2013-06-17T08:52:51-05:00 2012-08-31 366055558 Grant Thornton LLP 175 W Jackson Blvd Chicago IL 60604 990 2011-09-01 411456897 HealthEast St John's Hospital HEAL 6512321000 PO Box 64624 St Paul MN 551640624 Daniel G Kaye 6512322300 2013-06-13 0 Bridget Roche P00666837 3128560200 X 2011 2016-02-24 21:20:13Z Kathryn Correia 559 Capitol Blvd St Paul MN 55103 277161976 0 X www.healtheast.org X 1983 MN St. John's is an acute care hospital. The services provided support the hospital's health care mission to provide high quality, cost effective compassionate health care for Twin Cities East Metro residents. Hospital revenue includes payment from the Medicare and Medicaid programs. The medical services relate directly to the exempt purpose of caring for sick, infirm, aged and injured persons regardless of their race, color, creed, religion, national origin, sex, sexual preference, marital status, status with regard to public assistance, disability or age. This organization provides emergency and medically necessary non-emergency services regardless of ability to pay. Additionally, this organization offers financial aid for eligible services in the form of free or discounted care to those low income, underinsured or uninsured individuals who meet qualification criteria. 15 12 1690 440 285402 -20930 202671 2460184 255947616 269396073 1266345 2981241 2495300 2189897 259911932 277027395 0 0 0 0 109592296 110326982 0 0 0 130391705 133679294 239984001 244006276 19927931 33021119 110365485 111221106 34085328 35808675 76280157 75412431 X Rooted in Judeo-Christian values, our mission is high quality, compassionate, cost effective health care for the communities we serve. 0 0 206196652 271225372 St. John's Hospital is a full-service, acute care hospital offering superior diagnostic and therapeutic care to the community for more than 95 years. As a full service, acute care facility, St. John's is committed to providing superior health care to our growing communities. This 184-bed facility offers a wide variety of diagnostic and therapeutic services, including the following: *Emergency Care *Maternity Care *Heart Care *Orthopaedic Care *Medical/Surgical *Critical Care (ICU) *Cancer Care Center *Radiology Care *Breast Care Center *Rehabilitation *Stroke Care *Medical Laboratory From the moment patients and visitors walk into St. John's, they experience the warm, inviting atmosphere created by the physical environment and the caring, personal services offered by our staff. As a hospital dedicated to a growing community, caring for patients is the highest priority for the physicians, nurses and staff at St. John's. Patients trust the hospital to provide advanced treatments and services with a caring, personal touch. State-of-the-art technology, specialized physicians, nurses and staff, and a wide range of services combine seamlessly with St. John's innovative healing environment and personal, compassionate health care delivery. St. John's Hospital FY 2012 Statistics: *Hospital Inpatient Admissions: 14,216 *Births: 2,827 *Outpatient Visits: 214,864 *Emergency Department Visits: 39,456 St. John's Hospital is part of the HealthEast Care System. The HealthEast Care System is a community-focused, non-profit health care system that provides innovative technology, compassionate care and a full spectrum of family health services. In 1986, the leaders of seven hospitals in St. Paul blended their Baptist, Roman Catholic and Lutheran cultures to become HealthEast Care System, united in pursuit of a common mission built on Judeo-Christian values. Today, HealthEast Care System includes four hospitals, as well as 14 clinics, outpatient services, home care and medical transportation. Practicing financial responsibility, HealthEast Care System is the largest, locally-owned health care organization in the St. Paul/Minneapolis East Metro area. *Mission: Rooted in Judeo-Christian values, our mission is high-quality, compassionate, cost effective health care for the communities we serve. *Values: HealthEast Care System values originate in the tradition of its sponsor organizations, forming the foundation for the Mission and Vision of the HealthEast Care System. *Life: Life is a gift to be valued highly. *Compassion: Caring attends to physical, emotional and spiritual dimensions of persons. *Respect: Each person is unique and deserving of respect. *Community: We exist to serve our community. *Faith-Based Philosophy: By sustaining HealthEast Care System's Christian heritage and identity, we provide compassionate service that respects the dignity of each person and welcomes all faith traditions, cultures and communities. *Vision: Optimal health and well-being for our patients, our communities and ourselves. *Milestone Goal: Building on our benchmark performance, HealthEast will be a national leader in clinical quality, patient experience and cost effectiveness - the best value - by 2015. HealthEast Care System fiscal year 2012 statistics: *Total Hospital Inpatient Admissions: 35,594 *Total Outpatient Visits: 434,827 *Total Emergency Department Visits: 92,055 *Lab tests: over 2.7 Million *Home Care Patients Served: 7,524 *Home Care Patient Visits: 66,757 *Health Alert Subscribers: 3,421 *Clinic Professional Visits: 572,028 *Clinic Ancillary Services: 1,003,555 *Clinic Patients: 148,764 *Patient Transports: 33,569 *Employees: 7,346 206196652 1 1 0 1 0 0 0 0 0 0 1 0 1 0 1 0 0 1 0 0 0 0 0 0 0 0 1 1 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 1 1 1 1 0 0 1 X 0 0 1690 1 1 1 0 0 0 0 0 0 0 0 0 X 15 12 0 0 0 0 1 0 0 1 1 0 0 1 1 1 1 1 1 1 1 1 1 MN X Daniel G Kaye 6512322300 559 Capitol Boulevard St Paul MN 55103 X Larry K Ainsworth 0.00 X 0 28000 0 Diane M Berthel 0.00 X 0 50000 0 Julie S Causey 0.00 X 0 0 0 Patrick J Donovan 0.00 X 0 48000 0 Albert E Eggert 0.00 X 0 45000 0 John R Finnegan Jr PhD 0.00 X 0 26667 0 Fred Harris Jr 0.00 X X 0 65000 0 Roland L Hayes 0.00 X X 0 53200 0 Louis C Henry Jr 0.00 X 0 0 0 Anne M Pearson MD 0.00 X 0 284451 47274 Leonard M Randolph Jr MD 0.00 X 0 27833 0 Sister Marie H Seiter CSJ 0.00 X 0 0 0 David V Taylor PHD 0.00 X 0 28833 0 Jone M Tiffany 0.00 X 0 28000 0 Laure Waschbusch MD 0.00 X 0 39190 936 James W Wiltz 0.00 X 0 26000 0 Timothy H Hanson 0.00 X X 0 982866 298741 Kathryn G Correia 0.00 X X 0 0 0 Mary L Arnold 0.00 X 0 231011 99358 Catherine J Barr 0.00 X 0 296035 168531 Sara Criger 0.00 X 0 439920 73275 Brendon Cullinan MD 0.00 X 0 76301 98033 Shirley A Germann 0.00 X 0 174279 48305 Roger E Green 0.00 X 0 342141 208178 Scott W Hinrichs 0.00 X 0 248601 158098 Stephen J Kolar MD 0.00 X 0 463918 176505 Milton P McClurkan Jr 0.00 X 0 264529 28017 Michael F Nass 0.00 X 0 361996 235573 Scott L North 40.00 X 409546 0 186433 Brian Patty MD 0.00 X 0 629661 222429 John Piatkowski MD 0.00 X 0 227176 19895 Mary F Pynn 0.00 X 0 316433 141221 Julie A Schmidt 0.00 X 0 411066 168322 Thomas A Schmitt 0.00 X 0 292486 148611 Mindy A Smith 40.00 X 371902 0 148915 Leslie R Stern 0.00 X 0 251128 90278 Craig A Svendson MD 0.00 X 0 361052 184701 John Kvasnicka MD 40.00 X 375338 0 89468 Paul J Sovell MD 40.00 X 347201 0 67226 Paul M McCormick MD 40.00 X 330814 0 63144 Peter J Tanghe MD 40.00 X 327840 0 66310 Gerald L Hill MD 40.00 X 311456 0 66331 Joan A Grzywinski 0.00 X 0 19000 0 Robert D Gill 0.00 X 0 358736 141733 Ann M Schrader 0.00 X 0 562050 259548 Virginia Sullivan 0.00 X 0 228908 30192 Puneet S Cheema MD 0.00 X 0 1296657 88876 Kevin P Mulvey MD 0.00 X 0 598650 67528 Johathan C Grimes MD 0.00 X 0 324980 62765 June A Kim MD 0.00 X 0 971886 74732 2474097 11481640 4029482 91 1 1 1 University of Minnesota 420 Delaware Street SE Box 381 Minneapolis MN 55455 Medical Services 1776597 Metropolitan Mechanical Contractors 7450 Flying Could Drive Eden Prairie MN 55344 Repair & Maintenance Services 1243062 Associated Anesthesiologists CM-9710 PO Box 70870 St Paul MN 55170 Medical Services 978966 Varian Medical Systems 70140 Network Place Chicago IL 55164 Repair & Maintenance Services 895255 Parsons Electric LLC NW 9562 PO BOX 1450 Minneapolis MN 55485 Elelctrical Services 885451 36 2283589 176595 2460184 Patient Revenue 622110 261470170 261470170 Related Entity Rental 531120 4479628 4479628 Surgery Center Service 621400 3180302 3180302 Lab Services 621500 228794 11413 217381 Festival House Rental 531110 26299 26299 10880 10880 269396073 1964047 1964047 75196 0 75196 75196 75196 1151775 134581 1017194 1017194 1017194 Cafeteria Revenue 722310 1381269 1381269 Cash Discounts & Rebat 900099 331518 331518 Gift Shop Revenue 453220 181360 181360 220554 152533 68021 2114701 277027395 271225372 285402 3056437 1031844 1031844 84355819 82042588 2313231 6316655 6143438 173217 12581860 12236836 345024 6040804 5804155 236649 2915 2915 9465 9465 24284567 20251959 4032608 311341 28524 282817 13638437 12683743 954694 3344529 9715 3334814 6516102 6516102 118100 93843 24257 213032 206335 6697 3781536 3781536 5048650 5048650 1944759 1246273 698486 Medical Supplies 39226201 39226201 HealthEast Mgmt Fees 23892468 23892468 Bad Debt Expense 4989385 4989385 Minnesota Care Tax 3054427 3054427 3303380 2823477 479903 244006276 206196652 37809624 0 12016 13815 29513 1776 28082647 28702907 39899 24131 2195481 2381975 907563 998196 144724482 79794344 64368722 64930138 13447740 13098172 1281904 1069996 110365485 111221106 10846870 12391912 21521069 20373279 861780 699955 855609 2343529 34085328 35808675 X 76280157 75412431 76280157 75412431 110365485 111221106 X 33021119 -33888845 X X 0 1 1 X 0 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 0 0 0 0 0 0 0 0 1 9465 9465 0 Explanation of Lobbying Activities: Part II-B, Line 1: The organization pays annual membership dues to the American Hospital Association and the Minnesota Hospital Association. A portion of these annual dues are determined to be used for lobbying purposes. 2995111 2995111 93383329 47001201 46382128 5259508 2813507 2446001 35925155 25169709 10755446 7161379 4809927 2351452 64930138 Investment in HealthEast Surgery Center-Maplewood, LLC 13098172 C 13098172 Asbestos Abatement Liability 908446 Third Party Settlements 1435083 2343529 The financial statements did not include a footnote addressing the organization's liability for uncertain tax positions under FIN 48 because the organization did not have any such liabilities to report. 1 1 X 1 X 1 X 0 1 0 1 1 2056760 2056760 0.00860 31383857 24143170 7240687 0.03030 4591627 1287786 3303841 0.01380 38032244 25430956 12601288 0.05270 270177 55007 215170 0.00090 3310212 1151238 2158974 0.00900 936066 936066 0.00390 4516455 1206245 3310210 0.01380 42548699 26637201 15911498 0.06650 7171 7171 0.00000 202560 85897 116663 0.00050 209731 85897 123834 0.00050 1 5119975 0 88418821 96601254 -8182433 X 1 1 1 HealthEast Surgery Center-Maplewood LLC Surgery Center 0.74500 0.00000 0.15500 2 Maplewood Professional Building Limited Partnership Rental Real Estate 0.12600 0.00000 0.11400 1 1 HealthEast St John's Hospital

1575 Beam Avenue Maplewood MN 55109

X X X HealthEast St John's Hospital 1 1 1 200.000000000000 1 300.000000000000 1 X X X 1 1 X X X X X X 1 0 1 X 0 0 16 HealthEast Midway Outpatient Center

1700 University Ave West St Paul MN 55104

Outpatient Services Center HealthEast Optimum Rehabilitation-Maplew

1570 Beam Avenue Suite 200 Maplewood MN 55109

Outpatient Rehabilitation Clinic HealthEast Optimum Rehabilitation-Midway

1390 University Ave W St Paul MN 55104

Outpatient Rehabilitation Clinic HealthEast Optimum Rehabilitation-Oakdal

1099 Helmo Ave Suite 110 Oakdale MN 55128

Outpatient Rehabilitation Clinic HealthEast Optimum Rehabilitation-Woodbu

1825 Woodwinds Drive Woodbury MN 55125

Outpatient Rehabilitation Clinic HealthEast Optimum Rehabilitation-Stillw

2900 Curve Crest Blvd Stillwater MN 55082

Outpatient Rehabilitation Clinic HealthEast Surgery Center-Maplewood

1655 Beam Avenue Maplewood MN 55109

Outpatient Surgery Center HealthEast Surgery Center-Midway

1700 University Ave West St Paul MN 55104

Outpatient Surgery Center HealthEast Pain Care - Midway

1700 University Ave West St Paul MN 55104

Outpatient Pain Care Clinic HealthEast Sleep Center - Maplewood

3100 Kennard St Suite 200 Maplewood MN 55109

Outpatient Sleep Center HealthEast Radiology - Midway

1700 University Ave West St Paul MN 55104

Outpatient Radiology Center HealthEast Sleep Center - Eagan

1215 Town Centre Drive Suite 200 Eagan MN 55123

Outpatient Sleep Center HealthEast Vascular Center - Maplewood

1570 Beam Avenue Suite 200 Maplewood MN 55109

Outpatient Vascular Center HealthEast Vascular Center - St Paul

17 W Exchange St Suite 600 St Paul MN 55102

Outpatient Vascular Center HealthEast Vascular Center - Woodwinds

1875 Woodwinds Dr Suite 240 Woodbury MN 55125

Outpatient Vascular Center HealthEast Medical Imaging LLC

3640 Talmage Circle Suite 100 Vadnais Heights MN 55110

Outpatient Imaging Center Part I, Line 6a: This organization is part of the HealthEast Care System which prepares an annual community benefit report called "HealthEast Report to the Community" on a consolidated basis. Part I, Line 7: The cost to charge ratio used to report amounts in Form 990, Schedule H, Part I, Line 7 were derived from worksheet 2, in the Schedule H, Form 990 instructions. Part I, Line 7, Column (f): The Bad Debt expense included on Form 990, Part IX, Line 25, Column (A), but subtracted for purposes of calculating the percentage in this column is $ 4989385. Part II: HealthEast St. John's Hospital promotes the health of the community it serves by providing community building activities. One such activity is by providing tours of the hospital Maternity Care Center. The tour is offered to community members and provides participants with information about the Maternity Care Center and the services they offer. Those attending are also given health and wellness information about car seats, immunizations and precautions to take in order to avoid infant exposure to illness. Another activity HealthEast St. John's Hospital provides is free access to its Passport Program through their parent organization, HealthEast Care System. This program is dedicated to enhancing the quality of life for all as we age. We lead positive social change and deliver value to members through information, advocacy, lifelong learning, self-development and fulfillment. We accomplish this goal by offering social opportunities, educational seminars, opportunities to meet other members and volunteer opportunities. Part III, Line 1: The organization reports bad debt in accordance to Healthcare Financial Management Association (HFMA) Statement No. 15 to the extent that HFMA Statement No. 15 follows the Generally Accepted Accounting Principles (GAAP) for the reporting of bad debt. Part III, Line 4: The allowance for bad debt is based upon the assessment of historical and expected net collections considering business and economic conditions, trends in health care coverage, and other collection indicators.The bad debt allowance is calculated as a percentage of patient receivables after deductions for estimated provisions for contractual adjustments (discounts) on services provided to enrollees of Medicare, Medicaid, third-party payor programs, charity care, uninsured discounts, and other administrative adjustments.The following is the text of the footnote to the organizations financial statements that describe the bad debt allowance and bad debt expense: Net patient accounts receivable consist of gross charges for patient services less contractual adjustments and other reductions for anticipated uncollectible amounts. The allowance for doubtful patient accounts receivable is based upon an assessment of historical and expected net collections considering business and economic conditions, trends in health care coverage, and other collection indicators. Throughout the year, the adequacy of the allowance for doubtful accounts is assessed based upon historical write-off experience by payor category. The results of this review are used to make any modifications to the allowance for doubtful accounts. After satisfaction of amounts due from insurance and other third-party payors, established guidelines are followed for placing certain past-due patient balances with collection agencies.The organization has a financial assistance program that provides patients opportunities to apply for free or discounted care or to be enrolled in a government sponsored medical care program. The process includes identifying patients with a financial concern and providing financial counseling and assistance in applying for the organization's charity care and other financial assistance programs.Certain patient accounts are written off to bad debt because the organization does not have sufficient information to determine if the patient would qualify for free care or financial aid. Therefore, it is possible that some bad debt is actually charity care. However, if a patient account is written off to bad debt and the collection agency later determines that the patient would have qualified for free care or financial aid, then the bad debt expense is reclassified to charity care. Part III, Line 8: The organization believes that at least some portion of the costs we incur in excess of payments received from the Federal government for providing medical services to Medicare enrollees and beneficiaries under the Federal Medicare Program (shortfall or Medicare shortfall) constitutes a community benefit. Providing these services clearly lessens the burdens of the government by alleviating the Federal government from having to directly provide these medical services. As demonstrated and calculated on Form 990, Schedule H, Part III, Lines 5, 6 and 7, our Medicare "allowable costs" clearly exceed the payments we receive for providing these medical services under the Medicare Program. By absorbing the Medicare shortfall costs we are providing a community benefit as well as easing the burden of the Federal government having to cover these costs.To arrive at the Form 990, Schedule H, Part III, Line 6 amount we used actual Medicare charges from internal records and applied an estimated cost to charge ratio to determine the Medicare allowable costs. The estimated Medicare cost to charge ratio is the prior period Medicare Cost Report cost to charge ratio. Part III, Line 9b: The organization's collection policy and practices provide that a patient who indicates an inability to pay be provided with the information and application for the organization's financial aid policy. When a completed financial assistance application is received, it is processed according to the organization's policy to determine whether the patient qualifies for discounted or free medical services. However, if a patient expires or files for bankruptcy prior to providing a completed financial assistance application, there is no way to determine if the patient qualifies for charity care.The patient handbook also provides information regarding collection policies and practices. Bills provided to patients include the following statement: "Financial Aid Available: It is important that you let us know if you will have trouble paying your bill. HealthEast may be able to help you get free or low-cost health coverage through community or government programs. Although HealthEast can assist you in this process, you must apply for these benefits if you are eligible." HealthEast St. John's Hospital Part V, Section B, Line 13g: The organization communicates to patients during admission, financial counseling and collection calls that we have a financial assistance program and we can provide them with an application. HealthEast St. John's Hospital Part V, Section B, Line 19d: The organization shall not charge a patient whose annual household income is less than $125,000 for any uninsured treatment in an amount greater than the amount which the provider would be reimbursed for that service or treatment from its most favored insurer. The term "most favored insurer" means nongovernmental third party payers that provided the most revenue to the provider during the previous calendar year. Part VI, Line 2: The community health needs assessment process was guided by HealthEast advisory groups that represented each hospital and key departments. At multiple points in the assessment planning and implementation process, local public health departments were also contacted to provide input and feedback to the process and review relevant data.A mixed method approach was developed collaboratively by HealthEast and Wilder Research to describe the health and wellness needs of east metro residents, with particular attention to the needs of aging residents, those with chronic conditions, and medically underserved populations, including communities of color and uninsured/underinsured populations. Secondary, or existing, data sources were used to describe the characteristics of residents and patients, while the primary, or new, data collection approaches selected for the assessment were designed to gather feedback from specific priority populations during a short 6-week timeframe in order to align with HealthEast's decision making and reporting timelines.A variety of data collection strategies, described below, were used to gather information about the health and wellness needs of residents served by HealthEast, particularly those living in the east metro region of Dakota, Ramsey, and Washington Counties. The east metro geographic focus reflects the primary service area of three HealthEast Care System hospitals: St. John's Hospital, St. Joseph's Hospital, and Woodwinds Health Campus.The HealthEast Community Health Needs Assessment Data Collection Workgroup conducted a comprehensive review of the system's hospital (patient visit) data to define the population of patients served by HealthEast, identify current service delivery trends, and inform the scope of the assessment and its primary data collection strategies. In February 2012, the HealthEast Data Collection presented a summary report of their findings to the HealthEast Internal Advisory Committee and Steering Committee. The report described HealthEast's current service reach and aided the committees to focus the primary data collection strategies towards three key populations in the east metro: aging populations; populations with chronic disease; and populations of color, particularly those with chronic disease.Additional sources of secondary data were reviewed by the HealthEast Data Collection Workgroup and Wilder Research to describe the characteristics of east metro residents, incidence and current trends in key chronic disease areas, and risk factors contributing to the onset of these chronic conditions in this full report.There is a great deal of information available describing common barriers to accessing health care services in general. Factors including cost, clinic hours, concerns about insurance coverage, trust in medical providers, and perceived discrimination can all lead to delays in accessing health care, particularly preventive health care services. Populations of color, new immigrant populations, and lower-income residents are more likely to report these barriers.These issues are important for HealthEast and others to consider in identifying strategies to improve the accessibility of their services. However, because these barriers are already well-documented, the primary data collection plan focused primarily on better understanding characteristics of patients who are highly engaged in managing their health, as well as factors that lead to frequent emergency department utilization or poor chronic disease management among HealthEast patients. Special attention was given to gathering feedback from medically-underserved and aging patients, as well as patients of color.The primary data collection component of the Community Health Needs Assessment was designed in collaboration between Wilder Research and HealthEast staff, and guided by HealthEast internal advisory committees.Discussion with Passport members. Four town hall discussions, located in community centers in the east metro, were conducted in May 2012 with members of the HealthEast Passport program. At each session, Wilder Research facilitated a guided discussion about the strategies Passport members currently use to support their health, challenges they have in supporting their health, and their suggestions for how medical professionals can better support them in their efforts to stay healthy.Mixed method approaches to gather feedback from HealthEast Bethesda Hospital (Bethesda) staff and patients. In collaboration with HealthEast staff, a mixed-method approach consisting of key informant interviews with Bethesda staff and advocacy organizations, surveys with Bethesda support group participants, and follow up interviews with recently discharged patients was used to gather information about the unique needs of Bethesda patients.Interviews with HealthEast patients. A semi-structured face to face patient interview was developed in partnership with HealthEast staff to gather feedback from current hospital patients about the ways they try to stay healthy, challenges to their health, barriers to following hospital discharge instructions, and their preferred type and mode of health information communication. A convenience sampling approach was used to gather feedback from a sample of patients admitted to three HealthEast hospitals: St. Joseph's, St. John's, and Woodwinds. Patients readmitted to the hospital within the past 30 days, as well as those in the hospital for observation, were eligible for the interview. Interviews with emergency room patients were attempted, but were discontinued due to difficulties administering the interviews without interrupting patient flow.Interviews with representatives of cultural communities. Key informant interviews were conducted with individuals representing the following cultural communities: African American; African; Hispanic/Latino; Hmong; Karen; and homeless. The informants included key stakeholders who were members of (or who had direct experience working closely with) each community of interest, and who could speak to the health needs of community members of the east metro. Informants were asked about barriers to health and wellness in specific cultural communities and provided recommendations for health systems to consider when working to address these barriers. Part VI, Line 3: HealthEast St. John's Hospital has Financial Counselors and Social Workers available to assist patients in determining whether they qualify for help with their medical bills. Billing and Insurance Information brochures are also available to patients which explain the organization's billing and payment policies as well as contact information for discussing financial assistance with our Financial Counselors and Social Workers. Patients are informed about the availability of federal, state and local medical assistance programs, charity care availability as well as discounted care eligibility requirements.The patient handbook also provides information regarding collection policies and practices. Bills provided to patients include the following statement: "Financial Aid Available: It is important that you let us know if you will have trouble paying your bill. HealthEast may be able to help you get free or low-cost health coverage through community or government programs. Although HealthEast can assist you in this process, you must apply for these benefits if you are eligible." Part VI, Line 4: The primary service area for three of the four HealthEast Care System hospitals includes the three east metro counties of Dakota County, Ramsey County, and Washington County. Combined, the service area includes over one million residents. During the past decade, the east metro region has become increasingly culturally-diverse and home to a growing aging population. In addition, as a result of the recent economic recession, a growing number of east metro residents live in poverty. These recent and anticipated changes in the region's population may influence the types of services provided by HealthEast and the ways in which services are delivered.Since 2000, the population across all three counties has become increasingly culturally diverse, with nearly one-quarter (24%) of residents identified as persons of color in 2010. HealthEast currently serves a diverse patient population and is seeing growth in the number of hospital visits by patients of color, particularly new patients of new immigrant and refugee communities. Although most patient hospital visits are with patients who speak English as their primary language, over 8,000 of hospital visits in 2010 were with patients who spoke languages other than English. The demand for culturally- and linguistically-appropriate care is likely to increase. Over the next 30 years, the number of residents of color in the Twin Cities region is expected to double, while at the same time, the White, non-Hispanic population is expected to slightly decline.In 2010, 11 percent of east metro residents were age 65 or older. Not surprisingly, many of the patients who receive services at HealthEast hospitals also fall into this age group. In the three hospitals that serve the east metro region, as few as one in five patient visits and up to one in three patient visits were with patients age 65 or older in 2010. A dramatic increase in the number of seniors is expected over the next 30 years; by 2040, over 20 percent of Twin Cities residents are expected to fall into this age category.The recent economic recession has also had an impact on east metro residents. The percentage of residents living in poverty has roughly doubled in each of the east metro counties. Poverty rates are higher overall in Ramsey County, where there has also been a sharp increase in the percentage of residents living in poverty, from 9 percent in 2000 to17 percent in 2010. A substantial number of east metro residents may also have difficulty accessing health care services due to lack of insurance, limited money to afford services, or a lack of medical service providers. Although a growing number of residents will have health insurance as a result of federal health care reform, the percentage of uninsured residents varies from 7 percent in Washington County to 12 percent in Ramey County. In addition, American Indians are considered a medically-underserved community in the east metro and there are five federally-designated medically underserved neighborhoods in Ramsey County.The primary service area for three of the four HealthEast hospitals focuses on residents living in three east metro counties: Dakota County, Ramsey County, and Washington County. Combined, the service area includes over one million residents. The region, which includes urban, suburban, and rural communities, is home to a highly economically and culturally diverse population. The largest percentage of east metro residents live in Ramsey County; despite covering a smaller geographic area, Ramsey County has a population density approximately five times greater than Dakota and Washington Counties. One-third of Ramsey County residents are persons of color, compared to 18 percent of Dakota County and 14 percent of Washington County residents. A greater percentage of Ramsey County residents also live in poverty, compared to the other east metro counties.Key demographic characteristics of east metro residents (2010)County: Dakota Ramsey Washington CombinedTotal population 398,552 508,640 238,136 1,145,328Percent of color:2010 18% 33% 14% 24%2000 10% 25% 7%Percent foreign-born:2010 8% 13% 6% 10%2000 5% 11% 3%Percentage 65+:2010 10% 12% 11% 11%2000 7% 12% 8%Percent living in poverty:2010 7% 17% 6% 11%2000 4% 9% 3%Source: Minnesota Compass, 2010Eight percent of residents are Asian American, while fewer identify themselves as African American (7%), multi-racial (3%), American Indian (1%) or some other race (2%). Using the most recent data available from the American Community Survey (2006-2010), the estimated number of Hmong and Mexican immigrant/refugee residents are 15,632 and 14,193 residents, respectively. While these are there largest immigrant/refugee communities, there are a number of sizable communities in the region, including: Indian (6,413), Chinese (5,352), Vietnamese (4,838), Ethiopian (3,932), Somali (3,935), Korean (3,709) Laotian (2,520), Thai (2,200), Salvadoran (2,193), and Karen (1,340) residents.Overall, the region has become increasingly culturally diverse, particularly among younger residents. At the same time, the population as a whole is becoming older. As a result of the recession, more east metro residents are living in poverty now than in 2000. While the total population has increased in both Dakota and Washington Counties (by 12% and 18% since 2000, respectively), the population in Ramsey County has decreased 0.5 percent during the same time period.In addition to patients who are likely underserved because of their health insurance status, there are five federally-designated medically underserved neighborhoods in Ramsey County: Dayton's Bluff, Ramsey, Rice-Phalen, Summit-University, and Thomas-Dale. The Native American population in Ramsey County is also considered a medically underserved population.Overall, a majority of St. John's and St. Joseph's patients are residents of Ramsey County (67% and 52%, respectively), while the largest percentage of Woodwinds patients live in Washington County (49%). Dakota County residents comprise the smallest proportion of HealthEast hospital patients (17% of St. Joseph's patients and 14% of Woodwinds patients). Bethesda Hospital, a long-term acute care hospital, serves individuals who live throughout the state of Minnesota.To describe the demographic characteristics of patients served by HealthEast, their reasons for receiving care, and other key measures, The HealthEast Community Needs Assessment Data Collection Workgroup analyzed existing internal data for all patient visits in 2010. This section of the report highlights selected demographic information from the Workgroup's comprehensive report.HealthEast is one of multiple hospital systems that serve residents who live in Dakota, Ramsey, and Washington Counties. Overall, 41 percent of licensed hospital beds within the St. John's service area (Ramsey and Washington Counties) were HealthEast hospital beds, compared to 37 percent in the service areas for St. Joseph's and Woodwinds Hospitals (Dakota, Ramsey, and Washington Counties).Number and percentage of HealthEast hospital beds in each east metro county (2010): Number of licensed hospital beds % of HealthEast beds HealthEast Non-HealthEast in each countyDakota County a,b 0 244 0%Ramsey County a,b,c 839 1244 40%Washington County a,b,c 86 97 47%a-Counties included in the St. Joseph's Hospital service areab-Counties included in the Woodwinds Hospital service areac-Counties included in the St. John's Hospital service areaSource: Minnesota Health Care Facilities Programs, Minnesota Department of Health (2011)Recent hospital visit data suggest the hospitals may not be serving as many residents of color as expected, given the demographic characteristics of the population of residents living within each hospital service area. Looking specifically at HealthEast's short-term care hospitals, the percentage of Asian American patient visits is higher at St. John's Hospital (7%), compared to St. Joseph's or Woodwinds Hospitals (both 3%). However, approximately 8-10 percent of residents in the service area of each hospital are Asian American. Similarly, while Hispanic/Latin patients comprise 2-3 percent of all patient visits, there is a larger Hispanic/Latino population living in the hospital service areas (6% in each service area). SEE SCHEDULE O FOR CONTINUATION Part VI, Line 5: In addition to the community benefits and activities described in other parts of this filing, HealthEast St. John's Hospital is part of the HealthEast Care System which furthers its tax-exempt charitable purpose and promotes the health of the communities it serves including, but not limited to the following: The organization's hospitals extend medical staff privileges to all qualified physicians in the community. HealthEast St. John's Hospital as part of the HealthEast Care System, a tax-exempt health care system, reinvests any excess revenues back into the core operations of the organization for which the tax-exemption was granted.The organization offers various health care classes, health screenings, support groups and other events related to the promotion of health. Some examples are in the following areas: Diabetes, Pain Care, Pregnancy, Birthing, Parenting, Heart Disease, Weight Loss, Women's Health, Vein Therapy, Chemical Dependency, Stoke, Cancer, Brain Injury, Smoking Cessation and CPR (Cardiopulmonary Resuscitation).HealthEast Care System is governed by a board of directors that are members of the community the organization serves. Part VI, Line 6: HealthEast Care System is a community-focused, non-profit health care organization that provides innovative technology, compassionate care, and a full spectrum of family health services. HealthEast includes Bethesda Hospital, St. John's Hospital, St. Joseph's Hospital, and Woodwinds Health Campus as well as outpatient services, clinics, home care, and medical transportation services.Organization Mission and Goal:The mission of HealthEast is to provide high quality, cost-effective, compassionate health care for the communities it serves. Our current focus is around creating value for our patients. This is articulated in our 2015 Milestone Goal: "Building on our benchmark performance, HealthEast will be a national leader in clinical quality, patient experience and cost effectiveness - the best value - by 2015."HealthEast includes four hospitals, 14 primary care clinics, outpatient services, home care and medical transportation services. With 7,300 employees and 1,500 physicians on staff, it meets a broad array of community health needs, through a blend of "high tech" services, traditional medicine and integrative therapies.In fiscal year 2012, HealthEast saw 35,000 hospital inpatient admissions, 434,000 outpatient visits, 148,000 clinic patients and 92,000 emergency care cases. In 2012, HealthEast's charity care, costs in excess of Medicaid payments, and community benefit operations, education and workforce development reached a total of $65 million, which is more than the benefit gained by being a tax-exempt organization. Reports Filed With States Part VI, Line 7 MN X X 1 1 X X X X 1 1 0 0 0 0 0 1 0 Anne M Pearson MD 0 249256 0 23807 0 11388 0 28745 0 18529 0 331725 0 7254 Timothy H Hanson 0 639658 0 223757 0 119451 0 278064 0 20677 0 1281607 0 328967 Mary L Arnold 0 192575 0 37068 0 1368 0 88686 0 10672 0 330369 0 37068 Catherine J Barr 0 260850 0 32437 0 2748 0 147211 0 21320 0 464566 0 32437 Sara Criger 0 359605 0 78328 0 1987 0 63425 0 9850 0 513195 0 78328 Brendon Cullinan MD 0 76053 0 0 0 248 0 85634 0 12399 0 174334 0 0 Shirley A Germann 0 148279 0 26000 0 0 0 39708 0 8597 0 222584 0 26000 Roger E Green 0 247014 0 62290 0 32837 0 184608 0 23570 0 550319 0 91447 Scott W Hinrichs 0 180284 0 40782 0 27535 0 103924 0 54174 0 406699 0 64738 Stephen J Kolar MD 0 340574 0 60040 0 63304 0 161268 0 15237 0 640423 0 107591 Milton P McClurkan Jr 0 264529 0 0 0 0 0 12017 0 16000 0 292546 0 0 Michael F Nass 0 259507 0 100613 0 1876 0 211397 0 24176 0 597569 0 100613 Scott L North 320406 0 43346 0 45794 0 160331 0 26102 0 595979 0 86368 0 Brian Patty MD 0 286967 0 119002 0 223692 0 202222 0 20207 0 852090 0 327273 John Piatkowski MD 0 150152 0 70202 0 6822 0 9106 0 10789 0 247071 0 70202 Mary F Pynn 0 233325 0 52922 0 30186 0 125134 0 16087 0 457654 0 80020 Julie A Schmidt 0 287335 0 74435 0 49296 0 153933 0 14389 0 579388 0 113175 Thomas A Schmitt 0 245531 0 41588 0 5367 0 131570 0 17041 0 441097 0 41588 Mindy A Smith 274025 0 61656 0 36221 0 128439 0 20476 0 520817 0 96323 0 Leslie R Stern 0 194530 0 53366 0 3232 0 73138 0 17140 0 341406 0 53366 Craig A Svendson MD 0 280625 0 77130 0 3297 0 161656 0 23045 0 545753 0 77130 John Kvasnicka MD 340206 0 35132 0 0 0 72794 0 16674 0 464806 0 35132 0 Paul J Sovell MD 320958 0 17501 0 8742 0 48230 0 18996 0 414427 0 0 0 Paul M McCormick MD 296862 0 17501 0 16451 0 45972 0 17172 0 393958 0 10598 0 Peter J Tanghe MD 304139 0 23098 0 603 0 52372 0 13938 0 394150 0 0 0 Gerald L Hill MD 282134 0 17501 0 11821 0 42565 0 23766 0 377787 0 0 0 Joan A Grzywinski 0 19000 0 0 0 0 0 0 0 0 0 19000 0 0 Robert D Gill 0 144759 0 73834 0 140143 0 130150 0 11583 0 500469 0 195921 Ann M Schrader 0 414768 0 30996 0 116286 0 252216 0 7332 0 821598 0 104263 Virginia Sullivan 0 139872 0 0 0 89036 0 14286 0 15906 0 259100 0 25543 Puneet S Cheema MD 0 990639 0 0 0 306018 0 70274 0 18602 0 1385533 0 299714 Kevin P Mulvey MD 0 586792 0 0 0 11858 0 46684 0 20844 0 666178 0 0 Johathan C Grimes MD 0 287570 0 20577 0 16833 0 48636 0 14129 0 387745 0 10860 June A Kim MD 0 732185 0 0 0 239701 0 56138 0 18594 0 1046618 0 224705 Part I, Line 1a Rev. Scott Hinrichs, Vice President of Spiritual Care & Mission for HealthEast Care System received a housing allowance. This was treated as nontaxable compensation to Rev. Scott Hinrichs. Housing allowances are nontaxable compensation to ordained members of the clergy. Kathryn Correia, President and CEO of HealthEast Care System, received a housing allowance as well as spousal/family travel benefits in 2012. These amounts have been treated as a taxable benefit and included in her wages. Ms. Corriea's employment did not begin until January 2012, she did not receive a W-2 in calendar year 2011 and, accordingly, no wages or benefits are reported on this From 990. These amounts will be reported on the succeeding year's Form 990. Part I, Lines 4a-b The following individuals received severance payments during the year from this organization or a related organization : Roger E. Green $38,300; Mindy A. Smith $52,664, Leslie R. Stern $37,920 The terms and conditions of the severance payments are a signed release of rights and an agreement to not make any disparaging remarks about the organization from each individual. Eligible executives receive severance payments for one year. The following individuals participated in or received payment from a supplemental nonqualified retirement plan. The amount listed is the amount paid to the individual and reported accordingly on their 2011 W-2 Form. The terms and conditions of this supplemental nonqualified retirement plan is a five year cliff vesting arrangement: Anne M. Pearson M.D. $7,254; Timothy H. Hanson $105,210; Robert D. Gill $122,087; Roger E. Green $29,157; Rev. Scott Hinrichs $23,956; Stephen J. Kolar M.D. $47,550; Scott North $43,022; Brian Patty, M.D. $208,271; Mary F. Pynn $27,098; Julie A. Schmidt $38,740; Ann M. Schrader $73,267; Mindy A. Smith $34,667; Virginia Sullivan $25,543; Puneet S. Cheema M.D. $299,714; Jonathan C. Grimes M.D. $10,860; June A. Kim M.D. $224,705; Paul M. McCormick M.D. $10,599; Gerald L. Hill M.D. $9,680 The following individuals were participants in the supplemental nonqualified retirement plan but did not receive any payment as they are not yet vested in the plan: Mary Arnold, Catherine J. Barr, Sara Criger, John Kvasnicka M.D., Michael F. Nass, John Piatkowski M.D., Thomas A. Schmitt, Leslie R. Stern, Craig A. Svendson M.D., Kevin P. Mulvey M.D., Paul J. Sovell M.D., Peter J. Tanghe M.D. Part I, Line 7 HEALTHEAST MANAGEMENT INCENTIVE PROGRAM DESCRIPTION: For Patient Care Executives, Operation Executives and Senior Directors For Clinic Managers, Directors and System/Group Directors Summary Description and Goals: The Management Incentive Program provides lump sum financial awards based on system-wide, business unit and/or department financial and quality measures. The primary goal of the Program is to focus the manager on meeting key objectives related to the business while managing their operation(s) or function(s) effectively and efficiently to improve overall financial performance for the HealthEast organization. Annual goals, specifically tied to productivity and quality indicators, will be set for the fiscal year and an incentive paid out annually if key goals and measures are achieved. Goals are weighted based on strategic importance. Specific objectives of the Program are as follows: * Strengthen performance of HealthEast * Align goals of management with HealthEast's mission, values and strategic direction * Achieve "line of sight" by combining system-wide, business unit and/or department financial and quality performance objectives * Provide competitive levels of incentive opportunity to help attract and retain the best talent * Promote objectivity and fairness through rigorous goal setting and performance measurement * Provide feedback on performance relative to goals throughout the plan year to strengthen the link between individual performance and HealthEast's system-wide results Qualifications for Funding and Paying Awards: Before HealthEast can authorize payment of any awards, it must meet the following qualifications: * Financial - HealthEast must have sufficient net income for the fiscal year to cover the cost of any awards. * Accreditation - All HealthEast business units must maintain a level of quality and performance that results in, and maintains, accreditation by Joint Commission (JCAHO) and equivalent licensing boards * Approval -The HealthEast Board of Directors has final approval of all incentive program payouts. In addition, each participant must meet the following individual qualifications to be eligible to receive an award: * Performance - Participant must be performing at an acceptable level in order to be eligible for a payout. * Performance Management - Each participant must have completed performance appraisals for all direct reports with review dates on, or before, August 31 of the fiscal year for which the Program is in effect. * Mandatory Education - Each participant must have completed his/her annual calendar year Mandatory Education training. Award Determination Procedures: The awards are based on a percentage of the participant's salary. The Annual awards range from 0% to 24% of the participant's salary for Patient Care Executives, Operation Executives and Senior Directors. The Annual awards range from 0% to 12% of the participant's salary for Clinic Managers, Directors and System/Group Directors. The award is calculated according to the incentive opportunity assigned to each position, the level of performance achieved on each goal and the weight assigned to each goal. Supplemental Information Part III Form 990, Part VII, Section A, Line 5: Milton P. McClurkan, Jr. received compensation for the professional services rendered to this organization from Innovative Consulting Group, an unrelated organization. Explanation for number reported in Box 3 of Form 1096: Form 990, Part V, Line 1a Cash disbursements are centralized through the parent organization. Therefore the parent organization, HealthEast Care System, makes the payment and files the related Form 1099's and Form 1096 instead of HealthEast St. John's Hospital. Form 990, Part VI, Section A, line 6 The sole member of HealthEast St. John's Hospital is HealthEast Care System, a 501(c)(3) tax-exempt, non-profit organization. The member organization does not elect the members of HealthEast St. John's Hospital Board of Directors because HealthEast St. John's Hospital has a self-electing board. The member organization does not approve any decisions of the board. The member of the organization receives the organziations net assets upon dissolution. Form 990, Part VI, Section B, line 11 The Form 990 is sent electronically to all members of the Board of Directors prior to the filing of the Form 990 and prior to the Finance Committee and Board of Directors meetings in which it will be reviewed. The Director of Tax, if necessary, will attend the Finance Committee meeting and/or the Board of Directors meeting to discuss the Form 990 with the members of the Board and answer any questions from the Board. Form 990, Part VI, Section B, line 12c HealthEast Care System monitors proposed or ongoing transactions for conflicts of interest through the procedures set forth in its Conflicts of Interest Policy (the Policy). The Policy covers HealthEast Care System's Directors, Officers and members of a Committee with Board-delegated powers. A Director, Officer or member of a Committee with Board-delegated powers who has a direct or indirect financial interest, is an interested person under the terms of the Policy. If a person is an interested person with respect to any entity in the HealthEast Care System he or she is an interested person with respect to all entities in the HealthEast Care System. Pursuant to the terms of the Policy, in connection with any actual or possible conflicts of interest, an interested person must disclose the existence of his or her financial interest and must be given the opportunity to disclose all material facts relating to his or her financial interest to the Directors or members of Committees with Board-delegated powers considering the proposed transaction or arrangement. After disclosure of the financial interest and all material facts, and after any discussion with the interested person, the interested person must leave the Board (or Committee) meeting while the financial interest is discussed and voted upon. The remaining Board (or Committee) members shall decide if a conflict of interest exists. An interested person may make a presentation at the Board or Committee meeting regarding the proposed transaction or arrangement, but after such presentation, the interested person shall leave the meeting during the discussion of, and the vote on, the proposed transaction or arrangement that results in the conflict of interest. Form 990, Part VI, Section B, line 15 The Chair of the Board of Directors engages an external consulting firm to review the compensation of the organization's CEO, Senior Vice Presidents and Vice Presidents annually and was last completed in November 2011. The process includes the external consulting firm evaluating current base salaries and total cash and benefits compared to comparable positions within the comparator group. The external firm presents its findings to the Executive Committee of the Board and indicates any recommendations for change. The Executive Committee of the Board approves the salaries. The consulting firm issues a reasonable compensation letter to the Board of Directors. Form 990, Part VI, Section C, line 19 The Articles of Incorporation for this organization are available to the public through the Secretary of State Office. The organization's conflict of interest policy and other governing documents are not made available to the public. The financial statements for this organization are made available to the public through the Attorney General's Office and are also attached to this Form 990. Average hours worked per week devoted to related organizations: Form 990, Part VII, Section A, Column B Individuals listed on Form 990, Part VII, Section A, Column A worked the following average hours per week for a related organization: Larry Ainsworth 2 hours, Diane Berthel 2 hours, Julie Causey 2 hours, Patrick Donovan 2 hours, Albert Eggert 2 hours, John Finnegan, Jr. Ph.D. 2 hours, Joan Grzywinski 0 hours, Fred Harris Jr. 4 hours, Roland Hayes 4 hours, Loius Henry, Jr. 2 hours, Anne Pearson M.D. 40 hours, Leonard Randolph M.D. 2 hours, Sister Marie Seiter 2 hours, David Taylor 2 hours, Jone Tiffany 2 hours, Laure Waschbusch M.D. 2 hours, James Wiltz 2 hours, Timothy Hanson 40 hours, Kathryn Correia 40 hours, Mary Arnold 40 hours, Catherine Barr 40 hours, Sara Criger 40 hours, Brandon Cullinan, M.D. 40 hours, Shirley Germann 40 hours, Robert Gill 0 hours, Roger Green 40 hours, Scott Hinrichs 40 hours, Stephen Kolar 40 hours, Milton McClurkan Jr. 40 hours, Michael Nass 40 hours, Scott North 0 hours, Brian Patty M.D. 40 hours, John Piatkowski M.D. 40 hours, Mary Pynn 40 hours, Julie Schmidt 40 hours, Thomas Schmitt 40 hours, Ann Schrader 0 hours, Mindy Smith 0 hours, Leslie Stern 40 hours, Virginia Sullivan 0 hours, Craig Svendson M.D. 40 hours, John Kvasnicka M.D. 0 hours, Paul J. Sovell M.D. 0 hours, Paul McCormick M.D. 0 hours, Peter Tanghe M.D. 0 hours, Gerald L. Hill M.D. 0 hours, Puneet S. Cheema M.D. 40 hours, Kevin P. Mulvey M.D. 40 hours, Jonathan Grimes M.D. 40 hours, June A. Kim M.D. 40 hours. Average hours worked per week: Form 990, Part VII, Section A, Column B This organization is a subsidiary of HealthEast Care System, a 501(c)(3), tax-exempt, non-profit organization. The Board of Directors for this organization is the same as the Board of Directors for HealthEast Care System. All hours worked as a member of the Board of Directors are reported on the Form 990 for the parent organization, HealthEast Care System. Therefore, we have reported 0.00 hours worked by each member of the Board of Directors on this organization's return. Changes in Net Assets or Fund Balances: Form 990, Part XI, line 5: Donated Assets 21,130. Interest Income reported on tax return, not books -97. Partnership Income reported on tax return, not books -73,696. Contribution to Parent Company -33,286,862. Surgery Center Income reported on books, not on tax return 2,593,182. Partnership Distribution reported on books, not tax return 37,800. Surgery Center Income reported on tax return, not books -3,180,302. Total to Form 990, Part XI, Line 5: -33,888,845. Were financial statements audited by independent accountant: Form 990, Part XII, Line 2 HealthEast St. John's Hospital is part of HealthEast Care System and its various subsidiaries. Therefore, this organization's financial statements were only audited on a consolidated basis by an independent auditor as oppossed to separate audits. Continuation of Community Information: Schedule H, Part VI, Line 4 While these findings suggest HealthEast may not be serving as many patients of color as expected, there are a number of limitations to consider when comparing HealthEast hospital visit data to general county-level demographic information and interpreting this information. First, the data analyzed by HealthEast describes the number of patient visits, not unique patients. Individuals readmitted during the year will be reflected multiple times in the analysis. Second, because HealthEast is one of multiple hospital systems serving residents of the east metro, is it not possible to know whether patients not receiving services by HealthEast are having their health care needs met elsewhere. Finally, hospital care is a deep-end service, necessary to treat serious acute and chronic medical conditions; it may be that a more culturally diverse patient population is served by the HealthEast clinic system and other health care services. Patient demographic characteristics, by patient visit (2010) Bethesda St. John's St. Joseph's Woodwinds Hospital Hospital Hospital Hospital Gender Male 51% 36% 49% 35% Female 49% 64% 51% 65% Race/ethnicity American Indian <1% <1% 1% <1% Asian American 2% 7% 3% 3% African American 4% 5% 13% 6% White 86% 83% 72% 85% Hispanic/Latino 1% 2% 3% 2% Age 0-19 3% 6% 5% 11% 20-29 4% 10% 14% 15% 30-44 12% 16% 21% 23% 45-64 36% 37% 34% 29% 65+ 45% 32% 27% 22% Source: HealthEast Community Health Needs Assessment Talking Points and Secondary Data Analysis Report (2011). HealthEast is serving a growing number of recent immigrant and refugee patients. Overall, the number of Hmong patient visits has increased from 7,719 visits in 2000 to 8,646 visits in 2010. While the number of Hmong patient visits increased by over 50 percent at St. John's Hospital, there were reductions in the number of Hmong patient visits at St. Joseph's Hospital (a 37% reduction over time). During the past three years, there has been a more dramatic increase in the number of patient visits among Somali residents (from a total of 182 visits in 2008 to 1,014 visits in 2011). In addition, HealthEast is beginning to provide a growing amount of services to Karen patients. In 2011, there were 1,737 Karen patient visits in HealthEast's short-term care hospitals, with most visits (71%) at St. John's Hospital. Trends in patient visits over time, selected racial/ethnic groups (2010) Bethesda St. John's St. Joseph's Woodwinds Hospital Hospital Hospital Hospital Hmong 2000 166 4,198 2,224 591 2010 183 6,391 1,407 665 % change +10% +52% -37% +13% Somali 2008 4 54 26 98 2011 15 225 176 598 % change +300% +317% +577% +510% Source: HealthEast Community Health Needs Assessment Talking Points and Secondary Data Analysis Report (2011). Although HealthEast serves a predominantly English-speaking population, the hospital system provides care to patients who speak a variety of different languages. At each hospital, the vast majority of patient visits (94-97%) were with patients who spoke English as their primary language. However, HealthEast does need to address the needs of patients who speak a variety of languages. The interpretation and translation services to provide culturally-appropriate care to HealthEast patients is better understood by describing the number of patient visits with patients who spoke languages other than English. During 2010, nearly 5,000 patient visits were held with patients who primarily spoke Hmong, while over 1,000 patient visits were with patients who spoke Karen or Spanish. Overall, patients spoke a total of 11 different languages. While some patients may have family members who can serve as informal interpreters, many likely need medical interpreters and translated materials. Primary language spoken, by patient visits (2010) Bethesda St. John's St. Joseph's Woodwinds Hospital Hospital Hospital Hospital English 97% 94% 95% 95% Hmong 2% 3% 1% <1% Spanish 1% <1% 1% 1% Karen <1% 1% 1% <1% Somali <1% <1% <1% 1% Source: HealthEast Community Health Needs Assessment Talking Points and Secondary Data Analysis Report (2011). Number of patient visits, by patient primary language (2010) St. John's St. Joseph's Woodwinds Total non-English Hospital Hospital Hospital speaking patient visits Hmong 3,983 704 96 4,735 Karen 976 432 27 1,435 Spanish 609 387 99 1,095 Somali 118 85 492 645 Russian 72 38 11 121 Amharic 24 93 2 119 Burmese 74 35 0 109 Sign language 60 15 15 90 Chinese 50 13 7 70 Arabic 43 17 9 69 Tagalog 53 9 1 64 Source: HealthEast Community Health Needs Assessment Talking Points and Secondary Data Analysis Report (2011). Demographic trends to consider: Overall, population growth is expected to decline in Ramsey County while increasing in the region overall. According to projections from the Minnesota State Demographic Center, total growth between 2005 and 2035 is expected to be the highest in Washington County (38%); growth is also expected in Dakota County (27%) while ongoing decline is projected in Ramsey County (-4%). The senior population will continue to increase dramatically over the next 30 years. In 2010, 11 percent of Twin Cities residents were senior citizens (age 65 or older). The Metropolitan Council (2012) expects seniors will comprise 21 percent of the population by 2040. The region will continue to become increasingly culturally diverse. This is the result of ongoing migration and higher birth rates among Hispanic, African American, and Asian populations. Between 2010 and 2040, the number of residents of color in the Twin Cities region is expected to double while the White, non-Hispanic population will decrease 2 percent. Population growth is expected to be greatest within the Hispanic/Latino population, but African American and Asian populations are expected to more than double, as well. HealthEast Medical Imaging LLC 3640 Talmage Circle Vadnais Heights MN 55110 200509546 Medical Imaging Services MN 1858204 203019 HealthEast St John's Hospital D & T Facility Management Company PO Box 64624 St Paul MN 55164 411928275 Management of Diagnostic Medical Services MN 501(c)(3) 11a HealthEast Woodwinds Hospital 0 HealthEast Medical Research Institute PO Box 64624 St Paul MN 55164 411765832 Medical Research MN 501(c)(3) 4 HealthEast Care System 0 HealthEast Professional Services PO Box 64624 St Paul MN 55164 261226617 Physician services provided to related tax-exempt hospitals. MN 501(c)(3) 9 HealthEast Care System 0 HealthEast St Joseph's Hospital PO Box 64624 St Paul MN 55164 410693880 Hospital MN 501(c)(3) 3 HealthEast Care System 0 HealthEast Woodwinds Hospital PO Box 64624 St Paul MN 55164 411592761 Hospital MN 501(c)(3) 3 HealthEast Care System 0 HealthEast Care System PO Box 64624 St Paul MN 55164 363517697 Hospital MN 501(c)(3) 3 N/A 0 Maplewood Professional Building Limited Partnership 1655 Beam Avenue Maplewood MN 55109 411431847 Rental Real Estate MN HealthEast St John's Hospital Related 73793 381273 0 1 0.12600 HealthEast Surgery Center-Maplewood LLC 1655 Beam Avenue Maplewood MN 55109 203349887 Outpatient Surgery Center MN HealthEast St John's Hospital Related 3180302 2160717 0 0 0.74500 East Metro Insurance LTD 62 Forum Lane 3rd Floor Camana Ba Grand Cayman CJ KY1-1203 980417513 Captive Insurance Organization CJ N/A C HealthEast Diversified Services Inc PO Box 64624 St Paul MN 55164 411388583 Reference Lab & Rental Real Estate MN N/A C 1 1 0 1 0 0 0 0 1 1 1 1 0 0 1 1 0 1 HealthEast Maplewood Surgery Center-Maplewood LLC R 2942750 Fair Market Value Maplewood Professional Building Limited Partnership A 15817 Fair Market Value Maplewood Professional Building Limited Partnership J 315840 Fair Market Value