2011-07-12T20:08:10-05:00 2010-08-31 DELOITTE TAX LLP 1750 TYSONS BLVD MCLEAN VA 221024219 990 2009-09-01 582504530 SFH Inc SFHI 8642551000 One St Francis Drive Greenville SC 296013955 Ronnie Hyatt 8642551000 2011-07-12 1 7032511000 2009 2016-02-24 21:20:13Z Ronnie Hyatt One St Francis Drive Greenville SC 296013955 440075242 0 0928 X www.stfrancishealth.org X 1932 SC Provides acute care hospital services. 21 15 2843 345 352113 -115766 662327 431086 407073437 434198980 -403917 1044833 3492483 4163486 410824330 439838385 0 0 153360273 154933975 0 0 221235922 240829906 374596195 395763881 36228135 44074504 465951046 506998161 320076297 320202068 145874749 186796093 The mission is to bring compassion to health care and to be good help to those in need, especially those who are poor and dying. As a system of caregivers, we commit ourselves to help bring people and communities to health and wholeness. 0 0 361209076 434107980 BSSFHS primarily serves Greenville County, which is comprised of approximately 425,000 residents with a growth of over 40,000 people each year, 13.2% of residents in Greenville County are in households that fall below the federal poverty guidelines. Currently, 37.2% of Greenville County residents are medically underserved. Two specific populations with large growth rates in the county are the senior population, with a 17% growth of residents 60 an older since 2000, and the Hispanic population, with an estimated growth of over 1200% estimated between 1990 and 2013. The major health problems plaguing Greenville residents are cardiovascular disease, cancer and stroke. Please refer to the Community Benefit information on Schedule H. 361209076 1 1 0 1 0 0 0 0 0 1 0 1 0 0 0 0 0 0 0 0 1 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 1 1 0 0 1 205 0 1 2843 1 1 1 0 0 0 0 0 0 0 0 21 15 1 0 0 0 1 1 1 1 1 0 0 1 1 1 1 1 1 1 1 1 0 X Ronnie Hyatt 8642551000 One St Francis Drive Greenville SC 296053955 Leonard Byrne 4.00 X 0 0 0 Camilla Hertwig 4.00 X 0 0 0 Eric Le Corre 4.00 X 0 0 0 Sam B Phillips 4.00 X 0 0 0 David Poole 4.00 X 0 0 0 Linton B Puckett 4.00 X 0 0 0 Robert Hitt 4.00 X 0 0 0 Valerie Hollinger 4.00 X 0 0 0 Jeff Oak 50.00 X 0 530321 54275 Fletcher Kirkland 4.00 X 0 0 0 Brother Peter Campbell 4.00 X 0 0 0 Charlton Armstrong III MD 4.00 X 0 0 0 Wayne McDonald MD 4.00 X 0 0 0 Greg Haselden 4.00 X 0 0 0 Sr Rose Marie Jasinski 50.00 X X 0 0 0 Valinda Rutledge 50.00 X X 798608 0 92051 Thomas Morris 50.00 X X 0 417659 45481 Pearlie Harris 6.00 X X 0 0 0 John Shea 50.00 X X 0 792042 131791 Richard Hanson 50.00 X X 0 772746 108244 Mark Nantz 50.00 X X 0 0 0 Ronnie Hyatt 50.00 X 392665 0 87521 Irene Holcombe 50.00 X 86270 0 12881 Lisa Slayton 50.00 X 233120 0 64548 Johnna Reed 50.00 X 228191 0 61264 Teresa Ficicchy 50.00 X 270174 0 93196 Patricia Fowler 50.00 X 213221 0 81846 Randall Romberger 50.00 X 0 284443 3373 Mary Jo Cagle 50.00 X 401343 0 82586 Mark Klapperich 50.00 X 224975 0 46589 Nancy Graebner 50.00 X 299202 0 105561 Elizabeth Keith 50.00 X 194047 0 67691 James Phil Feisal 0.00 X 0 170412 27850 Mary Hassett 0.00 X 359673 0 1931 3701489 2967623 1168679 94 1 1 0 SE Emergency Physicians PO Box 634706 Cincinnati OH 45263 ER Physician Staffing 1768555 American Security PO Box 100199 Columbia SC 29202 Security Services 919206 Fayetteville Lithotripsy PO Box 847324 Dallas TX 75284 Lithotripsy Services 856340 Carolina Perfusion Associates 703 Lakewinds Blvd Inman SC 29349 Perfusion Services 788727 Sleepworks LLC 554 Hall Road Thomasville GA 31757 Sleep Study Services 723185 24 431086 431086 Patient Service Rev. 622110 431544614 431453614 91000 Disprop. Share Income 561499 2654366 2654366 434198980 477721 477721 68840 68840 68840 68840 803969 170282 66575 -170282 737394 567112 567112 Regency Hospital 621400 1960871 1960871 Cafeteria/Vending 900099 1480033 1480033 Laboratory Fees 621500 211960 211960 441782 49153 392629 4094646 439838385 434107980 352113 4947206 1555299 1555299 117817011 107345928 10471083 5853597 5321352 532245 18655791 16826248 1829543 11052277 9947049 1105228 540554 486499 54055 183250 164925 18325 12765 11490 1275 46626472 41963825 4662647 1552666 1397399 155267 1865053 1678548 186505 8826369 7943732 882637 557216 501494 55722 239892 215903 23989 8645750 7781175 864575 13490328 12141295 1349033 1582656 1424390 158266 Medical supplies 78726445 70853802 7872643 Bad debt 50215827 50215827 Repairs/Rental 6937383 6243645 693738 Tax and license fee 4908996 4418096 490900 UBIT expense 467879 421091 46788 15450405 13905363 1545042 395763881 361209076 34554805 0 -1 112624166 166160882 51477980 46078742 9069620 10631266 2408888 1671800 261128704 89988049 178023282 171140655 13464922 14490060 98882189 96824756 465951046 506998161 38262924 41528486 281813373 278673582 320076297 320202068 X 145874749 186796093 145874749 186796093 465951046 506998161 X 0 1 1 X 1 1 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 0 0 0 0 0 0 0 0 1 12765 12765 0 Part II-B, Line 1i: Explanation of Other Lobbying Activities: SFH, Inc. paid dues to the South Carolina Hospital Association (SCHA) and a portion of this dues is used for lobbying activities. The portion of dues allocated to lobbying activities for this organization is $12,765. 18689610 18689610 155433171 31612231 123820940 512815 264476 248339 65822742 39343552 26479190 20670366 18767790 1902576 171140655 Third party settlements 96824756 96824756 Due to affiliates 259300131 Millennium building liability 17059631 Other 2313820 278673582 Part X: Description of Uncertain Tax Positions Under FIN 48: Schedule D, Part X, Line 2 requires that the organization provide the text of the footnote to the organization's financial statements that reports the organization's liability for uncertain tax positions under FIN 48. As the organization does not conduct a separate audit of its financial statement, below is the related statement from the Bon Secours Health System, Inc. consolidated audited financial statements: The System and most of its subsidiaries (including certain joint venture entities) are exempt from federal income taxes under Section 501(c)(3) of the Internal Revenue Code of 1986, as amended. The system accounts for uncertain tax positions in accordance with ASC Topic 740. Income taxes of the System's for-profit subsidiaries are not material to the accompanying consolidated financial statements. The System's taxable subsidiaries have approximately $98,300 and $117,200 of net operating loss carryforwards as of August 31, 2010 and 2009, respectively, which expire in varying periods through 2030 and are available to offset future taxable income. The System's deferred tax assets are fully reserved at August 31, 2010 and 2009. Any changes to the valuation allowance on the deferred tax asset are reflected in the year of the change. 1 1 X 1 X 1 X 1 1 1 0 1 1 3724435 13500 3710935 0.01070 20655547 20503098 152449 0.00040 24379982 20516598 3863384 0.01110 105793 1718942 79501 1639441 0.00470 1753 1162363 1162363 0.00340 329 479688 3398 476290 0.00140 107875 3360993 82899 3278094 0.00950 107875 27740975 20599497 7141478 0.02060 6 559 175231 175231 0.00050 1 1318 1318 0.00000 1 92 42735 42735 0.00010 8 651 219284 219284 0.00060 1 11082633 145326096 163802032 -18475936 X 1 1 Upstate Surgery Center Ambulatory Surgery Center 0.58090 0.23070 SFH Inc dba St Francis- Downtown

One St Francis Drive Greenville SC 296013955

X X X X SFH Inc dba St Francis- Eastside

125 Commonwealth Drive Greenville SC 296154812

X X X X Part I, Line 6a: BSSFHS annually develops a report to the community, explaining the various community benefit services and programs that exist. This report also includes the annual financial commitment of the local system to the community, detailing monetary contributions for government sponsored healthcare shortfall, community benefit programs and charity care at cost. This report is published each year and posted on the web at http://www.stfrancishealth.org/communityreport.php on or around January 24, commemorating Foundation Day of the Sisters of Bon Secours. Part I, Line 7: Part I, line 7a: Charity Care at cost is computed by applying a cost-to-charge ratio to the aggregate charity adjustments recorded in the general ledger. Part I, line 7b: Unreimbursed Medicaid is computed by determining the cost of Medicaid services supplied less payments received for these services. To determine the cost of Medicaid services provided, a cost-to-charge ratio is applied to traditional and managed Medicaid gross charges recorded in the general ledger. Payments include payments for individual claims, payments from the Medicaid program paid outside the claim process (such as medical education payments) and expected or actual cost report settlements.Part I, line 7b(f): Prior to 2006, Medicaid in the state of South Carolina was reimbursed to hospitals on a fixed prospective basis (fixed rates not directly related to costs). For years 2006 - 2011, the state has adjusted their methodology from a fixed prospective basis to a cost-to-care basis (actual costs to provide services). As a result of this change, a greater percentage of Medicaid is reimbursed to hospitals and unreimbursed Medicaid as a percentage of total expenses is significantly lower than those of hospitals in other states. As a nonprofit hospital in South Carolina, the unreimbursed Medicaid percentage for SFH, Inc. is fairly consistent with those of other hospitals in the state.Part I, line 7c: Unreimbursed costs from other means-tested government programs are computed by applying a cost-to-charge ratio to the total charges to patients covered under these programs. The charges are identified by the financial class assigned to the patient. For Part I, Line 7 a-c computations: The cost-to-charge ratio is derived using the suggested computation in Worksheet 2, Ratio of Patient Care Cost-to-Charges. Operating expenses and Gross patient charges are taken from the general ledger. Expenses for nonpatient care activities recorded in operating expenses are approximated as directly equaling other operating revenue, assuming these activities do not provide profit. Part I, line 7e: Community health improvement services and community benefit operations are accumulated throughout the year and reported at actual cost in a software program that specifically addresses this purpose.Part I, line 7f: Health professions education cost is determined as the direct and indirect cost of qualifying education activities as traditionally reported in columns 21-24 on Worksheet B of the Medicare cost report as a Medical Education program, nursing school or other allied health program. Part I, Line 7f: Part I, Line 7, Column f: Current year bad debt expense not included in the calculation for line 7, Column (f): $50,736,215 Part III, Line 4: Part III, line 2: Bad Debt Expense at cost is computed by applying the cost-to-charge ratio computed on Worksheet 2 to the aggregate bad debt expense for patient accounts recorded in the general ledger. Bad debt expense on the general ledger includes: 1) actual write offs of discounted gross charges where it is determined an uninsured patient can pay and does not pay; and 2) the estimated write offs for uninsured patient accounts with outstanding balances after discount. Estimates are based on historical collection rates.When an uninsured patient is billed for patient care services, the charges are automatically discounted and the patient is requested to only pay the amount after discount. The discount is recorded as an adjustment to gross revenue and is not recorded in bad debt expense. If the balance after discount is not paid or not paid in full, the unpaid amount will be written off to bad debt expense. When a patient remits a payment on an account that has already been written off to bad debt expense, the payment is recorded as a recovery of bad debt, which reduces bad debt expense.Part III, line 3: The organization does not report an estimate for the portion of bad debt expense that may have been likely to qualify for financial assistance under the hospitals charity care policy. The organization takes the position that ample opportunity and assistance is provided to the patient to qualify under the financial assistance policy. If sufficient information is not provided, the organization must assume the patient does not qualify. Part III, Line 8: Part III, Line 6: Medicare allowable costs reflected in Part III come directly from the facility's Medicare cost report. The cost report segregates the total facility actual expenses into costs for support departments, clinical departments (routine and ancillary) and nonreimburseable departments. The cost report uses appropriate statistical bases to "step down" support costs to allowable clinical and nonreimburseable departments. The charges for clinical departments are matched to the total cost for these departments for a cost-to-charge ratio. Medicare-specific allowable costs for in- and outpatient ancillary departments are computed by applying the department-specific cost-to-charge ratio to the Medicare program charges by department. For routine departments, a per diem total cost is computed and applied to Medicare program days for the Medicare routine program cost.Part III, Line 8: The total shortfall of Medicare reimbursement compared to computed Medicare allowable costs should be treated as community benefit. The hospital improves access to patient care by providing services regardless of a patients ability to pay or the hospitals ability to receive full cost reimbursement for services. The hospital also relieves the government of a financial burden when it provides care to publically insured patients where reimbursement is less than cost of providing the service. Part III, Line 9b: Part III, Line 9b: The hospital has a written policy that describes collection practices applying to patients who qualify for charity care or financial assistance. If full assistance is approved, no collection efforts are pursued on that patient's account(s). If partial assistance is provided, the patient is responsible for the adjusted account balance and collection efforts will follow the established practices for all patients where a self-pay balance exists. Collection efforts are not pursued on any pending FAP account.Specific criteria exist for how much assistance, partial or total, will be provided to the patient based on the assessed need. Criteria is based on Federal Poverty Guidelines and is reviewed and updated annually. Once a patient has been deemed eligible for the Patient Financial Assistance Program (FAP), the patient is notified by letter within 60 days after receipt of the application and supporting documentation. The patient retains eligibility for a period of twelve months from the date of the approval. This eligibility is signaled to hospital admissions, billing and collection staff by the assignment of a specific financial class with accompanying eligibility dates. At the end of those twelve months, the patient is responsible for reapplying for FAP eligibility. Quantified Community Benefit and Community Building Activities: The financial information was prepared in accordance with the Catholic Health Association's community benefit reporting guidelines and IRS instructions. As a tax-exempt entity, BSSFHS is exempt from federal and state taxation. However, BSSFHS contributes value to the community that consistently exceeds the benefit of this tax exemption. Over the years, BSSFHS periodically has an independent analysis performed by outside consultants knowledgeable of tax law. The consultants help to quantify the value of its tax exemption including income, unemployment, real estate, property and excise taxes, and the benefit of being able to borrow at tax-exempt interest rates. This independent analysis provides BSSFHS with a baseline methodology to compare its cost of community benefit services and the taxes that it would pay if it were a taxable entity. For the fiscal year ending August 31, 2010, BSSFHS provided over $3 million in community benefit services and community building activities at cost. This is well in excess of the value of its potential tax obligation. Part VI, Line 2: Bon Secours St. Francis currently participates in local needs assessments of the medically underserved in Greenville County on a quinquennial basis through the direction of Greenville Forward (a local community organization). The fiscal agents behind the most recent needs assessment include BSSFHS, Greenville Forward, Greenville Hospital System (GHS), the United Way of Greenville County and the Piedmont Healthcare Foundation. The first health care assessment was conducted in 1998. Subsequent assessments since then have reflected successes and critical areas for action. A full report of findings, including over 400 pages of charts, graphs, and slide for the 2008 assessment can be found at http://www.greenvilleforward.com/healthassessment. Part VI, Line 3: BSSFHS Charity Care/Patient Financial Assistance Policy: BSSFHS is committed to ensuring access to health care services for all. As a health care provider, BSSFHS treats all patients, whether insured, underinsured or uninsured, with dignity, respect and compassion throughout admission, delivery of services, discharge and billing and collection processes. BSSFHS addresses the needs of the uninsured by providing free or reduced fees on hospital services, community outreach efforts to assist with Medicaid and SCHIP enrollment, and free community-based preventive and primary care services. BSSFHS proactively screens to identify individuals and their families who may qualify for federal, state or local health insurance programs or the Bon Secours Patient Financial Assistance Program (FAP) and assist the potential eligible patients through the qualification process. Potentially eligible patients that do not qualify for a federal or state health insurance program are referred to the Financial Assistance Coordinator located in Patient Financial Services for assistance in completing the documentation required to establish FAP eligibility. Patients are responsible for providing the information necessary to complete the documentation. The FAP aids uninsured and underinsured patients who do not qualify for government-sponsored health insurance and who communicate their inability to pay for their medical care. The FAP provides 100% financial assistance to uninsured patients with annual family incomes at or below 200% of the Federal Poverty Guidelines (FPG), as adjusted by the Medicare geographic wage index for each community served to reflect that communitys relative cost of living (Adjusted FPG). A sliding scale assistance policy is afforded patients that exceed the income guidelines for 100% assistance. Sliding scale assistance is provided to patients between 200% and 400% of the Adjusted FPG and progressively declines in proportion to the patients higher income level. Additionally, all uninsured (i.e. self pay) patients are given a reduction to the amount of the full charges for medically necessary services through a community service adjustment (CSA). The CSA is market adjusted and based on the payment discount received by other health care payers doing business in the community. For these patients, the FAP also sets a maximum annual family payment liability to ensure that no family suffers a catastrophic financial burden to receive necessary health care services. Based on research conducted by the Tax Foundation, a non partisan tax research group based in Washington DC, the maximum annual family liability is based on a sliding scale determined by the family income and size. The standard sliding scale is adjusted by the Medicare geographic wage index of each community served to reflect that community's relative cost of living. All patients are eligible for a Prompt Pay Discount. In addition, a variety of other potential payment options are available. This patient financial assistance policy is communicated to patients verbally upon registration, visible postings of the policy in common areas throughout the hospital, brochures and on BSSFHS website: www.stfrancisehalth.org. BSSFHS is dedicated to meeting the needs of non-English speaking patients. BSSFHS staffs 3 full-time onsite Spanish translators, as well as offering a dedicated Spanish phone line. In addition, BSSFHS employs the telephone language service, Cyracom, which assists in meeting any language needs that arise. The translation services are offered to non-English speaking patients from admission to discharge, including the financial process.Programs are available through St. Francis that assists with the financial burden of treatment of illness, one specifically being cancer. St. Francis uses funds received through the Susan G. Komen Grant to provide free mammograms to women who qualify. In addition, Bon Secours St. Francis Foundation offers financial assistance for oncology patients who cannot afford treatment or travel. Additionally, a new program is in development through the BSSFHS Batson Cancer Unit and Patient Financial Services departments that will hire an Oncology Patient Assistance Coordinator. This coordinator will responsible for utilizing existing drug and patient financial assistance resources to allow for maximum drug and service coverage along with minimum out-of-pocket expenses for our oncology patient population. Patient financial counseling and patient need assessments will also be conducted under this position. The coordinator will determine patient qualifications for grants, drug cost recovery programs and other paying sources related to lack of insurance coverage or lack of benefits, non-covered services, or patient ability to pay out of pocket costs. This position will permit follow-up and maintain patient accounts that qualify for assistance. Finally, the coordinator will create and maintain a patient assistance database and train staff to interpret and assist with maintaining the database. Any collection attorneys or agencies used by BSSFHS commit to follow BSSFHS value-based procedure, including, without limitation, BSHSI/BSSFHS Code of Conduct, in pursuit of estates, garnishments and judgments for non-payment. Part VI, Line 4: BSSFHS primarily serves Greenville County, which is comprised of approximately 425,000 residents with a growth of over 40,000 people each year. Greenville County is the largest county in the state and one of the fastest growing with a 13% population increase over the past 8 years. Conveniently located along Interstate 85 and less than a two-hour drive to Atlanta, Georgia and Charlotte, North Carolina, Greenville County has become a premiere destination for capital investment that now totals approximately $300 billion annually and is home to 170 corporate headquarters including Michelin North America, Bowater, and Kemet. Per capita income for Greenville County is an average of $24,215 (Greenville County Health Assessment, 2008). 13.2% of residents in Greenville County are in households that fall below the federal poverty guidelines (US. Census). Currently, 37.2% of Greenville County (169,000 residents) are medically underserved. 14.4% are currently using or qualify for Medicare and/or Medicaid. Two specific populations with large growth rates in the county are the senior population, with a 17% growth of residents 60 an older since 2000, and the Hispanic population, with an estimated growth of over 1200% estimated between 1990 and 2013 (Greenville County Health Assessment, 2008).The major health problems plaguing Greenville residents are cardiovascular disease, cancer and stroke. Greenville County data from 2008 indicates an age-adjusted rate of 181.4 (per 100,000) for cancer deaths. State level data from 2008 indicates an age-adjusted rate of 186.3 (per 100,000) for cancer deaths. Prevalence of cardiovascular disease in Greenville County is 5.5%, whereas the state of SC has a prevalence rate of 4.6%. Mortality rates for stoke for Greenville County reached an age-adjusted rate (per 100,000) of 51.6 in 2007, while the state of South Carolina had an age adjusted rate (per 100,000) of 53.3 (State of South Carolina, Department of Health and Environmental Control, Bureau of Community Health and Chronic Disease Prevention, County Chronic Disease Fact Sheet, February 2010).Risk factors that contribute to the incidence of these diseases are also an issue in Greenville County. County level data from 2008 indicates 23% of Greenville County residents smoke, compared to 20% of South Carolina. Additionally, 65% of Greenville residents are overweight, not significantly higher than 64% reflected by the state. Finally 42% of Greenville County residents have high cholesterol, not statistically different from 43% reflected by the state (State of South Carolina, Department of Health and Environmental Control, Bureau of Community Health and Chronic Disease Prevention, County Chronic Disease Fact Sheet, February 2010).BSSFHS uses these statistics to develop community programming in partnership with local agencies, as well as improve on services within the hospital. For example, the St. Francis Breast Health Center, which was recently granted a full accreditation designation by the National Accreditation Program for Breast Centers (NAPBC), offers free mammograms, breast ultrasounds, breast MRI's and needle biopsies for patients who are unable to pay for these breast procedures with the help of funds received by the Susan G. Komen Foundation. In addition, two full time Breast Health Navigators are available at no cost to patients who have mammogram results that indicate breast cancer, as well as those whose results are abnormal but non-cancerous. They offer emotional support to ensure our patients know all of their options and understand exactly what to expect during their testing and treatment.BSSFHS has two specialty services that are recognized centers of excellence. The first is a fully accredited bone marrow transplant program that is the first and only of its kind in the area and one of just two programs in South Carolina. The unit is currently undergoing major expansions that will more than double current capacity for both inpatient and outpatient services. In addition, BSSFHS is the only hospital in Greenville to offer Robotic Surgery in 2009. Part VI, Line 5: In 2008, BSSFHS conducted an analysis to identify the most vulnerable neighborhoods within the broader community. The analysis was based on socio/economic factors including household income, education, social/linguistic isolation, access to healthcare, housing, and environment. The criteria to select the initial vulnerable community of focus included the vulnerability assessment, the number of BSSFHS employees living in the community and the importance of BSSFHS presence as an anchor institution in the community. The BSSFHS decided to select Greenvilles Sterling community to have a full-time employee who works exclusively with this community. Sterling is one of the most low-income populations in Greenville County. According to the 2000 Census, Sterling was listed as a neighborhood with nearly 40% of its residents earning less than $15,000/year. The full time employees title is Director of Community Relationship Building, tasked with coordinating efforts to unite the community (Sterling and the wider Greenville area with Sterling) together as well as provide support for health and social issues. Specifically, the Director assesses the needs and assets of the community by conducting resident interviews, community forums, focus groups, and community summits. Data received is not only being used to develop programs and services that will work to alleviate paramount issues within this vulnerable community, but also create a sustainable, vibrant, and healthy environment. The community building activities exist for the sole purpose of co-creating a healthier community with the residents from that community. As an advocate for health, the Director facilitates dialogues, focus groups, and other related activities that help residents, caregivers, professionals, and others from an array of diverse backgrounds to see the connection between health, economics, culture, and neighborhood/environmental design/infrastructure. BSSFHS works with residents and various stakeholders to help promote positive change in Sterling through structured programming that empowers residents to make sustainable improvements in the areas of economic development and prosperity, environmental stewardship, and healthier lifestyle choices. Since the start of community building activities in the Fall of 2008 and throughout the 2009 calendar year, our efforts in Sterling have received wide community support and attention. The Director of Community Relationship Building spends considerable time monthly going door to door engaging the community of nearly 900 residents personally. He attends their events and meetings on a regular basis at local churches or community centers. He has held various community engagement and health advocacy related events to educate the community on things taking place as well as provide opportunities for residents to participate directly in the process as decision makers. In the Fall of 2008, the Director of Community Relationship Building revitalized community building efforts to be more tailored to the community of focus, calling the effort The Sterling Phoenix League. Into early 2009, the Sterling Phoenix League has seen over 100 participants rally behind the communitys effort to revitalize, rotating themselves across 8 different teams that were set up around the following areas: Health & Wellness Economic Development Housing Peace & Safety Community Spirit Going Green (Environment trails, gardens, urban farms, recycling) Youth Engagement Senior Advocacy The community also designed a Master Plan to help guide infrastructure improvements, promote economic development, and honor the character and history of the neighborhood. Sterling residents have been centrally involved in all aspects of the Sterling Phoenix League, eventually having created their own Sterling Community Land Trust in 2009, which is the first land trust organization in South Carolina. The Director of Community Relationship Building has spent considerable time facilitating and building the capacity of this organization as it will likely be a more organized and vocal representation for the community's interests in terms of historic preservation, housing, and economic development for the community. BSSFHS is slated to provide initial seed funding for the organization during the 2011 fiscal year (Fall 2010 calendar year). The Director of Community Relationship Building has met with the residents and facilitated their leadership development and capacity building and helped projects like the Land Trust, Sterling Trail System, Community Gardens, Sterling Health & Wellness events and assessments, and the Master Plan to come to fruition. Monthly meetings are held and bring residents, key stakeholders and community agencies together for updates and work sessions, at times facilitating groups as large as 50 to 80 people. The Director of Community Relationship Building has sought to leverage existing programs, resources, and relationships (or bridge new ones) within Sterling and from outside the community to cover costs, share costs, or more efficiently use established budgets. Part VI, Line 6: BSSFHS has an open medical staff with privileges available to all qualified physicians. BSSFHS operates an emergency room at both of its hospitals which provide services 24 hours a day, seven days a week to ensure access to needed emergency care for all persons. In 2009-2010, the health system was led in its mission to serve the community by a governing board that included 17 members, fourteen of whom are representative of the community. Additionally, BSSFHS supports several community programs through the Bon Secours mission to be good help to those in need:As part of this mission, BSSFHS provides dedicated staff and services with the sole purpose of measuring the needs of the community and engaging community partners to address the needs. These include the Community Ministries department, which has four full-time dedicated staff members, the Faith Community Nursing Program, LifeWise (a community initiative targeting adults 55 and older), and Open Arms Hospice, a partnership providing the only community Hospice House in the region. These dedicated staff assist in the following programs and also work to build collaborative partnerships in the community. Access to Oral Health Care Program Oral disease is the most common, yet preventable, chronic health problem among children - five times more common than asthma (CDC, Jan. 2005). BSSFHS in collaboration with the Community Health Alliance and the key service partners Greenville Technical College and New Horizon Family Health Services, Inc. (NHFHS), improved access to oral health care through an integrated service partnership that links businesses, funding agencies, a dental hygiene training program, and a mobile medical unit with a primary care provider. The target population for this program includes low income, uninsured and Medicaid-covered children and adults in Greenville and surrounding counties. The overall objective is to improve their oral health status by ensuring access to comprehensive and sustainable oral health services. Two key activities to accomplish this objective are: 1) a community-based dental clinic providing a full range of oral health services; and 2) operation of a mobile dental unit that will travel to churches, schools, shelters, and other sites. Both components provide preventive, primary and restorative care through Greenville Technical Colleges dental hygienist training program as well as NHFHS dentists. In 2009-2010, BSSFHS and the partners involved in this program were able to educate and provide direct service to 2,644 underserved children and over 900 underserved adults and seniors in Greenville County community. Healthy ConnectionsHealthy Connections (HC) is a collaboration among health care providers, Greenville County Schools, Communities-in-Schools, and the United Way of Greenville County. HC has staff in four Title I schools in Greenville County (a school is considered Title I when over 60% of students are eligible for free and reduced lunch). Each school involved in the HC program works closely with school nurses and additional school staff to identify health-related problems of students and determine the barriers to receiving needed care. Services provided by HC staff include coordinating the childs health care appointments, accompanying the child to the appointment, age appropriate education during visits and follow-up with the childs family. Particular attention is paid to the parent, child, and staff relationship.Self-Care for Families with School ChildrenAnnually, BSSFHS provides each family with a 4 year old kindergarten student residing in Greenville County a self-care manual/resource for accessing appropriate health care in Greenville. The self-care guides are purchased from the American Institute of Preventive Medicine, Health at Home, explains common medical issues and provides a decision tree for how to care for the problem at home and how and when to seek appropriate medical care. In 2009-2010, this health literacy project, A Healthy You, documented a six-month follow-up study concluding that 51% of families surveyed were able to avoid one or more visits to the doctor in the past 6 months because of the Health at Home book (22% said they were able to avoid a visit to the doctor 3-4 times). In addition, 58% of families thought that the Health at Home books saved them money on medical or health care in the past 6 months and at least 67% thought it would save them money on health care in the next 6 months.The Faith Community Nursing ProgramIn addition to the volunteer parish nurses and lay health promoters who met the needs of their local congregations, BSSFHS employs three nurses who directly serve and minister to vulnerable populations. These Faith Community nurses work with organizations throughout Greenville, focusing on the needs of the underserved in local organizations such as Triune Mercy Center, Mercy Housings Mulberry Court and St. Anthony of Padua Catholic Church. These Faith Community nurses keep the community healthy by helping people with major health issues connect to the appropriate resources available in the community with an emphasis on spiritual health.BSSFHS is actively involved in National Cover the Uninsured Week each year, assisting with advocacy efforts to help more people in Greenville County receive coverage. In addition, strong partnerships exist with the following local organizations: United Way of Greenville County; New Horizon Family Health Services (a federally-qualified health center); Greenville Free Medical Clinic; Greenville Technical College; Greenville Forward; Greenville County School District; Upstate Homeless Coalition; Mercy Housing; Meals on Wheels; and local churches and universities. These local organizations support BSSFHS to identify community needs, as well as gaps in services and work collaboratively to improve the health and wellness of Greenville County. Part VI, Line 7: Bon Secours Health System, Inc., a Maryland nonprofit, nonstock membership corporation (BSHSI), and all of the other entities that are controlled directly or indirectly by Bon Secours, Inc., a Maryland nonprofit, nonstock membership corporation (BSI) are described collectively as the System. BSI, which is the sole corporate member of BSHSI, has no healthcare operations. The System was organized in June 1983 to fulfill the healthcare mission of the United States Province of the Congregation of the Sisters of Bon Secours of Paris, a congregation of religious women of the Roman Catholic Church founded in France in 1824. The System's activities are in the states of New York, Pennsylvania, Maryland, Virginia, Kentucky, South Carolina, and Florida, each referred to as a local system. The Ministry of BSHSI aids those in need, particularly those who are sick and dying, by offering services that include but are not limited to acute inpatient, outpatient, pastoral, palliative, home health, nursing home, rehabilitative, primary and secondary care and assisted living without regard to race, religion, color, gender, age, marital status, national origin, sexual orientation, or disability. Activities directly associated with this purpose are considered operating activities. Operating activities also include other incidental services that are closely related to healthcare. BSSFHS exists to benefit the people living in the communities it serves. Through all of the services offered to the community, the mission is to bring compassion to health care and to be good help to those in need, especially those who are poor and dying. As a System of caregivers, we commit ourselves to help bring people and communities to health and wholeness as part of the healing ministry of Jesus Christ and the Catholic Church. BSSFHS shares the BSHSI Vision. Inspired by the healing ministry of Jesus Christ and the charisma of Bon Secours, Bon Secours Health System will be recognized for its leadership in justice, transforming the communities in which we serve and work into places of health and hope, and being a prophetic voice for systemic US health reform and a more humane world. BSSFHS is comprised of two general acute care hospitals (St. Francis - Downtown and St. Francis - Eastside) and a physician joint-ventured ambulatory surgery center (Upstate Surgery Center); all of which are located in Greenville, South Carolina. St. Francis downtown is located in downtown Greenville and has 245 licensed beds, 16 operating rooms and offers a full range of medical/surgical services. Core clinical areas of excellence include cardiology/CV surgery, orthopedics, and general surgery. St. Francis eastside is located on the eastside of Greenville County, the fastest growing area of county with regards to residential growth as well as commercial and business growth. This facility has 93 licensed beds (35 of which are Labor/Delivery/Recovery/Post-partum units) and eight operating rooms. Core clinical areas of excellence include OB/GYN, ENT, and orthopedics. The health system operates two emergency departments on opposite sides of the county to ensure that all persons, regardless of their ability to pay, have access to emergency care. The Upstate Surgery Center is a physician joint-ventured ambulatory surgery center that is located on the eastside of Greenville County, very close in proximity to St. Francis eastside. This facility has two licensed operating rooms and the primary surgical procedures performed are ENT and ophthalmology. SC X X X X X 0 1 0 0 0 0 0 0 0 Jeff Oak 0 278856 0 200024 0 51441 0 29576 0 24699 0 584596 0 0 Valinda Rutledge 428528 0 356742 0 13338 0 72325 0 19726 0 890659 0 0 0 Thomas Morris 0 225765 0 157345 0 34549 0 35338 0 10143 0 463140 0 0 John Shea 0 446997 0 341161 0 3884 0 116092 0 15699 0 923833 0 0 Richard Hanson 0 407990 0 335679 0 29077 0 80844 0 27400 0 880990 0 0 Ronnie Hyatt 309993 0 69125 0 13547 0 82524 0 4997 0 480186 0 0 0 Lisa Slayton 186701 0 42176 0 4243 0 61508 0 3040 0 297668 0 0 0 Johnna Reed 178849 0 38174 0 11168 0 54275 0 6989 0 289455 0 0 0 Teresa Ficicchy 220840 0 43858 0 5476 0 84747 0 8449 0 363370 0 0 0 Patricia Fowler 167832 0 39086 0 6303 0 70764 0 11082 0 295067 0 0 0 Randall Romberger 0 -3373 0 37538 0 250278 0 0 0 3373 0 287816 0 0 Mary Jo Cagle 325476 0 74771 0 1096 0 52024 0 30562 0 483929 0 0 0 Mark Klapperich 218260 0 108 0 6607 0 25656 0 20933 0 271564 0 0 0 Nancy Graebner 232313 0 52421 0 14468 0 87060 0 18501 0 404763 0 0 0 Elizabeth Keith 155154 0 35231 0 3662 0 54778 0 12913 0 261738 0 0 0 James Phil Feisal 0 131593 0 27500 0 11319 0 4400 0 23450 0 198262 0 0 Mary Hassett -1931 0 50625 0 310979 0 0 0 1931 0 361604 0 0 0 Part I, Line 4b: SFH, Inc. participates in a BSHSI sponsored executive retirement program that allows for deposits into additional retirement plans and available only to officers and key employees. The 457F plan is a non-qualified plan and is subject to a minimum three-year service requirement before vesting on deposits are made into this plan. Supplemental Information Part III Part I, Line 3: Bon Secours Health System, Inc., a related organization of SFH, Inc., uses the following to establish the compensation of the organization's CEO/Executive Director: Compensation Committee Independent Compensation Consultant Written Employment Contract Compensation Survey or Study Approval by the Board or Compensation Committee Form 990, Part VI, Section A, line 2 Board member Sam B. Phillips and board member David Poole have a business relationship. Form 990, Part VI, Section A, line 6 Bon Secours Health System, Inc. is the sole member of Bon Secours St. Francis Health System, Inc., which in turn is the sole member of SFH, Inc. Form 990, Part VI, Section A, line 7a The governing body of SFH, Inc. is appointed by its member Bon Secours St. Francis Health System, Inc. and subject to approval by Bon Secours Health System, Inc. Form 990, Part VI, Section A, line 7b Certain authorities of SFH, Inc. are reserved to its member or to Bon Secours Health System, Inc. Form 990, Part VI, Section B, line 11 The process the organization uses to review the Form 990 consists of a review by St. Francis Health System's audit and compliance board committee and providing the form to SFH, Inc.'s board of directors to allow for a thorough review by both before the filing date of July 15, 2011. St. Francis Health System's audit and compliance board committee and SFH, Inc.'s board of directors will review the Form 990 and ask any additional questions regarding the Form 990 before the return is filed by July 15, 2011. Form 990, Part VI, Section B, line 12c SFH, Inc. regularly and consistently monitors compliance with the conflict of interest policy. On an annual basis all persons subject to the policy, including all officers, directors and key employees are required to make certain disclosures. These include disclosures related to certain personal, financial and organizational relationships that may present a conflict, or the appearance of a conflict of interest, with SFH, Inc. All disclosures go through a three-part review process: (1) disclosures are reviewed first by the corporate responsibility officer (CRO); (2) a governance team comprised of the CEO, board president, board chair, CRO, and the BSHSI CRO participates in a second review of all disclosures during which recommendations are made as to the resolution of any conflicts or potential conflicts. Depending on the facts and circumstances, resolutions may include ongoing disclosure, recusal or removal of the conflict; and (3) all disclosures and recommendations are reviewed by a board committee (audit and compliance committee reviews the disclosures of management and the governance committee reviews the disclosures of the board and board committee members). Form 990, Part VI, Section B, line 15 The compensation committee of the board of Bon Secours Health System, Inc. engages in a comprehensive process for the oversight and management of remuneration for executive employees and disqualified parties of SFH, Inc. as well as other officers, key employees and highest paid employees. The compensation committee consists of a group of independent board members and engages an independent external compensation consultant to ensure the reasonableness of compensation paid to executives and disqualified parties. The committee maintains a Board-approved compensation philosophy, reviews pay practices against local, regional and national healthcare organizations and approves all remunerative decisions for this group of individuals. The committee reviews and receives assurances that all levels of pay within the organization are reasonable based on performance and validates incentives are met. These decisions are reported to the BSHSI Board of Directors and documented in the BSHSI compensation committee minutes. Form 990, Part VI, Section b , Line 15b - Compensation Process Other Officers/ Key Employees: The process included a review and approval by independent persons, comparability data, and contemporaneous substantiation of the deliberation and decision. In the review, the other officers or key employees of SFH, Inc. were compared to other hospitals' employees in the area that hold the same title. During the review and approval of the compensation, documentation of the decision was recorded in human resources. Form 990, Part VI, Section C, line 19 SFH, Inc. provides any documents open to public inspection upon request. Form 990, Part VII: Hours worked are not tracked on an entity by entity basis. All officer's and director's hours reported on Form 990, Part VII, Compensation of Officers, Directors, Trustees, Key Employees, Highest Compensated Employees, and Independent Contractors represent aggregate hours worked per week. Richard Hanson's compensation is paid by Bon Secours Health System, Inc., a related organization. The compensation he receives is for his role as the CEO of Bon Secours Hampton Roads Health System, Inc. (former). John Shea's compensation is from Bon Secours Health System, Inc., a related organization. The compensation he receives is for the role as an employee at Bon Secours Health System, Inc. Jeff Oak's compensation is paid by Bon Secours Health System, Inc., a related organization. The compensation he receives is for his role as the Chief Corporate Responsibility and Development Officer of Bon Secours Health System, Inc. Thom Morris's compensation is from Bon Secours Health System, Inc., a related organization. The compensation he receives is for the role as an SVP of Sponsorship at Bon Secours Health System, Inc. James Phil Feisal's compensation is paid by Bon Secours Health System, Inc., a related organization. The compensation he receives is for his role as the Executive Vice President of Bon Secours St. Francis Health System - Downtown. Randall Romberger's compensation is paid by Bon Secours Health System, Inc., a related organization. The compensation he received is for his role as the Executive Vice President of Bon Secours St. Francis Health System - Eastside. Sister Rose Marie Jasinski does not receive payroll distributions as she has taken a vow of poverty. Hours worked are based on hours spent across multiple entities. Hours worked are not tracked on an entity by entity basis. Physicians' Surgery Center at St Francis LLC One St Francis Drive Greenville SC 29601 SC SFH Inc Bon Secours St Francis Diagnostic One St Francis Drive Greenville SC 29601 800520229 SC SFH Inc Bon Secours Health System Inc 1505 Marriottsville Road Marriottsville SC 21104 521301088 Parent Org. Management Services SC 501(c)(3) Line 11, Type II: 50 N/A Bon Secours St Francis Health System Inc 1 St Francis Drive Greenville SC 296013955 582504528 Local System Parent Org. SC 501(c)(3) Line 11, Type II: 50 N/A St Francis Foundation 1 St Francis Drive Greenville SC 296013955 260012031 Grant Making Foundation SC 501(c)(3) Line 7: 170(b)(1)(a) N/A St Francis Physician Services 1 St Francis Drive Greenville SC 296013955 134290167 Physician Services SC 501(c)(3) Line 11, Type I: 509 N/A Upstate Surgery Center 1 St Francis Drive Greenville SC 296013955 562186977 Ambulatory Surgery Center SC N/A Related 584388 967617 0 0 Health Care Enterprises Inc 1 St Francis Drive Greenville SC 296013955 571012852 Holding Company SC N/A C 0 0 1 0 0 0 0 0 0 0 1 1 0 0 1 0 0 0 None