2012-11-05T09:00:12-06:00 2011-12-31 CROWE HORWATH LLP 70 West Madison Street Suite 700 Chicago IL 606024903 990 2011-01-01 362264414 ST BERNARD HOSPITAL STBE 7739624100 326 WEST 64TH STREET CHICAGO IL 60621 GUY ALTON 2012-10-30 true John Woodhull P01305268 3128997000 2011 2016-02-24 21:20:13Z SR ELIZABETH VAN STRATEN RHSJ 326 WEST 64TH STREET Chicago IL 60621 90413252 false X WWW.STBH.ORG X 1904 IL ST. BERNARD HOSPITAL (SBH) ASPIRES TO LIVE THE HEALING MISSION OF CHRIST WITHIN THE SOUTH SIDE COMMUNITY OF CHICAGO. DURING 2011 SBH PROVIDED $7.2 MIL IN CHARITY CARE AT COST UNDER ITS CHARITY CARE POLICY. 11 10 1008 32 0 0 1464250 1135819 87853000 85723340 71861 3838 3243938 3550255 92633049 90413252 0 0 0 0 48148301 47470729 0 0 26195 38681934 37416821 86830235 84887550 5802814 5525702 53400152 54589073 38896115 34575183 14504037 20013890 X A CATHOLIC FACILITY SPONSORED BY THE RELIGIOUS HOSPITALLERS OF SAINT JOSEPH, SINCE 1904, ST. BERNARD HOSPITAL (SBH) ASPIRES TO LIVE THE HEALING MISSION OF CHRIST WITHIN THE SOUTH SIDE COMMUNITY OF CHICAGO. CONTINUED IN SCHED O. false false 51943360 66243655 ST. BERNARD HOSPITAL OFFERS A FULL CONTINUUM OF INPATIENT SERVICES INCLUDING MEDICAL SURGICAL SERVICES, ICU, TELEMETRY, OBSTETRICS, NURSERY, NEONATOLOGY, MEDICAL DETOX, AND INPATIENT MENTAL HEALTH SERVICES. DURING 2011 ST. BERNARD HOSPITAL PROVIDED 40,465 INPATIENT DAYS OF SERVICE TO 9,031 PATIENTS. IN ADDITION, THE HOSPITAL HAD 1,134 NEWBORN DELIVERIES AS WELL AS 1,546 MENTAL HEALTH ADMISSIONS. 13961148 7910582 DURING 2011 EMERGENCY ROOM SERVICES WERE PROVIDED TO 40,997 PATIENTS. THE EMERGENCY ROOM OF ST. BERNARD HOSPITAL SERVES AS THE PSYCHIATRIC TRIAGE CENTER FOR THE SOUTH SIDE OF CHICAGO COMMUNITY. THE EMERGENCY ROOM ALSO INCLUDES A FAST TRACK TREATMENT AREA AS A WAY TO FASTER TREAT PATIENTS WITH LESS SEVERE MEDICAL CONDITIONS. THIS ENABLES ST. BERNARD HOSPITAL TO GIVE ITS PATIENTS THE RESPONSIVE AND IMMEDIATE TREATMENT THEY DESERVE. 9154787 11302681 DURING 2011 ST. BERNARD HOSPITAL PROVIDED A FULL RANGE OF OUTPATIENT DIAGNOSTIC TREATMENT TO 28,011 OUTPATIENTS. SUCH SERVICES INCLUDED LAB WORK, X-RAYS, ULTRASOUNDS, NUCLEAR MEDICINE, CT SCANS, MAMMOGRAPHY SERVICES, EKG'S, AND EEG'S. ST. BERNARD HOSPITAL ALSO OPERATES A NUMBER OF DIFFERENT CLINICS. CLINICS OF ST. BERNARD HOSPITAL ARE OPEN TO TREAT ASTHMA, ORTHOPEDIC AND PODIATRIC PATIENTS. IN ADDITION, ST. BERNARD HOSPITAL OPERATES A DENTAL CLINIC, WHICH OPENED IN 2007, GEARED TOWARD TREATING CHILDREN, THAT TREATED 5,145 PATIENTS IN 2011. THE HOSPITAL ALSO OPERATES A MOBILE MEDICAL UNIT PROGRAM, WHICH WAS OPENED IN 2003, IT TREATED 2,965 PATIENTS TO PROVIDE IMMUNIZATIONS AND SCHOOL PHYSICALS TO THE CHILDREN IN ENGLEWOOD AND OTHER NEIGHBORHOODS ON THE SOUTH SIDE OF CHICAGO. 433989 THE ORGANIZATION RECEIVES OTHER PROGRAM SERVICE REVENUE RELATED THE RENTAL OF SPACE FOR ITS PHYSICIANS AND NURSES SERVING PATIENTS OF SBH AS WELL AS OTHER REVENUE FROM MAINTENANCE AND MEDICAL RECORDS. 433989 75059295 true true false true false false false false true true false false false true true false true false false false false false false false false true true false false true false false false false false false false true false false false false false true true true false false true 83 0 true 1008 true false false false false false true true false false false false X 11 10 false false false false true true true true true false false true true true true true true true false true false X Guy Alton 7739624073 326 West 64th Street Chicago IL 60621 X X GREGORY WHITEHEAD 1.00 X X 0 0 0 HENRY WIGGINS MD 1.00 X X 0 0 0 LEON JACKSON 1.00 X X 0 0 0 SR ELIZABETH VAN STRATEN RHSJ 40.00 X X 0 0 0 SR MARY POKORNY OP 1.00 X X 0 0 0 AYONDE AKERE MD 1.00 X 0 0 0 DARRELL R HUBBARD 1.00 X 0 0 0 GEORGE DENGLER DO 1.00 X 0 0 0 MARIA ASHLEY DDS 1.00 X 0 0 0 SR JOANNE DELEHANTY OP 1.00 X 0 0 0 SR ROSEMARIE KUGEL RHSJ 1.00 X 0 0 0 CHARLES HOLLAND 40.00 X 250950 0 13777 EVELYN JONES 40.00 X 222256 0 14064 GUY ALTON 40.00 X 253120 0 21658 JANET NOHOS 40.00 X 277964 0 18286 ROLAND ABELLERA 40.00 X 221222 0 22778 RONALD CAMPBELL 40.00 X 261891 0 24848 JENNIFER HONG SURAPIBOONCHAI 76.00 X 279447 0 22374 JESUS DIOSMA 44.00 X 112220 0 9527 SATISH BHATT 40.00 X 142546 0 21613 SUCHITRA SURAPIBOONCHAI 71.00 X 300510 0 27627 VIPUL SINGHUL DDS 40.00 X 169474 0 18575 2491600 0 215127 24 false true false SOUTH YALE EMERGENCY PHYSICIANS 326 WEST 64TH ST CHICAGO IL 60621 ER PHYSICIAN FEES 3218416 AMOSIL PO BOX 767 HAMMOND IN 46325 REPIRATORY THERAPY & EKG SERVICES 1657116 COMPREHENSIVE CONSULTING INC 209 S MAIN ST MOUNT PROSPECT IL 60056 MENTAL HEALTH MANAGEMENT SERVICES 1027260 FRESENIUS MANAGEMENT SERVICES INC 16343 COLLECTION CENTER DR CHICAGO IL 60693 RENAL DIALYSIS SERVICES 532326 CHRISMAR FACILITIES MGMNT INC 3250 EAST GLENWOOD-DYER RD LYNWOOD IL 60411 PLANT OPERATIONS & MAINTENANCE MANAGEMENT 521096 18 718808 417011 1135819 INPATIENT REVENUE 66243655 66243655 OUTPATIENT REVENUE 11302681 11302681 EMERGENCY REVENUE 7910582 7910582 RENTAL REVENUE 266422 266422 0 0 0 0 85723340 3467 3467 0 0 0 0 0 271 100 271 100 371 371 0 0 0 FHN & PIH PAYMENTS 2950176 2950176 CAFETERIA 432512 432512 SISTERS MAINT & MED RECS 98468 98468 69099 69099 0 0 3550255 90413252 85890907 0 3386526 0 0 0 0 1602813 1602813 3218416 3218416 34295862 30866276 3429586 628363 570900 57463 5135535 4718621 416914 2589740 2330766 258974 3830741 2688146 1142595 32930 32930 150000 150000 276057 276057 0 4922 4922 4180882 4089821 91061 146205 146205 286333 286333 331576 248682 82894 0 2857462 2285970 571492 3975 3975 0 276 276 5033 4026 1007 0 3559188 3559188 1923532 1750093 173439 STATE ASSESSMENT 6713833 6713833 PROVISION FOR BAD DEBT 1048477 1048477 PATIENT SUPP. & DRUGS 9264912 8471837 793075 2800487 2494243 280049 26195 84887550 75059295 9802060 26195 0 1388305 1804285 8862954 8150369 607668 10000 8899897 10164319 1071830 932982 4221002 4300447 84800400 59028712 24876758 25771688 1129882 1153539 0 0 0 0 2341856 2301444 53400152 54589073 13358420 6560193 8550418 8550418 0 0 16987277 19464572 38896115 34575183 X 7852105 13583072 5346997 5141733 1304935 1289085 14504037 20013890 53400152 54589073 X 5525702 -15849 X false true true X false X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED false false false false false false true 276057 false false 276057 false Description of the activities reported on Lines 1a through 1i Schedule C, Part II-B, Line 1 AT THE STATE LEVEL LOBBYING WAS DONE TO EDUCATE LEGISLATORS AND GOVERNMENT OFFICIALS REGARDING ISSUES RELATING TO SAFETY NET HOSPITALS AND THE MEDICAID PROGRAM. AT THE FEDERAL LEVEL LOBBYING WAS DONE TO IMPACT LEGISLATION ON IMMIGRATION FOR NURSING PERSONNEL. 1336453 31071 2585 1364939 949953 274400 112100 0 0 0 1336453 788263 0 161690 0 0 949953 942504 500 -152858 0 1883 788263 0.94000 0.06000 false false 5331036 5331036 41883349 33987569 7895780 547430 547430 37038585 25041143 11997442 0 25771688 0 FIN 47 LIABILITY 627583 EST LIAB - SELF INSURANCE PROGRAM 14709755 EST PAYABLES - THIRD PARTY REIMB. 2145349 US BANK LOAN 1981885 19464572 90413252 84887550 5525702 -15849 -15849 5509853 0 0 0 0 0 0 0 0 0 0 0 0 Intended uses of endowment funds Schedule D, Part V, Line 4 THE INTENDED USES OF THE ENDOWMENT FUNDS ARE TO HELP FUND HOSPITAL OUTPATIENT SERVICES AND CHILDREN AND ADULT OUTREACH PROGRAMS TO BETTER SERVE THE COMMUNITY FIN 48 (ASC 740) footnote Schedule D, Part X, Line 2 THE CORPORATIONS (ST. BERNARD HOSPITAL & AFFILIATES) PREVIOUSLY ADOPTED ASC SUBTOPIC 740-10, INCOME TAXES - OVERALL. ASC SUBTOPIC 740-10 CLARIFIES THE ACCOUNTING FOR UNCERTAINTY IN TAX POSITIONS AND ALSO PROVIDES GUIDANCE ON WHEN THE TAX POSITIONS ARE RECOGNIZED IN AN ENTITY'S FINANCIAL STATEMENTS AND HOW THE VALUES OF THESE POSITIONS ARE DETERMINED. AT THE DATE OF ADOPTION, AND AS OF DECEMBER 31, 2011, THE CORPORATIONS DO NOT HAVE A LIABILITY FOR UNRECOGNIZED TAX BENEFITS. true true X true X true X 6 true true false true true 13121 13659630 6713220 6946410 0.08290 0 0 0 0.00000 203 262709 6112 256597 0.00310 0 13324 13922339 6719332 7203007 0.08600 3294641 713872 2580769 0.03080 587293 239115 348178 0.00420 6728146 2448361 4279785 0.05100 0 0 0 0.00000 37461 0 37461 0.00040 0 0 10647541 3401348 7246193 0.08640 0 13324 24569880 10120680 14449200 0.17240 0 0.00000 0 0.00000 0 0.00000 0 0.00000 0 0.00000 0 0.00000 0 0.00000 0 0.00000 0 0.00000 0 0 0 0 0 0.00000 true 1048477 0 25185738 25409744 -224006 X true true PARTNERS IN HEALTH PROVIDE HEALTH CARE SERVICES TO MEDICAID PATIENTS 0.5 0 0.5 1 1 ST BERNARD HOSPITAL

326 WEST 64TH STREET CHICAGO IL 60621

X X X X X Costing Methodology used to calculate financial assistance Schedule H, Part I, Line 7 A COST-TO-CHARGE RATIO WAS USED FOR ALL OF THE FIGURES REPORTED IN THE TABLE. THE COST-TO-CHARGE RATIO WAS DERIVED FROM WORKSHEET 2, RATIO OF PATIENT CARE COST-TO-CHARGES. Bad Debt Expense excluded from financial assistance calculation Schedule H, Part I, Line 7, column(f) 1,048,477 Subsidized Health Services Schedule H, Part I, Line 7g THE ORGANIZATION DID NOT INCLUDE, AS SUBSIDIZED HEALTH SERVICES, ANY COSTS ATTRIBUTABLE TO A PHYSICIAN CLINIC. Community Building Activities Schedule H, Part II ST. BERNARD HOSPITAL EXECUTIVES SIT ON BOARDS OF ORGANIZATIONS IN THE COMMUNITY AND PARTICIPATE IN COMMUNITY BUILDING ACTIVITES SUCH AS IMPROVING THE HOUSING AND ECONOMIC WELL BEING OF ENGLEWOOD, AND IMPROVING HEALTH CARE OF RESIDENTS BY ESTABLISHING AND IMPROVING THE NETWORK OF PROVIDERS AVAILABLE TO COMMUNITY RESIDENTS. Bad debt expense - financial statement footnote Schedule H, Part III, Line 4 THE ORGANIZATION'S AUDITED FINANCIAL STATEMENTS DO NOT INCLUDE A FOOTNOTE RELATED TO "ACCOUNTS RECEIVABLE," "ALLOWANCE FOR DOUBTFUL ACCOUNTS," OR SIMILAR DESIGNATIONS. THE ORGANIZATION DOES NOT INCLUDE BAD DEBT AMOUNTS AS PART OF ITS COMMUNITY BENEFIT. THE METHODOLOGY USED TO DETERMINE THE ORGANIZATIONS BAD DEBT EXPENSE IS FORGONE CHARGES WHERE A COLLECTION EFFORT WAS MADE AND THE BALANCE WAS DEEMED TO BE UNCOLLECTIBLE. NONE OF THE BAD DEBT IS ATTRIBUTABLE TO CHARITY CARE WHICH IS TRACKED SEPERATELY. Community benefit & methodology for determining medicare costs Schedule H, Part III, Line 8 THE HOSPITAL FEELS THAT 100% OF THE MEDICARE SHORTFALL SHOULD BE COUNTED AS COMMUNITY BENEFIT SINCE THE HOSPITAL SHORTFALL REDUCES THE TAXES THE FEDERAL GOVERNMENT WOULD HAVE HAD TO RAISE TO PAY AN OUTSIDE CONTRACTOR TO PROVIDE THE SAME SERVICES TO THE COMMUNITY THE HOSPITAL SERVES. THE HOSPITAL USES A CASE MIX ADJUSTED COST TO CHARGE RATIO METHODOLOGY TO DETERMINE THE AMOUNTS REPORTED ON PART III, LINE 6. Collection practices for patients eligible for financial assistance Schedule H, Part III, Line 9b OF THE MORE THAN 78,000 PATIENTS SEEN ANNUALLY AT ST. BERNARD HOSPITAL, 63% OF THEM RECEIVE MEDICAID AS COVERAGE FOR THEIR HEALTH CARE SERVICES. ANOTHER 14% ARE ON MEDICARE; AND 16% OF OUR PATIENTS ARE SELF-PAY PATIENTS. OUR PATIENT MIX NECESSITATES THAT A FUNDAMENTAL COMPONENT OF ST. BERNARD HOSPITAL'S COMMUNITY BENEFIT STRATEGY IS THE PROVISION OF CHARITY CARE TO THOSE WHO CANNOT AFFORD TO PAY FOR THEIR CARE. THE HOSPITAL PERFORMS NORMAL ACCEPTED COLLECTION PROCEDURES ON LEGITIMATE BALANCES OWED TO THE HOSPITAL. HOSPITAL PATIENT ACCESS STAFF ASSIST UNINSURED OR UNDERINSURED PATIENTS IN APPLYING FOR ANY GOVERNMENTAL ASSISTANCE PROGRAMS THEY MAY QUALIFY FOR. UNINSURED PATIENTS WITH INCOMES LESS THAN 200% OF THE FEDERAL POVERTY LEVEL ARE ELIGIBLE FOR A 100% CHARITY CARE DISCOUNT. THERE ARE NO FURTHER COLLECTION ACTIVITIES ONCE A PATIENT BALANCE HAS BEEN DESIGNATED AS A CHARITY WRITEOFF CONSISTENT WITH THE FINANCIAL ASSISTANCE POLICY. IN ADDITION, PATIENTS WITH INCOMES BETWEEN 200% AND 600% OF THE FEDERAL POVERTY GUIDELINES ARE ELIGIBLE FOR AN AUTOMATIC 50% DISCOUNT WITH THE REMAINING BALANCE DISCOUNTED ON A SLIDING SCALE. Means used to determine amounts billed Schedule H, Part V Section B, Line 19d (1) ST. BERNARD HOSPITAL - PURSUANT TO THE HOSPITAL UNINSURED PATIENT DISCOUNT ACT, PUBLIC ACT 95-0965, THE HOSPITAL EXTENDS A 50% DISCOUNT TO UNINSURED RESIDENTS OF ILLINOIS WHOSE FAMILY INCOME IS NOT MORE THAN 600% OF THE FEDERAL POVERTY GUIDELINES. IF THE TOTAL FAMILY INCOME FALLS BELOW 200% OF THE GUIDELINES, THE ENTIRE ACCOUNT (EXCLUDING LUXURY ITEMS) IS CHARGED TO CHARITY CARE. ; Needs assessment. Schedule H, Part VI, Line 2 THE HOSPITAL PERIODICALLY COMMISSIONS THE COMMUNITY NEEDS ASSESSMENT TO PROVIDE INFORMATION TO THE HEALTHCARE NEEDS OF THE COMMUNITY. THE LATEST COMMUNITY NEEDS ASSESSMENT WAS DONE IN 2009. THE HOSPITAL ALSO PARTICIPATES IN COMMUNITY BUILDING AND COMMUNITY HEALTHCARE ADVOCACY GROUPS TO HELP IDENTIFY NEEDS AND COORDINATE EFFORTS TO PROVIDE QUALITY HEALTHCARE SERVICES TO THE COMMUNITY. THE HOSPITAL PARTICIPATES IN LOCAL HEALTH FAIRS AND OPERATES A MOBILE MEDICAL VAN THAT GOES TO SCHOOLS PROVIDING IMMUNIZATIONS AND SCHOOL PHYSICALS. FROM ITS WORK THE VAN IDENTIFIED THAT THERE WAS A LACK OF DENTAL SERVICES FOR CHILDREN. THE HOSPITAL HAS OPENED A DENTAL CLINIC GEARED TOWARDS PEDIATRIC PATIENTS TO FILL THAT NEED. IN 2010 THE HOSPITAL OPENED A WOMEN'S WELLNESS CLINIC TO PROVIDE FREE HEALTHCARE SERVICES TO UNINSURED WOMEN OF CHILD BEARING AGE. Patient education of eligibility for assistance. Schedule H, Part VI, Line 3 SIGNS ARE POSTED IN THE WAITING AREAS OF THE HOSPITAL AS WELL AS THE HOSPITAL WEBSITE ANNOUNCING THE AVAILABILITY OF CHARITY CARE. HOSPITAL PATIENT ACCESS STAFF ASSIST UNINSURED OR UNDERINSURED PATIENTS IN APPLYING FOR ANY GOVERNMENTAL ASSISTANCE PROGRAMS THEY MAY QUALIFY FOR AS WELL AS THE HOSPITAL'S CHARITY CARE PROGRAM. HOSPITAL BILLS TO PATIENTS ALSO HAVE INFORMATION ON APPLYING FOR FINANCIAL ASSISTANCE. Community information. Schedule H, Part VI, Line 4 THE URBAN COMMUNITIES SURROUNDING THE HOSPITAL FROM WHICH THE HOSPITAL DRAWS MOST OF ITS PATIENTS ARE SOME OF THE POOREST COMMUNITIES ON THE SOUTH SIDE OF CHICAGO. WITHIN THE LAST 30 YEARS, THEY HAVE CONTINUED TO LOSE POPULATION AND HAVE SEEN HOUSING ABANDONMENT AND COMMERCIAL DISINVESTMENT GROW. HIGH RATES OF UNEMPLOYMENT HAVE HAD A DISASTROUS EFFECT ON THE SOCIAL FABRIC NECESSARY TO MAINTAIN A STABLE COMMUNITY. PEOPLE WHO HAVE CHOICES OFTEN LEAVE AND MOVE TO NEIGHBORHOODS WITH GREATER AMENITIES, LEAVING BEHIND THOSE WITH FEWER OPTIONS. DRUGS AND VIOLENT CRIME ARE RAMPANT WHILE 35% OF THE POPULATION LIVES BELOW THE FEDERAL POVERTY GUIDELINES. SIXTY THREE PERCENT OF THE PATIENTS THE HOSPITAL SERVES ARE ON MEDICAID, WHILE 16% ARE SELF-PAY, MOSTLY WITH NO PAYMENT SOURCE. THE AREA IS A FEDERALLY DESIGNATED UNDERSERVED AREA. THE HOSPITAL SERVES OVER 750,000 PATIENTS IN ITS PRIMARY AND SECONDARY SERVICE AREAS. THERE ARE NO OTHER HOSPITALS IN ITS PRIMARY SERVICE AREA, BUT THERE ARE THREE OTHER HOSPITALS LOCATED IN ITS SECONDARY SERVICE AREA. Promotion of community health Schedule H, Part VI, Line 5 ST. BERNARD HOSPITAL IS A 210-BED CATHOLIC COMMUNITY HOSPITAL FOUNDED IN 1904 BY THE RELIGIOUS HOSPITALLERS OF ST. JOSEPH UNDER THE SPONSORSHIP OF CATHOLIC HEALTH INTERNATIONAL. THE SISTERS OF THE RELIGIOUS HOSPITALLERS' ENDURING COMMITMENT TO THE HOSPITAL AND THE ENGLEWOOD COMMUNITY FOR 106 YEARS EPITOMIZES ST. BERNARD'S MISSION: TO CARE FOR THE SICK AND PROMOTE THE HEALTH OF SOUTH SIDE CHICAGO RESIDENTS, WHILE SUSTAINING VALUES OF RESPECT, DIGNITY, CARING AND COMPASSION FOR ALL PERSONS. THE HOSPITAL OPERATES 210 LICENSED BEDS INCLUDING MEDICAL/SURGICAL, OBSTETRICS, PEDIATRICS, INTENSIVE CARE, EMERGENCY MEDICINE, INPATIENT MENTAL HEALTH, AND MEDICAL DETOX SERVICES. THE ENGLEWOOD COMMUNITY, ALTHOUGH CHALLENGED BY THE IMPACTS OF ECONOMIC HARDSHIP, THE ENGLEWOOD COMMUNITY, ALTHOUGH CHALLENGED BY THE IMPACTS OF ECONOMIC HARDSHIP, LOOKS TO ST. BERNARD HOSPITAL AS AN INSTITUTIONAL ANCHOR. IT IS THE COMMUNITY'S SINGLE LARGEST EMPLOYER, EMPLOYING MORE THAN 900 PEOPLE. OVER 45% OF ITS EMPLOYEES LIVE IN THE HOSPITAL'S PRIMARY AND SECONDARY SERVICE AREA. ST. BERNARD TAKES A LEAD ROLE IN IMPROVING THE NEIGHBORHOOD AND THE LIVES OF ITS RESIDENTS BY PARTICIPATING IN ECONOMIC DEVELOPMENT ACTIVITIES, SUCH AS BUILDING AFFORDABLE HOMES IN BERNARD PLACE THROUGH ITS HOUSING DEVELOPMENT SUBSIDIARY. AS THE COMMUNITY'S MAJOR HEALTH CARE FACILITY, THE HOSPITAL PROVIDES SERVICES RANGING FROM EMERGENCY MEDICINE AND OBSTETRICS TO MENTAL HEALTH AND SUBSTANCE ABUSE RECOVERY. IN KEEPING WITH MODERN DEMANDS, ST. BERNARD IS PROUD TO PROVIDE STATE-OF-THE-ART TECHNOLOGICAL CAPABILITIES THAT GREATLY ENHANCE THE HOSPITAL'S HIGH QUALITY OF CARE AND PROMOTE PATIENT SAFETY. OF THE MORE THAN 78,000 PATIENTS SEEN AT ST. BERNARD HOSPITAL EACH YEAR, MORE THAN SEVENTY-SIX PERCENT RECEIVE MEDICAID OR MEDICARE AS COVERAGE FOR THEIR HEALTH CARE. THE HOSPITAL PROVIDES MORE THAN $16 MILLION IN CHARITY CARE EACH YEAR, OR 10.4% OF TOTAL PATIENT REVENUE. COMMUNITY OUTREACH, SUCH AS THE CHANCE CONCEPT FOR COMPREHENSIVE PEDIATRIC HEALTH, ADDRESSES UNMET HEALTH CARE NEEDS OF CHILDREN THROUGH OUR BABY IMMUNIZATION TRACKING SERVICE, PEDIATRIC MOBILE HEALTH UNIT, AND ON-SITE DENTAL CENTER. AS A SETTING FOR EDUCATION, ST. BERNARD IS A VIBRANT CLINICAL TRAINING CLASSROOM FOR MEDICAL AND NURSING STUDENTS, INCLUDING EMERGENCY MEDICINE RESIDENTS, SURGERY, OB, PSYCHIATRIC MEDICAL STUDENTS, AND NURSING ASSISTANT AND X-RAY TECH STUDENTS. ST. BERNARD REMAINS A CONSTANT, DRIVING FORCE HELPING TO STRENGTHEN THE FOUNDATIONS OF THE COMMUNITY BY DELIVERING HIGH QUALITY, COMPREHENSIVE HEALTH CARE SERVICES, DEVELOPING AFFORDABLE HOUSING, AND FOSTERING OPPORTUNITIES FOR ECONOMIC GROWTH. State filing of community benefit report Schedule H, Part VI, Line 7 IL X X X X false false false false false false false false false SATISH BHATT 130326 0 10000 0 2220 0 6522 0 15091 0 164159 0 0 0 JENNIFER HONG SURAPIBOONCHAI 279447 0 0 0 0 0 6731 0 15643 0 301821 0 0 0 GUY ALTON 185502 0 66500 0 1118 0 6363 0 15295 0 274778 0 0 0 RONALD CAMPBELL 194273 0 66500 0 1118 0 9520 0 15328 0 286739 0 0 0 SUCHITRA SURAPIBOONCHAI 296802 0 0 0 3708 0 11920 0 15707 0 328137 0 0 0 EVELYN JONES 154981 0 66500 0 775 0 7597 0 6467 0 236320 0 0 0 JANET NOHOS 235346 0 41500 0 1118 0 11521 0 6765 0 296250 0 0 0 VIPUL SINGHUL DDS 169294 0 0 0 180 0 3340 0 15235 0 188049 0 0 0 ROLAND ABELLERA 154452 0 66500 0 270 0 7597 0 15181 0 244000 0 0 0 CHARLES HOLLAND 183676 0 66500 0 774 0 7203 0 6574 0 264727 0 0 0 GEORGE DENGLER BOARD MEMBER AND OWNER OF ENITY DOING BUSINESS WITH SBH 3218416 100% OWNER OF AN ENTITY (SOUTH YALE ER PHYSICIANS) PROVIDING SERVICES TO SBH. false ORGANIZATION'S MISSION FORM 990, PART III, LINE 1 THIS MISSION CALLS SBH TO CARE FOR THE SICK AND PROMOTE THE HEALTH OF THE RESIDENTS IN THE COMMUNITY WHILE WITNESSING THE CHRISTIAN VALUES OF RESPECT, DIGNITY, CARE AND COMPASSION FOR ALL PERSONS. IN ALL MATTERS, ST. BERNARD HOSPITAL WILL SHOW A SPECIAL SENSITIVITY TO THE CULTURE OF THE PEOPLE IT SERVES AND THE SPECIAL NEEDS OF THE POOR AND POWERLESS. ST. BERNARD HOSPITAL IS LOCATED IN THE CHICAGO SOUTHSIDE COMMUNITY OF ENGLEWOOD, A PREDOMINANTLY AFRICAN AMERICAN COMMUNITY AREA THAT HAS SUFFERED THE CUMULATIVE EFFECTS OF POVERTY AND URBAN BLIGHT FOR DECADES. THE HOSPITAL OPERATES 210 LICENSED BEDS INCLUDING MEDICAL/SURGICAL, OBSTETRICS, PEDIATRICS, INTENSIVE CARE, EMERGENCY MEDICINE, INPATIENT MENTAL HEALTH, AND MEDICAL DETOX SERVICES AS WELL AS OUTPATIENT DIAGNOSTIC SERVICES. $7.2 MILLION IN FORGONE CHARGES AT COST UNDER THE ORGANIZATION'S CHARITY CARE POLICY WAS PROVIDED TO PATIENTS SERVED BY THE HOSPITAL IN 2011. Description of other program services Form 990, Part III, Line 4d THE ORGANIZATION RECEIVES OTHER PROGRAM SERVICE REVENUE RELATED THE RENTAL OF SPACE FOR ITS PHYSICIANS AND NURSES SERVING PATIENTS OF SBH AS WELL AS OTHER REVENUE FROM MAINTENANCE AND MEDICAL RECORDS. Classes of members or stockholders Form 990, Part VI, Section A, Line 6 ST. BERNARD HEALTH NETWORK, A RELATED TAX-EXEMPT, IS THE SOLE MEMBER OF ST. BERNARD HOSPITAL. Members or stockholders electing members of governing body Form 990, Part VI, Section A, Line 7a AS THE SOLE CORPORATE MEMBER OF ST. BERNARD HOSPITAL, ST. BERNARD HEALTH NETWORK HAS THE RIGHT TO APPOINT MEMBERS OF THE GOVERNING BODY OF ST. BERNARD HOSPITAL. Decisions requiring approval by members or stockholders Form 990, Part VI, Section A, Line 7b AS THE SOLE CORPORATE MEMBER OF ST. BERNARD HOSPITAL, ST. BERNARD HEALTH NETWORK HAS THE RIGHT TO APPROVE OR RATIFY SIGNIFICANT DECISIONS OF ST. BERNARD HOSPITAL'S GOVERNING BODY. SUCH RIGHTS INCLUDE APPROVING BUDGETS, APPROVING THE SELECTION OF THE HOSPITAL'S AUDITORS, AND APPROVING MEMBERS OF THE GOVERNING BODY OF ST. BERNARD HOSPITAL. Review of form 990 by governing body Form 990, Part VI, Section B, Line 11b A FULL COPY OF THE FORM 990 IS PROVIDED TO ALL MEMBERS OF THE GOVERNING BODY BEFORE IT IS FILED WITH THE IRS. THE FINANCE COMMITTEE OF THE INDEPENDENT GOVERNING BODY REVIEWS THE FORM 990 IN DETAIL, AND REPORTS TO THE FULL GOVERNING BODY AT A BOARD MEETING. DURING THE BOARD MEETING ANY QUESTIONS OR DISCUSSIONS RELATED TO THE FORM 990 ARE ADDRESSED. Conflict of interest policy Form 990, Part VI, Section B, Line 12c WRITTEN CONFLICT OF INTEREST STATEMENTS ARE REQUIRED TO BE COMPLETED AND SIGNED BY EACH MEMBER OF THE GOVERNING BODY, OFFICERS, AND KEY EMPLOYEES ON AN ANNUAL BASIS. THE CORPORATE BOARD OFFICERS MONITOR ANY CONFLICTS AND PROHIBIT ANY GOVERNING BODY MEMBER FROM PARTICIPATING IN ANY DELIBERATION OR DECISION WHERE THE MEMBER MAY HAVE A CONFLICT OF INTEREST. CORPORATE OFFICERS, INCLUDING THE CEO AND CHIEF COMPLIANCE OFFICER, MONITOR ANY CONFLICT OF INTEREST ISSUES WITH OFFICERS, KEY EMPLOYEES, AND MANAGEMENT. Process used to establish compensation of top management official Form 990, Part VI, Section B, Line 15a THE COMPENSATION COMMITTEE, WHICH CONSISTS OF INDEPENDENT MEMBERS OF THE BOARD, MEETS TO ESTABLISH AND APPROVE THE COMPENSATION OF THE CEO. HOSPITAL EXECUTIVE COMPENSATION STUDIES FROM METROPOLITAN CHICAGO HEALTHCARE COUNCIL AND MODERN HEALTHCARE AS WELL AS THE FORM 990S OF OTHER ORGANIZATIONS ARE USED TO DETERMINE THE FAIRNESS AND COMPARABILITY OF COMPENSATION PROVIDED TO THE CEO IN THE FORM OF SALARY AND BENEFITS. THE DELIBERATIONS AND DETERMINATIONS OF THE COMPENSATION COMMITTEE'S EFFORTS ARE DOCUMENTED ON A TIMELY BASIS AND PROVIDED TO HOSPITAL FINANCE FOR IMPLEMENTATION. THE PROCESS FOR DETERMINING COMPENSATION FOR THE HOSPITAL'S TOP MANAGEMENT OFFICIAL WAS LAST UNDERTAKEN IN 2010 FOR THE CALENDAR YEAR 2011 COMPENSATION. PROCESS USED TO ESTABLISH COMPENSATION FOR OTHER OFFICERS/KEY EMPLOYEES FORM 990, PART VI, LINE 15B THE SALARIES OF THE POSITIONS OF EXECUTIVE VICE PRESIDENT, CFO, VP OF PATIENT CARE, CHIEF NURSE EXECUTIVE, CHIEF COMPLIANCE OFFICER, AND VP OF PLANNING ARE REVIEWED AND APPROVED BY THE PRESIDENT/CEO ON AN ANNUAL BASIS. COMPENSATION SURVEYS FROM METROPOLITAN CHICAGO HEALTHCARE COUNCIL, HEALTHCARE FINANCIAL MANAGEMENT ASSOCIATION, AND MODERN HEALTHCARE AS WELL AS THE FORM 990S OF OTHER ORGANIZATIONS ARE USED TO ESTABLISH THE REASONABLENESS OF COMPENSATION FOR EACH POSITION AS WELL AS EMPLOYEE PERFORMANCE. SUBSTANTIATION DOCUMENTING THIS PROCESS IS MAINTAINED BY THE PRESIDENT/CEO AND SHARED WITH THE BOARD CHAIRMAN. WRITTEN RESULTS ARE PROVIDED TO THE HOSPITAL FINANCE COMMITTEE FOR IMPLEMENTATION. THE PROCESS FOR DETERMINING COMPENSATION FOR THE ABOVE MENTIONED INDIVIDUALS WAS LAST UNDERTAKEN IN 2010 FOR THE CALENDAR YEAR 2011 COMPENSATION. Governing documents, conflict of interest policy and financial statements available to the public Form 990, Part VI, Section C, Line 19 THE ORGANIZATION'S FINANCIAL STATEMENTS, GOVERNING DOCUMENTS, AND CONFLICT OF INTEREST POLICIES ARE NOT REQUIRED DISCLOSURES PURSUANT TO INTERNAL REVENUE CODE (IRC) SECTION 6104. THESE DOCUMENTS ARE NOT AVAILABLE TO THE PUBLIC AT THIS TIME. Average hours worked per week for related organization Form 990, Part VII, Section A, Column B SR ELIZABETH VAN STRATEN RHSJ - SR ELIZABETH VAN STRATEN, RHSJ, CEO, DEVOTES APPROXIMATELY 1 HOUR A WEEK TO ST. BERNARD HOUSING DEVELOPMENT CORPORATION, 1 HOUR A WEEK TO ST. BERNARD FOUNDATION AND APPROXIMATELY 1 HOUR A WEEK TO ST. BERNARD HEALTH NETWORK. JESUS DIOSMA - 0 DARRELL R. HUBBARD - 0 Other changes in net assets or fund balances Form 990, Part XI, Line 5 UNCOLLECTIBLE PERMANENTLY RESTRICTED PLEDGE RECEIVABLE - -15849; ST BERNARD HEALTH NETWORK 326 WEST 64TH ST CHICAGO IL 60621 201903584 HEALTHCARE IL 501(C)(3) 11 NA false ST BERNARD FOUNDATION 326 WEST 64TH ST CHICAGO IL 60621 300135130 SUPPORT SBH IL 501(C)(3) 11 SBHN false ST BERNARD HOUSING DEVELOPMENT CORP 326 WEST 64TH ST CHICAGO IL 60621 364322147 HOUSING DEVELOPMENT IL 501(C)(3) N/A SBH true PARTNERS IN HEALTH INC 326 WEST 64TH STREET CHICAGO IL 60621 363877089 HEALTHCARE SERV IL NA C CORPORATION 0.50000 FOUNDATION FOR EMERGENCY SERVICES 326 WEST 64TH STREET CHICAGO IL 60621 364330129 MEDICAL BILLING IL SBH C CORPORATION 0 0 1.00000 WOMEN'S HEALTH CENTER - SOUTH 326 WEST 64TH STREET CHICAGO IL 60621 364333745 WOMEN'S HEALTH IL SBH C CORPORATION 0 0 1.00000 false false false false false false false false false false false false true true false false false false