2024-05-15T18:05:05-05:00 2023-06-30 430831507 ANDERS CPAS AND ADVISORS 800 MARKET STREET STE 500 ST LOUIS MO 63101 990 2022-07-01 237246265 SAINT FRANCIS MEDICAL CENTER SAIN 5733313000 211 SAINT FRANCIS DRIVE CAPE GIRARDEAU MO 63703 MATTHEW BRANDT CHIEF FINANCIAL OFFICER 5733313000 2024-05-15 1 MATTHEW BRANDT 999009999 0 MARK G HINSEN P00047496 3146555500 2 AAL1 IAL1 2022 2023-04-26 12:10:37Z MATTHEW BRANDT 211 SAINT FRANCIS DRIVE CAPE GIRARDEAU MO 63703 698958228 0 X WWW.SFMC.NET X 1972 MO THE MISSION OF SAINT FRANCIS MEDICAL CENTER IS TO PROVIDE A MINISTRY OF HEALING, WELLNESS, QUALITY AND LOVE INSPIRED BY OUR FAITH IN JESUS CHRIST. 12 9 9 0 0 0 846984 1503910 532348494 625863150 -426951 71314751 13673373 0 546441900 698681811 0 0 0 0 117934217 4633569 0 0 0 431982921 604937089 549917138 609570658 -3475238 89111153 1081692774 1295654627 248793879 573824703 832898895 721829924 X SAINT FRANCIS MEDICAL CENTER IS A 306 BED FACILITY SERVING MORE THAN 715,000 PEOPLE THROUGHOUT MISSOURI, ILLINOIS, KENTUCKY, TENNESSEE, AND ARKANSAS. THE MEDICAL CENTER PROVIDES COMPREHENSIVE INPATIENT ACUTE CARE SERVICES FOR MEDICAL AND SURGICAL PATIENTS SPECIALIZING IN ORTHOPEDICS, NEUROSURGERY, CARDIOVASCULAR SERVICES, ONCOLOGY, DISEASE MANAGEMENT, GASTROENTEROLOGY, MATERNAL CHILD HEALTH AND NEUROLOGY. 0 0 518786327 SINCE ITS FOUNDING IN 1875, SAINT FRANCIS MEDICAL CENTER'S (SFMC) MISSION HAS BEEN TO PROVIDE HEALTH CARE SERVICES TO EVERYONE, REGARDLESS OF RACE, CREED, GENDER, NATIONAL ORIGIN, HANDICAP, AGE OR ABILITY TO PAY. ALTHOUGH REIMBURSEMENT FOR SERVICES RENDERED IS CRITICAL TO THE OPERATION AND STABILITY OF SFMC, IT IS RECOGNIZED THAT NOT ALL INDIVIDUALS POSSESS THE ABILITY TO PURCHASE ESSENTIAL MEDICAL SERVICES. IN FULFILLING OUR MISSION TO SERVE RESIDENTS OF CAPE GIRARDEAU AND THE SURROUNDING REGION, SFMC PROVIDES: -FREE AND/OR SUBSIDIZED CARE WHEN NEED AND/OR AN INDIVIDUAL'S INABILITY TO PAY COEXIST. THIS PAST YEAR, SFMC PROVIDED OVER $46.6 MILLION IN FREE AND/OR SUBSIDIZED CARE. -CARE FOR PERSONS COVERED BY GOVERNMENTAL PROGRAMS THAT REIMBURSE BELOW ACTUAL COST. -HEALTH SCREENINGS AND EDUCATIONAL PROGRAMS TO SUPPORT THE HEALTHCARE NEEDS OF THE COMMUNITY. SFMC PROVIDES A VARIETY OF WELLNESS PROGRAMS, COMMUNITY HEALTH EDUCATION ACTIVITIES, SPECIAL PROGRAMS FOR THE ELDERLY, HANDICAPPED, MEDICALLY UNDERSERVED AND PARTICIPATES IN A VARIETY OF BROAD COMMUNITY SUPPORT ACTIVITIES.SFMC SERVED 12,913 INPATIENTS, 39,791 EMERGENCY PATIENTS AND 674,799 OUTPATIENTS DURING THE FISCAL YEAR (FY) ENDING JUNE 30, 2023. DURING FY 2023, SFMC HAD A TOTAL OF 55,779 PATIENT DAYS IN ITS MEDICAL/SURGICAL, CRITICAL CARE, OBSTETRIC, AND REHABILITATION CARE UNITS. SFMC PROVIDESCARE TO PERSONS COVERED BY GOVERNMENTAL PROGRAMS, FOR WHICH IT IS REIMBURSED BELOW COST. RECOGNIZING ITS MISSION IN THE COMMUNITY, SFMC PROVIDES SERVICES TO BOTH MEDICARE AND MEDICAID PATIENTS. THE UNREIMBURSED VALUE OF PROVIDING CARE TO THESE PATIENTS WAS IN EXCESS OF$119.7 MILLION IN FY 2023. CHARITY CARE IS PROVIDED IN THE FORM OF MANY REDUCED PRICEAND FREE SERVICES OFFERED THROUGHOUT THE YEAR. SFMC STRONGLY BELIEVES THESE PROGRAMS AND SERVICES FILL A REAL NEED IN THE COMMUNITY. THESE PROGRAMS AND SERVICES INCLUDE THE FOLLOWING:-PARTICIPATION IN AND/OR SPONSORSHIP OF MANY COMMUNITY HEALTH FAIRS. THESE EVENTS RANGE FROM CHILDREN'S SPECIAL EVENTS TO SENIOR HEALTH FAIRS. THESE EVENTS DRAW SEVERAL THOUSAND ATTENDEES EACH YEAR. -SFMC SPONSORS THE REGIONAL ARTHRITIS CENTER, OFFERING INFORMATION AND ASSISTANCE TO PEOPLE THROUGHOUT SOUTHEAST MISSOURI. -FREE OR DISCOUNTED HEALTH SCREENINGS (CHOLESTEROL, BLOOD PRESSURE, GLAUCOMA, BLOOD SUGAR, ETC.) PROVIDED AT HEALTH FAIRS AND COMMUNITY HEALTH EDUCATION PROGRAMS, AS WELL AS OUR WEEKLY WEDNESDAY MORNING HEART HEALTH SCREENINGS.-COMMUNITY HEALTH FORUMS WERE OFFERED ON TOPICS SUCH AS ARTHRITIS, DIABETES, CARDIOVASCULAR FITNESS, CHILDREN'S HEALTH AND SAFETY, NUTRITION, BREAST CANCER AND OSTEOPOROSIS. OTHER WELLNESS PROGRAMS SUCH AS WEIGHT MANAGEMENT AND SMOKING CESSATION ARE SUBSIDIZED BY SFMC AND OFFERED FOR A NOMINAL FEE.-CHILDBIRTH, SIBLINGS, BREASTFEEDING AND INFANT CARE CLASSES ARE PROVIDED FREE OF CHARGE TO EXPECTANT MOTHERS AND YOUNG FAMILIES. SFMC SPONSORS HEALTHCARE SPEAKERS FOR COMMUNITY EVENTS AND CIVIC MEETINGS. SFMC STAFF PRESENTS FREE PROGRAMS ON A VARIETY OF HEALTH AND WELLNESS TOPICS TO VARIOUS COMMUNITY, SCHOOL AND CHURCH GROUPS THROUGHOUT THE YEAR. SEVERAL SFMC OUTPATIENT CLINICS ARE OFFERED AT REDUCED FEE OR NO COST TO PATIENTS AND THEIR FAMILIES. THE CLINICS ADDRESS DIABETIC FOOTCARE, GENETICS, ORTHOPEDICS AND SPORTS INJURIES. -SFMC PROVIDES FREE FIRST AID SERVICES AT THE WEEKLONG SEMO DISTRICT FAIR IN CAPE GIRARDEAU. MEDICAL CENTER PERSONNEL STAFF THE FIRST AID STATION AND PROVIDE MINOR MEDICAL SERVICES TO HUNDREDS OF PEOPLE DURING THE COURSE OF THE WEEK. SFMC ALSO PROVIDES STAFF AND FIRST AID MATERIALS FOR OTHER CIVIC FUNCTIONS DURING THE FISCAL YEAR. SFMC PROVIDES FREE MEETING ROOM SPACE AND RELATED ASSISTANCE TO MANY HEALTHCARE SUPPORT GROUPS. SEVERAL HUNDRED PEOPLE REGULARLY PARTICIPATE IN THESE SUPPORT GROUPS FOR DISEASES AND DISORDERS INCLUDING BREAST CANCER, MUSCULAR DYSTROPHY, SLEEP DISTURBANCE, HEAD INJURIES, LARYNGECTOMY, HEART SURGERY, DIGESTIVE DISEASES, PARKINSON'S, ARTHRITIS, MULTIPLE SCLEROSIS AND STROKES, AS WELL AS GRIEF SUPPORT FOR PEOPLE WHO HAVE LOST A LOVED ONE TO ILLNESS, INJURY OR DISEASE. -SFMC PROVIDES FINANCIAL AND INKIND SUPPORT FOR ACTIVITIES OF LOCAL CHARITIES SUCH AS THEAMERICAN CANCER SOCIETY, AMERICAN DIABETES ASSOCIATION, THE AMERICAN ARTHRITIS ASSOCIATION, THE MARCH OF DIMES, THE AMERICAN HEART ASSOCIATION AND THE AMERICAN LUNG ASSOCIATION. -SCHOLARSHIPS AND TUITION REIMBURSEMENT ARE AWARDED ANNUALLY BY SFMC TO UNDERGRADUATEAND GRADUATE STUDENTS ENROLLED IN VARIOUS HEALTHCARE CURRICULUMS. THE VALUE OF THIS INVESTMENT IN THE ADVANCEMENT OF EXISTING CARE PROVIDERS AND THE EDUCATION OF FUTURE CARE PROVIDERS WAS $154,809 IN FY 2023. -SFMC SPONSORS MEDICAL MINUTE. THESE WEEKLY EDUCATIONAL PROGRAMS, PRODUCED IN COOPERATION WITH MEMBERS OF THE MEDICAL COMMUNITY, PROVIDES INFORMATION ON NEW TECHNOLOGY AND PROCEDURES, TREATMENT FOR DISEASES AND DISORDERS, AND GENERAL MEDICAL EDUCATION TO AREA PATIENTS. -SFMC PROVIDES FREE INTERNET LIBRARY SEARCHES ON HEALTHCARE TOPICS TO AREA RESIDENTS WHO DO NOT HAVE OTHER ACCESS. HOSPITAL EDUCATION STAFF CONDUCTS THE SEARCH AND FAX OR EMAIL MATERIALS. -SFMC PROVIDES EMERGENCY CARE, CLOTHING AND PHARMACEUTICALS TO CHILDREN IN NEED THROUGH THE SAINT FRANCIS FOUNDATION CHILDREN HELPING CHILDREN FUND. -DURING FY 2023 SFMC VOLUNTEERS CONTRIBUTED APPROXIMATELY 18,638 HOURS OF SERVICE TO OUR PATIENTS, THEIR FAMILIES AND THE COMMUNITY. THE VALUE OF THIS CONTRIBUTION IS ESTIMATED AT OVER $279,000 AND IS GIVEN BACK TO THE COMMUNITY THROUGH LOWER COSTS IN PATIENT CARE SERVICES AND WELLNESS PROGRAMS SUCH AS THOSE DESCRIBED ELSEWHERE IN THIS DOCUMENT. -DURING FY 2023 SFMC PROVIDED 998 FREE MAMMOGRAMS AND ULTRASOUNDS TO AREA WOMEN WHO COULD NOT AFFORD THIS POTENTIALLY LIFESAVING SCREENING. THE VALUE OF THIS CONTRIBUTION IS ESTIMATED AT MORE THAN $95,900. 518786327 1 0 0 0 0 0 0 0 0 0 1 0 0 1 1 1 1 0 0 0 0 0 0 0 0 0 1 1 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 1 1 0 0 0 1 51 0 1 9 1 1 1 0 0 0 0 0 0 0 1 0 X 12 9 1 0 0 0 1 1 1 1 1 0 0 1 1 1 1 1 1 1 1 0 X MATTHEW BRANDT 5733313000 211 SAINT FRANCIS DRIVE CAPE GIRARDEAU MO 63703 STEVE DIRNBERGER CHAIR 2.00 2.00 X 0 0 0 JAMES BOLLINGER JR DIRECTOR 2.00 2.00 X 0 0 0 KEVIN GOVERO DIRECTOR 2.00 4.00 X 0 0 0 MIKE HIMMELBERG DIRECTOR 2.00 2.00 X 0 0 0 ADAM KIDD DIRECTOR 2.00 4.00 X 1472 0 0 JOSEPH MCLANE DIRECTOR 2.00 2.00 X 0 0 0 GINA RAFFETY DIRECTOR 2.00 2.00 X 0 0 0 KATHY SWAN DIRECTOR 2.00 2.00 X 0 0 0 JANET VARNON DIRECTOR 2.00 2.00 X 3850 0 0 DENNIS VOLLINK SECRETARY/TREASURER 2.00 4.00 X 0 0 0 LAURA YOUNGHOUSE VICE CHAIR 2.00 2.00 X 3358 0 0 JUSTIN DAVISON PRESIDENT & CEO 42.00 8.00 X X 0 660207 32742 JEFFREY HOTOP DIRECTOR 2.00 4.00 X 0 0 0 MATTHEW BRANDT CFO - VP-FINANCE 40.00 X 0 6962 0 STEVEN OGBURN VP OF SFMP 40.00 X 0 373975 43312 GERRY SALTER VP - SPECIALTY PRACTICES 40.00 X 0 318949 42756 JASON SNOW VICE PRESIDENT - HUMAN RES 40.00 X 0 266681 18247 JAMES WILFERTH VICE PRESIDENT - FOUNDATIO 40.00 2.00 X 0 267070 37959 ANDREW GODBEY MD CMO & PRESIDENT - SFMP 40.00 X 0 782635 43745 DEBBY SPRANDEL CHIEF NURSING OFFICER 40.00 X 0 244476 15074 JOEL SANDER VP - NORTHEAST OPERATIONS 40.00 X 0 239171 30517 LISA NEWCOMER VP - REGIONAL OPERATIONS 40.00 X 0 232142 39070 KAYWAN GAMADIA DO NEUROSURGEON 40.00 X 0 1417111 31606 BRANDON SCOTT DO NEUROSURGEON 40.00 X 0 1420635 43905 ANDREW TRUEBLOOD MD ORTHOPEDIC SURGEON 40.00 X 0 1099476 7009 JUSTIN BAIN DO NEPHROLOGIST 40.00 X 0 1116505 43894 JAMES MILLER MD CARDIOTHORACIC SURGEON 40.00 X 0 1244389 2390 CHRISTY SHAWAN VP - SOUTHWEST OPERATIONS (FORMER) 40.00 X 0 235222 32141 MARYANN REESE PRESIDENT & CEO (FORMER) 42.00 8.00 X 0 994743 5579 LORI STURGILL CHIEF INFORMATION OFFICER (FORMER) 40.00 X 0 349605 34693 THOMAS DIEMER MD CHIEF MEDICAL OFFICER (FOR 40.00 X 0 582844 32907 JAMES BURKE CAO & GENERAL COUNSEL (FOR 40.00 X 0 695588 2505 STEPHANIE LA PIERRE CHIEF NURSING OFFICER (FOR 40.00 X 0 411178 2689 8680 12959564 542740 0 1 1 0 MEDEFIS INC PO BOX 5068 NEW YORK NY 10087 MEDEFIS INC 10837436 CAPE ANESTHESIA GROUP BOX 1777 CAPE GIRARDEAU MO 63702 CAPE ANESTHESIA GROUP 4307016 INTERNAL MED ASSOC OF SE MO 225 PHYSICIANS PARK DRIVE SUITE 40 POPLAR BLUFF MO 63901 INTERNAL MED ASSOC 2497573 GREEN PAGES INC PO BOX 844844 BOSTON MA 02284 GREEN PAGES INC 1726728 MAYO COLLABORATIVE SERVICES DBA MAYO CLI PO BOC 9146 MINNEAPOLIS MN 55480 MAYO CLINIC 1296349 5 1503910 1503910 PATIENT SERVICE REVENUE 621400 596723256 596723256 MISC PROGRAM SERVICE REVENUE 621990 29139894 29139894 625863150 71591168 71591168 276417 -276417 -276417 -276417 698681811 625586733 0 71591168 2074949 2317141 -242192 2558620 141886 2416734 24699243 24679556 19687 26033616 107908 25925708 1575 1575 15139644 7243119 7896525 3862369 3862369 LEASED EMPLOYEES 285711455 285711455 MEDICAL SUPPLIES 194376168 143952614 50423554 DRUGS 50465351 50436726 28625 REPAIR & MAINTENANCE 3320086 3293570 26516 1327582 902352 425230 609570658 518786327 90784331 0 49075527 50760515 10355714 18292255 47906910 61210401 10810257 11162839 16281197 17848143 232962533 177966279 267441807 54996254 655995887 679450240 1374634 9476929 22450841 392457051 1081692774 1295654627 81517608 60081675 147305404 0 19970867 513743028 248793879 573824703 X 832898895 721829924 832898895 721829924 1081692774 1295654627 X 89111153 -200180123 X 0 1 X 1 1 1 X 795381 116910 678471 232167152 177849369 54317783 54996254 INVESTMENT IN SUB 1000000 RIGHT-OF-USE ASSET 53642741 DUE FROM RELATED PARTY 337814310 392457051 OPERATING LEASE OBLIGATIONS 53642741 DUE TO RELATED PARTY 460100287 513743028 X 698958227 276417 276417 698681810 0 698681810 610018943 448286 448286 609570657 0 609570657 PART X, LINE 2: THERE WERE NO UNCERTAIN TAX BENEFITS IDENTIFIED AND RECORDED AS A LIABILITY AT JUNE 30, 2023 OR 2022. PART XI, LINE 2D - OTHER ADJUSTMENTS: LOSS ON DISPOSAL PART XII, LINE 2D - OTHER ADJUSTMENTS: LOSS ON DISPOSAL BAD DEBT 1 1 1 X 0 1 1 1 0 1 1 17555007 17555007 0.02880 114751724 113540303 1211421 0.00200 132306731 113540303 18766428 0.03080 136018 136018 0.00020 13270399 5147444 8122955 0.01330 37792 37792 0.00010 13444209 5147444 8296765 0.01360 145750940 118687747 27063193 0.04440 136018 136018 0.00020 37792 37792 0.00010 8122955 8122955 0.01330 8296765 8296765 0.01360 1 171869 42967 196649272 255812873 -59163601 X 1 1 1 1 SAINT FRANCIS MEDICAL CENTER 211 SAINT FRANCIS DRIVE CAPE GIRARDEAU MO 63703 X X X SAINT FRANCIS MEDICAL CENTER 1 0 0 1 X X X X X X X X X 22 1 1 0 1 X WWW.SFMC.NET 1 22 1 WWW.SFMC.NET 0 1 X 200.000000000000 X 1 1 X X X 1 X WWW.SFMC.NET X WWW.SFMC.NET X WWW.SFMC.NET X X X X X X X 1 X 0 X X X X 1 X 0 0 SAINT FRANCIS MEDICAL CENTER PART V, SECTION B, LINE 3J: THE IMPACT OF ANY ACTIONS TAKEN TO ADDRESS THE SIGNIFICANT HEALTH NEEDS IDENTIFIED IN THE HOSPITAL FACILITY'S PRIOR CHNA. SAINT FRANCIS MEDICAL CENTER PART V, SECTION B, LINE 5: INDIVIDUALS REPRESENTING THE BOARD INTERESTSOF BOLLINGER, CAPE GIRARDEAU, SCOTT, AND STODDARD COUNTIES INCLUDED PEOPLEINVOLVED IN SOME OF THE FOLLOWING ORGANIZATIONS: PUBLIC HEALTH DEPARTMENTS RURAL HEALTH CLINICS LOCAL SCHOOL DISTRICTS SOCIAL SERVICE ORGANIZATIONS OTHER HOSPITALS MINORITY ADVOCACY GROUPSSIX FOCUS GROUPS WERE CONDUCTED VIA WEBEX WITH REPRESENTATIVES IN THE FOUR COUNTIES THIS RESEARCH TARGETS (CAPE GIRARDEAU, BUTLER, SCOTT AND STODDARD COUNTIES). THE QUESTIONS POSED TO PARTICIPANTS WERE:1. WHAT IS YOUR VISION FOR A HEALTH COMMUNITY AND COUNTY? WHAT IS CURRENTLY UNHEALTHY AND WHAT IS HEALTH ABOUT THIS REGION?2. WHAT IS YOUR PERCEPTION OF THE MOST SERIOUS HEALTH ISSUES FACING THIS COMMUNITY AND COUNTY? 3. WHAT ARE SOME OF THE CAUSES OF THESE PROBLEMS?4. WHAT COULD BE DONE TO SOLVE THESE PROBLEMS?5. WHAT IS YOUR PERCEPTION OF THE MOST BENEFICIAL HEALTH RESOURCES OR SERVICES IN THE COMMUNITY AND COUNTY? WHAT HEALTH ASSETS DO WE HAVE?6. WHAT ACTIONS, PROGRAMS AND HEALTH SERVICES CAN SAINT FRANCIS OFFER TO ADDRESS THE MOST CRITICAL HEALTH NEEDS OF THE COUNTY?MORE THAN 500 SURVEYS WERE COMPLETED BY RESIDENTS OF THE FOUR DESIGNATED COUNTIES.THE SURVEY DEMOGRAPHICS WERE REPRESENTATIVE OF THE AREA'S POPULATION:1. DEMOGRAPHICS: MULTIPLE-CHOICE QUESTIONS TO COLLECT INFORMATIONABOUT THE POPULATION OF THE COUNTY2. SOCIAL AND ECONOMIC FACTORS: MULTIPLE-CHOICE QUESTIONS TO COLLECTINFORMATION REGARDING THE POPULATION'S EDUCATION, EMPLOYMENT AND INCOMESTATUS.3. HEALTH BEHAVIORS: QUESTIONS TO COLLECT INFORMATION ON THE BEHAVIORSCORRELATED TO HEALTH OF ADULTS AND CHILDREN IN THE COUNTRY.4. MEDICAL CARE AND SERVICES: MULTIPLE-CHOICE, SHORT ANSWER AND RANKEDQUESTIONS TO COLLECT INFORMATION REGARDING HEALTHCARE ACCESS, HEALTHSTATUS, INSURANCE COVERAGE, AND OPINIONS ON HEALTH ISSUES. SAINT FRANCIS MEDICAL CENTER PART V, SECTION B, LINE 6A: SAINT FRANCIS HEALTHCARE SYSTEM CONDUCTED THE 2022 CHNA PRIMARY DATA GATHERING SAINT FRANCIS MEDICAL CENTER PART V, SECTION B, LINE 7D: THE COMMUNITY HEALTH NEEDS ASSESSMENT WASPLACED ON THE SAINT FRANCIS MEDICAL CENTER'S WEBSITE. THERE WERE NUMEROUSNEWS STORIES ON THE ASSESSMENT AND WHERE TO LOCATE THE INFORMATION. LOCALHEALTH AND HUMAN SERVICES AGENCIES WERE INFORMED WHEN THE ASSESSMENT WASCOMPLETED AT LOCAL MEETINGS.PRESENTATION OF THE CHNA FINDINGS WERE PRESENTED TO ALL BOARDS OF SAINTFRANCIS HEALTHCARE SYSTEM. THE CHNA WAS SHARED WITH MISSOURI DELTA MEDICALCENTER IN SIKESTON, MISSOURI AND THE HEALTH DEPARTMENTS IN EACH COUNTY.HTTPS://WWW.SFMC.NET/CHNA SAINT FRANCIS MEDICAL CENTER PART V, SECTION B, LINE 11: WHILE TREATMENT FOR SUBSTANCE ABUSE AND MENTAL HEALTH CONDITIONS ARE A SIGNIFICANT COMMUNITY HEALTH NEED IDENTIFIED BY THIS ASSESSMENT, SAINT FRANCIS HEALTHCARE SYSTEM WILL NOT FULLY ADDRESS THIS NEED AS PART OF ITS 2022-2025 CHNA IMPLEMENTATION PLAN FOR THE FOLLOWING REASONS:1. CONSIDERABLE SAINT FRANCIS RESOURCES HAVE BEEN ALLOCATED TO ADDRESSTHE OTHER TOP-PRIORITY HEALTH NEEDS IDENTIFIED BY THE 2022 CHNA.2. SOUTHEASTHEALTH, THE OTHER COMMUNITY HOSPITAL IN CAPE GIRARDEAU, IN PARTNERSHIP WITH UNIVERSAL HEALTH SERVICES, INC. RECENTLY OPENED A 102-BED FACILITY THAT OFFERS A WIDE RANGE OF MENTAL, EMOTIONAL AND BEHAVIORAL HEALTH SERVCIES FOR TEENS, ADULTS AND SENIORS EXPERIENCING MENTAL HEALTH ISSUES, SUCH AS DEPRESSION, ANXIETY AND CO-OCCURRING SUBSTANCE USE ISSUES. THE HOSPITAL OFFERS A FULL CONTINUUM OF INPATIENT AND OUTPATIENT SERVICES TO PEOPLE OF SOUTHEAST MISSOURI.3. SOUTHEASTHEALTH OFFERS A 15-BED, VOLUNTARY INPATIENT BEHAVIORAL HEALTH UNIT FOR ADULTS AT SOUTHEAST HEALTH CENTER OF STODDARD COUNTY IN DEXTER.4. MISSOURI DELTA MEDICAL CENTER IN SIKESTON PROVIDES SPECIALIZED INPATIENT CARE FOR ADOLESCENTS AND ADULTS IN A SAFE SETTING. DUPLICATION OF SUCH SERVICES IN THE SAME COMMUNITIES IS NOT THE BEST USE OF SAINT FRANCIS RESOURCES.5. JOHN J. PERSHING VETERANS' ADMINISTRATION MEDICAL CENTER IN POPLAR BLUFF OFFERS INPATIENT AND OUTPATIENT SPECIALIZED CARE FOR U.S. VETERANS (AND SOMETIMES THEIR FAMILIES AND CAREGIVERS) FOR A WIDE RANGE OF MENTAL HEALTH AND SUBSTANCE ABUSE ISSUES.6. THE SIGNIFICANT RESOURCE REQUIREMENTS THAT WOULD BE NECESSARY FOR SAINT FRANCIS HEALTHCARESYSTEM TO DEVELOP ITS OWN OUTPATIENT SUBSTANCE ABUSE AND/OR BEHAVIORAL HEALTH TREATMENT PROGRAMS FROM THE GROUND UP IS NOT FEASIBLE IN THE SERVICE AREA. SAINT FRANCIS WILL INSTEAD CONTINUE TO WORK WITH OTHER COMMUNITY PARTNERS THAT OFFER SUCH SERVICES IN THE COMMUNITY BY MAKING APPROPRIATE PATIENT REFFERALS.7. SAINT FRANCIS HEALTHCARE SYSTEM OFFERS BEHAVIORAL HEALTH SERVICES IN CAPE GIRARDEAU, SCOTT, STODDARD AND BUTLER COUNTIES THROUGH SAINT FRANCIS MEDICAL PARTNER CLINICS. SAINT FRANCIS ALSO PROVIDES PSYCHIATRIC SERVICES IN POPLAR BLUFF AND SIKESTON. ALL OF THESE CLINICS SERVE A WIDE RANGE OF PATIENTS IN THE REGION. SAINT FRANCIS MEDICAL CENTER PART V, SECTION B, LINE 13H: ALL UNINSURED PATIENTS RECEIVING SERVICES ATSAINT FRANCIS MEDICAL CENTER WILL RECEIVE A 75% REDUCTION ON ALL GROSSCHARGES AT THE TIME OF BILLING (WITHOUT APPLICATION).ALL SELF-PAY ACCOUNTS WILL BE PROCESSED THROUGH A PRESUMPTIVE SCORINGPROGRAM TO DETERMINE IF THEY QUALIFY FOR ASSISTANCE. IF THE PATIENT MEETSTHE QUALIFICATIONS, THE PATIENT'S ACCOUNT WILL BE REDUCED TO ZERO. IF THEQUALIFICATIONS ARE NOT MET, COLLECTIONS WILL BE ESCALATED. SAINT FRANCIS MEDICAL CENTER PART V, SECTION B, LINE 16J: ALL PATIENTS ARE NOTIFIED OF THE FINANCIALASSISTANCE POLICY VIA THE CONSENT FORM UPON ADMISSION. UNINSURED PATIENTSARE CONTACTED AFTER ADMISSION AND INFORMED OF THE FINANCIAL ASSISTANCEAVAILABLE THROUGH THE MEDICAL CENTER'S FINANCIAL ASSISTANCE POLICY. SAINT FRANCIS MEDICAL CENTER PART V, SECTION B, LINE 20E: IN-HOUSE AND THIRD PARTY REPRESENTATIVES WORKWITH UNINSURED PATIENTS TO HELP THEM QUALIFY FOR MEDICAID BENEFITS THROUGHTHEIR STATE OF RESIDENCE. FINANCIAL ASSISTANCE APPLICATIONS ARE OFFEREDFOR THOSE THAT DO NOT QUALIFY FOR MEDICAID AND EXPRESS THE INABILITY TOPAY FOR MEDICAL SERVICES. 29 1 - ADVANCED ORTHOPEDIC SPECIALISTS 48 DOCTORS PARK CAPE GIRARDEAU MO 63703 PHYSICIAN PRACTICE 2 - CAPE PHYSICIAN ASSOCIATES 3250 GORDONVILLE ROAD CAPE GIRARDEAU MO 63703 PHYSICIAN PRACTICE 3 - CAPE CARDIOLOGY GROUP 211 SAINT FRANCIS DRIVE CAPE GIRARDEAU MO 63703 PHYSICIAN PRACTICE 4 - SAINT FRANCIS MEDICAL CENTER POPLAR BLUF 225 PHYSICIANS PARK DRIVE SUITE 301 POPLAR BLUFF MO 63901 PHYSICIAN PRACTICE 5 - CAPE CARE FOR WOMEN 211 SAINT FRANCIS DRIVE CAPE GIRARDEAU MO 63703 PHYSICIAN PRACTICE 6 - FERGUSON MEDICAL GROUP - SIKESTON 1012 NORTH MAIN STREET SIKESTON MO 63801 PHYSICIAN PRACTICE 7 - CAPE SPINE AND NEUROSURGERY 150 S MOUNT AUBURN ROAD CAPE GIRARDEAU MO 63703 PHYSICIAN PRACTICE 8 - CAPE GASTROENTEROLOGY SPECIALISTS 28 S MOUNT AUBURN ROAD CAPE GIRARDEAU MO 63703 PHYSICIAN PRACTICE 9 - SAINT FRANCIS CLINIC - FARMINGTON 515 MAPLE VALLEY DRIVE FARMINGTON MO 63640 PHYSICIAN PRACTICE 10 - CAPE ENT GROUP 150 S MOUNT AUBURN ROAD CAPE GIRARDEAU MO 63703 PHYSICIAN PRACTICE 11 - HOSPICE 211 SAINT FRANCIS DRIVE CAPE GIRARDEAU MO 63703 HOSPICE 12 - PIEDMONT PHYSICIAN ASSOCIATES RT 4 BOX 4515 PIEDMONT MO 63957 PHYSICIAN PRACTICE 13 - CAPE MEDICAL ONCOLOGY 211 SAINT FRANCIS DRIVE CAPE GIRARDEAU MO 63703 PHYSICIAN PRACTICE 14 - CAPE THORACIC & CARDIOVASCULAR SURGER 3250 GORDONVILLE ROAD CAPE GIRARDEAU MO 63703 PHYSICIAN PRACTICE 15 - SAINT FRANCIS CLINIC - DEXTER 1212 SAINT FRANCIS DRIVE DEXTER MO 63841 PHYSICIAN PRACTICE 16 - CAPE PRIMARY CARE 1702 N KINGSHIGHWAY CAPE GIRARDEAU MO 63701 PHYSICIAN PRACTICE 17 - CAPE NEUROLOGY SPECIALISTS 3004 GORDONVILLE ROAD CAPE GIRARDEAU MO 63703 PHYSICIAN PRACTICE 18 - IMMEDIATE CONVENIENT CARE - CAPE 1702 N KINGSHIGHWAY CAPE GIRARDEAU MO 63701 PHYSICIAN PRACTICE 19 - FERGUSON MEDICAL GROUP - EAST PRAIRIE 320 NORTH LINCOLN EAST PRAIRIE MO 63845 PHYSICIAN PRACTICE 20 - SAINT FRANCIS HOME HEALTH 211 SAINT FRANCIS DRIVE CAPE GIRARDEAU MO 63703 HOME HEALTH 21 - SAINT FRANCIS GENERAL SURGERY - POPLAR B 225 PHYSICIANS PARK DRIVE SUITE 301 POPLAR BLUFF MO 63901 PHYSICIAN PRACTICE 22 - CAPE PULMONARY AND SLEEP MEDICINE 24 S MOUNT AUBURN ROAD CAPE GIRARDEAU MO 63703 PHYSICIAN PRACTICE 23 - CAPE NEUROSURGICAL ASSOCIATES 150 S MOUNT AUBURN ROAD CAPE GIRARDEAU MO 63703 PHYSICIAN PRACTICE 24 - FERGUSON MEDICAL GROUP - CHARLESTON 112 WEST COMMERCIAL CHARLESTON MO 63834 PHYSICIAN PRACTICE 25 - CAPE DIABETES & ENDOCRINOLOGY 211 SAINT FRANCIS DRIVE CAPE GIRARDEAU MO 63703 PHYSICIAN PRACTICE 26 - FITNESS PLUS 150 S MOUNT AUBURN ROAD CAPE GIRARDEAU MO 63703 FITNESS CENTER 27 - FERGUSON MEDICAL GROUP - SCOTT CITY 100 EAST OUTER ROAD SCOTT CITY MO 63780 PHYSICIAN PRACTICE 28 - SAINT FRANCIS CLINIC - JACKSON 2130 E JACKSON BLVD JACKSON MO 63755 PHYSICIAN PRACTICE 29 - FITNESS PLUS - DEXTER 1212 SAINT FRANCIS DRIVE DEXTER MO 63841 FITNESS CENTER PART I, LINE 3C: ALL UNINSURED PATIENTS RECEIVING SERVICES AT SAINT FRANCIS MEDICAL CENTER WILL RECEIVE A 75% REDUCTION ON ALL GROSS CHARGES AT THE TIME OF BILLING (WITHOUT APPLICATION). ALL SELF-PAY ACCOUNTS WILL BE PROCESSED THROUGH A PRESUMPTIVE SCORING PROGRAM TO DETERMINE IF THEY QUALIFY FOR ASSISTANCE. IF THE PATIENT MEETS THE QUALIFICATIONS, THE PATIENT'S ACCOUNT WILL BE REDUCED TO ZERO. IF THE QUALIFICATIONS ARE NOT MET, COLLECTIONS WILL BE ESCALATED. PART I, LINE 7: A COST-TO-CHARGE RATIO WAS USED IN ACCORDANCE WITH THE CALCULATION IN WORKSHEET 2, "RATIO OF PATIENT CARE COST TO CHARGES." PART I, LINE 7G: COSTS FOR SUBSIDIZED HEALTH SERVICES INCLUDE COSTS ASSOCIATED WITH PROVIDED NEONATOLOGY, TRAUMA, AND HOSPITALIST PHYSICIAN CLINICAL SERVICES WHERE OPERATIONS RESULT IN LOSSES. PART II, COMMUNITY BUILDING ACTIVITIES: SAINT FRANCIS MEDICAL CENTER'S COMMUNITY BUILDING ACTIVITIES ARE TARGETEDTO KEEP GOOD HEALTH IN THE FOREFRONT THROUGH NON-TRADITIONAL CHANNELS.THESE ACTIVITIES ARE USED TO DELIVER HEALTHCARE INFORMATION AND EDUCATIONDIRECTLY TO CITIZENS OF THE COMMUNITY. COMMUNITY FORUMS OR MEETINGS ALLOWREPRESENTATIVES OF THE MEDICAL CENTER TO PRESENT POTENTIALLY LIFE-SAVINGINFORMATION TO AN AUDIENCE NOT TYPICALLY REACHED BY COMMUNITY HEALTHAGENCIES OR SCREENINGS. PART III, LINE 2: A COST-TO-CHARGE RATIO WAS USED IN ACCORDANCE WITH THE CALCULATION INWORKSHEET 2, "RATIO OF PATIENT CARE COST TO CHARGES" TO DEVELOP COSTSASSOCIATED WITH BAD DEBT EXPENSE. PATIENT PAYMENTS AND DISCOUNTS AREAPPLIED TO THE PATIENT'S ACCOUNT BEFORE BAD DEBT DETERMINATION IS MADE. PART III, LINE 3: AN ESTIMATE OF BAD DEBT EXPENSE AT COST ATTRIBUTABLE TO PATIENTS ELIGIBLE UNDER THE MEDICAL CENTER'S FINANCIAL ASSISTANCE POLICY WAS CALCULATED BASED ON A STUDY OF POVERTY RATES IN THE UNITED STATES BY THE UNITED STATES CENSUS BUREAU. THE PERCENTAGE OF THE POPULATION WITH INCOME LEVELS AT OR BELOW 200% OF THE FEDERAL POVERTY GUIDELINES WAS OBTAINED AND THAT PERCENTAGE WAS THEN APPLIED TO THE ESTIMATED BAD DEBT EXPENSE TO OBTAIN THE ESTIMATED AMOUNT IN BAD DEBT EXPENSE ATTRIBUTABLE TO PATIENTS ELIGIBLE UNDER THE FINANCIAL ASSITANCE POLICY. THE COST-TO-CHARGE RATIO WAS THEN APPLIED TO CONVERT TO COST. PART III, LINE 4: THE FOLLOWING IS FROM FOOTNOTE B OF THE AUDITED FINANCIAL STATEMENTS FORSAINT FRANCIS MEDICAL CENTER FOR THE YEAR ENDED JUNE 30, 2023:THE MEDICAL CENTER ALSO PROVIDES A SIGNIFICANT AMOUNT OF UNCOMPENSATED CARE FORPATIENTS WHICH IS NOT INCLUDED ABOVE, BUT IS REPORTED IN NET PATIENT SERVICE REVENUE ONTHE STATEMENT OF ACTIVITIES AS A PROVISION FOR UNCOLLECTIBLE ACCOUNTS. MANY OF THOSEPATIENTS ARE UNINSURED OR UNDERINSURED, BUT DID NOT APPLY FOR OR QUALIFY FOR CHARITY CARE.DURING THE YEARS ENDED JUNE 30, 2023 AND 2022, THE MEDICAL CENTER REPORTED BAD DEBTEXPENSE OF $171,868.96 AND $12,435,579, RESPECTIVELY. PART III, LINE 8: THE COSTING METHODOLOGY USED FOR PART III, LINE 6, IS A COST-TO-CHARGERATIO DERIVED FROM THE PRIOR YEAR'S MEDICARE COST REPORT WHICH USES ONLYMEDICARE ALLOWABLE COSTS.IRS REV. RUL. 69-545, WHICH ESTABLISHED THE COMMUNITY BENEFIT STANDARD FORNONPROFIT HOSPITALS, STATES THAT IF A HOSPITAL SERVES PATIENTS WITHGOVERNMENT HEALTH BENEFITS, INCLUDING MEDICARE, THEN THIS IS AN INDICATIONTHAT THE HOSPITAL OPERATES TO PROMOTE THE HEALTH OF THE COMMUNITY. THISIMPLIES THAT TREATING MEDICARE PATIENTS IS A COMMUNITY BENEFIT.**FOR-PROFIT SPECIALTY HOSPITALS HAVE BEEN CARVING OUT CERTAIN HIGH-MARGINSERVICES (SUCH AS CARDIAC, ORTHOPEDICS, AND ONCOLOGY), LEAVING GENERALACUTE CARE HOSPITALS WITH LOWER-MARGIN MEDICARE SERVICES. THIS INDICATESTHAT MEDICARE LOSSES CAN BE A RESULT OF RENDERING THESE LOWER-MARGINSERVICES (WHICH BENEFIT THE COMMUNITY) RATHER THAN INEFFICIENT OPERATIONS.**IN SOME COMMUNITIES, MEDICARE IS THE LARGEST PAYER, AND HOSPITALS MUSTACCEPT THESE PATIENTS REGARDLESS OF WHETHER THEY MAKE A SURPLUS OR DEFICITFROM PROVIDING SUCH SERVICES. IF THE MEDICARE PARTICIPATION IS PREMISED ONTHIS FACT, THEN PROVIDING MEDICARE SERVICES PROMOTES ACCESS TO HEALTHCARESERVICES WHICH IS A COMMUNITY BENEFIT.**THERE ARE A NUMBER OF LOW-INCOME CONSUMERS RECEIVING MEDICARE BENEFITS.**THE ELDERLY ARE OFTEN AN UNDERSERVED POPULATION WHO EXPERIENCE ISSUESWITH ACCESS TO HEALTHCARE SERVICES. WITHOUT TAX-EXEMPT HOSPITALS PROVIDINGMEDICARE SERVICES, CMS WOULD BEAR THE BURDEN OF DIRECTLY PROVIDINGSERVICES TO THE ELDERLY.**MEDICARE PAYMENT ANOMALIES MAY BE PRESENT IN SOME STATES SO EVEN VERYEFFICIENT HOSPITALS ARE UNABLE TO AVOID LOSSES. THUS, LOSSES MAY NOT BEINDICATIVE OF INEFFICIENCY BUT RATHER PROVISION OF A COMMUNITY BENEFIT. PART III, LINE 9B: IF A PATIENT EXPRESSES FINANCIAL INABILITY TO PAY, THE REPRESENTATIVE OFTHE MEDICAL CENTER WILL OFFER A FINANCIAL ASSISTANCE APPLICATION TO THEPATIENT. THE PATIENT THEN RETURNS THE APPLICATION TO THE BUSINESS OFFICEFOR REVIEW. AFTER REVIEW, THE BUSINESS OFFICE WILL NOTIFY THE PATIENT INWRITING OF THE DECISION. IF APPROVED, THE BUSINESS OFFICE WILL WRITE OFFTHE REMAINING BALANCES. IF DENIED, THE BUSINESS OFFICE WILL CONTACT THEPATIENT TO MAKE PAYMENT ARRANGEMENTS. PART VI, LINE 2: SAINT FRANCIS IS PROACTIVE IN ASSESSING THE HEALTHCARE NEEDS OF ITSSERVICE AREA THROUGH GATHERING INFORMATION OR STUDIES FROM COMMUNITYHEALTHCARE AGENCIES, DEVELOPING AND SUPPORTING COMMUNITY HEALTH EDUCATORS,AND FOLLOWING UP ON INFORMATION FROM PATIENTS AND FAMILIES. SAINT FRANCISIS REACTIVE IN ASSESSING THE HEALTHCARE NEEDS OF ITS SERVICE AREA BYPROVIDING SUPPORT AND ASSISTANCE THROUGH LOCAL AND NATIONAL AGENCIES, WHICH PROVIDE DIRECT HEALTHCARE SERVICES TO THE MEDICAL CENTER'S SERVICE AREA. PART VI, LINE 3: HOSPITAL PERSONNEL, INCLUDING NURSES, PHYSICIANS, SOCIAL WORKERS ANDOTHERS, MAY IDENTIFY AND REQUEST AN APPLICATION FOR A PATIENT WHEN DEEMEDAPPROPRIATE. PATIENTS AND PERSONS WHO MAY BE BILLED RECEIVE AN APPLICATIONFOR ASSISTANCE WHEN A NEED IS EXPRESSED. REQUEST FOR ASSISTANCE IS USUALLYMADE WHEN THE PATIENT RECEIVES THE BILL, OR WHEN THE CUSTOMER SERVICEREPRESENTATIVE CONTACTS THE PATIENT FOR PAYMENT OF ACCOUNT. AT THE TIMENEED IS EXPRESSED, THE APPLICATION IS GIVEN PERSONALLY OR MAILED TO THEPATIENT. CUSTOMER SERVICE REPRESENTATIVES THEN WORK WITH THE PATIENT TOCOMPLETE ASSISTANCE REQUEST AND FORWARD APPLICATION FOR APPROVAL. ANYPATIENTS WHO RETURN TO THE MEDICAL CENTER TO PAY A BILL HAVE ACCESS TOASSISTANCE EDUCATION DOCUMENTATION AT THE BILLING OFFICE. PART VI, LINE 4: SAINT FRANCIS MEDICAL CENTER IS A LEADING TERTIARY CARE PROVIDER SERVINGPORTIONS OF A FIVE-STATE REGION - MISSOURI, ARKANSAS, TENNESSEE, KENTUCKYAND ILLINOIS. THE SYSTEM PROVIDES TO A POPULATION OF MORE THAN 740,000PEOPLE. THE PRIMARY SERVICE AREA CONSISTS OF CAPE GIRARDEAU COUNTY THATHAS AN ESTIMATED POPULATION OF 82,899 AS OF 2022. ACCORDING TO THEMISSOURI OFFICE OF ADMINISTRATION, BUDGET AND PLANNING, CAPE GIRARDEAUCOUNTY'S POPULATION IS EXPECTED TO INCREASE TO 84,612 BY 2030. THESECONDARY SERVICE AREA HAS A POPULATION OF NEARLY 150,000 AND INCLUDES THECOUNTIES OF ALEXANDER (4,858), PULASKI (4,991) AND UNION (16,767) INILLINOIS; AND BOLLINGER (10,518), MISSISSIPPI (11,688), NEW MADRID(15,695), PERRY (18,858), SCOTT (37,840), AND STODDARD (28,377) INMISSOURI. THE TERTIARY SERVICES AREA HAS A POPULATION OF MORE THAN 480,000AND INCLUDES THE COUNTIES OF BUTLER (42,179), CARTER (5,268), DUNKLIN(27,406), IRON (9,414), MADISON (12,753), PEMISCOT (14,841), REYNOLDS(6,006), RIPLEY (10,703), ST. FRANCOIS (66,969), STE. GENEVIEVE (18,644)AND WAYNE (10,792) IN MISSOURI; JACKSON (52,617), JOHNSON (13,381),RANDOLPH (30,068) AND WILLIAMSON (66,695) IN ILLINOIS; CLAY (14,265) ANDRANDOLPH (18,857) IN ARKANSAS; LAKE (6,507) AND OBION (30,394) INTENNESSEE; AND BALLARD (7,650), CARLISLE (4,720), FULTON(6,382) AND HICKMAN (4,422) IN KENTUCKY.THE SOUTHEAST REGION OF MISSOURI IS DECLINING IN POPULATION AND EVERYCOUNTY HAS A HIGHER THAN AVERAGE PERCENTAGE OF RETIREE-AGED PEOPLE ASCOMPARED WITH THE U.S. THIS REGION IS 85.4 PERCENT CAUCASIAN, 8.1 PERCENTAFRICAN-AMERICAN AND 3.0 PERCENT HISPANIC. PER CAPITA INCOME FOR CAPEGIRARDEAU COUNTY WAS $29,087. OF THE ENTIRE SOUTHEAST MISSOURI REGIONPOPULATION AGED 25 OR OLDER, 8 PERCENT DID NOT OBTAIN A HIGH SCHOOLDIPLOMA. APPROXIMATELY 92 PERCENT GRADUATED FROM HIGH SCHOOL OR HIGHER, 33PERCENT EARNED A COLLEGE DEGREE OR HIGHER AND 6 PERCENT COMPLETED AGRADUATE OR PROFESSIONAL DEGREE.ACCORDING TO EMPLOYMENT STATISTICS IN APRIL 2023, THE SOUTHEAST REGIONHAD AN UNEMPLOYMENT RATE OF 2.2 PERCENT. STATISTICS ARE FROM THE MISSOURIECONOMIC RESEARCH AND INFORMATION CENTER AND THE U.S. CENSUS BUREAU. PART VI, LINE 5: SAINT FRANCIS MEDICAL CENTER FURTHERS ITS EXEMPT PURPOSE BY PROVIDING FORAN OPEN MEDICAL STAFF COMPRISED OF PHYSICIANS IN ITS PRIMARY SERVICE AREA.THE BOARD OF DIRECTORS IS COMPRISED OF LOCAL COMMUNITY MEMBERS WITH AVESTED INTEREST IN PROMOTING AND IMPROVING THE HEALTH OF THE POPULATIONSERVED BY SAINT FRANCIS MEDICAL CENTER. IN ADDITION, SURPLUS FUNDSGENERATED BY THE OPERATINS OF THE MEDICAL CENTER ARE REINVESTED IN EQUIPMENT AND FACILITIES SO THAT SAINT FRANCIS MEDICAL CENTER CAN PROVIDECUTTING EDGE HEALTHCARE TO THE RESIDENTS OF ITS COMMUNITY. PART VI, LINE 6: SAINT FRANCIS HEALTHCARE SYSTEM IS A HOLDING COMPANY WHICH IS THE SOLEMEMBER OF SAINT FRANCIS MEDICAL CENTER. SAINT FRANCIS MEDICAL CENTEROPERATES A 306-BED ACUTE CARE HOSPITAL LOCATED IN CAPE GIRARDEAU,MISSOURI. ADMITTING PHYSICIANS ARE PRIMARILY PRACTITIONERS IN THE LOCALAREA. SAINT FRANCIS HEALTH DEVELOPMENT SERVICES, INC. WAS ORGANIZED BYSAINT FRANCIS HEALTHCARE SYSTEM. SAINT FRANCIS HEALTH DEVELOPMENTSERVICES, INC. FORMED IN 2002, OWNS A 100% INTEREST IN PHYSICIANS ALLIANCE,LC, A 100% INTEREST IN BLACK RIVER REAL ESTATE, LLC, A 30% INTEREST INLANDMARK HOSPITAL OF CAPE GIRARDEAU, LLC, A 100% INTEREST IN SAINT FRANCISHEALTH DEVELOPMENT REAL ESTATE, LLC, A 100% INTEREST IN BLACK RIVERAMBULATORY SURGERY CENTER, LLC AND A 30% INTEREST IN UC CLINIC 001, LLC,WHICH OPERATES AFC URGENT CARE CENTER. X X 1 1 X X X X X 0 0 0 0 0 1 0 0 0 BRANDON SCOTT DO NEUROSURGEON 0 717712 0 692627 0 10296 0 18300 0 25605 0 1464540 0 0 KAYWAN GAMADIA DO NEUROSURGEON 0 730667 0 679884 0 6560 0 6100 0 25506 0 1448717 0 0 JAMES MILLER MD CARDIOTHORACIC SURGEON 0 848091 0 0 0 396298 0 1308 0 1082 0 1246779 0 0 JUSTIN BAIN DO NEPHROLOGIST 0 820412 0 258830 0 37263 0 18300 0 25594 0 1160399 0 0 ANDREW TRUEBLOOD MD ORTHOPEDIC SURGEON 0 1001645 0 73481 0 24350 0 6100 0 909 0 1106485 0 0 MARYANN REESE PRESIDENT & CEO (FORMER) 0 849505 0 126000 0 19238 0 3310 0 2269 0 1000322 0 0 ANDREW GODBEY MD CMO & PRESIDENT - SFMP 0 503993 0 236254 0 42388 0 18300 0 25445 0 826380 0 0 JAMES BURKE CAO & GENERAL COUNSEL (FOR 0 443652 0 247394 0 4542 0 408 0 2097 0 698093 0 0 JUSTIN DAVISON PRESIDENT & CEO 0 554675 0 95928 0 9604 0 7157 0 25585 0 692949 0 0 THOMAS DIEMER MD CHIEF MEDICAL OFFICER (FOR 0 316711 0 152297 0 113836 0 17900 0 15007 0 615751 0 0 STEVEN OGBURN VP OF SFMP 0 307673 0 61692 0 4610 0 18300 0 25012 0 417287 0 0 STEPHANIE LA PIERRE CHIEF NURSING OFFICER (FOR 0 315354 0 95088 0 736 0 1214 0 1475 0 413867 0 0 LORI STURGILL CHIEF INFORMATION OFFICER (FORMER) 0 314335 0 30273 0 4997 0 15920 0 18773 0 384298 0 0 GERRY SALTER VP - SPECIALTY PRACTICES 0 248099 0 65318 0 5532 0 17590 0 25166 0 361705 0 0 JAMES WILFERTH VICE PRESIDENT - FOUNDATIO 0 240674 0 22379 0 4017 0 14389 0 23570 0 305029 0 0 JASON SNOW VICE PRESIDENT - HUMAN RES 0 242379 0 20684 0 3618 0 2112 0 16136 0 284929 0 0 LISA NEWCOMER VP - REGIONAL OPERATIONS 0 210471 0 17843 0 3828 0 14140 0 24929 0 271211 0 0 JOEL SANDER VP - NORTHEAST OPERATIONS 0 219447 0 16425 0 3299 0 14466 0 16051 0 269688 0 0 CHRISTY SHAWAN VP - SOUTHWEST OPERATIONS (FORMER) 0 210250 0 19156 0 5816 0 14119 0 18022 0 267363 0 0 DEBBY SPRANDEL CHIEF NURSING OFFICER 0 229334 0 9368 0 5774 0 7725 0 7349 0 259550 0 0 PART I, LINE 1A EXECUTIVE MEMBERS RECEIVE TRAVEL FOR THEIR SPOUSES. SPOUSAL TRAVEL IS ADDED TO W-2'S FOR EXECUTIVES. PART I, LINE 6 ALL EXECUTIVE BONUSES ARE BASED ON ATTAINMENT OF STRATEGIC GOALS. FORM 990, PART VI, SECTION A, LINE 2 A BUSINESS RELATIONSHIP IS CONSIDERED TO EXIST AMONGST OFFICERS AND/OR DIRECTORS OF SAINT FRANCIS MEDICAL CENTER (SFMC) WHO ALSO SERVE AS OFFICERS AND/OR DIRECTORS OF SAINT FRANCIS HEALTH DEVELOPMENT SERVICES, INC., WHICH IS A RELATED TAXABLE ENTITY OF SAINT FRANCIS MEDICAL CENTER. THE FOLLOWING OFFICERS AND/OR DIRECTORS SERVE ON BOTH THE SAINT FRANCIS MEDICAL CENTER AND SAINT FRANCIS HEALTH DEVELPMENT SERVICES, INC. BOARD OF DIRECTORS: MARYANN REESE - PRESIDENT AND CEO AT SFMC DON KAVERMAN - MEMBER OF SFMC BOARD OF DIRECTORS LAURA YOUNGHOUSE - MEMBER OF SFMC BOARD OF DIRECTORS KEVIN GOVERO - CHAIRMAN OF SFMC BOARD OF DIRECTORS ADAM KIDD - MEMBER OF SFMC BOARD OF DIRECTORS FORM 990, PART VI, SECTION A, LINE 6 SAINT FRANCIS HEALTHCARE SYSTEM IS THE SOLE MEMBER OF THE SAINT FRANCIS MEDICAL CENTER. FORM 990, PART VI, SECTION A, LINE 7A SAINT FRANCIS HEALTHCARE SYSTEM, AS THE SOLE MEMBER OF SAINT FRANCIS MEDICAL CENTER HAS THE POWER TO APPOINT AND REMOVE, WITH OR WITHOUT CAUSE, THE DIRECTORS, THE CHAIRMAN OF THE BOARD, THE VICE CHAIRMAN OF THE BOARD AND THE SECRETARY/TREASURER OF THE CORPORATION. FORM 990, PART VI, SECTION A, LINE 7B DECISIONS ARE SUBJECT TO THE BISHOP'S APPROVAL. FORM 990, PART VI, SECTION B, LINE 11B A COPY OF THE FORM 990 IS PROVIDED TO ALL THE MEMBERS OF THE BOARD OF DIRECTORS FOR REVIEW PRIOR TO BEING FILED WITH THE INTERNAL REVENUE SERVICE. FORM 990, PART VI, SECTION B, LINE 12C THE MEDICAL CENTER REQUIRES ALL OFFICERS, DIRECTORS, TRUSTEES AND KEY EMPLOYEES TO COMPLETE A CONFLICT OF INTEREST STATEMENT EACH YEAR. OFFICERS, DIRECTORS, TRUSTEES AND KEY EMPLOYEES ARE EDUCATED EACH YEAR ON THE DEFINITION OF A CONFLICT OF INTEREST AND HOW TO AVOID THEM. FORM 990, PART VI, SECTION B, LINE 15 AN OUTSIDE CONSULTANT IS ENGAGED TO PROVIDE BENCHMARK DATA FOR COMPARABLE POSITIONS IN COMPARABLY SIZED MEDICAL CENTERS. BASED ON THE DATA, THE CONSULTANT MAKES A RECOMMENDATION TO THE COMPENSATION COMMITTEE OF THE BOARD. THE BOARD DISCUSSES THE RECOMMENDATIONS AND MAKES A DECISION AS TO WHAT WILL BE PROVIDED FOR THE YEAR. THE PRESIDENT OF THE BOARD PROVIDES THE INFORMATION TO THE CHIEF FINANCIAL OFFICER TO IMPLEMENT. BASED ON DATA PROVIDED BY CONSULTANTS, THE BOARD OF DIRECTORS ESTABLISH PAY TARGETS FOR THE EXECUTIVE TEAM. THE PRESIDENT GRANTS THE VICE PRESIDENTS THEIR PAY INCREASES BASED ON PERFORMANCE IN THE PRECEEDING YEAR. FORM 990, PART VI, SECTION C, LINE 19 COPIES OF THE MEDICAL CENTERS GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, FINANCIAL STATEMENTS, AND FEDERAL FORM 990 ARE AVAILABLE AT THE ADMINISTRATIVE OFFICE UPON REQUEST. FORM 990, PART XI, LINE 9: SFMC DISTRIBUTIONS -200,008,255. BAD DEBT EXPENSE -171,868. FOUNDATION FOR OPIOID PRESCRIBING EDUCATION 211 SAINT FRANCIS DRIVE CAPE GIRARDEAU MO 63703 872081470 PHYS. PRACTICE MO SFMC SAINT FRANCIS HEALTHCARE SYSTEM 211 SAINT FRANCIS DRIVE CAPE GIRARDEAU MO 63703 430662499 HOLDING COMPANY MO 501(C)(3) LINE 12B, II N/A 0 SAINT FRANCIS FOUNDATION 211 SAINT FRANCIS DRIVE CAPE GIRARDEAU MO 63703 431111276 FUND. DEV. MO 501(C)(3) LINE 12B, II N/A 0 SAINT FRANCIS HEALTHCARE REAL ESTATE 211 SAINT FRANCIS DRIVE CAPE GIRARDEAU MO 63703 861891046 REAL ESTATE MO 501(C)(3) LINE 12B, II N/A 0 SAINT FRANCIS HEALTH DEVELOP SRVS 211 SAINT FRANCIS DRIVE CAPE GIRARDEAU MO 63703 470849798 HOLDING COMPANY MO C 0 SAINT FRANCIS HEALTH PLANS 211 SAINT FRANCIS DRIVE CAPE GIRARDEAU MO 63703 830526145 HOLDING COMPANY MO C 0 0 0 1 0 0 0 0 0 0 0 1 0 1 1 1 1 1 0 0