2011-05-13T09:00:11-05:00 2010-06-30 KPMG LLP 191 West Nationwide Blvd Ste 500 Columbus OH 432152568 990 2009-07-01 370663567 ST ELIZABETH'S HOSPITAL OF THE THIRD ORDER OF ST FRANCIS STEL 6182342120 211 SOUTH THIRD STREET BELLEVILLE IL 622201998 MARYANN REESE 2011-05-09 true 6142492300 2009 2016-02-24 21:20:13Z Maryann Reese 211 South Third Street Belleville IL 622201998 190894275 false 0928 X www.steliz.org X 1875 IL To MINISTER TO THOSE IN NEED OF HEALTHCARE IN RESPONSE TO GOD'S CALL TO SERVE EACH OTHER,ESPECIALLY THE POOR. IN THE PERFORMANCE OF ITS MISSION, ST.ELIZABETH'S WILL FOSTER RESPECT,CARE,COMPETENCE,AND JOY. 10 5 1934 142 25573 2062 374153 1021881 188359842 185756413 -4029513 720531 1281618 1394232 185986100 188893057 37725 5000 0 0 79339924 84036055 0 0 0 114299960 119121615 193677609 203162670 -7691509 -14269613 182418397 168039041 107260909 121623727 75157488 46415314 THE MISSION OF ST.ELIZABETH'S HOSPITAL IS TO MINISTER TO THOSE IN NEED OF HEALTHCARE IN RESPONSE TO GOD'S CALL TO SERVE EACH OTHER, ESPECIALLY THE POOR. IN THE PERFORMANCE OF ITS MISSION, ST. ELIZABETH'S HOSPITAL WILL FOSTER THE VALUES OF RESPECT, CARE, COMPETENCE, AND JOY. ST. ELIZABETH'S HOSPITAL IS COMMITTED TO PERFORMING ITS MISSION THROUGH COOPERATION WITH OTHER HEALTHCARE PROVIDERS AND THE COMMUNITY, WHENEVER POSSIBLE. false false 169226922 5000 185756413 SEE SCHEDULE O - PART III PROGRAM SERVICE ACCOMPLISHMENTS 169226922 true true false true false false false false false false true false true false false false false false false false false true false false true false false false false false true false false true false false false true true false false false true 231 0 1934 true true true false false false false false false false false false false false 10 5 false false false false true true true true true false false true true true true true true true true false X JOHNNY WATKINS 6182342120 211 SOUTH THIRD BELLEVILLE IL 622201998 Sister Gertrude OConnor OSF 1.0 X 0 0 0 Thomas M Egan 1.0 X X 0 0 0 William S Lyke 1.0 X X 0 0 0 Sister Marybeth Culnan OSF 1.0 X 0 0 0 Dennis E Bielke 1.0 X X 0 0 0 Anwar A Khan MD 1.0 X 48440 0 0 Kevin Pesko 1.0 X 0 0 0 FR James E Deiter 1.0 X 0 0 0 Linda Camp MD 1.0 X 546041 0 0 Steven Wolfe 1.0 X 0 0 0 Salil K Gupta 40.0 X 477918 0 46507 Robert S Miller 40.0 X 187545 0 144338 Johnny E Watkins 40.0 X 232541 0 40364 ANN CARR 1.0 X 0 153448 117382 Alice Chatley 40.0 X 123694 0 25826 Edward Jacquin 40.0 X 138532 0 17188 Mark Reifsteck 40.0 X 0 492738 164086 Sharon Timmons 40.0 X 0 0 0 Illa J David 40.0 X 123656 0 11626 Linda C Sutterer 40.0 X 109804 0 5382 Adam Thacker 40.0 X 138627 0 4241 Leslie Eckert 40.0 X 113326 0 17960 Thomas Baker 40.0 X 110853 0 10054 Kevin Shrake 40.0 X 0 385851 63829 2350977 1032037 668783 30 true true false PROFESSIONAL THERAPY SERVICES INC 2810 FRANK SCOTT PKWY WEST SUITE 8 BELLEVILLE IL 62223 THERAPIST STAFFING 4191574 DM ANESTHETISTS OF IL LLC 4194 MENDENHALL OAKS PKWY SUITE 16 HIGH POINT NC 27265 PHYSICIAN SERVICES 1195000 SLU CARE 3635 VISTA AVE PO BOX 15250 ST LOUIS MO 63110 PHYSICIAN SERVICES 1244449 ST LOUIS UNIV SCHOOL OF MEDICINE 1402 SOUTH GRAND ST LOUIS MO 63104 MED. RESIDENCY PROG. 952400 Sodexo Operations LLC 4880 PAYSPHERE CIRCLE CHICAGO IL 60674 Food Service 1959010 44 1019880 2001 62500 1021881 NET PATIENT REVENUE 900099 183292825 183292825 PHARMACY 446110 1078973 1078973 HEALTH PROGRAMS 900099 38391 38391 ONCOLOGY CENTER INCOME 900099 1346224 1346224 185756413 881871 881871 0 0 1362418 1839878 -477460 -477460 -477460 161340 -161340 -161340 -161340 0 0 0 CAFETERIA SALES 722210 516909 516909 CHILD CARE CENTER 900099 432571 432571 OUTSIDE LAUNDRY 812300 25573 25573 896639 896639 1871692 188893057 185756413 25573 2089190 5000 5000 0 0 0 1130231 571612 558619 0 63712422 55270178 8442244 2425624 2088921 336703 12305247 9977859 2327388 4462531 3843132 619399 4619883 4619883 2607402 2607402 0 31056 31056 0 0 28012306 22628888 5383418 535328 480151 55177 0 4666222 61707 4604515 0 1999326 1999326 105860 54680 51180 0 295500 99089 196411 193903 193903 0 9942125 8730628 1211497 3125073 2525059 600014 MEDICAL SUPPLIES 25651408 25651408 PROVISION FOR BAD DEBTS 18475914 18475914 LICENSE AND TAXES 7133400 7123553 9847 MAINTENANCE & REPAIRS 6369092 5252583 1116509 UTILITIES 2901351 2344292 557059 2456466 2011886 444580 203162670 169226922 33935748 0 859926 -1784789 3245447 4913810 27943491 25707708 41646 1706906 2519185 2700040 2095229 1684056 193207968 131565942 65617382 61642026 76169404 65888347 3332369 4678593 349631 594318 552713 182418397 168039041 18232201 15942972 1011 0 51359675 49888720 37668022 55792035 107260909 121623727 X 70106000 40981396 5046488 5423387 5000 10531 75157488 46415314 182418397 168039041 X false true true X true true X false false false RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 0 0 false false false false false false false false true 31056 31056 false DESCRIPTION OF OTHER LOBBYING ACTIVITIES SCHEDULE C, PART II-B, QUESTION 1I ST. ELIZABETH'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 AND PART OF THESE DUES ARE ATTRIBUTABLE TO LOBBYING FEES PAID BY THE ORGANIZATIONS. THE AMOUNT LISTED ABOVE IS THE AMOUNT ATTRIBUTABLE TO THE HOSPITAL FROM ITS DUES PAID. 3630755 3630755 106372003 71480473 34891530 328544 111610 216934 73199477 55101083 18098394 9677189 4872776 4804413 61642026 0 RETIREMENT OBLIGATION ASBESTOS 8067357 SELF INSURANCE COST 8627393 RATE SWAP PROGRAMS 3237635 ACCRUED BENEFIT LIABILITY 35859650 55792035 ASC SUBTOPIC 740-10 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. true true true X true X true true true false true true 5695616 5695616 0.03080 19385525 7971548 11413977 0.06180 25081141 7971548 17109593 0.09260 43 13445 209482 38817 170665 0.00090 2 662 14887 14887 0.00010 2740059 480411 2259648 0.01220 4 19 514 514 49 14126 2964942 519228 2445714 0.01320 49 14126 28046083 8490776 19555307 0.10580 18 3918 115555 18007 97548 0.00050 1 1200 244 244 7 950 3644 3644 18 7477 84977 20810 64167 0.00030 2 562 20151 20151 0.00010 3 19 312 312 49 14126 224883 38817 186066 0.00090 true 6188926 618892 64103402 88235171 -24131769 X true false MEM& STELIZ'S HEALTHCARE 0.50000 HEALTHCARE SVS SOUTHERN ILLINOIS CARDIOVASCULAR FAC FACILITATE CARDIOVASCULAR SVS 0.50000 St Elizabeth's Hospital - Belleville

211 SOUTH THIRD STREET BELLEVILLE IL 622201998

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 hospital's community benefit report is available upon request. Please contact Tom Vernier at 618-641-5466. Charity care is calculated by determining the total amount from patient billing that is written off to charity care charge codes or allowances. This amount matches the number that is reported on our fiscal year ending 2010 audited financial statements. The total charity care dollar amount is then reduced to cost by applying the Hospital's cost to charge ratio. The cost to charge ratio used was derived by dividing the hospital's operating expenses minus bad debt by net patient service revenue. The hospital does not have sufficient information at this time to determine if subsidized services exist based on the definition and calculations required by the IRS and is working to provide such information in next year's return. The percent of charity care and certain other benefits at cost as a percent of total expense less bad debt is 10.58%. allowances. This amount matches the number that is reported on our fiscal year ending 2010 audited financial statements. The total charity care dollar amount is then reduced to cost by applying the Hospital's cost to charge ratio. The cost to charge ratio used was derived by dividing the hospital's operating expenses minus bad debt by net patient service revenue. The hospital 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 hospital's bad debt includes a portion that could be classified as charity care if application for such care was sought and/or completed. Currently, the hospital is implementing processes, procedures and systems to more effectively determine charity care that will reduce a patient's documentation requirements and ease the patient's emotional burden in applying for charity care. This will provide a more accurate reporting of charity care services provided by the hospital. During the year, the hospital's bad debt expense (at cost) was $6.1 million. We believe that approximately 10% of this amount is owed by individuals who may qualify for charity care. The hospital 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 hospital to respond to community need, hospital 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. During the year, the hospital provided $24.1 million (at cost) in excess of Medicare payments. 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 hospital 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. Any patient accounts that are sent to a collection agency have an opportunity to complete a financial application for Charity/Christian Care if the patient makes a request or if the collection agency feels the patient may meet criteria. If an account meets the qualifications for financial assistance, St. Elizabeth's will recall the account from bad debt, open the account back up on the hospital's books, and adjust the appropriate amount off to charity care. The hospital does not have any healthcare facilities that are not registered as a healthcare facility under state law. St. Elizabeth's Hospital - Belleville - established a formal Community Benefit Committee in January, 2009. This committee consists of interdisciplinary department representatives and community representatives. The Community Benefit Committee consists of 15 members and meets bi-monthly to assess progress towards the year's goals and targets. With a cross-section of community representatives along with hospital leadership, the Community Benefit Committee truly has the appropriate resources and access to pertinent data and information to build, coordinate, and offer programs and education that meet the health needs of St. Clair County and surrounding counties. Data Sources and Findings: St. Elizabeth's Hospital determined community needs through a collaborative community process undertaken with the St. Clair County Healthcare Commission. The hospital incorporates new data and area health assessments into each year's strategic planning process. This year the committee had access to the most recent demographic healthcare report from the St. Louis Division of United Way, the latest study from the Illinois Behavioral Risk Factor Surveillance Report, and most recently, the assessment study of local communities produced by the Missouri Hospital Association. St. Elizabeth's Hospital was included in this study as a member of the metropolitan statistical area (MSA) for St. Louis. The major causes of death in St. Clair County have not changed much over the past two decades. Heart disease is at the top of the list, followed by cancer. More recent studies have shown the frequency rates of these major causes in the different populations and age groups in this metropolitan service area. The St. Clair County Health Department's IPLAN report, completed in 2006, identified six strategic issues to address in the next five years. The Illinois Project for Local Assessment of Needs or IPLAN is a county-level reporting process for the Illinois Department of Public Health (IDPH). Among these issues, the two that ranked highest were the need to improve health outcomes for conditions such as heart disease, diabetes, COPD, stroke, mental health-related conditions, accidents and violence; and the need to focus on comprehensive prevention programs that can be applied across a lifespan and encourage local communities to connect and collaborate for change. Obesity is another key health issue for the population of St. Clair County. Being obese (or even just overweight) is the second leading cause of preventable death in the United States and is measured by body mass index (BMI), a person's weight to height ratio. Overweight is defined as having a BMI over 25 and obese is defined as having a BMI above 30. In St. Clair County, almost a third of adults are overweight, and nearly 28% are considered obese. This issue is of particular concern because obese and overweight individuals are at much higher risk of suffering from various chronic conditions. Health Risk Factors for St. Clair County: Among the health risk factors are: high blood pressure, lack of physical activity, smoking, poor eating habits and high cholesterol. The Community Benefit Committee uses this data to evaluate past practices as well as to set new targets capitalizing on those resources that we have on staff. The Committee also recognized that efforts in educating the public regarding health risks should not stop with our patients. Each patient with a smoking addiction is identified in the patient's history and physical and is subsequently provided cessation information. Smoking or any of the health risks affect our community. This information is also available to family members and visitors. When St. Elizabeth's does not offer a particular health risk program, the hospital offers a listing of those programs in the community or in the state which address a specific need. Collaboration with other Agencies: St. Elizabeth's has been an active member of the St. Clair County Healthcare Commission, a coalition of major health and human service organizations within St. Clair County. The Commission's main goal has been to identify the health needs of the citizens of St. Clair County and to collaborate on strategies for solutions. The Commission is a valuable resource in that it serves as a central clearinghouse of needs and activities occurring in our service area. St. Elizabeth's has a representative on the Commission and our participation has helped us to identify community needs, as well as coordinate activities so there is less costly duplication of programs and services. Every five years, the Commission participates in a community health assessment and planning process as part of IDPH's IPLAN report. This is the final year of the 2005 plan and already St. Elizabeth's has been invited to take an active role in the planning process for the next five years of the Mobilizing for Action through Planning and Partnership (MAPP) assessment. As part of the new assessment, St. Elizabeth's and the Community Benefit Committee have taken an active role in "Survey Life in St. Clair County," which is being coordinated by nursing students from Southern Illinois University. St. Elizabeth's has been a key sponsor in the past three health assessments both through financial support and through people resources. As a result of this participation, St. Elizabeth's has gained access to the data collected and has provided first-hand input on identifying and helping to meet some of the community's healthcare needs. Each year the Commission sponsors a public conference to raise the awareness of chronic diseases and emerging health concerns and health disparities. Each conference has enhanced the missions of the participating organizations by complementing their existing initiatives. The conferences have also facilitated partnerships and cooperative efforts among participants. For example, as a result of one of the conferences, staff from the Illinois Department of Public Health and local hospitals agreed to provide data to the County Health Department to create the St. Clair County Health-Trak Information System, a population- based, public health surveillance system developed to report and evaluate health outcomes using local morbidity and mortality information. The conferences have also generated collaborative partnerships such as the establishment of the St. Clair County Youth Coalition and the Get Up & Go! Campaign initiated in late fall of 2007. St. Elizabeth's took a lead role in these partnerships. Having the Assistant Director of St. Clair County Healthcare Commission on the Community Benefit Committee and the hospital's Advisory Council has given St. Elizabeth's access to the latest information. This relationship allows us to participate in the delivery of relevant programs and services identified as needs in this county. The hospital's Community Benefit Committee each received a copy of the most recent assessment and studied it relative to our resources. It was the Committee's responsibility to evaluate those needs, and based on our resources, to determine how best we could serve the community. In addition, internal data regarding Emergency patients and our own mortality/morbidity reports were brought to this Committee. The county assessment also identified some needs beyond our resources. The St. Elizabeth's Community Benefit Committee led a consensus-building process of 65 community partners that analyzed the assessment results and determined more specifically where the hospital should focus resources. This analysis yielded seven strategic issues, which were adopted as the current goals of the St. Elizabeth's Community Benefit Committee: - Create a broader sense of community connectedness; - Improve health outcomes for cardiovascular diseases, maternal and child health and respiratory diseases; - Strengthen the public health workforce; - Address local behavioral health services and needs; - Increase efforts to reach out to the aging population in our community; - Establish a monthly dashboard reporting process; - Develop a hospital policy relative to Community Benefit; As national unemployment rises, the number of uninsured patients coming to St. Elizabeth's likewise increases. Illinois has a 9.1% unemployment rate. According to the Chicago Tribune (April 1, 2010), there are 1.7 million uninsured Illinoisans. That translates to 10.3% of the total population in St. Clair County. These uninsured struggle to afford medical care and are forced to choose other life essentials over medical coverage. The uninsured and underinsured population puts additional stress on the emergency room resources and increases our annual Charity Care totals. According to the "Fact Sheet from Families USA", the uninsured pay for about 35% of the cost of the care they receive out of pocket. Most people who are uninsured are in low-income families. Last year (FY 2009) Charity Care for St. Elizabeth's was $3.1 million; for FY 2010 it had increased to $5.6 million. That is an 81% increase in just one year. Recognizing this influx, special efforts have been put in place to direct those patients unable to afford their care to other resources. Information about how to apply for Christian Assistance is included on the Patient Information Guide, which is given to all patients admitted. It is also printed on the bills and monthly guarantor statements which are mailed to patients. St. Elizabeth's has contracted with Accordis to assist self-pay (uninsured) in-patients. Accordis provides a representative who visits the patients and discusses the feasibility of applying for Medicaid coverage. They assist patients with the Medicaid application, follow-up on requests from Medicaid, and conduct home visits with patients if needed. If the patient needs to file an appeal, Accordis assists with other qualifying conditions required. If during a visit with a patient, it is determined they do not qualify for Medicaid, then patients are provided one of St. Elizabeth's Charity (Christian Assistance) applications. ST. CLAIR COUNTY INFORMATION Comparison of Select Demographic, Biostatistical & Behavioral Data St. Clair County, Illinois based on the 2009 estimate Characteristic St. Clair County Illinois Total Population 263,617 12,910,409 Age Persons under 18 years old 25.3% 24.6% Persons 65 year old and over 12.6% 12.4% Percentage of female persons 52.2% Percentage of male persons 47.7% Race % White 67.3 79.0 % Black 29.6 14.9 Ethnicity Hispanic 2.9 15.2 Median Household Income $46,428 $54,141 Crude Coronary 2006 Mortality 173.9 149.0 Rate/100,000 Premature Coronary 2006 Mortality 42.6 34.2 Rate/100,000 % Adults Obese & Overweight 60.9 62.0 % Adults Not Meeting Physical Activity Standards 63.0 63.0 % Adults Eating <5 Fruits / Vegetables / day 83.6 75.0 % Youth Who Are Obese 2.9 According to the 2008 estimates of the US Census, the demographic make-up of St. Clair County is 68% white, 29% black and 3% other. The 2007 poverty rate for St. Clair County is 32.7% higher than the State of Illinois, with an estimated 16 out of 100 county residents living in poverty. This is a significant fact in that many of these residents are underinsured or uninsured. They need healthcare but cannot afford it. The net result is an alarming increase in our Charity Care. It is the mission of the Hospital Sisters of St. Francis and St. Elizabeth's Hospital to provide care for everyone who enters our facility. We will not turn away anyone with a healthcare need. St. Clair County is known to have communities where as many as 35 to 45 out of every 100 residents live in poverty (U.S. Census). The poor are in our midst and St. Elizabeth's is committed to their care. A comparison of 1999-2004 premature deaths to all women under the age of 65 years for Illinois and St. Clair County residents show mortality rates (per 100,000 population) with calculated percent differences that are significantly higher for female residents of St. Clair County than their Illinois counterparts for the following causes of death: Breast Cancer (14.6% higher), Cervical Cancer (16.3%), Lung Cancer (19.7%), HIV/AIDS (15.1%), Heart Failure (106.8%), Hypertension (96.1%), Stroke (33.1%), Chronic Obstructive Pulmonary Diseases (73.5%), Diabetes mellitus (147.2%), Motor Vehicle Fatalities (53.8%), Suicide (35.7%) and Homicide (90.9%). The combined years of potential life lost to the age of 65 years (YPLL65) for these conditions is a staggering 14,840 (Source: SCC Health-Trak). Hospitalizations for this same population of St. Clair County residents show that the five leading causes of hospitalizations (deliveries not included) are Mental Disorders (12.5%), Heart Disease & Stroke (7.5%), Pneumonia/Influenza (2.2%), Asthma (1.9%) and Diabetes (1.8%) (Source: IDPH EMS Reporting System). An important aspect of community building is ensuring there is broad representation of community leaders. St. Elizabeth's Hospital has recognized this involvement and participation as two-fold. First it gives this hospital the opportunity to hear first-hand what community leaders perceive as the top healthcare needs and challenges of this community. Whether it's the need for more physicians, supporting a community-wide effort or initiative within the community, or partnering with educational institutions in encouraging young people to consider a career in healthcare, these are all the types of dialogue that need to occur for mutual and beneficial support . Secondly, when a need is identified, this representation puts us in direct contact with those who have identified the need. This leads to opportunities to strengthen collaboration and help nurture the concept that building a healthy community is also improving individual health. Hospitals can only be a part of such an effort. Good health applies to all the residents in the village. But, St. Elizabeth's recognizes that as a healthcare leader, it has the resources, the knowledge and support that can help address these unmet needs. Currently St. Elizabeth's Hospital has staff serving on the Belleville Chamber of Commerce's Healthcare Subcommittee. We also have representation on the Board of Directors of the local YMCA, on two of the Hospice Organizations serving this community, on the Leadership Council of Southern Illinois, and active participation with the St. Clair County Board of Commissioners on Pioneering Healthy Communities. The Belleville Diocese conducts quarterly meetings of all the healthcare agencies in this Diocese, which serves 28 counties adjacent to Indiana, Kentucky and Missouri. This coalition offers a forum for all the hospitals and Catholic Charities to identify healthcare needs and to share the activities of each agency. Although, some of the Diocesan agencies concentrate on serving the poor in these extremely southern counties, many times those needs can be met through a cooperative effort among the participating agencies. In the past, St. Elizabeth's has offered educational programs and has provided informational material to areas where resources are limited. In the past year, St. Elizabeth's conducted two food drives to benefit local pantries and military families whose chief breadwinner was deployed. St. Elizabeth's has worked jointly with St. Clair County and its Mental Health Board in designing and sponsoring an annual community conference. The conference has adopted the brand of Removing the Stigma. St. Elizabeth's has developed a strong working relationship with area colleges and some of the area high schools. One example of high school participation is the annual service program. This is a three-week experience where high school seniors must choose a community social service agency, and then volunteer full-time doing a variety of assignments in order to get an understanding of what that service offers. This program is required for graduation. This is becoming more and more popular, as it is now being built into the curriculum for students in advanced classes. At the college level, St. Elizabeth's maintains over 30 college affiliation agreements. Interns from nursing, radiology, respiratory therapy, and physical therapy fulfill their required internship training. This training can be formal through classroom instruction or informal through simply observing delivery of medical care. There is no compensation associated with these affiliations. These students are already shouldering a full academic load and having access to St. Elizabeth's for their internships certainly reduces their time and travel. St. Elizabeth's has two in-house affiliations. The space for these additional programs is reimbursed, however it is the value of all the resources that support these programs which indirectly contribute to the community. The Respiratory Therapy program has a classroom and a lab training room in the hospital. Also on the campus of St. Elizabeth's is a General Practice Residency Program under the auspices of St. Louis University. This is a joint military/civilian residency program. There is an average of 42 residents in the program with half of them coming from the nearby Scott Air Force Base. Rated as one of the top medical residencies in Illinois, this residency program has provided the training which has directly impacted the local area. Many of the graduates have elected to remain in the area, serving especially the rural communities surrounding Belleville. Improving access to healthcare is truly a benefit to any community when a physician chooses to establish a practice serving a rural community. St. Elizabeth's Hospital is in the downtown district. It is the oldest part of town. Within 8 blocks of the hospital in all directions are elementary schools with exceptional needs. Managers from St. Elizabeth's give up their time monthly to visit a school. They each are assigned a student who may be experiencing a skills difficulty or is surviving in a dysfunctional environment. Having lunch with the student, listening to their reading or spelling assignment, or simply listening to their life trials, has been well received. In fact, some true friendships have developed through this program, and their mentors have maintained that relationship outside of school hours by including a student on a trip to local entertainment or attraction. Due to budget limitations, these students were lacking recess supplies. Those needs were brought to the management team at St. Elizabeth's and personal donations quickly filled that need. Mentoring, listening, caring, what child does not have those needs. And how can it be measured? The highlight of each year is when the mentors and students are introduced at a regular management huddle and they are treated to a tour of the hospital. St. Elizabeth's Hospital offers hope to our community in the tradition of the Hospital Sisters of St. Francis. St. Elizabeth's 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. Elizabeth's Hospital, it is recognized that not all individuals possess the ability to purchase essential medical services. It is our mission is to serve the sick, especially the poor, with quality healthcare services and healthcare education. We have further defined our mission of identifying those who are at greatest health risk, the elderly, children, those coping with mental illness, and those with less means who are dependent on quality healthcare. St. Elizabeth's Hospital takes a proactive role in educating its communities on wellness programs, sponsoring health screenings, collaborating with the local health district in targeting local health concerns, and organizing support groups. Reinvesting in the Needs of the Community Because of the hospital's purpose and tradition, it is organized to promote the health of Belleville and the 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. Elizabeth's is responding to community need in accordance with the process described under #2 above. Also consistent with its exempt status, St. Elizabeth's has an open medical staff with privileges available to all qualified physicians in the area. As a not-for-profit hospital, St. Elizabeth'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 operation are generally used to upgrade facilities, secure new technologies, improve patient care, and support initiatives designed to promote helath and insure access for all. The hospital's focus on improving health status for cardiac care, maternal and child health, and behavioral health are all examples of how the hospital is responding to community need. As described under #2 above, St. Elizabeth's is concentrating on quality of our cardiac services by meeting and/or exceeding standards of care. Our door-to-balloon time is an area in which we have consistently exceeded the national standard. We also have begun targeting the female population - that age group in particular that is at great risk than their male counterparts - primarily through education. Although it is too early to measure the true Community Benefit, St. Elizabeth's is the only hospital in southern Illinois with neonatal services and will soon be adding a perinatologist to its staff. The addition of the perinatologist resulted in 760 outpatient visits in a span of four months. In addition to the specialized care that this hospital is equipped and trained to deliver, these services demonstrate an improvement to patient access. Without special neonatal care, these babies would be transferred to St. Louis and the hardship on the parents would multiply. The combined admissions of these two specialists for FY 2010 were 1,150 patients. In addition, St. Elizabeth's offers the only in-patient and outpatient behavioral health program in St. Clair County. In the past year, there have been 1,600 psychiatric admissions and 431 detox admissions. Providing a Wide Range of Community Benefits St. Elizabeth's Hospital provided 59,835 adult and pediatric days of care and had 176,718 outpatient visits during FY 2010. During this period, St. Elizabeth's provided in excess of $43.6 million to support our commitment to the community. Included in this total was $5.6 million at cost of healthcare for individuals unable to afford their care. St. Elizabeth's Hospital also provided care to persons covered by governmental programs at or below cost. This resulted in providing $24.1 million of healthcare to Medicare and $11.4 million to Medicaid patients which was not reimbursed. This resulted in a total of $35.5 million healthcare provided for these two groups. Included in the total was the extensive number of free educational programs, screenings, clinical services and consultations provided at a reduced fee or at no charge to other healthcare agencies and human service agencies in our service area. To the extent that reimbursement was below cost, St. Elizabeth's Hospital recognized these expenses as a cost of fulfilling its mission for the entire community. Included in the above figures are the following initiatives aimed at improving access and promoting health for the people of Belleville and surrounding communities. Health Screenings: -Blood pressure screenings -Car seat inspections, installations, and free car seats -Reduced fee for mammograms -Lung Function screenings -Cardiac blood tests at reduced fee -Skin cancer screening -Alzheimer's Disease screening -Anxiety screening -Depression screening -Pulmonary function testing -Alcohol screening -Cholesterol screening -Stroke Screening -Alcohol Abuse Screenings Educational Programs -Student internships with numerous colleges and universities -A work-study program for mentally challenged high school students -Tours for high school students -Healthcare Professions Shadowing -Student volunteer programs (senior community project) -Prenatal classes -Lamaze classes -Mother Child Tours for Expectant Mothers -Adult, infant and child CPR classes -Nutrition classes -Arthritis self-help classes -Aging conference -Ethics conference -Advance Directives Workshop -Nursing support for school physicals -Variety of programs for seniors at the PSOP center -Lunch with a Doctor - ten programs Nutritional Support -Meal coupons for the homeless and indigent -Food items collected and donated to needy families and to an interdenominational food pantry in Belleville and to families of deployed soldiers -Clothing collected and donated to the Violence Prevention Center, Pregnancy Care Center, and Catholic Urban Program -Food coupons to local grocery stores -Diabetic Nutritional Counseling -Free prescriptions for patients unable to pay -Bus passes and cab fare Support Groups -St. Elizabeth's sponsors sixteen support groups and meetings -Diabetic Support Group -Memorial services for deceased family members -Compassionate Friends -Manic Depressive -Recovery, Inc. (support for those dealing with nervous symptoms and fears) -Parkinson Support Group -Life After Breast Cancer -Alcoholics Anonymous Sponsorship -Mended Hearts -Funeral services conducted by Pastoral Care chaplains -Burial along with graveside services for relatives of fetal/premature deaths -Alzheimer's Support Group -Rehab Support Group -Stroke Support Group -Defibbers Support Group -Narcotics Anonymous Sponsorship Health Fairs -At the community events in St. Clair and Monroe Counties -At senior centers and Our Lady of the Snows Retirement Apts -At area churches -For Women, By Women Health Fair -For area clergy -Lipstick Women's Conference Community Involvement -Wellness clinic at the Programs and Services for Older Persons Center -Provided flu shots to the underserved at no charge -Meeting and conference room space for health/civic groups -Actively participate in programs and services of St. Clair County's Health District -Held leadership role in community civic organizations - Healthcare Providers Committee - Greater Belleville Chamber of Commerce -Participated with community groups by providing healthcare information -Participated in major community health events - Cancer Walk and Ride, Trivia Night, March of Dimes Walk, American Lung, Diabetes Walk, Drug Awareness Red Ribbon Walk, Susan B Komen Denim Day, Ride Belleville, Bethany Anniversary -Conducted Lay Ministry Training Program for all denominations -Sponsored six blood drives -Cooperated with local judicial court on family violence programs -Provided space and equipment for the Family Visitation Exchange program -Charity consults with pharmacists -CPR classses -Participated on the planning committee for the St. Clair County Health conference -Gave support to the local AIDS support and residence service -Conducted quarterly memorial services and reception for family members of deceased patients -Red Heart Day sponsorship -Community-wide disaster preparation and drills -Career Days -Gateway Hospital Ethics Committee -Provide graveside services at no charge -Linen donations to area nursing homes and other medical supplies to Mission Outreach -School Mentoring Program -School Supplies for Children residing in the Violence Prevention Center -Food Drive for Local Food Pantry -Clinical education/affiliation with area healthcare programs St. Elizabeth'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 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. Enhancing the health status of the community A spirit of collaboration is pervasive for HSHS hospitals IL X true true X X X X X X false false false false false false false false false Kevin Shrake 0 279317 0 71470 0 35064 0 50274 0 16758 0 452883 0 28528 Salil K Gupta 430033 0 0 47885 25867 20640 524425 0 0 Robert S Miller 163615 0 0 23930 139282 5056 331883 0 0 Johnny E Watkins 210604 0 0 21937 30931 9433 272905 0 0 ANN CARR 0 131424 0 0 0 22024 0 104209 0 13649 0 271306 0 0 Linda Camp MD 546041 0 0 0 0 0 0 0 0 0 546041 0 0 0 Edward Jacquin 130003 0 0 0 8529 0 16681 0 507 0 155720 0 0 0 Mark Reifsteck 0 346885 0 119030 0 26823 0 145985 0 24845 0 663568 0 38948 Chicago Land Of Trust for O'Fallon Owner is Board Member 532253 RENT false Mascoutah Plaza Land of Trust Owner is Board Member 268261 Rent false PROFESSIONAL THERAPY SERVICES PTS OWNER IS BOARD MEMBER 4191574 STAFFING false X 2 62500 appraisal false false false N/A Program Services Form 990, Part III St. Elizabeth'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. Elizabeth's Hospital, it is recognized that not all individuals possess the ability to purchase essential medical services. It is our mission is to serve the sick, especially the poor, with quality healthcare services and healthcare education. We have further defined our mission of identifying those who are at greatest health risk, the elderly, children, those coping with mental illness, and those with less means who are dependent on quality healthcare. St. Elizabeth's Hospital takes a proactive role in educating its communities on wellness programs, sponsoring health screenings, collaborating with the local health district in targeting local health concerns, and organizing support groups. During FY 2010, St. Elizabeth's Hospital provided 59,835 adult and pediatric days of care and had 176,718 outpatient visits. During the period, St. Elizabeth's provided in excess of $19.5 million to support our commitment to the community. Included in this total was $5.6 million at cost of healthcare for individuals unable to afford their care. St. Elizabeth's Hospital also provided care to persons covered by governmental programs at or below cost. This resulted in providing $11.4 million to Medicaid patients which was not reimbursed. Also, included in the total was the extensive number of free educational programs, screenings, clinical services and consultations provided at a reduced fee or at no charge to other healthcare agencies and human service agencies in our service area. To the extent that reimbursement was below cost, St. Elizabeth's Hospital recognized these expenses as a cost of fulfilling its mission for the entire community. In addition to the Community Benefit total, St. Elizabeth's provided 18.4 million (at cost) in uncompensated care to patients that did not qualify for charity care or public assistance, and over $24.1 million (at cost) in excess of Medicare payment for health services. Included in the above Community Benefit figures are the following initiatives aimed at improving access and promoting health for the people of Belleville and surrounding communities. Health Screenings: Blood pressure screenings; Car seat inspections, installations, and free car seats; Reduced fee for mammograms; Lung Function screenings; Cardiac blood tests at reduced fee; Skin cancer screening; Alzheimer's Disease screening; Anxiety screening; Depression screening; Pulmonary function testing; Alcohol screening; Cholesterol screening; Stroke Screening; Sports Physicals for local high school; Bone density assessment; Body Fat Screening; Vascular Screenings; Alcohol Abuse Screenings Educational Programs Student internships with numerous colleges and universities; A work-study program for mentally challenged high school students; Tours for high school students; Healthcare Professions Shadowing; Student volunteer programs (senior community project; Four free community education programs; Prenatal classes; Lamaze classes; Mother Child Tours for Expectant Mothers; Adult, infant and child CPR classes; Nutrition classes; Arthritis self-help classes; Here's to Your Health (a series of 4 presentations); Aging conference; Ethics conference; Advance Directives Workshop; Nursing support for school physicals Variety of programs for seniors at the PSOP center Lunch with a Doctor - ten programs Nutritional Support Meal coupons for the homeless and indigent; Six tons of food items collected and donated to needy families and to an interdenominational food pantry in Belleville; Over one ton of clothing collected and donated to the Violence Prevention Center, Pregnancy Care Center, and Catholic Urban Program; Food coupons to local grocery stores; Diabetic Nutritional Counseling; Free prescriptions for patients unable to pay Support Groups St. Elizabeth's sponsors thirteen support groups and meetings; Grief support (adults); Memorial services for deceased family members; Compassionate Friends; Manic Depressive; Recovery, Inc. (support for those dealing with nervous symptoms and fears); Parkinson Support Group; Life After Breast Cancer; Alcoholics Anonymous Sponsorship; Mended Hearts; Funeral services conducted by Pastoral Care chaplains; Burial along with graveside services for relatives of fetal/ premature deaths; Alzheimer's Support Group; Rehab Support Group; Stroke Support Group; Defibbers Support Group; Narcotics Anonymous Sponsorship; Health Fairs At the community events in St. Clair and Monroe Counties; At senior centers and Our Lady of the Snows Retirement Apts; At area churches; For Women, By Women Health Fair; For area clergy; Lipstick Women's Conference; Community Involvement Wellness clinic at the Programs and Services for Older Persons Center; Provided flu shots to the underserved at no charge; Meeting and conference room space for health/civic groups; Actively participate in programs and services of St. Clair County's Health District; Held leadership role in community civic organizations; - Healthcare Providers Committee - Greater Belleville Chamber of Commerce; Participated with community groups by providing healthcare information; Participated in major community health events; - Cancer Walk and Ride, Trivia Night, March of Dimes Walk, American Lung, Diabetes Walk, Drug Awareness Red Ribbon Walk, Susan B Komen Denim Day, Ride Belleville, Bethany Anniversary; Conducted Lay Ministry Training Program for all denominations; Sponsored six blood drives; Cooperated with local judicial court on family violence programs; Provided space and equipment for the Family Visitation Exchange program; Charity consults with pharmacists; CPR classes; Participated on the planning committee for the St. Clair County Health conference; Gave support to the local AIDS support and residence service; Conducted quarterly memorial services and reception for family members of deceased patients; Red Heart Day sponsorship; Community-wide disaster preparation and drills; Career Days; Gateway Hospital Ethics Committee; Provide graveside services at no charge; Linen donations to area nursing homes and other medical supplies to Mission Outreach; School Mentoring Program; School Supplies for Children residing in the Violence; Prevention Center; Food Drive for Local Food Pantry; Clinical education/affiliation with area healthcare programs TAX EXEMPT BONDS FORM 990, PART IV, LINE 24 ST ELIZABETH'S MEMORIAL HOSPITAL 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. ELIZABETH'S HOSPITAL (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. Elizabeth's Hospital (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. 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 Hotline 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 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. 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. TRANSACTIONS WITH RELATED ENTITIES FORM 990 SCHEDULE R, PART V, LINE 2 The Transactions reported in Question 1 are between related 501(c)(3) public charities and are not reported in this section. Springfield Health Partners LLC 4936 Laverna Road Springfield IL 62707 371364419 Healthcare IL HSHS MG HOSPITAL SISTERS HEALTH SYSTEM 4936 LAVERNA ROAD SPRINGFIELD IL 62707 371058692 HEALTHCARE IL 501(c)(3) 11A NA HOSPITAL SISTERS SERVICES INC 4936 LAVERNA ROAD SPRINGFIELD IL 62707 371163402 HEALTHCARE IL 501(c)(3) 11A NA HOSPITAL SISTERS OF ST FRANCIS FDTN 4936 LAVERNA ROAD SPRINGFIELD IL 62707 371186514 HEALTHCARE IL 501(c)(3) 11A NA HSHS SELF INSURANCE TRUST FUND 4936 LAVERNA ROAD SPRINGFIELD IL 62707 371120626 INSURANCE IL 501(c)(3) 11A NA HSHS HEALTH CARE PLAN TRUST FUND 4936 LAVERNA ROAD SPRINGFIELD IL 62707 371137724 HEALTHCARE IL 501(c)(3) NA HOSPITAL SISTERS HEALTHCARE - WEST INC 2661 COUNTY HIGHWAY I CHIPPEWA FALLS WI 54729 510157933 HEALTHCARE WI 501(c)(3) 11A NA SACRED HEART HOSPITAL 900 W EST CLAIREMONT AVENUE EAU CLAIRE WI 54701 390807060 HEALTHCARE WI 501(c)(3) 3 NA ST ANTHONY'S HOSPITAL 503 N MAPLE STREET EFFINGHAM IL 62401 370661233 HEALTHCARE IL 501(c)(3) 3 NA ST JOHN'S HOSPITAL 800 EAST CARPENTER STREET SPRINGFIELD IL 62769 370661238 HEALTHCARE IL 501(c)(3) 3 NA ST FRANCIS HOSPITAL 1215 FRANCISCAN DRIVE LITCHFIELD IL 62056 370661236 HEALTHCARE IL 501(c)(3) 3 NA ST JOSEPH'S HOSPITAL 9515 HOLY CROSS LANE BREESE IL 62230 371208459 HEALTHCARE IL 501(c)(3) 3 NA ST JOSEPH'S HOSPITAL 1515 MAIN STREET HIGHLAND IL 62249 370663568 HEALTHCARE IL 501(c)(3) 3 NA ST JOSEPH'S HOSPITAL 2661 COUNTY HIGHWAY 1 CHIPPEWA FALLS WI 54729 390810545 HEALTHCARE WI 501(c)(3) 3 NA ST MARY'S HOSPITAL 1800 E LAKE SHORE DRIVE DECATUR IL 62521 362169181 HEALTHCARE IL 501(c)(3) 3 NA ST MARY'S HOSPITAL 111 SPRING STREET STREATOR IL 61364 362169181 HEALTHCARE IL 501(c)(3) 3 NA ST NICHOLAS HOSPITAL 3100 SUPERIOR AVENUE SHEBOYGAN WI 53081 390808480 HEALTHCARE WI 501(c)(3) 3 NA ST VINCENT HOSPITAL 835 S VAN BUREN GREEN BAY WI 54301 390817529 HEALTHCARE WI 501(c)(3) 3 NA ST MARY'S HOSPITAL MEDICAL CENTER 1726 SHAWANO AVENUE GREEN BAY WI 54303 390818682 HEALTHCARE WI 501(c)(3) 3 NA HSHS MEDICAL GROUP INC 4936 LAVERNA ROAD SPRINGFIELD IL 62707 263956318 HEALTHCARE IL 501(c)(3) 11A NA HSHS WISCONSIN MEDICAL GROUP INC 8040 EXCELSIOR DRIVE STE 200 MADISON WI 53717 264515959 HEALTHCARE WI 501(c)(3) 11A NA Orange Cross Ambulance Inc 919 Ashland Ave sheboygan WI 53081 391860942 healthcare WI 501(c)(3) 9 St Nicholas Wisconsin Upper Pen Onc Mngmt Services 835 S Van Buren green bay WI 54304 391677100 healthcare WI 501(c)(3) 3 St Vincents Unity Limited Partnerhship 2366 Oak Ridge Circle De Pere WI 54115 391750729 Healthcare WI 501(c)(3) 9 HSSI Memorial and St Elizabeth's Healthcare 4000 North Illinois Street Swansea IL 62226 371312961 HealthCare IL NA RELATED 1346224 4678593 false 0 false Health Ventures Of So Illinois LLC 2810 Frank Scott PKWY W STE 700 Belleville IL 62223 371334060 HealthCare IL NA RELATED false false Prairie Heart Insutute - Carbondale LLC 800 East Carpenter Street Springfield IL 62769 371321197 HealthCare IL St John's RELATED false false Northeast Wisconsin Radiation Therapy Se 1821 S Webster Avenue Suite 300 Green Bay WI 543079047 263749065 HealthCare WI St Vincent's RELATED false false Pain Center of Wisconsin 4131 W Loomis Road Suite 300 Greenfield WI 53221 263155343 HealthCare WI St Vincent's RELATED false false Surgery Center of Sheboygan LLC 3141 Saemann Ave Sheboygan WI 53081 260822209 HealthCare WI St Nicholas RELATED false false Prevea Ventures LLC 2710 EXECUTIVE DR Green Bay WI 54304 203775127 HealthCare WI HSSI RELATED false false Kiara Clinical Integration Network LLC 4936 Laverna Rd Springfield IL 62707 261417684 HealthCare IL Kiara Inc RELATED false false Carpenter Street Hotel LLC 525 North Sixth Street Springfield IL 62702 364128127 Hotel IL LaSante Inc Related false false Springfield Urgent Care Real Estate LLC PO Box 19456 Springfield IL 627949456 030413258 Rent. Real Estate IL LaSante Inc related false false Kiara Inc 4936 Laverna Rd Springfield IL 62707 371163401 HealthCare IL HSHS C Corp LaSante Wisconsin Inc 4936 Laverna Rd Springfield IL 62707 391572196 HealthCare IL Kiara Inc C Corp LaSante Inc 4936 Laverna Rd Springfield IL 62707 371163400 HealthCare IL Kiara Inc C Corp Prairie Cardiovascular 619 East Mason Suite 4P57 Springfield IL 62701 371071858 HealthCare IL Kiara Inc C Corp Prevea Health Services 2710 EXECUTIVE DR Green Bay WI 54304 391839351 HealthCare WI HSSI C Corp Prevea Clinic Inc 2710 EXECUTIVE DR Green Bay WI 54304 391839349 HealthCare WI HSSI C Corp Prevea Health Network 2710 EXECUTIVE DR Green Bay WI 54304 392000537 HealthCare WI HSSI C Corp Prevea Regional Services 2710 EXECUTIVE DR Green Bay WI 54304 391909993 HealthCare WI HSSI C Corp REnaissance Quality Insurance PO Box 1159 KY1-1102 Grand Cayman Cayman Islands CJ KY1-1102 980669953 Insurance CJ HSSI c corp false false true false false false false false false false false false false true true true false false