2011-05-13T08:26:41-05:00 2010-06-30 KPMG LLP 191 West Nationwide Blvd Ste 500 Columbus OH 432152568 990 2009-07-01 371058692 HOSPITAL SISTERS HEALTH SYSTEM HOSP 2175234747 4936 LAVERNA ROAD SPRINGFIELD IL 62707 MICHAEL W COTTRELL 2011-05-05 true 6142492300 2009 2016-02-24 21:20:13Z STEPHANIE MCCUTCHEON 4936 LAVERNA ROAD SPRINGFIELD IL 62707 92940219 false 0928 X N/A X 1978 IL TO REVEAL AND EMBODY CHRIST'S HEALING LOVE FOR ALL PEOPLE THROUGH A HEALTH CARE MINISTRY. 11 10 232 0 1500000 0 0 52993944 74356688 -4648333 7519505 12390547 11045386 60736158 92921579 0 0 0 0 27121012 33031518 0 0 0 40782087 49435213 67903099 82466731 -7166941 10454848 196028780 247386788 58332098 106684616 137696682 140702172 TO REVEAL AND EMBODY CHRIST'S HEALING LOVE FOR ALL PEOPLE THROUGH A HEALTH CARE MINISTRY. false false 78495653 74356688 HOSPITAL SISTERS HEALTH SYSTEM (HSHS) IS THE PARENT CORPORATION WHICH HOLDS THE VARIOUS HOSPITAL AND HEALTH CARE RELATED CORPORATIONS FOR THE CONGREGATION OF THE HOSPITAL SISTERS OF THE THIRD ORDER OF ST FRANCIS. INTEGRITY OF THE SISTERS' MISSION IS PRESERVED BY THE DESIGNATION OF HSHS AS THE SOLE CORPORATE MEMBER OF EACH OF THE AFFILIATED HEALTH CARE ORGANIZATIONS. THE MISSION OF HSHS IS TO PROVIDE A STRUCTURE AND THE MEANS WHEREBY THE HOSPITAL SISTERS CONTINUE THEIR HEALING MINISTRY. HSHS PROVIDES PROFESSIONAL AND TECHNICAL EXPERTISE IN THE MANAGEMENT OF THE AFFILIATED ORGANIZATIONS. 78495653 true false false true false false false false false true false true false false false false false false false false false false false true false false false false false false false false false false false false true true false false false true 72 0 232 true true true false false false false false false false false false false false 11 10 false false false false true true true true true false false true true true true true true true true false X MICHAEL W COTTRELL 2175234747 4936 LAVERNA ROAD SPRINGFIELD IL 62707 SISTER MARY ANN MINOR OSF 1.0 X X 0 0 0 SISTER MAUREEN OCONNOR OSF 1.0 X X 0 0 0 SISTER MARY MORIN OSF 1.0 X 0 0 0 LEO DONDANVILLE 1.0 X 0 0 0 SISTER MARYANN FALBE OSF 1.0 X 0 0 0 JOHN E STAUDT 1.0 X X 0 0 0 STEPHANIE S MCCUTCHEON 40.0 X X 1174803 0 1035997 SISTER MARY MOLLISON CSA 1.0 X X 0 0 0 SISTER BERNICE COREIL DC 1.0 X 0 0 0 STEPHEN J BOCHENEK 1.0 X 0 0 0 JOHN R COMBS 1.0 X 0 0 0 LAWRENCE SCHUMACHER 40.0 X 888737 0 166493 LEO A LENN 40.0 X 456850 0 204812 ANN CARR 40.0 X 153448 0 117382 MICHAEL W COTTRELL 40.0 X 582921 0 97834 GARY D LEACH 40.0 X 298719 0 285215 CHUCK MOE 1.0 X 134454 0 234514 3689932 0 2142247 60 true true false DEARBORN ADVISORS LLC PO BOX 95152 PALATINE IL 600950152 COMPUTER CONSULTING 21017484 LEVI RAY and SHOUP INC 2401 WEST MONROE SPRINGFIELD IL 62704 IS CONSULTING 2904424 JONES-BLYTHE CONSTRUCTION 1030 WEST REYNOLDS SPRINGFIELD IL 62705 CONSTRUCTION/REMODEL 6200427 MARSH USA INC PO BOX 96772 CHICAGO IL 606936772 INSURANCE 2683548 PPIC 11605 MIRACLE HILLS DRIVE OMAHA NE 68154 INSURANCE 4581784 5 0 AFFILIATE FEES 561000 74356688 72856688 1500000 74356688 7408839 0 0 129306 18640 129306 -18640 110666 110666 0 0 0 OTHER 900099 1190139 1190139 ADMINISTRATION REVENUE 561000 5855247 5855247 OTHER INCOME FROM DEVELOPMENT FUND 900099 4000000 4000000 11045386 92921579 72856688 1500000 11156052 0 0 0 0 3245971 2921374 324597 0 22865809 21263752 1602057 3403187 3121348 281839 1997189 1851774 145415 1519362 1436417 82945 0 1779386 1616002 163384 397696 357926 39770 594303 594303 0 0 13314638 12461266 853372 350231 315208 35023 2215871 2177356 38515 0 0 1340352 1300379 39973 439838 399222 40616 0 792454 745347 47107 1603038 1602905 133 0 10333844 10262067 71777 90159 83634 6525 EQUIP. RENTAL AND MAINT. 12699754 12665325 34429 SOFTWARE SUBSCRIPTIONS 2219260 2201047 18213 RECRUITING 606597 581480 25117 MISCELLANEOUS EXPENSES 219014 199254 19760 DUES & MEMBERSHIP 286278 258404 27874 152500 79863 72637 82466731 78495653 3971078 0 1692 3358205 13228426 13619052 4325000 4325000 40578 40578 3734791 3434909 178859713 55948480 82277552 122911233 91953897 99395067 466844 302744 196028780 247386788 29929301 40570016 28402797 66114600 58332098 106684616 X 136034342 139703735 1662340 998437 137696682 140702172 196028780 247386788 X false true true X true true X X X false false false HOSPITAL SISTERS OF ST FRANCIS FOUNDATION INC 371186514 03 true true true 0 HOSPITAL SISTERS SERVICES INC 371163402 03 true true true 0 HSHS HEALTH CARE PLAN TRUST FUND 371137724 0 true true true 0 HSHS SELF INSURANCE TRUST FUND 371120626 03 true true true 0 SACRED HEART HOSPITAL 390807060 03 true true true 0 ST ANTHONY'S HOSPITAL EFFINGHAM ILLINOIS 370661233 03 true true true 0 ST ELIZABETH'S HOSPITAL BELLEVILLE ILLINOIS 370663597 03 true true true 0 ST FRANCIS HOSPITAL LITCHFIELD ILLINOIS 370661236 03 true true true 0 ST JOHN'S HOSPITAL SPRINGFIELD ILLINOIS 370661238 03 true true true 0 ST JOSEPH'S HOSPITAL BREESE ILLINOIS 371208459 03 true true true 0 ST JOSEPH'S HOSPITAL 370663568 03 true true true 0 ST JOSEPH'S HOSPITAL 390810545 03 true true true 0 ST MARY'S HOSPITAL 370661244 03 true true true 0 ST MARY'S HOSPITAL 372169181 03 true true true 0 ST MARY'S HOSPITAL MEDICAL CENTER 390818682 03 true true true 0 ST NICHOLAS HOSPITAL 390808480 03 true true true 0 ST VINCENT HOSPITAL 390817529 03 true true true 0 HOSPITAL SISTERS HEALTHCARE - WEST INC 510157933 03 true true true 0 HSHS MEDICAL GROUP INC 263956318 03 true true true 0 HSHS WISCONSIN MEDICAL GROUP INC 264515959 03 true true true 0 20 0 hospital sisters health system ("HSHS") administers the Development Fund, Workers Compensation Fund, Health Care Trust Fund, Self insurance Fund, Flex Plan, and Investment Fund FOR HSHS AND THE RELATED HOSPITALS AND EXEMPT ORGANIZATIONS. HSHS utilizes these funds to provide centralized management and computer services to its 13 affiliated hospitals. The hospitals pay a management fee to HSHS for these services. additionally, HSHS administers the self~insurance programs for professional and general liability, workers' compensation, and employee health, along with a centralized investment program on behalf of all HSHS entities. monetary amounts of support provided are not determinable. The following is a list of management fees paid by each local hospital system: St. Elizabeth's Hospital - Belleville $ 8,581,000; St. Joseph's Hospital - Breese $ 1,694,000; St. Mary's Hospital - Decatur $ 5,186,008; St. Anthony's Hospital - Effingham $ 3,910,000; St. Joseph's Hospital - Highland $ 1,150,000; St. Francis Hospital - Litchfield $ 1,490,000; St. John's Hospital - Springfield $18,670,000; St. Mary's Hospital - Streator $ 2,760,000; St. Joseph's Hospital - Chippewa Falls $ 2,859,000; Sacred Heart Hospital - Eau Claire $ 7,225,000; St. Mary's Hospital - Green Bay $ 4,651,000; St. Vincent Hospital - Green Bay $10,949,000; St. Nicholas Hospital - Sheboygan $ 3,178,000; Total $72,303,008 0 0 false false false false false false true 594304 false false false 594304 false false N/A 25936 25936 7173812 3281152 3892660 17810775 12126998 5683777 153849190 40540330 113308860 122911233 0 RELATED HOSPITALS IT NOTES PAYABLE 66114600 66114600 FIN 48 DISCLOSURE FORM 990, SCHEDULE D, PART X On July 1, 2007, HSHS adopted ASC Subtopic 740-10, Accounting for Uncertainty in Income Taxes - an Interpretation of FASB Statement No. 109. ASC Subtopic 740-10 addresses the determination of how tax benefits claimed or expected to be claimed on a tax return should be recorded in the consolidated financial statements. Under ASC Subtopic 740-10, HSHS must recognize the tax benefit from an uncertain tax position only if it is more likely than not that the tax position will be sustained on examination by the taxing authorities, based on the technical merits of the position. The tax benefits recognized in the consolidated financial statements from such a position are measured based on the largest benefit that has a greater than 50% likelihood of being realized upon ultimate settlement. ASC Subtopic 740-10 also provides guidance on derecognition, classification, interest and penalties on income taxes, accounting in interim periods and requires increased disclosures. At the date of adoption, and as of June 30, 2010 and 2009, HSHS does not have a liability for unrecognized tax benefits. X X X X X true true X X X X X X false false false false false false false false false LAWRENCE SCHUMACHER 633034 0 226747 0 28956 0 149619 0 17647 0 1056003 0 0 68256 LEO A LENN 316478 0 83963 0 56409 0 197653 0 7932 0 662435 0 0 35810 GARY D LEACH 173371 0 0 0 125348 0 269120 0 16602 0 584441 0 0 44001 CHUCK MOE 89613 0 0 0 44841 0 224031 0 11118 0 369603 0 0 44671 ANN CARR 131424 0 0 0 22024 0 104209 0 13649 0 271306 0 0 0 STEPHANIE S MCCUTCHEON 778428 0 324588 0 71787 0 1017895 0 18875 0 2211573 0 0 0 MICHAEL W COTTRELL 396619 0 132282 0 54020 0 83909 0 14519 0 681349 0 0 0 member reserved powers form 990 part vi, line 7b Responsibility for the policy and operations of Hospital Sisters Health System (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 Members. The members of the corporation 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 the members' 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"). The members' reserved powers include all rights granted to them 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 organization 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 organization's CFO performs a thorough review of the return and reviews it with the organization's CEO and/or senior leaders before presenting it in its entirety to the hospital Board for questioning and review prior to the return's signing and submission to the IRS. CONFLICT OF INTEREST 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 our Conflict of Interest Policy, all Covered Persons have a duty to comply with the Conflict of Interest Policy for any contract, transaction, relationship or activity contemplated, entered into or conducted at HSHS 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. The Covered Persons are required to review and complete the corresponding Conflict of Interest Statement. The System Office Vice President - System Responsibility, Vice President - Risk & Compliance or members of the Audit and Integrity Committee ("Committee") are available to answers any questions a Covered Person may have. In addition, if, at any time after submitting an annual Conflict of Interest Statement, a Covered Person becomes aware of an Interest that he or she would have had to disclose at the annual interval, the Covered Person 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. COMPENSATION ARRANGEMENT FORM 990, PART VII, SECTION A HOSPITAL SISTERS HEALTH SYSTEM EMPLOYS THE MANAGEMENT/OFFICERS OF THE VARIOUS ENTITIES WHICH ARE CENTRALLY SUPPORTED FOR THE BENEFIT OF THE THIRTEEN HOSPITALS IT SPONSORS. POOLED INVESTMENT ACCOUNT FORM 990, PART X, LINE 11 HOSPITAL SISTERS HEALTH SYSTEM 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 SPONSORSED BY HSHS. THE POOLED ACCOUNT CONSISTS OF CASH, EQUITY AND DEBT SECURITIES that are publicly traded. IN ACCORDANCE WITH THE PROVISIONS OF SFAS NO. 124 "ACCOUNTING FOR CERTIAN 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 NOT IDENTIFIED TO THE PARTICIPANTS. RIGHTS OF MEMBERS TO ELECT GOVERNING BODY FORM 990 PART VI, LINES 6 AND 7A THE SENIOR GOVERNING BODY OF HOSPITAL SISTERS HEALTH SYSTEM ("HSHS") IS THE MEMBERS, WHO 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. PURSUANT TO SECTION 2.3 OF THE HSHS BYLAWS, THE MEMBERS HAVE THE RIGHT TO APPOINT AND REMOVE HSHS BOARD OF DIRECTORS, CHAIRPERSON OF THE BOARD AND PRESIDENT. AFFILIATED HEALTH SYSTEM DISCLOSURE Hospital Sisters Health System 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 who earn less than 250% of the federal poverty level. Under these guidelines a family of four without health insurance that has an annual household income of $55,125 or less is eligible for a 100% 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 standardization of quality assurance measures, the sharing of successful patient safety strategies, the addition of clinical research, workforce development and internal benchmarking. AFFILIATED HEALTH SYSTEM DISCLOSURE (CONTINUED) Enhancing the health status of the community A spirit of collaboration is pervasive for HSHS hospitals in all the communities we serve. Our hospitals work closely with a wide array of public and private organizations that share our commitment to enhancing health and wellness. We know that by working together, we can capitalize on shared resources, reduce duplication of services, and make it easier for residents to get the services and knowledge they need to live healthier lives. St. Joseph's Hospital in Chippewa Falls, WI leads the Chippewa Health Improvement Partnership (CHIP). This collaborative endeavor strives to enhance the quality of life of the residents of Chippewa County, through educational and preventative initiatives promoting wellness and good health. CHIP identifies health needs and establishes priorities from which collaborative activities are created to help improve the health status and quality of life in the community. Recognizing the special and diverse needs of their community, colleagues from St. Nicholas Hospital in Sheboygan, WI serve on the Hmong Health Advisory Committee and the Refugee Task Force. As a partner with the Public Health Department, Safe Harbor and Safe Kids, among others, St. Nicholas provides the Hmong community with access to free preventative health education programs such as stroke awareness, car seat safety, nutrition and foot care and screenings such as blood pressure and blood sugar, bone density and diabetes. "Reaching out and helping our community is what St. Nicholas stands for," explains Program Development Specialist Mary Paluchniak. St. Nicholas also offers alcohol, drug and prescription drug abuse programs in the community, and with the assistance of a grant from the county was able to establish a permanent 24/7 prescription drug drop-off box at the police department to alleviate the misappropriation of prescription drugs and environmental damage caused by disposing of prescriptions drugs in household trash or the public water stream. With more than a quarter of Illinois' population classified as "obese" by the Centers for Disease Control and Prevention, St. John's Hospital in Springfield, IL is working collaboratively to teach children and their parents about healthy lifestyle habits. St. John's is an Anchor Partner of Generation H (H is for Healthy), a newly formed coalition that works to improve children's health and combat the childhood obesity epidemic through programs focused on better nutrition and increased physical activity. On a quarterly basis, St. John's offers Continuing Parent Education Sessions at area schools on topics such as childhood wellness, eating healthy on a budget and summer exercise and safety. In addition, St. John's organizes family health fairs for CATCH Schools providing a variety of free screenings and educational booths, a valuable resource to school nurses and principals. St. John's also organizes the 100 Year Heart school health fairs at which each student spends 10 minutes apiece in seven booths geared toward teaching heart health such as smoking prevention and anaerobic exercise. At St. Mary's Hospital in Streator, IL dieticians offer bi-monthly nutritional programs to educate the public on topics such as diabetes management and salt intake. They also work with children to teach them about healthy eating habits. Skin cancer is the most prevalent type of cancer and annually more than one million cases of skin cancer are diagnosed in the United States. In response, St. Joseph's Hospital in Highland, IL, St. Joseph's Hospital in Breese, IL, and St. Elizabeth's Hospital in Belleville, IL partnered with New Dimensions Cosmetic and Reconstructive Surgery to offer educational programs and free skin cancer screenings at clinics throughout the Metro-east area. By planning major health promotions in partnership with area clinicians, the hospitals are increasing channels for people to access health care as well as capitalizing on shared resources and expertise and reducing duplication of services. Colleagues at St. Mary's Hospital in Decatur, IL noted that many people in the community rely on oxygen. The combination of heavy industry and farming in the area is believed to contribute to poor air quality. To address this concern, a colleague started a monthly COPD support group that consists of six physicians, five nurses, and two respiratory therapists. Together this group is working with the American Lung Association to provide two annual health fairs - one on World COPD Day in November and one for World Health Day in April. As a result of St. Mary's leadership, the word continues to spread about the Breath of Life Club and its membership is growing. St. Mary's is also in the process of placing the COPD Learn More Breathe Better Resource Kit in all their physician offices. In June, The Joint Commission recognized St. Mary's with a disease-specific certification for COPD, an acknowledgment of the work done to address this disease. Because more than 400 babies die annually, mainly through miscarriage in their county, colleagues at St. Nicholas Hospital in Sheboygan, WI recognized the need to provide support for those who had experienced a miscarriage, ectopic, stillbirth or early newborn loss. St. Nicholas' Hope After Loss Organization (HALO) program was created to support parents and their families in the community with resources and counseling regardless of when or where the death occurred. HALO provides bereavement counseling via email, telephone, one-on-one or at monthly HALO support group meetings. In addition, HALO invites parents to participate in memorial services which include a balloon release to honor and remember the babies; siblings, extended family members and friends are welcome. HSHS hospitals recognize that the health of our community depends on a healthy environment. That's why we embrace "green initiatives" and strive to incorporate environmentally friendly design elements as upgrades to our facilities. When the St. Vincent Regional Cancer Center at St. Mary's Hospital Medical Center in Green Bay, WI built a state-of-the-art addition, they included a third floor living roof garden that is the largest green roof in Wisconsin. This expansion was built with the environment in mind as it maximizes use of day light. Ninety percent of rainwater is recycled as irrigation and all storm water passes through a bio-filtration system to purify runoff water. Water-saving technology is used throughout the building and materials are low-PVC or PVC-free with natural finishes of wood and stone. Energy efficient heating and cooling was installed with heat reclamation devices in place. At St. Elizabeth's Hospital in Belleville, IL every hand is working to heal our earth. Annually St. Elizabeth's colleagues recycle 286 tons, almost 1/3 of their waste. The hospital's Environmental Services department initiated single stream recycling of aluminum cans and plastic bottles. Laundry meanwhile sent 1,073 pounds of linens to be made into rags and Pharmacy processes expired medications thus keeping them out of the air and water supplies. AFFILIATED HEALTH SYSTEM DISCLOSURE (CONTINUED) Supporting medical education and research At HSHS, we work to ensure the advancement of medical knowledge through our support of research and education. In Fiscal Year 2010 we contributed more than $13 million in research and education. Our hospitals support and host scores of Continuing Medical Education courses which are attended by hundreds of physicians each year. St. John's College, Department of Nursing in Springfield, IL is affiliated with St. John's Hospital The College offers an upper division Baccalaureate Nursing Degree Program and Continuing Education Programs to serve nurses and allied health professionals in Central and Southern Illinois. The College is transforming itself from a traditional educational institution to one that offers innovative and leading edge programs designed to prepare candidates to care for individuals throughout life in an integrated healthcare system. Accredited by the National League for Nursing Accreditation Commission, the College offers courses that are expressions of our mission. HSHS' investment in education and training is helping improve clinical quality and patient care. One example of this commitment is training that occurred with the deployment of the Evidence-Based Medicine (EBM) Program and corresponding order sets at our hospitals. Standardizing EBM supports enhanced efficiency and leads to improved outcomes of care by reducing variation in practice and by supporting proven practice approaches in order to meet or exceed community standards of care. Standardizing both content and processes for clinical care decisions also aids in the migration to Computerize Provider Order Entry (CPOE). Another example is our work sharing best practices with other health care providers. Prairie Heart Institute of Illinois (PHII) provides rural hospitals with a Congestive Heart Failure (CHF) Toolkit that includes standardized protocols, patient teaching aids, staff training materials and methods to measure the comparative effectiveness of treatments for CHF. Nationally a few unique programs exist to address the cost and quality of treating the CHF patient. "We've developed a comprehensive approach that involves a multidisciplinary team working together to treat patients with CHF. We want to share our successes with other hospitals because we recognize that we can improve people's lives and simultaneously make our health care system more efficient," explains Frank Mikell, MD, HSHS Chief Physician Executive. The CHF Toolkit was introduced to all 13 hospitals. St. Anthony's Hospital in Effingham, St. Mary's Hospital in Decatur, St. Elizabeth's Hospital in Belleville and St. Francis Hospital in Litchfield are making strides to adopt portions of the CHF Toolkit including the patient teaching aids and the standardized protocols for physicians in the ER. Commitment to Care HSHS is working tirelessly to bring together the various elements of health care services to create better, more efficient care for our patients. Our commitment to high quality, cost-effective care is based on our Franciscan and Catholic values. These values include coverage and access for all and special attention to the sick, poor and vulnerable. The more than 14,000 colleagues in Wisconsin and Illinois who are HSHS remain dedicated to continuing the healing ministry begun by the Hospital Sisters of St. Francis more than 135 years ago. 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