2014-05-15T11:29:20-05:00 2013-06-30 861065772 Deloitte Tax LLP 250 E Fifth Street Suite 1900 Cincinnati OH 45202 990 2012-07-01 820204264 St Joseph Regional Medical Center STJO 2087995470 PO Box 816 415 Sixth Street Lewiston ID 83501 Michael Rooney 2087995470 2014-05-15 1 Rebecca Lyons P01487105 5137847100 2012 2015-11-30 17:44:51Z Timothy P Sayler PO Box 816 415 Sixth Street Lewiston ID 83501 142592039 0 0928 X www.sjrmc.org X 1918 ID Provides inpatient, outpatient and emergency care services. 12 12 1097 125 489 -1018 62210 117856 133127067 138731958 3091433 2936652 9107964 579816 145388674 142366282 230996 233342 0 0 60631606 65010669 0 0 291355 67920552 67902699 128783154 133146710 16605520 9219572 145014763 162181366 43817211 53092148 101197552 109089218 X The organization's mission is to deliver health care services to the communities of Lewiston, ID, Clarkston, WA and the surrounding small communities. 0 0 108742829 233342 138731958 As a member of Ascension Health, the nation's largest Catholic Healthcare System, St. Joseph Regional Medical Center ("SJRMC") continues to build and strengthen sustainable collaborative efforts that benefit the health of individuals, families and society as a whole. The goal of SJRMC is to perpetuate the healing mission of the Church. SJRMC furthers this goal through the delivery of patient services, the provision of care to the elderly and indigent, and the creation of patient education and health awareness programs for the community. Our concern for all human life and the dignity of each person leads the organization to provide medical services to all people in the community without regard to the patient's race, creed, national origin, economic status or ability to pay. See Schedule H. 108742829 1 1 0 1 0 0 0 0 0 0 1 0 0 1 1 0 0 1 0 0 0 0 0 0 0 0 1 1 1 1 1 0 0 0 0 0 0 0 0 0 0 0 0 0 1 1 1 0 0 1 101 0 1 1097 1 1 1 0 0 0 0 0 0 0 0 0 0 X 12 12 0 0 0 0 1 1 1 1 1 0 0 1 1 1 1 1 1 1 1 0 ID X Ken Harris 2087995470 415 Sixth Street Lewiston ID 83501 Mike Thomason 1.00 0.00 X 0 0 0 Sr Esther Polacci 1.00 0.00 X 0 0 0 Kent Anderson MD 1.00 0.00 X 0 0 0 Butch Alford 1.00 0.00 X 0 0 0 Colin Doyle MD 1.00 0.00 X 0 0 0 Sr Kathleen Ann DuRoss 1.00 0.00 X 0 0 0 Donn Durgan 1.00 0.00 X 0 0 0 Tony Fernandez 1.00 0.00 X 0 0 0 Joe Hall 1.00 0.00 X 0 0 0 Sr Anne McMullen 1.00 0.00 X 0 0 0 Paul J Sanchirico MD 1.00 0.00 X 0 0 0 Jody Servatius 1.00 0.00 X 0 0 0 Timothy P Sayler 40.00 0.00 X 387655 0 31527 Thomas Safley 40.00 0.00 X 266523 0 26766 Kathleen Connerley 40.00 0.00 X 179316 0 13142 Brenda Forge 40.00 0.00 X 212915 0 31537 Bobby Joe Jones 40.00 0.00 X 175588 0 24317 Michael Rooney 40.00 0.00 X 222297 0 25088 John Ho 40.00 0.00 X 524665 0 24264 Binay K Shah 40.00 0.00 X 469206 0 22774 Katrina A Popham 40.00 0.00 X 529848 0 19465 Gerardo Midence 40.00 0.00 X 579258 0 42296 Sushma Pant 40.00 0.00 X 547590 0 22591 4094861 0 283767 61 0 1 0 Pathologists Regional Laboratory PO Box 956 Lewiston ID 83501 Laboratory Services 6095238 Lewiston ER Physicians Banner Bank PO Box 1628 Lewiston ID 83501 Physician Services 2658287 TriMedx LLC PO Box 1627 Indianapolis IN 46278 Professional Services 1973329 Touchpoint Support Services PO Box 102289 Atlanta GA 303882289 Dietary/Environmental Services 1802457 Cardio Solutions 4270 Glendale Milford Road Cincinnati OH 45242 Physician Services 1250000 18 64489 53367 117856 Net Patient Services 621990 138731958 138731958 138731958 3024608 3024608 411690 105851 305839 305839 305839 31950 119906 -87956 -87956 -87956 Gift Shop 453220 199689 199689 Non-Operating Income 621990 73799 73799 Catering Revenue 722320 489 489 273977 142366282 138731958 489 3515979 211818 211818 21524 21524 1538100 75907 1457133 5060 51819270 43625774 8193496 -488006 -399101 -88905 8612621 7043576 1569045 3528684 2885829 642855 147508 147508 93737 93737 15181 15181 8158192 7433179 725013 54499 54499 513502 395434 118068 4549345 4549345 3002830 652591 2350239 490070 275419 214651 936864 936864 1077473 1077473 4825006 3920920 904086 365237 299221 66016 Supplies - Med & Other 31663448 30650433 1013015 0 Purchased Services 8857244 8857244 0 0 Provider Tax 768114 768114 0 0 Minor Equipment 398732 308341 90391 1985717 623952 1075470 286295 133146710 108742829 24112526 291355 10673754 3454506 19458645 21606471 0 0 3015894 2875016 557054 545379 89354052 47049483 42803157 42304569 6635595 68506259 84759830 145014763 162181366 9860259 17752221 118034 170 33838918 35339757 43817211 53092148 X 101197552 109089218 0 0 101197552 109089218 145014763 162181366 X 9219572 2187307 -3515213 X X 0 1 X 1 0 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 0 1 0 0 0 0 1 9057 0 1 15181 24238 0 Explanation of Lobbying Activities: Part II-B, Line 1: Lobbying expenses represent the portion of dues paid to national and state hospital associations that is specifically allocable to lobbying. Additionally, dues are paid to Rural Referral Center/Sole Community Hospital Coalition to lobby on behalf of St. Joseph Regional Medical Center. St. Joseph Regional Medical Center does not participate in or intervene in (including the publishing or distributing of statements) any political campaign on behalf of (or in opposition to) any candidate for public office. 0 5039714 5039714 52225589 23263351 28962238 30280414 23461973 6818441 1808335 324159 1484176 42304569 Other Receivables 71118 Intercompany Receivables - TriMedx 69185 Interest in Investments Held by Ascension Health Alliance 75636303 Prepaid Pension 7987643 Other Miscellaneous Current Assets 995581 84759830 Intercompany Debt with Ascension Health Alliance 26791675 Payable to Third Party Payors 5651697 Self-Insurance Liability 939079 Asset Retirement Obligation 327306 Valuation Allowance Liability 1630000 35339757 1 1 X 1 X 1 X 1 1 1 0 1 1 3359479 3359479 0.02520 15783534 14708536 1074998 0.00810 0.00000 19143013 14708536 4434477 0.03330 258405 258405 0.00190 320349 320349 0.00240 10275290 8879342 1395948 0.01050 0.00000 283779 283779 0.00210 11137823 8879342 2258481 0.01690 30280836 23587878 6692958 0.05020 0.00000 10000 10000 0.00010 115303 115303 0.00080 0.00000 10162 10162 0.00010 3690 3690 0.00000 0.00000 20032 20032 0.00100 0.00000 159187 159187 0.00200 0 4877852 200811 58332555 67137783 -8805228 X 1 1 1 1 St Joseph Regional Medical Center

415 Sixth Street Lewiston ID 83501

www.sjrmc.org X X X St Joseph Regional Medical Center 1 1 X X X X X X X X X 12 1 0 1 X X X X X X 0 0 1 1 100.000000000000 1 200.000000000000 1 X X X X X X X 1 1 X X 1 0 1 X 0 0 4 SJRMC Outpatient Mental Health Clinic

428 6th Avenue Lewiston ID 83501

Medical Health Clinic SJRMC Lewiston Medical Center

307 St Johns Way Lewiston ID 83501

Medical Clinic SJRMC St Joseph Medical Oncology

1250 Idaho Street Lewiston ID 83501

Oncology Center SJRMC Radiation Oncology Center

504 Sixth Street Lewiston ID 83501

Oncology Center Part I, Line 7: The cost of providing charity care, means tested government programs, and community benefit programs is estimate using internal cost data and is in compliance with Catholic Health Association ("CHA") guidelines. The best data available was used to calculate the amount reported in the table. For certain categories in the table, this was direct costs from the general ledger, in other categories, a specific cost-to-charge ratio was used. Part I, Line 7g: The Medical Center provides in-kind clinical space (Value of $33,804) to the Lewis and Clark Clinic, a Federally Qualified Health Clinic serving the primary care needs in our geographic region. Part II: The St. Joseph Regional Medical Center ("St. Joseph") also provided services to meet additional community needs by supporting other health awareness, education and health promotion activities in the community as outlined below: - St. Joseph was an integral member of the Local Access to Care Committee that looked at available options to increase access to primary care. Working with the Community Health Association of Spokane, a grant for $1.3 million was secured. Following this, a Federally Qualified Health Clinic opened on July 1, 2009 as the Lewis Clark Health Clinic ("LCHC"). LCHC addresses access issues for all patients especially those with Medicare, Medicaid and no insurance. During its first year, St. Joseph provided free clinic space and provided $10,000 per month operating subsidy. By the end of that year, LCHC had recruited one full time physician's assistant and a .75 nurse practioner and established a medical home for over 1,700 patients. During its second year of operation, the cash contribution was no longer necessary, but St. Joseph continued to provide space without cost to the clinic. - Due to the rural nature of Idaho and Southeastern Washington, a shortage of mental health professionals exists. St. Joseph has developed strategies to address this issue by working with legislators to fund programs, continuing to develop mental health telemedicine involvement with Idaho's Region II hospitals and educating the region, professionals and non-professionals by sponsoring/facilitating the annual Rural Mental Health Symposium event. The Mental Health Center also has a Speaker Bureau Program where the Center's mental health physicians are available to speak on educational and informational topics. This is a free program. - St. Joseph purchased a Mobile Mammography Vehicle to provide mobile mammography and PACS access to some of the rural hospitals and clinics in the area who are otherwise unable to provide those services. The vehicle visits several outlying areas and hospitals at least once a month.- St. Joseph Regional Medical Center Foundation offered a series of free "Your Doctor Speaks" Programs covering four different healthcare topics presented by local physicians and national speakers. Almost 200 people attended these seminars. - St. Joseph Regional Medical Center Foundations "Think First" Program, which works with the local school districts, teaches head and spinal cord injury prevention to elementary and junior/senior high classes. - St. Joseph's Senior Life Program for adults over age 60 assisted 269 seniors with Medicare Part D through its pharmacy program. This program is free and open to the public. The coordinator of this program helped seniors sign up for Medicare Part D and select the options that best serve their needs. She also helped them sign up for medication assistance programs that made it possible for them to acquire medications that they could not otherwise afford.- The Outpatient Diabetes Education Center offered free monthly education classes covering a variety of topics from eyesight to proper nutrition. These classes are offered at no expense to the participants in an ongoing effort to continue to educate the public on the management of diabetes.- St. Joseph offers a free monthly stroke support educational class that covers a variety of topics for those who have suffered a stroke and their caregivers. Topics range from what normal emotions are after suffering a stroke to what resources are available.- St. Joseph's Community Health Education Center held an open house for our new cardiology service line to promote heart health. The open house included nutrition and exercise tips - all in an effort to improve the heart health in our service area. - Family Beginnings (nursery) service line holds several free classes for mothers and families, both pre and post delivery. The classes cover everything from how to properly breastfeed to a siblings class so older brothers and sisters know what to expect when a new baby comes home. Family Beginnings also holds children car seat inspections to make sure they are properly installed.- St. Joseph holds an annual Grief Workshop for those who have recently lost a loved one or who are struggling with their emotions of grief. St. Joseph also holds quarterly prayer services for those who have lost a loved one.- Our Rehabilitation Services started the first Autism Support Group in the Region. The group is scheduled to meet monthly and the meetings are free and open to all. Part III, Line 4: The provision for doubtful accounts is based upon management's assessment of expected net collections considering economic conditions, historical experience, trends in healthcare coverage, and other collection indicators. Periodically throughout the year, management assesses the adequacy of the allowance for uncollectible accounts based upon historical write-off experience by payor category, including those amounts not covered by insurance. The results of this review are then used to make any modifications to the provision for bad debts to establish an appropriate allowance for doubtful accounts. After satisfaction of amounts due from insurance and reasonable efforts to collect from the patient have been exhausted, the System follows established guidelines for placing certain past-due patient balances with collection agencies, subject to the terms of certain restrictions on collection efforts as determined by the System. Accounts receivable are written off after collection efforts have been followed in accordance with the System's policies.St. Joseph Regional Medical Center's bad debt deduction from in 2013 was $4,877,852 at charges. Part III, Line 8: St. Joseph Regional Medical Center follows the Catholic Health Association ("CHA") guidelines for determining community benefit. CHA community benefit reporting guidelines suggest that Medicare shortfall is not treated as community benefit. Part III, Line 9b: St. Joseph Regional Medical Center has a written debt collection policy that also includes a provision on the collection of practices to be followed for patients who are known to qualify for charity care or financial assistance. If a patient qualifies for charity care or financial assistance, certain collection practices do not apply. St. Joseph Regional Medical Center Part V, Section B, Line 3: A development team composed of a diverse group of representatives from St. Joseph Regional Medical Center, Idaho North Central District Health Department, local and regional hospitals and clinics, local social services agencies and community members. Representatives helped guide the formation of the Community Health Needs Assessment ("CHNA") process and provided key insights and involvement in the design and implementation of the CHNA. The development team met throughout the process to review the proposed plan design, review preliminary results, assist with prioritization of the identified needs and provide input into potential responses to the identified needs.Carol Moehrle, District Director, Idaho North Central District Health Department, Lewiston, ID provided special input throughout the process. For the past twenty years Carol has served as the District Director for North Central Idaho, which covers 13,500 square miles and a combined population of approximately 120,000. Carol is also active with the National Association of County and City Health Officials. She has served on the Board of the National Association of County and City Health Officials (NACCHO), the Public Health Accreditation Board (PHAB), and the National Association of Counties (NACo). St. Joseph Regional Medical Center Part V, Section B, Line 7: St. Joseph Regional Medical Center ("St. Joseph") recognizes the significance of all needs/concerns and their importance identified by the community. St. Joseph will not directly design strategies for every issue/need identified in the survey in the implementation plan because of our desire to be focused on the needs identified as most critical, and because the other issues are already being addressed in a variety of ways by St. Joseph's as well as other community partners, stakeholders and agencies. St. Joseph will continue to collaborate with key community partners, stakeholders and agencies to support initiatives and strategies to meet the needs of the community. St. Joseph Regional Medical Center Part V, Section B, Line 14g: St. Joseph Regional Medical Center posts plain language versions of the charity policy on the web and in the emergency room. St. Joseph Regional Medical Center Part V, Section B, Line 20d: All uninsured patients receive a minimum discount of at least 6%. Individuals whose income is at or below 100% of FPG received a charity care write-off equal to 100% of amounts billed. Individuals whose income is between 101% and 200% of FPG receive a charity care write-off between 90% and 5% of amounts billed based on a sliding scale. Part VI, Line 2: Recognizing the importance of a healthy community and desiring to respond to the needs of the community and region, St. Joseph Regional Medical Center ("St. Joseph") partnered with numerous community organizations that represented the broad interest of the community to conduct a Community Health Needs Assessment ("CHNA") from November to December, 2012. St. Joseph's objective was to align its mission with the vocalized needs of the community by creating a document that would serve as a key component of our Strategic Plan. The CHNA consisted of a survey, focus group sessions and a secondary data analysis of national, state and local demographics and community health database.Health needs identified through this process include: - Obesity - Heart disease and stroke - Diabetes care and management - Cancer - Mental health - Access to healthcareUsing the results of the Community Health Needs Assessment, St. Joseph seeks to improve the health of our community through actions, not just words. Part VI, Line 3: St. Joseph Regional Medical Center ("St. Joseph") financial assistance is available to all patients. St. Joseph's financial assistance notice is posted in all registration areas, the emergency department and the business services department. Information also is available online at www.sjrmc.org. Financial assistance applications are available at all registration areas, the business services offices and online on the St. Joseph web site. St. Joseph makes every attempt to identify/assist patients who may be eligible for charity or discounted care through St. Joseph's Charity Care Policy. A financial assistance counselor is available to all patients. The business office staff is trained on how to qualify patients for Medicaid, County Assistance and other payment programs. The financial assistance counselor discusses with patients the availability of various government assistance programs and assists the patient with qualifying for such programs. As a result of a grant through the state of Washington, a Medicaid eligibility case worker assists Washington applicants with their application process. The written summary and contact information is also provided in billing communications with patients. For the patient who has limited English proficiency, interpreter services are available at no charge. Part VI, Line 4: St. Joseph Regional Medical Center ("St. Joseph") is located in Lewiston, ID and serves residents of a nine county region including the Idaho counties of Nez Perce, Latah, Idaho, Clearwater and Lewis, the Washington counties of Asotin, Garfield and Whitman and the Oregon County of Wallowa. The primary service area consists of the Lewis-Clark Valley, home to over 60,000 people. Throughout the region an additional 122,000 people reside. In total, St. Joseph seeks to meet the needs of more than 180,000 people residing in over nearly 20,000 square miles. St. Joseph is the only full service Medical Center in the region with nine Critical Access Hospitals in the immediate geographic area. St Joseph provides approximately 80% of the inpatient acute care hospital services in its primary care area and 40% of the inpatient services in its regional service area. In FY13, St. Joseph served 4,494 men, women and children as inpatients, 546 mental health inpatients and 793 newborns, and an additional 117,421 outpatient visits occurred. St. Joseph provides a substantial portion of its services to the elderly and poor. In FY13, approximately 52.0% of services rendered were to elderly patients under the Medicare program, approximately 11.1% of the services were provided to patients with Medicaid Insurance and an additional 9.7% of services were provided to patients with other governmental types of insurance, county insurance or no insurance. St. Joseph provided $3,359,478, in unpaid costs of providing traditional charity care, $1,074,998 in unpaid costs of providing government sponsored health care, and $1,021,720 in unpaid costs of community health services, and $1,395,948 net cost of subsidized health services. Part VI, Line 5: St. Joseph Regional Medical Center ("St. Joseph") recognizes that it cannot meet all the community needs and has therefore collaborated with numerous community organizations to improve community health, expand access to healthcare, and benefit the community. In FY 13, St. Joseph supported and/or funded: - St. Joseph provided $312,999 in support to local ambulance and EMS support services, including training rural EMS services, by providing clinical locations and workforce experience. - St. Joseph maintained a Community Health Education Resource Center, at the expense of $145,865, in FY13 to provide health education information to associates, students and community members. - As the regional referral center, St. Joseph leads the way in preparing the region for emergency situations. In FY13, $105,904 was expended to train and educate community and regional partners in Emergency Preparedness. - St. Joseph funded health education scholarships, at the expense of $34,500, for books and tuition for students enrolled in clinical education at local colleges to expand the availability of qualified health workers in the future. - St. Joseph matched associate contributions to the local United Way, at the expense of $32,339, an agency which provides supplemental support to non-profit agencies. - Nursing Faculty at Lewis Clark State College were subsidized, at the expense of $44,000, by St. Joseph to enable increased nursing student enrollment. - The Snake River Community Clinic, a volunteer-staffed community clinic, which serves uninsured patients two nights per week, was supported by St. Joseph in the amount of $44,015. - St. Joseph operates the Carondelet House, on St. Joseph's campus, which provides free housing to patients and families. In FY13, SJRMC spent $13,950 housing people in need at the Carondelet House. - Indigent patients were provided funds, at the expense of $21,524, to purchase prescriptions and receive social services assistance, at the expense of $16,298. - St. Joseph supported Senior Services, including Meals on Wheels, and Senior Life, a program for adults over 60 years old that provides assistance to seniors with Medicare Part D, ongoing wellness programs and workshops for over 1,200 members. - St. Joseph engages in the training and education of caregivers to help address the shortages of trained clinicians and expand the availability of skilled caregivers to meet the health care needs of the region. St. Joseph has developed an extensive affiliation program with educational institutions throughout the Pacific Northwest, including Lewis-Clark State College, Walla Walla Community College, Washington State University, University of Washington, and Gonzaga University. In FY13, St. Joseph partnered with 12 educational programs to provide a clinical teaching site for 446 students, including 287 nursing students, 15 medical school students, 42 EMT/Paramedic Students, 20 Pharmacy Tech students and 12 Radiology students. St. Joseph does not engage in medical or scientific research programs.- St. Joseph believes that in order to provide the best health care to the community, all the associates, especially its clinical personnel, must receive ongoing medical education. See Appendix A for a complete list of the classes, seminars, and materials that SJRMC has provided to its associates, clinical staff and the community.St. Joseph's primary mission is to continue Christ's mission of mercy by meeting the health care needs of the individuals in the community. No one requiring medical care or services offered by St. Joseph is turned away regardless of race, creed, religion, national origin, sex, ability to pay or economic status. As the region's leader in the delivery of health care services, St. Joseph has, and will continue to accept the responsibility to contribute to the overall health and welfare of our community. St. Joseph is deeply committed to our community to help assure residents live healthy and productive lives through cost effective and quality healthcare and education services. St. Joseph offers a variety of services and programs that are not found elsewhere in the region and is constantly monitoring and assessing the needs of the region to ensure quality health care. Through our commitment to providing community benefit, St. Joseph has engaged in the following activities to ensure that our mission is accomplished: - St. Joseph is fully accredited by the Joint Commission and provides level III Adult/Pediatric trauma services. - St. Joseph operates an Emergency Room and Minor Care that is open 24/7 and serves all persons regardless of their ability to pay. - St. Joseph provides many inpatient and outpatient services to all persons while participating in Medicare, Medicaid, county insurance, TriCare, Indian Health Services and/or other government health care programs to assure access for patients. - St. Joseph's medical staff privileges are open to any qualified physician in the region. In FY13, SJRMC's medical/dental staff included 137 physicians (89% board certified), specializing in 30 fields. The active/associate medical/dental staff represents 74% of the total physicians, while 21% physicians have courtesy privileges and 5% have consulting privileges. - St. Joseph has a governing Board of Directors that consists of independent persons who represent the community. The governing body includes leaders in the religious community, the physician community and the local community. Part VI, Line 6: St. Joseph Regional Medical Center is a member of Ascension Health Alliance. Ascension Health Alliance is a Missouri nonprofit corporation formed on September 13, 2011. Ascension Health Alliance is the sole corporate member and parent organization of Ascension Health, a Catholic national health system consisting primarily of nonprofit corporations that own and operate local healthcare facilities, or Health Ministries, located in 23 of the United States and the District of Columbia.Ascension Health Alliance is sponsored by Ascension Health Ministries, a Public Juridic Person. The Participating Entities of Ascension Health Ministries are the Daughters of Charity of St. Vincent de Paul in the United States, St. Louise Province; the Congregation of St. Joseph; the Congregation of the Sisters of St. Joseph of Carondelet; the Congregation of Alexian Brothers of the Immaculate Conception Province, Inc. American Province; and the Sisters of the Sorrowful Mother of the Third Order of St. Francis of Assisi - US/Caribbean Province. As more fully described in the Organizational Changes note, Marian Health System, which was previously sponsored by the Sisters of the Sorrowful Mother of the Third Order of St. Francis of Assisi - US/Caribbean Province, became part of Ascension Health on April 1, 2013. In addition, Alexian Brothers Health System, which was previously sponsored by the Congregation of Alexian Brothers of the Immaculate Conception Province, Inc. - American Province, became part of Ascension Health on January 1, 2012.St. Joseph Regional Medical Center, located in Lewiston, Idaho, furthers its charitable purposes by providing a broad array of services to meet the healthcare needs of patients and organizations in the community. St. Joseph Regional Medical Center provides essential medical services to the community, trains and recruits healthcare professionals to serve the needs of the broader community, provides appropriate charity services to those patients who are not able to pay for their own healthcare needs, provides services to other organizations that allow them to provide quality services to their patients or constituents, and presents educational information classes and activities to the community in order to improve its overall health status. St. Joseph Regional Medical Center is related to Ascension Health's other sponsored organizations through common control. Substantially all expenses of Ascension Health and its sponsored organizations are related to providing health care services.Mission: The System directs its governance and management activities toward strong, vibrant, Catholic Health Ministries united in service and healing, and dedicates its resources to spiritually centered care which sustains and improves the health of the individuals and communities it serves. In accordance with the System's mission of service to those persons living in poverty and other vulnerable persons, each Health Ministry accepts patients regardless of their ability to pay. The System uses four categories to identify the resources utilized for the care of persons living in poverty and community benefit programs:1. Traditional charity care includes the cost of services provided to persons who cannot afford healthcare because of inadequate resources and/or who are uninsured or underinsured.2. Unpaid cost of public programs represents the unpaid cost of services provided to persons covered by public programs for the persons living in poverty and other vulnerable persons.3. Cost of other programs for the persons living in poverty and other vulnerable persons includes programs intentionally designed to serve the persons living in poverty and other vulnerable persons of the community including substance abusers, the homeless, victims of child abuse and persons with acquired immune deficiency syndrome.4. Community benefit consists of the unreimbursed costs of community benefit programs and services for the general community, not solely for persons living in poverty and other vulnerable persons, including health promotion and education, health clinics and screenings and medical research.Discounts are provided to all uninsured patients, including those with the means to pay. Discounts provided to those patients who did not qualify for assistance under charity care guidelines are not included in the cost of providing care of persons living in poverty and community benefit programs. The cost of providing care to persons living in poverty and community benefit programs is estimated by reducing charges forgone by a factor derived from the ratio of each entity's total operating expenses to the entity's billed charges for patient care.Certain costs such as graduate medical education and certain other activities are excluded from total operating expenses for purposes of this computation. The amount of traditional charity care provided, determined on the basis of cost, was $524,605 and $466,916 for the years ended June 30, 2013 and 2012, respectively. The amount of unpaid cost of public programs, cost of other programs for persons living in poverty and other vulnerable persons, and community benefit cost is reported in the accompanying supplementary information. Community Benefit Report St. Joseph Regional Medical CenterFor the Year Ended June 30, 2013 St. Joseph Regional Medical Center (St. Joseph) is a private, non-profit, Catholic hospital founded in 1902 by the Sisters of St. Joseph, currently a member of Ascension Health and designated a sole community hospital. As a member of Ascension Health, the nation's largest Catholic and largest non-profit healthcare system, St. Joseph continues to invest in the health and well-being of individuals, families, and society as a whole. Ascension Health directs its governance and management activities toward strong, vibrant, Catholic Health Ministries united in service and healing, and dedicates its resources to spiritually centered care which sustains and improves the health of the individuals and communities it serves. In accordance with Ascension Health's mission of service to those who are poor and vulnerable, each Health Ministry accepts patients regardless of their ability to pay. St. Joseph has a long history of providing community benefit to residents of the North Central Idaho region. This report illustrates the significant degree to which SJRMC contributed to the positive health status of the communities it serves during its fiscal year from July 1, 2012 through June 30, 2013. St. Joseph's Mission and VisionSt. Joseph seeks to enhance the quality of life of the citizens of the service area through the promotion of health, prevention of disease and injury and the provision of health services. St. Joseph witnesses the saving presence and mercy of the Risen Christ by providing high quality restorative, preventative, and acute health care services, respecting human dignity in the experience of sickness and death and fostering the physical, psychological, emotional, spiritual and social well-being of people. St. Joseph is a vibrant, dynamic Catholic faith based healthcare organization that continues to be a leader in the provision of health services by responding to and meeting the health needs of all people of the region. St. Joseph envisions maintaining our vital presence as the preferred healthcare provider, the source for health education, and the healthcare safety net for the Region. St. Joseph continues to develop inpatient and outpatient services; outpatient care sites; and partner with providers sharing similar commitments and values. We will expand patient education and strive to improve the community health status. We will collaborate with public and private agencies and businesses to assure an appropriate continuum of care, and develop strategic relationships with area providers to help maintain their vital presence, and further develop the referral network into St. Joseph and our medical/dental staff. As the leader in the Region, St. Joseph will utilize knowledge and tradition; along with wisdom, creativity and innovation to further position itself as the hub of services, and the regional care center for the nine counties we serve. Our Philosophy to Community BenefitSt. Joseph's primary mission is to continue Christ's mission of mercy by meeting the health care needs of the individuals in the community. No one requiring medical care or services offered by St. Joseph is turned away regardless of race, creed, religion, national origin, sex, ability to pay or economic status. As the region's leader in the delivery of health care services, St. Joseph has and will continue to accept the responsibility to contribute to the overall health and welfare of our community. St. Joseph is deeply committed to our community to help assure residents live healthy and productive lives through cost effective and quality healthcare and education services. St. Joseph offers a variety of services and programs that are not found elsewhere in the region and is constantly monitoring and assessing the needs of the region to ensure quality health care. Through our commitment to providing community benefit, St. Joseph has engaged in the following activities to ensure that our mission is accomplished:* St. Joseph is fully accredited by the Joint Commission and provides level III Adult/Pediatric trauma services.* St. Joseph operates an Emergency Room and Minor Care that is open 24/7 and serves all persons regardless of their ability to pay. * St. Joseph provides many inpatient and outpatient services to all persons while participating in Medicare, Medicaid, county insurance, TriCare, Indian Health Services and/or other government health care programs to assure access for patients. * St. Joseph's medical staff privileges are open to any qualified physician in the region. In FY13, SJRMC's medical/dental staff included 137 physicians (89% board certified), specializing in 30 fields. The active/associate medical/dental staff represents 74% of the total physicians, while 21% physicians have courtesy privileges and 5% have consulting privileges. * St. Joseph has a governing Board of Directors that consist of independent persons who represent the community. The governing body includes leaders in the religious community, the physician community and the local community. Who We ServeSt. Joseph is located in Lewiston, ID and serves residents of a nine county region including the Idaho counties of Nez Perce, Latah, Idaho, Clearwater and Lewis, the Washington counties of Asotin, Garfield and Whitman and Wallowa County in Oregon. The primary service area consists of the Lewis-Clark Valley, home to over 60,000 people. Throughout the region an additional 122,000 people reside. In total St. Joseph seeks to meet the needs of more than 180,000 people residing over nearly 20,000 square miles.Services ProvidedAs a team in FY13 SJRMC served:4,494 - Men, Women, Children as Inpatients546 - Mental Health Inpatients793 - Newborns 117,421 - Individual Outpatient VisitsThat totals: 5,833 - Total Admissions22,496 - Patient Discharge Days31,769 - Patients Entered our Emergency Room and Minor Care Services1,543 - Home Respiratory Visits4,131 - Surgical Cases16,344 - Physician Office Visits9,560 - Medical Oncology Visits4,049 - Hospice days of service Patient Services: Cancer Center Cardiology/VascularCardiopulmonaryCommunity Health/Education ResourcesDiagnostic Imaging Emergency Dept.Family BeginningsGI LabHospiceIntensive CareInterventional RadiologyLaboratory Medical ServicesMental Health - AdultMinor CareOutPatient ServicesPalliative CarePastoral CarePatient EducationPharmacyPhysician ClinicsProgressive CareRehabilitation ServicesSocial Services Surgical Services 1 Snake River Medical Clinic 215 10th Street Lewiston ID 83501 311726460 501(c)(3) 44015 Medical Services Twin County United Way 2207 E Main Street Lewiston ID 83501 820261086 501(c)(3) 33089 Community Support LCSC Nursing Faculty 500 8th Avenue Lewiston ID 83501 826000935 501(c)(3) 44000 Nursing Staff Valley Vision 111 Main Street Lewiston ID 83501 841367690 501(c)(6) 10000 Community Support 3 1 Prescriptions for indigent patients 862 21524 Book Prescriptions Procedure for Monitoring Grants in the U.S.: Part I, Line 2: Schedule I, Part I, Line 2: Before funds are disbursed, all grants must go through an approval process at St. Joseph Regional Medical Center. After approval and disbursement of the funds, expenditures are monitored by the applicable non-profit's board of directors. The Snake River Medical Clinic is provided drugs administred by a physician. As an exectuvie sponsor for United Way, contributions are used to cover administrative expenses of that organization. Funds disbursed to the LCSC Nursing Faculty and Lewis-Clark State College are used for a specific purposes and are acknowledged via receipts. Valley Vision has a specific charter to support economic development in local communities and expenditures are monitored by its Board. X X X X 0 0 0 0 0 0 0 0 0 Timothy P Sayler 382288 0 0 0 5367 0 4950 0 26577 0 419182 0 0 0 Thomas Safley 218094 0 46751 0 1678 0 11369 0 15397 0 293289 0 0 0 Kathleen Connerley 128060 0 38037 0 13219 0 2665 0 10477 0 192458 0 0 0 Brenda Forge 170444 0 35292 0 7179 0 16356 0 15181 0 244452 0 0 0 Bobby Joe Jones 161805 0 6421 0 7362 0 13280 0 11037 0 199905 0 0 0 Michael Rooney 221997 0 300 0 0 0 7429 0 17659 0 247385 0 0 0 John Ho 474177 0 50000 0 488 0 12600 0 11664 0 548929 0 0 0 Binay K Shah 425792 0 400 0 43014 0 7650 0 15124 0 491980 0 0 0 Katrina A Popham 517399 0 400 0 12049 0 12600 0 6865 0 549313 0 0 0 Gerardo Midence 536547 0 400 0 42311 0 12600 0 29696 0 621554 0 0 0 Sushma Pant 511330 0 400 0 35860 0 12600 0 9991 0 570181 0 0 0 Form 990, Part VI, Section A, line 6 St. Joseph Regional Medical Center has a single corporate member, Ascension Health. Form 990, Part VI, Section A, line 7a St. Joseph Regional Medical Center has a single corporate member, Ascension Health, who has the ability to elect members to the governing body of St. Joseph Regional Medical Center. Form 990, Part VI, Section A, line 7b Ascension Health has designed a system authority matrix which assigns authority for key decisions that are necessary in the operation of the system. Specific areas that are identified in the authority matrix are: new organizations & major transactions; governing documents; appointments/removals; evaluation; debt limits; strategic & financial plans; assets; system policies & procedures. These areas are subject to certain levels of approval by Ascension per the system authority matrix. Form 990, Part VI, Section B, line 11 Management, including certain officers, works diligently to complete the Form 990 and attached schedules in a thorough manner. Management presents the Form to the Board, or a designated committee, to review and answer any questions. Prior to filing the return, all Board Members are provided the Form 990 and management team members are available to answer any Board Members questions. Form 990, Part VI, Section B, line 12c The organization regularly and consistently monitors and enforces compliance with the conflict of interest policy in that any director, principal officer, or member of a committee with governing board delegated powers, who has a direct or indirect financial interest, must disclose the existence of the financial interest and be given the opportunity to disclose all material facts to the directors and members of the committees with governing board delegated powers considering the proposed transaction or arrangement. The remaining individuals on the governing board or committee will decide if conflicts of interest exist. Each director, principal officer and member of a committee with governing board delegated powers annually signs a statement which affirms such person has received a copy of the conflict of interest policy, has read and understands the policy, has agreed to comply with the policy, and understands that the organization is charitable and in order to maintain its federal tax exemption it must engage primarily in activities which accomplish its tax-exempt purpose. Form 990, Part VI, Section B, line 15 In determining compensation of the organization's CEO, the process included a review and approval by independent persons, comparability data, and contemporaneous substantiation of the deliberation and decision. The Executive Committee of the SJRMC Board and the SJRMC Board reviewed and approved the compensation. In the review of the compensation, the CEO was compared to individuals who worked at similarly sized organizations as well as organizations similar in complexity of operations, revenues and job responsibilities across the nation. During the review and approval of the compensation, documentation of the decision was recorded in the board minutes. Individual was not present when his compensation was decided. In determining compensation of other officers or key employees of the organization, the process included a review and approval by independent persons, comparability data, and contemporaneous substantiation of the deliberation and decision. The Executive Committee of the SJRMC Board and the SJRMC Board reviewed and approved the compensation. In the review of the compensations, the other officers or key employees of the organization were compared to individuals who worked at similarly sized organizations as well as organizations similar in complexity of operations, revenues and job responsibilities across the nation. During the review and approval of the compensation, documentation of the decision was recorded in the board minutes. Form 990, Part VI, Section C, line 19 The organization will provide any document open to public inspection upon request. Changes in Net Assets or Fund Balances: Form 990, Part XI, line 9: Transfers to/from Affiliates -2,179,079. Deferred Pension Costs -1,336,134. Explanation of Financial statements: Part XII, Line 2 The financial statements of St. Joseph Regional Medical Center fall under the specific scope audit of Ascension Health Alliance. The activity of St. Joseph Regional Medical Center is reported in the consolidated financial statements of Ascension Health Alliance. No individual audit of St. Joseph Regional Medical Center is completed. Therefore, the attached is the audited financial statements of Ascension Health Alliance and affiliates (which include the activity of St. Joseph Regional Medical Center). Ascension Health PO Box 45998 St Louis MO 63145 311662309 National Health System MO 501(c)(3) Schedule A, Line 11a Ascension Health Alliance 0 St Joseph Regional Medical Center Foundation Inc 415 Sixth Street Lewiston ID 83501 510168321 Fundraising ID 501(c)(3) Schedule A, Line 11a St Joseph Regional Medical Center 1 0 0 0 0 0 0 0 0 0 0 0 0 0 1 1 0 0 1 1 St Joseph Regional Medical Center Foundation O 113425 Actual amount paid St Joseph Regional Medical Center Foundation S 150942 Actual amount paid