2026-05-15T12:05:56-05:00 2025-06-30 470617373 COMMONSPIRIT HEALTH 198 INVERNESS DRIVE WEST ENGLEWOOD CO 80112 990 2024-07-01 930386868 COMMONSPIRIT OREGON COMM 5416772457 3033 N 3RD AVE PHOENIX AZ 85013 JAMIE POINDEXTER CFO 5416772457 2026-05-15 1 1 PAMELA KROHN P01210500 3032989100 2024 2025-03-06 01:10:19Z X RUSSELL WOOLLEY 3033 N 3RD AVE PHOENIX AZ 85013 353024895 0 0928 X WWW.CHIMERCYHEALTH.COM X 1909 OR THE MISSION OF COMMONSPIRIT OREGON IS TO PROVIDE EXCELLENT, COMPASSIONATE CARE FOR THE PEOPLE OF OUR COMMUNITY, REGARDLESS OF ABILITY TO PAY. 3 0 1521 91 3843490 2301434 1288248 682358 300270131 327128428 12084452 19696118 3008065 4545987 316650896 352052891 923158 2020994 0 0 110379431 122395395 0 0 0 157444471 179903021 268747060 304319410 47903836 47733481 665371890 1049426116 60182231 91633273 605189659 957792843 X AS AN AFFILIATE OF COMMONSPIRIT HEALTH, WE MAKE THE HEALING PRESENCE OF GOD KNOWN IN OUR WORLD BY IMPROVING THE HEALTH OF THE PEOPLE WE SERVE, ESPECIALLY THOSE WHO ARE VULNERABLE, WHILE WE ADVANCE SOCIAL JUSTICE FOR ALL. 1 0 278058681 2020994 324612119 SEE SCHEDULE H. 278058681 1 1 0 1 0 0 0 0 0 0 1 1 0 1 1 1 0 1 0 0 0 0 0 0 0 0 1 1 1 0 1 0 0 0 0 0 0 0 1 0 0 0 0 0 1 1 1 0 0 1 X 0 0 1521 1 1 1 0 0 0 0 0 0 0 0 0 0 0 X 3 0 0 1 1 0 1 1 1 1 1 0 0 1 1 1 1 1 1 0 0 1 0 OR X DAVID NOSACKA CFO 2536804000 1717 S J STREET TACOMA WA 98405 KETUL PATEL EX OFFICIO/REGION PRESIDENT NW 1.00 59.00 X 0 5665901 88958 DANIEL BARCHI BOARD MEMBER 1.00 59.00 X 0 4514498 405348 KATHLEEN SANFORD BOARD MEMBER 1.00 49.00 X 0 2984531 54602 DAVID NOSACKA CORPORATE TREASURER/SVP&CFO NORTHWEST REGION 1.00 49.00 X 0 872310 61972 SUSAN WILLIAMS MD BOARD MEMBER THRU 4/30/25/PHYSICIAN 1.00 40.00 X 0 839952 40965 RUSSELL WOOLLEY MARKET PRESIDENT/BOARD MEMBER THRU 4/30/25 59.00 1.00 X X 708857 0 102943 JASON GRAY MD FORMER OFFICER 40.00 10.00 X 544559 0 49122 BRIAN PINELLE FORMER COO & CNO 0.00 0.00 X 438775 35850 20499 MIRIAM CHAMBLISS CORPORATE SECRETARY/VP GENERAL COUNSEL NORTHWEST R 1.00 49.00 X 0 428659 45640 JAMIE POINDEXTER MARKET VP OPERATIONAL FINANCE/CFO 59.00 1.00 X 0 343113 37367 GREGORY JACKSON FORMER MARKET VP OPERATIONAL FINANCE/INTERIM CFO 0.00 0.00 X 0 345106 22304 HOLLY COOK MKT CNO - ROSEBURG 10.00 40.00 X 38875 261218 39046 JERRY SMEAD DIRECTOR PHARMACY (THRU 7/3/2024) 40.00 0.00 X 306238 0 26798 ANN FULLER DIRECTOR CLINICAL INFORMATICS (THRU 7/1/2024) 40.00 0.00 X 296881 0 22679 DEBRA RINAKER DIRECTOR FAMILY BIRTH CENTER (THRU 7/1/2024) 40.00 0.00 X 287633 0 15667 DEBORA ST MARIE-LIGHTCAP MKT DIRECTOR HR OPERATIONS (THRU 7/1/2024) 40.00 0.00 X 282870 0 10083 AARON BALLENSKY PHARMACY MANAGER 40.00 0.00 X 252641 0 23756 BRAD SEELY BOARD MEMBER THRU 4/30/25/OPHTHALMOLOGIST 1.00 0.00 X 0 121511 27149 NEAL BROWN CHAIR THRU 4/30/25 1.00 0.00 X X 0 0 0 GABRIELLE JONES RSM VICE CHAIR THRU 4/30/25 1.00 0.00 X X 0 0 0 ADEN BLISS TREASURER & SECRETARY THRU 4/30/25 1.00 0.00 X X 0 0 0 LAYNE JORGENSEN BOARD MEMBER THRU 4/30/25 1.00 0.00 X 0 0 0 TOBY LUTHER BOARD MEMBER THRU 4/30/25 1.00 0.00 X 0 0 0 MELONY MARSH BOARD MEMBER THRU 4/30/25 1.00 0.00 X 0 0 0 TIMOTHY POWELL MD BOARD MEMBER THRU 4/30/25 1.00 0.00 X 0 0 0 ANA RAMIREZ BOARD MEMBER THRU 4/30/25 1.00 0.00 X 0 0 0 3157329 16412649 1094898 299 1 1 1 PROFESSIONAL MGMT OF OREGON LLC 2801 NW MERCY DRIVE STE 200 ROSEBURG OR 97470 MANAGEMENT SERVICE BUSINESS 11026600 MEDICAL SOLUTIONS LLC 1010 N 102ND ST STE 300 OMAHA NE 68114 STAFFING SERVICES 4904513 CEP AMERICA-ANESTHESIA PC 2100 POWELL ST STE 400 EMERYVILLE CA 94608 MEDICAL SERVICES 4342908 AVIVA HEALTH 150 NE KENNETH FORD DR ROSEBURG OR 97470 MEDICAL SERVICES 2632394 GALEN INPATIENT PHYSICIANS INC 225 N JACKSON AVE SAN JOSE CA 95116 MEDICAL SERVICES 2374455 57 668787 13571 682358 PATIENT SERVICES 900099 324612119 324612119 0 0 EQUITY CHANGES OF UNCO 900099 2516309 0 2516309 0 327128428 5478246 5478246 792139 972004 -179865 -179865 -179865 14217872 0 14217872 14217872 14217872 9953 0 9953 9953 LABORATORY SERVICES 621500 1662145 0 1310231 351914 EMPLOYEE RETENTION CRE 900099 1222903 0 0 1222903 CAFETERIA 722100 1062547 0 0 1062547 768304 16950 751354 4715899 352052891 324612119 3843490 22914924 X 2020994 2020994 989096 27447 961649 95055284 91090728 3964556 4525053 4366306 158747 14531985 13861866 670119 7293977 6929278 364699 455086 455086 11714 11128 586 23278 23278 76944272 72203463 4740809 233076 221422 11654 6330309 6013794 316515 10448807 10448807 5953747 5656060 297687 594448 564726 29722 43106 40951 2155 561496 561496 7497983 7123084 374899 8320303 7904288 416015 1466384 1466384 MEDICAL SUPPLIES 37235031 37235031 0 0 STATE PROVIDER TAX 17749259 16861796 887463 0 REPAIRS AND MAINTENANCE 2383223 2264062 119161 0 UNRELATED BUSINESS TAXE 1515911 0 1515911 0 2135588 1634377 501211 304319410 278058681 26260729 0 3100 2528 22927136 41963332 0 65889690 96000652 0 0 1055745 1051231 6938056 10397822 3132476 2619077 320956908 230039899 45117697 90917009 0 309146822 552286236 0 0 211161168 254188229 665371890 1049426116 21921106 39441710 0 4405 0 0 0 0 0 38261125 52187158 60182231 91633273 X 605189659 957792843 0 605189659 957792843 665371890 1049426116 X 47733481 17654580 287215123 X 0 1 X 1 0 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 0 0 0 0 0 1 23278 0 0 0 23278 0 PART II-B, LINE 1: THE PORTION OF ORGANIZATION DUES THAT ARE RELATED TO LOBBYING ARE AS FOLLOWS: AMERICAN HOSPITAL ASSOCIATION - $7,228 CATHOLIC HEALTH ASSOCIATION - $3,527 HOSPITAL ASSOCIATION OF OREGON - $12,407 340B DUES - $116 2744501 2744501 143670516 79053853 64616663 12410477 10691663 1718814 151842673 135446590 16396083 10288741 4847793 5440948 90917009 CSH OPERATING INVESTMENT POOL 552286236 F 552286236 INTERCOMPANY RECEIVABLES 197418036 INVESTMENTS IN UNCONSOLIDATED ORGS - CONTROLLING INTEREST 45225548 DEPOSITS 19793 ROU FINANCE - NET 1227975 ROU OPERATING 10296877 254188229 2026810 CHI DEBT PROGRAM 9639901 CURRENT PORTION OF OPERATING LEASE LIABILITY 4288128 CURRENT PORTION OF FINANCE LEASE LIABILITY 475239 LONG-TERM PORTION OF OPERATING LEASE LIABILITY 7946222 LONG-TERM PORTION OF FINANCE LEASE LIABILITY 711533 UNCLAIMED PROPERTY 47312 PHYSICIAN RECRUIT AND GUARANTEE PAYABLE 5300753 INTERCOMPANY PAYABLES 20691192 OTHER LIABILITIES 848200 ACCRUED GRANTS 211868 52187158 X PART X, LINE 2: COMMONSPIRIT OREGON'S FINANCIAL INFORMATION IS INCLUDED IN COMMONSPIRIT HEALTH'S CONSOLIDATED AUDITED FINANCIAL STATEMENTS, WHICH INCLUDES THE FOLLOWING DISCLOSURE: COMMONSPIRIT REVIEWS ITS POSITIONS QUARTERLY AND HAS DETERMINED THAT THERE ARE NO MATERIAL UNCERTAIN TAX POSITIONS THAT REQUIRE RECOGNITION IN THE ACCOMPANYING CONSOLIDATED FINANCIAL STATEMENTS. 1 1 X 1 X 1 X 1 1 1 0 1 1 24571 5852565 0 5852565 0.01920 73331 74198376 58406797 15791579 0.05190 0 0 97902 80050941 58406797 21644144 0.07110 12 5986 1004048 0 1004048 0.00330 4 39 8602649 835599 7767050 0.02550 4 19152 16862828 11710683 5152145 0.01690 0 0 0 0 12 8704 1621664 0 1621664 0.00530 32 33881 28091189 12546282 15544907 0.05100 32 131783 108142130 70953079 37189051 0.12210 3 133 16129 0 16129 0.00010 3 133 16129 16129 0.00010 1 460521 0 40200512 52568577 -12368065 X 1 1 2 1 MERCY MEDICAL CENTER INC 2700 STEWART PARKWAY ROSEBURG OR 97471 HTTP://WWW.CHIMERCYHEALTH.COM/ 14-1133 X X X A 2 ST ANTHONY HOSPITAL 2801 ST ANTHONY WAY PENDLETON OR 97801 HTTP://WWW.SAHPENDLETON.ORG 14-0034 X X X X B FACILITY REPORTING GROUP - A 0 0 1 X X X X X X X X X 24 1 0 0 1 X SEE SCHEDULE H SUPPLEMENTAL INFO X X 1 25 1 SEE SCHEDULE H SUPPLEMENTAL INFO 0 1 X 200.000000000000 400.000000000000 X X X X X X 1 1 X X X 1 X HTTPS://CHIMERCYHEALTH.COM/PATIENTS-VISITORS/FINANCIAL-ASSISTANCE/ X HTTPS://CHIMERCYHEALTH.COM/PATIENTS-VISITORS/FINANCIAL-ASSISTANCE/ X HTTPS://CHIMERCYHEALTH.COM/PATIENTS-VISITORS/FINANCIAL-ASSISTANCE/ X X X X X X 1 X 0 X X X X 1 X 0 0 FACILITY REPORTING GROUP - B 0 1 1 X X X X X X X X X 24 1 0 0 1 X SEE SCHEDULE H SUPPLEMENTAL INFO X X 1 25 1 SEE SCHEDULE H SUPPLEMENTAL INFO 0 1 X 200.000000000000 400.000000000000 X X X X X X 1 1 X X X 1 X HTTPS://WWW.SAHPENDLETON.ORG/FINANCIAL-ASSISTANCE X HTTPS://WWW.SAHPENDLETON.ORG/FINANCIAL-ASSISTANCE X HTTPS://WWW.SAHPENDLETON.ORG/FINANCIAL-ASSISTANCE X X X X X X 1 X 0 X X X X 1 X 0 0 SCHEDULE H, PART V, SECTION B, LINE 3E: THE SIGNIFICANT HEALTH NEEDS ARE A PRIORITIZED DESCRIPTION OF THE SIGNIFICANT HEALTH NEEDS OF THE COMMUNITY AS IDENTIFIED THROUGH THE CHNA. SCHEDULE H, PART V, SECTION B, LINE 7: COMMONSPIRIT OREGON:HTTPS://CHIMERCYHEALTH.COM/ABOUT-US/HEALTH-NEEDS-REPORTS/ST. ANTHONY HOSPITAL, PENDLETON:HTTPS://WWW.SAHPENDLETON.ORG/ABOUT-US/COMMUNITY-BENEFIT PART V, LINE 10A, IMPLEMENTATION STRATEGY WEBSITE COMMONSPIRIT OREGON:HTTPS://CHIMERCYHEALTH.COM/ABOUT-US/HEALTH-NEEDS-REPORTS/ST. ANTHONY HOSPITAL, PENDLETON:HTTPS://WWW.SAHPENDLETON.ORG/ABOUT-US/COMMUNITY-BENEFIT PART V, SECTION B FACILITY REPORTING GROUP A FACILITY REPORTING GROUP A CONSISTS OF: - FACILITY 1: MERCY MEDICAL CENTER, INC. FACILITY REPORTING GROUP - A PART V, SECTION B, LINE 5: HEALTH NEEDS WERE RANKED BASED ON THEIR IMPORTANCE AND POTENTIAL IMPACT ON THE COMMUNITY. THIS PRIORITIZATION PROCESS INCORPORATED A COMPREHENSIVE REVIEW OF SECONDARY DATA INDICATORS, INSIGHTS GATHERED THROUGH STAKEHOLDER INTERVIEWS AND FOCUS GROUPS, AND COLLABORATIVE DISCUSSIONS WITH COMMUNITY PARTNERS. THE PARTICIPATING KEY STAKEHOLDERS INCLUDED: ADAPT, AVIVA HEALTH, BLUE ZONES PROJECT (UMPQUA THRIVE), CHI MERCY HEALTH AND FOUNDATION LEADERSHIP, COW CREEK BAND OF UMPQUA TRIBE OF INDIANS, CREATING COMMUNITY RESILIENCE AND PACIFIC HEALTH, UHA CAC MEMBER, UMPQUA HEALTH, UNITED COMMUNITY ACTION NETWORK, DOUGLAS ESD, PEACE AT HOME, DOUGLAS CARES, SHERIFF'S DEPT, EVERGREEN FAMILY MEDICINE, DOUGLAS COUNTY PUBLIC HEALTH, FAMILY DEVELOPMENT CENTER, ADVANTAGE DENTAL, ROSEBURG SCHOOL DISTRICT, MSK BUILDING SUPPLY AND SOUTH UMPQUA SCHOOL BOARD, OREGON PACIFIC BANK, OSU EXT SNAP EDUCATION, DHS, UMPQUA ECONOMIC PARTNERSHIP, VA, BOYS AND GIRLS CLUB, FORD FAMILY FOUNDATION, DOUGLAS COUNTY FAIRGROUNDS, NEIGHBORHOOD WORKS, HARMS REDUCTION CENTER, AND HIGHLAND ELEMENTARY-REEDSPORT. FACILITY REPORTING GROUP - A PART V, SECTION B, LINE 7D: THE CHNA REPORT WAS ALSO SHARED WITH ORGANIZATIONS APPLYING FOR THE COMMONSPIRIT COMMUNITY HEALTH IMPROVEMENT GRANT PROGRAM. FACILITY REPORTING GROUP - A PART V, SECTION B, LINE 11: THE CHNA SIGNIFICANT NEEDS BEING ADDRESSED FOR THE STIPULATED PERIOD IN QUESTION ARE ADOLESCENT & YOUTH HEALTH AND EARLY CHILDHOOD DEVELOPMENT AND ENGAGEMENT, AND ACCESS TO AFFORDABLE, QUALITY, AND EQUITABLE HEALTHCARE SERVICES. AS PART OF OUR COMMITMENT TO HEALTH IMPROVEMENT IN DOUGLAS COUNTY, CHI MERCY MEDICAL CENTER WILL BE OFFERING ANNUALLY REPEATING GRANT AMOUNTS THAT RANGE UP TO $150,000. THESE FUNDS WILL BE USED BY APPLICANTS TO PROMOTE THE WELL-BEING AND HEALTH ADVANCEMENT OF VULNERABLE AND UNDERSERVED POPULATIONS THROUGH THE FORMATION AND PROLIFERATION OF VITAL SERVICES THAT ALIGN WITH ADDRESSING KEY ISSUES THAT WERE IDENTIFIED IN THE COMMUNITY HEALTH ASSESSMENT WORK. THE SPECIFIC PROGRAMS AND/OR INITIATIVES ARE YET TO BE DETERMINED BUT WILL SHOW DIRECT RESONANCE WITH THE IMPROVEMENT TARGETS AS OUTLINED IN THIS CHIS.IN ADDITION TO THIS GRANT DRIVEN MECHANISM, THE FIRST HEALTH NEED IS SUPPORTED BY THE FOLLOWING PROGRAMS AIMED AT CHILDREN, AGES 05, SCHOOL-AGED YOUTH, ADOLESCENTS, AND FAMILIES IN DOUGLAS COUNTY: (1) BEYOND THE DIAGNOSIS; A TYPE 1 DIABETES INITIATIVE THAT PROVIDES EDUCATION, PEER SUPPORT, AND FAMILY-CENTERED ACTIVITIES FOR YOUTH WITH T1D TOIMPROVE DISEASE MANAGEMENT AND LONG-TERM HEALTH OUTCOMES. (2) HKOP (HEALTHY KIDS OUTREACH PROGRAM) WHICH DELIVERS SCHOOL-BASED DENTAL, NURSING, AND HEALTH EDUCATION SERVICES ACROSS 13 SCHOOL DISTRICTS IN PARTNERSHIP WITH THE ESD.PLANNED RESOURCES: MERCY FOUNDATION STAFFING, COMMUNITY HEALTH IMPROVEMENT GRANT FUNDING, SCHOOL PARTNERSHIPS.PLANNED COLLABORATORS: EDUCATION SERVICE DISTRICT, EVERGREEN FAMILY MEDICINE, 13 DOUGLAS COUNTY SCHOOL DISTRICTS, AVIVA, MERCY FOUNDATION, COWCREEK TRIBE, DHS, AND OSU EXTENSION SNAP EDUCATION.ANTICIPATED IMPACTS (OVERALL LONG-TERM GOALS): IMPROVED MANAGEMENT OF TYPE 1 DIABETES, BETTER ORAL AND PHYSICAL HEALTH FOR YOUTH, ENHANCED EARLY CHILDHOOD DEVELOPMENT AND SCHOOL READINESS.MEASURES AND DATA SOURCES: FAMILY SURVEYS, ER VISIT RECORDS, STUDENT ENCOUNTER DATA, PARTNER REPORTS. THE SECOND IDENTIFIED HEALTH NEED I.E. ACCESS TO AFFORDABLE, QUALITY, AND EQUITABLE HEALTHCARE SERVICES WILL BE SUPPORTED BY THE FOLLOWING PROGRAMS AND INITIATIVES: (1) FAMILY PRACTICE RESIDENCY PROGRAM WHICH PROVIDES CLINICAL RESIDENCY OPPORTUNITIES TO FAMILY MEDICINE PHYSICIANS TO BUILD THE LOCAL PROVIDER PIPELINE. (2) UROLOGY RECRUITMENT STRATEGY WHICH AIMS TO EXPAND SPECIALTY CARE BY RECRUITING UROLOGY PROVIDERS. THIS EFFORT INCLUDES $75,000 IN BUILT-ENVIRONMENT RENOVATION INVESTMENTS TO SUPPORT THE OPENING OF A NEW CLINIC. (3) FAMILY PRACTICE ENDOSCOPY INITIATIVE WHICH INVOLVES BROADENING SPECIALTY CARE ACCESS BY RECRUITING ENDOSCOPIC DOCTORS AND PROVIDING PASS-THROUGH COST SUPPORT FOR PATIENT CARE SPACE REMODELING AND ONGOING ANNUAL LEASE EXPENSES. (4) THE NURSE RESIDENCY EFFORT ENTAILS CREATING, MANAGING AND AUGMENTING A STRUCTURED CLINIC CAREER PATHWAY FOR NEWLY GRADUATED NURSES TO IMPROVE RETENTION AND STRENGTHEN THE NURSING WORKFORCE.(5) THE AVIVA DENTAL RESIDENCY PROGRAM IS DESIGNED TO EXPAND ACCESS TO AFFORDABLE DENTAL SERVICES FOR ADULTS AND YOUTH. WE ARE FINANCIALLY SUPPORTING THIS INITIATIVE WITH A $50,000 NON-REPEATING CONTRIBUTION TO OUR FQHC PARTNER; AVIVA HEALTH. PLANNED RESOURCES: HOSPITAL RECRUITMENT FUNDS, RENOVATION AND RESIDENCY INVESTMENTS, CHIG CONTRIBUTION, MERCY FOUNDATION SUPPORT.PLANNED COLLABORATORS: ENDOSCOPY AND UROLOGY PRACTICES (CMG SURGERY, EVERGREEN FAMILY MEDICINE, PRACTICE MANAGEMENT ORGANIZATION), AVIVA, UMPQUA COMMUNITY COLLEGE, OREGON HEALTH SCIENCE UNIVERSITY, LINUS OAKES CHI SENIOR LIVING, ST. ANTHONY'S. ANTICIPATED IMPACTS (OVERALL LONG-TERM GOALS): INCREASED ACCESS TO SPECIALTY AND DENTAL CARE, IMPROVED PROVIDER PIPELINE AND RETENTION, STRONGER HEALTHCARE WORKFORCE. MEASURE DATA SOURCE: WORKFORCE VACANCY RATES (VISIER, ICIMS), PARTNER REPORTS, PROGRAM/GRANT RECIPIENT PROGRESS REPORTS. THE CHNA (COMMUNITY HEALTH NEEDS ASSESSMENT) IDENTIFIED MATERNAL, FETAL, AND INFANT, HEALTH AND SUBSTANCE USE AND ALCOHOL USE DISORDERS AS SIGNIFICANT CONCERNS, AND WHILE CHI MERCY HEALTH CONTINUES TO SUPPORT PROGRAMS AND LEAD EFFORTS THAT ARE AIMED AT REDUCING SERVICE GAPS IN THESE TARGET AREAS, WE ARE NOT INCLUDING THOSE EFFORTS IN THIS 20252027 IMPLEMENTATION PLAN. REASONS INCLUDE: (1) COMMUNITY PARTNERSHIPS: OTHER ORGANIZATIONS IN DOUGLAS COUNTY, INCLUDING LOCAL PUBLIC HEALTH AGENCIES, EARLY LEARNING SYSTEMS, AND BEHAVIORAL HEALTH PROVIDERS, ARE ACTIVELY LEADING INITIATIVES IN THESE AREAS. (2) RESOURCE PRIORITIZATION: THE HOSPITAL IS PRIORITIZING RESOURCES TOWARD YOUTH HEALTH/ENGAGEMENT AND IMPROVING ACCESS TO AFFORDABLE, EQUITABLE HEALTHCARE, WHERE IT HAS THE GREATEST ABILITY TO MAKE A MEASURABLE IMPACT. (3) EXISTING HOSPITAL PROGRAMS AND MEASURES ARE ALREADY IN PLACE TO FOSTER AND SUPPORT PROGRESS IN MATERNAL, FETAL, AND INFANT HEALTH AND SUBSTANCE ABUSE AND ALCOHOL USE DISORDERS.CHI MERCY HEALTH WILL CONTINUE TO COLLABORATE WITH COMMUNITY PARTNERS ADDRESSING MATERNAL/CHILD HEALTH AND SUBSTANCE USE AND WILL PROVIDE REFERRALS, EDUCATION, PROGRAMMING AND SUPPORT WHERE APPROPRIATE, BUT WILL NOT DIRECTLY PRIORITIZE STRATEGIES OR ALLOCATE MAJOR RESOURCES IN THESE AREAS FOR THE PURPOSE OF THIS COMMUNITY HEALTH IMPROVEMENT STRATEGY. FACILITY REPORTING GROUP - A PART V, SECTION B, LINE 13H: THE PATIENT MUST HAVE A MINIMUM ACCOUNT BALANCE OF TEN DOLLARS ($10.00) WITH THE COMMONSPIRIT HOSPITAL ORGANIZATION. MULTIPLE ACCOUNT BALANCES MAY BE COMBINED TO REACH THIS AMOUNT. PATIENTS/GUARANTORS WITH BALANCES BELOW TEN DOLLARS ($10.00) MAY CONTACT A FINANCIAL COUNSELOR TO MAKE MONTHLY INSTALLMENT PAYMENT ARRANGEMENTS. THE PATIENT MUST SUBMIT A COMPLETED FINANCIAL ASSISTANCE APPLICATION. IN ACCORDANCE WITH ORS 442.614, A PATIENT WHO QUALIFIES FOR FINANCIAL ASSISTANCE WILL RECEIVE FREE OR DISCOUNTED EMCARE. A PATIENT IS NOT REQUIRED TO APPLY FOR MEDICAL ASSISTANCE, AS DEFINED IN ORS 414.025, BEFORE BEING SCREENED FOR OR PROVIDED FINANCIAL ASSISTANCE.HOSPITAL FACILITIES SHALL SCREEN A PATIENT FOR PRESUMPTIVE FINANCIAL ASSISTANCE IF THE PATIENT:* IS UNINSURED;* IS ENROLLED IN THE STATE MEDICAL ASSISTANCE PROGRAM; OR* OWES THE HOSPITAL $500 OR MORE AFTER ALL ADJUSTMENTS FROM INSURANCE OR THIRD-PARTY PAYERS, IF APPLICABLE, HAVE BEEN MADE.BEFORE BILLING THE PATIENT, THE HOSPITAL FACILITY SHALL SCREEN THE PATIENT FOR PRESUMPTIVE FINANCIAL ASSISTANCE AND APPLY ANY ASSISTANCE FOR WHICH THE PATIENT QUALIFIES. A HOSPITAL FACILITY SHALL NOTIFY THE PATIENT THAT THEY WERE SCREENED FOR PRESUMPTIVE FINANCIAL ASSISTANCE AND PROVIDE THE PATIENT WITH INFORMATION ON HOW TO APPLY FOR FINANCIAL ASSISTANCE IF THE PATIENT WAS DENIED, OR HOW TO APPLY FOR ADDITIONAL FINANCIAL ASSISTANCE ABOVE WHAT THE PATIENT MAY HAVE BEEN PREVIOUSLY AWARDED. A HOSPITAL FACILITY MAY USE THE THIRD-PARTY SERVICES OF CONIFER, WAYSTAR, OR EXPERIAN, TO SCREEN AND APPROXIMATE A PATIENT'S HOUSEHOLD INCOME AND HOUSEHOLD SIZE ACCORDING TO THE ELIGIBILITY CRITERIA SET FORTH IN THIS ADDENDUM. THE SCREENING PROCESS WILL NOT CAUSE ANY NEGATIVE IMPACT ON THE PATIENT'S CREDIT SCORE. PATIENTS WILL NOT BE REQUIRED TO PROVIDE ANY SEPARATE SUPPORTING DOCUMENTATION AS PART OF THE SCREENING FOR PRESUMPTIVE FINANCIAL ASSISTANCE, BUT A PATIENT MAY PROVIDE SUCH DOCUMENTATION VOLUNTARILY. IF THE SCREENING PROCESS FAILS TO RETURN INFORMATION ABOUT THE PATIENT, OR SPECIFIES THAT THE PATIENT'S INCOME IS UNKNOWN, THE HOSPITAL FACILITY WILL MAKE A GOOD FAITH EFFORT TO DETERMINE THE PATIENT'S PRESUMPTIVE ELIGIBILITY STATUS BASED ON OTHER INFORMATION AVAILABLE. A HOSPITAL FACILITY WILL DOCUMENT THE METHODS UTILIZED TO CONDUCT THE PRESUMPTIVE ELIGIBILITY SCREENINGPATIENT COOPERATION STANDARDS - A PATIENT MUST COOPERATE WITH THE HOSPITAL FACILITY IN PROVIDING THE INFORMATION AND DOCUMENTATION NECESSARY TO DETERMINE ELIGIBILITY. SUCH COOPERATION INCLUDES COMPLETING ANY REQUIRED APPLICATIONS OR FORMS. THE PATIENT IS RESPONSIBLE FOR NOTIFYING THE HOSPITAL FACILITY OF ANY CHANGE IN FINANCIAL SITUATION THAT WOULD IMPACT THE ASSESSMENT OF ELIGIBILITY. A PATIENT MUST EXHAUST ALL OTHER PAYMENT OPTIONS, INCLUDING PRIVATE COVERAGE, FEDERAL, STATE AND LOCAL MEDICAL ASSISTANCE PROGRAMS, AND OTHER FORMS OF ASSISTANCE PROVIDED BY THIRD PARTIES PRIOR TO BEING APPROVED. AN APPLICANT FOR FINANCIAL ASSISTANCE IS RESPONSIBLE FOR APPLYING TO PUBLIC PROGRAMS FOR AVAILABLE COVERAGE. HE OR SHE IS ALSO EXPECTED TO PURSUE PUBLIC OR PRIVATE HEALTH INSURANCE PAYMENT OPTIONS FOR CARE PROVIDED BY A COMMONSPIRIT HOSPITAL ORGANIZATION WITHIN A HOSPITAL FACILITY. A PATIENT'S AND, IF APPLICABLE, ANY GUARANTOR'S COOPERATION IN APPLYING FOR APPLICABLE PROGRAMS AND IDENTIFIABLE FUNDING SOURCES, INCLUDING COBRA COVERAGE (A FEDERAL LAW ALLOWING FOR A TIME-LIMITED EXTENSION OF EMPLOYEE HEALTHCARE BENEFITS), SHALL BE REQUIRED. IF A HOSPITAL FACILITY DETERMINES THAT COBRA COVERAGE IS POTENTIALLY AVAILABLE, AND THAT A PATIENT IS NOT A MEDICARE OR MEDICAID BENEFICIARY, THE PATIENT OR GUARANTOR SHALL PROVIDE THE HOSPITAL FACILITY WITH INFORMATION NECESSARY TO DETERMINE THE MONTHLY COBRA PREMIUM FOR SUCH PATIENT, AND SHALL COOPERATE WITH HOSPITAL FACILITY STAFF TO DETERMINE WHETHER HE OR SHE QUALIFIES FOR HOSPITAL FACILITY COBRA PREMIUM ASSISTANCE, WHICH MAY BE OFFERED FOR A LIMITED TIME TO ASSIST IN SECURING INSURANCE COVERAGE. A HOSPITAL FACILITY SHALL MAKE AFFIRMATIVE EFFORTS TO HELP A PATIENT OR PATIENT'S GUARANTOR APPLY FOR PUBLIC AND PRIVATE PROGRAMS. PURSUANT TO THE TERMS OF THE FINANCIAL ASSISTANCE POLICY, UNLESS ELIGIBLE FOR PRESUMPTIVE FINANCIAL ASSISTANCE, CERTAIN ELIGIBILITY CRITERIA MUST BE MET IN ORDER FOR A PATIENT TO QUALIFY FOR FINANCIAL ASSISTANCE. THIS ADDENDUM UPDATES SUCH ELIGIBILITY CRITERIA WITH THE FOLLOWING: * THE PATIENT'S FAMILY INCOME MUST BE AT OR BELOW 400% OF THE FPL.* ANY PATIENT WHOSE FAMILY INCOME IS AT OR BELOW 200% OF THE FPL SHALL RECEIVE FREE CARE.* ANY PATIENT WHOSE FAMILY INCOME IS BETWEEN 201% TO 300% OF THE FPL SHALL RECEIVE DISCOUNTED CARE UP TO 75% FROM HIS OR HER ACCOUNT BALANCE FOR EMCARE PROVIDED TO THE PATIENT AFTER PAYMENT, IF ANY, BY ANY THIRD-PARTY(IES).* ANY PATIENT WHOSE FAMILY INCOME IS BETWEEN 301% TO 350% OF THE FPL SHALL RECEIVE DISCOUNTED CARE UP TO THE GREATER OF 50% OR THE HOSPITAL FACILITY'S AGB FROM THEIR ACCOUNT BALANCE FOR EMCARE PROVIDED TO THE PATIENT AFTER PAYMENT, IF ANY, BY ANY THIRD-PARTY(IES).* ANY PATIENT WHOSE FAMILY INCOME IS BETWEEN 351% TO 400% OF THE FPL SHALL RECEIVE DISCOUNTED CARE UP TO THE GREATER OF 25% OR THE HOSPITAL FACILITY'S AGB FROM THEIR ACCOUNT BALANCE FOR EMCARE PROVIDED TO THE PATIENT AFTER PAYMENT, IF ANY, BY ANY THIRD-PARTY(IES). PART V, SECTION B FACILITY REPORTING GROUP B FACILITY REPORTING GROUP B CONSISTS OF: - FACILITY 2: ST. ANTHONY HOSPITAL FACILITY REPORTING GROUP - B PART V, SECTION B, LINE 2: ON MAY 1ST, 2025 ALL THE ASSETS AND OPERATIONS OF ST. ANTHONY HOSPITAL (93-0391614), A RELATED 501(C)(3) ORGANIZATION, WERE MERGED INTO COMMONSPIRIT OREGON. FACILITY REPORTING GROUP - B PART V, SECTION B, LINE 5: THE COMMUNITY HEALTH NEEDS ASSESSMENT UTILIZED A MULTI-FACETED APPROACH TO GATHER COMMUNITY INPUT. PRIMARY RESEARCH WAS CONDUCTED VIA A COMPREHENSIVE PRC COMMUNITY HEALTH SURVEY. THIS INVOLVED A RANDOM SAMPLE OF 201 COMMUNITY RESIDENTS AGED 18 AND OLDER, CONDUCTED VIA TELEPHONE SURVEY. DATA WERE DATA WEIGHTED IN PROPORTION TO THE ACTUAL POPULATION DISTRIBUTION SO AS TO ACCURATELY REPRESENT THE TOTAL SERVICE AREA AS A WHOLE. COMPLEMENTING THIS, AN ONLINE KEY INFORMANT SURVEY CONSULTED 54 KEY COMMUNITY STAKEHOLDERS, INCLUDING PHYSICIANS, PUBLIC HEALTH AND OTHER HEALTH PROVIDERS, SOCIAL SERVICE PROVIDERS, AND COMMUNITY LEADERS, SPECIFICALLY FOCUSING ON GATHERING INSIGHTS INTO THE HEALTH NEEDS OF LOW-INCOME, MINORITY, AND MEDICALLY UNDERSERVED POPULATIONS. PARTICIPATING ORGANIZATIONS INCLUDED: ADVANTAGE DENTAL, CAPECO, CASON'S PLACE, CREATING CONQUERORS, DESIRE FOR HEALING, DOULAS LATINAS INTERNATIONAL, EUVALCREE, GREATER OREGON BEHAVIORAL HEALTH INC, HELIX SCHOOL DISTRICT, HERMISTON SCHOOL DISTRICT, HORIZON PROJECT, INC., INTERMOUNTAIN EDUCATIONAL SERVICE DISTRICT, MILTON FREEWATER SCHOOL DISTRICT, MODA HEALTH, OREGON CHILD DEVELOPMENT COALITION, OREGON DEPARTMENT OF HUMAN SERVICES, OREGON STATE POLICE, OREGON WASHINGTON HEALTH NETWORK, PENDLETON SCHOOL DISTRICT, PIONEER RELIEF NURSERY, ST. ANTHONY HOSPITAL, UMATILLA COUNTY, UMATILLA COUNTY DEVELOPMENTAL DISABILITIES PROGRAM, UMATILLA COUNTY PUBLIC HEALTH, UMATILLA MORROW COUNTY HEAD START, WIC, YAKIMA VALLEY FARM WORKERS CLINIC AND YELLOWHAWK TRIBAL HEALTH CENTER. FACILITY REPORTING GROUP - B PART V, SECTION B, LINE 7D: THE CHNA REPORT WAS PRESENTED IN A PUBLIC ONLINE SESSION IN THE SPRING OF 2025. ALL INTERESTED PARTIES WERE INVITED TO ATTEND. THIS SESSION WAS ALSO RECORDED, AND THE RECORDING IS AVAILABLE ON ST. ANTHONY HOSPITAL'S WEBSITE AS WELL AS YOUTUBE.THE CHNA REPORT WAS ALSO SHARED WITH ORGANIZATIONS APPLYING FOR THE COMMONSPIRIT COMMUNITY HEALTH IMPROVEMENT GRANT PROGRAM. FACILITY REPORTING GROUP - B PART V, SECTION B, LINE 11: THE HOSPITAL INTENDS TO ADDRESS EACH OF THE IDENTIFIED SIGNIFICANT NEEDS TO SOME EXTENT. THESE NEEDS AND PROGRAMS ARE AS FOLLOWS:1. BEHAVIORAL HEALTH- PROGRAM ACTIVITIES:* SUICIDE PREVENTION:- SUMMARY: PARTNER WITH COMMUNITY COUNSELING SOLUTIONS TO PROVIDE MENTAL HEALTH FIRST AID (MHFA) AND APPLIED SUICIDE INTERVENTION SKILLS TRAINING (ASIST) FOR THE COMMUNITY. PROVIDE SUPPORT FOR THE CREATING CONQUERORS SUICIDE AND SUBSTANCE USE PREVENTION PROGRAM.- KEY METRICS (ANTICIPATED IMPACTS): NUMBER OF COMMUNITY MEMBERS TRAINED IN MHFA AND ASIST; REFERRALS TO EASTERN OREGON PERINATAL LOSS COLLABORATIVE (FOR PERINATAL LOSS SUPPORT PROGRAMS).- COLLABORATING ORGANIZATIONS: COMMUNITY COUNSELING SOLUTIONS, CREATING CONQUERORS, EASTERN OREGON PERINATAL LOSS COLLABORATIVE.* COMMUNITY OUTREACH:- SUMMARY: PROVIDE COMMUNITY-BASED OUTREACH SERVICES WITH HEALTH AND WELLNESS EDUCATION.- KEY METRICS (ANTICIPATED IMPACTS): NUMBER OF PARTICIPANTS IN COMMUNITY-BASED OUTREACH HEALTH AND WELLNESS EDUCATION EVENTS.- COLLABORATING ORGANIZATIONS: INTERNAL WITH EXTERNAL REACH* PERINATAL LOSS SUPPORT:- SUMMARY: PROVIDE MENTAL HEALTH ASSISTANCE/RESOURCES FOR FAMILIES EXPERIENCING PERINATAL LOSS.- KEY METRICS (ANTICIPATED IMPACTS): NUMBER OF PEOPLE ACCESSING MENTAL HEALTH ASSISTANCE AND RESOURCES FOR PERINATAL LOSS.- COLLABORATING ORGANIZATIONS: EASTERN OREGON PERINATAL LOSS COLLABORATIVE.2. CANCER- PROGRAM ACTIVITIES:* CANCER TREATMENT:- SUMMARY: PROVIDE CONSULTATION AND TREATMENT IN THE HOSPITAL'S MEDICAL ONCOLOGY CENTER.- KEY METRICS (ANTICIPATED IMPACTS): NUMBER OF PATIENTS SEEN AT ST. ANTHONY HOSPITAL ONCOLOGY CLINIC.- COLLABORATING ORGANIZATIONS: INTERNAL PROGRAM* CANCER SCREENINGS:- SUMMARY: INCREASE VISIBILITY OF RECOMMENDED CANCER SCREENINGS THROUGH MARKETING CAMPAIGNS, WITH EMPHASIS ON COLORECTAL CANCER SCREENING, REPRODUCTIVE CANCER SCREENING, AND BREAST CANCER SCREENING.- KEY METRICS (ANTICIPATED IMPACTS): PERCENTAGE INCREASE IN CANCER SCREENING RATES AMONG ELIGIBLE POPULATIONS.- COLLABORATING ORGANIZATIONS: MARKETING TEAM, PUBLIC HEALTH DEPARTMENT.* PROVIDER RECRUITMENT:- SUMMARY: RECRUIT PROVIDERS TO CARE FOR PATIENTS WITH CANCER DIAGNOSES AND TO PROVIDE WOMEN'S AND PRIMARY CARE TO INCREASE CANCER SCREENINGS.- KEY METRICS (ANTICIPATED IMPACTS): NUMBER OF PRIMARY CARE PROVIDERS AT ST. ANTHONY HOSPITAL.- COLLABORATING ORGANIZATIONS: RECRUITING TEAM.3. TOBACCO USE- PROGRAM ACTIVITIES:* SMOKING CESSATION PROGRAM:- SUMMARY: BOOST EFFORTS TO PROVIDE A ROBUST AND COMPREHENSIVE SMOKING CESSATION PROGRAM TO SUPPORT COMMUNITY MEMBERS IN QUITTING TOBACCO USE.- KEY METRICS (ANTICIPATED IMPACTS): PERCENTAGE OF PARTICIPANTS SUCCESSFULLY COMPLETING THE PROGRAM; PERCENTAGE OF PROGRAM COMPLETERS REPORTING SUSTAINED ABSTINENCE AT 3 AND 6 MONTHS.- COLLABORATING ORGANIZATIONS: UMATILLA COUNTY PUBLIC HEALTH, COMMUNITY OUTREACH PARTNERS.* COMMUNITY EDUCATION:- SUMMARY: PROVIDE EDUCATION TO COMMUNITY MEMBERS ABOUT THE HARMS OF TOBACCO AND VAPING AND AVAILABLE QUIT RESOURCES.- KEY METRICS (ANTICIPATED IMPACTS): INCREASE IN COMMUNITY KNOWLEDGE REGARDING THE HARMS OF TOBACCO/VAPING AND CESSATION RESOURCES.- COLLABORATING ORGANIZATIONS: UMATILLA COUNTY PUBLIC HEALTH, COMMUNITY OUTREACH PARTNERS.4. NUTRITION, PHYSICAL ACTIVITY, & WEIGHT- PROGRAM ACTIVITIES:* NUTRITIONAL COUNSELING:- SUMMARY: PROVIDE 1:1 NUTRITION COUNSELING BY REGISTERED DIETITIANS FOR PATIENTS WITH OBESITY AND OTHER HEALTH CONDITIONS.- KEY METRICS (ANTICIPATED IMPACTS): NUMBER OF PATIENTS RECEIVING 1:1 NUTRITIONAL COUNSELING; SELF-REPORTED INCREASE IN HEALTHY EATING HABITS AMONG COUNSELING PARTICIPANTS.- COLLABORATING ORGANIZATIONS: UNSPECIFIED (INTERNAL PROGRAM).* LIFESTEPS PROGRAM:- SUMMARY: OFFER A WEIGHT MANAGEMENT PROGRAM AT LEAST ANNUALLY FOR ADULTS.- KEY METRICS (ANTICIPATED IMPACTS): NUMBER OF ADULTS PARTICIPATING IN THE LIFESTEPS WEIGHT MANAGEMENT PROGRAM; AVERAGE WEIGHT LOSS/BMI REDUCTION AMONG LIFESTEPS PARTICIPANTS.- COLLABORATING ORGANIZATIONS: UNSPECIFIED (INTERNAL PROGRAM).* SUPPORT OF FARMERS' MARKET:- SUMMARY: PROVIDE FINANCIAL SUPPORT FOR THE PENDLETON FARMERS' MARKET, WHICH OPERATES WEEKLY FROM LATE SPRING TO EARLY FALL.- KEY METRICS (ANTICIPATED IMPACTS): INCREASED UTILIZATION OF THE PENDLETON FARMERS' MARKET.- COLLABORATING ORGANIZATIONS: OSU EXTENSION SERVICE, PENDLETON FARMERS' MARKET.* COMMUNITY EXERCISE SUPPORT:- SUMMARY: PROVIDE FINANCIAL AND OTHER SUPPORT TO COMMUNITY EXERCISE PROGRAMS, INCLUDING THOSE TARGETED FOR SENIORS.- KEY METRICS (ANTICIPATED IMPACTS): NUMBER OF COMMUNITY MEMBERS PARTICIPATING IN SUPPORTED EXERCISE PROGRAMS.- COLLABORATING ORGANIZATIONS: OSU EXTENSION SERVICES.5. DIABETES- PROGRAM ACTIVITIES (YEAR ENDING JUNE 30, 2025 - AS PER NEW IMPLEMENTATION STRATEGY):* DIABETIC EDUCATION PROGRAM:- SUMMARY: PROVIDE 1:1 COUNSELING TO DIABETIC AND PRE-DIABETIC PATIENTS REFERRED BY THEIR PROVIDERS.- KEY METRICS (ANTICIPATED IMPACTS): AVERAGE REDUCTION IN HBA1C LEVELS FOR PARTICIPATING DIABETIC PATIENTS; INCREASE IN SELF-REPORTED ADHERENCE TO DIABETES MANAGEMENT PLANS (DIET, EXERCISE, MEDICATION).- COLLABORATING ORGANIZATIONS: INTERNAL PROGRAM* COMMUNITY OUTREACH:- SUMMARY: PROVIDE INFORMATION ON HEALTHY EATING AND DIABETES MANAGEMENT AT COMMUNITY EVENTS.- KEY METRICS (ANTICIPATED IMPACTS): NUMBER OF COMMUNITY MEMBERS ATTENDING DIABETES EDUCATION EVENTS; INCREASE IN COMMUNITY KNOWLEDGE ABOUT DIABETES RISK FACTORS, PREVENTION STRATEGIES, AND HEALTHY EATING FOR DIABETES.- COLLABORATING ORGANIZATIONS: INTERNAL PROGRAM FACILITY REPORTING GROUP - B PART V, SECTION B, LINE 13H: THE PATIENT MUST HAVE A MINIMUM ACCOUNT BALANCE OF TEN DOLLARS ($10.00) WITH THE COMMONSPIRIT HOSPITAL ORGANIZATION. MULTIPLE ACCOUNT BALANCES MAY BE COMBINED TO REACH THIS AMOUNT. PATIENTS/GUARANTORS WITH BALANCES BELOW TEN DOLLARS ($10.00) MAY CONTACT A FINANCIAL COUNSELOR TO MAKE MONTHLY INSTALLMENT PAYMENT ARRANGEMENTS. THE PATIENT MUST SUBMIT A COMPLETED FINANCIAL ASSISTANCE APPLICATION. IN ACCORDANCE WITH ORS 442.614, A PATIENT WHO QUALIFIES FOR FINANCIAL ASSISTANCE WILL RECEIVE FREE OR DISCOUNTED EMCARE. A PATIENT IS NOT REQUIRED TO APPLY FOR MEDICAL ASSISTANCE, AS DEFINED IN ORS 414.025, BEFORE BEING SCREENED FOR OR PROVIDED FINANCIAL ASSISTANCE.HOSPITAL FACILITIES SHALL SCREEN A PATIENT FOR PRESUMPTIVE FINANCIAL ASSISTANCE IF THE PATIENT:* IS UNINSURED;* IS ENROLLED IN THE STATE MEDICAL ASSISTANCE PROGRAM; OR* OWES THE HOSPITAL $500 OR MORE AFTER ALL ADJUSTMENTS FROM INSURANCE OR THIRD-PARTY PAYERS, IF APPLICABLE, HAVE BEEN MADE.BEFORE BILLING THE PATIENT, THE HOSPITAL FACILITY SHALL SCREEN THE PATIENT FOR PRESUMPTIVE FINANCIAL ASSISTANCE AND APPLY ANY ASSISTANCE FOR WHICH THE PATIENT QUALIFIES. A HOSPITAL FACILITY SHALL NOTIFY THE PATIENT THAT THEY WERE SCREENED FOR PRESUMPTIVE FINANCIAL ASSISTANCE AND PROVIDE THE PATIENT WITH INFORMATION ON HOW TO APPLY FOR FINANCIAL ASSISTANCE IF THE PATIENT WAS DENIED, OR HOW TO APPLY FOR ADDITIONAL FINANCIAL ASSISTANCE ABOVE WHAT THE PATIENT MAY HAVE BEEN PREVIOUSLY AWARDED. A HOSPITAL FACILITY MAY USE THE THIRD-PARTY SERVICES OF CONIFER, WAYSTAR, OR EXPERIAN, TO SCREEN AND APPROXIMATE A PATIENT'S HOUSEHOLD INCOME AND HOUSEHOLD SIZE ACCORDING TO THE ELIGIBILITY CRITERIA SET FORTH IN THIS ADDENDUM. THE SCREENING PROCESS WILL NOT CAUSE ANY NEGATIVE IMPACT ON THE PATIENT'S CREDIT SCORE. PATIENTS WILL NOT BE REQUIRED TO PROVIDE ANY SEPARATE SUPPORTING DOCUMENTATION AS PART OF THE SCREENING FOR PRESUMPTIVE FINANCIAL ASSISTANCE, BUT A PATIENT MAY PROVIDE SUCH DOCUMENTATION VOLUNTARILY. IF THE SCREENING PROCESS FAILS TO RETURN INFORMATION ABOUT THE PATIENT, OR SPECIFIES THAT THE PATIENT'S INCOME IS UNKNOWN, THE HOSPITAL FACILITY WILL MAKE A GOOD FAITH EFFORT TO DETERMINE THE PATIENT'S PRESUMPTIVE ELIGIBILITY STATUS BASED ON OTHER INFORMATION AVAILABLE. A HOSPITAL FACILITY WILL DOCUMENT THE METHODS UTILIZED TO CONDUCT THE PRESUMPTIVE ELIGIBILITY SCREENINGPATIENT COOPERATION STANDARDS - A PATIENT MUST COOPERATE WITH THE HOSPITAL FACILITY IN PROVIDING THE INFORMATION AND DOCUMENTATION NECESSARY TO DETERMINE ELIGIBILITY. SUCH COOPERATION INCLUDES COMPLETING ANY REQUIRED APPLICATIONS OR FORMS. THE PATIENT IS RESPONSIBLE FOR NOTIFYING THE HOSPITAL FACILITY OF ANY CHANGE IN FINANCIAL SITUATION THAT WOULD IMPACT THE ASSESSMENT OF ELIGIBILITY. A PATIENT MUST EXHAUST ALL OTHER PAYMENT OPTIONS, INCLUDING PRIVATE COVERAGE, FEDERAL, STATE AND LOCAL MEDICAL ASSISTANCE PROGRAMS, AND OTHER FORMS OF ASSISTANCE PROVIDED BY THIRD PARTIES PRIOR TO BEING APPROVED. AN APPLICANT FOR FINANCIAL ASSISTANCE IS RESPONSIBLE FOR APPLYING TO PUBLIC PROGRAMS FOR AVAILABLE COVERAGE. HE OR SHE IS ALSO EXPECTED TO PURSUE PUBLIC OR PRIVATE HEALTH INSURANCE PAYMENT OPTIONS FOR CARE PROVIDED BY A COMMONSPIRIT HOSPITAL ORGANIZATION WITHIN A HOSPITAL FACILITY. A PATIENT'S AND, IF APPLICABLE, ANY GUARANTOR'S COOPERATION IN APPLYING FOR APPLICABLE PROGRAMS AND IDENTIFIABLE FUNDING SOURCES, INCLUDING COBRA COVERAGE (A FEDERAL LAW ALLOWING FOR A TIME-LIMITED EXTENSION OF EMPLOYEE HEALTHCARE BENEFITS), SHALL BE REQUIRED. IF A HOSPITAL FACILITY DETERMINES THAT COBRA COVERAGE IS POTENTIALLY AVAILABLE, AND THAT A PATIENT IS NOT A MEDICARE OR MEDICAID BENEFICIARY, THE PATIENT OR GUARANTOR SHALL PROVIDE THE HOSPITAL FACILITY WITH INFORMATION NECESSARY TO DETERMINE THE MONTHLY COBRA PREMIUM FOR SUCH PATIENT, AND SHALL COOPERATE WITH HOSPITAL FACILITY STAFF TO DETERMINE WHETHER HE OR SHE QUALIFIES FOR HOSPITAL FACILITY COBRA PREMIUM ASSISTANCE, WHICH MAY BE OFFERED FOR A LIMITED TIME TO ASSIST IN SECURING INSURANCE COVERAGE. A HOSPITAL FACILITY SHALL MAKE AFFIRMATIVE EFFORTS TO HELP A PATIENT OR PATIENT'S GUARANTOR APPLY FOR PUBLIC AND PRIVATE PROGRAMS. PURSUANT TO THE TERMS OF THE FINANCIAL ASSISTANCE POLICY, UNLESS ELIGIBLE FOR PRESUMPTIVE FINANCIAL ASSISTANCE, CERTAIN ELIGIBILITY CRITERIA MUST BE MET IN ORDER FOR A PATIENT TO QUALIFY FOR FINANCIAL ASSISTANCE. THIS ADDENDUM UPDATES SUCH ELIGIBILITY CRITERIA WITH THE FOLLOWING: * THE PATIENT'S FAMILY INCOME MUST BE AT OR BELOW 400% OF THE FPL.* ANY PATIENT WHOSE FAMILY INCOME IS AT OR BELOW 200% OF THE FPL SHALL RECEIVE FREE CARE.* ANY PATIENT WHOSE FAMILY INCOME IS BETWEEN 201% TO 300% OF THE FPL SHALL RECEIVE DISCOUNTED CARE UP TO 75% FROM HIS OR HER ACCOUNT BALANCE FOR EMCARE PROVIDED TO THE PATIENT AFTER PAYMENT, IF ANY, BY ANY THIRD-PARTY(IES).* ANY PATIENT WHOSE FAMILY INCOME IS BETWEEN 301% TO 350% OF THE FPL SHALL RECEIVE DISCOUNTED CARE UP TO THE GREATER OF 50% OR THE HOSPITAL FACILITY'S AGB FROM THEIR ACCOUNT BALANCE FOR EMCARE PROVIDED TO THE PATIENT AFTER PAYMENT, IF ANY, BY ANY THIRD-PARTY(IES).* ANY PATIENT WHOSE FAMILY INCOME IS BETWEEN 351% TO 400% OF THE FPL SHALL RECEIVE DISCOUNTED CARE UP TO THE GREATER OF 25% OR THE HOSPITAL FACILITY'S AGB FROM THEIR ACCOUNT BALANCE FOR EMCARE PROVIDED TO THE PATIENT AFTER PAYMENT, IF ANY, BY ANY THIRD-PARTY(IES). 13 1 - MERCY INSTITUTE OF REHABILITATION 2400 NW STEWART PARKWAY ROSEBURG OR 97471 OUTPATIENT THERAPY SERVICES 2 - MMC - CCC LAB DRAW SITE 2880 NW STEWART PARKWAY ROSEBURG OR 97471 OUTPATIENT LABORATORY DRAWING CENTER 3 - MMC - MYRTLE CREEK DRAW SITE 861 OLD HWY MYRTLE CREEK OR 97457 OUTPATIENT LABORATORY DRAWING CENTER 4 - MERCY OUTPATIENT LABORATORY 2480 STEWART PARKWAY ROSEBURG OR 97471 OUTPATIENT LABORATORY DRAWING CENTER 5 - HOME HEALTH & HOSPICE 2400 NW STEWART PARKWAY 200 ROSEBURG OR 97471 HOME CARE 6 - MERCY OUTPATIENT IMAGING 1813 W HARVARD AVE SUITE 411 ROSEBURG OR 97471 OUTPATIENT IMAGING SERVICES 7 - MERCY UMPQUA ORTHOPEDIC RADIOLOGY 277 MEDICAL LOOP ROSEBURG OR 97471 OUTPATIENT IMAGING SERVICES 8 - MERCY SLEEP LAB 2400 STEWART PARKWAY SUITE 300 ROSEBURG OR 97471 SLEEP TESTING SERVICES 9 - MMC OUTPATIENT IMAGING & LAB DRAW SITE 2570 NW EDENBOWER ROSEBURG OR 97471 OUTPATIENT IMAGING SERVICES AND OUTPATIENT LAB DRAW SITE 10 - ST ANTHONY FAMILY CARE CLINIC 3001 ST ANTHONY WAY PENDLETON OR 97801 RURAL HEALTH CLINIC 11 - ST ANTHONY WOMEN'S CLINIC 3001 ST ANTHONY WAY PENDLETON OR 97801 CLINIC FOR PREGNANCY/OBGYN ISSUES 12 - ST ANTHONY ORTHOPEDIC CLINIC 3001 ST ANTHONY WAY PENDLETON OR 97801 ORTHO PHYSICIAN CLINIC 13 - ST ANTHONY OUTPATIENT PHYSICAL THERAPY 1425 SOUTHGATE PENDLETON OR 97801 CLINIC FOR PHYSICAL, OCCUPATIONAL AND SPEECH OUTPATIENT THERAPY PART I, LINE 3C: UNLESS ELIGIBLE FOR PRESUMPTIVE FINANCIAL ASSISTANCE, THE FOLLOWING ELIGIBILITY CRITERIA MUST BE MET IN ORDER FOR A PATIENT TO QUALIFY FOR FINANCIAL ASSISTANCE:* THE PATIENT MUST HAVE A MINIMUM ACCOUNT BALANCE OF TEN DOLLARS ($10.00) WITH THE COMMONSPIRIT HOSPITAL ORGANIZATION. MULTIPLE ACCOUNT BALANCES MAY BE COMBINED TO REACH THIS AMOUNT. PATIENTS/GUARANTORS WITH BALANCES BELOW TEN DOLLARS ($10.00) MAY CONTACT A FINANCIAL COUNSELOR TO MAKE MONTHLY INSTALLMENT PAYMENT ARRANGEMENTS. * COMPLETED A FINANCIAL ASSISTANCE APPLICATION AND PROVIDED SUPPORTING DOCUMENTATION TO VERIFY INCOME. IN SOME CASES, PATIENTS MAY BE AWARDED FINANCIAL ASSISTANCE WITHOUT A FORMAL APPLICATION. DETAILS ARE OUTLINED IN THE FINANCIAL ASSISTANCE POLICY AND FINANCIAL ASSISTANCE POLICY ADDENDUM-OREGON.* THE PATIENT MUST COMPLY WITH PATIENT COOPERATION STANDARDS AS DESCRIBED [IN THE FAP]. A PATIENT IS NOT REQUIRED TO APPLY FOR MEDICAL ASSISTANCE, AS DEFINED IN ORS 414.025, BEFORE BEING SCREENED FOR OR PROVIDED FINANCIAL ASSISTANCE. * THE PATIENT'S FAMILY INCOME MUST BE AT OR BELOW 400% OF THE FPG.PURSUANT TO THE TERMS OF THE FINANCIAL ASSISTANCE POLICY, UNLESS ELIGIBLE FOR PRESUMPTIVE FINANCIAL ASSISTANCE, CERTAIN ELIGIBILITY CRITERIA MUST BE MET IN ORDER FOR A PATIENT TO QUALIFY FOR FINANCIAL ASSISTANCE. THIS ADDENDUM UPDATES SUCH ELIGIBILITY CRITERIA WITH THE FOLLOWING:* THE PATIENT'S FAMILY INCOME MUST BE AT OR BELOW 400% OF THE FPL.* ANY PATIENT WHOSE FAMILY INCOME IS AT OR BELOW 200% OF THE FPL SHALL RECEIVE FREE CARE.* ANY PATIENT WHOSE FAMILY INCOME IS BETWEEN 201% TO 300% OF THE FPL SHALL RECEIVE DISCOUNTED CARE UP TO 75% FROM HIS OR HER ACCOUNT BALANCE FOR EMCARE PROVIDED TO THE PATIENT AFTER PAYMENT, IF ANY, BY ANY THIRD-PARTY(IES).* ANY PATIENT WHOSE FAMILY INCOME IS BETWEEN 301% TO 350% OF THE FPL SHALL RECEIVE DISCOUNTED CARE UP TO THE GREATER OF 50% OR THE HOSPITAL FACILITY'S AGB FROM THEIR ACCOUNT BALANCE FOR EMCARE PROVIDED TO THE PATIENT AFTER PAYMENT, IF ANY, BY ANY THIRD-PARTY(IES).* ANY PATIENT WHOSE FAMILY INCOME IS BETWEEN 351% TO 400% OF THE FPL SHALL RECEIVE DISCOUNTED CARE UP TO THE GREATER OF 25% OR THE HOSPITAL FACILITY'S AGB FROM THEIR ACCOUNT BALANCE FOR EMCARE PROVIDED TO THE PATIENT AFTER PAYMENT, IF ANY, BY ANY THIRD-PARTY(IES). IN ACCORDANCE WITH ORS 442.614, A PATIENT WHO QUALIFIES FOR FINANCIAL ASSISTANCE WILL RECEIVE FREE OR DISCOUNTED EMCARE. A PATIENT IS NOT REQUIRED TO APPLY FOR MEDICAL ASSISTANCE, AS DEFINED IN ORS 414.025, BEFORE BEING SCREENED FOR OR PROVIDED FINANCIAL ASSISTANCE. HOSPITAL FACILITIES SHALL SCREEN A PATIENT FOR PRESUMPTIVE FINANCIAL ASSISTANCE IF THE PATIENT:* IS UNINSURED;* IS ENROLLED IN THE STATE MEDICAL ASSISTANCE PROGRAM; OR* OWES THE HOSPITAL $500 OR MORE AFTER ALL ADJUSTMENTS FROM INSURANCE OR THIRD-PARTY PAYERS, IF APPLICABLE, HAVE BEEN MADE.BEFORE BILLING THE PATIENT, THE HOSPITAL FACILITY SHALL SCREEN THE PATIENT FOR PRESUMPTIVE FINANCIAL ASSISTANCE AND APPLY ANY ASSISTANCE FOR WHICH THE PATIENT QUALIFIES. A HOSPITAL FACILITY SHALL NOTIFY THE PATIENT THAT THEY WERE SCREENED FOR PRESUMPTIVE FINANCIAL ASSISTANCE AND PROVIDE THE PATIENT WITH INFORMATION ON HOW TO APPLY FOR FINANCIAL ASSISTANCE IF THE PATIENT WAS DENIED, OR HOW TO APPLY FOR ADDITIONAL FINANCIAL ASSISTANCE ABOVE WHAT THE PATIENT MAY HAVE BEEN PREVIOUSLY AWARDED. A HOSPITAL FACILITY MAY USE THE THIRD-PARTY SERVICES OF CONIFER, WAYSTAR, OR EXPERIAN, TO SCREEN AND APPROXIMATE A PATIENT'S HOUSEHOLD INCOME AND HOUSEHOLD SIZE ACCORDING TO THE ELIGIBILITY CRITERIA SET FORTH IN THIS ADDENDUM. THE SCREENING PROCESS WILL NOT CAUSE ANY NEGATIVE IMPACT ON THE PATIENT'S CREDIT SCORE. PATIENTS WILL NOT BE REQUIRED TO PROVIDE ANY SEPARATE SUPPORTING DOCUMENTATION AS PART OF THE SCREENING FOR PRESUMPTIVE FINANCIAL ASSISTANCE, BUT A PATIENT MAY PROVIDE SUCH DOCUMENTATION VOLUNTARILY. IF THE SCREENING PROCESS FAILS TO RETURN INFORMATION ABOUT THE PATIENT, OR SPECIFIES THAT THE PATIENT'S INCOME IS UNKNOWN, THE HOSPITAL FACILITY WILL MAKE A GOOD FAITH EFFORT TO DETERMINE THE PATIENT'S PRESUMPTIVE ELIGIBILITY STATUS BASED ON OTHER INFORMATION AVAILABLE. A HOSPITAL FACILITY WILL DOCUMENT THE METHODS UTILIZED TO CONDUCT THE PRESUMPTIVE ELIGIBILITY SCREENING.COMMONSPIRIT HOSPITAL ORGANIZATIONS RECOGNIZE THAT NOT ALL PATIENTS AND GUARANTORS ARE ABLE TO COMPLETE THE FAA OR PROVIDE REQUISITE DOCUMENTATION. FINANCIAL COUNSELORS ARE AVAILABLE AT EACH HOSPITAL FACILITY LOCATION TO ASSIST ANY INDIVIDUAL SEEKING APPLICATION ASSISTANCE. FOR PATIENTS AND GUARANTORS WHO ARE UNABLE TO PROVIDE REQUIRED DOCUMENTATION, A HOSPITAL FACILITY MAY GRANT PRESUMPTIVE FINANCIAL ASSISTANCE BASED ON INFORMATION OBTAINED FROM OTHER RESOURCES. IN PARTICULAR, PRESUMPTIVE ELIGIBILITY MAY BE DETERMINED ON THE BASIS OF INDIVIDUAL LIFE CIRCUMSTANCES THAT MAY INCLUDE:* RECIPIENT OF STATE-FUNDED PRESCRIPTION PROGRAMS;* HOMELESS OR ONE WHO RECEIVED CARE FROM A HOMELESS OR FREE CARE CLINIC;* PARTICIPATION IN WOMEN, INFANTS AND CHILDREN PROGRAMS (WIC);* FOOD STAMP ELIGIBILITY;* ELIGIBILITY OR REFERRALS FOR OTHER STATE OR LOCAL ASSISTANCE PROGRAMS (E.G., MEDICAID);* LOW INCOME/SUBSIDIZED HOUSING IS PROVIDED AS A VALID ADDRESS; OR* PATIENT IS DECEASED WITH NO KNOWN SPOUSE OR KNOWN ESTATE. PART I, LINE 6A: COMMONSPIRIT OREGON PREPARES ITS OWN ANNUAL WRITTEN COMMUNITY BENEFIT REPORT. ITS COMMUNITY BENEFIT REPORT IS NOT CONTAINED IN THAT OF A RELATED ORGANIZATION. PART I, LINE 7: COMMONSPIRIT HEALTH HOSPITALS USE AN ADJUSTED COST TO CHARGE RATIO (CCR) CALCULATED IN A MANNER CONSISTENT WITH WORKSHEET 2 FOR EACH REPORTING FACILITY, TO DERIVE THE REPORTED COSTS OF FINANCIAL ASSISTANCE, MEDICAID AND OTHER MEANS-TESTED PROGRAMS. WORKSHEET 3 IS USED IN THE COMMUNITY BENEFIT INVENTORY FOR SOCIAL ACCOUNTABILITY (CBISA) SOFTWARE TO CALCULATE MEDICAID AND OTHER MEANS-TESTED PROGRAMS EXPENSE AND REVENUE, INCLUDING WHERE APPLICABLE MEDICAID PROVIDER FEES AND PAYMENTS FROM UNCOMPENSATED CARE PROGRAMS. ACTUAL OR ESTIMATED COST AND ANY DIRECT OFFSETTING REVENUE IS REPORTED, AND SCHEDULE H WORKSHEETS OR THEIR EQUIVALENTS ARE USED, FOR OTHER COMMUNITY BENEFIT ACTIVITIES INCLUDING COMMUNITY HEALTH IMPROVEMENT SERVICES, COMMUNITY BENEFIT OPERATIONS, HEALTH PROFESSIONS EDUCATION, SUBSIDIZED HEALTH SERVICES, RESEARCH, AND CASH AND IN-KIND DONATIONS. PART II, COMMUNITY BUILDING ACTIVITIES: ST. ANTHONY HOSPITAL, PENDLETON:THROUGH COMMUNITY BUILDING ACTIVITIES, ST. ANTHONY HOSPITAL ASSISTS IN PROMOTING THE HEALTH OF THE COMMUNITY BY IMPROVING ACCESS TO SERVICES, SUPPORTING FAMILIES, AND PROVIDING DIRECT PROGRAM SUPPORT.THE HOSPITAL PROVIDES FREE HOUSING FOR NURSING STUDENTS COMPLETING CLINICALS IN OUR COMMUNITY. WE ARE ALSO ABLE TO HOST AMERICAN RED CROSS BLOOD DRIVES, PROVIDING SPACE AND FOOD TO AID IN THEIR EFFORTS AT NO COST TO THE RED CROSS. WE PROVIDE SPACE FOR CANCER SURVIVORS TO MEET AND RECEIVE SUPPORT, A SUPPORT GROUP FOR CAREGIVERS OF PATIENTS WITH DEMENTIA, AND EMERGENCY PLANNING EFFORTS IN OUR COMMUNITY. WE PROVIDE MINISTERIAL FELLOWSHIP TO THOSE IN OUR COMMUNITY. THE HOSPITAL ALSO SPONSORS THE ATHLETIC TRAINER PROVIDED TO PENDLETON HIGH SCHOOL AT NO CHARGE TO WORK WITH STUDENT ATHLETES. DURING THE SUMMER MONTHS, THE HOSPITAL PROVIDES FREE FIRST AID STATIONS AT THREE AREA MUSIC FESTIVALS THAT ARE WIDELY ATTENDED, AS WELL AS MEDICAL STATION SUPPORT FOR UMATILLA COUNTY FAIR.THE HOSPITAL SUPPORTS FAMILIES IN THE COMMUNITY THROUGH ITS SUPPORT OF PIONEER RELIEF NURSERY. SAH PROVIDES SUPPLIES, UTILITIES AND FREE SPACE FOR PIONEER RELIEF NURSERY. THE NURSERY PROVIDES FREE CHILDCARE AND TRAINING TO PARENTS WHO HAVE RISK FACTORS FOR ABUSE AND NEGLECT. ITS GOAL IS TO PREVENT CHILD ABUSE AND NEGLECT IN UMATILLA COUNTY THROUGH INTENSIVE FAMILY SUPPORT. THEY ADDRESS THE CYCLE OF CHILD ABUSE AND NEGLECT BY PROVIDING THERAPEUTIC EARLY CHILDHOOD CLASSROOMS, PARENTING EDUCATION, PLANNED RESPITE AND COMPREHENSIVE FAMILY SUPPORT. PRN UTILIZES RESEARCH-BASED STRATEGIES TO HELP FAMILIES BUILD SKILLS TO COPE WITH THE STRESSES OF RAISING CHILDREN IN FAMILIES WITH RISK FACTORS SUCH AS POVERTY, SUBSTANCE ABUSE, DOMESTIC VIOLENCE AND ISOLATION.THE HOSPITAL SUPPORTS THE COMMUNITY BY HELPING TO PROVIDE MEALS WEEKLY FOR THE UNDERSERVED AT THE SALVATION ARMY. ST. ANTHONY HOSPITAL HAS FAITHFULLY PROVIDED THIS SERVICE TO THOSE IN NEED IN OUR COMMUNITY FOR MANY YEARS. ST. ANTHONY HOSPITAL ALSO CONTINUES TO WORK COLLABORATIVELY AND PROVIDE SUPPORT FOR THE UMATILLA COUNTY HEALTH PARTNERSHIP.COMMONSPIRIT OREGON:HOSTED ITS 10TH ANNUAL KIDS SAFETY DAY AT A LOCALLY OWNED GROCERY STORE WITH OVER 20 NON-PROFIT VENDORS, INCLUDING MERCY, TO PROMOTE SAFETY TOPICS FOR OUR CHILDREN. THE THEME IS SELECTED BY TRAUMA HOSPITAL STAFF. SEVERAL HOSPITAL STAFF COORDINATED AND PARTICIPATED IN THE ONE-DAY EVENT.THIS EVENT ALSO INCLUDED HOSPITAL VOLUNTEERS. THE LOCALLY OWNED GROCERY STORE PROVIDED THE SPACE WITHOUT FEES. PART III, LINE 2: THE AMOUNT OF THE ORGANIZATION'S BAD DEBT AT COST IS DETERMINED BY APPLYING THE COST TO CHARGE RATIO TO PATIENT CHARGES THAT ARE DEEMED TO BE UNCOLLECTIBLE. THIS AMOUNT REPRESENTS THE COST OF SERVICES PROVIDED TO PATIENTS WHO ARE UNABLE OR REFUSE TO PAY THEIR BILLS AND DO NOT QUALIFY FOR FREE OR ADDITIONAL DISCOUNTED CARE, GOVERNMENT SPONSORED PROGRAMS OR OTHER PAYMENT ASSISTANCE, AND ARE OTHERWISE UNINSURED.THE FILING ORGANIZATION PROVIDES FREE CARE TO ANY PATIENT WHOSE FAMILY INCOME IS AT OR BELOW 200% OF THE FEDERAL POVERTY LEVEL, OR DISCOUNTED CARE TO UNINSURED OR UNDER-INSURED INDIVIDUALS WHOSE FAMILY INCOME IS ABOVE 201% BUT LOWER THAN 400% OF THE FEDERAL POVERTY LEVEL. THE FILING ORGANIZATION ALSO PROVIDES OPTIONS FOR INTEREST-FREE EXTENDED PAYMENT PLANS FOR PATIENTS WHO HAVE DEMONSTRATED GOOD FAITH AND ARE COOPERATING IN RESOLVING THEIR HOSPITAL BILLS. ALL ACCOUNTS FOR ELIGIBLE UNINSURED PATIENTS AT ALL FACILITIES RECEIVE AN AUTOMATIC UNINSURED DISCOUNT. THE EXPECTED PATIENT PAYMENT AMOUNT ON THE PATIENT'S BILL REFLECTS THIS DISCOUNT. DISCOUNTS ARE ACCOUNTED FOR AS DEDUCTIONS FROM REVENUE, NOT AS BAD DEBT EXPENSE. PART III, LINE 3: COMMONSPIRIT OREGON MAKES EVERY EFFORT TO DETERMINE IF A PATIENT QUALIFIES FOR FINANCIAL ASSISTANCE UPON ADMISSION. COMMONSPIRIT OREGON'S FINANCIAL ASSISTANCE POLICY IS COMMUNICATED TO PATIENTS UPON ADMISSION AND IS AVAILABLE IN THE LANGUAGES PRIMARILY SPOKEN IN THE COMMUNITY. IT IS ALSO POSTED IN VARIOUS COMMON AREAS OF THE HOSPITAL, SUCH AS EMERGENCY ROOMS, URGENT CARE CENTERS, ADMITTING AND REGISTRATION DEPARTMENTS, HOSPITAL BUSINESS OFFICES LOCATED ON FACILITY CAMPUSES, AND OTHER PUBLIC PLACES, AND IS PROVIDED UPON BILLING IF ELIGIBILITY IS NOT PREVIOUSLY DETERMINED. ELIGIBILITY IS REEVALUATED AS NEEDED AND AMOUNTS ARE CLASSIFIED AS CHARITY AS SOON AS ELIGIBILITY IS KNOWN. COMMONSPIRIT OREGON ALSO UTILIZES A WAYSTAR SCORING SYSTEM TO ASSIST IN DETERMINING IF A PATIENT MAY QUALIFY FOR PAYMENT ASSISTANCE EVEN THOUGH THEY HAVE NOT APPLIED FOR IT. WAYSTAR USES A METHODOLOGY THAT APPLIES CONSISTENT SCREENING AND APPLICATION STANDARDS TO ALL PATIENTS UTILIZING HISTORICAL DATA TO DEVELOP A PREDICTIVE MODEL FOR HEALTHCARE PAYMENT ASSISTANCE. IN ITS DEVELOPMENT, SPECIAL ATTENTION WAS PAID TO THOSE SOCIOECONOMIC FACTORS THAT MIGHT ADVERSELY AFFECT THOSE PATIENTS DESERVING THE MOST ATTENTION. OTHER CRITERIA ARE ALSO UTILIZED TO ENSURE THAT SERVICES THAT HAVE QUALIFIED AS FINANCIAL ASSISTANCE ARE NOT REPORTED AS BAD DEBT. AS SUCH, COMMONSPIRIT OREGON DOES NOT BELIEVE THAT ANY AMOUNTS INCLUDED IN PART III, LINE 2, ARE ATTRIBUTABLE TO PATIENTS ELIGIBLE UNDER THE ORGANIZATION'S PAYMENT ASSISTANCE POLICY, AND THEREFORE, NO PORTION OF BAD DEBT EXPENSE IS INCLUDED AS COMMUNITY BENEFIT EXPENSE. PART III, LINE 4: COMMONSPIRIT OREGON DOES NOT ISSUE SEPARATE COMPANY AUDITED FINANCIAL STATEMENTS. HOWEVER, THE ORGANIZATION IS INCLUDED IN THE CONSOLIDATED FINANCIAL STATEMENTS OF COMMONSPIRIT HEALTH. THE FOLLOWING IS AN EXCERPT FROM COMMONSPIRIT'S CONSOLIDATED ANNUAL AUDITED FINANCIAL STATEMENTS FOR THE YEAR ENDED JUNE 30, 2025, RELATED TO PATIENT ACCOUNTS RECEIVABLE AND NET PATIENT REVENUE. THE ENTIRE FOOTNOTE CAN BE VIEWED IN THE ATTACHED COMMONSPIRIT CONSOLIDATED FINANCIAL STATEMENTS ON PAGES 11-12."PATIENT SERVICE REVENUE IS REPORTED AT THE AMOUNTS THAT REFLECT THE CONSIDERATION COMMONSPIRIT EXPECTS TO BE PAID IN EXCHANGE FOR PROVIDING PATIENT CARE. THESE AMOUNTS ARE DUE FROM PATIENTS, THIRD-PARTY PAYORS (INCLUDING HEALTH INSURERS AND GOVERNMENT PROGRAMS) AND OTHERS AND INCLUDE CONSIDERATION FOR RETROACTIVE REVENUE ADJUSTMENTS DUE TO SETTLEMENT OF AUDITS AND REVIEWS. GENERALLY, PERFORMANCE OBLIGATIONS FOR PATIENTS RECEIVING INPATIENT ACUTE CARE SERVICES AND OUTPATIENT SERVICES ARE RECOGNIZED OVER TIME AS SERVICES ARE PROVIDED. NET PATIENT REVENUE IS PRIMARILY COMPRISED OF HOSPITAL AND PHYSICIAN SERVICES." PART III, LINE 8: COMMONSPIRIT HEALTH HOSPITALS PREPARE MEDICARE COST REPORTS IN A MANNER THAT COMPORTS WITH PROVIDER REIMBURSEMENT MANUAL (PRM) 15-1 AND PRM 15-2 CHAPTER 40 (TRANSMITTAL 18). AS SUCH, THE FOLLOWING LANGUAGE PER PRM 15-1 DESCRIBES THE COMPUTATION OF COSTS PER THE MEDICARE COST REPORT: TOTAL ALLOWABLE COSTS OF A PROVIDER ARE APPORTIONED BETWEEN PROGRAM BENEFICIARIES AND OTHER PATIENTS SO THAT THE SHARE BORNE BY THE PROGRAM IS BASED UPON ACTUAL SERVICES RECEIVED BY PROGRAM BENEFICIARIES. THE RATIO OF COVERED BENEFICIARY CHARGES TO TOTAL PATIENT CHARGES FOR THE SERVICES OF EACH ANCILLARY DEPARTMENT IS APPLIED TO THE COST OF THE DEPARTMENT. ADDED TO THIS AMOUNT IS THE COST OF ROUTINE SERVICES FOR PROGRAM BENEFICIARIES, DETERMINED ON THE BASIS OF A SEPARATE AVERAGE COST PER DIEM FOR ALL PATIENTS FOR GENERAL ROUTINE PATIENT CARE AREAS. ANOTHER FACTOR CONSIDERED IS A SEPARATE AVERAGE COST PER DIEM FOR EACH INTENSIVE CARE UNIT, CORONARY CARE UNIT, AND OTHER SPECIAL CARE INPATIENT HOSPITAL UNITS. COMMONSPIRIT HEALTH AND ITS SUBORDINATE CORPORATIONS BELIEVE THAT THE ENTIRE MEDICARE SHORTFALL FOR THE CONSOLIDATED ENTITIES CONSTITUTES COMMUNITY BENEFIT. THE IRS COMMUNITY BENEFIT STANDARD INCLUDES THE PROVISION OF CARE TO THE ELDERLY AND MEDICARE PATIENTS. MEDICARE SHORTFALLS MUST BE ABSORBED BY COMMONSPIRIT HEALTH HOSPITALS IN ORDER TO CONTINUE TREATING THE ELDERLY IN OUR COMMUNITIES. THE HOSPITALS PROVIDE CARE REGARDLESS OF THIS SHORTFALL AND THEREBY RELIEVE THE FEDERAL GOVERNMENT OF THE BURDEN OF PAYING THE FULL COST FOR MEDICARE BENEFICIARIES. COMMONSPIRIT OREGON'S SHORTFALL, AS REPORTED ON PART III, SECTION B, LINE 7, OF $ 12,368,065 REPRESENTS THE FILING ORGANIZATION'S MEDICARE COST REPORTS. PART III, LINE 9B: COMMONSPIRIT HEALTH ENSURES THAT PATIENT ACCOUNTS ARE PROCESSED FAIRLY AND CONSISTENTLY. COMMONSPIRIT HEALTH'S BILLING AND COLLECTION POLICY CONTAINS PROVISIONS THAT PROHIBIT THE COLLECTION OF AMOUNTS DUE FROM PATIENTS WHO THE ORGANIZATION KNOWS QUALIFY FOR FINANCIAL ASSISTANCE. ACCOUNTS WITH INCORRECT OR INCOMPLETE DEMOGRAPHIC INFORMATION ARE ASSIGNED TO A COLLECTION AGENCY IF THE COMMONSPIRIT HEALTH FACILITY, OR BILLING COMPANY RETAINED BY COMMONSPIRIT HEALTH, IS UNABLE TO OBTAIN AN UPDATED ADDRESS THROUGH SKIP TRACING OR OTHER MEANS. FOR PATIENTS WHO HAVE AN APPLICATION PENDING FOR EITHER GOVERNMENT-SPONSORED ASSISTANCE OR FOR ASSISTANCE UNDER COMMONSPIRIT HEALTH'S FINANCIAL ASSISTANCE POLICY, OR WHERE THE PATIENT IS ATTEMPTING IN GOOD FAITH TO SETTLE AN OUTSTANDING BILL WITH THE FACILITY VIA PAYMENT PLANS, COMMONSPIRIT HEALTH WILL NOT KNOWINGLY SEND THAT PATIENT'S BILL TO AN OUTSIDE COLLECTION AGENCY. ON SELF-PAY ACCOUNTS THAT DO NOT MEET THE CRITERIA NOTED ABOVE, THE INITIAL DETERMINATION OF ASSIGNMENT TO A COLLECTION AGENCY WILL VARY DEPENDING ON THE NATURE OF THE ACCOUNT WITH THE FINAL DECISION BEING AT THE DISCRETION OF THE BILLING COMPANY RETAINED BY COMMONSPIRIT HEALTH. UPON ASSIGNMENT OF SUCH A PATIENT ACCOUNT TO A COLLECTION AGENCY, COMMONSPIRIT HEALTH REQUIRES THE AGENCY TO COMPLY WITH THE FAIR DEBT COLLECTION PRACTICES ACT. PART VI, LINE 3: INFORMATION ABOUT COMMONSPIRIT HEALTH'S FINANCIAL ASSISTANCE PROGRAM AND A CONTACT NUMBER ARE MADE AVAILABLE TO PATIENTS AND THE PUBLIC. PATIENTS ARE INFORMED OF COMMONSPIRIT HEALTH'S FINANCIAL ASSISTANCE PROGRAM VIA SIGNAGE IN ALL ADMITTING AREAS AND IN VARIOUS COMMON AREAS OF THE HOSPITAL. FINANCIAL ASSISTANCE PROGRAM INFORMATION NOTICES ARE POSTED IN THE EMERGENCY AND ADMITTING DEPARTMENTS AND AT OTHER PUBLIC PLACES AS EACH FACILITY MAY ELECT. SUCH INFORMATION IS PROVIDED IN THE PRIMARY LANGUAGES SPOKEN IN THE COMMUNITIES COMMONSPIRIT HEALTH SERVES. THE SIGNAGE INCLUDES NOTIFICATION THAT FURTHER DISCOUNTS MAY BE PROVIDED UPON THE COMPLETION AND SUBMISSION OF A FINANCIAL ASSISTANCE APPLICATION AND HOW TO REACH STAFF THAT CAN ASSIST WITH ANSWERING QUESTIONS AND GUIDE PATIENTS THROUGH THE APPLICATION PROCESS. INFORMATION CAN ALSO BE FOUND ON THE FACILITY WEBSITES. HOSPITALS' PUBLICLY AVAILABLE COMMUNITY HEALTH IMPLEMENTATION STRATEGIES STATE THAT IT IS THE POLICY OF COMMONSPIRIT HEALTH TO PROVIDE, WITHOUT DISCRIMINATION, EMERGENCY MEDICAL CARE AND MEDICALLY NECESSARY CARE IN COMMONSPIRIT HOSPITAL FACILITIES TO ALL PATIENTS, WITHOUT REGARD TO A PATIENT'S FINANCIAL ABILITY TO PAY, AND THAT THE POLICY, PLAIN LANGUAGE SUMMARY AND RELATED MATERIALS ARE AVAILABLE IN MULTIPLE LANGUAGES ON THE HOSPITAL'S WEBSITE. IF FINANCIAL ASSISTANCE ELIGIBILITY IS NOT DETERMINED PRIOR TO BILLING, INITIAL BILLING STATEMENTS TO PATIENTS INCLUDE A REQUEST TO THE PATIENT TO PROVIDE ANY INSURANCE INFORMATION THAT WAS VALID FOR THE DATES OF SERVICE BILLED AND A STATEMENT INFORMING PATIENTS HOW TO CONTACT US REGARDING FINANCIAL ASSISTANCE. ADDITIONALLY, CONTRACT TERMS WITH COLLECTION VENDORS WORKING ON BEHALF OF COMMONSPIRIT HEALTH REQUIRE THEY FOLLOW COMMONSPIRIT HEALTH FINANCIAL ASSISTANCE POLICY. ALSO, REFERRAL OF PATIENTS FOR FINANCIAL ASSISTANCE MAY BE MADE BY ANY MEMBER OF THE COMMONSPIRIT HOSPITAL ORGANIZATION NON-MEDICAL OR MEDICAL STAFF, INCLUDING PHYSICIANS, NURSES, FINANCIAL COUNSELORS, SOCIAL WORKERS, CASE MANAGERS, CHAPLAINS, AND RELIGIOUS SPONSORS. A REQUEST FOR ASSISTANCE MAY BE MADE BY THE PATIENT OR A FAMILY MEMBER, CLOSE FRIEND OR ASSOCIATE OF THE PATIENT, SUBJECT TO APPLICABLE PRIVACY LAWS. PART VI, LINE 4: COMMONSPIRIT OREGON:COMMUNITIES ARE MOSTLY RURAL; RESIDENTS ARE OLDER, LESS DIVERSE WITH LOWER INCOMES AND EDUCATION. THE HEALTH RESOURCES AND SERVICE ADMINISTRATION (HRSA) HAS DESIGNATED THE COUNTY AS A MEDICALLY UNDERSERVED AREA. THE COUNTY SEAT IN ROSEBURG IS THE LARGEST WITH 23,237 RESIDENTS. APPROXIMATELY HALF OF THE POPULATION RESIDE IN THE THIRTY-TWO UNINCORPORATED AREAS AND ONLY THREE OTHER COMMUNITIES HAVE MORE THAN 5,000 RESIDENTS. HOUSEHOLD INCOMES LAG BEHIND. THE MEDIAN INCOME IN DOUGLAS COUNTY IS $50,031 COMPARED TO THE STATE AVERAGE OF $65,667 AND NATIONALLY AT $64,994. THE CONNECTION BETWEEN EDUCATION AND INCOME IS CLEAR WITH ONLY 18.5% OF CITIZENS ATTAINING A BACHELOR'S DEGREE COMPARED TO 34.4% STATEWIDE AND 32.9% NATIONALLY. RESIDENTS MOSTLY IDENTIFY AS WHITE 87.5%. THE CHART TO THE RIGHT ILLUSTRATES THE AVERAGE AGE OF ITS RESIDENTS. ST. ANTHONY HOSPITAL, PENDLETON:GEOGRAPHIC AREA: THE HOSPITAL PRIMARILY SERVES UMATILLA COUNTY, IN RURAL EASTERN OREGON, WHICH ENCOMPASSES 3,215.45 SQUARE MILES AND IS LOCATED IN NORTHEAST OREGON. THE COMMUNITY SERVED ALSO EXTENDS TO SOUTHERN MORROW COUNTY AND INCLUDES THE CONFEDERATED TRIBES OF THE UMATILLA INDIAN RESERVATION. THE LARGEST CITIES WITHIN UMATILLA COUNTY ARE HERMISTON, PENDLETON, UMATILLA, AND MILTON-FREEWATER.DEMOGRAPHICS:* POPULATION SIZE: THE TOTAL POPULATION OF THE SERVICE AREA (PRIMARILY UMATILLA COUNTY) IS 79,904 RESIDENTS (ACCORDING TO THE LATEST CENSUS ESTIMATES).* POPULATION COMPOSITION (RACE & ETHNICITY):- WHITE: 76.3%- HISPANIC: 28.1% (NOTE: HISPANIC IS OFTEN CONSIDERED AN ETHNICITY AND CAN OVERLAP WITH RACIAL CATEGORIES, BUT IT IS LISTED SEPARATELY IN THE PROVIDED DATA).- AMERICAN INDIAN OR ALASKA NATIVE: 3.2%- ASIAN: 0.9%- BLACK: 0.8%- NATIVE HAWAIIAN/PACIFIC ISLANDER: 0.1%* AVERAGE INCOME: THE MEDIAN HOUSEHOLD INCOME IN UMATILLA COUNTY IS $70,322.* THE PERCENT OF POPULATION LIVING IN POVERTY (BELOW 100% FPL) IS 11.7%. ADDITIONALLY, 23.7% OF RESIDENTS STATED THEY WOULD NOT BE ABLE TO AFFORD A $400 EMERGENCY EXPENSE WITHOUT GOING INTO DEBT, INDICATING FINANCIAL VULNERABILITY BEYOND JUST THE POVERTY LINE.* PERCENTAGE OF PATIENTS OR RESIDENTS WHO ARE UNINSURED OR MEDICAID RECIPIENTS:- PERCENT OF PEOPLE WITHOUT HEALTH INSURANCE: 11.1%- PERCENT OF PEOPLE WITH MEDICAID: 28.1%* UNEMPLOYMENT RATE: THE UNEMPLOYMENT RATE (SEPTEMBER 2024) IS 3.7%.* EDUCATION: 15.5% OF THE POPULATION AGED 25 AND OLDER DO NOT HOLD A HIGH SCHOOL DIPLOMA OR GED.* NON-ENGLISH SPEAKING: 2.6% OF PEOPLE AGED 5 AND OLDER ARE NON-ENGLISH SPEAKING.NUMBER OF OTHER HOSPITALS SERVING THE COMMUNITY: THERE IS ONE ADDITIONAL HOSPITAL IN UMATILLA COUNTY, LOCATED APPROXIMATELY 30 MILES FROM ST. ANTHONY HOSPITAL.THE COMMUNITY INCLUDES DESIGNATED MEDICALLY UNDERSERVED AREAS/POPULATIONS; SPECIFICALLY, PRIMARY CARE, DENTAL, AND MENTAL HEALTH ARE DESIGNATED AS HEALTH PROFESSIONAL SHORTAGE AREAS. PART VI, LINE 5: FINANCIAL ASSISTANCE: IT IS THE POLICY OF COMMONSPIRIT HEALTH TO PROVIDE, WITHOUT DISCRIMINATION, EMERGENCY MEDICAL CARE AND MEDICALLY NECESSARY CARE IN COMMONSPIRIT HOSPITAL FACILITIES TO ALL PATIENTS, WITHOUT REGARD TO A PATIENT'S FINANCIAL ABILITY TO PAY. THIS HOSPITAL HAS A FINANCIAL ASSISTANCE POLICY THAT DESCRIBES THE ASSISTANCE PROVIDED TO PATIENTS FOR WHOM IT WOULD BE A FINANCIAL HARDSHIP TO FULLY PAY THE EXPECTED OUT-OF-POCKET EXPENSES FOR SUCH CARE, AND WHO MEET THE ELIGIBILITY CRITERIA FOR SUCH ASSISTANCE. THE FINANCIAL ASSISTANCE POLICY, A PLAIN LANGUAGE SUMMARY AND RELATED MATERIALS ARE AVAILABLE IN MULTIPLE LANGUAGES ON THE HOSPITAL'S WEBSITE.USE OF SURPLUS FUNDS: AS A NOT-FOR-PROFIT HOSPITAL ORGANIZATION DEDICATED TO IMPROVING THE QUALITY OF LIFE, THE HOSPITAL REINVESTS ALL OF ITS SURPLUS FUNDS FROM OPERATING AND INVESTMENT ACTIVITIES TO IMPROVE THE QUALITY OF PATIENT CARE, EXPAND AND REPLACE EXISTING FACILITIES AND EQUIPMENT, INVEST IN TECHNOLOGICAL ADVANCEMENTS, SUPPORT COMMUNITY HEALTH PROGRAMS, AND ADVANCE MEDICAL TRAINING, EDUCATION, AND RESEARCH. THIS ACTIVE REINVESTMENT OF FUNDS MAKES IT POSSIBLE FOR THE HOSPITAL TO DELIVER ON ITS MISSION, INCLUDING HELPING TO ENSURE THAT EVERYONE IN THE COMMUNITIES SERVED HAS ACCESS TO HEALTH CARE.OPEN MEDICAL STAFF: MEDICAL STAFF PRIVILEGES ARE OPEN TO PHYSICIANS WHOSE EXPERIENCE AND TRAINING ARE VERIFIED THROUGH A CREDENTIALING PROCESS. THE PROCESS INCLUDES GATHERING AND VERIFYING CREDENTIALS, ALLOWING THE MEDICAL STAFF TO EVALUATE AN APPLICANT'S QUALIFICATIONS, PREVIOUS EXPERIENCE, AND COMPETENCE, AND ULTIMATELY MAKING A DECISION TO GRANT OR DENY MEDICAL STAFF MEMBERSHIP AND CLINICAL PRIVILEGES ON THE BASIS OF AUTHENTIC AND VALID CREDENTIALS.ROLE OF THE BOARD: THE COMMONSPIRIT HEALTH BOARD AND SPECIFIC COMMITTEES HAVE ORGANIZATIONAL, POLICY-BASED ROLES TO OVERSEE COMMUNITY BENEFIT AND COMMUNITY HEALTH PROGRAMS, AND THEY RECEIVE REPORTS ON ACTIVITIES AND PERFORMANCE. HOSPITAL AND MARKET COMMUNITY BOARDS OF COMMUNITY ADVISORS (OR THEIR DESIGNATED COMMITTEES) ARE RESPONSIBLE FOR ENSURING THAT THE HOSPITALS CONDUCT AND ADOPT COMMUNITY HEALTH NEEDS ASSESSMENTS AND IMPLEMENTATION STRATEGIES, TAKE ACTIONS TO HELP ADDRESS IDENTIFIED SIGNIFICANT HEALTH NEEDS WITH AN EMPHASIS ON POOR AND VULNERABLE POPULATIONS AND HEALTH EQUITY, AND MONITORING ACTIONS AND PROGRESS TOWARD IDENTIFIED GOALS. PART VI, LINE 6: THE ORGANIZATION IS AFFILIATED WITH COMMONSPIRIT HEALTH. COMMONSPIRIT HEALTH WAS CREATED BY THE ALIGNMENT OF CATHOLIC HEALTH INITIATIVES AND DIGNITY HEALTH IN EARLY 2019. COMMONSPIRIT HEALTH, A NONPROFIT, FAITH-BASED HEALTH SYSTEM IS COMMITTED TO BUILDING HEALTHIER COMMUNITIES, ADVOCATING FOR THOSE WHO ARE POOR AND VULNERABLE, AND INNOVATING HOW AND WHERE HEALING CAN HAPPEN - BOTH INSIDE ITS HOSPITALS AND OUT IN THE COMMUNITY. COMMONSPIRIT HEALTH OWNS AND OPERATES HEALTH CARE FACILITIES IN 24 STATES AND IS THE SOLE CORPORATE MEMBER (PARENT CORPORATION) OF OTHER PRIMARILY NONPROFIT CORPORATIONS. COMMONSPIRIT HEALTH AND SUBSTANTIALLY ALL OF ITS DIRECT AFFILIATES AND SUBSIDIARIES HAVE BEEN GRANTED EXEMPTIONS FROM FEDERAL INCOME TAX AS CHARITABLE ORGANIZATIONS UNDER SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE. AS OF SEPTEMBER 24, 2025, COMMONSPIRIT HEALTH IS COMPRISED OF APPROXIMATELY 2,300 CARE SITES, CONSISTING OF 138 HOSPITALS, INCLUDING ACADEMIC HEALTH CENTERS, MAJOR TEACHING HOSPITALS, AND CRITICAL ACCESS FACILITIES, COMMUNITY HEALTH SERVICES ORGANIZATIONS, ACCREDITED NURSING COLLEGES, HOME HEALTH AGENCIES, LIVING COMMUNITIES, A MEDICAL FOUNDATION AND OTHER AFFILIATED MEDICAL GROUPS, AND OTHER FACILITIES AND SERVICES THAT SPAN THE INPATIENT AND OUTPATIENT CONTINUUM OF CARE. AN ADDITIONAL 20 HOSPITALS ARE OPERATED THROUGH UNCONSOLIDATED JOINT VENTURES. IN FISCAL YEAR 2025, COMMONSPIRIT HEALTH PROVIDED MORE THAN $3.071 BILLION IN FINANCIAL ASSISTANCE AND COMMUNITY BENEFIT FOR PROGRAMS AND SERVICES FOR THE POOR, FREE CLINICS, EDUCATION AND RESEARCH. FINANCIAL ASSISTANCE AND COMMUNITY BENEFIT TOTALED MORE THAN $5.156 BILLION WITH THE INCLUSION OF THE UNPAID COSTS OF MEDICARE. THE HEALTH SYSTEM, WHICH GENERATED OPERATING REVENUES OF $39.1 BILLION IN FISCAL YEAR 2025, HAS TOTAL ASSETS OF APPROXIMATELY $57.26 BILLION.COMMONSPIRIT HEALTH PROVIDES STRATEGIC PLANNING AND MANAGEMENT SERVICES AS WELL AS CENTRALIZED SERVICES FOR ITS DIVISIONS. THE PROVISION OF CENTRALIZED MANAGEMENT AND SHARED SERVICES INCLUDING AREAS SUCH AS ACCOUNTING, HUMAN RESOURCES, PAYROLL AND SUPPLY CHAIN PROVIDES ECONOMIES OF SCALE AND PURCHASING POWER TO THE DIVISIONS. THE COST SAVINGS ACHIEVED THROUGH COMMONSPIRIT HEALTH'S CENTRALIZATION ENABLE DIVISIONS TO DEDICATE ADDITIONAL RESOURCES TO HIGH-QUALITY HEALTH CARE AND COMMUNITY OUTREACH SERVICES TO THE MOST VULNERABLE MEMBERS OF OUR SOCIETY. PART VI, LINE 7, REPORTS FILED WITH STATES OR 1 MERCY FOUNDATION 2700 STEWART PARKWAY ROSEBURG OR 97471 936088946 501(C)3 709216 0 GENERAL SUPPORT TRUTH INITIATIVE FOUNDATION 900 G STREET NW 4TH FLOOR WASHINGTON DC 20001 901956621 501(C)3 33570 0 GENERAL SUPPORT DOUGLAS COUNTY OF OREGON 2110 FREAR STEEET SW ROSEBURG OR 97471 936002293 GOVERNMENT 10000 0 GENERAL SUPPORT UMPQUA COMMUNITY COLLEGE PO BOX 967 ROSEBURG OR 97470 930519151 501(C)3 1000000 0 GENERAL SUPPORT WINSTON CHRISTIAN CHURCH 231 SHERRY ST WINSTON OR 97496 930561882 501(C)3 10000 0 GENERAL SUPPORT UMPQUA COMMUNITY HEALTH CENTER INC 150 NE KENNEDY FORD DR ROSEBURG OR 97470 931070304 501(C)3 50000 0 GENERAL SUPPORT DOUGLAS COUNTY CANCER SERVICES 2880 NW STEWART PKWY ROSEBURG OR 97471 943113835 501(C)3 84167 0 GENERAL SUPPORT HIV ALLIANCE INC 1195 CITY VIEW ST EUGENE OR 97402 930963546 501(C)3 30000 0 GENERAL SUPPORT EXPLORE ENGAGE ENJOY 2198 NE STEPHENS ST SUITE 101 ROSEBURG OR 97470 882261805 501(C)3 30500 0 GENERAL SUPPORT FRIENDLY KITCHEN 1440 UMPQUA COLLEGE RD ROSEBURG OR 97471 930779289 501(C)3 5270 0 GENERAL SUPPORT 10 0 PART I, LINE 2: ALL DONATIONS ARE GIVEN TO NON-PROFIT ORGANIZATIONS TO BE USED IN ACCORDANCE WITH THEIR CHARITABLE PURPOSE; AND AS SUCH, USE OF THE FUNDS GIVEN TO THE GRANTEE IS NOT MONITORED BEYOND THEIR DISTRIBUTION. THE ORGANIZATION MAKES A RECORD OF ALL DONATIONS IN THE GENERAL LEDGER. 1 1 0 0 0 0 0 0 0 KETUL PATEL EX OFFICIO/REGION PRESIDENT NW 0 1399822 0 4002957 0 263122 0 74757 0 14201 0 5754859 0 0 DANIEL BARCHI BOARD MEMBER 0 1390381 0 2711475 0 412642 0 367951 0 37397 0 4919846 0 0 KATHLEEN SANFORD BOARD MEMBER 0 914805 0 1792752 0 276974 0 18925 0 35677 0 3039133 0 0 DAVID NOSACKA CORPORATE TREASURER/SVP&CFO NORTHWES 0 624949 0 243163 0 4198 0 20325 0 41647 0 934282 0 0 SUSAN WILLIAMS MD BOARD MEMBER THRU 4/30/25/PHYSICIAN 0 822570 0 15000 0 2382 0 12520 0 28445 0 880917 0 0 RUSSELL WOOLLEY MARKET PRESIDENT/BOARD MEMBER THRU 4 421092 0 181409 0 106356 0 60653 0 42290 0 811800 0 0 0 JASON GRAY MD FORMER OFFICER 416293 0 125180 0 3086 0 16085 0 33037 0 593681 0 0 0 BRIAN PINELLE FORMER COO & CNO 142080 0 0 0 296695 35850 13649 0 6850 0 459274 35850 0 0 MIRIAM CHAMBLISS CORPORATE SECRETARY/VP GENERAL COUNS 0 306158 0 121211 0 1290 0 12689 0 32951 0 474299 0 0 JAMIE POINDEXTER MARKET VP OPERATIONAL FINANCE/CFO 0 235610 0 33672 0 73831 0 4506 0 32861 0 380480 0 0 GREGORY JACKSON FORMER MARKET VP OPERATIONAL FINANCE 0 270234 0 73827 0 1045 0 10283 0 12021 0 367410 0 0 HOLLY COOK MKT CNO - ROSEBURG 38510 182507 0 38988 365 39723 11799 0 19008 8239 69682 269457 0 0 JERRY SMEAD DIRECTOR PHARMACY (THRU 7/3/2024) 123711 0 43552 0 138975 0 12423 0 14375 0 333036 0 0 0 ANN FULLER DIRECTOR CLINICAL INFORMATICS (THRU 78117 0 29857 0 188907 0 8392 0 14287 0 319560 0 0 0 DEBRA RINAKER DIRECTOR FAMILY BIRTH CENTER (THRU 7 93136 0 32597 0 161900 0 9019 0 6648 0 303300 0 0 0 DEBORA ST MARIE-LIGHTCAP MKT DIRECTOR HR OPERATIONS (THRU 7/1 89539 0 30722 0 162609 0 9109 0 974 0 292953 0 0 0 AARON BALLENSKY PHARMACY MANAGER 227176 0 25158 0 307 0 10563 0 13193 0 276397 0 0 0 PART I, LINE 3: DURING THE CALENDAR YEAR 2024, COMPENSATION FOR THE TOP MANAGEMENT OFFICIAL WAS ESTABLISHED AND PAID BY COMMONSPIRIT HEALTH, A RELATED ORGANIZATION. COMMONSPIRIT HEALTH USED ONE OR MORE OF THE METHODS DESCRIBED IN SCHEDULE J, PART I, LINE 3 TO ESTABLISH THE TOP MANAGEMENT OFFICIAL'S COMPENSATION: (1) INDEPENDENT COMPENSATION CONSULTANT; (2) COMPENSATION SURVEY OR STUDY. SEE SCHEDULE O DISCLOSURE FOR FORM 990, PART VI, SECTION B, LINE 15 FOR ADDITIONAL INFORMATION. PART I, LINE 4A: CERTAIN REPORTABLE INDIVIDUALS ARE COVERED BY AN EXECUTIVE SEVERANCE POLICY THAT PROVIDES MARKET-STANDARD COMPENSATION, RANGING FROM PAYMENTS OF 9 MONTHS TO 2 YEARS OF BASE COMPENSATION, DEPENDING ON THE EXECUTIVE'S POSITION, IN THE EVENT OF A POSITION ELIMINATION OR OTHER INVOLUNTARY TERMINATION, IN ACCORDANCE WITH THE GUIDELINES OF THE POLICY. CERTAIN REPORTABLE INDIVIDUALS ARE COVERED BY A NON-EXECUTIVE SEVERANCE POLICY THAT PROVIDES MARKET-STANDARD COMPENSATION, RANGING FROM PAYMENTS OF 2 WEEKS TO 52 WEEKS OF BASE COMPENSATION, DEPENDING ON THE EMPLOYEE'S POSITION AND TENURE, IN THE EVENT OF A POSITION ELIMINATION OR OTHER INVOLUNTARY TERMINATION, IN ACCORDANCE WITH THE GUIDELINES OF THE POLICY. THE FOLLOWING REPORTABLE INDIVIDUALS RECEIVED SEVERANCE PAYMENTS DURING THE 2024 CALENDAR YEAR, AND THESE SEVERANCE PAYMENTS WERE INCLUDED IN THE INDIVIDUALS' W-2 INCOME AND REPORTABLE COMPENSATION ON PART VII AND SCHEDULE J, PART II, COLUMN (B)(III): ANN FULLER, $172,293; BRIAN PINELLE, $229,537; DEBRA RINAKER, $156,738; JERRY SMEAD, $118,709; DEBORA ST. MARIE-LIGHTCAP $139,039 PART I, LINE 4B: CERTAIN LISTED PERSONS PARTICIPATE IN THE COMMONSPIRIT HEALTH SUPPLEMENTAL EXECUTIVE RETIREMENT PLAN (SERP), A NONQUALIFIED RETIREMENT PLAN DESIGNED TO PROVIDE DEFERRED COMPENSATION TO KEY EXECUTIVES WHO HAVE CONTRIBUTED MATERIALLY TO THE SUCCESS OF OUR MINISTRY. THE SERP IS INTENDED TO PROVIDE HIGHLY COMPENSATED INDIVIDUALS WITH ADDITIONAL RETIREMENT INCOME TO HELP OFFSET REGULATORY LIMITS IN PLACE ON QUALIFIED RETIREMENT PLANS AND SOCIAL SECURITY. EACH ANNUAL CONTRIBUTION IS SUBJECT TO A FOUR-YEAR VESTING OR RETENTION PERIOD. UPON COMPLETION OF THE APPLICABLE FOUR-YEAR RETENTION PERIOD FOR EACH ANNUAL CONTRIBUTION, VESTING WILL OCCUR, AND ANY ACCUMULATED BENEFIT UNDER THE PLAN WILL BE RECEIVED. ON THE FIRST DAY OF THE CALENDAR MONTH AFTER THE FOURTH ANNIVERSARY OF THE SERP BENEFIT, THE ANNUAL CONTRIBUTION AND ITS ASSOCIATED INVESTMENT GAINS OR LOSSES BECOME 100% VESTED. IN ADDITION, THE PARTICIPANT'S SERP BENEFIT BECOMES 100% VESTED UPON ANY OF THE FOLLOWING EVENTS: 1) REACHING THE AGE OF 65 (THE PLAN'S NORMAL RETIREMENT AGE), OR 2) DEATH, OR BECOME DISABLED UNDER THE LONG-TERM DISABILITY PLAN OR SOCIAL SECURITY. SHOULD EMPLOYMENT END FOR ANY REASON OTHER THAN TERMINATION WITH SEVERANCE, RETIREMENT AT AGE 65 OR OLDER, DISABILITY, OR DEATH, UNVESTED SERP FUNDS ARE FORFEITED. IF EMPLOYMENT IS TERMINATED WITH SEVERANCE, THE TERMS AND CONDITIONS OUTLINED WITHIN THE SERP, AND NOT THOSE OF ANY SEVERANCE AGREEMENT, WILL CONTROL AND GOVERN PAYMENT ENTITLEMENT UNDER THE SERP. CERTAIN ELIGIBLE LISTED PERSONS RECEIVED AN ADDITIONAL PAYMENT DURING 2024 DUE TO A DELAY IN THE START DATE OF THE SERP. DURING 2024 THE FOLLOWING DISTRIBUTIONS WERE MADE BY COMMONSPIRIT FROM THE DEFERRED COMPENSATION PLAN: KATHLEEN SANFORD, $82,742 AND DANIEL BARCHI, $400,000. CERTAIN LISTED PERSONS ARE ELIGIBLE TO PARTICIPATE IN THE CATHOLIC HEALTH INITIATIVES SUPPLEMENTAL EXECUTIVE RETIREMENT PLAN, A SUPPLEMENTAL NON-QUALIFIED DEFERRED COMPENSATION PLAN FOR REGION CEOS/PRESIDENTS AND OTHER DESIGNATED COMMONSPIRIT EXECUTIVES AT THE LEVEL OF SENIOR VICE PRESIDENT AND ABOVE. DUE TO THE "SUPER" VESTING RULES UNDER COMMONSPIRIT'S DEFERRED COMPENSATION PLAN, PARTICIPANTS WHO HAVE MET CERTAIN REQUIREMENTS SUCH AS INVOLUNTARY TERMINATION WITHOUT CAUSE, AGE, AGE AND YEARS OF SERVICE, OR MORE THAN 5 YEARS OF PLAN PARTICIPATION ARE ELIGIBLE TO RECEIVE THEIR 2024 CONTRIBUTIONS IN CASH. THESE CASH PAYOUTS ARE INCLUDED IN THE PARTICIPANT'S REPORTABLE COMPENSATION IN COLUMN (III) OTHER REPORTABLE COMPENSATION ON SCHEDULE J PART II. DURING 2024, THE FOLLOWING PAYMENTS WERE MADE PURSUANT TO THE SUPER VESTING RULES: KATHLEEN SANFORD, $158,357 AND KETUL PATEL, $244,754. PART II: COMMONSPIRIT OREGON FOLLOWS COMMONSPIRIT'S EXECUTIVE COMPENSATION PHILOSOPHY. COMMONSPIRIT'S EXECUTIVE COMPENSATION PHILOSOPHY IS DESIGNED TO ASSIST COMMONSPIRIT IN ATTRACTING AND RETAINING THE CALIBER OF EXECUTIVES REQUIRED TO ENABLE COMMONSPIRIT TO FULFILL ITS MISSION OF PROVIDING HIGH QUALITY HEALTHCARE FOR ALL PERSONS REGARDLESS OF THEIR ABILITY TO PAY FOR SERVICES, IMPROVING THE QUALITY OF LIFE IN THE COMMUNITIES COMMONSPIRIT SERVES, PROMOTING PATIENT AND EMPLOYEE SATISFACTION, AND ENSURING FINANCIAL STABILITY. A SUBSTANTIAL PORTION OF EXECUTIVE COMPENSATION IS PERFORMANCE BASED AND IS LINKED TO ORGANIZATIONAL GOALS APPROVED IN ADVANCE BY THE HUMAN RESOURCES AND COMPENSATION COMMITTEE. THESE GOALS INCLUDE ATTAINMENT OF ANNUAL AND LONG-TERM FINANCIAL PERFORMANCE, CERTAIN HEALTHCARE QUALITY STANDARDS AND COMMONSPIRIT'S COMMITMENT TO SERVING THE POOR AND DISENFRANCHISED IN THE COMMUNITIES IT SERVES. TOTAL COMPENSATION, WHICH INCLUDES BASE SALARY, ANNUAL, AND LONG-TERM INCENTIVE COMPENSATION, IS ESTABLISHED TO APPROXIMATE THE PREVAILING MARKET CONDITIONS FOR EXECUTIVES OF COMPANIES OF SIMILAR SIZE, REVENUES AND COMPLEXITY. PAYMENTS PURSUANT TO A LONG-TERM FINANCIAL PERFORMANCE GOAL WERE PAID IN CALENDAR YEAR 2024. BRIAN PINNELLE'S COMPENSATION REPORTED IN SCH J, PT. II INCLUDES $101,818 FOR SERVICES PROVIDED TO COMMONSPIRIT OREGON FROM AN UNRELATED ORGANIZATION AMN HEALTHCARE TODD LUTHER FAMILY MEMBER OF BOARD MEMBER 269366 COMPENSATION & BENEFITS 0 ANDREA GRAY MD FAMILY MEMBER OF BOARD MEMBER 34700 PHYSICIAN CALL SERVICES 0 EVERGREEN FAMILY MEDICINE TIMOTHY POWELL IS A BOARD MEMBER IN BOTH EVERGREEN FAMILY MEDICINE AND MMC 45670991 MANAGEMENT SERVICES 0 FORM 990, PART III, LINE 2 ON MAY 1ST, 2025 ALL THE ASSETS AND OPERATIONS OF ST. ANTHONY HOSPITAL (93-0391614), A RELATED 501(C)(3) ORGANIZATION, WERE MERGED INTO COMMONSPIRIT OREGON. FORM 990, PART V, LINE 1C: PAYMENTS TO VENDORS PAYMENTS TO VENDORS FOR ENTITIES THAT ARE PART OF COMMONSPIRIT HEALTH ARE MADE BY COMMONSPIRIT HEALTH. THEREFORE, NO FORMS 1099 ARE ISSUED BY COMMONSPIRIT OREGON. COMMONSPIRIT HEALTH FILES THE FORMS 1099 AND COMPLIES WITH THE BACKUP WITHHOLDING RULES FOR REPORTABLE PAYMENTS TO VENDORS AND GAME WINNINGS. THE FORMS 1099 ISSUED ON BEHALF OF COMMONSPIRIT OREGON ARE REPORTED TO THE IRS. FORM 990, PART VI, SECTION A, LINE 3 COMMONSPIRIT OREGON HAS DELEGATED LIMITED CONTROL OVER MANAGEMENT DUTIES FOR CERTAIN HOSPITAL DEPARTMENTS TO THE FOLLOWING MANAGEMENT COMPANIES: PROFESSIONAL MANAGEMENT OF OREGON, LLC, CEP AMERICA, DOUGLAS MEDICAL GROUP, STEWART PARKWAY MEDICAL GROUP, UMPQUA MEDICAL GROUP AND EVERGREEN FAMILY MEDICINE, PC. THE SURGICAL AND EMERGENCY AREAS ARE MANAGED BY THESE MANAGEMENT ORGANIZATIONS. THE MANAGEMENT COMPANIES HAVE THEIR OWN EMPLOYEES THAT THEY HIRE, FIRE AND SUPERVISE. TIM POWELL, AS CEO OF EVERGREEN FAMILY MEDICINE, PC, PROVIDES EXECUTIVE LEADERSHIP SERVICES TO CENTENNIAL MEDICAL GROUP EAST DBA EVERGREEN FAMILY MEDICINE, A DISREGARED ENTITY OF CENTENNIAL MEDICAL GROUP. DURING CALENDAR YEAR 2024 TIM POWELL RECEIVED $773,849 AS COMPENSATION FOR HIS SERVICES TO COMMONSPIRIT OREGON AND CENTENNIAL MEDICAL GROUP. NO OTHER CURRENT OR FORMER OFFICER, DIRECTOR, ETC. HAVE RECEIVED COMPENSATION FROM THE MANAGEMENT COMPANIES DURING THE 2024 CALENDAR YEAR. FORM 990, PART VI, SECTION A, LINE 4 IN CONNECTION WITH COMMONSPIRIT HEALTH'S SYSTEM WIDE GOVERNANCE ALIGNMENT AND CORPORATE RESTRUCTURING, THE ORGANIZATION'S ARTICLES OF INCORPORATION AND BYLAWS WERE AMENDED AND RESTATED. SEVERAL SIGNIFICANT CHANGES WERE MADE TO THE GOVERNING DOCUMENTS INCLUDING: 1. THE ORGANIZATION'S NAME WAS CHANGED TO COMMONSPIRIT OREGON. 2. BOARD OF DIRECTORS "BOARD AND STANDING COMMITTEES: A. THE NUMBER OF BOARD MEMBERS AND THE COMPOSITION OF THE BOARD HAS CHANGED. THE BOARD NOW CONSISTS OF THREE (3) DIRECTORS, WHO ARE APPOINTED BY THE CORPORATE MEMBER. ONE OF THOSE DIRECTORS IS THE REGION PRESIDENT, WHO SERVES AS AN EX OFFICIO VOTING BOARD MEMBER. THE NEW GOVERNING DOCUMENTS ELIMINATE FOUR STANDING BOARD COMMITTEES (GOVERNANCE, EXECUTIVE, AUDIT AND COMPLIANCE, AND QUALITY AND VALUE) WHILE MAINTAINING THE BOARD'S ABILITY BY RESOLUTION ADOPTED BY A MAJORITY OF THE DIRECTORS THEN IN OFFICE, TO ESTABLISH ONE OR MORE STANDING OR AD HOC COMMITTEES. 3. BOARD OF COMMUNITY ADVISORS: A. THE NEW GOVERNING DOCUMENTS REQUIRE THE BOARD TO ESTABLISH ONE OR MORE BOARDS OF COMMUNITY ADVISORS RELATED TO HOSPITALS OWNED AND OPERATED BY THE CORPORATION. ALL BOARDS OF COMMUNITY ADVISORS ARE TO BE OPERATED SUBSTANTIALLY IN ACCORDANCE WITH, AND HAVE THE RESPONSIBILITIES GENERALLY DESCRIBED IN, A SET OF BYLAWS, APPROVED BY THE BOARD (THE "BOARD OF COMMUNITY ADVISORS BYLAWS"). ANY PROPOSED AMENDMENT OR MODIFICATION TO THE BOARD OF COMMUNITY ADVISORS BYLAWS APPLICABLE TO A BOARD OF COMMUNITY ADVISORS IS SUBJECT TO APPROVAL BY THE BOARD. B. THE BOARD MAKES APPOINTMENTS TO THE BOARDS OF COMMUNITY ADVISORS. EACH BOARD OF COMMUNITY ADVISORS MUST CONSIST OF NO FEWER THAN SIX AND NO MORE THAN TWELVE MEMBERS. THE BOARD RETAINS THE POWER TO REMOVE MEMBERS OF THE BOARD OF COMMUNITY ADVISORS, WITH OR WITHOUT CAUSE. C. THE BOARD DELEGATED CERTAIN FIDUCIARY DUTIES TO THE BOARDS OF COMMUNITY ADVISORS, AND GRANTED THE BOARDS OF COMMUNITY ADVISORS AUTHORITY TO ACT ON BEHALF OF THE BOARD, WITH RESPECT TO THE FOLLOWING MATTERS FOR THE HOSPITAL(S) SUPPORTED BY THAT BOARD OF COMMUNITY ADVISORS: * MEDICAL STAFF MEMBERSHIP, CREDENTIALING, AND PRIVILEGES * QUALITY, SAFETY, AND PATIENT EXPERIENCE * APPROVE HOSPITAL POLICIES AND PROCEDURES IN ADDITION THE BOARD MAY DELEGATE OTHER DUTIES AND RESPONSIBILITIES, INCLUDING ADVISORY RESPONSIBILITIES WITH RESPECT TO THE SUPPORTED HOSPITALS, TO THE BOARDS OF COMMUNITY ADVISORS. FORM 990, PART VI, SECTION A, LINE 6 ACCORDING TO THE BYLAWS OF COMMONSPIRIT OREGON THE ENTITY'S SOLE MEMBER IS COMMONSPIRIT HEALTH, A COLORADO NONPROFIT ORGANIZATION. FORM 990, PART VI, SECTION A, LINE 7A WITH THE EXCEPTION OF AN EX OFFICIO DIRECTOR, THE CORPORATE MEMBER SHALL APPOINT AND APPROVE EACH MEMBER OF THE BOARD IN ACCORDANCE WITH THE GOVERNANCE MATRIX. (CHCF RESERVED RIGHTS) EXCEPT AS OTHERWISE PROVIDED IN THE CORPORATION'S ARTICLES OF INCORPORATION OR THE LAWS OF THE STATE OF ORGANIZATION, CATHOLIC HEALTH CARE FEDERATION ("CHCF") SHALL HAVE SUCH RIGHTS AS ARE RESERVED TO THE CORPORATE MEMBER, ACTING IN ITS CAPACITY AS THE MEMBERSHIP BODY OF CHCF, UNDER THE GOVERNANCE MATRIX. FORM 990, PART VI, SECTION A, LINE 7B THE ORGANIZATION'S CORPORATE MEMBER IS COMMONSPIRIT HEALTH. PURSUANT TO SECTION 5.4 OF THE ORGANIZATION'S BYLAWS, THE CORPORATE MEMBER SHALL HAVE THE SPECIFIC RIGHTS SET FORTH IN THE GOVERNANCE MATRIX. PURSUANT TO THE GOVERNANCE MATRIX THE FOLLOWING RIGHTS ARE RESERVED TO THE COMMONSPIRIT HEALTH BOARD DIRECTLY OR THROUGH POWERS DELEGATED TO THE COMMONSPIRIT HEALTH CHIEF EXECUTIVE OFFICER: - SUBSTANTIAL CHANGE IN THE MISSION OR PHILOSOPHY OF THE COMMONSPIRIT OREGON - AMENDMENT OF THE CORPORATE DOCUMENTS OF THE COMMONSPIRIT OREGON - APPROVE MEMBERS OF THE COMMONSPIRIT OREGON BOARD - REMOVAL OF A MEMBER OF THE GOVERNING BODY OF THE COMMONSPIRIT OREGON - APPROVAL OF ISSUANCE OF DEBT BY COMMONSPIRIT OREGON - APPROVAL OF PARTICIPATION OF COMMONSPIRIT OREGON IN A JOINT VENTURE - APPROVAL OF FORMATION OF A NEW CORPORATION BY COMMONSPIRIT OREGON - APPROVAL OF A MERGER INVOLVING THE COMMONSPIRIT OREGON - APPROVAL OF THE SALE OF ALL OR SUBSTANTIALLY ALL OF THE ASSETS OF THE COMMONSPIRIT OREGON - TO REQUIRE THE TRANSFER OF ASSETS BY THE COMMONSPIRIT OREGON TO COMMONSPIRIT HEALTH TO ACCOMPLISH COMMONSPIRIT HEALTH'S GOALS AND OBJECTIVES, AND TO SATISFY COMMONSPIRIT HEALTH DEBTS. - ADOPTION OF LONG RANGE AND STRATEGIC PLANS FOR COMMONSPIRIT OREGON PURSUANT TO SECTION 5.5.2 OF THE ORGANIZATION'S BYLAWS, COMMONSPIRIT HEALTH MAY, IN EXERCISE OF ITS APPROVAL POWERS, GRANT OR WITHHOLD APPROVAL IN WHOLE OR IN PART, OR MAY, IN ITS COMPLETE DISCRETION, AFTER CONSULTATION WITH THE BOARD AND THE PRESIDENT AND CHIEF EXECUTIVE OFFICER OF THE ORGANIZATION, RECOMMEND SUCH OTHER OR DIFFERENT ACTIONS AS IT DEEMS APPROPRIATE. (CHCF RESERVED RIGHTS) EXCEPT AS OTHERWISE PROVIDED IN THE CORPORATION'S ARTICLES OF INCORPORATION OR THE LAWS OF THE STATE OF ORGANIZATION, CATHOLIC HEALTH CARE FEDERATION ("CHCF") SHALL HAVE SUCH RIGHTS AS ARE RESERVED TO THE CORPORATE MEMBER, ACTING IN ITS CAPACITY AS THE MEMBERSHIP BODY OF CHCF, UNDER THE GOVERNANCE MATRIX. FORM 990, PART VI, SECTION B, LINE 11B ONCE THE RETURN IS PREPARED, THE RETURN IS REVIEWED BY THE CHIEF FINANCIAL OFFICER AND CONTROLLER. A COPY OF THE DRAFT RETURN IS MADE AVAILABLE TO BOARD MEMBERS THAT WOULD LIKE TO REVIEW IT. SUBSEQUENT TO THE REVIEW BY THE CFO, THE TAX DEPARTMENT FILES THE RETURN WITH THE APPROPRIATE FEDERAL AND STATE AGENCIES, MAKING ANY NON-SUBSTANTIVE CHANGES NECESSARY TO EFFECT E-FILING. ANY SUCH CHANGES ARE NOT RE-SUBMITTED TO THE BOARD. FORM 990, PART VI, SECTION B, LINE 12C THE ORGANIZATION HAS A CONFLICTS OF INTEREST ("COI") POLICY (THE "POLICY") IN PLACE TO PROTECT THE INTERESTS OF COMMONSPIRIT HEALTH ("COMMONSPIRIT") IN CIRCUMSTANCES THAT MAY RESULT IN A CONFLICT BETWEEN PERSONAL INTERESTS OF A PERSON AND THE INTERESTS OF THE ORGANIZATION AND THOSE IT SERVES. COMMONSPIRIT'S COI POLICY APPLIES TO COMMONSPIRIT, ITS DIRECT AFFILIATES AND SUBSIDIARIES AND ANY RELATED ENTITY THE GOVERNING DOCUMENTS OF WHICH REQUIRE THE ENTITY TO COMPLY WITH COMMONSPIRIT POLICY (COLLECTIVELY THE "SYSTEM ENTITIES"). THE FOLLOWING PERSONS ARE REQUIRED TO DISCLOSE ACTUAL OR POTENTIAL CONFLICTS OF INTEREST AS SOON AS THEY BECOME AWARE OF IT AND AT LEAST ANNUALLY THEREAFTER (VIA A FORMAL SYSTEM-ADMINISTERED SURVEY) IF THE PERSON'S AFFILIATION WITH COMMONSPIRIT CONTINUES: - MEMBERS OF CORPORATE AND COMMUNITY BOARDS OF SYSTEM ENTITIES - MEMBERS OF COMMITTEES OF CORPORATE AND COMMUNITY BOARDS OF SYSTEM ENTITIES - MEMBERS OF THE EXECUTIVE LEADERSHIP TEAM ("ELT") OF COMMONSPIRIT - CORPORATE OFFICERS OF SYSTEM ENTITIES - EMPLOYED PHYSICIANS AND ADVANCED PRACTICE PROVIDERS - KEY EMPLOYEES AND HIGHEST COMPENSATED EMPLOYEES AS SPECIFIED BY THE INTERNAL REVENUE SERVICE FOR FORM 990 PURPOSES WHO ARE NOT OTHERWISE INCLUDED IN THE CATEGORIES ABOVE - EMPLOYEES OF SYSTEM ENTITIES AT THE VICE PRESIDENT LEVEL AND ABOVE - ALL INDIVIDUALS ENGAGED IN RESEARCH AT INSTITUTIONS OWNED OR OPERATED BY A SYSTEM ENTITY - SELECT EMPLOYEES AS DETERMINED FROM TIME TO TIME BY LEADERSHIP A FAILURE TO DISCLOSE MAY RESULT IN DISCIPLINARY OR CORRECTIVE ACTIONS. REVIEW, AND MANAGEMENT OF PERCEIVED, POTENTIAL, OR ACTUAL CONFLICTS OF INTEREST ARE ACCOMPLISHED THROUGH A DEFINED COI DISCLOSURE REVIEW PROCESS AS FURTHER DESCRIBED BELOW. REPORTED POTENTIAL OR ACTUAL CONFLICTS OF INTEREST ARE INITIALLY REVIEWED BY LEGAL, CORPORATE RESPONSIBILITY OR RESEARCH INTEGRITY STAFF. STANDARD MANAGEMENT APPROACHES PER COI POLICY ARE APPLIED TO DISCLOSED CONFLICTS. DISCLOSURES THAT IDENTIFY PERCEIVED, POTENTIAL, OR ACTUAL COIS THAT REQUIRE IMMEDIATE MATERIAL ACTION TO RESOLVE, WILL BE IDENTIFIED, AND, A CONFLICT OF INTEREST MANAGEMENT PLAN DEVELOPED, WHICH PLAN SHALL BE SUBJECT TO ACCEPTANCE BY THE APPROPRIATE DIRECT MANAGER, SUPERVISOR, MEDICAL STAFF OFFICE, BOARD OR BOARD COMMITTEE (FOR BOARD, BOARD COMMITTEE, ELT OR CORPORATE OFFICER CONFLICTS), OR OTHER APPROPRIATE INDIVIDUAL OR BODY. ONCE ACCEPTED, THE CONFLICT OF INTEREST MANAGEMENT PLAN IS COMMUNICATED TO THE PERSON WITH THE ACTUAL OR POTENTIAL CONFLICT AND THE INDIVIDUAL MUST CONDUCT THEMSELVES IN CONFORMITY WITH THE PLAN. IN THE EVENT THAT A TRANSACTIONAL CONFLICT INTEREST ARISES IN CONNECTION WITH A SYSTEM ENTITY BOARD MEETING, THE CONFLICTED INDIVIDUAL MUST DISCLOSE THAT CONFLICT PRIOR TO OR AT THE BEGINNING OF THE MEETING IN WHICH THE MATTER IS TO BE CONSIDERED. THE CONFLICTED INDIVIDUAL IS EXCLUDED FROM VOTING ON THE TRANSACTION AND IS PROHIBITED FROM USING PERSONAL INFLUENCE WITH RESPECT TO THE MATTER, BUT IS NOT PROHIBITED FROM PROVIDING INPUT IF REQUESTED TO DO SO. FORM 990, PART VI, SECTION B, LINE 15 COMMONSPIRIT'S BOARD OF STEWARDSHIP TRUSTEES APPOINTS A HUMAN RESOURCES AND COMPENSATION COMMITTEE, COMPRISED EXCLUSIVELY OF INDEPENDENT DIRECTORS, WHO ARE ACCOUNTABLE FOR ADOPTING A REASONABLE COMPENSATION PHILOSOPHY AND SETTING REASONABLE COMPENSATION PRACTICES FOR THE ORGANIZATION. COMMONSPIRIT'S COMPENSATION DEPARTMENT ENSURES THAT ITS PRACTICES ARE CONSISTENT WITH THE ORGANIZATION'S PHILOSOPHY, PRACTICES, AND PRINCIPLES, AS DETERMINED BY THE HUMAN RESOURCES AND COMPENSATION COMMITTEE. WHEN NECESSARY, THE COMPENSATION DEPARTMENT ALSO ENGAGES AN INDEPENDENT CONSULTANT, AS WELL AS QUALIFIED INDEPENDENT COMPENSATION AND BENEFITS SPECIALISTS (INDEPENDENT EXPERTS) TO VALIDATE THE ORGANIZATION'S BENCHMARKING APPROACH FOR THE TOTAL COMPENSATION AND BENEFITS PACKAGES FOR CERTAIN EXECUTIVES. APPROPRIATE COMPARABILITY DATA IS ALSO OBTAINED BY THE COMMONSPIRIT HEALTH COMPENSATION DEPARTMENT FROM INDEPENDENT THIRD-PARTY SALARY SURVEYS, AS PART OF THE ORGANIZATION'S COMPENSATION PRACTICES (E.G., TOTAL ECONOMIC BENEFITS PAID BY SIMILARLY SITUATED ORGANIZATIONS, BOTH TAXABLE AND TAX-EXEMPT, FOR SIMILAR JOB RESPONSIBILITIES). THE DOCUMENTATION OF COMPENSATION DECISIONS INCLUDES THE COMPARABILITY DATA OBTAINED AND RELIED UPON BY THE COMPENSATION DEPARTMENT AND THE SOURCES FROM WHICH THE DATA WAS OBTAINED. FORM 990, PART VI, SECTION C, LINE 19 THE ORGANIZATION'S FINANCIAL STATEMENTS, CONFLICT OF INTEREST POLICY AND GOVERNING DOCUMENTS ARE AVAILABLE TO THE PUBLIC UPON REQUEST. THE ORGANIZATION'S FINANCIAL STATEMENTS ARE INCLUDED IN COMMONSPIRIT HEALTH'S CONSOLIDATED AUDITED FINANCIAL STATEMENTS THAT ARE AVAILABLE AT WWW.COMMONSPIRIT.ORG. FORM 990, PART VI, SECTION B, LINE 16A: COMMONSPIRIT OREGON HAS NOT FORMALLY ADOPTED A WRITTEN POLICY OR WRITTEN PROCEDURE REGARDING JOINT VENTURES. HOWEVER COMMONSPIRIT HEALTH'S SYSTEM-WIDE JOINT VENTURE MODEL OPERATING AGREEMENT INCORPORATES CONTROLS OVER THE VENTURE SUFFICIENT TO ENSURE THAT (1) THE EXEMPT ORGANIZATION AT ALL TIMES RETAINS CONTROL OVER THE VENTURE SUFFICIENT TO ENSURE THAT THE PARTNERSHIP FURTHERS THE EXEMPT PURPOSE OF THE ORGANIZATION; (2) IN ANY PARTNERSHIP IN WHICH THE EXEMPT ORGANIZATION IS A PARTNER, ACHIEVEMENT OF EXEMPT PURPOSES IS PRIORITIZED OVER MAXIMIZATION OF PROFITS FOR THE PARTNERS; (3) THE PARTNERSHIP DOES NOT ENGAGE IN ANY ACTIVITIES THAT WOULD JEOPARDIZE THE EXEMPT ORGANIZATION'S EXEMPTION; AND (4) RETURNS OF CAPITAL, ALLOCATIONS, AND DISTRIBUTIONS MUST BE MADE IN PROPORTION TO THE PARTNERS' RESPECTIVE OWNERSHIP INTERESTS. ANY JOINT VENTURE AGREEMENTS THAT DO NOT CONFORM TO THE MODEL AGREEMENT ARE GENERALLY REVIEWED BY COUNSEL. FORM 990, PART IX, LINE 11G CONSULTING: PROGRAM SERVICE EXPENSES 212,489. MANAGEMENT AND GENERAL EXPENSES 11,184. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 223,673. CONTRACT SERVICES: PROGRAM SERVICE EXPENSES 17,659,360. MANAGEMENT AND GENERAL EXPENSES 1,962,151. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 19,621,511. CONTRACT LABOR: PROGRAM SERVICE EXPENSES 24,007,685. MANAGEMENT AND GENERAL EXPENSES 1,263,562. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 25,271,247. PURCHASED SERVICES: PROGRAM SERVICE EXPENSES 15,443,699. MANAGEMENT AND GENERAL EXPENSES 720,742. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 16,164,441. OTHER FEES FOR SERVICES: PROGRAM SERVICE EXPENSES 14,880,230. MANAGEMENT AND GENERAL EXPENSES 783,170. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 15,663,400. FORM 990, PART XI, LINE 9: ST ANTHONY HOSPITAL ASSETS TRANSER 290,907,431. AFFILIATE TRANSFERS TO MERCY SERVICES CORP -24,858. AFFILIATE TRANSFERS TO ST ANTHONY HOSPITAL -2,286,043. TRANSFER TO/FROM AFFILIATES -1,080,407. ZONE CLEARING -301,000. ALEGENT CREIGHTON CLINIC 12809 W DODGE RD OMAHA NE 68154 470765154 HOSPITAL NE 501(C)(3) LINE 3 ACH 0 ALEGENT CREIGHTON HEALTH 12809 W DODGE RD OMAHA NE 68154 470757164 HOSPITAL NE 501(C)(3) LINE 3 CHI NEBRASKA 0 ALEGENT HEALTH - BERGAN MERCY HEALTH SYSTEM 7500 MERCY RD OMAHA NE 68124 470484764 HOSPITAL NE 501(C)(3) LINE 3 CHI NEBRASKA 0 ALEGENT HEALTH - COMM MEM HOSPITAL OF MO VALLEY IA 631 N 8TH ST MISSOURI VALLEY IA 51555 420776568 HOSPITAL IA 501(C)(3) LINE 3 CHI NEBRASKA 0 ALEGENT HEALTH - IMMANUEL MEDICAL CENTER 6901 N 72ND ST OMAHA NE 68122 470376615 HOSPITAL NE 501(C)(3) LINE 3 CHI NEBRASKA 0 ALEGENT HEALTH - MEMORIAL HOSPITAL SCHUYLER 104 W 17TH ST SCHUYLER NE 68661 470399853 HOSPITAL NE 501(C)(3) LINE 3 CHI NEBRASKA 0 ALEGENT HEALTH - MERCY HOSPITAL CORNING IOWA PO BOX 368 CORNING IA 50841 420782518 HOSPITAL IA 501(C)(3) LINE 3 CHI NEBRASKA 0 ALVERNA APARTMENTS 300 SE 8TH AVE LITTLE FALLS MN 56345 411351177 LTERM CARE MN 501(C)(3) LINE 10 CSH 0 APPLETREE COURT 601 OAK ST BRECKENRIDGE MN 56520 411850500 SENIOR LIVING MN 501(C)(3) LINE 10 SFH 0 ARROYO GRANDE COMMUNITY HOSPITAL FOUNDATION 345 S HALCYON RD ARROYO GRANDE CA 93420 203256066 FUNDRAISING FOUNDATION CA 501(C)(3) LINE 12A, I DH 0 BAKERSFIELD MEMORIAL HOSPITAL 420 34TH STREET BAKERSFIELD CA 93301 951802779 HOSPITAL CA 501(C)(3) LINE 3 DCC 0 BAYLOR ST LUKE'S HEALTH VENTURES 17200 ST LUKES WAY STE 170 THE WOODLANDS TX 77384 274499340 PHYSICIANS TX 501(C)(3) LINE 12A, I SLHS 0 BAYLOR ST LUKE'S MEDICAL GROUP 6624 FANNIN ST STE 1100 HOUSTON TX 77030 760458535 PHYSICIANS TX 501(C)(3) LINE 3 BSLHV 0 BENAROYA RESEARCH INSTITUTE AT VIRGINIA MASON 1201 9TH AVE SEATTLE WA 98101 910653422 RESEARCH WA 501(C)(3) LINE 4 VMFH 0 BORNEMANN HEALTHCARE CORPORATION 198 INVERNESS DRIVE WEST ENGLEWOOD CO 80112 232187242 INACTIVE PA 501(C)(3) LINE 12A, I CSH 0 BURLESON ST JOSEPH HEALTH CENTER 2801 FRANCISCAN DRIVE BRYAN TX 77802 742759890 HOSPITAL TX 501(C)(3) LINE 3 SLH-CO 0 BURLESON ST JOSEPH MANOR 2801 FRANCISCAN DRIVE BRYAN TX 77802 742913931 REHABILITATION TX 501(C)(3) LINE 10 SJSC 0 CALIFORNIA HOSPITAL MEDICAL CENTER FOUNDATION 1401 SOUTH GRAND AVENUE LOS ANGELES CA 90015 954000909 FUNDRAISING FOUNDATION CA 501(C)(3) LINE 12A, I DCC 0 CARRINGTON HEALTH CENTER 800 N 4TH ST CARRINGTON ND 58421 450227311 HOSPITAL ND 501(C)(3) LINE 3 CSH 0 CATHOLIC HEALTH INITIATIVES - COLORADO 9100 EAST MINERAL CIRCLE CENTENNIAL CO 80112 840405257 HOSPITAL CO 501(C)(3) LINE 3 CSH 0 CATHOLIC HEALTH INITIATIVES COLORADO FOUNDATION 9100 EAST MINERAL AVE CENTENNIAL CO 80112 840902211 FUNDRAISING FOUNDATION CO 501(C)(3) LINE 7 CHIC 0 CATHOLIC HEALTH INITIATIVES NATIONAL FOUNDATION 1150 KELLY JOHNSON BLVD 204 COLORADO SPRINGS CO 80920 270930004 FUNDRAISING FOUNDATION CO 501(C)(3) LINE 12A, I CSH 0 CATHOLIC HEALTH INITIATIVES VIRTUAL HEALTH SERVICES 198 INVERNESS DRIVE WEST ENGLEWOOD CO 80112 460992796 TELEHEALTH CO 501(C)(3) LINE 12A, I CSH 0 CENTENNIAL MEDICAL GROUP INC 2700 STEWART PKWY ROSEBURG OR 97471 263946191 SURGERY CENTER OR 501(C)(3) LINE 10 CS OR 1 CENTRAL CALIFORNIA HEALTH CENTERS 300 OLD RIVER ROAD STE 200 BAKERSFIELD CA 93311 844171789 CLINIC CA 501(C)(3) LINE 3 DCC 0 CENTRAL KANSAS MEDICAL CENTER 9100 E MINERAL CIRCLE CENTENNIAL CO 80112 480543724 INACTIVE KS 501(C)(3) LINE 3 CSH 0 CHI HEALTH CONNECT AT HOME - FARGO 4816 AMBER VALLEY PKWY S FARGO ND 58104 271966847 SENIOR LIVING MN 501(C)(3) LINE 10 CSH 0 CHI HEALTH FOUNDATION 12809 W DODGE RD OMAHA NE 68154 470648586 FUNDRAISING FOUNDATION NE 501(C)(3) LINE 7 ACH 0 CHI KENTUCKY INC 3900 OLYMPIC BLVD STE 400 ERLANGER KY 41018 202741651 INVESTMENTS KY 501(C)(3) LINE 12A, I CSH 0 CHI LIVING COMMUNITIES 930 S WYNN ROAD OREGON OH 43616 341892096 SENIOR LIVING OH 501(C)(3) LINE 12A, I SFH-OH 0 CHI MEMORIAL HOSPITAL - GEORGIA 100 GROSS CRESCENT CIRCLE FORT OGLETHORPE GA 30742 822748395 HOSPITAL GA 501(C)(3) LINE 3 MHCS 0 CHI NEBRASKA 12809 WEST DODGE ROAD OMAHA NE 68510 363233121 HOLDING CO NE 501(C)(3) LINE 12A, I CSH 0 CHI ST JOSEPH CHILDREN'S HEALTH 1929 LINCOLN HWY E STE 150 LANCASTER PA 17602 232342997 HEALTHCARE PA 501(C)(3) LINE 12A, I CSH 0 CHI ST JOSEPH'S CHILDREN 1516 5TH ST NW ALBUQUERQUE NM 87102 710897107 COMMUNITY NM 501(C)(3) LINE 12A, I CSH 0 CHI ST VINCENT HOSPITAL HOT SPRINGS 300 WERNER ST HOT SPRINGS AR 71913 710236913 HOSPITAL AR 501(C)(3) LINE 3 CHI-SVHS 0 CHI ST VINCENT HOT SPRINGS 300 WERNER ST HOT SPRINGS AR 71913 261125064 HOLDING CO AR 501(C)(3) LINE 12A, I SVIMC 0 CHI ST VINCENT MEDICAL GROUP HOT SPRINGS 300 WERNER ST HOT SPRINGS AR 71913 261125131 PHYSICIANS AR 501(C)(3) LINE 3 CHI-SVHS 0 COMMONSPIRIT HEALTH 198 INVERNESS DRIVE WEST ENGLEWOOD CO 80112 470617373 HEALTHCARE CO 501(C)(3) LINE 12A, I N/A 0 COMMONSPIRIT HEALTH DIVERSIFIED HOLDINGS 198 INVERNESS DRIVE WEST ENGLEWOOD CO 80112 421178204 REHABILITATION IA 501(C)(3) LINE 12A, I CSH 0 COMMONSPIRIT HEALTH FOUNDATION 198 INVERNESS DRIVE WEST ENGLEWOOD CO 80112 853374038 FUNDRAISING FOUNDATION CO 501(C)(3) LINE 7 CSH 0 COMMONSPIRIT 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FOUNDATION 1717 SOUTH J ST TACOMA WA 98405 911145592 FUNDRAISING FOUNDATION WA 501(C)(3) LINE 10 FHS 0 FRANCISCAN HEALTH SYSTEM 1717 SOUTH J ST TACOMA WA 98405 910564491 HOSPITAL WA 501(C)(3) LINE 3 CSH 0 FRANCISCAN MEDICAL GROUP 1313 BROADWAY STE 200 TACOMA WA 98402 911939739 PHYSICIANS WA 501(C)(3) LINE 10 FHS 0 FRENCH HOSPITAL MEDICAL CENTER FOUNDATION 1911 JOHNSON AVENUE SAN LUIS OBISPO CA 93401 203256125 FUNDRAISING FOUNDATION CA 501(C)(3) LINE 12A, I DCC 0 GARRISON MEMORIAL HOSPITAL 407 THIRD AVENUE SOUTHEAST GARRISON ND 58540 450227752 HOSPITAL ND 501(C)(3) LINE 3 SAMC 0 GLENDALE MEMORIAL HEALTH FOUNDATION 1420 SOUTH CENTRAL AVENUE GLENDALE CA 91204 953625651 FUNDRAISING FOUNDATION CA 501(C)(3) LINE 12A, I DCC 0 GLOBAL HEALTH INITIATIVES 198 INVERNESS DRIVE WEST ENGLEWOOD CO 80112 201536108 INACTIVE CO 501(C)(3) LINE 12A, I CSH 0 GOOD SAMARITAN COLLEGE OF NURSING & HEALTH SCIENCE 625 EDEN PARK DRIVE 7TH FLOOR CINCINNATI OH 45202 311778403 EDUCATION OH 501(C)(3) LINE 2 GSH 0 GOOD 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INC 225 FALCON DR MOUNT STERLING KY 40353 272884584 FUNDRAISING FOUNDATION KY 501(C)(3) LINE 7 SJHS 0 SAINT JOSEPH'S HOSPITAL FOUNDATION 2500 FAIRWAY STREET DICKINSON ND 58601 363418207 FUNDRAISING FOUNDATION ND 501(C)(3) LINE 12A, I SJHHC 0 SCHUYLER MEMORIAL HOSPITAL FOUNDATION INC 104 W 17TH ST SCHUYLER NE 68661 363630014 FUNDRAISING FOUNDATION NE 501(C)(3) LINE 12A, I AHMHS 0 SIERRA NEVADA MEMORIAL-MINERS HOSPITAL 155 GLASSON WAY GRASS VALLEY CA 95945 941439787 HOSPITAL CA 501(C)(3) LINE 3 DCC 0 SJRMC JOPLIN MISSOURI 198 INVERNESS DRIVE WEST ENGLEWOOD CO 80112 440545809 INACTIVE MO 501(C)(3) LINE 3 CSH 0 ST FRANCIS HOSPITAL SUPPORT CORPORATION 601 E MICHELTORENA STREET SANTA BARBARA CA 93103 770022302 INACTIVE CA 501(C)(3) LINE 12A, I DH 0 ST JOHN'S HEALTHCARE FOUNDATION 1600 NORTH ROSE AVENUE OXNARD CA 93030 202865781 FUNDRAISING FOUNDATION CA 501(C)(3) LINE 12A, I DH 0 ST JOSEPH'S FOUNDATION (PHOENIX) 350 WEST THOMAS ROAD PHOENIX AZ 85013 942941245 FUNDRAISING FOUNDATION AZ 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