INTERMOUNTAIN FRONT RANGE INC: Form 990, tax year 2012
View the entire original 990 at ProPublica ↗
- Organization
- INTERMOUNTAIN FRONT RANGE INC (EIN 84-1103606)
- Tax period
- 2012-01-01 to 2012-12-31
- Filed
- 2013-11-13
- IRS object ID
- 201303179349306115
- Schema version
- 2012v2.1
- Source
- Download XML · Original 990 at ProPublica
Every field in the e-filed return. Faint text is the IRS element name, for citing.
- Return header
- Form 990
- Schedule A
- Schedule B
- Schedule C
- Schedule D
- Schedule F
- Schedule H
- Schedule I
- Schedule J
- Schedule O
- Schedule R
Return header ReturnHeader
| Field | Value | IRS element (for citing) |
|---|---|---|
| Timestamp | 2013-11-13T17:48:04-06:00 | Timestamp |
| Tax Period End Date | 2012-12-31 | TaxPeriodEndDate |
Preparer Firm PreparerFirm
Preparer Firm Business Name PreparerFirmBusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | ERNST & YOUNG US LLP | BusinessNameLine1 |
Preparer Firm US Address PreparerFirmUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 178 S RIO GRANDE STREET SUITE 400 | AddressLine1 |
| City | SALT LAKE CITY | City |
| State | UT | State |
| ZIP Code | 84101 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990 | ReturnType |
| Tax Period Begin Date | 2012-01-01 | TaxPeriodBeginDate |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 841103606 | EIN |
Name Name
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | EXEMPLA INC FKA LUTHERAN HOSPITAL | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| In Care Of Name | % EXEMPLA INC C/O SHARON OWENS | InCareOfName |
| Name Control | EXEM | NameControl |
| Phone | 3034674430 | Phone |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 2420 West 26th Ave Suite 100D | AddressLine1 |
| Address Line2 | Suite | AddressLine2 |
| City | Denver | City |
| State | CO | State |
| ZIP Code | 80211 | ZIPCode |
Officer Officer
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name | Robert Ladenburger | Name |
| Title | President/CEO | Title |
| Date Signed | 2013-11-13 | DateSigned |
Preparer Preparer
| Field | Value | IRS element (for citing) |
|---|---|---|
| Phone | 8013503300 | Phone |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax Year | 2012 | TaxYear |
| Build TS | 2016-02-24 21:20:13Z | BuildTS |
Form 990 IRS990
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Of Principal Officer Person | ROBERT LADENBURGER | NameOfPrincipalOfficerPerson |
| Gross Receipts | 692128251 | GrossReceipts |
| Group Return For Affiliates | false | GroupReturnForAffiliates |
| Organization501c3 | X | Organization501c3 |
| Web Site | WWW.EXEMPLA.ORG | WebSite |
| Type Of Organization Corporation | X | TypeOfOrganizationCorporation |
| Year Formation | 1905 | YearFormation |
| State Legal Domicile | CO | StateLegalDomicile |
| Activity Or Mission Description | WE REVEAL AND FOSTER GOD'S HEALING LOVE BY IMPROVING THE HEALTH OF THE PEOPLE AND COMMUNITIES WE SERVE, ESPECIALLY THOSE WHO ARE POOR AND VULNERABLE. | ActivityOrMissionDescription |
| Nbr Voting Members Governing Body | 9 | NbrVotingMembersGoverningBody |
| Nbr Independent Voting Members | 6 | NbrIndependentVotingMembers |
| Total Nbr Employees | 5419 | TotalNbrEmployees |
| Total Nbr Volunteers | 1303 | TotalNbrVolunteers |
| Total Gross UBI | 248236 | TotalGrossUBI |
| Net Unrelated Business Txbl Income | 198130 | NetUnrelatedBusinessTxblIncome |
| Contributions Grants Prior Year | 851145 | ContributionsGrantsPriorYear |
| Contributions Grants Current Year | 950284 | ContributionsGrantsCurrentYear |
| Program Service Revenue Prior Year | 632213008 | ProgramServiceRevenuePriorYear |
| Program Service Revenue CY | 672336029 | ProgramServiceRevenueCY |
| Investment Income Prior Year | 8590908 | InvestmentIncomePriorYear |
| Investment Income Current Year | 13737537 | InvestmentIncomeCurrentYear |
| Other Revenue Prior Year | 20177599 | OtherRevenuePriorYear |
| Other Revenue Current Year | 1651613 | OtherRevenueCurrentYear |
| Total Revenue Prior Year | 661832660 | TotalRevenuePriorYear |
| Total Revenue Current Year | 688675463 | TotalRevenueCurrentYear |
| Grants And Similar Amnts Prior Year | 757960 | GrantsAndSimilarAmntsPriorYear |
| Grants And Similar Amnts CY | 750100 | GrantsAndSimilarAmntsCY |
| Benefits Paid To Members Prior Year | 0 | BenefitsPaidToMembersPriorYear |
| Benefits Paid To Members CY | 0 | BenefitsPaidToMembersCY |
| Salaries Etc Prior Year | 320796735 | SalariesEtcPriorYear |
| Salaries Etc Current Year | 301121289 | SalariesEtcCurrentYear |
| Total Prof Fundrsng Exp Prior Year | 0 | TotalProfFundrsngExpPriorYear |
| Total Prof Fundrsng Exp CY | 0 | TotalProfFundrsngExpCY |
| Total Fundrsng Exp Current Year | 0 | TotalFundrsngExpCurrentYear |
| Other Expense Prior Year | 303553068 | OtherExpensePriorYear |
| Other Expenses Current Year | 352538252 | OtherExpensesCurrentYear |
| Total Expenses Prior Year | 625107763 | TotalExpensesPriorYear |
| Total Expenses Current Year | 654409641 | TotalExpensesCurrentYear |
| Revenues Less Expenses Prior Year | 36724897 | RevenuesLessExpensesPriorYear |
| Revenues Less Expenses CY | 34265822 | RevenuesLessExpensesCY |
| Total Assets BOY | 925782307 | TotalAssetsBOY |
| Total Assets EOY | 956351142 | TotalAssetsEOY |
| Total Liabilities BOY | 521531546 | TotalLiabilitiesBOY |
| Total Liabilities EOY | 514335976 | TotalLiabilitiesEOY |
| Net Assets Or Fund Balances BOY | 404250761 | NetAssetsOrFundBalancesBOY |
| Net Assets Or Fund Balances EOY | 442015166 | NetAssetsOrFundBalancesEOY |
| Info In Schedule O Part III | X | InfoInScheduleOPartIII |
| Mission Description | We reveal and foster God's healing love by improving the health of the people and communities we serve, especially those who are poor and vulnerable. | MissionDescription |
| Significant New Program Services | false | SignificantNewProgramServices |
| Significant Change | false | SignificantChange |
| Expense | 439029971 | Expense |
| Grants | 465195 | Grants |
| Revenue | 573802226 | Revenue |
| Description | Provision of hospital based healthcare services, including charity care and unreimbursed Medicaid - see description in Schedule O | Description |
Activity2 Activity2
| Field | Value | IRS element (for citing) |
|---|---|---|
| Expense | 69019450 | Expense |
| Grants | 0 | Grants |
| Revenue | 55435533 | Revenue |
| Description | Physician clinics - See detailed descriptions in Schedule O | Description |
Activity3 Activity3
| Field | Value | IRS element (for citing) |
|---|---|---|
| Expense | 15902633 | Expense |
| Grants | 0 | Grants |
| Revenue | 19653199 | Revenue |
| Description | West Pines Behavioral Health - See detailed description in Schedule O | Description |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Of Other Program Service Exp | 19634016 | TotalOfOtherProgramServiceExp |
| Total Of Other Program Service Grnt | 284905 | TotalOfOtherProgramServiceGrnt |
| Total Of Other Program Service Rev | 25163935 | TotalOfOtherProgramServiceRev |
| Total Program Service Expense | 543586070 | TotalProgramServiceExpense |
| Described In501 C3 | true | DescribedIn501C3 |
| Schedule B Required | true | ScheduleBRequired |
| Political Activities | false | PoliticalActivities |
| Lobbying Activities | true | LobbyingActivities |
| Subject To Proxy Tax | false | SubjectToProxyTax |
| Donor Advised Funds | false | DonorAdvisedFunds |
| Conservation Easements | false | ConservationEasements |
| Collections Of Art | false | CollectionsOfArt |
| Credit Counseling | false | CreditCounseling |
| Term Or Permanent Endowments | false | TermOrPermanentEndowments |
| Report Land Bldg Equip | true | ReportLandBldgEquip |
| Report Invest Oth Securities | false | ReportInvestOthSecurities |
| Report Prog Rel Invest | false | ReportProgRelInvest |
| Report Other Assets | false | ReportOtherAssets |
| Report Other Liabilities | true | ReportOtherLiabilities |
| Report Fin48 Footnote | false | ReportFin48Footnote |
| Independent Audit Financial Stmt | false | IndependentAuditFinancialStmt |
| Consolidated Audit Financial Stmt | true | ConsolidatedAuditFinancialStmt |
| School | false | School |
| Foreign Office | false | ForeignOffice |
| Foreign Activities | true | ForeignActivities |
| More Than5000 K To Organizations | true | MoreThan5000KToOrganizations |
| More Than5000 K To Individuals | false | MoreThan5000KToIndividuals |
| Professional Fundraising | false | ProfessionalFundraising |
| Fundraising Activities | false | FundraisingActivities |
| Gaming | false | Gaming |
| Hospital | true | Hospital |
| Financial Stmt Attached | true | FinancialStmtAttached |
| Grants To Organizations | true | GrantsToOrganizations |
| Grants To Individuals | true | GrantsToIndividuals |
| Schedule J Required | true | ScheduleJRequired |
| Tax Exempt Bonds | false | TaxExemptBonds |
| Excess Benefit Transaction | false | ExcessBenefitTransaction |
| Prior Excess Benefit Transaction | false | PriorExcessBenefitTransaction |
| Loan To Officer Or DQP | false | LoanToOfficerOrDQP |
| Grant To Related Person | false | GrantToRelatedPerson |
| Bsnss Rltnshp With Organization | false | BsnssRltnshpWithOrganization |
| Bsnss Rltnshp Thru Family Member | false | BsnssRltnshpThruFamilyMember |
| Officer Entity With Bsnss Rltnshp | false | OfficerEntityWithBsnssRltnshp |
| Deductible Non Cash Contributions | false | DeductibleNonCashContributions |
| Deductible Contributions Of Art | false | DeductibleContributionsOfArt |
| Terminated | false | Terminated |
| Partial Liquidation | false | PartialLiquidation |
| Disregarded Entity | true | DisregardedEntity |
| Related Entity | true | RelatedEntity |
| Related Org Controlled Entity | true | RelatedOrgControlledEntity |
| Transaction Related Entity | true | TransactionRelatedEntity |
| Transfers To Exempt Non Chrtbl Org | false | TransfersToExemptNonChrtblOrg |
| Activities Conducted Partnership | false | ActivitiesConductedPartnership |
| Schedule O Required | true | ScheduleORequired |
| Number Forms Transmitted With1096 | 592 | NumberFormsTransmittedWith1096 |
| Number W2 G Included | 0 | NumberW2GIncluded |
| Compliance With Backup Witholding | true | ComplianceWithBackupWitholding |
| Number Of Employees | 5419 | NumberOfEmployees |
| Employment Tax Returns Filed | true | EmploymentTaxReturnsFiled |
| Unrelated Business Income | true | UnrelatedBusinessIncome |
| Form990-T Filed | true | Form990-TFiled |
| Foreign Financial Account | false | ForeignFinancialAccount |
| Prohibited Tax Shelter Trans | false | ProhibitedTaxShelterTrans |
| Taxable Party Notification | false | TaxablePartyNotification |
| Non Deductible Contributions | false | NonDeductibleContributions |
| Quid Pro Quo Contributions | false | QuidProQuoContributions |
| Form8282 Property Disposed Of | false | Form8282PropertyDisposedOf |
| Funds To Pay Premiums | false | FundsToPayPremiums |
| Premiums Paid | false | PremiumsPaid |
| Indoor Tanning Services | false | IndoorTanningServices |
| Info In Schedule O Part VI | X | InfoInScheduleOPartVI |
| Nbr Voting Governing Body Members | 9 | NbrVotingGoverningBodyMembers |
| Number Independent Voting Members | 6 | NumberIndependentVotingMembers |
| Family Or Business Relationship | false | FamilyOrBusinessRelationship |
| Delegation Of Management Duties | true | DelegationOfManagementDuties |
| Changes To Organizing Docs | true | ChangesToOrganizingDocs |
| Material Diversion Or Misuse | false | MaterialDiversionOrMisuse |
| Members Or Stockholders | true | MembersOrStockholders |
| Election Of Board Members | true | ElectionOfBoardMembers |
| Decisions Subject To Approval | true | DecisionsSubjectToApproval |
| Minutes Of Governing Body | true | MinutesOfGoverningBody |
| Minutes Of Committees | true | MinutesOfCommittees |
| Officer Mailing Address | false | OfficerMailingAddress |
| Local Chapters | true | LocalChapters |
| Policies Reference Chapters | true | PoliciesReferenceChapters |
| Form990 Provided To Governing Body | true | Form990ProvidedToGoverningBody |
| Conflict Of Interest Policy | true | ConflictOfInterestPolicy |
| Annual Disclosure Covered Persons | true | AnnualDisclosureCoveredPersons |
| Regular Monitoring Enforcement | true | RegularMonitoringEnforcement |
| Whistleblower Policy | true | WhistleblowerPolicy |
| Document Retention Policy | true | DocumentRetentionPolicy |
| Compensation Process CEO | false | CompensationProcessCEO |
| Compensation Process Other | true | CompensationProcessOther |
| Investment In Joint Venture | true | InvestmentInJointVenture |
| Written Policy Or Procedure | true | WrittenPolicyOrProcedure |
| Upon Request | X | UponRequest |
The Books Are In Care Of TheBooksAreInCareOf
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Person | EXEMPLA INC CO SHARON OWENS | NamePerson |
| Telephone Number | 3038135280 | TelephoneNumber |
Address US AddressUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 2480 W 26TH AVENUE STE 200B | AddressLine1 |
| City | Denver | City |
| State | CO | State |
| ZIP Code | 80211 | ZIPCode |
Form990 Part VII Section A Form990PartVIISectionA (28 entries)
| TitleTitle | Average Hours Per WeekAverageHoursPerWeek | Average Hours Per Week RelatedAverageHoursPerWeekRelated | Individual Trustee Or DirectorIndividualTrusteeOrDirector | Reportable Comp From OrganizationReportableCompFromOrganization | Reportable Comp From Related OrgsReportableCompFromRelatedOrgs | Other CompensationOtherCompensation | OfficerOfficer | Key EmployeeKeyEmployee | Highest Compensated EmployeeHighestCompensatedEmployee |
|---|---|---|---|---|---|---|---|---|---|
| KOGER PROPST | |||||||||
| DIRECTOR, VICE CHAIR | 2.0 | 0.0 | X | 0 | 0 | 0 | |||
| FELIX W COOK SR | |||||||||
| DIRECTOR | 2.0 | 0.0 | X | 0 | 0 | 0 | |||
| BRUCE WARING MD | |||||||||
| DIRECTOR through 10/20/12 | 2.0 | 0.0 | X | 0 | 0 | 0 | |||
| SISTER AMY WILLCOTT | |||||||||
| DIRECTOR | 2.0 | 0.0 | X | 0 | 0 | 0 | X | ||
| STEPHEN W COBB | |||||||||
| CHIEF MEDICAL OFFICER (EPN) | 50.0 | 0.0 | X | 0 | 272196 | 60439 | |||
| MICHAEL A SLUBOWSKI | |||||||||
| CHAIR,PRESIDENT AND CEO(SCLHS) | 2.0 | 50.0 | X | 0 | 1513703 | 36584 | X | ||
| MARLA J WILLIAMS | |||||||||
| DIRECTOR | 2.0 | 0.0 | X | 0 | 0 | 0 | |||
| SALLY WOOLSEY | |||||||||
| DIRECTOR | 2.0 | 0.0 | X | 0 | 0 | 0 | |||
| LYDIA JUMONVILLE | |||||||||
| SVP FINANCE & CFO | 50.0 | 0.0 | X | 0 | 665251 | 89581 | X | ||
| RICK LOPES | |||||||||
| SVP Health Networks | 50.0 | 0.0 | X | 0 | 917605 | 55755 | |||
| TODD A CONKLIN | |||||||||
| SVP & CFO, TREASURER | 25.0 | 25.0 | 0 | 626681 | 76029 | X | |||
| BOB LADENBURGER | |||||||||
| PRESIDENT & CEO of EXEMPLA | 25.0 | 25.0 | 0 | 1376046 | 106636 | X | |||
| DAVID HAMM | |||||||||
| PRESIDENT & CEO-EGSMC | 50.0 | 0.0 | 0 | 494364 | 94295 | X | |||
| ROBERT G BILLERBECK | |||||||||
| VP-CHIEF MEDICAL OFFICER | 50.0 | 0.0 | 0 | 357486 | 61013 | X | |||
| ELISA WETHERBEE | |||||||||
| CHIEF OPERATING OFFICER EPN | 50.0 | 0.0 | 0 | 305534 | 56790 | X | |||
| S ANN EVANS | |||||||||
| VP-CHIEF NURSING OFFICER(ELMC) | 50.0 | 0.0 | 195861 | 0 | 5322 | X | |||
| BETH C FORSYTH | |||||||||
| VP-CLIN & SUPPORT SVCS (EGSMC) | 50.0 | 0.0 | 0 | 271869 | 50387 | X | |||
| MARGARET CAIN PRICE | |||||||||
| VP-OPERATIONS (ELMC) | 50.0 | 0.0 | 0 | 268103 | 51458 | X | |||
| KAREN M SCREMIN | |||||||||
| VP-FINANCE (ELMC) | 50.0 | 0.0 | 0 | 231319 | 42331 | X | |||
| SUSAN E KERSCHEN | |||||||||
| VP-CHIEF NURSING OFFCR (EGSMC) | 50.0 | 0.0 | 0 | 230786 | 47136 | X | |||
| JOHN D HIGGINS | |||||||||
| VP FINANCE (EGSMC) | 50.0 | 0.0 | 0 | 197838 | 48775 | X | |||
| GRANT WICKLUND | |||||||||
| PRESIDENT & CEO-ELMC | 50.0 | 0.0 | 0 | 523203 | 71423 | X | |||
| TOWNDROWGERALDINE M | |||||||||
| VP-CHIEF NURSING OFFICER(ELMC) | 50.0 | 0.0 | 231600 | 0 | 7380 | X | |||
| MARK C WATTS | |||||||||
| PHYSICIAN | 50.0 | 0.0 | 725795 | 0 | 25844 | X | |||
| KEVIN B MILLER | |||||||||
| PHYSICIAN | 50.0 | 0.0 | 691783 | 0 | 34733 | X | |||
| LAMONDRODERICK G | |||||||||
| PHYSICIAN | 50.0 | 0.0 | 834953 | 0 | 32159 | X | |||
| LANKENAUJOHN E | |||||||||
| PHYSICIAN | 50.0 | 0.0 | 804331 | 0 | 34599 | X | |||
| THOMPSONDONALD C | |||||||||
| PHYSICIAN | 50.0 | 0.0 | 663380 | 0 | 25056 | X | |||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | 4147703 | TotalReportableCompFromOrg |
| Total Reportable Comp Frm Rltd Orgs | 8251984 | TotalReportableCompFrmRltdOrgs |
| Total Other Compensation | 1113725 | TotalOtherCompensation |
| Number Individuals GT100 K | 7 | NumberIndividualsGT100K |
| Formers Listed | false | FormersListed |
| Total Comp GT150 K | true | TotalCompGT150K |
| Compensation From Other Sources | false | CompensationFromOtherSources |
Contractor Compensation ContractorCompensation (5 entries)
| Address Line1AddressOfContractor/AddressUS/AddressLine1 | CityAddressOfContractor/AddressUS/City | StateAddressOfContractor/AddressUS/State | ZIP CodeAddressOfContractor/AddressUS/ZIPCode | Description Of ServicesDescriptionOfServices | CompensationCompensation |
|---|---|---|---|---|---|
| COLORADO DIAGNOSTIC LABS | |||||
| PO BOX 840274 | DALLAS | TX | 75284 | PROFESSIONAL SERVICE | 4488752 |
| MIDTOWN INPATIENT MEDICINE LLC | |||||
| 1721 E 19TH AVE UNIT 366 | DENVER | CO | 80218 | PROFESSIONAL SERVICE | 4533048 |
| HL DAVISDAVIS A JOINT VENTURE | |||||
| 1755 BLAKE ST SUITE 400 | DENVER | CO | 80202 | CONSTRUCTION DESIGN | 12849427 |
| WESTERN PARKING MAGEMENT | |||||
| 682 S NILE WAY | AURORA | CO | 80012 | VALLEY SERVICES | 2906546 |
| HESKY-FISHER-LUKNIC COOK LLC | |||||
| 7880 E 6TH AVE | DENVER | CO | 80230 | PROFESSIONAL SERVICE | 1951715 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of Contractors GT100 K | 5 | NumberOfContractorsGT100K |
| Related Organizations | 673062 | RelatedOrganizations |
| Government Grants | 20227 | GovernmentGrants |
| All Other Contributions | 256995 | AllOtherContributions |
| Total Contributions | 950284 | TotalContributions |
Program Service Revenue ProgramServiceRevenue (5 entries)
| DescriptionDescription | Business CodeBusinessCode | Total Revenue ColumnTotalRevenueColumn | Related Or Exempt Function IncomeRelatedOrExemptFunctionIncome | Unrelated Business RevenueUnrelatedBusinessRevenue |
|---|---|---|---|---|
| NET PATIENT REVENUE | 621110 | 659471500 | 659228027 | 243473 |
| OTHER AFFILIATED RENT INCOME | 531120 | 1302411 | 1302411 | |
| PHARMACY SALES | 446110 | 221446 | 221446 | |
| MEANINGFUL USE INCENTIVE | 621110 | 3978185 | 3978185 | |
| ADMIN MISC INCOME | 900099 | 4763 | 4763 |
Total Oth Program Service Revenue TotalOthProgramServiceRevenue
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 7357724 | TotalRevenueColumn |
| Related Or Exempt Function Income | 7357724 | RelatedOrExemptFunctionIncome |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | 672336029 | TotalProgramServiceRevenue |
Investment Income InvestmentIncome
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 6329600 | TotalRevenueColumn |
| Exclusion | $6,329,600 | ExclusionAmount |
Income From Invest Bond Proceeds IncomeFromInvestBondProceeds
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 0 | TotalRevenueColumn |
Royalties Revenue RoyaltiesRevenue
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 0 | TotalRevenueColumn |
Gross Rents GrossRents
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | 376230 | Real |
Less Rental Expenses LessRentalExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | 443481 | Real |
Rental Income Or Loss RentalIncomeOrLoss
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | -67251 | Real |
| Personal | 0 | Personal |
Net Rental Income Or Loss NetRentalIncomeOrLoss
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | -67251 | TotalRevenueColumn |
| Exclusion | -$67,251 | ExclusionAmount |
Gross Amount Sales Assets GrossAmountSalesAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | 7442816 | Securities |
| Other | 22596 | Other |
Less Cost Oth Basis Sales Expenses LessCostOthBasisSalesExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | 57475 | Other |
Gain Or Loss GainOrLoss
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | 7442816 | Securities |
| Other | -34879 | Other |
Net Gain Or Loss Investments NetGainOrLossInvestments
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 7407937 | TotalRevenueColumn |
| Exclusion | $7,407,937 | ExclusionAmount |
Net Income From Fundraising Events NetIncomeFromFundraisingEvents
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 0 | TotalRevenueColumn |
Net Income From Gaming NetIncomeFromGaming
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 0 | TotalRevenueColumn |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Sales Of Inventory | 2801059 | GrossSalesOfInventory |
| Cost Of Goods Sold | 2951832 | CostOfGoodsSold |
Net Income Or Loss NetIncomeOrLoss
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | -150773 | TotalRevenueColumn |
| Related Or Exempt Function Income | -150773 | RelatedOrExemptFunctionIncome |
Other Revenue Misc OtherRevenueMisc (2 entries)
| DescriptionDescription | Business CodeBusinessCode | Total Revenue ColumnTotalRevenueColumn | Related Or Exempt Function IncomeRelatedOrExemptFunctionIncome |
|---|---|---|---|
| OTHER RENTAL REVENUE | 900099 | 68082 | 68082 |
| EQUALIZATION | 900099 | 1801555 | 1801555 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Other Revenue | 1869637 | TotalOtherRevenue |
Total Revenue TotalRevenue
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 688675463 | TotalRevenueColumn |
| Related Or Exempt Function Income | 673806657 | RelatedOrExemptFunctionIncome |
| Unrelated Business Revenue | 248236 | UnrelatedBusinessRevenue |
| Exclusion | $13,670,286 | ExclusionAmount |
Grants To Domestic Orgs GrantsToDomesticOrgs
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 238905 | Total |
| Program Services | 238905 | ProgramServices |
Grants To Domestic Individuals GrantsToDomesticIndividuals
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 465195 | Total |
| Program Services | 465195 | ProgramServices |
Foreign Grants ForeignGrants
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 46000 | Total |
| Program Services | 46000 | ProgramServices |
Benefits To Members BenefitsToMembers
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Comp Current Officers Directors CompCurrentOfficersDirectors
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 4009776 | Total |
| Program Services | 3417508 | ProgramServices |
| Management And General | 592267 | ManagementAndGeneral |
Comp Disqual Persons CompDisqualPersons
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Other Salaries And Wages OtherSalariesAndWages
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 241235874 | Total |
| Program Services | 205603873 | ProgramServices |
| Management And General | 35632001 | ManagementAndGeneral |
Pension Plan Contributions PensionPlanContributions
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 13630164 | Total |
| Program Services | 11616906 | ProgramServices |
| Management And General | 2013258 | ManagementAndGeneral |
Other Employee Benefits OtherEmployeeBenefits
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 26046417 | Total |
| Program Services | 22199204 | ProgramServices |
| Management And General | 3847214 | ManagementAndGeneral |
Payroll Taxes PayrollTaxes
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 16199058 | Total |
| Program Services | 13806358 | ProgramServices |
| Management And General | 2392699 | ManagementAndGeneral |
Fees For Services Management FeesForServicesManagement
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 67075421 | Total |
| Program Services | 44487796 | ProgramServices |
| Management And General | 22587625 | ManagementAndGeneral |
Fees For Services Legal FeesForServicesLegal
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 597172 | Total |
| Management And General | 597172 | ManagementAndGeneral |
Fees For Services Accounting FeesForServicesAccounting
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Fees For Services Lobbying FeesForServicesLobbying
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 15235 | Total |
| Management And General | 15235 | ManagementAndGeneral |
Fees For Services Prof Fundraising FeesForServicesProfFundraising
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Fees For Services Invst Mgmnt Fees FeesForServicesInvstMgmntFees
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Fees For Services Other FeesForServicesOther
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 27021534 | Total |
| Program Services | 21480755 | ProgramServices |
| Management And General | 5540779 | ManagementAndGeneral |
Advertising Advertising
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 1732761 | Total |
| Management And General | 1732761 | ManagementAndGeneral |
Office Expenses OfficeExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 8677069 | Total |
| Program Services | 5426987 | ProgramServices |
| Management And General | 3250082 | ManagementAndGeneral |
Information Technology InformationTechnology
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 278896 | Total |
| Program Services | 10289 | ProgramServices |
| Management And General | 268607 | ManagementAndGeneral |
Royalties Royalties
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Occupancy Occupancy
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 16879698 | Total |
| Program Services | 13935296 | ProgramServices |
| Management And General | 2944402 | ManagementAndGeneral |
Travel Travel
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 538100 | Total |
| Program Services | 248552 | ProgramServices |
| Management And General | 289548 | ManagementAndGeneral |
Travel Entrtnmnt Public Officials TravelEntrtnmntPublicOfficials
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Conferences Meetings ConferencesMeetings
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 701954 | Total |
| Program Services | 507910 | ProgramServices |
| Management And General | 194044 | ManagementAndGeneral |
Interest Interest
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 15686109 | Total |
| Management And General | 15686109 | ManagementAndGeneral |
Payments To Affiliates PaymentsToAffiliates
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Depreciation Depletion DepreciationDepletion
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 42929896 | Total |
| Program Services | 33676005 | ProgramServices |
| Management And General | 9253891 | ManagementAndGeneral |
Insurance Insurance
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 2522504 | Total |
| Program Services | 337670 | ProgramServices |
| Management And General | 2184835 | ManagementAndGeneral |
Other Expenses OtherExpenses (4 entries)
| DescriptionDescription | TotalTotal | Program ServicesProgramServices | Management And GeneralManagementAndGeneral |
|---|---|---|---|
| MEDICAL SUPPLIES | 93703749 | 93544509 | 159240 |
| BAD DEBTS | 20800106 | 20800106 | |
| EQUIP RENTAL & MAINTENANCE | 2496286 | 2416474 | 79811 |
| MEDICAID PROVIDER FEE | 41167124 | 41167124 |
All Other Expenses AllOtherExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 9714639 | Total |
| Program Services | 8152648 | ProgramServices |
| Management And General | 1561991 | ManagementAndGeneral |
Total Functional Expenses TotalFunctionalExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 654409641 | Total |
| Program Services | 543586070 | ProgramServices |
| Management And General | 110823571 | ManagementAndGeneral |
| Fundraising | 0 | Fundraising |
Cash Non Interest Bearing CashNonInterestBearing
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 36838938 | BOY |
| EOY | 37123179 | EOY |
Savings And Temp Cash Investments SavingsAndTempCashInvestments
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 20000007 | BOY |
| EOY | 7 | EOY |
Pledges And Grants Receivable PledgesAndGrantsReceivable
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 0 | BOY |
| EOY | 0 | EOY |
Accounts Receivable AccountsReceivable
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 78956055 | BOY |
| EOY | 77582388 | EOY |
Receivables From Officers Etc ReceivablesFromOfficersEtc
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 0 | BOY |
| EOY | 0 | EOY |
Receivables From Disqual Persons ReceivablesFromDisqualPersons
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 0 | BOY |
| EOY | 0 | EOY |
Other Notes Loans Receivable Net OtherNotesLoansReceivableNet
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 15755574 | BOY |
| EOY | 18619696 | EOY |
Inventories For Sale Or Use InventoriesForSaleOrUse
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 9877289 | BOY |
| EOY | 11170590 | EOY |
Prepaid Expenses Deferred Charges PrepaidExpensesDeferredCharges
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 6209225 | BOY |
| EOY | 4885023 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Buildings Equipment Basis | 1033339025 | LandBuildingsEquipmentBasis |
| Land Bldg Equipment Accum Deprec | 550394462 | LandBldgEquipmentAccumDeprec |
Land Buildings Equipment Basis Net LandBuildingsEquipmentBasisNet
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 518658820 | BOY |
| EOY | 482944563 | EOY |
Investments Pub Traded Securities InvestmentsPubTradedSecurities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 235899311 | BOY |
| EOY | 319620389 | EOY |
Investments Other Securities InvestmentsOtherSecurities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 639339 | BOY |
| EOY | 1457558 | EOY |
Investments Program Related InvestmentsProgramRelated
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 0 | BOY |
| EOY | 0 | EOY |
Intangible Assets IntangibleAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 0 | BOY |
| EOY | 0 | EOY |
Other Assets Total OtherAssetsTotal
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 2947749 | BOY |
| EOY | 2947749 | EOY |
Total Assets TotalAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 925782307 | BOY |
| EOY | 956351142 | EOY |
Accounts Payable Accrued Expenses AccountsPayableAccruedExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 85436196 | BOY |
| EOY | 76973827 | EOY |
Grants Payable GrantsPayable
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 0 | BOY |
| EOY | 0 | EOY |
Deferred Revenue DeferredRevenue
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 1203012 | BOY |
| EOY | 943340 | EOY |
Tax Exempt Bond Liabilities TaxExemptBondLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 1601494 | BOY |
| EOY | 1601494 | EOY |
Escrow Account Liability EscrowAccountLiability
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 0 | BOY |
| EOY | 0 | EOY |
Loans From Officers Directors LoansFromOfficersDirectors
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 0 | BOY |
| EOY | 0 | EOY |
Mort Notes Pybl Secured Invest Prop MortNotesPyblSecuredInvestProp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 0 | BOY |
| EOY | 0 | EOY |
Unsecured Notes Loans Payable UnsecuredNotesLoansPayable
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 21077752 | BOY |
| EOY | 19594147 | EOY |
Other Liabilities OtherLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 412213092 | BOY |
| EOY | 415223168 | EOY |
Total Liabilities TotalLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 521531546 | BOY |
| EOY | 514335976 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Follow SFAS117 | X | FollowSFAS117 |
Unrestricted Net Assets UnrestrictedNetAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 404184776 | BOY |
| EOY | 441936645 | EOY |
Temporarily Restricted Net Assets TemporarilyRestrictedNetAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 65985 | BOY |
| EOY | 78521 | EOY |
Permanently Restricted Net Assets PermanentlyRestrictedNetAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 0 | BOY |
| EOY | 0 | EOY |
Total Net Assets Fund Balances TotalNetAssetsFundBalances
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 404250761 | BOY |
| EOY | 442015166 | EOY |
Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 925782307 | BOY |
| EOY | 956351142 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part XI | X | InfoInScheduleOPartXI |
| Reconcilation Revenue Expenses | 34265822 | ReconcilationRevenueExpenses |
| Reconciliation Unrealized Invest | 11310022 | ReconciliationUnrealizedInvest |
| Reconcilation Other Changes | -7811439 | ReconcilationOtherChanges |
| Method Of Accounting Accrual | X | MethodOfAccountingAccrual |
| Accountant Compile Or Review | false | AccountantCompileOrReview |
| FS Audited | true | FSAudited |
FS Audited Basis FSAuditedBasis
| Field | Value | IRS element (for citing) |
|---|---|---|
| Financial Statement Consolidated | X | FinancialStatementConsolidated |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Audit Committee | true | AuditCommittee |
| Federal Grant Audit Required | false | FederalGrantAuditRequired |
Schedule A IRS990ScheduleA
| Field | Value | IRS element (for citing) |
|---|---|---|
| Hospital170b1 Aiii | X | Hospital170b1Aiii |
Schedule B IRS990ScheduleB
Contributor Info ContributorInfo
| Field | Value | IRS element (for citing) |
|---|---|---|
| Contributor Number | RESTRICTED | ContributorNumber |
Contributor Name Business ContributorNameBusiness
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | RESTRICTED | BusinessNameLine1 |
Contributor Address US ContributorAddressUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | RESTRICTED | AddressLine1 |
| Address Line2 | RESTRICTED | AddressLine2 |
| City | RESTRICTED | City |
| State | RESTRICTED | State |
| ZIP Code | RESTRICTED | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Aggregate Contributions | RESTRICTED | AggregateContributions |
Schedule C IRS990ScheduleC
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Grassroots Lobbying | TotalGrassrootsLobbying | |
| Total Direct Lobbying | TotalDirectLobbying | |
| Total Lobbying Expenditures | TotalLobbyingExpenditures | |
| Other Exempt Purpose Expenditures | OtherExemptPurposeExpenditures | |
| Total Exempt Purpose Expenditures | TotalExemptPurposeExpenditures | |
| Lobbying Nontaxable | LobbyingNontaxableAmount | |
| Grassroots Nontaxable | GrassrootsNontaxableAmount | |
| Tot Lobbying Grassroot Minus Non Tx | TotLobbyingGrassrootMinusNonTx | |
| Tot Lobby Expend Mns Lobbying Nontx | TotLobbyExpendMnsLobbyingNontx | |
| Volunteers | false | Volunteers |
| Paid Staff Or Management | false | PaidStaffOrManagement |
| Media Advertisements | false | MediaAdvertisements |
| Mailings Members | false | MailingsMembers |
| Publications Or Broadcast | false | PublicationsOrBroadcast |
| Grants Other Organizations | false | GrantsOtherOrganizations |
| Direct Contact Legislators | false | DirectContactLegislators |
| Rallies Demonstrations | false | RalliesDemonstrations |
| Other Activities | true | OtherActivities |
| Other Activities | $15,235 | OtherActivitiesAmount |
| Total Lobbying Expenditures IIB | 15235 | TotalLobbyingExpendituresIIB |
| Not Described In501c3 | false | NotDescribedIn501c3 |
Form990 Schedule C Part IV Form990ScheduleCPartIV
| Field | Value | IRS element (for citing) |
|---|---|---|
| Identifier | LOBBYING EXPENDITURES | Identifier |
| Return Reference | SCHEDULE C, PART II-B, QUESTION 1I | ReturnReference |
| Explanation | $15,235 OF OTHER LOBBYING EXPENDITURES INCLUDES PORTIONS OF VARIOUS MEMBERSHIP DUES THAT ARE DESIGNATED AS LOBBYING EXPENSE BY THOSE ORGANIZATIONS IN WHICH EXEMPLA OR EXEMPLA ENTITIES ARE MEMBERS. | Explanation |
Schedule D IRS990ScheduleD
| Field | Value | IRS element (for citing) |
|---|---|---|
| Art Public Exhibition Amts | ArtPublicExhibitionAmts | |
| Held Works Of Art Amts | HeldWorksOfArtAmts | |
| Agent Trustee Etc | false | AgentTrusteeEtc |
| Current Year Minus3 Years | CurrentYearMinus3Years | |
| Current Year Minus4 Years | CurrentYearMinus4Years |
Land Land
| Field | Value | IRS element (for citing) |
|---|---|---|
| Investment Cost Or Other Basis | 0 | InvestmentCostOrOtherBasis |
| Other Cost Or Other Basis | 25464714 | OtherCostOrOtherBasis |
| Book Value | 25464714 | BookValue |
Buildings Buildings
| Field | Value | IRS element (for citing) |
|---|---|---|
| Investment Cost Or Other Basis | 0 | InvestmentCostOrOtherBasis |
| Other Cost Or Other Basis | 567500014 | OtherCostOrOtherBasis |
| Depreciation | 233395140 | Depreciation |
| Book Value | 334104874 | BookValue |
Leasehold Improvements LeaseholdImprovements
| Field | Value | IRS element (for citing) |
|---|---|---|
| Investment Cost Or Other Basis | 0 | InvestmentCostOrOtherBasis |
| Other Cost Or Other Basis | 39320329 | OtherCostOrOtherBasis |
| Depreciation | 23146568 | Depreciation |
| Book Value | 16173761 | BookValue |
Equipment Equipment
| Field | Value | IRS element (for citing) |
|---|---|---|
| Investment Cost Or Other Basis | 0 | InvestmentCostOrOtherBasis |
| Other Cost Or Other Basis | 390647076 | OtherCostOrOtherBasis |
| Depreciation | 293572618 | Depreciation |
| Book Value | 97074458 | BookValue |
Other Land Buildings OtherLandBuildings
| Field | Value | IRS element (for citing) |
|---|---|---|
| Investment Cost Or Other Basis | 0 | InvestmentCostOrOtherBasis |
| Other Cost Or Other Basis | 10406892 | OtherCostOrOtherBasis |
| Depreciation | 280136 | Depreciation |
| Book Value | 10126756 | BookValue |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Of Book Value Land Buildings | 482944563 | TotalOfBookValueLandBuildings |
| Federal Income Tax Liability | 0 | FederalIncomeTaxLiability |
Other Liabilities OtherLiabilities (10 entries)
| DescriptionDescription | AmountAmount |
|---|---|
| DUE TO 3RD PARTY PAYORS | $3,745,503 |
| ACCRUED INTEREST PAYABLE | $8,169,254 |
| OTHER CURRENT LIABILITIES | $26,401 |
| MALPRACTICE LIABILITY | $11,217,265 |
| OTHER LIABILITIES | $2,503,717 |
| PENSION LIABILITIES | $24,073,020 |
| NOTE PAYABLE TO ESJH | $60,000,000 |
| NOTES PAYABLE TO SCLHS | $264,244,732 |
| ACCRUED INTEREST PAYABLE TO SC | $13,782,878 |
| ACCRUED INTEREST PAYABLE TO ES | $27,460,398 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Of Amounts | 415223168 | TotalOfAmounts |
Schedule F IRS990ScheduleF
| Field | Value | IRS element (for citing) |
|---|---|---|
| Grant Records Maintained | true | GrantRecordsMaintained |
Accts Actvs Out US Table AcctsActvsOutUSTable
| Field | Value | IRS element (for citing) |
|---|---|---|
| Region | Sub-Saharan Africa | Region |
| Type Of Activities Conducted | Program Services | TypeOfActivitiesConducted |
| Specific Services Provided | HOSPITAL | SpecificServicesProvided |
| Total Expenditures | 46000 | TotalExpenditures |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Subtotal Amount Spent | 46000 | SubtotalAmountSpent |
| Total Amount Spent | 46000 | TotalAmountSpent |
Grants To Orgs Outside US GrantsToOrgsOutsideUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Region | Sub-Saharan Africa | Region |
| Purpose Of Grant | SUPPORT ARUSHA LUTHERAN MEDICAL CENTRE | PurposeOfGrant |
| Amount Of Cash Grant | 46000 | AmountOfCashGrant |
| Manner Of Cash Disbursement | WIRE TRANS | MannerOfCashDisbursement |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Number Of Other Orgs | 1 | TotalNumberOfOtherOrgs |
| Transfer To Foreign Corp | false | TransferToForeignCorp |
| Interest In Foreign Trust | false | InterestInForeignTrust |
| Own Foreign Corp | false | OwnForeignCorp |
| Passive Foreign Invest Co | false | PassiveForeignInvestCo |
| Foreign Partnership | false | ForeignPartnership |
| Boycott Countries | false | BoycottCountries |
Form990 Schedule F Part V Form990ScheduleFPartV
| Field | Value | IRS element (for citing) |
|---|---|---|
| Identifier | MONITORING OF FUNDS | Identifier |
| Return Reference | PART I, LINE 2 | ReturnReference |
| Explanation | EXEMPLA PROVIDES ASSISTANCE TO ONLY ONE ORGANIZATION OUTSIDE THE U.S. EXEMPLA OBTAINED AN INITIAL NEEDS ASSESSMENT REPORT FROM THE ORGANIZATION, WHICH ALSO OUTLINED THE COMMITMENT OF EXEMPLA TO PROVIDE SUPPORT TO THE ORGANIZATION BASED ON AN INITIAL SITE VISIT. EXEMPLA MAINTAINS REGULAR CONTACT WITH THE ORGANIZATION, SENDS A TEAM OF CLINICIANS FOR SITE VISITS TO THE ORGANIZATION EVERY YEAR AND RECEIVES AND REVIEWS THE ORGANIZATION'S ANNUAL REPORT. | Explanation |
Schedule H IRS990ScheduleH
| Field | Value | IRS element (for citing) |
|---|---|---|
| Charity Care Policy | true | CharityCarePolicy |
| Written Policy | true | WrittenPolicy |
| Policy Applied To All Hospitals | X | PolicyAppliedToAllHospitals |
| FPG Reference Free Care | true | FPGReferenceFreeCare |
| Pcent200 | X | Pcent200 |
| FPG Reference Discounted Care | true | FPGReferenceDiscountedCare |
| Pcent400 | X | Pcent400 |
| Free Disc Care Medically Indigent | true | FreeDiscCareMedicallyIndigent |
| Amounts Budgeted For Charity Care | true | AmountsBudgetedForCharityCare |
| Expenses Exceeded Budget | true | ExpensesExceededBudget |
| Unable To Provide Care | false | UnableToProvideCare |
| Annual Community Benefit Report | true | AnnualCommunityBenefitReport |
| Report Publically Available | true | ReportPublicallyAvailable |
Charity Care At Cost CharityCareAtCost
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of Activities Or Programs | 1 | NumberOfActivitiesOrPrograms |
| Total Community Benefit Expense | 15535893 | TotalCommunityBenefitExpense |
| Net Community Benefit Expense | 15535893 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.02500 | PercentOfTotalExpense |
Unreimbursed Medicaid UnreimbursedMedicaid
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of Activities Or Programs | 1 | NumberOfActivitiesOrPrograms |
| Total Community Benefit Expense | 42804409 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 22925449 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 19878960 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.03100 | PercentOfTotalExpense |
Total Charity Care TotalCharityCare
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of Activities Or Programs | 2 | NumberOfActivitiesOrPrograms |
| Total Community Benefit Expense | 58340302 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 22925449 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 35414853 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.05600 | PercentOfTotalExpense |
Community Health Services CommunityHealthServices
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of Activities Or Programs | 15 | NumberOfActivitiesOrPrograms |
| Total Community Benefit Expense | 443771 | TotalCommunityBenefitExpense |
| Net Community Benefit Expense | 443771 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.00100 | PercentOfTotalExpense |
Health Professions Education HealthProfessionsEducation
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of Activities Or Programs | 8 | NumberOfActivitiesOrPrograms |
| Total Community Benefit Expense | 1815900 | TotalCommunityBenefitExpense |
| Net Community Benefit Expense | 1815900 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.00300 | PercentOfTotalExpense |
Subsidized Health Services SubsidizedHealthServices
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of Activities Or Programs | 17 | NumberOfActivitiesOrPrograms |
| Total Community Benefit Expense | 8317499 | TotalCommunityBenefitExpense |
| Net Community Benefit Expense | 8317499 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.01300 | PercentOfTotalExpense |
Research Research
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of Activities Or Programs | 1 | NumberOfActivitiesOrPrograms |
| Total Community Benefit Expense | 85216 | TotalCommunityBenefitExpense |
| Net Community Benefit Expense | 85216 | NetCommunityBenefitExpense |
Cash And In Kind Contributions CashAndInKindContributions
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of Activities Or Programs | 24 | NumberOfActivitiesOrPrograms |
| Total Community Benefit Expense | 1453763 | TotalCommunityBenefitExpense |
| Net Community Benefit Expense | 1453763 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.00200 | PercentOfTotalExpense |
Total Other Benefits TotalOtherBenefits
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of Activities Or Programs | 65 | NumberOfActivitiesOrPrograms |
| Total Community Benefit Expense | 12116149 | TotalCommunityBenefitExpense |
| Net Community Benefit Expense | 12116149 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.01900 | PercentOfTotalExpense |
Total Community Benefits TotalCommunityBenefits
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of Activities Or Programs | 67 | NumberOfActivitiesOrPrograms |
| Total Community Benefit Expense | 70456451 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 22925449 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 47531002 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.07500 | PercentOfTotalExpense |
Economic Development EconomicDevelopment
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of Activities Or Programs | 5 | NumberOfActivitiesOrPrograms |
| Total Community Building Expense | 7908 | TotalCommunityBuildingExpense |
| Net Community Building Expense | 7908 | NetCommunityBuildingExpense |
Community Support CommunitySupport
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of Activities Or Programs | 1 | NumberOfActivitiesOrPrograms |
| Total Community Building Expense | 14332 | TotalCommunityBuildingExpense |
| Net Community Building Expense | 14332 | NetCommunityBuildingExpense |
Workforce Development WorkforceDevelopment
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of Activities Or Programs | 1 | NumberOfActivitiesOrPrograms |
| Total Community Building Expense | 406 | TotalCommunityBuildingExpense |
| Net Community Building Expense | 406 | NetCommunityBuildingExpense |
Total Total
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of Activities Or Programs | 7 | NumberOfActivitiesOrPrograms |
| Total Community Building Expense | 22646 | TotalCommunityBuildingExpense |
| Net Community Building Expense | 22646 | NetCommunityBuildingExpense |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bad Debt Expense Reported | true | BadDebtExpenseReported |
| Bad Debt Expense | $9,244,694 | BadDebtExpenseAmount |
| Amount Attributable To | 1153000 | AmountAttributableTo |
| Amount Reimbursed By Medicare | 59424470 | AmountReimbursedByMedicare |
| Cost Of Care Reimbursed By Medicare | 66759719 | CostOfCareReimbursedByMedicare |
| Medicare Surplus Or Shortfall | -7335249 | MedicareSurplusOrShortfall |
Costing Methodology Used CostingMethodologyUsed
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cost To Charge Ratio | X | CostToChargeRatio |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Written Debt Collection Policy | true | WrittenDebtCollectionPolicy |
| Provision For Charity Care | true | ProvisionForCharityCare |
Form990 Schedule H Part IV Form990ScheduleHPartIV
Name Of Entity NameOfEntity
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Lutheran ASC LLC | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Description Ent Primary Activity | Outpatient Surgery | DescriptionEntPrimaryActivity |
| Organization Profit Or Ownership | 0.52320 | OrganizationProfitOrOwnership |
| Physicans Profit Or Ownership | 0.47680 | PhysicansProfitOrOwnership |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of Hospital Facilities | 2 | NumberOfHospitalFacilities |
Form990 Schedule H Part V Section A Form990ScheduleHPartVSectionA (2 entries)
| Facility NumberFacilityNumber | Address Line1Address/AddressLine1 | CityAddress/City | StateAddress/State | ZIP CodeAddress/ZIPCode | Licensed HospitalLicensedHospital |
|---|---|---|---|---|---|
| Exempla Lutheran Medical Center | |||||
| 1 | 8300 W 38th Ave | Wheat Ridge | CO | 80211 | X |
| Exempla Good Samaritan Medical Center | |||||
| 2 | 200 Exempla Circle | Lafayette | CO | 80026 | X |
Form990 Schedule H Part V Section B Form990ScheduleHPartVSectionB (2 entries)
| Hospital Facility NumberHospitalFacilityNumber | Eligibility Criteria ExplainedEligibilityCriteriaExplained | Uses FPG FreeUsesFPGFree | FPG Free PercentFPGFreePercent | Uses FPG DiscountedUsesFPGDiscounted | FPG Discount PercentFPGDiscountPercent | Explains BasisExplainsBasis | Income LevelIncomeLevel | Asset LevelAssetLevel | Medical IndigencyMedicalIndigency | Insurance StatusInsuranceStatus | Uninsured DiscountUninsuredDiscount | Medicaid MedicareMedicaidMedicare | Explains Application MethodExplainsApplicationMethod | Includes Publicity MeasuresIncludesPublicityMeasures | Posted On WebsitePostedOnWebsite | Available On RequestAvailableOnRequest | Actions On NonpaymentActionsOnNonpayment | Collection ActivitiesCollectionActivities | Nondiscrim Emergency Care PolicyNondiscrimEmergencyCarePolicy | Used Other MethodUsedOtherMethod | Amounts Generally BilledAmountsGenerallyBilled | Gross ChargesGrossCharges |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Exempla Lutheran Medical Center | ||||||||||||||||||||||
| 1 | true | true | 200. | true | 400. | true | X | X | X | X | X | X | true | true | X | X | true | false | true | X | false | false |
| Exempla Good Samaritan Medical Center | ||||||||||||||||||||||
| 2 | true | true | 200. | true | 400. | true | X | X | X | X | X | X | true | true | X | X | true | false | true | X | false | false |
Form990 Schedule H Part V Section C Form990ScheduleHPartVSectionC
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of Other Facilities | 48 | NumberOfOtherFacilities |
Other Facilities OtherFacilities (48 entries)
| Address Line1Address/AddressLine1 | CityAddress/City | StateAddress/State | ZIP CodeAddress/ZIPCode | Facility TypeFacilityType |
|---|---|---|---|---|
| EXEMPLA COLORADO LUTHERAN HOME | ||||
| 7991 W 71st AVE | ARVADA | CO | 80004 | NURSING HOME |
| EXEMPLA LUTHERAN HOSPICE AT COLLIER HOSP | ||||
| 3210 LUTHERAN PARKWAY | WHEAT RIDGE | CO | 80033 | HOSPICE |
| LUTHERAN CAMPUS ASC | ||||
| 3455 LUTHERAN PKWY 150 | WHEAT RIDGE | CO | 80033 | AMBULATORY SURGERY CENTER |
| EXEMPLA THORNTON MEDICAL CENTER | ||||
| 3814 EAST 120TH AVENUE | DENVER | CO | 80033 | PHYSICIAN CLINIC |
| EXEMPLA DENVER MEDICAL ASSOCIATES | ||||
| 1960 OGDEN ST Suite 120 | DENVER | CO | 80218 | PHYSICIAN CLINIC |
| EXEMPLA FAMILY PRACTICE SPECIALISTS | ||||
| 3550 LUTEHRAN PARKWAY G-20 | WHEAT RIDGE | CO | 80033 | PHYSICIAN CLINIC |
| EXEMPLA FAMILY PEDIATRIC & INTERNAL MED | ||||
| 2600 CAMPUS DRIVE SUITE A | LAFAYETTE | CO | 80026 | PHYSICIAN CLINIC |
| EXEMPLA NW FAMILY & OCC MED & PHYS THER | ||||
| 12169 Sheridan BLVD | Broomfield | CO | 80020 | PHYSICIAN CLINIC |
| EXEMPLA GREEN MT FAM & OCC MED & PHYS TH | ||||
| 12790-A WEST ALAMEDA PARKWAY | LAKEWOOD | CO | 80228 | PHYSICIAN CLINIC |
| EXEMPLA COLORADO LUTHERAN APARTMENTS | ||||
| 8001 W 71ST AVE | ARVADA | CO | 80004 | ASSISTED LIVING RESIDENCE |
| EXEMPLA LUTHERAN MEDICAL CENTER TCU | ||||
| 8300 W 38TH AVE | WHEAT RIDGE | CO | 80033 | NURSING HOME |
| EXEMPLA LUTHERAN SOUTHWEST URGENT CARE | ||||
| 13402 WEST COAL MINE AVE SUITE 110 | LITTLETON | CO | 80127 | PHYSICIAN CLINIC |
| EXEMPLA WELLMORE FAMILY PRACTICE | ||||
| 7777 WEST 38TH AVE SUITE A-118 | WHEAT RIDGE | CO | 80033 | PHYSICIAN CLINIC |
| EXEMPLA WHEAT RIDGE OCC MED & PHYS THER | ||||
| 9830 I-70 FRONTAGE ROAD SOUTH | WHEAT RIDGE | CO | 80033 | PHYSICIAN CLINIC |
| EXEMPLA BLUESTONE ADVANCED SURGICAL CARE | ||||
| 300 EXEMPLA CIRCLE SUITE 360 | LAFAYETTE | CO | 80026 | PHYSICIAN CLINIC |
| EXEMPLA COLORADO PINNACLE ORTHO ASSOC | ||||
| 3455 LUTHERAN PARKWAY SUITE 210 | WHEAT RIDGE | CO | 80033 | PHYSICIAN CLINIC |
| EXEMPLA DENVER NEURO SURGERY & SPINE | ||||
| 1960 OGDEN ST SUITE 530 | DENVER | CO | 80218 | PHYSICIAN CLINIC |
| EXEMPLA MT STATES UROGYNECOLOGY - ESJH | ||||
| 1960 OGDEN ST SUITE 520 | DENVER | CO | 80205 | PHYSICIAN CLINIC |
| EXEMPLA LARKRIDGE FAMILY & OCC MED & PT | ||||
| 16570 WASHINGTON STREET | THORNTON | CO | 80023 | PHYSICIAN CLINIC |
| EXEMPLA STAPLETON FAMILY & OCC MED | ||||
| 2803 ROSLYN STREET | DENVER | CO | 80238 | PHYSICIAN CLINIC |
| EXEMPLA DIABETES & ENDOCRINE SERVICES | ||||
| 3555 LUTHERAN PARKWAY SUITE 180 | WHEAT RIDGE | CO | 80033 | PHYSICIAN CLINIC |
| EXEMPLA SURGICAL SPECIALISTS | ||||
| 1960 OGDEN ST SUITE 530 | DENVER | CO | 80205 | PHYSICIAN CLINIC |
| EXEMPLA LUTHERAN MATERNAL FETAL MEDICINE | ||||
| 3655 LUTHERAN PARKWAY SUITE 408 | WHEAT RIDGE | CO | 80033 | PHYSICIAN CLINIC |
| EXEMPLA PLASTIC RECONSTRUCT & AESTH SURG | ||||
| 3455 LUTHERAN PARKWAY SUITE 220 | WHEAT RIDGE | CO | 80033 | PHYSICIAN CLINIC |
| EXEMPLA DENVER NEURO SURGERY & SPINE | ||||
| 3455 LUTHERAN PARKWAY SUITE 280 | WHEAT RIDGE | CO | 80033 | PHYSICIAN CLINIC |
| EXEMPLA INTERNAL MEDICINE OF LAFAYETTE | ||||
| 300 EXEMPLA CIRCLE SUITE 300 | LAFAYETTE | CO | 80026 | PHYSICIAN CLINIC |
| EXEMPLA FRONT RANGE CARDIAC & THOR SURG | ||||
| 1960 OGDEN ST SUITE 540 | DENVER | CO | 80205 | PHYSICIAN CLINIC |
| EXEMPLA FIRESTONE FAMILY MEDICINE | ||||
| 8350 WCR 13 SUITE 160 | FIRESTONE | CO | 80504 | PHYSICIAN CLINIC |
| EXEMPLA URGENT CARE OF WESTMINSTER | ||||
| 7625 WEST 92ND AVENUE | WESTMINSTER | CO | 80021 | PHYSICIAN CLINIC |
| EXEMPLA MT STATES UROGYNECOLOGY - WEST | ||||
| 3555 Lutheran pkwy SUITE 406 | WHEAT RIDGE | CO | 80033 | PHYSICIAN CLINIC |
| EXEMPLA LUTHERAN SW URGENT CARE&OCC MED | ||||
| 13402 WEST COAL MINE AVENUE SUITE | LITTLETON | CO | 80127 | PHYSICIAN CLINIC |
| EXEMPLA FOOTHILLS NEUROLOGY ASSOCIATES | ||||
| 300 EXEMPLA CIRCLE SUITE 300 | LAFAYETTE | CO | 80026 | PHYSICIAN CLINIC |
| EXEMPLA LUTHERAN NEUROLOGY | ||||
| 3550 LUTHERAN PARKWAY WEST SUITE 2 | WHEAT RIDGE | CO | 80033 | PHYSICIAN CLINIC |
| EXEMPLA OASIS FAMILY MEDICINE | ||||
| 360 S GARFIELD ST Ste 500 | DENVER | CO | 80209 | PHYSICIAN CLINIC |
| EXEMPLA DIABETES EDUCATION CENTER | ||||
| 3555 LUTHERAN PKWY Suite 180 | WHEAT RIDGE | CO | 80033 | PHYSICIAN CLINIC |
| EXEMPLA ESSENTIAL WOMENS CARE | ||||
| 1960 OGDEN St SUITE 230 | Denver | CO | 80218 | PHYSICIAN CLINIC |
| ROCKY MOUNTAIN CV ASSOCIATES UNION | ||||
| 355 Union BLVD Suite 200 | Lakewood | CO | 80228 | PHYSICIAN CLINIC |
| ROCKY MOUNTAIN CV ASSOCIATES NORTH | ||||
| 8300 Alcott St Suite 300 | Westminster | CO | 80031 | PHYSICIAN CLINIC |
| ROCKY MOUNTAIN CV ASSOCIATES GSMC | ||||
| 300 EXEMPLA CIRCLE Suite 310 | Lafayette | CO | 80026 | PHYSICIAN CLINIC |
| ROCKY MOUNTAIN CV ASSOCIATES LMC | ||||
| 3655 Lutheran PKWY Suite 201 | Wheat Ridge | CO | 80033 | PHYSICIAN CLINIC |
| ROCKY MOUNTAIN CV ASSOCIATES SJD | ||||
| 1960 Ogden St Suite 110 | Denver | CO | 80218 | PHYSICIAN CLINIC |
| EXEMPLA CAPITOL HILL INTERNAL MEDICINE | ||||
| 1960 OGDEN ST SUITE 120 | DENVER | CO | 80218 | PHYSICIAN CLINIC |
| EXEMPLA STAPLETON OB-GYN | ||||
| 2807 ROSLYN ST | DENVER | CO | 80238 | PHYSICIAN CLINIC |
| EXEMPLA NEUROLOGY SERVICES OF DENVER | ||||
| 1960 Ogden Street Suite 120 | Denver | CO | 80218 | PHYSICIAN CLINIC |
| EXEMPLA MOUNTAIN STATES UROGYNECOLOGY - | ||||
| 300 EXEMPLA cIRCLE SUITE 250 | LAFAYETTE | CO | 80026 | PHYSICIAN CLINIC |
| EXEMPLA DIABETES&ENDOCRINE SERVICES | ||||
| 3555 LUTHERAN PKWY SUITE 180 | WHEAT RIDGE | CO | 80033 | PHYSICIAN CLINIC |
| EXEMPLA LUTHERAN HEMATOLOGY & ONCOLOGY | ||||
| 3550 LUTHERAN PARKWAY SUITE 100-a | WHEAT RIDGE | CO | 80033 | PHYSICIAN CLINIC |
| EXEMPLA UNION FAMILY MEDICINE | ||||
| 355 UNION BLVD SUITE 200 | LAKEWOOD | CO | 80228 | PHYSICIAN CLINIC |
Form990 Schedule H Part VI Form990ScheduleHPartVI (14 entries)
| IdentifierIdentifier | Return ReferenceReturnReference | ExplanationExplanation |
|---|---|---|
| COMMUNITY BENEFIT REPORT | PART I, LINE 6A | COMMUNITY BENEFITS ARE INCLUDED IN A REPORT PREPARED BY SCL HEALTH SYSTEM. |
| COSTS ATTRIBUTABLE TO PHYSICIAN CLINICS | PART I, LINE 7G | THE ORGANIZATION INCLUDED AS SUBSIDIZED HEALTH SERVICES $584,570.64 IN LOSSES ATTRIBUTABLE TO PHYSICIAN CLINICS. |
| BAD DEBT EXPENSE | PART I, LINE 7, COLUMN(F) | BAD DEBT EXPENSE INCLUDED ON PART IX, LINE 25, COLUMN (A), BUT SUBTRACTED FOR PURPOSES OF CALCULATING THE PERCENTAGE OF TOTAL EXPENSES IN SCHEDULE H PART I, LINE 7, COLUMN (H) IS $20,800,106. |
| COSTING METHODOLOGY | PART I, LINE 7 | THE COST ACCOUNTING SYSTEM WAS USED AS THE BASIS TO CALCULATE THE AMOUNTS REPORTED AS CHARITY CARE AND MEANS-TESTED GOVERNMENT PROGRAMS. THE COST ACCOUNTING SYSTEM ADDRESSES ALL PATIENT SEGMENTS. THE COST OF SUBSIDIZED SERVICES WAS CALCULATED AS THE NET LOSS OF THE RELEVANT DEPARTMENT USING THE DEPARTMENTAL EXPENSES AND ALLOCATED OVERHEAD EXPENSES, AND THE DEDUCTION RATIO PER THE COST ACCOUNTING SYSTEM. FOR SUBSIDIZED SERVICES, THE COST OF CHARITY, MEDICAID, AND SELF PAY PATIENTS WERE REMOVED IN THE CALCULATION. |
| COMMUNITY BUILDING ACTIVITIES | PART II | THE COMMUNITY BUILDING ACTIVITIES FOR EXEMPLA GOOD SAMARITAN MEDICAL CENTER (EGSMC) WERE FOCUSED ON MENTAL HEALTH AND "COMMUNITY HEALTH ADVOCACY". Exempla Lutheran Medical Center (ELMC) FOCUSED ON "COMMUNITY HEALTH ADVOCACY" FOR TOBACCO CESSATION, EDUCATION AND PREVENTION AND REDUCING OVERWEIGHT AND OBESITY. ELMC AND EGSMC's RECRUITMENT OF PHYSICIANS TO MEDICAL SHORTAGE AREAS WITHIN OUR PRIMARY SERVICE AREA (PSA) CONTRIBUTED TO THE IMPROVEMENT OF HEALTH IN OUR COMMUNITY. WE USE A STANDARD PROCESS FOR DETERMINING THE COMMUNITY NEED OF EACH PHYSICIAN SPECIALTY. SEVERAL CURRENT DATA ELEMENTS AND CONDITIONS ARE CONSIDERED. THE LARGEST PORTION OF OUR COMMUNITY BUILDING FUNDS WAS DESIGNATED FOR THIS PURPOSE SINCE WE DETERMINED A SHORTAGE OF SEVERAL SPECIALTIES WITHIN OUR PSA. "DISASTER READINESS AND PUBLIC HEALTH EMERGENCY TRAININGS" WERE ADDITIONAL FOCUS AREAS WITHIN COMMUNITY BUILDING ACTIVITIES. EGSMC AND ELMC ARE TAKING A LEADERSHIP ROLE IN OUR RESPECTIVE COUNTIES FOR READINESS TRAINING BEYOND THE REQUIREMENTS OF ACCREDITING BODIES OR GOVERNMENT ENTITIES. FOUR (4) HOSPITALS WITHIN BOULDER COUNTY PARTICIPATE ON A REGULAR BASIS AND BOULDER COUNTY HAS BEEN RECOGNIZED AS ONE OF THE LEADERS IN THE STATE OF COLORADO. THE STAFF FROM EGSMC AND ELMC CONTRIBUTE SIGNIFICANT TIME AND RESOURCES EACH YEAR TO LEAD THE DISASTER READINESS AND PUBLIC HEALTH EMERGENCY ACTIVITIES FOR THE COUNTY AND THE REGION. IN ADDITION TO "COMMUNITY HEALTH ADVOCACY" AND "DISASTER READINESS," EGSMC AND ELMC ACTIVELY PARTICIPATE IN "ECONOMIC DEVELOPMENT" IN THE FORM OF DONATIONS TO LOCAL CHAMBERS OF COMMERCE (E.G. LAFAYETTE CHAMBER, BROOMFIELD ECONOMIC DEVELOPMENT COUNCIL, JEFFERSON COUNTY ECONOMIC COUNCIL, BOULDER CHAMBER OF COMMERCE, AND OTHERS) AND "COMMUNITY HEALTH IMPROVEMENT ADVOCACY" FOR OUR COMMUNITY. THE COMMUNITY BUILDING ACTIVITIES SELECTED BY EGSMC AND ELMC EACH YEAR PROMOTE THE HEALTH OF THE COMMUNITY IN SIGNIFICANT WAYS. |
| BAD DEBT EXPENSE COSTING METHODOLOGY AND OTHER INFO | PART III, LINE 4 | A COST TO CHARGE RATIO IS USED AS THE METHODOLOGY FOR DETERMINING THE AMOUNTS REPORTED AS COST OF BAD DEBT EXPENSE. FOR ALL SELF-PAY ACCOUNTS, A STANDARD 40% DISCOUNT IS FIRST APPLIED TO CHARGES AS A DEDUCTION OF REVENUE. BAD DEBT EXPENSE IS REFLECTED NET OF DISCOUNTS APPLIED AND PAYMENTS RECEIVED. THE ORGANIZATION DOES NOT INCLUDE IN BAD DEBT EXPENSE ANY AMOUNT THAT COULD REASONABLY BE ATTRIBUTABLE TO PATIENTS WHO LIKELY WOULD QUALIFY FOR FINANCIAL ASSISTANCE UNDER THE HOSPITALS' CHARITY CARE POLICY. THE FOLLOWING ARE THE RELEVANT PORTIONS OF THE COMPANY'S FOOTNOTE TO THE FINANCIAL STATEMENTS RELATED TO BAD DEBT: INCLUDED IN NET RECEIVABLES IS THE ALLOWANCE FOR UNCOLLECTIBLE RECEIVABLES. THE ALLOWANCE FOR UNCOLLECTIBLE RECEIVABLES IS BASED UPON MANAGEMENT'S ASSESSMENT OF HISTORICAL AND EXPECTED NET COLLECTIONS AND TAKES INTO CONSIDERATION HISTORICAL BUSINESS AND ECONOMIC CONDITIONS, TRENDS IN HEALTHCARE COVERAGE, AND OTHER COLLECTION INDICATORS. MANAGEMENT PERIODICALLY ASSESSES THE ADEQUACY OF THE ALLOWANCES FOR UNCOLLECTIBLE ACCOUNTS BASED UPON HISTORICAL WRITE-OFF EXPERIENCE BY PAYOR CATEGORY. THE RESULTS OF THESE ASSESSMENTS ARE USED TO MODIFY, AS NECESSARY, THE PROVISION FOR BAD DEBTS AND TO ESTABLISH APPROPRIATE ALLOWANCES FOR UNCOLLECTIBLE NET PATIENT ACCOUNTS RECEIVABLE. |
| COSTING METHODOLOGY FOR MEDICARE COSTS | PART III, LINE 8 | INPATIENT AND OUTPATIENT MEDICARE COSTS ARE CALCULATED ON THE COST REPORT. INPATIENT COSTS ARE A PRODUCT OF ROUTINE SERVICE COSTS BASED ON PER DIEMS AND ANCILLARY COSTS BASED ON INPATIENT MEDICARE CHARGES FACTORED BY INPATIENT COST TO CHARGE RATIOS. OUTPATIENT COSTS ARE BASED ON MEDICARE OUTPATIENT CHARGES FACTORED BY OUTPATIENT COST TO CHARGE RATIOS. EXEMPLA, INC. DOES NOT RECOGNIZE THE MEDICARE SHORTFALL AS A COMMUNITY BENEFIT. DEBT COLLECTION POLICY PART III, LINE 9B AN INTEGRAL COMPONENT OF OUR MISSION IS TO BE GOOD FINANCIAL STEWARDS. THIS REQUIRES US TO DETERMINE WHICH PATIENTS ARE IN NEED OF CHARITY CARE AND WHICH ARE ABLE TO CONTRIBUTE SOME PAYMENT FOR CARE RECEIVED. WE MAINTAIN A BALANCE THAT ENABLES US TO CONTINUE TO PROVIDE CHARITY CARE TO THOSE WHO NEED IT MOST, AND TO ENSURE THAT WE MANAGE OUR RESOURCES SO THAT WE CAN CONTINUE TO BE HERE WHEN PEOPLE NEED US MOST. EXEMPLA, INC NOTIFIES PATIENTS OF FINANCIAL ASSISTANCE POLICY UPON ADMISSION, DISCHARGE AND IN COMMUNICATION REGARDING PATIENT BILLS. PATIENTS ARE CONTACTED MULTIPLE TIMES ABOUT UNPAID BALANCES PRIOR TO INITIATING ANY COLLECTION ACTION. IF A PATIENT IS DETERMINED TO BE ELIGIBLE FOR FINANCIAL ASSISTANCE AT ANY TIME DURING THE COLLECTION PROCESS, THE ACCOUNT IS RECLASSIFIED AS FINANCIAL ASSISTANCE AND DEBT COLLECTION EFFORTS ARE CEASED. |
| PUBLICIZING THE FINANCIAL ASSISTANCE POLICY | PART V, LINE 13G | EXEMPLA, INC TREATS PATIENTS WITH RESPECT AND DIGNITY REGARDLESS OF THEIR ABILITY TO PAY. EXEMPLA, INC HAS A WRITTEN FINANCIAL ASSISTANCE POLICY THAT EXPLAINS ELIGIBILITY CRITERIA FOR FINANCIAL ASSISTANCE AT VARIOUS LEVELS, INCLUDING A 100% DISCOUNT, AND IS BASED ON FEDERAL POVERTY GUIDELINES. WE WORK WITH PATIENTS TO HELP THEM UNDERSTAND THEIR FINANCIAL RESPONSIBILITY FOR CARE RECEIVED, FINANCIAL ASSISTANCE AVAILABLE TO THEM, AND TO ESTABLISH PAYMENT PROGRAMS IN DEMONSTRATION OF OUR CORE VALUE OF RESPECT. AS PART OF OUR RESPONSIBILITY TO EDUCATE, WE INFORM OUR PATIENTS AND THEIR FAMILIES OF THE AVAILABILITY OF ASSISTANCE, INCLUDING GOVERNMENT PROGRAMS. WE COMMUNICATE THIS IN A VARIETY OF WAYS TO ENSURE THAT MESSAGES REACH MULTIPLE AUDIENCES. BEFORE, DURING AND/OR AFTER ADMISSION, WE ENCOURAGE OUR SELF PAY PATIENTS TO VISIT WITH A FINANCIAL COUNSELOR TO DISCUSS QUALIFICATIONS FOR FINANCIAL ASSISTANCE. WE POST FINANCIAL ASSISTANCE INFORMATION IN THE FORM OF A FINANCIAL ASSISTANCE BROCHURE IN EMERGENCY AND ADMISSIONS AREAS, ON BILLINGS INVOICES, IN VARIOUS AREAS AROUND THE HOSPITAL AND CLINIC SITES AND ON THE HOSPITAL WEBSITE. THE BROCHURE EXPLAINS OUR FINANCIAL ASSISTANCE POLICY AND HOW IT IS ADMINISTERED. THIS COVERS ELIGIBILITY, STEPS TO FOLLOW TO DETERMINE IF A PATIENT QUALIFIES FOR ASSISTANCE, TYPICAL CHARGES A PATIENT MAY EXPECT FOR ROUTINE PROCEDURES, AND ASSISTANCE AVAILABLE BASED ON A PATIENT'S INCOME LEVEL. WE PROVIDE THESE MATERIALS AND EDUCATION WHEN PATIENTS ARE DISCHARGED, AND INCLUDE INFORMATION IN BILLING STATEMENTS, INCLUDING PHONE NUMBERS AND OTHER METHODS TO CONTACT US WITH QUESTIONS. WE ENSURE THAT OUR FINANCIAL COUNSELORS, ADMISSION EMPLOYEES, SOCIAL WORKERS AND OTHER EMPLOYEES UNDERSTAND OUR POLICIES TO BE ABLE TO ASSIST PATIENTS IN THE MOST APPROPRIATE WAY. WE ALSO PROVIDE THE DETAILED FINANCIAL ASSISTANCE POLICY TO INDIVIDUALS UPON REQUEST AND POST THE POLICY TO OUR WEBSITE TO ENSURE THE ENTIRE COMMUNITY HAS ACCESS TO SUCH INFORMATION. AMOUNTS BILLED TO UNINSURED INDIVIDUALS PART V, LINE 20D EACH FACILITY (EXEMPLA GOOD SAMARITAN MEDICAL CENTER AND EXEMPLA LUTHERAN MEDICAL CENTER) AUTOMATICALLY APPLIES A 40% DISCOUNT FOR ANY PATIENT WITHOUT INSURANCE. IF AN INDIVIDUAL QUALIFIES FOR FINANCIAL ASSISTANCE AND HAS INCOME BELOW 200% OF THE FEDERAL POVERTY GUIDELINES, THE FULL ACCOUNT BALANCE IS ADJUSTED TO ZERO. IF INCOME IS BETWEEN 200% AND 400% OF THE FEDERAL POVERTY GUIDELINES OR IS DETERMINED TO BE MEDICALLY INDIGENT EVEN IF THEIR INCOME IS ABOVE 400% OF THE FEDERAL POVERTY GUIDELINES, A MODEST PATIENT FINANCIAL RESPONSIBILITY IS DETERMINED FOLLOWING A COPAY GRID. THE GRID TAKES INTO CONSIDERATION INCOME AND FAMILY SIZE, AND IS DESIGNED TO RESULT IN AN AMOUNT THAT IS LOWER THAN THE LOWEST COMMERCIAL PAYER RATES. |
| NEEDS ASSESSMENT | PART VI, LINE 2 | AS PART OF OUR CORE VALUE OF RESPONSE TO NEED, WE TAKE STEPS TO DETERMINE WHERE THERE IS THE MOST NEED IN ORDER TO PROVIDE THE GREATEST GOOD. EXEMPLA GOOD SAMARITAN MEDICAL CENTER AND EXEMPLA LUTHERAN MEDICAL CENTER HAVE REGULARLY PARTICIPATED IN NEEDS ASSESSMENTS TO IDENTIFY THE ONGOING AND CHANGING NEEDS OF THE COMMUNITY. FOR 2012, THE PROCESS INCLUDED A THIRD HOSPITAL, EXEMPLA ST.JOSEPH HOSPITAL IN DENVER, COLORADO. THE MOST RECENT SURVEY WAS CONDUCTED IN 2012, AND OTHER SURVEYS WILL BE CONDUCTED ON A REGULAR BASIS. The final Community Health Needs Assessments (CHNA) for Exempla Good Samaritan Medical Center and Exempla Lutheran Medical Center was approved by the Exempla Board in June 2012. The CHNA was made widely to the public in 2013 after all community input was obtained and made available on the Exempla website, is available to the public upon request, and was provided to community organization who request funding or donations from the hospital. The Center for Health Administration at the University of Colorado Denver was retained to conduct data collection for the 2012 CHNA for Exempla per Internal Revenue Code requirements. As part of the Affordable Care Act of 2010 (ACA), each freestanding non-profit (501(c)3) hospital is required to conduct a CHNA every three years. This report is the first CHNA on behalf of the Exempla hospitals that comply with the IRS mandate. This CHNA describes the health status of each hospital's community and is to be used by the hospital and other collaborators when it develops an implementation plan that addresses the identified community needs. Data for the CHNA was predominantly collected from the Colorado Department of Public Health and Environment (CDPHE). Health professionals and the public have become increasingly aware of the role of such lifestyle factors as cigarette smoking, overweight, sedentary lifestyle, and the nonuse of seat belts in contributing to injury, illness and death. To measure such factors in adults, the Colorado Behavioral Risk Factor Surveillance System Survey (BRFSS) was used. BRFSS is a system of telephone surveys sponsored by the Centers for Disease Control (CDC). Since 1981, CDC has been using the Behavioral Risk Factor Surveillance System as a method of estimating the prevalence of high risk behaviors and lifestyle factors that contribute to death and disease. Colorado specific data was obtained via the CDPHE website and can be accessed at http://www.chd.dphe.state.co.us/topics.aspx?q=Adult_Health_Data . To measure risk factors in youth, the national Youth Risk Behavior Survey was included to determine behaviors that impact the health of students in 9th through 12th grades. The survey is conducted by select school systems across the nation and reported back to CDC. The CDC's Youth Risk Behavior Surveillance System (YRBSS) monitors six types of health-risk behaviors that contribute to the leading causes of death and disability among youth and adults, including unintentional injuries and violence, alcohol and other drug use, tobacco use, dietary behaviors, and inadequate physical activity. YRBSS also measures the prevalence of obesity and asthma among youth and young adults. Colorado specific data was obtained via the CDC website and can be accessed at http://apps.nccd.cdc.gov/youthonline/App/Results.aspx?LID=CO . The Exempla CHNA mirrors applicable parts of the CDPHE's 2012 Colorado's 10 Winnable Battles which identifies key health issues where progress can be made in the next five years. By aligning with the CDPHE, Exempla joins forces with an ally in efforts to make an impact on improving the health of its hospitals' communities. Through this process, Exempla also meets stipulations set by the ACA that requires hospitals to collaborate with their Public Health Departments to improve their communities' health. To ensure alignment with publically available CDPHE data, Exempla leaders decided which Colorado counties would make up the geographic area for the 2012 CHNA. Individual Exempla hospital facilities then examined their primary market areas and identified Colorado counties in which at least 10% of their patient population resided. The counties identified by each facility comprise the "Primary Service Area" used in the data reports. When county data was unavailable, Health Statistic Region data was substituted. The health indicators that were chosen for this report were selected based on publically available CDPHE data, and many were also identified as part of Colorado's 10 Winnable Battles. The health indicators are as follows: Overall Health Status; Access; Cancer; Diabetes; Heart Disease and Cerebrovascular Disease; HIV/AIDS; Communicable Disease; Injury; Mental Health; Obesity, Nutrition and Physical Activity; Oral Health; Sexual Health; Substance Abuse; and Tobacco. Exempla Good Samaritan Medical Center vetted the results of the CHNA and top health indicators by determining which indicators were below the Colorado state average for both Boulder and Broomfield Counties. The following indicators were selected: 1. Access, 2. Cancer 3. Communicable Diseases 4. Mental Health 5. Obesity, Nutrition and Physical Activity 6. Oral Health 7. Overall Health Status 8. Sexual Health and HIV / AIDS Community partners brought to the table for planning interventions were Centura Health System, Boulder County Health Department, Broomfield Health & Human Services, Mental Health Partners, West Pines, Exempla Physician Network, physicians from Ergentus, and numerous community organizations. The remainder of the needs identified in the CHNA is important to Exempla but due to limited expertise and the availability of community organizations, who are already addressing needs, Exempla Good Samaritan Medical Center will collaborate with community organizations to ensure all needs and health indicators are being addressed. Exempla Lutheran Medical Center vetted the results of the CHNA and top health indicators and selected the following indicators to be addressed: 1. Obesity 2. Nutrition and 3. Physical Activity. Community partners brought to the table for planning interventions were Jefferson County Health Department, West Pines, Wheat Ridge (WR) 2020, LiveWell WR, Enterprise WR, WR Business Association, City of WR, Weight Watchers, Sodexo, LiveLocal, Jefferson County Public Schools, and Pridemark EMS. The remainder of the needs identified in the CHNA is important to Exempla but due to limited expertise and the availability of community organizations in the community, who are already addressing needs, Lutheran will collaborate with community organization to ensure all needs and health indicators are being addressed. In support of the CHNA, Exempla has a defined COMMUNITY SERVED BY THE HOSPITALS. This is ACCOMPLISHED BY PARTNERING WITH LOCAL GOVERNMENT AND SOCIAL AGENCIES; COMBINING EFFORTS WITH OTHER LOCAL HOSPITALS AND HEALTH CARE ORGANIZATIONS; AND CONDUCTING SURVEYS AND ASSESSMENTS WITH THE ASSISTANCE OF OUTSIDE CONSULTANTS. WE ALSO CONTINUOUSLY ASSESS THE NEEDS OF THE COMMUNITY THROUGH CLOSE WORKING RELATIONSHIPS AND PARTNERSHIPS WITH SERVICE AGENCIES IN THE COMMUNITY, AND BY EVALUATING STATE AND COUNTY HEALTH STATISTICS. Exempla has A MULTITUDE OF PROGRAMS IN PLACE THROUGH ITS CANCER CENTER AND NEUROVASCULAR CENTER AND THROUGH COMMUNITY OUTREACH. A VARIETY OF CLASSES ARE OFFERED ON WEIGHT MANAGEMENT AND SUPPORT GROUPS FOR CANCER PATIENTS. WE ALSO ROUTINELY OFFER COMMUNITY HEALTH AND SAFETY CLINICS, SKIN CANCER SCREENINGS, BREAST CANCER SURVIVORSHIP PROGRAMS, CLASSES FOR PROSPECTIVE PARENTS AND DIABETES MANAGEMENT CLASSES, TO NAME A FEW. EXEMPLA ALSO RECOGNIZE THE ESSENTIAL NEED TO ENHANCE AND IMPROVE MEDICAL OUTCOMES, QUALITY AND SERVICES. IN RESPONSE, A BEST IN THE NATION STRATEGY AND PROGRAM WAS IMPLEMENTED. THE OBJECTIVES OF THE PROGRAM ARE TO BE THE BEST IN THE NATION IN PREDEFINED QUALITY, SERVICE AND COST INDICATORS. THE QUALITY INDICATORS ARE IN ALIGNMENT WITH MAJOR PUBLICLY COMPARABLE DATABASES INCLUDING THE COLORADO HEALTH AND HOSPITAL ASSOCIATION AND CENTERS FOR MEDICARE AND MEDICAID SERVICES. COLLECTIVELY WITH ITS 534 LICENSED BEDS AT ELMC AND EGSMC, EXEMPLA SERVED THE COMMUNITY WITH 28,705 INPATIENT ADMISSIONS AND 112,328 EMERGENCY ROOM (ER) VISITS. COMPREHENSIVE MEDICAL SERVICES INCLUDE, BUT ARE NOT LIMITED TO, CARDIOLOGY, ONCOLOGY, ORTHOPEDIC, WOMEN AND FAMILY, EMERGENCY AND TRAUMA, NEONATAL INTENSIVE CARE, NEUROLOGY, NEUROSURGERY,OB/GYN, GENERAL SURGICAL AND MEDICAL, PRIMARY CARE, INTERNAL MEDICINE, BEHAVIORAL HEALTH, HOSPICE CARE AND INTEGRATIVE HEALTH SERVICES. |
| PATIENT EDUCATION OF ELIGIBILITY FOR ASSISTANCE | PART VI, LINE 3 | EXEMPLA, INC TREATS PATIENTS WITH RESPECT AND DIGNITY REGARDLESS OF THEIR ABILITY TO PAY. EXEMPLA, INC HAS A WRITTEN FINANCIAL ASSISTANCE POLICY THAT EXPLAINS ELIGIBILITY CRITERIA FOR FINANCIAL ASSISTANCE AT VARIOUS LEVELS, INCLUDING A 100% DISCOUNT, AND IS BASED ON FEDERAL POVERTY GUIDELINES. WE WORK WITH PATIENTS TO HELP THEM UNDERSTAND THEIR FINANCIAL RESPONSIBILITY FOR CARE RECEIVED, FINANCIAL ASSISTANCE AVAILABLE TO THEM, AND TO ESTABLISH PAYMENT PROGRAMS IN DEMONSTRATION OF OUR CORE VALUE OF RESPECT. AS PART OF OUR RESPONSIBILITY TO EDUCATE, WE INFORM OUR PATIENTS AND THEIR FAMILIES OF THE AVAILABILITY OF ASSISTANCE, INCLUDING GOVERNMENT PROGRAMS. WE COMMUNICATE THIS IN A VARIETY OF WAYS TO ENSURE THAT MESSAGES REACH MULTIPLE AUDIENCES. BEFORE, DURING AND/OR AFTER ADMISSION, WE ENCOURAGE OUR SELF PAY PATIENTS TO VISIT WITH A FINANCIAL COUNSELOR TO DISCUSS QUALIFICATIONS FOR FINANCIAL ASSISTANCE. THE FINANCIAL COUNSELOR WORKS WITH THE PATIENT TO COMPLETE A FINANCIAL ASSISTANCE FORM TO DETERMINE THE LEVEL OF DISCOUNT FOR WHICH THE PATIENT MAY BE ELIGIBLE. WE POST FINANCIAL ASSISTANCE INFORMATION IN EMERGENCY AND ADMISSIONS AREAS, ON BILLINGS INVOICES, IN VARIOUS AREAS AROUND THE HOSPITAL AND CLINIC SITES AND ON THE HOSPITAL WEBSITE. WE PROVIDE WRITTEN MATERIALS TO PATIENTS THAT DETAIL OUR FINANCIAL ASSISTANCE POLICY AND HOW IT IS ADMINISTERED. THIS COVERS ELIGIBILITY, STEPS TO FOLLOW TO DETERMINE IF A PATIENT QUALIFIES FOR ASSISTANCE, TYPICAL CHARGES A PATIENT MAY EXPECT FOR ROUTINE PROCEDURES, AND ASSISTANCE AVAILABLE BASED ON A PATIENT'S INCOME LEVEL. WE PROVIDE MATERIALS AND EDUCATION WHEN PATIENTS ARE DISCHARGED, AND INCLUDE INFORMATION IN BILLING STATEMENTS, INCLUDING PHONE NUMBERS AND OTHER METHODS TO CONTACT US WITH QUESTIONS. WE ENSURE THAT OUR FINANCIAL COUNSELORS, ADMISSION EMPLOYEES, SOCIAL WORKERS AND OTHER EMPLOYEES UNDERSTAND OUR POLICIES TO BE ABLE TO ASSIST PATIENTS IN THE MOST APPROPRIATE WAY. WE ALSO PROVIDE PAYMENT PLAN OPTIONS TO OUR PATIENTS. THIS HELPS PATIENTS MEET THEIR FINANCIAL OBLIGATIONS IN A REASONABLE AND DIGNIFIED MANNER BASED ON THEIR ABILITY TO PAY, AND ALLOWS THEM TO CONTINUE TO ENSURE THE ONGOING WELFARE OF THEIR FAMILIES. THIS IS DONE IN ACCORDANCE WITH OUR CORE VALUE OF RESPECT. |
| COMMUNITY INFORMATION | PART VI, LINE 4 | SCL Health System's acute care facility in the north Denver metropolitan area is Exempla Good Samaritan Medical Center ("EGSMC"). EGSMC is located in Lafayette, Colorado, and provides healthcare services to a wide array of communities in the north metropolitan area. The primary service area, which is based on the geographic area of contiguous zip codes from which the hospital draws approximately 75% of its inpatient discharges, is comprised of 23 standard zip codes located in Broomfield County (2 zip codes), Boulder County (5 zip codes), Adams County (10 zip codes), Jefferson County (4 zip codes) and Weld County (2 zip codes). The combined primary and secondary service area, which is based on the geographic area of contiguous zip codes from which the hospital draws approximately 90% of its inpatient discharges, is comprised of the 23 zip codes from the primary service area and 26 zip codes in the secondary service area located in the counties of Adams, Boulder, Gilpin, Jefferson, Larimer and Weld. EGSMC is the leading acute care provider in its primary service area and treats about one in five inpatients in that area, highest among hospitals in the market. The care site's highest concentration of patients originate from the corridor along US Highway 36 across to Interstate 70; comprised of the communities of Broomfield, Lafayette, Westminster, western Brighton and Thornton. EGSMC sees a substantial amount of patients enrolled with Kaiser Permanente and serves as Kaiser's main inpatient provider in the northern portion of the Denver metropolitan area. There are six acute care facilities located in EGMSC's primary service area, including, EGSMC, two Centura Health hospitals (not-for-profit) - Avista Adventist Hospital and Saint Anthony North Hospital, one HealthONE hospital (for-profit) - North Suburban Hospital, and two unaffiliated not-for-profit facilities, Platte Valley Medical Center and Longmont United Hospital. EGSMC's secondary service area includes four other acute care facilities, three of which are affiliated with local health systems (Exempla Lutheran Medical Center, McKee Medical Center - Banner Health, and Medical Center of the Rockies - University Health) and one independent hospital, Boulder Community Hospital. Exempla Lutheran Medical Center ("ELMC") is situated in the western portion of the Denver metropolitan area in the city of Wheat Ridge, Colorado. The care sites services many communities in the western metropolitan area including Wheat Ridge, Arvada, Golden, Lakewood, Westminster as well as communities in the foothills of the Front Range. ELMC's primary service area consists of 18 standard zip codes, mainly located in Jefferson County (13 zip codes), but also represented by zip codes in the counties of Denver (3 zip codes), Adams (1 zip code) and Gilpin (1 zip code). The secondary service area includes 20 zip codes and extends through Adams County, Broomfield County, Clear Creek County, Denver County and Jefferson County. The primary service area is defined as the geographic area of contiguous zip codes from which the hospital draws approximately 75% of its inpatient discharges and the combined primary and secondary service area is based on approximately 90% of discharges. ELMC's main concentration of care is provided to the communities of Wheat Ridge, Arvada and Golden. 50% of the care site's discharges come from eight zip codes within those cities. Additionally, ELMC services the most patients within its primary service area when compared to other hospitals furnishing close to 30% of the inpatient care. Up until 2010, ELMC had been the sole provider of acute care services within its primary service area until Saint Anthony Hospital, a Centura Health affiliate, re-located its facility from western Denver to an area in Lakewood closer to ELMC's campus. Currently, ELMC, Saint Anthony Hospital and Ortho Colorado Hospital at Saint Anthony Hospital, an orthopedic specialty hospital jointly owned by Centura Health and local physicians, are the acute care hospitals located in ELMC's primary service area. There are three acute care hospitals located in the secondary service area, Saint Anthony North Hospital (an affiliate of the not-for-profit Centura Health organization), North Suburban Medical Center (an affiliate of the for-profit HealthONE system) and Denver Health (government owned). THE COMMUNITY SERVED BY EXEMPLA, INC. IS A CONTINUUM OF MUNICIPALITIES AND SECTIONS OF MUNICIPALITIES WITHIN THE GREATER DENVER METRO AREA, EXTENDING FROM THE CENTRAL WEST METRO DENVER CITIES OF LAKEWOOD AND EVERGREEN TO LONGMONT, THE MOST NORTHWEST MUNICIPALITY IN THE METRO DENVER AREA (EXCLUDING THE CITY OF BOULDER PROPER). WHILE THERE ARE SOME MOUNTAIN AND RURAL AREAS OVER THIS COMMUNITY EXPANSE, MOST OF THE COMMUNITY SERVED IS SUBURBAN AND URBAN AREAS. THE POPULATION OF THE ENTIRE COMMUNITY SERVED IS 1,066,000 AS OF YEAR 2010. THIS AREA REPRESENTS A LITTLE LESS THAN 40% OF THE WHOLE DENVER METRO AREA. BESIDES THE EXEMPLA INC. HOSPITALS, EXEMPLA LUTHERAN MEDICAL CENTER, WHEAT RIDGE AND EXEMPLA GOOD SAMARITAN, LAFAYETTE THERE ARE five OTHER NOT-FOR-PROFIT HOSPITALS IN THE COMMUNITY: - ST. ANTHONY NORTH HOSPITAL-CENTURA HEALTH, WESTMINSTER - ST. ANTHONY WEST HOSPITAL-CENTURA HEALTH, LAKEWOOD - AVISTA ADVENTIST HOSPITAL-CENTURA HEALTH, LOUISVILLE - LONGMONT UNITED HOSPITAL, LONGMONT - Boulder Community Hospital, Boulder THERE IS ALSO ONE FOR-PROFIT HOSPITAL, NORTH SUBURBAN MEDICAL CENTER-HEALTHONE, THORNTON. The community served by EGSMC contains the following demographic information. POPULATION, RACE, ETHNICITY, AND GENDER In the Exempla Primary Service Areas/EGSMC, total population is 1,499,686, according to 2010 census data. Broomfield also has the highest percentage of all youth under 18 years of age, 26.1%, and Boulder County has 21.3%. Boulder County has 10% and Broomfield County 9.9% of their populations aged over 65. Both counties are predominantly white with Boulder at 87.2% and Broomfield at 86.1%, exceeding the state average of 81.3%. The next largest racial group is Asian with Broomfield at 6.1% and Boulder at 4.1%, again both exceeding the state average. Both Boulder & Broomfield have only small percentages of black residents and are lower than the state average. Persons of Hispanic or Latino origin make up 13.3% of Boulder County and 11.1% of Broomfield County. This is under the state average of about 21%. Broomfield County has slightly more females than males (50.4% vs 49.6%) and Boulder County has more males than females (49.8% female vs. 50.2% male) EDUCATION Both Boulder and Broomfield Counties exceed the state average for high school graduates and for those with bachelor's degrees or higher. Boulder has the highest education level in the state with 56.6% of the population with degrees. INCOME Boulder and Broomfield Counties have higher median income than the state average. Broomfield has the highest median income in the state at $77,606. Boulder meets the state average for persons below the poverty level and Broomfield has only 4.9% of population at poverty level. Boulder and Broomfield Counties are both under the state unemployment rate according to 2010 numbers. Broomfield was listed at 7.9% and Boulder at 7.1%. HEALTH STATUS Broomfield and Boulder Counties are well below the state average of 12% of persons who say their health is poor or fair. Boulder County has 8% and Broomfield County 7.3% of their populations self-identifying as such. Both Broomfield and Boulder Counties are below the state average of smokers in the population with Boulder at 12.8% and Broomfield at 13.9%. Both Boulder and Broomfield have population overweight percentages below the state average. Boulder's obesity rate is below the state average at 13.1%, but Broomfield at 20.8% is above the state average. Boulder is above the state average for high risk drinking at least once in the past month, while Broomfield is below state average. Both counties are below the state average for binge drinking at least once in the past month. The community served by ELMC contains the following demographic information. POPULATION, RACE, ETHNICITY, AND GENDER In the Exempla Primary Service Areas/ELMC, total population is 534,543, according to 2010 census data. Jefferson County also has the highest percentage of all youth under 18 years of age, 21.5%. Jefferson and Clear Creek Counties have the highest percentage of residents over age 65 and exceed the state average. Jefferson County has 12.6% and Clear Creek County 12.5% of their population ages over 65. Jefferson County is predominantly white, which includes Hispanics self-identifying, at 88.4%, exceeding the state average. The next largest racial group is Asian with Jefferson County at 2.6%, only a small percentage of black residents and are lower than the state average. Persons of Hispanic or Latino origin make up 14.3% of Jefferson County. This is below the state average. Jefferson County has more fema |
| PROMOTION OF COMMUNITY HEALTH | PART VI, LINE 5 | WE EXTEND OUR CARE BEYOND OUR HOSPITALS' WALLS IN ORDER TO IMPROVE THE HEALTH OF OUR COMMUNITY. OUR COMMUNITY ACTIVITIES DEMONSTRATE THIS COMMITMENT. OUR COMMUNITY ACTIVITIES AT EXEMPLA LUTHERAN MEDICAL CENTER INCLUDE A VARIETY OF CLASSES ON WEIGHT MANAGEMENT AND SUPPORT GROUPS FOR CANCER PATIENTS. ELMC ALSO ROUTINELY OFFERS COMMUNITY HEALTH AND SAFETY CLINICS, SKIN CANCER SCREENINGS, BREAST CANCER SURVIVORSHIP PROGRAMS, CLASSES FOR PROSPECTIVE PARENTS AND DIABETES MANAGEMENT CLASSES, TO NAME A FEW. EXEMPLA GOOD SAMARITAN MEDICAL CENTER'S HEALTH & HEALING CENTER CONDUCTS HEART HEALTH SCREENINGS IN THE COMMUNITY INCLUDING CHOLESTEROL SCREENING AND BLOOD PRESSURE SCREENINGS SEVERAL TIMES THROUGHOUT THE YEAR. WE ALSO PROMOTE HEALTH AND WELLNESS FOR OUR EMPLOYEES THROUGH PROGRAMS SUCH AS POUND POUNDERS TO PROMOTE WEIGHT LOSS. WE ALSO PROVIDE PRESENTATIONS TO COMMUNITY GROUPS ON SUBJECTS SUCH AS BALANCE, EXERCISE AND STRETCHING. WELLNESS QUEST CLASSES LED BY EGSMC PHYSICIANS ARE HELD IN THE COMMUNITY FOR PREVENTIVE-CARE EDUCATION AND INDIVIDUAL RESPONSIBILITY FOR HEALTH PROMOTION. WE HAVE PARTNERED WITH SUCH ORGANIZATIONS AS THE LAFAYETTE SENIOR CENTER, THE LAFAYETTE RECREATION CENTER AND OTHER COMMUNITY ORGANIZATIONS PROVIDING SERVICES TO OUR COMMUNITY. EGSMC ALSO PROVIDES HEALTH SCREENINGS FOR EMPLOYEES OF BOULDER VALLEY SCHOOL DISTRICT AND SCREENINGS AT EVENTS SEVERAL TIMES THROUGHOUT THE YEAR TO RESIDENTS OF BROOMFIELD, LAFAYETTE AND OTHERS IN THE SURROUNDING AREAS. WE ARE AN IMPORTANT PART OF OUR COMMUNITY AND SERVE IN MANY WAYS, FROM DELIVERING CORE HEALTH CARE TO PREVENTIVE CARE TO SUPPORT OF OTHER CIVIC GROUPS. IN 2012, EXEMPLA INC PROVIDED COMMUNITY BENEFIT TO INCLUDE TRADITIONAL CHARITY CARE AND THE UNPAID COST OF MEDICAID. OUR BOARD OF DIRECTORS REPRESENTS MEDICAL AND BUSINESS PROFESSIONALS, AND ALL PROVIDE HOURS OF SERVICE IN SUPPORT OF OUR HOSPITAL. THEY ARE DEEPLY INVOLVED IN OUR NEEDS ASSESSMENT PROCESS, BUILDING PROGRAMS AND SERVICES, AND COMMUNITY OUTREACH TO ENSURE THAT PEOPLE KNOW ABOUT SERVICES AVAILABLE TO THEM THROUGH OUR HOSPITAL. WHEN EXEMPLA, INC. HAS EXCESS REVENUE OVER OPERATING EXPENSES, WE USE THOSE FUNDS TO OBTAIN CURRENT HEALTH CARE TECHNOLOGIES AND EQUIPMENT, IMPROVE PATIENT CARE, PROVIDE MEDICAL TRAINING EDUCATION AND RESEARCH, AND TO EXPAND ACCESS TO POINTS OF CARE. THESE INVESTMENTS ENSURE WE'LL BE HERE TO CARE FOR FUTURE GENERATIONS. WE ALSO SUPPORT OUR EMPLOYEES IN VOLUNTEERING FOR COMMUNITY ORGANIZATIONS, INCLUDING SERVING ON COMMUNITY BOARDS, AND PROVIDE OPPORTUNITIES FOR THEM TO SUPPORT CAUSES THROUGH HOSPITAL EVENTS SUCH AS CANCER, HEART DISEASE, AMERICAN HEART ASSOCIATION, RACE FOR THE CURE, AND MARCH OF DIMES. WE ARE GOOD CITIZENS AND PARTNER WITH OTHER ORGANIZATIONS AND AGENCIES TO SUPPORT A THRIVING COMMUNITY, SUCH AS THE JEFFERSON COUNTY AND BOULDER COUNTY HEALTH DEPARTMENT, LIVEWELL COLORADO, THE METRO COMMUNITY PROVIDER NETWORK, MENTAL HEALTH PARTNERS OF BOULDER, MEALS ON WHEELS (BROOMFIELD & BOULDER COUNTIES), BROOMFIELD HEALTH & HUMAN SERVICES AND OTHER AGENCIES IN A SIX-COUNTY AREA. AS PART OF SCL HEALTH SYSTEM (SCLHS), WE PROMOTE THE SHARED MISSION THAT "WE REVEAL AND FOSTER GOD'S HEALING LOVE BY IMPROVING THE HEALTH OF THE PEOPLE AND COMMUNITIES WE SERVE, ESPECIALLY THOSE WHO ARE POOR OR VULNERABLE." WE ARE COMMITTED TO LIVING AND DEMONSTRATING OUR CORE VALUES OF EXCELLENCE, CARING SPIRIT, INTEGRITY, STEWARDSHIP AND GOOD HUMOR. SCLHS SUPPORTS ITS HOSPITALS BYPROVIDING GUIDANCE, OVERSIGHT, AND RESOURCES TO HELP THEM ACCOMPLISH INITIATIVES THAT IMPROVE HEALTH IN ALL OUR COMMUNITIES. THIS INCLUDES COORDINATING COMMUNITY BENEFIT PROCESSES, PROVIDING GUIDANCE WITH COMMUNITY NEEDS ASSESSMENTS, AND ESTABLISHING CONSISTENT FINANCIAL ASSISTANCE AND CHARITY CARE POLICIES AND PROCEDURES. OTHER WAYS SCLHS BENEFITS ITS HOSPITALS INCLUDE QUALITY IMPROVEMENT AND PERFORMANCE EXCELLENCE INITIATIVES; SYSTEM-WIDE INFORMATION TECHNOLOGY IMPLEMENTATION AND INFRASTRUCTURE; STRATEGIC AND OPERATIONS DIRECTION AND OVERSIGHT; SUPPLY CHAIN MANAGEMENT AND PURCHASING; BENEFITS ADMINISTRATION (INCLUDING A WELLNESS PROGRAM FREE TO EMPLOYEES THAT PROMOTES THEIR HEALTH AND WELL-BEING); RISK MANAGEMENT; DISASTER PLANNING AND CRISIS ASSISTANCE. BY SHARING THE WORK ACROSS OUR SYSTEM WE ARE ABLE TO LIGHTEN THE BURDEN FOR ALL IN ORDER TO FULFILL OUR MISSION OF IMPROVING HEALTH IN OUR COMMUNITIES. SCLHS IMPROVES OVERALL HEALTH IN OUR COMMUNITIES BY PROVIDING INFRASTRUCTURE TO SUPPORT AND SUSTAIN THREE CLINICS FOR THE UNINSURED IN KANSAS AND COLORADO. THE SCLHS CLINICS FOR THE UNINSURED ARE OFTEN THE ONLY SAFETY NET CLINIC IN THEIR COMMUNITY AND PROVIDE VALUABLE SERVICES FOR THOSE WHO ARE MOST VULNERABLE. EACH HOSPITAL IS SUPPORTED BY A FOUNDATION TO ACCESS AND OPTIMIZE LOCAL PHILANTHROPIC ORGANIZATIONS AND INDIVIDUALS. THESE FOUNDATIONS RAISE FUNDS THROUGH OUTREACH, SPECIAL EVENTS, AND BUILDING DONOR RELATIONS THROUGHOUT THEIR COMMUNITY TO SUPPORT THE NEEDS OF THE HOSPITAL. |
| AFFILIATED HEALTH CARE SYSTEM | PART VI, LINE 6 | SCL HEALTH SYSTEM IS A CONTROLLED ENTITY OF THE SISTERS OF CHARITY OF LEAVENWORTH HEALTH SYSTEM, INC. (SCLHS). SCLHS AND ITS AFFILIATED ENTITIES HAVE A COMMON CALLING AND MISSION "TO REVEAL GOD'S HEALING LOVE BY IMPROVING THE HEALTH OF THE INDIVIDUALS AND COMMUNITIES IT SERVES, ESPECIALLY THOSE WHO ARE POOR OR VULNERABLE." EXEMPLA, INC. PROMOTES THE HEALTH OF THE COMMUNITY BY DELIVERING DIRECT HIGH QUALITY HEALTHCARE SERVICES THAT ARE RESPONSIVE TO THE NEEDS OF ITS PATIENTS AND THEIR FAMILIES. SCLHS SUPPORTS THE EFFORTS OF THE HOSPITAL THROUGH STRATEGIC DIRECTION AND OPERATING OVERSIGHT. SCLHS SUPPLIES OVERHEAD SUPPORT SERVICES TO EXEMPLA, INC. INCLUDING INFORMATION TECHNOLOGY SERVICES, CENTRAL CASH MANAGEMENT AND INVESTMENT, RISK MANAGEMENT AND INSURANCE AND QUALITY IMPROVEMENT LEADERSHIP. |
| STATE FILING OF COMMUNITY BENEFIT REPORT | PART VI, LINE 7 | THE SISTERS OF CHARITY OF LEAVENWORTH HEALTH SYSTEM FILES A COMMUNITY BENEFIT REPORT IN FOUR STATES: CALIFORNIA, COLORADO, KANSAS AND MONTANA. |
Schedule I IRS990ScheduleI
| Field | Value | IRS element (for citing) |
|---|---|---|
| Records Maintained | true | RecordsMaintained |
Recipient Table RecipientTable (6 entries)
| Address Line1AddressUS/AddressLine1 | CityAddressUS/City | StateAddressUS/State | ZIP CodeAddressUS/ZIPCode | EIN Of RecipientEINOfRecipient | IRC SectionIRCSection | Amount Of Cash GrantAmountOfCashGrant | Purpose Of GrantPurposeOfGrant |
|---|---|---|---|---|---|---|---|
| YOUNG AMERICANS CENTER | |||||||
| 3550 E FIRST AVE | DENVER | CO | 80206 | 841564926 | 501(c)(3) | 10000 | Sponsor Medical Shop |
| METRO COMMUNITY PROVIDER NETWORK | |||||||
| 3701 S Broadway | ENGLEWOOD | CO | 80113 | 742477108 | 501(C)(3) | 50000 | SUPPORT FOR ESTES STREET COMMUNITY HEALTH CLINIC |
| MOUNT SAINT VINCENT | |||||||
| 4159 Lowell Blvd | DENVER | CO | 80211 | 840405260 | 501(C)(3) | 15000 | Golf for kids event. |
| SISTER CARMEN COMMUNITY CENTER | |||||||
| 655 ASPEN RIDGE DRIVE | LAFAYETTE | CO | 80026 | 840820308 | 501(c)(3) | 10000 | TO SUPPORT ACCESS TO HEALH CARE SERVICES |
| MENTAL HEALTH FOUNDATION | |||||||
| 1333 Iris Avenue | Boulder | CO | 80304 | 840520493 | 501(C)(3) | 25000 | To support mental health |
| MEALS ON WHEELS OF BOULDER | |||||||
| 909 ARAPAHOE AVE STE 121 | BOULDER | CO | 80302 | 840594180 | 501(C)(3) | 7206 | TO PROVIDE NUTRITIOUS MEALS TO RESIDENTS OF BOULDER |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Nbr Of501 C3 And Govt Grants | 6 | TotalNbrOf501C3AndGovtGrants |
Form990 Schedule I Part III Form990ScheduleIPartIII
| Field | Value | IRS element (for citing) |
|---|---|---|
| Type Of Grant | FREE PRESCRIPTION DRUGS FOR INDIGENT PATIENTS | TypeOfGrant |
| Amount Of Non Cash Assistance | 465195 | AmountOfNonCashAssistance |
| Method Of Valuation | BOOK | MethodOfValuation |
| Description Of Non Cash Assistance | PRESCRIPTION DRUGS | DescriptionOfNonCashAssistance |
Form990 Schedule I Part IV Form990ScheduleIPartIV
| Field | Value | IRS element (for citing) |
|---|---|---|
| Identifier | DESCRIPTION OF ORGANIZATION'S PROCEDURES FOR MONITORING THE USE OF GRANTS | Identifier |
| Return Reference | PART 1, QUESTION 2 | ReturnReference |
| Explanation | THE ORGANIZATION KEEPS RECORDS TO SUPPORT THE AMOUNTS PROVIDED OR REASONS FOR SUCH SUPPORT. SUPPORT IS NOT CONSIDERED GRANTS, BUT RATHER MISCELLANEOUS DONATIONS AND SPONSORSHIPS. ELIGIBILITY FOR FUNDING IS DETERMINED ON AN INDIVIDUAL BASIS, CONSIDERING THE USE OF THE FUNDS AND HOW THE USE RELATES TO EXEMPLA'S MISSION. | Explanation |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Idemnification Gross Up Payments | X | IdemnificationGrossUpPayments |
| Written Policy Re T And E Expenses | true | WrittenPolicyReTAndEExpenses |
| Substantiation Required | true | SubstantiationRequired |
| Severance Payment | true | SeverancePayment |
| Supplemental Nonqual Retire Plan | true | SupplementalNonqualRetirePlan |
| Equity Based Comp Arrangement | false | EquityBasedCompArrangement |
| Comp Based On Revenue Of Filing Org | false | CompBasedOnRevenueOfFilingOrg |
| Comp Based On Revenue Related Orgs | false | CompBasedOnRevenueRelatedOrgs |
| Comp Based Net Earnings Filing Org | false | CompBasedNetEarningsFilingOrg |
| Comp Based Net Earnings Relate Orgs | false | CompBasedNetEarningsRelateOrgs |
| Any Non Fixed Payments | true | AnyNonFixedPayments |
| Initial Contract Exception | false | InitialContractException |
Form990 Schedule J Part II Form990ScheduleJPartII (22 entries)
| TitleTitle | Base Compensation Filing OrgBaseCompensationFilingOrg | Comp Based On Related OrgsCompBasedOnRelatedOrgs | Bonus Filing OrgBonusFilingOrg | Bonus Related OrgsBonusRelatedOrgs | Other Compensation Filing OrgOtherCompensationFilingOrg | Other Compensation Related OrgsOtherCompensationRelatedOrgs | Deferred Comp Filing OrgDeferredCompFilingOrg | Deferred Comp Related OrgsDeferredCompRelatedOrgs | Nontaxable Benefits Filing OrgNontaxableBenefitsFilingOrg | Nontaxable Benefits Related OrgsNontaxableBenefitsRelatedOrgs | Total Compensation Filing OrgTotalCompensationFilingOrg | Total Compensation Related OrgsTotalCompensationRelatedOrgs | Comp Report Prior990 Filing OrgCompReportPrior990FilingOrg | Comp Report Prior990 Related OrgsCompReportPrior990RelatedOrgs |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| DAVID HAMM | ||||||||||||||
| PRESIDENT & CEO-EGSMC | 0 | 360207 | 0 | 113907 | 0 | 20250 | 0 | 81907 | 0 | 12388 | 0 | 588659 | 0 | 0 |
| ROBERT G BILLERBECK | ||||||||||||||
| VP-CHIEF MEDICAL OFFICER | 0 | 296073 | 0 | 55019 | 0 | 6394 | 0 | 48558 | 0 | 12455 | 0 | 418499 | 0 | 0 |
| ELISA WETHERBEE | ||||||||||||||
| CHIEF OPERATING OFFICER EPN | 0 | 226225 | 0 | 74659 | 0 | 4650 | 0 | 40352 | 0 | 16438 | 0 | 362324 | 0 | 0 |
| S ANN EVANS | ||||||||||||||
| VP-CHIEF NURSING OFFICER(ELMC) | 0 | 0 | 0 | 0 | 195861 | 0 | 0 | 0 | 5322 | 0 | 201183 | 0 | 0 | 0 |
| BETH C FORSYTH | ||||||||||||||
| VP-CLIN & SUPPORT SVCS (EGSMC) | 0 | 222896 | 0 | 39516 | 0 | 9457 | 0 | 38367 | 0 | 12020 | 0 | 322256 | 0 | 0 |
| MARGARET CAIN PRICE | ||||||||||||||
| VP-OPERATIONS (ELMC) | 0 | 224920 | 0 | 39483 | 0 | 3700 | 0 | 39141 | 0 | 12317 | 0 | 319561 | 0 | 0 |
| KAREN M SCREMIN | ||||||||||||||
| VP-FINANCE (ELMC) | 0 | 195692 | 0 | 34819 | 0 | 808 | 0 | 35497 | 0 | 6834 | 0 | 273650 | 0 | 0 |
| TODD A CONKLIN | ||||||||||||||
| SVP & CFO, TREASURER | 0 | 377511 | 0 | 236016 | 0 | 13154 | 0 | 59483 | 0 | 16546 | 0 | 702710 | 0 | 0 |
| SUSAN E KERSCHEN | ||||||||||||||
| VP-CHIEF NURSING OFFCR (EGSMC) | 0 | 191630 | 0 | 35605 | 0 | 3551 | 0 | 35074 | 0 | 12062 | 0 | 277922 | 0 | 0 |
| JOHN D HIGGINS | ||||||||||||||
| VP FINANCE (EGSMC) | 0 | 164168 | 0 | 28437 | 0 | 5233 | 0 | 33000 | 0 | 15775 | 0 | 246613 | 0 | 0 |
| GRANT WICKLUND | ||||||||||||||
| PRESIDENT & CEO-ELMC | 0 | 394762 | 0 | 104652 | 0 | 23789 | 0 | 54760 | 0 | 16663 | 0 | 594626 | 0 | 0 |
| BOB LADENBURGER | ||||||||||||||
| PRESIDENT & CEO of EXEMPLA | 0 | 660676 | 0 | 203467 | 0 | 511903 | 0 | 94171 | 0 | 12465 | 0 | 1482682 | 0 | 0 |
| MARK C WATTS | ||||||||||||||
| PHYSICIAN | 699795 | 0 | 26000 | 0 | 0 | 0 | 18000 | 0 | 7844 | 0 | 751639 | 0 | 0 | 0 |
| KEVIN B MILLER | ||||||||||||||
| PHYSICIAN | 482672 | 0 | 209111 | 0 | 0 | 0 | 18000 | 0 | 16733 | 0 | 726516 | 0 | 0 | 0 |
| STEPHEN W COBB | ||||||||||||||
| CHIEF MEDICAL OFFICER (EPN) | 0 | 238645 | 0 | 24557 | 0 | 8994 | 0 | 46845 | 0 | 13594 | 0 | 332635 | 0 | 0 |
| MICHAEL A SLUBOWSKI | ||||||||||||||
| CHAIR,PRESIDENT AND CEO(SCLHS) | 0 | 993061 | 0 | 398970 | 0 | 121672 | 0 | 24119 | 0 | 12465 | 0 | 1550287 | 0 | 0 |
| LYDIA JUMONVILLE | ||||||||||||||
| SVP FINANCE & CFO | 0 | 499288 | 0 | 152073 | 0 | 13890 | 0 | 73035 | 0 | 16546 | 0 | 754832 | 0 | 0 |
| RICK LOPES | ||||||||||||||
| SVP Health Networks | 0 | 507612 | 0 | 96853 | 0 | 313140 | 0 | 43290 | 0 | 12465 | 0 | 973360 | 0 | 0 |
| TOWNDROWGERALDINE M | ||||||||||||||
| VP-CHIEF NURSING OFFICER(ELMC) | 231600 | 0 | 0 | 0 | 0 | 0 | 6948 | 0 | 432 | 0 | 238980 | 0 | 0 | 0 |
| LAMONDRODERICK G | ||||||||||||||
| PHYSICIAN | 551208 | 0 | 175060 | 0 | 108685 | 0 | 18000 | 0 | 14159 | 0 | 867112 | 0 | 0 | 0 |
| LANKENAUJOHN E | ||||||||||||||
| PHYSICIAN | 776709 | 0 | 27622 | 0 | 0 | 0 | 18000 | 0 | 16599 | 0 | 838930 | 0 | 0 | 0 |
| THOMPSONDONALD C | ||||||||||||||
| PHYSICIAN | 587533 | 0 | 75847 | 0 | 0 | 0 | 18000 | 0 | 7056 | 0 | 688436 | 0 | 0 | 0 |
Form990 Schedule J Part III Form990ScheduleJPartIII (5 entries)
| IdentifierIdentifier | Return ReferenceReturnReference | ExplanationExplanation |
|---|---|---|
| TAX INDEMNIFICATION AND GROSS UP PAYMENTS | SCH J, PART I, QUESTION 1A | 26 INDIVIDUALS RECEIVED GROSS UP PAYMENTS FOR GIFTS OR OTHER ITEMS THAT WERE TAXABLE TO THE INDIVIDUAL IN THEIR W-2'S. THESE TOTALED $859.33 IN THE AGGREGATE. |
| SEVERANCE AND CHANGE OF CONTROL PAYMENTS | SCHEDULE J, PART I, QUESTION 4A | A CHANGE OF CONTROL PAYMENT WAS MADE TO KATHRYN BALLINGER IN THE AMOUNT OF $314,536.56 IN 2012. SISTERS OF CHARITY OF LEAVENWORTH HEALTH SYSTEM, INC. (SCLHS) PERIODICALLY INCURS SEVERANCE PAYMENTS RELATED TO FORMER EMPLOYEES. A SEVERANCE PAYMENT WAS MADE TO S. A. EVANS IN THE AMOUNT OF $198,013 IN 2012. |
| SUPPLEMENTAL NONQUALIFIED RETIREMENT PLANS | SCHEDULE J, PART I QUESTION 4B | EXEMPLA HAS A 457(F) SUPPLEMENTAL NONQUALIFIED DEFERED COMPENSATION PLAN, IN WHICH CERTAIN KEY OFFICERS PARTICIPATE. OTHER REPORTABLE COMPENSATION SHOWN IN SCHEDULE J PART II COLUMN (B) (III) CONTAINS AN ANNUAL REPORTING ADJUSTMENT FOR CERTAIN EMPLOYEES WHO PARTICIPATE IN THE SUPPLEMENTAL NONQUALIFIED RETIREMENT PLANS. SCLHS PROVIDES NONQUALIFIED RETIREMENT PLANS FOR EXECUTIVES TO COMPENSATE FOR IRS IMPOSED LIMITATIONS IN QUALIFIED RETIREMENT PLANS AND TO PROVIDE A BENEFIT CONSISTENT WITH OTHER NOT FOR PROFIT HEALTH SYSTEMS. THESE PLANS ENABLE THE EXECUTIVE TO EARN BENEFITS DURING EACH YEAR THAT THEY PARTICIPATE. ON THE ADVICE OF COUNSEL, SCLHS HAS DETERMINED THAT THESE BENEFITS SHOULD BE SUBJECT TO TAXATION AS THEY ARE EARNED AND VESTED RATHER THAN WHEN THEY ARE RECEIVED. AS A RESULT, THE TOTAL NONQUALIFIED RETIREMENT PLAN BENEFITS, WHICH WERE ACCRUED AND VESTED IN THE CURRENT YEAR, ARE NOW CONSIDERED TAXABLE AND THUS WERE TAXED TO THE PARTICIPANTS. |
| INCENTIVE PLANS | SCHEDULE J, PART I, QUESTION 7 | THE MANAGEMENT INCENTIVE PLANS ARE BASED ON A COMBINATION OF MEASURES. MANAGEMENT AND SENIOR LEADERSHIP ARE ELIGIBLE FOR THE INCENTIVE COMPENSATION. PERFORMANCE CATEGORIES ARE MADE UP OF A COMBINATION OF CLINICAL QUALITY MEASURES AND OPERATING INCOME. THE OPERATING INCOME CATEGORY IS GENERALLY RELATED TO THE NET EARNINGS OF THE DIVISION IN WHICH THE INDIVIDUAL WORKS, OR IN THE CASE OF SYSTEM SERVICES SENIOR MANAGEMENT, THE NET EARNINGS OF THE COMPANY. |
| COMPENSATION OF BOARD MEMBER | SCHEDULE J, PART II | SCLHS CONSISTS OF ELEVEN HOSPITALS AND FOUR CLINICS (AFFILIATES) IN FOUR STATES INCLUDING EXEMPLA, INC. SCLHS AND ITS AFFILIATES ADHERE TO GOVERNANCE EXCELLENCE STANDARDS INCLUDING TRANSPARENCY AND ACCOUNTABILITY. MICHAEL A. SLUBOWSKI IS PRESIDENT & CHIEF EXECUTIVE OFFICER FOR SISTERS OF CHARITY OF LEAVENWORTH HEALTH SYSTEM (SCLHS). HE ALSO SERVES AS A MEMBER OF THE EXEMPLA, INC.'S (EXEMPLA) BOARD AND AS CHAIRMAN. THE COMPENSATION REFLECTED IS THAT OF MR. SLUBOWSKI'S POSITION AS AN SCLHS EXECUTIVE AND NOT AS A MEMBER OF EXEMPLA'S BOARD. IN KEEPING WITH SCLHS' CORE VALUE OF STEWARDSHIP, NO BOARD MEMBER SERVING ON SCLHS OR AFFILIATE BOARDS IS COMPENSATED FOR THAT SERVICE. |
Schedule O IRS990ScheduleO
General Explanation GeneralExplanation (12 entries)
| IdentifierIdentifier | Return ReferenceReturnReference | ExplanationExplanation |
|---|---|---|
| EXEMPT PURPOSE ACHIEVEMENTS | FORM 990, PART III, QUESTION 4A - 4D | EXEMPLA INC. (EXEMPLA) OPERATES EXEMPLA LUTHERAN MEDICAL CENTER (ELMC), SERVING PRIMARILY WESTERN AND SOUTHERN SUBURBAN AREAS OF METRO DENVER, EXEMPLA GOOD SAMARITAN MEDICAL CENTER (EGSMC), SERVING PRIMARILY BOULDER AND NORTHWEST COUNTIES OF METRO DENVER, AND OTHER AFFILIATED MEDICAL OPERATIONS. THE SYSTEM'S COLLECTIVE PROGRAM SERVICES ACCOMPLISHMENTS INCLUDE BUT ARE NOT LIMITED TO THE FOLLOWING: MEDICAL SERVICES ARE PROVIDED TO ALL WHO SEEK SERVICE REGARDLESS OF RACE, CREED, SEX, NATIONAL ORIGIN, HANDICAP, AGE, OR ABILITY TO PAY. ALTHOUGH REIMBURSEMENT FOR SERVICES IS CRITICAL FOR THE OPERATION AND STABILITY OF EXEMPLA, IT IS RECOGNIZED THAT NOT ALL INDIVIDUALS POSSESS THE ABILITY TO PURCHASE ESSENTIAL MEDICAL SERVICES. THEREFORE, IN KEEPING WITH EXEMPLA'S COMMITMENT TO SERVE ALL MEMBERS OF ITS COMMUNITY, FREE CARE AND/OR SUBSIDIZED CARE WILL BE CONSIDERED AND PROVIDED WHERE THE NEED AND/OR AN INDIVIDUAL'S INABILITY TO PAY EXIST. IN ADDITION, EXEMPLA RECOGNIZES THE ESSENTIAL NEED TO BE EXCEPTIONAL STEWARDS OF MEDICARE, MEDICAID AND COMMUNITY/PRIVATE FUNDING DOLLARS. FOR 2012, EXEMPLA PROVIDED BENEFIT TO THE COMMUNITY AT A COST OF $47,553,648, INCLUDING CHARITY CARE, UNREIMBURSED MEDICAID, OTHER SUBSIDIZED HEALTH SERVICES AND EDUCATION. EXEMPLA ALSO RECOGNIZES THE ESSENTIAL NEED TO ENHANCE AND IMPROVE MEDICAL OUTCOMES, QUALITY AND SERVICES. IN RESPONSE, A BEST IN THE NATION STRATEGY AND PROGRAM WAS IMPLEMENTED. THE OBJECTIVES OF THE PROGRAM ARE TO BE THE BEST IN THE NATION IN PREDEFINED QUALITY, SERVICE AND COST INDICATORS. THE QUALITY INDICATORS ARE IN ALIGNMENT WITH MAJOR PUBLICLY COMPARABLE DATABASES INCLUDING THE COLORADO HEALTH AND HOSPITAL ASSOCIATION AND CENTERS FOR MEDICARE AND MEDICAID SERVICES. COLLECTIVELY WITH ITS 572 LICENSED BEDS AT ELMC AND EGSMC, EXEMPLA SERVED THE COMMUNITY WITH 27,215 INPATIENT ADMISSIONS, 114,109 EMERGENCY ROOM (ER) VISITS AND 362,700 EXEMPLA PHYSICIAN NETWORK (OUTPATIENT CLINICS) ENCOUNTERS. COMPREHENSIVE MEDICAL SERVICES INCLUDE, BUT ARE NOT LIMITED TO, CARDIOLOGY, ONCOLOGY, ORTHOPEDIC, WOMEN AND FAMILY, PEDIATRICS, EMERGENCY AND TRAUMA, NEONATAL INTENSIVE CARE, NEUROLOGY, NEUROSURGERY, OB/GYN, GENERAL SURGICAL AND MEDICAL, PRIMARY CARE, INTERNAL MEDICINE, BEHAVIORAL HEALTH, HOSPICE CARE AND INTEGRATIVE HEALTH SERVICES. A STRONG COMMITMENT TO THE HEALTH OF THE COMMUNITY IS FURTHER EXEMPLIFIED, BUT NOT LIMITED TO, THE FOLLOWING PROGRAMS: EXEMPLA LUTHERAN MEDICAL CENTER WITH ITS 338 LICENSED BEDS, ELMC SERVED THE COMMUNITY WITH 13,983, INPATIENT ADMISSIONS AND 73,030 EMERGENCY ROOM VISITS. SERVICES AND PROGRAMS -THE CANCER CENTER AT ELMC INCLUDES ALL STAGES OF CARE INCLUDING INITIAL DIAGNOSIS; GIVING, MONITORING, AND MANAGING MEDICATIONS; PATIENTS AND FAMILY. THE CENTER INCLUDES STATE-OF-THE -ART-RADIATION ONCOLOGY CENTER, INFUSION CENTER, ONCOLOGY UNIT, CLINICAL TRIALS, NUTRITION COUNSELING, SOCIAL WORK SERVICES, SITE SPECIFIC CARE TEAM, EDUCATION AND SUPPORT SERVICES. -AT THE HEART AND NEUROVASCULAR CENTER, PATIENTS ARE TREATED BY AN INTERDISCIPLINARY TEAM FOR CARDIAC AND NEUROLOGICAL CARE. PATIENTS DO NOT NEED TO BE TRANSFERRED TO ANOTHER FACILITY. THE CENTER FEATURES ADVANCED IMAGING EQUIPMENT AND NEUROLOGICAL SUITES TO SPEED PATIENTS' CARE. -THE BREAST CARE CENTER ACCREDITED BY THE AMERICAN COLLEGE OF RADIOLOGY AND THE NATIONAL ACCREDITATION BREAST CARE CENTER, PROVIDES A FULL RANGE OF HIGH-TECH SERVICES IN ITS SCREENING AND DIAGNOSTIC SUITES INCLUDING DIGITAL MAMMOGRAPHY SCREENINGS AND DIAGNOSTIC SUITES INCLUDING DIGITAL MAMMOGRAPHY SCREENINGS AND DIAGNOSTIC SERVICES ULTRASOUND, STEREOTACTIC BIOPSIES, MEDICAL CONSULTATION, EDUCATION, AS WELL AS AN ALTERNATIVE HEALTH CENTER AND EMOTIONAL SUPPORT. -THE WOMEN AND FAMILY CENTER INCLUDES A LEVEL III NEONATAL INTENSIVE CARE UNIT AND COMPREHENSIVE PRENATAL AND PARENTING EDUCATION. THE ANTEPARTUM FAMILY UNIT HELPS PREGNANT WOMEN WHO NEED SPECIALIZED CARE FOR THEMSELVES AND/OR THEIR UNBORN BABIES. SUPPORT FOR THE NEW UNIT HELPS US REACH OUR GOAL TO HELP WOMEN HAVE HEALTHY PREGNANCIES, BIRTHS AND BABIES. o THE DIAGNOSTIC IMAGING CENTER IS ONE OF DENVER'S MOST ADVANCED IMAGING CENTER FEATURING COMPREHENSIVE STATE-OF-THE-ART DIAGNOSTIC IMAGING SERVICES FIVE BASIC MODALITIES: 40 SLICE CT SCANNER; 3.0 TELSA MRI SYSTEM; 3d MAMMO EQUIPMENT ULTRASOUND ROOMS WITH ADJOINED CHANGING ROOMS AND RESTROOMS; AND DIAGNOSTIC TECHNOLOGY IN ALL-DIGITAL ENVIRONMENT. -THE HUMAN MOTION INSTITUTE (HMI) OFFERS STATE-OF-THE-ART MUSCULOSKELETAL CARE. HMI COMBINES THE MOST ADVANCED MEDICAL TECHNOLOGY WITH A DEDICATED TEAM OF PHYSICIANS AND MEDICAL PROFESSIONALS. THE FOCUS IS ON PREVENTION, ASSESSMENT, TREATMENT AND REHABILITATION OF MUSCULOSKELETAL INJURIES. -BUSY 52 BED LEVEL 3 EMARGENCY DEPARTMENT PROVIDING CARE FOR ALL DIFFERENT TYPES OF PATIENTS RANGING FROM NEWBORN THOUGHT GERIARTICS. THE EMERGENCY DEPARTMENT PROVIDES MORE THAN 72,000 VISITS PER YEAR BETWEEN OUR MAIN ED AND OUR SENIOR EMAGRENCY DEPARTMENT. QUALIFIED PHYSICIANS, RN'S, AND TECHS ARE AVAILABLE 24 HRS/DAY, 7 DAYS A WEEK TO ATTEND TO ALL DIFFERENT TYPES OF EMERGENCIES. WE DELIVER CARE FOR ALL LEVELS THAT RANGE FROM SPRAINS AND STRAINS TO THE LIFE THREATENING EMERGENCIES SUCH AS TRAUMA, CARDIAC, AND STROKES. -COLLIER HOSPICE CENTER PROVIDES COMPASSIONATE, COMPREHENSIVE, INTERDISCIPLINARY END-OF-LIFE CARE FOR TERMINALLY ILL PATIENTS AND SUPPORT FOR THEIR FAMILIES. PATIENTS ARE SERVED IN THEIR HOMES, IN NURSING HOMES AND IN THE HOSPICE INPATIENT UNIT LOCATED ON ELMC'S CAMPUS. FREE COMMUNITY SERVICES: VOLUNTEER-BASED PRE-HOSPICE SUPPORT, GRIEF SUPPORT GROUPS, GRIEF EDUCATION WORKSHOPS, CAREGIVER SUPPORT GROUPS AND GRIEF SUPPORT FOR YOUNG PEOPLE. -EXEMPLA COLORADO LUTHERAN HOME (CLH) PROVIDES INDEPENDENT AND ASSISTED-LIVING ACCOMMODATIONS FOR OLDER ADULTS AND IS RECOGNIZED AS AN EDEN ALTERNATIVE FACILITY. IT IS AN ELDER-CENTERED COMMUNITY THAT IMBUES DAILY LIFE WITH VARIETY AND SPONTANEITY. CLH IS A SKILLED NURSING FACILITY THAT INCLUDES A SECURED ALZHEIMER'S UNITS FOR PATIENTS NEEDING 24/7 CARE. -EXEMPLA WEST PINES IS A BEHAVIORAL HEALTH FACILITY THAT PROVIDES INPATIENT AND OUTPATIENT PSYCHIATRIC AND ADDICTION SERVICES TO ADULTS. THE WEST PINES RECOVERY CENTER OFFERS AN INNOVATIVE TWO-WEEK ADDICTION RECOVERY PROGRAM TO CLIENTS AND THEIR FAMILIES WHO STRUGGLE WITH ADDICTION, OR ADDICTION PLUS MENTAL ILLNESS. AFTER THE TWO-WEEK STAY, CLIENTS RECEIVE INTENSIVE OUTPATIENT ASSISTANCE AND OPTIONAL MEDICATION MANAGEMENT. THE PROGRAM PROVIDES SHORTER STAYS AND LOWER COSTS. THE SENIOR BEHAVIORAL HEALTH IS A 20 BED UNIT LOCATED AT ELMC TO TREAT SENIORS WITH PSYCHIATRIC ILLNESSES. -BRIDGES INTEGRATIVE HEALTH AND WELLNESS OFFERS INTEGRATIVE CARE (ACUPUNCTURE, MASSAGE, HEALING TOUCH, PULMONARY REHABILITATION, PHYSICAL THERAPY AND CARDIAC REHABILITATION). -THE EXEMPLA LUTHERAN MEDICAL CENTER FOUNDATION WAS ESTABLISHED IN 2007, IN RESPONSE TO DONOR DEMAND FOR A FOUNDATION EXCLUSIVELY DEDICATED TO THE CURRENT AND FUTURE NEEDS OF ELMC. AT ITS CORE, THE FOUNDATION HAS A COMMITMENT AND DEDICATION TO PROVIDING FOR THE EVOLVING HEALTH CARE NEEDS OF OUR COMMUNITY, WHETHER THAT IS UPDATING FACILITIES, ADDING NEW TECHNOLOGIES, OR DEVELOPING INNOVATIVE NEW PARTNERSHIPS AND SERVICES. -ESTES STREET COMMUNITY CLINIC IS A PARTNERSHIP BETWEEN ELMC, THE JEFFCO ACTION CENTER AND METRO COMMUNITY PROVIDER NETWORK. THE CLINIC SERVES HOMELESS AND LOW-INCOME CHILDREN AND ADULTS WITHOUT INSURANCE. IT PROVIDES ACUTE AND PREVENTIVE CARE, IMMUNIZATIONS AND WELL-CHILD AND WELL-WOMEN CHECKUPS. |
| -ELMC PROVIDES COMPREHENSIVE EDUCATION PROGRAMS WITH OPPORTUNITIES FOR ALL | AGES. THROUGH EDUCATION, RELIABLE HEALTH INFORMATION AND SUPPORT, THE PROGRAM PARTNERS WITH DOCTORS AND OTHER HEALTH CARE EXPERTS TO IMPROVE COMMUNITY HEALTH. EXEMPLA GOOD SAMARITAN MEDICAL CENTER WITH ITS 234 LICENSED BEDS, EGSMC SERVED THE COMMUNITY WITH 13,232 INPATIENT ADMISSIONS AND 41,079 EMERGENCY ROOM VISITS. SERVICES AND PROGRAMS o CARDIAC AND VASCULAR SERVICES INCLUDES THE CARDIAC CALCIUM SCORE FOR DETECTING HEART DISEASE RISK. -EMERGENCY AND TRAUMA SERVICES INCLUDES A LEVEL III TRAUMA CENTER, INCLUDING STROKE AND TELEMEDICINE. -BONE AND JOINT INSTITUTE INCLUDES A COMPREHENSIVE TREATMENT OF ALL JOINT INJURIES AND REPLACEMENT. FULL SERVICE PHYSICAL THERAPY IS ALSO AVAILABLE. -NEUROSCIENCES: IN 2009, GOOD SAMARITAN MEDICAL CENTER ADDED TWO BREAKTHROUGH NEUROSCIENCE TECHNOLOGIES - THE INFRARED 800TM AND THE OPMI PENTERO - FOR TREATMENT OF STROKES, ANEURYSMS, BRAIN TUMORS AND OTHER CONDITIONS. IN 2010, THE HOSPITAL EMPLOYED A STROKE FELLOWSHIP-TRAINED PHYSICIAN AND HAS CREATED A STROKE CENTER. -OTOLARYNGOLOGY INCLUDES BALLOON SINUPLASTY. -WOMEN AND FAMILY CENTER INCLUDES A LEVEL II NEONATAL INTENSIVE CARE AND COMPREHENSIVE PRENATAL AND PARENTING EDUCATION. SUPPORT FOR THE UNIT HELPS US REACH OUR GOAL TO HELP WOMEN HAVE HEALTHY PREGNANCIES, BIRTHS AND BABIES. EGSMC ALSO IS THE FIRST HOSPITAL TO RECEIVE THE BABY-FRIENDLY DESIGNATION IN COLORADO. o INPATIENT AND OUTPATIENT SURGICAL SERVICES INCLUDES A BONE & JOINT INSTITUTE. -NEUROSURGERY, INCLUDING O-ARM TECHNOLOGY FOR COMPLEX NEUROSURGICAL CASES AND THE OPMI PENTERO MICROSCOPE, A STATE OF THE ART IMPROVEMENT IN INTRA-OPERATIVE VISUALIZATION FOR BRAIN TUMORS AND ANEURYSMS, THE ONLY ONE OF ITS KIND IN THE REGION. EGSMC ALSO BEGAN A DEEP BRAIN STIMULATION SERVICE FOR TREATMENT OF SEVERE MOVEMENT DISORDER LIKE ADVANCED PARKINSON'S DISEASE -INTERVENTIONAL AND DIAGNOSTIC RADIOLOGY INCLUDING A 64-SLICE CT SCANNER. OTHER SERVICES INCLUDE MRI, ULTRASOUND AND DIAGNOSTIC IMAGING. -EGSMC'S HEALTH & HEALING CENTER OFFERS INPATIENT AND OUTPATIENT INTEGRATIVE CARE (ACUPUNCTURE, MASSAGE, HEALING TOUCH, PULMONARY REHABILITATION, PHYSICAL THERAPY AND CARDIAC REHABILITATION). -THE EXEMPLA GOOD SAMARITAN MEDICAL CENTER FOUNDATION WAS ESTABLISHED IN 2005 TO FUND THE CURRENT AND FUTURE NEEDS OF EGSMC. AT ITS CORE, THE FOUNDATION HAS A COMMITMENT AND DEDICATION TO PROVIDING FOR THE EVOLVING HEALTH CARE NEEDS OF OUR COMMUNITY, WHETHER IT IS UPDATING FACILITIES, ADDING NEW TECHNOLOGIES, OR DEVELOPING INNOVATIVE NEW PARTNERSHIPS AND SERVICES. -EGSMC PROVIDES WELLNESS QUEST, A COMPREHENSIVE EDUCATION PROGRAM WITH OPPORTUNITIES FOR ALL AGES. THROUGH EDUCATION, RELIABLE HEALTH INFORMATION AND SUPPORT, THE PROGRAM PARTNERS WITH DOCTORS, OTHER HEALTH CARE EXPERTS AND SCHOOLS TO IMPROVE COMMUNITY HEALTH. -EGSMC WORKS CLOSELY WITH CLINICA CAMPESINA, A LAFAYETTE-BASED, FEDERALLY-QUALIFIED CLINIC FOR INDIGENT AND LOW INCOME INDIVIDUALS IN BOULDER COUNTY, PROVIDING ASSISTANCE TO FAMILIES IN NEED. -EGSMC PARTICIPATES IN THE CRAYONS TO CALCULATORS PROGRAM ANNUALLY TO ASSIST FAMILIES IN NEED WITH NECESSARY SCHOOL SUPPLIES, INCLUDING BACKPACKS. -EGSMC'S BABY'S FIRST RIDE PROGRAM IS A SERVICE OFFERED TO ALL FAMILIES DELIVERING AT OUR HOSPITAL. PARENTS ARE TAUGHT THE PROPER WAY TO INSTALL AND USE A CAR SEAT TO ENSURE THEIR BABY'S FIRST RIDE IS A SAFE ONE. -THE EGSMC FOUNDATION STRIVES TO BE THE OPEN DOOR FOR THOSE IN OUR COMMUNITY WHO ARE AS PASSIONATELY COMMITTED TO THE EXEMPLA GOOD SAMARITAN MEDICAL CENTER'S VISION AS WE ARE. THROUGH THE FOUNDATION, DONORS WILL BE ABLE TO HELP EXEMPLA GOOD SAMARITAN MEDICAL CENTER REMAIN A UNIQUE HEALING ENVIRONMENT IN THIS COMMUNITY, USE THE MOST ADVANCED MEDICAL TECHNOLOGY, USE THE BEST PRACTICES IN CLINICAL CARE ANYWHERE, AND BE A GOOD SAMARITAN TO THOSE WHO NEED US MOST. EXEMPLA PHYSICIAN NETWORK 2012 VOLUME - 362,700 CLINIC VISITS -19 PRIMARY CARE/OCCUPATIONAL MEDICINE/PHYSICAL AND OCCUPATIONAL THERAPY CLINICS -26 SPECIALTY CLINICS INCLUDE CARDIOLOGY, CARDIO-THORACIC SURGERY, ORTHOPEDIC SURGERY, NEUROSURGERY, NEUROLOGY, ENDOCRINOLOGY, OB-GYN, UROGYNECOLOGY, SPORTS MEDICINE, AND GENERAL SURGERY. -1 URGENT CARE CLINICS | |
| BOND ISSUANCES | PART IV, QUESTION 24 | DURING 2010, ALL TAX-EXEMPT BONDS, WITH THE EXCEPTION OF BONDS ISSUED PRIOR TO DECEMBER 31, 2002, WERE TRANSFERRED TO SISTERS OF CHARITY OF LEAVENWORTH HEALTH SYSTEM'S (SCLHS) MASTER TRUST INDENTURE. FURTHER, ALL EXISTING FIXED RATE DEBT OF EXEMPLA, INC. WAS REFINANCED UNDER THE SCLHS MASTER TRUST INDENTURE DURING 2010. AS EXEMPLA, INC. HAS NO OUTSTANDING TAX-EXEMPT BONDS ISSUED AFTER DECEMBER 31, 2002, EXEMPLA IS NOT REQUIRED TO COMPLETE SCHEDULE K. ALL DISCLOSURES FOR THE BONDS THAT ARE WITHIN SCLHS'S MASTER TRUST INDENTURE ARE INCLUDED IN THE SCLHS FORM 990. DELEGATION OF BOARD AUTHORITY TO AN EXECUTIVE COMMITTEE FORM 990, PART VI, QUESTION 1A PURSUANT TO THE BYLAWS, THE EXECUTIVE COMMITTEE OF THE ORGANIZATION HAS THE POWER TO TRANSACT ALL REGULAR BUSINESS OF THE ORGANIZATION DURING THE INTERIM BETWEEN MEETINGS OF THE BOARD, PROVIDED THAT ANY ACTION TAKEN BY THE EXECUTIVE COMMITTEE DOES NOT CONFLICT WITH THE ARTICLES OF INCORPORATION, THE BYLAWS OR THE POLICIES OR EXPRESSED WISHES OF THE BOARD. THE EXECUTIVE COMMITTEE SHALL REPORT ALL MATTERS ACTED UPON TO THE BOARD AT THE BOARD'S NEXT MEETING. THE EXECUTIVE COMMITTEE CONSISTS OF AT LEAST THREE MEMBERS, ALL OF WHOM SHALL BE MEMBERS OF THE BOARD OF DIRECTORS, AND INCLUDE THE CHAIRPERSON OF THE BOARD, THE PRESIDENT/CEO AND OTHERS AS DESIGNATED BY THE CHAIRPERSON. DELEGATION OF CONTROL OVER MANAGEMENT DUTIES FORM 990, PART VI, QUESTION 3 IN JUNE 2008, EXEMPLA, INC., AS MANAGER OF EXEMPLA SAINT JOSEPH HOSPITAL, ENTERED INTO A MANAGEMENT AGREEMENT WITH INSIGHT ONCOLOGY FOR THE MANAGEMENT OF THE HOSPITAL'S COMPREHENSIVE CANCER CENTER SERVICES. IN DECEMBER 2008, LUTHERAN CAMPUS ASC, LLC, LOCATED ON THE ELMC CAMPUS, OF WHICH EXEMPLA PARTNERS, LLC IS A MEMBER, ENTERED INTO AN AGREEMENT WITH PINNACLE III, LLC FOR THE MANAGEMENT OF THE COMPANY. CHANGES TO ORGANIZATIONAL DOCUMENTS FORM 990, Part VI, QUESTION 4 EFFECTIVE OCTOBER 1, 2012, SISTERS OF CHARITY OF LEAVENWORTH HEALTH SYSTEM (SCLHS) AND COMMUNITY FIRST FOUNDATION AGREED TO AMEND AND RESTATE THE BYLAWS OF EXEMPLA. UNDER THE AMENDMENTS, COMMUNITY FIRST FOUNDATION'S INTEREST IN THE JOINT OPERATING AGREEMENT AND OTHER RIGHTS OF COMMUNITY FIRST FOUNDATION RELATED TO EXEMPLA WERE TERMINATED. IN RETURN, SCLHS COMMITTED TO PROVIDE $275 MILLION TO COMMUNITY FIRST FOUNDATION OVER A PERIOD OF 20 YEARS. THE BOARD OF DIRECTORS OF EXEMPLA WILL CONTINUE TO CONSIST OF 10 MEMBERS, 9 OF WHICH ARE APPOINTED BY SCLHS AND 1 OF WHICH IS APPOINTED BY COMMUNITY FIRST FOUNDATION. |
| MEMBERS OR STOCKHOLDERS | FORM 990, PART VI, QUESTION 6 | THE ORGANIZATION HAS TWO MEMBERS: COMMUNITY FIRST FOUNDATION (CFF) AND SISTERS OF CHARITY OF LEAVENWORTH HEALTH SYSTEM (SCLHS) |
| ELECTION OF MEMBERS OF GOVERNING BODY | FORM 990, PART VI, QUESTION 7A | CFF APPOINTS 5 OF THE DIRECTORS AND SCLHS APPOINTS 5. |
| DECISIONS OF GOVERNING BODY SUBJECT TO APPROVAL | FORM 990, PART VI, QUESTION 7B | BOTH MEMBERS (COMMUNITY FIRST FOUNDATION AND SISTERS OF CHARITY OF LEAVENWORTH HEALTH SYSTEM, SCLHS) HAVE CERTAIN RESERVE POWERS TO APPROVE CHANGES TO THE BYLAWS REGARDING APPOINTMENT OF BOARD MEMBERS. SCLHS ALSO HAS EXTENSIVE RESERVE POWERS OVER ANY CHANGE IN MISSION, CHANGES TO THE ARTICLES OF INCORPORATION OR BYLAWS, ACQUISITION OF ASSETS, INCURRENCE OF DEBT, MERGER OR DISSOLUTION, APPROVAL OF STRATEGIC PLANS AND BUDGETS, AND APPOINTMENT OF AUDITORS. |
| 990 REVIEW PROCESS | FORM 990, PART VI, QUESTION 11B | ALL 990 REPORTING WAS REVIEWED INTERNALLY WITH SENIOR MANAGEMENT. ALL QUESTIONS AND CHANGES PROPOSED WERE ADDRESSED PRIOR TO FILING FORM 990. A DRAFT 990 WAS PROVIDED TO THE MEMBERS OF THE FINANCE COMMITTEE AND OF THE BOARD FOR REVIEW. A COMPLETE COPY OF THE FINAL FORM 990 WAS THEN PROVIDED ELECTRONICALLY TO EACH VOTING MEMBER OF THE EXEMPLA BOARD OF DIRECTORS PRIOR TO ITS SUBMISSION TO THE INTERNAL REVENUE SERVICE. |
| MONITORING COMPLIANCE WITH CONFLICT OF INTEREST POLICY | FORM 990, PART VI, QUESTION 12C | THE ORGANIZATION REGULARLY AND CONSISTENTLY MONITORS AND ENFORCES ITS CONFLICT OF INTEREST POLICY BY PROVIDING EDUCATION AND TRAINING FOR EACH OF ITS EMPLOYEES, STAFF, OFFICERS AND DIRECTORS, AS WELL AS HAVING EACH OF THESE INDIVIDUALS COMPLETE A CONFLICT OF INTEREST STATEMENT ON AN ANNUAL BASIS TO DISCLOSE ANY POTENTIAL CONFLICT ISSUES. THESE STATEMENTS ARE CAREFULLY REVIEWED BY THE LEGAL DEPARTMENT. WHEN A CONFLICT IS IDENTIFIED, THE LEGAL DEPARTMENT COMPILES ALL REPORTED CONFLICTS, AND EVALUATES THE DISCLOSURES FOR ACTUAL CONFLICTS. A REPORT IS PROVIDED TO ORGANIZATION'S PRESIDENT/CEO REGARDING EMPLOYEES AND OFFICERS, AND TO THE CHAIR OF THE BOARD AND CHAIR OF THE GOVERNANCE COMMITTEE REGARDING BOARD MEMBERS. THOSE WITH IDENTIFIED CONFLICTS OF INTEREST MUST RECUSE THEMSELVES FROM ANY MEETING DURING THE DISCUSSION AND VOTE THEREOF. |
| PROCESS FOR DETERMINING COMPENSATION OF CEO, OFFICERS, OR KEY EMPLOYEES | FORM 990, PART VI, QUESTION 15A & 15B | COMPENSATION FOR THE CEO IS PAID BY SISTERS OF CHARITY OF LEAVENWORTH HEALTH SYSTEM, A RELATED NON-PROFIT ORGANIZATION. COMPENSATION OF OTHER OFFICERS AND KEY EMPLOYEES IS PAID BY EITHER EXEMPLA, INC. OR SISTERS OF CHARITY OF LEAVENWORTH HEALTH SYSTEM. WHEN REVIEWING AND SETTING COMPENSATION FOR 'DISQUALIFIED PERSONS', EXEMPLA'S PROCESS INCLUDES: THE COMPENSATION COMMITTEE OF THE BOARD IS CHARGED WITH THE RESPONSIBILITY FOR SETTING THE OVERALL COMPENSATION PHILOSOPHY AND FOR EVALUATING THE TOTAL COMPENSATION PROGRAMS FOR DISQUALIFIED PERSONS. THE BOARD MEMBERS ARE INDEPENDENT MEMBERS AND IN THESE DISCUSSIONS THE CEO RECUSES HIMSELF FROM THE DISCUSSIONS AROUND HIS OWN COMPENSATION. THE COMMITTEE OBTAINS VALID, COMPARABLE MARKET DATA (FROM INDEPENDENTLY PUBLISHED SOURCES) FOR COMPARABLE POSITIONS AND FROM FORM 990 FILINGS. THIS COMMITTEE ENGAGES THE SERVICES OF AN INDEPENDENT EXPERT IN EXECUTIVE COMPENSATION TO REVIEW THE MARKET DATA AND PROVIDE AN OPINION AS TO THE REASONABLENESS OF THE TOTAL COMPENSATION PROGRAM. FOR THE PAST SEVERAL YEARS, THE INDEPENDENT FIRM HAS BEEN WATSON WYATT. WATSON WYATT VALIDATES THE PROCESS USED BY MANAGEMENT FOR IDENTIFYING 'DISQUALIFIED PERSONS' AND THEN CONDUCTS A COMPARABILITY STUDY/ANALYSIS OF PAY AT SIMILAR TYPES AND SIZES OF ORGANIZATIONS AND REVIEWS BASE SALARY, INCENTIVE (OR OVER-BASE PROGRAMS), BENEFITS, RETIREMENT PLANS AND PERQUISITES. WATSON WYATT REVIEWS THE FINDINGS WITH THE BOARD COMMITTEE AND MINUTES ARE PREPARED AND SHARED WITH ALL THE VOTING BOARD MEMBERS EACH YEAR THAT DOCUMENTS THE DISCUSSION AND ANY ACTIONS THAT MAY HAVE BEEN TAKEN. A COPY OF A FORMAL OPINION LETTER PREPARED BY WATSON WYATT FOLLOWING THE DISCUSSION WITH THE COMPENSATION COMMITTEE IS PROVIDED TO THE BOARD CHAIR AND SHARED WITH THE FULL BOARD. THIS PROCESS IS UNDERTAKEN EACH YEAR. SCLHS EMPLOYS THE EXECUTIVE TEAM AT EACH OF ITS HOSPITAL AFFILIATES, INCLUDING EXEMPLA. AS PART OF ITS ANNUAL REVIEW PROCESS, SCLHS USES THE FOLLOWING IN ESTABLISHING THE COMPENSATION OF THOSE IN THESE POSITIONS: 1) COMPENSATION COMMITTEE, 2) INDEPENDENT COMPENSATION CONSULTANT, 3) FORM 990 OF OTHER ORGANIZATIONS, 4) WRITTEN EMPLOYMENT CONTRACTS, 5) COMPENSATION SURVEYS AND STUDIES, 6) APPROVAL BY THE BOARD OR COMPENSATION COMMITTEE. THE ABOVE SUPPORT THE COMPENSATION COMMITTEE'S EFFORTS TO ENSURE THAT THE LEVEL OF COMPENSATION PROVIDED TO ITS EXECUTIVES (OFFICERS, KEY EMPLOYEES, ETC.) IS CONSISTENT WITH MARKET VALUE AND THE PAY PHILOSOPHY SET BY THE BOARD. THE PAY PHILOSOPHY SET BY THE BOARD IS TO PAY AT THE MIDDLE OF THE MARKET FOR EXECUTIVES OF SIMILAR SIZED ORGANIZATIONS OVERALL. SCLHS' EXECUTIVE COMPENSATION IS COMPARABLE TO THAT PROVIDED IN SIMILAR, NOT-FOR-PROFIT HEALTHCARE SYSTEMS AND HOSPITALS. |
| AVAILABILITY OF GOVERNING DOCS, CONFLICT OF INTEREST POLICY, FINANCIALS | FORM 990, PART VI, QUESTION 19 | GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, FINANCIAL STATEMENTS, AND RELATED DOCUMENTS ARE PROVIDED UPON REQUEST AS DEEMED APPROPRIATE. |
| INDEPENDENT CONTRACTORS | PART VII, SECTION B, QUESTION 2 AND PART V, LINES 1A-1B | EXEMPLA, INC., AS THE PARENT COMPANY/MANAGER OF OTHER ENTITIES, INCLUDING ST JOSEPH HOSPITAL, MAKES ALL VENDOR PAYMENTS FOR THOSE ENTITIES. THE DOLLAR AMOUNTS AND TOTAL NUMBER OF PAYMENTS TO INDEPENDENT CONTRACTORS REFLECTED IN THIS RETURN ARE THE COMBINED PAYMENTS FOR EXPENDITURES OF ALL SUCH ENTITIES. |
| OTHER CHANGES IN NET ASSETS | PART XI, LINE 9 | OTHER CHANGES IN NET ASSETS: CHANGE IN FUNDED STATUS OF PENSION (2,171,446) CHANGE IN INVESTMENT IN SCLHS (5,623,047) MISCELLANEOUS ADJUSTMENT (16,946) TOTAL (7,811,439) |
Schedule R IRS990ScheduleR
Form990 Schedule R Part I Form990ScheduleRPartI (3 entries)
| Address Line1AddressUS/AddressLine1 | CityAddressUS/City | StateAddressUS/State | ZIP CodeAddressUS/ZIPCode | EINEIN | Primary ActivitiesPrimaryActivities | Legal Domicile StateLegalDomicileState | Total IncomeTotalIncome | EOY AssetsEOYAssets | Business Name Line1DirectControllingEntityName/BusinessNameLine1 |
|---|---|---|---|---|---|---|---|---|---|
| EXEMPLA PARTNERS LLC | |||||||||
| 8300 W 38TH AVE | WHEAT RIDGE | CO | 80033 | 020749530 | JT VENTURE IN | CO | 48114 | 2030235 | EXEMPLA INC |
| Lutheran Health Partners LLC | |||||||||
| 8300 W 38TH AVE | WHEAT RIDGE | CO | 80033 | 841103606 | HC IMPROVEMEN | CO | 0 | 550370 | EXEMPLA PART |
| EXEMPLA GOOD SAMARITAN MEDICAL CTR LLC | |||||||||
| 200 EXEMPLA CIRCLE | LAFAYETTE | CO | 80026 | 431982139 | HEALTHCARE | CO | 256422929 | 388642559 | EXEMPLA INC |
Form990 Schedule R Part II Form990ScheduleRPartII (28 entries)
| Address Line1AddressUS/AddressLine1 | CityAddressUS/City | StateAddressUS/State | ZIP CodeAddressUS/ZIPCode | EINEIN | Primary ActivitiesPrimaryActivities | Legal Domicile StateLegalDomicileState | Exempt Code SectionExemptCodeSection | Public Charity StatusPublicCharityStatus | Business Name Line1DirectControllingEntityName/BusinessNameLine1 | Controlled OrgControlledOrg |
|---|---|---|---|---|---|---|---|---|---|---|
| SISTERS OF CHARITY LEAVENWORTH HLTH SYST | ||||||||||
| 2420 W 26TH AVE SUITE 100D | DENVER | CO | 80211 | 237379161 | SUPPORT MMBRS | KS | 501(C)(3) | 11B-TYPE II | NA | false |
| CARITAS CLINICS INC | ||||||||||
| 818 NORTH 7TH STREET | LEAVENWORTH | KS | 66048 | 481009910 | CLINIC SVCS | KS | 501(C)(3) | 3 | SCLHS | true |
| MARIAN CLINIC INC | ||||||||||
| 1001 SW GARFIELD | TOPEKA | KS | 66604 | 481046905 | CLINIC SVCS | KS | 501(C)(3) | 3 | SCLHS | true |
| MARILLAC CLINIC INC | ||||||||||
| 2333 N 6TH STREET | GRAND JUNCTION | CO | 81501 | 841085822 | CLINIC SVCS | CO | 501(C)(3) | 3 | SCLHS | true |
| PROVIDENCE MEDICAL CENTER | ||||||||||
| 8929 PARALLEL PARKWAY | KANSAS CITY | KS | 66112 | 480784446 | HEALTHCARE | KS | 501(C)(3) | 3 | SCLHS | true |
| ST JOHN HOSPITAL INC | ||||||||||
| 3500 SOUTH FOURTH STREET | LEAVENWORTH | KS | 66048 | 480543768 | HEALTHCARE | KS | 501(C)(3) | 3 | PMC | true |
| BETHANY COMMUNITY PLAZA INC | ||||||||||
| 15 NORTH 12TH STREET | KANSAS CITY | KS | 66102 | 481207407 | HEALTHCARE | KS | 501(C)(3) | 3 | PMC | true |
| PROVIDENCEST JOHN FOUNDATION INC | ||||||||||
| 8929 PARALLEL PARKWAY | KANSAS CITY | KS | 66112 | 480925688 | SUPPORT 501C3 | KS | 501(C)(3) | 7 | PMC | true |
| ST FRANCIS HEALTH CENTER INC | ||||||||||
| 1700 SW 7TH STREET | TOPEKA | KS | 66606 | 480547719 | HEALTHCARE | KS | 501(C)(3) | 3 | SCLHS | true |
| ST FRANCIS HEALTH CENTER FOUNDATION | ||||||||||
| 1700 SW 7TH STREET | TOPEKA | KS | 66606 | 481092520 | SUPPORT 501C3 | KS | 501(C)(3) | 11A-TYPE I | SFHC | true |
| ST MARYS HOSPITAL & MEDICAL CENTER INC | ||||||||||
| 2635 N 7TH STREET | GRAND JUNCTION | CO | 81502 | 840425720 | HEALTHCARE | CO | 501(C)(3) | 3 | SCLHS | true |
| ST MARYS HOSPITAL FOUNDATION | ||||||||||
| 2635 N 7TH STREET | GRAND JUNCTION | CO | 81502 | 237001007 | SUPPORT 501C3 | CO | 501(C)(3) | 11A-TYPE I | SMHMC | true |
| SAINT JOSEPH HOSPITAL FOUNDATION | ||||||||||
| 1835 FRANKLIN STREET | DENVER | CO | 80218 | 840735096 | SUPPORT 501C3 | CO | 501(C)(3) | 11A-TYPE I | SJH | true |
| HOLY ROSARY HEALTHCARE | ||||||||||
| 2600 WILSON | MILES CITY | MT | 59301 | 810231792 | HEALTHCARE | MT | 501(C)(3) | 3 | SCLHS | true |
| HOLY ROSARY HEALTHCARE FOUNDATION INC | ||||||||||
| 2600 WILSON | MILES CITY | MT | 59301 | 202270238 | SUPPORT 501C3 | MT | 501(C)(3) | 11A-TYPE I | HRHC | true |
| ST VINCENT HEALTHCARE | ||||||||||
| 1233 NORTH 30TH | BILLINGS | MT | 59101 | 810232124 | HEALTHCARE | MT | 501(C)(3) | 3 | SCLHS | true |
| ST VINCENT HEALTHCARE FOUNDATION | ||||||||||
| PO BOX 35200 | BILLINGS | MT | 59107 | 810468034 | SUPPORT 501C3 | MT | 501(C)(3) | 7 | SVHC | true |
| NORTHWEST RESEARCH & EDUCATION INSTITUTE | ||||||||||
| 315 NORTH 25TH STREET | BILLINGS | MT | 59101 | 201343024 | COMM HLTH RES | MT | 501(C)(3) | 9 | SVHC | true |
| ST JAMES HEALTHCARE | ||||||||||
| 400 SOUTH CLARK STREET | BUTTE | MT | 59701 | 810231785 | HEALTHCARE | MT | 501(C)(3) | 3 | SCLHS | true |
| ST JAMES HEALTHCARE FOUNDATION | ||||||||||
| 400 SOUTH CLARK STREET | BUTTE | MT | 59701 | 651202190 | SUPPORT 501C3 | MT | 501(C)(3) | 11A-TYPE I | SJHC | true |
| SAINT JOHNS HEALTH CENTER | ||||||||||
| 2121 SANTA MONICA BLVD | SANTA MONICA | CA | 90404 | 951684082 | HEALTHCARE | CA | 501(C)(3) | 3 | SCLHS | true |
| JOHN WAYNE CANCER INSTITUTE | ||||||||||
| 2000 SANTA MONICA BLVD | SANTA MONICA | CA | 90404 | 954291515 | CANCER R&D | CA | 501(C)(3) | 4 | SJHHC | true |
| SAINT JOHNS HOSPITAL & HLTH CENTER FNDTN | ||||||||||
| 2121 SANTA MONICA BLVD | SANTA MONICA | CA | 90404 | 956100079 | SUPPORT 501C3 | CA | 501(C)(3) | 11A-TYPE I | SJHHC | true |
| EXEMPLA LUTHERAN MEDICAL CENTER FNDTN | ||||||||||
| 2480 W 26TH AVESUITE 360B | DENVER | CO | 80211 | 208846152 | SUPPORT 501C3 | CO | 501(C)(3) | 7 | EXEMPLA INC | true |
| EXEMPLA GOOD SAMARITAN MEDICAL CTR FNDTN | ||||||||||
| 200 EXEMPLA CIRCLE | LAFAYETTE | CO | 80026 | 841649162 | SUPPORT 501C3 | CO | 501(C)(3) | 7 | EXEMPLA INC | true |
| LUTH MED CNTR PRO&GEN LIAB SELF-INS TRST | ||||||||||
| 2480 W 26TH AVE SUITE 360B | DENVER | CO | 80211 | 742571584 | INSURANCE | CO | 501(C)(3) | 11A-TYPE I | EXEMPLA INC | true |
| SAINT JOSEPH HOSPITAL | ||||||||||
| 1835 FRANKLIN STREET | DENVER | CO | 80218 | 840417134 | HEALTHCARE | CO | 501(C)(3) | 3 | SCLHS | true |
| MOUNT ST VINCENT HOME INC | ||||||||||
| 4159 LOWELL BOULEVARD | DENVER | CO | 80211 | 840405260 | RESIDENT CARE | CO | 501(C)(3) | 11A-TYPE I | SCLHS | true |
Form990 Schedule R Part III Form990ScheduleRPartIII (7 entries)
| Address Line1AddressUS/AddressLine1 | CityAddressUS/City | StateAddressUS/State | ZIP CodeAddressUS/ZIPCode | EINEIN | Primary ActivityPrimaryActivity | Legal Domicile StateLegalDomicileState | Business Name Line1DirectControllingEntityName/BusinessNameLine1 | Predominant Income TypePredominantIncomeType | Disproportionate AllocationsDisproportionateAllocations | General Or Managing PartnerGeneralOrManagingPartner | Share Of Total IncomeShareOfTotalIncome | Share Of EOY AssetsShareOfEOYAssets | Percentage OwnershipPercentageOwnership | Code VCodeVAmount |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| PAVILION IMAGING LLC | ||||||||||||||
| 750 WELLINGTON | GRAND JUNCTION | CO | 81501 | 030516198 | RADIOLOGY | CO | NA | N/A | false | false | ||||
| GRAND VALLEY SURGICAL CENTER LLC | ||||||||||||||
| 710 WELLINGTON | GRAND JUNCTION | CO | 81501 | 841505075 | OP SURGERY | CO | NA | N/A | false | false | ||||
| SAN JUAN CANCER CENTER LLC | ||||||||||||||
| 600 SOUTH 5TH STREET | MONTROSE | CO | 81401 | 202856331 | OP CANCER | CO | NA | N/A | false | false | ||||
| BILLINGS MRI CENTER LLC | ||||||||||||||
| 1041 NORTH 29TH STREET | BILLINGS | MT | 59101 | 810450943 | MRI-PET SCAN | MT | NA | N/A | false | false | ||||
| LUTHERAN CAMPUS ASC LLC | ||||||||||||||
| 3455 LUTHRN PKW SUITE 150 | WHEATRIDGE | CO | 800336028 | 020749532 | OP SURGERY | CO | EXEMPLA PTNRS | RELATED | false | false | 969875 | 1274214 | 0.52320 | |
| COLORADO SURGICAL VENTURES LLC | ||||||||||||||
| 30 S WACKER DR SUITE 2302 | CHICAGO | IL | 60605 | 208038915 | OP SURGERY | CO | St Joseph Hosp | Related | false | false | 0.85000 | $0 | ||
| COLORADO SURGICAL HOSPITAL LLC | ||||||||||||||
| 30 S WACKER DR SUITE 2302 | CHICAGO | IL | 60605 | 208038977 | OP SURGERY | CO | CO SURG VENTURE | N/A | false | false | 0.51000 | $0 | ||
Form990 Schedule R Part IV Form990ScheduleRPartIV (2 entries)
| Address Line1AddressUS/AddressLine1 | CityAddressUS/City | StateAddressUS/State | ZIP CodeAddressUS/ZIPCode | EINEIN | Primary ActivityPrimaryActivity | Legal Domicile StateLegalDomicileState | Type Of EntityTypeOfEntity | Address Line1AddressForeign/AddressLine1 | CityAddressForeign/City | Province Or StateAddressForeign/ProvinceOrState | CountryAddressForeign/Country | Postal CodeAddressForeign/PostalCode | Legal Domicile Foreign CountryLegalDomicileForeignCountry |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| CARITAS INC AND SUBSIDIARIES | |||||||||||||
| 9801 RENNER BOULEVARD SUITE 100 | LENEXA | KS | 66219 | 480941069 | OTHER MEDICAL | KS | C CORP | ||||||
| LEAVEN INSURANCE COMPANY LTD | |||||||||||||
| 980370522 | INSURANCE | 23 LIME TREE BAY AVE PO BOX 1051 | GEORGETOWN | GRAND CAYMAN | CJ | KY1-1102 | CJ | ||||||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Receipt Of Int Ann Rents Royalties | false | ReceiptOfIntAnnRentsRoyalties |
| Gift Grant Or Cap Contr To Other Org | true | GiftGrantOrCapContrToOtherOrg |
| Gift Grant Or Cap Contr Fr Other Org | true | GiftGrantOrCapContrFrOtherOrg |
| Loans Or Guarantees To Other Org | true | LoansOrGuaranteesToOtherOrg |
| Loans Or Guarantees From Other Org | true | LoansOrGuaranteesFromOtherOrg |
| Sale Of Assets To Other Org | false | SaleOfAssetsToOtherOrg |
| Purchase Of Assets From Other Org | false | PurchaseOfAssetsFromOtherOrg |
| Exchange Of Assets | false | ExchangeOfAssets |
| Rental Of Facilities To Other Orgs | true | RentalOfFacilitiesToOtherOrgs |
| Rental Of Facilities Fr Other Orgs | false | RentalOfFacilitiesFrOtherOrgs |
| Perform Of Services For Other Orgs | true | PerformOfServicesForOtherOrgs |
| Perform Of Services By Other Orgs | false | PerformOfServicesByOtherOrgs |
| Sharing Of Facilities | true | SharingOfFacilities |
| Sharing Of Paid Employees | true | SharingOfPaidEmployees |
| Reimbursement Paid To Other Org | true | ReimbursementPaidToOtherOrg |
| Reimbursement Paid By Other Org | true | ReimbursementPaidByOtherOrg |
| Other Transfer To Other Org | false | OtherTransferToOtherOrg |
| Other Transfer From Other Org | true | OtherTransferFromOtherOrg |
Transactions Related Orgs Table TransactionsRelatedOrgsTable (14 entries)
| Transaction TypeTransactionType | Amount InvolvedAmountInvolved | Method Of Amt DeterminationMethodOfAmtDetermination |
|---|---|---|
| SAINT JOSEPH HOSPITAL | ||
| O | 174552345 | ACCRUAL |
| SAINT JOSEPH HOSPITAL | ||
| N | 5623048 | CHANGE IN INVES |
| SAINT JOSEPH HOSPITAL | ||
| L | 44167683 | ACCRUAL |
| SAINT JOSEPH HOSPITAL | ||
| S | 1801555 | ACCRUAL |
| SAINT JOSEPH HOSPITAL | ||
| E | 60000000 | AMOUNT LOANED |
| EXEMPLA LUTHERAN MEDICAL CENTER FOUNDATION | ||
| O | 242245 | ACCRUAL |
| EXEMPLA GOOD SAMARITAN MEDICAL CTR FOUNDATION | ||
| O | 260715 | ACCRUAL |
| EXEMPLA GOOD SAMARITAN MEDICAL CTR FOUNDATION | ||
| P | 212467 | ACCRUAL |
| EXEMPLA GOOD SAMARITAN MEDICAL CTR FOUNDATION | ||
| C | 142107 | ACCRUAL |
| LUTHERAN CAMPUS ASC LLC | ||
| D | 2456128 | AMT GUARANTEED |
| SAINT JOSEPH HOSPITAL | ||
| Q | 151700629 | ACCRUAL |
| SAINT JOSEPH HOSPITAL | ||
| D | 12250785 | ACCRUAL |
| SAINT JOSEPH HOSPITAL | ||
| P | 19706 | ACCRUAL |
| EXEMPLA LUTHERAN MEDICAL CENTER FOUNDATION | ||
| C | 530955 | ACCRUAL |
Form990 Schedule R Part VII Form990ScheduleRPartVII
| Field | Value | IRS element (for citing) |
|---|---|---|
| Identifier | METHOD TO DETERMINE VALUE OF SCHEDULE R TRANSACTIONS | Identifier |
| Return Reference | SCHEDULE R, PART V, LINE 2 COLUMN D | ReturnReference |
| Explanation | THE ORGANIZATION USED THE AMOUNT RECOGNIZED ON THE BOOKS AND RECORDS OF THE ORGANIZATION OF CASH RECEIVED OR PROVIDED, ADJUSTED TO THE ACCRUAL BASIS, TO DETERMINE THE VALUE OF SCHEDULE R TRANSACTIONS, WHICH APPROXIMATES FAIR VALUE. | Explanation |
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