2011-11-14T09:26:03-06:00 2010-12-31 ERNST & YOUNG US LLP TWO NORTH CENTRAL AVENUE STE 2300 PHOENIX AZ 85004 990 2010-01-01 840417134 ST JOSEPH HOSPITAL STJO 3034674430 1835 FRANKLIN STREET DENVER CO 80218 TODD CONKLIN 3034674430 2011-11-11 6023223000 2010 2016-02-24 21:20:13Z BAIN FARRIS 427458478 false 0928 X WWW.EXEMPLA.ORG X 1873 CO THE JOINT MISSION OF EXEMPLA AND ST JOSEPH HOSPITAL IS TO FOSTER HEALING AND HEALTH FOR THE GREATER DENVER COLORADO METROPOLITAN SERVICE AREA. 10 9 0 339 817393 305513 760000 1044496 387141939 416572921 4129266 5997458 -661643 -1290702 391369562 422324173 245560 112811 0 0 197784485 188531515 0 0 0 170671178 206938815 368701223 395583141 22668339 26741032 429141510 456254669 96129700 95082292 333011810 361172377 X THE JOINT MISSION OF EXEMPLA AND ST JOSEPH HOSPITAL IS TO FOSTER HEALING AND HEALTH FOR THE GREATER DENVER COLORADO METROPOLITAN SERVICE AREA. false false 310694373 0 380259077 Provision of hospital based healthcare services, including charity care and unreimbursed Medicaid - see description in Schedule O. 15463165 0 12503043 Health professions education - See detailed descriptions in Schedule O. 15398936 0 23336266 COMPREHENSIVE CANCER CENTER - See detailed descriptions in Schedule O. 772117 112811 474535 342328591 true true false true false false false false false true false true true true true false true false false false false false false false false true false true false true false false false false false false false true false false false false false true true false false false true 0 0 0 true true false false false false false false false false false X 10 9 false true true false true true true true true false false true true true true true true true true true true X EXEMPLA INC CO BRENDA CHILMAN 3034674430 2480 W 26TH AVE 360B DENVER CO 80211 X WILLIAM M MURRAY 2.0 X 0 1706457 169086 KOGER PROPST 2.0 X FELIX W COOK SR 2.0 X MICHAEL CHASE MD 2.0 X KENNETH W EGGEMAN PHD 2.0 X JOHN V MCDERMOTT 2.0 X KATHRYN A PAUL 2.0 X DAVID ROLL 2.0 X BRUCE WARING MD 2.0 X SISTER AMY WILLCOTT 2.0 X JEFFREY D SELBERG 50.0 X 0 3728704 22356 ROBERT ALAN MINKIN 50.0 X 1215312 0 13481 TODD A CONKLIN 50.0 X 0 612506 37987 ROBERT H MALTE 50.0 X 0 1137188 19002 DAVID HAMM 50.0 X 0 732786 46529 JUDY A MITCHELL 50.0 X 0 825403 25237 DAVID C PECORARO 25.0 X 0 412341 31024 KATHRYN LOUISE BALLINGER 50.0 X 0 404500 37801 LISA S KETTERING 50.0 X 0 357303 38806 BAIN FARRIS 50.0 X 0 525916 73804 GRANT WICKLUND 50.0 X 0 424675 54600 ROBERT LADENBURGER 50.0 X 0 1224099 63373 BRADLEY KEITH LUDFORD 50.0 X 235505 0 38327 MARY E SHEPLER 50.0 X 203581 0 40763 BARBARA A JAHN 50.0 X 217228 0 25417 MARGO A KARSTEN 50.0 X 211611 0 26174 GEORGE L RUDLOFF 50.0 X 211441 0 25491 VANITA BELLEN 50.0 X 150628 0 12332 ROBERT GIBBONS 50.0 X 354793 0 39993 JOHN T MOORE 50.0 X 316811 0 40306 JOHN Q ADAMS 50.0 X 305662 0 40069 DEBORAH DAVIS-MERRITT 50.0 X 292019 0 33364 AARON CALDERON 50.0 X 260096 0 38158 MARTIN CARROLL HELLDORFER 0.0 X 0 132630 9126 3974687 12224508 1002606 177 true true false 0 1020191 24305 24305 1044496 NET PATIENT REV. 621500 404839897 404022504 817393 EDUCATION & OTHER 611600 9906545 9906545 ADMIN MISC INCOME 900099 1826479 1826479 416572921 4325937 4325937 0 0 2167648 2497703 -330055 -330055 -330055 1567116 107225 104404 1567116 2821 1671521 1671521 0 0 1571551 2532198 -960647 -960647 0 422324173 415755528 817393 4706756 112811 112811 0 0 0 5501902 4947121 554781 0 144989191 130369280 14619911 6599704 5884006 715698 21946926 19566914 2380012 9493792 8464248 1029544 17899770 17062311 837459 556835 0 556835 0 0 0 0 25648210 21557487 4090723 698613 0 698613 2486939 1304134 1182805 230751 207434 23317 0 5942348 2819669 3122679 373874 264734 109140 0 651743 577263 74480 2715318 0 2715318 0 28455234 17970254 10484980 2833325 0 2833325 BAD DEBT EXPENSE 13061779 13061779 0 MEDICAID PROVIDER FEE 16117100 16117100 0 MEDICAL SUPPLIES 56729518 55931018 798500 SYSTEM EQUALIZATION EXPENSE 12783753 12783753 0 EQUIPMENT RENTAL & MAINTENANCE 8705743 8351586 354157 11047962 4975689 6072273 395583141 342328591 53254550 0 2850623 7902871 9162173 608178 41645386 55326421 60000000 60000000 4170068 5390429 967384 1080529 477935945 269670664 198184258 208265281 38785268 51585500 47185836 39170249 26190514 26925211 429141510 456254669 21476788 33350686 2789 4224 53474187 0 21175936 61727382 96129700 95082292 X 332830836 360990781 180974 181596 333011810 361172377 429141510 456254669 X 26741032 1419535 X false true true X false X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED false false false false false false false false true 7551 7551 false LOBBYING EXPENDITURES SCHEDULE C, PART II-B, QUESTION 1I ST JOSEPH HOSPITAL INCURRED $7,551 IN LOBBYING EXPENDITURES. THIS INCLUDES PORTIONS OF VARIOUS MEMBERSHIP DUES THAT ARE DESIGNATED AS LOBBYING EXPENSE BY THOSE ORGANIZATIONS IN WHICH ST JOSEPH HOSPITAL IS A MEMBER. 11963812 11963812 138820006 51518016 87301990 23959426 5377667 18581759 275927024 210215431 65711593 27265677 2559550 24706127 208265281 INVESTMENT IN SYSTEM 39170249 C 39170249 INTEREST RCVBLE FROM EXEMPLA 23305316 DEFERRED COMPENSATION ANNUITY 1818569 PHARMACY SUPPLY DEPOSIT 1801326 26925211 0 ESTIMATED THIRD PARTY PAYER SETTLEMENTS 909402 ACCRUED INTEREST PAYABLE TO SCLHS 1606610 OTHER LIABILITIES 75033 ASBESTOS MITIGATION LIABILITY 3595194 MALPRACTICE LIABILITY 1866143 NOTES PAYABLE TO SCLHS 53675000 61727382 LIABILITY FOR UNCERTAIN TAX POSITIONS SCHEDULE D PART X EXEMPLA ACCOUNTS FOR UNCERTAINTY IN TAX POSITIONS IN ACCORDANCE WITH THE ACCOUNTING STANDARDS CODIFICATION (ASC) 740, INCOME TAXES, WHICH PRESCRIBES CRITERIA FOR THE FINANCIAL STATEMENT RECOGNITION AND MEASUREMENT OF A TAX POSITION TAKEN OR EXPECTED TO BE TAKEN IN A TAX RETURN. ASC 740 ALSO PROVIDES GUIDANCE ON DERECOGNITION, CLASSIFICATION, INTEREST AND PENALTIES, ACCOUNTING IN INTERIM PERIODS, DISCLOSURE, AND TRANSITION. MANAGEMENT HAS DETERMINED THAT THERE ARE NO MATERIAL UNCERTAIN TAX POSITIONS AS OF DECEMBER 31, 2010 AND 2009. TAX YEARS 2007 THROUGH 2009 REMAIN SUBJECT TO EXAMINATION BY FEDERAL AND STATE JURISDICTIONS. true true X true X true X true true true false true true 1 16238302 16238302 0.04250 1 20853554 15134132 5719422 0.01500 2 37091856 15134132 21957724 0.05750 17 629400 629400 0.00160 5 19229285 6041097 13188188 0.03450 8 31637895 19463788 12174107 0.03180 1 153193 153193 0.00040 9 206259 206259 0.00050 40 51856032 25504885 26351147 0.06880 42 88947888 40639017 48308871 0.12630 1 1415 1415 0.00000 4 35512 35512 0.00010 2 20240 20240 0.00010 7 57167 57167 0.00020 true 3315257 0 17392332 19851388 -2459056 X true true CO ORTH SURG HOSP ORTHOPEDIC SPECIALTY HOSPITAL 0.51000 0.00000 0.40000 1 1 ST JOSEPH HOSPITAL

1835 FRANKLIN STREET DENVER CO 80218

X ST JOSEPH HOSPITAL 1 COMMUNITY BENEFIT REPORT PART I, LINE 6A COMMUNITY BENEFITS OF ST JOSEPH HOSPITAL (ESJH) ARE INCLUDED IN A REPORT PREPARED BY EXEMPLA HEALTHCARE. COSTS ATTRIBUTABLE TO PHYSICIAN CLINICS PART I, LINE 7G THE ORGANIZATION DID NOT INCLUDE AS SUBSIDIZED HEALTH SERVICES ANY COSTS ATTRIBUTABLE TO PHYSICIAN CLINICS. BAD DEBT EXPENSE PART I, LINE 7G, COLUMN (F) BAD DEBT EXPENSE INCLUDED ON PART IX, LINE 25, COLUMN (A), BUT SUBTRACTED FOR PURPOSES OF CALCULATING THE PERCENTAGE OF TOTAL EXPENSES IN SCHEDULE H PART I, LINE 7, COLUMN (H) IS $13,061,779. COSTING METHODOLOGY PART I, LINE 7 THE COST ACCOUNTING SYSTEM WAS USED AS THE BASIS TO CALCULATE THE AMOUNTS REPORTED AS CHARITY CARE AND MEANS-TESTED GOVERNMENT PROGRAMS. THE COST ACCOUNTING SYSTEM ADDRESSES ALL PATIENT SEGMENTS. THE COST OF SUBSIDIZED SERVICES WAS CALCULATED AS THE NET LOSS OF THE RELEVANT DEPARTMENT USING THE DEPARTMENTAL EXPENSES AND ALLOCATED OVERHEAD EXPENSES, AND THE DEDUCTION RATIO PER THE COST ACCOUNTING SYSTEM. FOR SUBSIDIZED SERVICES, THE COST OF CHARITY, MEDICAID, AND SELF PAY PATIENTS WERE REMOVED IN THE CALCULATION. COMMUNITY BUILDING ACTIVITIES PART II ST JOSEPH HOSPITAL INITIATED AND HOSTS A COMMUNITY BUILDING ACTIVITY CALLED THE COMMUNITY RESOURCES FORUM. THE PRIMARY PURPOSE OF THE COMMUNITY RESOURCES FORUM IS TO IMPROVE HEALTH IN THE COMMUNITY. IT CREATES AND FOSTERS NETWORKS OF PARTNERSHIPS ACROSS AGENCIES WITH A SPECIAL EMPHASIS ON SERVING VULNERABLE POPULATIONS AND MAXIMIZING SUPPORT AND RESOURCES FOR THESE COMMUNITY MEMBERS. EACH MONTH BETWEEN SEVENTY-FIVE AND ONE HUNDRED REPRESENTATIVES FROM COMMUNITY AGENCIES,ORGANIZATIONS, GOVERNMENTAL SERVICE PROGRAMS, BUSINESSES AND HEALTH CARE PARTNERS MEET AT THE HOSPITAL TO NETWORK AND SHARE INFORMATION ABOUT HOW THEIR SERVICES BENEFIT THE COMMUNITY AND INDIVIDUALS. DURING THESE MEETINGS, FIVE AGENCIES PRESENT MORE DETAILED INFORMATION WITH TIME FOR QUESTIONS AND COMMENTS FROM THE AUDIENCE. THE COMMUNITY RESOURCES FORUM IS NOT DESIGNED TO PROVIDE ANY ADDITIONAL BENEFIT TO THE HOSPITAL AND WAS NOT CREATED AS A MARKETING ACTIVITY OR TO INCREASE REFERRALS OF PATIENTS. THE HOSPITAL PROVIDES THE MEETING ROOM LOCATION, CONTINENTAL BREAKFAST AND STAFF COORDINATION OF THE FORUM AS THE HOSTS OF A SERVICE TO THE GREATER DENVER METRO COMMUNITY. OVER 700 ORGANIZATIONS ARE LISTED IN THE COMMUNITY RESOURCE FORUM DATABASE FROM MAKING CONTACT WITH THE FORUM. THE DATABASE IS NOT USED FOR ANY PURPOSE OTHER THAN NOTIFICATION OF UPCOMING COMMUNITY RESOURCE FORUM MEETINGS AND EVENTS. BAD DEBT EXPENSE COSTING METHODOLOGY AND OTHER INFO PART III, LINE 4 A COST TO CHARGE RATIO IS USED AS THE METHODOLOGY FOR DETERMINING THE AMOUNTS REPORTED AS COST OF BAD DEBT EXPENSE. FOR ALL SELF-PAY ACCOUNTS, A STANDARD 40% DISCOUNT IS FIRST APPLIED TO CHARGES AS A DEDUCTION OF REVENUE. BAD DEBT EXPENSE IS REFLECTED NET OF DISCOUNTS APPLIED AND PAYMENTS RECEIVED. THE ORGANIZATION DOES NOT INCLUDE IN BAD DEBT EXPENSE ANY AMOUNT THAT COULD REASONABLY BE ATTRIBUTABLE TO PATIENTS WHO LIKELY WOULD QUALIFY FOR FINANCIAL ASSISTANCE UNDER THE HOSPITAL'S CHARITY CARE POLICY. THE FOLLOWING ARE THE RELEVANT PORTIONS OF THE COMPANY'S FOOTNOTE TO THE FINANCIAL STATEMENTS RELATED TO BAD DEBT: INCLUDED IN NET RECEIVABLES IS THE ALLOWANCE FOR UNCOLLECTIBLE RECEIVABLES. THE ALLOWANCE FOR UNCOLLECTIBLE RECEIVABLES IS BASED UPON MANAGEMENT'S ASSESSMENT OF HISTORICAL AND EXPECTED NET COLLECTIONS AND TAKES INTO CONSIDERATION HISTORICAL BUSINESS AND ECONOMIC CONDITIONS, TRENDS IN HEALTHCARE COVERAGE, AND OTHER COLLECTION INDICATORS. MANAGEMENT PERIODICALLY ASSESSES THE ADEQUACY OF THE ALLOWANCES FOR UNCOLLECTIBLE ACCOUNTS BASED UPON HISTORICAL WRITE-OFF EXPERIENCE BY PAYOR CATEGORY. THE RESULTS OF THESE ASSESSMENTS ARE USED TO MODIFY, AS NECESSARY, THE PROVISION FOR BAD DEBTS AND TO ESTABLISH APPROPRIATE ALLOWANCES FOR UNCOLLECTIBLE NET PATIENT ACCOUNTS RECEIVABLE. COSTING METHODOLOGY FOR MEDICARE COSTS PART III, LINE 8 INPATIENT AND OUTPATIENT MEDICARE COSTS ARE CALCULATED ON THE COST REPORT. INPATIENT COSTS ARE A PRODUCT OF ROUTINE SERVICE COSTS BASED ON PER DIEMS AND ANCILLARY COSTS BASED ON INPATIENT MEDICARE CHARGES FACTORED BY INPATIENT COST TO CHARGE RATIOS. OUTPATIENT COSTS ARE BASED ON MEDICARE OUTPATIENT CHARGES FACTORED BY OUTPATIENT COST TO CHARGE RATIOS. ST JOSEPH HOSPITAL DOES NOT RECOGNIZE THE MEDICARE SHORTFALL AS A COMMUNITY BENEFIT. DEBT COLLECTION POLICY PART III, LINE 9B AN INTEGRAL COMPONENT OF OUR MISSION IS TO BE GOOD FINANCIAL STEWARDS. THIS REQUIRES US TO DETERMINE WHICH PATIENTS ARE IN NEED OF CHARITY CARE AND WHICH ARE ABLE TO CONTRIBUTE SOME PAYMENT FOR CARE RECEIVED. WE MAINTAIN A BALANCE THAT ENABLES US TO CONTINUE TO PROVIDE CHARITY CARE TO THOSE WHO NEED IT MOST, AND TO ENSURE THAT WE MANAGE OUR RESOURCES SO THAT WE CAN CONTINUE TO BE HERE WHEN PEOPLE NEED US MOST. ST JOSEPH HOSPITAL NOTIFIES PATIENTS OF FINANCIAL ASSISTANCE POLICY UPON ADMISSION, DISCHARGE AND IN COMMUNICATION REGARDING PATIENT BILLS. PATIENTS ARE CONTACTED MULTIPLE TIMES ABOUT UNPAID BALANCES PRIOR TO INITIATING ANY COLLECTION ACTION. IF A PATIENT IS DETERMINED TO BE ELIGIBLE FOR FINANCIAL ASSISTANCE AT ANY TIME DURING THE COLLECTION PROCESS, THE ACCOUNT IS RECLASSIFIED AS FINANCIAL ASSISTANCE AND DEBT COLLECTION EFFORTS ARE CEASED. NEEDS ASSESSMENT PART VI, LINE 2 AS PART OF OUR CORE VALUE OF RESPONSE TO NEED, WE TAKE STEPS TO DETERMINE WHERE THERE IS THE MOST NEED IN ORDER TO PROVIDE THE GREATEST GOOD. ST JOSEPH HOSPITAL (ESJH) HAS REGULARLY PARTICIPATED IN NEEDS ASSESSMENT SURVEYS TO IDENTIFY THE ONGOING AND CHANGING NEEDS OF THE COMMUNITY. THE MOST RECENT SURVEY WAS CONDUCTED IN DECEMBER 2009, AND ONE IS SCHEDULED TO BE COMPLETED IN 2012. THIS ASSESSMENT STUDIES A DEFINED COMMUNITY SERVED BY ST JOSEPH HOSPITAL, AND IS DONE BY PARTNERING WITH LOCAL GOVERNMENT AND SOCIAL AGENCIES, AND CONDUCTING SURVEYS AND ASSESSMENTS WITH THE ASSISTANCE OF OUTSIDE CONSULTANTS. WE ALSO CONTINUOUSLY ASSESS THE NEEDS OF THE COMMUNITY THROUGH CLOSE WORKING RELATIONSHIPS AND PARTNERSHIPS WITH SERVICE AGENCIES IN THE COMMUNITY, AND BY EVALUATING STATE AND COUNTY HEALTH STATISTICS. IN 2009 ESJH FORMED A COMMUNITY OUTREACH COUNCIL FOR THE FOLLOWING PURPOSES: TO EMPOWER COMMUNITY MEMBERS, PARTICULARLY THE UNDERSERVED, TO ACHIEVE IMPROVED HEALTH AND WELLNESS; TO COLLABORATE WITH EXTERNAL PARTNERS AND RESOURCES TO ADDRESS IDENTIFIED NEEDS; AND TO FOSTER AN APPRECIATION FOR COMMUNITY SERVICE AND ENGAGEMENT IN SERVICE ACTIVITIES AMONG HOSPITAL EMPLOYEES. THE COMMUNITY OUTREACH COUNCIL WAS CHARGED TO DEVELOP AND OVERSEE THE COMMUNITY BENEFIT PROGRAMS FOR THE HOSPITAL. TO DEVELOP THE COMMUNITY BENEFIT PLAN FOR 2009, THE COMMUNITY OUTREACH COUNCIL COMPLETED A NEEDS ASSESSMENT OF COMMON COMMUNITY HEALTH INDICATORS AND REVIEWED INTERNAL CHARITY CARE PATIENT DATA. ADDITIONALLY, THE COUNCIL REVIEWED CURRENT COMMUNITY BENEFIT PROGRAMMING TO ASSESS OPPORTUNITIES TO ALIGN CURRENT COMMUNITY BENEFIT EFFORTS WITH IDENTIFIED NEEDS. THE INITIAL NEEDS ASSESSMENT INDICATED THREE AREAS OF CONCERN FOR CERTAIN SUBPOPULATIONS OF THE UNDERSERVED: POOR HEALTH INDICATORS, POOR PERI-NATAL HEALTH AND POOR ACCESS TO CARE. USING THESE INDICATORS, THE COUNCIL CREATED FOUR GOALS: - DEVELOP THE NEWLY FORMED COUNCIL INTO A HIGHLY EFFECTIVE AND ENGAGED COMMUNITY OUTREACH COUNCIL - MAXIMIZE COMMUNITY PARTNERSHIPS WITH A FOCUS ON THE MEDICALLY UNDERSERVED GEOGRAPHIC AREAS OF THE HOSPITAL - INTEGRATE THE FAMILY CENTERED CARE MODEL IN OUTPATIENT SETTING FOR VULNERABLE PREGNANT WOMEN, THEIR SUPPORT SYSTEMS AND THEIR CHILDREN FROM CONCEPTION THOUGH AGE THREE - PROVIDE CANCER PREVENTION, SCREENING AND TREATMENT TO UNDERSERVED POPULATIONS IN THE AREAS OF GYNECOLOGICAL, BREAST AND COLORECTAL CANCERS THE COMMUNITY OUTREACH COUNCIL REALIZED THE FOLLOWING OUTCOMES: - TEN TOURS CONDUCTED WITH LOCAL AGENCIES FOR ANALYSIS OF SYNCHRONICITY BETWEEN HOSPITAL AND LOCAL PARTNER. THE AGENCIES WERE EVALUATED WITH A WEIGHTED PRIORITY MATRIX AND DECISIONS WERE MADE TO SUPPORT THESE AGENCIES BASED ON THE POTENTIAL OUTCOMES FOR IMPROVED HEALTH. - RESEARCH AND DEFINITION OF FAMILY CENTERED CARE MODEL INCLUDING PATIENT AND EMPLOYEE SURVEYS. STRATEGIC ENGAGEMENT OF KEY PARTNERS TO MOVE THIS WORK FORWARD INCLUDING THE WOMEN'S AND CHILDREN'S SERVICE LINE TEAM. - IMPROVED COORDINATION AND PROCESSES FOR CONNECTING UNDERSERVED CANCER PATIENTS WITH AVAILABLE RESOURCES AND CARE. MAXIMIZED THE USE OF AVAILABLE FINANCIAL RESOURCES FOR CANCER PATIENTS AND INCREASED THE NUMBER OF UNDERSERVED WOMEN RECEIVING SERVICE FROM THE ESJH MOBILE MAMMOGRAPHY VAN. PATIENT EDUCATION OF ELIGIBILITY ASSISTANCE PART VI, LINE 3 ST JOSEPH HOSPITAL TREATS PATIENTS WITH RESPECT AND DIGNITY REGARDLESS OF THEIR ABILITY TO PAY. ST JOSEPH HOSPITAL HAS A WRITTEN FINANCIAL ASSISTANCE POLICY THAT EXPLAINS ELIGIBILITY CRITERIA FOR FINANCIAL ASSISTANCE AT VARIOUS LEVELS, INCLUDING A 100% DISCOUNT, AND IS BASED ON FEDERAL POVERTY GUIDELINES. WE WORK WITH PATIENTS TO HELP THEM UNDERSTAND THEIR FINANCIAL RESPONSIBILITY FOR CARE RECEIVED, FINANCIAL ASSISTANCE AVAILABLE TO THEM, AND TO ESTABLISH PAYMENT PROGRAMS IN DEMONSTRATION OF OUR CORE VALUE OF RESPECT. AS PART OF OUR RESPONSIBILITY TO EDUCATE, WE INFORM OUR PATIENTS AND THEIR FAMILIES OF THE AVAILABILITY OF ASSISTANCE, INCLUDING GOVERNMENT PROGRAMS. WE COMMUNICATE THIS IN A VARIETY OF WAYS TO ENSURE THAT MESSAGES REACH MULTIPLE AUDIENCES. BEFORE, DURING AND/OR AFTER ADMISSION, WE ENCOURAGE OUR SELF PAY PATIENTS TO VISIT WITH A FINANCIAL COUNSELOR TO DISCUSS QUALIFICATIONS FOR FINANCIAL ASSISTANCE. THE FINANCIAL COUNSELOR WORKS WITH THE PATIENT TO COMPLETE A FINANCIAL ASSISTANCE FORM TO DETERMINE THE LEVEL OF DISCOUNT FOR WHICH THE PATIENT MAY BE ELIGIBLE. WE POST FINANCIAL ASSISTANCE INFORMATION IN EMERGENCY AND ADMISSIONS AREAS, ON BILLINGS INVOICES, IN VARIOUS AREAS AROUND THE HOSPITAL AND CLINIC SITES AND ON THE HOSPITAL WEBSITE. WE PROVIDE WRITTEN MATERIALS TO PATIENTS THAT DETAIL OUR FINANCIAL ASSISTANCE POLICY AND HOW IT IS ADMINISTERED. THIS COVERS ELIGIBILITY, STEPS TO FOLLOW TO DETERMINE IF A PATIENT QUALIFIES FOR ASSISTANCE, TYPICAL CHARGES A PATIENT MAY EXPECT FOR ROUTINE PROCEDURES, AND ASSISTANCE AVAILABLE BASED ON A PATIENT'S INCOME LEVEL. WE PROVIDE MATERIALS AND EDUCATION WHEN PATIENTS ARE DISCHARGED, AND INCLUDE INFORMATION IN BILLING STATEMENTS, INCLUDING PHONE NUMBERS AND OTHER METHODS TO CONTACT US WITH QUESTIONS. WE ENSURE THAT OUR FINANCIAL COUNSELORS, ADMISSION EMPLOYEES, SOCIAL WORKERS AND OTHER EMPLOYEES UNDERSTAND OUR POLICIES TO BE ABLE TO ASSIST PATIENTS IN THE MOST APPROPRIATE WAY. WE ALSO PROVIDE PAYMENT PLAN OPTIONS TO OUR PATIENTS. THIS HELPS PATIENTS MEET THEIR FINANCIAL OBLIGATIONS IN A REASONABLE AND DIGNIFIED MANNER BASED ON THEIR ABILITY TO PAY, AND ALLOWS THEM TO CONTINUE TO ENSURE THE ONGOING WELFARE OF THEIR FAMILIES. THIS IS DONE IN ACCORDANCE WITH OUR CORE VALUE OF RESPECT. COMMUNITY INFORMATION PART VI, LINE 4 ST JOSEPH HOSPITAL (ESJH) IS LOCATED IN AN URBAN AREA AND SERVES A BROAD GEOGRAPHIC AREA, INCLUDING URBAN AND SUBURBAN COMMUNITIES. THE HOSPITAL'S PRIMARY SERVICE AREA IS 26.6% HISPANIC, 61% WHITE, AND 6.4% BLACK. THE POPULATION OF PEOPLE OVER 65 YEARS OF AGE IS 11.0% AND THE POPULATION OF CHILDREN UNDER AGE 14 IS 20.4%. THE POPULATION OF THE PRIMARY SERVICE AREA IS OVER 1.7 MILLION PEOPLE WITH OVER 700,000 HOUSEHOLDS. THOSE WITH AN ANNUAL INCOME UNDER $25,000 CONSTITUTE 18.6% OF THE POPULATION, WHILE APPROXIMATELY 54% OF THE HOUSEHOLDS HAVE AN ANNUAL INCOME GREATER THAN $50,000. THE ESJH COMMUNITY NEEDS ASSESSMENT USED UNITED STATES CENSUS DATA FOR THE CITY OF DENVER AND FOUND THAT 17.4% OF PERSONS LIVE BELOW POVERTY LEVEL. THE 2008-2009 COLORADO HOUSEHOLD SURVEY SPONSORED BY THE COLORADO DEPARTMENT OF HEALTH CARE POLICY AND FINANCING FOUND THAT 18.4% OF THOSE IN THE CITY AND COUNTY OF DENVER ARE UNINSURED AND 11.2% DO NOT HAVE A USUAL SOURCE OF CARE. COMPETITORS IN THE DENVER METROPOLITAN AREA INCLUDE THREE INVESTOR-OWNED HOSPITALS, A NONPROFIT SYSTEM-AFFILIATED HOSPITAL, AND TWO INDEPENDENT HOSPITALS INCLUDING THE PRIMARY CITY HOSPITAL. PROMOTION OF COMMUNITY HEALTH PART VI, LINE 5 WE EXTEND OUR CARE BEYOND OUR HOSPITAL'S WALLS IN ORDER TO IMPROVE THE HEALTH OF OUR COMMUNITY. OUR COMMUNITY BUILDING ACTIVITIES DEMONSTRATE THIS COMMITMENT. DURING THIS YEAR, OUR COMMUNITY BUILDING ACTIVITIES INCLUDED COMMUNITY HEALTH EDUCATION WITH A PARTICULAR EMPHASIS ON PRENATAL CARE FOR POOR AND VULNERABLE POPULATIONS INCLUDING THE BABY BOUTIQUE PROGRAM, TEEN CHILDBIRTH EDUCATION AND TEEN BREASTFEEDING CLASSES. THESE OUTREACH EFFORTS ARE FOCUSED ON DECREASING THE OCCURRENCE OF LOW-BIRTH WEIGHT INFANTS BY INCREASING HEALTHY BEHAVIORS AND PROMOTING HEALTH LITERACY. ST JOSEPH HOSPITAL (ESJH) ALSO SERVES THE ENTIRE COMMUNITY THROUGH THE CONSUMER LIBRARY AND PROVIDES PACKETS OF INFORMATION ON HEALTH CONDITIONS RESEARCHED BY MEDICAL LIBRARIANS TO ANYONE AT NO CHARGE. ACCESS TO CANCER CARE SERVICES IS AN IDENTIFIED NEED THROUGH THE COMMUNITY NEEDS ASSESSMENT. ESJH PARTNERS WITH CANCER SUPPORT COMMUNITY COLORADO BY OFFERING IN-KIND OFFICE SPACE AND ADMINISTRATIVE SUPPORT FOR THIS COMMUNITY AGENCY THAT OFFERS FREE-OF-CHARGE PSYCHOSOCIAL SERVICES TO ALL THOSE IMPACTED BY CANCER. WE ARE AN IMPORTANT PART OF OUR COMMUNITY AND SERVE IN MANY WAYS, FROM DELIVERING CORE HEALTH CARE TO PREVENTIVE CARE TO SUPPORT OF OTHER CIVIC GROUPS. IN 2010, WE PROVIDED COMMUNITY BENEFIT TOTALING $48,366,038, INCLUDING TRADITIONAL CHARITY CARE AND THE UNPAID COST OF MEDICAID. OUR BOARD OF DIRECTORS REPRESENTS MEDICAL AND BUSINESS PROFESSIONALS, AND ALL PROVIDE HOURS OF SERVICE IN SUPPORT OF OUR HOSPITAL. THEY ARE DEEPLY INVOLVED IN OUR NEEDS ASSESSMENT PROCESS, BUILDING PROGRAMS AND SERVICES, AND COMMUNITY OUTREACH TO ENSURE THAT PEOPLE KNOW ABOUT SERVICES AVAILABLE TO THEM THROUGH OUR HOSPITAL. WHEN ST JOSEPH HOSPITAL HAS EXCESS REVENUE OVER OPERATING EXPENSES, WE USE THOSE FUNDS TO OBTAIN CURRENT HEALTH CARE TECHNOLOGIES AND EQUIPMENT, IMPROVE PATIENT CARE, PROVIDE MEDICAL TRAINING EDUCATION AND RESEARCH, AND TO EXPAND ACCESS TO POINTS OF CARE. THESE INVESTMENTS ENSURE WE'LL BE HERE TO CARE FOR FUTURE GENERATIONS. WE ALSO SUPPORT OUR EMPLOYEES IN VOLUNTEERING FOR COMMUNITY ORGANIZATIONS, INCLUDING SERVING ON COMMUNITY BOARDS, AND PROVIDE OPPORTUNITIES FOR THEM TO SUPPORT CAUSES THROUGH HOSPITAL EVENTS SUCH AS FOOD DRIVES FOR LOCAL FOOD BANKS, HYGIENE SUPPLY DRIVES FOR LOCAL HOMELESS SHELTERS, SCHOOL SUPPLY DRIVES FOR LOCAL SCHOOLS, AMERICAN HEART WALK AND KOMEN RACE FOR THE CURE. WE ARE GOOD CITIZENS AND PARTNER WITH OTHER ORGANIZATIONS AND AGENCIES TO SUPPORT A THRIVING COMMUNITY. WE ARE MEMBERS OF THE DENVER CHAMBER OF COMMERCE, CAPITOL HILL UNITED NEIGHBORHOODS, INC., AND CAPITOL HILL UNITED MINISTRIES. WE PROVIDE FOCUSED OPERATIONAL AND STRATEGIC SUPPORT FOR BRUNER FAMILY MEDICINE CENTER, CARITAS CLINIC, SETON WOMEN'S CENTER AND A CERTIFIED NURSE MIDWIVES CLINIC. THESE CLINICS SERVE THE HEALTH NEEDS FOR THE UNINSURED. WE WORK CLOSELY TOGETHER TO PROVIDE INTEGRATED CARE FOR THOSE WHO COME TO EITHER THE HOSPITAL FACILITY OR THE OUTPATIENT CLINICS FOR THEIR HEALTH NEEDS. BRUNER FAMILY MEDICINE CENTER, CARITAS CLINIC, SETON WOMEN'S CENTER AND THE CERTIFIED NURSE MIDWIVES CLINIC PROVIDE QUALITY PRIMARY HEALTH CARE SERVICES FOR UNINSURED, LOW-INCOME PATIENTS REGARDLESS OF THEIR ABILITY TO PAY. THE CLINICS ARE COMMITTED TO PROVIDING ACCESS TO COMPASSIONATE AND TRUSTWORTHY CARE FOR THE UNINSURED POOR. SERVICES THE CLINIC PROVIDES INCLUDE PRIMARY CARE, ONGOING MANAGEMENT OF CHRONIC DISEASES, AND MEDICATION ASSISTANCE. COMMUNITY BENEFITS PROVIDED IN 2010 THROUGHOUT SISTERS OF CHARITY OF LEAVENWORTH HEALTH SYSTEM (SCLHS) TOTALED $48.4 MILLION. AS PART OF SCLHS, WE PROMOTE THE SHARED MISSION THAT "WE WILL, IN THE SPIRIT OF THE SISTERS OF CHARITY, REVEAL GOD'S HEALING LOVE BY IMPROVING THE HEALTH OF THE INDIVIDUALS AND COMMUNITIES WE SERVE, ESPECIALLY THOSE WHO ARE POOR OR VULNERABLE." WE ARE COMMITTED TO LIVING AND DEMONSTRATING OUR CORE VALUES OF EXCELLENCE, RESPECT, RESPONSE TO NEED, STEWARDSHIP AND WHOLENESS. SCLHS SUPPORTS ITS HOSPITALS BY PROVIDING GUIDANCE, OVERSIGHT, AND RESOURCES TO HELP THEM ACCOMPLISH INITIATIVES THAT IMPROVE HEALTH IN ALL OUR COMMUNITIES. THIS INCLUDES COORDINATING COMMUNITY BENEFIT PROCESSES, PROVIDING GUIDANCE WITH COMMUNITY NEEDS ASSESSMENTS, AND ESTABLISHING CONSISTENT FINANCIAL ASSISTANCE AND CHARITY CARE POLICIES AND PROCEDURES. OTHER WAYS SCLHS BENEFITS ITS HOSPITALS INCLUDE QUALITY IMPROVEMENT AND PERFORMANCE EXCELLENCE INITIATIVES; SYSTEM-WIDE IT IMPLEMENTATION AND INFRASTRUCTURE; STRATEGIC AND OPERATIONS DIRECTION AND OVERSIGHT; SUPPLY CHAIN MANAGEMENT AND PURCHASING; BENEFITS ADMINISTRATION (INCLUDING A WELLNESS PROGRAM FREE TO EMPLOYEES THAT PROMOTES THEIR HEALTH AND WELL-BEING); RISK MANAGEMENT; DISASTER PLANNING AND CRISIS ASSISTANCE. BY SHARING THE WORK ACROSS OUR SYSTEM WE ARE ABLE TO LIGHTEN THE BURDEN FOR ALL IN ORDER TO FULFILL OUR MISSION OF IMPROVING HEALTH IN OUR COMMUNITIES. SCLHS IMPROVES OVERALL HEALTH IN OUR COMMUNITIES BY PROVIDING INFRASTRUCTURE TO SUPPORT AND SUSTAIN FOUR CLINICS FOR THE UNINSURED IN KANSAS AND COLORADO. THE SCLHS CLINICS FOR THE UNINSURED ARE OFTEN THE ONLY SAFETY NET CLINIC IN THEIR COMMUNITY AND PROVIDE VALUABLE SERVICES FOR THOSE WHO ARE MOST VULNERABLE. EACH HOSPITAL IS SUPPORTED BY A FOUNDATION TO ACCESS AND OPTIMIZE LOCAL PHILANTHROPIC ORGANIZATIONS AND INDIVIDUALS. THESE FOUNDATIONS RAISE FUNDS THROUGH OUTREACH, SPECIAL EVENTS, AND BUILDING DONOR RELATIONS THROUGHOUT THEIR COMMUNITY TO SUPPORT THE NEEDS OF THE HOSPITAL. AFFILIATED HEALTH CARE SYSTEM PART VI, LINE 6 ST JOSEPH HOSPITAL IS A CONTROLLED ENTITY OF THE SISTERS OF CHARITY OF LEAVENWORTH HEALTH SYSTEM, INC. (SCLHS). SCLHS AND ITS AFFILIATED ENTITIES HAVE A COMMON CALLING AND MISSION "TO REVEAL GOD'S HEALING LOVE BY IMPROVING THE HEALTH OF THE INDIVIDUALS AND COMMUNITIES IT SERVES, ESPECIALLY THOSE WHO ARE POOR OR VULNERABLE." ST JOSEPH HOSPITAL PROMOTES THE HEALTH OF THE COMMUNITY BY DELIVERING DIRECT HIGH QUALITY HEALTHCARE SERVICES THAT ARE RESPONSIVE TO THE NEEDS OF ITS PATIENTS AND THEIR FAMILIES. SCLHS SUPPORTS THE EFFORTS OF THE HOSPITAL THROUGH STRATEGIC DIRECTION AND OPERATING OVERSIGHT. SCLHS SUPPLIES OVERHEAD SUPPORT SERVICES TO ST JOSEPH HOSPITAL, INCLUDING INFORMATION TECHNOLOGY SERVICES, CENTRAL CASH MANAGEMENT AND INVESTMENT, RISK MANAGEMENT AND INSURANCE AND QUALITY IMPROVEMENT LEADERSHIP. STATE FILING OF COMMUNITY DENEFIT REPORT PART VI, LINE 7 THE SISTERS OF CHARITY OF LEAVENWORTH HEALTH SYSTEM FILES A COMMUNITY BENEFIT REPORT IN FOUR STATES: CALIFORNIA, COLORADO, KANSAS AND MONTANA. true SUSAN G KOMEN BREAST CANCER FOUNDATION 1835 FRANKLIN ST DENVER CO 80218 841199858 501(c)(3) 25000 PINK TIE AFFAIR SPONSORSHIP AMERICAN HEART ASSOCIATION 1280 S PARKER RD DENVER CO 80231 135613797 501(c)(3) 10000 DENVER HEART BALL SPONSORSHIP ARRUPE CORPORATE WORK STUDY PROGRAM 4343 UTICA DENVER CO 80212 460508814 501(c)(3) 25500 SUPPORT FOR WORK STUDY PROGRAM OF THE SCHOOL COLORADO PERINATAL CARE COUNCIL 820 S MONACO PARKWAY 161 DENVER CO 80224 742119506 501(C)(3) 7662 MOTHER & INFANT HEALTH PROGRAMS 4 0 DESCRIPTION OF ORGANIZATION'S PROCEDURES FOR MONITORING THE USE OF GRANTS SCHEDULE I, PART I - THE ORGANIZATION KEEPS RECORDS TO SUPPORT THE AMOUNTS PROVIDED OR REASONS FOR SUCH SUPPORT. SUPPORT IS NOT CONSIDERED GRANTS, BUT RATHER MISCELLANEOUS DONATIONS AND SPONSORSHIPS. ELIGIBILITY FOR FUNDING IS DETERMINED ON AN INDIVIDUAL BASIS, CONSIDERING THE USE OF THE FUNDS AND HOW THE USE RELATES TO THE ORGANIZATION'S MISSION. X X true true X X X X X X true true false false false false false false true true JEFFREY D SELBERG 0 174329 0 798246 0 2756129 0 20006 0 2350 0 3751060 0 1327697 ROBERT ALAN MINKIN 104739 0 0 0 1110573 0 11496 0 1985 0 1228793 0 130884 0 TODD A CONKLIN 0 360063 0 207291 0 45152 0 16396 0 21591 0 650493 0 0 ROBERT H MALTE 0 107148 0 80921 0 949119 0 16040 0 2962 0 1156190 0 146152 DAVID HAMM 0 337971 0 80993 0 313822 0 27892 0 18637 0 779315 0 275300 JUDY A MITCHELL 0 135951 0 70975 0 618477 0 19736 0 5501 0 850640 0 95312 MARTIN CARROLL HELLDORFER 0 40 0 2000 0 130590 0 0 0 9126 0 141756 0 0 DAVID C PECORARO 0 305997 0 83044 0 23300 0 16105 0 14919 0 443365 0 0 KATHRYN LOUISE BALLINGER 0 311320 0 54643 0 38537 0 24060 0 13741 0 442301 0 0 WILLIAM M MURRAY 0 910180 0 489328 0 306949 0 157816 0 11270 0 1875543 0 0 LISA S KETTERING 0 320810 0 15656 0 20837 0 15028 0 23778 0 396109 0 0 ROBERT GIBBONS 301565 0 10474 0 42754 0 27892 0 12101 0 394786 0 0 0 JOHN T MOORE 285467 0 9275 0 22069 0 16396 0 23910 0 357117 0 0 0 JOHN Q ADAMS 273047 0 10453 0 22162 0 20228 0 19841 0 345731 0 0 0 DEBORAH DAVIS-MERRITT 258018 0 11964 0 22037 0 20228 0 13136 0 325383 0 0 0 AARON CALDERON 212556 0 7580 0 39960 0 18346 0 19812 0 298254 0 0 0 BRADLEY KEITH LUDFORD 200479 0 18489 0 16537 0 16062 0 22265 0 273832 0 0 0 MARY E SHEPLER 171275 0 12829 0 19477 0 17436 0 23327 0 244344 0 0 0 BARBARA A JAHN 172189 0 23002 0 22037 0 17691 0 7726 0 242645 0 0 0 MARGO A KARSTEN 1085 0 0 0 210526 0 11496 0 14678 0 237785 0 0 0 GEORGE L RUDLOFF 78892 0 19163 0 113386 0 9441 0 16050 0 236932 0 0 0 VANITA BELLEN 122460 0 13857 0 14311 0 8010 0 4322 0 162960 0 0 0 BAIN FARRIS 0 425155 0 83164 0 17597 0 63105 0 10699 0 599720 0 0 GRANT WICKLUND 0 379170 0 0 0 45505 0 40226 0 14374 0 479275 0 0 ROBERT LADENBURGER 0 576595 0 268750 0 378754 0 52613 0 10760 0 1287472 0 0 SOCIAL CLUB DUES SCH J, PART I, QUESTION 1A SOCIAL CLUB DUES WERE PAID BY EXEMPLA ON BEHALF OF JEFFREY D. SELBERG ($280), ROBERT ALAN MINKIN ($559), AND TODD A CONKLIN ($1,580) DURING 2010. TAX INDEMNIFICATION AND GROSS UP PAYMENTS SCH J, PART I, QUESTION 1A 28 INDIVIDUALS RECEIVED GROSS UP PAYMENTS FOR GIFTS OR OTHER ITEMS THAT WERE TAXABLE TO THE INDIVIDUAL IN THEIR W-2'S. THESE TOTALED $2,095 IN THE AGGREGATE. SEVERANCE AND CHANGE OF CONTROL PAYMENTS SCHEDULE J, PART I, QUESTION 4A SEVERANCE PAYMENTS WERE MADE TO THE FOLLOWING INDIVIDUALS IN THE FOLLOWING AMOUNTS DURING 2010: JEFFREY D SELBERG - $1,330,420 ROBERT ALAN MINKIN - $960,372 ROBERT H MALTE - $750,132 JUDY A MITCHELL - $485,702 MARGO A KARSTEN - $210,526 GEORGE L RUDLOFF - $86,551 MARTIN CARROLL HELLDORFER - $130,590 CHANGE OF CONTROL PAYMENTS WERE MADE TO THE FOLLOWING INDIVIDUALS DURING 2010 AS PAYOUTS OF THE FORMER 457(F) PLAN IN CONJUNCTION WITH THE CHANGE OF CONTROL PROVISIONS OF THAT PLAN: JEFFREY D SELBERG - $1,327,697 ROBERT ALAN MINKIN - $130,884 ROBERT H MALTE - $146,152 JUDY A MITCHELL - $95,312 DAVID HAMM - $275,300 SUPPLEMENTAL NONQUALIFIED RETIREMENT PLANS SCHEDULE J, PART I, QUESTION 4B EXEMPLA HAD A 457(F) SUPPLEMENTAL NONQUALIFIED DEFERRED COMPENSATION PLAN, IN WHICH CERTAIN KEY OFFICERS PARTICIPATED UNTIL A CHANGE OF CONTROL OF THE ORGANIZATION IN 2009. THE FOLLOWING OFFICERS RECEIVED CHANGE OF CONTROL DISTRIBUTIONS FROM THE 457(F) PLAN IN 2010 IN ACCORDANCE WITH THE PROVISIONS OF THAT PLAN: JEFFREY D SELBERG - $1,327,697 ROBERT ALAN MINKIN - $130,884 ROBERT H MALTE - $146,152 JUDY A MITCHELL - $95,312 DAVID HAMM - $275,300 FURTHER, OTHER REPORTABLE COMPENSATION SHOWN IN SCHEDULE J PART II COLUMN (B) (III) CONTAINS AN ANNUAL REPORTING ADJUSTMENT FOR CERTAIN EMPLOYEES WHO PARTICIPATE IN THE SUPPLEMENTAL NONQUALIFIED RETIREMENT PLANS. SISTERS OF CHARITY OF LEAVENWORTH HEALTH SYSTEM (SCLHS) PROVIDES NONQUALIFIED RETIREMENT PLANS FOR EXECUTIVES TO COMPENSATE FOR IRS IMPOSED LIMITATIONS IN QUALIFIED RETIREMENT PLANS AND TO PROVIDE A BENEFIT CONSISTENT WITH OTHER NOT FOR PROFIT HEALTH SYSTEMS. THESE PLANS ENABLE THE EXECUTIVE TO EARN BENEFITS DURING EACH YEAR THAT THEY PARTICIPATE. ON THE ADVICE OF COUNSEL, SCLHS HAS DETERMINED THAT THESE BENEFITS SHOULD BE SUBJECT TO TAXATION AS THEY ARE EARNED AND VESTED RATHER THAN WHEN THEY ARE RECEIVED. AS A RESULT, THE TOTAL NONQUALIFIED RETIREMENT PLAN BENEFITS, WHICH WERE ACCRUED AND VESTED IN THE CURRENT YEAR, ARE NOW CONSIDERED TAXABLE AND THUS WERE TAXED TO THE PARTICIPANTS. AN AMOUNT EQUAL TO THE PARTICIPANT'S EXPECTED INCOME TAX LIABILITY WAS WITHDRAWN FROM THE PARTICIPANT'S ACCOUNT AND REMITTED TO THE IRS AS WITHHOLDING ON THE TAXABLE BENEFIT. THE AMOUNTS WITHDRAWN FROM THE PLAN FOR TAXES IN 2010 WERE: ROBERT W. LADENBURGER - $120,631 WILLIAM M. MURRAY - $113,244 INCENTIVE PLANS SCHEDULE J, PART I, QUESTION 6A THE MANAGEMENT INCENTIVE PLANS ARE BASED ON A COMBINATION OF MEASURES, AND ARE TAILORED TO INDIVIDUAL PARTICIPANTS. SENIOR LEADERSHIP IS ELIGIBLE FOR THE SENIOR MANAGEMENT INCENTIVE PLAN (SMIP). PERFORMANCE CATEGORIES FOR THE SMIP ARE LIVES SAVED, MEDICARE CORE MEASURES, PATIENT SAFETY COMPOSITE, INPATIENT SATISFACTION, LEVEL OF INPATIENTS THAT WOULD RECOMMEND, EMPLOYEE ENGAGEMENT, BEST PLACE TO PRACTICE RESULTS FOR PHYSICIANS, ADJUSTED ADMISSIONS, EMERGENCY AVAILABILITY, FLEX BUDGET COMPLIANCE, AND OPERATING CASH FLOW MARGIN. THE FINAL TWO CATEGORIES ARE GENERALLY RELATED TO THE NET EARNINGS OF THE DIVISION IN WHICH THE INDIVIDUAL WORKS, OR IN THE CASE OF SYSTEM SERVICES SENIOR MANAGEMENT, THE NET EARNINGS OF THE COMPANY. THE RELATIVE WEIGHT OF EACH CATEGORY IS TAILORED TO THE INDIVIDUAL PARTICIPANT. DESIGNATED MANAGERS AND DIRECTORS ARE ELIGIBLE FOR THE MANAGEMENT INCENTIVE PLAN (MIP). PERFORMANCE CATEGORIES FOR THE MIP ARE HOSPITAL OPERATING MARGIN, HOSPITAL PATIENT SATISFACTION, CLINICAL AND OPERATIONAL EXCELLENCE, FINANCIAL PERFORMANCE, SERVICE EXCELLENCE, EMPLOYEE ENGAGEMENT, AND PHYSICIAN ENGAGEMENT. THE RELATIVE WEIGHT OF EACH CATEGORY IS TAILORED TO THE INDIVIDUAL PARTICIPANT. INITIAL CONTRACT EXCEPTION SCHEDULE J, PART I, QUESTION 8 ROBERT MINKIN WAS HIRED IN JUNE 2006, AND WAS PAID PURSUANT TO A CONTRACT THAT WAS SUBJECT TO THE INITIAL CONTRACT EXCEPTION DESCRIBED IN REGS. SECTION 53.4958-4(A)(3). COMPENSATION OF BOARD MEMBER SCHEDULE J, PART II THE SISTERS OF CHARITY OF LEAVENWORTH HEALTH SYSTEM, INC. (SCLHS) CONSISTS OF ELEVEN HOSPITALS AND FOUR CLINICS (AFFILIATES) IN FOUR STATES INCLUDING ST JOSEPH HOSPITAL IN DENVER, COLORADO. SCLHS AND ITS AFFILIATES ADHERE TO GOVERNANCE EXCELLENCE STANDARDS INCLUDING TRANSPARENCY AND ACCOUNTABILITY. WILLIAM M. MURRAY IS PRESIDENT & CHIEF EXECUTIVE OFFICER FOR SISTERS OF CHARITY OF LEAVENWORTH HEALTH SYSTEM (SCLHS). HE ALSO SERVES AS A MEMBER OF THE EXEMPLA, INC.'S (EXEMPLA) BOARD. THE COMPENSATION REFLECTED IS THAT OF MR. MURRAY'S POSITION AS AN SCLHS EXECUTIVE AND NOT AS A MEMBER OF EXEMPLA'S BOARD. IN KEEPING WITH SCLHS' CORE VALUE OF STEWARDSHIP, NO BOARD MEMBER SERVING ON SCLHS OR AFFILIATE BOARDS IS COMPENSATED FOR THAT SERVICE. MIDTOWN INPATIENT MEDICINE PARTNER / EXEMPLA KEY EMP 4530479 HOSPITALIST SVCS AGREEMENT false HOSPITAL SHARED SERVICES BOD / EXEMPLA KEY EMP 4210807 CONTRACTED SERVICES false BUSINESS TRANSACTION RELATIONSHIPS PART IV LISA KETTERING, A KEY EMPLOYEE, IS A PARTNER IN MIDTOWN INPATIENT MEDICINE. BRADLEY LUDFORD, A KEY EMPLOYEE, SERVES ON THE BOARD OF DIRECTORS OF HOSPITAL SHARED SERVICES. EXEMPT PURPOSE ACHIEVEMENTS FORM 990, PART III, LINES 4A - 4D ST JOSEPH HOSPITAL (ESJH) IS OWNED BY SISTERS OF CHARITY OF LEAVENWORTH HEALTH SYSTEM (SCLHS). EXEMPLA HEALTHCARE (EXEMPLA) IS A HEALTH CARE DELIVERY SYSTEM FORMED ON JANUARY 1, 1998, BY A JOINT OPERATING AGREEMENT AMONG SCLHS, ESJH, LMC COMMUNITY FOUNDATION (CURRENTLY COMMUNITY FIRST FOUNDATION) AND EXEMPLA, INC. (EXEMPLA). EXEMPLA OPERATES EXEMPLA LUTHERAN MEDICAL CENTER, EXEMPLA GOOD SAMARITAN MEDICAL CENTER AND OTHER AFFILIATED MEDICAL SERVICES INCLUDING THE EXEMPLA PHYSICIAN NETWORK. THE SYSTEM'S COLLECTIVE PROGRAM SERVICES ACCOMPLISHMENTS INCLUDE BUT ARE NOT LIMITED TO THE FOLLOWING: THE MEDICAL SERVICES ARE PROVIDED TO ALL WHO SEEK SERVICE REGARDLESS OF RACE, CREED, SEX, NATIONAL ORIGIN, HANDICAP, AGE, OR ABILITY TO PAY. ALTHOUGH REIMBURSEMENT FOR SERVICES IS CRITICAL FOR THE OPERATION AND STABILITY OF EXEMPLA AND ESJH, IT IS RECOGNIZED THAT NOT ALL INDIVIDUALS POSSESS THE ABILITY TO PURCHASE ESSENTIAL MEDICAL SERVICES. THEREFORE, IN KEEPING WITH EXEMPLA'S AND ESJH'S COMMITMENT TO SERVE ALL MEMBERS OF ITS COMMUNITY, FREE CARE AND/OR SUBSIDIZED CARE WILL BE CONSIDERED AND PROVIDED WHERE THE NEED AND/OR AN INDIVIDUAL'S INABILITY TO PAY EXIST. IN ADDITION, EXEMPLA AND ESJH RECOGNIZE THE ESSENTIAL NEED TO BE EXCEPTIONAL STEWARDS OF MEDICARE, MEDICAID AND COMMUNITY/PRIVATE FUNDING DOLLARS. FOR 2010, ESJH PROVIDED BENEFIT TO THE COMMUNITY AT A COST OF $48.4 MILLION, INCLUDING CHARITY CARE, UNREIMBURSED MEDICAID, OTHER SUBSIDIZED HEALTH SERVICES AND EDUCATION. EXEMPLA AND ESJH ALSO RECOGNIZE THE ESSENTIAL NEED TO ENHANCE AND IMPROVE MEDICAL OUTCOMES, QUALITY, AND SERVICES. IN RESPONSE, A BEST IN THE NATION STRATEGY AND PROGRAM WAS IMPLEMENTED. THE OBJECTIVES OF THE PROGRAM ARE TO BE THE BEST IN THE NATION ON PREDEFINED QUALITIES, SERVICE AND COST INDICATORS. THE QUALITY INDICATORS ARE IN ALIGNMENT WITH MAJOR PUBLICLY COMPARABLE DATABASES INCLUDING THE COLORADO HEALTH AND HOSPITAL ASSOCIATION AND CENTERS FOR MEDICARE AND MEDICAID SERVICES. CURRENTLY, THE PROGRAM IS IN THE EIGHTH YEAR OF THIS INITIATIVE. RECOGNIZED QUALITY ACHIEVEMENTS INCLUDE, BUT ARE NOT LIMITED TO THE FOLLOWING: - IN 2010 THE SOCIETY OF THORACIC SURGEONS (STS) RECOGNIZED THE ESJH CARDIAC & VASCULAR INSTITUTE FOR THE FOURTH YEAR IN A ROW BY AWARDING IT THE HIGHEST RATING POSSIBLE, A 3-STAR RATING, WHICH PLACES IT IN THE TOP 10 PERCENT OF ALL OPEN-HEART PROGRAMS IN THE UNITED STATES. - IN 2010, ESJH CARDIAC & VASCULAR INSTITUTE CONTINUES TO BE THE ONLY PROGRAM IN THE STATE OF COLORADO AND ONE OF ONLY FIVE IN THE COUNTRY TO BE RECOGNIZED BY THE CENTERS FOR MEDICARE AND MEDICAID AS A CENTER OF VALUE FOR ITS MEMBERS. - IN 2010, ESJH RECEIVED THE 2010-11 HEALTH GRADES MATERINTY CARE EXCELLENCE AWARD AND IS THE ONLY HOSPITAL IN COLORADO TO BE RANKED IN THE TOP 10 PERCENT AND TO RECEIVE A 5-STAR RATING FOR MATERNITY CARE. USING OBJECTIVE PATIENT-OUTCOME DATA COLLECTED FROM STATE GOVERNMENTS, THE INDEPENDENT RATINGS ORGANIZATION RANKED HOSPITALS BASED ON THEIR MATERNAL COMPLICATION RATES FOR VAGINAL AND C-SECTION DELIVERIES AS WELL AS NEONATAL MORTALITY RATES. - IN 2010, THE EMERGENCY DEPARTMENT WAS GIVEN THE KAISER PERMANENTE SERVICE QUALITY AWARD FOR IMPROVEMENT IN SERVICE EXCELLENCE. - IN 2010, ESJH WAS AWARDED THE CENTER OF EXCELLENCE DESIGNATION BY THE AMERICAN SOCIETY OF METABOLIC AND BARIATRIC SURGERY. - IN 2010, THE AMERICAN COLLEGE OF SURGEONS NATIONAL SURGICAL QUALITY IMPROVEMENT PROGRAM RECOGNIZED ESJH FOR THE SECOND YEAR IN A ROW, IN AFFILIATION WITH KAISER PERMANENTE COLORADO, AS ONE OF 25 HEALTH CARE ORGANIZATIONS IN THE UNITED STATES TO ACHIEVE EXEMPLARY OUTCOMES FOR SURGICAL PATIENT CARE. ESJH IS THE FIRST HOSPITAL IN COLORADO TO RECEIVE THE HONORS. THE ACS NSQIP RECOGNITION PROGRAM COMMENDS A SELECT GROUP OF HOSPITALS FOR SUPERIOR OUTCOMES RELATED TO PATIENT MANAGEMENT IN FIVE CLINICAL AREAS: DEEP-VEIN THROMBOSIS, CARDIAC INCIDENTS, RESPIRATORY INCIDENTS, SURGICAL SITE INFECTIONS, AND URINARY TRACT INFECTIONS. - IN 2010, THE TRUEBEAM LINEAR ACCELERATOR WAS INSTALLED FOR RADATION ONCOLOGY THERAPY AND IS THE THIRD TRUEBEAM FUNCTIONAL IN THE WORLD. - IN 2010, ESJH RECEIVED REACCREDITATION BY THE FOLLOWING GROUPS: AMERICAN ASSOCIATION OF BLOOD BANKS, COLLEGE OF AMERICAN PATHOLOGISTS, AMERICAN COLLEGE OF RADIOLOGY. WITH ITS 565 LICENSED BEDS, ESJH SERVED THE COMMUNITY WITH 19,809 INPATIENT ADMISSIONS, 169,701 OUTPATIENT VISITS AND 49,495 EMERGENCY ROOM VISITS. SERVICES - COMPREHENSIVE MEDICAL SERVICES INCLUDE, BUT ARE NOT LIMITED TO, CARDIOLOGY, ONCOLOGY, ORTHOPEDIC, WOMEN AND FAMILY, PEDIATRICS, EMERGENCY AND TRAUMA, NEONATAL INTENSIVE CARE, NEUROLOGY, OB/GYN AND GENERAL SURGICAL AND MEDICAL. - ESJH IS A LEADING HEART HOSPITAL IN DENVER PERFORMING APPROXIMATELY 400 OPEN-HEART SURGERIES ANNUALLY, MORE THAT ANY OTHER COLORADO HOSPITAL. - ESJH DELIVERS MORE BABIES THAT ANY OTHER COLORADO HOSPITAL WITH 4,650 BIRTHS IN 2010. ALONG WITH NORMAL DELIVERIES, THE HOSPITAL ALSO CARES FOR CRITICALLY ILL NEWBORNS AND HIGH-RISK MOTHERS. - ESJH IS AMONG THE TOP THREE COLORADO HOSPITALS FOR NEWLY DIAGNOSED CANCER CASES. IN ORDER TO MEET THE SPECIAL NEEDS OF THESE PATIENTS, THE COMPREHENSIVE CANCER CENTER BRINGS TOGETHER IN ONE PLACE THE ESJH BREAST CARE CENTER, CANCER PSYCHOSOCIAL SERVICES, MEDICAL AND SURGICAL ONCOLOGY, A LABORATORY, A RESEARCH DEPARTMENT, A NEW CANCER PHARMACY AND THE INFUSION CENTER. THIS MEANS THAT THE PROFESSIONALS FROM ONCOLOGISTS TO LAB TECHNICIANS TO PSYCHOTHERAPISTS TO INFUSION SPECIALISTS, PHARMACIST AND RADIOLOGISTS -HAVE ACCESS TO LEADING-EDGE TECHNOLOGY AND CAN BETTER INTERACT WITH ONE ANOTHER TO PROVIDE FULLY COORDINATED CARE TO EACH OF OUR PATIENTS. - THE HIGHLY TRAINED PHYSICIANS, NURSES AND SUPPORT STAFF IN THE EMERGENCY DEPARTMENT TREAT MORE THAN 136 PATIENTS PER DAY FOR A WIDE RANGE OF EMERGENCY MEDICAL CONDITIONS. PROGRAMS A STRONG COMMITMENT TO THE HEALTH OF THE COMMUNITY IS FURTHER EXEMPLIFIED, BUT NOT LIMITED TO, THE FOLLOWING PROGRAMS: - THE GRADUATE MEDICAL EDUCATION PROGRAM TRAINS 104 MEDICAL RESIDENTS EACH YEAR IN THE FIELDS OF FAMILY PRACTICE, INTERNAL MEDICINE, OBSTETRICS/GYNECOLOGY AND GENERAL SURGERY. IN 2010, THE INTERNAL MEDICINE RECEIVED THE HIGHEST LEVEL OF ACCREDITATION FOR FIVE YEARS BY THE AMERICAN COLLEGE OF GRADUATE MEDICAL EDUCATION. ALL FOUR PROGRAMS CONTINUED TO ENHANCE MEDICAL KNOWLEDGE THROUGH ADVANCED SCHOLARSHIP INCLUDING OVER TWENTY PUBLISHED PAPERS AND SEVERAL NATIONAL PRESENTATIONS. - THE CARITAS CLINIC, SISTER JOANNA BRUNER FAMILY MEDICINE CENTER, EXEMPLA FAMILY MEDICAL CENTER, AND SETON WOMEN'S CENTER PROVIDE A CONTINUUM OF CARE FROM PREVENTIVE THROUGH ACUTE CARE TO MEDICALLY UNDERSERVED INDIVIDUALS IN A PHYSICIAN OFFICE SETTING. THE THREE ON-CAMPUS CLINICS PROVIDE MORE THAN 40,000 PATIENT VISITS EACH YEAR AND OFFER PAYMENT FOR SERVICES VIA A SLIDING FEE PROGRAM. NO PATIENT IS DENIED SERVICE DUE TO AN INABILITY TO PAY. - BOOT CAMP FOR NEW DADS IS AN INNOVATIVE PROGRAM DESIGNED TO BUILD CONFIDENCE AND PREPARE FIRST-TIME DADS FOR THE CHALLENGES OF PARENTHOOD. VETERAN DADS AND THEIR NEWBORNS ORIENT ROOKIE DADS. IT SERVED APPROXIMATELY 1,200 EXPECTANT FATHERS IN 2010. - THE BABY BOUTIQUE IS AN AWARD-WINNING INCENTIVE PROGRAM THAT ENCOURAGES PRENATAL CARE AMONG EXPECTANT FAMILIES. BY FOLLOWING APPROPRIATE PRENATAL CARE AND REGULAR OFFICE VISIT SCHEDULES AND ATTENDING PRENATAL EDUCATIONAL CLASSES, EXPECTANT FAMILIES EARN COUPONS FOR NECESSARY BABY SUPPLIES, CLOTHES AND EQUIPMENT. IN 2010, APPROXIMATELY 760 FAMILIES WERE SERVED, WITH MOST FAMILIES RETURNING REGULARLY TO THE BABY BOUTIQUE AS THE COURSE OF PREGNANCY PROCEEDED. INCIDENCE OF LOW BIRTH WEIGHT WAS LESS IN PARTICIPATING FAMILIES THAN IN NON-PARTICIPATING FAMILIES. - THE ST JOSEPH HOSPITAL FOUNDATION RAISES AND MANAGES FUNDS FOR THE BENEFIT OF THE HOSPITAL AND ITS COMMUNITY PROGRAMS. FUNDS RAISED BY THE FOUNDATION ENABLE THE HOSPITAL TO OFFER A VARIETY OF HEALTH CARE PROGRAMS TO THE COMMUNITY, PARTICULARLY THE MEDICALLY UNDERSERVED. - ESJH MOBILE MAMMOGRAPHY - THROUGH SUPPORT FROM THE DENVER AFFILIATE OF THE KOMEN FOUNDATION AND ST JOSEPH HOSPITAL FOUNDATION, ESJH PROVIDES DIAGNOSTIC CARE FOR MEDICALLY UNDERSERVED, AT RISK WOMEN. INTRODUCED IN SEPTEMBER 2005, THE MOBILE MAMMOGRAPHY UNIT SERVES SOME 2,000 COLORADO WOMEN ANNUALLY. - THE WILLIAM V. GERVASINI MEMORIAL LIBRARY IS A HEALTH INFORMATION RESOURCE FOR PATIENTS, THEIR FAMILIES, AND THE COMMUNITY. THE LIBRARY COLLECTION FOCUSES ON UNDERSTANDABLE, OBJECTIVE INFORMATION ABOUT MEDICAL ISSUES AND CONDITIONS. MAILING SERVICES ARE AVAILABLE FOR THOSE WHO ARE UNABLE TO VISIT THE LIBRARY. - THE SCHOOL AT WORK PROGRAM, WHICH IS PART OF ESJH'S WORKFORCE DEVELOPMENT INITIATIVE, OFFERS PROFESSIONAL DEVELOPMENT OPPORTUNITIES TO HIGH PERFORMING EMPLOYEES WHO WISH TO ENHANCE THEIR COMPUTER SKILLS AND HEALTH CARE KNOWLEDGE FOR ENTRY INTO HEALTH CARE CAREERS. THE STUDENTS TAKE CLASSES AT THE HOSPITAL FOR SEVERAL HOURS A WEEK FOR EIGHT MONTHS. THEY ARE PROVIDED WITH TEXT BOOKS AND MATERIALS AND ARE EXPECTED TO COMPLETE SEVERAL HOURS OF HOMEWORK ON-LINE. - THE WOMEN'S PAVILION OFFERS COMMUNITY HEALTH EDUCATION FOCUSED ON PRENATAL CARE, PARENTING AND WOMEN'S HEALTH. IN 2010, THE WOMEN'S PAVILION PROVIDED HEALTH EDUCATION TO OVER 6,100 WOMEN AND THEIR SPOUSES AND SUPPORT PERSONS. PAVILION PROVIDED HEALTH EDUCATION TO OVER 6,100 WOMEN AND THEIR SPOUSES AND SUPPORT PERSONS. DELEGATION OF CONTROL OVER MANAGEMENT DUTIES FORM 990, PART VI, QUESTION 3 IN JUNE 2008, EXEMPLA, INC., AS MANAGER OF ST JOSEPH HOSPITAL (ESJH), ENTERED INTO A MANAGEMENT AGREEMENT WITH INSIGHT ONCOLOGY FOR THE MANAGEMENT OF THE HOSPITAL'S COMPREHENSIVE CANCER CENTER SERVICES. EXEMPLA, INC. MANAGES AND GOVERNS ST JOSEPH HOSPITAL UNDER A JOINT OPERATING AGREEMENT. IN JULY 2009, ESJH CONTRACTED WITH INSIGHT ONCOLOGY TO MANAGE A BREAST CENTER, SURGICAL SERVICES, RADIATION ONCOLOGY, OUTPATIENT INFUSION SERVICES, A PHARMACY, INPATIENT SERVICES, AND OTHER SPECIALIZED CARE TO PATIENTS WITH ONCOLOGY DISEASES AND DISORDERS. IN OCTOBER 2009, ESJH CONTRACTED WITH ROCKY MOUNTAIN CARDIOVASCULAR INSTITUTE, LLC (RMCI) TO PURCHASE MANAGEMENT AND OTHER SERVICES FOR ITS CARDIAC CATHETERIZATION LABS. RMCI SUBCONTRACTED WITH CARDIAC PARTNERS, LLC TO PROVIDE THE MANAGEMENT SERVICES. CHANGES TO ORGANIZATIONAL DOCUMENTS FORM 990, PART VI, QUESTION 4 EFFECTIVE APRIL 14, 2010, THE MEMBERS OF EXEMPLA AGREED TO AN AMENDMENT TO THE JOINT OPERATING AGREEMENT (JOA) THAT STATES THAT ON JUNE 30, 2014, OR EARLIER UNDER CERTAIN CIRCUMSTANCES, COMMUNITY FIRST FOUNDATION'S INTEREST IN THE JOA AND OTHER RIGHTS RELATING TO EXEMPLA WOULD BE TERMINATED AT A PRICE NOT TO EXCEED $280 MILLION. EFFECTIVE APRIL 14, 2010, THE MEMBERS OF EXEMPLA AGREED TO AN AMENDMENT TO THE JOINT OPERATING AGREEMENT (JOA) THAT STATES THAT ON JUNE 30, 2014, OR EARLIER UNDER CERTAIN CIRCUMSTANCES, COMMUNITY FIRST FOUNDATION'S INTEREST IN THE JOA AND OTHER RIGHTS RELATING TO EXEMPLA WOULD BE TERMINATED AT A PRICE NOT TO EXCEED $280 MILLION. MEMBERS OR STOCKHOLDERS FORM 990, PART VI, QUESTION 6 ST JOSEPH HOSPITAL HAS ONE MEMBER, SISTERS OF CHARITY OF LEAVENWORTH HEALTH SYSTEM. ST JOSEPH HOSPITAL IS MANAGED AND GOVERNED BY EXEMPLA, INC. EXEMPLA, INC. HAS TWO MEMBERS: COMMUNITY FIRST FOUNDATION (CFF) AND SISTERS OF CHARITY OF LEAVENWORTH HEALTH SYSTEM (SCLHS). ELECTION OF MEMBERS OF GOVERNING BODY FORM 990, PART VI, QUESTION 7A SISTERS OF CHARITY LEAVENWORTH HEALTH SYSTEMS, THE SOLE MEMBER OF SAINT JOSEPH HOSPITAL APPOINTS MEMBERS OF THE SAINT JOSEPH HOSPITAL BOARD OF DIRECTORS. SAINT JOSEPH HOSPITAL IS MANAGED AND GOVERNED BY EXEMPLA, INC. EXEMPLA, INC HAS TWO MEMBERS, SISTERS OF CHARITY LEAVENWORTH HEALTH SYSTEMS AND COMMUNITY FIRST FOUNDATION. CFF APPOINTS 5 OF THE DIRECTORS AND SCLHS APPOINTS 5 OF THE DIRECTORS. DECISIONS OF GOVERNING BODY SUBJECT TO APPROVAL FORM 990, PART VI, QUESTION 7B BOTH MEMBERS (COMMUNITY FIRST FOUNDATION AND SISTERS OF CHARITY OF LEAVENWORTH HEALTH SYSTEM, SCLHS) HAVE CERTAIN RESERVE POWERS TO APPROVE CHANGES TO THE BYLAWS REGARDING APPOINTMENT OF BOARD MEMBERS. SCLHS ALSO HAS EXTENSIVE RESERVE POWERS OVER ANY CHANGE IN MISSION, CHANGES TO THE ARTICLES OF INCORPORATION OR BYLAWS, ACQUISITION OF ASSETS, INCURRENCE OF DEBT, MERGER OR DISSOLUTION, APPROVAL OF STRATEGIC PLANS AND BUDGETS, AND APPOINTMENT OF AUDITORS. 990 REVIEW PROCESS FORM 990, PART VI, QUESTION 11 ALL 990 REPORTING WAS REVIEWED INTERNALLY WITH SENIOR MANAGEMENT. ALL QUESTIONS AND CHANGES PROPOSED WERE ADDRESSED PRIOR TO FILING. A COMPLETE COPY OF THE FINAL FORM 990 WAS PROVIDED ELECTRONICALLY TO EACH VOTING MEMBER OF THE BOARD OF DIRECTORS PRIOR TO ITS SUBMISSION TO THE INTERNAL REVENUE SERVICE. MONITORING COMPLIANCE WITH CONFLICT OF INTEREST POLICY FORM 990, PART VI, QUESTION 12C THE ORGANIZATION REGULARLY AND CONSISTENTLY MONITORS AND ENFORCES ITS CONFLICT OF INTEREST POLICY BY PROVIDING EDUCATION AND TRAINING FOR EACH OF ITS EMPLOYEES, STAFF, OFFICERS AND DIRECTORS, AS WELL AS HAVING EACH OF THESE INDIVIDUALS COMPLETE A CONFLICT OF INTEREST STATEMENT ON AN ANNUAL BASIS TO DISCLOSE ANY POTENTIAL CONFLICT ISSUES. THESE STATEMENTS ARE CAREFULLY REVIEWED BY THE LEGAL DEPARTMENT. WHEN A CONFLICT IS IDENTIFIED, THE LEGAL DEPARTMENT COMPILES ALL REPORTED CONFLICTS, AND EVALUATES THE DISCLOSURES FOR ACTUAL CONFLICTS. A REPORT IS PROVIDED TO ORGANIZATION'S PRESIDENT/CEO REGARDING EMPLOYEES AND OFFICERS, AND TO THE CHAIR OF THE BOARD AND CHAIR OF THE GOVERNANCE COMMITTEE REGARDING BOARD MEMBERS. THOSE WITH IDENTIFIED CONFLICTS OF INTEREST MUST RECUSE THEMSELVES FROM ANY MEETING DURING THE DISCUSSION AND VOTE THEREOF. PROCESS FOR DETERMINING COMPENSATION OF CEO, OFFICERS, OR KEY EMPLOYEES FORM 990, PART VI, QUESTION 15A & 15B WHEN REVIEWING AND SETTING COMPENSATION FOR "DISQUALIFIED PERSONS", EXEMPLA'S PROCESS INCLUDES: THE COMPENSATION COMMITTEE OF THE BOARD IS CHARGED WITH THE RESPONSIBILITY FOR SETTING THE OVERALL COMPENSATION PHILOSOPHY AND FOR EVALUATING THE TOTAL COMPENSATION PROGRAMS FOR DISQUALIFIED PERSONS. THE BOARD MEMBERS ARE INDEPENDENT MEMBERS AND IN THESE DISCUSSIONS THE CEO RECUSES HIMSELF FROM THE DISCUSSIONS AROUND HIS OWN COMPENSATION. THE COMMITTEE OBTAINS VALID, COMPARABLE MARKET DATA (FROM INDEPENDENTLY PUBLISHED SOURCES) FOR COMPARABLE POSITIONS AND FROM 990 FILINGS. THIS COMMITTEE ENGAGES THE SERVICES OF AN INDEPENDENT EXPERT IN EXECUTIVE COMPENSATION TO REVIEW THE MARKET DATA AND PROVIDE AN OPINION AS TO THE REASONABLENESS OF THE TOTAL COMPENSATION PROGRAM. FOR THE PAST SEVERAL YEARS, THE INDEPENDENT FIRM HAS BEEN WATSON WYATT. WATSON WYATT VALIDATES THE PROCESS USED BY MANAGEMENT FOR IDENTIFYING "DISQUALIFIED PERSONS' AND THEN CONDUCTS A COMPARABILITY STUDY/ANALYSIS OF PAY AT SIMILAR TYPES AND SIZES OF ORGANIZATIONS AND REVIEWS BASE SALARY, INCENTIVE (OR OVER-BASE PROGRAMS), BENEFITS, RETIREMENT PLANS AND PERQUISITES. WATSON WYATT REVIEWS THE FINDINGS WITH THE BOARD COMMITTEE AND MINUTES ARE PREPARED AND SHARED WITH ALL THE VOTING BOARD MEMBERS EACH YEAR THAT DOCUMENTS THE DISCUSSION AND ANY ACTIONS THAT MAY HAVE BEEN TAKEN. A COPY OF A FORMAL OPINION LETTER PREPARED BY WATSON WYATT FOLLOWING THE DISCUSSION WITH THE COMPENSATION COMMITTEE IS PROVIDED TO THE BOARD CHAIR AND SHARED WITH THE FULL BOARD. THIS PROCESS IS UNDERTAKEN EACH YEAR. SISTERS OF CHARITY OF LEAVENWORTH HEATLH SYSTEM (SCLHS) EMPLOYS THE EXECUTIVE TEAM AT EACH OF ITS HOSPITAL AFFILIATES, INCLUDING ST JOSEPH HOSPITAL. AS PART OF ITS ANNUAL REVIEW PROCESS, SCLHS USES THE FOLLOWING IN ESTABLISHING THE COMPENSATION OF THOSE IN THESE POSITIONS: -COMPENSATION COMMITTEE -INDEPENDENT COMPENSATION CONSULTANT -FORM 990 OF OTHER ORGANIZATIONS -WRITTEN EMPLOYMENT CONTRACTS -COMPENSATION SURVEYS AND STUDIES -APPROVAL BY THE BOARD OR COMPENSATION COMMITTEE THE ABOVE SUPPORT THE COMPENSATION COMMITTEE'S EFFORTS TO ENSURE THAT THE LEVEL OF COMPENSATION PROVIDED TO ITS EXECUTIVES (OFFICERS, KEY EMPLOYEES, ETC.) IS CONSISTENT WITH MARKET VALUE AND THE PAY PHILOSOPHY SET BY THE BOARD. THE PAY PHILOSOPHY SET BY THE BOARD IS TO PAY AT THE MIDDLE OF THE MARKET FOR EXECUTIVES OF SIMILAR SIZED ORGANIZATIONS OVERALL. SCLHS' EXECUTIVE COMPENSATION IS COMPARABLE TO THAT PROVIDED IN SIMILAR, NOT-FOR-PROFIT HEALTHCARE SYSTEMS AND HOSPITALS. AVAILABILITY OF GOVERNING DOCS, CONFLICT OF INTEREST POLICY, FINANCIALS FORM 990, PART VI, QUESTION 19 GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, FINANCIAL STATEMENTS, AND RELATED DOCUMENTATION ARE PROVIDED UPON REQUEST AS DEEMED APPROPRIATE. INDEPENDENT CONTRACTORS PART VII, SECTION B, QUESTION 2 NO VENDOR PAYMENTS ARE PAID BY ST JOSEPH HOSPITAL. THEY ARE ALL PAID BY EXEMPLA, INC. AND THE NUMBER OF INDEPENDENT CONTRACTORS PAID OVER $100,000 ARE REFLECTED IN THE EXEMPLA, INC. FORM 990 AS THE TOTAL PAID FOR ALL ENTITIES OWNED/MANAGED BY EXEMPLA, INC. OTHER CHANGES IN NET ASSETS PART XI, LINE 5 THE FOLLOWING IS THE DETAIL OF OTHER CHANGES IN NET ASSETS: CONTRIBUTIONS TO/FROM RELATED ORGANIZATIONS (589,820) CONTRIBUTIONS OF TEMPORARILY RESTRICTED NET ASSETS 620 UNREALIZED GAIN/LOSS 2,008,735 TOTAL 1,419,535 HOURS DEVOTED FOR RELATED ORGANIZATION FORM 990 PART VII NAME:WILLIAM M MURRAY TITLE:CHAIRMAN HOURS:50 HOURS DEVOTED FOR RELATED ORGANIZATION FORM 990 PART VII NAME:DAVID C PECORARO TITLE:VP & CIO HOURS:25 SISTERS OF CHARITY LEAVENWORTH HLTH SYST 9801 RENNER BLVD STE 100 LENEXA KS 66219 237379161 SUPPORT MMBRS KS 501(C)(3) 11B-TYPE II NA CARITAS CLINICS INC 818 NORTH 7TH STREET LEAVENWORTH KS 66048 481009910 CLINIC SVCS KS 501(C)(3) 3 NA MARIAN CLINIC INC 1001 SW GARFIELD TOPEKA KS 66604 481046905 CLINIC SVCS KS 501(C)(3) 3 NA MARILLAC CLINIC INC 2333 N 6TH STREET GRAND JUNCTION CO 81501 841085822 CLINIC SVCS CO 501(C)(3) 3 NA PROVIDENCE MEDICAL CENTER 8929 PARALLEL PARKWAY KANSAS CITY KS 66112 480784446 HEALTHCARE KS 501(C)(3) 3 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