2012-05-10T08:56:39-05:00 2011-06-30 Deloitte Tax LLP 111 Monument Circle Suite 2000 Indianapolis IN 462045108 990 2010-07-01 351712001 StVincent Seton Specialty Hospital Inc STVI 3174158357 8071 Township Line Road No 200 Indianapolis IN 46260 Peter H Alexander 3174158354 2012-05-10 1 Shawna Jimenez 3174648600 2010 2016-02-24 21:20:13Z Peter H Alexander 8071 Township Line Road No 200 Indianapolis IN 46260 68736960 0 X www.stvincent.org X 1987 IN We are a nonprofit hospital dedicated to providing healthcare that leaves no one behind. 7 6 473 6 0 0 58722 2763173 63920082 61967530 3436326 3857346 132600 140061 67547730 68728110 0 1600000 0 0 29352221 31400566 0 0 0 25546415 24159014 54898636 57159580 12649094 11568530 66724393 79640105 10373187 8562466 56351206 71077639 X St.Vincent Seton Specialty Hospital is dedicated to providing spiritually-centered, holistic healthcare that sustains and improves the health of those served, with special attention to the poor and vulnerable. Both inpatient and outpatient health services are provided without regard to patient race, creed, national origin, economic status, insurance status or ability to pay. This mission extends well beyond the provision of core medical services to encompass medical and scientific research programs, the training and educating of health care professionals and active support of community-based partnerships and programs to improve health and quality of life. 0 0 48528264 1600000 61967530 St.Vincent Seton Specialty Hospital (SVSSH) is a 104 (74+30)-bed, long term acute care hospital primarily serving Marion, Tippecanoe and contiguous counties and providing services without regard to patient race, creed, national origin, economic status, or ability to pay. It is a unique organization that specializes in caring for acute, critically ill and catastrophically injured patients requiring longer hospital stays averaging more than 25 days. During fiscal year 2011, SVSSH treated 1,042 patients for a total of 30,429 inpatient days of service. See Schedule O for a non-exhaustive list of community benefit programs and descriptions. 2289317 St.Vincent Seton Specialty Hospital (SVSSH) provides a substantial portion of its core health services to the poor, uninsured or underinsured and has proactively taken steps to address the accessibility, financing, and delivery of healthcare to the underserved. During the fiscal year ending June 30, 2011, the unreimbursed cost of free or discounted services provided to patients who were deemed indigent under state, county, or hospital guidelines was $2,289,317, which included $564,439 of traditional charity care and $1,724,878 in unpaid costs of care for those qualifying for Medicaid or other public programs for the poor. See Schedule O for a non-exhaustive list of the community benefit programs and descriptions. 141540 In addition to core medical services, St.Vincent Seton Specialty Hospital (SVSSH) partners with its community to assess community assets and needs and to work together to address issues impacting health and quality of life, with special emphasis on the poor and vulnerable. In fiscal year 2011, SVSSH provided $141,540 in unbilled services to the poor and to the broader community. (When combined with the costs of free or discounted services for the poor listed in Line 4b, SVSSH provided a total Community Benefit of $2,430,857 in fiscal year 2011.) SVSSH serves and supports its community through such programs as donation of time to the Indiana Veterans' Home and health fairs. See Schedule O for a non-exhaustive list of the community benefit programs and descriptions. 50959121 1 1 0 1 0 0 0 0 0 1 0 0 1 1 0 0 1 0 0 0 0 0 0 0 0 1 1 1 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 1 1 1 0 0 1 26 0 1 473 1 0 0 0 0 0 0 0 0 0 0 X 7 6 0 0 0 0 1 1 1 1 1 0 1 1 1 1 1 1 1 1 1 1 0 IN X David M Girten CFO 3174158357 8071 Township Line Road Ste 200 Indianapolis IN 46260 X George D Martin 0.50 X X 0 0 0 Ronald E Rosenberg 0.50 X X 0 0 0 Deborah A Lawrence 0.50 X X 0 0 0 David J Handel 0.50 X 0 0 0 David A Heimansohn MD 0.50 X 0 0 0 James S Parsons 0.50 X 0 0 0 Alan D Snell MD 0.50 X 0 279100 45850 Peter H Alexander 40.00 X 245954 0 52108 David M Girten 40.00 X 187492 0 35738 Troy T Reiff 40.00 X 177141 0 35973 Melanie G Holt 40.00 X 159211 0 14871 Linda Carroll 40.00 X 0 104072 22819 Merly S Shaw 40.00 X 199506 0 37826 Toni A Turpin 40.00 X 174180 0 38433 Theresa M Anderson 40.00 X 158714 0 36188 Jerry J Jensen 40.00 X 150887 0 11835 Timothy Chambers 40.00 X 148401 0 18670 1601486 383172 350311 36 0 1 0 South Bend Medical Foundation 530 N Lafayette Blvd South Bend IN 46601 Lab services 1129153 Fresenius Medical Services 16343 Collections Center Dr Chicago IL 60693 Medical services 545487 Rural Metro of Indiana LP Dept 8157 Carol Stream IL 601228157 Ambulance transportation services 208564 Liberty Dialysis PO Box 10147 Uniondale NY 11555 Dialysis services 175269 Assured Healthcare LLC 7922 E Edgewood Avenue Indianapolis IN 46239 Nursing services 164037 5 2724026 39147 2763173 Net Medicare/Medicaid 621990 38712774 38712774 Net patient revenue 621990 23254756 23254756 61967530 3866196 3866196 8850 -8850 -8850 -8850 Cafeteria revenue 722210 140061 140061 140061 68728110 61967530 0 3997407 1600000 1600000 842254 842254 23703213 21269817 2433396 1279356 1148016 131340 3899278 3498974 400304 1676465 1504357 172108 630470 565745 64725 76651 68782 7869 689 618 71 711 638 73 458910 411798 47112 867470 778415 89055 212649 190818 21831 16828 15100 1728 1646815 1477751 169064 93280 93280 Supplies 6562201 5888519 673682 Purchased services 3653761 3278662 375099 Contract labor 2933433 2632284 301149 Community benefit 2430857 2430857 Miscellaneous 1404421 1260244 144177 3169868 2844446 325422 57159580 50959121 6200459 0 3334572 2847928 9136457 8017836 478060 466268 34884 23951868 8075649 17200278 15876219 36540142 52431854 66724393 79640105 4470807 4664017 5902380 3898449 10373187 8562466 X 56311064 71038422 40142 39217 56351206 71077639 66724393 79640105 X 11568530 3157903 X 0 1 1 X 1 1 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 0 0 0 0 0 0 0 0 1 1878 1878 0 Explanation of Other Lobbying Activities: Part II-B, Line 1i: Lobbying expenses represent the portion of dues paid to national and state hospital associations that is specifically allocable to lobbying. 847629 847629 16813421 4180503 12632918 3157 973 2184 6260770 3894173 2366597 26891 26891 15876219 Receivable from third party payors 613302 Donor restricted funds 39217 Health System Depository Account 51779335 52431854 Payables to third party programs 1772726 Intercompany payables 1614479 Other liabilities 72327 Intercompany debt to Ascension Health 438917 3898449 1 1 X 1 X 1 X 1 1 1 0 1 1 564439 564439 0.00990 1724878 1724878 0.03020 2289317 2289317 0.04010 2007 67785 67785 0.00120 178 20320 20320 0.00040 2339 46507 46507 0.00080 4524 134612 134612 0.00240 4524 2423929 2423929 0.04250 164 6928 6928 0.00010 164 6928 6928 0.00010 0 -47407 0 38525956 39440189 -914233 X 1 1 2 1 StVincent Seton Specialty Hospital Inc

8071 Township Line Road Indianapolis IN 46260

X 2 StVincent Seton Specialty Hospital Inc

1501 Hartford Street Lafayette IN 47904

X StVincent Seton Specialty Hospital Inc 1 StVincent Seton Specialty Hospital Inc 2 Part I, Line 3c: The organization provides medically necessary care to all patients, regardless of race, color, creed, ethnic origin, gender, disability or economic status. The hospital uses a percentage of federal poverty level (FPL) to determine free and discounted care. At a minimum, patients with income less than or equal to 200% of the FPL, which may be adjusted for cost of living utilizing the local wage index compared to the national wage index, will be eligible for 100% charity care write off of charges for services that have been provided to them. Also, at a minimum, patients with incomes above 200% of the FPL but not exceeding 400% of the FPL, subject to adjustments for cost of living utilizing the local wage index compared to national wage index, will receive a discount on the services provided to them. Part I, Line 7: The cost of providing charity care, means tested government programs, and community benefit programs is estimated using internal cost data, and is calculated in compliance with Catholic Health Association ("CHA") guidelines. The organization uses a cost accounting system that addresses all patient segments (for example, inpatient, outpatient, emergency room, private insurance, Medicaid, Medicare, uninsured, or self pay). The best available data was used to calculate the amounts reported in the table. For the information in the table, a cost-to-charge ratio was calculated and applied. Part II: St.Vincent Seton Specialty Hospital (SVSSH) as a long term acute care hospital is focused on intense care that the patients receive for their complete recovery. SVSSH's community benefit activities directly impact the health of its communities. Part III, Line 4: The organization is a part of the St.Vincent Health System consolidated audit. The provision for bad debts is based upon management's assessment of expected net collections considering economic conditions, historical experience, trends in health care coverage, and other collection indicators. On a monthly basis, management assesses the adequacy of the allowance for uncollectible accounts for each patient, including those amounts not covered by insurance. The results of this review are then used to make modifications to the provision for bad debts to establish an appropriate allowance for uncollectible accounts. After satisfaction of amounts due from insurance and reasonable efforts to collect from the patient have been exhausted, the Corporation follows established guidelines for placing certain past-due patient balances within collection agencies, subject to the terms of certain restrictions on collection efforts as determined by Ascension Health. Accounts receivable are written off after collection efforts have been followed in accordance with the Corporations policies. The share of the bad debt expense in fiscal year 2011 was ($128,908) at charges (-$47,407 at cost). Part III, Line 8: Ascension Health and related health ministries follow the Catholic Health Association ("CHA") guidelines for determining community benefit. CHA community benefit reporting guidelines suggest that Medicare shortfall is not treated as community benefit. Part III, Line 9b: The organization has a written debt collection policy that also includes a provision on the collection practices to be followed for patients who are known to qualify for charity care or financial assistance. If a patient qualifies for charity or financial assistance certain collection practices do not apply. St.Vincent Seton Specialty Hospital (SVSSH) and its related St.Vincent Health affiliates file a Community Benefit report in the state of Indiana. A copy of the full report (including the SVSSH section) is available at http://www.stvincent.org. Part VI, Line 2: Communities are dynamic systems in which multiple factors interact to impact quality of life and health status. St.Vincent Seton Specialty Hospital (SVSSH) helps to periodically assess assets and needs within the long term acute care community, prioritize action, and work in partnership to address identified challenges. As part of the St.Vincent Health System, the goal of SVSSH is to work with its community to conduct an assessment at least every three years. Assessments may include primary survey data, secondary data, focus group input, community leaders' survey and other data. SVSSH follows the St.Vincent Indianapolis's protocol for this procedure. Results are made available to organizations and individuals throughout the community. These needs assessments are also utilized in creating the hospital's Integrated Strategic Financial and Operational Plan. Part VI, Line 3: St.Vincent Seton Specialty Hospital communicates with patients in multiple ways to ensure that those who are billed for services are aware of the hospital's charity care program as well as their potential eligibility for local, state or federal programs. Signs are prominently posted in each service area, and bills contain a formal notice explaining the hospital's charity care program. In addition, the hospital consults with patients about their eligibility for financial assistance programs and helps patients in applying for any public programs for which they may qualify. Part VI, Line 4: St.Vincent Seton Specialty Hospital (SVSSH) is located in Indianapolis and Lafayette, Indiana and serves Marion, Tippecanoe and contiguous counties, in northwest and Central Indiana. With the special care that SVSSH performs, the patients come from all over the state of Indiana and even bordering states. Patients of all ages come to SVSSH to receive treatment for ailments from motorcycle accidents to severe strokes. SVSSH is for medically complex patients who still need a high level of acute care services. Part VI, Line 6: To provide the highest quality healthcare to all persons in the community, and in keeping with its not-for-profit status, St.Vincent Seton Specialty Hospital:- delivers patient services to all individuals requiring healthcare, without regard to patient race, ethnicity, economic status, insurance status or ability to pay- maintains an open medical staff that allows credentialed physicians to practice at its facilities- trains and educates health care professionals- participates in government-sponsored programs such as Medicaid and Medicare to provide healthcare to the poor and elderly- is governed by a board in which independent persons who are representative of the community comprise a majority Part VI, Line 7: As part of the St.Vincent Health System, St.Vincent Seton Specialty Hospital (SVSSH) is dedicated to improving the health status and quality of life for the communities it serves. While designated associates at SVSSH devote all or a significant portion of their time to leading and administering local community-based programs and partnerships, associates throughout the organization are active participants in community outreach. They are assisted and supported by designated St.Vincent Health community development and service staff who work with each healthcare facility to advocate for and provide technical assistance for community outreach, needs assessments and partnerships as well as to support regional and state-wide programs, community programs sponsored by St.Vincent Health in which SVSSH participates. Reports Filed With States Part VI, Line 7 IN 1 StVincent Hospital and Health Care Center Inc 2001 W 86th Street Indianapolis IN 46260 350869066 501(c)(3) 1600000 Operating grant 1 Procedure for Monitoring Grants in the U.S.: Part I, Line 2: Schedule I, Part I, Line 2: The finance committee ensures that funds are distributed aporopriately according to Acension Health's strategic business plan and consistent with corporate policies and procedures. X 1 1 X X X X 0 1 0 0 0 0 0 0 0 Alan D Snell MD 0 253535 0 25565 0 0 0 31068 0 14782 0 324950 0 0 Peter H Alexander 207948 0 38006 0 0 0 33703 0 18405 0 298062 0 0 0 David M Girten 168816 0 18676 0 0 0 24805 0 10933 0 223230 0 0 0 Troy T Reiff 158544 0 18597 0 0 0 12880 0 23093 0 213114 0 0 0 Melanie G Holt 142714 0 16497 0 0 0 11501 0 3370 0 174082 0 0 0 Merly S Shaw 192634 0 6872 0 0 0 21591 0 16235 0 237332 0 0 0 Toni A Turpin 170741 0 3439 0 0 0 27417 0 11016 0 212613 0 0 0 Theresa M Anderson 146590 0 12124 0 0 0 14455 0 21733 0 194902 0 0 0 Jerry J Jensen 144395 0 6492 0 0 0 11835 0 0 0 162722 0 0 0 Timothy Chambers 137720 0 10681 0 0 0 5943 0 12727 0 167071 0 0 0 Part I, Line 1a St.Vincent Seton Specialty Hospital paid for cell phone usage and deminimus gift for nine of the listed officers/directors and highest compensated employees in Part VII. St.Vincent Seton Specialty Hospital will only reimburse a business expense when all three (3) of the following IRS requirements are met: 1. The expense must have a business connection (i.e., the expenses must be incurred while performing services on behalf of a SVH Entity); 2. The expense must be adequately substantiated by the Associate within a reasonable period of time; and 3. The Associate must return any excess reimbursement or allowance within a reasonable period of time. St.Vincent Seton Specialty Hospital "grossed up" the above applicable non-business expenses and included in the employees' W-2 as additional taxable compensation. Part I, Line 4b The following individuals participated in, or received payment from a supplemental non-qualified retirement plan: David M Girten - $16,485 Alan D Snell - $16,500 Form 990, Part VI, Section A, line 6 St.Vincent Seton Specialty Hospital, Inc. has a single corporate member, St.Vincent Health, Inc. Form 990, Part VI, Section A, line 7a St.Vincent Seton Specialty Hospital, Inc. has a single corporate member, St.Vincent Health, Inc. who has the ability to elect members to the governing body of St.Vincent Seton Specialty Hospital, Inc. Form 990, Part VI, Section A, line 7b All decisions that have a material impact to St.Vincent Seton Specialty Hospital, Inc.'s financial information or corporation as a whole are subject to approval by its sole corporate member, St.Vincent Health, Inc. Form 990, Part VI, Section B, line 11 Management, including certain officers, works diligently to complete the Form 990 and attached schedules in a thorough manner. Management presents the Form 990 to a designated committee of the Board to review and answer any questions. Prior to filing the returns, all Board members are provided the Form 990 and management team members are available to answer any Board member questions. Form 990, Part VI, Section B, line 12c The organization regularly and consistently monitors and enforces compliance with the conflict of interest policy in that any director, principal officer, or member of a committee with governing board delegated powers, who has a direct or indirect financial interest must disclose the existence of the financial interest and be given the opportunity to disclose all material facts to the directors and members of the committee with governing board delegated powers considering the proposed transaction or arrangement. The remaining individuals on the governing board or committee meeting will decide if conflicts of interest exist. Each director, principal officer and member of a committee with governing board delegated powers annually signs a statement which affirms such person has received a copy of the conflicts of interest policy, has read and understands the policy, has agreed to comply with the policy, and understands that the organization is charitable and in order to maintain its federal tax exemption it must engage primarily in activities which accomplish its tax exempt purpose. Form 990, Part VI, Section B, line 15 In determining compensation of the organization's CEO, executive director, or top management official, the process included a review and approval by independent persons, comparability data, and contemporaneous substantiation of the deliberation and decision. The board, in executive session, reviewed and approved the compensation. In review of the compensation, the CEO was compared to other hospitals in the area that hold the same position. During the review and approval of the compensation, documentation of the decision was recorded in the board minutes. Individuals were not present when their compensation was decided. In determining compensation of other officers or key employees of the organization, the process included a review and approval by independent persons, comparability data, and contemporaneous substantiation of the deliberation and decision. The board, in executive session, reviewed and approved the compensation. In the review of the compensation, the other officers or key employees of the organization were compared to other hospitals' employees in the area that hold the same position. Form 990, Part VI, Section C, line 19 The organization will provide any documents open to public inspection upon request. Form 990, Part VII, Section A The average hours per week that was devoted to related organizations during the year: Alan D Snell, MD - 40 hours Changes in Net Assets or Fund Balances: Form 990, Part XI, line 5: Net unrealized gains on investments: 3,157,903. Total Number of Volunteers Part I, Line 6 The total number of volunteers for the organization is 6. This consists of the board members which participate in all board activities as well as activities that include various community service programs that the hospital performs within the community. Tax Exempt Bond Issuance Part IV, Line 24A St.Vincent Seton Specialty Hospital, Inc. is a health facility that is part of Ascension Health System. Ascension Health is the borrower for tax exempt hospital revenue bonds. St.Vincent Seton Specialty Hospital, Inc. holds an intercompany note payable with Ascension Health, and this information is reported on the balance sheet. Community Benefit Report Form 990, Part III, Line 4a, 4b and 4c SVSSH provides inpatient health care services that include: adult nursing services, surgical services, radiology, laboratory, pharmacy, endoscopy, electrocardiology, renal dialysis, respiratory therapy, physical therapy, occupational therapy, speech therapy, wound care, and electroencephanlography. Some of these services operate at a loss in order to ensure that comprehensive services are available to the community. Such community-focused programs improve access to healthcare, advocate for the poor and vulnerable, promote health through free education and screenings and help build better communities by improving quality of life. Community Benefit Overview St.Vincent Seton Specialty Hospital (SVSSH) is part of St.Vincent Health, a non-profit healthcare system consisting of 20 locally-sponsored ministries serving over 47 counties throughout Central Indiana. Sponsored by Ascension Health, the nation's largest Catholic healthcare system, St.Vincent Health is one of the largest healthcare employers in the state. As part of St.Vincent Health, the St.Vincent Seton Specialty vision is to deliver a continuum of holistic, high-quality health services and improve the lives and health of Indiana individuals and communities, with special attention to the poor and vulnerable. This is accomplished through strong partnerships with businesses, community organizations, local, state and federal government, physicians, St.Vincent Seton Specialty associates and others. Community benefit is not the work of a single department or group within St.Vincent Seton Specialty, but is part of the St.Vincent mission and cultural fabric. It is initiated and implemented at all levels of the organization, by each ministry, and in every community. Community Benefit Report Patient Services for Poor and Vulnerable Hospital and outpatient care is provided to patients that cannot pay for services, including hospitalizations, surgeries, prescription drugs, medical equipment and medical supplies. Patients with income less than 200% of the Federal Poverty level (FPL) are eligible for 100% charity care for services. Patients with incomes at or above 200% of the FPL, but not exceeding 400% of the FPL, receive discounted services based on an income-dependent sliding scale. Hospital financial counselors assist patients in determining eligibility and in completing necessary documentation. SVSSH is committed to 100% access, and is proactive in providing healthcare that leaves no one behind. Public Program Participation SVSSH participates in government programs including Medicaid, SCHIP (Hoosier Healthwise), Healthy Indiana Plan (HIP) and Medicare and assists patients in enrolling for programs for which they are eligible. Per Catholic Health Association guidelines and St.Vincent Health's conservative approach, Medicare shortfall is not included as community benefit. Community Assessment St.Vincent Seton Specialty Hospital draws patients from all over the state who need the special care provided by this facility, bridging the gap between the Intensive Care Unit and sub-acute services. Seton participates in local, state, and national dialogues about best practices for caring for these patients and families, and advocates for their specialized needs. In addition, the Indianapolis location's close proximity to the St.Vincent Indianapolis Hospital allows Seton Specialty to use the geographic survey completed by St.Vincent Indianapolis to target initiatives to the needs and service gaps of the local community. For more information about the assessment process, please refer to the St.Vincent Indianapolis campus report. Health Profession Education In an effort to prepare future healthcare professionals, especially in the area of long-term acute care, St.Vincent Seton Specialty in Indianapolis and Lafayette, in collaboration with area schools, offer a variety of clinical settings and internships for undergraduate and vocational allied health professionals, including nurses and respiratory therapists. Last year 150 students from Marian University, St. Elizabeth Nursing School, Ivy Tech, ITT Tech, Indiana Wesleyan University, Ball State University, Indiana University, and MedTech received specialized training from Seton Specialty health professionals. Health Fairs and Screenings St.Vincent Seton Specialty participated in numerous health fairs and screenings throughout the year, including those held at the Indiana State Fair. Blood pressure, pulmonary, cholesterol tests, and others are among the many free or discounted tests offered throughout the year. Materials on health information and preventative services are a vital part of health fairs and screenings. Community Health Education St.Vincent Seton Specialty participated in St.Vincent Health Fair Day at the Indiana State Fair and Carmel Senior Health Fair. At last year's fairs, over 300 fair-goers learned the importance of good lung health, and were offered free pulmonary function tests by Seton Specialty associates. Pulmonary function tests measure how well the lungs take in and release air, and are used to diagnose certain types of lung disease, especially asthma bronchitis, and emphysema, to find the cause behind shortness of breath and determine exposure to contaminants at home or work. Community Benefit Cash and In-Kind Contributions In addition to the outreach programs operated by the hospital, the hospital makes cash and in-kind donations to a variety of community organizations focused on improving health status in the community. These take the form of cash donations to outside organizations, the donation of employee time and services to outside organizations and the representation of the hospital on community boards and committees working to improve health status and quality of life within the community. Community Building Activities Research shows that social determinants and quality of life play a major role in the health status of individuals and communities. Community building activities, which focus on improving the quality of life within a community, ultimately influence and improve health status. Fay Biccard Glick Neighborhood Center Associates from St.Vincent Seton Specialty Indianapolis are involved with Fay Biccard Glick Neighborhood Center at Crooked Creek programs over the course of the year. Last December, associates served snacks and spent time making holiday crafts with children of the Sweet Pickles and Sweet Peas pre-school class. One associate put on the "Vincent the Bear" costume and made new pals with the children at the Center. In addition to Hope for the Holidays, Seton associates bought and wrapped gifts for a family of three from the Crooked Creek neighborhood. As a way to keep children actively involved during ten weeks of summer break, the Center hosts a day camp for children ages 3 - 13. Last year St.Vincent Seton Specialty gave funds to the summer camp to support families with children who could not afford camp for their children. Back Pack'Em Project The Back Pack'Em project focuses on equipping Indianapolis area children grades K-5 in need with school supplies, school clothing, and funds necessary for their education. Through the St.Vincent Health Back Pack'Em for School Program, St.Vincent Seton Specialty associates collect money, gift cards, and school supplies. Last year, over 16 back packs were fully filled with supplies to support this incredible cause. Pastoral Care Services As a faith based hospital, St.Vincent Seton Specialty Hospital addresses the spiritual needs of patients and their families by providing pastoral care services. The mission of pastoral care is to meet the spiritual needs of St.Vincent Seton Specialty Hospital patients, their families and the associates of the hospital. This is done in a non-judgmental way, open to all, regardless of race, age or religious beliefs. The chaplain's gift includes an ability to listen, empathize and journey with those who were dying or in crises. Medical Supplies Donations St.Vincent Seton Specialty continues its response to Haiti after the earthquake in supporting Nehemiah Vision Ministries' community health development project in Chambrun, Haiti. Chambrun is located 12 miles northeast of Port-au-Prince, the capital of Haiti. The hospital plans include two surgical suites, exam rooms, a lab, in-patient beds, a pharmacy, eye clinic and dental clinic. In fiscal year 2011, St.Vincent Seton Specialty sent about $9,000 in medication and supplies which includes 13 hospital beds to help furnish the hospital. Transportation St.Vincent Seton Specialty Hospital committed provided transportation services without charge to patients and/or family members who could not afford medical transportation to the facility from miles away. The method of transportation varied from ambulance to providing gas cards for personal transportation. Salvation Army With the need greater than ever, Seton associates take a major interest in the Lafayette community raising awareness and funds for the Salvation Army Angel Tree program with an annual Chili Cook-Off. The Angel Tree program provides needed support and a special Christmas to children and seniors living in poverty. Last year's judges included Tony Roswarski, Mayor of Lafayette; Celia May, Physician, and Jim Irvine, Salvation Army Major. St.Vincent Seton Specialty Lafayette associates joined other community members committed to bringing the army bell to help raise additional funds. Indiana Veterans' Home Each year associates from St.Vincent Seton Specialty reach out to Indiana Veterans' Home, a landmark facility in West Lafayette that provides nursing and domiciliary care for Hoosier Veterans and their spouses. Last year several associates volunteered to help serve a Thanksgiving lunch at the Veterans Home. Over 100 Veterans were served. In December associates coordinated the Christmas dance, providing cookies and ice cream for the event. CIHS Newco LLC 8425 Harcourt Road Indianapolis IN 46260 352174403 Land holding company IN 787753 5903010 Central Indiana Health System Cardiac Services Inc Endoscopy Center LLC 3755 E 82nd St Ste 270 Indianapolis IN 46240 320029881 Endoscopy center IN 873755 90669 StVincent Carmel Hospital Inc StJoseph Primary Care LLC 1907 W Sycamore Street Kokomo IN 46901 742979291 Physician practices IN 2350871 850379 StJoseph Hospital & Health Center Inc Quality Healthcare Solutions LLC 8425 Harcourt Road Indianapolis IN 46260 272818049 Health care consulting IN 16091347 28977876 StVincent Health Inc StVincent Physician Network LLC 10330 N Meridian Ste 300 Indianapolis IN 46290 201338729 Physician practices IN 69212649 19206791 StVincent Health Inc Ascension Health PO Box 45998 St Louis MO 63145 311662309 National health system MO 501(C)(3) 11A, I N/A 0 Central Indiana Health System Cardiac Services Inc 2001 W 86th Street Indianapolis IN 46260 351869951 Freestanding outpatient center IN 501(C)(3) 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National Avenue Brazil IN 47834 352112529 Critical access hospital IN 501(C)(3) 3 StVincent Health Inc 1 StVincent Dunn Hospital Inc 1600 23rd Street Bedford IN 47421 272192831 Critical access hospital IN 501(C)(3) 3 StVincent Health Inc 1 StVincent Frankfort Hospital Inc 1300 S Jackson Frankfort IN 46041 352099320 Critical access hospital IN 501(C)(3) 3 StVincent Health Inc 1 StVincent Frankfort Hospital Foundation Inc 1300 S Jackson Frankfort IN 46041 351531734 Supporting organization IN 501(C)(3) 11A, I StVincent Frankfort Hospital Inc 1 StVincent Health Inc 8425 Harcourt Road Indianapolis IN 46260 352052591 Parent company IN 501(C)(3) 11C, III-FI Ascension Health 0 StVincent Hospital and Health Care Center Inc 2001 W 86th Street Indianapolis IN 46260 350869066 Hospital IN 501(C)(3) 3 StVincent Health Inc 1 StVincent Hospital Foundation Inc 10330 N Meridian Street Ste 430N Indianapolis IN 46290 356088862 Supporting organization IN 501(C)(3) 11A, I StVincent Hospital & Health Care Center Inc 1 StVincent Jennings Hospital Inc 301 Henry Street North Vernon IN 47265 351841606 Critical access hospital IN 501(C)(3) 3 StVincent Health Inc 1 StVincent Madison County Health System Inc 1331 South A Street Elwood IN 46036 350876389 Hospital IN 501(C)(3) 3 StVincent Health Inc 1 StVincent Medical Group Inc 8425 Harcourt Road Indianapolis IN 46260 272039417 Physician professional services IN 501(C)(3) 9 StVincent Health Inc 1 StVincent Mercy Hospital Foundation Inc 1331 South A Street Elwood IN 46036 311066871 Supporting organization IN 501(C)(3) 11A, I StVincent Madison County Health System Inc 1 StVincent New Hope Inc 8450 N Payne Road Indianapolis IN 46260 351733591 Intermediate care facility IN 501(C)(3) 9 StVincent Health Inc 1 StVincent Pediatric Rehab Center Inc 1707 W 86th Street Indianapolis IN 46260 352048898 Specialty hospital IN 501(C)(3) 3 StVincent Hospital & Health Care Center Inc 1 StVincent Randolph Hospital Inc 473 Greenville Avenue Winchester IN 47394 352103153 Critical access hospital IN 501(C)(3) 3 StVincent Health Inc 1 StVincent Randolph Hospital Foundation Inc 473 Greenville Avenue Winchester IN 47394 352133006 Supporting organization IN 501(C)(3) 11A, I StVincent Randolph Hospital Inc 1 StVincent Salem Hospital Inc 911 N Shelby Street Salem IN 47167 270847538 Critical access hospital IN 501(C)(3) 3 StVincent Health Inc 1 StVincent Williamsport Hospital Inc 412 N Monroe Street Williamsport IN 47993 350784551 Critical access hospital IN 501(C)(3) 3 StVincent Health Inc 1 StVincent Williamsport Hospital Foundation Inc 412 N Monroe Street Williamsport IN 47993 743130159 Supporting organization IN 501(C)(3) 11A, I StVincent Williamsport Hospital Inc 1 SVSM Inc 2001 W 86th Street Indianapolis IN 46260 810607827 Holding company IN 501(C)(3) 11A, I StVincent Health Inc 1 Breast MRI Leasing Company LLC 10330 N Meridian St Ste 430N Indianapolis IN 46290 426662493 Sale and rental services IN StVincent Hospital & Health Care Center Inc Related 121068 65456 0 0 0.50000 Care Group Cardiovascular Management LLC 8333 Naab Road Ste 200 Indianapolis IN 46960 223937477 Management of cardiovascular service lines IN Central Indiana Health System Cardiac Services Inc Related 219289 0 0 0.00000 Carmel Ambulatory Surgery Center LLC 13421 Old Meridian St Ste 150 Carmel IN 46032 320014795 Ambulatory surgery center IN StVincent Carmel Inc Related 5760736 1334486 0 0 0.45000 Chartwell Midwest Indiana LLC 8040 Castleway Drive Indianapolis IN 46250 351985233 Home care IV/infusion services IN StVincent Hospital & Health Care Center Inc Related 21300 0 0 0.00000 Cooperative Managed Care Services LLC 6602 E 75th Street Suite 300 Indianapolis IN 46250 351999227 Case management IN StVincent Hospital & Health Care Center Inc Unrelated 122350 1421132 0 0 0.50000 Endoscopy Center LLC 13421 Old Meridian St Ste 150 Carmel IN 46032 320029881 Endoscopy center IN StVincent Carmel Inc Related 873755 220530 0 0 0.60000 Fishers Ambulatory Surgery Center LLC 136914 E State Road 238 Fishers IN 46037 262001288 Ambulatory surgery center IN StVincent Hospital & Health Care Center Inc Related -277774 532587 0 0 0.80000 Hancock Physician Network LLC 801 N State Street Greenfield IN 46140 352051598 Primary care physician practices IN StVincent Hospital & Health Care Center Inc Related -2365413 1101907 0 0 0.50000 HRH SVH Real Estate Development Co LLC 10330 N Meridian St Ste 430N Indianapolis IN 46290 272933470 Real estate holding IN StVincent Hospital & Health Care Center Inc Related 3131 3131 0 0 1.00000 Lafayette Heart Program Holding LLC 11515 W Dragoon Trail Mishawaka IN 46544 383750811 Cardiac care services IN Central Indiana Health System Cardiac Services Inc Related 7800000 0 0 0.49000 Meridian Heights Associates LLC 6100 W 96th Street Ste 250 Indianapolis IN 46278 264020296 Real estate holding IN StVincent Carmel Inc Related -497691 2030813 0 0 0.50000 Neuro Oncology Equipment LLC 10330 N Meridian St Ste 430N Indianapolis IN 46290 743103803 Sale and rental services IN StVincent Hospital & Health Care Center Inc Related 312355 271453 0 0 0.50000 Northside Cardiac Cath Lab Partnership 2001 W 86th Street Indianapolis IN 46260 351854388 Outpatient cath lab IN Central Indiana Health System Cardiac Services Inc Related 59307 0 0 0.06820 Saint John's Ambulatory Surgery Center LLC 2015 Jackson Street Anderson IN 46016 010822977 Surgery center IN StVincent Madison County Health System Inc Related -18650 0 0 0.00000 StVincent Heart Center of Indiana LLC 10580 N Meridian Street Indianapolis IN 46290 364492612 Heart hospital IN Central Indiana Health System Cardiac Services Inc Related 15885142 27774130 0 0 0.74040 StVincent Northwest Radiology LLC 5756 W 71st Street Indianapolis IN 46278 352047427 MRI facilities IN StVincent Hospital & Health Care Center Inc Related -8834 0 0 0.00000 The Care Labs LLC 2001 W 86th Street Indianapolis IN 46260 351854352 Outpatient vascular lab IN Central Indiana Health System Cardiac Services Inc Related 158226 663 0 0 0.35080 0 1 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 StVincent Hospital and Health Care Center Inc B 1600000 Fair market value StVincent Health Inc C 2723196 Fair market value