2012-05-14T09:51:01-05:00 2011-06-30 Deloitte Tax LLP 250 East Fifth Street Suite 1900 Cincinnati OH 45202 990 2010-07-01 820204264 St Joseph Regional Medical Center STJO 2087995470 PO Box 816 415 Sixth Street Lewiston ID 83501 Howard A Hayes 2087995470 2012-05-11 1 Rebecca Lyons 5137847100 2010 2016-02-24 21:20:13Z Timothy Sayler PO Box 816 415 Sixth Street Lewiston ID 83501 132110863 0 0928 X www.sjrmc.org X 1918 ID Provides inpatient, outpatient and emergency care services. 11 10 1055 174 2117 -55 24683 37636 118049835 126168209 3163754 5107635 603291 601352 121841563 131914832 204350 308225 0 0 55808861 59260687 0 0 304347 58920602 64018782 114933813 123587694 6907750 8327138 125008362 139602635 45396613 43239277 79611749 96363358 The organization's mission is to deliver health care services to the communities of Lewiston, ID, Clarkston, WA and the surrounding small communities. 0 0 101119430 308225 126168209 As a member of Ascension Health, the nation's largest Catholic Healthcare System, SJRMC continues to build and strengthen sustainable collaborative efforts that benefit the health of individuals, families and society as a whole. The goal of SJRMC is to perpetuate the healing mission of the Church. SJRMC furthers this goal through 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 the dignity of each person leads the organization to provide medical services to all people in the community without regard to the patient's race, creed, national origin, economic status or ability to pay. Description continued in attached community benefit report (See Schedule O). 101119430 1 0 0 1 0 0 0 0 0 1 0 0 1 1 0 0 1 0 0 0 0 0 0 0 0 1 1 1 1 1 0 0 0 1 0 0 0 1 0 0 0 0 0 1 1 1 0 0 1 88 0 1 1055 1 1 1 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 ID X Ken Harris 2087995470 415 Sixth Street Lewiston ID 83501 Kent Anderson MD 1.00 X 0 0 0 Joy Rapp 1.00 X 0 0 0 Sr Esther Polacci 1.00 X 0 0 0 Sr Kathleen Ann DuRoss 1.00 X 0 0 0 Bob Coleman 1.00 X 0 0 0 Mike Day 0.00 X 0 0 0 Colin Doyle MD 1.00 X 0 0 0 Terry Kolb 1.00 X 0 0 0 Sr Anne McMullen 1.00 X 0 0 0 Marcy Spilker 1.00 X 0 0 0 Mike Thomason 1.00 X 0 0 0 Sister Mary Williams 0.00 X 0 0 0 Morgan Wilson MD 1.00 X 0 0 0 Howard A Hayes 40.00 X 314488 0 49590 Timothy P Sayler 40.00 X 0 0 0 Thomas Safley 40.00 X 200712 0 28666 Kathleen Connerley 40.00 X 182142 0 33611 Thomas Pfliger 40.00 X 181868 0 20536 Sushma Pant 40.00 X 553304 0 23739 Gerardo Midence 40.00 X 548477 0 22359 Katrina A Popham 40.00 X 524606 0 18776 Michael C Minick 40.00 X 400704 0 28924 William C Dir 40.00 X 374759 0 27880 3281060 0 254081 54 0 1 0 Pathologists Regional Laboratory PO Box 956 Lewiston ID 83501 Laboratory Services 5094045 Lewiston ER Physicians c/o Banner Bank PO Box 1628 Lewiston ID 83501 Physician Services 2556384 TriMedx LLC PO Box 1627 Indianapolis IN 46278 Professional Services 1551757 Valley Anesthesia Associates PO Box 94743 Seattle WA 98124 Professional Services 819500 Alliance Imaging Inc PO Box 6600 Newport Beach CA 92660 Professional Services 591180 11 37636 37636 Net Patient Services 621990 126168209 126168209 126168209 5151099 5151099 459031 150017 309014 309014 309014 2550 46014 -43464 -43464 -43464 Gift Shop 453220 217952 217952 Non-Operating Income 621990 72269 72269 Catering Revenue 722320 2117 2117 292338 131914832 126168209 2117 5706870 250397 250397 57828 57828 1496597 76441 1384205 35951 45221269 38685496 6535773 1599286 1324529 274538 219 7755026 6443147 1311586 293 3188509 2652329 536180 130123 130123 88885 88885 18630 18393 237 5153610 5096618 56992 131113 131113 369056 146564 222492 3615470 3615470 2842737 657306 2185431 435241 225508 209733 1042328 1042328 774157 774157 4851272 4166922 684350 275654 231400 44254 Supplies - Med & Other 28810546 27970355 840191 Bad Debt Expense 4158257 4158257 Other Purchased Service 1769801 1437566 332235 Provider Tax 1633322 1633322 Physician Recruitment 252800 252800 7665780 6493417 904479 267884 123587694 101119430 22163917 304347 5689294 7274381 16843558 20018833 479 386325 277144 3676326 3008070 1557398 441150 80127296 39980874 43199462 40146422 53655999 68436156 125008362 139602635 10316677 8968705 67666 131816 35012270 34138756 45396613 43239277 X 79611749 96363358 79611749 96363358 125008362 139602635 X 8327138 8424471 X 0 1 1 X 0 X 0 1 0 0 0 0 1 271 0 1 18630 18901 0 Explanation of Other Lobbying Activities: Part II-B, Line 1i: Lobbying expenses represent the portion of dues paid to national and state hospital associations that is specifically allocable to lobbying. Additionally, dues are paid to Rural Referral Center/Sole Community Hospital Coalition to lobby on behalf of The Medical Center. St. Joseph Regional Medical Center does not participate in or intervene in (including the publishing or distributing of statements) any political campaign on behalf of (or in opposition to) any candidate for public office. 4861989 4861989 47226484 18259470 28967014 27390813 21467142 5923671 648010 254262 393748 40146422 Other Receivables 291870 Receivable from Third Party Payors 409311 Intercompany Receivable 28411 Deferred Compensation Asset 111682 Health System Depository Account 61670652 Prepaid Pension 4774696 Other Miscellaneous Current Assets 1149534 68436156 Intercompany Debt to Ascension Health 27187478 Payable to Third Party Payors 4014331 Deferred Compensation Liability 111682 Self-Insurance Liability 1071508 Asset Retirement Obligation 283390 Valuation Allowance Liability 1440000 Pension Liability 30367 34138756 1 1 1 X 1 X 101.000000000000 1 1 1 0 1 1 2883794 2883794 0.02410 17340054 14751063 2588991 0.02170 20223848 14751063 5472785 0.04580 273968 273968 0.00230 322111 322111 0.00270 13 8022984 5083789 2939195 0.02460 270626 270626 0.00230 13 8889689 5083789 3805900 0.03190 13 29113537 19834852 9278685 0.07770 99301 99301 0.00080 191595 191595 0.00160 290896 290896 0.00240 1815915 154927 30772766 37470280 -6697514 X 1 1 1 1 St Joseph Regional Medical Center

415 Sixth Street Lewiston ID 83501

X X X NA 1 3 SJRMC Outpatient Mental Health Clinic

428 6th Avenue Lewiston ID 83501

Mental Health Clinic SJRMC Lewiston Medical Clinic

307 St Johns Way Lewiston ID 83501

Medical Clinic SJRMC St Joseph Medical Oncology

1250 Idaho Street Lewiston ID 83501

Oncology Center Part I, Line 7: The cost of providing charity care, means tested government programs, and community benefit programs is estimated using internal cost data and is in compliance with the Catholic Health Association ("CHA") guidelines. The best data available was used to calculate the amount reported in the table. For certain categories in the table, this was direct costs from the general ledger, in other categories, a specific cost-to-charge ratio was used. Part I, Line 7g: The Medical Center provides in-kind clinical space (value of $33,804) to the Lewis and Clark Health Center, a Federally Qualified Health Clinic serving the primary care needs in our geographic region. Part I, L7 Col(f): The amount of bad debt expense reported on Form 990, Part IX, Line 25, Column (A), but subtracted for purposes of calculating the percentages in Part I, Line 7, Column (f) is $4,158,257. Part III, Line 4: Footnote per the Medical Center's financial statements:The provision for bad debts is based upon management's assessment of historical and expected net collections considering economic conditions, trends in health care benefit 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 payer 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 Medical Center follows established guidelines for placing certain past-due patient balances with collection agencies, subject to the terms of certain restrictions on collection efforts as determined by Ascension Health. Accounts receivable are written off after collection efforts have been followed in accordance with the Medical Center's policies.The Medical Center's bad debt expense in 2011 was $4,158,257 at charges ($1,815,915 at cost). Part III, Line 8: The Medical Center follows the Catholic Health Association ("CHA") guidelines for determining community benefit. CHA community benefit reporting guidelines suggest that Medicare shortfall is not treated as community benefit. Part III, Line 9b: The Medical Center has a written debt collection policy that also includes a provision on the collection of practices to be followed for patients who are known to qualify for charity care or financial assistance. If a patient qualifies for charity care or financial assistance certain collection practices do not apply. Part VI, Line 2: A survey was conducted in fall of 2009 in the Lewis-Clark Valley to determine the community needs regarding issues related to education/youth, emergency services, and health services. A random sample of 430 people completed the needs assessment enabling a 95% confidence interval to be defined around plus or minus five percentage points for each question.The three most important education youth goals were (1) reduce teen drug, tobacco & alcohol use, (2) provide a safe environment for children after school, and (3) reduce the high school dropout rate. The community strongly supported safe after school childcare/daycare, intervention programs for at-risk youth, preschool/kindergarten readiness, tutoring or academic assistance, and mentorship programs. Those familiar with local daycare/childcare services rate the quality, availability, and staff to child ratio as fair. Affordability is rated less favorably and services for special needs children seems wanting. High levels of concern were found for our community's youth with regard to drugs & alcohol, negative home environment/family life, academic achievement, bullying, relationships/teen sex, depression/self harm, and obesity.The three most important emergency services goals were (1) increase services to the number of families with basic needs such as food and shelter, (2) increase job training and educational programs to help individuals increase income, and (3) decrease the number of families and individuals suffering from violence and abuse. Strong community support exists for assistance for low-income persons in the area of food banks/hunger support, domestic violence prevention and treatment, advocates for children in the courts, disaster services/house fires & natural disasters, and shelter for the homeless. The three most important health care goals were (1) increase the number of families able to get regular medical checkups and access preventative medicine, (2) increase the number of families able to access urgent healthcare, and (3) increase the number of people living drug-free. Community members appear to be well aware of the range of health care programs and believe the need is particularly high for family doctors, chemical dependency treatment, emergency care, and public health services. While not rated as high, a very sizable number in the valley believe more respite care, counseling services, dentists, mental health services, and nursing homes are needed. While only 13% report not having medical insurance coverage and only 17% do not have prescription coverage, over a third do not have dental, vision, or mental health insurance. The cost of the insurance is the biggest factor keeping community members from getting health care followed by a lack of insurance itself. People in this community strongly rely on their doctors for information about their health care decisions and they tend to listen to their doctors more than any other sources. The Internet is used as a resource for health decisions twice as much as either the television or newspaper. Community members view health screenings, lack of exercise, poor nutrition, heart problems, and obesity as the most important concerns for their own health and wellness. During FY 2011, additional information was obtained in the initial phase of the strategic planning process entered into by SJRMC which identified other needs, and that information will be utilized in identifying additional services needed as well as collaborative opportunities. Part VI, Line 3: St. Joseph Regional Medical Center's financial assistance is available to all patients. The Medical Center's financial assistance notice is posted in all registration areas, emergency department and business services department. Financial assistance applications are available at all registration areas and business services offices. The Medical Center makes every attempt to identify/assist patients who may be eligible for charity or discounted care through the Medical Center's Charity Care Policy. A financial assistance counselor is available to all patients. The Business Office staff is trained on how to qualify patients for Medicaid, County Assistance and other payment programs. The financial assistance counselor discusses with the patient the availability of various government assistance programs and assists the patient with qualification for such programs. As the result of a grant through the state of Washington, a Medicaid eligibility case worker assists Washington applicants in with their application process. Written summary and contact information is also provided in billing communications with patients. For the patient who has limited English proficiency, interpreter services are available at no charge. Part VI, Line 4: The Medical Center serves as both a primary care facility and a secondary referral facility for residents of the Medical Center's nine county service area, which includes: Nez Perce, Latah, Idaho, Clearwater and Lewis counties, ID; Asotin, Garfield and Whitman counties, WA; and Wallowa county, OR. The service area has an aggregate population of approximately 174,000 people in north central Idaho, southeast Washington and northeast Oregon. St. Joseph Regional Medical Center is the only full service Medical Center in a region with nine Critical Access Hospitals in the immediate geographic area. St. Joseph Regional Medical Center provides approximately 80% of the inpatient acute care hospital services in its primary care area and 40% of the inpatient services in its regional service area. In FYE June 2011, St. Joseph Regional Medical Center treated 5,791 inpatients and recorded an additional 122,332 outpatient visits. The Medical Center provided a substantial portion of its services to the elderly and poor. In FYE June 2011 approximately 47.1% of services rendered were to elderly patients under the Medicare program, and approximately 14.1% of the services were provided to patients deemed indigent under state, county, or Medical Center guidelines. The Medical Center provided $2,883,794 in unpaid costs of providing traditional charity care, $2,588,992 in unpaid costs of public programs, $157,544 net cost of programs to the poor, and $3,939,249 net expenses for services and community benefit programs provided at a loss to meet community needs. The following comments duplicate the comments for the first bullet point under Part VI, Line 5. At the expense of the Medical Center, the clinic was completely renovated to meet the needs of the Lewis Clark Health Clinic (LCHC). Part VI, Line 6: The Medical Center also provided services to meet additional community needs by supporting other health awareness, education and health promotion activities in the community as outlined below: - The Medical Center was an integral member of the Local Access to Care Committee that looked at available options to increase access to Primary Care. Working with the Community Health Association of Spokane, a grant for $1.3 million was secured. Following this, a Federally Qualified Health Clinic opened on July 1, 2009 as the Lewis Clark Health Clinic (LCHC). The LCHC addresses access issues for all patients especially those with Medicare, Medicaid and no insurance. During its first year, the Medical Center provided free clinic space and provided a $10,000 per month operating subsidy. By the end of that year, LCHC had recruited one full time PA and a .75 NP and established a medical home for over 1,700 patients. During its second year of operation, the cash contribution was no longer necessary, but the Medical Center continued to provide space without cost to the clinic. - Due to the rural nature of Idaho and Southeastern Washington, a shortage of mental health professionals exists. The Medical Center has developed strategies to address this issue by working with legislators to fund programs, continuing to develop Mental Health Telemedicine involvement with Idaho's Region II hospitals and educating the region, professionals and non-professionals by sponsoring/facilitating the annual Rural Mental Health Symposium event. The Mental Health Center also has a speaker bureau program where the centers mental health physicians are available to speak on educational and informational topics. This is a free program.- Provided mobile mammography and PACS access to some of the rural hospitals and clinics in the area who are otherwise unable to provide those services.- The Medical Center Foundation offered a series of free "Your Doctor Speaks" programs covering six different healthcare topics presented by local physicians and national speakers. Almost 240 people attended these seminars. - The Medical Center Foundation's "Think First" program, which works with the local school districts, teaches head and spinal cord injury prevention to elementary and junior/ senior high classes. - The Medical Center's Senior Life program for adults over age 60 assisted 269 seniors with Medicare Part D through its pharmacy program. This program is free and open to the public. The coordinator of this program helped seniors sign up for Medicare Part D and select the options that best serve their needs. She also helped them sign up for medication assistance programs that made it possible for them to acquire medications that they could not otherwise afford.- The Outpatient Diabetes Education Center offered free education classes titled "Pre-Diabetes Awareness", "Supermarket Tours and Budget Tips", "Diabetes Boot Camp", and "Diabetes Awareness Fair". These classes are offered at no expense to the participants in an ongoing effort to continue to educate the public on the management of diabetes. - The Medical Center's Community Health Education Resource Center presented "Go Red for Women" day, an event designed to increase awareness of heart disease, the #1 killer of women. This Open House event gave attendees a chance to learn about healthy choices in eating, exercise and risk factor reduction, and other lifestyle options - all in an effort to improve the heart health of the women in our service area. Part VI, Line 7: St. Joseph Regional Medical Center continued the training and education of health care professionals to help address the shortage of and expand the availability of trained clinicians. This has been accomplished with a governing body that draws from leaders in the religious community, the physician community and the local community. Idaho has one of the lowest physicians to population ratios in the United States. So, it is very important to emphasize the recruitment and retention of physicians in order to meet the healthcare needs of the community. In FYE June 2010 the Medical Center worked very closely with its Medical Staff to enhance recruitment efforts of new physicians to the community. In addition to working with the Medical Staff, the Medical Center employed an in-house physician recruiter, who developed ongoing relationships with Ascension Health Physician Recruitment Services and Recruitment Firms throughout the country to market the provider opportunities in the community. In FYE June 2010 the Medical Center successfully recruited Oncologists and worked closely with Valley Medical Center to recruit an Obstetrician/ Gynecologist, a Foot and Ankle Surgeon/ Podiatrist and a Family Practice physician. The Medical Center also worked with the local pathology group to recruit a Pathologist. St. Joseph Regional Medical Center welcomed an additional Ophthalmologist and an Oral and Maxillofacial Surgeon to the Medical/Dental staff. Recruitment efforts continue in Neurology, Psychiatry, and Outpatient Family and Internal MedicineIn FYE June 2010 the Medical Center committed to providing a larger space for the St. Joseph Regional Cancer Center. In 2010, the Cancer Center (Medical Oncology Clinic) relocated into the newly remodeled location, tripling the Cancer Center's space from 3,000 square feet to 9,000 square feet. The Medical Center spent $933,000 to complete this remodel which included five additional exam rooms, four additional infusion chairs, plus additional waiting space, physician and staff offices, and separate spaces for pharmacy and social services. The new facility also offers increased privacy for our patients and their families. The Medical Center provides the only cancer care within a 110 mile radius and serves patients from throughout the region. Further actions associated with the development of the Medical Oncology program included successful recruitment of two additional Oncologists in FYE June 2010. During FY 2011, the number of visits recorded at the Cancer Center rose from 8,687 in 2010 to 9,804.The Medical Center is designated by CMS as a Sole Community Hospital and provides many of the same services as a much larger acute care facility. The nearest acute care facility is located more than 110 miles to the north of our service area. Part VI, Line 7: St. Joseph Regional Medical Center is a member of Ascension Health. Ascension Health is a Catholic, national health system consisting primarily of not-for-profit corporations that own and operate local health care facilities or Health Ministries, located in 20 of the United States and the District of Columbia. Ascension Health is sponsored by the Northeast, Southeast, East Central and West Central Provinces of the Daughters of Charity of St. Vincent de Paul (DC), the Congregation of St. Joseph (SSJ) and the Sisters of St. Joseph of Carondelet (CSJ).The Medical Center, located in Lewiston, Idaho, is a not-for-profit acute care hospital. The Medical Center provides inpatient, outpatient and emergency care services for the residents in the areas surrounding Lewiston, Idaho and Clarkston, Washington. Admitting physicians are primarily practitioners in the local area. The Medical Center is related to Ascension Health's other sponsored organizations through common control. Substantially all expenses of Ascension Health and its sponsored organizations are related to providing health care services. 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. Ascension Health uses four categories to identify the resources utilized for the care of persons who are poor and community benefit programs:1. 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.2. Unpaid cost of public programs represents the unpaid cost of services provided to persons covered by public programs for the poor.3. Cost of other programs for the poor includes programs intentionally directed at serving the poor and vulnerable of the community including substance abusers, the homeless, victims of child abuse and persons with Acquired Immune Deficiency Syndrome.4. Community benefit consists of the unreimbursed costs of community benefit programs and services for the general community, not solely for the poor, including health promotion and education, health clinics and screenings and medical research.St. Joseph Regional Medical Center continues to serve as the only full service acute care hospital in the region. Its goal is to improve the health status of the whole community, by providing essential medical services to all patients, including those unable to pay for their healthcare needs. This continues to be the mission and philosophy of St. Joseph Regional Medical Center. By offering a broad selection of educational offerings and healthcare services, the Medical Center strives to better meet the healthcare needs of the patients and organizations in the service area. The Community Health Resource and Education Center continues to help facilitate classes and training for associates, community members and patients in an effort to better meet the educational and informational needs in the community and surrounding area. St. Joseph Regional Medical Center maintains its position as the regional leader in health education, community-based programs, and providing healthcare services to all its patients.In FYE June 2011 the Medical Center treated 5,789 adult, pediatric, newborn, transitional care and psychiatric inpatients for a total of 27,003 patient days of service. The Medical Center also provided service to 121,042 outpatients, including 2,710 outpatient surgery patients, 30,058 emergency and minor care patient visits, 9,804 Oncology clinic visits and 79,760 other outpatient visits. All Medical Center services are provided without regard to the patient's race, creed, national origin, economic status, or ability to pay. The Medical Center provided $9,569,579 million in un-reimbursed cost of services to the poor and to meet the needs of the community. 1 Snake River Clinic 215 10th Street Lewiston ID 83501 311726460 501(c)(3) 36961 Medical Services Twin County United Way 2207 E Main Street Lewiston ID 83501 820261086 501(c)(3) 42422 Community Support LCSC Nursing Faculty 500 8th Avenue Lewiston ID 83501 826000935 501(c)(3) 44000 Nursing Staff Valley Vision 111 Main Street Lewiston ID 83501 841367690 501(c)(6) 10000 Community Support 3 1 Medical Prescriptions 57828 Prescriptions for Indigent Patients Procedure for Monitoring Grants in the U.S.: Part I, Line 2: Schedule I, Part I, Line 2: Before funds are disbursed, all grants must go through an approval process at the Medical Center. After approval and disbursement of the funds, the funds are monitored by the applicable non-profit's board of directors. Each non-profit organization that receives funds has one or more Medical Center employee(s) that sits on its board of directors to help ensure the funds are spent as directed. X 1 1 X X X X 0 0 0 0 0 0 0 0 0 Howard A Hayes 268787 0 0 0 45701 0 21726 0 27864 0 364078 0 0 0 Thomas Safley 198572 0 0 0 2140 0 10393 0 18273 0 229378 0 0 0 Kathleen Connerley 181425 0 0 0 717 0 14820 0 18791 0 215753 0 0 0 Thomas Pfliger 174571 0 0 0 7297 0 13908 0 6628 0 202404 0 0 0 Sushma Pant 553304 0 0 0 0 0 12201 0 11538 0 577043 0 0 0 Gerardo Midence 548477 0 0 0 0 0 7788 0 14571 0 570836 0 0 0 Katrina A Popham 524606 0 0 0 0 0 12201 0 6575 0 543382 0 0 0 Michael C Minick 400704 0 0 0 0 0 12201 0 16723 0 429628 0 0 0 William C Dir 374759 0 0 0 0 0 7782 0 20098 0 402639 0 0 0 Part I, Line 1a The organization paid for temporary housing for the new CFO Timothy Saylor. The amount paid was treated as a taxable benefit to him. Brenda Forge Purchase Computer X 1129 479 0 1 1 479 Pathologists Regional Laboratory Board member is a shareholder 5026787 Lab Service 0 Schedule L, Part IV Business Transactions Involving Interested Persons: All transactions reported on Part IV are reported as arms-length and negotiated for fair market value. Form 990, Part VI, Section A, line 6 St. Joseph Regional Medical Center has a single corporate member, Ascension Health. Form 990, Part VI, Section A, line 7a St. Joseph Regional Medical Center has a single corporate member, Ascension Health, who has the ability to elect members to the governing body of St. Joseph Regional Medical Center. Form 990, Part VI, Section A, line 7b Ascension Health has designed a system authority matrix which assigns authority for key decisions that are necessary in the operation of the system. Specific areas that are identified in the authority matrix are: new organizations & major transactions; governing documents; appointments/removals; evaluation; debt limits; strategic & financial plans; assets; system policies & procedures. These areas are subject to certain levels of approval by Ascension per the system authority matrix. Form 990, Part VI, Section B, line 11 Management, including certain officers, works diligently to complete the Form 990 and attached schedules in a thorough manner. Management presents the Form to the Board, or a designated committee, to review and answer any questions. Prior to filing the return, all Board Members are provided the Form 990 and management team members are available to answer any Board Members questions. Form 990, Part VI, Section B, line 12c The organization regularly and consistently monitors and enforces compliance with the conflict of interest policy in that any director, principal officer, or member of a committee with governing board delegated powers, who has a direct or indirect financial interest, must disclose the existence of the financial interest and be given the opportunity to disclose all material facts to the directors and members of the committees with governing board delegated powers considering the proposed transaction or arrangement. The remaining individuals on the governing board or committee meeting will decide if conflicts of interest exist. Each director, principal officer and member of a committee with governing board delegated powers annually signs a statement which affirms such person has received a copy of the conflicts of interest policy, has read and understands the policy, has agreed to comply with the policy, and understands that the organization is charitable and in order to maintain its federal tax exemption it must engage primarily in activities which accomplish its tax-exempt purpose. Form 990, Part VI, Section B, line 15 In determining compensation of the organization's CEO, the process included a review and approval by independent persons, comparability data, and contemporaneous substantiation of the deliberation and decision. The Executive Committee of the SJRMC Board and the SJRMC Board reviewed and approved the compensation. In the review of the compensation, the CEO was compared to similarly sized organizations as well as organizations similar in complexity of operations, revenues and job responsibilities across the nation. During the review and approval of the compensation, documentation of the decision was recorded in the board minutes. Individual was not present when his compensation was decided. In determining compensation of other officers or key employees of the organization, the process included a review and approval by independent persons, comparability data, and contemporaneous substantiation of the deliberation and decision. The Executive Committee of the SJRMC Board and the SJRMC Board reviewed and approved the compensation. In the review of the compensations, the other officers or key employees of the organization were compared to similarly sized organizations as well as organizations similar in complexity of operations, revenues and job responsibilities across the nation. During the review and approval of the compensation, documentation of the decision was recorded in the board minutes. Form 990, Part VI, Section C, line 19 The organization will provide any document open to public inspection upon request. Changes in Net Assets or Fund Balances: Form 990, Part XI, line 5: Net unrealized gains on investments: 4,502,658. Other Activity 12,895. Transfers to/from Affiliates -2,344,679. Deferred Pension Costs 6,253,597. Total to Form 990, Part XI, Line 5: 8,424,471. Form 990, Part III, Line 4: St. Joseph Regional Medical Center Community Benefit Report For the Period Ended June 30, 2011 This report is designed to provide information regarding the considerable time, financial contributions, and on-going efforts to which St. Joseph Regional Medical Center (the Medical Center) contributes to the positive health status of the communities it serves. As a member of Ascension Health, the nation's largest Catholic healthcare system and largest non-profit health care system, the Medical Center continues to build and strengthen sustainable collaborative services that benefit the health of individuals, families, communities, and society as a whole. The Medical Center strives to facilitate the healing mission of the Church through the delivery of patient services, care to the elderly and indigent, patient education and health awareness programs for the community. The concern for all human life and the dignity of each person leads the organization to provide medical services to all people in the community without regard to the patient's race, creed, national origin, economic status, or ability to pay. The full extent to which the Medical Center provides community benefits and services to the region and to the patients is outlined below: Individuals, Families, and Communities Benefited by the Medical Center: St. Joseph Regional Medical Center, located in Lewiston, Idaho, has 125 acute care beds, a 20 bed inpatient psychiatric unit and a 16-bed sub-acute unit. It is estimated that the Medical Center provides approximately 80% of the inpatient acute care hospital services in its primary care area and 40% of the inpatient services in its regional service area. The Medical Center serves as both a primary care facility and a secondary referral facility for residents of the Medical Center's nine county service area, which includes: Nez Perce, Latah, Idaho, Clearwater and Lewis Counties, ID; Asotin, Garfield and Whitman Counties, WA; and Wallowa County, OR, which has an aggregate population of approximately 168,000 people in north central Idaho, Southeast Washington and Northeast Oregon. The Medical Center is fully accredited by the Joint Commission on the Accreditation of Healthcare Organizations and has a regional cancer program accredited by the American College of Surgeons "With Commendation", which is only awarded to the top 5% of the ACS accredited hospitals in the country. In addition to providing healthcare services to all individuals who require medical attention, the Medical Center seeks to improve the physical, mental, social, and spiritual health status of its surrounding community. Operations and Governance to Providing Community Benefit: In this community, the Medical Center: - Operates an Emergency Room and Minor Care that is open to all persons regardless of the ability to pay; - Provides a comprehensive array of inpatient and outpatient services to all persons without regard to race, color, creed, national origin, economic status, or ability to pay; - Participates in Medicare, Medicaid, County, TriCare, Indian Health Services and/or other government-sponsored health care programs to assure access of patients to services; - Provides a wide range of services and educational offerings to better meet the healthcare needs of patients in the region and improve the health status of the community; - Engages in the training and education of health care professionals to help address the shortage of and expand the availability of trained clinicians required to meet the health care needs of the community and region; and - Has a governing body that draws from leaders in the religious community, the physician community and the local community. Patients Served: In FY2011 the Medical Center treated 5,789 adult, pediatric, newborn, transitional care and psychiatric inpatients for a total of 27,003 patient days of service. The Medical Center also provided service to 122,332 outpatients, including 2,710 outpatient surgery patients, 30,058 emergency and minor care patient visits, 9,804 Oncology clinic visits and 79,760 other outpatient visits. All Medical Center services are provided without regard to the patient's race, creed, national origin, economic status, or ability to pay. Patient Services Provided: St. Joseph Regional Medical Center operates as a regional referral center providing a range of acute care inpatient and outpatient services comparable to much larger hospitals in urban areas. Some services are operated at a loss in order to assure that the service is available to meet community health care needs. BIO-MEDICAL ENGINEERING CARDIOPULMONARY Cardiac Stress Testing - Electrocardiogram (EKG) - Thallium stress testing - Treadmill Neurodiagnostic Laboratory - Electroencephalogram(EEG) - Electromyogram (EMG) - Evoked Potential - Sleep studies Pulmonary Lung Function Testing Remote Cardiac Monitoring - Holter - King-of-Hearts Respiratory Therapy - Inpatient - Outpatient - Home respiratory program DIAGNOSTIC IMAGING (RADIOLOGY) Bone Densitometry Cardiac Catheterization Lab Computerized Tomography (CT) Digital Angiography Echocardiography Magnetic Resonance Imaging (MRI) Digital Mammography Mobile Mammography Mobile PET/CT Scanner Nuclear Medicine Stereotactic Breast Biopsy Ultrasound Diagnostic X-Ray FOOD & NUTRITIONAL SERVICES Inpatient Registered Dietitians Outpatient Registered Dietitians Meals on Wheels PALLIATIVE CARE PASTORAL CARE PATIENT ACCOUNTS REPRESENTATIVE PATIENT CARE AREAS(INPATIENT) Family Beginnings - Neonatal Intensive Care Unit (Level II) - Obstetrics (LDR's) - Pediatrics Intensive/ Cardiac Care Medical Service Oncology Service Palliative Care Unit Progressive Care Surgical Service Transitional Care Unit PATIENT CARE AREAS(OUTPATIENT) Emergency Department - Minor Care - Trauma Center Endoscopy Laboratory Family Hospice (Medicare Certified) IV Services Mental Health - Adult Inpatient & Outpatient Mobile Lithotripsy REGIONAL CANCER CENTER - Oncology/Hematology Clinic - Chemotherapy Radiation Oncology Center - Brachytherapy - IMRT SURGICAL SERVICES Inpatient and outpatient Anesthesiology Ear, nose, throat General surgery Gynecology Neurosurgery Ophthalmology Oral surgery Orthopedic surgery Plastic surgery Thoracic surgery Urology surgery Vascular surgery PHARMACY REGIONAL PATHOLOGY LABORATORY - Blood Bank - Chemistry - Cytology - Hematology - Histology - Pathology REHABILITATION SERVICES Inpatient & Outpatient - Occupational therapy - Physical therapy - Speech therapy - Pediatric o/p rehabilitation SENIORLIFE SOCIAL SERVICE The patients served in this community are done so by a wide range of physician specialities. The Medical Center has cooperated with the medical community to attract well-qualified physicians in a broad array of primary and specialty areas to help insure access to quality health care for patients in the region. Idaho continues to have one of the lowest physicians to population ratios in the United States. Therefore, it is very important to emphasize recruitment and retention of physicians in order to help meet the healthcare needs of the community. In FY2011 the Medical Center worked very closely with its Medical Staff to enhance recruitment efforts of new physicians to the community. In addition to working with the Medical Staff, the Medical Center continues in-house recruiting efforts through Human Resources and developing ongoing relationships with Ascension Health Physician Recruitment Services and Recruitment Firms throughout the country to market the provider opportunities in the community. In FY 2011 the Medical Center successfully recruited an Orthopedic Hospitalist, Psychiatrist, and Neurologist (for locum work.) The Medical Center also worked closely the Valley Medical Center to recruit a Pediatrician and Family Medicine physician, and also with Pathology Regional Lab to recruit a Pathologist. The community and the Medical Center also welcomed an Oral and Maxillofacial Surgeon, Gastroenterologist and Wound Care physician. Recruitment efforts continue in Primary Care, Cardiology, Neurology, and Interventional Radiology. The Medical Center performs periodic reviews of medically needed services that are not currently being provided to residents of its service area. This review has led to the introduction of new services over the years: - Medical Oncology, neurosurgery, cardiology, and neurology (1983); - Expanded outpatient surgery, emergency services, and endoscopy laboratory (1985); - Radiation therapy services and magnetic resonance imaging services (1988); - Expanded nuclear medicine capabilities (1990); - Added inpatient and expanded outpatient adult mental health (1992); - Transitional Care Unit (1995); - Expanded outpatient services (ER, Minor care, pain clinic, endoscopy lab (1999); - Picture Archiving Computer (2000); - Radiation Therapy Treatment Planning (2004); - Diagnostic Cardiac Catheterization (2005); - IMRT, New MRI, 64-Slice CT (2006); - Addition of an Inpatient Palliative Care Unit (2008); - Relocation of the Cancer Clinic (2010). In FY2010 and 2011, the Medical Center committed to providing a larger space for the St. Joseph Regional Cancer Center. The Cancer Center relocated into the newly remodeled Idaho Street location. The Medical Center spent $932,528 to complete this remodel which included five additional exam rooms, four additional infusion chairs and tripled the square footage from 3,000 square feet to 9,000 square feet, including additional waiting space, physician and staff offices, and separate spaces for pharmacy and social services. SJRMC provides the only cancer care within a 110 mile radius and serves patients from throughout the region. The relocation of the Cancer Center provided an opportunity to move Outpatient Mental Health to the vacated Cancer Center. This building provides an enhanced layout for Mental Health Services as exam rooms transformed to counseling rooms in November 2011. In FY2011, other major capital improvement projects completed at the Medical Center focused on enhancing patient safety and expanding services available to patients in the regional referral area. These projects included adding a digital fluro room which includes an x-ray fluro. This project was completed to enhance patient services in the area at a cost of $513,000. As patient safety remains a top priority to the Medical Center, at total of $270,000 was spent on new patient beds for the medical/surgical departments. Also aligned with enhancing patient safety, the pharmacy department spent $97,000 installing new Pyxis scanning equipment throughout the Medical Center including the only local OB department. The Medical Center administers the largest surgery department in the region and in FY2011 the Operating Room completed a number of capital projects. These projects included the addition of a C-arm, an orthopedic drill, Stryker TPS/ commend replacement, an updated Endoscopy cart and for the recovery room an improved patient monitoring system, Datascope patient care monitors. These projects totaled $244,000. The total cost of these 4 projects was over $1.125 million, including a variety of other capital projects done in FY 2011, the Medical Center invested over $1.523 million into improving and enhancing the quality of patient services and increasing patient safety. Net Costs of Services Provided to the Elderly and Poor and to meet the Community need: In the spirit of principles adopted by Ascension Health, the Medical Center has taken proactive steps to address those issues that will affect accessibility, the financing and the delivery of health care to all persons, especially the uninsured, underinsured, and the underserved. The Medical Center provides a substantial portion of its services to the elderly and the poor. In FY2011 approximately 47.1% of the cost of services rendered was to elderly patients under the Medicare program, and approximately 14.1% of the services were provided to patients who were deemed indigent under state, county, or Medical Center guidelines. The Medical Center provided $9,569,579 in un-reimbursed cost of services to the poor and to meet the needs of the community as outlined below: - The unpaid cost of providing charity care based on a patient's inability to pay $2,883,794 - The unpaid costs of public programs for individuals $2,588,992 - The net cost of other programs for the poor $157,544 - The net expense of services and community benefit programs $3,939,249 provided at a loss to meet community needs Total cost for care of persons who are poor and community benefit programs $9,569,579 The Medical Center provided hospital inpatient and outpatient services at a net loss in the following departments to maintain services to meet community needs: - Mental Health Inpatient and Outpatient Services - Transitional Care Unit - Occupational Therapy - Inpatient Physical Therapy - Speech Therapy - Special Procedures Unit - Outpatient Education - Palliative Care - Nicotine Intervention Program - Home Respiratory - Hospice - Pastoral Care The Medical Center also provided services to meet community needs to support other Health Awareness, Education and Health Promotion activities in the community as outlined below: - Based on work previously done by the Local Access to Care Committee the Community Health Association of Spokane opened the Lewis Clark Health Center, a Federal Qualified Health Clinic, on July 1, 2009 to help address access issues for Medicare, Medicaid, and uninsured patients. SJRMC provides the clinic with free office space directly across from the Hospital Emergency Room/ Minor Care. - Provided support to the Snake River Medical Clinic, a volunteer-staffed community clinic open two nights per week to treat the uninsured. - Provided funds to purchase initial prescriptions for indigent patients of the Medical Center. - Subsidized faculty expenses at Lewis-Clark State College (LCSC) to enable increased nursing student enrollments to address a local, regional and national shortage of nurses. - Provided Carondelet Scholarships and other scholarships for books and tuition for students enrolled in clinical education programs at local colleges to expand the availability of qualified health care workers in the future. - Provided a 100% match of associate donations to the local United Way, an agency which provides supplemental support to non-profit agencies involved in Health Awareness, Education and Promotion. - Provided support to assist in recruitment of physicians to the community to meet community health care needs. Uninsured patients continue to receive a discount off their initial bills in order to improve the affordability of health care to these patients. All uninsured and insured patients are eligible for financial screening for further adjustment to their bills based on documented income and expense profiles provided by the patient or guarantor; and the resulting ability to pay all of, or part of, the remainder of the bill over a four year period of time. Financial Assistance materials have been included in the Admission packets and are available at all Registration Areas alerting the patient to the availability of Financial Assistance. Information is also included on bills sent to patients so they can contact the Medical Center to request an application for Financial Assistance in the settlement of their bill. The Medical Center will write off 100% of a bill for a patient/family with no insurance which has a documented income profile level that is 100% or less of the Federal Poverty Level. Eligibility for further discounts is based on an ability of the patient to pay after the patient completes a financial application for the Medical Center evaluation. The Medical Center reviews the completed application regarding income, expense, assets, and liabilities to determine the extent of Financial Assistance that can be offered according to the Medical Center policies. The Medical Center has an arrangement with a financing company to enable the patient or guarantor to finance payment of medical bills. The Medical Center has a policy that all alternative sources of financial assistance, including application to various Medicaid, County and other available programs must be applied for, and rejected, before Financial Assistance is provided by the Medical Center. Failure of the patient or guarantor to follow-through on the application of financial assistance that may be available from another source will constitute reason for denial of an application for Financial Assistance from the Medical Center. Trends, Needs, and Issues in the Community and the Medical Center Strategies to Address Them: Shortage of Primary Care Physicians There are not enough Primary Care Physicians (Family Practice and Internal Medicine) to meet the needs of the community, and provide timely access to care, especially those without insurance or on Medicaid. The shortage is such that some Medicare patients and patients with insurance are not able to establish a Primary Care relationship. Due to this shortage, the Medical Center is experiencing an increase in volume in our Minor Care and Emergency Department. The Medical Center strategies to address the issue: - Employ local primary care physicians. The Medical Center began employing primary care physicians in February 2011 with the employment of a family practice physician whose practice is on campus. The Medical Center assumed all aspects of running this practice, including the employment of the physician and the staff, billing and collections, compliance and management. The Medical Center has plans to employ more local primary care providers in FY 2012. - Purchased the Lewiston Medical Center Office buildings to ensure that the 20 physicians located there would have a place to continue their practice. - Provide the Community Health Association of Spokane (CHAS Clinic) free rent for two years, FY2010 and FY2011 for establishing a Federally Qualified Health Clinic in the Lewis-Clark Valley with two providers offering services. - Recruitment efforts for Internal Medicine, Family Practice and Neurology include recruitment fees and expenses, relocation assistance and income guarantee with "loan" forgiveness in conjunction with the Medical Staff. - Establish a Primary Care Strategic Directions Committee to develop strategies to address physician shortages. Growing Number of Uninsured North Central Idaho has not seen the growth or economic prosperity that the rest of Idaho has experienced over the past several years. This region still has a natural resource based economy and the loss of jobs in timber and agriculture, that traditionally had insurance benefits, has not rebounded. This is especially true in the outlying communities and counties. The shift in jobs has been to lower paying jobs, many with limited or without health benefits. The Medical Center has also seen a dramatic increase in the amount of deductibles and co-pays, especially patients with individual coverage. The Medical Center strategies to address the issue: - Work with the Idaho Hospital Association to continue to fund ACCESS IDAHO, a private/public program to provide health insurance access to lower paid workers - Continue to advocate for CHIP funding at the State and Federal levels - Participate in Ascension Health Leadership Plan including the 100% Access Campaign - Continued involvement with Cover the Uninsured Week activities - Continue the Medical Center's Patient Advocate/ Representative program - Assist with the establishment of a Federally Qualified Health Clinic in the community. Medical Education: The Medical Center is concerned that a number of educational programs for health care professionals are either not available in the local community, or are not graduating enough students to meet the health care needs of the community. Therefore, the Medical Center has developed an extensive affiliation program with educational institutions. 367 students utilized the Medical Center as a clinical teaching site in FY2011, a 30% increase in utilization from FY2010, in the programs outlined below: Registered Nurse Education: Walla Walla Community College - 133 Lewis - Clark State College - 107 Life Flight - 5 Certified Nurse Assistant: Lewis - Clark State College - 40 Bachelors of Social Work: Lewis - Clark State College - 1 Masters of Social Work: Boise State University - 2 Psychology Students: Fielding Institute - 1 Medical School Rotations: WWAMI Program - 4 Physicians Assistant/Family Nurse Practioners: University of Washington - 2 Gonzaga University - 1 Idaho State University - 1 Washington State University - 1 Physical Therapy: Eastern Washington University - 4 EMT/ Paramedic: Lewis - Clark State College - 30 Moscow Fire Department - 12 Radiology Technicians: Lewis - Clark State College - 16 Wenatchee Community College - 2 Respiratory Therapy: Independence University - 2 PharmD Students: Washington State University - 2 Pharmacy Students: Washington State University - 1 Total - 367 Access to Mental Health Services: With the rural nature of Idaho and Southeastern Washington, Mental Health Services are often only found at the larger population centers. This is due to a shortage of mental health professionals and very inadequate reimbursement for those who provide service. People often don't seek help until their mental health problems have created a crisis. The Medical Center strategies to address this issue: - Continue work with Senator Stegner (District State Senator) to champion additional Regional Mental Health Councils, fund programs, and create additional legislation to better address mental health and drug addiction services. - Continue Mental Health Telemedicine involvement with the Regional Tele-health Board, and Idaho's Region II hospitals. - Maintain presence on Regional Mental Health Board. - Advocate Legislature for a Drug Treatment Center for North Central/Northern Idaho. - Work with the Social Detox Committee, through the United Way and various other locations. - Continue to educate the region, professionals and non-professionals, thru the annual education event the Rural Mental Health Symposium. Community organizations collaborating with the hospital to improve community health, expand access to health care, or in other ways benefit the community: - Lewis-Clark State College, Walla Walla Community College and other educational institutions outlined Medical Education utilize the Medical Center as a clinical teaching site for 367 students in 13 specific educational programs and increase the number of clinical service students that would choose employment in the community after graduation. - Coordination with the North-Central Health District on health screening programs to identify developmentally disabled children who can benefit from an improvement in their physical abilities and/or speech functions. - Donations to support of the Snake River Community Clinic for the uninsured population. - Bringing the Hospitalist Program in house to better recruit additional Hospitalist which will allow PCP's to practice solely in the outpatient clinic setting; extend PCP's work life, and better position the community to recruit needed physicians to the area. - Sponsor educational programs on wellness, health education and disease-specific support groups to improve the health status of the community. - Collaborate with Meals on Wheels to produce dietary appropriate, balanced meals to the home-bound. - Provided mobile mammography and PACS access to some of the rural hospitals and clinics in the area who are otherwise unable to provide those services. - Contracted to provide Mental Health professional services in local nursing homes. - Provided contracted Physical, Occupational, and Speech Therapy services to Head Start and school districts that don't have the capability of supporting those services independently. - Expanded / Upgraded IT linkages between the Medical Center and physician offices to transmit test results and radiology, MRI, CT and other images to accelerate diagnosis and treatment. - Assist the community Access to Care group and CHAS Clinic to establish a Federally Qualified Health Clinic (FQHC) in the community. - Provided a Nicotine Intervention Program. - The Medical Center Foundation works with the local school districts. Presenting Think First, a head and spinal cord prevention program to elementary and junior/ senior high classes. - The Medical Center collaborates with the American Cancer Society to sponsor a community resource center at the Medical Center to serve the needs of cancer patients. - The Medical Center Foundation developed a presentation, "Methamphetamine Prevention", on the negative impact methamphetamine has on its users and the community overall that was used as a teaching tool at the local and surrounding high schools. - The Medical Center's Senior Life program for adults over age 60 assisted many seniors with Medicare Part D through its indigent pharmacy program and with ongoing wellness programs and workshops throughout the year for its 1,200 members. - The Medical Center matches employee donations dollar for dollar to the United Way to improve the breadth of services provided by the United Way agencies. - The Medical Center associates are involved with a number of local organizations, including the Northwest Children's Home, Consumer Credit Counseling, Lewiston School District and Regional Health Care Planning Group among others to stay current on issues and challenges faced in the community. - The Social Services and Pastoral Care divisions of the Medical Center provides many support groups, including Cancer, Parkinson's, "Friends Reach Out" (grief support group), and SHARE (for families who have lost babies). - Provided over 781 nights of free housing at the Carondelet House to patients and families from out of town to stay at during treatments or hospital admissions. - The Medical Center made available free Child Birth class scholarships to all expecting parents, Car Seat training and distribution, Parenting for Life classes, and supplies to the Pregnancy Counseling Center. - Worked with the United Way to create and print an updated Community Wide Needs Assessment for the Lewis Clark Valley to included Health, Emergency Services, Education and other social services. - Provided the Federally Quality Health Center, Lewis - Clark Health Clinic, a member of the Community Health Association of Spokane, a rent-free space to see primary care patients. Patient and Associate Education: The Medical Center believes that, in order to provide the best health care to the community, its personnel must receive ongoing medical education. Educational resources are provided in-house, and externally, to insure that both clinical and non-clinical personnel maintain up-to-date education related to their area of responsibility. Through the Medical Center's educational tuition reimbursement program available to all employees, incentives are provided to upgrade the staff's knowledge base, encourage continued professional development and training, and offer potential advancement opportunities. In addition to educating its own staff, the Medical Center also facilitates and funds education programs for other health care providers in the region. The Hospital Satellite Network, an educational service subscribed to by the Medical Center, is available throughout the area. Funding is provided for additional faculty at Lewis Clark State College in the nursing and radiographic technology programs to increase the number of students in these fields (where there is current shortages). Carondelet scholarships are provided for books and tuition to local students to assist them in attaining their educational objectives; in return these scholars have agreed to provide service to the Medical Center's patients upon graduation from their respective programs. THE SJRMC Auxiliary awards four $1,500 scholarships each year to students in the Nursing programs at neighboring Lewis-Clark State College and Walla Walla Community College. Both in-house and throughout the community and region, the Medical Center strives to supply educational opportunities at all levels. From students, to employees and area healthcare providers the Medical Center continues to be a strong supporter of medical education. Expanding Awareness, Education and Health Promotion Offerings at the Medical Center: General Areas of Emphasis for all Associates: - Emergency Management - Hand washing - Hazardous Materials/Waste Training - HIPAA Education - Infection Control - Moderate Conscious Deep Sedation - Limited English Proficiency - Loss and Grief In-service - P.I.E.S Customer Service Program - Patient Experience Commitment - 100% - Safety and Environment of Care - Up-to-Date Online Medical Reference Library General Areas of Emphasis for Patient Care Services: - 2009 Rural Mental Health Symposium - Abuse, Neglect, Abandonment & Domestic Violence - Advanced Oral Care - Associate Mentoring Program - Blood Bank Procedures - BLS CPR Provider Training - BLS CPR Instructor Training - Charge Nurse Program - Dennis De Simone - Code 11 Security - Code 4 Practice Sessions - Complicated Bereavement - Crisis Prevention Intervention Training and Updates - Diversity Lunch & Learn - E.A.S.Y. Assessment: Department Specific Education - Cardiac - Endocrine - Fluid & Electrolytes - Neurological - Respiratory - Vascular Miscellaneous Newsletter Resources: - Nurse Advise - ERR Newsletter - Pharmacy & Therapeutics Newsletter Specific Offerings in Ascension Health Corporate Compliance: - Corporate Responsibility Program Annual/Ongoing Compliance Training-via Mandatory Updates - Corporate Responsibility Program Specialized Training - Corporate Responsibility Program Training for New Employees at General Orientation - HIPAA & Confidentiality - Understanding Your Responsibility - National HIPAA Week Education/Train Specific Offerings in the Pediatric/Age Specific Category: - Easy Assessment: Pediatric and Newborn focused education - EFM Collaborative Training - EFM Strip Review/Common Fetal Monitoring - Emergency Nurse Pediatric Course - Genetic Evaluations - Newborn Resuscitation Program (Staff and Physicians) - Noelle Skills Lab - Noelle - Cardiac Arrest - Pediatric Advanced Life Support - Pediatric Advanced Life Support Instructor Training - Providence Sacred Heart Pediatric Grand Rounds - Pediatric Sleep - Sound Beginnings Specific Offerings in Ethics Presents: - Lunch & Learn Diversity - Ethical Issues Affecting the ED - Providing Care and Services - Ethics of Privacy Continuing Medical Education: - Tumor Case Review w/Gritman and Pullman Regional - Providence Sacred Heart Grand Rounds - National Corporate Compliance and Ethics Week Specific Offerings in Critical Care: - Advanced Cardiac Life Support - Advanced Cardiac Life Support Instructor Training - Arrhythmia Course - Code 4 Documentation Reviews - Code 4 Medication Reviews - Code 4 Team Leader Reviews - Course in Advanced Trauma Nurse - Critical Care Class & Skills Fair - ENPC - Rapid Response Team Training - Trauma Nurse Core Course Specific Offerings in Information Management: - Bedside Medication Verification Training - Clinical Documentation Training - Incidence command System Training - Micromedex/Carenotes Training - MSDS Computer System - Office Automation - Online Event Reporting Computer Training - Order Entry - Password/Confidentiality - Patient Care Inquiry Training - Physician and Departmental Specific Offerings in Medical Coding & Documentation: - 10 Hours of Required Ascension Health Coding via EDUCODE - Basic intro ICD-10-CM - Coding Clinic Update - Coding with ICD-10 & ICD-10-PCS - ICD-9-CM Updates for 2009 - Core Components of a solid Charge Master - FY CMS IPPS Update - Joint Replacement Coding - Ms-DRG List: a Clinical Review - RAC Healthport Training - Medicare Consultation Code changes in 2010 Specific Offerings in Management Development: - Patient Experience Commitment - 100% - Brenda McIntosh R.N., M.Ed. Controlling Unemployment Costs through Effective Documentation, Discipline and Discharge. - Deanna O'Toole, IHA, Vice President Human Resources & Employment Issues for Managers; Steve Berenter, Hawley, Troxell, Ennis & Hawley Joint Commission Satellite Network Teleconferences: - Infection Control: Reducing Risk, Improving Care - Disruptive Behavior; Impacting Quality and Patient Safety - Being prepared for the H1N1 Pandemic - Overview of 2010 NPSG - Using Performance Improvement Methodologies to Increase Compliance/ Measuring Outcomes - Facing the Challenge of the Joint Commission - Update: Joint Commission and CMS - Patient Records Management - Emergency Preparedness: Standards, Practices and Solutions - Survey Survival: What You Need to Know - Reducing the Risk; preventing Hospital Acquired Infections - Creating a Safe and Functional Environment of Care Equipment In-services: - Anatomy of a Ridge Scope - Aquamantys - Balloon Pump - Banking Bone and Camino Cart - Button Vaporization - Cleaning and Decontaminating Medical Devices - Crano Fix 2 - Elastic Nail & Clavical Plates - ETEX Bone Substitute - Entertan System - Graded compression Stockings - Jet X Bar - KUSA Inservice - Mastergaft Matrix - Natus Algo 5 Hearing Screener - Neoprobe - OBTRYX Sling - Scopes Care and Handling - Stryker Bone Mill - Versacare Bed - VLP Plates and Screws - Woundvac Expanding Awareness, Education and Health Promotion Offerings in the community: Diabetes Education, including Gestational Diabetes Classes: - Asotin School District staff presentation series on Type 1 Diabetes - Burrell Street Station presentation to the residents on Pre-Diabetes and basics of Type 2 Diabetes and prevention - City of Lewiston Health Fair attendance and distribution of free education materials and blood glucose testing - Asotin County School Health Nurse Type 1 Diabetes education - Clarkston Boys and Girls Club and Lewiston Boys and Girls Club presentations of basic diabetic information to bring awareness of World Diabetes Month in November - GO RED booth with diabetes facts, nutrition educational materials and free blood glucose testing - Highlander Apartment Complex presentation on Pre-Diabetes and basics of Type 2 Diabetes and prevention - Ladies Night Out attendance, free educational materials and free blood glucose testing - McSorely Elementary School, St. Stanislaus Tri-Parish School and Parkway Elementary School presentations to the students, teachers and staff on Type 1 Diabetes - Senior Health and Fitness Fair and Sterling Senior Health and Fitness Fair attendance, free educational materials, and blood glucose testing Wound/ Ostomy Education: - Ostomy Basics & Beyond - Choosing the Right Dressing - Skin Defense Team - Defend Skin Prevent Pressure Ulcers Pastoral Care Educational Offerings: - Community Workshops on Advanced Directives - Including participation in National Healthcare Decision Day - Holiday Grief Workshop for the Community - Quarterly Community Memorial Services - Assist community members with completion of advanced directives - Provide Funeral services when requested - Friends Reach Out - Grief Support Group for the Community every 2nd and 4th Monday - Host the Monthly Ministerial Meeting for area clergy - Christmas Brunch for area clergy - S.H.A.R.E. Support Group for parents/families who have lost babies - Hosted National Health Care Decision Day for the Community - Talk with staffs of the Skilled Nursing Facilities and Assisted Living Facilities about POST and Advanced Directives - Provide time to people from the community who walk in and need someone to talk to about grief issues - Send bereavement cards and information about grieving to families who have lost loved ones. - Relay for Life Prayer Service Critical Care Education Course Offerings: - Advanced Cardiac Life Support (ACLS) - Pediatric Advanced Life Support (PALS) - Course in Advanced Trauma Nursing (CATN) - Trauma Nurse Core Course (TNCC) - Emergency Nursing Pediatric Course (ENPC) - Critical Care Class - Arrhythmia Class "Your Doctor Speaks" series - "What To Do When Your Bootstraps Break: Coping with the Effects of Fear" by Mary Moller, DNP, ARNP, BC, CPRP - "Current Cutting-Edge Treatments" by Sandra Lotstein, D.O. - "Human Pappiloma Virus & Vaccine" by Kim Fisher, M.D. - "Partial Knee Replacements" by Bryan Beardsley, M.D. - "Gum Disease & Systemic Health/ Dental Implants" by Brad Morlock, D.D.S & Dan Wilson, D.D.S. - "Diabetes & the Eye" by Mark Eggleston, M.D. - "Sleep Apnea: New Developments, Diagnosis & Treatment" by Luke Pluto, M.D. Family Beginnings Community Education Course Offerings: - Lamaze - Preparation for Childbirth - Lamaze - Childbirth Seminar - Lamaze - Moms on the Go - Private Childbirth Class - Private Tours of Family Beginnings - Pre-Delivery Interview - ABC's of Parenting - Breastfeeding Basics - Natural Family Planning - New Mom's Group - Sibling Class - Safe Sitter Classes - Car Seat Safety Checks Community Health Education Resource Center: - American Heart Association Community Training Center - BLS First Aid and CPR Courses - ACLS, PALS & BLS Instructor Course - Community Wellness Education Series Presentations: - "Practical Nutrition - Improving Your Nutrition from the Ground Up" - "Obstructive Sleep Apnea Syndrome - Current Testing and Treatment" - National Healthcare Decision Day Event - National Heart Health Month - GO RED for Women's Health Open House Event - Ladies Night Out - Women's Connection Community Event - WA/Idaho Volunteer Senior Health & Fitness Fair - ATK/CCI - Speer Employee Health Fair - Clearwater Paper Corporation Employee Health Fair - City of Lewiston & Nez Perce County Employee Health Fair - National Breast Cancer Awareness Month - World Diabetes Day Awareness Event - "Tobacco Free You" Nicotine Intervention Program - Senior Life Program Summary: St. Joseph Regional Medical Center continues to serve as the only full service acute care hospital in the region. Improving the health status of the whole community, by providing essential medical services to all patients, including those who have an inability to pay for their healthcare needs, continues to be the goal and mission of St. Joseph's. The Community Health Resource and Education Center continues to help facilitate classes and training for associates, community members and patients in an effort to better meet the educational and informational needs in the community and surrounding area. By offering a broad selection of educational offerings and healthcare services, the Medical Center strives to better meet the healthcare needs of the patients and organizations in the service area. St. Joseph Regional Medical Center maintains its position as the regional leader in health education, community based programs, and providing healthcare services to all patients. Ascension Health PO Box 45998 St Louis MO 63145 311662309 National Health System MO Section 501(c)(3) Schedule A, Line 11a N/A 0 St Joseph Regional Medical Center Foundation Inc 415 Sixth Street Lewiston ID 83501 510168321 Fundraising ID Section 501(c)(3) Schedule A, Line 11a St Joseph Regional Medical Center 1 1 0 0 0 0 0 0 0 0 0 0 0 1 1 0 0 1 0 St Joseph Regional Medical Center Foundation Inc N 116465 Cost Ascension Health Q 3115333 Cost