2023-05-15T16:40:21-05:00 2022-06-30 470617373 COMMONSPIRIT HEALTH 198 INVERNESS DRIVE WEST ENGLEWOOD CO 80112 990 2021-07-01 910564491 FRANCISCAN HEALTH SYSTEM FRAN 2536804005 1717 S J STREET TACOMA WA 98405 DAVID NOSACKA CFO 2536804005 2023-05-15 1 DAVID NOSACKA 999009999 ANGELA NOEL P01051055 3032989100 3 AAL1 IAL1 2021 2023-04-26 12:10:37Z KETUL PATEL 1717 S J STREET TACOMA WA 98405 1546242913 0 0928 X WWW.VMFH.ORG X 1891 WA FHS WAS FOUNDED ON THE PRINCIPLE TO PROVIDE COMPASSIONATE CARE TO EVERYONE REGARDLESS OF ABILITY TO PAY OR SOCIAL STATUS. FHS INCLUDES MULTIPLE FACILITIES AND HOSPICE, AND AN EXPANDING NETWORK OF CLINICS. 17 17 9177 221 7737207 0 82927830 9818784 1360473257 1491727004 7476760 5504634 31385991 39192491 1482263838 1546242913 914859 1546535 0 0 633698651 714846607 0 0 0 714557527 921166509 1349171037 1637559651 133092801 -91316738 1151561991 1007410025 497392026 453967738 654169965 553442287 AS AN AFFILIATE OF COMMONSPIRIT HEALTH, WE MAKE THE HEALING PRESENCE OF GOD KNOWN IN OUR WORLD BY IMPROVING THE HEALTH OF THE PEOPLE WE SERVE, ESPECIALLY THOSE WHO ARE VULNERABLE, WHILE WE ADVANCE SOCIAL JUSTICE FOR ALL. 0 0 1410778769 1546535 1503847655 SEE SCHEDULE H 1410778769 1 1 0 1 0 0 0 0 0 0 1 0 0 1 1 1 0 1 0 0 1 1 0 0 0 0 1 1 1 0 1 0 0 0 0 0 0 1 0 0 0 0 0 1 1 1 1 0 0 1 X 0 0 9177 1 1 1 0 0 0 0 0 0 0 0 0 1 0 X 17 17 0 0 0 0 1 1 1 1 1 0 0 1 1 1 1 1 0 0 1 1 0 X DAVID NOSACKA 2536804000 1717 SOUTH J STREET TACOMA WA 98405 KETUL PATEL PRESIDENT / CHIEF EXECUTIVE OFFICER VMFH 2.00 48.00 X 0 3565171 30974 IAN WORDEN SVP/COO (THROUGH 1/7/22) 60.00 0.00 X 1570146 0 38240 MICHAEL ANDERSON SVP/CHIEF MEDICAL OFFICER 40.00 20.00 X 877259 0 38240 THOMAS KRUSE SVP/CHIEF STRATEGY OFFICER 60.00 0.00 X 855964 0 48207 MIKE FITZGERALD FORMER TREASURER/CFO 0.00 0.00 X 780982 0 27390 SHARON ROYNE VP/CHIEF HUMAN RESOURCES OFFICER 40.00 0.00 X 570885 0 38065 DHYAN LAL DIV VP PAYER STRATEGY-ACCOUNT CARE 40.00 0.00 X 549841 0 48815 TIMOTHY OHAVER CHIEF OPERATING OFFICER ST JOSEPH MEDICAL CENTER ( 50.00 0.00 X 567435 0 20005 KIMBERLY MOORE VP-MEDICAL OPERATIONS & ASC CMO 50.00 0.00 X 509906 0 30754 KHALID ASLAM HOSPITALIST INTERNAL MEDICINE 40.00 0.00 X 462449 0 53375 ASHWIN SHIVAKUMAR DIV DIRECTOR INPATIENT SVCS 40.00 0.00 X 458277 0 49580 PATRICIA ELLISOR INTERIM SVP/CNO (THROUGH 10/15/21) 40.00 0.00 X 289322 168657 31811 DEAN FIELD DIV VP CLIN INFORMATICS 40.00 0.00 X 432418 0 47931 DAVID WEISS MARKET VP/ ACMO ST ANTHONY HOSPITAL 40.00 0.00 X 452086 0 20474 DAVID BUTCHERITE TREASURER (THROUGH 7/29/21) / DIV VP FINANCE 50.00 0.00 X 398847 0 40822 ROSE SHANDROW SVP/CHIEF MISSION OFFICER 40.00 0.00 X 394814 0 28155 THERESA RAMBOSEK FORMER SECRETARY 0.00 0.00 X 0 403511 10175 DAVID NOSACKA TREASURER / SVP & CFO 48.00 2.00 X 385359 0 13230 RUSSELL WOOLLEY CHIEF OPERATING OFFICER ST FRANCIS HOSPITAL & ST A 40.00 0.00 X 47457 248027 52166 DINO JOHNSON CHIEF OPERATING OFFICER ST ANTHONY HOSPITAL 40.00 0.00 X 279493 0 50848 SYDNEY BERSANTE FORMER PIERCE REGION PRESIDENT 0.00 0.00 X 318774 0 3424 LOIS ERICKSON CHIEF OPERATING OFFICER ST CLARE HOSPITAL 40.00 0.00 X 278130 0 37569 MIRIAM CHAMBLISS CORPORATE SECRETARY / VP GENERAL COUNSEL 2.00 48.00 X 0 251576 36754 ROBERT VALENCIA CORPORATE SECRETARY (THROUGH 7/29/21) / DIV VP-GEN 2.00 48.00 X 0 262486 6599 ANTHONY MCLEAN FORMER KING REGION PRESIDENT 0.00 0.00 X 243667 0 0 JENNIFER SCHOMBURG PRESIDENT ST JOSEPH MEDICAL CENTER 40.00 0.00 X 227831 0 6310 DIANNE AROH SVP/CHIEF NURSING OFFICER 40.00 0.00 X 160463 0 421 LAURIE BROWN RN FORMER CHIEF EXPERIENCE OFFICER 0.00 0.00 X 127524 0 0 JAMES SMALLEY BOARD MEMBER 2.00 4.00 X 0 2000 0 JAMES CIVILLA BOARD MEMBER 2.00 4.00 X 0 1500 0 LARRY BJORK BOARD MEMBER 2.00 4.00 X 0 0 0 BOB CARLILE BOARD MEMBER 2.00 4.00 X 0 0 0 ULI CHI PHD CHAIR 2.00 4.00 X X 0 0 0 SISTER JUDE CONNELLY OSF BOARD MEMBER 2.00 4.00 X 0 0 0 CAROLYN CORVI BOARD MEMBER 2.00 4.00 X 0 0 0 SISTER RUTH GOODWIN OSF BOARD MEMBER 2.00 4.00 X 0 0 0 TOD HAMACHEK BOARD MEMBER 2.00 4.00 X 0 0 0 MICHAEL HOFFMAN BOARD MEMBER 2.00 4.00 X 0 0 0 DENNIS HUNTHAUSEN BOARD MEMBER 2.00 4.00 X 0 0 0 KAREN LEE BOARD MEMBER 2.00 4.00 X 0 0 0 ROBERT LEMON VICE CHAIR 2.00 4.00 X X 0 0 0 SR ANNE MCNAMARA OSF BOARD MEMBER 2.00 4.00 X 0 0 0 GREGG MEYER MD MSC BOARD MEMBER 2.00 4.00 X 0 0 0 JOHN OPPENHEIMER BOARD MEMBER 2.00 4.00 X 0 0 0 DIANN PULS BOARD MEMBER 2.00 4.00 X 0 0 0 11239329 4902928 810334 1633 1 1 0 HEALTHTRUST WORKFORCE SOL LLC PO BOX 742697 ATLANTA GA 30374 STAFFING SERVICES 24057601 MEDICAL SOLUTIONS LLC 1010 N 102ND ST SUITE 300 OMAHA NE 68114 TRAVEL NURSE SERVICES 12856299 BLOODWORKS NORTHWEST 921 TERRY AVE SEATTLE WA 98104 LAB SERVICES 5981556 PEOPLE 20 GLOBAL LLC 222 VALLEY CREEK BLVD SUITE 100 EXTON PA 19341 RECRUITING/STAFFING 5506349 RENAL CARE GROUP NORTHWEST 16343 COLLECTIONS CENTER DR CHICAGO IL 60693 MEDICAL SERVICES 4927343 189 1246758 7944599 627427 9818784 NET PATIENT SERVICES 900099 1489236104 1489236104 0 0 RENTAL INCOME 900099 2490900 2490900 0 0 1491727004 596671 596671 1846524 0 1846524 1846524 1846524 3259188 1648775 0 0 3259188 1648775 4907963 4907963 PHARMACY SERVICES 446110 19857858 12120651 7737207 0 CAFETERIA 722100 4461131 0 0 4461131 SERVICES SOLD 900099 4206369 0 0 4206369 8820609 8820609 37345967 1546242913 1503847655 7737207 24839267 X 969547 969547 576988 576988 9630525 9630525 565331532 495744159 69587373 27708843 23909774 3799069 68391269 58501696 9889573 43784438 37216772 6567666 2379096 2260141 118955 284334 270117 14217 142340 142340 327260298 248019644 79240654 7689007 7304557 384450 33272962 31609314 1663648 59391013 56421462 2969551 25468262 24194849 1273413 1053636 632182 421454 163252 40813 122439 6711195 6711195 32293747 32293747 85586648 81307316 4279332 7366765 7366765 MEDICAL SUPPLIES 242103203 242103203 0 0 STATE PROVIDER TAX 40349831 38332339 2017492 0 REPAIRS AND MAINTENANCE 17823178 16932019 891159 0 UNRELATED BUSINESS TAXE 23919 0 23919 0 31803823 30353917 1449906 1637559651 1410778769 226780882 0 3369 115473526 70286885 0 223284510 220851740 0 0 0 48615619 44934187 6474511 7362666 1480563314 985957023 548941634 494606291 0 77040328 40608650 0 16183995 16165461 115547868 112590776 1151561991 1007410025 286504420 246768332 0 4763294 249080 0 0 0 0 0 206124312 206950326 497392026 453967738 X 653921465 553193787 248500 248500 654169965 553442287 1151561991 1007410025 X -91316738 -5287101 -4123839 X 0 1 X 1 1 1 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 0 0 0 0 0 1 142340 0 0 0 142340 0 PART II-B, LINE 1: THE PORTION OF ORGANIZATION DUES THAT ARE RELATED TO LOBBYING ARE AS FOLLOWS: AMERICAN HOSPITAL ASSOCIATION - $17,529 CATHOLIC HEALTH ASSOCIATION - $11,561 WASHINGTON STATE HOSPITAL ASSOCIATION - $113,250 31803055 31803055 572400015 275987254 296412761 76712102 42694717 34017385 769949848 658283162 111666686 29698294 8991890 20706404 494606291 INVESTMENTS IN UNCONSOLIDATED ORGS - CONTROLLING INTEREST 45903335 INVESTMENTS IN UNCONSOLIDATED ORGS - NONCONTROLLING INTEREST 2528018 OTHER ASSETS 16992437 LEASE RIGHT OF USE ASSETS 45764859 INTERCOMPANY RECEIVABLE 1402127 112590776 INTERCOMPANY PAYABLES 53355382 ENVIRONMENTAL REMEDIATION LIABILITY 1432927 UNCLAIMED PROPERTY 630455 OTHER LIABILITIES 12770566 LEASE RIGHT OF USE LIABILITIES 48537191 CHI DEBT PROGRAM 90223805 206950326 X PART X, LINE 2: FRANCISCAN HEALTH SYSTEM'S FINANCIAL INFORMATION IS INCLUDED IN COMMONSPIRIT HEALTH'S CONSOLIDATED AUDITED FINANCIAL STATEMENTS, WHICH INCLUDES THE FOLLOWING DISCLOSURE: COMMONSPIRIT REVIEWS ITS TAX POSITIONS QUARTERLY AND HAS DETERMINED THAT THERE ARE NO MATERIAL UNCERTAIN TAX POSITIONS THAT REQUIRE RECOGNITION IN THE ACCOMPANYING CONSOLIDATED FINANCIAL STATEMENTS. 0 EAST ASIA AND THE PACIFIC - AUSTRALIA, BRUNEI, BURMA, CAMBODIA, PROGRAM SERVICES DONATION OF MEDICAL SUPPLIES 307327 SUB-SAHARAN AFRICA - ANGOLA, BENIN, BOTSWANA, BURKINA FASO, PROGRAM SERVICES DONATION OF MEDICAL SUPPLIES 269661 0 0 0 0 0 0 576988 0 576988 EAST ASIA AND THE PACIFIC - AUSTRALIA, BRUNEI, BURMA, CAMBODIA, MEDICAL 0 307327 MED SUPPLIES AND EQUIPMENT COST SUB-SAHARAN AFRICA - ANGOLA, BENIN, BOTSWANA, BURKINA FASO, MEDICAL 0 269661 MED SUPPLIES AND EQUIPMENT COST 1 0 0 0 0 0 0 PART I, LINE 2: FHS ONLY GRANTS TO 501(C)(3) AND 501(C)(6) ORGANIZATIONS TO ENSURE THE FUNDS WILL BE USED PROPERLY. PART I, LINE 3: THE DONATED MEDICAL SUPPLIES ARE ACCOUNTED FOR AT COST. PART III ACCOUNTING METHOD: 1 1 X 1 X 1 X 1 1 1 0 1 1 16675647 0 16675647 0.01020 381481872 231308476 150173396 0.09170 398157519 231308476 166849043 0.10190 36 51541 3914383 316337 3598046 0.00220 13 1163 1775872 5025 1770847 0.00110 2 190038 190038 0.00010 12 265 1316862 1316862 0.00080 63 52969 7197155 321362 6875793 0.00420 63 52969 405354674 231629838 173724836 0.10610 4 28 1481 1481 0.00000 4 28 1481 1481 0.00000 1 37967693 0 271039439 371394907 -100355468 X 0 1 MILITARY ROAD PROPERTIES REAL ESTATE RENTAL 0.50000 0.00000 0.50000 2 PERFORMANCE MODALITIES INC DURABLE EQUIPMENT RENTAL 0.50000 0.00000 0.50000 6 1 ST JOSEPH MEDICAL CENTER 1717 SOUTH J STREET TACOMA WA 98405 VMFH.ORG/OUR-HOSPITALS/ST-JOSEPH-MEDIC HAC.FS.00000032 X X X X A 2 ST ANTHONY HOSPITAL 11567 CANTERWOOD BLVD NW GIG HARBOR WA 98332 VMFH.ORG/OUR-HOSPITALS/ST-ANTHONY-HOSP HAC.FS.60075769 X X X A 3 ST CLARE HOSPITAL 11315 BRIDGEPORT WAY SW LAKEWOOD WA 98499 VMFH.ORG/OUR-HOSPITALS/ST-CLARE-HOSPIT HAC.FS.00000132 X X X A 4 ST FRANCIS HOSPITAL 34515 9TH AVE S FEDERAL WAY WA 98003 VMFH.ORG/OUR-HOSPITALS/ST-FRANCIS-HOSP HAC.FS.00000201 X X X X A 5 CHI FRANCISCAN REHABILITATION HOSPITAL 815 S VASSAULT ST TACOMA WA 984652008 VMFH.ORG/OUR-HOSPITALS/REHABILITATION- HAC.FS.60833232 X REHAB HOSPITAL A 6 ST ANNE HOSPITAL 16251 SYLVESTER ROAD SW BURIEN WA 98166 VMFH.ORG/OUR-HOSPITALS/ST-ANNE-HOSPITA HAC.FS.00000126 X X X A FACILITY REPORTING GROUP - A 0 1 1 X X X X X X X X X 21 1 1 1 1 X SEE PART V, PAGE 8 X 1 22 1 SEE PART V, PAGE 8 0 1 X 200.000000000000 400.000000000000 X X X X X X 1 1 X X X 1 X SEE PART V, PAGE 8 X SEE PART V, PAGE 8 X SEE PART V, PAGE 8 X X X X X X 1 X 0 X X X X 1 X 0 0 PART V, SECTION B FACILITY REPORTING GROUP A FACILITY REPORTING GROUP A CONSISTS OF: - FACILITY 1: ST. JOSEPH MEDICAL CENTER, - FACILITY 5: CHI FRANCISCAN REHABILITATION HOSPITAL, - FACILITY 2: ST. ANTHONY HOSPITAL, - FACILITY 3: ST. CLARE HOSPITAL, - FACILITY 4: ST. FRANCIS HOSPITAL, - FACILITY 6: ST. ANNE HOSPITAL FACILITY REPORTING GROUP - A PART V, SECTION B, LINE 2: HIGHLINE MEDICAL CENTER (ALSO KNOWN AS ST. ANNE HOSPITAL) MERGED INTO FRANCISCAN HEALTH SYSTEM IN APRIL OF 2021. FRANCISCAN HEALTH SYSTEM WAS PREVIOUSLY THE SOLE CORPORATE MEMBER OF HIGHLINE MEDICAL CENTER. FACILITY REPORTING GROUP - A PART V, SECTION B, LINE 5: VIRGINIA MASON FRANCISCAN HEALTH CONTRACTS WITH THE TACOMA PIERCE COUNTY HEALTH DEPARTMENT TO CONDUCT AND CREATE THE COMMUNITY HEALTH NEEDS ASSESSMENT FOR ST. JOSEPH MEDICAL CENTER. TO ENSURE MEANINGFUL COMMUNITY ENGAGEMENT TWO METHODS WERE EMPLOYED TO GATHER AND RECEIVE INPUT - COMMUNITY WORKSHOPS AND KEY INFORMANT INTERVIEWS. ASSESSMENT OUTREACH AND ENGAGEMENT WAS SPECIFICALLY DESIGNED TO ENSURE THAT THE VOICES OF OUR BLACK, INDIGENOUS AND PERSONS OF COLOR COMMUNITIES WERE REPRESENTED AND RECOGNIZED. THREE COMMUNITY WORKSHOPS WERE CONDUCTED TO HEAR DIRECTLY FROM RESIDENTS IN SMALL GROUP SETTINGS. POPULATIONS OF INTEREST WERE IDENTIFIED BASED ON GAPS IN PREVIOUS ASSESSMENTS AND RECOGNIZED HEALTH DISPARITIES AND INCLUDED LGBTQ ADULTS, YOUTH AGES 14-17, AND PEOPLE EXPERIENCING HOMELESSNESS. ALL THREE GROUPS INCLUDED INDIVIDUALS REPRESENTING DIVERSITY IN RACE, ETHNICITY, GENDER, AND SEXUAL ORIENTATION. TEN KEY INFORMANT INTERVIEWS WERE CONDUCTED WITH COMMUNITY LEADERS ACROSS SEVEN SECTORS. THE FOLLOWING COMMUNITY ORGANIZATIONS WERE REPRESENTED IN THE KEY INFORMANT INTERVIEWS OR SUPPORTED THE FACILITATION OF FOCUS GROUPS: CENTRAL LATINO, CLOVER PARK SCHOOL DISTRICT, DEGREES OF CHANGE, EMERGENCY FOOD NETWORK, FIRST 5 FUNDAMENTALS, FRANKLIN PIERCE SCHOOL DISTRICT, GRADUATE TACOMA, GREATER TACOMA COMMUNITY COLLEGE, MARY BRIDGE CHILDREN'S HOSPITAL, OASIS YOUTH CENTER, PIERCE COLLEGE, PIERCE TRANSIT, TACID, TACOMA COMMUNITY COLLEGE, TACOMA HOUSING AUTHORITY, TACOMA PIERCE COUNTY COALITION TO END HOMELESSNESS, TACOMA PUBLIC SCHOOLS, PIERCE TRANSIT, AND RAINBOW CENTER. TO ENSURE REPRESENTATION FROM THE COMMUNITY, NUMEROUS COMMUNITY-BASED ORGANIZATIONS, CLINICS, STATE AND LOCAL AGENCIES, COALITIONS, SCHOOLS AND HOSPITALS HAVE BEEN ENGAGED TO ELEVATE BOTH THE STRENGTHS AND CONCERNS OF THE COMMUNITIES SERVED. THESE INCLUDED SEATTLE AND KING COUNTY PUBLIC HEALTH. ADDITIONALLY, 48 LOCAL COMMUNITY NEEDS ASSESSMENTS, STRATEGIC PLANS, AND REPORTS (FROM 2018 TO 2020) THAT INCLUDED ASPECTS OF COMMUNITY ENGAGEMENT WERE REVIEWED TO IDENTIFY NEEDS, PROVIDE CONTEXT TO THE QUANTITATIVE DATA PRESENTED, AND ENHANCE OUR UNDERSTANDING OF KING COUNTY RESIDENTS' PRIORITIES AND STRENGTHS. THROUGH THE COMPREHENSIVE REVIEW OF THE REPORTS AND ASSESSMENTS INCLUDED IN THE CHNA, EACH REGION WITHIN KING COUNTY WAS REPRESENTED, AS WELL AS THE DIVERSE COMMUNITIES THAT MAKE UP THE SERVICE AREA. OF THE 48 ASSESSMENTS AND PLANS REVIEWED, APPROXIMATELY HALF WERE COMPLETED BY CITIES, COUNTIES, THE STATE, UNIVERSITIES, HOSPITALS AND HEALTH PLANS, WITH THE OTHER HALF COMPLETED BY COALITIONS, EDUCATIONAL DISTRICTS AND ORGANIZATIONS SERVING AND REPRESENTING DIVERSE COMMUNITY NEEDS AND PRIORITIES. FACILITY REPORTING GROUP - A PART V, SECTION B, LINE 6A: ST FRANCIS HOSPITAL AND ST ANNE HOSPITAL ARE IN KING COUNTY, WASHINGTON. HOSPITAL SYSTEMS IN KING COUNTY COLLABORATE ON A COUNTY-WIDE CHNA. THE HOSPITAL SYSTEMS IN KING COUNTY COLLABORATE ON THE CHNA. THE HOSPITAL SYSTEMS WHICH PARTICIPATED IN THE CHNA INCLUDE VIRGINIA MASON FRANCISCAN HEALTH, EVERGREENHEALTH, KAISER PERMANENTE, MULTICARE HEALTH SYSTEM, OVERLAKE MEDICAL CENTER AND CLINICS, SEATTLE CANCER CARE ALLIANCE, SEATTLE CHILDREN'S, SWEDISH HEALTH SERVICES, AND UW MEDICINE.ST JOSEPH MEDICAL CENTER, CHI FRANCICSAN REHABILITATION HOSPITAL, ST CLARE HOSPITAL, AND ST ANTHONY HOSPITAL ARE LOCATED IN PIERCE COUNTY, WASHINGTON. OTHER HOSPITALS WHO PARTICIPATED IN THE CHNA INCLUDE ALLENMORE HOSPITAL, GOOD SAMARITAN HOSPITAL, TACOMA GENERAL HOSPITAL, AND WELLFOUND BEHAVIORAL HEALTH HOSPITAL. FACILITY REPORTING GROUP - A PART V, SECTION B, LINE 6B: VIRGINIA MASON FRANCISCAN HEALTH PARTNERS WITH THE TACOMA PIERCE COUNTY HEALTH DEPARTMENT TO COMPLETE AND COMPILE THE CHNA. IN KING COUNTY, VIRGINIA MASON FRANCISCAN HEALTH WORKS WITH PUBLIC HEALTH - SEATTLE & KING COUNTY, NAVOS, WASHINGTON STATE HOSPITAL ASSOCIATION, KING COUNTY DEPARTMENT OF COMMUNITY AND HUMAN SERVICES, KING COUNTY PROSECUTING ATTORNEY'S OFFICE, AND URBAN INDIAN HEALTH INSTITUTE. FACILITY REPORTING GROUP - A PART V, SECTION B, LINE 11: ST ANTHONY HOSPITALSIGNIFICANT NEEDS IDENTIFIED IN THE CHNA INCLUDE ACCESS TO CARE INCLUDING MATERNAL CHILD HEALTH, CHRONIC DISEASE, BEHAVIORAL HEALTH, AND VIOLENCE PREVENTION. ST. ANTHONY HOSPITAL IS TAKING ACTION AND DEDICATING RESOURCES TO ADDRESS EACH OF THESE PRIORITIES. ACCESS TO CARE - TOWARD IMPROVING ACCESS TO CARE FOR THOSE WHO ARE UNHOUSED, UNINSURED, OR UNDER-INSURED, ST. ANTHONY HOSPITAL SUPPORTED NUMEROUS PROGRAMS TO HELP THOSE IN NEED, INCREASE COMMUNITY EDUCATION, AND INCREASE ACCESS TO MATERNAL CHILD HEALTH PROGRAMS. THE HOSPITAL SYSTEM PROVIDED FINANCIAL SUPPORT AND DONATED CARE TO PROJECT ACCESS PROGRAMS ACROSS THE SERVICE AREA, INCLUDING INSURANCE PREMIUM SUPPORT, DONATED CARE, AND CARE COORDINATION TO VULNERABLE COMMUNITY MEMBERS. THE HOSPITAL ADDITIONALLY PROVIDED DEDICATED SPACE/MEDICAL RESPITE FOR UNHOUSED PATIENTS TO RECUPERATE FOLLOWING A HOSPITAL STAY. FREE LAB WORK AND DIAGNOSTIC IMAGING WAS PROVIDED FOR THE KEY FREE CLINIC ON THE KEY PENINSULA. CARE MANAGEMENT STAFF PROVIDED PATIENT SUPPORT TO ASSIST LOW-INCOME AND UNHOUSED INDIVIDUALS WITH TRANSPORTATION, HOUSING, MEDICAL EQUIPMENT, CLOTHING, AND OTHER NEEDS. THROUGH THE WIC CLINICS, THE HOSPITAL PROVIDED SUPPLEMENTAL NUTRITION SUPPORT FOR LOW-INCOME PREGNANT WOMEN AND FAMILIES. A COMMUNITIES OF FOCUS PROGRAM IN PARTNERSHIP WITH THE TACOMA PIERCE COUNTY HEALTH DEPARTMENT ENGAGED RESIDENTS AND STAKEHOLDERS WITH HIGH RATES OF HEALTH INEQUITY. FRANCISCAN MEDICAL GROUP PROVIDED MEDICAL CARE TO THE WA CORRECTIONAL CENTER FOR WOMEN IN PURDY, WA. CHRONIC DISEASE - THE HOSPITAL CONTINUED ACTIVATION OF A COMPREHENSIVE CONGREGATIONAL HEALTH MINISTRIES PROGRAM CALLED "FAITHHEALTH IN ACTION" WHICH SUPPORTED THE CREATION OF HEALTH MINISTRIES WITHIN FAITH COMMUNITIES OF COLOR. THROUGH PARTNERSHIP WITH THE TACOMA PIERCE COUNTY HEALTH DEPARTMENT, THE HOSPITAL PROVIDED PROGRAM SUPPORT TO REDUCE HEART FAILURE AS WELL AS DIABETES PROGRAMS FOR NEWLY DIAGNOSED PATIENTS. BREAST CANCER AND BLOOD PRESSURE SCREENINGS WERE CONDUCTED REGULARLY THROUGHOUT THE SERVICE AREA. THROUGH THE ONCOLOGY PROGRAM, SUPPORT GROUPS FOR CANCER PATIENTS AND SURVIVORS WERE IMPLEMENTED. BEHAVIORAL HEALTH - THE HOSPITAL PARTNERED WITH CONCERT HEALTH TO PROVIDE VIRTUAL CONSULTATIONS AND CARE TO VULNERABLE PATIENTS. THROUGH A PARTNERSHIP WITH QUARTET HEALTH, THE SYSTEM PROVIDED VIRTUAL PSYCHIATRY TO MEDICAID PATIENTS WHO DO NOT HAVE A PRIMARY CARE PROVIDER OR ACCESS TO OTHER BEHAVIORAL HEALTH SERVICES. VIOLENCE PREVENTION - THE HOSPITAL SUPPORTED THE GIG HARBOR KEY PENINSULA SUICIDE PREVENTION COALITION. IN PARTNERSHIP WITH WITH REBUILDING HOPE, THE HOSPITAL CONTINUED SUPPORT OF MEDICAL ADVOCACY PROGRAMS FOR VICTIM SURVIVORS OF SEXUAL ASSAULT AND HUMAN TRAFFICKING. A PARTNERSHIP WITH SAFE STREETS SUPPORTED EFFORTS TO MOBILIZE VIOLENCE PREVENTION PROJECTS ACROSS PIERCE COUNTY, WA.ST ANNE HOSPITALST. ANNE HOSPITAL IS ADDRESSING EACH OF THE COMMUNITY HEALTH NEEDS IDENTIFIED IN THE MOST RECENT COMMUNITY HEALTH NEEDS ASSESSMENT INCLUDING ACCESS TO CARE, BEHAVIORAL HEALTH, CHRONIC DISEASE INCLUDING FOOD SECURITY, AND VIOLENCE PREVENTION. HIGHLIGHTS OF KEY COMMUNITY HEALTH STRATEGIES ARE LISTED BELOW. ACCESS TO CARE - ST. ANNE HOSPITAL PROVIDED FINANCIAL SUPPORT AND DONATED CARE TO PROJECT ACCESS PROGRAMS ACROSS THE SERVICE AREA, INCLUDING INSURANCE PREMIUM SUPPORT, DONATED CARE, AND CARE COORDINATION TO VULNERABLE COMMUNITY MEMBERS. THROUGH A COLLABORATION WITH LOCAL NON-PROFIT ORGANIZATIONS, THE HOSPITAL PROVIDED DEDICATED SPACE FOR UNHOUSED PATIENTS TO RECUPERATE AFTER A HOSPITAL STAY. THROUGH THE WIC CLINICS, THE HOSPITAL PROVIDED SUPPLEMENTAL NUTRITION SUPPORT FOR LOW INCOME PREGNANT WOMEN AND FAMILIES. CARE MANAGEMENT STAFF PROVIDED PATIENT SUPPORT TO ASSIST PATIENTS WITH TRANSPORTATION, HOUSING, MEDICAL EQUIPMENT, CLOTHING AND OTHER NEEDS. BEHAVIORAL HEALTH - THROUGH A COLLABORATION WITH CONCERT HEALTH AND QUARTET HEALTH, ST. ANNE HOSPITAL PROVIDED VIRTUAL CONSULTATIONS AND CARE TO VULNERABLE PATIENTS AND VIRTUAL PSYCHIATRY TO MEDICAID PATIENTS WHO DO NOT HAVE A PRIMARY CARE PROVIDER OR ACCESS TO OTHER BEHAVIORAL HEALTH SERVICES. CHRONIC DISEASE - ST. ANNE HOSPITAL SUPPORTED FAITH COMMUNITIES IN CREATING AND SUSTAINING HEALTH MINISTRIES THROUGH A PROGRAM CALLED "FAITHHEALTH IN ACTION", DESIGNED TO SUPPORT FAITH COMMUNITIES OF COLOR IN THE CREATION OF HEALTH MINISTRIES. THE HOSPITAL CONDUCTED REGULAR BLOOD PRESSURE SCREENINGS AT EVENTS THROUGHOUT THE REGION, AND PROVIDED RESOURCES TO SUPPORT GROUPS FOR CANCER SURVIVORS FOCUSED ON KNITTING. VIOLENCE PREVENTION - FACILITATED AND SUPPORTED THE REACH OUT DES MOINES COALITION WHICH CONNECTS COMMUNITY ORGANIZATIONS, SCHOOLS, AND GOVERNMENTS TO REDUCE YOUTH VIOLENCE. SUPPORTED THE SOUTH KING COUNTY YOUTH VIOLENCE PREVENTION INITIATIVE TOWARD VIOLENCE PREVENTION.ST CLARE HOSPITALSIGNIFICANT NEEDS IDENTIFIED IN THE CHNA INCLUDE ACCESS TO CARE INCLUDING MATERNAL CHILD HEALTH, CHRONIC DISEASE, BEHAVIORAL HEALTH, AND VIOLENCE PREVENTION. ST. CLARE HOSPITAL IS TAKING ACTION AND DEDICATING RESOURCES TO ADDRESS EACH OF THESE PRIORITIES. ACCESS TO CARE - TOWARD IMPROVING ACCESS TO CARE FOR THOSE WHO ARE UNHOUSED, UNINSURED, OR UNDER-INSURED, ST. CLARE HOSPITAL SUPPORTED NUMEROUS PROGRAMS TO HELP THOSE IN NEED, INCREASE COMMUNITY EDUCATION, AND INCREASE ACCESS TO MATERNAL CHILD HEALTH PROGRAMS. THE HOSPITAL SYSTEM PROVIDED FINANCIAL SUPPORT AND DONATED CARE TO PROJECT ACCESS PROGRAMS ACROSS THE SERVICE AREA, INCLUDING INSURANCE PREMIUM SUPPORT, DONATED CARE, AND CARE COORDINATION TO VULNERABLE COMMUNITY MEMBERS. THE HOSPITAL ADDITIONALLY PROVIDED DEDICATED SPACE/MEDICAL RESPITE FOR UNHOUSED PATIENTS TO RECUPERATE FOLLOWING A HOSPITAL STAY. CARE MANAGEMENT STAFF PROVIDED PATIENT SUPPORT TO ASSIST LOW-INCOME AND UNHOUSED INDIVIDUALS WITH TRANSPORTATION, HOUSING, MEDICAL EQUIPMENT, CLOTHING, AND OTHER NEEDS. THROUGH THE WIC CLINICS, THE HOSPITAL PROVIDED SUPPLEMENTAL NUTRITION SUPPORT FOR LOW-INCOME PREGNANT WOMEN AND FAMILIES. A COMMUNITIES OF FOCUS PROGRAM IN PARTNERSHIP WITH THE TACOMA PIERCE COUNTY HEALTH DEPARTMENT ENGAGED RESIDENTS AND STAKEHOLDERS WITH HIGH RATES OF HEALTH INEQUITY. VOUCHERS WERE PROVIDED TO CLOVER PARK SCHOOL DISTRICT FAMILIES TOWARD THE PURCHASE OF HEALTHY FOOD FROM THE LAKEWOOD FARMERS MARKET. CHRONIC DISEASE - THE HOSPITAL CONTINUED ACTIVATION OF A COMPREHENSIVE CONGREGATIONAL HEALTH MINISTRIES PROGRAM CALLED "FAITHHEALTH IN ACTION" WHICH SUPPORTED THE CREATION OF HEALTH MINISTRIES WITHIN FAITH COMMUNITIES OF COLOR. THROUGH PARTNERSHIP WITH THE TACOMA PIERCE COUNTY HEALTH DEPARTMENT, THE HOSPITAL PROVIDED PROGRAM SUPPORT TO REDUCE HEART FAILURE IN HIGH RISK ZIP CODES. BREAST CANCER AND BLOOD PRESSURE SCREENINGS ARE CONDUCTED REGULARLY THROUGHOUT THE SERVICE AREA. BEHAVIORAL HEALTH - THE HOSPITAL PARTNERED WITH CONCERT HEALTH TO PROVIDE VIRTUAL CONSULTATIONS AND CARE TO VULNERABLE PATIENTS. THROUGH A PARTNERSHIP WITH QUARTET HEALTH, THE SYSTEM PROVIDED VIRTUAL PSYCHIATRY TO MEDICAID PATIENTS WHO DO NOT HAVE A PRIMARY CARE PROVIDER OR ACCESS TO OTHER BEHAVIORAL HEALTH SERVICES. VIOLENCE PREVENTION - THE HOSPITAL ACTIVELY SUPPORTED AND ENGAGED IN COMMUNITY EFFORTS TO PREVENT YOUTH VIOLENCE IN THE PARKLAND AREA OF PIERCE COUNTY IN PARTNERSHIP WITH THE SCHOOL DISTRICT, UNITED WAY OF PIERCE COUNTY, AND THE TACOMA PIERCE COUNTY HEALTH DEPARTMENT. THE HOSPITAL SYSTEM SUPPORTED SAFE STREETS TO ACTIVATE VIOLENCE PREVENTION PROJECTS THROUGHOUT THE SERVICE AREA, AND CONTINUED SUPPORT FOR MEDICAL ADVOCACY FOR VICTIM SURVIVORS OF SEXUAL ASSAULT AND HUMAN TRAFFICKING. ST FRANCIS HOSPITALST. FRANCIS HOSPITAL IS ADDRESSING EACH OF THE COMMUNITY HEALTH NEEDS IDENTIFIED IN THE MOST RECENT COMMUNITY HEALTH NEEDS ASSESSMENT INCLUDING ACCESS TO CARE, BEHAVIORAL HEALTH, CHRONIC DISEASE INCLUDING FOOD SECURITY, AND VIOLENCE PREVENTION. HIGHLIGHTS OF KEY COMMUNITY HEALTH STRATEGIES ARE LISTED BELOW. ACCESS TO CARE - ST. FRANCIS HOSPITAL PROVIDED FINANCIAL SUPPORT AND DONATED CARE TO PROJECT ACCESS PROGRAMS ACROSS THE SERVICE AREA, INCLUDING INSURANCE PREMIUM SUPPORT, DONATED CARE, AND CARE COORDINATION TO VULNERABLE COMMUNITY MEMBERS. THROUGH A COLLABORATION WITH LOCAL NON-PROFIT ORGANIZATIONS, THE HOSPITAL PROVIDED DEDICATED SPACE FOR UNHOUSED PATIENTS TO RECUPERATE AFTER A HOSPITAL STAY. CARE MANAGEMENT STAFF PROVIDED PATIENT SUPPORT TO ASSIST PATIENTS WITH TRANSPORTATION, HOUSING, MEDICAL EQUIPMENT, CLOTHING AND OTHER NEEDS. BEHAVIORAL HEALTH - THROUGH A COLLABORATION WITH CONCERT HEALTH AND QUARTET HEALTH, ST. FRANCIS HOSPITAL PROVIDED VIRTUAL BEHAVIORAL HEALTH CONSULTATIONS AND CARE TO VULNERABLE PATIENTS AND VIRTUAL PSYCHIATRY TO MEDICAID PATIENTS WHO DO NOT HAVE A PRIMARY CARE PROVIDER OR ACCESS TO OTHER BEHAVIORAL HEALTH SERVICES. CONTINUED IN SUPPLEMENTAL INFO FACILITY REPORTING GROUP - A PART V, SECTION B, LINE 13H: NO MINIMUM ACCOUNT BALANCE SHALL BE REQUIRED FOR A PATIENT TO QUALIFY FOR FINANCIAL ASSISTANCE.THE PATIENT MUST SUBMIT A COMPLETED FINANCIAL ASSISTANCE APPLICATION.PATIENT COOPERATION STANDARDS - A PATIENT MUST EXHAUST ALL OTHER PAYMENT OPTIONS, INCLUDING PRIVATE COVERAGE, FEDERAL, STATE AND LOCAL MEDICAL ASSISTANCE PROGRAMS, AND OTHER FORMS OF ASSISTANCE PROVIDED BY THIRD-PARTIES PRIOR TO BEING APPROVED. AN APPLICANT FOR FINANCIAL ASSISTANCE IS RESPONSIBLE FOR APPLYING TO PUBLIC PROGRAMS FOR AVAILABLE COVERAGE. HE OR SHE IS ALSO EXPECTED TO PURSUE PUBLIC OR PRIVATE HEALTH INSURANCE PAYMENT OPTIONS FOR CARE PROVIDED BY A COMMONSPIRIT HOSPITAL ORGANIZATION WITHIN A HOSPITAL FACILITY. A PATIENT'S AND, IF APPLICABLE, ANY GUARANTOR'S COOPERATION IN APPLYING FOR APPLICABLE PROGRAMS AND IDENTIFIABLE FUNDING SOURCES, INCLUDING COBRA COVERAGE (A FEDERAL LAW ALLOWING FOR A TIME-LIMITED EXTENSION OF EMPLOYEE HEALTHCARE BENEFITS), SHALL BE REQUIRED. IF A HOSPITAL FACILITY DETERMINES THAT COBRA COVERAGE IS POTENTIALLY AVAILABLE, AND THAT A PATIENT IS NOT A MEDICARE OR MEDICAID BENEFICIARY, THE PATIENT OR GUARANTOR SHALL PROVIDE THE HOSPITAL FACILITY WITH INFORMATION NECESSARY TO DETERMINE THE MONTHLY COBRA PREMIUM FOR SUCH PATIENT, AND SHALL COOPERATE WITH HOSPITAL FACILITY STAFF TO DETERMINE WHETHER HE OR SHE QUALIFIES FOR HOSPITAL FACILITY COBRA PREMIUM ASSISTANCE, WHICH MAY BE OFFERED FOR A LIMITED TIME TO ASSIST IN SECURING INSURANCE COVERAGE. A HOSPITAL FACILITY SHALL MAKE AFFIRMATIVE EFFORTS TO HELP A PATIENT OR PATIENT'S GUARANTOR APPLY FOR PUBLIC AND PRIVATE PROGRAMS."PATIENT COOPERATION STANDARDS," AS DEFINED IN THE FINANCIAL ASSISTANCE POLICY, SHALL ONLY APPLY TO THE EXTENT THEY:1) ALLOW THE HOSPITAL FACILITY TO PURSUE REIMBURSEMENT FROM ANY THIRD-PARTY COVERAGE THAT MAY BE IDENTIFIED TO THE HOSPITAL FACILITY, IN ACCORDANCE WITH WAC 246-453-020(1);2) ALLOW THE HOSPITAL FACILITY TO MAKE EVERY REASONABLE EFFORT TO DETERMINE THE EXISTENCE OR NONEXISTENCE OF THIRD-PARTY SPONSORSHIP THAT MIGHT COVER IN FULL OR IN PART THE CHARGES FOR SERVICES PROVIDED TO EACH PATIENT, IN ACCORDANCE WITH WAC246-453-020(4); AND3) DO NOT IMPOSE APPLICATION PROCEDURES FOR CHARITY CARE SPONSORSHIP WHICH PLACE AN UNREASONABLE BURDEN UPON THE RESPONSIBLE PARTY, TAKING INTO ACCOUNT ANY PHYSICAL, MENTAL, INTELLECTUAL, OR SENSORY DEFICIENCIES OR LANGUAGE BARRIERS WHICH MAY HINDER THE RESPONSIBLE PARTY'S CAPABILITY OF COMPLYING WITH THE APPLICATION PROCEDURES, IN ACCORDANCE WITH WAC 246-453-020(5). PART V, LINE 16A, FAP WEBSITE: HTTPS://WWW.VMFH.ORG/BILLING-INSURANCE/CHI-BILLING-INSURANCE-FINANCES/FINANCIAL-ASSISTANCE-DISCOUNTS.HTML PART V, LINE 16B, FAP APPLICATION WEBSITE: HTTPS://WWW.VMFH.ORG/BILLING-INSURANCE/CHI-BILLING-INSURANCE-FINANCES/FINANCIAL-ASSISTANCE-DISCOUNTS.HTML PART V, LINE 16C, FAP PLAIN LANGUAGE SUMMARY WEBSITE: HTTPS://WWW.VMFH.ORG/BILLING-INSURANCE/CHI-BILLING-INSURANCE-FINANCES/FINANCIAL-ASSISTANCE-DISCOUNTS.HTML PART V, LINE 7A, CHNA ON HOSPITAL WEBSITE: HTTPS://VMFH.ORG/ABOUT-VMFH/WHY-CHOOSE-VMFH/REPORTS-TO-THE-COMMUNITY/COMMUNITY-HEALTH-NEEDS-ASSESSMENT PART V, LINE 10A, IMPLEMENTATION STRATEGY ON HOSPITAL WEBSITE: HTTPS://VMFH.ORG/ABOUT-VMFH/WHY-CHOOSE-VMFH/REPORTS-TO-THE-COMMUNITY/COMMUNITY-HEALTH-NEEDS-ASSESSMENT PART V, LINE 11, HOW ADDRESSING SIGNIFICANT NEEDS CONTINUED ST FRANCIS HOSPITAL - CONTINUEDTHE SHOUT PROGRAM WAS IMPLEMENTED TO SUPPORT TREATMENT OF PATIENTS WITH OPIOID DISORDERS. CHRONIC DISEASE - ST. FRANCIS HOSPITAL SUPPORTED FAITH COMMUNITIES IN CREATING AND SUSTAINING HEALTH MINISTRIES THROUGH A PROGRAM CALLED "FAITHHEALTH IN ACTION", DESIGNED TO SUPPORT FAITH COMMUNITIES OF COLOR IN THE CREATION OF HEALTH MINISTRIES. THE HOSPITAL CONDUCTED REGULAR BLOOD PRESSURE SCREENINGS AT EVENTS THROUGHOUT THE REGION, AND PROVIDED RESOURCES FOR CANCER SUPPORT GROUPS THAT FOCUS ON KNITTING. VIOLENCE PREVENTION - THE HOSPITAL ACTIVATED AND SUPPORTED A HUMAN TRAFFICKING TASK FORCE AND PARTICIPATED IN THE SOUTH KING COUNTY YOUTH VIOLENCE PREVENTION INITIATIVE TO WORK TOWARD PREVENTING VIOLENCE ACROSS KING COUNTY COMMUNITIES. ADDITIONAL SUPPORT WAS PROVIDED TO BUILD THE BRIDGE COALITION, WHICH BRINGS STAKEHOLDERS TOGETHER TO PLAN AND IMPLEMENT VIOLENCE PREVENTION PROGRAMS AND THE REACH OUT DES MOINES COALITION, DESIGNED TO CONNECT LOCAL ORGANIZATIONS, SCHOOLS, AND GOVERNMENTS TOWARD REDUCING YOUTH VIOLENCE. ST JOSEPH HOSPITALSIGNIFICANT NEEDS IDENTIFIED IN THE CHNA INCLUDE ACCESS TO CARE INCLUDING MATERNAL CHILD HEALTH, CHRONIC DISEASE, BEHAVIORAL HEALTH, AND VIOLENCE PREVENTION. ST. JOSEPH MEDICAL CENTER IS TAKING ACTION AND DEDICATING RESOURCES TO ADDRESS EACH OF THESE PRIORITIES. ACCESS TO CARE - TOWARD IMPROVING ACCESS TO CARE FOR THOSE WHO ARE UNHOUSED, UNINSURED, OR UNDER-INSURED, ST. JOSEPH MEDICAL CENTER SUPPORTED NUMEROUS PROGRAMS TO HELP THOSE IN NEED, INCREASE COMMUNITY EDUCATION, AND INCREASE ACCESS TO MATERNAL CHILD HEALTH PROGRAMS. THE HOSPITAL SYSTEM PROVIDED FINANCIAL SUPPORT AND DONATED CARE TO PROJECT ACCESS PROGRAMS ACROSS THE SERVICE AREA, INCLUDING INSURANCE PREMIUM SUPPORT, DONATED CARE, AND CARE COORDINATION TO VULNERABLE COMMUNITY MEMBERS. THE HOSPITAL SYSTEM ADDITIONALLY PROVIDED DEDICATED SPACE/MEDICAL RESPITE FOR UNHOUSED PATIENTS TO RECUPERATE FOLLOWING A HOSPITAL STAY. FREE LAB WORK WAS PROVIDED FOR THE NEIGHBORHOOD CLINIC IN TACOMA. CARE MANAGEMENT STAFF PROVIDED PATIENT SUPPORT TO ASSIST LOW-INCOME AND UNHOUSED INDIVIDUALS WITH TRANSPORTATION, HOUSING, MEDICAL EQUIPMENT, CLOTHING, AND OTHER NEEDS. THROUGH THE WIC CLINICS, THE HOSPITAL PROVIDED SUPPLEMENTAL NUTRITION SUPPORT FOR LOW-INCOME PREGNANT WOMEN AND FAMILIES. A COMMUNITIES OF FOCUS PROGRAM IN PARTNERSHIP WITH THE TACOMA PIERCE COUNTY HEALTH DEPARTMENT ENGAGED RESIDENTS AND STAKEHOLDERS WITH HIGH RATES OF HEALTH INEQUITY. CHRONIC DISEASE - THE HOSPITAL SYSTEM CONTINUED ACTIVATION OF A COMPREHENSIVE CONGREGATIONAL HEALTH MINISTRIES PROGRAM CALLED "FAITHHEALTH IN ACTION" WHICH SUPPORTED THE CREATION OF HEALTH MINISTRIES WITHIN FAITH COMMUNITIES OF COLOR. IN PARTNERSHIP WITH THE EMERGENCY FOOD NETWORK AND OTHER HUNGER RELIEF ORGANIZATIONS, THE HOSPITAL SYSTEM PROVIDED LEADERSHIP ENGAGEMENT AND INVESTED IN PROGRAMS THAT PROVIDE FOOD AND HEALTHY EATING EDUCATION TO VULNERABLE COMMUNITIES. THROUGH PARTNERSHIP WITH THE TACOMA PIERCE COUNTY HEALTH DEPARTMENT, THE HOSPITAL PROVIDED PROGRAM SUPPORT TO REDUCE HEART FAILURE AS WELL AS DIABETES PROGRAMS FOR NEWLY DIAGNOSED PATIENTS. BREAST CANCER AND BLOOD PRESSURE SCREENINGS ARE CONDUCTED REGULARLY THROUGHOUT THE SERVICE AREA. BEHAVIORAL HEALTH - THE HOSPITAL SYSTEM PARTNERED WITH CONCERT HEALTH TO PROVIDE VIRTUAL CONSULTATIONS AND CARE TO VULNERABLE PATIENTS. THROUGH A PARTNERSHIP WITH QUARTET HEALTH, THE SYSTEM PROVIDED VIRTUAL PSYCHIATRY TO MEDICAID PATIENTS WHO DO NOT HAVE A PRIMARY CARE PROVIDER OR ACCESS TO OTHER BEHAVIORAL HEALTH SERVICES. THE SHOUT PROGRAM WAS IMPLEMENTED AT ST. JOSEPH HOSPITAL TO TREAT PATIENTS WITH OPIOID DISORDERS WITH A MULTI-DISCIPLINARY APPROACH. VIOLENCE PREVENTION - THE HOSPITAL SYSTEM ACTIVELY SUPPORTED AND ENGAGED IN COMMUNITY EFFORTS TO PREVENT YOUTH VIOLENCE IN THE PARKLAND AREA OF PIERCE COUNTY IN PARTNERSHIP WITH THE SCHOOL DISTRICT, UNITED WAY OF PIERCE COUNTY, AND THE TACOMA PIERCE COUNTY HEALTH DEPARTMENT. THE HOSPITAL SYSTEM PROVIDED FUNDING TO SAFE STREETS TO ACTIVATE VIOLENCE PREVENTION PROJECTS THROUGHOUT THE CITY OF TACOMA. ADDITIONALLY, ST. JOSEPH MEDICAL CENTER SUPPORTED A MEDICAL ADVOCACY PROGRAM FOR VICTIM SURVIVORS OF SEXUAL ASSAULT AND HUMAN TRAFFICKING.REHAB HOSPITALSIGNIFICANT NEEDS IDENTIFIED IN THE CHNA INCLUDE ACCESS TO CARE INCLUDING MATERNAL CHILD HEALTH, CHRONIC DISEASE, BEHAVIORAL HEALTH, AND VIOLENCE PREVENTION. DUE TO THE SPECIALIZED NATURE OF THE FACILITY AND LIMITED RESOURCES, CHI FRANCISCAN REHABILITATION HOSPITAL IS TAKING ACTION AND DEDICATING RESOURCES TO ADDRESS ACCESS TO CARE AND CHRONIC DISEASE. ACCESS TO CARE - CHI FRANCISCAN REHABILITATION HOSPITAL CONTINUED TO BUILD CAPACITY AND OPEN MORE BEDS FOR PATIENTS NEEDING ACUTE REHABILITATION CARE. THE HOSPITAL MAKES ACCESS TO FINANCIAL ASSISTANCE EASY AND ACCESSIBLE FOR ALL WHO QUALIFY. CHI FRANCISCAN REHABILITATION HOSPITAL PROVIDED HOME VISITS TO PATIENTS TO ENSURE THE HOME IS READY FOR A PATIENT'S CONTINUED RECOVERY AND CONNECTED PATIENTS TO POST-ACUTE SERVICES. CHRONIC DISEASE - CHI FRANCISCAN REHABILITATION HOSPITAL SUPPORTS PATIENTS WITH CHRONIC CONDITIONS AND COORDINATES POST DISCHARGE FOLLOW UP FOR CONTINUING CARE. THE HOSPITAL PROVIDES PATIENT EDUCATION FROM AN INTERDISCIPLINARY TEAM TO ENSURE SUCCESSFUL CHRONIC DISEASE MANAGEMENT. PART I, LINE 3C: UNLESS ELIGIBLE FOR PRESUMPTIVE FINANCIAL ASSISTANCE, THE FOLLOWING ELIGIBILITY CRITERIA MUST BE MET IN ORDER FOR A PATIENT TO QUALIFY FOR FINANCIAL ASSISTANCE: NO MINIMUM ACCOUNT BALANCE SHALL BE REQUIRED FOR A PATIENT TO QUALIFY FOR FINANCIAL ASSISTANCE IF YOU ARE UNINSURED OR UNDERINSURED WITH A FAMILY INCOME OF UP TO 200% OF THE FEDERAL POVERTY LEVEL, YOU MAY BE ELIGIBLE TO RECEIVE A 100% DISCOUNT FROM YOUR BALANCE FOR ELIGIBLE HOSPITAL SERVICES. IF YOU ARE UNINSURED OR UNDERINSURED WITH AN ANNUAL FAMILY INCOME BETWEEN 201-400% OF THE FEDERAL POVERTY LEVEL, YOU MAY BE ELIGIBLE TO HAVE YOUR BALANCE FOR HOSPITAL SERVICES REDUCED TO THE AMOUNT GENERALLY BILLED (AGB), WHICH IS AN AMOUNT SET UNDER FEDERAL LAW THAT REFLECTS THE AMOUNT THAT WOULD HAVE BEEN PAID TO THE HOSPITAL BY PRIVATE HEALTH INSURERS AND MEDICARE (INCLUDING CO-PAYS AND DEDUCTIBLES) FOR THE MEDICALLY NECESSARY SERVICES.ASSISTANCE IS OFFERED TO THOSE WHOSE ANNUAL FAMILY INCOME FALLS WITHIN THE CATEGORIES ABOVE AND HAVE: COOPERATED WITH EFFORTS TO EXHAUST ALL OTHER PAYMENT OPTIONS; AND COMPLETED A FINANCIAL ASSISTANCE APPLICATION AND PROVIDED SUFFICIENT SUPPORT TO VERIFY INCOME. IN SOME CASES, PATIENTS MAY BE AWARDED FINANCIAL ASSISTANCE WITHOUT A FORMAL APPLICATION. DETAILS ARE OUTLINED IN THE FINANCIAL ASSISTANCE POLICYTHE PATIENT COOPERATION STANDARDS AS DEFINED IN THE FINANCIAL ASSISTANCE POLICY, SHALL ONLY APPLY TO THE EXTENT THEY:1) ALLOW THE HOSPITAL FACILITY TO PURSUE REIMBURSEMENT FROM ANY THIRD-PARTY COVERAGE THAT MAY BE IDENTIFIED TO THE HOSPITAL FACILITY, IN ACCORDANCE WITH WAC 246-453-020(1);2) ALLOW THE HOSPITAL FACILITY TO MAKE EVERY REASONABLE EFFORT TO DETERMINE THE EXISTENCE OR NONEXISTENCE OF THIRD-PARTY SPONSORSHIP THAT MIGHT COVER IN FULL OR IN PART THE CHARGES FOR SERVICES PROVIDED TO EACH PATIENT, IN ACCORDANCE WITH WAC 246-453-020(4); AND3) DO NOT IMPOSE APPLICATION PROCEDURES FOR CHARITY CARE SPONSORSHIP WHICH PLACE AN UNREASONABLE BURDEN UPON THE RESPONSIBLE PARTY, TAKING INTO ACCOUNT ANY PHYSICAL, MENTAL, INTELLECTUAL, OR SENSORY DEFICIENCIES OR LANGUAGE BARRIERS WHICH MAY HINDER THE RESPONSIBLE PARTY'S CAPABILITY OF COMPLYING WITH THE APPLICATION PROCEDURES, IN ACCORDANCE WITH WAC 246-453-020(5).COMMONSPIRIT HOSPITAL ORGANIZATIONS RECOGNIZE THAT NOT ALL PATIENTS AND GUARANTORS ARE ABLE TO COMPLETE THE FINANCIAL ASSISTANCE APPLICATION OR PROVIDE REQUISITE DOCUMENTATION. FINANCIAL COUNSELORS ARE AVAILABLE AT EACH HOSPITAL FACILITY LOCATION TO ASSIST ANY INDIVIDUAL SEEKING APPLICATION ASSISTANCE. FOR PATIENTS AND GUARANTORS WHO ARE UNABLE TO PROVIDE REQUIRED DOCUMENTATION, A HOSPITAL FACILITY MAY GRANT PRESUMPTIVE FINANCIAL ASSISTANCE BASED ON INFORMATION OBTAINED FROM OTHER RESOURCES. IN PARTICULAR, PRESUMPTIVE ELIGIBILITY MAY BE DETERMINED ON THE BASIS OF INDIVIDUAL LIFE CIRCUMSTANCES THAT MAY INCLUDE: RECIPIENT OF STATE-FUNDED PRESCRIPTION PROGRAMS; HOMELESS OR ONE WHO RECEIVED CARE FROM A HOMELESS OR FREE CARE CLINIC; PARTICIPATION IN WOMEN, INFANTS AND CHILDREN PROGRAMS (WIC); FOOD STAMP ELIGIBILITY; ELIGIBILITY OR REFERRALS FOR OTHER STATE OR LOCAL ASSISTANCE PROGRAMS (E.G., MEDICAID); LOW INCOME/SUBSIDIZED HOUSING IS PROVIDED AS A VALID ADDRESS; OR PATIENT IS DECEASED WITH NO KNOWN SPOUSE OR KNOWN ESTATE.IN THE EVENT THE RESPONSIBLE PARTY'S IDENTIFICATION AS AN INDIGENT PERSON IS OBVIOUS TO HOSPITAL FACILITY PERSONNEL, AND THE HOSPITAL FACILITY PERSONNEL ARE ABLE TO ESTABLISH THE POSITION OF THE INCOME LEVEL WITHIN THE BROAD CRITERIA DESCRIBED IN WAC 246-453-040, BASED ON THE INDIVIDUAL LIFE CIRCUMSTANCES CONTAINED WITHIN THE FINANCIAL ASSISTANCE POLICY OR OTHERWISE, THE HOSPITAL FACILITY IS NOT OBLIGATED TO ESTABLISH THE EXACT INCOME LEVEL OR TO REQUEST DOCUMENTATION FROM THE RESPONSIBLE PARTY, UNLESS THE RESPONSIBLE PARTY REQUESTS FURTHER REVIEW.HOSPITAL FACILITIES SHALL MAKE EVERY REASONABLE EFFORT TO REACH INITIAL AND FINAL DETERMINATIONS OF ELIGIBILITY FOR FINANCIAL ASSISTANCE IN A TIMELY MANNER. NEVERTHELESS, HOSPITAL FACILITIES SHALL MAKE THOSE DETERMINATIONS AT ANY TIME, EVEN AFTER THE APPLICATION PERIOD, UPON LEARNING OF FACTS OR RECEIVING THE DOCUMENTATION DESCRIBED HEREIN, INDICATING THAT THE RESPONSIBLE PARTY'S INCOME IS EQUAL TO OR BELOW TWO HUNDRED PERCENT (200%) OF THE FEDERAL POVERTY GUIDELINES AS ADJUSTED FOR FAMILY SIZE. THE TIMING OF REACHING A FINAL DETERMINATION OF ELIGIBILITY FOR FINANCIAL ASSISTANCE SHALL HAVE NO BEARING ON THE HOSPITAL FACILITY'S IDENTIFICATION OF CHARITY CARE DEDUCTIONS FROM REVENUE AS DISTINCT FROM BAD DEBTS. WAC 246-453-020(10). PART I, LINE 7: COMMONSPIRIT HEALTH HOSPITALS USE A COST ACCOUNTING SYSTEM OR AN ADJUSTED COST TO CHARGE RATIO CALCULATED IN A MANNER CONSISTENT WITH WORKSHEET 2 FOR EACH REPORTING FACILITY, TO DERIVE THE REPORTED COSTS OF FINANCIAL ASSISTANCE, MEDICAID AND OTHER MEANS-TESTED PROGRAMS. WORKSHEET 3 OR THE EQUIVALENT IN THE COMMUNITY BENEFIT INVENTORY FOR SOCIAL ACCOUNTABILITY ("CBISA") SOFTWARE ARE USED TO CALCULATE EXPENSE AND REVENUE, INCLUDING WHERE APPLICABLE MEDICAID PROVIDER FEES AND PAYMENTS FROM UNCOMPENSATED CARE PROGRAMS. ACTUAL OR ESTIMATED COST AND ANY DIRECT OFFSETTING REVENUE IS REPORTED, AND SCHEDULE H WORKSHEETS OR THEIR EQUIVALENTS ARE USED, FOR OTHER COMMUNITY BENEFIT ACTIVITIES SUCH AS COMMUNITY HEALTH IMPROVEMENT SERVICES, COMMUNITY BENEFIT OPERATIONS, HEALTH PROFESSIONS EDUCATION, SUBSIDIZED HEALTH SERVICES, RESEARCH, AND CASH AND IN-KIND DONATIONS. PART III, LINE 2: THE AMOUNT OF THE ORGANIZATION'S BAD DEBT AT COST IS DETERMINED BY APPLYING THE COST TO CHARGE RATIO TO PATIENT CHARGES THAT ARE DEEMED TO BE UNCOLLECTIBLE. THIS AMOUNT REPRESENTS THE COST OF SERVICES PROVIDED TO PATIENTS WHO ARE UNABLE OR REFUSE TO PAY THEIR BILLS AND DO NOT QUALIFY FOR FREE OR DISCOUNTED CARE, GOVERNMENT SPONSORED PROGRAMS OR OTHER PAYMENT ASSISTANCE, AND ARE OTHERWISE UNINSURED.THE FILING ORGANIZATION PROVIDES FREE CARE TO ANY PATIENT WHOSE FAMILY INCOME IS AT OR BELOW 200% OF THE FEDERAL POVERTY LEVEL, OR DISCOUNTED CARE TO UNINSURED OR UNDER-INSURED INDIVIDUALS WHOSE FAMILY INCOME IS ABOVE 201% BUT LOWER THAN 400% OF THE FEDERAL POVERTY LEVEL. THE FILING ORGANIZATION ALSO PROVIDES OPTIONS FOR PROMPT PAY DISCOUNTS, AND INTEREST-FREE EXTENDED PAYMENT PLANS FOR PATIENTS WHO HAVE DEMONSTRATED GOOD FAITH AND ARE COOPERATING IN RESOLVING THEIR HOSPITAL BILLS. ALL ACCOUNTS FOR ELIGIBLE UNINSURED PATIENTS AT ALL FACILITIES RECEIVE AN AUTOMATIC UNINSURED DISCOUNT. THE EXPECTED PATIENT PAYMENT AMOUNT ON THE PATIENT'S BILL REFLECTS THIS DISCOUNT. DISCOUNTS ARE ACCOUNTED FOR AS DEDUCTIONS FROM REVENUE, NOT AS BAD DEBT EXPENSE. PART III, LINE 3: FRANCISCAN HEALTH SYSTEM MAKES EVERY EFFORT TO DETERMINE IF A PATIENT QUALIFIES FOR FINANCIAL ASSISTANCE UPON ADMISSION. FRANCISCAN HEALTH SYSTEM'S FINANCIAL ASSISTANCE POLICY IS COMMUNICATED TO PATIENTS UPON ADMISSION AND IS AVAILABLE IN THE LANGUAGES PRIMARILY SPOKEN IN THE COMMUNITY. IT IS ALSO POSTED IN VARIOUS COMMON AREAS OF THE HOSPITAL, SUCH AS EMERGENCY ROOMS, URGENT CARE CENTERS, ADMITTING AND REGISTRATION DEPARTMENTS, HOSPITAL BUSINESS OFFICES LOCATED ON FACILITY CAMPUSES, AND OTHER PUBLIC PLACES, AND IS PROVIDED UPON BILLING IF ELIGIBILITY IS NOT PREVIOUSLY DETERMINED. ELIGIBILITY IS REEVALUATED AS NEEDED AND AMOUNTS ARE CLASSIFIED AS CHARITY AS SOON AS ELIGIBILITY IS KNOWN. FRANCISCAN HEALTH SYSTEM ALSO UTILIZES A PAYMENT ASSISTANCE RANK ORDERING (PARO) SCORING SYSTEM TO ASSIST IN DETERMINING IF AN UNINSURED PATIENT MAY QUALIFY FOR PAYMENT ASSISTANCE EVEN THOUGH THEY HAVE NOT APPLIED FOR IT. PARO IS A METHODOLOGY THAT APPLIES CONSISTENT SCREENING AND APPLICATION STANDARDS TO ALL UNINSURED PATIENTS UTILIZING HISTORICAL DATA TO DEVELOP A PREDICTIVE MODEL FOR HEALTHCARE PAYMENT ASSISTANCE. IN ITS DEVELOPMENT, SPECIAL ATTENTION WAS PAID TO THOSE SOCIOECONOMIC FACTORS THAT MIGHT ADVERSELY AFFECT THOSE PATIENTS DESERVING THE MOST ATTENTION. OTHER CRITERIA ARE ALSO UTILIZED TO ENSURE THAT SERVICES THAT HAVE QUALIFIED AS FINANCIAL ASSISTANCE ARE NOT REPORTED AS BAD DEBT. AS SUCH, FRANCISCAN HEALTH SYSTEM DOES NOT BELIEVE THAT ANY AMOUNTS INCLUDED IN PART III, LINE 2, ARE ATTRIBUTABLE TO PATIENTS ELIGIBLE UNDER THE ORGANIZATION'S PAYMENT ASSISTANCE POLICY, AND THEREFORE, NO PORTION OF BAD DEBT EXPENSE IS INCLUDED AS COMMUNITY BENEFIT EXPENSE. PART III, LINE 4: FRANCISCAN HEALTH SYSTEM DOES NOT ISSUE SEPARATE COMPANY AUDITED FINANCIAL STATEMENTS. HOWEVER, THE ORGANIZATION IS INCLUDED IN THE CONSOLIDATED FINANCIAL STATEMENTS OF COMMONSPIRIT HEALTH. THE FOLLOWING IS AN EXCERPT FROM COMMONSPIRIT'S CONSOLIDATED ANNUAL AUDITED FINANCIAL STATEMENTS FOR THE YEAR ENDED JUNE 30, 2022, RELATED TO PATIENT ACCOUNTS RECEIVABLE AND NET PATIENT REVENUE. THE ENTIRE FOOTNOTE CAN BE VIEWED IN THE ATTACHED COMMONSPIRIT CONSOLIDATED FINANCIAL STATEMENTS ON PAGES 12-13."PATIENT SERVICE REVENUE IS REPORTED AT THE AMOUNTS THAT REFLECT THE CONSIDERATION COMMONSPIRIT EXPECTS TO BE PAID IN EXCHANGE FOR PROVIDING PATIENT CARE. THESE AMOUNTS ARE DUE FROM PATIENTS, THIRD-PARTY PAYORS (INCLUDING HEALTH INSURERS AND GOVERNMENT PROGRAMS), AND OTHERS, AND INCLUDE CONSIDERATION FOR RETROACTIVE REVENUE ADJUSTMENTS DUE TO SETTLEMENT OF AUDITS AND REVIEWS. GENERALLY, PERFORMANCE OBLIGATIONS FOR PATIENTS RECEIVING INPATIENT ACUTE CARE SERVICES AND OUTPATIENT SERVICES ARE RECOGNIZED OVER TIME AS SERVICES ARE PROVIDED. NET PATIENT REVENUE IS PRIMARILY COMPRISED OF HOSPITAL AND PHYSICIAN SERVICES." PART III, LINE 8: COMMONSPIRIT HEALTH HOSPITALS PREPARE MEDICARE COST REPORTS IN A MANNER THAT COMPORTS WITH PROVIDER REIMBURSEMENT MANUAL (PRM) 15-1 AND PRM 15-2 CHAPTER 40 (TRANSMITTAL 13). AS SUCH, THE FOLLOWING LANGUAGE PER PRM 15-1 DESCRIBES THE COMPUTATION OF COSTS PER THE MEDICARE COST REPORT: TOTAL ALLOWABLE COSTS OF A PROVIDER ARE APPORTIONED BETWEEN PROGRAM BENEFICIARIES AND OTHER PATIENTS SO THAT THE SHARE BORNE BY THE PROGRAM IS BASED UPON ACTUAL SERVICES RECEIVED BY PROGRAM BENEFICIARIES. THE RATIO OF COVERED BENEFICIARY CHARGES TO TOTAL PATIENT CHARGES FOR THE SERVICES OF EACH ANCILLARY DEPARTMENT IS APPLIED TO THE COST OF THE DEPARTMENT. ADDED TO THIS AMOUNT IS THE COST OF ROUTINE SERVICES FOR PROGRAM BENEFICIARIES, DETERMINED ON THE BASIS OF A SEPARATE AVERAGE COST PER DIEM FOR ALL PATIENTS FOR GENERAL ROUTINE PATIENT CARE AREAS. ANOTHER FACTOR CONSIDERED IS A SEPARATE AVERAGE COST PER DIEM FOR EACH INTENSIVE CARE UNIT, CORONARY CARE UNIT, AND OTHER SPECIAL CARE INPATIENT HOSPITAL UNITS. COMMONSPIRIT HEALTH AND ITS SUBORDINATE CORPORATIONS BELIEVE THAT THE ENTIRE MEDICARE SHORTFALL FOR THE CONSOLIDATED ENTITIES CONSTITUTES COMMUNITY BENEFIT. THE IRS COMMUNITY BENEFIT STANDARD INCLUDES THE PROVISION OF CARE TO THE ELDERLY AND MEDICARE PATIENTS. MEDICARE SHORTFALLS MUST BE ABSORBED BY COMMONSPIRIT HEALTH HOSPITALS IN ORDER TO CONTINUE TREATING THE ELDERLY IN OUR COMMUNITIES. THE HOSPITALS PROVIDE CARE REGARDLESS OF THIS SHORTFALL AND THEREBY RELIEVE THE FEDERAL GOVERNMENT OF THE BURDEN OF PAYING THE FULL COST FOR MEDICARE BENEFICIARIES. FRANCISCAN HEALTH SYSTEM'S SHORTFALL, AS REPORTED ON PART III, SECTION B, LINE 7, OF $100,355,468 REPRESENTS THE FILING ORGANIZATION'S MEDICARE COST REPORTS. PART III, LINE 9B: COMMONSPIRIT HEALTH ENSURES THAT PATIENT ACCOUNTS ARE PROCESSED FAIRLY AND CONSISTENTLY. COMMONSPIRIT HEALTH'S BILLING AND COLLECTION POLICY CONTAINS PROVISIONS THAT PROHIBIT THE COLLECTION OF AMOUNTS DUE FROM PATIENTS WHO THE ORGANIZATION KNOWS QUALIFY FOR FINANCIAL ASSISTANCE. ACCOUNTS WITH INCORRECT OR INCOMPLETE DEMOGRAPHIC INFORMATION ARE ASSIGNED TO A COLLECTION AGENCY IF THE COMMONSPIRIT HEALTH FACILITY, OR BILLING COMPANY RETAINED BY COMMONSPIRIT HEALTH, IS UNABLE TO OBTAIN AN UPDATED ADDRESS THROUGH SKIP TRACING OR OTHER MEANS. FOR PATIENTS WHO HAVE AN APPLICATION PENDING FOR EITHER GOVERNMENT-SPONSORED ASSISTANCE OR FOR ASSISTANCE UNDER COMMONSPIRIT HEALTH'S FINANCIAL ASSISTANCE POLICY, OR WHERE THE PATIENT IS ATTEMPTING IN GOOD FAITH TO SETTLE AN OUTSTANDING BILL WITH THE FACILITY VIA PAYMENT PLANS, COMMONSPIRIT HEALTH WILL NOT KNOWINGLY SEND THAT PATIENT'S BILL TO AN OUTSIDE COLLECTION AGENCY. ON SELF-PAY ACCOUNTS THAT DO NOT MEET THE CRITERIA NOTED ABOVE, THE INITIAL DETERMINATION OF ASSIGNMENT TO A COLLECTION AGENCY WILL VARY DEPENDING ON THE NATURE OF THE ACCOUNT WITH THE FINAL DECISION BEING AT THE DISCRETION OF THE BILLING COMPANY RETAINED BY COMMONSPIRIT HEALTH. UPON ASSIGNMENT OF SUCH A PATIENT ACCOUNT TO A COLLECTION AGENCY, COMMONSPIRIT HEALTH REQUIRES THE AGENCY TO COMPLY WITH THE FAIR DEBT COLLECTION PRACTICES ACT. PART VI, LINE 2: VIRGINIA MASON FRANCISCAN HEALTH STAFF ARE ACTIVE MEMBERS OF VARIOUS COMMUNITY COALITIONS THROUGHOUT THE SERVICE AREA TO ASCERTAIN THE HEALTH CARE NEEDS OF THE COMMUNITIES SERVED. PART VI, LINE 3: INFORMATION ABOUT COMMONSPIRIT HEALTH'S FINANCIAL ASSISTANCE PROGRAM AND A CONTACT NUMBER ARE MADE AVAILABLE TO PATIENTS AND THE PUBLIC. PATIENTS ARE INFORMED OF COMMONSPIRIT HEALTH'S FINANCIAL ASSISTANCE PROGRAM VIA SIGNAGE IN ALL ADMITTING AREAS AND IN VARIOUS COMMON AREAS OF THE HOSPITAL. FINANCIAL ASSISTANCE PROGRAM INFORMATION NOTICES ARE POSTED IN THE EMERGENCY AND ADMITTING DEPARTMENTS AND AT OTHER PUBLIC PLACES AS EACH FACILITY MAY ELECT. SUCH INFORMATION IS PROVIDED IN THE PRIMARY LANGUAGES SPOKEN IN THE COMMUNITIES COMMONSPIRIT HEALTH SERVES. THE SIGNAGE INCLUDES NOTIFICATION THAT FURTHER DISCOUNTS MAY BE PROVIDED UPON THE COMPLETION AND SUBMISSION OF A FINANCIAL ASSISTANCE APPLICATION AND HOW TO REACH STAFF THAT CAN ASSIST WITH ANSWERING QUESTIONS AND GUIDE PATIENTS THROUGH THE APPLICATION PROCESS. INFORMATION CAN ALSO BE FOUND ON THE FACILITY WEBSITES. IF FINANCIAL ASSISTANCE ELIGIBILITY IS NOT DETERMINED PRIOR TO BILLING, INITIAL BILLING STATEMENTS TO PATIENTS INCLUDE A REQUEST TO THE PATIENT TO PROVIDE ANY INSURANCE INFORMATION THAT WAS VALID FOR THE DATES OF SERVICE BILLED AND A STATEMENT INFORMING PATIENTS HOW TO CONTACT US REGARDING FINANCIAL ASSISTANCE. ADDITIONALLY, CONTRACT TERMS WITH COLLECTION VENDORS WORKING ON BEHALF OF COMMONSPIRIT HEALTH REQUIRE THEY FOLLOW COMMONSPIRIT HEALTH FINANCIAL ASSISTANCE POLICY. ALSO, REFERRAL OF PATIENTS FOR FINANCIAL ASSISTANCE MAY BE MADE BY ANY MEMBER OF THE COMMONSPIRIT HOSPITAL ORGANIZATION NON-MEDICAL OR MEDICAL STAFF, INCLUDING PHYSICIANS, NURSES, FINANCIAL COUNSELORS, SOCIAL WORKERS, CASE MANAGERS, CHAPLAINS, AND RELIGIOUS SPONSORS. A REQUEST FOR ASSISTANCE MAY BE MADE BY THE PATIENT OR A FAMILY MEMBER, CLOSE FRIEND OR ASSOCIATE OF THE PATIENT, SUBJECT TO APPLICABLE PRIVACY LAWS. PART VI, LINE 4: THE PRIMARY SERVICE AREA FOR ST. ANTHONY HOSPITAL, CHI FRANCISCAN REHABILITATION HOSPITAL, ST CLARE HOSPITAL, AND ST JOSEPH MEDICAL CENTER IS PIERCE COUNTY, WASHINGTON. PIERCE COUNTY HAS A POPULATION OF MORE THAN 900,000 RESIDENTS. THE COMPOSITION OF THE COUNTY IS PRIMARILY NON-HISPANIC WHITE RESIDENTS, WITH THE HISPANIC POPULATION REPRESENTING 11% OF THE POPULATION. THE PROPORTION OF ADULTS 55 YEARS AND HIGHER CONTINUES TO INCREASE. FOR THE PERIOD 2015-2017, THE SERVICE AREA REFLECTS 404,000 MEDICAID BENEFICIARIES. NEARLY HALF OF PIERCE COUNTY STUDENTS ARE ELIGIBLE FOR FREE OR REDUCED-PRICE LUNCH. THE FOUR-YEAR AVERAGE PERCENTAGE OF ADULTS AGED 25 YEARS OR OLDER WHO EARNED A BACHELOR'S DEGREE IS LOWER IN PIERCE COUNTY COMPARED TO THE STATE-WIDE AVERAGE. OVERALL, LIFE EXPECTANCY WITHIN THE SERVICE AREA IS SIGNIFICANTLY LOWER AS COMPARED TO THE STATE-WIDE AVERAGE. INDIVIDUALS IDENTIFYING WITH MORE THAN ONE RACE HAVE THE LONGEST LIFE EXPECTANCY, WHILE NATIVE HAWAIIAN/OTHER PACIFIC ISLANDERS EXPERIENCE THE SHORTEST LIFE EXPECTANCY. FEDERALLY DESIGNATED MEDICALLY UNDERSERVED AREAS ARE PRESENT IN PIERCE COUNTY.THE PRIMARY SERVICE AREA FOR ST ANNE HOSPITAL AND ST FRANCIS HOSPITAL IS KING COUNTY, WASHINGTON. KING COUNTY HAS OVER 2.1 MILLION RESIDENTS AND COVERS OVER 2,300 SQUARE MILES. THE COMMUNITY IS INCREASING ITS RACIAL AND ETHNIC DIVERSITY. THE POPULATION OF CHILDREN UNDER 18 IS NOW 53% PEOPLE OF COLOR. ONE IN FOUR KING COUNTY RESIDENTS LIVE IN A HOUSEHOLD WHERE A LANGUAGE OTHER THAN ENGLISH IS SPOKEN. ONE IN FIVE RESIDENTS LIVE IN POVERTY OR NEAR POVERTY. RACIAL AND ETHNIC GAPS IN HEALTH AND WEALTH HAVE BEEN DOCUMENTED AND INCLUDE GAPS IN HOUSEHOLD NET WORTH, EDUCATIONAL ATTAINMENT, HOUSEHOLD INCOME, UNEMPLOYMENT, FOOD SECURITY, HOUSING, AND TRANSPORTATION. FOR THE PURPOSES OF THE CHNA, THE COUNTY HAS BEEN DIVIDED INTO FOUR REGIONS: THE NORTH REGION, SEATTLE, THE EAST REGION, AND THE SOUTH REGION. THE SOUTH REGION OF THE COUNTY IS DISPROPORTIONATELY IMPACTED WITH SIGNIFICANT GAPS IN BOTH HEALTH AND WEALTH. FEDERALLY DESIGNATED MEDICALLY UNDERSERVED AREAS ARE PRESENT IN KING COUNTY. PART VI, LINE 5: FINANCIAL ASSISTANCE: IT IS THE POLICY OF COMMONSPIRIT HEALTH TO PROVIDE, WITHOUT DISCRIMINATION, EMERGENCY MEDICAL CARE AND MEDICALLY NECESSARY CARE IN COMMONSPIRIT HOSPITAL FACILITIES TO ALL PATIENTS, WITHOUT REGARD TO A PATIENT'S FINANCIAL ABILITY TO PAY. THIS HOSPITAL HAS A FINANCIAL ASSISTANCE POLICY THAT DESCRIBES THE ASSISTANCE PROVIDED TO PATIENTS FOR WHOM IT WOULD BE A FINANCIAL HARDSHIP TO FULLY PAY THE EXPECTED OUT-OF-POCKET EXPENSES FOR SUCH CARE, AND WHO MEET THE ELIGIBILITY CRITERIA FOR SUCH ASSISTANCE. THE FINANCIAL ASSISTANCE POLICY, A PLAIN LANGUAGE SUMMARY AND RELATED MATERIALS ARE AVAILABLE IN MULTIPLE LANGUAGES ON THE HOSPITAL'S WEBSITE.USE OF SURPLUS FUNDS: AS A NOT-FOR-PROFIT HOSPITAL ORGANIZATION DEDICATED TO IMPROVING THE QUALITY OF LIFE, THE HOSPITAL REINVESTS ALL OF ITS SURPLUS FUNDS FROM OPERATING AND INVESTMENT ACTIVITIES TO IMPROVE THE QUALITY OF PATIENT CARE, EXPAND AND REPLACE EXISTING FACILITIES AND EQUIPMENT, INVEST IN TECHNOLOGICAL ADVANCEMENTS, SUPPORT COMMUNITY HEALTH PROGRAMS, AND ADVANCE MEDICAL TRAINING, EDUCATION, AND RESEARCH. THIS ACTIVE REINVESTMENT OF FUNDS MAKES IT POSSIBLE FOR THE HOSPITAL TO DELIVER ON ITS MISSION, INCLUDING HELPING TO ENSURE THAT EVERYONE IN THE COMMUNITIES SERVED HAS ACCESS TO HEALTH CARE.OPEN MEDICAL STAFF: MEDICAL STAFF PRIVILEGES ARE OPEN TO PHYSICIANS WHOSE EXPERIENCE AND TRAINING ARE VERIFIED THROUGH A CREDENTIALING PROCESS. THE PROCESS INCLUDES GATHERING AND VERIFYING CREDENTIALS, ALLOWING THE MEDICAL STAFF TO EVALUATE AN APPLICANT'S QUALIFICATIONS, PREVIOUS EXPERIENCE, AND COMPETENCE, AND ULTIMATELY MAKING A DECISION TO GRANT OR DENY MEDICAL STAFF MEMBERSHIP AND CLINICAL PRIVILEGES ON THE BASIS OF AUTHENTIC AND VALID CREDENTIALS.ROLE OF THE BOARD: THE COMMONSPIRIT HEALTH BOARD AND SPECIFIC COMMITTEES HAVE ORGANIZATIONAL, POLICY-BASED ROLES TO OVERSEE COMMUNITY BENEFIT AND COMMUNITY HEALTH PROGRAMS, AND THEY RECEIVE REGULAR REPORTS ON ACTIVITIES AND PERFORMANCE. HOSPITAL COMMUNITY BOARDS (OR THEIR DESIGNATED COMMUNITY HEALTH OR COMMUNITY BENEFIT COMMITTEES) ARE RESPONSIBLE FOR ENSURING THAT THE HOSPITALS CONDUCT AND ADOPT COMMUNITY HEALTH NEEDS ASSESSMENTS AND IMPLEMENTATION STRATEGIES, TAKE ACTIONS TO HELP ADDRESS IDENTIFIED SIGNIFICANT HEALTH NEEDS WITH AN EMPHASIS ON POOR AND VULNERABLE POPULATIONS AND HEALTH EQUITY, AND MONITORING ACTIONS AND PROGRESS TOWARD IDENTIFIED GOALS. PART VI, LINE 6: THE ORGANIZATION IS AFFILIATED WITH COMMONSPIRIT HEALTH. COMMONSPIRIT HEALTH WAS CREATED BY THE ALIGNMENT OF CATHOLIC HEALTH INITIATIVES AND DIGNITY HEALTH IN EARLY 2019. COMMONSPIRIT HEALTH, A NONPROFIT, FAITH-BASED HEALTH SYSTEM IS COMMITTED TO BUILDING HEALTHIER COMMUNITIES, ADVOCATING FOR THOSE WHO ARE POOR AND VULNERABLE, AND INNOVATING HOW AND WHERE HEALING CAN HAPPEN BOTH INSIDE ITS HOSPITALS AND OUT IN THE COMMUNITY. COMMONSPIRIT HEALTH OWNS AND OPERATES HEALTH CARE FACILITIES IN 21 STATES AND IS THE SOLE CORPORATE MEMBER (PARENT CORPORATION) OF OTHER PRIMARILY NONPROFIT CORPORATIONS THAT ARE EXEMPT FROM FEDERAL AND STATE INCOME TAXES. AS OF JUNE 30, 2022, COMMONSPIRIT HEALTH IS COMPRISED OF APPROXIMATELY 2,200 CARE SITES, CONSISTING OF 142 HOSPITALS, INCLUDING ACADEMIC HEALTH CENTERS, MAJOR TEACHING HOSPITALS, AND CRITICAL ACCESS FACILITIES, COMMUNITY HEALTH SERVICES ORGANIZATIONS, ACCREDITED NURSING COLLEGES, HOME HEALTH AGENCIES, LIVING COMMUNITIES, A MEDICAL FOUNDATION AND OTHER AFFILIATED MEDICAL GROUPS, AND OTHER FACILITIES AND SERVICES THAT SPAN THE INPATIENT AND OUTPATIENT CONTINUUM OF CARE. IN FISCAL YEAR 2022, COMMONSPIRIT HEALTH PROVIDED MORE THAN $3.16 BILLION IN FINANCIAL ASSISTANCE AND COMMUNITY BENEFIT FOR PROGRAMS AND SERVICES FOR THE POOR, FREE CLINICS, EDUCATION AND RESEARCH. FINANCIAL ASSISTANCE AND COMMUNITY BENEFIT TOTALED MORE THAN $4.89 BILLION WITH THE INCLUSION OF THE UNPAID COSTS OF MEDICARE. THE HEALTH SYSTEM, WHICH GENERATED OPERATING REVENUES OF $33.9 BILLION IN FISCAL YEAR 2022, HAS TOTAL ASSETS OF APPROXIMATELY $50.31 BILLION.COMMONSPIRIT HEALTH PROVIDES STRATEGIC PLANNING AND MANAGEMENT SERVICES AS WELL AS CENTRALIZED SERVICES FOR ITS DIVISIONS. THE PROVISION OF CENTRALIZED MANAGEMENT AND SHARED SERVICES INCLUDING AREAS SUCH AS ACCOUNTING, HUMAN RESOURCES, PAYROLL AND SUPPLY CHAIN PROVIDES ECONOMIES OF SCALE AND PURCHASING POWER TO THE DIVISIONS. THE COST SAVINGS ACHIEVED THROUGH COMMONSPIRIT HEALTH'S CENTRALIZATION ENABLE DIVISIONS TO DEDICATE ADDITIONAL RESOURCES TO HIGH-QUALITY HEALTH CARE AND COMMUNITY OUTREACH SERVICES TO THE MOST VULNERABLE MEMBERS OF OUR SOCIETY. PART VI, LINE 7, REPORTS FILED WITH STATES WA 1 PROJECT ACCESS NORTHWEST 1111 HARVARD AVENUE SEATTLE WA 98122 204377921 501(C)(3) 696490 0 PROGRAM SUPPORT REBUILDING HOPE 101 E 26TH ST SUITE 200 TACOMA WA 98421 910962226 501(C)(3) 21150 0 PROGRAM SUPPORT CAROL MILGARD BREAST CENTER 4525 S 19TH ST TACOMA WA 98405 262377858 501(C)(3) 78238 0 PROGRAM SUPPORT THE LEAPFROG GROUP 1775 K STREET NW NO 400 WASHINGTON DC 20006 522359517 501(C)(3) 10000 0 PROGRAM SUPPORT COMMONSPIRIT HEALTH RESEARCH 198 INVERNESS DRIVE WEST ENGLEWOOD CO 80112 271050565 501(C)(3) 54581 0 PROGRAM SUPPORT 5 0 PART I, LINE 2: FHS ONLY GRANTS TO 501(C)(3) AND 501(C)(6) ORGANIZATIONS TO ENSURE THE FUNDS WILL BE USED PROPERLY. X X 1 1 1 1 0 0 0 0 0 0 0 KETUL PATEL PRESIDENT / CHIEF EXECUTIVE OFFICER 0 1306982 0 1791306 0 466883 0 19375 0 11599 0 3596145 0 190880 IAN WORDEN SVP/COO (THROUGH 1/7/22) 827408 0 662986 0 79752 0 17275 0 20965 0 1608386 0 0 0 MICHAEL ANDERSON SVP/CHIEF MEDICAL OFFICER 673054 0 198661 0 5544 0 17275 0 20965 0 915499 0 0 0 THOMAS KRUSE SVP/CHIEF STRATEGY OFFICER 658382 0 195650 0 1932 0 16392 0 31815 0 904171 0 0 0 MIKE FITZGERALD FORMER TREASURER/CFO 292346 0 458298 0 30338 0 17100 0 10290 0 808372 0 0 0 SHARON ROYNE VP/CHIEF HUMAN RESOURCES OFFICER 436206 0 129135 0 5544 0 17100 0 20965 0 608950 0 0 0 DHYAN LAL DIV VP PAYER STRATEGY-ACCOUNT CARE 370523 0 177450 0 1868 0 17275 0 31540 0 598656 0 0 0 TIMOTHY OHAVER CHIEF OPERATING OFFICER ST JOSEPH ME 225775 0 44351 0 297309 0 17741 0 2264 0 587440 0 0 0 KIMBERLY MOORE VP-MEDICAL OPERATIONS & ASC CMO 427498 0 80476 0 1932 0 16600 0 14154 0 540660 0 0 0 KHALID ASLAM HOSPITALIST INTERNAL MEDICINE 375232 0 83463 0 3754 0 17100 0 36275 0 515824 0 0 0 ASHWIN SHIVAKUMAR DIV DIRECTOR INPATIENT SVCS 396451 0 60497 0 1329 0 17275 0 32305 0 507857 0 0 0 PATRICIA ELLISOR INTERIM SVP/CNO (THROUGH 10/15/21) 285094 60782 0 106966 4228 909 17454 0 13592 765 320368 169422 0 0 DEAN FIELD DIV VP CLIN INFORMATICS 358695 0 68320 0 5403 0 17179 0 30752 0 480349 0 0 0 DAVID WEISS MARKET VP/ ACMO ST ANTHONY HOSPITAL 379005 0 69509 0 3572 0 17236 0 3238 0 472560 0 0 0 DAVID BUTCHERITE TREASURER (THROUGH 7/29/21) / DIV VP 307143 0 88897 0 2807 0 17100 0 23722 0 439669 0 0 0 ROSE SHANDROW SVP/CHIEF MISSION OFFICER 297054 0 89698 0 8062 0 16989 0 11166 0 422969 0 0 0 THERESA RAMBOSEK FORMER SECRETARY 0 53696 0 0 0 349815 0 9879 0 296 0 413686 0 0 DAVID NOSACKA TREASURER / SVP & CFO 218510 0 100000 0 66849 0 0 0 13230 0 398589 0 0 0 RUSSELL WOOLLEY CHIEF OPERATING OFFICER ST FRANCIS H 47374 209241 0 38364 83 422 14410 0 25510 12246 87377 260273 0 0 DINO JOHNSON CHIEF OPERATING OFFICER ST ANTHONY H 242630 0 36389 0 474 0 15061 0 35787 0 330341 0 0 0 SYDNEY BERSANTE FORMER PIERCE REGION PRESIDENT 0 0 0 0 318774 0 3424 0 0 0 322198 0 0 0 LOIS ERICKSON CHIEF OPERATING OFFICER ST CLARE HOS 238166 0 36485 0 3479 0 15904 0 21665 0 315699 0 0 0 MIRIAM CHAMBLISS CORPORATE SECRETARY / VP GENERAL COU 0 189141 0 42339 0 20096 0 8882 0 27872 0 288330 0 0 ROBERT VALENCIA CORPORATE SECRETARY (THROUGH 7/29/21 0 173026 0 0 0 89460 0 6599 0 0 0 269085 0 0 ANTHONY MCLEAN FORMER KING REGION PRESIDENT 0 0 0 0 243667 0 0 0 0 0 243667 0 0 0 JENNIFER SCHOMBURG PRESIDENT ST JOSEPH MEDICAL CENTER 155988 0 30000 0 41843 0 0 0 6310 0 234141 0 0 0 DIANNE AROH SVP/CHIEF NURSING OFFICER 73186 0 50000 0 37277 0 0 0 421 0 160884 0 0 0 LAURIE BROWN RN FORMER CHIEF EXPERIENCE OFFICER 0 0 0 0 127524 0 0 0 0 0 127524 0 0 0 PART I, LINE 1A ONE KEY EMPLOYEE RECEIVED A HOUSING ALLOWANCE AND ONE OFFICER RECEIVED RELOCATION BENEFITS AND TAX GROSS-UP PAYMENTS TO OFFSET THE INCOME TAX CONSEQUENCES OF THE BENEFITS. ALL OF THESE AMOUNTS WERE TREATED AS TAXABLE COMPENSATON. PART I, LINE 3 DURING THE CALENDAR YEAR 2021, COMPENSATION FOR THE TOP MANAGEMENT OFFICIAL WAS ESTABLISHED AND PAID BY COMMONSPIRIT HEALTH, A RELATED ORGANIZATION. COMMONSPIRIT HEALTH USED THE FOLLOWING TO ESTABLISH THE TOP MANAGEMENT OFFICIAL'S COMPENSATION: (1) COMPENSATION COMMITTEE; (2) INDEPENDENT COMPENSATION CONSULTANT; (3) COMPENSATION SURVEY OR STUDY; (4) APPROVAL BY THE BOARD OR COMPENSATION COMMITTEE. PART I, LINES 4A-B CERTAIN REPORTABLE INDIVIDUALS ARE COVERED BY AN EXECUTIVE SEVERANCE POLICY THAT PROVIDES MARKET-STANDARD COMPENSATION, RANGING FROM PAYMENTS OF 9 MONTHS TO 2 YEARS OF BASE COMPENSATION, DEPENDING ON THE EXECUTIVE'S POSITION, IN THE EVENT OF A POSITION ELIMINATION OR OTHER INVOLUNTARY TERMINATION, IN ACCORDANCE WITH THE GUIDELINES OF THE POLICY. CERTAIN REPORTABLE INDIVIDUALS ARE COVERED BY A NON-EXECUTIVE SEVERANCE POLICY THAT PROVIDES MARKET-STANDARD COMPENSATION, RANGING FROM PAYMENTS OF 2 WEEKS TO 52 WEEKS OF BASE COMPENSATION, DEPENDING ON THE EMPLOYEE'S POSITION AND TENURE, IN THE EVENT OF A POSITION ELIMINATION OR OTHER INVOLUNTARY TERMINATION, IN ACCORDANCE WITH THE GUIDELINES OF THE POLICY. THE FOLLOWING REPORTABLE INDIVIDUALS RECEIVED SEVERANCE PAYMENTS DURING THE 2021 CALENDAR YEAR, AND THESE SEVERANCE PAYMENTS WERE INCLUDED IN THE INDIVIDUALS' W-2 INCOME AND REPORTABLE COMPENSATION ON PART VII AND SCHEDULE J, PART II, COLUMN (B)(III): SYDNEY BERSANTE, $318,774; LAURIE BROWN, $127,524; ANTHONY MCLEAN, $243,667; THERESA RAMBOSEK, $349,024; TIMOTHY OHAVER, $296,158. DURING THE 2021 CALENDAR YEAR, COMMONSPIRIT MAINTAINED A SUPPLEMENTAL NON-QUALIFIED DEFERRED COMPENSATION PLAN FOR DIVISION CEOS/PRESIDENTS AND OTHER DESIGNATED COMMONSPIRIT EXECUTIVES AT THE LEVEL OF SENIOR VICE PRESIDENT AND ABOVE. DURING 2021 THE FOLLOWING DISTRIBUTIONS WERE MADE BY COMMONSPIRIT FROM THE DEFERRED COMPENSATION PLAN: KETUL PATEL, $255,284 DUE TO THE "SUPER" VESTING RULES UNDER THE DEFERRED COMPENSATION PLAN, PARTICIPANTS WHO HAVE MET CERTAIN REQUIREMENTS SUCH AS INVOLUNTARY TERMINATION WITHOUT CAUSE, AGE, AGE AND YEARS OF SERVICE, OR MORE THAN 5 YEARS OF PLAN PARTICIPATION ARE ELIGIBLE TO RECEIVE THEIR 2021 CONTRIBUTIONS IN CASH. DURING 2021, THE FOLLOWING PAYMENTS WERE MADE PURSUANT TO THE SUPER VESTING RULES: MIKE FITZGERALD, $25,414; KETUL PATEL, $198,267 AND IAN WORDEN, $69,084 KELLEN MUMMERT FAMILY MEMBER OF A KEY EMPLOYEE 82440 EMPLOYEE PAYROLL WAGES 0 FORM 990, PART V, LINE 1C: PAYMENTS TO VENDORS FOR ENTITIES THAT ARE PART OF COMMONSPIRIT HEALTH ARE MADE BY COMMONSPIRIT HEALTH. THEREFORE, NO FORMS 1099 ARE ISSUED BY FRANCISCAN HEALTH SYSTEM. COMMONSPIRIT HEALTH FILES THE FORMS 1099 AND COMPLIES WITH THE BACKUP WITHHOLDING RULES FOR REPORTABLE PAYMENTS TO VENDORS AND GAME WINNINGS. THE FORMS 1099 ISSUED ON BEHALF OF FRANCISCAN HEALTH SYSTEM ARE REPORTED TO THE IRS. FORM 990, PART VI, SECTION A, LINE 6 THE SOLE MEMBER OF THE ORGANIZATION IS COMMONSPIRIT HEALTH, A COLORADO NON PROFIT CORPORATION. FORM 990, PART VI, SECTION A, LINE 7A THE SOLE MEMBER HAS THE POWER TO APPOINT, REPLACE OR REMOVE THE MEMBERS OF THE BOARD OF DIRECTORS. (CHCF RESERVED RIGHTS) EXCEPT AS OTHERWISE PROVIDED IN THE CORPORATION'S ARTICLES OF INCORPORATION OR THE LAWS OF THE STATE OF ORGANIZATION, CATHOLIC HEALTH CARE FEDERATION ("CHCF") SHALL HAVE SUCH RIGHTS AS ARE RESERVED TO THE CORPORATE MEMBER, ACTING IN ITS CAPACITY AS THE MEMBERSHIP BODY OF CHCF, UNDER THE GOVERNANCE MATRIX. FORM 990, PART VI, SECTION A, LINE 7B THE ORGANIZATION'S CORPORATE MEMBER IS COMMONSPIRIT HEALTH (CSH). PURSUANT TO SECTION 5.4 OF THE ORGANIZATION'S BYLAWS, THE CORPORATE MEMBER SHALL HAVE THE SPECIFIC RIGHTS SET FORTH IN THE GOVERNANCE MATRIX. PURSUANT TO THE GOVERNANCE MATRIX THE FOLLOWING RIGHTS ARE RESERVED TO THE CSH BOARD DIRECTLY OR THROUGH POWERS DELEGATED TO THE CSH CHIEF EXECUTIVE OFFICER: - SUBSTANTIAL CHANGE IN THE MISSION OR PHILOSOPHY OF FHS - AMENDMENT OF THE CORPORATE DOCUMENTS OF FHS - APPROVE MEMBERS OF THE FHS BOARD - REMOVAL OF A MEMBER OF THE GOVERNING BODY OF FHS - APPROVAL OF ISSUANCE OF DEBT BY FHS - APPROVAL OF PARTICIPATION OF FHS IN A JOINT VENTURE - APPROVAL OF FORMATION OF A NEW CORPORATION BY FHS - APPROVAL OF A MERGER INVOLVING THE FHS - APPROVAL OF THE SALE OF ALL OR SUBSTANTIALLY ALL OF THE ASSETS OF THE FHS - TO REQUIRE THE TRANSFER OF ASSETS BY FHS TO CSH TO ACCOMPLISH CSH'S GOALS AND OBJECTIVES, AND TO SATISFY CSH DEBTS. - ADOPTION OF LONG RANGE AND STRATEGIC PLANS FOR FHS PURSUANT TO SECTION 5.5.2 OF THE ORGANIZATION'S BYLAWS, CSH MAY, IN EXERCISE OF ITS APPROVAL POWERS, GRANT OR WITHHOLD APPROVAL IN WHOLE OR IN PART, OR MAY, IN ITS COMPLETE DISCRETION, AFTER CONSULTATION WITH THE BOARD AND THE PRESIDENT AND CHIEF EXECUTIVE OFFICER OF THE ORGANIZATION, RECOMMEND SUCH OTHER OR DIFFERENT ACTIONS AS IT DEEMS APPROPRIATE. (CHCF RESERVED RIGHTS) EXCEPT AS OTHERWISE PROVIDED IN THE CORPORATION'S ARTICLES OF INCORPORATION OR THE LAWS OF THE STATE OF ORGANIZATION, CATHOLIC HEALTH CARE FEDERATION ("CHCF") SHALL HAVE SUCH RIGHTS AS ARE RESERVED TO THE CORPORATE MEMBER, ACTING IN ITS CAPACITY AS THE MEMBERSHIP BODY OF CHCF, UNDER THE GOVERNANCE MATRIX. FORM 990, PART VI, SECTION B, LINE 11B THE CFO REVIEWS THE FORM AND ANY NECESSARY CHANGES ARE INCLUDED IN THE FINAL VERSION THAT IS APPROVED FOR FILING WITH THE IRS. THE CFO ALSO PROVIDES THE RETURN TO THE BOARD, AND ALL BOARD MEMBERS HAVE THE OPPORTUNITY TO REVIEW THE 990 PRIOR TO FILING WITH THE IRS. SUBSEQUENT TO REVIEW, THE TAX DEPARTMENT FILES THE RETURN WITH THE APPROPRIATE FEDERAL AGENCIES, MAKING ANY NON-SUBSTANTIVE CHANGES NECESSARY TO EFFECT E-FILING. ANY SUCH CHANGES ARE NOT RESUBMITTED TO THE BOARD. FORM 990, PART VI, SECTION B, LINE 12C THE ORGANIZATION HAS A CONFLICTS OF INTEREST ("COI") POLICY (THE "POLICY") IN PLACE TO PROTECT THE INTERESTS OF COMMONSPIRIT HEALTH ("COMMONSPIRIT") IN CIRCUMSTANCES THAT MAY RESULT IN A CONFLICT BETWEEN PERSONAL INTERESTS OF A PERSON AND THE INTERESTS OF THE ORGANIZATION AND THOSE IT SERVES. COMMONSPIRIT'S COI POLICY APPLIES TO COMMONSPIRIT, ITS DIRECT AFFILIATES AND SUBSIDIARIES AND ANY RELATED ENTITY THE GOVERNING DOCUMENTS OF WHICH REQUIRE THE ENTITY TO COMPLY WITH COMMONSPIRIT POLICY (COLLECTIVELY THE "SYSTEM ENTITIES"). THE FOLLOWING PERSONS ARE REQUIRED TO DISCLOSE ACTUAL OR POTENTIAL CONFLICTS OF INTEREST AT LEAST ANNUALLY (VIA A FORMAL SYSTEM-ADMINISTERED SURVEY) IF THE PERSON'S AFFILIATION WITH COMMONSPIRIT CONTINUES: - MEMBERS OF CORPORATE AND COMMUNITY BOARDS OF SYSTEM ENTITIES - MEMBERS OF COMMITTEES OF CORPORATE AND COMMUNITY BOARDS OF SYSTEM ENTITIES - MEMBERS OF THE EXECUTIVE LEADERSHIP TEAM ("ELT") OF COMMONSPIRIT - CORPORATE OFFICERS OF SYSTEM ENTITIES - KEY EMPLOYEES AND HIGHEST COMPENSATED EMPLOYEES AS SPECIFIED BY THE INTERNAL REVENUE SERVICE FOR FORM 990 PURPOSES WHO ARE NOT OTHERWISE INCLUDED IN THE CATEGORIES ABOVE - EMPLOYEES OF SYSTEM ENTITIES AT THE VICE PRESIDENT LEVEL AND ABOVE - ALL INDIVIDUALS ENGAGED IN RESEARCH AT INSTITUTIONS OWNED OR OPERATED BY A SYSTEM ENTITY - SELECT EMPLOYEES AS DETERMINED FROM TIME TO TIME BY LEADERSHIP DISCLOSURE, REVIEW, AND MANAGEMENT OF PERCEIVED, POTENTIAL, OR ACTUAL CONFLICTS OF INTEREST ARE ACCOMPLISHED THROUGH A DEFINED COI DISCLOSURE REVIEW PROCESS. EACH PERSON IS REQUIRED TO PROMPTLY AND FULLY DISCLOSE ANY SITUATION OR CIRCUMSTANCE THAT MAY CREATE A CONFLICT OF INTEREST AS SOON AS SHE/HE BECOMES AWARE OF IT. IN ADDITION, AT THE INCEPTION OF AN INDIVIDUAL'S RELATIONSHIP WITH COMMONSPIRIT (E.G. HIRING, BOARD APPOINTMENT), AND FOR CERTAIN POSITIONS, ANNUALLY THEREAFTER, WRITTEN CONFLICT OF INTEREST DISCLOSURE FORMS MUST BE COMPLETED. A FAILURE TO DISCLOSE MAY RESULT IN DISCIPLINARY OR CORRECTIVE ACTIONS. REPORTED POTENTIAL OR ACTUAL CONFLICTS OF INTEREST ARE INITIALLY REVIEWED BY LEGAL, CORPORATE RESPONSIBILITY OR RESEARCH INTEGRITY STAFF. IF NECESSARY, A CONFLICT OF INTEREST MANAGEMENT PLAN IS DEVELOPED, WHICH PLAN SHALL BE SUBJECT TO ACCEPTANCE BY THE APPROPRIATE DIRECT MANAGER, SUPERVISOR, MEDICAL STAFF OFFICE, BOARD OR BOARD COMMITTEE (FOR BOARD, BOARD COMMITTEE, ELT OR CORPORATE OFFICER CONFLICTS), OR OTHER APPROPRIATE INDIVIDUAL OR BODY. ONCE ACCEPTED, THE CONFLICT OF INTEREST MANAGEMENT PLAN IS COMMUNICATED TO THE PERSON WITH THE ACTUAL OR POTENTIAL CONFLICT AND THE INDIVIDUAL MUST CONDUCT THEMSELVES IN CONFORMITY WITH THE PLAN. IN THE EVENT THAT A TRANSACTIONAL CONFLICT INTEREST ARISES IN CONNECTION WITH A SYSTEM ENTITY BOARD MEETING, THE CONFLICTED INDIVIDUAL MUST DISCLOSE THAT CONFLICT PRIOR TO OR AT THE BEGINNING OF THE MEETING IN WHICH THE MATTER IS TO BE CONSIDERED. THE CONFLICTED INDIVIDUAL IS EXCLUDED FROM VOTING ON THE TRANSACTION AND IS PROHIBITED FROM USING PERSONAL INFLUENCE WITH RESPECT TO THE MATTER, BUT IS NOT PROHIBITED FROM PROVIDING INPUT IF REQUESTED TO DO SO. FORM 990, PART VI, SECTION B, LINE 15B ALL EXECUTIVE COMPENSATION ARRANGEMENTS WITH ANY PERSON OF SUBSTANTIAL INFLUENCE ARE SUBJECT TO REVIEW AND APPROVAL BY THE BOARD OF DIRECTORS, OR AN AUTHORIZED COMMITTEE OF THE BOARD, IN ACCORDANCE WITH THE EXECUTIVE COMPENSATION REVIEW POLICY. EXECUTIVE COMPENSATION ARRANGEMENTS WITH ANY PHYSICIAN WHO IS A PERSON OF SUBSTANTIAL INFLUENCE ARE NOT SUBJECT TO THIS POLICY, BUT SHALL BE REVIEWED AND APPROVED IN ACCORDANCE WITH THE SYSTEM'S PHYSICIAN TRANSACTION REVIEW POLICY. FORM 990, PART VI, SECTION C, LINE 19 THE ORGANIZATION'S FINANCIAL STATEMENTS, CONFLICT OF INTEREST POLICY AND GOVERNING DOCUMENTS ARE AVAILABLE TO THE PUBLIC UPON REQUEST. THE ORGANIZATION'S FINANCIAL STATEMENTS ARE INCLUDED IN COMMONSPIRIT HEALTH'S CONSOLIDATED AUDITED FINANCIAL STATEMENTS THAT ARE AVAILABLE AT WWW.COMMONSPIRIT.ORG OR WWW.CATHOLICHEALTHINITIATIVES.ORG. FORM 990, PART VI, SECTION B, LINE 15A: THE ORGANIZATION'S TOP MANAGEMENT OFFICIAL'S COMPENSATION WAS PAID BY COMMONSPIRIT HEALTH, A RELATED ORGANIZATION. THE BOARD OF STEWARDSHIP TRUSTEES APPOINTS A HUMAN RESOURCES AND COMPENSATION COMMITTEE, COMPRISED EXCLUSIVELY OF INDEPENDENT DIRECTORS, WHO ARE ACCOUNTABLE FOR APPROVING REASONABLE COMPENSATION PACKAGES FOR EACH OFFICER AND CERTAIN KEY EMPLOYEES (INCLUDING THE PRESIDENT/CEO). THE HUMAN RESOURCES AND COMPENSATION COMMITTEE APPROVES, CONSISTENT WITH THE ORGANIZATION'S PHILOSOPHY AND PRINCIPLES, THE ANNUAL PERFORMANCE GOALS AND CRITERIA TO BE USED IN DETERMINING MERIT INCREASES AND VARIABLE COMPENSATION CRITERIA FOR OFFICERS AND KEY EXECUTIVES. THE HUMAN RESOURCES AND COMPENSATION COMMITTEE ALSO ENGAGES AN INDEPENDENT CONSULTANT AS NECESSARY AND QUALIFIED INDEPENDENT COMPENSATION AND BENEFITS SPECIALISTS (INDEPENDENT EXPERTS) TO REVIEW, ANALYZE AND PROVIDE BENCHMARKING DATA FOR THE TOTAL COMPENSATION AND BENEFITS PACKAGES OF OFFICERS AND KEY EXECUTIVES. APPROPRIATE COMPARABLE DATA IS OBTAINED FROM THE INDEPENDENT EXPERTS, (E.G., TOTAL ECONOMIC BENEFITS PAID BY SIMILARLY SITUATED ORGANIZATIONS, BOTH TAXABLE AND TAX-EXEMPT, FOR SIMILAR JOB RESPONSIBILITIES). KEY DELIBERATIONS OF THE COMMITTEE ARE DOCUMENTED IN MEETING MINUTES WHICH ARE APPROVED AT THE NEXT COMMITTEE MEETING AND PROVIDED TO THE BOARD OF STEWARDSHIP TRUSTEES. THE DOCUMENTATION OF THE DELIBERATIONS INCLUDES (A) THE TERMS OF THE AGREEMENT APPROVED AND THE DATE APPROVED; (B) THE MEMBERS OF THE COMMITTEE WHO WERE PRESENT DURING DISCUSSION OF THE APPROVED AGREEMENT AND THOSE WHO VOTED ON IT; AND (C) THE COMPARABILITY DATA OBTAINED AND RELIED UPON BY THE COMMITTEE AND HOW THE DATA WAS OBTAINED. FORM 990, PART VI, SECTION B, LINE 16B: FRANCISCAN HEALTH SYSTEM HAS NOT FORMALLY ADOPTED A WRITTEN POLICY OR WRITTEN PROCEDURE REGARDING JOINT VENTURES. HOWEVER COMMONSPIRIT HEALTH'S SYSTEM-WIDE JOINT VENTURE MODEL OPERATING AGREEMENT INCORPORATES CONTROLS OVER THE VENTURE SUFFICIENT TO ENSURE THAT (1) THE EXEMPT ORGANIZATION AT ALL TIMES RETAINS CONTROL OVER THE VENTURE SUFFICIENT TO ENSURE THAT THE PARTNERSHIP FURTHERS THE EXEMPT PURPOSE OF THE ORGANIZATION; (2) IN ANY PARTNERSHIP IN WHICH THE EXEMPT ORGANIZATION IS A PARTNER, ACHIEVEMENT OF EXEMPT PURPOSES IS PRIORITIZED OVER MAXIMIZATION OF PROFITS FOR THE PARTNERS; (3) THE PARTNERSHIP DOES NOT ENGAGE IN ANY ACTIVITIES THAT WOULD JEOPARDIZE THE EXEMPT ORGANIZATION'S EXEMPTION; AND (4) RETURNS OF CAPITAL, ALLOCATIONS, AND DISTRIBUTIONS MUST BE MADE IN PROPORTION TO THE PARTNERS' RESPECTIVE OWNERSHIP INTERESTS. ANY JOINT VENTURE AGREEMENTS THAT DO NOT CONFORM TO THE MODEL AGREEMENT ARE GENERALLY REVIEWED BY COUNSEL. FORM 990, PART IX, LINE 11G OTHER FEES: PROGRAM SERVICE EXPENSES 55,444,020. MANAGEMENT AND GENERAL EXPENSES 13,861,005. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 69,305,025. CONTRACT LABOR: PROGRAM SERVICE EXPENSES 97,968,200. MANAGEMENT AND GENERAL EXPENSES 10,885,356. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 108,853,556. CONSULTING: PROGRAM SERVICE EXPENSES 2,914,194. MANAGEMENT AND GENERAL EXPENSES 4,371,291. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 7,285,485. CONTRACT SERVICES: PROGRAM SERVICE EXPENSES 71,882,759. MANAGEMENT AND GENERAL EXPENSES 47,921,839. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 119,804,598. PURCHASED SERVICES: PROGRAM SERVICE EXPENSES 19,810,471. MANAGEMENT AND GENERAL EXPENSES 2,201,163. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 22,011,634. FORM 990, PART XI, LINE 9: NONCONTROLLING INTEREST IN OWNERSHIP CHANGES -824,400. CAPITAL TRANSFERS -4,763,210. EQUITY CHANGES IN JOINT VENTURES 1,035,002. SERP LIABILITY ADJUSTMENT 428,769. 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