2013-05-15T14:57:17-05:00 2012-06-30 861065772 Deloitte Tax LLP 250 East Fifth Street Suite 1900 Cincinnati OH 45202 990 2011-07-01 260479484 St Luke's-St Vincent's Healthcare STLU 9043087300 4205 Belfort Road Suite 4030 Jacksonville FL 32216 Mark Doyle 9043087300 2013-05-15 1 Rebecca Lyons P01487105 5137847100 2013-05-10 2011 2016-02-24 21:20:13Z St Luke's Hospital Moody L Chisholm 1 Shircliff Way Jacksonville FL 32204 174112731 0 0928 X www.jaxhealth.com X 2007 FL Spiritually centered care which sustains & improves the health of the community. 11 10 1344 172 0 0 26895 20699 130497875 172789131 79429 119086 389074 408254 130993273 173337170 0 20472 0 0 46740958 52357963 0 0 0 98459493 113635802 145200451 166014237 -14207178 7322933 133806453 159537226 136605586 142856090 -2799133 16681136 X Ascension Health directs its governance and management activities toward strong, vibrant, Catholic Health Ministries united in service and healing and dedicates its resources to spiritually centered care which sustains and improves the health of the individuals and communities it serves. In accordance with Ascension Health's mission of service to those who are poor and vulnerable, each Health Ministry accepts patients regardless of their ability to pay. 0 0 160076321 171832608 Please refer to Schedule O for the Community Benefit Report. 225278 956523 Medical Staff Fees and Exempt Affiliate Rents. 160301599 1 1 0 1 0 0 0 0 0 0 1 0 0 1 1 1 0 1 0 0 0 0 0 0 0 0 1 1 1 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 1 1 1 0 0 1 124 0 1 1344 1 0 0 0 0 0 0 0 0 0 0 0 X 11 10 0 0 0 0 1 1 1 1 1 0 0 1 1 1 1 1 1 1 1 0 X Coleen Tisdell-Newton 9044506001 4205 Belfort Road Suite 4015 Jacksonville FL 32216 X C Daniel Rice 3.00 X X 0 0 0 Sidney S Simmons II 1.00 X X 0 0 0 Richard Mullaney 1.00 X X 0 0 0 Paul J Chappano MD 1.00 X 0 0 0 Gary R Chartrand 1.00 X 0 0 0 Dudley Greenhut 1.00 X 0 0 0 David G Kulik 1.00 X 0 0 0 Ricardo Morales Jr 1.00 X 0 0 0 Sr Nancy Murphy DC 1.00 X 0 0 0 Sr Elyse Staab DC 1.00 X 0 0 0 Moody Chisholm Sch O 40.00 X X 0 886566 53986 Mark Doyle Sch O 40.00 X 0 399449 37464 Lorraine M Keith 40.00 X 202898 0 17013 Gene K Miyamoto Sch O 40.00 X 0 479652 26787 Phil C Perry Sch O 40.00 X 0 445420 38907 Karen F Darnell Sch O 40.00 X 0 293225 36925 Janice G Lipsky Sch O 40.00 X 0 296291 49092 Laurie S Teppert end 1211 40.00 X 0 324438 18423 Dale Younkman 40.00 X 132648 0 20565 Rebecca Goldwasser 40.00 X 142566 0 19783 Charles Griffey 40.00 X 143747 0 32259 Donald Fisher 40.00 X 151658 0 327 Jill Wenzel 40.00 X 133299 0 23444 Scott A Whalen end 709 0.00 X 0 268385 0 906816 3393426 374975 25 1 1 0 Healthcare Svcs Inc dba Accretive Heal 401 N MI Ave Ste 2700 Chicago IL 60611 Patient Accounting 5968779 Owens & Minor PO Box 860437 Orlando FL 32886 Facilities Services 5895369 Mckesson Drug Co Inc PO Box 409521 Atlanta GA 30384 Medical Supplies 4344026 Depuy Orthopedics Inc PO Box 406663 Atlanta GA 30384 Patient Services 3443053 Brooks Rehab Hospital 3599 University Blvd South Jacksonville FL 32216 Skilled Nursing 2736827 96 20699 20699 Net Patient Revenue 621990 171832608 171832608 Exempt Affiliates Rent 532000 784127 784127 Medical Staff Fees 621990 172396 172396 172789131 119086 119086 502098 686034 -183936 -183936 -183936 117799 89527 28272 28272 Cafeteria Sales 722320 563918 563918 563918 173337170 172789131 0 527340 20472 20472 219911 210257 9654 43878254 41954181 1924073 699254 668592 30662 4501462 4303398 198064 3059082 2924483 134599 143113 143113 127704 127704 16776417 15413507 1362910 80835 80835 1164901 1090127 74774 4158843 3950900 207943 43270 32452 10818 10227 7671 2556 4345477 4215112 130365 8412737 8160354 252383 1830676 1798148 32528 Medical Supplies 35528412 35341780 186632 Bad Debt 18179190 18179190 Equipment Rent/Maint 5321414 5007639 313775 SNU Management Services 2324256 2324256 15188330 14618245 570085 166014237 160301599 5712638 0 5950 6000 6274946 2250668 17226926 26067086 2464139 2761761 328314 403601 154904572 61823129 94053259 93081443 5744211 3838996 5690009 4177995 2018699 26949676 133806453 159537226 13250962 17360578 123354624 125495512 136605586 142856090 X -8543344 12842140 5744211 3838996 0 -2799133 16681136 133806453 159537226 X 7322933 12157336 X 0 1 1 X 0 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 0 0 0 0 0 0 0 0 1 0 0 Explanation of Lobbying Activities: Part II-B, Line 1: St. Luke's-St. Vincent's Healthcare had lobbying expenses related to the portion of dues paid to national and state hospital associations that are specifically allocable to lobbying. However, St. Luke's-St. Vincent's Healthcare was not able to determine the amount. St. Luke's-St. Vincent's Healthcare does not participate in or intervene in (including the publishing or distributing of statements) any political campaign on behalf of (or in opposition to) any candidate for public office. 14487081 14487081 68695704 13501812 55193892 48855170 42367919 6487251 22866617 5953398 16913219 93081443 Third Party Settlements 3034777 Other Current Assets 3554149 Interest in Investments held by Ascension Health Alliance's Alpha Fund 18389420 Other Assets 1971330 26949676 Estimated Third-Party Payor Settlements 512343 Due to Affiliates 5227024 Pension and Other Post Retirement Liabilities 163427 Self-Insurance Liabilities-NonCurrent 722604 Intercompany Debt with Ascension Health Alliance 116768899 Other 2101215 125495512 Description of Uncertain Tax Positions Under FIN 48: Part X: From the consolidated financial statements of St. Vincent's Health System, Inc. (which include the activity of St. Lukes's-St. Vincent's Healthcare): The Health Ministry accounts for uncertainity in income tax positions by appyling a recognition threshold and measurement attribute for financial statement recognition and measurement of tax position taken or expected to be taken in a tax return. 1 1 X 1 X 1 X 1 1 1 0 1 1 5673441 5673441 0.03840 12967427 4414478 8552949 0.05790 18640868 4414478 14226390 0.09630 94071 32746 61325 0.00040 17808 17808 0.00010 68979 276 68703 0.00050 180858 33022 147836 0.00100 18821726 4447500 14374226 0.09730 394 394 0.00000 2228 2228 0.00000 1775 1775 0.00000 4315 4315 0.00000 8712 8712 0 3815721 1854275 63050130 66307654 -3257524 X 1 1 1 1 St Luke's-St Vincent's Healthcare

4201 Belfort Road Suite 4030 Jacksonville FL 32216

X X X St Luke's-St Vincent's Healthcare 1 1 1 200.000000000000 1 400.000000000000 1 X X X X X X X 1 1 X X 1 X X 1 X X X X X X 1 X X 0 0 Part I, Line 7: The cost of providing charity care, means tested government programs, and community benefit programs is estimated using internal cost data, and is calculated in compliance with Catholic Health Association ("CHA") guidelines. The organization uses a cost accounting system that addresses all patient segments. The best available data was used to calculate the amounts reported in the table.St. Luke's Hospital posts information about availability of charity care in its emergency room and admissions areas. Referrals for charity care are made by the financial specialist, patient accounting personnel, social work personnel, Collection agency personnel, physicians and community members. All patients potentially eligible for charity care status are screened by the financial specialist/collection representatives for assistance through federal, state, county and other social service programs. The financial specialists/collection representatives work collaboratively with other health care members to explore alternative financial resources for the patients. The Charity Care Policy is available to patients upon request and provided the patient does not qualify for any funded program. Medicaid patients upon exhaustion of benefits will automatically qualify for charity care allowance as long as they remain eligible for Medicaid.Patients will be denied charity based on non-compliance with attempts to obtain insurance for eligibility coverage through other programs (i.e., Medicaid-eligible individuals who have failed to keep required appointments with their case worker). Patients should be screened prior to sending to Florida Department of Children and Family Services to determine if they qualify for Medicaid. Patients can be selected for presumptive charity care by using an electronic screening process. Patients may also be referred to St. Vincent's Health System's outreach programs for continuing care.Information about the Charity Care Policy is included in the patient bills indicating financial assistance is available along with information about contacting the Hospital to seek assistance. We do not provide the "criteria" within the bills themselves. Any uninsured patient or patient requesting assistance is referred to a patient financial advocate to assist with resolving the bill with the Hospital. This process includes assisting the patient with filing an application for any government sponsored health care program. All patient financial services areas maintain a list of available translators for any non-English speaking patients. There are all bi-lingual associates in the patient financial services department and are available as needed to assist with non-English speaking patients.All registration staff is trained and responsible for completing an initial financial assistance screening application that is used for assessing the patient's family financial situation. The financial assistance screening application is then forwarded to a patient financial advocate who will review and assist the patient with the process.The Collection Agencies used by St. Luke's are required to follow St. Luke's policies regarding patient notification about the availability of financial assistance. Those patients who indicate an inability to pay for their services are referred back to the hospital to apply for charity care. In addition to this process, open accounts are routinely screened using computer software tools for potential charity care qualified patients. Any patient with family income less that 200% of Federal Poverty Guidelines will qualify for 100% charity care write-off. Part I, L7 Col(f): The Bad Debt expense included on Form 990, Part IX, Line 25, Column (A), subtracted for purposes of calculating the percentage in this column is $18,179,190. Part II: St. Vincent's HealthCare has been part of Jacksonville for over 95 years. St. Luke's Hospital has been part of the system for over five years. It has welcomed the sick and vulnerable to its doors. In its Mission Statement, St. Luke's proclaims that it provides care to all, but with special attention to the poor and vulnerable. This is the emphasis it employs in its Community Building Programs. It uses multiple tools to determine community need including data collection from the Health Planning Council, Agency for Healthcare Administration, County Health Departments, The Florida Department of Health, live estimates via Thompson Reuters, inpatient and outpatient utilization rates and state inpatient/outpatient data allows St. Vincent's to participate in the following programs:Cash support for the Park and King Merchants Association (RAP) and the Riverside Fine Arts Association. As a regional employer St. Luke's does not neglect the neighborhoods of the City. Over the past seven years RAP has spearheaded a major rehabilitation project with street and landscaping resulting in lower vacancy and crime rates. Riverside Fine Arts has a program to take music to lower income schools throughout the community, an opportunity to hear live serious music, an opportunity the children likely would not have without the organization.Cash support for the Jacksonville Area Chamber of Commerce and the Clay County Chamber of Commerce. The Chambers objectives are to drive business in the region with emphasis on initiatives for the un/under employed in the area through their Career Academies and Youth Summer Initiatives. St. Luke's supports preparation for all members of the community for entering and remaining in the workforce. This is especially important in an area with over 10.5% unemployment.Cash support for organizations such as the Girl Scouts and Boys and Girls Club, The Bridge and Community Connections. These organizations are devoted to assisting young people into becoming educated and active members of the community. Each of these organizations works with low income at risk students; students as identified by zip codes with the lowest incomes. These are the children who are the most likely to be forgotten and drop out of school. Through their various programs they ensure that children are safe after school and in an environment that fosters learning. For instance, Community Connections provides housing for the homeless. The Bridge serves children and adolescents with holistic program in an impoverished, crime-ridden section of the city. Girl Scouts of Gateway works with adults to promote leadership development and social conscience in the girls it serves by helping the girls to discover these attributes for themselves though a comprehensive program. The Boys and Girls Clubs work with children, especially those from low income areas to realize their potential through established programs. Part III, Line 4: From the consolidated audited financial statements of St. Vincent's Health System and subsidiaries: The provision for bad debts is based upon management's assessment of expected net collections considering economic conditions, historical experience, trends in health care coverage, and other collection indicators. Periodically throughout the year, management assesses the adequacy of the allowance for uncollectible accounts based upon historical write-off experience by payor category, including those amounts not covered by insurance. The results of this review are then used to make any modifications to the provision for bad debts to establish an appropriate allowance for uncollectible accounts. After satisfaction of amounts due from insurance and reasonable efforts to collect from the patient have been exhausted, the Health System follows established guidelines for placing past-due patient balances with collection agencies, subject to the terms of certain restrictions on collection efforts as determined by Ascension Health. Accounts receivable are written off after collection efforts have been followed in accordance with the Health Ministry's policies.The organization's share of bad debt expense in 2011 was $18,179,190 at charges ($3,815,721 at cost). Part III, Line 8: Ascension Health and related health ministries follow the Catholic Health Association ("CHA") guidelines for determining community benefit. CHA community benefit reporting guidelines suggest that Medicare shortfall is not treated as community benefit. Part III, Line 9b: The organization does have a written debt collection policy and Charity Care Policy (financial assistance). Patients without insurance are interviewed face-to-face to determine if they qualify for any third party payers or governmental programs. Patient statements contain messages requesting the patients to contact the organization should they need assistance with their debt. Patients that do not request assistance or provide the information necessary to qualify for financial assistance will follow a routing collection methodology. St. Luke's-St. Vincent's Healthcare Part V, Section B, Line 15e: Auto Liens. St. Luke's-St. Vincent's Healthcare Part V, Section B, Line 16e: Auto Liens. St. Luke's-St. Vincent's Healthcare Part V, Section B, Line 19d: The self pay discount is calculated based upon the highest paying payor that represents greater than 3% of gross revenue. Part VI, Line 2: St. Luke's Hospital has not conducted a formal Community Health Needs Assessment during the current fiscal year. It will conduct the assessment, have it approved and implemented by June 30, 2013. Currently the hospital uses the following methods to assess needs.St. Luke's Hospital (St. Luke's) uses multiple tools to determine community need: data from the Health Planning Council, Agency for Healthcare Administration, County Health Departments, The Florida Department of Health, live estimates via Thomson Reuters, inpatient and outpatient utilization rates, and state inpatient/outpatient discharge data. Part VI, Line 3: St. Luke's Hospital posts information about availability of charity care in its emergency room and admissions areas. Referrals for charity care are made by Financial Specialist, Patient Accounting personnel, Social Work personnel, Collection agency personnel, physicians and community members. All patients potentially eligible for charity care status are screened by the Financial Specialist/Collection representatives for assistance through federal, state, county and other social service programs. The Financial Specialists/Collection representatives work collaboratively with other health care members to explore alternative financial resources for the patients. The Charity Care Policy is available to patients upon request and provided the patient does not qualify for any funded program. Medicaid patients upon exhaustion of benefits will automatically qualify for charity care allowance as long as they remain eligible for Medicaid.A new program began during the fiscal year called The HOPE (Hospital Outreach Eligibility Program) to improve access to healthcare. Information about the program is available, not only at St. Luke's Hospital but also in physician offices, on the website, on the medical clinic vans, and at various locations throughout the community. HOPE staff works to provide this service to the entire community, not just patients likely to use St. Luke's. Staff participates in neighborhood and community-wide enrollment fairs and health screenings in which, not only are patients who come to St. Luke's Hosital screened, but persons throughout the community are screened to determine eligibility for insurance. Programs for which HOPE staff works diligently to enroll include Medicaid, Florida KidCare, Charity programs, other state and federally funded programs including Medicare, COBRA, and HCRA. Staff also assists with applications for food stamps, utilities and discount phone service. Temporary cash is also available for qualifying applicants.Patients will be denied charity based on non-compliance with attempts to obtain insurance for eligibility coverage though other programs (i.e., Medicaid-eligible individuals who have failed to keep required appointments with their case worker). Patients should be screened prior to sending to Florida Department of Children and Family Services to determine if they qualify for Medicaid. Patients can be selected for presumptive charity care by using an electronic screening process. Information about the Charity Care Policy is included in the patient bills indicating financial assistance is available and information about contacting the hospital to seek assistance. We do not provide the "criteria" within the bills themselves. Any uninsured patient or patient requesting assistance is referred to a patient financial advocate to assist with resolving the bill with the hospital. This process includes assisting the patient with filing an application for any government sponsored health care program. All patient financial services areas maintain a list of available translators for any non-English speaking patients. There are all bi-lingual associates in the patient financial services department and are available as need to assist with non-English speaking patients.All registration staff are trained and responsible for completing an initial financial assistance screening application that is used for assessing the patient's family's financial situation. The financial assistance screening application is then forwarded to a patient financial advocate who will review and assist the patient with the process. The Collection Agencies used by St. Luke's are required to follow St. Luke's policies regarding patient notification about the availability of financial assistance. Those patients who indicate an inability to pay for their services are referred back to the hospital to apply for charity care. In addition to this process, open accounts are routinely screened using computer software tools for potential charity care qualified patients. Any patient with family income less that 200% of Federal Poverty Guidelines will qualify for 100% charity care write-off. Part VI, Line 4: St. Luke's looks at the community it serves in two ways. On a regional level, five counties fall into the overall planning region: Duval, Clay, Nassau, Baker, and St. John's. On a more narrow level, 75% of the primary service area is reviewed by zip code, which is comprised of approximately 90,000 inpatient cases.The zip codes on which St. Luke's Hospital focuses in Duval County, Jacksonville are: 32207, 32208, 32210, 32211, 32216, 32217, 32218, 32223, 32224, 32225, 32244, 32246, 32250, 32256, 32257 and 32258; in St. John's County, Florida are: 32082 and 32259.The facilities within the area are-Baptist Medical Center, an acute care not-for-profit facility in Jacksonville with 619 beds; -Baptist Medical Center Beaches, an acute care not-for-profit facility in Jacksonville Beach with 146 beds; -Baptist Medical Center Nassau, an acute care not-for-profit facility in Fernandina Beach with 54 beds; -Baptist Medical Center South, an acute care not-for-profit facility in Jacksonville with 196 beds;-Ed Fraser Hospital, an acute care not-for-profit facility in MacClenny with 25 beds; -Flagler Hospital, an acute care not-for-profit facility in St. Augustine with 302 beds; -Kindred Hospital North Florida, an acute care for-profit facility in Green Cove Springs with 80 beds;-Mayo Clinic Jacksonville, an academic not-for-profit facility in Jacksonville with 214 beds; -Memorial Hospital Jacksonville, an acute care for-profit facility in Jacksonville with 425 beds; -Orange Park Medical Center, an acute care for-profit facility in Orange Park with 252 beds; -St. Vincent's Medical Center, an acute care not-for-profit facility in Jacksonville with 528 beds; -Shands Jacksonville Medical Center, an acute care not-for-profit facility in Jacksonville with 639 beds; -Specialty Hospital Jacksonville, an acute care for-profit facility in Jacksonville with 107 beds; -St. Luke's Hospital, an acute care not-for-profit facility in Jacksonville with 294 beds; -Ten Broeck Hospital, Jacksonville a psychiatric for-profit facility in Jacksonville with 99 beds; -Ten Broeck Jacksonville, Wekiva Springs an acute care for-profit facility in Jacksonville with 68 beds.Various metrics are reviewed when establishing community outreach programs. The following are examples of the data St. Luke's collects when determining regional and community needs:-St. Luke's Hospital compares county population by race against the state. SLH also compares population by race in each of the zip codes. The findings from the comparison indicate that of the 1,378,416 persons in the region the significant racial breakdowns are 66% white, 22% African American, and 6% Hispanic. The percentage of non-English speaking populations in the 2000 census in the region was 0.1%-St. Luke's compares the Jacksonville Metropolitan Statistical Area (MSA) in average household income against the federal poverty percentage finding that in the five county area household incomes ranged from almost $90,000 in St. John's County to $54,000 in Baker County. The percentage of persons below the Federal Poverty Rate ranged from a low of 7.9% in St. John's County to a high of 15.3% in Baker County. The Florida average was 13.3%Florida CHARTS tables which are provided by the Florida Department of Health, Office of Planning, Evaluation and Data Analysis are utilized to determine Behavioral Risk Factors and Chronic (BRFSS) disease prevalence in the region. By reviewing FL CHARTS, County Profiles and BRFSS data, along with internal volume and financial data, St. Luke's is able to determine areas of need and chronic disease prevalence in relation to behavioral risk factors. The analysis below is an example of the data often compiled from the resources mentioned above. Analysis for Baker County:Baker County demonstrates the least favorable situation with comparison to the other counties in the state with regards to the following diseases: CAD (deaths), stroke (deaths and hospitalizations), lung cancer (death and smoking rate), prostate cancer (death), skin cancer (death) and diabetes (death, hospitalization and percentage of adults with diabetes). This county has the least favorable situation in comparison to all counties on the following measures in the Behavioral Risk Factors (BRFSS) Data: percentage of adults who meet vigorous physical activity recommendations, percentage of adults who engage in no leisure-time physical activity, percentage of adults who eat at least 5 servings of fruits and vegetables a day, and the percentage of adults who are obese.Analysis of Duval County:Duval County demonstrates the least favorable situation in comparison to the other counties in the state with regards to the following diseases: stroke (death and hospitalizations), heart failure (hospitalizations from congestive heart failure), breast and prostate cancers (deaths), cervical cancer (percentage of women 18 years of age and older who received a pap test in the past year), CLRD (asthma hospitalizations), and diabetes (death, hospitalization and amputation). On the Behavioral Risk Factors (BRFSS) Data Duval has one measure in the least favorable situation which is the percentage of adults who meet moderate physical activity recommendations.Uninsured population in the region: Analysis Health Care Safety Net for Uninsured Persons:All county service areas except for Nassau County rank in the first quartile which is the most favorable. However, this data is from 2007 may be inaccurate due to the economic downturn. It is anticipated that population with health insurance has declined. The parent company's, St. Vincent's HealthCare (SVHC), website provides information and phone numbers for patients whose incomes are 200% below the federal poverty level. Financial counselors are available to decide whether a patient qualifies for charity care. Patients who do not have insurance are eligible for discounts on their bill when they agree to a payment plan; this service is also provided by the financial counselors. The SVHC website contains a wealth of information on services which SVHC provides to the less fortunate. The Seton Center for Women and Infants' Health was established to ensure that as many poor expectant mothers as is possible get proper prenatal care. However, the Center cares for mothers and babies of all incomes. The Center provides information to expectant parents on childbirth and new infant care giving. It also offers infant health screening which includes a full assessment and examination of the baby and examination of the mother.-Volunteers are part of the assistance given to the people of that county. Part VI, Line 5: St. Luke's Hospital is the oldest private hospital in the state of Florida. During its 138 years of operation the facility has been in five locations and has been its current locale since the mid-1980s. St. Luke's joined St. Vincent's HealthCare in 2008. Like its other St. Vincent's HealthCare sibling St. Vincent's Medical Center, St. Luke's welcomes the sick and vulnerable to its doors. In its Mission Statement, St. Luke's proclaims that it provides care to all, but with special attention to the poor and vulnerable. This is the emphasis St. Luke's uses in its community benefit programs.St. Luke's has a medical staff open to all qualified physicians in the Jacksonville area. The majority of the dedicated members of the Board of Directors of parent organization, St. Vincent's HealthCare, are persons who live and work in the Jacksonville area and who, by virtue of their continuous service to the community, are acutely aware of the social and health needs of the Northeast Florida region. These individuals along with the members of the medical staff are committed to the Mission Statement and its call to provide healthcare for all who come to its doors.The website is an encyclopedia with wellness tools for the community to gain information to live a healthier life style. St. Luke's promotes regular radio programming presented by healthcare professionals promoting prevention and wellness. St. Luke's Hospital is mindful of its call to be a steward of the community, St. Luke's provided over $123,000 in space to community organizations meeting care of the poor, community benefit or community building criteria including, but not limited to Alcoholics Anonymous, Breastfeeding Support, Overeaters Anonymous, Allergy Support Group, Citizens Planning Group.Through cash contributions St. Luke's Hospital has supported the Medical Clinic of the Sulzbacher Homeless Center; Emergency Pregnancy Services; Catholic Charities; summer camp for special children for the Diocese of St. Augustine; ICARE, a social justice advocacy collaboration of area clergy;, Northeast Florida Health Planning Council; the American Cancer Society;, the Cancer Society; Duval County Health Department (space for an FQHC); The Way Free Medical Clinic in Green Cove Springs, FL; the Florida Bioethics Network; Brooks College of Health at the University of North Florida and many other organizations whose mission is compatible with St. Luke's Hospital. Part VI, Line 6: St. Luke's Hospital (the Hospital) is a wholly owned subsidiary of St. Vincent's Health System, Inc. (SVHS), which is a member of Ascension Health. Ascension Health Alliance became the sole corporate member and parent organization of Ascension Health, a Catholic, national health system consisting primarily of nonprofit corporations that own and operate local health care facilities, or Health Ministries, located in 21 of the United States and the District of Columbia.The Hospital, located in Jacksonville, Florida, is a nonprofit acute care hospital. The Hospital provides inpatient, outpatient, and emergency care services for the residents of northeast Florida and southeast Georgia. Admitting physicians are primarily practitioners in the local area. The Hospital is related to Ascension Health's other sponsored organizations through common control. Substantially all expenses of Ascension Health and its sponsored organizations are related to providing health care services.Sponsorship:Ascension Health Alliance is sponsored by Ascension Health Ministries, a Public Juridic Person. The Participating Entities of Ascension Health Ministries are the Daughters of Charity of St. Vincent de Paul in the United States, St. Louise Province, the Congregation of St. Joseph, the Congregation of the Sisters of St. Joseph of Carondelet, and the Congregation of Alexian Brothers of the Immaculate Conception Province - American Province. As more fully described in the Organizational Changes note, Alexian Brothers Health System, which was previously sponsored by the Congregation of Alexian Brothers of the Immaculate Conception Province - American Province, became part of Ascension Health on January 1, 2012.Mission:The System directs its governance and management activities toward strong, vibrant, Catholic Health Ministries united in service and healing and dedicates its resources to spiritually centered care which sustains and improves the health of the individuals and communities it serves. In accordance with System's mission of service to those persons living in poverty and other vulnerable persons, each Health Ministry accepts patients regardless of their ability to pay. The System uses four categories to identify the resources utilized for the care of persons living in poverty and community benefit programs:- Traditional charity care includes the cost of services provided to persons who cannot afford health care because of inadequate resources and/or who are uninsured or underinsured.- Unpaid cost of public programs, excluding Medicare, represents the unpaid cost of services provided to persons covered by public programs for persons living in poverty and other vulnerable persons. - Cost of other programs for persons living in poverty and other vulnerable persons includes unreimbursed costs of programs intentionally designed to serve the persons living in poverty and other vulnerable persons of the community, including substance abusers, the homeless, victims of child abuse, and persons with acquired immune deficiency syndrome.- Community benefit consists of the unreimbursed costs of community benefit programs and services for the general community, not solely for the persons living in poverty, including health promotion and education, health clinics and screenings, and medical research.Discounts are provided to all uninsured patients, including those with the means to pay. Discounts provided to those patients who did not qualify for assistance under charity care guidelines are not included in the cost of providing care of persons living in poverty and community benefit programs. The cost of providing care of persons living in poverty and community benefit programs is estimated using internal cost data and is calculated in compliance with guidelines established by both the Catholic Health Association (CHA) and the Internal Revenue Service (IRS).Additional affiliates and members of the St. Vincent's Health System, Inc. include: St. Vincent's Medical Center, Inc., St. Catherine's Laboure Manor, St. Vincent's Ambulatory Care, Inc., First Coast Primary Care, Inc., St. Vincent's Physician Enterprise, Inc., Consolidated Pharmacy Services, Inc. and St. Vincent's Foundation, Inc. 0 X 1 1 0 0 0 0 0 0 0 Moody Chisholm Sch O 0 540264 0 337614 0 8688 0 38500 0 15486 0 940552 0 0 Mark Doyle Sch O 0 342330 0 45117 0 12002 0 33000 0 4464 0 436913 0 0 Lorraine M Keith 164685 0 36332 0 1881 0 16500 0 513 0 219911 0 0 0 Gene K Miyamoto Sch O 0 348801 0 111921 0 18930 0 22000 0 4787 0 506439 0 0 Phil C Perry Sch O 0 324390 0 110215 0 10815 0 23000 0 15907 0 484327 0 0 Karen F Darnell Sch O 0 211151 0 75847 0 6227 0 22000 0 14925 0 330150 0 0 Janice G Lipsky Sch O 0 210857 0 75201 0 10233 0 36000 0 13092 0 345383 0 0 Laurie S Teppert end 1211 0 231613 0 82761 0 10064 0 16500 0 1923 0 342861 0 0 Dale Younkman 126240 0 6290 0 118 0 9156 0 11409 0 153213 0 0 0 Rebecca Goldwasser 142461 0 0 0 105 0 0 0 19783 0 162349 0 0 0 Charles Griffey 143592 0 0 0 155 0 16500 0 15759 0 176006 0 0 0 Donald Fisher 144857 0 6458 0 343 0 0 0 327 0 151985 0 0 0 Jill Wenzel 133143 0 0 0 156 0 16500 0 6944 0 156743 0 0 0 Scott A Whalen end 709 0 0 0 3663 0 264722 0 0 0 0 0 268385 0 0 Supplemental Information Part III Part I, Line 3: St. Vincent's Health System, Inc., a related organization of St. Luke's-St. Vincent's Healthcare, uses the following to establish the compensation of the organization's CEO: - Compensation Committee, - Independent Compensation Consultant, - Written Employment Contract, - Compensation Survey or Study, and - Approval by the Board or Compensation Committee Supplemental Information Part III Part I, Line 4a: Severance Payment: Scott A. Whalen - $264,723 Supplemental Information Part III Part I, Line 4b: Eligible executives participate in a program that provides for supplemental retirement benefits. The payment of benefits under the program, if any, is entirely dependent upon the facts and circumstances under which the executive terminates employment with the organization. Benefits under the program are unfunded and non-vested. Due to the substantial risk of forfeiture provision, there is no guarantee that these executives will ever receive any benefit under the program. Any amount ultimately paid under the program to the executives is reported as compensation on Form 990 Schedule J, Part II, Column B in the year paid. Neither contributions to nor distributions from the supplemental nonqualified retirement plan were made in the current year. Form 990, Part VI, Section A, line 6 St. Luke's-St. Vincent's Healthcare has a single corporate member, St. Vincent's Health System, Inc. Form 990, Part VI, Section A, line 7a St. Luke's-St. Vincent's Healthcare has a single corporate member, St. Vincent's Health System, Inc., who has the ability to elect members to the governing body of St. Luke's-St. Vincent's Healthcare. Form 990, Part VI, Section A, line 7b All decisions that have a material impact to St. Luke's-St. Vincent's Healthcare financial information or corporation as a whole are subject to approval by its sole corporate member, St. Vincent's Health System, Inc. Form 990, Part VI, Section B, line 11 Management, including certain officers, works diligently to complete the Form 990 and attached schedules in a thorough manner. Prior to filing the return, all Board Members are provided the Form 990 and management team members are available to answer any Board Members questions. Form 990, Part VI, Section B, line 12c Officers, directors or trustees, and key employees are required to complete a Conflict of Interest Attestation Statement at the time of hiring or when their service begins. Annually, the Corporate Responsibility Officer sends the Conflict of Interest Policy and Attestation Statement to all officers, directors or trustees, and key employees for completion and return within two weeks. Three separate mailings are sent out with two week deadlines to receive a maximum response. The responses from the returned Attestation Statement are organized in a spreadsheet and are carefully reviewed by the Corporate Responsibility Officer, the Chief Legal Officer, and the Chief Executive Officer. A full report is presented to the Audit Committee and any potential conflicts of interest are handled by the committee in an appropriate manner. Form 990, Part VI, Section B, line 15 In determining the compensation of the organization's CEO, the process, perfomed by St. Vincent's Health System, Inc. (a related organization who paid the CEO), included a review and approval by independent persons, comparability data, and contemporaneous substantiation of the deliberation and decision. The Compensation Committee reviewed and approved the compensation. In the review of the compensation, the CEO was compared to individuals at hospitals in the area who hold the same title. During the review and approval of the compensation, documentation of the decision was recorded in the board minutes. The individual was not present when his compensation was decided. In determining the compensation of other officers or key employees of the organization, the process, performed by St. Vincent's Health System, Inc. (a related organization who paid the other officers or key employees), included a review and approval by independent persons, comparability data, and contemporaneous substantiation of the deliberation and decision. The Compensation Committee reviewed and approved the compensation. In the review of the compensation, the other officers or key employees were compared to individuals at other hospitals in the area who hold the same title. During the review and approval of the compensation, documentation of the decision was recorded in the board minutes. Form 990, Part VI, Section C, line 19 The organization will provide any documents open to public inspection upon request. Explanation of Hours for Officers and Key Employees: Form 990, Part VII, Section A: Officers and key employees of St. Luke's-St. Vincent's Healthcare provide services to St. Vincent's Health System, Inc. and its subsidiaries. Hours worked are not tracked on an entity by entity basis. Therefore, all officers' and key employees' hours (as noted with reference to Schedule O) reported on Form 990, Part VII, Compensation of Officers, Directors, Trustees, Key Employees, Highest Compensated Employees, and Independent Contractors represent aggregate hours worked per week for all entities. Changes in Net Assets or Fund Balances: Form 990, Part XI, line 5: Donated services and use of facilities: 3,890,487. Prior period adjustments: -20,590,868. Cash Transfers 30,031,920. Pension Related Net Assets -1,174,203. Total to Form 990, Part XI, Line 5: 12,157,336. Community Benefit Report: Form 990, Part III, Line 4a: This report illustrates the significant degree to which St. Luke's Hospital, (dba St. Vincent's Medical Center Southside) contributes to the positive health status of the residents of Jacksonville, Florida and surrounding communities. As a member of Ascension Health, the nation's largest Catholic healthcare system, St. Luke's Hospital continues to build and strengthen sustainable collaborative efforts that benefit the health of individuals, families, and society as a whole. The goal of St. Luke's Hospital is to perpetuate the healing mission of the church. St. Luke's Hospital furthers this goal through delivery of patient services, care to the elderly and indigent, patient education and health awareness programs for the community. Our concern for all human life and dignity of each person leads the organization to provide medical services to all people in the community without regard to the patient's race, creed, national origin, economic status, or ability to pay. In order to portray the full breadth of our contribution, our community benefit information is described below: Organizational Commitment to Providing Community Benefit St. Luke's Hospital is a 313 bed nonprofit acute care hospital. The Hospital provides health care services for the residents of Northeast Florida and Southeast Georgia. St. Luke's seeks to improve the physical, mental, social and spiritual health status of its surrounding community. In addition to providing health care services to all individuals who require medical attention, St. Luke's has developed the programs to help achieve its mission. "Expanding Awareness, Education, and Health Promotion" St. Luke's Hospital believes that quality of health is an advocacy issue that affects the entire community, not just its individual members. St. Luke's believes that it is essential to educate people regarding the types of behavior that improve their chances of living a healthy life. St. Luke's has invested significantly in unique, top quality health education and materials that the Ministry has provided to the community. Community Building In its Community Building activities St. Luke's reaches out to the community to improve the lives of its residents. St. Luke's encourages community groups with missions similar to meet on its campus. Through its memberships in the Jacksonville Area and Clay County Chambers of Commerce St. Luke's works to bring about positive change in the lives of area residents though economic development. The greater Jacksonville area has been especially hard hit by the economic downturn with an unemployment rate hovering over ten percent. The chambers work to recruit new business and retain existing businesses. The chambers also provide training opportunities though the Career Academies and Youth Summer Initiatives. St. Luke's is a supporter of the social justice advocacy organization ICARE. One of ICARE's major advocacy items is creating "Baby Friendly Hospitals." in which new moms are given necessary support to breast feed their infants. Good Samaritan Fund: The St. Vincent's Auxiliary began the Good Samaritan Fund in 1959 to help those less fortunate by providing financial assistance for medical needs post acute care. It has been expanded to St. Luke's Hospital. Many of the patients at St. Luke's Hospital need help with getting prescription medications, purchasing medical equipment and supplies, and paying for home health services, just to mention a few. The Good Samaritan Fund assists St. Luke's patients with these expenses when there are no community resources available. Outreach Actions In its outreach efforts, the St. Luke's Hospital offers programs that offer services to the indigent and the working poor, especially though its Faith Community Nursing program. Faith Community Nursing Faith Community Nurses are licensed, registered nurses who focus on assisting the members of a faith community in maintaining and/or regaining health and wholeness in body and spirit. They have a unique and ongoing relationship with families in a faith community, particularly the underserved. The Faith Community Nursing Ministry of St. Luke's Hospital extends the mission of St. Luke's and its commitment to care for the sick and the poor into the community. Over the past year, we have served over 2000 individuals from over 200 churches, schools, and community groups in Duval, Clay, Nassau, and St. Johns counties. Our services included: health screenings, health fairs, and health education programs tailored to the particular health needs of the congregation, particularly heart disease and stroke prevention; initiated referrals for support services to community agencies and health care professionals; provided prayerful presence and comfort as well as basic clothing, toiletries and supplies during times of need. Medical Services Center of Excellence: Spine, Hip, Knee and Shoulder Surgeries St. Luke's Hospital is the first hospital in the nation to receive the Joint Commission's Gold Seal of Approval - the Center of Excellence designation for spine, hip, knee and shoulder surgeries. After an on-site review in early April 2012, the hospital received the elite designations and stands out as the first hospital in the country with all four. The Joint Commission evaluated St. Luke's Hospital for compliance with standards of care specific to the needs of patients and families, including infection prevention and control, leadership and medication management. Orthopedist Gavan Duffy, MD said "we are constantly striving to achieve the best success for our patients and the COE designation means we've passed with flying colors." Bariatric Surgery Program: St. Luke's Hospital is committed to maintaining the highest standards of excellence in caring for the bariatric patient population. St. Luke's Hospital was among the first nationally to offer the Realize Adjustable Gastric Band-C, that is surgically implanted around the stomach to help people with morbid obesity lose weight and improve or resolve obesity-related health conditions including type 2 diabetes, sleep apnea and high cholesterol. St. Luke's has expanded its Bariatric Surgical Program to also include Laparoscopic Vertical Sleeve Gastrectomy and Laparoscopic Roux-en-Y Gastric Bypass. Family Birth Place: St. Luke's Hospital is home to Northeast Florida's first, all-private Neonatal Intensive Care Unit (NICU). The new NICU suites are designed to provide parents and their premature infants' comfort in a private, quiet setting. Research has shown the single-room model of infant care in the NICU decreases complications, improves weight gain and shortens the hospital stay for these tiny infants. In the traditional open bay NICU, babies are exposed to lights and sounds that disrupt their sleep and interfere with their growth. St. Luke's Hospital is committed to improving healthcare services for women in the Northeast Florida community. Inpatient and outpatient lactation support is provided by Internationally Board Certified Lactation Consultants. Outpatient services are provided regardless of ability to pay. Robotic-Assisted Minimally Invasive Surgery By dramatically enhancing visualization, precision, control and dexterity, the da Vinci System overcomes the limitations of traditional laparoscopic technology, helping physicians to perform complex surgery in a manner never before experienced. With enhanced surgical capabilities, physicians are now able to extend the benefits of minimally invasive surgery to the broadest possible range of patients. The da Vinci Surgical System consists of an ergonomically designed surgeon's console, a patient-side cart with four interactive robotic arms, a high-performance vision system and proprietary EndoWrist Instruments. The System cannot be programmed, nor can it make decisions on its own. The da Vinci System requires that every surgical maneuver be performed with direct input from the surgeon. Spine and Brain Institute: The Spine and Brain Institute is the superior neurosciences program at St. Luke's Hospital, specializing in the treatment of brain tumors, deep brain stimulation (DBS), epilepsy, neurological disorders, the spine and strokes. Since many conditions require both medical and surgical treatment, the Neurology and Neurosurgery divisions are equipped with the best, state of the art technology and the most talented group of physicians and staff. The Spine and Brain Institute is known for providing the highest quality of care to patients with neurological disorders all over Northeast Florida. Unreimbursed Services Provided to the Elderly and the Poor In the spirit of principles adopted by Ascension Health, St. Luke's Hospital has taken proactive steps to address those issues that will affect accessibility, the financing, and the delivery of healthcare to all persons, especially the uninsured and the underserved. The HOPE Program. St. Luke's Hospital maintains a program (called the HOPE Program) to assist patients (and members of the public) in identifying public and private insurance programs for which they might be eligible and assisting in enrolling in the program. This applies to Medicare, Medicaid, KidCare and private insurances. One does not have to be a patient at St. Luke's Hospital to be eligible to participate in this program. The HOPE staff participates in numerous community festivals and health fairs with the specific goal of enrolling eligibles. During the year ended June 30, 2012 the estimated unreimbursed cost of services provided to the elderly, uninsured, and underserved totaled $19,763.00. St. Luke's Hospital provides a substantial portion of its services to the elderly and poor. During the year ended June 30, 2012, approximately 61.5% of the value of services rendered were to elderly patients under the Medicare program, and approximately 7% of the services were provided to patients who were deemed indigent under state, county, or St. Luke's Hospital guidelines. In accordance with the philosophy, mission and core values of St. Luke's Hospital, health care services are provided to the poor and those who lack financial resources to obtain health services. Medicaid patients, upon exhaustion of benefits, qualify for charity care. Other patients are evaluated by financial specialists for eligibility. Confidentiality of information and the dignity of the individual are maintained. Physicians, social workers, and staff refer patients. Operations and governance St. Luke's Hospital - operates an emergency room that is open to all persons regardless of ability to pay; - has an open medical staff with privileges available to all qualified physicians in the area; - has a governing body in which independent persons representative of the community comprise a majority; - engages in medical or scientific research programs; - engages in the training and education of health care professionals; and - Participates in Medicaid, Medicare, CHAMPUS, Tricare, and/or other government-sponsored health care programs. Patient Services St. Luke's Hospital provided 49,171 days of acute inpatient care and 2,600 days of newborn care. 40,000 patients received emergency room treatments. There were 883 catheterizations/interventions provided by the Cardiac program of the Hospital. Some services provided at the Hospital operate at a loss in order to ensure that all services are available to meet community health care needs. These include labor and delivery and emergency medicine. Financial Information The financial information presented below was prepared in accordance with the Catholic Health association's (CHA) community reporting guidelines. These guidelines recommend the following: - Report care of the poor at cost, not charges. - Do not include bad debt, contractual allowances, and quick pay discounts as part of care of the poor expense. - Do not count Medicare shortfall as a community benefit. - Report the net expense for community benefit service, i.e., the total community benefit expense minus any associated revenue from patients, payers, and other external sources. The CHA reporting guidelines reflect a conservative approach to reporting quantifiable community benefit. The goal of the reporting guidelines is to produce community benefit financial reports that reflect true costs and that describe community benefit activities that increase access to health care and improve community health. 1. Care of the poor, at cost - $5,671,000 2. Unpaid cost of public programs for the poor - $8,547,100 3. Other programs for the poor - $125,000 4. Community benefit programs - $116,000 Summary St. Luke's Hospital furthers its charitable purposes by providing a broad array of services to meet the healthcare needs of patients and organizations in the community. The Medical Center provider essential medical services to the community, train and recruit healthcare professionals to serve the needs of the broader community, provide appropriate charity services to those patients who are not able to pay for their own healthcare needs, provide services to other organizations that allow them to provide quality services to their patients or constituents, and present education information classes and activities to the community in order to improve its overall health status. St. Vincent's Healthcare, the parent of St. Luke's Hospital, supports the community through its participation in various programs that serve the poor, the homeless, the handicapped, the afflicted, and others in need of special care. Many employees of the Health Ministry give of their time, talent, and treasure to support these programs. St. Vincent's Healthcare is recognized as a community leader for its support of activities that align with its mission to serve the sick and poor. The Health Ministry is proud to have St. Luke's Hospital as part of its family to continue the work of the Daughters of Charity begun a century ago in Jacksonville, Florida. 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