fresh produce, books for the children and the option for parents to receive a free flu shot. It is a collaborative effort between St. Vincent's Birmingham, St. Vincent's East and St. Vincent's One Nineteen.King's Home - St. Vincent's One Nineteen provides assistance to this local home for women and children experiencing homelessness or domestic violence. One Nineteen hosts a race event benefiting the organization and residents participate in the Christmas Store initiative. Camp Bluebird is a St. Vincent's Birmingham and St. Vincent's East program for adult cancer survivors. The camp provides retreat and supportive services for participants. The model has acquired national recognition and other healthcare providers have adopted the program's model. St. Vincent's Wellness Services provide a wide variety of community outreach and health education. From free or low cost workshops to health fairs and classes, the outreach is designed to emphasize healthy living and healthy habits. Wellness Services perform screenings at local churches free of charge and at events related to the Hispanic Outreach. Wellness Services provides programming in local assisted living facilities, especially those in underserved areas, free of charge. They have also worked closely with schools and neighborhood organizations to provide programs about nutrition to children and young adults. St. Vincent's Birmingham and St. Vincent's East both maintain a cancer registry, which provides information for the community's benefit. These two facilities also support research that is unsponsored but ultimately benefits the greater community as well.As a Health System, St. Vincent's is committed to disaster preparedness, especially in light of recent events. Our System Safety Officer facilitates trainings and education above and beyond what is required to ensure that the employees are more than prepared for any emergency situations.St. Vincent's St. Clair, Blount and East all participate in local organizations such as Rotary Club, Chamber of Commerce and Kiwanis to educate local leaders about health issues. St. Vincent's Case Management at all facilities frequently go above and beyond the required care by providing assistance in applying for public benefits (MedAssist), providing transportation services for medical appointments (shuttle service), sponsoring sitters/companions for those who are unable to afford, and medication assistance to those who cannot afford prescriptions.St. Vincent's East provides community support in the form of various on-campus support groups. The groups include support for: cancer survivors, individuals living with low vision, gastric bypass, diabetes, grief support and heart health.At every St. Vincent's facility, students and interns shadow and train with associates in a variety of fields: nursing, physical therapy, health information management, business administration, respiratory therapy, patient care assisting, phlebotomy, medical secretary, radiology, surgery, sterile processing, as well as a medical residency program and clinic in collaboration with St. Vincent's East. We provide essential medical services to the community, train and recruit healthcare professionals to serve the needs of the broader community, provide appropriate charity services to those unable to pay for their health care needs, and provide services to other organizations that allow them to provide quality services to their patients or constituents. St. Vincent's Health System currently partners with local chapters of national organizations with intent to assist those with varying health issues. Among the organizations that associates may volunteer with, participate in and raise funds for are: American Cancer Society, American Diabetes Association, American Heart Association, Leukemia and Lymphoma Society, March of Dimes, Susan G. Komen for the Cure, Dispensary of Hope, Red Cross, and United Way. Local health-related organizations that receive support from St. Vincent's Health System include: Birmingham AIDS Outreach, Tot Shots (free vaccination program), Sickle Cell Foundation, Cahaba Valley Health Care (dental and vision), Office of Women's Health, and M-POWER Ministries (free clinic). Other organizations in the community that St. Vincent's sponsors and supports are: - Cristo Rey - an internship program for inner city youth at Holy Family Catholic School; - Royal Family Kids Camp - which provides a summer camp experience for foster care children; - Magic City Harvest - provides food distribution to homeless shelters;- Ladies of Charity - raise funds and volunteer in the spirit of St. Vincent dePaul;- The Nest - a homeless health outreach; - Christian Service Mission - provides emergency donations and need (especially in recent disaster relief efforts);- YWCA and Pathways - a set of services designed to assist homeless women become self-sufficient;- Our Lady of Fatima and St. Barnabas Catholic Schools - which provide private school education in underserved communities; - The Exceptional Foundation - that supports mentally challenged children to learn skills and socialize;- Jones Valley Urban Farm - which supports urban farming and healthy nutrition. Part III, Line 4: From the consolidated audited financial statements of Ascension Health Alliance (which includes the activity of St. Vincent's Birmingham): The provision for doubtful accounts is based upon management's assessment of expected net collections considering economic conditions, historical experience, trends in healthcare coverage, and other collection indicators. Periodically throughout the year, management assesses the adequacy of the allowance for doubtful accounts based upon historical write-off experience by payor category, including those amounts not covered by insurance. The results of this review are then used to make any modifications to the povision for doubtful accounts to establish an appropriate allowance for doubtful accounts. After satisfaction of amounts due from insurance and reasonable efforts to collect from the patient have been exhausted, the System follows established guidelines for placing certain past-due patient balances with collection agencies,subject to the terms of certain restrictions on collection efforts as determined by the System.The cost-to-charge ratio was used to determine the bad debt expense at cost. Bad debt expense at cost attributable to patients eligible under the organization's charity polity was calculated by using the US Census date to determine the percentage of population below 200% of the FPL and applied that percentage to bad debt expense at cost as an estimate of charity in bad debt. 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. The cost-to-charge ratio method is used in determining the shortfall. Part III, Line 9b: St. Vincent's Health System follows the Ascension guidelines for collection practices related to patients qualifying for charity or financial assistance. A patient can apply for charity or financial assistance at any time during the collection cycle. Once qualifying documentation is received the patient's account is adjusted. Patient accounts for the qualifying patient in the previous six months may also be considered for charity or financial assistance. Once a patient qualifies for charity or financial assistance, all collection activity is suspended. St. Vincent's Birmingham Part V, Section B, Line 3: To prepare the CHNA report data was gathered from multiple sources in an effort to construct a current and accurate snapshot of the health issues in Jefferson County, Alabama. Data was obtained from multiple public data bases and opinions were solicited from public health experts, community leaders and patients within the community served bySt. Vincent's Birmingham Hospital. This information was summarized for final consideration by a CHNA team consisting of hospital and system personnel as well as community members. Part VI, Line 2: Our most recent community needs assessment was conducted in April 2013 by St. Vincent's Birmingham and was limited geographically to the seven counties served by St. Vincent's Health System. The assessment was completed by interviewing key stakeholders both within St. Vincent's Health System and in the external community. The interviews were conducted between December 2012 and April 2013. Interviewees included a range of CEO's and program managers from area health care organizations, and more than 50 interviews were completed. The needs assessment consists of census data, public health information, and findings from the interviews. These findings include an assessment of the local healthcare infrastructure and the service gaps, especially in regards to those in our community who lack access to basic healthcare services. Part VI, Line 3: St. Vincent's Birmingham uses visual aids to inform patients of available financial assistance. The statement of Patient Financial Services Financial Assistance is displayed at all registration areas throughout the hospital, including the Emergency Department to make patients aware that assistance is available. Our staff, when discussing collections with patients, also makes patients aware of the available assistance if they are unable to pay. Part VI, Line 4: St. Vincent's Health System primarily services residents of central Alabama in the following seven counties: Blount, Cullman, Jefferson, Shelby, St. Clair, Talladega, and Walker. - Our primary service area consists of both rural and urban communities with a population of 658,931; median income of $45,750. - Age of population: 23.55% age 0-18, 54.7% age 19-64, 13.3% age 65+.- Ethnicity: 54.7% White non-Hispanic, 42.3% Black non-Hispanic, 1.9% Other.- Language: English speaking 94.2%, Non-English age 5+ 5.8%.- Insurance coverage breakdown is 49.3% Private, 43.18% Medicare, 3.1% Medicaid, and 4.5% Uninsured.- Poverty: 16.2% on average in poverty. - Hospitals in service area: 13 total, 11 Nonprofit, 2 For profit, 1 academic medical center.- Health Statistics- Obesity: 32%.- Leading causes of death: Heart disease, Cancer, Stroke. Part VI, Line 5: This report illustrates the significant degree to which St. Vincent's Health System through its four hospitals and Health & Wellness facility, contributes to the positive health status of the communities we serve. The system's four hospitals include: St. Vincent's Birmingham, St. Vincent's East, St. Vincent's Blount and St. Vincent's St. Clair. Each hospital has a separate Tax ID number. Each makes an important contribution to caring for their community, including those who are underserved. As a member of Ascension Health, St. Vincent's Health System continues to build and strengthen sustainable collaborative efforts that benefit the health of individuals, families and the community as a whole. The Health System's mission is to extend the healing ministry of Christ. The hospitals of the health system further the mission through the delivery of patient services, care to the elderly and indigent, patient education, and health awareness programs for the community. Our concern for all human life and commitment to the dignity of each person leads us to provide medical services to all people in the community without regard to race, creed, national origin, economic status, or ability to pay. Based on our Core Values and in the spirit of principles adopted by Ascension Health, our Health System has taken proactive steps to address those issues that affect accessibility, the financing, and the delivery of health care to all persons, especially the uninsured, underinsured, and the underserved. The following chart demonstrates the significant number of patient days and the estimated unreimbursed cost of services provide by our four hospitals to the uninsured or underserved. FY13 Number of Number of Estimated Licensed Beds Patient Days Unreimbursed costSt. Vincent's Birmingham 499 101,558 13,395,225 St. Vincent's East 346 81,163 14,195,123St. Vincent's Blount 40 4,122 1,335,501St. Vincent's St. Clair 40 9,136 2,417,474 Total 925 195,979 31,343,323St. Vincent's Heath System has a deep commitment to serving the community. We earmark a certain percentage of our yearly profits for charitable donations. Through this charitable donation program, we are able to support local chapters of national organizations such as: the American Cancer Society, the American Heart Association, March of Dimes, and Susan G. Komen for the Cure. We also fund local programs and initiatives such as the United Way. Many of our executives serve on the boards of these organizations.We provide essential medical services to the community, train and recruit healthcare professionals to serve the needs of the broader community, provide appropriate charity services to those unable to pay for their health care needs, and provide services to other organizations that allow them to provide quality services to their patients or constituents. Some of these services include Liz Moore Low Vision Center located at St. Vincent's East, Jeremiah's Hope Skills Program, Hispanic Outreach Ministry, Access to Care and Elder Care Services program which are all located at St. Vincent's Birmingham.The goal of the Liz Moore Low Vision Center at St. Vincent's East is to assist the person with low vision to use functional vision to the utmost capacity. A person with low vision may be legally blind but able to function with visual aids that enhance the remaining vision. With the assistance of magnification and adaptations of the special low vision aids that are useful for certain daily tasks, the visually impaired person can function with less difficulty. The Vision Center provides services for the person with low vision. These services are designed to benefit a person's daily life activities, which may be hindered by the visual loss.St. Vincent's Birmingham Jeremiah's Hope Skills Program focuses on training at-risk individuals, particularly women, for entry level jobs in the healthcare industry. Today, more than _ people have graduated from Jeremiah's Hope, and most are still working in the healthcare industry. St. Vincent's has also recently partnered with Jeff State Community College to begin identifying "under-employed" individuals from within our own workforce and training them to become nurses. Philanthropy allowed this revolutionary program to blossom and it has now become a model for other healthcare facilities nationwide.In 2003, St. Vincent's Birmingham initiated a Hispanic Outreach program, La Sana Esperanza/The Healthy Hope, recognizing the changing demographics in Birmingham. This program provides health and medical assistance to the burgeoning Latino population, often an isolated sector of our community. By identifying and placing high-risk persons in our Access to Care, we are providing critical care for those in need in a fiscally responsible manner. We have provided health fairs, health screenings, health information, case management assistance, and language assistance to a myriad of persons within the Birmingham community in order to break down the barriers that lead to poor heath in the Latino population.Access to Care is a healthcare option for the "working poor" in the Birmingham area, serving individuals who are employed but lack health insurance. The Clinic treats up to _ patients at any given time, providing for all of their healthcare needs at no cost to the patient. St. Vincent's works with patients to identify ways to acquire insurance and screens patients based on a willingness to make life changes conducive to good health. This charity care is only made possible because of charitable gifts which provide the equipment, space and staffing the Clinic needs. The Clinic is a service for those patients who have no other options and is possible because of the many philanthropists who support this ministry.The St. Vincent's Birmingham Elder Care Services Program was created in response to a need expressed by a donor to St. Vincent's Foundation. That donor is a self-described Elder Orphan. She has few family members and no prospects to assist her with care as she ages. She worries about her future when the time comes when she is no longer able to drive herself to and from physician appointments and to the grocery store. She trusts St. Vincent's to care for her medical needs and wondered if there was a way for St. Vincent's to assist people like her who will need additional assistance as they age. The idea was presented to Susann Montgomery-Clark in the Foundation office, and after more than two years of focus groups and meetings with St. Vincent's associates, the project was officially launched. Initial funding was requested from a group of focus group members who were supportive and excited about the project and a grant was obtained from the Daughters of Charity to begin work on the outline of services that the Elder Care Services Program might provide. Just in its infancy, the Elder Care Program has hopes to become one that assists our original donor and those like her who will need support services in their twilight years. We Are Called To: - Service of the Poor - Generosity of spirit, especially for persons most in need- Reverence - Respect and compassion for the dignity and diversity of life- Integrity- Inspiring trust through personal leadership- Wisdom- Integrating excellence and stewardship- Creativity- Courageous innovation- Dedication- Affirming the hope and joy of our ministry.St. Vincent's Health System is made up of five facilities: St. Vincent's Birmingham, St. Vincent's Blount, St. Vincent's East, St. Vincent's St. Clair, and One Nineteen Health and Wellness. Together, we provide a special brand of high-touch, high-tech quality care to people in more than 40 different zip codes. Our healthcare family has an extensive network of skilled physicians and associates, as well as the most advanced technologies available. We are a part of Ascension Health, the nation's largest Catholic and non-profit health system, with more than 100,000 associates serving in _ states and the District of Columbia. We are committed to providing healthcare that works, healthcare that is safe, and healthcare that leaves no one behind for life. Part VI, Line 6: St. Vincent's Health System (the Health Ministry) is a member of Ascension Health. Ascension Health Alliance is a Missouri nonprofit corporation formed on September 13, 2011. Ascension Health Alliance is the sole corporate member and parent organization of Ascension Health, a Catholic national health system consisting primarily of nonprofit corporations that own and operate local healthcare facilities, or Health Ministries, located in 23 of the United States and the District of Columbia.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; the Congregation of the Sisters of St. Joseph of Carondelet; the Congregation of Alexian Brothers of the Immaculate Conception Province, Inc. - American Province; and the Sisters of the Sorrowful Mother of the Third Order of St. Francis of Assisi - US/Caribbean Province. As more fully described in the Organization Changes notes, Marian Health System which was previously sponsored by the Sisters of the Sorrowful Mother of the Third Order or St. Francis of Assisi - US/Caribbean Province, because part of Ascension Health on April 1, 2013. In addition, Alexian Brothers Health System, which was previously sponsored by the Congregation of Alexian Brothers of the Immaculate Conception Province, Inc. - American Province, became part of Ascension Health on January 1, 2012.Mission:The System directs its governance and management activities toward strong, vibrant, Catholic Health Ministries united in service and healing, and dedicates its resources to spiritually centered care which sustains and improves the health of the individuals and communities it serves. In accordance with the System's mission of service to those persons living in poverty and other vulnerable persons, each Health Ministry accepts patients regardless of their ability to pay. The System uses four categories to identify the resources utilized for the care of persons living in poverty and community benefit programs:1. Traditional charity care includes the cost of services provided to persons who cannot afford healthcare because of independent resources and/or who are uninsured or underinsured.2. Unpaid cost of public programs represents the unpaid cost of services provided to persons covered by public programs for the persons living in poverty and other vulnerable persons.3. Cost of other programs for the persons living in poverty and other vulnerable persons includes 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.4. Community benefit consists of the unreimbursed costs of community benefit programs and services for the general community, not solely for persons living in poverty and other vulnerable persons, 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 by reducing charges forgone by a factor derived from the ratio of each entity's total operating expenses to the entity's billed charges for patient care.Certain costs such as graduate medical education and certain other activities are excluded from total operating expenses for the purposes of this computation. 0 Vestavia High School 1204 Montgomery Highway Birmingham AL 35216 630590762 N/A 34500 General Support Mountain Brook High School 3650 Bethune Drive Mountain Brook AL 35223 631076010 N/A 32000 General Support Homewood High School 1901 S Lakeshore Dr Homewood AL 35209 630586314 501(c)(3) 27000 General Support Briarwood High School 2204 Briarwood Way Birmingham AL 35243 630653634 501(c)(3) 12500 General Support Bessemer Academy 1705 4th Ave Southwest Bessemer AL 35022 630521463 501(c)(3) 11250 General Support Pelham High School 2500 Panther Circle Pelham AL 35124 636001081 N/A 10500 General Support American Cancer Society 1100 Ireland Way Suite 300 Birmingham AL 35205 640329009 501(c)(3) 10000 General Support Calera High School 100 Calera Eagle Drive Calera AL 35040 636001081 N/A 9500 General Support Hewitt Trussville High School 6450 Husky Parkway Trussville AL 35173 630595540 N/A 7500 General Support St Vincent's Health System 810 St Vincents Drive Birmingham AL 35205 630931008 501(c)(3) 79959 General Support 5 5 1 0 1 0 0 0 0 0 0 0 John D O'Neil 0 574472 0 1166059 0 160408 0 4900 0 19185 0 1925024 0 0 David A Cauble 0 377280 0 165000 0 60025 0 7500 0 18394 0 628199 0 0 Vicki L Briggs 0 440042 0 146953 0 51824 0 250 0 19678 0 658747 0 0 Nan M Priest 0 293915 0 125813 0 69947 0 7500 0 15434 0 512609 0 20508 Gregory L James 0 370327 0 132258 0 74991 0 7500 0 9246 0 594322 0 0 Carol A Maietta 0 229156 0 84219 0 17708 0 6958 0 10040 0 348081 0 0 William A Davis 322009 0 105003 0 85496 0 7500 0 17921 0 537929 0 3401 0 Christopher L Moore 200822 0 53813 0 54567 0 6301 0 17723 0 333226 0 0 0 Janith Gannon 167849 0 0 0 1179 0 0 0 8567 0 177595 0 0 0 Brian K Mader 186187 0 0 0 11853 0 5743 0 15305 0 219088 0 0 0 Lydia E Esty 150517 0 23331 0 126 0 0 0 14273 0 188247 0 0 0 Sam A Faircloth 129114 0 0 0 52033 0 4656 0 16210 0 202013 0 0 0 Roger Lee Quinn 132816 0 0 0 39463 0 4391 0 11665 0 188335 0 0 0 Dianne W Norris 136834 0 0 0 32971 0 4224 0 11858 0 185887 0 0 0 Neeysa C Biddle end 611 0 0 0 0 0 143177 0 0 0 0 0 143177 0 82918 Part I, Line 3 The following are used by St. Vincent's Health System to establish the compensation of the organization's CEO: -Compensation Committee -Independent Compensation Consultant -Compensation Survey or Study -Approval by the Board or Compensation Committee Supplemental Information Part III 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 executive is reported as compensation on Form 990, Schedule J, Part II, Column B in the year paid. A related organization that paid the salaries of the individuals listed in Schedule J, Part II, paid out of the supplemental nonqualified retirement plan in the amounts as noted: Neeysa C. Biddle - $82,918 William A. Davis - $3,401 Nan M. Priest - $20,508 A related organization that paid the salaries of the individuals listed in Schedule J, Part II, contributed to the supplemental nonqualified retirement plan in the amounts as noted: John D. O'Neil - $42,150 David A. Cauble - $4,375 Vicki L. Briggs - $146,115 Nan M. Priest - $61,545 Gregory L. James - $7,500 Carol A. Maietta - $2,235 William A. Davis - $7,100 Christopher L. Moore - $23,254 Janith Monroe Gannon - $34,207 Schedule J, Part II: Description of Compensation: Executive compensation, in keeping with Ascension Health's philosophy, is in line with the national average. Compensation may include short or long term incentive pay, deferred compensation, PTO (vacation/holiday) converted to cash, etc. Southwest Medical Group Board Member is President 171699 Medical Director Fees, Call Coverage, Block Lease of Cardiac Equipment/Personnel 0 Kathryn Monroe Daughter of Key Employee 32687 Compensation for Employment 0 Explanation of Attached Audited Financial Statements: Form 990, Part IV, Line 20b: The financial statements of St. Vincent's Health System, which include the activity of St. Vincent's Birmingham, fall under the full scope audit of Ascension Health Alliance. The activity of St. Vincent's Birmingham and other members of St. Vincent's Health System are reported in the consolidated financial statements of Ascension Health Alliance. No individual audit for St. Vincent's Birmingham is completed. Therefore, the attached audited financial statements are of Ascension Health Alliance and Affiliates (which include the activity of St. Vincent's Birmingham). Number of Forms 1099 Filed: Form 990, Part V, Line 1a: St. Vincent's Health System, a related organization of St. Vincent's Birmingham, uses a common paymaster to compensate all independent contractors used within the Health System. The number attributable to each hospital is not easily distinguishable. The total amount of Forms 1099 fled for the entire Health System appears on Part V, Line 1a of St. Vincent's Health System's Form 990. Form 990, Part VI, Section A, line 6 St. Vincent's Birmingham has a single corporate member, St. Vincent's Health System. Form 990, Part VI, Section A, line 7a St. Vincent's Birmingham has a single corporate member, St. Vincent's Health Sytem, who has the ability to elect members of the governing body of St. Vincent's Birmingham. Form 990, Part VI, Section A, line 7b All decisions that have a material impact to St. Vincent's Birmingham, as a whole, are subject to approval by its sole corporate member, St. Vincent's Health System. Form 990, Part VI, Section A, line 8b There are not any separate committees that have the authority to act on behalf of the governing body for St. Vincent's Birmingham. 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 Member's questions. Form 990, Part VI, Section B, line 12c The organization regularly and consistently monitors and enforces compliance with the conflict of interest policy in that any director or principal officer, 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 considering the proposed transaction or arrangement. The remaining individuals on the governing board will decide if conflicts of interest exist. Each director or principal officer 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 status. Form 990, Part VI, Section B, line 15 In determining compensation for the President of St. Vincent's Birmingham, the process, performed by St. Vincent's Health System, included a review and approval by independent persons, comparability data, and contemporaneous substantiation of the deliberation and decision. The Health System Compensation Committee reviewed and approved the compensation with the facilitation by the SCP of HR and the Director of Compensation. In the review of the compensation, the President 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 minutes. The individual was not present when his compensation was decided. In determining compensation of other officers of the organization, the process, performed by St. Vincent's Health System, included a review and approval by independent persons, comparability data, and contemporaneous substantiation of the deliberation and decision. The Health System Compensation 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 VI, Section B, Line 14: St. Vincent's Health System, the parent organization of St. Vincent's Birmingham has drafted a document retention and destruction policy to be approved by the board of directors or designated committee. The policy was drafted but not approved prior to the close of the current fiscal year; however, St. Vincent's Health System plans to have the policy in place prior to June 30, 2014. Changes in Net Assets or Fund Balances: Form 990, Part XI, line 9: Other Pension-Related Cost 208,822. Transfer from Affiliates -391,062. 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 810 St Vincents Drive Birmingham AL 35205 630931008 Health System Parent AL Section 501(c)(3) Schedule A, Line 11c Ascension Health 0 St Vincent's Blount 150 Gilbreath Drive Oneonta AL 35121 630909073 Hospital AL Section 501(c)(3) Schedule A, Line 3 St Vincent's Health System 1 St Vincent's East 50 Medical Park East Drive Birmingham AL 35235 630578923 Hospital AL Section 501(c)(3) Schedule A, Line 3 St Vincent's Health System 1 American Sports Medicine Institute 2660 10th Avenue South No 505 Birmingham AL 35205 630952490 Sports Medicine AL Section 501(c)(3) Schedule A, Line 7 St Vincent's Birmingham 1 Universal Health Services 810 St Vincents Drive Birmingham AL 35205 630932323 Physician Group AL Section 501(c)(3) Schedule A, Line 11b St Vincent's Health System 1 St Vincent's Foundation of Alabama Inc 810 St Vincents Drive Birmingham AL 35205 630868068 Fundraising AL Section 501(c)(3) Schedule A, Line 7 St Vincent's Health System 1 Seton Property Corporation of North Alabama 810 St Vincents Drive Birmingham AL 35205 237326976 Real Estate AL Section 501(c)(2) N/A St Vincent's Health System 1 St Vincent's Outpatient Surgery Services LLC 800 St Vincents Drive Birmingham AL 35205 200708162 Outpatient Surgery AL St Vincent's Birmingham Related 498353 957907 0 0 0.61000 St Vincent's Sleep Disorder Center LLC 800 St Vincents Drive Birmingham AL 35205 631282288 Sleep Disorder Center AL N/A Vincentian Ventures of North Alabama Inc 810 St Vincents Drive Birmingham AL 35205 630965456 Misc Healthcare Services AL N/A C 0 Ascension Ventures Corporation 810 St Vincents Drive Birmingham AL 35205 631217059 Misc Healthcare Services AL N/A C 0 Eastside Ventures 810 St Vincents Drive Birmingham AL 35205 630846221 Misc Healthcare Services AL N/A C 0 0 0 1 0 0 0 0 0 0 0 1 0 0 0 0 1 0 0 0 St Vincent's Foundations C 594529 Journal Entry Transaction St Vincent's Sleep Disorder Center LLC K 1340380 Journal Entry Transaction Seton Property Corporation of North Alabama K 1549557 Journal Entry Transaction St Vincent's Outpatient Surgery Services LLC K 242460 Journal Entry Transaction St Vincent's Outpatient Surgery Services LLC K 2208317 Journal Entry Transaction St Vincent's Health System P 45484593 Journal Entry Transaction