2014-07-14T20:58:42-05:00 2013-08-31 861065772 Deloitte Tax LLP 191 Peachtree Street Suite 2000 Atlanta GA 303031749 990 2012-09-01 582504530 St Francis Hospital Inc STFR 8642551000 One St Francis Drive Greenville SC 296013955 Ronnie Hyatt 8642551000 2014-07-14 1 David A Craig P00542227 4042201500 2012 2015-11-30 17:44:51Z Mark Nantz One St Francis Drive Greenville SC 296013955 519319508 0 0928 X www.stfrancishealth.org X 1932 SC Provides acute care hospital services. 16 12 2942 343 470273 104980 6091360 3146444 493330144 508363581 758735 2123654 6530587 5497982 506710826 519131661 837228 780122 0 0 168077821 171789747 0 0 0 270309285 279820130 439224334 452389999 67486492 66741662 629460247 690919912 320135936 319668296 309324311 371251616 X The mission is to bring compassion to health care and to be good help to those in need, especially those who are poor and dying. As a system of caregivers, we commit ourselves to help bring people and communities to health and wholeness. 0 0 412629440 780122 509994446 Bon Secours St. Francis Health System (BSSFHS) primarily serves Greenville County, which is comprised of approximately 451,000, in 2012, residents with an 19% population increase over the last decade. 15.3% of residents in Greenville County are in households that fall below the federal poverty guidelines. Currently, 27% of Greenville County residents are considered medically uninsured. Two specific populations with large growth rates in the county are the senior population, with a 17% growth of residents 60 and older since 2000, and the Hispanic population, with an estimated growth of over 147% over the past decade. The three leading causes of death for Greenville County are cancer, cardiovascular disease and accidents. See Community benefit information in Sch H. The Community Benefit Report is available on the SFH website. 412629440 1 1 0 1 0 0 0 0 0 0 1 0 0 0 1 1 0 1 0 0 0 0 0 0 0 0 1 1 1 0 1 0 0 0 0 0 0 1 0 0 0 0 0 1 1 1 1 0 0 1 141 0 1 2942 1 1 1 0 0 0 0 0 0 0 0 0 0 X 16 12 0 0 0 0 1 1 1 1 1 0 0 1 1 1 1 1 1 1 1 1 1 X Ronnie Hyatt 8642551000 One St Francis Drive Greenville SC 296053955 X Charlton Armstrong III MD 2.00 0.00 X 0 0 0 Brother Peter Campbell 2.00 0.50 X 0 0 0 John Castile 2.00 0.00 X 0 0 0 Greg Haselden 2.00 0.00 X 0 0 0 Robert Hitt 2.00 0.00 X 0 0 0 Valerie Hollinger 2.00 0.00 X 0 0 0 Fletcher Kirkland 2.00 0.50 X 0 0 0 Joanie Martin 2.00 0.00 X 0 0 0 Wayne McDonald MD 2.00 0.50 X 0 0 0 Jeff Oak PhD 2.00 48.00 X 0 567670 64067 Linton B Puckett 2.00 0.00 X 0 0 0 Joe Sullivan 2.00 0.00 X 0 0 0 Angela Webb 2.00 0.00 X 0 0 0 Camilla Hertwig 3.00 0.50 X X 0 0 0 Mark Nantz 25.00 25.00 X X 0 952104 80530 Thomas Morris PhD 3.00 47.00 X X 0 522375 52845 Daniel Duggan 48.00 2.00 X 0 495487 42949 Irene Holcombe 50.00 0.00 X 86852 0 14699 Ronnie Hyatt 36.00 14.00 X 445433 0 32744 Teresa Ficicchy 50.00 0.00 X 324827 0 25758 Patricia Fowler 50.00 0.00 X 235591 0 33850 Rose M Leo 50.00 0.00 X 187038 0 25471 Johnna Reed 50.00 0.00 X 249763 0 21438 Fernando Fleites 50.00 0.00 X 328602 0 25903 Elizabeth Keith 50.00 0.00 X 251266 0 19085 John S Pietras 50.00 0.00 X 276478 0 51441 Frank C Smeeks 50.00 0.00 X 503681 0 38379 Jerome J Weems Jr MD 50.00 0.00 X 271766 0 22353 3161297 2537636 551512 141 0 1 0 Sleepworks LLC 554 Hall Road Thomasville GA 31757 Sleep Study 854920 Fayeteville Lithotripters LP PO Box 847324 Dallas TX 75284 Lithotripsy Services 640000 Anesthesia Business Consultant PO Box 77000 Detroit MI 482770181 Billing Services 295534 Carolina Perfusion Assoc Inc 703 Lakewinds BLVD Inman SC 29349 Profusion Services 295183 Upstate Carolina Radiology PA PO Box 27049 Greenville SC 29616 Radiology readings 290847 20 1014851 2131593 3146444 Patient Service Rev. 622110 507141268 507050272 90996 Disprop. Share Income 561499 1222313 1222313 508363581 637176 637176 490956 12667 0 0 490956 12667 503623 13408 490215 1509061 165264 0 187847 1509061 -22583 1486478 1486478 Regency Hospital 900099 1721861 1721861 Supplies - Rebates 900099 1181029 1181029 Cafeteria/Vending/Gift 561499 807913 807913 1283556 365869 917687 4994359 519131661 509994446 470273 5520498 780122 780122 1741633 1567471 174162 135012920 121511628 13501292 6383494 5745145 638349 18100144 16290130 1810014 10551556 9496400 1055156 1056662 950996 105666 210095 189085 21010 21168 19051 2117 10485284 9436756 1048528 2477802 2230022 247780 2971943 2674749 297194 10812596 9731336 1081260 10000063 9000057 1000006 926231 833608 92623 352736 317462 35274 6945682 6945682 17892436 16103192 1789244 2225279 2002751 222528 Medical Supplies 106319592 95687633 10631959 Bad Debt Expense 47058593 47058593 Purchased Services 31125586 28013027 3112559 BSHSI Mgmt. Allocation 15668712 14101841 1566871 13269670 11942703 1326967 452389999 412629440 39760559 0 9550 10864 278689736 318393517 59116396 72411315 13410820 14744505 2423498 1459216 289734008 124984219 157539047 164749789 17673054 19558397 83640996 83640996 16957150 15951313 629460247 690919912 39917502 39604829 280218434 280063467 320135936 319668296 X 309324311 371251616 309324311 371251616 629460247 690919912 X 66741662 98050 -4912407 X 0 1 X 1 1 1 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 0 0 0 0 0 0 0 0 1 21168 21168 0 Explanation of Lobbying Activities: Part II-B, Line 1: The filing organization maintains memberships to various professional healthcare associations. Portions of their membership dues are used for lobbying activities. The lobbying portion of such dues is included on line 1i. 20442764 20442764 161112957 44493415 116619542 1398058 609943 788115 91103627 56962375 34141252 15676602 22918486 -7241884 164749789 Due to BSHSI 259300131 Hospice House liability 7920277 HPL/GL liability 7292924 Third party settlements 4392320 FIN 47 liability 873823 Capital Lease Liability 120000 LT Deferred Rent 163992 280063467 X Description of Uncertain Tax Positions Under FIN 48: Part X, Line 2: Schedule D, Part X, Line 2 requires that the organization provide the text of the footnote to the organization's financial statements that reports the organization's liability for uncertain tax positions under ASC 740 (Formerly FIN48). ASC 740 (Formerly FIN48) addresses the accounting for uncertainty in income taxes recognized in an entity's financial statements and prescribes a threshold of more-likely-than-not for recognition and de-recognition of tax positions taken or expected to be taken in a tax return. The adoption of ASC 740 (Formerly FIN48) by BSHSI on September 1, 2007 did not have a material impact on BSHSI's consolidated financial statements. As the organization does not conduct a separate audit of its financial statements, below is the related statement from the Bon Secours Health System, Inc. consolidated audited financial statements: The System and most of its subsidiaries (including certain joint venture entities) are exempt from federal income taxes under Section 501(c)(3) of the Internal Revenue Code of 1986, as amended. The system accounts for uncertain tax positions in accordance with ASC Topic 740. Income taxes of the System's for-profit subsidiaries are not material to the accompanying consolidated financial statements. The System's taxable subsidiaries have approximately $66,681 and $95,733 of net operating loss carryforwards as of August 31, 2013 and 2012, respectively, which expire in varying periods through 2032 and are available to offset future taxable income. The System's deferred tax assets are fully reserved at August 31, 2013 and 2012. Any changes to the valuation allowance on the deferred tax asset are reflected in the year of the change. 1 1 X 1 X 1 X 1 1 0 1 1 7393175 7393175 0.01820 33390492 32688233 702259 0.00170 40783667 32688233 8095434 0.01990 24 119766 2300133 2300133 0.00570 1 1579 3435712 3435712 0.00850 1 1 21787 21787 0.00010 5 57 689169 689169 0.00170 31 121403 6446801 6446801 0.01600 31 121403 47230468 32688233 14542235 0.03590 4 157 194139 194139 0.00050 2 351 77856 77856 0.00020 1 4261 4261 0.00000 1 27 41693 41693 0.00010 8 535 317949 317949 0.00080 1 8209589 73343638 84591746 -11248108 X 1 1 1 Upstate Surgery Center Ambulatory Surgery Center 0.00580 0.00000 0.00240 2 1 St Francis- Downtown

One St Francis Drive Greenville SC 296013955

http://www.stfrancishealth.org X X X X X 2 St Francis- Eastside

125 Commonwealth Drive Greenville SC 296154812

http://www.stfrancishealth.org X X X X St Francis- Downtown 1 1 X X X X X X X X X 12 1 1 1 X X X X X X X X X X 0 0 1 1 200.000000000000 1 200.000000000000 1 X X 1 1 X X X X X 0 0 1 X 0 0 St Francis- Eastside 2 1 X X X X X X X X X 12 1 1 1 X X X X X X X X X X 0 0 1 1 200.000000000000 1 200.000000000000 1 X X 1 1 X X X X X 0 0 1 X 0 0 22 St Francis Outpatient Center

3 St Francis Drive Floor 12 Greenville SC 29601

Outpatient services St Francis Eastside Outpatient Lab

135 Commonwealth Drive Suite 255 Greenville SC 29615

Outpatient Lab St Francis Rehab

131 Commonwealth Drive Suite 200 Greenville SC 29615

Outpatient Rehabilitation - Physical, Occupational, Speech, & Massage therap St Francis Outpatient Rehab

120 Sumner Street Greenville SC 29601

Outpatient Rehabilitation St Francis Physical Therapy

712 Congaree Rd Greenville SC 29607

Outpatient Rehabilitation St Francis Therapy Services

1130 Grove Rd Greenville SC 29605

Outpatient Rehabilitation St Francis Powdersville Rehab

3407 HWY 153 Piedmont SC 29673

Outpatient Rehabilitation St Francis Physical Therapy

209 Patewood Dr Suite 100 Greenville SC 29615

Outpatient Rehabilitation St Francis Homecare

131 Commonwealth Drive Suite 230 Greenville SC 29615

Homecare Offices McCall Hospice House

1836 West Georgia Rd Simpsonville SC 29680

Hospice St Francis Sleep Disorder Center

3 St Francis Drive Suite 340 Greenville SC 29601

Sleep Disorder Center St Francis Wound Healing Center

131 Commonwealth Drive Suite 100 Greenville SC 29615

Wound Care Rehab Central Registration & Lab

2 Innovation Drive Suite 110 Greenville SC 29607

Registration and Lab HealThy Self Cardiovascular Rehabilitati

2 Innovation Drive Suite 200 Greenville SC 29607

Cardiac/Pulmonary/Vascular Fitness/Diabeties Care Sleep Lab

2 Innovation Drive Suite 340 Greenville SC 29607

Sleep Lab Sports Medicine & Workwell Admin

135 Commonwealth Drive Suite 250 Greenville SC 29615

Workwell & Sports Administration Offices Workwell Occupational Health

135 Commonwealth Drive Suite 120 Greenville SC 29615

Occupational Health/ Employee Health Early Detection & Renewal

2 Innovation Drive Suite 350 Greenville SC 29607

Diagnostics & Early Detection Center Sports & Exe Medi & Phy Therapy

2 Innovation Drive Suite 250 Greenville SC 29607

Sports & Exercise Medicine and Physical Therapy Nu-Life

2 Innovation Drive Suite 330 Greenville SC 29607

Executive Physicals Community Education

2 Innovation Drive Suite 100 Greenville SC 29607

Classroom St Francis Pearlie Harris Breast Ctr

131 Commonwealth Drive Suite 220 Greenville SC 29615

Breast Cancer Treatment Facility Part I, Line 7: Part I, line 7a: Charity Care at cost is computed by applying a cost-to-charge ratio to the aggregate charity adjustments recorded in the general ledger. Part I, line 7b: Unreimbursed Medicaid is computed by determining the cost of Medicaid services supplied less payments received for these services. To determine the cost of Medicaid services provided, a cost-to-charge ratio is applied to traditional and managed Medicaid gross charges recorded in the general ledger. Payments include payments for individual claims, payments from the Medicaid program paid outside the claim process (such as medical education payments) and expected or actual cost report settlements.Part I, line 7b(f): Prior to 2006, Medicaid in the state of South Carolina was reimbursed to hospitals on a fixed prospective basis (fixed rates not directly related to costs). For years 2006 - 2012, the State reimbursed Hospitals on a cost basis (actual costs to provide services). This reimbursement resulted in the hospitals receiving payments close to their costs. Starting is 2013 the State changed reimbursement methodologies to a fixed rate prospective basis (fixed rates not directly related to costs). For the first year the rates state wide were set to approximate the hospital's cost to provide service. For the subsequent years the fixed rate will be adjusted by a state wide inflationary factor and not related to an individual hospitals cost. For 2013 the Hospital's unreimbursed Medicaid percentage for St. Francis Hospital, Inc. is fairly consistent with those of other hospitals in the state. Part I, line 7c: Unreimbursed costs from other means-tested government programs are computed by applying a cost-to-charge ratio to the total charges to patients covered under these programs. The charges are identified by the financial class assigned to the patient. For Part I, Line 7 a-c computations: The cost-to-charge ratio is derived using the suggested computation in Worksheet 2, Ratio of Patient Care Cost-to-Charges. Operating expenses and Gross patient charges are taken from the general ledger. Expenses for nonpatient care activities recorded in operating expenses are approximated as directly equaling other operating revenue, assuming these activities do not provide profit. Part I, line 7e: Community health improvement services and community benefit operations are accumulated throughout the year and reported at actual cost in a software program that specifically addresses this purpose.Part I, line 7f: Health professions education cost is determined as the direct and indirect cost of qualifying education activities as traditionally reported in columns 21-24 on Worksheet B of the Medicare cost report as a Medical Education program, nursing school or other allied health program. Part I, L7 Col(f): Bad debt expense included in Part IX; line 25 and excluded from the "percent of total expense" calculation is: $47,058,593 Community Building Activities Part II The Bon Secours' Building Healthy Communities Initiative was created in 2008 to lead efforts towards building healthier communities in which each Bon Secours facility serves. Using a multi-level process of community engagement, grassroots advocacy, and strategic partnerships with public or private organizations and individuals, the Bon Secours St. Francis Healthy Community Initiative works to strengthen the assets of the community while identifying needs to ultimately improve the overall health of community residents. The Bon Secours St. Francis Healthy Community Initiative seeks to leverage our health care resources, outreach services and programs, clinical expertise, and relationships to best target the sources of poor health rather than just address the symptoms. Part III, Line 4: Part III, line 2: Bad Debt Expense at cost is computed by applying the cost-to-charge ratio computed on Worksheet 2 to the aggregate bad debt expense for patient accounts recorded in the general ledger. Bad debt expense on the general ledger includes: 1) actual write offs of discounted gross charges where it is determined an uninsured patient can pay and does not pay; and 2) the estimated write offs for uninsured patient accounts with outstanding balances after discount. Estimates are based on historical collection rates.When an uninsured patient is billed for patient care services, the charges are automatically discounted and the patient is requested to only pay the amount after discount. The discount is recorded as an adjustment to gross revenue and is not recorded in bad debt expense. If the balance after discount is not paid or not paid in full, the unpaid amount will be written off to bad debt expense. When a patient remits a payment on an account that has already been written off to bad debt expense, the payment is recorded as a recovery of bad debt, which reduces bad debt expense.Part III, line 3: The organization does not report an estimate for the portion of bad debt expense that may have been likely to qualify for financial assistance under the hospital's charity care policy. The organization takes the position that ample opportunity and assistance is provided to the patient to qualify under the financial assistance policy. If sufficient information is not provided, the organization must assume the patient does not qualify. Part III, Line 8: Part III, Line 6: Medicare allowable costs reflected in Part III come directly from the facility's Medicare cost report. The cost report segregates the total facility actual expenses into costs for support departments, clinical departments (routine and ancillary) and nonreimburseable departments. The cost report uses appropriate statistical bases to "step down" support costs to allowable clinical and nonreimburseable departments. The charges for clinical departments are matched to the total cost for these departments for a cost-to-charge ratio. Medicare-specific allowable costs for in- and outpatient ancillary departments are computed by applying the department-specific cost-to-charge ratio to the Medicare program charges by department. For routine departments, a per diem total cost is computed and applied to Medicare program days for the Medicare routine program cost.Part III, Line 8: The organization feels the total shortfall of Medicare reimbursement compared to computed Medicare allowable costs should be treated as community benefit. The hospital improves access to patient care by providing services regardless of a patient's ability to pay or the hospital's ability to receive full cost reimbursement for services. The hospital also relieves the government of a financial burden when it provides care to publically insured patients where reimbursement is less than cost of providing the service. Part III, Line 9b: The hospital has a written policy that describes collection practices applying to patients that qualify for charity care or financial assistance. If full assistance is approved, no collection efforts are pursued on that patient's account(s). If partial assistance is provided, the patient is responsible for the adjusted account balance and collection efforts will follow the established practices for all patients where a self-pay balance exists. Collection efforts are not pursued on any pending Patient Financial Assistance Program (FAP) account.Specific criteria exist for how much financial assistance, partial or total, will be provided to the patient based on the assessed need. Criteria is based on Federal Poverty Guidelines and is reviewed and updated annually. Once a patient has been deemed eligible for the Patient FAP, the patient is notified by letter within 60 days after receipt of the application and supporting documentation. The patient retains eligibility for a period of twelve months from the date of the application. This eligibility is signaled to hospital admissions, billing and collection staff by the assignment of a specific financial class with accompanying eligibility dates. At the end of those twelve months, the patient is responsible for reapplying for FAP eligibility. St. Francis- Downtown Part V, Section B, Line 3: BSSFHS took into account input from persons who represented the community through a county-wide telephone survey, with an over-sampling of low income households. Focus groups were organized to capture perspectives from individuals that represent the chronically ill. Participants included representatives from Taylors Free Medical Clinic, The Greenville Free Medical Clinic, BSSF-Downtown, Faces and Voices of Recovery (substance abuse recovery program), Carolina Centers for Behavioral Health, community residents suffering from chronic disease, AID Upstate, the Greenville County Medical Society, New Horizon Family Health Services, Cancer Society of Greenville, Greenville County EMS and SCDHEC. These focus groups generated insightful perspective on the struggles and strengths of individuals experience in managing a chronic disease in Greenville County. Representatives also discussed common traits and characteristics of the current populations they serve. Expert Interviews were conducted using the NPHPSP (National Public Health Performance Standards Program) Local Public Health System Performance (LPHSA) assessment instrument. This instrument evaluated responses from key experts in the community, measuring how well Greenville County provides the 10 Essential Public Health Services. A serious of 8 group interviews was conducted. Those with special knowledge in public health were consulted throughout the CHNA process. They included Natalie Dougherty (BSSFHS), Lillie Hall (SC Department of Health and Environment Control), Dr. Alicia Powers (Health Sciences professor, Furman University). St. Francis- Eastside Part V, Section B, Line 3: BSSFHS took into account input from persons who represented the community through a county-wide telephone survey, with an over-sampling of low income households. Focus groups were organized to capture perspectives from individuals that represent the chronically ill. Participants included representatives from Taylors Free Medical Clinic, The Greenville Free Medical Clinic, BSSF-Eastside, Faces and Voices of Recovery (substance abuse recovery program), Carolina Centers for Behavioral Health, community residents suffering from chronic disease, AID Upstate, the Greenville County Medical Society, New Horizon Family Health Services, Cancer Society of Greenville, Greenville County EMS and SCDHEC. These focus groups generated insightful perspective on the struggles and strengths of individuals experience in managing a chronic disease in Greenville County. Representatives also discussed common traits and characteristics of the current populations they serve. Expert Interviews were conducted using the NPHPSP (National Public Health Performance Standards Program) Local Public Health System Performance (LPHSA) assessment instrument. This instrument evaluated responses from key experts in the community, measuring how well Greenville County provides the 10 Essential Public Health Services. A serious of 8 group interviews was conducted. Those with special knowledge in public health were consulted throughout the CHNA process. They included Natalie Dougherty (BSSFHS), Lillie Hall (SC Department of Health and Environment Control), Dr. Alicia Powers (Health Sciences professor, Furman University). St. Francis- Downtown Part V, Section B, Line 4: Greenville Health System St. Francis- Eastside Part V, Section B, Line 4: Greenville Health System St. Francis- Downtown Part V, Section B, Line 7: Identified needs through the CHNA that could not be addressed through BSSFHS were asthma, mental health, alcohol/substance abuse, current technology to manage and communicate population health data to the public, and public health policy development. These needs could not be addressed by BSSFHS either because limited resources and infrastructure to address issue, or there are current community organizations that already exist to mitigate the need. St. Francis- Eastside Part V, Section B, Line 7: Identified needs through the CHNA that could not be addressed through BSSFHS were asthma, mental health, alcohol/substance abuse, current technology to manage and communicate population health data to the public, and public health policy development. These needs could not be addressed by BSSFHS either because limited resources and infrastructure to address issue, or there are current community organizations that already exist to mitigate the need. St. Francis- Downtown Part V, Section B, Line 12h: Please see the narrative for Part VI, Line 3regarding the Financial Assistance Policy. St. Francis- Eastside Part V, Section B, Line 12h: Please see the narrative for Part VI, Line 3regarding the Financial Assistance Policy. St. Francis- Downtown Part V, Section B, Line 14g: Please see the narrative for Part VI, Line 3regarding the Financial Assistance Policy. St. Francis- Eastside Part V, Section B, Line 14g: Please see the narrative for Part VI, Line 3regarding the Financial Assistance Policy. St. Francis- Downtown Part V, Section B, Line 20d: Please see the narrative for Part VI, Line 3regarding the Financial Assistance Policy. St. Francis- Eastside Part V, Section B, Line 20d: Please see the narrative for Part VI, Line 3regarding the Financial Assistance Policy. Part VI, Line 2: BSSFHS conducted a comprehensive needs assessment over the course of 18 months, and released it in 2013. The CHNA process included a community telephone survey, secondary data analysis, and focus groups. This was completed with input provided by those with public health knowledge. Additional groups were well-captured through this document, including individuals representing the broad interests of the community, persons with special knowledge of the medically underserved, low-income, minority, and chronic disease populations. This CHNA process will be conducted every three years. Part VI, Line 3: Patient financial assistance policy is communicated to patients verbally upon scheduling, registration, visible postings of the policy in common areas throughout the hospital, brochures and on Bon Secours website. In addition, patient statements request that patients apply for financial assistance, if needed, once any patient financial obligation is determined.Bon Secours is committed to ensuring access to health care services for all. As a health care provider, Bon Secours treats all patients, whether insured, underinsured or uninsured, with dignity, respect and compassion throughout admission, delivery of services, discharge and billing and collection processes. Bon Secours addresses the needs of the uninsured by providing free or reduced fees on hospital services, community outreach efforts to assist with enrollment in Medicaid and other medical coverage programs, including free community-based preventive and primary care services. Bon Secours proactively screens to identify individuals and their families who may qualify for federal, state or local health insurance programs or the Bon Secours Patient Financial Assistance Program (FAP) and assist the potential eligible patients through the qualification process. Potentially eligible patients that do not qualify for a federal or state health insurance program are referred to the Financial Assistance Coordinator located in Patient Financial Services for assistance in completing the documentation required to establish FAP eligibility. Patients are responsible for providing the information necessary to complete the documentation. The FAP aids uninsured and underinsured patients who do not qualify for government-sponsored health insurance and who communicate their inability to pay for their medical care. The FAP provides 100% financial assistance to uninsured patients with annual family incomes at or below 200% of the Federal Poverty Guidelines (FPG), as adjusted by the Medicare geographic wage index for each community served to reflect that communitys relative cost of living (Adjusted FPG). Adjustments to these guidelines are made in certain States, where applicable. A sliding scale assistance policy is afforded patients that exceed the income guidelines for 100% assistance. Sliding scale assistance is provided to patients and progressively declines in proportion to the patient's higher income level. Additionally, all uninsured (i.e. self pay) patients are given a reduction to the amount of the full charges for medically necessary services through a community service adjustment (CSA). The CSA is market adjusted and based on the payment discount received by other health care payers doing business in the community. For these patients, the FAP also sets a maximum annual family payment liability to ensure that no family suffers a catastrophic financial burden to receive necessary health care services. Based on research conducted by the Tax Foundation, a non partisan tax research group based in Washington DC, the maximum annual family liability is based on a sliding scale determined by the family income and size. The standard sliding scale is adjusted by the Medicare geographic wage index of each community served to reflect that community's relative cost of living. All patients are also eligible for a Prompt Pay Discount. In addition, a variety of other potential payment options are available. Bon Secours is dedicated to meeting the needs of non-English speaking patients by having on-site Spanish translators, and other language translation services. In addition, Bon Secours employs a telephone language service which assists in meeting any language needs that arise. The translation services are offered to non-English speaking patients from admission to discharge, including the financial process. Part VI, Line 4: BSSF Downtown primarily serves Greenville County, which is comprised of approximately 450,000 residents. Greenville County is the largest county in the state and one of the fastest growing, with a nearly 18% increase in population over the past decade. As aforementioned, this CHNA was conducted by multiple organizations, including both BSSF-Downtown and BSSF-Eastside facilities. All contributing partners agreed to complete this CHNA for the service area of Greenville County; therefore the identified service area and identified needs overlap both BSSF-Downtown and BSSF-Eastside facility CHNAs. While BSSF-Downtown and BSSF-Eastside will be referenced individually in separate documents, both BSSF-Downtown and BSSF-Eastside work together to fulfill the mission of BSSFHS and will contribute to each other's Implementation Plans.As of 2011, the median household income for Greenville County $48,147 was higher than the median income of South Carolina $44,695, yet a greater percentage of people 18.6% are in poverty than the state poverty rate 17%. Approximately 21% of children under the age of 18 live in poverty. It is estimated that 27% of the county's population, or an estimated 117,578 people, are considered medically uninsured, a higher percentage of residents (27%) than the state percent of uninsured as a whole (23.5%). Part VI, Line 5: BSSFHS has an open medical staff with privileges available to all qualified physicians. BSSFHS operates an emergency room at both of its hospitals which provide services 24 hours a day, seven days a week to ensure access to needed emergency care for all persons. In 2013, the health system was driven by the Bon Secours mission to serve the community by the leadership of a governing board that included 15 members, twelve of whom are representative of the community. BSSFHS supports several community programs through the Bon Secours mission to be "good help to those in need". As part of this mission, BSSFHS provides dedicated staff and services with the sole purpose of measuring the needs of the community and engaging community partners to address the needs. These include the Community Ministries department, the Community Health Outreach department, LifeWisetm (a community initiative targeting adults 55 and older), and Open Arms Hospice, a partnership providing the only community Hospice House in the region. The dedicated staff assist in the following programs and also work to build collaborative partnerships in the community.Access to Oral Health Care Program: The BSSFHS Oral Health Services program provides access to oral health care through an integrated service partnership providing a mutually beneficial relationship between businesses, funding agencies, a dental hygiene training program, and a college of dentistry. The St. Francis Mobile Dental Unit provides the opportunity to reach out to outlying portions of the county and reach populations that face multiple barriers to care, including transportation. The fixed sites at the Greenville Free Medical Clinic and the New Horizon Family Dental Care ensure that a range of comprehensive oral health services are available in the community on a sliding fee scale or at no cost for the underserved. During Fiscal Year 2012-2013, the BSSFHS Oral Health Services program was able to conduct 7,143 oral health screenings, hygiene cleanings, and dental restorations to low income adults and children. Screenings and cleanings were provided by Greenville Technical College dental hygiene students. The Medical University of South Carolina College of Dentistry joined BSSFHS in December of 2010 to create a new model of service for the Mobile Dental Unit. Under the direct supervision of a licensed dentist (employed by BSSFHS) and credentialed faculty from the Medical University of South Carolina, senior dental students performed limited restorative services to underserved populations in our Greenville communities. This new model also allows Greenville Technical College dental assisting students to work in tandem with the Medical University of South Carolina senior dental students to provide comprehensive oral health prevention and dental services, while receiving hands-on-training experience. Care for Families and Children:Annually, BSSFHS provides each family with a 4-year-old kindergarten student residing in Greenville County a self-care manual/resource for accessing appropriate health care in Greenville. The self-care guides are purchased from the American Institute of Preventive Medicine (Health at Home) explains common medical issues and provides a decision tree for how to care for the problem at home and how and when to seek appropriate medical care. On average, this health literacy project, "A Healthy You", documents nearly 50% of families able to avoid one or more visits to the doctor in the past 6 months because of the Health at Home book. In addition, over 60% of families specify that Health at Home books helped them decide when to see a doctor, and thought that the Health at Home books saved them money on medical or health care in the past 6 months.Another way BSSFHS reaches out to families is through supporting of case management of children's services through Communities in Schools (CIS). CIS works to improve services among high-risk children in Greenville County, and works with seven Title I schools in Greenville County (a school is considered Title I when over 60% of students are eligible for free and reduced lunch). Each school involved in the CIS program works directly with school nurses and additional school staff to identify oral health health-related problems of students and determine the barriers to receiving needed oral health care. Services provided by the CIS staff include coordinating the BSSFHS Community Ministries programs and or services in oral health around the needs of preventative education sessions and visits conducted on the Bon Secours St. Francis Mobile Dental Unit. Finally, the Center for Developmental Services (CDS) is a local organization that ensures children with special developmental needs and their families are linked with appropriate interventions in a comfortable, convenient and organized manner; parents, siblings, and caregivers are supported throughout their time in the service delivery system. BSSFHS financially supports the Bilingual Support and Hispanic Outreach program administered by CDS. This program assists thousands of Spanish-speaking families in making certain their children with developmental delays and disabilities receive services in a culturally respective and understandable way. From September 2012 through August 2013 over 48 Hispanic families per month received translation services at CDS because of BSSFHS's involvement. Additionally, BSSFHS unveiled a new, state-of-the-art bilingual kiosk in the CDS waiting area. This kiosk links Spanish speaking families to on-line health resources and information that might not otherwise be available in Spanish. On average, 200 health-related sites are visited each month and over 1,800 families utilized the kiosk CDS services. The kiosk also offers Spanish-language take-home health materials and a telephone available that immediately links the person United Way's 211 system, Greenville County's comprehensive source for community health and human service assistance. Hispanic Outreach through CDS engaged in over 26 community health fairs with an attendance of more than 5,000 participants. Community Health Outreach:Two teams of nursing and social work professionals bring their expansive experience to the community, including bilingual staff. Clients are treated holistically-mind, body, and spirit. By fostering trusting relationships with community members, the health outreach team helps transform hurt into hope, promotes and defends human dignity, and fosters a healing and caring environment. Community Health Outreach (CHO) provides the most vulnerable members of the community with opportunities to improve their health and quality of life, focusing on reaching those who are underserved and uninsured. Staff assist individuals and families with navigating the healthcare system and accessing community resources, including health education, personal safety, and basic life skills. Clients are able to establish a patient-primary care provider relationship, improve overall health, reduce unnecessary emergency department admissions, and decrease readmission to the healthcare system. CHO assists clients with finding affordable health care, medications, medical supplies, transportation, and food/clothing. In 2012, CHO provided over 200 individuals with medication assistance vouchers filling at least 500 medications and approximately 700 bus passes for transportation needs. In addition, our interventions redirected over 250 individuals to primary care that would have gone to the hospital's emergency department for treatment. Additionally, they provided individual and group presentations, screenings, and written literature in addition to annual flu clinics. In 2012, our nurses and social workers had more than 2,000 individual contacts and participated in over 90 events serving 3,000 plus participants. Part VI, Line 6: Bon Secours Health System, Inc., a Maryland nonprofit, nonstock membership corporation (BSHSI), and all of the other entities that are controlled directly or indirectly by Bon Secours, Inc., a Maryland nonprofit, nonstock membership corporation (BSI) are described collectively as the System. BSI, which is the sole corporate member of BSHSI, has no healthcare operations. The System was organized in June 1983 to fulfill the healthcare mission of the United States Province of the Congregation of the Sisters of Bon Secours of Paris, a congregation of religious women of the Roman Catholic Church founded in France in 1824. The System's activities are in the states of New York, Pennsylvania, Maryland, Virginia, Kentucky, South Carolina, and Florida, each referred to as a local system. The Ministry of BSHSI aids those in need, particularly those who are sick and dying, by offering services that include but are not limited to acute inpatient, outpatient, pastoral, palliative, home health, nursing home, rehabilitative, primary and secondary care and assisted living without regard to race, religion, color, gender, age, marital status, national origin, sexual orientation, or disability. BSHSI's vision to bring about the holistic health of the communities it serves is implemented through its Strategic Quality Plan which provides focus in five goal areas for the current three year period (2013-2015). One of those goals was to bring our communities to wholeness. To accomplish this, two key strategies are to: - Improve Health Locally and Globally- Build Partnerships for Population Health As a member of the Catholic health ministry and a member of Bon Secours Health System, Inc. (BSHSI), this organization and it's related entities are called to continue the healing ministry of Jesus. We exist to benefit the people living in the communities it serves. Through all of the services offered to the community, the mission is "to bring compassion to health care and to be good help to those in need, especially those who are poor and dying. As a System of caregivers, we commit ourselves to help bring people and communities to health and wholeness as part of the healing ministry of Jesus Christ and the Catholic Church." This organization and related organizations share the BSHSI Vision. "Inspired by the healing ministry of Jesus Christ and the charism of Bon Secours, Bon Secours Health System will be recognized for its leadership in justice, transforming the communities in which we serve and work into places of health and hope, and being a prophetic voice for systemic US health reform and a more humane world." Please see Schedule R for listings of the related organizations. Reports Filed With States Part VI, Line 7 SC 1 Bon Secours - St Francis Health System Foundation Inc One St Francis Drive Greenville SC 29601 260012031 501(c)(3) 780122 Cost of administrative services provided to the Foundation 1 0 Procedure for Monitoring Grants in the U.S.: Part I, Line 2: Schedule I, Part I, Line 2: The organization complies with Bon Secours Health System, Inc.'s system-wide financial and accounting policies. Contributions are generally made as reimbursements for funds spent. In such cases, the donee/grantee organization must provide documentation to the filing organization before funds are approved for disbursement. 0 1 0 0 0 0 0 0 0 Jeff Oak PhD 0 302204 0 224950 0 40516 0 35752 0 28315 0 631737 0 0 Mark Nantz 0 546573 0 364503 0 41028 0 61960 0 18570 0 1032634 0 0 Thomas Morris PhD 0 265262 0 185027 0 72086 0 33904 0 18941 0 575220 0 14543 Daniel Duggan 0 290135 0 149241 0 56111 0 22875 0 20074 0 538436 0 8837 Ronnie Hyatt 332771 0 68167 0 44495 0 15000 0 17744 0 478177 0 28125 0 Teresa Ficicchy 231479 0 49730 0 43618 0 14233 0 11525 0 350585 0 0 0 Patricia Fowler 166199 0 30542 0 38850 0 24602 0 9248 0 269441 0 10048 0 Rose M Leo 140631 0 26444 0 19963 0 9715 0 15756 0 212509 0 0 0 Johnna Reed 178113 0 32439 0 39211 0 11912 0 9526 0 271201 0 0 0 Fernando Fleites 190415 0 43051 0 95136 0 8298 0 17605 0 354505 0 0 0 Elizabeth Keith 145825 0 34743 0 70698 0 9936 0 9149 0 270351 0 27522 0 John S Pietras 174544 0 78389 0 23545 0 23411 0 28030 0 327919 0 9300 0 Frank C Smeeks 324452 0 73500 0 105729 0 13566 0 24813 0 542060 0 0 0 Jerome J Weems Jr MD 214268 0 54995 0 2503 0 12946 0 9407 0 294119 0 0 0 Part I, Line 3 Bon Secours Health System, Inc., a related organization of the filing organization uses the following to establish the compensation of the organization's CEO/Executive Director: Compensation Committee Independent Compensation Consultant Written Employment Contract Compensation Survey or Study Approval by the Board or Compensation Committee Supplemental Information Part III Part I, Lines 4b: The filing organization participates in a BSHSI sponsored executive retirement program that allows for deposits into additional retirement plans and available only to key employees. The 457F plan is a non-qualified plan and is subject to a minimum three-year service requirement before vesting on deposits made into this plan. Individuals that received a distribution include: Thomas Morris, Ph.D., $23,265; Elizabeth Keith, $31,484; Ronnie Hyatt, $39,089; John S. Pietras, $16,114; Daniel Duggan, $13,203; Patricia Fowler, $18,294. Katie Hertwig Daughter-in-law of BM Camilla Hertwig 158260 Employment 0 Form 990, Part VI, Section A, line 6 Bon Secours Health System, Inc. is the sole member of Bon Secours St. Francis Health System, Inc., which in turn is the sole member of St. Francis Hospital, Inc. Form 990, Part VI, Section A, line 7a The governing body of St. Francis Hospital, Inc. is appointed by its member Bon Secours St. Francis Health System, Inc. and subject to approval by Bon Secours Health System, Inc. Form 990, Part VI, Section A, line 7b Certain authorities of St. Francis Hospital, Inc. are reserved to its member or to Bon Secours Health System, Inc. Form 990, Part VI, Section B, line 11 The process the organization uses to review the Form 990 consists of a review by the local system's audit and compliance board-committee and providing the form to the local system board of directors to allow for a thorough review by both before the filing date. The local system's audit and compliance committee and board of directors have reviewed the Form 990, scheduled time on meeting agendas, and asked questions regarding the Form 990 before the return is filed. Form 990, Part VI, Section B, line 12c The organization regularly and consistently monitors compliance with the conflict of interest policy. On an annual basis, all persons subject to the policy, including all officers, directors and key employees are required to make certain disclosures. These include disclosures related to certain personal, financial and organizational relationships that may present a conflict, or the appearance of a conflict of interest with the organization. All disclosures go through a three-part review process: (1) disclosures are reviewed first by the corporate responsibility officer (CRO); (2) a governance team comprised of the CEO, board president, board chair, CRO, and the BSHSI CRO participate in a second review of all disclosures during which recommendations are made as to the resolution of any conflicts or potential conflicts. Depending on the facts and circumstances, resolutions may include ongoing disclosure, recusal or removal of the conflict; and (3) all disclosures and recommendations are reviewed by a board committee (audit and compliance committee reviews the disclosures of management and the governance committee reviews the disclosures of the board and board committee members). Form 990, Part VI, Section B, line 15 The compensation committee of the board of Bon Secours Health System, Inc. (BSHSI) engages in a comprehensive process for the oversight and management of remuneration for executive employees and disqualified parties of the BSHSI. The compensation committee consists of a group of independent board members and engages independent external compensation consultant to ensure they receive appropriate analysis of market and follow the practices necessary to obtain full compliance with the IRS' rebuttable presumption of reasonableness. The committee establishes and maintains a compensation philosophy; reviews pay practices against local, regional and national healthcare organizations and approves all remunerative decisions for this group of individuals. The committee reviews and receives assurances that all levels of pay within the organization are reasonable based on performance and validates incentives are met. These decisions are documented in the BSHSI board of directors' and compensation committee minutes. Form 990, Part VI, Section B, Line 15b - Compensation Process Other Officers/Key Employees: For those key employees and highest paid employees that are not reviewed by the BSHSI compensation committee, the process included a review and approval by independent persons, comparability data, and contemporaneous substantiation of the deliberation and decision. In the review, the other officers or key employees of the organization were compared to other hospitals' employees in the area that hold the same title. During the review and approval of the compensation, documentation of the decision was recorded in human resources. Form 990, Part VI, Section C, line 19 The filing organization provides any documents open to public inspection upon request. Avg hours devoted to related org(s) when related comp is reported: Form 990, Part VII: Board Member positions are generally voluntary in nature. Compensated employees of the filing organization and other related organizations who also hold board positions are compensated only in relation to their employment and do not receive additional compensation for their board responsibilities. Changes in Net Assets or Fund Balances: Form 990, Part XI, line 9: Transfers to BSHSI for principal and swap -5,215,919. Distributions from JV 303,512. Physicians' Surgery Center at St Francis LLC One St Francis Drive Greenville SC 29601 No Activity SC 0 0 St Francis Hospital Inc Bon Secours Health System Inc 1505 Marriottsville Road Marriottsville MD 21104 521301088 Parent Org. - Management Services MD 501(c)(3) 11b Bon Secours Inc 0 Bon Secours St Francis Health System Inc One St Francis Drive Greenville SC 296013955 582504528 Local System Parent Org. SC 501(c)(3) 11b Bon Secours Health System Inc 0 Bon Secours St Francis Health System Foundation Inc One St Francis Drive Greenville SC 296013955 260012031 Grant Making Foundation SC 501(c)(3) 7 St Francis Hospital Inc 1 St Francis Physician Services One St Francis Drive Greenville SC 296013955 134290167 Physician Services SC 501(c)(3) 11a Bon Secours St Francis Health System Inc 0 Upstate Surgery Center One St Francis Drive Greenville SC 296013955 562186977 Ambulatory Surgery Center SC St Francis Hospital Inc Related 450978 1000808 0 0 0.58090 Health Care Enterprises Inc One St Francis Drive Greenville SC 296013955 571012852 Holding Company SC St Francis Health System Inc C 0 0 1 1 0 0 0 0 0 0 1 0 1 1 0 0 1 1 1 1 Bon Secours - St Francis Health System Foundation Inc B 780122 Actual Bon Secours - St Francis Health System Foundation Inc C 1014851 Actual Upstate Surgery Center L 90996 Cost Upstate Surgery Center R 303512 Actual