2014-05-15T15:00:39-05:00 2013-06-30 470617373 CATHOLIC HEALTH INITIATIVES 198 INVERNESS DRIVE WEST ENGLEWOOD CO 80112 990 2012-07-01 223319886 SAINT CLARE'S HOSPITAL INC SAIN 9736256000 25 Pocono Road Denville NJ 07834 DIANNE HALFORD 2015-05-15 true Mark Stocki P00642127 3032989100 2012 2015-11-30 17:44:51Z LESLIE HIRSCH PRESIDENTCEO 25 Pocono Road Denville NJ 07834 303552610 false 0928 X WWW.SAINTCLARES.ORG X 1953 NJ THE ORGANIZATION STRIVES TO IMPROVE HEALTH AND WELL-BEING BY PROVIDING HIGH QUALITY, COMPASSIONATE CARE TO THOSE IN NEED WITH SPECIAL CONCERN FOR THE VULNERABLE AND POOR. 15 11 3063 1080 366603 0 15873225 24907046 286409449 273298915 526401 2015411 4795461 3248353 307604536 303469725 132562 119871 0 0 161735589 159195737 0 0 0 171522250 197212595 333390401 356528203 -25785865 -53058478 226939112 174974172 226640009 227744935 299103 -52770763 X THE ORGANIZATION'S MISSION IS TO NURTURE THE HEALING MINISTRY OF THE CHURCH BY BRINGING IT NEW LIFE, ENERGY AND VIABILITY IN THE 21ST CENTURY. FIDELITY TO THE GOSPEL URGES US TO EMPHASIZE HUMAN DIGNITY AND SOCIAL JUSTICE AS WE MOVE TOWARD THE CREATION OF HEALTHIER COMMUNITIES. false true 194939727 119871 273298915 SEE SCHEDULE H 194939727 true true false true false false false false false true false false true true true false true false false false false false false false false true true true false true false false false false false false false false false false false false false true false false false false true 0 0 3063 true true true false false false false false false false false false X 15 11 false false false false true true true true true false false true true true true true false false true false NJ X John Barone 9739831760 66 Ford Road Denville NJ 07834 X EDWARD MCMANUS 2.00 2.00 X X 0 0 0 JAMES HARRIS 2.00 3.00 X X 0 0 0 JOHN FENTON 2.00 2.00 X X 0 0 0 LESLIE HIRSCH 40.00 20.00 X X 0 911194 101167 SR FRANCIS RAFTERY 2.00 1.00 X X 0 0 0 JAMES R JONES III 2.00 1.00 X 0 0 0 JAMES SALERNO 2.00 1.00 X 0 0 0 JOHN FISHER 2.00 1.00 X 35550 0 0 JOHNICE THONE 2.00 1.00 X 0 0 0 MARY ELIZABETH O'BRIEN 2.00 58.00 X 0 924954 116308 MICHAEL BLICK MD 2.00 1.00 X 0 0 0 MURRAY LAS MD 2.00 1.00 X 22500 0 0 OWEN RANKIN 2.00 2.00 X 0 0 0 THOMAS R CURTIN 2.00 1.00 X 0 0 0 XIOMARA GUEVARA 2.00 1.00 X 0 0 0 MARK HERBERS 40.00 4.00 X 0 0 0 ALMA RATCLIFFE 40.00 20.00 X 403575 0 32584 DEBRA REGEN 40.00 5.00 X 223576 0 25804 GAIL COHEN 40.00 0 X 258475 0 40676 JAMES LAPSLEY 40.00 0 X 332844 0 28922 JEFFREY LAMIE 0.00 40.00 X 223716 0 30387 SUELLYN ELLERBE 40.00 7.00 X 415902 0 27948 VERNON PERTELLE 40.00 0 X 218425 0 37046 BARBARA GIRZ 40.00 0 X 386947 0 38304 DONALD CANN 40.00 0 X 766071 0 44376 DURGESH HAJELA 40.00 0 X 318550 0 28034 JAMES BELLAMY 40.00 0 X 189250 0 39454 TIMOTHY CHEN MD 40.00 0.00 X 329452 9820 36357 4124833 1845968 627367 91 false true false FTI CONSULTING 909 COMMERCE ROAD ANNAPOLIS MD 21409 CONSULTING SERVICES 6721128 CENTER FOR FAMILY GUIDANCE 765 RT 70 E BLDG A MARLTON NJ 08053 BEHAVIORAL HEALTH PHYSICIANS 4763667 MORRIS ANESTHESIA GROUP PA PO BOX 464 RUTHERFORD NJ 07070 ANESTHESIA SERVICES 1587056 EMERGENCY PHYSICIANS OF ST CLARE'S PO BOX 1246 DENVILLE NJ 07834 ER PHYSICIANS 965664 MEDICAL SOLUTIONS INC 3901 CENTERVIEW DRIVE SUITE L CHANTILLY VA 20151 NURSING SERVICES 907814 43 6522567 18346240 38239 24907046 PATIENT SERVICES 900099 271568674 271568674 RENTAL INCOME 900099 1598212 1598212 EDUCATION 611710 132029 132029 0 0 0 0 0 0 273298915 415651 -255 415906 0 0 0 0 0 0 0 1603345 79300 82885 1603345 -3585 1599760 1599760 0 0 0 CAFETERIA 722100 1528344 32004 1496340 SERVICES SOLD 900099 1001901 1001901 LABORATORY SERVICES 621500 334854 334854 383254 0 0 383254 3248353 303469725 273298915 366603 4897161 119871 119871 0 0 0 2044533 230151 1814382 0 122404143 95457172 26946971 6758761 6758761 17115478 1910 17113568 10872822 6945287 3927535 0 943524 943524 4000 4000 0 0 0 46396241 27226724 19169517 0 1106387 1106387 11015032 4429422 6585610 14396550 512903 13883647 0 8507233 1653996 6853237 154467 78420 76047 0 114772 70998 43774 5367657 5367657 6722014 6722014 15003085 8217082 6786003 3025335 144826 2880509 IMPAIRMENT 33182328 33182328 MEDICAL SUPPLIES 29425578 29378608 46970 BAD DEBT 12317469 12317469 REPAIRS & MAINTENANCE 4875330 1717247 3158083 4655593 1069984 3585609 0 356528203 194939727 161588476 0 0 10394 16221 2177780 1509028 40069189 42380599 0 0 4105971 3563717 728809 414692 182037450 74430244 146380540 107607206 0 15785517 0 0 0 17680912 19482709 226939112 174974172 31208131 27293450 170215 77275 0 0 195261663 200374210 226640009 227744935 X 249103 -52820763 50000 50000 299103 -52770763 226939112 174974172 X -53058478 -11388 X false true X true true true X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED false false false false false true 6313 false false false 6313 false Description of the activities reported on Lines 1a through 1i Schedule C, Part II-B, Line 1 THE PORTION OF ORGANIZATION DUES THAT ARE RELATED TO LOBBYING ARE AS FOLLOWS: AMERICAN HOSPITAL ASSOCIATION $4,548 CATHOLIC HEALTH ASSOCIATION $1,765 67307 67307 115352336 29602500 85749836 1330290 1094910 235380 64500546 43711860 20788686 786971 20974 765997 107607206 PROFESSIONAL LIABILITY GROSS UP (ESTIMATED CLAIMS) 12824820 WORKERS COMPENSATION GROSS UP (ESTIMATED CLAIMS) 5588699 INVESTMENTS IN UNCONSOLIDATED ORGS (CONTROLLING INTEREST) 656037 NJ SELF INSURANCE DEPOSITS 380669 RENTAL PROPERTY DEPOSITS 25392 OTHER ASSETS 7092 19482709 0 INTERCOMPANY PAYABLES 61911254 CHI DEBT PROGRAM 110937631 SELF INSURANCE RESERVES & CLAIMS 18413519 BOONTON COMPLIANCE PROGRAM 4454599 ENVIRONMENTAL REMEDIATION LIABILITY 2898105 MEMORIAL SLOAN KETTERING LIABILITY 1312628 GRANT RESTRICTIONS LIABILITY 377354 UNCLAIMED PROPERTY 69120 200374210 X FIN 48 (ASC 740) footnote Schedule D, Part X, Line 2 ST. CLARE'S HOSPITAL'S FINANCIAL INFORMATION IS INCLUDED IN THE CONSOLIDATED AUDITED FINANCIAL STATEMENTS OF ST. CLARE'S HEALTH SYSTEM, INC. (SCHS), A RELATED ORGANIZATION. SCHS' FIN 48 (ASC 740) FOOTNOTE FOR THE YEAR ENDED JUNE 30, 2013, READS AS FOLLOWS: "THE SYSTEM, HOSPITAL, FOUNDATION, LIFE CARE, COMMUNITY CARE, AND VNA ARE NOT-FOR-PROFIT ORGANIZATIONS AS DESCRIBED IN SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE (THE CODE) AND ARE EXEMPT FROM FEDERAL INCOME TAXES ON RELATED INCOME PURSUANT TO SECTION 501(A) OF THE CODE. THESE ENTITIES ARE ALSO EXEMPT FROM STATE AND LOCAL INCOME TAXES. PRIMARY CARE IS A FOR-PROFIT ORGANIZATION SUBJECT TO BOTH FEDERAL AND STATE INCOME TAXES. NO INCOME TAXES HAVE BEEN PROVIDED FOR AT JUNE 30, 2013 AND 2012 DUE TO CARRY FORWARD NET LOSSES, FOR WHICH THE ULTIMATE REALIZABLE AMOUNT IS UNCERTAIN. SUCH AMOUNTS ARE NOT MATERIAL TO THE SYSTEM'S CONSOLIDATED FINANCIAL STATEMENTS." ST. CLARE'S HOSPITAL'S FINANCIAL INFORMATION IS ALSO INCLUDED IN THE CONSOLIDATED AUDITED FINANCIAL STATEMENTS OF CATHOLIC HEALTH INITIATIVES (CHI), A RELATED ORGANIZATION. CHI'S FIN 48 (ASC 740) FOOTNOTE FOR THE YEAR ENDED JUNE 30, 2013, READS AS FOLLOWS: "CHI IS A TAX-EXEMPT COLORADO CORPORATION AND HAS BEEN GRANTED AN EXEMPTION FROM FEDERAL INCOME TAX UNDER SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE. CHI OWNS CERTAIN TAXABLE SUBSIDIARIES AND ENGAGES IN CERTAIN ACTIVITIES THAT ARE UNRELATED TO ITS EXEMPT PURPOSE AND THEREFORE SUBJECT TO INCOME TAX. MANAGEMENT REVIEWS ITS TAX POSITIONS ANNUALLY AND HAS DETERMINED THAT THERE ARE NO MATERIAL UNCERTAIN TAX POSITIONS THAT REQUIRE RECOGNITION IN THE ACCOMPANYING CONSOLIDATED FINANCIAL STATEMENTS." true true X true X true X true true true false true true 15859 20830049 18795087 2034962 0.00590 8480 11631480 6378334 5253146 0.01530 0 0.00000 0 24339 32461529 25173421 7288108 0.02120 45 20548 938451 4363 934088 0.00270 11 5598 119527 19065 100462 0.00030 3 7729 35972 0 35972 0.00010 0 0.00000 7 2786 200113 0 200113 0.00060 66 36661 1294063 23428 1270635 0.00370 66 61000 33755592 25196849 8558743 0.02490 0 0.00000 0 0.00000 2 30 8442 0 8442 0.00000 0 0.00000 0 0.00000 5 487 123272 0 123272 0.00040 0 0.00000 0 0.00000 1 39 0 0.00000 8 556 131714 0 131714 0.00040 true 12317469 0 73851716 87023656 -13171940 X true true 4 1 SAINT CLARES HOSPITAL INC

25 POCONO ROAD DENVILLE NJ 07834

SAINTCLARES.ORG X X X BEHAVIORAL HEALTH A 2 SAINT CLARE'S HOSPITAL DOVER GENERAL

400 WEST BLACKWELL STREET DOVER NJ 07802

SAINTCLARES.ORG X X X A 3 SAINT CLARE'S HOSPITAL BOONTON TOWNSHIP

130 POWERVILLE ROAD BOONTON NJ 07005

SAINTCLARES.ORG X BEHAVIORAL HEALTH A 4 SAINT CLARE'S HOSPITAL SUSSEX

20 WALNUT STREET SUSSEX NJ 07461

SAINTCLARES.ORG X X SED A A 1 true X X X X X X X 12 true true true X X X X X X X X X true false true true 200 true 300 true X X X X X X X true true X X X X true false true X false false 3 ST CLARES IMAGING & PAT CENTERS

ROUTE 46 PARSIPPANY NJ 07054

MEDICAL IMAGING SAINT CLARE'S HOSPITAL REHABILITATION CENTER

253 NEWTON-SPARTA ROAD NEWTON NJ 07860

REHABILITATION CENTER SAINT CLARE'S HOSPITAL REHABILITATION CENTER

VERNON COLONIAL PLAZA ROUTE 94 MCAFEE NJ 07428

REHABILITATION CENTER PREPARATION OF COMMUNITY BENEFIT REPORT SCHEDULE H, PART I, LINE 6A SAINT CLARE'S HOSPITAL, INC. PREPARES ITS OWN ANNUAL WRITTEN COMMUNITY BENEFIT REPORT. ITS COMMUNITY BENEFIT REPORT IS NOT CONTAINED IN THAT OF A RELATED ORGANIZATION. Costing Methodology used to calculate financial assistance Schedule H, Part I, Line 7 A COST ACCOUNTING SYSTEM WAS NOT USED TO COMPUTE AMOUNTS IN THE TABLE; RATHER COSTS IN THE TABLE WERE COMPUTED USING THE ORGANIZATION'S COST-TO-CHARGE RATIO. THE COST-TO-CHARGE RATIO COVERS ALL PATIENT SEGMENTS. Bad Debt Expense excluded from financial assistance calculation Schedule H, Part I, Line 7, column(f) 12,317,469 Subsidized Health Services Schedule H, Part I, Line 7g THERE ARE NO PHYSICIAN CLINICS INCLUDED IN SUBSIDIZED HEALTH SERVICES. Bad debt expense - methodology used to estimate amount Schedule H, Part III, Line 2 COSTING METHODOLOGY FOR AMOUNTS REPORTED ON LINE 2 IS DETERMINED USING THE ORGANIZATION'S COST/CHARGE RATIO OF 22.1%. WHEN DISCOUNTS ARE EXTENDED TO SELF-PAY PATIENTS, THESE PATIENT ACCOUNT DISCOUNTS ARE RECORDED AS A REDUCTION IN REVENUE, NOT AS BAD DEBT EXPENSE. Bad debt expense - methodology used to estimate amount as community benefit Schedule H, Part III, Line 3 SAINT CLARE'S HOSPITAL INC. DOES NOT BELIEVE THAT ANY PORTION OF BAD DEBT EXPENSE COULD REASONABLY BE ATTRIBUTED TO PATIENTS WHO QUALIFY FOR FINANCIAL ASSISTANCE SINCE AMOUNTS DUE FROM THOSE INDIVIDUALS' ACCOUNTS WILL BE RECLASSIFIED FROM BAD DEBT EXPENSE TO CHARITY CARE WITHIN 30 DAYS FOLLOWING THE DATE THAT THE PATIENT IS DETERMINED TO QUALIFY FOR CHARITY CARE. Bad debt expense - financial statement footnote Schedule H, Part III, Line 4 SAINT CLARE'S HOSPITAL, INC. DOES NOT ISSUE SEPARATE COMPANY AUDITED FINANCIAL STATEMENTS. HOWEVER, THE ORGANIZATION IS INCLUDED IN THE CONSOLIDATED FINANCIAL STATEMENTS OF CATHOLIC HEALTH INITIATIVES (CHI), A RELATED ORGANIZATION. THE CONSOLIDATED FOOTNOTE READS AS FOLLOWS: "THE PROVISION FOR BAD DEBTS IS BASED UPON MANAGEMENT'S ASSESSMENT OF HISTORICAL AND EXPECTED NET COLLECTIONS, TAKING INTO CONSIDERATION HISTORICAL BUSINESS AND ECONOMIC CONDITIONS, TRENDS IN HEALTH CARE COVERAGE AND OTHER COLLECTION INDICATORS. MANAGEMENT ROUTINELY ASSESSES THE ADEQUACY OF THE ALLOWANCES FOR UNCOLLECTIBLE ACCOUNTS BASED UPON HISTORICAL WRITE-OFF EXPERIENCE BY PAYOR CATEGORY. THE RESULTS OF THESE REVIEWS ARE USED TO MODIFY, AS NECESSARY, THE PROVISION FOR BAD DEBTS AND TO ESTABLISH APPROPRIATE ALLOWANCES FOR UNCOLLECTIBLE NET PATIENT ACCOUNTS RECEIVABLE. AFTER SATISFACTION OF AMOUNTS DUE FROM INSURANCE, CHI FOLLOWS ESTABLISHED GUIDELINES FOR PLACING CERTAIN PATIENT BALANCES WITH COLLECTION AGENCIES, SUBJECT TO THE TERMS OF CERTAIN RESTRICTIONS ON COLLECTION EFFORTS AS DETERMINED BY EACH FACILITY. IN ACCORDANCE WITH ACCOUNTING STANDARDS UPDATE (ASU) NO. 2011-07, PRESENTATION AND DISCLOSURE OF PATIENT SERVICES REVENUE, PROVISION FOR BAD DEBTS, AND ALLOWANCES FOR DOUBTFUL ACCOUNTS FOR CERTAIN HEALTH ENTITIES, THE PROVISION FOR BAD DEBTS IS PRESENTED ON THE CONSOLIDATED STATEMENT OF OPERATIONS AS A DEDUCTION FROM PATIENT SERVICES REVENUES (NET OF CONTRACTUAL ALLOWANCES AND DISCOUNTS) SINCE CHI ACCEPTS AND TREATS ALL PATIENTS WITHOUT REGARD TO THE ABILITY TO PAY." Community benefit & methodology for determining medicare costs Schedule H, Part III, Line 8 USING ESSENTIALLY THE SAME MEDICARE COST REPORT PRINCIPLES AS TO THE ALLOCATION OF GENERAL SERVICES COSTS AND "APPORTIONMENT" METHODS, THE "CHI WORKBOOK" CALCULATES A PAYERS' GROSS ALLOWABLE COSTS BY SERVICE (SO AS TO FACILITATE A CORRESPONDING COMPARISON BETWEEN GROSS ALLOWABLE COSTS AND ULTIMATE PAYMENTS RECEIVED). THE TERM "GROSS ALLOWABLE COSTS" MEANS COSTS BEFORE ANY DEDUCTIBLES OR CO-INSURANCE ARE SUBTRACTED. SAINT CLARE'S HOSPITAL, INC.'S ULTIMATE REIMBURSEMENT WILL BE REDUCED BY ANY APPLICABLE COPAYMENT/ DEDUCTIBLE. WHERE MEDICARE IS THE SECONDARY INSURER, AMOUNTS DUE FROM THE INSURED'S PRIMARY PAYER WERE NOT SUBTRACTED FROM MEDICARE ALLOWABLE COSTS BECAUSE THE AMOUNTS ARE TYPICALLY IMMATERIAL. ALTHOUGH NOT PRESENTED ON THE MEDICARE COST REPORT, IN ORDER TO FACILITATE A MORE ACCURATE UNDERSTANDING OF THE "TRUE" COST OF SERVICES (FOR "SHORTFALL" PURPOSES) THE CHI WORKBOOK ALLOWS A HEALTH CARE FACILITY NOT TO OFFSET COSTS THAT MEDICARE CONSIDERS TO BE NON-ALLOWABLE, BUT FOR WHICH THE FACILITY CAN LEGITIMATELY ARGUE ARE RELATED TO THE CARE OF THE FACILITY'S PATIENTS. IN ADDITION, ALTHOUGH NOT REPORTABLE ON THE MEDICARE COST REPORT, THE CHI WORKBOOK INCLUDES THE COST OF SERVICES THAT ARE PAID VIA A SET FEE-SCHEDULE RATHER THAN BEING REIMBURSED BASED ON COSTS (E.G. OUTPATIENT CLINICAL LABORATORY). FINALLY, THE CHI WORKBOOK ALLOWS A FACILITY TO INCLUDE OTHER HEALTH CARE SERVICES PERFORMED BY A SEPARATE FACILITY (SUCH AS A PHYSICIAN PRACTICE) THAT ARE MAINTAINED ON SEPARATE BOOKS AND RECORDS (AS OPPOSED TO THE MAIN FACILITY'S BOOKS AND RECORDS WHICH HAS ITS COSTS OF SERVICE INCLUDED WITHIN A COST REPORT). TRUE COSTS OF MEDICARE COMPUTED USING THIS METHODOLOGY: TOTAL MEDICARE REVENUE: $73,851,716 TOTAL MEDICARE COSTS: $87,023,656 SHORTFALL: $(13,171,940) SAINT CLARE'S HOSPITAL, INC. BELIEVES THAT EXCLUDING MEDICARE LOSSES FROM COMMUNITY BENEFIT MAKES THE OVERALL COMMUNITY BENEFIT REPORT MORE CREDIBLE FOR THESE REASONS: UNLIKE SUBSIDIZED AREAS SUCH AS BURN UNITS OR BEHAVIORAL-HEALTH SERVICES, MEDICARE IS NOT A DIFFERENTIATING FEATURE OF TAX-EXEMPT HEALTH CARE ORGANIZATIONS. IN FACT, FOR-PROFIT HOSPITALS FOCUS ON ATTRACTING PATIENTS WITH MEDICARE COVERAGE, ESPECIALLY IN THE CASE OF WELL-PAID SERVICES THAT INCLUDE CARDIAC AND ORTHOPEDICS. SIGNIFICANT EFFORT AND RESOURCES ARE DEVOTED TO ENSURING THAT HOSPITALS ARE REIMBURSED APPROPRIATELY BY THE MEDICARE PROGRAM. THE MEDICARE PAYMENT ADVISORY COMMISSION (MEDPAC), AN INDEPENDENT CONGRESSIONAL AGENCY, CAREFULLY STUDIES MEDICARE PAYMENT AND THE ACCESS TO CARE THAT MEDICARE BENEFICIARIES RECEIVE. THE COMMISSION RECOMMENDS PAYMENT ADJUSTMENTS TO CONGRESS ACCORDINGLY. THOUGH MEDICARE LOSSES ARE NOT INCLUDED BY CATHOLIC HOSPITALS AS COMMUNITY BENEFIT, THE CATHOLIC HEALTH ASSOCIATION GUIDELINES ALLOW HOSPITALS TO COUNT AS COMMUNITY BENEFIT SOME PROGRAMS THAT SPECIFICALLY SERVE THE MEDICARE POPULATION. FOR INSTANCE, IF HOSPITALS OPERATE PROGRAMS FOR PATIENTS WITH MEDICARE BENEFITS THAT RESPOND TO IDENTIFIED COMMUNITY NEEDS, GENERATE LOSSES FOR THE HOSPITAL, AND MEET OTHER CRITERIA, THESE PROGRAMS CAN BE INCLUDED IN THE CHA FRAMEWORK IN CATEGORY C AS "SUBSIDIZED HEALTH SERVICES." MEDICARE LOSSES ARE DIFFERENT FROM MEDICAID LOSSES, WHICH ARE COUNTED IN THE CHA COMMUNITY BENEFIT FRAMEWORK, BECAUSE MEDICAID REIMBURSEMENTS GENERALLY DO NOT RECEIVE THE LEVEL OF ATTENTION PAID TO MEDICARE REIMBURSEMENT. MEDICAID PAYMENT IS LARGELY DRIVEN BY WHAT STATES CAN AFFORD TO PAY, AND IS TYPICALLY SUBSTANTIALLY LESS THAN WHAT MEDICARE PAYS. Collection practices for patients eligible for financial assistance Schedule H, Part III, Line 9b SAINT CLARE'S HOSPITAL, INC.'S DEBT COLLECTION POLICY PROVIDES THAT SAINT CLARE'S HOSPITAL, INC. WILL PERFORM A REASONABLE REVIEW OF EACH INPATIENT ACCOUNT PRIOR TO TURNING AN ACCOUNT OVER TO A THIRD-PARTY COLLECTION AGENT AND PRIOR TO INSTITUTING ANY LEGAL ACTION FOR NON-PAYMENT, TO ASSURE THAT THE PATIENT AND PATIENT GUARANTOR ARE NOT ELIGIBLE FOR ANY ASSISTANCE PROGRAM (E.G. MEDICAID) AND DO NOT QUALIFY FOR COVERAGE THROUGH SAINT CLARE'S HOSPITAL, INC. COMMUNITY ASSISTANCE POLICY. AFTER HAVING BEEN TURNED OVER TO A THIRD-PARTY COLLECTION AGENT, ANY PATIENT ACCOUNT THAT IS SUBSEQUENTLY DETERMINED TO MEET THE SAINT CLARE'S HOSPITAL, INC.COMMUNITY ASSISTANCE POLICY IS REQUIRED TO BE RETURNED IMMEDIATELY BY THE THIRD-PARTY COLLECTION AGENT TO SAINT CLARE'S HOSPITAL, INC. FOR APPROPRIATE FOLLOW-UP. SAINT CLARE'S HOSPITAL, INC. REQUIRES ITS THIRD-PARTY COLLECTION AGENTS TO INCLUDE A MESSAGE ON ALL STATEMENTS INDICATING THAT IF A PATIENT OR PATIENT GUARANTOR MEETS CERTAIN STIPULATED INCOME REQUIREMENTS, THE PATIENT OR PATIENT GUARANTOR MAY BE ELIGIBLE FOR FINANCIAL ASSISTANCE. ALL OF CATHOLIC HEALTH INITIATIVES' (CHI) HOSPITALS' CONTRACTS WITH THIRD PARTY COLLECTION AGENCIES INCLUDE THE FOLLOWING STANDARDS: * NEITHER CHI HOSPITALS NOR THEIR COLLECTION AGENCIES WILL REQUEST BENCH OR ARREST WARRANTS AS A RESULT OF NON-PAYMENT; * NEITHER CHI HOSPITALS NOR THEIR COLLECTION AGENCIES WILL SEEK LIENS THAT WOULD REQUIRE THE SALE OR FORECLOSURE OF A PRIMARY RESIDENCE; AND * NO CATHOLIC HEALTH INITIATIVES' COLLECTION AGENCY MAY SEEK COURT ACTION WITHOUT HOSPITAL APPROVAL. FINALLY, COLLECTION AGENCIES ARE TRAINED ON THE CATHOLIC HEALTH INITIATIVES MISSION, CORE VALUES AND STANDARD OF CONDUCT TO MAKE SURE ALL PATIENTS ARE TREATED WITH DIGNITY AND RESPECT. Community Served by Needs Assessment Schedule H, Part V Section B, Line 3 (1) SAINT CLARES HOSPITAL, INC. - COMMUNITY ENGAGEMENT AND FEEDBACK WERE AN INTEGRAL PART OF THE CHNA PROCESS. SAINT CLARE'S SOUGHT COMMUNITY INPUT THROUGH FOCUS GROUPS WITH COMMUNITY MEMBERS, KEY INFORMANT INTERVIEWS WITH COMMUNITY STAKEHOLDERS, AND/OR INCLUSION OF COMMUNITY PARTNERS IN THE PRIORITIZATION AND IMPLEMENTATION PLANNING PROCESS. PUBLIC HEALTH AND HEALTH CARE PROFESSIONALS SHARED KNOWLEDGE AND EXPERTISE ABOUT HEALTH ISSUES, AND LEADERS AND REPRESENTATIVES OF NON-PROFIT AND COMMUNITY-BASED ORGANIZATIONS PROVIDED INSIGHT ON THE COMMUNITY SERVED BY SAINT CLARE'S, INCLUDING MEDICALLY UNDERSERVED, LOW INCOME, AND MINORITY POPULATIONS. RESEARCH COMPONENTS INCLUDED TELEPHONE SURVEYS AND FOCUS GROUPS WITH COMMUNITY RESIDENTS, AS WELL AS DATA FROM THE HEALTH RESEARCH AND EDUCATIONAL TRUST OF NEW JERSEY.; Community Served by Needs Assessment Schedule H, Part V Section B, Line 3 (2) SAINT CLARE'S HOSPITAL, DOVER GENERAL - SAINT CLARE'S HOSPITAL TEAMED UP WITH OTHER COMMUNITY PARTNERS TO CONDUCT THEIR CHNA. RESEARCH COMPONENTS INCLUDED TELEPHONE SURVEYS AND FOCUS GROUPS WITH COMMUNITY RESIDENTS, AS WELL AS DATA FROM THE HEALTH RESEARCH AND EDUCATIONAL TRUST OF NEW JERSEY.; Community Served by Needs Assessment Schedule H, Part V Section B, Line 3 (3) SAINT CLARE'S HOSPITAL, BOONTON TOWNSHIP - SAINT CLARE'S HOSPITAL TEAMED UP WITH OTHER COMMUNITY PARTNERS TO CONDUCT THEIR CHNA. RESEARCH COMPONENTS INCLUDED TELEPHONE SURVEYS AND FOCUS GROUPS WITH COMMUNITY RESIDENTS, AS WELL AS DATA FROM THE HEALTH RESEARCH AND EDUCATIONAL TRUST OF NEW JERSEY.; Community Served by Needs Assessment Schedule H, Part V Section B, Line 3 (4) SAINT CLARE'S HOSPITAL, SUSSEX - SAINT CLARE'S HOSPITAL TEAMED UP WITH OTHER COMMUNITY PARTNERS TO CONDUCT THEIR CHNA. RESEARCH COMPONENTS INCLUDED TELEPHONE SURVEYS AND FOCUS GROUPS WITH COMMUNITY RESIDENTS, AS WELL AS DATA FROM THE HEALTH RESEARCH AND EDUCATIONAL TRUST OF NEW JERSEY.; Other Hospital Facilities included in Needs Assessment Schedule H, Part V Section B, Line 4 (1) SAINT CLARES HOSPITAL, INC. - THE CHNA WAS DONE IN COLLABORATION WITH THE COMMUNITY HEALTH ALLIANCE OF NORTHWESTERN CENTRAL NEW JERSEY, A COLLABORATIVE OF NINE HOSPITALS AND HEALTH SYSTEMS IN CENTRAL NEW JERSEY, TO ASSESS REGIONAL HEALTH NEEDS.; Other Hospital Facilities included in Needs Assessment Schedule H, Part V Section B, Line 4 (2) SAINT CLARE'S HOSPITAL, DOVER GENERAL - THE CHNA WAS DONE IN COLLABORATION WITH THE COMMUNITY HEALTH ALLIANCE OF NORTHWESTERN CENTRAL NEW JERSEY, A COLLABORATIVE OF NINE HOSPITALS AND HEALTH SYSTEMS IN CENTRAL NEW JERSEY, TO ASSESS REGIONAL HEALTH NEEDS.; Other Hospital Facilities included in Needs Assessment Schedule H, Part V Section B, Line 4 (3) SAINT CLARE'S HOSPITAL, BOONTON TOWNSHIP - THE CHNA WAS DONE IN COLLABORATION WITH THE COMMUNITY HEALTH ALLIANCE OF NORTHWESTERN CENTRAL NEW JERSEY, A COLLABORATIVE OF NINE HOSPITALS AND HEALTH SYSTEMS IN CENTRAL NEW JERSEY, TO ASSESS REGIONAL HEALTH NEEDS.; Other Hospital Facilities included in Needs Assessment Schedule H, Part V Section B, Line 4 (4) SAINT CLARE'S HOSPITAL, SUSSEX - THE CHNA WAS DONE IN COLLABORATION WITH THE COMMUNITY HEALTH ALLIANCE OF NORTHWESTERN CENTRAL NEW JERSEY, A COLLABORATIVE OF NINE HOSPITALS AND HEALTH SYSTEMS IN CENTRAL NEW JERSEY, TO ASSESS REGIONAL HEALTH NEEDS.; LINES 2, 4 & 5: NEEDS ASSESSMENT, COMMUNITY INFORMATION & PROMOTION OF COMMUNITY HEALTH SCHEDULE H, PART VI SAINT CLARE'S HOSPITAL, INC. STATEMENT OF COMMUNITY BENEFIT AND NEEDS ASSESSMENT ORGANIZATION'S MISSION, VISION, AND TAX-EXEMPT PURPOSE SAINT CLARE'S HOSPITAL, INC. WAS FOUNDED TO ALLEVIATE A SHORTAGE OF HOSPITAL BEDS IN THE COMMUNITY IN 1953. AS THE FIRST CATHOLIC HOSPITAL TO SERVE THE COMMUNITY, SAINT CLARE'S HOSPITAL EMBRACED THE MISSION OF THE FOUNDING RELIGIOUS CONGREGATION, WHICH HAS SINCE JOINED WITH OTHER RELIGIOUS CONGREGATIONS TO FORM CATHOLIC HEALTH INITIATIVES. THE MISSION OF SAINT CLARE'S HOSPITAL, INC. IS TO DEVELOP A HEALTHY COMMUNITY AND PROVIDE CARE TO ALL IN NEED. ITS BOARD OF DIRECTORS IS COMPRISED OF INDEPENDENT COMMUNITY REPRESENTATIVES. SAINT CLARE'S HOSPITAL, INC. OPERATES A 24-HOUR EMERGENCY ROOM 365 DAYS PER YEAR. THAT EMERGENCY ROOM IS OPEN TO ALL INDIVIDUALS REGARDLESS OF ABILITY TO PAY. SAINT CLARE'S HOSPITAL, INC. HAS AN OPEN MEDICAL STAFF, PARTICIPATES IN MEDICARE AND MEDICAID, AND HAS AN ACTIVE CHARITY CARE PROGRAM. COMMUNITY SERVICE HAS ALWAYS BEEN AT THE CORE OF SAINT CLARE'S HOSPITAL, INC.'S ACTIVITIES. EACH YEAR, SERVICES AND PROGRAMS ARE EXPANDED TO PROMOTE A HEALTHY COMMUNITY. THE PROGRAMS AND SERVICES DESCRIBED THROUGHOUT THIS REPORT NOT ONLY SERVE THE COMMUNITY, BUT ALSO WORK TO PROVIDE THE LOCAL COMMUNITY BASIC HEALTH CARE, HEALTH AND SAFETY EDUCATION, AND COOPERATIVE PROGRAMS TO THE PEOPLE OF MORRIS COUNTY. SAINT CLARE'S HOSPITAL, INC. IS INCLUDED IN THE OFFICIAL CATHOLIC DIRECTORY AS A TAX-EXEMPT HOSPITAL. SAINT CLARE'S HOSPITAL, INC., WAS FORMED IN 1953 AS A NOT-FOR-PROFIT, GENERAL ACUTE CARE HOSPITAL. THE CURRENT LAYOUT OF SAINT CLARE'S HOSPITAL INCLUDES FOUR (4) CAMPUSES: DENVILLE, DOVER, SUSSEX AND BOONTON. THE INPATIENT BED COMPLIMENT IS AS FOLLOWS: DENVILLE, DOVER, AND SUSSEX COMBINED HAVE 374 ACUTE CARE BEDS; BOONTON HAS 104 BEDS DEVOTED TO BEHAVIORAL HEALTH. AS A TAX-EXEMPT 501(C)(3) LONG TERM CARE FACILITY, SAINT CLARE'S HOSPITAL INC. IS COMMITTED TO SERVING THE NEEDS OF COMMUNITY MEMBERS WITHOUT REGARD TO ONE'S ABILITY TO PAY. SAINT CLARE'S HOSPITAL INC. REQUIRES RESIDENTS TO DEMONSTRATE THE ABILITY TO PAY THE FACILITY FEES AND CHARGES, WHICH ARE SET AT A RATE THAT IS AFFORDABLE TO A SIGNIFICANT SEGMENT OF THE ELDERLY RESIDING IN THE AREA. HOWEVER, THE HOSPITAL WILL NOT FORCE A RESIDENT TO MOVE FROM THE FACILITY IF THE INDIVIDUAL AND/OR THE INDIVIDUAL'S FAMILY BECOMES UNABLE TO PAY THE FACILITY CHARGES. SAINT CLARE'S HOSPITAL INC. IS ALSO COMMITTED TO THE PROMOTION OF HEALTHIER COMMUNITIES. SAINT CLARE'S HOSPITAL INC. IS PROUD OF ITS CATHOLIC HERITAGE AND ITS ABILITY TO PROVIDE DIRECT AND INDIRECT SUPPORT TO THE COMMUNITIES IT SERVES. COMMUNITY BENEFIT APPROACH WITH HOSPITALS IN DENVILLE, DOVER, BOONTON, AND SUSSEX, NEW JERSEY, ST. CLARE'S HEALTH SYSTEM SERVES OVER 60 TOWNS IN NORTHWESTERN NEW JERSEY AND NORTHEASTERN PENNSYLVANIA. MORRIS COUNTY: THE MOST RECENT 2012 ESTIMATES BASED ON THE LAST OFFICIAL COUNT FROM 2010 OF THE U.S. CENSUS BUREAU REFLECT THE COUNTY AS AN AFFLUENT, OLDER, AND DIVERSE COMMUNITY. MORRIS COUNTY HAS A MEDIAN AGE OF 41.3, UP FROM 38 IN 2000; MORRIS COUNTY 2010 MEDIAN INCOME WAS $96,747; THE BABY BOOMERS BORN BETWEEN 1946 AND 1964 ARE THE LARGEST GENERATION WITH MANY REACHING THE STATUS OF A SENIOR CITIZEN; AND THE COUNTY UNEMPLOYMENT RATE IS 6.8% AS OF JUNE 2013. ACCORDING TO THE 2010 US CENSUS DATA, THERE ARE MORE THAN 56,000 HISPANICS IN MORRIS COUNTY. THIS REPRESENTS APPROXIMATELY 11% OF THE MORRIS COUNTY POPULATION. TOWN OF DOVER: DOVER HAS THE LARGEST HISPANIC POPULATION (70%); LOWEST MEDIAN INCOME IN 2012 OF $66,763; AND THE HIGHEST PERCENTAGE OF PERSONS LIVING BELOW THE POVERTY LINE IN ALL OF MORRIS COUNTY. THE BUREAU OF PRIMARY HEALTH CARE HAS DESIGNATED MORRIS COUNTY AND THE NEIGHBORING TOWN OF DOVER AS AREAS WITH "MEDICALLY UNDERSERVED POPULATIONS." SAINT CLARE'S HOSPITAL, INC. HAS BEEN INTIMATELY INVOLVED IN COMMUNITY HEALTH COLLABORATION AND SPEARHEADED THE ORIGINAL TEAM TO LOOK AT AREA HEALTH ISSUES, SET PRIORITIES, AND PLAN FOR IMPROVEMENT. SAINT CLARE'S HOSPITAL, INC. CONTINUES OUR DEEP COMMITMENT AND INVOLVEMENT IN THE COMMUNITY HEALTH COLLABORATIVE TODAY. SAINT CLARE'S HOSPITAL INC.'S COMMUNITY BENEFIT PLAN IS BASED ON OUR UNDERSTANDING OF UNIQUE COMMUNITIES' NEEDS DERIVED FROM THE COLLABORATIVE NEEDS ASSESSMENTS, FOCUS GROUPS, AND SURVEYS CONDUCTED WITH OUR COMMUNITY PARTNERS. THE COMMUNITY HEALTH COLLABORATIVE (CHC) WAS FORMED AS A COLLABORATIVE ENTITY OF HEALTH AND HUMAN SERVICE PROVIDERS WITH A GENERAL DESIRE TO REDUCE DUPLICATION OF EFFORTS, THEREBY PROVIDING A MORE EFFICIENT USE OF LIMITED RESOURCES. ADDITIONALLY, IT WAS GENERALLY RECOGNIZED THAT THE HEALTH OF THE COMMUNITY WAS NOT THE RESPONSIBILITY OF ANY ONE ENTITY, BUT RATHER REQUIRED THE COORDINATED EFFORTS OF MANY ENTITIES - PUBLIC AND PRIVATE - TO REALIZE AN IMPROVED HEALTH STATUS OF A COMMUNITY. THE CHC HAS BEEN WORKING FOR SEVERAL YEARS TO MEASURE AND IMPROVE THE HEALTH STATUS OF THE COMMUNITY. THE COMMUNITY HEALTH COLLABORATIVE COMPLETED AN IN-DEPTH COMMUNITY HEALTH STATUS REPORT IN JANUARY 2010. THE REPORT REFLECTS THE COMPILATION AND ANALYSIS OF EXTENSIVE DATA SOURCES TO IDENTIFY ISSUES HAVING A SIGNIFICANT IMPACT ON THE HEALTH AND GENERAL WELL-BEING OF AREA RESIDENTS. SUMMARY OF ASSESSMENT FINDINGS TEN KEY FACTORS HAVING THE GREATEST IMPACT ON THE OVERALL WELLNESS OF THE AREA EMERGED IN THE COMMUNITY HEALTH STATUS REVIEW. THE TEN ISSUES WERE THEN PRIORITIZED THROUGH A GROUP PRIORITIZATION PROCESS. COMMUNITY STAKEHOLDERS WERE INVITED TO PRIORITIZE THE ISSUES OF MOST IMPORTANCE TO THEM, KEEPING IN MIND HOW AWARE THE COMMUNITY WAS OF EACH ISSUE AND HOW DIFFICULT THE ISSUE WAS TO CHANGE. AS A RESULT, THE ISSUES FELL INTO THE FOLLOWING ORDER OF PRIORITY. 1. HEALTHY BEHAVIORS 2. CHILD AND MATERNAL HEALTH 3. SMOKING AND TOBACCO 4. ACCESS TO HEALTH CARE SERVICES 5. DISEASE AND MORTALITY 6. UNINTENTIONAL INJURIES 7. ENVIRONMENT 8. PERSONAL AND FAMILY SAFETY 9. INCOME, EMPLOYMENT, AND EDUCATION 10. ALCOHOL AND DRUGS PRIORITIZATION SESSIONS WERE HELD IN OCTOBER 2012 TO REVIEW THE RESULTS OF THE COMPLETED COMMUNITY HEALTH NEEDS ASSESSMENT (CHNA) OF THE SAINT CLARE'S SERVICE AREA. THROUGH FACILITATED DISCUSSION, THE PARTICIPANTS DEVELOPED A MASTER LIST OF COMMUNITY HEALTH NEEDS DERIVED FROM QUANTITATIVE RESULTS OF THE CHNA STUDY AND THE EXPERT KNOWLEDGE OF GROUP PARTICIPANTS. THE FOLLOWING KEY COMMUNITY HEALTH ISSUES EMERGED: PHYSICAL ACTIVITY AND NUTRITION ACCESS TO CARE MENTAL HEALTH AND WELL-BEING SUBSTANCE USE AND ABUSE (CONTINUED) LINES 2, 4 & 5: NEEDS ASSESSMENT, COMMUNITY INFORMATION & PROMOTION OF COMMUNITY HEALTH SCHEDULE H, PART VI SAINT CLARE'S HOSPITAL, INC. STATEMENT OF COMMUNITY BENEFIT AND NEEDS ASSESSMENT (CONTINUED) QUALITATIVE DESCRIPTION OF COMMUNITY BENEFIT COMMUNITY OUTREACH FOR THE POOR SAINT CLARE'S HOSPITAL IS IMPROVING THE HEALTH AND QUALITY OF LIFE FOR PEOPLE IN THE COMMUNITIES WE SERVE. OUR GOAL IS TO PROVIDE OUR COMMUNITIES WITH COMPASSIONATE AND LEADING-EDGE CARE BY HAVING THE BEST PHYSICIANS, THE HIGHEST LEVEL OF TECHNOLOGY, AND STATE-OF-THE-ART FACILITIES. THROUGH ITS OUTREACH EFFORTS, SAINT CLARE'S HOSPITAL CONTINUES TO ADDRESS THE NEEDS OF THE COMMUNITY BY PROVIDING FREE EDUCATIONAL, SOCIAL, AND PREVENTATIVE HEALTH PROGRAMS TO ENSURE ACCESS TO THESE VITAL SERVICES BY THOSE PEOPLE WHO MIGHT NOT OTHERWISE BE ABLE TO AFFORD THEM. SISTER CATHERINE COMMUNITY HEALTH CENTER CLINIC ("THE CLINIC") HAS BEEN SERVING THE COMMUNITY FOR MORE THAN 20 YEARS PROVIDING HIGH QUALITY, COMPASSIONATE CARE TO THE VULNERABLE, POOR, UNDERSERVED AND UNINSURED. THE CLINIC OFFERS COMPREHENSIVE SERVICES FOR ALL FAMILY HEALTH NEEDS, INCLUDING INTERNAL MEDICINE, OBSTETRICS, GYNECOLOGY, AND PEDIATRICS, ALL IN A SINGLE CONVENIENT LOCATION. THE CENTER IS STAFFED WITH BOARD-CERTIFIED PHYSICIANS WHO SPECIALIZE IN INTERNAL MEDICINE, PEDIATRICS, AND OBSTETRICS, NURSES, SOCIAL WORKERS, DIETICIANS, FINANCIAL COUNSELORS, AND SUPPORT STAFF. IN ADDITION, IT COLLABORATES WITH THE MORRIS COUNTY OFFICE OF TEMPORARY ASSISTANCE TO PROVIDE AN OUT-STATION MEDICAID WORKER TO ASSIST CURRENT CLINIC CLIENTS IN APPLYING FOR MEDICAID PROGRAMS. APPROXIMATELY 95% OF NON-CLINICAL STAFF IS BILINGUAL. LATINO AND ASIAN COMMUNITY OUTREACH: THE OUTREACH PROGRAM WORKS IN COORDINATION WITH MULTIPLE COMMUNITY ORGANIZATIONS SUCH AS HEAD START SCHOOL, MORRIS COUNTY OFFICE OF HISPANIC AFFAIRS, MORRIS COUNTY PROSECUTORS OFFICE, MORRIS COUNTY PREVENTION IS KEY, NORWESCAP, EL PRIMER PASO, AND COMMISSION OF THE BLIND, TO OFFER A WIDE VARIETY OF HEALTH AND WELLNESS PROGRAMS TO THE HISPANIC COMMUNITY. IN ADDITION, THERE IS A FOCUS ON ENSURING THAT THE ASIAN, HINDU, AND CHINESE COMMUNITIES RECEIVE EDUCATION AND INFORMATION ON DISEASES THAT MAY IMPACT THEIR COMMUNITY. COLLABORATIVE EFFORTS WITH COMMUNITY MINISTRY: SAINT CLARE'S HOSPITAL, INC. WORKS IN CONCERT WITH FAITH COMMUNITIES IN A HOLISTIC APPROACH TO IMPROVE HEALTH. THE CONGREGATIONAL HEALTH MINISTRY PROVIDES EDUCATION, GUIDANCE, SUPPORT, AND RESOURCES TO HELP CONGREGATIONS PROMOTE SPIRITUAL, EMOTIONAL, AND PHYSICAL WELL-BEING IN MORRIS, SUSSEX, AND WARREN COUNTIES. THE PROGRAM ASSISTS PASTORS, NURSES, AND OTHER INTERESTED MEMBERS OF EACH CONGREGATION TO SELECT AND MAINTAIN A COMMITTEE OR HEALTH CABINET THAT MEETS REGULARLY TO ASSESS THE HEALTH NEEDS OF THE CONGREGATION AND DETERMINE HOW TO ADDRESS THOSE NEEDS MOST EFFECTIVELY. EACH PROGRAM IS UNIQUELY TAILORED AND PLANNED WITH THE CONGREGATION. FINANCIAL COUNSELING / CHARITY CARE: FINANCIAL COUNSELORS ARE AVAILABLE TO HELP PATIENTS IN THE CLINICS AT SAINT CLARE'S HOSPITAL, INC. THEY ASSIST WITH APPLICATION COMPLETION FOR THE CHARITY CARE PROGRAM, RUN BY THE STATE OF NEW JERSEY. COUNSELORS OFFER PEACE OF MIND TO PATIENTS DEALING WITH MEDICAL CONCERNS. MEDICAID WORKERS ARE AVAILABLE TO ASSIST WITH APPLICATIONS TO THE GOVERNMENT PROGRAM. SOCIAL WORKERS ASSIST PATIENTS WITH COMMUNITY RESOURCES. PUBLIC HEALTH NURSE SERVICES COLLABORATION: SAINT CLARE'S HOSPITAL, INC. HAS PARTNERED WITH THE LOCAL COMMUNITY HEALTH DEPARTMENT TO PROVIDE OUTREACH PROGRAMS THAT FOCUS ON TOTAL FAMILY HEALTH, COMMUNITY OUTREACH, EDUCATION, HEALTH SCREENINGS, AND COMMUNICABLE DISEASE INVESTIGATION. OUR OUTREACH IS THERE TO COMPLEMENT THE SERVICES PROVIDED BY THE TOWN OF DOVER. THE GOAL IS TO EDUCATE AND INFORM THE MULTIGENERATIONAL AND CULTURALLY DIVERSE COMMUNITY ABOUT HEALTH AND SOCIAL ISSUES AFFECTING THEM. THE EDUCATIONAL PROGRAMS ARE FREE OF CHARGE AND HELD AT VARIOUS ORGANIZATIONS AND LOCATIONS, THUS PROVIDING EASY ACCESS TO COMMUNITY RESIDENTS. PROGRAMS ARE OFFERED IN BOTH ENGLISH AND SPANISH. THESE PROGRAMS ARE REPEATED THROUGHOUT THE YEAR TO MAXIMIZE OUTREACH TO THE COMMUNITY. NEW JERSEY SELF-HELP CLEARINGHOUSE: SINCE 1981, SAINT CLARE'S HOSPITAL, INC. SELF-HELP CLEARINGHOUSE HAS ASSISTED PEOPLE IN FINDING AND CREATING SELF-HELP SUPPORT GROUPS WITHIN THE STATE AND COUNTRY. ASSISTANCE IS PROVIDED THROUGH A DATABASE OF MORE THAN 6,750 SUPPORT GROUPS FOR ALL TYPES OF NEEDS: ADDICTIONS, DISABILITIES, LOSS OF A LOVED ONE, PARENTING SITUATIONS, ABUSE SITUATIONS, AND OTHER STRESSFUL LIFE SITUATIONS. OVER THE LAST 30 YEARS, THIS FREE SERVICE HAS HELPED MORE THAN 120,000 PEOPLE FIND SUPPORT GROUPS. SUPPORTED COMMUNITY LIVING PROGRAM: SAINT CLARE'S HOSPITAL, INC. PROVIDES IN-HOME SERVICES TO ADULT POPULATIONS (18 YEARS OR OLDER) WHO SUFFER FROM PSYCHIATRIC DISORDERS. COUNSELORS WORK WITH PERSONS WHO ARE LIVING INDEPENDENTLY, BUT NEED ASSISTANCE WITH INTEGRATION IN TO THE LOCAL COMMUNITY AND/OR IMPROVEMENT IN HOUSEHOLD MANAGEMENT/ACTIVITIES OF DAILY LIVING SKILLS. TRANSITIONS: SAINT CLARE'S HOSPITAL, INC. ASSISTS ADULTS WITH PSYCHIATRIC ILLNESSES AND/OR CO-OCCURRING DISORDERS AS A STEP DOWN FROM AN INPATIENT STAY OR TO DIVERT INPATIENT ADMISSIONS. PROGRAMMING EMPHASIZES COMPLETE WELLNESS AND RECOVERY AND INCLUDES A VARIETY OF EVIDENCED-BASED TREATMENT OPTIONS. Patient education of eligibility for assistance. Schedule H, Part VI, Line 3 SAINT CLARE'S HOSPITAL, INC. INCLUDES INFORMATION CONCERNING ITS FINANCIAL ASSISTANCE POLICY ON ITS WEBSITE. IN ADDITION, SAINT CLARE'S HOSPITAL, INC. PROMINENTLY DISPLAYS ITS FINANCIAL ASSISTANCE POLICY IN BOTH ENGLISH AND SPANISH IN OBVIOUS LOCATIONS THROUGHOUT THE HOSPITALS, INCLUDING THE EMERGENCY ROOMS AND OTHER PATIENT INTAKE AREAS, AS WELL AS IN SAINT CLARE'S HOSPITAL, INC. OUTPATIENT FACILITIES. IN ADDITION, SAINT CLARE'S HOSPITAL, INC. REGISTRATION CLERKS ARE TRAINED TO PROVIDE CONSULTATION TO THOSE WHO HAVE NO INSURANCE OR POTENTIALLY INADEQUATE INSURANCE CONCERNING THEIR FINANCIAL OPTIONS INCLUDING APPLICATION FOR MEDICAID AND FOR FINANCIAL ASSISTANCE UNDER SAINT CLARE'S HOSPITAL, INC.'S FINANCIAL ASSISTANCE POLICY. UPON REGISTRATION (AND ONCE ALL EMTALA REQUIREMENTS ARE MET), PATIENTS WHO ARE IDENTIFIED AS UNINSURED (AND NOT COVERED BY MEDICARE OR MEDICAID) ARE PROVIDED WITH A PACKET OF INFORMATION THAT ADDRESSES THE FINANCIAL ASSISTANCE POLICY AND PROCEDURES INCLUDING AN APPLICATION FOR ASSISTANCE. SAINT CLARE'S HOSPITAL, INC. REGISTRATION CLERKS READ THE ORGANIZATION'S MEDICAL ASSISTANCE POLICY TO THOSE WHO APPEAR TO BE INCAPABLE OF READING, AND PROVIDE TRANSLATORS FOR NON ENGLISH-SPEAKING INDIVIDUALS. SAINT CLARE'S HOSPITAL, INC. STAFF WILL ALSO ASSIST THE PATIENT/GUARANTOR WITH APPLYING FOR OTHER AVAILABLE COVERAGE (SUCH AS MEDICAID), IF NECESSARY. COUNSELORS ASSIST MEDICARE ELIGIBLE PATIENTS IN ENROLLMENT BY PROVIDING REFERRALS TO THE APPROPRIATE GOVERNMENT AGENCIES. Affiliated health care system Schedule H, Part VI, Line 6 SAINT CLARE'S HOSPITAL, INC., ALONG WITH ITS AFFILIATED NON-PROFIT AND FOR-PROFIT ENTITIES ARE PART OF CATHOLIC HEALTH INITIATIVES. CATHOLIC HEALTH INITIATIVES (CHI) IS A NATIONAL FAITH-BASED NONPROFIT HEALTH CARE ORGANIZATION WITH HEADQUARTERS IN ENGLEWOOD, COLORADO. CHI'S EXEMPT PURPOSE IS TO SERVE AS AN INTEGRAL PART OF ITS NATIONAL SYSTEM OF HOSPITALS AND OTHER CHARITABLE ENTITIES, WHICH ARE DESCRIBED AS MARKET-BASED ORGANIZATIONS, OR MBOS. AN MBO IS A DIRECT PROVIDER OF CARE OR SERVICES WITHIN A DEFINED MARKET AREA THAT MAY BE AN INTEGRATED HEALTH SYSTEM AND/OR A STAND-ALONE HOSPITAL OR OTHER FACILITY OR SERVICE PROVIDER. CHI SERVES AS THE PARENT CORPORATION OF ITS MBOS WHICH ARE COMPRISED OF 73 HOSPITALS; 40 LONG-TERM CARE, ASSISTED- AND RESIDENTIAL-LIVING FACILITIES; TWO COMMUNITY HEALTH-SERVICES ORGANIZATIONS; TWO ACCREDITED NURSING COLLEGES; AND HOME HEALTH AGENCIES. TOGETHER, THESE FACILITIES PROVIDED $762 MILLION IN CHARITY CARE AND COMMUNITY BENEFIT IN THE 2013 FISCAL YEAR, INCLUDING SERVICES FOR THE POOR, FREE CLINICS, EDUCATION, AND RESEARCH. CHI PROVIDES STRATEGIC PLANNING AND MANAGEMENT SERVICES AS WELL AS CENTRALIZED "SHARED SERVICES" FOR THE MBOS. THE PROVISION OF CENTRALIZED MANAGEMENT AND SHARED SERVICES - INCLUDING AREAS SUCH AS ACCOUNTING, HUMAN RESOURCES, PAYROLL AND SUPPLY CHAIN -- PROVIDES ECONOMIES OF SCALE AND PURCHASING POWER TO THE MBOS. THE COST SAVINGS ACHIEVED THROUGH CHI'S CENTRALIZATION ENABLE MBOS TO DEDICATE ADDITIONAL RESOURCES TO HIGH-QUALITY HEALTH CARE AND COMMUNITY OUTREACH SERVICES TO THE MOST VULNERABLE MEMBERS OF OUR SOCIETY. SAINT CLARE'S HOSPITAL, INC. OPERATES WITH ITS WHOLLY OWNED AFFILIATES AND ITS FUNDRAISING ARM, SAINT CLARE'S FOUNDATION, TO SERVE THE HEALTH CARE NEEDS OF THE MORRIS AND SUSSEX COUNTIES. State filing of community benefit report Schedule H, Part VI, Line 7 NJ true MORRIS COUNTY ORG FOR HISPANIC AFFAIRS 95-97 BASSETT HIGHWAY DOVER NJ 07081 222137333 501(C)(3) 11000 PROGRAM SUPPORT SUSSEX COUNTY CHAMBER OF COMMERCE 120 HAMPTON HOUSE ROAD NEWTON NJ 07860 221915590 501(C)(6) 6000 PROGRAM SUPPORT 1 1 Procedures for monitoring use of grant funds Schedule I, Part I, Line 2 THE GRANT FUNDS ARE PROVIDED AS SPONSORSHIPS IN SUPPORT OF THE GENERAL PROGRAMS OF VARIOUS COMMUNITY ORGANIZATIONS. true true false false false false false false false ALMA RATCLIFFE 343911 0 43918 0 15746 0 20596 0 11988 0 436159 0 0 0 BARBARA GIRZ 346805 0 37104 0 3038 0 20596 0 17708 0 425251 0 0 0 DEBRA REGEN 202361 0 14621 0 6594 0 17544 0 8260 0 249380 0 0 0 DONALD CANN 764274 0 0 0 1797 0 20596 0 23780 0 810447 0 0 0 DURGESH HAJELA 314783 0 0 0 3767 0 20596 0 7438 0 346584 0 0 0 GAIL COHEN 217268 0 28223 0 12984 0 20596 0 20080 0 299151 0 0 0 JAMES BELLAMY 187788 0 0 0 1462 0 15740 0 23714 0 228704 0 0 0 JAMES LAPSLEY 279231 0 36680 0 16933 0 20596 0 8326 0 361766 0 0 0 JEFFREY LAMIE 172852 0 21231 0 29633 0 14342 0 16045 0 254103 0 0 0 LESLIE HIRSCH 0 672587 0 142524 0 96083 0 81194 0 19973 0 1012361 0 69139 MARY ELIZABETH O'BRIEN 0 714927 0 139200 0 70827 0 106965 0 9343 0 1041262 0 43883 SUELLYN ELLERBE 249496 0 0 0 166406 0 20596 0 7352 0 443850 0 0 0 TIMOTHY CHEN MD 264660 0 0 0 64792 9820 20596 0 15761 0 365809 9820 0 0 VERNON PERTELLE 44209 0 0 0 174216 0 17562 0 19484 0 255471 0 0 0 Arrangement used to establish the top management official's compensation Schedule J, Part I, Line 3 COMPENSATION FOR THE TOP MANAGEMENT OFFICIAL WAS ESTABLISHED AND PAID BY CATHOLIC HEALTH INITIATIVES (CHI), A RELATED ORGANIZATION. CHI USED THE FOLLOWING TO ESTABLISH THE TOP MANAGEMENT OFFICIAL'S COMPENSATION: (1) COMPENSATION COMMITTEE; (2) INDEPENDENT COMPENSATION CONSULTANT; (3) WRITTEN EMPLOYMENT CONTRACTS; (4) COMPENSATION SURVEY OR STUDY; (5) APPROVAL BY THE BOARD OR COMPENSATION COMMITTEE. Severance or change-of-control payment Schedule J, Part I, Line 4a POST-TERMINATION PAYMENTS ARE ADDRESSED IN EXECUTIVE EMPLOYMENT AGREEMENTS FOR CATHOLIC HEALTH INITIATIVES (CHI) AND RELATED ORGANIZATIONS' EMPLOYEES AT THE LEVEL OF VICE PRESIDENT AND ABOVE, INCLUDING THE MBO CEOS. THESE EMPLOYMENT AGREEMENTS REQUIRE THAT IN ORDER FOR THE EXECUTIVE TO RECEIVE POST-TERMINATION PAYMENTS, THESE INDIVIDUALS MUST EXECUTE A GENERAL RELEASE AND SETTLEMENT AGREEMENT. POST-TERMINATION PAYMENT ARRANGEMENTS ARE PERIODICALLY REVIEWED FOR OVERALL REASONABLENESS IN LIGHT OF THE EXECUTIVE'S OVERALL COMPENSATION PACKAGE. THE FOLLOWING REPORTABLE INDIVIDUALS RECEIVED SEVERANCE PAYMENTS FROM CHI DURING THE 2012 CALENDAR YEAR, AND THESE SEVERANCE PAYMENTS WERE INCLUDED IN THE INDIVIDUAL'S W-2 INCOME AND REPORTABLE COMPENSATION ON SCHEDULE J: VERNON PERTELLE - $159,216 SUELLYN ELLERBE - $123,508 Supplemental nonqualified retirement plan Schedule J, Part I, Line 4b DURING THE 2012 CALENDAR YEAR CATHOLIC HEALTH INITIATIVES (CHI), A RELATED ORGANIZATION, MAINTAINED A SUPPLEMENTAL NON-QUALIFIED DEFERRED COMPENSATION PLAN FOR MBO CEOS AND OTHER CHI EMPLOYEES AT THE LEVEL OF SENIOR VICE PRESIDENT AND ABOVE. THE FOLLOWING REPORTABLE INDIVIDUALS WERE ELIGIBLE TO PARTICIPATE IN THAT PLAN: LESLIE HIRSCH AND MARY ELIZABETH O'BRIEN. DURING 2012, THE FOLLOWING CONTRIBUTIONS WERE MADE BY CHI TO THE DEFERRED COMPENSATION PLAN: LESLIE HIRSCH - $60,598 MARY ELIZABETH O'BRIEN - $83,869 DURING 2012, THE FOLLOWING DISTRIBUTIONS WERE MADE BY CHI FROM THE DEFERRED COMPENSATION PLAN: LESLIE HIRSCH - $69,139 MARY ELIZABETH O'BRIEN - $43,883 Significant changes in program services Form 990, Part III, Line 3 IN 2012, THE SAINT CLARE'S HOSPITAL SUSSEX LOCATION CLOSED AS AN ACUTE CARE FACILITY AND IS NOW OPERATING AS A HEALTH CENTER. SAINT CLARE'S HEALTH CENTER AT SUSSEX CONTINUES TO PROVIDE A WIDE RANGE OF MEDICAL SERVICES, INCLUDING A FULL-SERVICE, 24/7 SATELLITE EMERGENCY DEPARTMENT (SED), THE WOMEN'S HEALTH CENTER, AND A NUMBER OF DIAGNOSTIC AND TESTING SERVICES, SUCH AS CT SCANNING, X-RAY, LABORATORY, NUCLEAR MEDICINE, ECHOCARDIOGRAPHY, AND ULTRASOUND, TO MEET THE NEEDS OF THE COMMUNITY SERVED IN SUSSEX COUNTY. PATIENTS REQUIRING INPATIENT MEDICAL CARE WILL BE TRANSPORTED TO NEARBY HOSPITALS IN ACCORDANCE WITH THE WISHES OF THE PATIENT, FAMILY, AND/OR ATTENDING PHYSICIAN; THESE HOSPITALS MAY INCLUDE SAINT CLARE'S HOSPITAL FACILITIES IN DENVILLE AND DOVER. Delegate broad authority to a committee Form 990, Part VI, Section A, Line 1a PURSUANT TO SECTION 8.6 OF THE BYLAWS OF SAINT CLARE'S HOSPITAL, INC., THE EXECUTIVE COMMITTEE IS COMPOSED OF THE BOARD CHAIR, THE BOARD VICE CHAIR, THE PRESIDENT AND CEO, EACH OF WHOM SHALL SERVE AS AN EX OFFICIO VOTING MEMBER OF THE EXECUTIVE COMMITTEE, AND TWO VOTING MEMBERS APPOINTED BY THE BOARD OF DIRECTORS. EACH INDIVIDUAL APPOINTED TO THE EXECUTIVE COMMITTEE SHALL SERVE FOR A TERM OF ONE YEAR OR UNTIL HIS OR HER SUCCESSOR IS DULY APPOINTED BY THE BOARD OF DIRECTORS. THE EXECUTIVE COMMITTEE SHALL CONSIST OF ONLY DIRECTORS OF THE CORPORATION. PURSUANT TO SECTION 8.1 OF THE CORPORATION'S BYLAWS, COMMITTEES, SUCH AS THE EXECUTIVE COMMITTEE, THAT ARE GRANTED THE AUTHORITY TO ACT ON BEHALF OF THE BOARD OF DIRECTORS MAY INCLUDE ONLY DIRECTORS OF THE CORPORATION. FURTHER, PURSUANT TO SECTION 8.6 OF THE CORPORATION'S BYLAWS, THE EXECUTIVE COMMITTEE HAS AND MAY EXERCISE SUCH POWERS AS MAY BE DELEGATED TO IT BY THE BOARD OF DIRECTORS. THE EXECUTIVE COMMITTEE ALSO POSSESSES THE POWER TO TRANSACT ROUTINE BUSINESS OF THE CORPORATION IN THE INTERIM PERIOD BETWEEN REGULARLY SCHEDULED MEETINGS OF THE BOARD OF DIRECTORS. Classes of members or stockholders Form 990, Part VI, Section A, Line 6 SAINT CLARE'S HEALTH SERVICES, INC., A NEW JERSEY NON-PROFIT CORPORATION, IS THE SOLE MEMBER OF THE ORGANIZATION. SAINT CLARE'S HEALTH SERVICES, INC. IS A SUBSIDIARY OF CATHOLIC HEALTH INITIATIVES, A COLORADO NON-PROFIT CORPORATION. Members or stockholders electing members of governing body Form 990, Part VI, Section A, Line 7a ACCORDING TO THE ORGANIZATION'S BYLAWS, DIRECTORS SHALL BE APPOINTED OR REFUSED BY THE CORPORATE MEMBER. THE CORPORATE MEMBER MAY APPOINT ONE OR MORE INDIVIDUALS TO THE BOARD OF DIRECTORS, AND MAY AT ANY TIME REMOVE, WITH OR WITHOUT CAUSE, ANY MEMBER OF THE BOARD OF DIRECTORS. ACCORDING TO THE ORGANIZATION'S BYLAWS, DIRECTORS OF THE CORPORATION SHALL BE APPOINTED BY THE CORPORATE MEMBER NO LATER THAN JUNE 30 OF EACH YEAR. THE NAMES AND QUALIFICATIONS OF EACH INDIVIDUAL ACCEPTED BY THE BOARD OF DIRECTORS SHALL BE SUBMITTED TO THE CORPORATE MEMBER, WHO SHALL APPOINT OR REFUSE EACH NOMINEE IN ACCORDANCE WITH THE CORPORATE MEMBER'S BYLAWS AND WITH ENDORSEMENT OF THE SENIOR VICE PRESIDENT OF OPERATIONS. THE CORPORATE MEMBER MAY UNILATERALLY APPOINT ONE OR MORE INDIVIDUALS TO THE BOARD OF DIRECTORS SHOULD THE BOARD FAIL TO FURNISH THE CORPORATE MEMBER WITH A LIST OF INDIVIDUALS QUALIFIED TO SERVE ON THE BOARD OF DIRECTORS OF THE CORPORATION. Decisions requiring approval by members or stockholders Form 990, Part VI, Section A, Line 7b THE ORGANIZATION'S CORPORATE MEMBER IS SAINT CLARE'S HEALTH SERVICES, INC. PURSUANT TO SECTION 5.4 OF THE ORGANIZATION'S BYLAWS, BOTH SAINT CLARE'S HEALTH SERVICES, INC. AND CATHOLIC HEALTH INITIATIVES (CHI) (SAINT CLARE'S HEALTH SERVICES' SOLE CORPORATE MEMBER) HAVE RESERVED POWERS AS OUTLINED IN THE CHI GOVERNANCE MATRIX. PURSUANT TO THE GOVERNANCE MATRIX THE FOLLOWING RIGHTS ARE HELD BY THE SAINT CLARE'S HEALTH SERVICES BOARD: -APPROVE MEMBERS OF THE SAINT CLARE'S HOSPITAL, INC. BOARD; -AMENDMENT OF THE CORPORATE DOCUMENTS OF SAINT CLARE'S HOSPITAL, INC.; -APPROVE REMOVAL OF A MEMBER OF THE GOVERNING BODY OF SAINT CLARE'S HOSPITAL, INC.; -ADOPTION OF LONG RANGE AND STRATEGIC PLANS FOR SAINT CLARE'S HOSPITAL, INC. THE FOLLOWING RIGHTS ARE RESERVED TO THE CHI BOARD DIRECTLY OR THROUGH POWERS DELEGATED TO THE CHI CHIEF EXECUTIVE OFFICER: -SUBSTANTIAL CHANGE IN THE MISSION OR PHILOSOPHY OF SAINT CLARE'S HOSPITAL, INC.; -REMOVAL OF A MEMBER OF THE GOVERNING BODY OF SAINT CLARE'S HOSPITAL, INC.; -APPROVAL OF ISSUANCE OF DEBT BY SAINT CLARE'S HOSPITAL, INC.; -APPROVAL OF PARTICIPATION OF SAINT CLARE'S HOSPITAL, INC. IN A JOINT VENTURE; -APPROVAL OF FORMATION OF A NEW CORPORATION BY SAINT CLARE'S HOSPITAL, INC.; -APPROVAL OF A MERGER INVOLVING SAINT CLARE'S HOSPITAL, INC.; -APPROVAL OF THE SALE OF ALL OR SUBSTANTIALLY ALL OF THE ASSETS OF SAINT CLARE'S HOSPITAL, INC.; -TO REQUIRE THE TRANSFER OF ASSETS BY SAINT CLARE'S HOSPITAL, INC. TO CHI TO ACCOMPLISH CHI'S GOALS AND OBJECTIVES, AND TO SATISFY CHI DEBTS. PURSUANT TO SECTION 5.4 OF THE ORGANIZATION'S BYLAWS, SAINT CLARE'S HEALTH SERVICES, INC. OR CHI MAY, IN EXERCISE OF THEIR APPROVAL POWERS, GRANT OR WITHHOLD APPROVAL IN WHOLE OR IN PART, OR MAY, IN ITS COMPLETE DISCRETION, AFTER CONSULTATION WITH THE BOARD AND ITS PRESIDENT AND THE CHIEF EXECUTIVE OFFICER OF THE ORGANIZATION, RECOMMEND SUCH OTHER OR DIFFERENT ACTIONS AS IT DEEMS APPROPRIATE. Review of form 990 by governing body Form 990, Part VI, Section B, Line 11b ONCE THE RETURN IS PREPARED, THE RETURN IS REVIEWED BY THE CHIEF FINANCIAL OFFICER. THE CHIEF FINANCIAL OFFICER PROVIDES A COPY OF THE RETURN TO ST. CLARE'S HOSPITAL, INC.'S BOARD PRIOR TO FILING. SUBSEQUENT TO PROVIDING A COPY TO THE BOARD, THE TAX DEPARTMENT FILES THE RETURN WITH THE APPROPRIATE FEDERAL AND STATE AGENCIES, MAKING ANY NON-SUBSTANTIVE CHANGES NECESSARY TO EFFECT E-FILING. ANY SUCH CHANGES ARE NOT RE-SUBMITTED TO THE BOARD. Conflict of interest policy Form 990, Part VI, Section B, Line 12c ANNUALLY, OFFICERS, TRUSTEES, AND KEY EMPLOYEES ARE REQUIRED TO COMPLETE A CONFLICT OF INTEREST STATEMENT ACKNOWLEDGING THAT THEY HAVE NO CONFLICTS OF INTEREST. THE COMPLETED FORMS ARE RETURNED TO THE CORPORATE RESPONSIBILITY OFFICER FOR REVIEW. IN ADDITION, ANY CONFLICTS THAT MAY ARISE DURING THE YEAR MUST BE DISCLOSED TO THE RESPONSIBILITY OFFICER AND AT THE BEGINNING OF EACH MEETING. WRITTEN DOCUMENT RETENTION AND DESTRUCTION POLICY FORM 990, PART VI, LINE 14 THE ORGANIZATION HAS A DOCUMENT RETENTION AND DESTRUCTION POLICY THAT IT FOLLOWS; HOWEVER, THIS POLICY HAS NOT BEEN FORMALLY ADOPTED BY THE ORGANIZATION'S GOVERNING BODY. PROCESS USED TO DETERMINE COMPENSATION FOR TOP MANAGEMENT OFFICIAL FORM 990, PART VI, LINE 15A THE ORGANIZATION'S CEO'S COMPENSATION IS PAID BY CATHOLIC HEALTH INITIATIVES (CHI), A RELATED ORGANIZATION. CHI HAS A DEFINED COMPENSATION PHILOSOPHY. BOTH THE EXECUTIVE AND NON-EXECUTIVE COMPENSATION STRUCTURES AND RANGES ARE REVIEWED ANNUALLY IN COMPARISON TO MARKET DATA. CHI USES THE HAY GROUP AS THE INDEPENDENT THIRD PARTY TO ASSESS EXECUTIVE COMPENSATION PROGRAMS AND TO ENSURE THE REASONABLENESS OF ACTUAL SALARIES AND TOTAL COMPENSATION PACKAGES. COMPENSATION OF THE SENIOR MOST EXECUTIVES IS REVIEWED ANNUALLY. THE HAY GROUP REVIEWS BOTH CASH AND TOTAL COMPENSATION FOR OVERALL REASONABLENESS, FOR ADHERENCE TO CHI'S COMPENSATION PHILOSOPHY, AND FOR COMPARABILITY TO THE NOT-FOR-PROFIT HEALTHCARE MARKET. THIS INDEPENDENT REVIEW IS DELIVERED BY HAY GROUP TO THE HR COMMITTEE OF THE CHI BOARD OF STEWARDSHIP TRUSTEES ANNUALLY AT THEIR SEPTEMBER MEETING AND MINUTES ARE SHARED WITH THE FULL BOARD AT THE DECEMBER MEETING. THE LAST REVIEW WAS SEPTEMBER 17, 2013. IN ADDITION, IN DECEMBER 2009, HAY GROUP COMPLETED A COMPREHENSIVE REVIEW OF ALL POSITIONS AT THE LEVEL OF VICE PRESIDENT AND ABOVE TO DETERMINE AND VALIDATE APPROPRIATE COMPENSATION LEVELS. THESE LEVELS HAVE BEEN REVIEWED ANNUALLY SINCE AND REVISED BASED ON MARKET DATA, WHERE APPLICABLE. Process used to establish compensation of other officers/key employees Form 990, Part VI, Section B, Line 15b COMPENSATION FOR OTHER OFFICERS AND KEY EMPLOYEES IS SET BY THE COMPENSATION COMMITTEE OF SAINT CLARE'S HEALTH SERVICES, INC. USING RECOMMENDATIONS MADE BY THE PRESIDENT/CEO. THE COMMITTEE IS COMPRISED OF INDEPENDENT BOARD MEMBERS. THE COMMITTEE USES MARKET STUDIES AND EMPLOYS AN INDEPENDENT COMPENSATION CONSULTANT IN THE DETERMINATION OF COMPENSATION. THIS PROCESS WAS LAST UNDERTAKEN IN 2013. Governing documents, conflict of interest policy and financial statements available to the public Form 990, Part VI, Section C, Line 19 THE ORGANIZATION'S FINANCIAL STATEMENTS, CONFLICT OF INTEREST POLICY, AND GOVERNING DOCUMENTS ARE AVAILABLE TO THE PUBLIC UPON REQUEST. THE ORGANIZATION'S FINANCIAL STATEMENTS ARE INCLUDED IN CATHOLIC HEALTH INITIATIVES' CONSOLIDATED AUDITED FINANCIAL STATEMENTS THAT ARE AVAILABLE AT WWW.CATHOLICHEALTHINIT.ORG OR AT WWW.DACBOND.ORG. COMPENSATION OF INTERIM CFO FORM 990, PART VII, SECTION A, LINE 1A MARK HERBERS IS THE INTERIM CFO FOR SAINT CLARE'S HOSPITAL AND IS PAID BY FTI CONSULTING. CATHOLIC HEALTH INITIATIVES (CHI), THE PARENT COMPANY TO SAINT CLARE'S HEALTH SERVICES, INC., PAYS FTI CONSULTING FOR MARK HERBERS' SERVICES AND FOR SEVERAL OTHER INTERIM POSITIONS THROUGHOUT THE ORGANIZATION'S HEALTH CARE SYSTEM. THEREFORE, MARK HERBERS WILL SHOW $0 REPORTABLE COMPENSATION FROM THE FILING ORGANIZATION AND FROM ANY RELATED ORGANIZATION AS HE IS PAID DIRECTLY BY FTI CONSULTING. Other Expenses Form 990, Part IX, Line 11g OTHER FEES FOR SERVICES - TOTAL EXPENSE: 31688059, PROGRAM SERVICE EXPENSE: 18166822, MANAGEMENT AND GENERAL EXPENSES: 13521237, FUNDRAISING EXPENSES: ; CONTRACT LABOR - NURSING - TOTAL EXPENSE: 3805711, PROGRAM SERVICE EXPENSE: 3752041, MANAGEMENT AND GENERAL EXPENSES: 53670, FUNDRAISING EXPENSES: ; CONTRACT LABOR - BEHAVIORAL - TOTAL EXPENSE: 5135533, PROGRAM SERVICE EXPENSE: 4952234, MANAGEMENT AND GENERAL EXPENSES: 183299, FUNDRAISING EXPENSES: ; CONTRACT LABOR - CONSULTING - TOTAL EXPENSE: 5766938, PROGRAM SERVICE EXPENSE: 355627, MANAGEMENT AND GENERAL EXPENSES: 5411311, FUNDRAISING EXPENSES: ; Other changes in net assets or fund balances Form 990 , Part XI, Line 9 CAPITAL POOL CONTRIBUTION - -11388; ALEGENT CREIGHTON CLINIC 12809 WEST DODGE ROAD OMAHA NE 68154 HEALTHCARE NE 501(C)(3) 3 ACH true ALEGENT CREIGHTON HEALTH 12809 WEST DODGE ROAD OMAHA NE 68154 HEALTHCARE NE 501(C)(3) 3 NA true ALEGENT HEALTH - BERGAN MERCY HEALTH SYS 7500 MERCY ROAD OMAHA NE 68124 HEALTHCARE NE 501(C)(3) 3 ACH true ALEGENT HEALTH COMMUNITY MEMORIAL HOSPITAL OF MISSOURI VALLEY IA 631 N 8TH STREET MISSOURI VALLEY IA 51555 HEALTHCARE IA 501(C)(3) 3 AHIMC true ALEGENT HEALTH FOUNDATION 12809 WEST DODGE ROAD OMAHA NE 68154 FUNDRAISING NE 501(C)(3) 7 ACH true ALEGENT HEALTH IMMANUEL MEDICAL CENTER 6901 NORTH 72ND STREET OMAHA NE 68122 HEALTHCARE NE 501(C)(3) 3 ACH true ALEGENT HEALTH MEMORIAL HOSPITAL SCHUYLER NE 104 W 17TH STREET SCHUYLER NE 68661 HEALTHCARE NE 501(C)(3) 3 AHIMC true ALEGENT HEALTH - MERCY HOSPITAL CORNING IOWA PO BOX 368 CORNING IA 50841 HEALTHCARE IA 501(C)(3) 3 AHBMHS true ALVERNA APARTMENTS 300 SE 8TH AVENUE LITTLE FALLS MN 56345 LTERM CARE MN 501(C)(3) 9 CHI true APPLETREE COURT 601 OAK STREET BRECKENRIDGE MN 56520 SENIOR HOMES MN 501(C)(3) 9 SFH true BISHOP DRUMM RETIREMENT CENTER 1111 6TH AVENUE DES MOINES IA 50314 LTERM CARE IA 501(C)(3) 9 CHI-IA CORP true BORNEMANN HEALTH CORPORATION 2500 BERNVILLE RD PO BOX 316 READING PA 19603 HEALTHCARE PA 501(C)(3) 11 - Type I CHI true CARRINGTON HEALTH CENTER 800 NORTH 4TH STREET CARRINGTON ND 58421 HEALTHCARE ND 501(C)(3) 3 CHI true CATHOLIC HEALTH INITIATIVES 198 INVERNESS DRIVE WEST ENGLEWOOD CO 80112 HEALTHCARE CO 501(C)(3) 9 NA true CATHOLIC HEALTH INITIATIVES COLORADO FOUNDATION 6385 CORPORATE DRIVE COLORADO SPRINGS CO 80919 FUNDRAISING CO 501(C)(3) 7 CHIC true CATHOLIC HEALTH INITIATIVES INSTITUTE FOR RESEARCH AND INNOVATION 198 INVERNESS DRIVE WEST ENGLEWOOD CO 80112 HEALTHCARE CO 501(C)(3) 11 - Type I CHI true CATHOLIC HEALTH INITIATIVES NATIONAL FOUNDATION 6385 CORPORATE DRIVE COLORADO SPRINGS CO 80919 FUNDRAISING CO 501(C)(3) 9 CHI true CATHOLIC HEALTH INITIATIVES-COLORADO 188 INVERNESS DRIVE WEST SUITE 500 ENGLEWOOD CO 80112 HEALTHCARE CO 501(C)(3) 3 CHI true CATHOLIC HEALTH INITIATIVES-IOWA CORP DBA MERCY MEDICAL CENTER-DES MOINES 1111 6TH AVENUE DES MOINES IA 50314 HEALTHCARE IA 501(C)(3) 3 CHI true CENTENNIAL MEDICAL GROUP INC 2700 STEWART PARKWAY ROSEBURG OR 97470 PHYSICIANS OR 501(C)(3) 9 MMC true CENTRAL KANSAS MEDICAL CENTER 3515 BROADWAY GREAT BEND KS 67530 SURGERY CNTR KS 501(C)(3) 3 CHI true CHI HEALTH CONNECT AT HOME - FARGO 4816 AMBER VALLEY PARKWAY SOUTH FARGO ND 58104 HEALTHCARE ND 501(C)(3) 9 CHI true CHI KENTUCKY INC 3900 OLYMPIC BLVD SUITE 400 ERLANGER KY 41018 HEALTHCARE KY 501(C)(3) 11 - Type I CHI true CHI NATIONAL HOME CARE 198 INVERNESS DRIVE WEST ENGLEWOOD CO 80112 HEALTHCARE CO 501(C)(3) 9 CHI NHC true CHI NATIONAL SERVICES 198 INVERNESS DRIVE WEST ENGLEWOOD CO 80112 HEALTHCARE CO 501(C)(3) 11 - Type I CHI true CHI NEBRASKA 6940 O STREET LINCOLN NE 68510 HEALTHCARE NE 501(C)(3) 11 - Type I CHI true COMMUNITY LIMITED CARE DIALYSIS CENTER 619 OAK STREET - ACCOUNTING 3 WEST CINCINNATI OH 45206 DIALYSIS OH 501(C)(2) N/A GSH true COMMUNITY MEMORIAL HOSPITAL MEDICAL SERVICE FOUNDATION MISSOURI VALLEY IA 631 N 8TH STREET MISSOURI VALLEY IA 51555 FUNDRAISING IA 501(C)(3) 11 - Type I AHCMH true CONTINUING CARE HOSPITAL 150 NORTH EAGLE CREEK DRIVE LEXINGTON KY 40509 LTACH KY 501(C)(3) 3 SJHS true COVENANT HOME CARE 198 INVERNESS DRIVE WEST ENGLEWOOD CO 80112 HOME HEALTH PA 501(C)(3) 11 - Type II NA true ENUMCLAW REGIONAL HOSPITAL ASSOCIATION 1450 BATTERSBY AVENUE ENUMCLAW WA 98022 HEALTHCARE WA 501(C)(3) 3 FHS true FLAGET HEALTHCARE INC 4305 NEW SHEPHERDSVILLE ROAD BARDSTOWN KY 40004 HEALTHCARE KY 501(C)(3) 3 KOH true FLAGET MEMORIAL HOSPITAL FOUNDATION 4305 NEW SHEPHERDSVILLE ROAD BARDSTOWN KY 40004 FUNDRAISING KY 501(C)(3) 11 - Type I FH true FRANCISCAN FOUNDATION 1717 SOUTH J STREET TACOMA WA 98405 FUNDRAISING WA 501(C)(3) 9 FHS true FRANCISCAN HEALTH SYSTEM 1717 SOUTH J STREET TACOMA WA 98405 HEALTHCARE WA 501(C)(3) 3 CHI true FRANCISCAN MEDICAL GROUP 1708 SOUTH YAKIMA AVENUE TACOMA WA 98405 HEALTHCARE WA 501(C)(3) 9 FHS true FRANCISCAN VILLA OF SOUTH MILWAUKEE 3601 SOUTH CHICAGO AVENUE SOUTH MILWAUKEE WI 53172 HEALTHCARE WI 501(C)(3) 9 CHI true GETTYSBURG MEDICAL CENTER 606 EAST GARFIELD AVENUE GETTYSBURG SD 57442 HEALTHCARE SD 501(C)(3) 3 SMHC true GLOBAL HEALTH INITIATIVES 198 INVERNESS DRIVE WEST ENGLEWOOD CO 80112 MINISTRIES CO 501(C)(3) 11 - Type I CHI true GOOD SAMARITAN COLLEGE OF NURSING & HEALTH SCIENCE 619 OAK STREET - ACCOUNTING 3 WEST CINCINNATI OH 45206 EDUCATION OH 501(C)(3) 2 GSH true GOOD SAMARITAN FOUNDATION OF CINCINNATI INC 619 OAK STREET - ACCOUNTING 3 WEST CINCINNATI OH 45206 FUNDRAISING OH 501(C)(3) 11 - Type I GSH true GOOD SAMARITAN HOSPITAL PO BOX 1990 KEARNEY NE 68848 HEALTHCARE NE 501(C)(3) 3 CHI NEBRASKA true GOOD SAMARITAN HOSPITAL FOUNDATION 111 W 31ST STREET KEARNEY NE 68847 FUNDRAISING NE 501(C)(3) 7 GSH true ST LUKE'S MEDICAL GROUP FKA GREATER HOUSTON HEALTH NETWORK 6624 FANNIN HOUSTON TX 77030 PHY PRACTICES TX 501(C)(3) 3 SLHS true HEALTH SET 4200 WEST CONEJOS PLACE 436 DENVER CO 80204 LOW INC.CARE CO 501(C)(3) 7 CHIC true HEALTHCARE AND WELLNESS FOUNDATION 2400 ST FRANCIS DRIVE BRECKENRIDGE MN 56520 FUNDRAISING MN 501(C)(3) 11 - Type I SFMC true HIGHLINE MEDICAL CENTER 16251 SYLVESTER RD SW BURIEN WA 98166 HEALTHCARE WA 501(C)(3) 3 FHS true HOSPITAL ASSOCIATION FOR ST JOSEPH HOSPITAL 7601 OSLER DRIVE TOWSON MD 21204 HEALTHCARE MD 501(C)(3) 9 SJMC true HOUSE OF MERCY 1111 6TH AVENUE DES MOINES IA 50314 SHELTER IA 501(C)(3) 7 CHI-IA CORP true JEWISH HOSPITAL AND ST MARY'S HEALTHCARE INC 539 S 4TH STREET LOUISVILLE KY 40202 HEALTHCARE KY 501(C)(3) 3 KOH true JEWISH PHYSICIAN GROUP INC 539 S 4TH STREET LOUISVILLE KY 40202 HEALTHCARE KY 501(C)(3) 9 JHSMH true KENTUCKYONE HEALTH INC FKA JH PROPERTIES INC 200 ABRAHAM FLEXNER WAY LOUISVILLE KY 40202 HEALTHCARE KY 501(C)(3) 9 CHI true LAKEWOOD HEALTH CENTER 600 MAIN AVENUE SOUTH BAUDETTE MN 56623 HEALTHCARE MN 501(C)(3) 3 CHI true LINUS OAKES INC 2700 STEWART PARKWAY ROSEBURG OR 97470 SENIOR LIVING OR 501(C)(3) 9 MMC true LISBON AREA HEALTH SERVICES 905 MAIN STREET LISBON ND 58054 HEALTHCARE ND 501(C)(3) 3 CHI true MEMORIAL HEALTH CARE SYSTEM FOUNDATION 2525 DE SALES AVENUE CHATTANOOGA TN 37404 FUNDRAISING TN 501(C)(3) 7 MHCS true MEMORIAL HEALTH CARE SYSTEM INC 2525 DE SALES AVENUE CHATTANOOGA TN 37404 HEALTHCARE TN 501(C)(3) 3 CHI true MEMORIAL HEALTH PARTNERS FOUNDATION INC 5600 BRAINERD ROAD SUITE 500 CHATTANOOGA TN 37411 HEALTHCARE TN 501(C)(3) 9 MHCS true MERCY AUXILIARY OF CENTRAL IOWA 1111 6TH AVENUE DES MOINES IA 50314 AUXILIARY IA 501(C)(3) 11 - Type I CHI-IA CORP true MERCY CLINICS INC 1111 6TH AVENUE DES MOINES IA 50314 PHYSICIAN IA 501(C)(3) 9 CHI-IA CORP true MERCY COLLEGE OF HEALTH SCIENCES 1111 6TH AVENUE DES MOINES IA 50314 EDUCATION IA 501(C)(3) 2 CHI-IA CORP true MERCY FOUNDATION OF DES MOINES IA 1111 6TH AVENUE DES MOINES IA 50314 FUNDRAISING IA 501(C)(3) 7 CHI-IA CORP true MERCY FOUNDATION INC 2700 STEWART PARKWAY ROSEBURG OR 97470 FUNDRAISING OR 501(C)(3) 7 MMC true MERCY HEALTH CARE FOUNDATION PO BOX 368 CORNING IA 50841 FUNDRAISING NE 501(C)(3) 11 - Type I AHMH true MERCY HEALTHCARE FOUNDATION 570 CHAUTAUQUA BOULEVARD VALLEY CITY ND 58072 FUNDRAISING ND 501(C)(3) 11 - Type III - FI MHVC true MERCY HOSPITAL FOUNDATION COUNCIL BLUFFS 800 MERCY DRIVE COUNCIL BLUFFS IA 51503 FUNDRAISING IA 501(C)(3) 11 - Type I AHBMHS true MERCY HOSPITAL OF DEVILS LAKE 1031 SEVENTH STREET NE DEVILS LAKE ND 58301 HEALTHCARE ND 501(C)(3) 3 CHI true MERCY HOSPITAL OF DEVILS LAKE FOUNDATION 1031 SEVENTH STREET NE DEVILS LAKE ND 58301 FUNDRAISING ND 501(C)(3) 7 CHI true MERCY HOSPITAL OF VALLEY CITY 570 CHAUTAUQUA BOULEVARD VALLEY CITY ND 58072 HEALTHCARE ND 501(C)(3) 3 CHI true MERCY MEDICAL CENTER 1301 15TH AVENUE WEST WILLISTON ND 58801 HEALTHCARE ND 501(C)(3) 3 CHI true MERCY MEDICAL CENTER - CENTERVILLE ONE ST JOSEPHS DRIVE CENTERVILLE IA 52544 HEALTHCARE IA 501(C)(3) 3 CHI-IA CORP true MERCY MEDICAL CENTER INC 2700 STEWART PARKWAY ROSEBURG OR 97470 HEALTHCARE OR 501(C)(3) 3 CHI true MERCY MEDICAL FOUNDATION 1301 15TH AVENUE WEST WILLISTON ND 58801 FUNDRAISING ND 501(C)(3) 11 - Type I MMC true MERCY PROFESSIONAL PRACTICE ASSOCIATES INC 1111 6TH AVENUE DES MOINES IA 50314 PHYSICIAN IA 501(C)(3) 9 CHI-IA CORP true MLIFECARES 198 INVERNESS DRIVE WEST ENGLEWOOD CO 80112 PROPERTY MGMT MO 501(C)(3) 11 - Type I SJRMC true MNMCH INC 198 INVERNESS DRIVE WEST ENGLEWOOD CO 80112 HEALTHCARE KS 501(C)(3) 3 SJRMC true MT ST JOSEPH INC 198 INVERNESS DRIVE WEST ENGLEWOOD CO 80112 NURSING CARE OR 501(C)(3) 11 - Type I CHI true NEBRASKA HEART HOSPITAL 7500 SOUTH 91ST STREET LINCOLN NE 68526 HEALTHCARE NE 501(C)(3) 3 CHI NEBRASKA true OAKES COMMUNITY HOSPITAL 314 SOUTH 8TH STREET OAKES ND 58474 HEALTHCARE ND 501(C)(3) 3 CHI true OAKES COMMUNITY HOSPITAL FOUNDATION 1200 N 7TH STREET OAKES ND 58474 FUNDRAISING ND 501(C)(3) 11 - Type I OCH true PUEBLO STEPUP 1925 EAST ORMAN AVE SUITE G52 PUEBLO CO 81004 COMMUNITY CO 501(C)(3) 7 CHIC true SET OF COLORADO SPRINGS INC 2864 S CIRCLE DRIVE SUITE 450 COLORADO SPRINGS CO 80906 LTERM CARE CO 501(C)(3) 7 CHIC true SAINT CLARE'S COMMUNITY CARE 25 POCONO ROAD DENVILLE NJ 07834 HEALTHCARE NJ 501(C)(3) 11 - Type II SCHS true SAINT CLARE'S FOUNDATION 25 POCONO ROAD DENVILLE NJ 07834 FUNDRAISING NJ 501(C)(3) 7 SCHS true SAINT CLARE'S HEALTH SERVICES INC 25 POCONO ROAD DENVILLE NJ 07834 MANAGEMENT NJ 501(C)(3) 7 CHI true SAINT CLARE'S HOSPITAL 25 POCONO ROAD DENVILLE NJ 07834 HEALTHCARE NJ 501(C)(3) 3 SCHS true SAINT ELIZABETH FOUNDATION 555 SOUTH 70TH STREET LINCOLN NE 68510 FUNDRAISING NE 501(C)(3) 7 SERMC true SAINT ELIZABETH HEALTH SERVICES 555 SOUTH 70TH STREET LINCOLN NE 68510 HEALTHCARE NE 501(C)(3) 3 SERMC true SAINT ELIZABETH REGIONAL MEDICAL CENTER 555 SOUTH 70TH STREET LINCOLN NE 68510 HEALTHCARE NE 501(C)(3) 3 CHI NEBRASKA true SAINT FRANCIS MEDICAL CENTER 2620 WEST FAIDLEY GRAND ISLAND NE 68803 HEALTHCARE NE 501(C)(3) 3 CHI NEBRASKA true SAINT FRANCIS MEDICAL CENTER FOUNDATION PO BOX 9804 GRAND ISLAND NE 68802 FUNDRAISING NE 501(C)(3) 7 SFMC true SAINT JOSEPH BEREA HOSPITAL FOUNDATION INC 305 ESTILL STREET BEREA KY 40403 FUNDRAISING KY 501(C)(3) 7 SJHS true SAINT JOSEPH HEALTH SYSTEM INC 424 LEWIS HARGETT CIRCLE 160 LEXINGTON KY 40503 HEALTHCARE KY 501(C)(3) 3 CHI true SAINT JOSEPH LONDON FOUNDATION INC 1001 SAINT JOSEPH LANE LONDON KY 40741 FUNDRAISING KY 501(C)(3) 7 SJHS true SAINT JOSEPH MEDICAL FOUNDATION INC 200 ABRAHAM FLEXNER WAY LOUISVILLE KY 40202 PHY PRACTICES KY 501(C)(3) 3 SJHS true SAINT JOSEPH MOUNT STERLING FOUNDATION INC 225 FALCON DRIVE MOUNT STERLING KY 40353 FUNDRAISING KY 501(C)(3) 7 SJHS true SAINT JOSEPH'S HOSPITAL FOUNDATION 30 WEST 7TH STREET DICKINSON ND 58601 FUNDRAISING ND 501(C)(3) 11 - 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