2023-04-28T18:46:49+00:00 2022-06-30 350921680 CROWE LLP 225 West Wacker Drive Suite 2600 Chicago IL 606061224 990 2021-07-01 370661244 St Mary's Hospital Decatur of the Hospital Sisters of the Third Order of St Francis STMA 2174642966 1800 E Lake Shore Drive Decatur IL 62521 Corey Hastings Interim Division CFO 2023-04-28 true Patricia Allen 999009999 Mallory Fairless P01321579 3128997000 2021 2023-04-26 12:10:37Z Theresa Rutherford 1800 E Lake Shore Drive Decatur IL 62521 176794029 false 0928 X www.hshs.org/stmarysdecatur X 1878 IL TO PARTICIPATE IN THE HEALTH CARE MINISTRY OF THE CHURCH AND PROVIDE A FAMILY-CENTERED APPROACH IN MEETING THE COMMUNITY'S HEALTH CARE NEEDS REGARDLESS OF ABILITY TO PAY. 7 6 988 159 58108 12880 8328984 2833406 161273089 170277402 38415 29139 1260735 906500 170901223 174046447 0 0 0 56749251 63193830 0 0 120994081 130641380 177743332 193835210 -6842109 -19788763 137050489 127891404 198427523 217425864 -61377034 -89534460 THE MISSION OF ST. MARY'S HOSPITAL IS TO REVEAL AND EMBODY CHRIST'S HEALING LOVE FOR ALL PEOPLE THROUGH OUR HIGH QUALITY FRANCISCAN HEALTH CARE MINISTRY. false false 176136848 171991296 ST. MARY'S HOSPITAL PROVIDES QUALITY MEDICAL HEALTHCARE REGARDLESS OF RACE, CREED, SEX, NATIONAL ORIGIN, HANDICAP, AGE, OR ABILITY TO PAY. ALTHOUGH REIMBURSEMENT FOR SERVICES RENDERED IS CRITICAL TO THE OPERATION AND STABILITY OF ST. MARY'S HOSPITAL, IT IS RECOGNIZED THAT NOT ALL INDIVIDUALS POSSESS THE ABILITY TO PURCHASE NECESSARY MEDICAL SERVICES. INHERENT TO OUR MISSION, WE PROVIDE CARE TO THE POOR, THE ELDERLY, AND THE NEEDY OF THE COMMUNITY THROUGH VARIOUS PROGRAMS AND SERVICES. THESE ACTIVITIES INCLUDE COMMUNITY EDUCATION PROGRAMS, WELLNESS PROGRAMS, AND SPECIAL PROGRAMS FOR THE ELDERLY, HANDICAPPED, MEDICALLY UNDER-SERVED, AND A VARIETY OF BROAD COMMUNITY SUPPORT ACTIVITIES. DURING FISCAL YEAR 2022, ST. MARY'S HOSPITAL PROVIDED 34,518 ADULT AND PATIENT DAYS OF CARE AND 163,198 OUTPATIENT REGISTRATIONS DURING THE SAME TIME PERIOD. ST. MARY'S HOSPITAL PROVIDES BOTH BENEFITS TO THE POOR AND TO THE BROADER COMMUNITY. BENEFITS TO THE POOR ARE PROVIDED IN THE FORM OF TRADITIONAL CHARITY CARE FOR THOSE WHO CANNOT AFFORD TO PAY, UNPAID COSTS OF PUBLIC PROGRAMS SUCH AS MEDICAID AND GENERAL RELIEF, NON-BILLED SERVICES FOR THE POOR AND MANY IN-KIND DONATIONS. THE TOTAL VALUES OF THESE UNREIMBURSED BENEFITS FOR THE POOR WERE $23,413,784 IN FISCAL YEAR 2022. ST. MARY'S HOSPITAL PROVIDES NUMEROUS BENEFITS TO THE BROADER COMMUNITY. THIS IS CARRIED OUT THROUGH OUR PARTICIPATION IN THE MEDICARE PROGRAM, PROVIDING MANY PROGRAMS AND SERVICES FREE OR AT A REDUCED PRICE, AND PROVIDING SERVICES THAT BENEFIT THE COMMUNITY BUT HAVE A NEGATIVE MARGIN TOTALED $4,612,856 DURING FISCAL YEAR 2022. ALL OTHER NON-BILLED SERVICES PROVIDED TO THE COMMUNITY AND SERVICES PROVIDED AT LOW OR NEGATIVE MARGINS TOTALED $18,295,736 FOR THE YEAR ENDED 6/30/2022. BELOW ARE SPECIFIC EXAMPLES OF SERVICES INCLUDED IN THE ABOVE FIGURES: THROUGH THE OPERATION OF ITS PRENATAL CLINIC, THE HOSPITAL PROVIDES BOTH PRE AND POST NATAL CARE TO THE POOR. THE HOSPITAL ROUTINELY DONATES FOOD TO LOCAL FOOD PANTRIES. OBSOLETE EQUIPMENT IS ALSO OCCASIONALLY DONATED TO LOCAL AGENCIES. THE HOSPITAL PROVIDES TRAINING TO THE LOCAL PARAMEDICS, FIRST RESPONDER GROUPS, AND FIRE DEPARTMENTS. IN ADDITION, AREA ORGANIZATIONS RECEIVE CPR TRAINING THROUGH THE HOSPITAL'S EMS DEPARTMENT. THE HOSPITAL PARTICIPATES IN THE SECONDARY TRANSITIONAL EXPERIENCE PROGRAM BY PROVIDING EMPLOYMENT OPPORTUNITIES TO HANDICAPPED STUDENTS. PASTORAL CARE AND SOCIAL SERVICE DEPARTMENTS PROVIDE ASSISTANCE FOR PATIENT AND FAMILY NEEDS. EMPLOYEES SERVE AS SPEAKERS AT HEALTH FAIRS, SCHOOLS, AND A VARIETY OF AREA ORGANIZATIONS. THE HOSPITAL ASSISTS THE UNITED WAY CAMPAIGN BY HAVING STAFF MEMBERS ORGANIZE THE HOSPITAL'S ANNUAL FUND DRIVE. THE HOSPITAL PROVIDES A VARIETY OF HEALTH SCREENINGS TO THE PUBLIC IN DIFFERENT LOCATIONS THROUGHOUT THE COMMUNITY. 176136848 true true false true false false false false false true false false false true true false true false false false false false false false false true true false false true false false false false false false false false false false false false true true false false false true X 1058 0 true 988 true true true false false false false false false false false false false false X 7 6 false false false false true true true true true false false true true true true true true true true true true Darrell Hardy 6182342120 1800 E LAKE SHORE DRIVE DECATUR IL 62521 EVERT J KUIPER Division CEO - Illinois (until Jan 2022) 7.2 52.8 X X 0 1325482 225887 Gary Birschbach 2021 & 2022 SECRETARY 1.0 0 X X 0 0 0 Lori Kerans 2021 & 2022 Vice Chair 1.0 1.5 X X 0 0 0 Matt Bennett 2021 & 2022 CHAIR 1.0 0 X X 0 0 0 THERESA J RUTHERFORD President & CEO 60.0 0.0 X X 0 586418 181188 Alan Frigy Board Member (until 10/31/21) 1.0 0 X 0 0 0 Amy Bliefnick BOARD MEMBER 1.0 0 X 0 0 0 FR Rick Weltin BOARD MEMBER 1.0 0 X 0 0 0 MICHAEL W COTTRELL Board Member (Until March 2022) / HSHS CFO 1.0 59.0 X 0 1013193 174020 SR GERTRUDE O'CONNOR OSF BOARD MEMBER 0.3 0 X 0 0 0 Corey J Hastings Interim Division CFO (until 4/15/22) 6.0 54.0 X 0 211880 75146 DAVID NOSACKA DIVISION CFO - ILLINOIS (until 7/27/21) 6.0 54.0 X 0 512300 76172 TODD Smart Treasurer 0.3 59.8 X 0 230248 29959 Amy Dobrinick CERTIFIED REGISTERED NURSE ANESTHETIST 40.0 0 X 308073 0 41984 Beth A McCoy Certified Registered Nurse Anesthetist 40.0 0 X 344420 0 132066 Deanna Y Hitchens Certified Registered Nurse Anesthetist 40.0 0 X 292297 0 109412 Laura Long CRNA 40.0 0 X 262853 0 14849 Robyn Reising CNO 40.0 0 X 265977 0 3993 ANN M CARR Former Treasurer 0.0 1.0 X 0 263877 2041 1473620 4143398 1066717 55 true true false SHEARWATER HEALTH INC 20 BURTON HILLS BOULEVARD SUITE 400 NASHVILLE TN 37215 CONTRACT LABOR - INTERNATIONAL 2620716 MEDICAL SOLUTIONS PO BOX 850737 MINNEAPOLIS MN 554850737 CONTRACT LABOR 2601033 HAROLD O'SHEA BUILDERS 3401 CONSTITUTION DR SPRINGFIELD IL 627117013 GENERAL BUILDING CONTRACTORS 2118049 INFINITY HEALTHCARE PHYSICIANS SC 7032 COLLECTION CENTER DRIVE CHICAGO IL 60693 PHYSICIAN SERVICES 2091726 BERKELEY RESEARCH GROUP LLC 2200 POWELL STREET SUITE 1200 EMERYVILLE CA 94608 PROFESSIONAL SERVICES 1799205 61 213094 2620312 2833406 Net Patient Service Revenue 621990 163427620 163427620 Ambulance Services 621910 6849782 6849782 0 0 0 0 170277402 17627 17627 1767125 2747582 -980457 0 -980457 -980457 11512 11512 0 11512 11512 Gift Shop 900099 114955 114955 Physician Answering Service 561000 35570 35570 Reference Lab 621500 22538 22538 1713894 1713894 0 0 1886957 174046447 171991296 58108 -836363 X 47909335 46726720 1182615 2810523 2741104 69419 9269200 9040250 228950 3204772 3125614 79158 10344 10344 9182 9182 66958985 54965744 11993241 0 597128 25341 571787 892399 516392 376007 6775425 6527373 248052 4574750 4532939 41811 61201 40442 20759 79541 59461 20080 356084 356084 6837556 6594590 242966 3951794 3601952 349842 Medical Supplies 28803418 27676287 1127131 Medicaid Tax Assessment 8088024 8088024 Equipment Rental 1102698 1100174 2524 Recruitment Expenses 507760 2978 504782 1035091 771463 263628 0 193835210 176136848 17698362 0 -1911167 -6067381 19196346 20042185 0 0 0 0 3776573 5263282 1845267 1857204 272128748 170428145 103831375 101700603 8247430 4491872 0 0 2064665 603639 137050489 127891404 45104548 32323516 24526892 23117314 0 0 566621 251957 128229462 161733077 198427523 217425864 X -61635388 -89810425 258354 275965 -61377034 -89534460 137050489 127891404 X -19788763 -45366 -8323297 X false true X true true true X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED false false false false false false false false true 37735 37735 false Schedule C, Part II-B, Line 1 DETAILED DESCRIPTION OF THE LOBBYING ACTIVITY ST. MARY'S HOSPITAL ("THE HOSPITAL") IS A MEMBER OF THE CATHOLIC HEALTH ASSOCIATION ("CHA"), THE ILLINOIS HOSPITAL ASSOCIATION ("IHA"), THE NATIONAL ASSOCIATION FOR HOME CARE AND HOSPICE, AND THE AMERICAN HOSPITAL ASSOCIATION ("AHA"). AS A MEMBER OF THESE ORGANIZATIONS, THE HOSPITAL PAYS DUES. A PART OF THESE DUES IS ATTRIBUTABLE TO LOBBYING FEES PAID BY THE ORGANIZATIONS. THE AMOUNT LISTED IS THE AMOUNT ATTRIBUTABLE TO THE HOSPITAL FROM ITS DUES PAID. THE ASSOCIATIONS THE HOSPITAL PAYS ARE AS FOLLOWS: - AMERICAN HOSPITAL ASSOCIATION ("AHA") AT 26.47% LOBBYING EXPENSE - CATHOLIC HEALTH ASSOCIATION ("CHA") AT 3.00% LOBBYING EXPENSE - ILLINOIS HOSPITAL ASSOCIATION ("IHA") AT 44.00% LOBBYING EXPENSE - NATIONAL ASSOCIATION FOR HOME CARE & HOSPICE AT 23.00% LOBBYING EXPENSE THE TOTAL AMOUNT OF ANNUAL DUES PAID TO EACH ASSOCIATION IS MULTIPLIED BY THE PERCENTAGE OF DUES ALLOCATED TO LOBBYING EXPENSE TO CALCULATE THE TOTAL LOBBYING EXPENDITURES PAID. 3295160 3295160 177504438 93909553 83594885 3282 1267 2015 88534316 73726102 14808214 2791552 2791223 329 101700603 RETIRE OBLIGATION - ASBESTOS 2094164 ACCRUED BENEFIT LIABILITY -1525878 Line of Credit - between affiliates 161158000 Derivative Instrument 6791 161733077 X Schedule D, Part X, Line 2 FIN 48 (ASC 740) footnote HSHS and the Foundation are Illinois not-for-profit organizations as described in Section 501(c) (3) of the Internal Revenue Code (the Code) and are exempt from federal income taxes on related income pursuant to Section 501(a) of the Code. Kiara, Inc. is an Illinois for-profit corporation that recognizes income taxes under the asset-and-liability method. Deferred tax assets and liabilities are recognized for the future tax consequences attributable to differences between the consolidated financial statement carrying amounts of existing assets and liabilities and their respective tax basis and operating loss and tax credit carryforwards. Deferred tax assets and liabilities are measured using the enacted tax rates expected to apply to taxable income in the years in which those temporary differences are expected to be recovered or settled. The effect on deferred tax assets and liabilities of a change in tax rates is recognized in income in the period that includes the enactment date. The net operating loss carryforwards result in a deferred tax asset of $3,548 and $3,650 at June 30, 2022 and 2021, respectively. In assessing the realizability of deferred tax assets, management considers whether it is more likely than not that some portion or all of the deferred tax assets will not be realized. The ultimate realization of deferred tax assets is dependent upon the generation of future taxable income during the periods in which those temporary differences become deductible. Management considers projected future taxable income and tax planning strategies in making this assessment. Based upon the level of historical taxable losses and projections for future taxable losses over the periods for which the deferred tax assets are deductible, management believes it is more likely Kiara, Inc. will not realize the majority of the benefits of these deductible differences. Full valuation allowances have been applied against the deferred tax assets attributable to the net operating loss carryforwards not realized as of June 30, 2022 and 2021 in the accompanying consolidated financial statements due to the uncertainty of realization. HSHS recognizes the tax benefit from an uncertain tax position only if it is more likely than not the tax position will be sustained on examination by the taxing authorities, based on the technical merits of the position. As of June 30, 2022 and 2021, HSHS does not have any liabilities for unrecognized tax benefits. true true X true X true X 600 true true true false true true 170995 170995 0.0009 32776117 14651376 18124741 0.0935 0 0.0 0 0 32947112 14651376 18295736 0.0944 516574 516574 0.0027 593609 593609 0.0031 11415457 7559624 3855833 0.0199 0 0.0 152032 152032 0.0008 0 0 12677672 7559624 5118048 0.0264 0 0 45624784 22211000 23413784 0.1208 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0 0 0 0 0.0 true 0 0 43739781 48352637 -4612856 X true true 1 1 ST MARY'S HOSPITAL 1700 E LAKE SHORE DR DECATUR IL 62521 https://www.hshs.org/stmarysdecatur/ 0905-2097 X X X ST MARY'S HOSPITAL 1 false false true X X X X X X X X X 20 true true true true X https://www.hshs.org/HSHSFamily/media/St.Marys-Decatur/About%20us/CHNA_report_SMD_2021_FINAL.PDF X true 21 true https://www.hshs.org/HSHSFamily/media/St.Marys-Decatur/About%20us/Implementation-Plan_SMD_2021.pdf false true X 200.0 600.0 X X X X X X true true X X X true X https://www.hshs.org/FAP X https://www.hshs.org/FAP X https://www.hshs.org/FAP X X X X X X true X false X X X X true X false false Schedule H, Part V, Section B, Line 3E Yes, the significant health needs are a prioritized description of the significant health needs of the community and were identified through the CHNA process. Schedule H, Part V, Section B, Line 5 Facility , 1 Facility , 1 - HSHS St. Mary's Hospital. St. Mary's Hospital undertook a ten-month planning and implementation effort to develop the CHNA, identify and prioritize community health needs for its service area and formulate an implementation plan to guide ongoing population health initiatives with like-missioned partners and collaborators. These planning and development activities included the following internal and external steps: 1. Identified the CHNA core group comprised of St. Mary's Hospital, Decatur Memorial Hospital and Macon County Health Department. 2. Convened the Community Advisory Council ("CAC") to solicit input and help narrow identified priorities. 3. Conducted a community survey to get input from community members around the priorities identified. 4. Convened an internal advisory committee respective to each organization to force rank the final priorities and select the FY2022-FY2024 CHNA priorities. External St. Mary's Hospital worked with a core group of partners to leverage existing relationships and provide diverse input for a comprehensive review and analysis of community health needs in Macon County. Representation on the CAC was sought from health and social service organizations that: 1. Serve low-income populations 2. Serve at-risk populations 3. Serve minority members of the community 4. Represent the general community The following community stakeholders were invited to serve on the CAC: Heritage Behavioral Health* Decatur Memorial Hospital* Decatur Community Partnership* SIU School of Medicine Center for Family Medicine* HSHS St. Mary's Hospital* Millikin University Macon County Health Department* City of Decatur Decatur Fire Department Springfield Clinic Macon County Emergency Management Crossing Healthcare* United Way* Baby Talk* Boys and Girls Club of Decatur* Economic Development Corporation of Macon County* Macon-Piatt Regional Office of Education Community Foundation of Macon County* Old King's Orchard* Decatur Public Schools* Good Samaritan Inn* Macon County CASA* University of Illinois Extension Decatur Regional Chamber of Commerce Macon County Sheriff Macon County Mental Health Board Workforce Investment Solutions CHELP: Local Home Care Provider for Seniors Decatur Park District Northeast Community Fund* Tyler Yount Foundation Richland Community College Decatur Family YMCA* NAACP* Decatur Police Department United Way* DOVE Inc.* * Denotes groups representing the under resourced in our community including low-income seniors, children living in poverty and families who struggle with shelter and food. Schedule H, Part V, Section B, Line 6a Facility , 1 Facility , 1 - HSHS St. Mary's Hospital. Decatur Memorial Hospital Schedule H, Part V, Section B, Line 6b Facility , 1 Facility , 1 - ST. MARY'S HOSPITAL, DECATUR. Heritage Behavioral Health* Decatur Memorial Hospital* Decatur Community Partnership* SIU School of Medicine Center for Family Medicine* HSHS St. Mary's Hospital* Millikin University Macon County Health Department* City of Decatur Decatur Fire Department Springfield Clinic Macon County Emergency Management Crossing Healthcare* United Way* Baby Talk* Boys and Girls Club of Decatur* Economic Development Corporation of Macon County* Macon-Piatt Regional Office of Education Community Foundation of Macon County* Old King's Orchard* Decatur Public Schools* Good Samaritan Inn* Macon County CASA* University of Illinois Extension Decatur Regional Chamber of Commerce Macon County Sheriff Macon County Mental Health Board Workforce Investment Solutions CHELP: Local Home Care Provider for Seniors Decatur Park District Northeast Community Fund* Tyler Yount Foundation Richland Community College Decatur Family YMCA* NAACP* Decatur Police Department United Way* DOVE Inc.* * Denotes groups representing medically underserved, low-income and minority populations Schedule H, Part V, Section B, Line 11 Facility , 1 Facility , 1 - HSHS St. Mary's Hospital. The following priorities were selected as part of St. Mary's Hospital's FY2021 CHNA: 1. Access to mental and behavioral health services 2. Access to health 3. Disparities in economy 4. Child abuse and neglect In FY2022, HSHS Illinois ministries engaged in an 18-month planning process to identify solutions to crisis screening gaps in the emergency department. In FY2023, the plan will be presented to strategy and finance teams with the goal of deploying a pilot in January 2023. As part of this plan, local ministries will have 365-day psychiatric coverage in the emergency department. We will analyze the initiative and explore expansion across HSHS Illinois ministries in FY2025. SMD continues to invest in the Health Connect program. In FY2022, a total of $108,000 was invested in providing case management services to assist individuals visiting the emergency department frequently in identifying needed community-based services and providers to address their determinants of health. The program successfully graduated 10-clients in FY2022 and saw a reduction in ED utilization of nearly 100% for those clients. Two of the clients were relocated to safer housing, one was relocated to group housing and a number of them were assisted in obtaining insurance and primary care. In FY2022, HSHS launched the DEI steering committee including the cultural competence and workforce equity subcommittees. Under the workforce equity subcommittee, we conducted a gap analysis of our recruiting, hiring and employee policies to ensure best DEI practices were being deployed. At the end of FY2021, we presented a strategic plan proposal to increase diversity in the workforce and address any barriers to career obtainment. This plan will be implemented in FY2022 and expand to work with local schools and community colleges in developing pipeline programs from school to healthcare career. SMD continues to serve as part of the Central Illinois Human Trafficking Task Force. In the last several years, they were the first HSH ministry to adopt human trafficking specific policy in their ED. That policy continues to be reviewed and updated to best identify and meet the needs of persons who have been trafficked. As an outcome of the prioritization process, the following community health needs were also identified but will not be addressed directly by the hospital for the reasons indicated: * Safe and affordable housing: While not a direct priority issue, affordable housing challenges and barriers will be explored within the strategic plan of mental and behavioral health services. * Emergency preparedness: Our hospital and health department are addressing this through state plans in place. * Gun violence: While not named in the top three priority areas, gun violence stemming from mental health and poverty will be further investigated and addressed in the CHIP. * Unmanaged chronic conditions, including food insecurity: While not a direct priority issue, we will further investigate the impact of access to health and health care barriers on unmanaged chronic conditions. Schedule H, Part V, Section B, Line 13 Facility , 1 Facility , 1 - St. Mary's Hospital (SMD). Presumptive eligibility is presumed under certain circumstances for uninsured patients based on their enrollment in other means-tested programs or other sources of information, not provided directly by the patient. Once determined, presumptive eligibility provides individuals participating in one of the following categories with a 100% write off. These programs are granted by outside organizations based on screening criteria of less than 200% of the FPG. 1. Homelessness 2. Deceased with no estate 3. Mental incapacitation with no one to act on patient's behalf 4. Medicaid eligibility, but not on date of service or for non-covered services 5. Incarceration in a penal institution 6. Enrollment in the following assistance programs for low-income individuals: 6a. Temporary Assistance for Needy Families (TANF) 6b. Illinois Housing Development Authority's Rental Housing Support Program 6c. Wisconsin Department of Health Services Housing Assistance Program 7. Participation in Women, Infants and Children programs (WIC); 8. Supplemental Nutrition Assistance Program (SNAP) eligibility; 9. Low Income Home Energy Assistance Program (LIHEAP); 10. Wisconsin Home Energy Assistance Program (WHEAP); 11. Enrollment in an organized community-based program providing access to medical care that assesses and documents limited low-income financial status as criteria; 12. Receipt of grant assistance for medical services 1 St Mary's Adult Day Services 2075 E Lake Shore Drive Decatur IL 62521 Adult Day Services Schedule H, Part I, Line 7g Subsidized Health Services NO COSTS ATTRIBUTABLE TO A PHYSICIAN CLINIC ARE INCLUDED ON LINE 7G. Schedule H, Part I, Line 7 Costing Methodology used to calculate financial assistance THE COSTING METHODOLOGY USED TO CALCULATE THE AMOUNTS REPORTED VARY ACCORDING TO INFORMATION REQUESTED AND THE MOST ACCURATE MEANS OF GATHERING THE REQUIRED INFORMATION. THE IRS PROVIDED WORKSHEET 2 WAS USED TO CALCULATE A COST TO CHARGE RATIO USING INFORMATION FROM THE ORGANIZATION'S GENERAL LEDGER AND COST REPORTS. THAT RATIO WAS THEN USED IN CONJUNCTION WITH IRS WORKSHEET 1 TO CALCULATE THE COST OF FINANCIAL ASSISTANCE PROVIDED AND WORKSHEET 3 TO CALCULATE UNREIMBURSED MEDICAID AMOUNTS. THE COMMUNITY HEALTH IMPROVEMENT AND COMMUNITY BENEFIT PROGRAMS, HEALTH PROFESSIONS EDUCATION, SUBSIDIZED HEALTH SERVICES, RESEARCH PROGRAM, AND DONATIONS ARE STATED AT ACTUAL COST (when applicable). THE COST OF THESE ITEMS ARE TRACKED THROUGH THE GENERAL LEDGER PROCESS AND THROUGH OTHER ACCOUNTING SOFTWARE. Schedule H, Part III, Line 2 Bad debt expense - methodology used to estimate amount FOR FINANCIAL STATEMENT PURPOSES, HOSPITAL SISTERS HEALTH SYSTEM HAS ADOPTED ACCOUNTING STANDARDS UPDATE NO. 2014-09 (TOPIC 606). IMPLICIT PRICE CONCESSIONS INCLUDES BAD DEBTS. THEREFORE, BAD DEBTS ARE INCLUDED IN NET PATIENT REVENUE IN ACCORDANCE WITH HEALTHCARE FINANCIAL MANAGEMENT ASSOCIATION STATEMENT NO. 15 AND BAD DEBT EXPENSE IS NOT SEPARATELY REPORTED AS AN EXPENSE. Schedule H, Part III, Line 4 Bad debt expense - financial statement footnote The text of the footnote to the organization's financial statements that describes bad debt expense can be found on pages 16-17 in the HSHS Consolidated Audit Report. Schedule H, Part III, Line 8 Community benefit & methodology for determining medicare costs HSHS St. Mary's Hospital continually strives to provide excellent patient care in the most cost effective fashion. Nonetheless, the Medicare program, in many cases, does not provide payment that covers the full cost of the care provided. Since it is the mission of the hospital to respond to community need, hospital management continually advocates for improved Medicare payment so that the cost of quality care to those patients who are not able to afford it is not compromised and is fairly subsidized by all payers. While this shortfall in Medicare payments is not classified as community benefit by the IRS, we nonetheless believe it is an important contribution made by the hospital to the health and well-being of the community. If the Medicare program did not exist, many Medicare patients would be eligible for charity care or other means-tested government programs. Further, by absorbing this payment shortfall and providing care below cost to these individuals, St. Mary's Hospital is relieving the burdens of the government. Accordingly, this shortfall restricts St. Mary's ability to make funds available to provide for charity care and other community benefits. The hospital Medicare shortfall at cost for fiscal year 2022 was $4,612,856. Schedule H, Part III, Line 9b Collection practices for patients eligible for financial assistance Every effort is made prior to, during and after provision of medical services to determine whether a patient is eligible for charity/community care and to assist the patient in completing the application and provide adequate documentation. If the patient qualified for charity/community care for the full balance of their account, the entire amount is written off to charity/community care and hence no debt collection is pursued. If the patient qualified for charity/community care for a portion of their account balance, that portion is written off to charity/community care, with the patient being responsible for the remainder of the balance. Additionally, reasonable effort will be made to obtain third-party or government payer reimbursement on behalf of the patient. If those efforts are not fruitful, an offer will be extended to the patient to make installment payments on their balance. Only at such point that the patient defaults on installment payments or refuses to cooperate with the hospital's efforts to be reimbursed will the account be sent to collections. The hospital will make reasonable efforts to determine whether a patient is eligible under the financial assistance policy before it engages in an ECA. To the extent a patient is determined to be eligible for financial assistance under the FAP, the hospital will take all reasonably available measures to reverse any ECA taken against the patient to obtain payment for the care. Schedule H, Part V, Section B, Line 16a FAP website - ST MARY'S HOSPITAL: Line 16a URL: https://www.hshs.org/FAP; Schedule H, Part V, Section B, Line 16b FAP Application website - ST MARY'S HOSPITAL: Line 16b URL: https://www.hshs.org/FAP; Schedule H, Part V, Section B, Line 16c FAP plain language summary website - ST MARY'S HOSPITAL: Line 16c URL: https://www.hshs.org/FAP; Schedule H, Part VI, Line 2 Needs assessment HSHS St. Mary's Hospital conducted a Community Health Needs Assessment (CHNA) in FY2021 (July 1, 2020 through June 30, 2021). Throughout the three-year CHNA cycle, the hospital continuously reviews updated local and state data, Illinois Comp Data, patient surveys and feedback, and local needs assessments conducted by community groups. Additionally, the hospital received input from public health officials, community groups and community boards on an ongoing basis. The information received and reviewed is used to inform ongoing strategic initiatives developed to meet CHNA health priorities; as well as new areas of need that are going unmet. Schedule H, Part VI, Line 3 Patient education of eligibility for assistance The Registration Department provides brochures to patients upon registration regarding the Financial Assistance Program available to them at the Hospital. The brochures are also supplied in waiting and ancillary areas for easy access by the patient. To better serve our patient population, the Hospital offers information on our financial assistance program in Spanish. This includes the Financial Assistance Policy, Brochure and Application, which allows the hospital to serve populations in its county and the surrounding area for whom Spanish is their primary language. Patients are also provided a Fair Billing Act notification at the point of registration regarding separate physician billing they can expect to receive, plus information about the patient's financial responsibility if their insurance plan is out of network. One-on-one conversations to educate patients about financial assistance often stem from patients receiving a statement or a pre-collection letter. At that point, the customer service representative or cashier, or other qualified staff, will inform/educate the caller about financial assistance options. The first pre-collection letter reminds the patient their account is in delinquent status. It also informs them they may be eligible for financial assistance through the organization's charity care program. The letter provides direct contact information to begin the application process for charity care and lists the Internet address where the policy can be obtained. A third-party vendor also assists individuals in determining their eligibility for state health plans or insurance on the open health insurance marketplace. They can also assist with the application process. Schedule H, Part VI, Line 4 Community information HSHS St. Mary's Hospital is a not-for-profit hospital located in Macon County, Illinois. This is its primary service area (PSA). Parts of the adjacent four counties (DeWitt, Moultrie, Christian and Shelby) constitute its secondary service area (SSA). ). The total primary and secondary service area of the hospital has a population of 229,581 people, 104,009 people from Macon County and 86,595 people from the surrounding counties. Aside from the city of Decatur, the economy of St. Mary's secondary service area is primarily rural and is supported by small businesses, industries, mining and agriculture. Decatur, on the other hand, is an urban area supported by large businesses, such as Archer Daniels Midland and Caterpillar. Based on 2019 population estimates Macon County's population of 104,009 people is comprised of 77.7% Caucasians, 17.8% African-Americans, 0.3% American Indians/Alaska Natives, 1.2% Asians, 0.03% Native Hawaiians/Other Pacific Islanders and 2.9% people stating two or more races. Eighty-nine percent of Macon County's residents have a high school diploma, 22.8% have a Bachelor's Degree. The current unemployment rate of Macon County is 5.6%, according to the US Bureau of Labor Statistics, and the median household income is $47,477. St. Mary's secondary service area is comprised of 86,595 people, of whom 83.08% are Caucasian, 12.82% are African-American, 0.21% are American Indian/Alaska Native, 0.95% are Asian, 0.03% are Native Hawaiian/Other Pacific Islander, 0.69% state another race, and 2.22% state two or more races. Educational levels of this population reflect that 35.7% graduated high school, 12.85% graduated with a Bachelor's Degree. The average unemployment rate of the combined counties is 6.6% and the median household income is $50,480. Within the report area 17.3% or 18,753 individuals are living in households with income below the Federal Poverty Level (FPL). This is higher than the statewide poverty levels 13%. This indicator is relevant because poverty creates barriers to access including health services, nutritional food and other necessities that contribute to poor health status. HSHS St. Mary's Hospital's service area is comprised of approximately 580.69 square miles with a population of approximately 142,986 and a population density of 190.80 per square mile. The service area consists of 3-cities, 16-townships, 9-villages and 2-unincorporated communities. The hospital does not exclude Medically Underserved Areas (MUAs), low income or minority populations from its service area. Schedule H, Part VI, Line 5 Promotion of community health As a healing ministry of the Catholic Church and an affiliate of Hospital Sisters Health System (HSHS), St. Mary's Hospital is committed to delivering high quality, compassionate, and cost-effective health care services to all. Founded in 1878 the hospital brings a healing presence and improves the health of our community, especially those persons who are sick, poor, and disadvantaged. Because of the hospital's mission and heritage, the hospital is dedicated to promoting the health of Decatur and surrounding areas. The hospital is governed by a Board of Directors, most of whom reside in the hospital's primary service area and are neither employees nor independent contractors of the hospital (nor family members thereof). The Board ensures that St. Mary's Hospital is responding to community need. Consistent with its exempt purpose, St. Mary's has an open medical staff with privileges available to all qualified physicians in the area. The hospital also operates an emergency department that is open 24 hours to all persons regardless of their ability to pay. As a not-for-profit hospital, St. Mary's reinvests surplus funds to support the mission of the organization and promote the health of the community rather than distributing surplus funds as profits to shareholders or individuals. Funds not committed to ongoing operations are generally used to upgrade facilities, secure new technologies, improve patient care, and support initiatives designed to promote health and ensure access for all. St. Mary's hospital, in accordance with its mission, distinguishes itself by its care for those with mental disabilities and chemical dependencies. St. Mary's also devotes significant resources to access for patients who cannot afford care, along with other Community Benefits. In FY2022, St. Mary's provided more than $23 million in Community Benefit, including financial assistance at cost, unpaid costs of Medicaid and other public programs, and a range of diverse programs designed to enhance access and improve community health. St. Mary's provides a range of Community Benefit initiatives and programs that further our mission and long-standing commitment to our community. In many cases, these Community Benefits would not exist without the leadership role played by St. Mary's and they often relieve a burden that would otherwise be carried by government. Schedule H, Part VI, Line 6 Affiliated health care system Headquartered in Springfield, Illinois, Hospital Sisters Health System (HSHS) is a highly integrated, multi-institutional health care system comprised of 15 hospitals and more than 200 physician practice sites in Illinois and Wisconsin. HSHS is sponsored by Hospital Sisters Ministries (HSM), which is a public juridic person of the Roman Catholic Church. HSHS continues the health care ministries begun by its founders, the Hospital Sisters of St. Francis, more than 140 years ago, in rural and midsized communities throughout Illinois and Wisconsin. HSHS provides compassionate, holistic, high quality, and cost-effective health care through its acute care hospitals, physician practices, home health programs, palliative and hospice programs, and community outreach services. In addition, HSHS affiliated hospitals include critical access facilities that offer essential health services that otherwise would not be available in many communities. Our mission calls us to reveal and embody Christ's healing love for all people, and we extend our high quality Franciscan health care ministry beyond the walls of our hospitals by providing community health improvement services with special emphasis on the poor and vulnerable. In addition to providing community health improvement services to the broader community, HSHS cares for everyone who comes to its facilities, regardless of their ability to pay. In tandem with a variety of cross sector community partners, HSHS's Community Benefit initiatives are strategically planned and professionally implemented to improve access to health care services; enhance the health of the community; advance medical or general health care knowledge; and relieve or reduce the burden of government to improve health. The COVID-19 pandemic caused an unprecedented disruption in healthcare services across the United States. HSHS responded with services that benefited our communities, including free telehealth screenings, free testing, and coordination with other healthcare providers in the communities we serve to best ensure access to needed care. In FY2022, HSHS collectively provided $218.9 million in Community Benefit (8.3% of total hospital expenses). Of the total Community Benefit provided, HSHS spent $11.6 million provided for Financial Assistance (aka Charity Care) and $146.1 million for unreimbursed care provided as part of the Medicaid program. In addition, HSHS hospitals committed significant resources to treat Medicare patients. The cost of providing services to primarily elderly beneficiaries of the Medicare program - in excess of governmental and managed care contract payments - was $23.2 million. HSHS hospitals also recorded $68.7 million in uncollectible accounts. While HSHS does not count the latter two amounts as Community Benefit, they nonetheless reflect our commitment to serving all persons in need of care. In addition to the dollars invested in our Community Benefit programs, HSHS continues to reinvest any surplus revenue from operations and investments into new medical technology, facility infrastructure and health care services in our communities. By doing so, we ensure our ability to meet the ongoing demand for high quality, efficient and easily accessible health care. Schedule H, Part VI, Line 7 State filing of community benefit report IL X X X X X true true false false false false false false false EVERT J KUIPER Division CEO - Illinois (until Jan 2022) 0 869727 0 223426 0 232329 0 199698 0 26189 0 1551369 0 142807 THERESA J RUTHERFORD President & CEO 0 424061 0 87270 0 75087 0 161627 0 19561 0 767606 0 38103 MICHAEL W COTTRELL Board Member (Until March 2022) / HSHS CFO 0 724037 0 188039 0 101117 0 151709 0 22311 0 1187213 0 81097 ANN M CARR Former Treasurer 0 49007 0 24145 0 190725 0 0 0 2041 0 265918 0 140277 DAVID NOSACKA DIVISION CFO - ILLINOIS (until 7/27/21) 0 264563 0 38318 0 209419 0 59477 0 16695 0 588472 0 92408 TODD Smart Treasurer 0 155999 0 0 0 74249 0 20716 0 9243 0 260207 0 0 Corey J Hastings Interim Division CFO (until 4/15/22) 0 198503 0 1000 0 12377 0 49079 0 26067 0 287026 0 0 Amy Dobrinick CERTIFIED REGISTERED NURSE ANESTHETIST 290488 0 17250 0 335 0 13549 0 28435 0 350057 0 0 0 Deanna Y Hitchens Certified Registered Nurse Anesthetist 269772 0 17250 0 5275 0 89490 0 19922 0 401709 0 0 0 Laura Long CRNA 231177 0 17250 0 14426 0 13901 0 948 0 277702 0 0 0 Beth A McCoy Certified Registered Nurse Anesthetist 321662 0 17250 0 5508 0 103631 0 28435 0 476486 0 0 0 Robyn Reising CNO 105549 0 0 0 160428 0 3262 0 731 0 269970 0 0 0 Schedule J, Part I, Line 3 Arrangement used to establish the top management official's compensation PLEASE SEE RESPONSE TO FORM 990, PART VI, LINE 15A IN SCHEDULE O. Schedule J, Part I, Line 4a Severance or change-of-control payment ORGANIZATION: St. Mary's Hospital, Decatur, of the Hospital Sisters of the Third Order of St. Francis EIN: 37-0661244 INTERESTED PERSON: Robyn Reising AMOUNT: $103,031 TERMS: COMPENSATION PAID AS A RESULT OF A SEVERANCE FROM THE POSITION OF CNO. Schedule J, Part I, Line 4b Supplemental nonqualified retirement plan HSHS EXECUTIVES ELIGIBLE TO PARTICIPATE IN SUPPLEMENTAL EXECUTIVE RETIREMENT PLAN (SERP) ARE DEFINED IN THE SERP PLAN DOCUMENTS. THE SERP WAS ESTABLISHED TO PROVIDE ADDITIONAL RETIREMENT BENEFITS TO ENSURE REASONABLE MARKET COMPETITIVE BENEFITS IN ACCORDANCE WITH THE HSHS EXECUTIVE COMPENSATION PHILOSOPHY ESTABLISHED BY THE HSHS COMPENSATION COMMITTEE. THE PLAN PROVIDES A DEFINED RETIREMENT CONTRIBUTION TO PARTICIPANTS COMMENCING ON JANUARY 1, 2008, EQUAL TO A PERCENTAGE OF COMPENSATION AS DEFINED IN THE SERP PLAN DOCUMENTS FOR THE PLAN YEAR. PARTICIPANTS CONSTRUCTIVELY RECEIVE A DISTRIBUTION FROM THE PLAN NO LATER THAN MARCH 15TH OF THE CALENDAR YEAR FOLLOWING THE CALENDAR YEAR IN WHICH AN AMOUNT IS VESTED AND TAXABLE PURSUANT TO A VESTING SCHEDULE AS SPECIFIED IN THE PLAN DOCUMENT. THE ACTUAL DISTRIBUTION OF THE VESTED BENEFIT UNDER THE PLAN IS PAID IN A SINGLE LUMP SUM TO THE PARTICIPANT OR THE PARTICIPANT'S BENEFICIARY UPON THE EARLIER OF THE PARTICIPANT'S TERMINATION OF EMPLOYMENT, DEATH, OR TOTAL AND PERMANENT DISABILITY. THE FOLLOWING INTERESTED PERSONS CONSTRUCTIVELY RECEIVED DEFERRALS TO THE SUPPLEMENTAL EXECUTIVE RETIREMENT PLAN (SERP) IN 2021 THESE DEFERRALS ARE INCLUDED IN SCHEDULE J, PART II, COLUMN (C). Michael Cottrell -- $112,844 Evert J. Kuiper -- $134,507 Theresa Rutherford -- $51,620 Todd Smart -- $12,608 THE FOLLOWING INTERESTED PERSONS RECEIVED DISTRIBUTIONS FROM THE SUPPLEMENTAL EXECUTIVE RETIREMENT PLAN (SERP) IN 2021 THESE PAYMENTS ARE INCLUDED IN SCHEDULE J, PART II, COLUMN (B)(III) AND SCHEDULE J, PART II, COLUMN (F), AS APPLICABLE. Ann Carr -- $140,277 Michael Cottrell -- $81,097 Evert J. Kuiper -- $142,807 David Nosacka -- $92,408 Theresa Rutherford -- $38,103 Form 990, Part IV, Line 24a TAX EXEMPT BONDS ST. MARY'S DECATUR HOLDS A LIABILITY ON ITS BOOKS FOR TAX-EXEMPT BONDS, WHICH IS AN ALLOCATION FROM ITS SOLE CORPORATE MEMBER, HOSPITAL SISTERS SERVICES, INC. AS A RESULT, THIS QUESTION WAS ANSWERED NO, AND SCHEDULE K WILL BE COMPLETED ON THE HOSPITAL SISTERS SERVICES, INC. FORM 990. Form 990, Part IV, Line 10 Endowment Funds The organization maintains net assets with donor restrictions and without donor restrictions on its balance sheet. Such funds are held by Hospital Sisters of St. Francis Foundation, Inc., a related tax-exempt organization. While these funds are held to further one or more exempt purposes of the filing organization, they are not maintained exclusively for the filing organization. The board of directors of Hospital Sisters of St. Francis Foundation, Inc. maintains ownership and ultimately authority and discretion over the use of these funds. Based on the above, the related amounts have not been reported as endowment funds on Part V of Schedule D. Form 990, Part V, Line 1a NUMBER REPORTED IN BOX 3 OF FORM 1096 THE FORM 1096, ANNUAL SUMMARY AND TRANSMITTAL OF U.S. INFORMATION RETURN IS FILED BY THE ORGANIZATION'S PARENT, HOSPITAL SISTERS HEALTH SYSTEM (HSHS) ON THE ORGANIZATION'S BEHALF TO TRANSMIT TO THE IRS FORMS 1099, 1098, 5498, AND W-2G. THE ORGANIZATION IS UNABLE TO DETERMINE THE NUMBER OF FORMS 1099, 1098, 5498 AND W-2G FILED BY HSHS, ON THEIR BEHALF. HOWEVER, AS THE PARENT ORGANIZATION, HSHS ENSURES THAT THE FILING ORGANIZATION COMPLIES WITH ALL INFORMATION RETURN REPORTING REQUIREMENTS AND BACKUP WITHHOLDING RULES FOR REPORTABLE PAYMENTS TO VENDORS AND REPORTABLE GAMING WINNINGS TO PRIZE WINNERS, AS APPLICABLE. Form 990, Part VI, Line 13 WHISTLEBLOWER POLICY PROVISIONS WITHIN THE CORPORATE COMPLIANCE PROGRAM AND CONFLICT OF INTEREST POLICY PROVIDE PROTECTIONS FOR WHISTLEBLOWER TYPE ACTIVITIES. Form 990, Part VI, Line 16b JOINT VENTURES HOSPITAL SISTERS HEALTH SYSTEM ADOPTED A JOINT VENTURE COMPLIANCE PROGRAM POLICY EFFECTIVE ON JANUARY 1, 2012 FOR ALL SYSTEM HOSPITALS. THE OVERALL PURPOSE OF THE POLICY IS TO PROVIDE PRACTICAL GUIDELINES FOR ETHICAL BUSINESS CONDUCT, TO ACHIEVE COMPLIANCE, AND TO DETECT AND PREVENT VIOLATIONS OF APPLICABLE LAWS. THE POLICY REQUIRES ALL HSHS HOSPITALS, TO EVALUATE THEIR PARTICIPATION IN JOINT VENTURE ARRANGEMENTS, INCLUDING UNDER APPLICABLE FEDERAL TAX LAWS, AND TO SAFEGUARD THE ORGANIZATION'S TAX EXEMPT STATUS WITH RESPECT TO ANY JOINT VENTURE ARRANGEMENTS. Form 990, Part VI, Line 1a Delegate broad authority to a committee PER ARTICLE 5.5 OF THE ORGANIZATION'S BY-LAWS, THE GOVERNING BODY DELEGATES BROAD AUTHORITY TO AN EXECUTIVE COMMITTEE. THE EXECUTIVE COMMITTEE SHALL BE VESTED WITH AND MAY IN ITS DISCRETION EXERCISE THE FULL POWERS, DUTIES, RESPONSIBILITIES, AND AUTHORITY OF THE BOARD EXCEPT WHERE PROHIBITED BY LAW AND SUBJECT TO ANY LIMITATIONS IMPOSED BY THE BYLAWS OR THE BOARD OF DIRECTORS. AS PROVIDED IN THE BY-LAWS, THE EXECUTIVE COMMITTEE SHALL CONSIST OF THREE TO SIX MEMBERS, INCLUDING THE CHAIRPERSON OF THE BOARD, THE VICE CHAIRPERSON, THE PRESIDENT AND OTHER MEMBERS SELECTED FROM AMONG THE DIRECTORS BY THE BOARD. Form 990, Part VI, Line 6 Classes of members or stockholders THE SOLE CORPORATE MEMBER OF ST. MARY'S HOSPITAL (THE CORPORATION) IS HOSPITAL SISTERS SERVICES, INC. ("HSSI"), AN ILLINOIS NOT FOR PROFIT CORPORATION EXEMPT FROM FEDERAL TAXATION UNDER SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE. Form 990, Part VI, Line 7a Members or stockholders electing members of governing body PURSUANT TO SECTION 2.3 OF THE CORPORATION'S BYLAWS, THE ORGANIZATION'S MEMBER, HOSPITAL SISTERS SERVICES, INC. ("HSSI"), AN ILLINOIS NOT FOR PROFIT CORPORATION EXEMPT FROM FEDERAL TAXATION UNDER SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE, HAS THE RIGHT TO APPOINT AND REMOVE THE CORPORATION'S BOARD OF DIRECTORS. Form 990, Part VI, Line 7b Decisions requiring approval by members or stockholders RESPONSIBILITY FOR THE POLICY AND OPERATIONS OF ST. MARY'S HOSPITAL DECATUR(THE "CORPORATION") IS VESTED IN ITS BOARD OF DIRECTORS, EXCEPT WITH RESPECT TO SPECIFIC POWERS RESERVED IN THE CORPORATION'S BYLAWS TO THE CORPORATION'S MEMBER, HOSPITAL SISTERS SERVICES, INC. ("HSSI"), AN ILLINOIS NOT FOR PROFIT CORPORATION EXEMPT FROM FEDERAL TAXATION UNDER SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE. THE MEMBER OF HSSI IS HOSPITAL SISTERS HEALTH SYSTEM ("HSHS"), AN ILLINOIS NOT FOR PROFIT CORPORATION EXEMPT FROM FEDERAL TAXATION UNDER SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE. THE GOVE RNANCE AND OPERATIONS OF THE CORPORATION ARE SUBJECT TO HSSI'S RIGHT TO EXERCISE THESE RESERVED POWERS WITH RESPECT TO THE CORPORATION AND ORGANIZATIONS OF WHICH THE CORPORATION IS EITHER, DIRECTLY OR INDIRECTLY, A CONTROLLING MEMBER OR A CONTROLLING SHAREHOLDER ("AFFILIATES"). HSSI'S RIGHT TO EXERCISE CERTAIN OF THESE RESERVED POWERS IS, IN TURN, SUBJECT TO THE APPROVAL OF HSHS AND HSHS' MEMBERS. THE RESERVED POWERS INCLUDE ALL RIGHTS GRANTED TO HSSI BY LAW AND THE RIGHT TO: (A) ADOPT, APPROVE AMENDMENTS TO, OR AMEND ANY STATEMENT OF PHILOSOPHY, MISSION, MISSION INTEGRATION OR VALUES, OR ANY NAME, LOGO, OR MARK OF THE CORPORATION OR OF ANY AFFILIATE; (B) ADOPT, APPROVE AMENDMENTS TO, OR AMEND THE ARTICLES OF INCORPORATION OF THE CORPORATION OR OF ANY AFFILIATE; (C) ADOPT, APPROVE AMENDMENTS TO, OR AMEND THE BYLAWS OF THE CORPORATION OR OF ANY AFFILIATE; (D) APPOINT AND REMOVE THE BOARD OF DIRECTORS, ANY ONE OR MORE OF THE DIRECTORS OF THE CORPORATION OR OF ANY AFFILIATE, AND THE PRESIDENT OF THE CORPORATION OR OF ANY AFFILIATE; (E) APPROVE THE RECOMMENDATION OF THE BOARD OF DIRECTORS TO APPOINT OR REMOVE THE BOARD OF DIRECTORS, ANY ONE OR MORE DIRECTORS OF THE CORPORATION OR OF ANY AFFILIATE, OR THE CHAIRPERSON AND PRESIDENT OF THE CORPORATION OR OF ANY AFFILIATE. (F) WITH RESPECT TO THE CORPORATION OR ANY AFFILIATE, APPROVE THE PURCHASE, SALE, ALIENATION, EXCHANGE, LEASE, OR ENCUMBRANCE OF ANY REAL PROPERTY OF THE CORPORATION OR OF ANY AFFILIATE, WHICH PROPERTY HAS A VALUE IN EXCESS OF LIMITS SET FROM TIME TO TIME BY HSSI; (G) APPROVE DEBT INCURRED BY THE CORPORATION OR ANY AFFILIATE IN AN AMOUNT IN EXCESS OF LIMITS SET FROM TIME TO TIME BY THE MEMBER. (H) APPROVE THE OPERATING AND CAPITAL BUDGETS OF THE CORPORATION OR OF ANY AFFILIATE, AND ANY DEVIATIONS BY THE CORPORATION OR OF ANY AFFILIATE FROM SUCH BUDGETS IN AN AMOUNT OR PERCENTAGE SPECIFIED BY HSSI FROM TIME TO TIME; (I)APPROVE THE STRATEGIC PLAN AND ANNUAL GOALS OF THE CORPORATION OR OF ANY AFFILIATE; (J) APPROVE THE SALE OF SUBSTANTIALLY ALL OF THE ASSETS OF THE CORPORATION OR OF ANY AFFILIATE; (K) APPROVE THE MERGER OR DISSOLUTION OF THE CORPORATION OR OF ANY AFFILIATE; (L) ADOPT OR AMEND THE PLAN FOR MINISTRY EDUCATION AND GOVERNANCE FOR THE CORPORATION AND ITS AFFILIATES; (M) APPROVE THE CORPORATION'S MISSION ACCOUNTABILITY REPORTS AND THOSE OF ANY AFFILIATE; (N) APPROVE THE FINANCIAL POLICIES AND PROCEDURES OF THE CORPORATION OR OF ANY AFFILIATE, AND APPROVE ANY DEVIATIONS FROM SUCH POLICIES AND PROCEDURES BY THE CORPORATION OR ANY AFFILIATE; AND (O) ADOPT POLICIES TO IMPLEMENT THE RESERVED POWERS OF HSSI. Form 990, Part VI, Line 11b Review of form 990 by governing body THE HOSPITAL EMPLOYS CROWE LLP TO ASSIST IN THE OVERALL REVIEW AND ELECTRONIC SUBMISSION OF ITS FORM 990. CROWE LLP PROVIDES GUIDANCE IN IDENTIFYING CRITICAL ERRORS IN THE RETURN SUBMISSION AND FEEDBACK ON QUANTITATIVE AND QUALITATIVE RESPONSES. ADDITIONALLY, THE HOSPITAL CFO PERFORMS A THOROUGH REVIEW OF THE RETURN AND REVIEWS IT WITH THE HOSPITAL CEO AND/OR SENIOR LEADERS BEFORE PRESENTING IT IN ITS ENTIRETY TO THE HOSPITAL BOARD FOR QUESTIONING AND REVIEW PRIOR TO THE RETURN'S SIGNING AND SUBMISSION TO THE IRS. Form 990, Part VI, Line 12c Conflict of interest policy THE ORGANIZATION IS SUBJECT TO THE CORPORATE COMPLIANCE PROGRAM AND CONFLICT OF INTEREST POLICY ("POLICY") OF HOSPITAL SISTERS HEALTH SYSTEM, AN ILLINOIS NOT FOR PROFIT CORPORATION EXEMPT FROM FEDERAL TAXATION UNDER SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE. A REVISED CORPORATE COMPLIANCE PROGRAM AND CONFLICT OF INTEREST POLICY HAVE BEEN IMPLEMENTED SINCE JANUARY, 2009 TO MANAGE CONFLICTS OF INTEREST USING A SYSTEM-WIDE PROTOCOL FOR DISCLOSURE STATEMENTS. IN ACCORDANCE WITH THE ORGANIZATON'S CONFLICT OF INTEREST POLICY, ALL COVERED PERSONS HAVE A DUTY TO COMPLY WITH THE CONFLICT OF INTEREST POLICY FOR ANY CONTRACT, TRANSACTION, RELATIONSHIP, OR ACTIVITY CONTEMPLATED, ENTERED INTO, OR CONDUCTED AT HSHS OR ITS AFFILIATES. THE POLICY DEFINES COVERED PERSONS AS BOARD MEMBERS, BOARD COMMITTEE MEMBERS, OFFICERS, BOARD DESIGNEES, SENIOR MANAGEMENT, MEMBERS OF ANY COMMITTEE THAT OVERSEES THE APPROVAL OF PHARMACEUTICALS AND MEDICAL DEVICES, AND ANY OTHER INDIVIDUAL WHO HOLDS A POSITION OF TRUST. ON AN ANNUAL BASIS, HSHS DISCLOSES A COPY OF THE CONFLICT OF INTEREST POLICY (AND ALL CORRESPONDING PROCEDURES, GUIDELINES, FORMS, AND TOOLS) TO ALL COVERED PERSONS AND ADVISES ALL COVERED PERSONS IN WRITING OF ANY SUBSTANTIVE CHANGES TO THIS POLICY AND SUCH RELATED MATERIALS. COVERED PERSONS ARE REQUIRED TO REVIEW AND COMPLETE THE CORRESPONDING CONFLICT OF INTEREST STATEMENT. THE SYSTEM OFFICE VICE PRESIDENT - SYSTEM RESPONSIBILITY, VICE PRESIDENT - RISK & COMPLIANCE, OR MEMBERS OF THE AUDIT AND INTEGRITY COMMITTEE ("COMMITTEE") ARE AVAILABLE TO ANSWER ANY QUESTIONS A COVERED PERSON MAY HAVE. IN ADDITION, IF, AT ANY TIME AFTER SUBMITTING AN ANNUAL CONFLICT OF INTEREST STATEMENT, A COVERED PERSON BECOMES AWARE OF AN INTEREST THAT HE OR SHE WOULD HAVE HAD TO DISCLOSE AT THE ANNUAL INTERVAL, THE COVERED PERSON IS REQUIRED PROMPTLY TO DISCLOSE THE INTEREST TO THE COMMITTEE USING THE HSHS CONFLICT OF INTEREST DISCLOSURE STATEMENT. COMPLETED CONFLICT OF INTEREST STATEMENTS ARE SUBMITTED TO THE COMMITTEE, WHICH IS RESPONSIBLE FOR IDENTIFYING, ASSESSING, AND MANAGING CONFLICTS OF INTEREST THAT ARISE IN THE COURSE OF CONDUCTING THE AFFAIRS OF HSHS AND ITS AFFILIATES. IF THE COMMITTEE DETERMINES THAT A CONFLICT OF INTEREST EXISTS, THE CONFLICT OF INTEREST POLICY REQUIRES HSHS NOT TO ENGAGE IN, OR ENTER INTO A PROPOSED CONTRACT, TRANSACTION, RELATIONSHIP, ARRANGEMENT, OR ACTIVITY UNLESS THE COMMITTEE OR, WHERE NECESSARY, THE BOARD OF DIRECTORS (ACTING THROUGH ITS DISINTERESTED MEMBERS), HAS INVESTIGATED ALTERNATIVES TO THE PROPOSED CONTRACT, TRANSACTION, RELATIONSHIP, ARRANGEMENT, OR ACTIVITY AND, IN THE ABSENCE OF ALTERNATIVES THAT ARE IN THE BEST INTERESTS OF HSHS, HAS DETERMINED: 1. THAT, REGARDLESS OF WHETHER THE COVERED PERSON PARTICIPATES IN THE IMPLEMENTATION OF THE PROPOSED CONTRACT, TRANSACTION, RELATIONSHIP, ARRANGEMENT, OR ACTIVITY; 2. THE CONTRACT, TRANSACTION, ARRANGEMENT, OR ACTIVITY IS IN THE BEST INTERESTS OF HSHS; 3. THE CONTRACT, TRANSACTION, ARRANGEMENT, OR ACTIVITY IS FAIR AND REASONABLE FROM THE PERSPECTIVE OF HSHS; AND 4. HSHS CANNOT OBTAIN A MORE ADVANTAGEOUS CONTRACT, TRANSACTION, ARRANGEMENT, OR ACTIVITY WITH REASONABLE EFFORTS UNDER THE CIRCUMSTANCES. IN DETERMINING WHETHER A CONTRACT, TRANSACTION OR ARRANGEMENT IS FAIR AND REASONABLE TO HSHS, THE COMMITTEE SHALL CONSIDER, WHERE APPLICABLE: 1. APPRAISALS OR OTHER INDEPENDENT VALUATIONS OF THE FAIR MARKET VALUE OF THE CONTRACT, TRANSACTION, OR ARRANGEMENT; 2. INFORMATION REGARDING COMPARABLE CONTRACTS, TRANSACTIONS, OR ARRANGEMENTS BETWEEN UNRELATED PARTIES; 3. OFFERS FROM COMPARABLE COMPETING ENTITIES; AND/OR 4. STUDIES OF COMPARABLE COMPENSATION ARRANGEMENTS. IN ANY CASE IN WHICH THE COMMITTEE FINDS, AFTER TAKING THE STEPS DESCRIBED ABOVE, THAT HSHS SHOULD PARTICIPATE IN A PROPOSED TRANSACTION OR ARRANGEMENT DESPITE THE EXISTENCE OF A CONFLICT OF INTEREST, THE COMMITTEE SHALL DEVELOP, IMPLEMENT, MONITOR, AND ENFORCE COMPLIANCE WITH A CONFLICT MANAGEMENT PLAN FOR MANAGING THE CONFLICT OF INTEREST AS IT CONSIDERS NECESSARY FOR SUCH FINDINGS TO REMAIN VALID THROUGHOUT THE LIFE OF THE CONTRACT, TRANSACTION, RELATIONSHIP, ARRANGEMENT, OR ACTIVITY. ALL CONFLICT MANAGEMENT PLANS SHALL: 1. STATE THAT THE COMMITTEE WILL OVERSEE, MONITOR, AND ENFORCE COMPLIANCE WITH THE PLAN THROUGHOUT THE COURSE OF THE STUDY AND SPECIFY MEANS FOR DOING SO, INCLUDING, WITHOUT LIMITATION, THAT THE APPROPRIATE INDIVIDUALS MUST PROVIDE THE COMMITTEE WITH WRITTEN REPORTS PERTAINING TO COMPLIANCE WITH THE CONFLICT MANAGEMENT PLAN, THAT THE COMMITTEE SHALL HAVE THE RIGHT TO AUDIT THE STUDY FOR SUCH COMPLIANCE AND THE RIGHT TO IMPOSE SANCTIONS FOR NON-COMPLIANCE; 2. STATE THAT THE PLAN MUST BE SHARED WITH COVERED PERSON WHOSE INTERESTS IT WAS DEVELOPED TO MANAGE; 3. STATE THAT THE PLAN MUST BE SHARED WITH, AND PERIODIC REPORTS ON COMPLIANCE WITH THE PLAN MUST BE PROVIDED TO, THE BOARD, SENIOR MANAGEMENT, AND/OR GOVERNMENT AGENCIES; AND 4. PROVIDE FOR SUCH OTHER MANAGEMENT STEPS AND MECHANISMS THE COMMITTEE CONSIDERS NECESSARY AND APPROPRIATE. IN ADDITION TO THE COMMITTEE, THE SYSTEM OFFICE VICE PRESIDENTS OF SYSTEM RESPONSIBILITY AND RISK & COMPLIANCE MAY RETAIN SUCH INDEPENDENT ADVISORS OR EXPERTS AS DEEMED NECESSARY TO ASSIST IN MAKING ITS DETERMINATIONS AND DECISIONS. IF THE COMMITTEE DETERMINES THAT THE CONTEMPLATED TRANSACTION, RELATIONSHIP, ARRANGEMENT, OR ACTIVITY CANNOT PROCEED DUE TO A CONFLICT OF INTEREST, THE COMMITTEE SHALL INFORM THE APPLICABLE COVERED PERSON OR DECISION-MAKING BODY OF SUCH DETERMINATION WITHIN ONE WEEK OF THE COMMITTEE MEETING AT WHICH THE CONTEMPLATED TRANSACTION WAS DISCUSSED. THE COMMITTEE SHALL DOCUMENT ITS REJECTION OF THE CONTEMPLATED TRANSACTION IN THE COMMITTEE'S MEETING MINUTES. Form 990, Part VI, Line 15a Process to establish compensation of top management official THE COMPENSATION COMMITTEE (COMMITTEE) IS COMPRISED OF INDEPENDENT MEMBERS OF THE BOARD OF DIRECTORS. THE COMMITTEE DEVELOPS A COMPENSATION PHILOSOPHY FOR THE SYSTEM AND ALL AFFILIATES. THE COMMITTEE SELECTS AND HIRES THE INDEPENDENT COMPENSATION CONSULTANT TO DEVELOP COMPARABILITY DATA AND ADVISE THE COMMITTEE DURING ITS DELIBERATIONS REGARDING ALL ELEMENTS OF TOTAL COMPENSATION FOR ALL HSHS EXECUTIVES, (the top management official, other officers and key employees). INTEGRATED HEALTHCARE STRATEGIES ("IHS"), THE CONSULTANTS UTILIZED BY THE COMMITTEE, USE DATA FROM MULTIPLE TAX-EXEMPT PEER GROUP SOURCES TO DETERMINE SALARY RANGES, INCENTIVE OPPORTUNITY RANGES AND BENEFITS FOR THE HSHS executives. IHS THEN ASSISTS THE COMMITTEE IN PREPARING CONTEMPORANEOUS DOCUMENTATION OF ALL ACTIONS. EACH COMMITTEE MEETING IS CONDUCTED WITH THE INTENT TO CREATE A REBUTTABLE PRESUMPTION OF REASONABLENESS FOR ALL ELEMENTS OF EXECUTIVE TOTAL COMPENSATION. THE CHAIRMAN MAKES THIS DECLARATION AND ALSO INQUIRES IF THERE ARE ANY CONFLICTS OF INTEREST BY ANY ATTENDEES. ANY CONFLICTS ARE DISCLOSED AND THE COMMITTEE THEN ACTS IN A MANNER TO AVOID ANY CONFLICTED INDIVIDUAL PARTICIPATING IN ANY MANNER WHERE A CONFLICT MIGHT EXIST. AT THE END OF THE MEETING, THE COMMITTEE PREPARES CONTEMPORANEOUS MINUTES THAT RECORD ALL ACTIONS TAKEN DURING THE MEETING. Form 990, Part VI, Line 15b Process to establish compensation of other employees PLEASE SEE RESPONSE TO FORM 990, PART VI, LINE 15A. Form 990, Part VI, Line 19 Required documents available to the public BOARD-APPROVED FINANCIAL STATEMENTS ARE MADE AVAILABLE TO THE PUBLIC UPON REQUEST. THE GOVERNING DOCUMENTS AND CONFLICT OF INTEREST POLICY ARE NOT MADE AVAILABLE TO THE GENERAL PUBLIC AT THIS TIME. Form 990, Part VIII, Line 11d Other Miscellaneous Revenue Shield Illinois COVID Testing - Total Revenue: 1321899, Related or Exempt Function Revenue: 1321899, Unrelated Business Revenue: , Revenue Excluded from Tax Under Sections 512, 513, or 514: ; Other Revenue - Total Revenue: 391995, Related or Exempt Function Revenue: 391995, Unrelated Business Revenue: , Revenue Excluded from Tax Under Sections 512, 513, or 514: ; Form 990, Part IX, Line 11g Other Fees Management & Contracted Service - Total Expense: 542097, Program Service Expense: 533139, Management and General Expenses: 8958, Fundraising Expenses: ; SBO Fee - Total Expense: 6581220, Program Service Expense: , Management and General Expenses: 6581220, Fundraising Expenses: ; SSC Management Fee - Total Expense: 2559482, Program Service Expense: , Management and General Expenses: 2559482, Fundraising Expenses: ; Medical Physician Fees - Total Expense: 10615236, Program Service Expense: 10615236, Management and General Expenses: , Fundraising Expenses: ; Consulting and Management Fee - Total Expense: -309964, Program Service Expense: 610024, Management and General Expenses: -919988, Fundraising Expenses: ; Contract Labor - Total Expense: 15996373, Program Service Expense: 14579989, Management and General Expenses: 1416384, Fundraising Expenses: ; Med. Equip. Service Contracts - Total Expense: 2095179, Program Service Expense: 2092780, Management and General Expenses: 2399, Fundraising Expenses: ; Laundry Services - Total Expense: 646063, Program Service Expense: 646063, Management and General Expenses: , Fundraising Expenses: ; Outside Services-EVS - Total Expense: 485469, Program Service Expense: 485469, Management and General Expenses: , Fundraising Expenses: ; Purchased Services - Total Expense: 25301720, Program Service Expense: 23856442, Management and General Expenses: 1445278, Fundraising Expenses: ; Purchase Service Fee - HR - Total Expense: 899508, Program Service Expense: , Management and General Expenses: 899508, Fundraising Expenses: ; Outside Services-FANS - Total Expense: 1546602, Program Service Expense: 1546602, Management and General Expenses: , Fundraising Expenses: ; Form 990, Part X, Line 11 POOLED INVESTMENT ACCOUNT ST. MARY'S HOSPITAL CASH RESERVES ARE INVESTED IN A POOLED INVESTMENT ACCOUNT MAINTAINED BY HOSPITAL SISTERS HEALTH SYSTEM (HSHS). PARTICIPATION IN THE POOLED INVESTMENT FUND IS LIMITED TO THE 501(C)(3) HOSPITALS AND HEALTH SERVICES ORGANIZATIONS SPONSORED BY HSHS. THE POOLED ACCOUNT CONSISTS OF CASH, EQUITY AND DEBT SECURITIES THAT ARE PUBLICLY TRADED. IN ACCORDANCE WITH THE PROVISIONS OF STATEMENT OF FINANCIAL ACCOUNTING STANDARDS (SFAS) NO. 124, "ACCOUNTING FOR CERTAIN INVESTMENTS HELD BY NOT-FOR-PROFIT ORGANIZATIONS", INVESTMENTS IN EQUITY SECURITIES WITH READILY DETERMINABLE FAIR VALUES AND ALL INVESTMENTS IN DEBT SECURITIES ARE REPORTED AT FAIR VALUE ON THE BALANCE SHEET. INCOME, REALIZED AND UNREALIZED GAINS AND LOSSES ARE POOLED AND ALLOCATED TO THE PARTICIPANTS. INDIVIDUAL COMPONENTS OF ASSETS AND REVENUE ARE NOT IDENTIFIED TO THE INDIVIDUAL HOSPITAL PARTICIPANTS. Form 990, Part XI, Line 9 Other changes in net assets or fund balances TRANSFER TO/FROM AFFILIATES - -12749970; CHANGE IN FAIR VALUE OF INTEREST RATE SWAPS - 3815; PENSION - MTM - 663156; PENSION - OTHER - 3528997; NET ASSETS RECLASSED FROM RESTRICTIONS USED FOR THE PURCHASE OF PROPERTY, PLANT AND EQIUPMENT - 213094; CHANGE IN TEMPORARILY RESTRICTED NET ASSETS - 17611; KIARA CLINICAL INTEGRATION NETWORK LLC 4936 LAVERNA ROAD SPRINGFIELD IL 62707 261417684 HEALTHCARE IL -187394 554439 HSSI PHYSICIAN CLINICAL INTEGRATION NETWORK LLC 4936 LAVERNA ROAD SPRINGFIELD IL 62707 371668647 HEALTHCARE IL 625612 14756411 KCIN HSHS ACO LLC 4936 LAVERNA ROAD SPRINGFIELD IL 62707 320465666 HEALTHCARE & SOCIAL ASSISTANCE IL 231342 1299915 KCIN HOSPITAL SISTERS HEALTH SYSTEM 4936 LAVERNA ROAD SPRINGFIELD IL 62707 371058692 HEALTHCARE IL 501(c)(3) Type III-FI NA false HOSPITAL SISTERS OF ST FRANCIS FOUNDATION 4936 LAVERNA ROAD SPRINGFIELD IL 62707 371186514 HEALTHCARE IL 501(c)(3) 7 HSHS true HOSPITAL SISTERS HEALTHCARE WEST INC 2661 COUNTY HIGHWAY 1 CHIPPEWA FALLS WI 54729 510157933 HEALTHCARE WI 501(c)(3) Type I HSSI true SACRED HEART HOSPITAL 990 WEST CLAIREMONT AVENUE EAU CLAIRE WI 54701 390807060 HEALTHCARE WI 501(c)(3) 3 HSSI true ST ANTHONY'S HOSPITAL 503 N MAPLE STREET EFFINGHAM IL 62401 370661233 HEALTHCARE IL 501(c)(3) 3 HSSI true ST ELIZABETH'S HOSPITAL ONE ST ELIZABETHS BLVD OFALLON IL 62269 370663567 HEALTHCARE IL 501(c)(3) 3 HSSI true ST NICHOLAS HOSPITAL 3100 SUPERIOR AVENUE SHEBOYGAN WI 53081 390808480 HEALTHCARE WI 501(c)(3) 3 HSSI true ST JOHN'S HOSPITAL 800 EAST CARPENTER STREET SPRINGFIELD IL 62769 370661238 HEALTHCARE IL 501(c)(3) 3 HSSI true ST JOSEPH'S HOSPITAL 9515 HOLY CROSS LANE BREESE IL 62230 371208459 HEALTHCARE IL 501(c)(3) 3 HSSI true ST JOSEPH'S HOSPITAL 2661 COUNTY HIGHWAY 1 CHIPPEWA FALLS WI 54729 390810545 HEALTHCARE WI 501(c)(3) 3 HSSI true ST MARY'S HOSPITAL MEDICAL CENTER 1762 SHAWANO AVENUE GREEN BAY WI 54303 390818682 HEALTHCARE WI 501(c)(3) 3 HSSI true ST VINCENT HOSPITAL 835 S VAN BUREN GREEN BAY WI 51301 390817529 HEALTHCARE WI 501(c)(3) 3 HSSI true ST JOSEPH'S HOSPITAL 12866 TROXLER AVENUE HIGHLAND IL 62249 370663568 HEALTHCARE IL 501(c)(3) 3 HSSI true ST FRANCIS HOSPITAL 1215 FRANCISCAN DRIVE LITCHFIELD IL 62056 370661236 HEALTHCARE IL 501(c)(3) 3 HSSI true HOSPITAL SISTERS SERVICES INC 4936 LAVERNA ROAD SPRINGFIELD IL 62707 371163402 HEALTHCARE IL 501(c)(3) Type III-FI HSHS true HSHS MEDICAL GROUP INC 3215 EXECUTIVE PARK DRIVE SPRINGFIELD IL 62703 263956318 HEALTHCARE IL 501(c)(3) Type III-FI HSSI true HSHS WISCONSIN MEDICAL GROUP INC 3215 EXECUTIVE PARK DRIVE SPRINGFIELD IL 62703 264515959 HEALTHCARE WI 501(c)(3) Type III-FI HSSI true ORANGE CROSS AMBULANCE INC 919 ASHLAND AVENUE SHEBOYGAN WI 53081 391860942 HEALTHCARE WI 501(c)(3) 10 ST NICHOLAS true UNITY LIMITED PARTNERSHIP 2366 OAK RIDGE CIRCLE DE PERE WI 54115 391750729 HEALTHCARE WI 501(c)(3) 10 HSSI true PRAIRIE EDUCATION & RESEARCH COOPERATIVE 317 NORTH 5TH STREET SPRINGFIELD IL 62701 371157915 HEALTHCARE IL 501(c)(3) 4 HSSI true ST CLARE MEMORIAL HOSPITAL 855 S MAIN STREET OCONTO FALLS WI 54154 390848401 HEALTHCARE WI 501(c)(3) 3 HSSI true HSHS HOLY FAMILY HOSPITAL 200 HEALTHCARE DRIVE GREENVILLE IL 62246 370792770 HEALTHCARE IL 501(c)(3) 3 HSSI true UTLAUT MEMORIAL FOUNDATION 200 HEALTHCARE DRIVE GREENVILLE IL 62246 371140166 FUNDRAISING IL 501(c)(3) Type II HSSI true HSHS GOOD SHEPHERD HOSPITAL INC 200 SOUTH CEDAR STREET SHELBYVILLE IL 62565 370512290 HEALTHCARE IL 501(c)(3) 3 HSSI true SHELBY MEMORIAL HOSPITAL EMPLOYEE BENEFIT TRUST 200 SOUTH CEDAR STREET SHELBYVILLE IL 62565 371778753 TRUST IL 501(a) HSSI true SOUTHERN ILLINOIS CARDIOVASCULAR FACILITY INC ONE ST ELIZABETHS BLVD OFALLON IL 62269 371276333 HEALTHCARE IL 501(c)(3) 3 ST ELIZABETH'S HOSPITAL false HOSPITAL SISTERS MISSION OUTREACH CORPORATION 4849 LAVERNA ROAD SPRINGFIELD IL 62707 352271729 RECYCLING MEDICAL SUPPLIES IL 501(c)(3) HSHS true PRAIRIE CARDIOVASCULAR CONSULTANTS LTD 4936 LAVERNA ROAD SPRINGFIELD IL 62707 371071858 HEALTHCARE IL 501(c)(3) 10 HSSI true CARPENTER STREET HOTEL LLC 525 NORTH SIXTH STREET SPRINGFIELD IL 62702 364128127 HOTEL IL LASANTE INC N/A 0 SPRINGFIELD URGENT CARE REAL ESTATE LLC PO BOX 19456 SPRINGFIELD IL 627949456 030413258 RENTAL REAL ESTATE IL LASANTE INC N/A 0 PRAIRIE HEART INSTITUTE MANAGEMENT COMPANY LLC 4936 LAVERNA ROAD SPRINGFIELD IL 62707 261479945 MEDICAL IL HSHS Related -6963 19229 false true 1 SOUTHWEST ILLINOIS HEALTH SERVICES REAL ESTATE LLP 4000 NORTH ILLINOIS STREET SWANSEA IL 62226 823633320 REAL ESTATE IL ST ELIZABETH'S Related -108805 1568301 false false 0.5 REHABILITATION HOSPITAL OF WESTERN WISCONSIN LLC 900 W Clairemont Avenue Eau Claire WI 54701 871489748 Medical DE HSHS Related 0 0.5 KIARA INC 4936 LAVERNA ROAD SPRINGFIELD IL 62707 371163401 HEALTHCARE IL HSHS C Corporation -151955 18269653 1 true LASANTE WISCONSIN INC 4936 LAVERNA ROAD SPRINGFIELD IL 62707 391572196 HEALTHCARE IL KIARA INC C Corporation true LASANTE INC 4936 LAVERNA ROAD SPRINGFIELD IL 62707 371163400 HEALTHCARE IL KIARA INC C Corporation true PREVEA HEALTH SERVICES INC 2710 EXECUTIVE DRIVE GREEN BAY WI 54304 391839351 HEALTHCARE WI HSSI C Corporation -25530 26059531 0.5 true PREVEA CLINIC INC 2710 EXECUTVE DRIVE GREEN BAY WI 54304 391839349 HEALTHCARE WI PHSI C Corporation true RENAISSANCE QUALITY INSURANCE LTD PO BOX 1159 GRAND CAYMAN CJ KY11102 980669953 INSURANCE CJ HSSI C Corporation 0 159241050 1 true OJV INC 4936 LAVERNA ROAD SPRINGFIELD IL 62707 460873384 HEALTHCARE IL LASANTE INC C Corporation true false false true false true false false false false true false true false false true true true true true Schedule R, Part VII Related Organizations Due to the increasingly complex organization structure of Hospital Sisters Health System and Affiliates, the filing organization has elected to report all organizations within Hospital Sisters Health System as related, regardless of ownership interest or "control" as defined by the instructions to Schedule R. The intent of this reporting is to promote transparency and increase consistency across the numerous Form 990 submissions by Hospital Sisters Health System and Affiliates.