ST ELIZABETHS HOSPITAL OF THE HOSPITAL SISTERS OF THE THIRD ORDE: Form 990, tax year 2010

View the entire original 990 at ProPublica ↗

Organization
ST ELIZABETHS HOSPITAL OF THE HOSPITAL SISTERS OF THE THIRD ORDE (EIN 37-0663567)
Tax period
2010-07-01 to 2011-06-30
Filed
2012-05-15
IRS object ID
201211369349301946
Schema version
2010v3.7
Source
Download XML · Original 990 at ProPublica

Every field in the e-filed return. Faint text is the IRS element name, for citing.

Return header ReturnHeader

FieldValueIRS element (for citing)
Timestamp2012-05-15T09:43:18-04:00Timestamp
Tax Period End Date2011-06-30TaxPeriodEndDate

Preparer Firm PreparerFirm

Preparer Firm Business Name PreparerFirmBusinessName

FieldValueIRS element (for citing)
Business Name Line1KPMG LLPBusinessNameLine1

Preparer Firm US Address PreparerFirmUSAddress

FieldValueIRS element (for citing)
Address Line1191 West Nationwide Blvd Ste 500AddressLine1
CityColumbusCity
StateOHState
ZIP Code432152568ZIPCode
FieldValueIRS element (for citing)
Return Type990ReturnType
Tax Period Begin Date2010-07-01TaxPeriodBeginDate

Filer Filer

FieldValueIRS element (for citing)
EIN370663567EIN

Name Name

FieldValueIRS element (for citing)
Business Name Line1ST ELIZABETH'S HOSPITALBusinessNameLine1
Business Name Line2OF THE THIRD ORDER OF ST FRANCISBusinessNameLine2
FieldValueIRS element (for citing)
Name ControlSTELNameControl
Phone6182342120Phone

US Address USAddress

FieldValueIRS element (for citing)
Address Line1211 SOUTH THIRD STREETAddressLine1
CityBELLEVILLECity
StateILState
ZIP Code622201998ZIPCode

Officer Officer

FieldValueIRS element (for citing)
NameLeslie EckertName
TitleChief Financial OfficerTitle
Phone6182342120Phone
Date Signed2012-05-08DateSigned
Authorize Third PartytrueAuthorizeThirdParty

Preparer Preparer

FieldValueIRS element (for citing)
NameKPMG LLPName
Phone6142492300Phone
FieldValueIRS element (for citing)
Tax Year2010TaxYear
Build TS2016-02-24 21:20:13ZBuildTS

Form 990 IRS990

FieldValueIRS element (for citing)
Name Of Principal Officer PersonMaryann ReeseNameOfPrincipalOfficerPerson

Address Principal Officer US AddressPrincipalOfficerUS

FieldValueIRS element (for citing)
Address Line1211 South Third StreetAddressLine1
CityBellevilleCity
StateILState
ZIP Code622201998ZIPCode
FieldValueIRS element (for citing)
Gross Receipts179323035GrossReceipts
Group Return For AffiliatesfalseGroupReturnForAffiliates
Group Exemption Number0928GroupExemptionNumber
Organization501c3XOrganization501c3
Web Sitewww.steliz.orgWebSite
Type Of Organization CorporationXTypeOfOrganizationCorporation
Year Formation1875YearFormation
State Legal DomicileILStateLegalDomicile
Activity Or Mission DescriptionTo MINISTER TO THOSE IN NEED OF HEALTHCARE IN RESPONSE TO GOD'S CALL TO SERVE EACH OTHER, ESPECIALLY THE POOR. IN THE PERFORMANCE OF ITS MISSION, ST. ELIZABETH'S WILL FOSTER RESPECT, CARE, COMPETENCE AND JOYActivityOrMissionDescription
Nbr Voting Members Governing Body9NbrVotingMembersGoverningBody
Nbr Independent Voting Members5NbrIndependentVotingMembers
Total Nbr Employees1948TotalNbrEmployees
Total Nbr Volunteers140TotalNbrVolunteers
Total Gross UBI20071TotalGrossUBI
Net Unrelated Business Txbl Income1605NetUnrelatedBusinessTxblIncome
Contributions Grants Prior Year1021881ContributionsGrantsPriorYear
Contributions Grants Current Year366018ContributionsGrantsCurrentYear
Program Service Revenue Prior Year185756413ProgramServiceRevenuePriorYear
Program Service Revenue CY173382447ProgramServiceRevenueCY
Investment Income Prior Year720531InvestmentIncomePriorYear
Investment Income Current Year2249698InvestmentIncomeCurrentYear
Other Revenue Prior Year1394232OtherRevenuePriorYear
Other Revenue Current Year1057936OtherRevenueCurrentYear
Total Revenue Prior Year188893057TotalRevenuePriorYear
Total Revenue Current Year177056099TotalRevenueCurrentYear
Grants And Similar Amnts Prior Year5000GrantsAndSimilarAmntsPriorYear
Grants And Similar Amnts CY0GrantsAndSimilarAmntsCY
Benefits Paid To Members Prior Year0BenefitsPaidToMembersPriorYear
Benefits Paid To Members CY0BenefitsPaidToMembersCY
Salaries Etc Prior Year84036055SalariesEtcPriorYear
Salaries Etc Current Year81215417SalariesEtcCurrentYear
Total Prof Fundrsng Exp Prior Year0TotalProfFundrsngExpPriorYear
Total Prof Fundrsng Exp CY0TotalProfFundrsngExpCY
Total Fundrsng Exp Current Year0TotalFundrsngExpCurrentYear
Other Expense Prior Year119121615OtherExpensePriorYear
Other Expenses Current Year118902735OtherExpensesCurrentYear
Total Expenses Prior Year203162670TotalExpensesPriorYear
Total Expenses Current Year200118152TotalExpensesCurrentYear
Revenues Less Expenses Prior Year-14269613RevenuesLessExpensesPriorYear
Revenues Less Expenses CY-23062053RevenuesLessExpensesCY
Total Assets BOY168039041TotalAssetsBOY
Total Assets EOY127988273TotalAssetsEOY
Total Liabilities BOY121623727TotalLiabilitiesBOY
Total Liabilities EOY96905178TotalLiabilitiesEOY
Net Assets Or Fund Balances BOY46415314NetAssetsOrFundBalancesBOY
Net Assets Or Fund Balances EOY31083095NetAssetsOrFundBalancesEOY
Info In Schedule O Part IIIXInfoInScheduleOPartIII
Mission DescriptionSEE SCHEDULE O.MissionDescription
Significant New Program ServicesfalseSignificantNewProgramServices
Significant ChangefalseSignificantChange
Expense24032679Expense
Grants0Grants
Revenue23583543Revenue
DescriptionCardiac Services - see schedule ODescription

Activity2 Activity2

FieldValueIRS element (for citing)
Expense10339275Expense
Grants0Grants
Revenue9286931Revenue
Descriptionorthopedic servicse - see schedule oDescription

Activity3 Activity3

FieldValueIRS element (for citing)
Expense10099274Expense
Grants0Grants
Revenue9802010Revenue
Descriptionrehabilitation services - see schedule oDescription
FieldValueIRS element (for citing)
Total Of Other Program Service Exp122813758TotalOfOtherProgramServiceExp
Total Of Other Program Service Grnt0TotalOfOtherProgramServiceGrnt
Total Of Other Program Service Rev130709963TotalOfOtherProgramServiceRev
Total Program Service Expense167284986TotalProgramServiceExpense
Described In501 C3trueDescribedIn501C3
Schedule B RequiredtrueScheduleBRequired
Political ActivitiesfalsePoliticalActivities
Lobbying ActivitiestrueLobbyingActivities
Subject To Proxy TaxfalseSubjectToProxyTax
Donor Advised FundsfalseDonorAdvisedFunds
Conservation EasementsfalseConservationEasements
Collections Of ArtfalseCollectionsOfArt
Credit CounselingfalseCreditCounseling
Term Or Permanent EndowmentsfalseTermOrPermanentEndowments
Report Land Bldg EquiptrueReportLandBldgEquip
Report Invest Oth SecuritiesfalseReportInvestOthSecurities
Report Prog Rel InvestfalseReportProgRelInvest
Report Other AssetsfalseReportOtherAssets
Report Other LiabilitiestrueReportOtherLiabilities
Report Fin48 FootnotetrueReportFin48Footnote
Independent Audit Financial StmtfalseIndependentAuditFinancialStmt
Consolidated Audit Financial StmttrueConsolidatedAuditFinancialStmt
SchoolfalseSchool
Foreign OfficefalseForeignOffice
Foreign ActivitiesfalseForeignActivities
More Than5000 K To OrganizationsfalseMoreThan5000KToOrganizations
More Than5000 K To IndividualsfalseMoreThan5000KToIndividuals
Professional FundraisingfalseProfessionalFundraising
Fundraising ActivitiesfalseFundraisingActivities
GamingfalseGaming
HospitaltrueHospital
Financial Stmt AttachedtrueFinancialStmtAttached
Grants To OrganizationsfalseGrantsToOrganizations
Grants To IndividualsfalseGrantsToIndividuals
Schedule J RequiredtrueScheduleJRequired
Tax Exempt BondsfalseTaxExemptBonds
Excess Benefit TransactionfalseExcessBenefitTransaction
Prior Excess Benefit TransactionfalsePriorExcessBenefitTransaction
Loan To Officer Or DQPfalseLoanToOfficerOrDQP
Grant To Related PersonfalseGrantToRelatedPerson
Bsnss Rltnshp With OrganizationtrueBsnssRltnshpWithOrganization
Bsnss Rltnshp Thru Family MemberfalseBsnssRltnshpThruFamilyMember
Officer Entity With Bsnss RltnshpfalseOfficerEntityWithBsnssRltnshp
Deductible Non Cash ContributionsfalseDeductibleNonCashContributions
Deductible Contributions Of ArtfalseDeductibleContributionsOfArt
TerminatedfalseTerminated
Partial LiquidationfalsePartialLiquidation
Disregarded EntitytrueDisregardedEntity
Related EntitytrueRelatedEntity
Related Org Controlled EntityfalseRelatedOrgControlledEntity
Transaction Related EntityfalseTransactionRelatedEntity
Transfers To Exempt Non Chrtbl OrgfalseTransfersToExemptNonChrtblOrg
Activities Conducted PartnershipfalseActivitiesConductedPartnership
Schedule O RequiredtrueScheduleORequired
Number Forms Transmitted With1096218NumberFormsTransmittedWith1096
Number W2 G Included0NumberW2GIncluded
Number Of Employees1948NumberOfEmployees
Employment Tax Returns FiledtrueEmploymentTaxReturnsFiled
Unrelated Business IncometrueUnrelatedBusinessIncome
Form990-T FiledtrueForm990-TFiled
Foreign Financial AccountfalseForeignFinancialAccount
Prohibited Tax Shelter TransfalseProhibitedTaxShelterTrans
Taxable Party NotificationfalseTaxablePartyNotification
Non Deductible ContributionsfalseNonDeductibleContributions
Quid Pro Quo ContributionsfalseQuidProQuoContributions
Form8282 Property Disposed OffalseForm8282PropertyDisposedOf
Funds To Pay PremiumsfalseFundsToPayPremiums
Premiums PaidfalsePremiumsPaid
Indoor Tanning ServicesfalseIndoorTanningServices
Info In Schedule O Part VIXInfoInScheduleOPartVI
Nbr Voting Governing Body Members9NbrVotingGoverningBodyMembers
Number Independent Voting Members5NumberIndependentVotingMembers
Family Or Business RelationshipfalseFamilyOrBusinessRelationship
Delegation Of Management DutiesfalseDelegationOfManagementDuties
Changes To Organizing DocsfalseChangesToOrganizingDocs
Material Diversion Or MisusefalseMaterialDiversionOrMisuse
Members Or StockholderstrueMembersOrStockholders
Election Of Board MemberstrueElectionOfBoardMembers
Decisions Subject To ApprovaltrueDecisionsSubjectToApproval
Minutes Of Governing BodytrueMinutesOfGoverningBody
Minutes Of CommitteestrueMinutesOfCommittees
Officer Mailing AddressfalseOfficerMailingAddress
Local ChaptersfalseLocalChapters
Form990 Provided To Governing BodytrueForm990ProvidedToGoverningBody
Conflict Of Interest PolicytrueConflictOfInterestPolicy
Annual Disclosure Covered PersonstrueAnnualDisclosureCoveredPersons
Regular Monitoring EnforcementtrueRegularMonitoringEnforcement
Whistleblower PolicytrueWhistleblowerPolicy
Document Retention PolicytrueDocumentRetentionPolicy
Compensation Process CEOtrueCompensationProcessCEO
Compensation Process OthertrueCompensationProcessOther
Investment In Joint VenturefalseInvestmentInJointVenture
Upon RequestXUponRequest

The Books Are In Care Of TheBooksAreInCareOf

FieldValueIRS element (for citing)
Name PersonLeslie EckertNamePerson
Telephone Number6182342120TelephoneNumber

Address US AddressUS

FieldValueIRS element (for citing)
Address Line1211 SOUTH THIRDAddressLine1
CityBELLEVILLECity
StateILState
ZIP Code622201998ZIPCode
FieldValueIRS element (for citing)
Info In Schedule O Part VIIXInfoInScheduleOPartVII

Form990 Part VII Section A Form990PartVIISectionA (29 entries)

TitleTitleAverage Hours Per WeekAverageHoursPerWeekIndividual Trustee Or DirectorIndividualTrusteeOrDirectorReportable Comp From OrganizationReportableCompFromOrganizationReportable Comp From Related OrgsReportableCompFromRelatedOrgsOther CompensationOtherCompensationOfficerOfficerKey EmployeeKeyEmployeeHighest Compensated EmployeeHighestCompensatedEmployeeFormerFormer
Steven C Wolf
Board Member1.0X000
Thomas M Egan
Board Secretary1.0X000X
William S Lyke
Board Chairperson1.0X000X
Sister Marybeth Culnan OSF
Board Member1.0X000
Dennis E Bielke
Board Vice Chairperson1.0X000X
Anwar A Khan MD
Board Member1.0X4274900
Kevin Pesko
Board Member1.0X000
Linda A Camp MD
Board Member1.0X05350340
Rev James E Deiters
Board Member1.0X000
Maryann L Reese RN
President & CEO70.0X000X
Sister Janice Schneider OSF
Board Member1.0X000
Sister Gertrude O'Connor OSF
Board Member1.0X000
Johnny E Watkins
Division CFO35.0236604040164X
Ann Carr
Treasurer0.250191336109542X
Leslie Eckert
Chief Financial Officer70.0127080019793X
Mark Reifsteck
Division CEO52.50417093161140X
Salil K Gupta
Chief Medical Officer70.0474639052376X
Robert S Miller
Chief Operating Officer70.0195895083286X
Illa J David
Division CIO52.5140957013888X
Alice Chatley
Chief Nursing Officer70.0175343030289X
Edward Jacquin
Asst Admin-Support Svcs70.0140569025858X
Shelley Harris
Chief Nursing Officer70.081535046908X
Terrence Wade MD
Chief Medical Officer70.0000X
James Rushford
Physician70.0602093046310X
Donald Johnston
Physician70.0576682040068X
David Haymes
Physician70.0447269036282X
Christopher Arett
Physician70.0289255012663X
James Burke
Division VP of Legal Services52.5174982034530X
Kevin Shrake
Former CEO0.0034868574999X
FieldValueIRS element (for citing)
Total Reportable Comp From Org3705652TotalReportableCompFromOrg
Total Reportable Comp Frm Rltd Orgs1492148TotalReportableCompFrmRltdOrgs
Total Other Compensation828096TotalOtherCompensation
Number Individuals GT100 K34NumberIndividualsGT100K
Formers ListedtrueFormersListed
Total Comp GT150 KtrueTotalCompGT150K
Compensation From Other SourcesfalseCompensationFromOtherSources

Contractor Compensation ContractorCompensation (5 entries)

Address Line1AddressOfContractor/AddressUS/AddressLine1CityAddressOfContractor/AddressUS/CityStateAddressOfContractor/AddressUS/StateZIP CodeAddressOfContractor/AddressUS/ZIPCodeDescription Of ServicesDescriptionOfServicesCompensationCompensation
ERLINGER CONSTRUCTION CO
2502 S Belt WestBELLEVILLEIL62226construction4616554
PROFESSIONAL THERAPY SVC INC
2810 Frank Scott Pkwy West Suite 8BELLEVILLEIL62223therapist staffing3675133
SODEXO OPERATIONS LLC
4880 Payshere CircleCHICAGOIL60674food service1979904
SLU CARE
1402 S Grand BlvdST LOUISMO63104physician services1285818
SOUTHERN IL CARDIOVASCULAR
211 S ThirdBELLEVILLEIL62220cardiovascular svcs642000
FieldValueIRS element (for citing)
Number Of Contractors GT100 K35NumberOfContractorsGT100K
Related Organizations366018RelatedOrganizations
Total Contributions366018TotalContributions

Program Service Revenue ProgramServiceRevenue (4 entries)

DescriptionDescriptionBusiness CodeBusinessCodeTotal Revenue ColumnTotalRevenueColumnRelated Or Exempt Function IncomeRelatedOrExemptFunctionIncome
NET PATIENT REVENUE900000171185016171185016
PHARMACY446110752184752184
HEALTH PROGRAMS9000002915529155
ONCOLOGY CENTER INCOME90000014160921416092
FieldValueIRS element (for citing)
Total Program Service Revenue173382447TotalProgramServiceRevenue

Investment Income InvestmentIncome

FieldValueIRS element (for citing)
Total Revenue Column2250096TotalRevenueColumn
Exclusion$2,250,096ExclusionAmount

Income From Invest Bond Proceeds IncomeFromInvestBondProceeds

FieldValueIRS element (for citing)
Total Revenue Column0TotalRevenueColumn

Royalties Revenue RoyaltiesRevenue

FieldValueIRS element (for citing)
Total Revenue Column0TotalRevenueColumn

Gross Rents GrossRents

FieldValueIRS element (for citing)
Real1340515Real

Less Rental Expenses LessRentalExpenses

FieldValueIRS element (for citing)
Real2200388Real

Rental Income Or Loss RentalIncomeOrLoss

FieldValueIRS element (for citing)
Real-859873Real

Net Rental Income Or Loss NetRentalIncomeOrLoss

FieldValueIRS element (for citing)
Total Revenue Column-859873TotalRevenueColumn
Exclusion-$859,873ExclusionAmount

Gross Amount Sales Assets GrossAmountSalesAssets

FieldValueIRS element (for citing)
Other66150Other

Less Cost Oth Basis Sales Expenses LessCostOthBasisSalesExpenses

FieldValueIRS element (for citing)
Other66548Other

Gain Or Loss GainOrLoss

FieldValueIRS element (for citing)
Other-398Other

Net Gain Or Loss Investments NetGainOrLossInvestments

FieldValueIRS element (for citing)
Total Revenue Column-398TotalRevenueColumn
Exclusion-$398ExclusionAmount

Net Income From Fundraising Events NetIncomeFromFundraisingEvents

FieldValueIRS element (for citing)
Total Revenue Column0TotalRevenueColumn

Net Income From Gaming NetIncomeFromGaming

FieldValueIRS element (for citing)
Total Revenue Column0TotalRevenueColumn

Net Income Or Loss NetIncomeOrLoss

FieldValueIRS element (for citing)
Total Revenue Column0TotalRevenueColumn

Other Revenue Misc OtherRevenueMisc (3 entries)

DescriptionDescriptionTotal Revenue ColumnTotalRevenueColumnExclusionExclusionAmountBusiness CodeBusinessCode
PURCHASE DISCOUNTS512405$512,405
CAFETERIA SALES484909$484,909722210
ADMINISTRATION INCOME459794$459,794

Miscellaneous Revenue MiscellaneousRevenue

FieldValueIRS element (for citing)
Total Revenue Column460701TotalRevenueColumn
Unrelated Business Revenue20071UnrelatedBusinessRevenue
Exclusion$440,630ExclusionAmount
FieldValueIRS element (for citing)
Total Other Revenue1917809TotalOtherRevenue

Total Revenue TotalRevenue

FieldValueIRS element (for citing)
Total Revenue Column177056099TotalRevenueColumn
Related Or Exempt Function Income173382447RelatedOrExemptFunctionIncome
Unrelated Business Revenue20071UnrelatedBusinessRevenue
Exclusion$3,287,563ExclusionAmount

Grants To Domestic Orgs GrantsToDomesticOrgs

FieldValueIRS element (for citing)
Total0Total

Grants To Domestic Individuals GrantsToDomesticIndividuals

FieldValueIRS element (for citing)
Total0Total
Program Services0ProgramServices

Foreign Grants ForeignGrants

FieldValueIRS element (for citing)
Total0Total

Benefits To Members BenefitsToMembers

FieldValueIRS element (for citing)
Total0Total

Comp Current Officers Directors CompCurrentOfficersDirectors

FieldValueIRS element (for citing)
Total1247544Total
Program Services527301ProgramServices
Management And General720243ManagementAndGeneral

Comp Disqual Persons CompDisqualPersons

FieldValueIRS element (for citing)
Total0Total

Other Salaries And Wages OtherSalariesAndWages

FieldValueIRS element (for citing)
Total58750189Total
Program Services50726399ProgramServices
Management And General8023790ManagementAndGeneral

Pension Plan Contributions PensionPlanContributions

FieldValueIRS element (for citing)
Total4420734Total
Program Services3776459ProgramServices
Management And General644275ManagementAndGeneral

Other Employee Benefits OtherEmployeeBenefits

FieldValueIRS element (for citing)
Total12546117Total
Program Services10098139ProgramServices
Management And General2447978ManagementAndGeneral

Payroll Taxes PayrollTaxes

FieldValueIRS element (for citing)
Total4250833Total
Program Services3631487ProgramServices
Management And General619346ManagementAndGeneral

Fees For Services Management FeesForServicesManagement

FieldValueIRS element (for citing)
Total3051402Total
Management And General3051402ManagementAndGeneral

Fees For Services Legal FeesForServicesLegal

FieldValueIRS element (for citing)
Total1410890Total
Management And General1410890ManagementAndGeneral

Fees For Services Accounting FeesForServicesAccounting

FieldValueIRS element (for citing)
Total0Total

Fees For Services Lobbying FeesForServicesLobbying

FieldValueIRS element (for citing)
Total0Total

Fees For Services Prof Fundraising FeesForServicesProfFundraising

FieldValueIRS element (for citing)
Total0Total

Fees For Services Invst Mgmnt Fees FeesForServicesInvstMgmntFees

FieldValueIRS element (for citing)
Total0Total

Fees For Services Other FeesForServicesOther

FieldValueIRS element (for citing)
Total26879397Total
Program Services21400084ProgramServices
Management And General5479313ManagementAndGeneral

Advertising Advertising

FieldValueIRS element (for citing)
Total177561Total
Program Services122384ProgramServices
Management And General55177ManagementAndGeneral

Office Expenses OfficeExpenses

FieldValueIRS element (for citing)
Total1845519Total
Program Services1431934ProgramServices
Management And General413585ManagementAndGeneral

Information Technology InformationTechnology

FieldValueIRS element (for citing)
Total7337437Total
Program Services71339ProgramServices
Management And General7266098ManagementAndGeneral

Royalties Royalties

FieldValueIRS element (for citing)
Total0Total

Occupancy Occupancy

FieldValueIRS element (for citing)
Total4440631Total
Program Services3864889ProgramServices
Management And General575742ManagementAndGeneral

Travel Travel

FieldValueIRS element (for citing)
Total112794Total
Program Services73499ProgramServices
Management And General39295ManagementAndGeneral

Travel Entrtnmnt Public Officials TravelEntrtnmntPublicOfficials

FieldValueIRS element (for citing)
Total0Total

Conferences Meetings ConferencesMeetings

FieldValueIRS element (for citing)
Total100558Total
Program Services52099ProgramServices
Management And General48459ManagementAndGeneral

Interest Interest

FieldValueIRS element (for citing)
Total192167Total
Management And General192167ManagementAndGeneral

Payments To Affiliates PaymentsToAffiliates

FieldValueIRS element (for citing)
Total0Total

Depreciation Depletion DepreciationDepletion

FieldValueIRS element (for citing)
Total9313369Total
Program Services8919752ProgramServices
Management And General393617ManagementAndGeneral

Insurance Insurance

FieldValueIRS element (for citing)
Total3372139Total
Program Services2731433ProgramServices
Management And General640706ManagementAndGeneral

Other Expenses OtherExpenses (5 entries)

DescriptionDescriptionTotalTotalProgram ServicesProgramServicesManagement And GeneralManagementAndGeneral
PROVISION FOR BAD DEBTS2429678524296785
MEDICAL SUPPLIES2386336523863365
LICENSE AND TAXES6831922681441217510
MAINTENANCE & REPAIRS52481224769258478864
DUES, BOOKS AND SUBSCRIPTIONS428677113968314709

Total Functional Expenses TotalFunctionalExpenses

FieldValueIRS element (for citing)
Total200118152Total
Program Services167284986ProgramServices
Management And General32833166ManagementAndGeneral
Fundraising0Fundraising

Savings And Temp Cash Investments SavingsAndTempCashInvestments

FieldValueIRS element (for citing)
BOY-1784789BOY
EOY-2050973EOY

Pledges And Grants Receivable PledgesAndGrantsReceivable

FieldValueIRS element (for citing)
BOY4913810BOY
EOY935530EOY

Accounts Receivable AccountsReceivable

FieldValueIRS element (for citing)
BOY25707708BOY
EOY23000542EOY

Other Notes Loans Receivable Net OtherNotesLoansReceivableNet

FieldValueIRS element (for citing)
BOY1706906BOY
EOY464693EOY

Inventories For Sale Or Use InventoriesForSaleOrUse

FieldValueIRS element (for citing)
BOY2700040BOY
EOY2400379EOY

Prepaid Expenses Deferred Charges PrepaidExpensesDeferredCharges

FieldValueIRS element (for citing)
BOY1684056BOY
EOY1490338EOY
FieldValueIRS element (for citing)
Land Buildings Equipment Basis201545359LandBuildingsEquipmentBasis
Land Bldg Equipment Accum Deprec137494118LandBldgEquipmentAccumDeprec

Land Buildings Equipment Basis Net LandBuildingsEquipmentBasisNet

FieldValueIRS element (for citing)
BOY61642026BOY
EOY64051241EOY

Investments Pub Traded Securities InvestmentsPubTradedSecurities

FieldValueIRS element (for citing)
BOY65888347BOY
EOY32839677EOY

Investments Program Related InvestmentsProgramRelated

FieldValueIRS element (for citing)
BOY4678593BOY
EOY4344685EOY

Intangible Assets IntangibleAssets

FieldValueIRS element (for citing)
BOY349631BOY
EOY0EOY

Other Assets Total OtherAssetsTotal

FieldValueIRS element (for citing)
BOY552713BOY
EOY512161EOY

Total Assets TotalAssets

FieldValueIRS element (for citing)
BOY168039041BOY
EOY127988273EOY

Accounts Payable Accrued Expenses AccountsPayableAccruedExpenses

FieldValueIRS element (for citing)
BOY15942972BOY
EOY14382276EOY

Deferred Revenue DeferredRevenue

FieldValueIRS element (for citing)
EOY2130EOY

Tax Exempt Bond Liabilities TaxExemptBondLiabilities

FieldValueIRS element (for citing)
BOY49888720BOY
EOY48367764EOY

Other Liabilities OtherLiabilities

FieldValueIRS element (for citing)
BOY55792035BOY
EOY34153008EOY

Total Liabilities TotalLiabilities

FieldValueIRS element (for citing)
BOY121623727BOY
EOY96905178EOY
FieldValueIRS element (for citing)
Follow SFAS117XFollowSFAS117

Unrestricted Net Assets UnrestrictedNetAssets

FieldValueIRS element (for citing)
BOY40981396BOY
EOY24892315EOY

Temporarily Restricted Net Assets TemporarilyRestrictedNetAssets

FieldValueIRS element (for citing)
BOY5423387BOY
EOY6146850EOY

Permanently Restricted Net Assets PermanentlyRestrictedNetAssets

FieldValueIRS element (for citing)
BOY10531BOY
EOY43930EOY

Total Net Assets Fund Balances TotalNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY46415314BOY
EOY31083095EOY

Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY168039041BOY
EOY127988273EOY
FieldValueIRS element (for citing)
Info In Schedule O Part XIXInfoInScheduleOPartXI
Reconcilation Revenue Expenses-23062053ReconcilationRevenueExpenses
Reconcilation Other Changes7729834ReconcilationOtherChanges
Info In Schedule O Part XIIXInfoInScheduleOPartXII
Method Of Accounting AccrualXMethodOfAccountingAccrual
Accountant Compile Or ReviewfalseAccountantCompileOrReview
FS AuditedtrueFSAudited
Audit CommitteetrueAuditCommittee
Financial Statement ConsolidatedXFinancialStatementConsolidated
Federal Grant Audit RequiredtrueFederalGrantAuditRequired
Federal Grant Audit PerformedtrueFederalGrantAuditPerformed

Schedule A IRS990ScheduleA

FieldValueIRS element (for citing)
Hospital170b1 AiiiXHospital170b1Aiii

Schedule B IRS990ScheduleB

Contributor Info ContributorInfo

FieldValueIRS element (for citing)
Contributor NumberRESTRICTEDContributorNumber

Contributor Name Business ContributorNameBusiness

FieldValueIRS element (for citing)
Business Name Line1RESTRICTEDBusinessNameLine1

Contributor Address US ContributorAddressUS

FieldValueIRS element (for citing)
Address Line1RESTRICTEDAddressLine1
Address Line2RESTRICTEDAddressLine2
CityRESTRICTEDCity
StateRESTRICTEDState
ZIP CodeRESTRICTEDZIPCode
FieldValueIRS element (for citing)
Aggregate ContributionsRESTRICTEDAggregateContributions

Schedule C IRS990ScheduleC

FieldValueIRS element (for citing)
Amt Of4955 Tax0AmtOf4955Tax
Amt Of4955 Tax On Managers0AmtOf4955TaxOnManagers
Org Belongs To Affiliated GroupXOrgBelongsToAffiliatedGroup
Total Grassroots LobbyingTotalGrassrootsLobbying
Total Direct LobbyingTotalDirectLobbying
Total Lobbying ExpendituresTotalLobbyingExpenditures
Other Exempt Purpose ExpendituresOtherExemptPurposeExpenditures
Total Exempt Purpose ExpendituresTotalExemptPurposeExpenditures
Lobbying NontaxableLobbyingNontaxableAmount
Grassroots NontaxableGrassrootsNontaxableAmount
Tot Lobbying Grassroot Minus Non TxTotLobbyingGrassrootMinusNonTx
Tot Lobby Expend Mns Lobbying NontxTotLobbyExpendMnsLobbyingNontx
VolunteersfalseVolunteers
Paid Staff Or ManagementfalsePaidStaffOrManagement
Media AdvertisementsfalseMediaAdvertisements
Mailings MembersfalseMailingsMembers
Publications Or BroadcastfalsePublicationsOrBroadcast
Grants Other OrganizationsfalseGrantsOtherOrganizations
Direct Contact LegislatorsfalseDirectContactLegislators
Rallies DemonstrationsfalseRalliesDemonstrations
Other ActivitiestrueOtherActivities
Other Activities$31,328OtherActivitiesAmount
Total Lobbying Expenditures IIB31328TotalLobbyingExpendituresIIB
Not Described In501c3falseNotDescribedIn501c3

Form990 Schedule C Part IV Form990ScheduleCPartIV

FieldValueIRS element (for citing)
IdentifierDESCRIPTION OF OTHER LOBBYING ACTIVITIESIdentifier
Return ReferenceSCHEDULE C, PART II-B, QUESTION 1IReturnReference
ExplanationST. ELIZABETH'S HOSPITAL ("THE HOSPITAL") IS A MEMBER OF THE CATHOLIC HEALTH ASSOCIATION ("CHA"), THE ILLINOIS HEALTH ASSOCIATION ("IHA"), THE NATIONAL ASSOCIATION FOR HOME CARE AND HOSPICE, AND THE AMERICAN HEALTH ASSOCIATION ("AHA"). AS A MEMBER OF THESE ORGANIZATIONS, THE HOSPITAL PAYS DUES, PART OF WHICH ARE ATTRIBUTABLE TO LOBBYING FEES PAID BY THE ORGANIZATIONS. THE AMOUNT LISTED ABOVE IS THE AMOUNT ATTRIBUTABLE TO THE HOSPITAL FROM ITS DUES PAID.Explanation

Schedule D IRS990ScheduleD

FieldValueIRS element (for citing)
Art Public Exhibition AmtsArtPublicExhibitionAmts
Held Works Of Art AmtsHeldWorksOfArtAmts

Land Land

FieldValueIRS element (for citing)
Investment Cost Or Other Basis0InvestmentCostOrOtherBasis
Other Cost Or Other Basis3630755OtherCostOrOtherBasis
Book Value3630755BookValue

Buildings Buildings

FieldValueIRS element (for citing)
Investment Cost Or Other Basis0InvestmentCostOrOtherBasis
Other Cost Or Other Basis106481652OtherCostOrOtherBasis
Depreciation74831073Depreciation
Book Value31650579BookValue

Leasehold Improvements LeaseholdImprovements

FieldValueIRS element (for citing)
Investment Cost Or Other Basis0InvestmentCostOrOtherBasis
Other Cost Or Other Basis359390OtherCostOrOtherBasis
Depreciation147081Depreciation
Book Value212309BookValue

Equipment Equipment

FieldValueIRS element (for citing)
Investment Cost Or Other Basis0InvestmentCostOrOtherBasis
Other Cost Or Other Basis73353841OtherCostOrOtherBasis
Depreciation57372197Depreciation
Book Value15981644BookValue

Other Land Buildings OtherLandBuildings

FieldValueIRS element (for citing)
Investment Cost Or Other Basis0InvestmentCostOrOtherBasis
Other Cost Or Other Basis17719721OtherCostOrOtherBasis
Depreciation5143767Depreciation
Book Value12575954BookValue
FieldValueIRS element (for citing)
Total Of Book Value Land Buildings64051241TotalOfBookValueLandBuildings
Federal Income Tax Liability0FederalIncomeTaxLiability

Other Liabilities OtherLiabilities (3 entries)

DescriptionDescriptionAmountAmount
ACCRUED BENEFIT LIABILITY$23,303,123
RETIREMENT OBLIGATION ASBESTOS$8,021,701
SELF INSURANCE COST$2,828,184
FieldValueIRS element (for citing)
Total Of Amounts34153008TotalOfAmounts

Form990 Schedule D Part XIV Form990ScheduleDPartXIV

FieldValueIRS element (for citing)
IdentifierASC SUBTOPIC 740-10Identifier
ExplanationON JULY 1, 2007, HSHS ADOPTED ASC SUBTOPIC 740-10, ACCOUNTING FOR UNCERTAINTY IN INCOME TAXES - AN INTERPRETATION OF FASB STATEMENT NO. 109. ASC SUBTOPIC 740-10 ADDRESSES THE DETERMINATION OF HOW TAX BENEFITS CLAIMED OR EXPECTED TO BE CLAIMED ON A TAX RETURN SHOULD BE RECORDED IN THE CONSOLIDATED FINANCIAL STATEMENTS. UNDER ASC SUBTOPIC 740-10, HSHS MUST RECOGNIZE THE TAX BENEFIT FROM AN UNCERTAIN TAX POSITION ONLY IF IT IS MORE LIKELY THAN NOT THAT THE TAX POSITION WILL BE SUSTAINED ON EXAMINATION BY THE TAXING AUTHORITIES, BASED ON THE TECHNICAL MERITS OF THE POSITION. THE TAX BENEFITS RECOGNIZED IN THE CONSOLIDATED FINANCIAL STATEMENTS FROM SUCH A POSITION ARE MEASURED BASED ON THE LARGEST BENEFIT THAT HAS A GREATER THAN 50% LIKELIHOOD OF BEING REALIZED UPON ULTIMATE SETTLEMENT. ASC SUBTOPIC 740-10 ALSO PROVIDES GUIDANCE ON DERECOGNITION, CLASSIFICATION, INTEREST, AND PENALTIES ON INCOME TAXES, ACCOUNTING IN INTERIM PERIODS AND REQUIRES INCREASED DISCLOSURES. AT THE DATE OF ADOPTION, AND AS OF JUNE 30, 2011 AND 2010, HSHS DOES NOT HAVE A LIABILITY FOR UNRECOGNIZED TAX BENEFITS.Explanation

Schedule H IRS990ScheduleH

FieldValueIRS element (for citing)
Charity Care PolicytrueCharityCarePolicy
Written PolicytrueWrittenPolicy
FPG Reference Free CaretrueFPGReferenceFreeCare
Pcent100XPcent100
FPG Reference Discounted CaretrueFPGReferenceDiscountedCare
Pcent200 DXPcent200D
Free Disc Care Medically IndigenttrueFreeDiscCareMedicallyIndigent
Amounts Budgeted For Charity CaretrueAmountsBudgetedForCharityCare
Expenses Exceeded BudgettrueExpensesExceededBudget
Unable To Provide CarefalseUnableToProvideCare
Annual Community Benefit ReporttrueAnnualCommunityBenefitReport
Report Publically AvailabletrueReportPublicallyAvailable

Charity Care At Cost CharityCareAtCost

FieldValueIRS element (for citing)
Total Community Benefit Expense4761952TotalCommunityBenefitExpense
Direct Offsetting Revenue0DirectOffsettingRevenue
Net Community Benefit Expense4761952NetCommunityBenefitExpense
Percent Of Total Expense0.02670PercentOfTotalExpense

Unreimbursed Medicaid UnreimbursedMedicaid

FieldValueIRS element (for citing)
Total Community Benefit Expense30466222TotalCommunityBenefitExpense
Direct Offsetting Revenue22782760DirectOffsettingRevenue
Net Community Benefit Expense7683462NetCommunityBenefitExpense
Percent Of Total Expense0.04320PercentOfTotalExpense

Unreimbursed Costs UnreimbursedCosts

FieldValueIRS element (for citing)
Total Community Benefit Expense0TotalCommunityBenefitExpense
Direct Offsetting Revenue0DirectOffsettingRevenue
Net Community Benefit Expense0NetCommunityBenefitExpense
Percent Of Total Expense0.00000PercentOfTotalExpense

Total Charity Care TotalCharityCare

FieldValueIRS element (for citing)
Total Community Benefit Expense35228174TotalCommunityBenefitExpense
Direct Offsetting Revenue22782760DirectOffsettingRevenue
Net Community Benefit Expense12445414NetCommunityBenefitExpense
Percent Of Total Expense0.06990PercentOfTotalExpense

Community Health Services CommunityHealthServices

FieldValueIRS element (for citing)
Persons Served7781PersonsServed
Total Community Benefit Expense59207TotalCommunityBenefitExpense
Direct Offsetting Revenue15614DirectOffsettingRevenue
Net Community Benefit Expense43593NetCommunityBenefitExpense
Percent Of Total Expense0.00020PercentOfTotalExpense

Health Professions Education HealthProfessionsEducation

FieldValueIRS element (for citing)
Total Community Benefit Expense0TotalCommunityBenefitExpense
Direct Offsetting Revenue0DirectOffsettingRevenue
Net Community Benefit Expense0NetCommunityBenefitExpense
Percent Of Total Expense0.00000PercentOfTotalExpense

Subsidized Health Services SubsidizedHealthServices

FieldValueIRS element (for citing)
Total Community Benefit Expense0TotalCommunityBenefitExpense
Direct Offsetting Revenue0DirectOffsettingRevenue
Net Community Benefit Expense0NetCommunityBenefitExpense
Percent Of Total Expense0.00000PercentOfTotalExpense

Research Research

FieldValueIRS element (for citing)
Total Community Benefit Expense1871320TotalCommunityBenefitExpense
Direct Offsetting Revenue465595DirectOffsettingRevenue
Net Community Benefit Expense1405725NetCommunityBenefitExpense
Percent Of Total Expense0.00790PercentOfTotalExpense

Cash And In Kind Contributions CashAndInKindContributions

FieldValueIRS element (for citing)
Persons Served831PersonsServed
Total Community Benefit Expense40832TotalCommunityBenefitExpense
Direct Offsetting Revenue0DirectOffsettingRevenue
Net Community Benefit Expense40832NetCommunityBenefitExpense
Percent Of Total Expense0.00020PercentOfTotalExpense

Total Other Benefits TotalOtherBenefits

FieldValueIRS element (for citing)
Persons Served8612PersonsServed
Total Community Benefit Expense1971359TotalCommunityBenefitExpense
Direct Offsetting Revenue481209DirectOffsettingRevenue
Net Community Benefit Expense1490150NetCommunityBenefitExpense
Percent Of Total Expense0.00830PercentOfTotalExpense

Total Community Benefits TotalCommunityBenefits

FieldValueIRS element (for citing)
Persons Served8612PersonsServed
Total Community Benefit Expense37199533TotalCommunityBenefitExpense
Direct Offsetting Revenue23263969DirectOffsettingRevenue
Net Community Benefit Expense13935564NetCommunityBenefitExpense
Percent Of Total Expense0.07820PercentOfTotalExpense

Community Support CommunitySupport

FieldValueIRS element (for citing)
Number Of Activities Or Programs7NumberOfActivitiesOrPrograms
Persons Served485PersonsServed
Total Community Building Expense4918TotalCommunityBuildingExpense
Net Community Building Expense4918NetCommunityBuildingExpense
Percent Of Total Expense0.00000PercentOfTotalExpense

Coalition Building CoalitionBuilding

FieldValueIRS element (for citing)
Number Of Activities Or Programs1NumberOfActivitiesOrPrograms
Persons Served362PersonsServed
Total Community Building Expense5792TotalCommunityBuildingExpense
Net Community Building Expense5792NetCommunityBuildingExpense
Percent Of Total Expense0.00000PercentOfTotalExpense

Workforce Development WorkforceDevelopment

FieldValueIRS element (for citing)
Number Of Activities Or Programs1NumberOfActivitiesOrPrograms
Persons Served185PersonsServed
Total Community Building Expense28777TotalCommunityBuildingExpense
Net Community Building Expense28777NetCommunityBuildingExpense
Percent Of Total Expense0.00020PercentOfTotalExpense

Total Total

FieldValueIRS element (for citing)
Number Of Activities Or Programs9NumberOfActivitiesOrPrograms
Persons Served1032PersonsServed
Total Community Building Expense39487TotalCommunityBuildingExpense
Net Community Building Expense39487NetCommunityBuildingExpense
Percent Of Total Expense0.00020PercentOfTotalExpense
FieldValueIRS element (for citing)
Bad Debt Expense ReportedtrueBadDebtExpenseReported
Bad Debt Expense$7,823,564BadDebtExpenseAmount
Amount Attributable To0AmountAttributableTo
Amount Reimbursed By Medicare65095686AmountReimbursedByMedicare
Cost Of Care Reimbursed By Medicare71734465CostOfCareReimbursedByMedicare
Medicare Surplus Or Shortfall-6638779MedicareSurplusOrShortfall

Costing Methodology Used CostingMethodologyUsed

FieldValueIRS element (for citing)
Cost To Charge RatioXCostToChargeRatio
FieldValueIRS element (for citing)
Written Debt Collection PolicytrueWrittenDebtCollectionPolicy
Provision For Charity CarefalseProvisionForCharityCare

Form990 Schedule H Part IV Form990ScheduleHPartIV (4 entries)

Description Ent Primary ActivityDescriptionEntPrimaryActivityOrganization Profit Or OwnershipOrganizationProfitOrOwnershipOfficers Etc Profit Or OwnershipOfficersEtcProfitOrOwnershipPhysicans Profit Or OwnershipPhysicansProfitOrOwnership
Mem & St Eliz's
HEALTHCARE0.500000.000000.00000
Healthcare svs
Southern Illinois
Facilitate cardiovascular svs0.500000.000000.00000
cardiovascular fac
FieldValueIRS element (for citing)
Number Of Hospital Facilities1NumberOfHospitalFacilities

Form990 Schedule H Part V Section A Form990ScheduleHPartVSectionA

FieldValueIRS element (for citing)
Facility Number1FacilityNumber

Name Name

FieldValueIRS element (for citing)
Business Name Line1St Elizabeth's Hospital - BellevilleBusinessNameLine1

Address Address

FieldValueIRS element (for citing)
Address Line1211 South Third StreetAddressLine1
CityBellevilleCity
StateILState
ZIP Code622201998ZIPCode
FieldValueIRS element (for citing)
Licensed HospitalXLicensedHospital

Form990 Schedule H Part V Section B Form990ScheduleHPartVSectionB

Hospital Facility Name HospitalFacilityName

FieldValueIRS element (for citing)
Business Name Line1St Elizabeth's Hospital - BellevilleBusinessNameLine1
FieldValueIRS element (for citing)
Hospital Facility Number1HospitalFacilityNumber

Form990 Schedule H Part VI Form990ScheduleHPartVI (15 entries)

IdentifierIdentifierExplanationExplanationReturn ReferenceReturnReference
Part I, Line 3cNOT APPLICABLE AS THE ORGANIZATION DOES FOLLOW FEDERAL POVERTY GUIDELINES TO DETERMINE ELIGIBILITY FOR PROVIDING CHARITY AND DISCOUNTED CARE TO LOW-INCOME UNINSURED AND UNDERINSURED INDIVIDUALS.
Part I, Line 6aThe hospital's community benefit report is available upon request. Please contact Tom Vernier at 618-641-5466.
Part I, Line 7gNot applicable as the hospital does not have any subsidized health services.
Part I, Line 7, column (F)The percent of charity care and certain other benefits at cost as a percent of total expense less bad debt is 7.83%. The amount of bad debt expense removed when calculating the percentages in Part I, Line 7, Column (F) was $24,296,785.
Part I, Line 7Charity care is calculated by determining the total amount from patient billing that is written off to charity care charge codes or allowances. This amount matches the number that is reported on our fiscal year ending 2011 audited financial statements. The total charity care dollar amount is then reduced to cost by applying the Hospital's cost to charge ratio. The cost to charge ratio used was derived by dividing the hospital's operating expenses minus bad debt by net patient service revenue less any non patient care activities.
Part IIAn important aspect of community building is representation at the table of community leaders. St. Elizabeth's Hospital has recognized this involvement and participation as two fold. First, it gives this hospital the opportunity to hear first hand the healthcare needs and challenges of this community as perceived by community leaders. Whether it regards the need for more physicians, or supporting an effort within the community and the education institutions of encouraging young people to consider a career in healthcare. These are the types of discussions that need to be heard and mutual support is necessary. Second, when a need is identified, this representation puts us in direct contact with those who have identified the need. This leads to opportunities to build collaboration, and helps strengthen the concept that healthy communities is not only a community need, but also an individual need. Hospitals can only be a part of such effort. Good health applies to all the residents in the village. St. Elizabeth's recognizes that as a healthcare leader, it has the resources, the knowledge, and support material which addresses these needs. Currently St. Elizabeth's Hospital has a member on the Belleville Chamber of Commerce and its subcommittee on healthcare in the greater Belleville area. We also have representation on the Board of Directors of the local YMCA, on two of the Hospice Organizations serving this community, on the Leadership Council of Southern Illinois, active participation with the St. Clair County Board of Commissioners on Pioneering Healthy Communities. The Belleville Diocese conducts meetings of all the healthcare agencies in this Diocese which serves 28 counties adjacent to Indiana, Kentucky, and Missouri. This coalition offers a forum for all the hospitals and Catholic Charities to identify healthcare needs and to share the activities of each agency. Although some of the Diocesan agencies concentrate on serving the poor in these extremely southern counties, many times those needs can be met through a cooperative effort among the participating agencies. In the past, St. Elizabeth's has offered educational programs, and provided informational material to areas where resources are limited. In the past year, St. Elizabeth's conducted two food drives to benefit local pantries and military families whose chief breadwinner was deployed. St. Elizabeth's has worked jointly with the St. Clair County and its Mental Health Board in designing and sponsoring an annual community conference. The conference has adopted the brand of Removing the Stigma from behavioral health. Behavioral health needs exist in all communities. Some of these needs can be met through treatment. Some of the needs are more in the way of education. This involves educating the public to the challenges of patients and family members dealing with a mental condition, understanding the importance of support and where that support can be found, and gaining insight into serving those with behavioral challenges. St. Elizabeth's has developed a strong working relationship with area colleges and some of the area high schools. One example of high school participation is the annual service program. This is a three-week experience where seniors in high school must choose a community service institution, and then volunteer full-time doing a variety of assignments in order to get an understanding of what that service does. This program is required for graduation. This is becoming more and more popular, as it is now being built into the curriculum for students in advanced classes. On the college level, St. Elizabeth's maintains over thirty college affiliation agreements. Interns from nursing, radiology, respiratory therapy, and physical therapy fulfill their required internship training. This training can be formal through classroom instruction or informal through simply observing medical care in the area of studies. There is no compensation associated with these affiliations. The learning experience is so critical to their process of becoming healthcare professionals. St. Elizabeth's has two in-house affiliations. Although the space for these programs is reimbursed, it is the value of all the resources that support these programs which are indirectly a contribution to the community. These students are already shouldering a full academic load. Having access to St. Elizabeth's for their internships certainly reduces their time and travel. The Respiratory Therapy program has a classroom and a lab training room in the hospital. Also on the campus of St. Elizabeth's is a General Practice Residency Program under the auspices of St. Louis University. This is a joint military/civilian residency program. There is an average of 42 residents in the program with half of them coming from the nearby Scott Air Force Base. Rated as one of the top medical residencies in the state of Illinois, this residency program has provided the training which has directly impacted the local area. Many of the graduates have elected to remain in the area, serving especially the rural communities surrounding Belleville. Improving access to healthcare is truly a benefit to any community when a physician chooses to establish a practice serving a rural community. St. Elizabeth's Hospital is in the downtown district. It is the oldest part of town. Within eight blocks of the hospital in all directions are elementary schools with exceptional needs. Managers from St. Elizabeth's give up their time monthly to visit a school. They each are assigned a student who may be experiencing a skills difficulty or is surviving in a dysfunctional environment. Having lunch with the students, listening to their reading or spelling assignment, or simply listening to their life trials is something that is very important to the students. This need is not always met by other factors in the students' lives. In fact, some true friendships have developed through this program, and their mentors have maintained that relationship outside of school hours by including a student on a trip to a local entertainment or attraction. Due to budget limitations, these students were lacking recess supplies. What good is a basketball standard if there is no ball? Those needs were brought to the management team at St. Elizabeth's and personal donations quickly filled that need. How can you measure the needs of mentoring, listening, and caring? These are needs every child has. The highlight of each year is when the mentors and students are introduced at a regular management huddle and they are treated to a grand tour of the hospital.
Part III, Line 4The hospital strongly believes that its charity care, and the related community benefit obtained from such care, is understated because of those patients that potentially qualify for charity care but do not wish to apply for it. In addition, some care is not classified as charity due to missing documentation on patient resources. Thus, the hospital's bad debt includes a portion that could be classified as charity care if application for such care was sought and/or completed. Currently, the hospital is implementing processes, procedures and systems to more effectively determine charity care that will reduce a patient's documentation requirements and ease the patient's emotional burden in applying for charity care. This will provide a more accurate reporting of charity care services provided by the hospital. During the year, the hospital's bad debt expense (at cost) was $7.8 million. We believe that approximately 10% of this amount is owed by individuals who may qualify for charity care.
Part III, Line 8The hospital continually strives to provide excellent patient care in the most cost effective fashion. Nonetheless, the Medicare program, in many cases, does not provide payment that covers the full cost of the care provided. Since it is the mission of the hospital to respond to community need, hospital management continually advocates for improved Medicare payment so that the cost of quality care to those patients that are not able to afford it is not compromised and is fairly subsidized by all payers. During the year, the hospital provided $6.6 million (at cost) in excess of Medicare payments. While this shortfall in Medicare payments is not classified as community benefit by the IRS, we nonetheless believe it is an important contribution made by the hospital to the health and well being of the community. Our mission calls us to serve all patients with the highest possible quality and efficiency, even if we are not paid fully for doing so.
Part III, Line 9bAny patient accounts that are sent to a collection agency have an opportunity to complete a financial application for Charity/Christian Care if the patient makes a request or if the collection agency feels the patient may meet criteria. If an account meets the qualifications for financial assistance, St. Elizabeth's will recall the account from bad debt, open the account back up on the hospital's books, and adjust the appropriate amount off to charity care.
Needs AssessmentSt. Elizabeth's Hospital - Belleville - established a formal Community Benefit Committee in January, 2009. This committee consists of interdisciplinary department representatives and community representatives. The Community Benefit Committee consists of seventeen members and meets bi-monthly to assess progress on the goals and targets established for each fiscal year. With a cross-section of community representatives along with hospital leadership, the Community Benefit Committee truly has the appropriate resources and access to relevant data and information to build, coordinate, and offer programs and education which meets the health needs of St. Clair County and the four adjacent counties in our service area. The Commission's focus this year has been developing the strategic assessment and implementation plan for the St. Clair County Health Department's IPLAN 2010 - 2015. St. Elizabeth's actively participated in the design and the assessment. As part of the assessment, a Quality of Life in St. Clair County survey was conducted. St. Elizabeth's served as the host for the community's open forum. The Community Benefit Committee members helped in the Quality of Life survey by completing that survey and making it available to colleagues and hospital visitors. The Quality of Life survey analyzed 1,500 responses to thirteen questions. The study was designed and orchestrated by the Southern Illinois University - Edwardsville, School of Nursing. DATA SOURCES AND FINDINGS: St. Elizabeth's Hospital determines community needs through a collaborative community process directed by the St. Clair County Healthcare Commission. The hospital then incorporates new data and area health assessments into each year's strategic planning process. This year the committee had the most recent demographic healthcare report from St. Louis Division of United Way, the latest study from the Illinois Behavioral Risk Factor Surveillance Report, and the assessment of local communities study produced by the Missouri Hospital Association in 2010. St. Elizabeth's Hospital is included in the metropolitan statistical area ("MSA") study. In addition, St. Elizabeth's used data generated by the University of Wisconsin County Health Rankings which was released in 2011. Information from the Center for Disease Control and Prevention was collected and shared by students at McKendree University as part of this report. Recent statistics and studies indicate there are many opportunities to improve the community's health in St. Clair County and surrounding counties of Madison, Monroe, Clinton, and Bond County. In health outcomes, St. Clair ranked 94th of 102 Illinois counties. In health risk factors, St. Clair ranked 100th among the same population of counties. Findings were not much better in the categories of mortality and morbidity; St. Clair County ranked 96th in mortality and 93rd in morbidity. These rankings coincide with the health behavior rankings where studies show St. Clair County is 101st of 102 counties. The major causes of death in St. Clair County have not seen any significant changes over the past two decades. The latest statistics from the Illinois Department of Public Health show that there were 25,979 deaths in Illinois in 2008 due to heart disease. Heart disease is followed by cancer and cerebrovascular diseases and chronic lower respiratory diseases. This data has some unique breakouts. Among the ages of 5-44, the leading causes of death are motor vehicle accidents and other accidents (total mortality figures for these age groups - 1,694) followed by malignant neoplasms, assault, intentional self-harm, and then diseases of the heart. For those 45 to 64 of age, the leading cause is malignant neoplasms (total mortality figures for this age group - 6,601) followed by heart and then accidents (motor vehicle and other). But again the largest cause of death in Illinois for those ages of 65 and older is disease of heart at 20,675 followed by malignant neoplasms at 16,834 and cerebrovascular diseases at 4,952. One further breakout of the local study is suicide. It is the third leading cause of death for persons aged 15-24 years in St. Clair County. This is becoming a serious concern of local health officials. All of the studies that the Community Benefit Committee reviews mirrors our internal records which show that in 2009, heart related (Diagnosis Related Groupings) DRGs were among the top twenty admitted to St. Elizabeth's. These included heart failure, cardiac arrhythmia, chest pain, and acute myocardial infarction. Of the top twenty total cases admitted to St. Elizabeth's Hospital in 2009, 642 were heart related, or 24% of patients admitted. This was followed by psychoses and various forms of respiratory conditions. A significant change of strategy has occurred with the development of the new 2010 IPLAN. In the past, focus by providers was the reduction of mortality but in an indirect manner. Much attention was devoted to educating the general public about health risks. The new focus is still on public health education but with a laser focus on specific populations and personal prevention. This new approach will be elaborated on later in this report. Blood pressure checks were made available whenever St. Elizabeth's participated in a health fair. A blood pressure check provides the patient a snapshot of their current status but frequently we did not pursue the many causes of this abnormality. Today, we continue to offer blood pressure checks, but spend more time in educating the participant on the contributing factors of high blood pressure. That shift in strategic action is truly in the prevention modality. If we can counsel an individual to choose a healthy diet, eliminate a habit of tobacco use, or direct them to activity centers, we can lower that hypertension, reduce long term healthcare costs and saving the government's reimbursement, and extend the quality life of the individual. As a leading provider in healthcare in this county, St. Elizabeth's has the expertise, resources, and credibility to sponsor community education programs such as lunch with a doctor. This approach underscores the role of St. Elizabeth's Hospital in increasing health care knowledge and ultimately improving the overall health of the communities we serve.
Patient Education of Eligibility for AssistanceAs unemployment rises, the number of uninsured patients coming to St. Elizabeth's likewise increases. According to the most recent Illinois Department of Employment Security, St. Clair County has a labor force of 124,858; 111,192 are employed; 13,666 are unemployed. A health insurance study (2009) showed that there were 30,287 adults uninsured. This is 13.5% of the total population in St. Clair County, an increase of 1.8% since 2005. This population puts additional stress on the emergency room resources and impacts our annual Charity Care totals. The number of emergency room visits for FY - 2011 exceeded the previous year's total by 115. Recognizing this influx, special efforts have been put in place to direct those patients unable to afford their care to other resources. Information about how to apply for Christian Assistance is included on the Patient Information Guide which is given to all patients admitted. It is also printed on the bills and monthly guarantor statements which are mailed to the patients. Self Pay (uninsured) inpatients, St. Elizabeth's has contracted with Accordis to assist the uninsured inpatients. Accordis representatives visit uninsured patients and discuss their possibility of applying for Medicaid coverage. Accordis will assist the patient with the application, follow up on requests from Medicaid, conduct home visits with the patient if needed, when they need to file an appeal, and assist with any other qualifying conditions required. If during a visit with a patient, it is determined they do not qualify for Medicaid, then the patient is provided one of St. Elizabeth's Charity (Christian Assistance) applications. Particular attention has been increased for those non-emergent patients seeking hospital care but are lacking the financial resources. These patients are assisted by financial counselors in completing the appropriate applications in order to qualify for care and receive assistance.
Community InformationHEALTH RISK FACTORS FOR ST. CLAIR COUNTY: When one looks at the raw statistics one must consider the health factors which are contributing to the leading causes of mortality and morbidity. Heart disease is preventable. Understanding and incorporating specific behaviors will reduce the incidence of high cholesterol, high blood pressure, diabetes, unhealthy eating habits, physical inactivity, obesity, extreme alcohol intake, use of tobacco products, not to mention one's family history. Use of tobacco products is a major health risk. In some aspects, St. Clair County has seen significant improvements in the reduction of tobacco use. Surveys of 2004-06 indicated that 20% of the adults surveyed were regular smokers. In the most recent survey of 2007-09, there was a 5% reduction in usage; 15% surveyed were regular smokers. Examining our own database of patients admitted, we are able to identify patients who are regular tobacco users. Each of these regular users are visited by a respiratory therapist to discuss and encourage smoking cessation. There is an average of 250 patient visits each month. As part of an information packet, the patient is given a list of local resources should the patient want to pursue cessation. The St. Clair County Health Department also has resources which are available at no cost and the hospital often directs patients to the health department. Obesity is a national health concern. Being obese or overweight is the second leading cause of preventable death in the United States and is measured by body mass index (BMI), a person's weight to height ration. Overweight is defined as having a BMI over 25 and obese is defines as having a BMI above 30. The most recent Premature Mortality Rates (<65 years of age) indicate that over 30% of St. Clair County Adults are considered overweight; slightly under 30% are considered obese. Studies have also found that for the past 13 years in St. Clair County, over 80% of adults have not been getting their recommended daily intake of fruits and vegetables. St. Elizabeth's provides nutritional counseling as part of our patient care plans. In addition, we offer outpatient guidance by registered dietitians for the community. During FY 2011, our dietitians conducted 4,108 nutritional assessments. It is estimated that 600 of those visits had a co-morbidity due to obesity or overweight according to national benchmarks. ST. CLAIR COUNTY DEMOGRAPHICS: Comparison of Select Demographic, Bio-statistical & Behavioral Data St. Clair Co Illinois based on the 2010 census Characteristic St. Clair County Illinois Total Population 270,056 12,910,409 % Male 47.8% % Female 52.2% Age Median Age 35 years Persons 18 years > 74.7% Persons 65 years > 12.6% Race % White 64.6% 79.0 % Black 30.5% 14.9 % Asian 1.2% 15.2 % Hispanic 3.3% Median Household Income $46,368 $53,974 Population Below Poverty 17.1% 13.3% Crude Coronary 2006 Mortality Rate/100,000 173.9 149.0 Premature Coronary 2006 Mortality Rate/100,000 42.6 34.2 % Adults Obese & Overweight 60.9 62.0 % Adults Not Meeting Physical Activity Standards 63.0 63.0 % Adults Eating <5 Fruits / Vegetables / day 83.6 75.0 According to the 2009 estimates of the Social Impact Research Center, the demographic make-up of St. Clair County is 64.6% white, 30.5% black and 7% other. The poverty rate for St. Clair County increased to 17% from 39,468 in 2008 to 44,516 in 2009. This is not statistically significant until one compares the most recent numbers with those of 1999 which was 36,468. The number of people in extreme poverty increased from 16,779 in 2008 to 18,611 in 2009. What is just as alarming is the number of children in poverty which rose again in 2009 to 17,088. The current unemployment rate is 9.7%. All of these social and economic factors have an impact on the health of St. Clair County. A comparison of 2000 to 2007 data of premature deaths under the age of 65 years for Illinois and St. Clair County residents show mortality rates (per 100,000 population) with calculated percent differences that are significantly higher for residents of St. Clair County than their Illinois counterparts for the following causes of death: Breast Cancer (20% higher), Lung Cancer (31.6%), HIV/AIDS (33.3%), Heart Failure (129.4%), Hypertension (209.1%), Stroke (38%), Chronic Obstructive Pulmonary Diseases (125%), Diabetes mellitus (143.1%), Motor Vehicle Fatalities (41.3%), Suicide (50%) and Homicide (87.5%). The increase of incidence of heart failure, which had been at 106.8% and hypertension, previously reported at 96.1% underscores the importance of public education, diet modification, healthy activity levels, and the reduction of the use of tobacco. With the most recent statistics of specific diseases and societal health conditions, the task of St. Elizabeth's Community Benefit committee will be to design a strategy that focuses on prevention specific to heart disease. The risk factors have been clearly spelled out by the Centers for Disease Control and Prevention. Each of those factors will be reviewed by the St. Elizabeth's Community Benefit Committee to assess which of those factors we have the resources and expertise to focus on in collaboration with the local health department. For example, use of tobacco is identified as part of a patient's record. As part of our patient care plan, each patient who acknowledges a tobacco use is visited by either a nurse or a respiratory therapist. In the new fiscal year, St. Elizabeth's will be able to refer patients interested in smoking cessation to the Cancer Treatment Center to acquire free nicotine replacement therapy. Our registered dieticians visit the majority of patients. There are many opportunities to improve the community's health status within the hospital's walls - they are our patients who trust us with their care. Obesity is another key health issue for the population of St. Clair County. Being obese (or even just overweight) is the second leading cause of preventable death in the United States and is measured by body mass index ("BMI"), a person's weight to height ration. Overweight is defined as having a BMI over 25 and obsess is defined a s having a BMI above 30. In St. Clair County, almost a third of adults are overweight, and nearly 28 percent are considered obese. This issue is of particular concern because obese and overweight individuals are at a much higher risk of suffering from various chronic conditions.
Promotion of Community HealthFURTHERING TAX EXEMPT PURPOSE: St. Elizabeth's Hospital offers hope to our community in the tradition of the Hospital Sisters of St. Francis. St. Elizabeth's provides quality medical healthcare regardless of race, creed, sex, national origin, handicap, age, or ability to pay. Although reimbursement for services rendered is critical to the operation and stability of St. Elizabeth's Hospital, it is recognized that not all individuals possess the ability to purchase essential medical services. It is our mission is to serve the sick, especially the poor, with quality healthcare services and healthcare education. We have further defined our mission of identifying those who are at greatest health risk, the elderly, children, expectant mothers and neonates, those coping with mental illness, and those with less means who deserve and depend on quality healthcare. St. Elizabeth's Hospital takes a proactive role in educating its communities on wellness programs, sponsoring health screenings, collaborating with the local health district in targeting local health concerns, sponsoring health presentations by our medical staff at a local senior center, making available flu immunizations at local community sites, and organizing support groups. REINVESTING IN THE NEEDS OF THE COMMUNITY: Because of the hospital's purpose and tradition, it is organized to promote the health of Belleville and the surrounding areas. The hospital is governed by a Board of Directors, the majority of which is comprised of persons who reside in the organization's primary service area and who are neither employees nor contractors of the hospital (nor family members thereof.) The Board ensures that St. Elizabeth's is responding to the community need in accordance with the process described in Sources and Data. Also consistent with its exempt status, St. Elizabeth's has an open medical staff with privileges available to all qualified physicians in the area. As a not-for-profit hospital, St. Elizabeth's reinvests surplus funds into the mission of the organization and health of the community rather than distributing them as profits to shareholders or individuals. Funds not committed to ongoing operation are generally used to upgrade facilities, secure new technologies, improve patient care, and support initiatives designed to promote health and ensure access for all. The hospital's focus on improving health status for cardiac care, maternal and child health, and behavioral health are all examples of how the hospital is responding to community need. As described earlier, St. Elizabeth's is concentrating on quality of our cardiac services by meeting and/or exceeding standards of care. Our door-to-balloon time is an area in which we have consistently exceeded the national standard. Over the past two years, we have exceeded the national benchmark of 90 minutes with an average Door to Balloon time of 65 minutes. We also have begun targeting the female population - that age group in particular that is at greater risk than their male counterparts - primarily through education. In the hospital's core measures, our acute myocardial infarction ("AMI") care has been at 100% compliance in FY - 2011. St. Elizabeth's is in the process of establishing a direct relationship with Prairie Heart Institute - Springfield, IL which is in the top 10% of heart attack care. Heart disease is a health threat in this community and St. Elizabeth's continues to strengthen its position as a leader in heart care. PROVIDING A WIDE RANGE OF COMMUNITY BENEFITS: St. Elizabeth's Hospital provided 50,674 adult and pediatric days of care and had 173,488 outpatient visits during FY 2011. During this period, St. Elizabeth's provided in excess of $13.9 million to support our commitment to the community. Included in this total was $4.7 million at cost of healthcare for individuals unable to afford their care. St. Elizabeth's Hospital also provided care to persons covered by governmental programs at or below cost. This resulted in providing $6.6 million of healthcare to Medicare and $7.7 million to Medicaid patients which was not reimbursed. This resulted in a total of $14.3 million healthcare provided for these two groups. Included in the total was the extensive number of free educational programs, screenings, clinical services and consultations provided at a reduced fee or at no charge to other healthcare agencies and human service agencies in our service area. To the extent that reimbursement was below cost, St. Elizabeth's Hospital recognized these expenses as a cost of fulfilling its mission for the entire community. Included in the above figures are the following initiatives aimed at improving access and promoting health for the people of Belleville and surrounding communities. HEALTH SCREENINGS: * Blood pressure screenings * Car seat inspections, installations, and free car seats * Lung Function screenings * Cardiac screenings at reduced fee * Skin cancer screening * Alzheimer's Disease screening * Anxiety screening * Depression screening * Alcohol screening * Cholesterol screening * Stroke Screening - carotid ultrasound screening at reduced fee * Alcohol Abuse Screenings EDUCATIONAL PROGRAMS: * Student internships with numerous colleges and universities * A work-study program for mentally challenged high school students * Tours for high school students * Healthcare Professions Shadowing * Student volunteer programs (senior community project) * Prenatal classes * Lamaze classes * Mother Child Tours for Expectant Mothers * Adult, infant and child CPR classes * Nutrition classes * Aging conference * Ethics conference * Nursing support for school physicals * Variety of programs for seniors at the PSOP center * Lunch with a Doctor - ten programs NUTRITIONAL SUPPORT: * Meal coupons for the homeless and indigent * Food items collected and donated to needy families and to an interdenominational food pantry in Belleville and to families of deployed soldiers * Clothing collected and donated to the Violence Prevention Center, Pregnancy Care Center, and Catholic Urban Program * Food coupons to local grocery stores * Diabetic Nutritional Counseling * Free prescriptions for patients unable to pay * Bus passes and cab fare SUPPORT GROUPS: * St. Elizabeth's sponsors ten support groups and meetings * Diabetic Support Group * Memorial services for deceased family members * Compassionate Friends * Manic Depressive * Recovery, Inc. (support for those dealing with nervous symptoms and fears) * Parkinson Support Group * Life After Breast Cancer * Alcoholics Anonymous Sponsorship * Mended Hearts * Funeral services conducted by Pastoral Care chaplains * Burial along with graveside services for relatives of fetal/premature deaths * Alzheimer's Support Group * Rehab Support Group * Stroke Support Group * Defibbers Support Group * Narcotics Anonymous Sponsorship HEALTH FAIRS: * At the community events in St. Clair and Monroe County Co-Op * At senior centers and Our Lady of the Snows Retirement Apts * At area churches * For Women, Go Red for Healthy Heart * For area clergy COMMUNITY INVOLVEMENT: * Wellness clinic at the Programs and Services for Older Persons Center * Provided flu shots to the underserved at no charge * Meeting and conference room space for health/civic groups * Actively participate in programs and services of St. Clair County's Health District * Held leadership role in community civic organizations - Healthcare Providers Committee - Greater Belleville Chamber of Commerce * Participated with community groups by providing healthcare information * Host March of Dimes bi-monthly meetings * Conducted Lay Ministry Training Program for all denominations * Sponsored six blood drives * Cooperated with local judicial court on family violence programs * Provided space and equipment for the Family Visitation Exchange program * Charity consults with pharmacists * CPR classes * Participated on the planning committee for the St. Clair County Health conference * Gave support to the local AIDS support and residence service * Conducted quarterly memorial services and reception for family members of deceased patients * Go Red - February Healthy Heart awareness * Community-wide disaster preparation and drills * Career Days * Gateway Hospital Ethics Committee * Provide graveside services at no charge * Linen donations to area nursing homes and other medical supplies to Mission Outreach * School Mentoring Program * School Supplies for Children residing in the Violence Prevention Center * Food Drive for Local Food Pantry * Clinical education/affiliation with area healthcare programs COLLABORATION WITH OTHER AGENCIES: St. Elizabeth's has been an active leader on the St. Clair County Healthcare Commission, a coalition of 20 major health and human service organizations within St. Clair County. The Commission's main goal has been to identify the health needs of this county's residents and to collaborate with other healthcare providers on strategi
Afilliated Health Care SystemSt. Elizabeth's Hospital is an affiliate of Hospital Sisters Health System. The mission of Hospital Sisters Health System ("HSHS") is to serve those in need through a health care ministry that values compassion, respect and reverence for life. The nearly 14,000 colleagues who make up HSHS are dedicated to this mission and to providing high quality health care to whoever seeks our services. By living our mission each day, HSHS colleagues constantly strive to provide the highest quality and most cost-effective and compassionate health care to those we are privileged to serve. Our health care ministry extends across 12 communities in Wisconsin and Illinois and includes 13 hospitals, dozens of community-based health centers and clinics, and more than 2,000 physician partners. As part of our mission to provide healing and hope to the three million people we serve, we have developed Community Benefit initiatives that 1) expand access to health care, 2) enhance overall health status and 3) promote medical education. In the Fiscal Year that ended June 30, 2011, HSHS hospitals provided $166.1 million in Community Benefits (or 8.7% of total expenses), an increase of $15.7 million from FY 2010. Of this amount, $37.1 million was provided for charity care and $99.8 million was the amount of unreimbursed care provided under the Medicaid program. In addition, HSHS hospitals committed significant resources in serving the Medicare population. The cost of providing services to primarily elderly beneficiaries of the Medicare program, in excess of governmental and managed care contract payments, was $183.8 million during Fiscal Year 2011. HSHS hospitals also recorded $103.9 million in uncollectible accounts. HSHS strengthens the health of our communities by continually reinvesting any surplus revenue from operations and investments into new medical technology, facility infrastructure and health care services. These investments ensure that our hospitals can continue to provide high quality, compassionate care to our patients. During Fiscal Year 2011, HSHS also continued to invest in our Care Integration strategy that places the patient at the center of our work while allowing us to deliver care in a more cost-effective and efficient manner. These investments are designed to better coordinate care, improve health outcomes, create new efficiencies, and help ensure that patients (especially those with chronic conditions) get well and stay well. Our Care Integration strategy is delivering promising results. An example is our three Medical Home pilot projects. Diabetic Patients enrolled in Medical Homes in rural Illinois experienced an average 42 percent decrease in their blood glucose levels while their unplanned readmissions to the hospital dropped to zero. HSHS is making significant progress implementing interoperable health information technologies and robust health information exchanges. In central Illinois, HSHS is joining with other health care providers to develop a statewide Health Information Exchange ("HIE") that will allow health care providers to exchange clinical information, such as medication histories and test results, access that information at the point of care and make better informed decisions with their patients. HSHS understands that our investments in information technology will have a positive impact on the quality, safety and efficiency of health care. 1. Expanding access to health care An integral component of our Community Benefit initiatives is to provide care to every patient who seeks our services without exception. To that end, HSHS hospitals have established Charity Care program guidelines that cover 100% of hospital charges for individuals and families who earn 125% to 250% of the federal poverty level. HSHS hospital's Charity Care guidelines have sliding scales, in some instances providing up to a 50% discount on charges for those earning up to 600% of the federal poverty level. HSHS hospitals have created simple forms for those wishing to apply for Charity Care and assign counselors to visit with inpatients who are uninsured to let them know about our charity care policies and provide assistance filling out applications for financial assistance or enrollment in publicly funded health care programs. HSHS hospitals also work collaboratively with others to enhance access to health care services for those in need. St. John's Hospital in Springfield, IL has partnered with Memorial Medical Center, Southern Illinois University School and Medicine and other community partners to support the Coordinated Access to Community Health ("CATCH") initiative. The free program is being made available to uninsured adults in Sangamon County to help them access routine medical care, specialty doctors and affordable medicine. Launched in May 2011, CATCH enrolls patients as they visit social service agencies or when they leave hospital emergency rooms. Enrollees are then referred to Springfield's federally funded primary care clinic, Capitol Community Health Center, or participating doctors' private offices. Grants from St. John's Hospital, Memorial Medical Center, United Way of Central Illinois and the Dominican Sisters offset CATCH's first year of expenses. Patient advocates at St. John's Hospital and Memorial Medical Center help uninsured patients find primary or specialty doctors and make appointments, and arrange for financial assistance from participating social service agencies for prescription drugs. In the first three months since the program was launched, CATCH signed up more than 250 physicians in the community who agreed to see patients at no charge. The program endeavors to enroll up to 6,000 uninsured patients within the next few years. By making it easier for uninsured residents to get preventive health care services, CATCH organizers believe uninsured patients' medical problems will be addressed early, helping improve their quality of life. St. Mary's Hospital Medical Center in Green Bay, WI supports the NEW Community Clinic, a 38-year-old free health center for the uninsured and underinsured. St. Mary's provides free and discounted laboratory and radiology services to the clinic. More than 70 percent of patients say the clinic's care allowed them to avoid having to seek care in a local Emergency Room. For the past decade, St. Anthony's Memorial Hospital in Effingham, IL has teamed up with Effingham Catholic Charities to co-sponsor the Prescription Assistance Program. Catholic Charities' staff members work with clients who need prescription medication but may not be able to afford them because they are uninsured or underinsured. Due to the financial support of St. Anthony's, the program is able to provide needed prescriptions to dozens of residents each month. St. Francis Hospital in Litchfield, IL collaborated with local dental care providers to coordinate and provide a free day of dental care to uninsured individuals. The collaboration was the result of a community needs assessment that determined access to dental care was a priority in the community. The "Community Day of Dental Care" provided free dental cleanings, X-Rays, and extractions to 90 uninsured individuals. Among those 90 people served included a military veteran who has been unable to obtain dental care after a St. Louis facility closed. He was able to have five teeth extracted. Another person served was a young woman who needed some minor restorative care which greatly improved her appearance. She was very grateful because she had a job interview coming up and would be able to attend the interview feeling better about her appearance. 2. Enhancing the health status of the community Another component of our Community Benefit initiatives is to improve the quality of life in our communities. Our hospitals work closely with a wide array of public and private organizations that share our commitment to enhancing health and wellness. We know that by working together, we can maximize our efforts by sharing resources, reduce duplication of services, and make it easier for residents to get the services and knowledge they need to live healthier lives. HSHS hospitals also understand they need to listen closely to the residents of the communities they serve to ensure the health care needs of all are being met. Sacred Heart Hospital in Eau Claire, WI invited more than 1,400 area residents to share their vision for health care during a series of focus groups. Participants included constituents that are often overlooked: low-income, vulnerable populations and minority groups. The visioning sessions captured the voices of special populations, Among Mutual Assistance Association members, Amish farmers, seniors, young children and other diverse groups. The feedback provided led to more than 100 actionable items that were assessed and/or implemented over the first six months since the sessions concluded. One action taken by Sacred Heart Hospital and St. Joseph's Hospital in Chippe
STATE FILING OF COMMUNITY BENEFIT REPORTIL,990 SCHEDULE H, PART VI

Schedule J IRS990ScheduleJ

FieldValueIRS element (for citing)
Compensation CommitteeXCompensationCommittee
Independent ConsultantXIndependentConsultant
Form990 Of Other OrganizationsXForm990OfOtherOrganizations
Written Employment ContractXWrittenEmploymentContract
Compensation SurveyXCompensationSurvey
Board Or Committee ApprovalXBoardOrCommitteeApproval
Severance PaymenttrueSeverancePayment
Supplemental Nonqual Retire PlanfalseSupplementalNonqualRetirePlan
Equity Based Comp ArrangementfalseEquityBasedCompArrangement
Comp Based On Revenue Of Filing OrgfalseCompBasedOnRevenueOfFilingOrg
Comp Based On Revenue Related OrgsfalseCompBasedOnRevenueRelatedOrgs
Comp Based Net Earnings Filing OrgfalseCompBasedNetEarningsFilingOrg
Comp Based Net Earnings Relate OrgsfalseCompBasedNetEarningsRelateOrgs
Any Non Fixed PaymentsfalseAnyNonFixedPayments
Initial Contract ExceptionfalseInitialContractException

Form990 Schedule J Part II Form990ScheduleJPartII (15 entries)

Base Compensation Filing OrgBaseCompensationFilingOrgComp Based On Related OrgsCompBasedOnRelatedOrgsBonus Filing OrgBonusFilingOrgBonus Related OrgsBonusRelatedOrgsOther Compensation Filing OrgOtherCompensationFilingOrgOther Compensation Related OrgsOtherCompensationRelatedOrgsDeferred Comp Filing OrgDeferredCompFilingOrgDeferred Comp Related OrgsDeferredCompRelatedOrgsNontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgNontaxable Benefits Related OrgsNontaxableBenefitsRelatedOrgsTotal Compensation Filing OrgTotalCompensationFilingOrgTotal Compensation Related OrgsTotalCompensationRelatedOrgsComp Report Prior990 Filing OrgCompReportPrior990FilingOrgComp Report Prior990 Related OrgsCompReportPrior990RelatedOrgs
Kevin Shrake
0348685000006670208297042368400
Linda A Camp MD
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Salil K Gupta
458139000165000279210253440527904000
Robert S Miller
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Johnny E Watkins
23660400000309310101220277657000
Illa J David
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Ann Carr
01913360000092165017377030087800
Alice Chatley
1653430100000002898907210205053000
Edward Jacquin
1405690000018366081550167090000
Mark Reifsteck
041709300000133800027340057823300
James Rushford
577093025000000259010211930649187000
Donald Johnston
57668200000192210216040617507000
David Haymes
4472690000030936058820484087000
Christopher Arett
2892550000000132840302539000
James Burke
1749820000099430254000210325000

Form990 Schedule J Part III Form990ScheduleJPartIII

FieldValueIRS element (for citing)
IdentifierSeverance PaymentIdentifier
Return ReferenceSchedule J, Part I, Line 4aReturnReference
ExplanationKevin Shrake received $154,740 as a severance payment during the year for his services as CEO.Explanation

Schedule L IRS990ScheduleL

Form990 Schedule L Part IV Form990ScheduleLPartIV (3 entries)

RelationshipRelationshipAmount Of TransactionAmountOfTransactionDescription Of TransactionDescriptionOfTransactionSharing Of RevenuesSharingOfRevenues
Chicago Land Of Trust for O'Fallon
Owner is Board Member532253Rentfalse
Mascoutah Plaza Land of Trust
Owner is Board Member274615Rentfalse
Professional Therapy Service
Owner is Board Member3675133Staffingfalse

Schedule O IRS990ScheduleO

General Explanation GeneralExplanation (19 entries)

IdentifierIdentifierReturn ReferenceReturnReferenceExplanationExplanation
Organization's MissionForm 990, Part III, Line 1The mission of St. Elizabeth's Hospital is to minister to those in NEED OF HEALTHCARE IN RESPONSE TO GOD'S CALL TO SERVE EACH OTHER, ESPECIALLY THE POOR. IN THE PERFORMANCE OF ITS MISSION, ST. ELIZABETH'S HOSPITAL WILL FOSTER THE VALUES OF RESPECT, CARE, COMPETENCE, AND JOY. ST. ELIZABETH'S HOSPITAL IS COMMITTED TO PERFORMING ITS MISSION THROUGH COOPERATION WITH OTHER HEALTHCARE PROVIDERS AND THE COMMUNITY, WHENEVER POSSIBLE.
Program ServicesForm 990, Part III, Line 4acardiac services St. Elizabeth's provides comprehensive cardiovascular services from diagnosis to surgery to rehabilitation and wellness. St. Elizabeth's is accredited by the Society of Chest Pain Centers, a professional organization focused on improving care for patients with acute coronary syndromes and teaching the public to recognize and react to the early symptoms of a possible heart attack. This accreditation attests that St. Elizabeth's meets strict criteria for recognizing and treating patients who come to the emergency room with heart attack symptoms. We are also a heart attack receiving center. Currently, more than 5 area hospitals send their patients to us for heart attack care. Our patients benefit from our highly credentialed physicians and state-of-the-art technologies, as well as our commitment to superior patient outcomes. Some of the services provided included: Cardiac catheterization, stent placement, stress testing, pacemaker, implantable cardioverter defibrillator ("ICD"), electrocardiography, coronary artery bypass graft (open heart) surgery and cardiac rehabilitation. During FY 2011, St. Elizabeth's Hospital had 8,992 cardiac cases. Form 990, part iii, line 4b orthopedic services St. Elizabeth's specializes in the treatment and prevention of orthopedic problems and sports-related musculoskeletal injuries. We perform surgical and non-surgical procedures. Our orthopedic surgical services are provided on an inpatient and outpatient basis. Our physicians are all board certified and provide first class care. Some of the orthopedic services provided include: General orthopedics, fracture care, total joint replacement, carpal tunnel treatment, arthroscopic and reconstructive surgery, and foot and ankle orthopedic care. During FY 2011, St. Elizabeth's Hospital had 8,843 orthopedic cases. form 990, part iii, line 4c rehabilitation services St. Elizabeth's Hospital's comprehensive rehabilitation unit provides the care that maximizes the patient's capabilities. We assist in achieving full recovery potential allowing patients to live as independently as possible. We support patients families by providing them with the education, resources and encouragement needed to achieve positive outcomes. Our comprehensive integrated inpatient rehabilitation program is accredited by the Commission on Accreditation of Rehabilitation Facilities ("CARF"). We are one of the few accredited rehab facilities in Southern Illinois and the only one available in St. Clair County. The rehabilitation unit is accredited to provide services to those adults who have been affected by stroke, amputation, arthritis, spinal cord injury, joint replacement, hip fracture, neurological disease, and more. When admitted to our program, patients are treated by a multi-disciplinary team of caring professionals. During FY 2011 our Rehabilitation Unit performed 5,257 cases. Total IP days for the fiscal year was 6,287. form 990, part iii, line 4d Healthcare services St. Elizabeth's delivers a comprehensive array of healthcare services to both inpatients and outpatients. Our accredited programs have consistently demonstrated quality outcomes that positively impact our patients, their families and the entire community. We provides quality medical healthcare regardless of race, creed, sex, national origin, handicap, age, or ability to pay. Although reimbursement for services rendered is critical to the operation and stability of St. Elizabeth's Hospital, it is recognized that not all individuals possess the ability to purchase essential medical services. It is our mission to serve the sick, especially the poor, with quality healthcare services and healthcare education. We have further defined our mission of identifying those who are at greatest health risk, the elderly, children, those coping with mental illness, and those with less means who are dependent on quality healthcare. During FY 2011, St. Elizabeth's Hospital provided 50,674 adult and pediatric days of care and had 173,488 outpatient visits. Community Benefit Charity and Government Means-Tested Program: During the period, St. Elizabeth's provided in excess of $13,935,564 million to support our commitment to the community. Included in this total was charity care provided to individuals unable to afford their care. The cost of charity care was $4,761,952. St. Elizabeth's Hospital also provided care to persons covered by governmental programs at or below cost. This resulted in providing $7,683,462 to Medicaid patients which was not reimbursed. Also, included in the total was the extensive number of free educational programs, screenings, clinical services and consultations provided at a reduced fee or at no charge to other healthcare agencies and human service agencies in our service area. To the extent that reimbursement was below cost, St. Elizabeth's Hospital recognized these expenses as a cost of fulfilling its mission for the entire community. Other Benefits: St. Elizabeth's Hospital takes a proactive role in educating its communities on wellness programs, sponsoring health screenings, collaborating with the local health district in targeting local health concerns, and organizing support groups. Included in the above Community Benefit figures are the following initiatives aimed at improving access and promoting health for the people of Belleville and surrounding communities. The total other benefits reported value $1,490,150. *Health Screenings: *Blood pressure screenings; *Car seat inspections, installations, and free car seats; *Reduced fee for mammograms; *Lung Function screenings; *Cardiac blood tests at reduced fee; *Skin cancer screening; *Alzheimer's Disease screening; *Anxiety screening; *Depression screening; *Pulmonary function testing; *Alcohol screening; *Cholesterol screening; *Stroke Screening; *Sports Physicals for local high school; *Bone density assessment; *Body Fat Screening; *Vascular Screenings; *Alcohol Abuse Screenings; *Educational Programs; *Student internships with numerous colleges and universities; *A work-study program for mentally challenged high school students; *Tours for high school students; *Healthcare Professions Shadowing; *Student volunteer programs (senior community project; *Four free community education programs; *Prenatal classes; *Lamaze classes; *Mother Child Tours for Expectant Mothers; *Adult, infant and child CPR classes; *Nutrition classes; *Arthritis self-help classes; *Here's to Your Health (a series of 4 presentations); *Aging conference; *Ethics conference; *Advance Directives Workshop; *Nursing support for school physicals Variety of programs for seniors at the PSOP center *Lunch with a Doctor - ten programs
program servicesFORM 990, PART Iii, line 4aNutritional Support *Meal coupons for the homeless and indigent; *Six tons of food items collected and donated to needy families and to an interdenominational food pantry in Belleville; *Over one ton of clothing collected and donated to the Violence Prevention Center, Pregnancy Care Center, and Catholic Urban Program; *Food coupons to local grocery stores; *Diabetic Nutritional Counseling; *Free prescriptions for patients unable to pay Support Groups *St. Elizabeth's sponsors thirteen support groups and meetings; *Grief support (adults); *Memorial services for deceased family members; *Compassionate Friends; *Manic Depressive; *Recovery, Inc. (support for those dealing with nervous symptoms and fears); *Parkinson Support Group; *Life After Breast Cancer; *Alcoholics Anonymous Sponsorship; *Mended Hearts; *Funeral services conducted by Pastoral Care chaplains; *Burial along with graveside services for relatives of fetal/ premature deaths; *Alzheimer's Support Group; *Rehab Support Group; *Stroke Support Group; *Defibbers Support Group; *Narcotics Anonymous Sponsorship; Health Fairs *At the community events in St. Clair and Monroe Counties; *At senior centers and Our Lady of the Snows Retirement Apts; *At area churches; *For Women, By Women Health Fair; *For area clergy; *Lipstick Women's Conference; Community Involvement *Wellness clinic at the Programs and Services for Older Persons Center; *Provided flu shots to the underserved at no charge; *Meeting and conference room space for health/civic groups; *Actively participate in programs and services of St. Clair County's Health District; *Held leadership role in community civic organizations; *Healthcare Providers Committee - Greater Belleville Chamber of Commerce; *Participated with community groups by providing healthcare information; *Participated in major community health events; *Cancer Walk and Ride, Trivia Night, March of Dimes Walk, American Lung, Diabetes Walk, Drug Awareness Red Ribbon Walk, Susan B Komen Denim Day, Ride Belleville, Bethany Anniversary; *Conducted Lay Ministry Training Program for all denominations; *Sponsored six blood drives; *Cooperated with local judicial court on family violence programs; *Provided space and equipment for the Family Visitation Exchange program; *Charity consults with pharmacists; *CPR classes; *Participated on the planning committee for the St. Clair County Health conference; *Gave support to the local AIDS support and residence service; *Conducted quarterly memorial services and reception for family members of deceased patients; *Red Heart Day sponsorship; *Community-wide disaster preparation and drills; *Career Days; *Gateway Hospital Ethics Committee; *Provide graveside services at no charge; *Linen donations to area nursing homes and other medical supplies to Mission Outreach; *School Mentoring Program; *School Supplies for Children residing in the Violence; *Prevention Center; *Food Drive for Local Food Pantry; *Clinical education/affiliation with area healthcare programs In addition to the Community Benefit total, St. Elizabeth's provided 7.8 million (at cost) in uncompensated care to patients that did not qualify for charity care or public assistance, and over $6.6 million (at cost) in excess of Medicare payment for health services. TAX EXEMPT BONDS FORM 990, PART IV, LINE 24 ST ELIZABETH'S HOSPITAL HOLDS A LIABILITY ON ITS BOOKS FOR TAX-EXEMPT BONDS, WHICH IS AN ALLOCATION FROM ITS SOLE CORPORATE MEMBER, HOSPITAL SISTERS SERVICES, INC. AS A RESULT, THIS QUESTION WAS ANSWERED NO, AND SCHEDULE K WILL BE COMPLETED ON THE HOSPITAL SISTERS SERVICES, INC. FORM 990. 990.
RIGHTS OF MEMBERS TO ELECT GOVERNING BODYFORM 990, PART VI, LINEs 6 & 7ATHE SENIOR GOVERNING BODY OF ST. ELIZABETH'S HOSPITAL (THE "CORPORATION") IS THE MEMBER OF THE CORPORATION, WHICH IS HOSPITAL SISTERS HEALTH SERVICES, INC. ("HSSI"), AN ILLINOIS NOT FOR PROFIT CORPORATION EXEMPT FROM FEDERAL TAXATION UNDER SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE. PURSUANT TO SECTION 2.3 OF THE CORPORATION'S BYLAWS, HSSI HAS THE RIGHT TO APPOINT AND REMOVE THE CORPORATION'S BOARD OF DIRECTORS, CHAIRPERSON OF THE BOARD AND PRESIDENT.
MEMBER RESERVED POWERSFORM 990, PART VI, LINE 7BResponsibility for the policy and operations of St. Elizabeth's Hospital (the "Corporation") is vested in its Board of Directors, except with respect to specific powers reserved in the Corporation's Bylaws to the Corporation's Member, Hospital Sisters Health Services, Inc. ("HSSI"), an Illinois not for profit corporation exempt from federal taxation under Section 501(c)(3) of the Internal Revenue Code. The member of HSSI is Hospital Sisters Health System ("HSHS"), an Illinois not for profit corporation exempt from federal taxation under Section 501(c)(3) of the Internal Revenue Code. The members of HSHS are the individual sisters who from time to time are the duly elected Provincial Superior and Provincial Councilors, respectively of the American Province of the Hospital Sisters of St. Francis ("American Province"). The American Province is the United States organization of the Congregation of the Hospital Sisters of the Third Order Regular of St. Francis, a religious institute of the Roman Catholic Church. The governance and operations of the Corporation are subject to HSSI's right to exercise these reserved powers with respect to the Corporation and organizations of which the Corporation is either, directly or indirectly, a controlling member or a controlling shareholder ("Affiliates"). HSSI's right to exercise certain of these reserved powers is, in turn, subject to the approval of HSHS and HSHS' members. The reserved powers include all rights granted to HSSI by law and the right to: (a) Adopt, approve amendments to, or amend any statement of philosophy, mission, mission integration or values or any name, logo, or mark of the Corporation or of any Affiliate; (b) Adopt, approve amendments to, or amend the Articles of Incorporation of the Corporation or of any Affiliate; (c) Adopt, approve amendments to, or amend the Bylaws of the Corporation or of any Affiliate; (d) Appoint and remove the Board of Directors, any one or more of the Directors of the Corporation or of any Affiliate, and the Chairperson and President of the Corporation or of any Affiliate; (e) Approve the recommendation of the Board of Directors to appoint or remove the Board of Directors, any one or more Directors of the Corporation or of any Affiliate, or the Chairperson and President of the Corporation or of any Affiliate. (f) With respect to the Corporation or any Affiliate, approve the purchase, sale, alienation, exchange, lease or encumbrance of any real property of the Corporation or of any Affiliate, which property has a value in excess of limits set from time to time by HSSI; (g) Approve the operating and capital budgets of the Corporation or of any Affiliate, and any deviations by the Corporation or of any Affiliate from such budgets in an amount or percentage specified by HSSI from time to time; (h) Approve the strategic plan and goals of the Corporation or of any Affiliate; (i) Approve the sale of substantially all of the assets of the Corporation or of any Affiliate; (j) Approve the merger or dissolution of the Corporation or of any Affiliate; (k) Adopt or amend the plan for ministry education and governance for the Corporation and its Affiliates; (l) Approve the Corporation's Mission Accountability Reports and those of any Affiliate; (m) Approve the financial policies and procedures of the Corporation or of any Affiliate and approve any deviations from such policies and procedures by the Corporation or any Affiliate; and (n) Adopt policies to implement the Reserved Powers of HSSI.
FORM 990 REVIEW PROCESSFORM 990, PART VI, LINE 11bThe hospital employs KPMG to assist in the overall review and electronic submission of its Form 990. KPMG provides guidance in identifying critical errors in the return submission and feedback on quantitative and qualitative responses. Additionally, the hospital CFO performs a thorough review of the return and reviews it with the hospital CEO and/or senior leaders before presenting it in its entirety to the hospital Board for questioning and review prior to the return's signing and submission to the IRS.
CONFLICT OF INTEREST POLICYFORM 990, PART VI, LINE 12CA revised Corporate Compliance Program and Conflict of Interest Policy has been used since January, 2009 to establish the practice of managing conflicts of interest using a system-wide protocol for disclosure statements. In accordance with our Conflict of Interest Policy all Covered Persons have a duty to comply with the Conflict of Interest Policy for any contract, transaction, relationship or activity contemplated, entered into or conducted at HSHS. The policy defines covered persons as A.) Board members, Board committee members, Officers, Board designees, senior management, members of any committee that oversees the approval of pharmaceuticals and medical devices, any other individual who holds a position of trust and B.) Non-employed members of the medical staff who also either: 1) hold paid or unpaid medical administrative positions, such as chairs of clinical departments, section and division chiefs, directors of special care units, directors of research or individual s who otherwise direct or materially influence research; or 2) have procurement responsibility, or the authority effectively to recommend such procurement. On a annual basis HSHS discloses a copy of the Conflict of Interest Policy (and all corresponding procedures, guidelines, forms and tools), to all Covered Persons and advises all Covered Persons in writing of any substantive changes to this Policy and such related materials. The Covered Persons are required to review and complete the corresponding Conflict of Interest Statement. The System Office Vice President, System Responsibility, Vice President, Risk & Compliance or members of the Audit and Integrity Committee ("Committee") are available to answers any questions a Covered Person may have. In addition, if, at any time after submitting an annual Conflict of Interest Statement, a Covered Person becomes aware of an Interest that he or she would have had to disclose at the annual interval, the Covered Person shall promptly disclose the Interest to the Committee using the HSHS Conflict of Interest Disclosure Statement. Completed Conflict of Interest statements are submitted to the Committee of HSHS which is responsible for identifying, assessing, and managing Conflicts of Interest that arise in the course of conducting the affairs of HSHS. If the Committee determines that a Conflict of Interest exists, HSHS shall not engage in or enter into a proposed contract, transaction, relationship, arrangement or activity unless the Committee or, where necessary, the Board of Directors (acting through its disinterested members), has investigated alternatives to the proposed contract, transaction, relationship, arrangement or activity and, in the absence of alternatives that are in the best interests of HSHS, has determined: 1. that, regardless of whether the Covered Person participates in the implementation of the proposed contract, transaction, relationship, arrangement, or activity; 2. the contract, transaction, arrangement or activity is in the best interests of HSHS; 3. the contract, transaction, arrangement or activity is fair and reasonable from the perspective of HSHS;and 4. HSHS cannot obtain a more advantageous contract, transaction, arrangement or activity with reasonable efforts under the circumstances. In determining whether a contract, transaction or arrangement is fair and reasonable to HSHS, the Committee shall consider, where applicable: 1. appraisals or other independent valuations of the Fair Market Value of the contract, transaction or arrangement; 2. information regarding comparable contracts, transactions or arrangements between unrelated parties; 3. offers from comparable competing entities; and/or 4. studies of comparable compensation arrangements. In any case in which the Committee finds, after taking the steps described above, that HSHS should participate in a proposed transaction or arrangement despite the existence of a conflict of interest, the Committee shall develop, implement, monitor, and enforce compliance with, a Conflict Management Plan for managing the Conflict of Interest as it considers necessary for such findings to remain valid throughout the life of the contract, transaction, relationship, arrangement or activity. All Conflict Management Plans shall: 1. state that the Committee will oversee, monitor and enforce compliance with the plan throughout the course of the study and specify means for doing so, including, without limitation, that the appropriate individuals must provide the Committee with written reports pertaining to compliance with the Conflict Management Plan, that the Committee shall have the right to audit the study for such compliance and the right to impose sanctions for non-compliance; 2. state that the Plan must be shared with Covered Person whose Interests it was developed to manage; 3. state that the Plan must be shared with, and periodic reports on compliance with the Plan must be provided to, the Board, senior management and/or government agencies; and 4. provide for such other management steps and mechanisms the Committee considers necessary and appropriate. In addition to the Committee, the System Office Vice Presidents of System Responsibility and Risk & Compliance may retain such independent advisors or experts as deemed necessary to assist in making its determinations and decisions. If the Committee determines that the contemplated transaction, relationship arrangement or activity cannot proceed due to a Conflict of Interest, the Committee shall inform the applicable Covered Person or decision-making body of such determination within one week of the Committee meeting at which the contemplated transaction was discussed. The Committee shall document its rejection of the contemplated transaction in the Committee's meeting minutes.
WHISTLEBLOWER POLICYFORM 990, PART VI, LINE 13Provisions within the Corporate Compliance Hotline and Conflict of Interest Policy provide protections for whistleblower type activities.
COMPENSATION PROCESSFORM 990, PART VI, LINE 15The Compensation Committee ("Committee") is comprised of independent members of the Board of Directors. The Committee develops a compensation philosophy for the System and all affiliates. The Committee selects and hires the independent compensation consultant to develop comparability data and advise the Committee during its deliberations regarding all elements of total compensation for all disqualified individuals. Integrated Healthcare Strategies ("IHS"), the consultants utilized by the Committee, use data from multiple tax-exempt peer group sources to determine salary ranges, incentive opportunity ranges and benefits for the disqualified individuals. IHS then assists the Committee in preparing contemporaneous documentation of all actions. Each Committee meeting is conducted with the intent to create a rebuttable presumption of reasonableness for all elements of executive total compensation for the disqualified individuals. The Chairman makes this declaration and also inquires if there are any conflicts of interest by any attendees. Any conflicts are disclosed and the Committee then acts in a manner to avoid any conflicted individual participating in any manner where a conflict might exist. At the end of the meeting, the Committee prepares contemporaneous minutes that record all actions taken during the meeting.
DISCLOSURE: DOCUMENTS AVAILABLE TO THE PUBLICFORM 990, PART VI, LINE 19Board-approved financial statements are made available to the public upon request. The governing documents and conflict of interest policy are not made available to the general public at this time.
POOLED INVESTMENT ACCOUNTFORM 990, PART X, LINE 11PARTICIPATION IN THE POOLED FUND IS LIMITED TO THE 501(C)(3) HOSPITALS AND RELATED HEALTH SERVICES ORGANIZATIONS SPONSORED BY HOSPITAL SISTERS HEALTH SYSTEM. THE POOLED ACCOUNT CONSISTS OF CASH, EQUITY AND DEBT SECURITIES THAT ARE PUBLICLY TRADED. IN ACCORDANCE WITH THE PROVISIONS OF SFAS NO. 124 "ACCOUNTING FOR CERTAIN INVESTMENTS HELD BY NOT-FOR-PROFIT ORGANIZATIONS", INVESTMENTS IN EQUITY SECURITIES WITH READILY DETERMINABLE VALUES AND ALL INVESTMENTS IN DEBT SECURITIES ARE REPORTED AT FAIR VALUE ON THE BALANCE SHEET. INCOME, REALIZED AND UNREALIZED GAINS AND LOSSES ARE POOLED AND ALLOCATED TO THE PARTICIPANTS. INDIVIDUAL COMPONENTS OF ASSETS AND REVENUE ARE NOT IDENTIFIED TO THE PARTICIPANTS.
OTHER CHANGES IN NET ASSETS OR FUND BALANCESFORM 990, PART XI, LINE 5Unrealized Gain on Investments 3,169,909 Recognition of Changes in pension funded status 12,557,001 Cumulative effect of change in accounting principle (351,058) contributions from related parties (366,018) temporarily restricted net income 1,048,000 permanently restricted net income 33,000 Transfer to Affiliates (8,361,000) ----------- Total Other Changes in Net assets or fund balances 7,729,834 ===========
transactions with related entitiesForm 990 Schedule R, Part v, line 2The Transactions reported in Question 1 are between related 501(c)(3) public charities and are not reported in this section.
HOURS DEVOTED FOR RELATED ORGANIZATIONFORM 990 PART VIINAME:Johnny E. Watkins TITLE:Division CFO HOURS:35
HOURS DEVOTED FOR RELATED ORGANIZATIONFORM 990 PART VIINAME:Ann Carr TITLE:Treasurer HOURS:75
HOURS DEVOTED FOR RELATED ORGANIZATIONFORM 990 PART VIINAME:Mark Reifsteck TITLE:Division CEO HOURS:18
HOURS DEVOTED FOR RELATED ORGANIZATIONFORM 990 PART VIINAME:Illa J. David TITLE:Division CIO HOURS:18
HOURS DEVOTED FOR RELATED ORGANIZATIONFORM 990 PART VIINAME:James Burke TITLE:Division VP of Legal Services HOURS:18
HOURS DEVOTED FOR RELATED ORGANIZATIONFORM 990 PART VIINAME:Kevin Shrake TITLE:Former CEO HOURS:70

Schedule R IRS990ScheduleR

Form990 Schedule R Part I Form990ScheduleRPartI (2 entries)

Address Line1AddressUS/AddressLine1CityAddressUS/CityStateAddressUS/StateZIP CodeAddressUS/ZIPCodeEINEINPrimary ActivitiesPrimaryActivitiesLegal Domicile StateLegalDomicileStateTotal IncomeTotalIncomeEOY AssetsEOYAssetsBusiness Name Line1DirectControllingEntityName/BusinessNameLine1
SPRINGFIELD HEALTH PARTNERS LLC
4936 LAVERNA ROADSPRINGFIELDIL62707371364419HEALTHCAREIL00HSHS MG
Kiara Clinical Integration Network LLC
4936 Laverna RdspringfieldIL62707261417684HealthCareIL00Kiara Inc

Form990 Schedule R Part II Form990ScheduleRPartII (23 entries)

Address Line1AddressUS/AddressLine1CityAddressUS/CityStateAddressUS/StateZIP CodeAddressUS/ZIPCodeEINEINPrimary ActivitiesPrimaryActivitiesLegal Domicile StateLegalDomicileStateExempt Code SectionExemptCodeSectionPublic Charity StatusPublicCharityStatusBusiness Name Line1DirectControllingEntityName/BusinessNameLine1
HOSPITAL SISTERS HEALTH SYSTEM
4936 LAVERNA ROADSPRINGFIELDIL62707371058692HEALTHCAREIL501(c)(3)11ANA
HOSPITAL SISTERS SERVICES INC
4936 LAVERNA ROADSPRINGFIELDIL62707371163402HEALTHCAREIL501(c)(3)11ANA
HOSPITAL SISTERS OF ST FRANCIS FDTN
4936 LAVERNA ROADSPRINGFIELDIL62707371186514HEALTHCAREIL501(c)(3)11ANA
HSHS SELF INSURANCE TRUST FUND
4936 LAVERNA ROADSPRINGFIELDIL62707371120626INSURANCEIL501(c)(3)11ANA
HSHS HEALTH CARE PLAN TRUST FUND
4936 LAVERNA ROADSPRINGFIELDIL62707371137724HEALTHCAREIL501(c)(9)N/ANA
HOSPITAL SISTERS HEALTHCARE - WEST INC
2661 COUNTY HIGHWAY ICHIPPEWA FALLSWI54729510157933HEALTHCAREWI501(c)(3)11ANA
SACRED HEART HOSPITAL
900 WEST CLAIREMONT AVENUEEAU CLAIREWI54701390807060HEALTHCAREWI501(c)(3)3NA
ST ANTHONY'S HOSPITAL
503 N MAPLE STREETEFFINGHAMIL62401370661233HEALTHCAREIL501(c)(3)3NA
ST JOHN'S HOSPITAL
800 EAST CARPENTER STREETSPRINGFIELDIL62769370661238HEALTHCAREIL501(c)(3)3NA
ST FRANCIS HOSPITAL
1215 FRANCISCAN DRIVELITCHFIELDIL62056370661236HEALTHCAREIL501(c)(3)3NA
ST JOSEPH'S HOSPITAL
9515 HOLY CROSS LANEBREESEIL62230371208459HEALTHCAREIL501(c)(3)3NA
ST JOSEPH'S HOSPITAL
1515 MAIN STREETHIGHLANDIL62249370663568HEALTHCAREIL501(c)(3)3NA
ST JOSEPH'S HOSPITAL
2661 COUNTY HIGHWAY 1CHIPPEWA FALLSWI54729390810545HEALTHCAREWI501(c)(3)3NA
ST MARY'S HOSPITAL
1800 E LAKE SHORE DRIVEDECATURIL62521362169181HEALTHCAREIL501(c)(3)3NA
ST MARY'S HOSPITAL
111 SPRING STREETSTREATORIL61364362169181HEALTHCAREIL501(c)(3)3NA
ST NICHOLAS HOSPITAL
3100 SUPERIOR AVENUESHEBOYGANWI53081390808480HEALTHCAREWI501(c)(3)3NA
ST VINCENT HOSPITAL
835 S VAN BURENGREEN BAYWI54301390817529HEALTHCAREWI501(c)(3)3NA
ST MARY'S HOSPITAL MEDICAL CENTER
1726 SHAWANO AVENUEGREEN BAYWI54303390818682HEALTHCAREWI501(c)(3)3NA
HSHS MEDICAL GROUP INC
4936 LAVERNA ROADSPRINGFIELDIL62707263956318HEALTHCAREIL501(c)(3)11ANA
HSHS WISCONSIN MEDICAL GROUP INC
8040 EXCELSIOR DRIVE STE 200MADISONWI53717264515959HEALTHCAREWI501(c)(3)11ANA
Orange Cross Ambulance Inc
919 Ashland AvesheboyganWI53081391860942healthcareWI501(c)(3)9St Nicholas
Wisconsin Upper Pen Onc Mngmt Services
835 S Van Burengreen bayWI54304391677100healthcareWI501(c)(3)3St Vincent
Unity Limited Partnerhship
2366 Oak Ridge CircleDe PereWI54115391750729HealthcareWI501(c)(3)9HSSI

Form990 Schedule R Part III Form990ScheduleRPartIII (8 entries)

Address Line1AddressUS/AddressLine1CityAddressUS/CityStateAddressUS/StateZIP CodeAddressUS/ZIPCodeEINEINPrimary ActivityPrimaryActivityLegal Domicile StateLegalDomicileStateBusiness Name Line1DirectControllingEntityName/BusinessNameLine1Predominant Income TypePredominantIncomeTypeShare Of Total IncomeShareOfTotalIncomeShare Of EOY AssetsShareOfEOYAssetsDisproportionate AllocationsDisproportionateAllocationsCode VCodeVAmountGeneral Or Managing PartnerGeneralOrManagingPartnerPercentage OwnershipPercentageOwnership
Memorial and St Elizabeth's Healthcare
4000 North Illinois StreetSwanseaIL62226371312961HealthCareILNArelated14160924344686false$0false0.50000
Prairie Heart Institute - Carbondale LL
800 East Carpenter StreetSpringfieldIL62769371321197HealthCareILSt John'srelated00false$0false0.00000
Northeast Wisconsin Radiation Therapy Se
1821 S Webster Avenue Suite 300Green BayWI543079047263749065HealthCareWIHSSIrelated00false$0false0.00000
Pain Center of Wisconsin
4131 W Loomis Road Suite 300GreenfieldWI53221263155343HealthCareWISt Vincentrelated00false$0false0.00000
Surgery Center of Sheboygan LLC
3141 Saemann AveSheboyganWI53081260822209HealthCareWISt Nicholasrelated00false$0false0.00000
Prevea Ventures LLC
2710 EXECUTIVE DRGreen BayWI54304203775127HealthCareWIHSSIrelated00false$0false0.00000
CARPENTER STREET HOTEL LLC 36-
HOTELILLASANTE INCRELATED00false$0false0.00000
SPRINGFIELD URGENT CARE REAL E
ILLASANTE INCRELATED00false$0false0.00000

Form990 Schedule R Part IV Form990ScheduleRPartIV (8 entries)

Address Line1AddressUS/AddressLine1CityAddressUS/CityStateAddressUS/StateZIP CodeAddressUS/ZIPCodeEINEINPrimary ActivityPrimaryActivityLegal Domicile StateLegalDomicileStateBusiness Name Line1DirectControllingEntityName/BusinessNameLine1Type Of EntityTypeOfEntityShare Of Total IncomeShareOfTotalIncomeShare Of EOY AssetsShareOfEOYAssetsPercentage OwnershipPercentageOwnershipAddress Line1AddressForeign/AddressLine1CityAddressForeign/CityProvince Or StateAddressForeign/ProvinceOrStateCountryAddressForeign/CountryPostal CodeAddressForeign/PostalCodeLegal Domicile Foreign CountryLegalDomicileForeignCountry
Kiara Inc
4936 Laverna RdSpringfieldIL62707371163401HealthCareILHSHSC Corp000.00000
LaSante Wisconsin Inc
4936 Laverna RdSpringfieldIL62707391572196HealthCareILKiara IncC Corp000.00000
LaSante Inc
4936 Laverna RdSpringfieldIL62707371163400HealthCareILKiara IncC Corp000.00000
Prairie Cardiovascular
619 East Mason Suite 4P57SpringfieldIL62701371071858HealthCareILKiara IncC Corp000.00000
Prevea Health Services
2710 EXECUTIVE DRGreen BayWI54304391839351HealthCareWIHSSIC Corp000.00000
Prevea Clinic Inc
2710 EXECUTIVE DRGreen BayWI54304391839349HealthCareWIHSSIC Corp000.00000
Prevea Health Network
2710 EXECUTIVE DRGreen BayWI54304392000537HealthCareWIHSSIC Corp000.00000
REnaissance Quality Insurance
980669953InsuranceHSSIc corp000.00000PO Box 1159 KY1-1102Grand CaymanCayman IslandsCJKY1-1102CJ
FieldValueIRS element (for citing)
Receipt Of Int Ann Rents RoyaltiesfalseReceiptOfIntAnnRentsRoyalties
Gift Grant Or Cap Contr To Other OrgfalseGiftGrantOrCapContrToOtherOrg
Gift Grant Or Cap Contr Fr Other OrgtrueGiftGrantOrCapContrFrOtherOrg
Loans Or Guarantees To Other OrgfalseLoansOrGuaranteesToOtherOrg
Loans Or Guarantees From Other OrgfalseLoansOrGuaranteesFromOtherOrg
Sale Of Assets To Other OrgfalseSaleOfAssetsToOtherOrg
Purchase Of Assets From Other OrgfalsePurchaseOfAssetsFromOtherOrg
Exchange Of AssetsfalseExchangeOfAssets
Rental Of Facilities To Other OrgsfalseRentalOfFacilitiesToOtherOrgs
Rental Of Facilities Fr Other OrgsfalseRentalOfFacilitiesFrOtherOrgs
Perform Of Services For Other OrgsfalsePerformOfServicesForOtherOrgs
Perform Of Services By Other OrgsfalsePerformOfServicesByOtherOrgs
Sharing Of FacilitiesfalseSharingOfFacilities
Sharing Of Paid EmployeestrueSharingOfPaidEmployees
Reimbursement Paid To Other OrgtrueReimbursementPaidToOtherOrg
Reimbursement Paid By Other OrgtrueReimbursementPaidByOtherOrg
Other Transfer To Other OrgfalseOtherTransferToOtherOrg
Other Transfer From Other OrgfalseOtherTransferFromOtherOrg

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