2011-05-13T07:42:19-05:00 2010-06-30 KPMG LLP 191 West Nationwide Blvd Ste 500 Columbus OH 432152568 990 2009-07-01 370661244 ST MARY'S HOSPITAL SISTERS OF THE THIRD ORDER OF ST FRANCIS STMA 2174642966 1800 E LAKE SHORE DRIVE DECATUR IL 62521 Kevin F Kast 2174642966 2011-05-09 true KPMG LLP 6142492300 2009 2016-02-24 21:20:13Z ORDER OF ST FRANCIS kevin f kast 1800 E LAKE SHORE DRIVE DECATUR IL 62521 135795542 false 0928 X WWW.STMARYSDECATUR.COM X 501(C) (3) 1878 IL To participate in the health care ministry of the church and provide a family-centered approach in meeting the community's health care needs regardless of ability to pay. 10 7 1423 210 165955 2771025 3287686 116177780 126707304 -2877476 1516301 2806460 2071531 118877789 133582822 0 0 0 0 55724620 57514189 0 0 0 65876901 78895901 121601521 136410090 -2723732 -2827268 148736612 149184672 66112922 83481117 82623690 65703555 To participate in the health care ministry of the church and provide a family-centered approach in meeting the community's health care needs regardless of ability to pay. false false 103882598 126707304 SEE SCHEDULE O - Statement of Program Service Accomplishments 103882598 true true false true false false false false false true false true false false false false false false false false true false false true false false false true false true false true false false false false true true false false false true 65 0 1423 true true true false false false false false false false false false false false 10 7 false false false false true true true true true true false true true true true true true true true false X REBECCA COLKER 2174642970 1800 E LAKE SHORE DRIVE DECATUR IL 62521 SR HELEN MARIE PLUMMER OSF 1.0 X 0 0 0 SR MARYBETH CULNAN OSF 1.0 X 0 0 0 KEVIN KAST 40.0 X X 0 427770 141108 JOHN SKEFFINGTON 1.0 X X 0 0 0 KEVIN BREHENY 1.0 X X 0 0 0 JOHN J WHITE 1.0 X 0 0 0 JON ROBINSON 1.0 X X 0 0 0 MARK CHEVIRON 1.0 X 0 0 0 PAT DAWSON 1.0 X 0 0 0 Fr JOE MOLLOY 1.0 X 0 0 0 BOB WIESEMANN 1.0 X 0 0 0 THERESA J RUTHERFORD 40.0 X 185661 0 47335 ANN CARR 1.0 X 0 153448 117382 ADAM CUMBO 1.0 X 181100 0 8842 Becky Colker 40.0 X 106999 0 3197 GORDON CHU MD 40.0 X 589801 0 39932 NAEEMUDDIN JATOI MD 40.0 X 286195 0 51963 JOHN BRITT MD 40.0 X 624586 0 17246 Beth A McCoy 40.0 X 237051 0 84220 Roberta McBride 40.0 X 232657 0 214700 2444050 581218 725925 47 false true false Central Illinois Emergency Physicia 75 Remittance Drive Suite 1707 Chicago IL 60675 Emergency Physicians 996022 Pencek Terrence MD 1750 E Lake Shore Drive Suite LL2 Decatur IL 62521 PHYSICIANS 725000 Urologic Surgery Assoc SC 1700 E Lake Shore Drive Decatur IL 62521 PHYSICIANS 431028 Rehab Care Group Inc PO Box 502096 St Louis MO 63150 Rehab Management 548180 John C Kefalas MD SC 1770 E Lake Shore Drive Decatur IL 62521 PHYSICIANS 490205 21 3287686 3287686 NET PATIENT SERVICE REVENUE 900099 126707304 126707304 126707304 1415791 1415791 0 0 1346563 2167630 -821067 -821067 -821067 142100 3500 45090 142100 -41590 100510 100510 0 0 0 CAFETERA/CAFE 722210 590320 590320 OUTSIDE LAUNDRY 812300 52408 52408 REFERENCE LAB 621500 113547 113547 2136323 2136323 2892598 133582822 126707304 165955 3421877 0 0 0 0 420634 0 420634 0 0 41890690 37295773 4594917 1582622 1582622 10570115 10493029 77086 3050128 3050128 4767658 358349 4409309 466754 13923 452831 197644 197644 26090 26090 0 0 16552128 13921663 2630465 1070216 76775 993441 640535 423197 217338 70314 70314 0 1918204 1688111 230093 120757 78449 42308 0 0 0 5236705 12867 5223838 6862728 30859 6831869 1425026 186431 1238595 SUPPLIES 17073247 17061944 11303 BAD DEBTS 16927495 16927495 0 MEDICAID TAX ASSESSMENT 3817944 3817944 OTHER 1722456 680983 1041473 136410090 103882598 32527492 0 285988 285989 3553393 5435395 27124006 21239368 2489706 2867210 1666695 935278 167832699 111435301 57518193 56397398 55224371 60035556 874260 1988478 148736612 149184672 15825048 19128795 29797 26608 30286267 29633909 19971810 34691805 66112922 83481117 X 73152690 53104217 8240000 11369452 1231000 1229886 82623690 65703555 148736612 149184672 X false true true X true true X false false false RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED false false false false false false false false true 62090 62090 false false DESCRIPTION OF OTHER LOBBYING ACTIVITIES SCHEDULE C, PART II B, QUESTION 11 ST. MARY'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. A PART OF THESE DUES IS ATTRIBUTABLE TO LOBBYING FEES PAID BY THE ORGANIZATIONS. OF THE AMOUNT LISTED ABOVE, $26,090 IS THE AMOUNT ATTRIBUTABLE TO THE HOSPITAL FROM ITS DUES PAID. The Hospital also engaged the services of Curry & Associates, LLC ("Curry") and Bolen, Robinson, & Ellis, LLP ("Bolen") to perform lobbying activities on its behalf. The hospital paid a $3,000 monthly retainer fee to Bolen. Bolen would then pay this to curry for lobbying services. Of the amount listed above, $36,000 is attributable to these services. 3295160 3295160 28775635 49110856 47195639 30690852 13970420 67292978 61479277 19784121 150012 5237638 2760385 2627265 56397398 0 ESTIMATED SELF INSURANCE LIABILITY 6006363 RETIRE OBLIGATION - ASBESTOS 1574159 ACCRUED BENEFIT LIABILITY 25200283 DERIVATIVE INSTRUMENTS 1911000 34691805 ASC SUBTOPIC 740-10 On July 1, 2007, the Obligated Group 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, the Obligated Group 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, and accounting in interim periods and requires increased disclosures. As of June 30, 2010 and 2009, the Obligated Group does not have a liability for unrecognized tax benefits. true true true X true X true true true false true true 1 2357 1652631 1652631 0.01380 1 1 10628575 10628575 0.08900 1 3322 519358 412028 107330 0.00090 3 5680 12800564 412028 12388536 0.10370 445 14891 499335 1857 497478 0.00420 4 2125 276660 13863 262797 0.00220 5 36532 85215371 82305714 2909657 0.02500 5 21724 1474387 1134119 340268 0.00300 459 75272 87465753 83455553 4010200 0.03440 462 80952 100266317 83867581 16398736 0.13810 1 1486 94992 33579 61413 0.00050 1 1486 94992 33579 61413 0.00050 true 6652506 42033 30384520 51690260 -21305740 X true true ST MARY'S HOSPITAL

1700 E LAKE SHORE DR DECATUR IL 62521

X X X Not 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. THE ORGANIZATION SUBMITS AN ANNUAL COMMUNITY BENEFIT REPORT WITH THE STATE OF ILLINOIS' ATTORNEY GENERAL'S OFFICE. IN ADDITION, EVERY THREE YEARS, THE ORGANIZATION PARTICIPATES WITH OTHER ORGANIZATIONS IN THE COMMUNITY TO ASSESS COMMUNITY NEEDS. STARTING FISCAL YEAR ENDING 6/30/2011, A MORE DETAILED COMMUNITY BENEFIT REPORT WILL BE COMPLETED ON AN ANNUAL BASIS. Costing methodology for amounts reported in table: The common method for estimating the true economic cost of medical services is to adjust the charges through the use of cost-to-charge ratios. Cost-to-charge ratios convert charges for medical services to their true economic costs. Applying cost-to-charge ratios to medical service charges produces average estimates of true costs. The Cost/Charge Ratio represents total hospital operating costs divided by total gross billed charges. The exception to the costing methodology described in the preceding paragraph is for the amount for subsidized services on line 7g, for which a costing information system was utilized. More accurate allocations of direct costs are available through the use of that system, and were applied for the subsidized health services. a. For FY2010, total charity care cost was $4,208,789 as reported on the income statement. The net community benefit cost, after applying the cost-to-charge ratio of 39.3%, was $1,652,631. b. For FY2010, unpaid cost of Medicaid was $23,202,799. The net community benefit cost, after applying the cost-to-charge ratio of 39.3%, was $9,110,857. Actual cost is the net of revenue (charges) minus expenses. Actual cost can be traced directly to (or identified with) a specific cost center or cost object such as a department, process, or product. The following other benefits are calculated using actual costs from the income statement. c. For FY2010, unreimbursed cost from other means tested government programs realized revenue of $412,028 and expenses of $519,358. The net community benefit expense was $107,330. d. Total of lines 7a through 7c. e. For FY2010, community health improvement services and benefit operations realized revenue of $1,857 and expenses of $499,335. The net community benefit expense was $497,478. f. For FY2010, health professions education realized revenues of $13,863 and expenses of $276,660. The net community benefit expense was $262,797. i. For FY2010, cash and in-kind contributions realized revenues of $875,786 and expenses of $1,184,075. The net community benefit expense was $308,289. Actual cash contributions of $169,877 are included and consist of charitable contributions made to organizations in the community. j. Total of lines 7e through 7i. k. Total of lines 7d and 7j. k. Total of lines 7d and 7j. The organization provides numerous clinical services despite the fact those services yield a net financial loss to the organization. Subsidized health services provided by the organization include the service lines of emergency services, obstetrics/nursery, observation, and behavioral health. The percent of charity care and certain other benefits at cost as a percent of total expenses less bad debt is 13.5 %. The footnote text related to bad debt expense from the audited financial statements reads as follows: "The Obligated Group also provides a significant amount of uncompensated care for patients, which is not included above, but is reported in the consolidated statements of operations as a provision for uncollectible accounts. Many of those patients are uninsured or underinsured, but did not apply for, or qualify for, charity care." Please note that reference is made to the "Obligated Group", of which this organization is a member. The organization 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 organization's bad debt includes a portion that could be classified as charity care if application for such care was sought and/or completed. The organization is in the process of implementing processes, procedures, and systems to more effectively determine charity care that will reduce a patient's documentation requirements when applying for charity care. This will provide a more accurate reporting of charity care services provided by the organization. Actual bad debt expense was $16,927,495 as reported on the income statement. After applying the cost-to-charge ratio of 39.3%, the total cost of bad debt was $6,652,506. The amount of bad debt expense attributable to patients eligible under the organization's charity care policy was $106,954. After applying the cost-to-charge ratio of 39.3%, the total cost of bad debt was $42,033. Bad debt costs attributable to charity represents the bad debt cost of services provided to charity care patients that were identified initially as eligible for charity care. A system report was created on patient accounts written off to bad debt and a second report was created that showed accounts with charity adjustments during fiscal year ended June 30, 2010. Identical patient accounts from each type of report were identified in order to determine which "charity" accounts were finally written off to bad debts at some point thereafter. The organization's cost to charge ratio was applied to the bad debt amounts identified to arrive at an estimated bad debt cost. The organization 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 organization to respond to community need, the organization's 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. 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 organization 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. The organization serves thousands of persons covered by Medicare. Like Medicaid, Medicare funding does not cover the actual cost of delivering hospital services to people enrolled in the program. In the fiscal year ended June 30, 2010, the organization had to make up the $21.3 million difference between what Medicare paid and the actual cost of services to Medicare beneficiaries. The organization has a policy on account resolution that outlines the procedures to be followed in collecting balances on outstanding patient bills. Besides addressing the procedures and follow-up for accounts covered by insurance or governmental programs, the policy discusses situations where the patient may be eligible for financial assistance through our charity care program. If a patient is deemed eligible, reference is made to the organization's charity care policy. Even with the best intentions, patients cannot always meet their responsibility to pay for the care they receive. For a number of reasons, from the loss of a job to temporary hardships, this leaves the organization to cover the unpaid balance or even the entire bill, an expense for the organization referred to as "bad debt". In the fiscal year ended June 30, 2010, bad debt expense was almost $17 million with no outside source of funding to help compensate for the expense. The cost, after applying the cost to charge ratio, was $6.6 million. This is a growing problem. Bad debt accounted for 5% of our total costs in the fiscal year ended June 30, 2010 and constituted a significant contribution to the community. The organization does not have any healthcare facilities that are not registered as a healthcare facility under State law. An integral part of the mission of St. Mary's Hospital is the commitment to meet the health care needs of all in the community, regardless of ability to pay. The organization's service to the community would not be possible without the shared leadership and active engagement of our community partners. Together, we assess the health care needs of the community, identify health priorities, and work to create viable solutions to fulfill the growing health-related needs and challenges in our community. In the past, the organization collaborated with United Way, other non-profit organizations, and local community groups in the community in conducting a community health needs assessment survey, which was conducted every four years. The results were evaluated for unmet and underserved healthcare needs and utilized for determining whether programs should be added, expanded, or in some cases, scaled back so resources can be allocated to areas of greater need. The assessment helped us develop strategies for improving community health. Currently, the organization is participating in a community needs assessment in partnership with Macon County Health Department. The assessment began in calendar year 2010, and the list of needs is being evaluated and prioritized as of the filing date of this return. The organization is one of thirteen hospitals under a parent organization, Hospital Sisters Health System, Inc. The parent organization has formed a team that is currently developing suggested guidelines for each hospital's local needs assessment for implementation during the year ended June 30, 2012. In the meantime, our organization is continuing to participate with other community organizations through the Macon County Health Department efforts. Three Advisory Councils assist the organization in identifying community health care needs and organizations for involvement. These councils are comprised of members of the community representing area businesses, clergy, education, and non-profit organizations, as well as patients. The focus of these groups is two-way communication between the hospital and the community. The St. Mary's Hospital Advisory Council advises the hospital on a wide range of strategies, including unmet needs in the community. The Oncology Advisory Council advises St. Mary's specifically about cancer-related needs and services, and is comprised entirely of cancer survivors. The Rehabilitation Advisory Council likewise advises specifically about rehabilitative-related needs and services. Additional efforts to engage and seek input from the community include the formation of a Strategic Planning Committee during the year ended June 30, 2010. Community leaders were selected and invited to participate as a member of this committee, along with representatives from the organization's management team, Board of Directors, and medical staff. This committee developed a five year strategic plan for the organization. Involvement from the community leaders insured the community has a voice in the healthcare services being offered and also those identified as needs for enhancement or development. One of the activities reviewed by the committee in establishing plans was a community survey regarding healthcare in our service area. This committee will remain intact and meets on a regular basis to review progress and adjust plans as necessary to meet the needs of our community. Input is obtained from the patients we serve through patient satisfaction surveys. Input provided through some of these surveys was taken into consideration in the development of the hospital's master facility plan, which has resulted in a current major Emergency Room capital project. The hospital Board of Directors is community-based and maintains a good pulse on the community we serve. They provide valuable input on an ongoing basis on the community's healthcare needs. The System (parent organization) revised the process for selecting the hospital Board of Directors from a System-dominated board to a community-focused board in 2008. The Registration Department provides brochures to patients upon registration regarding the payment assistance programs available to them at St. Mary's Hospital. The brochures are also supplied in waiting and ancillary areas for easy access by the patient. Contact numbers for several agencies are listed in the brochure, as well as information about how to read and understand the bill. The organization has a representative on site to assist patients who may be eligible for Medicaid assistance through the Illinois Department of Public Aid. They work with patients to determine if they may be eligible, and if so, assist in pulling together the necessary application for submission. Patients are also provided a Fair Billing Act Notification at the point of registration regarding separate physician billing they can expect to receive, plus information about the patient's financial responsibility if their insurance plan is out of network. The organization's website provides information to patients and their families about the hospital's billing practices. The charity application is available online, as well as contact information for various government programs and hospital contacts. One-on-one conversations to educate patients about financial assistance often stem from patients receiving a statement or a pre-collection letter. At that point, the customer service representative or cashier, or other qualified staff, will inform/educate the caller about financial assistance options. The first pre-collection letter reminds the patient their account is in delinquent status. It also informs them they may be eligible for financial assistance through the organization's Charity Care program. The letter provides direct contact information to begin the application process for Charity Care. The organization's primary service area is Macon County, Illinois, with surrounding counties comprising much of the secondary and tertiary service area. The population of Macon County in 2009 was estimated at 108,000, which represented a decrease of 5.7% since 2000. The median household income, as reported in 2008, was $45,664. The poverty rate for the same period was 13.5%. Primary, secondary and tertiary service area demographic information is used to identify ages and incomes of each segment. The only growing population in each service area is age 64+. The aging population will have an impact on the development of future services at the organization. The racial makeup of the county in 2009 was 82% White, 15% African American, with other races comprising the remaining 3%. Macon County has experienced high unemployment rates the past few years, but improvement was reported by the end of calendar year 2010. The unemployment rate (not seasonally adjusted) as of December 2010 was 10.4%, down from a rate of 12.6% in December 2009. Macon County has 580 square miles in land area and a population density of 186.6 per square mile. The town of Decatur, which is where St. Mary's Hospital is located, is the county seat and also the largest city in Macon County. In 2008 manufacturing was the largest of twenty major sectors, representing 22.6% of all jobs in the county. Health care and social assistance comprised the next largest sector, representing 13.8%. The Lake Shore Connection program is focused on individuals age 55 and over. Participants in the program can obtain courtesy transportation to and from health related appointments. The organization offers participants free quarterly health screenings, discounts on monthly lunch and learn programs, and other resources to assist participants in staying productive, healthy, and independent well into the future. We touched the lives of 1,496 participating senior citizens through this community program. St. Mary's Hospital offers hope to our community in the tradition of the Hospital Sisters of St. Francis. As a healing ministry of the Catholic Church and an affiliate of the Hospital Sisters Health System (HSHS), St. Mary's is committed to delivering high quality, compassionate, and cost-effective health care services to all. The hospital was founded over 130 years ago to bring a healing presence and improve the health of our community, especially for people who are sick, poor, and disadvantaged. St. Mary's hospital remains committed to serving the health care needs of the community, regardless of ability to pay. Because of the hospital's purpose and tradition, it is organized to promote the health of Decatur and 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. Mary's is responding to community need as described under #2 above. As a not-for-profit hospital, St. Mary'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 operations are generally used to upgrade facilities, secure new technologies, improve patient care, train clinicians, and support initiatives designed to promote health for all. For example, St. Mary's is working with its parent organization, Hospital Sisters Health System, to continuously enhance quality and improve coordination of care both inside the hospital and with a growing number of physician partners. Supported by investments in information technology, this "care integration" strategy is 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. St. Mary's devotes significant resources to access for patients who cannot afford care, along with other community benefits. In the fiscal year ended June 30, 2010, the organization provided $16.4 million in Community Benefit services, including charity care at cost, unpaid costs of Medicaid and other public programs, and a range of diverse programs designed to enhance access and improve community health. Additionally, during this period, the organization provided $6.4 million (at cost) in uncompensated care to patients that did not qualify for charity care or public assistance and $21.3 million (at cost) in excess of Medicare payment for health care services. The range of benefits provided by St. Mary's Hospital flows from our mission and long-standing commitment to our community. In many cases, these programs would be unlikely to exist without the leadership role played by St. Mary's Hospital, and they often relieve a burden that would otherwise be carried by government. Some of the notable examples of how the organization contributes to the wellness, prevention, and improving the health of the community include: a) The Prenatal Clinic: The prenatal clinic serves uninsured and underinsured mothers. It provides both prenatal and postnatal care. Each year, the clinic cares for approximately 250 women and babies, with an estimated 3,500 visits. The clinic is unique in that each woman has her own physician, ensuring comprehensive and consistent prenatal care. In addition, community resources are invited to participate in the clinic, giving patients full exposure to options available to them. b) Power to End Stroke: St. Mary's partners with the American Heart Association's Power to End Stroke program. This program raises awareness in the African-American community about the risk factors and prevalence of stroke. Community awareness events are held as part of this program. c) Adult Day Care: The organization operates an adult day care program for adults unable to totally care for themselves and who do not have home assistance during the day. d) Collaborative Post-Acute Care Initiative: The organization formed a community collaborative with post-acute care providers during the fiscal year ended June 30, 2010 to address the needs of patients needing care after their acute hospital stay. Participants include assisted living facilities, critical access hospitals, supported living facilities, and nursing homes. This initiative will continue to develop into the upcoming year. e) Educational Support: Employees often serve as speakers at schools in our service areas, community events, etc. St. Mary's and its staff support the programs of Project Success in working to help children succeed in school by collaborating with local agencies, schools and other businesses in the community (example is the school supply distribution program). Staff members provide training to the local paramedics, first responder groups, and fire departments. Additionally, area organizations receive CPR training through the hospital's EMS Department. f) AthletiCare Program: The organization provides athletic training services to the surrounding community athletes. This includes recreational athletes participating in community events, such as the Rodney T. Miller Lakeside Triathlon and the Shoreline Classic 5k/15k race. The hospital provides athletic training services to various area junior and senior high schools for injury management and prevention of selected athletic programs. Athletic trainers employed by the hospital serve as experts on physical exercise for the community and provide informational presentations several times a year. They also provide instruction for new athletes to begin training in a safe and successful manner with the Decatur Tri-Gators, a local USAT triathlon club. g) Lake Shore Connection: This is a program focused on individuals age 55 and over. Participants in the program can obtain courtesy transportation to and from health related appointments, free quarterly health screenings, discounts on monthly lunch and learn programs, and other resources to assist participants in staying productive, healthy, and independent well into the future. h) Ambassadors for Christ Ministries/Stop the Violence Outreach Health Fairs: These outreach health fairs bring much needed education, testing and care to the high risk inner-city community population. The goal is that awareness, prevention and care for those who are at risk will provide the necessary treatment and ultimately save lives. Ambassadors for Christ Ministries is collaborating with organizations, including St. Mary's, to provide a team of health care providers, social service agencies and private individuals to address health issues such as HIV, AIDS, breast cancer, prostate cancer, high blood pressure, diabetes, heart disease, and high cholesterol. i) Items Donated: The organization routinely donates food to local food pantries. Other donations to nonprofit causes include equipment and medical supplies. Additionally, our staff contributes their time in volunteering to assist these organizations in their valuable community efforts. j) Community Health Fairs: St. Mary's maintains partnerships with many organizations in the community to promote health and wellness. The hospital participates in numerous community health fairs, including 35 community health screenings held during the fiscal year ending June 30, 2010. In addition to the health fairs, the organization collaborates with members of the medical staff to provide sessions on important health education topics to members of the community. Sessions conducted during the year ended June 30, 2010 included several topics, such as shoulder pain, orthopedic injuries, prostate screenings, reconstructive surgery, electrophysiology, healthy eating and cooking, and stroke. The organization's support groups offer patients and their families, and members of the community the opportunity to learn more about their health and have their voices heard. A number of benefits are associated with participating in programs offered. For example, participating in support groups can decrease psychological distress and elevate a participant's mood. Participants can exchange information and experience emotional connections through their interaction and participation. Employees, volunteers, Board members and medical staff participate in charitable activities in the community that reflect the hospital's commitment to the underserved. They contribute both financial support and their time to worthy non-profit health-related organizations in the community, including the American Heart Association, American Cancer Society, American Red Cross, Easter Seals, and the Diabetes Association. They participate with organizations such as United Way to assist in worthwhile community needs. Time and expertise is also provided to various organizations by serving on their Boards or related committees - examples include the organ St. Mary's Hospital is an affiliate of Hospital Sisters Health System. The foundational mission principles of Hospital Sisters Health System (HSHS) embody the belief that every life is a sacred gift and every human being is a unity of body, mind and spirit. Our health care ministry calls on us to foster healing, serve with compassion, and promote wellness for all persons, with special attention to our neighbors who are sick, poor, underserved, and most vulnerable. These principles have made it possible for HSHS to provide high quality, cost-effective and compassionate health care for millions of people in Illinois and Wisconsin. Our health care ministry consists of 13 hospitals and numerous physician partners committed to continuing the healing ministry of Jesus Christ. Beyond functioning as a primary source for health care in the 12 primary communities we serve, HSHS also provides a wide array of Community Benefits that expand residents' access to health care, enhance their overall health status, and further medical education. In the Fiscal Year that ended June 30, 2010, HSHS hospitals provided $152.2 million in Community Benefits (or 8.5% of total expenses), an increase of $28 million from FY 2009. Of this amount, $32.3 million was provided for charity care and $89.2 million was the amount of unreimbursed care provided under the Medicaid program. In addition, HSHS hospitals provided $159.3 million in health care services primarily to the elderly beneficiaries of the Medicare program in excess of governmental and managed care contract payments. HSHS hospitals also recorded $95 million in uncollectible accounts. HSHS is committed to sustaining and strengthening 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 ongoing enhancements ensure that our hospitals can continue to provide high quality, compassionate care to our patients. During Fiscal Year 2010, HSHS continued to pursue a Care Integration strategy designed to continuously enhance quality and improve coordination of care both inside the hospital and with a growing number of physician partners. Supported by the system investments in information technology, this strategy is 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. The Care Integration strategy includes, among other efforts, three "Medical Home" pilot projects, the coordination of care for cardiac patients living in rural communities through the use of telemedicine, and development of a "clinical integration network" that will help independent physicians improve quality and the patient experience by benchmarking their care against best practices. HSHS also placed a special emphasis on investing in interoperable health information technologies and robust health information exchanges. We recognize that our investments in information technology will have a positive impact on the quality, safety and efficiency of health care. These investments also ensure that the patient is at the center of a high quality, highly integrated, compassionate health care delivery system. Expanding access to health care At the heart of our health care ministry is the commitment to care for every patient who seeks our help. Because not all patients have health insurance, HSHS hospitals have generous Charity Care program guidelines that cover 100% of hospital charges for individuals and families whose earnings are at or below 150% of the federal poverty level and 50% of hospital charges for individuals and families whose earnings are at or below 250% of the federal poverty level. Under these guidelines a family of four without health insurance that has an annual household income of $33,075 or less is eligible for a 100% discount on their hospital bill, and a family of four without health insurance that has an annual household income of $55,125 or less is eligible for a 50% discount on their hospital bill. HSHS Charity Care programs have a sliding scale, in some instances providing up to a 60% discount on charges for those earning up to 600% of the federal poverty level. Hospitals have created a simple two page form 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. The gratitude of the people who have benefitted from our Charity Care program (sometimes referred to as Christian Care) is reflected in some of the thank you letters sent to St. Anthony's Memorial Hospital in Effingham, IL. Comments included: "When I opened your letter today and read that you gave me a 100% Christian Care adjustment, I gasped and started crying. I am so grateful. I count this as an unexpected miracle from God working through people willing to show his love to others." - D.K. The King will reply, "I tell you the truth, whatever you did for one of the least of these brothers of mine, you did for me." - Matthew 25:40. "We just want to take a moment to express our deepest gratitude! Your generosity has eased our minds, hearts & pocket book!! Thank you, Thank you, Thank you! God Bless You All! I pray someday I will be able to help someone in such a generous way! You have no idea what a relief this is for us! Thank You seems too simple of words!" - S.L. and C.S. "I want to say at all those who have made it possible to help us pay my hospital bills - Thank You! I don't have words to thank you for all the worry that you have taken away. A thousand "thanks." May God bless you." - L.B. (translated by N.R. and W.R.) "My husband K. and I would like to express our deepest gratitude for your assistance with his medical bill from the hospital. We cannot thank you enough for the help and how this eased a financial burden that we faced. Keeping this gift in mind, we will strive to help others who are in need in whatever way we can to 'Pay it forward.' Thank you and bless you all!" - K.S. and L.S. Our Charity Care programs are only one aspect of our commitment to increasing access to health care services in Illinois and Wisconsin. In many of our communities, HSHS collaborates with Federally Qualified Health Centers (FQHCs) to provide greater access to health care services for low-income residents. For example, St. Elizabeth's Hospital in Belleville, IL hosts a FQHC primary care clinic adjacent to its Emergency Department and St. John's Hospital in Springfield, IL coordinates specialty physician referrals with the local FQHC and provides free health care to its clients. HSHS hospitals work collaboratively in their communities to support the various social services that together make up the fabric of the health care safety net. Sacred Heart Hospital in Eau Claire, WI provides leadership, staff support and laboratory and radiology services for the Chippewa Valley Free Clinic. During FY2010 Sacred Heart's Lab performed 676 tests for patients from the clinic St. Mary's Hospital Medical Center in Green Bay, WI supports a Women's Place, which provides health care services and referrals for men and women in the Latino community. "Because of language barriers, erratic work schedules and the lack of insurance and transportation, many in the Latino community aren't able to access our health system," explains Program Director Carol Ponce. "I feel it is important to overcome those barriers and build bridges for people in the Latino community to access health care and other services that contribute to their well-being. Our programs not only bring health care to the Latino community but joy and connection to other people from Mexico, Honduras, Nicaragua, Peru and Puerto Rico." In rural Illinois, Prairie Heart Institute of Illinois (PHII), a physician group affiliated with HSHS, is bringing a higher level of cardiovascular care to patients in their communities through extensive collaboration with local hospitals and physicians. Through regularly scheduled clinics and sharing of protocols and best practices, rural hospitals across central and southern Illinois can more rapidly and accurately identify heart attack patients and speed treatment to minimize damage to the heart muscle. Meanwhile, access to clinical trials provides opportunities for patients in rural areas to have access to drugs and treatments available only through PHII. "The result of this unique commitment is that regardless of where a patient lives, they will have access to care designed to detect heart disease earlier. We can also offer previously unavailable life-saving techniques and drugs and ensure a return to a quality of life," explains Jim Zito, PHII CEO. The benefits of this type of collaboration are many, including the st IL X X true true X X X X X X true false false false false false false false false KEVIN KAST 0 352197 0 53393 0 22180 0 100813 21420 18875 21420 547458 0 40681 THERESA J RUTHERFORD 184928 0 0 0 733 0 30247 0 17818 0 233726 0 0 0 ANN CARR 0 131424 0 0 0 22024 0 104209 0 13649 0 271306 0 0 GORDON CHU MD 556207 0 33000 0 594 0 17406 0 23307 0 630514 0 0 0 NAEEMUDDIN JATOI MD 270841 0 14700 0 654 0 29937 0 22807 0 338939 0 0 0 JOHN BRITT MD 574451 0 50000 0 135 0 0 0 17877 0 642463 0 0 0 ADAM CUMBO 131128 0 0 0 49972 0 -13149 0 22443 0 190394 0 0 0 Beth A McCoy 231239 0 5284 0 528 0 58749 0 29345 0 325145 0 0 0 Roberta McBride 226391 0 5284 0 982 0 197359 0 18095 0 448111 0 0 0 SEVERANCE PAYMENTS SCHEDULE J, PART I, LINE 4A ADAM CUMBO RECEIVED $49,670 OF SEVERANCE FOR THE 2009 TAX YEAR. Deceased Board Member Schedule J, Part III John J. White, who was a board member during fiscal year 2009, has since passed away in January 2010. Surgical Specialists of Central Illinois SC X 362509 293014 true false true 293014 Bolen Robinson Ellis Board Member 345680 legal services false Surgical Specialist of Decatur Board Member 402265 leases office space false JL HUBBARD INSURANCE AND BONDS BOARD MEMBER 12903 PURCHASED BONDS false STATEMENT OF PROGRAM SERVICE ACCOMPLISHMENTS FORM 990, PAGE 3 PART III FORM 990 - GENERAL EXPLANATION ATTACHMENT STATEMENT OF PROGRAM SERVICE ACCOMPLISHMENTS FORM 990, PAGE 3 PART III, STATEMENT OF PROGRAM SERVICE ACCOMPLISHMENTS ST. MARY'S HOSPITAL 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. MARY'S HOSPITAL, IT IS RECONGNIZED THAT NOT ALL INDIVIDUALS POSSESS THE ABILITY TO PURCHASE NECESSARY MEDICAL SERVICES. INHERENT TO OUR MISSION, WE PROVIDE CARE TO THE POOR, THE ELDERLY, AND THE NEEDY OF THE COMMUNITY THROUGH VARIOUS PROGRAMS AND SERVICES. THESE ACTIVITIES INCLUDE COMMUNITY EDUCATION PROGRAMS, WELLNESS PROGRAMS, AND SPECIAL PROGRAMS FOR THE ELDERLY, HANDICAPPED, MEDICALLY UNDERSERVED, AND A VARIETY OF BROAD COMMUNITY SUPPORT ACTIVITIES. DURING FICAL YEAR 2010, ST. MARY'S HOSPITAL PROVIDED 37,100 ADULT AND PEDIATRIC DAYS OF CARE AND 137,175 OUTPATIENT VISITS DURING THE SAME TIME PERIOD. ST. MARY'S HOSPITAL PROVIDES BOTH BENEFITS TO THE POOR AND TO THE BROADER COMMUNITY. BENEFITS TO THE POOR ARE PROVIDED ON THE FORM OF TRADITIONAL CHARITY CARE FOR THOSE WHO CANNOT AFFORD TO PAY, UNPAID COSTS FO PUBLIC PROGRAMS SUCH AS MEDICAID AND GENERAL RELIEF, NONBILLED SERVICES FOR THE POOR AND MANY IN-KIND DONATIONS. THE TOTAL VALUES OF THESE UNREIMBURSED BENEFITS FOR THE POOR WERE $12,388,536 IN FISCAL YEAR 2010. ST. MARY'S HOSPITAL PROVIDES NUMEROUS BENEFITS TO THE BROADER COMMUNITY. THIS IS CARRIED OUT THROUGH OUR PARTICIPATION IN THE MEDICARE PROGRAM, PROVIDING MANY PROGRAMS AND SERVICES FREE OR AT A REDUCED PRICE, AND PROVIDING SERVICES THAT BENEFIT THE COMMUNITY BUT HAVE A NEGATIVE MARGIN TOTALED $17,953,697 DURING FISCAL YEAR 2010. ALL OTHER NONBILLED SERVICES PROVIDED TO THE COMMUNITY AND SERVICES PROVIDED AT LOW OR NEGATIVE MARGINS TOTALED $898,687 FOR THE YEAR ENDED 6/30/2010. BELOW ARE SPECIFIC EXAMPLES OF SERVICES INCLUDED IN THE ABOVE FIGURES: THROUGH THE OPERATION OF ITS PRENATAL CLINIC, THE HOSPITAL PROVIDES BOTH PRE AND POST NATAL CARE TO THE POOR. THE HOSPITAL ROUTINELY DONATES FOOD TO LOCAL FOOD PANTRIES. OBSOLETE EQUIPMENT IS ALSO OCCASIONALLY DONATED TO LOCAL AGENCIES. PROVIDE TRAINING TO THE LOCAL PARAMEDICS, FIRST RESPONDER GROUPS, AND FIRE DEPARTMENTS. IN ADDITIONA, AREA ORGANIZATIONS RECEIVE CPR TRAINING THROUGHT THE HOSPITAL'S EMS DEPARTMENT. FORM 990 - GENERAL EXPLANATION ATTACHMENT HOSPITAL PARTICIPATES IN THE SECONDARY TRANSITIONAL EXPERIENCE PROGRAM BY PROVIDING EMPLOYMENT OPPORTUNITIES TO HANDICAPPED STUDENTS. PASTORAL CARE AND SOCIAL SERVICE DEPARTMENTS PROVIDE ASSISTANCE FOR PATIENT AND FAMILY NEEDS. PROVIDED LIFELINE VOICE COMMUNICATORS TO ELDERLY PATIENTS WITH SPECIAL NEEDS. EMPLOYEES SERVE AS SPEAKERS AT HEALTH FAIRS, SCHOOLS, AND A VARIETY OF AREA ORGANIZATIONS. ASSIST THE UNTIED WAY CAMPAIGN BY HAVING STAFF MEMBERS ORGANIZE THE HSOPITAL'S ANNUAL FUND DRIVE. PROVIDE A VARIETY OF HEALTH SCREENINGS TO THE PUBLIC IN DIFFERENT LOCATIONS THROUGHOUT THE COMMUNITY. TAX EXEMPT BONDS FORM 990, PART IV, QUESTION 24 St. Mary's Decatur 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. RIGHTS OF MEMBERS TO ELECT GOVERNING BODY FORM 990, PART VI, LINES 6 & 7A THE SENIOR GOVERNING BODY OF ST. MARY'S HOSPITAL DECATUR (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 POWERS FORM 990, PART VI, LINE 7B Responsibility for the policy and operations of St. Mary's Hospital Decatur (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 PROCESS FORM 990, PART VI, LINE 11a The 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. ADDRESS OF OFFICERS WHO CANNOT BE REACHED AT THE HOSPITAL FORM 990, PART VI, LINE 11 Adam Cumbo 528 Lucas Lane Forsyth, IL 62535 CONFLICT OF INTEREST POLICY FORM 990, PART VI, LINE 12C The organization is subject to the corporate compliance program and conflict of interest policy ("policy") of Hospital Sisters Health System, an Illinois not for profit corporation exempt from federal taxation under section 501(c)(3) of the internal revenue code. A REVISED CORPORATE COMPLIANCE PROGRAM AND CONFLICT OF INTEREST POLICY HAVE BEEN IMPLEMENTED SINCE JANUARY, 2009 TO MANAGE CONFLICTS OF INTEREST USING A SYSTEM-WIDE PROTOCOL FOR DISCLOSURE STATEMENTS. IN ACCORDANCE WITH the organizaton's 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 OR ITS AFFILIATES. THE POLICY DEFINES COVERED PERSONS AS 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. ON AN 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. 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 IS REQUIRED PROMPTLY TO DISCLOSE THE INTEREST TO THE COMMITTEE USING THE HSHS CONFLICT OF INTEREST DISCLOSURE STATEMENT. COMPLETED CONFLICT OF INTEREST STATEMENTS ARE SUBMITTED TO THE COMMITTEE, WHICH IS RESPONSIBLE FOR IDENTIFYING, ASSESSING, AND MANAGING CONFLICTS OF INTEREST THAT ARISE IN THE COURSE OF CONDUCTING THE AFFAIRS OF HSHS AND ITS AFFILIATES. IF THE COMMITTEE DETERMINES THAT A CONFLICT OF INTEREST EXISTS, THE CONFLICT OF INTEREST POLICY REQUIRES HSHS NOT TO 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 POLICY FORM 990, PART VI, LINE 13 Provisions within the Corporate Compliance Program and Conflict of Interest Policy provide protections for whistleblower type activities. COMPENSATION PROCESS FORM 990, PART VI, LINE 15 THE 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 PUBLIC FORM 990, PART VI, LINE 19 Board-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 ACCOUNT FORM 990, PART X, LINE 11 ST. MARY'S HOSPITAL'S CASH RESERVES ARE INVESTED IN A POOLED INVESTMENT ACCOUNT. PARTICIPATION 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. INVESTMENTS FOR THE POOLED ACCOUNTS ARE ALL HELD FOR OTHER THAN TRADING PURPOSES. 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. LOANS TO INTERESTED PERSONS FORM 990 SCHEDULE L, PART II John J. White was an owner of Surgical Specialists of Central Illinois, S.C. who received a loan from the Hospital. THE $362,509 ISSUED TO SURGICAL SPECIALISTS OF CENTRAL ILLINOIS, S.C. WAS ISSUED AS TWO SEPARATE LOANS. $163,196 OF THE ENDING BALANCE REPRESENTS THE LOAN THAT WAS IN DEFAULT AT THE END OF THE FISCAL YEAR. THIS LOAN WAS SETTLED IN NOVEMBER OF 2010 AFTER THE END OF THE FISCAL YEAR. BUSINESS TRANSACTIONS INVOLVING INTERESTED PERSONS FORM 990 SCHEDULE L, PART IV BOARD MEMEBER, JON ROBINSON, IS A 50% PARTNER IN THE BOLEN, ROBINSON LAW FIRM. THE FIRM PROVIDES LEGAL SERVICES TO THE ORGANIZATION AND ALL SERVICES WERE CONSIDERED TO BE ARMS-LENGTH TRANSACTIONS. 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