FRANCISCAN HEALTH RENSSELAER: Form 990, tax year 2022

View the entire original 990 at ProPublica ↗

Organization: FRANCISCAN HEALTH RENSSELAER (EIN 47-3825106)
Tax period: 2022-01-01 to 2022-12-31
Filed: 2023-11-15
IRS object ID: 202333199349322333
Schema version: 2022v5.0
Source: Download XML · Original 990 at ProPublica

Every field in the e-filed return. Faint text is the IRS element name, for citing.

Return header
Form 990
Schedule A
Schedule B
Schedule D
Schedule H
Schedule J
Schedule O
Schedule R

Return header ReturnHeader

Field	Value	IRS element (for citing)
Return	2023-11-15T15:37:19-06:00	ReturnTs
Tax Period End	2022-12-31	TaxPeriodEndDt

Preparer Firm PreparerFirmGrp

Preparer Firm Name PreparerFirmName

Field	Value	IRS element (for citing)
Business Name Line1	PwC US Tax LLP	BusinessNameLine1Txt

Preparer US Address PreparerUSAddress

Field	Value	IRS element (for citing)
Address Line1	2001 MARKET ST SUITE 1800	AddressLine1Txt
City	PHILADELPHIA	CityNm
State Abbreviation	PA	StateAbbreviationCd
ZIP	19103	ZIPCd

Field	Value	IRS element (for citing)
Return Type	990	ReturnTypeCd
Tax Period Begin	2022-01-01	TaxPeriodBeginDt

Filer Filer

Field	Value	IRS element (for citing)
EIN	473825106	EIN

Business Name BusinessName

Field	Value	IRS element (for citing)
Business Name Line1	FRANCISCAN HEALTH RENSSELAER INC	BusinessNameLine1Txt

Field	Value	IRS element (for citing)
In Care Of	% JASON GEDDES	InCareOfNm
Business Name Control	FRAN	BusinessNameControlTxt
Phone	2198665141	PhoneNum

US Address USAddress

Field	Value	IRS element (for citing)
Address Line1	1104 E GRACE ST	AddressLine1Txt
City	RENSSELAER	CityNm
State Abbreviation	IN	StateAbbreviationCd
ZIP	47978	ZIPCd

Business Officer BusinessOfficerGrp

Field	Value	IRS element (for citing)
Person	SISTER LETHIA MARIE LEVEILLE	PersonNm
Person Title	SECRETARY & TRUSTEE	PersonTitleTxt
Phone	5742563935	PhoneNum
Signature	2023-11-15	SignatureDt
Discuss With Paid Preparer	Yes (true)	DiscussWithPaidPreparerInd

Signing Officer SigningOfficerGrp

Person Full Name PersonFullName

Field	Value	IRS element (for citing)
Person First	SISTER LETHIA MARIE	PersonFirstNm
Person Last	LEVEILLE	PersonLastNm

Field	Value	IRS element (for citing)
SSN	999009999	SSN

Preparer Person PreparerPersonGrp

Field	Value	IRS element (for citing)
Preparer Person	ERIC M MCNEIL	PreparerPersonNm
PTIN	P00460263	PTIN
Phone	2673303000	PhoneNum
Preparation	2023-11-15	PreparationDt

Additional Filer Information AdditionalFilerInformation

Trusted Customer TrustedCustomerGrp

Field	Value	IRS element (for citing)
Trusted Customer	2	TrustedCustomerCd

Field	Value	IRS element (for citing)
Tax	2022	TaxYr
Build TS	2023-04-26 12:10:37Z	BuildTS

Form 990 IRS990

Field	Value	IRS element (for citing)
Principal Officer	KEVIN D LEAHY	PrincipalOfficerNm

US Address USAddress

Field	Value	IRS element (for citing)
Address Line1	1515 DRAGOON TRAIL	AddressLine1Txt
City	MISHAWAKA	CityNm
State Abbreviation	IN	StateAbbreviationCd
ZIP	46544	ZIPCd

Field	Value	IRS element (for citing)
Gross Receipts	$32,197,626	GrossReceiptsAmt
Group Return For Affiliates	false	GroupReturnForAffiliatesInd
Group Exemption	0928	GroupExemptionNum
Organization501c3	Yes (X)	Organization501c3Ind
Website Address	WWWW.FRANCISCANALLIANCE.ORG	WebsiteAddressTxt
Type Of Organization Corp	Yes (X)	TypeOfOrganizationCorpInd
Formation	2015	FormationYr
Legal Domicile State	IN	LegalDomicileStateCd
Activity Or Mission	SEE SCHEDULE O	ActivityOrMissionDesc
Voting Members Governing Body	5	VotingMembersGoverningBodyCnt
Voting Members Independent	4	VotingMembersIndependentCnt
Total Employee	186	TotalEmployeeCnt
Total Volunteers	6	TotalVolunteersCnt
Total Gross UBI	$11,885	TotalGrossUBIAmt
Net Unrelated Bus Txbl Incm	$0	NetUnrelatedBusTxblIncmAmt
PY Contributions Grants	$181,616	PYContributionsGrantsAmt
CY Contributions Grants	$286,464	CYContributionsGrantsAmt
PY Program Service Revenue	$33,677,037	PYProgramServiceRevenueAmt
CY Program Service Revenue	$31,890,726	CYProgramServiceRevenueAmt
PY Investment Income	$1,147	PYInvestmentIncomeAmt
CY Investment Income	$0	CYInvestmentIncomeAmt
PY Other Revenue	$20,356	PYOtherRevenueAmt
CY Other Revenue	$20,436	CYOtherRevenueAmt
PY Total Revenue	$33,880,156	PYTotalRevenueAmt
CY Total Revenue	$32,197,626	CYTotalRevenueAmt
PY Grants And Similar Paid	$0	PYGrantsAndSimilarPaidAmt
CY Grants And Similar Paid	$0	CYGrantsAndSimilarPaidAmt
PY Benefits Paid To Members	$0	PYBenefitsPaidToMembersAmt
CY Benefits Paid To Members	$0	CYBenefitsPaidToMembersAmt
PY Salaries Comp Emp Bnft Paid	$13,513,184	PYSalariesCompEmpBnftPaidAmt
CY Salaries Comp Emp Bnft Paid	$13,899,277	CYSalariesCompEmpBnftPaidAmt
PY Total Prof Fndrsng Expns	$0	PYTotalProfFndrsngExpnsAmt
CY Total Prof Fndrsng Expns	$0	CYTotalProfFndrsngExpnsAmt
CY Total Fundraising Expense	$0	CYTotalFundraisingExpenseAmt
PY Other Expenses	$23,705,341	PYOtherExpensesAmt
CY Other Expenses	$23,827,450	CYOtherExpensesAmt
PY Total Expenses	$37,218,525	PYTotalExpensesAmt
CY Total Expenses	$37,726,727	CYTotalExpensesAmt
PY Revenues Less Expenses	-$3,338,369	PYRevenuesLessExpensesAmt
CY Revenues Less Expenses	-$5,529,101	CYRevenuesLessExpensesAmt
Total Assets BOY	$23,707,166	TotalAssetsBOYAmt
Total Assets EOY	$21,765,388	TotalAssetsEOYAmt
Total Liabilities BOY	$49,319,152	TotalLiabilitiesBOYAmt
Total Liabilities EOY	$52,906,475	TotalLiabilitiesEOYAmt
Net Assets Or Fund Balances BOY	-$25,611,986	NetAssetsOrFundBalancesBOYAmt
Net Assets Or Fund Balances EOY	-$31,141,087	NetAssetsOrFundBalancesEOYAmt
Info In Schedule O Part III	Yes (X)	InfoInScheduleOPartIIIInd
Mission	SEE SCHEDULE O	MissionDesc
Significant New Program Srvc	false	SignificantNewProgramSrvcInd
Significant Change	false	SignificantChangeInd
Expense	$32,473,166	ExpenseAmt
Grant	$0	GrantAmt
Revenue	$31,817,223	RevenueAmt
Desc	FRANCISCAN HEALTH RENSSELAER, INC. IS A TWENTY-FIVE BED CRITICAL ACCESS HOSPITAL LOCATED IN RENSSELAER, INDIANA PROVIDING HEALTH ACCESS SERVICES TO THE RESIDENTS OF JASPER AND SURROUNDING COUNTIES. SERVICES PROVIDED INCLUDE INPATIENT AND OUTPATIENT MEDICAL, SURGICAL, EXTENDED CARE, DIAGNOSTIC, EMERGENCY CARE, AS WELL AS THE OPERATION OF TWO RURAL HEALTH CLINICS. SPECIALTY SERVICES INCLUDE CARDIOLOGY, ORTHOPEDICS, UROLOGY, AND ONCOLOGY.	Desc
Total Program Service Expenses	$32,473,166	TotalProgramServiceExpensesAmt
Described In Section501c3	Yes (true)	DescribedInSection501c3Ind
Schedule B Required	Yes (true)	ScheduleBRequiredInd
Political Campaign Acty	false	PoliticalCampaignActyInd
Lobbying Activities	false	LobbyingActivitiesInd
Subject To Proxy Tax	false	SubjectToProxyTaxInd
Donor Advised Fund	false	DonorAdvisedFundInd
Conservation Easements	false	ConservationEasementsInd
Collections Of Art	false	CollectionsOfArtInd
Credit Counseling	false	CreditCounselingInd
Donor Rstr Or Quasi Endowments	false	DonorRstrOrQuasiEndowmentsInd
Report Land Building Equipment	Yes (true)	ReportLandBuildingEquipmentInd
Report Investments Other Sec	false	ReportInvestmentsOtherSecInd
Report Program Related Invst	false	ReportProgramRelatedInvstInd
Report Other Assets	false	ReportOtherAssetsInd
Report Other Liabilities	Yes (true)	ReportOtherLiabilitiesInd
Include FIN48 Footnote	false	IncludeFIN48FootnoteInd
Independent Audit Fincl Stmt	false	IndependentAuditFinclStmtInd
Consolidated Audit Fincl Stmt	Yes (true)	ConsolidatedAuditFinclStmtInd
School Operating	false	SchoolOperatingInd
Foreign Office	false	ForeignOfficeInd
Foreign Activities	false	ForeignActivitiesInd
More Than5000 K To Org	false	MoreThan5000KToOrgInd
More Than5000 K To Individuals	false	MoreThan5000KToIndividualsInd
Professional Fundraising	false	ProfessionalFundraisingInd
Fundraising Activities	false	FundraisingActivitiesInd
Gaming Activities	false	GamingActivitiesInd
Operate Hospital	Yes (true)	OperateHospitalInd
Audited Financial Stmt Att	Yes (true)	AuditedFinancialStmtAttInd
Grants To Organizations	false	GrantsToOrganizationsInd
Grants To Individuals	false	GrantsToIndividualsInd
Schedule J Required	Yes (true)	ScheduleJRequiredInd
Tax Exempt Bonds	false	TaxExemptBondsInd
Engaged In Excess Benefit Trans	false	EngagedInExcessBenefitTransInd
PY Excess Benefit Trans	false	PYExcessBenefitTransInd
Loan Outstanding	false	LoanOutstandingInd
Grant To Related Person	false	GrantToRelatedPersonInd
Business Rln With Org Mem	false	BusinessRlnWithOrgMemInd
Business Rln With Fam Mem	false	BusinessRlnWithFamMemInd
Business Rln With35 Ctrl Ent	false	BusinessRlnWith35CtrlEntInd
Deductible Non Cash Contri	false	DeductibleNonCashContriInd
Deductible Art Contribution	false	DeductibleArtContributionInd
Terminate Operations	false	TerminateOperationsInd
Partial Liquidation	false	PartialLiquidationInd
Disregarded Entity	false	DisregardedEntityInd
Related Entity	Yes (true)	RelatedEntityInd
Related Organization Ctrl Ent	false	RelatedOrganizationCtrlEntInd
Trnsfr Exmpt Non Chrtbl Rltd Org	false	TrnsfrExmptNonChrtblRltdOrgInd
Activities Conducted Prtshp	false	ActivitiesConductedPrtshpInd
Schedule O Required	Yes (true)	ScheduleORequiredInd
IRP Document	82	IRPDocumentCnt
IRP Document W2 G	0	IRPDocumentW2GCnt
Backup Wthld Compliance	Yes (true)	BackupWthldComplianceInd
Employee	186	EmployeeCnt
Employment Tax Returns Filed	Yes (true)	EmploymentTaxReturnsFiledInd
Unrelated Bus Incm Over Limit	Yes (true)	UnrelatedBusIncmOverLimitInd
Form990 T Filed	Yes (true)	Form990TFiledInd
Foreign Financial Account	false	ForeignFinancialAccountInd
Prohibited Tax Shelter Trans	false	ProhibitedTaxShelterTransInd
Taxable Party Notification	false	TaxablePartyNotificationInd
Nondeductible Contributions	false	NondeductibleContributionsInd
Quid Pro Quo Contributions	false	QuidProQuoContributionsInd
Form8282 Property Disposed Of	false	Form8282PropertyDisposedOfInd
Rcv Fnds To Pay Prsnl Bnft Cntrct	false	RcvFndsToPayPrsnlBnftCntrctInd
Pay Premiums Prsnl Bnft Cntrct	false	PayPremiumsPrsnlBnftCntrctInd
Indoor Tanning Services	false	IndoorTanningServicesInd
Subj To Tax Rmnrtn Ex Prcht Pymt	false	SubjToTaxRmnrtnExPrchtPymtInd
Subject To Excs Tax Net Invst Inc	false	SubjectToExcsTaxNetInvstIncInd
Info In Schedule O Part VI	Yes (X)	InfoInScheduleOPartVIInd
Governing Body Voting Members	5	GoverningBodyVotingMembersCnt
Independent Voting Member	4	IndependentVotingMemberCnt
Family Or Business Rln	false	FamilyOrBusinessRlnInd
Delegation Of Mgmt Duties	false	DelegationOfMgmtDutiesInd
Change To Org Documents	false	ChangeToOrgDocumentsInd
Material Diversion Or Misuse	false	MaterialDiversionOrMisuseInd
Members Or Stockholders	Yes (true)	MembersOrStockholdersInd
Election Of Board Members	false	ElectionOfBoardMembersInd
Decisions Subject To Approva	Yes (true)	DecisionsSubjectToApprovaInd
Minutes Of Governing Body	Yes (true)	MinutesOfGoverningBodyInd
Minutes Of Committees	Yes (true)	MinutesOfCommitteesInd
Officer Mailing Address	false	OfficerMailingAddressInd
Local Chapters	false	LocalChaptersInd
Form990 Provided To Gvrn Body	Yes (true)	Form990ProvidedToGvrnBodyInd
Conflict Of Interest Policy	Yes (true)	ConflictOfInterestPolicyInd
Annual Disclosure Covered Prsn	Yes (true)	AnnualDisclosureCoveredPrsnInd
Regular Monitoring Enfrc	Yes (true)	RegularMonitoringEnfrcInd
Whistleblower Policy	false	WhistleblowerPolicyInd
Document Retention Policy	false	DocumentRetentionPolicyInd
Compensation Process CEO	false	CompensationProcessCEOInd
Compensation Process Other	false	CompensationProcessOtherInd
Investment In Joint Venture	false	InvestmentInJointVentureInd
States Where Copy Of Return Is Fld	IN	StatesWhereCopyOfReturnIsFldCd
Other Website	Yes (X)	OtherWebsiteInd
Upon Request	Yes (X)	UponRequestInd

Books In Care Of Detail BooksInCareOfDetail

Field	Value	IRS element (for citing)
Person	JASON GEDDES	PersonNm
Phone	7655024474	PhoneNum

US Address USAddress

Field	Value	IRS element (for citing)
Address Line1	1515 DRAGOON TRAIL	AddressLine1Txt
City	MISHAWAKA	CityNm
State Abbreviation	IN	StateAbbreviationCd
ZIP	46544	ZIPCd

Field	Value	IRS element (for citing)
Info In Schedule O Part VII	Yes (X)	InfoInScheduleOPartVIIInd

Form990 Part VII Section A Form990PartVIISectionAGrp (12 entries)

TitleTitleTxt	Average Hours Per WeekAverageHoursPerWeekRt	Average Hours Per Week Rltd OrgAverageHoursPerWeekRltdOrgRt	Individual Trustee Or DirectorIndividualTrusteeOrDirectorInd	OfficerOfficerInd	Reportable Comp From OrgReportableCompFromOrgAmt	Reportable Comp From Rltd OrgReportableCompFromRltdOrgAmt	Other CompensationOtherCompensationAmt	Highest Compensated EmployeeHighestCompensatedEmployeeInd
KEVIN D LEAHY
PRESIDENT & TRUSTEE	5.0	55.0	Yes (X)	Yes (X)	$0	$2,085,355	-$100,816
TERRANCE WILSON
FACILITY CEO/PRES OF HOSP DIV	5.0	40.0		Yes (X)	$0	$831,800	-$12,123
AGNES THERADY
SENIOR VICE PRESIDENT CNO	5.0	40.0		Yes (X)	$0	$473,178	$33,221
KARI L GOODMAN
DIRECTOR PATIENT CARE SERVICES	40.0	0.0			$137,807	$0	$14,333	Yes (X)
SUSAN L HOOKER
MANAGER PHARMACY SERVICES	40.0	0.0			$132,810	$0	$15,238	Yes (X)
AMY J SIGNMAN
REGISTERED NURSE	40.0	0.0			$127,341	$0	$7,507	Yes (X)
CYNTHIA J REED
IMAGING MANAGER	40.0	0.0			$113,461	$0	$15,724	Yes (X)
ERIN A WILLIAMSON
MANAGER THERAPY SERVICES	40.0	0.0			$109,155	$0	$15,259	Yes (X)
SISTER JANE MARIE KLEIN
CHAIR & TRUSTEE	5.0	55.0	Yes (X)		$0	$0	$0
SISTER M ANN KATHLEEN MAGIERA
TREASURER & TRUSTEE	5.0	50.0	Yes (X)	Yes (X)	$0	$0	$0
SISTER M MADONNA ROUGEAU
TRUSTEE	5.0	50.0	Yes (X)		$0	$0	$0
SISTER LETHIA MARIE LEVEILLE
SECRETARY & TRUSTEE	5.0	55.0	Yes (X)	Yes (X)	$0	$0	$0

Field	Value	IRS element (for citing)
Total Reportable Comp From Org	$620,574	TotalReportableCompFromOrgAmt
Tot Reportable Comp Rltd Org	$3,390,333	TotReportableCompRltdOrgAmt
Total Other Compensation	-$11,657	TotalOtherCompensationAmt
Indiv Rcvd Greater Than100 K	14	IndivRcvdGreaterThan100KCnt
Former Ofcr Employees Listed	false	FormerOfcrEmployeesListedInd
Total Comp Greater Than150 K	Yes (true)	TotalCompGreaterThan150KInd
Compensation From Other Srcs	false	CompensationFromOtherSrcsInd

Contractor Compensation ContractorCompensationGrp (5 entries)

Address Line1ContractorAddress/USAddress/AddressLine1Txt	CityContractorAddress/USAddress/CityNm	State AbbreviationContractorAddress/USAddress/StateAbbreviationCd	ZIPContractorAddress/USAddress/ZIPCd	ServicesServicesDesc	CompensationCompensationAmt
TONN BLANK CONSTRUCTIONLLC
1623 GREENWOOD AVE	MICHIGAN CITY	IN	46360	MAINTENANCE	$553,309
HEALTHTRUST WORKFORCE SOLUTIONS
3322 W END AVE STE 201	NASHVILLE	TN	37203	CONTRACT LABOR	$546,013
UROLOGIC SURGERY ASSOCIATES LLC
400 W 84TH DR	MERRILLVILLE	IN	46410	PHYSICIAN SERVICES	$253,260
CANON MEDICAL SYSTEMS CORPORATION
2441 MICHELLE DRIVE	TUSTIN	CA	92780	MAINTENANCE/SRV CONT	$183,912
UNITY HEALTHCARE LLC
1250 S CREASY LN	LAFAYETTE	IN	47905	PHYSICIAN SERVICES	$149,638

Field	Value	IRS element (for citing)
Cntrct Rcvd Greater Than100 K	5	CntrctRcvdGreaterThan100KCnt
Related Organizations	$286,464	RelatedOrganizationsAmt
Total Contributions	$286,464	TotalContributionsAmt

Program Service Revenue ProgramServiceRevenueGrp (2 entries)

DescDesc	BusinessBusinessCd	Total Revenue ColumnTotalRevenueColumnAmt	Related Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt	ExclusionExclusionAmt
PATIENT SERVICE AND OTHER REVENUES	622110	$31,817,223	$31,817,223
CAFETERIA	622110	$73,503		$73,503

Field	Value	IRS element (for citing)
Total Program Service Revenue	$31,890,726	TotalProgramServiceRevenueAmt

Investment Income InvestmentIncomeGrp

Field	Value	IRS element (for citing)
Total Revenue Column	$0	TotalRevenueColumnAmt

Incm From Invest Bond Proceeds IncmFromInvestBondProceedsGrp

Field	Value	IRS element (for citing)
Total Revenue Column	$0	TotalRevenueColumnAmt

Royalties Revenue RoyaltiesRevenueGrp

Field	Value	IRS element (for citing)
Total Revenue Column	$0	TotalRevenueColumnAmt

Gross Rents GrossRentsGrp

Field	Value	IRS element (for citing)
Real	$8,551	RealAmt

Rental Income Or Loss RentalIncomeOrLossGrp

Field	Value	IRS element (for citing)
Real	$8,551	RealAmt
Personal	$0	PersonalAmt

Net Rental Income Or Loss NetRentalIncomeOrLossGrp

Field	Value	IRS element (for citing)
Total Revenue Column	$8,551	TotalRevenueColumnAmt
Exclusion	$8,551	ExclusionAmt

Gross Amount Sales Assets GrossAmountSalesAssetsGrp

Field	Value	IRS element (for citing)
Other	$0	OtherAmt

Gain Or Loss GainOrLossGrp

Field	Value	IRS element (for citing)
Other	$0	OtherAmt

Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp

Field	Value	IRS element (for citing)
Total Revenue Column	$0	TotalRevenueColumnAmt

Field	Value	IRS element (for citing)
Fundraising Gross Income	$0	FundraisingGrossIncomeAmt
Fundraising Direct Expenses	$0	FundraisingDirectExpensesAmt

Net Incm From Fundraising Evt NetIncmFromFundraisingEvtGrp

Field	Value	IRS element (for citing)
Total Revenue Column	$0	TotalRevenueColumnAmt

Field	Value	IRS element (for citing)
Gaming Gross Income	$0	GamingGrossIncomeAmt
Gaming Direct Expenses	$0	GamingDirectExpensesAmt

Net Income From Gaming NetIncomeFromGamingGrp

Field	Value	IRS element (for citing)
Total Revenue Column	$0	TotalRevenueColumnAmt

Field	Value	IRS element (for citing)
Gross Sales Of Inventory	$0	GrossSalesOfInventoryAmt
Cost Of Goods Sold	$0	CostOfGoodsSoldAmt

Net Income Or Loss NetIncomeOrLossGrp

Field	Value	IRS element (for citing)
Total Revenue Column	$0	TotalRevenueColumnAmt

Other Revenue Misc OtherRevenueMiscGrp

Field	Value	IRS element (for citing)
Desc	LABORATORY	Desc
Business	900099	BusinessCd
Total Revenue Column	$11,885	TotalRevenueColumnAmt
Unrelated Business Revenue	$11,885	UnrelatedBusinessRevenueAmt

Field	Value	IRS element (for citing)
Other Revenue Total	$11,885	OtherRevenueTotalAmt

Total Revenue TotalRevenueGrp

Field	Value	IRS element (for citing)
Total Revenue Column	$32,197,626	TotalRevenueColumnAmt
Related Or Exempt Func Income	$31,817,223	RelatedOrExemptFuncIncomeAmt
Unrelated Business Revenue	$11,885	UnrelatedBusinessRevenueAmt
Exclusion	$82,054	ExclusionAmt

Field	Value	IRS element (for citing)
Info In Schedule O Part IX	Yes (X)	InfoInScheduleOPartIXInd

Grants To Domestic Orgs GrantsToDomesticOrgsGrp

Field	Value	IRS element (for citing)
Total	$0	TotalAmt

Grants To Domestic Individuals GrantsToDomesticIndividualsGrp

Field	Value	IRS element (for citing)
Total	$0	TotalAmt

Foreign Grants ForeignGrantsGrp

Field	Value	IRS element (for citing)
Total	$0	TotalAmt

Benefits To Members BenefitsToMembersGrp

Field	Value	IRS element (for citing)
Total	$0	TotalAmt

Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp

Field	Value	IRS element (for citing)
Total	$0	TotalAmt

Comp Disqual Persons CompDisqualPersonsGrp

Field	Value	IRS element (for citing)
Total	$0	TotalAmt

Other Salaries And Wages OtherSalariesAndWagesGrp

Field	Value	IRS element (for citing)
Total	$10,491,844	TotalAmt
Program Services	$9,611,045	ProgramServicesAmt
Management And General	$880,799	ManagementAndGeneralAmt

Pension Plan Contributions PensionPlanContributionsGrp

Field	Value	IRS element (for citing)
Total	$454,018	TotalAmt
Program Services	$415,903	ProgramServicesAmt
Management And General	$38,115	ManagementAndGeneralAmt

Other Employee Benefits OtherEmployeeBenefitsGrp

Field	Value	IRS element (for citing)
Total	$2,277,880	TotalAmt
Program Services	$2,086,650	ProgramServicesAmt
Management And General	$191,230	ManagementAndGeneralAmt

Payroll Taxes PayrollTaxesGrp

Field	Value	IRS element (for citing)
Total	$675,535	TotalAmt
Program Services	$618,823	ProgramServicesAmt
Management And General	$56,712	ManagementAndGeneralAmt

Fees For Services Management FeesForServicesManagementGrp

Field	Value	IRS element (for citing)
Total	$0	TotalAmt

Fees For Services Legal FeesForServicesLegalGrp

Field	Value	IRS element (for citing)
Total	$0	TotalAmt

Fees For Services Accounting FeesForServicesAccountingGrp

Field	Value	IRS element (for citing)
Total	$0	TotalAmt

Fees For Services Lobbying FeesForServicesLobbyingGrp

Field	Value	IRS element (for citing)
Total	$0	TotalAmt

Fees For Services Prof Fundraising FeesForServicesProfFundraising

Field	Value	IRS element (for citing)
Total	$0	TotalAmt

Fees For Srvc Invst Mgmnt Fees FeesForSrvcInvstMgmntFeesGrp

Field	Value	IRS element (for citing)
Total	$0	TotalAmt

Fees For Services Other FeesForServicesOtherGrp

Field	Value	IRS element (for citing)
Total	$1,535,558	TotalAmt
Program Services	$1,495,940	ProgramServicesAmt
Management And General	$39,618	ManagementAndGeneralAmt

Advertising AdvertisingGrp

Field	Value	IRS element (for citing)
Total	$15,133	TotalAmt
Program Services	$13,618	ProgramServicesAmt
Management And General	$1,515	ManagementAndGeneralAmt

Office Expenses OfficeExpensesGrp

Field	Value	IRS element (for citing)
Total	$21,645	TotalAmt
Program Services	$12,771	ProgramServicesAmt
Management And General	$8,874	ManagementAndGeneralAmt

Information Technology InformationTechnologyGrp

Field	Value	IRS element (for citing)
Total	$22,996	TotalAmt
Program Services	$22,996	ProgramServicesAmt

Royalties RoyaltiesGrp

Field	Value	IRS element (for citing)
Total	$0	TotalAmt

Occupancy OccupancyGrp

Field	Value	IRS element (for citing)
Total	$29,800	TotalAmt
Program Services	$29,800	ProgramServicesAmt

Travel TravelGrp

Field	Value	IRS element (for citing)
Total	$24,111	TotalAmt
Program Services	$17,478	ProgramServicesAmt
Management And General	$6,633	ManagementAndGeneralAmt

Pymt Travel Entrtnmnt Pub Ofcl PymtTravelEntrtnmntPubOfclGrp

Field	Value	IRS element (for citing)
Total	$0	TotalAmt

Conferences Meetings ConferencesMeetingsGrp

Field	Value	IRS element (for citing)
Total	$7,088	TotalAmt
Program Services	$4,304	ProgramServicesAmt
Management And General	$2,784	ManagementAndGeneralAmt

Interest InterestGrp

Field	Value	IRS element (for citing)
Total	$803,284	TotalAmt
Program Services	$803,284	ProgramServicesAmt

Payments To Affiliates PaymentsToAffiliatesGrp

Field	Value	IRS element (for citing)
Total	$0	TotalAmt

Depreciation Depletion DepreciationDepletionGrp

Field	Value	IRS element (for citing)
Total	$2,786,543	TotalAmt
Program Services	$2,202,036	ProgramServicesAmt
Management And General	$584,507	ManagementAndGeneralAmt

Insurance InsuranceGrp

Field	Value	IRS element (for citing)
Total	$262,699	TotalAmt
Program Services	$258,056	ProgramServicesAmt
Management And General	$4,643	ManagementAndGeneralAmt

Other Expenses OtherExpensesGrp (4 entries)

DescDesc	TotalTotalAmt	Program ServicesProgramServicesAmt	Management And GeneralManagementAndGeneralAmt
CORPORATE ASSESSMENT	$4,101,858	$3,648,339	$453,519
PURCHASED SERVICES	$5,298,835	$4,030,173	$1,268,662
MEDICAL SUPPLIES/DRUGS	$3,658,574	$3,617,288	$41,286
HAF	$1,528,997	$1,528,997	$0

All Other Expenses AllOtherExpensesGrp

Field	Value	IRS element (for citing)
Total	$3,730,329	TotalAmt
Program Services	$2,055,665	ProgramServicesAmt
Management And General	$1,674,664	ManagementAndGeneralAmt

Total Functional Expenses TotalFunctionalExpensesGrp

Field	Value	IRS element (for citing)
Total	$37,726,727	TotalAmt
Program Services	$32,473,166	ProgramServicesAmt
Management And General	$5,253,561	ManagementAndGeneralAmt
Fundraising	$0	FundraisingAmt

Cash Non Interest Bearing CashNonInterestBearingGrp

Field	Value	IRS element (for citing)
BOY	$1,100	BOYAmt
EOY	$111,019	EOYAmt

Savings And Temp Cash Invst SavingsAndTempCashInvstGrp

Field	Value	IRS element (for citing)
BOY	$0	BOYAmt
EOY	$0	EOYAmt

Pledges And Grants Receivable PledgesAndGrantsReceivableGrp

Field	Value	IRS element (for citing)
BOY	$0	BOYAmt
EOY	$0	EOYAmt

Accounts Receivable AccountsReceivableGrp

Field	Value	IRS element (for citing)
BOY	$4,431,577	BOYAmt
EOY	$4,766,091	EOYAmt

Receivables From Officers Etc ReceivablesFromOfficersEtcGrp

Field	Value	IRS element (for citing)
BOY	$0	BOYAmt
EOY	$0	EOYAmt

Rcvbl From Disqualified Prsn RcvblFromDisqualifiedPrsnGrp

Field	Value	IRS element (for citing)
BOY	$0	BOYAmt
EOY	$0	EOYAmt

Oth Notes Loans Receivable Net OthNotesLoansReceivableNetGrp

Field	Value	IRS element (for citing)
BOY	$0	BOYAmt
EOY	$0	EOYAmt

Inventories For Sale Or Use InventoriesForSaleOrUseGrp

Field	Value	IRS element (for citing)
BOY	$770,320	BOYAmt
EOY	$813,608	EOYAmt

Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp

Field	Value	IRS element (for citing)
BOY	$0	BOYAmt
EOY	$68,638	EOYAmt

Field	Value	IRS element (for citing)
Land Bldg Equip Cost Or Other Bss	$33,320,954	LandBldgEquipCostOrOtherBssAmt
Land Bldg Equip Accum Deprec	$17,679,370	LandBldgEquipAccumDeprecAmt

Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp

Field	Value	IRS element (for citing)
BOY	$17,447,103	BOYAmt
EOY	$15,641,584	EOYAmt

Investments Pub Traded Sec InvestmentsPubTradedSecGrp

Field	Value	IRS element (for citing)
BOY	$0	BOYAmt
EOY	$0	EOYAmt

Investments Other Securities InvestmentsOtherSecuritiesGrp

Field	Value	IRS element (for citing)
BOY	$83,413	BOYAmt
EOY	$83,413	EOYAmt

Investments Program Related InvestmentsProgramRelatedGrp

Field	Value	IRS element (for citing)
BOY	$0	BOYAmt
EOY	$0	EOYAmt

Intangible Assets IntangibleAssetsGrp

Field	Value	IRS element (for citing)
BOY	$0	BOYAmt
EOY	$0	EOYAmt

Other Assets Total OtherAssetsTotalGrp

Field	Value	IRS element (for citing)
BOY	$973,653	BOYAmt
EOY	$281,035	EOYAmt

Total Assets TotalAssetsGrp

Field	Value	IRS element (for citing)
BOY	$23,707,166	BOYAmt
EOY	$21,765,388	EOYAmt

Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp

Field	Value	IRS element (for citing)
BOY	$2,534,464	BOYAmt
EOY	$2,453,937	EOYAmt

Grants Payable GrantsPayableGrp

Field	Value	IRS element (for citing)
BOY	$0	BOYAmt
EOY	$0	EOYAmt

Deferred Revenue DeferredRevenueGrp

Field	Value	IRS element (for citing)
BOY	$0	BOYAmt
EOY	$0	EOYAmt

Tax Exempt Bond Liabilities TaxExemptBondLiabilitiesGrp

Field	Value	IRS element (for citing)
BOY	$0	BOYAmt
EOY	$0	EOYAmt

Escrow Account Liability EscrowAccountLiabilityGrp

Field	Value	IRS element (for citing)
BOY	$0	BOYAmt
EOY	$0	EOYAmt

Loans From Officers Directors LoansFromOfficersDirectorsGrp

Field	Value	IRS element (for citing)
BOY	$0	BOYAmt
EOY	$0	EOYAmt

Mortg Notes Pybl Scrd Invst Prop MortgNotesPyblScrdInvstPropGrp

Field	Value	IRS element (for citing)
BOY	$0	BOYAmt
EOY	$0	EOYAmt

Unsecured Notes Loans Payable UnsecuredNotesLoansPayableGrp

Field	Value	IRS element (for citing)
BOY	$0	BOYAmt
EOY	$0	EOYAmt

Other Liabilities OtherLiabilitiesGrp

Field	Value	IRS element (for citing)
BOY	$46,784,688	BOYAmt
EOY	$50,452,538	EOYAmt

Total Liabilities TotalLiabilitiesGrp

Field	Value	IRS element (for citing)
BOY	$49,319,152	BOYAmt
EOY	$52,906,475	EOYAmt

Field	Value	IRS element (for citing)
Organization Follows FASB117	Yes (X)	OrganizationFollowsFASB117Ind

No Donor Restriction Net Assets NoDonorRestrictionNetAssetsGrp

Field	Value	IRS element (for citing)
BOY	-$25,695,399	BOYAmt
EOY	-$31,224,500	EOYAmt

Donor Restriction Net Assets DonorRestrictionNetAssetsGrp

Field	Value	IRS element (for citing)
BOY	$83,413	BOYAmt
EOY	$83,413	EOYAmt

Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp

Field	Value	IRS element (for citing)
BOY	-$25,611,986	BOYAmt
EOY	-$31,141,087	EOYAmt

Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp

Field	Value	IRS element (for citing)
BOY	$23,707,166	BOYAmt
EOY	$21,765,388	EOYAmt

Field	Value	IRS element (for citing)
Reconcilation Revenue Expnss	-$5,529,101	ReconcilationRevenueExpnssAmt
Other Changes In Net Assets	$0	OtherChangesInNetAssetsAmt
Method Of Accounting Accrual	Yes (X)	MethodOfAccountingAccrualInd
Accountant Compile Or Review	false	AccountantCompileOrReviewInd
FS Audited	Yes (true)	FSAuditedInd

FS Audited Basis FSAuditedBasisGrp

Field	Value	IRS element (for citing)
Consolidated Basis Fincl Stmt	Yes (X)	ConsolidatedBasisFinclStmtInd

Field	Value	IRS element (for citing)
Audit Committee	Yes (true)	AuditCommitteeInd
Federal Grant Audit Required	false	FederalGrantAuditRequiredInd

Schedule A IRS990ScheduleA

Field	Value	IRS element (for citing)
Hospital	Yes (X)	HospitalInd

Schedule B IRS990ScheduleB

Contributor Information ContributorInformationGrp

Field	Value	IRS element (for citing)
Contributor	RESTRICTED	ContributorNum

Contributor Business Name ContributorBusinessName

Field	Value	IRS element (for citing)
Business Name Line1	RESTRICTED	BusinessNameLine1

Contributor US Address ContributorUSAddress

Field	Value	IRS element (for citing)
Address Line1	RESTRICTED	AddressLine1
Address Line2	RESTRICTED	AddressLine2
City	RESTRICTED	City
State	RESTRICTED	State
ZIP Code	RESTRICTED	ZIPCode

Field	Value	IRS element (for citing)
Total Contributions	RESTRICTED	TotalContributionsAmt

Schedule D IRS990ScheduleD

Field	Value	IRS element (for citing)
Art Public Exhibition Amounts		ArtPublicExhibitionAmountsGrp
Held Works Art		HeldWorksArtGrp
CY Minus3 Yr Endwmt Fund		CYMinus3YrEndwmtFundGrp
CY Minus4 Yr Endwmt Fund		CYMinus4YrEndwmtFundGrp

Land LandGrp

Field	Value	IRS element (for citing)
Other Cost Or Other Basis	$675,791	OtherCostOrOtherBasisAmt
Book Value	$675,791	BookValueAmt

Buildings BuildingsGrp

Field	Value	IRS element (for citing)
Other Cost Or Other Basis	$20,474,734	OtherCostOrOtherBasisAmt
Depreciation	$8,257,022	DepreciationAmt
Book Value	$12,217,712	BookValueAmt

Leasehold Improvements LeaseholdImprovementsGrp

Field	Value	IRS element (for citing)
Other Cost Or Other Basis	$0	OtherCostOrOtherBasisAmt
Depreciation	$0	DepreciationAmt

Equipment EquipmentGrp

Field	Value	IRS element (for citing)
Other Cost Or Other Basis	$12,170,429	OtherCostOrOtherBasisAmt
Depreciation	$9,422,348	DepreciationAmt
Book Value	$2,748,081	BookValueAmt

Other Land Buildings OtherLandBuildingsGrp

Field	Value	IRS element (for citing)
Other Cost Or Other Basis	$0	OtherCostOrOtherBasisAmt
Depreciation	$0	DepreciationAmt
Book Value	$0	BookValueAmt

Field	Value	IRS element (for citing)
Total Book Value Land Buildings	$15,641,584	TotalBookValueLandBuildingsAmt
Federal Income Tax Liability	$0	FederalIncomeTaxLiabilityAmt

Other Liabilities Org OtherLiabilitiesOrgGrp (5 entries)

DescDesc	AmtAmt
DUE TO THIRD PARTY PAYORS	$5,415,700
ESTIMATED INSURANCE LIABILITY	$116,990
OTHER LIABILITIES	$1,730,550
PAYABLE TO RELATED PARTY	$41,689,298
ASSET RETIREMENT OBLIGATION	$1,500,000

Field	Value	IRS element (for citing)
Total Liability	$50,452,538	TotalLiabilityAmt

Schedule H IRS990ScheduleH

Field	Value	IRS element (for citing)
Financial Assistance Policy	Yes (true)	FinancialAssistancePolicyInd
Written Policy	Yes (true)	WrittenPolicyInd
All Hospitals Policy	Yes (X)	AllHospitalsPolicyInd
FPG Reference Free Care	Yes (true)	FPGReferenceFreeCareInd
Percent200	Yes (X)	Percent200Ind
FPG Reference Discounted Care	Yes (true)	FPGReferenceDiscountedCareInd
Percent400	Yes (X)	Percent400Ind
Free Care Medically Indigent	Yes (true)	FreeCareMedicallyIndigentInd
Financial Assistance Budget	Yes (true)	FinancialAssistanceBudgetInd
Expenses Exceed Budget	Yes (true)	ExpensesExceedBudgetInd
Unable To Provide Care	false	UnableToProvideCareInd
Annual Community Bnft Report	Yes (true)	AnnualCommunityBnftReportInd
Report Publically Available	Yes (true)	ReportPublicallyAvailableInd

Financial Assistance At Cost Typ FinancialAssistanceAtCostTyp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$1,093,129	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$0	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$1,093,129	NetCommunityBenefitExpnsAmt
Total Expense	0.02900	TotalExpensePct

Unreimbursed Medicaid UnreimbursedMedicaidGrp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$9,428,636	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$5,666,222	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$3,762,414	NetCommunityBenefitExpnsAmt
Total Expense	0.09970	TotalExpensePct

Total Financial Assistance Typ TotalFinancialAssistanceTyp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$10,521,765	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$5,666,222	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$4,855,543	NetCommunityBenefitExpnsAmt
Total Expense	0.12870	TotalExpensePct

Community Health Services CommunityHealthServicesGrp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$117,886	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$0	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$117,886	NetCommunityBenefitExpnsAmt
Total Expense	0.00310	TotalExpensePct

Subsidized Health Services SubsidizedHealthServicesGrp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$951,199	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$865,291	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$85,908	NetCommunityBenefitExpnsAmt
Total Expense	0.00230	TotalExpensePct

Cash And In Kind Contributions CashAndInKindContributionsGrp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$1,872	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$0	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$1,872	NetCommunityBenefitExpnsAmt
Total Expense	0.00010	TotalExpensePct

Total Other Benefits TotalOtherBenefitsGrp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$1,070,957	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$865,291	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$205,666	NetCommunityBenefitExpnsAmt
Total Expense	0.00550	TotalExpensePct

Total Community Benefits TotalCommunityBenefitsGrp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$11,592,722	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$6,531,513	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$5,061,209	NetCommunityBenefitExpnsAmt
Total Expense	0.13420	TotalExpensePct

Field	Value	IRS element (for citing)
Bad Debt Expense Reported	Yes (true)	BadDebtExpenseReportedInd
Bad Debt Expense	$244,892	BadDebtExpenseAmt
Reimbursed By Medicare	$18,199,417	ReimbursedByMedicareAmt
Cost Of Care Reimbursed By Medcr	$21,382,271	CostOfCareReimbursedByMedcrAmt
Medicare Surplus Or Shortfall	-$3,182,854	MedicareSurplusOrShortfallAmt

Costing Methodology Used CostingMethodologyUsedGrp

Field	Value	IRS element (for citing)
Cost To Charge Ratio	Yes (X)	CostToChargeRatioInd

Field	Value	IRS element (for citing)
Written Debt Collection Policy	Yes (true)	WrittenDebtCollectionPolicyInd
Financial Assistance Prvsn	Yes (true)	FinancialAssistancePrvsnInd
Hospital Facilities	1	HospitalFacilitiesCnt

Hospital Facilities HospitalFacilitiesGrp

Field	Value	IRS element (for citing)
Facility	1	FacilityNum

Business Name BusinessName

Field	Value	IRS element (for citing)
Business Name Line1	FRANCISCAN HEALTH RENSSELAER INC	BusinessNameLine1Txt

US Address USAddress

Field	Value	IRS element (for citing)
Address Line1	1104 E GRACE ST	AddressLine1Txt
City	RENSSELAER	CityNm
State Abbreviation	IN	StateAbbreviationCd
ZIP	47978	ZIPCd

Field	Value	IRS element (for citing)
Website Address	WWW.FRANCISCANALLIANCE.ORG/HOSPITALS	WebsiteAddressTxt
State License	15-005072-1	StateLicenseNum
Licensed Hospital	Yes (X)	LicensedHospitalInd
Critical Access Hospital	Yes (X)	CriticalAccessHospitalInd
Emergency Room24 Hrs	Yes (X)	EmergencyRoom24HrsInd

Hospital Fclty Policies Prctc HospitalFcltyPoliciesPrctcGrp

Hospital Facility Name HospitalFacilityName

Field	Value	IRS element (for citing)
Business Name Line1	FRANCISCAN HEALTH RENSSELAER INC	BusinessNameLine1Txt

Field	Value	IRS element (for citing)
First Licensed CY Or PY	false	FirstLicensedCYOrPYInd
Tax Exempt Hospital CY Or PY	false	TaxExemptHospitalCYOrPYInd
CHNA Conducted	Yes (true)	CHNAConductedInd
Community Definition	Yes (X)	CommunityDefinitionInd
Community Demographics	Yes (X)	CommunityDemographicsInd
Existing Resources	Yes (X)	ExistingResourcesInd
How Data Obtained	Yes (X)	HowDataObtainedInd
Community Health Needs	Yes (X)	CommunityHealthNeedsInd
Other Health Issues	Yes (X)	OtherHealthIssuesInd
Community Hlth Needs Id Process	Yes (X)	CommunityHlthNeedsIdProcessInd
Consulting Process	Yes (X)	ConsultingProcessInd
Prior CHNA Impact	Yes (X)	PriorCHNAImpactInd
CHNA Conducted	22	CHNAConductedYr
Take Into Account Others Input	Yes (true)	TakeIntoAccountOthersInputInd
CHNA Conducted With Other Fclts	false	CHNAConductedWithOtherFcltsInd
CHNA Conducted With Non Fclts	false	CHNAConductedWithNonFcltsInd
CHNA Report Widely Available	Yes (true)	CHNAReportWidelyAvailableInd
Rpt Available On Own Website	Yes (X)	RptAvailableOnOwnWebsiteInd
Own Website URL	SEE PART V-C	OwnWebsiteURLTxt
Paper Copy Public Inspection	Yes (X)	PaperCopyPublicInspectionInd
Implementation Strategy Adopt	Yes (true)	ImplementationStrategyAdoptInd
Implementation Strategy Adpt	22	ImplementationStrategyAdptYr
Strategy Posted Website	Yes (true)	StrategyPostedWebsiteInd
Strategy Website URL	SEE PART V-C	StrategyWebsiteURLTxt
Organization Incur Excise Tax	false	OrganizationIncurExciseTaxInd
Elig Criteria Explained	Yes (true)	EligCriteriaExplainedInd
FPG Family Incm Lmt Free Dscnt	Yes (X)	FPGFamilyIncmLmtFreeDscntInd
FPG Family Incm Lmt Free Care	200.	FPGFamilyIncmLmtFreeCarePct
FPG Family Incm Lmt Dscnt Care	400.	FPGFamilyIncmLmtDscntCarePct
Asset Level Criteria	Yes (X)	AssetLevelCriteriaInd
Medical Indigency Criteria	Yes (X)	MedicalIndigencyCriteriaInd
Underinsurance Stat Criteria	Yes (X)	UnderinsuranceStatCriteriaInd
Explained Basis	Yes (true)	ExplainedBasisInd
App Financial Asst Expln	Yes (true)	AppFinancialAsstExplnInd
Described Info	Yes (X)	DescribedInfoInd
Described Suprt Doc	Yes (X)	DescribedSuprtDocInd
Provided Hospital Contact	Yes (X)	ProvidedHospitalContactInd
Includes Publicity Measures	Yes (true)	IncludesPublicityMeasuresInd
FAP Available On Website	Yes (X)	FAPAvailableOnWebsiteInd
FAP Available On Website URL	SEE SECTION C	FAPAvailableOnWebsiteURLTxt
FAP App Available On Website	Yes (X)	FAPAppAvailableOnWebsiteInd
FAP App Available On Website URL	SEE SECTION C	FAPAppAvailableOnWebsiteURLTxt
FAP Summary On Website	Yes (X)	FAPSummaryOnWebsiteInd
FAP Summary On Website URL	SEE SECTION C	FAPSummaryOnWebsiteURLTxt
FAP Avlbl On Request No Charge	Yes (X)	FAPAvlblOnRequestNoChargeInd
FAP App Avlbl On Request No Chrg	Yes (X)	FAPAppAvlblOnRequestNoChrgInd
FAP Sum Avlbl On Request No Chrg	Yes (X)	FAPSumAvlblOnRequestNoChrgInd
Notified FAP Copy Bill Display	Yes (X)	NotifiedFAPCopyBillDisplayInd
FAP Translated	Yes (X)	FAPTranslatedInd
FAP Actions On Nonpayment	Yes (true)	FAPActionsOnNonpaymentInd
Permit No Actions	Yes (X)	PermitNoActionsInd
Collection Activities	false	CollectionActivitiesInd
Provided Written Notice	Yes (X)	ProvidedWrittenNoticeInd
Made Effort Orally Notify	Yes (X)	MadeEffortOrallyNotifyInd
Processed FAP Application	Yes (X)	ProcessedFAPApplicationInd
Made Presumptive Elig Determ	Yes (X)	MadePresumptiveEligDetermInd
Nondis Emergency Care Policy	Yes (true)	NondisEmergencyCarePolicyInd
Look Back Medicare Private	Yes (X)	LookBackMedicarePrivateInd
Amounts Generally Billed	false	AmountsGenerallyBilledInd
Gross Charges	false	GrossChargesInd

Supplemental Information SupplementalInformationGrp (8 entries)

Form And Line ReferenceFormAndLineReferenceDesc	ExplanationExplanationTxt
LINE 3E	PLEASE SEE THE RESPONSE TO SCHEDULE H, PART V, LINE 11 BELOW FOR AN EXPLANATION OF HOW THE HEALTH NEEDS IDENTIFIED IN THE CHNA WERE PRIORITIZED.
LINE 5: INPUT FROM INDIVIDUALS IN THE COMMUNITY	FOR THE 2018-2021 CHNA, AN EXTENSIVE SURVEY WAS DEPLOYED FOLLOWING THIS PROCESS AND METHODOLOGY: TO COLLECT PRIMARY DATA FROM THE HOSPITAL'S SERVICE AREA POPULATION, A SURVEY WAS DESIGNED, FIELDED, AND ANALYZED TO ENSURE THAT THE PERSPECTIVES OF THE RESIDENTS OF THE SERVICE AREA WERE INCLUDED IN THIS ASSESSMENT, THE HOSPITAL USED A RIGOROUS POPULATION-BASED METHODOLOGICAL APPROACH TO COVER THE SERVICE AREA. TO DEVELOP THE SURVEY USED FOR THE CHNA, THE HOSPITAL PARTNERED WITH FACULTY FROM INDIANA-BASED UNIVERSITIES WHO HAD PARTICULAR EXPERTISE IN COMMUNITY-BASED SURVEY RESEARCH. DR. WILLIAM MCCONNELL OF THE UNIVERSITY OF EVANSVILLE SERVED AS THE LEAD RESEARCHER ON THE PROJECT, IN PARTNERSHIP WITH DR. MICHAEL REECE AND DR. CATHERINE SHERWOOD-LAUGHLIN (BOTH OF THE INDIANA UNIVERSITY SCHOOL OF PUBLIC HEALTH). THE UNIVERSITY OF EVANSVILLE CONTRACTED WITH THE CENTER FOR SURVEY RESEARCH (CSR) AT INDIANA UNIVERSITY TO ADMINISTER THIS SURVEY IN TWO PHASES: PHASE I WAS CONDUCTED AS A PAPER SURVEY MAILED TO A RANDOM ADDRESS-BASED SAMPLE AND PHASE II WAS CONDUCTED AS A PAPER SURVEY ADMINISTERED BY THE HOSPITALS TO A CONVENIENCE SAMPLE OF THEIR CHOOSING. THE SURVEY WAS CONDUCTED WITH APPROVAL OF THE INSTITUTIONAL REVIEW BOARD (IRB) OF THE UNIVERSITY OF EVANSVILLE. PLANNING AND DEVELOPMENT FOR THE SURVEY BEGAN IN THE WINTER OF 2017. USING A CONSTRUCT-BASED APPROACH THAT IDENTIFIED THE LEADING AREAS TO BE INCLUDED ON THE SURVEY, THE HOSPITALS AND FACULTY DEVELOPED A SURVEY. THE SURVEY INCLUDED MEASURES THAT HAD BEEN VALIDATED FOR USE IN SIMILAR PROJECTS BY OTHER RESEARCHERS AND ADDITIONAL MEASURES THAT WERE DEVELOPED BY THE PARTNERS FOR SPECIFIC NEEDS OF THIS CHNA. THE SURVEY COVERED TEN MAJOR AREAS. TWO WEIGHTING ADJUSTMENTS WERE MADE TO ENHANCE CONSISTENCY BETWEEN THE SURVEY SAMPLE AND THE CHARACTERISTICS OF THE HOSPITAL'S SERVICE POPULATION. THE FIRST WAS A BASE WEIGHT ADJUSTMENT TO ACCOUNT FOR UNEQUAL PROBABILITIES OF SELECTION WITHIN HOUSEHOLD. THE SECOND WAS A POSTSTRATIFICATION ADJUSTMENT TO THE U.S. CENSUS BUREAU 2012-2016 AMERICAN COMMUNITY SURVEY FIVE-YEAR POPULATION ESTIMATES. THE TWO WEIGHTING ADJUSTMENTS WERE MULTIPLIED TO CALCULATE A PRELIMINARY FINAL WEIGHT FOR EACH HOSPITAL'S CATCHMENT AREA. THESE PRELIMINARY WEIGHTS WERE THEN TRIMMED AND SCALED SO THAT THE FINAL WEIGHTS SUMMED TO THE NUMBER OF RESPONDENTS IN EACH CATCHMENT AREA. DUE TO THE SCIENTIFIC RIGOR OF THIS SURVEY, IN PREPARATION FOR THE 2022-2024 CHNA, THE SAME SURVEY WAS SENT TO RESIDENTS USING CONVENIENCE SAMPLING TO VERIFY THAT THE RESULTS OF THE SURVEY WERE ACCURATE. ADDITIONAL QUESTIONS WERE ADDED RELATED TO COVID TO ASSIST IN UNDERSTANDING ANY DIFFERENCE DUE TO THE PANDEMIC. BECAUSE DATA COLLECTION OCCURRED DURING THE PANDEMIC, FOCUS GROUPS WERE UNABLE TO BE HELD. TO GAIN A FURTHER UNDERSTANDING OF COMMUNITY NEEDS, A SURVEY TO COMMUNITY PARTNERS, SUCH AS THE ONES LISTED BELOW, WAS ADMINISTERED. THE SURVEY MIRRORED THE RESIDENT SURVEY, WITH THE INCLUSION OF QUESTIONS RELATED TO COVID AND RECOVERY. SAMPLE OF PARTICIPATING ORGANIZATIONS - HEAD START (2) - NORTH CENTRAL RURAL CRISIS CENTER - JASPER NEWTON FOUNDATION - JASPER COUNTY PUBLIC LIBRARY - RENSSELAER COMMUNITY SCHOOL CORPORATION (2) - FRANCISCAN HEALTH (4) - JASPER COUNTY ECONOMIC DEVELOPMENT CORPORATION (2) - COVERING KIDS AND FAMILIES (3) - JASPER COUNTY HEALTH DEPARTMENT - PURDUE UNIVERSITY - WABASH VALLEY ALLIANCE (2) - MAYOR'S OFFICE - JASPER COUNTY SHERIFF - DUNEBROOK (2)
LINE 7	ALL CHNA REPORTS ARE AVAILABLE ON FRANCISCAN ALLIANCE'S WEBSITE AT HTTPS://WWW.FRANCISCANHEALTH.ORG/COMMUNITYHEALTH. IN ADDITION, A PRINT COPY IS AVAILABLE FREE OF CHARGE IN EACH HOSPITAL'S ADMINISTRATIVE OFFICE.
LINE 10	ALL IMPLEMENTATION PLANS ARE CONTAINED IN THE CHNA AS 'CHAPTER 6: CALL TO ACTION.' THE REPORTS ARE AVAILABLE ON FRANCISCAN ALLIANCE'S WEBSITE AT HTTPS://WWW.FRANCISCANHEALTH.ORG/COMMUNITYHEALTH
LINE 11: COMMUNITY HEALTH NEEDS ASSESSMENT	THE TOP HEALTH NEEDS IN A COMMUNITY IS A DIFFICULT PROCESS. MANY POOR HEALTH OUTCOMES, HEALTH DISPARITIES, AND POOR SOCIAL DETERMINANTS OF HEALTH WEIGH HEAVILY ON SEGMENTS OF OUR COMMUNITY. WE ALSO ACKNOWLEDGE THAT THERE ARE MANY STRENGTHS AND POSITIVE GROWTH THAT BALANCE SOME OF THESE CHALLENGES. FRANCISCAN HEALTH DETERMINED THE TOP HEALTH NEEDS BY REVIEWING SECONDARY DATA, SURVEY RESPONSES, AND FEEDBACK FROM INPUT MEETINGS. A CORE TEAM OF SIX STAFF MEMBERS WITH EDUCATION AND EXPERIENCE IN PUBLIC HEALTH WORKED WITH STAFF IN EACH COMMUNITY TO COME TO A CONSENSUS ON THE TOP ISSUES. A COMBINATION OF MULTIVOTE RANKING AND THE HANLON METHOD WERE USED. ONCE A REFINED LIST OF THE TOP TEN ISSUES WAS BROUGHT TO CONSENSUS, EACH STAFF MEMBER RANKED HEALTH ISSUES BASED ON SIZE, SERIOUSNESS, EQUITY, TYPES OF INTERVENTION, AND URGENCY. TO ASSIST WITH INTERVENTION PLANNING, A SECOND SCORE ON THE POTENTIAL FOR FRANCISCAN HEALTH TO PRIORITIZE THE HEALTH ISSUE WAS DETERMINED. SCORING CRITERIA INCLUDED INTERNAL CAPACITY, COMMUNITY ACCEPTABILITY, SUSTAINABILITY, AND LONG-TERM IMPACT. USING A MIX OF HANLON AND PEARL TECHNIQUES, THE FRANCISCAN HEALTH COMMUNITY HEALTH TEAM SCORED THE SECONDARY DATA, FEEDBACK MEETING COMMENTS, AND SURVEY DATA TO PRODUCE THE LIST OF TOP HEALTH NEEDS IN THE COMMUNITY. IN DETERMINING COMMUNITY HEALTH INTERVENTIONS FOR THE SELECTED PRIORITY HEALTH NEEDS, HEALTH EQUITY, SUSTAINABILITY, AND AN EMPHASIS ON SOCIAL DETERMINANTS OF HEALTH WERE HEAVILY WEIGHTED. WHILE MOST INTERVENTIONS FOCUS ON INDIVIDUAL LIFESTYLE FACTORS, KNOWLEDGE, SKILLS, AND BEHAVIORS, CONSIDERATION OF THE CULTURAL AND ENVIRONMENTAL CONTEXTS ARE JUST AS IMPORTANT. FRANCISCAN ALLIANCE ACKNOWLEDGES THAT TRUE CHANGE COMES WITH MAJOR SHIFTS IN ALL AREAS. THE FIRST CRITERIA USED TO DETERMINE IMPLEMENTATION STRATEGIES IS THE CONNECTION TO THE SOCIO-ECOLOGICAL MODEL AND SOCIAL DETERMINENTS OF HEALTH. INTERVENTIONS IMPLEMENTED BY FRANCISCAN ALLIANCE ARE PERSON-CENTERED AND DESIGNED TO CREATE LASTING CHANGE. MALCOLM KNOWLES' PRINCIPLES OF ANDRAGOGY PROVIDED THE FRAMEWORK. WHILE THIS MODEL IS BASED ON EDUCATIONAL PROGRAMMING, IT APPLIES TO ALL TYPES OF INTERVENTIONS. FOR EXAMPLE, IN THE PROVISION OF CLINICAL CARE OR MEDICATION ASSISTANCE, PARTICIPANTS NOT ONLY RECEIVE THE CARE OR MEDICATION, THEY ALSO LEARN TO BETTER MANAGE THEIR OWN HEALTH OR ACCESS COMPONENTS OF THE HEALTH SYSTEM OR ASSISTANCE PROGRAM. REFLECTION, TEACH-BACK, AND COMMUNICATION TECHNIQUES ARE UTILIZED TO EMPOWER THE PARTICIPANT TO MOVE BEYOND A ONE-TIME INTERACTION OR ASSISTANCE. FRANCISCAN ALLIANCE USES EVIDENCE-BASED PRACTICES IN PLANNING INTERVENTIONS WHENEVER POSSIBLE, AS THESE PROGRAMS HAVE BEEN THOROUGHLY TESTED AND HAVE PROVEN EFFICACY. WHEN EVIDENCE-BASED PROGRAMS ARE NOT AVAILABLE, BEST PRACTICES AND DOCUMENTED RESEARCH GUIDES THE DEVELOPMENT AND IMPLEMENTATION OF THE INTERVENTION. IMPLEMENTATION ACTIVITIES WILL BE EVALUATED TO THE FULLEST EXTENT. USING THE KIRKPATRICK MODEL (A STANDARDIZED EVALUATION SYSTEM BASED ON REACTION, LEARNING, BEHAVIOR, AND RESULTS) AS A GUIDE, EVALUATION OF NOT ONLY THE PROGRAM, BUT ITS IMPACT AND RESULTS WILL BE REVIEWED. THIS PROCESS ALLOWS FOR CHANGES TO BE MADE TO IMPROVE THE PROGRAM ON AN ONGOING BASIS. WHILE IT CAN BE DIFFICULT TO DETERMINE THE EXACT CAUSE OF INDIVIDUAL BEHAVIORAL CHANGE, BIOMETRICS, POST-FOLLOW UP SURVEYS, AND OTHER METHODS WERE USED TO CAPTURE QUALITATIVE AND QUANTITATIVE DATA.
LINE 11: COMMUNITY HEALTH NEEDS ASSESSMENT CON'T	THE FOLLOWING SHOWS THE TOP HEALTH NEEDS IN THREE CATEGORIES: SOCIAL NEED, POOR HEALTH BEHAVIORS, AND POOR HEALTH OUTCOMES. THIS TAKES INTO ACCOUNT THE COMPLEXITY OF SOCIAL DETERMINANTS OF HEALTH AND THE MANY FACTORS THAT MAKE UP INDIVIDUAL HEALTH. IN SOME CASES, ONE WILL NOTICE A CLEAR PATH BETWEEN SOCIAL NEED, POOR BEHAVIORS, AND THE RESULTING OUTCOME. MANY NEEDS ARE SELF-EXPLANATORY OR BASED ON COMMONLY UNDERSTOOD DEFINITIONS. HOWEVER, SOME ISSUES ARE A BIT NUANCED OR EMERGING COMMUNITY TRENDS. THE DEPARTMENT OFFERS THESE DEFINITIONS TO AID IN UNDERSTANDING IDENTIFIED ISSUES: SOCIAL COHESION - INCLUDES OVERALL SENSE OF COMMUNITY, SOCIAL BONDING, BRIDGING, CONNECTEDNESS, SUPPORT NETWORKS, FAMILY BUILDING, "WARM HAND-OFF" FOR RESOURCES, UNDERSTANDING OF OTHERS, COMMUNICATION AND CONFLICT SKILL DEVELOPMENT - HOW WE KNOW: VICTIMIZATION RATES, BEHAVIORAL HEALTH ISSUES, SOCIAL SERVICE AGENCIES REPORT/SURVEY, SERVICE PROVIDER RATES (PATIENT:PROVIDER RATIO), PUBLIC SURVEY DATA, PROFESSIONAL SURVEY DATA VICTIMS OF VIOLENCE - INCLUDES DOMESTIC AND INTERPERSONAL VIOLENCE, CHILD ABUSE/NEGLECT, HUMAN TRAFFICKING, VIOLENT CRIME, ELDER ABUSE/NEGLECT - HOW WE KNOW: MORTALITY RATES, PUBLIC SURVEY DATA, PROFESSIONAL SURVEY DATE, LACK OF SERVICE PROVIDER CAPACITY; CHINS CASES, DCS/DCFS SUBSTANTIATED ABUSE CASES, VIOLENT CRIME RATES, ED DATA, HATE CRIME RATES BEHAVIORAL HEALTH - INCLUDES DIAGNOSED AND UNDIAGNOSED MENTAL HEALTH ISSUES, SUICIDE, SELF-HARM, DEPRESSION, ANXIETY - HOW WE KNOW: SERVICE PROVIDER RATES (PATIENT:PROVIDER RATIO), SUICIDE RATES, SELF-HARM RATES, POOR MENTAL HEALTH DAYS, PROFESSIONAL SURVEY DATA, PUBLIC SURVEY DATA, LACK OF RESOURCES SUBSTANCE ABUSE - INCLUDES ILLEGAL DRUGS, PRESCRIPTION ABUSE, ALCOHOL - HOW WE KNOW: MORTALITY RATES, OVERDOSE RATES, DUI, ED/PATIENT DATA, PUBLIC SURVEY DATA, PROFESSIONAL SURVEY DATA ACCESS TO HEALTH CARE - INCLUDES BARRIERS THAT PREVENT OR LIMIT ACCESS TO NEEDED HEALTH CARE SERVICES, NO TRANSPORTATION, LACK OF INSURANCE, UNDERINSURED, TRANSPORTATION, AVAILABILITY OF PROVIDERS AND SERVICES - HOW WE KNOW: PUBLIC SURVEY DATA, PROFESSIONAL SURVEY DATA, INSURANCE RATES, SERVICE PROVIDER RATES (PATIENT:PROVIDER RATIO) FRANCISCAN HEALTH RENSSELAER MADE THE FOLLOWING PROGRESS DURING 2022 IN ADDRESSING THE IDENTIFIED COMMUNITY HEALTH NEEDS FROM ITS MOST RECENT CHNA: TOP HEALTH NEEDS INCLUDE (TOP NEEDS FIRST): - ACCESS TO HEALTH CARE - PRENATAL CARE - FOOD INSECURITY - SOCIAL COHESION - HOUSING - UNSAFE DRIVING - INJURIES - TOBACCO USE - CARDIOVASCULAR DISEASE - OBESITY - DIABETES 'HEALTHY BODIES, HEALTHY MINDS, AND HEALTHY CONNECTIONS' TO DESCRIBE A COMPREHENSIVE APPROACH TO THESE TOP HEALTH NEEDS, THE FOLLOWING INTERVENTIONS WERE PROVIDED: - FREE PHYSICAL ACTIVITY PROGRAMMING, INCLUDING 'WALK WITH A DOC' - EDUCATION ON HEALTHY FOOD/NUTRITION, 'EAT SMART, MOVE MORE' - SUICIDE PREVENTION COURSES, INCLUDING QPR - FACILITATION OF A COMMUNITY WIDE RESILIENCE COALITION - PROFESSIONAL TRAINING ON TRAUMA INFORMED CARE, RESILIENCE AND MINDFULNESS FOR NON-PROFITS - ADOPTION OF THE NATIONAL 'REACH OUT AND READ' PROGRAM - EXPANSION OF THE PRENATAL ASSISTANCE PROGRAM - OFFERING OF YOUTH MENTAL HEALTH FIRST AID COURSE - LEAD AGENCY FOR TOBACCO PREVENTION AND CESSATION FOR THE STATE OF INDIANA
LINE 15 AND 16	THROUGH FRANCISCAN ALLIANCE, INC. ("FRANCISCAN"), WE CONTINUE THE HEALING MINISTRY OF CHRIST IN A CATHOLIC HEALTH CARE SYSTEM THAT UPHOLDS THE MORAL VALUES AND TEACHINGS OF THE CATHOLIC CHURCH. CENTRAL CONCERNS OF THIS CORPORATE MINISTRY INCLUDE COMPASSION FOR THOSE IN NEED, RESPECT FOR LIFE AND THE DIGNITY OF PERSONS. FRANCISCAN BELIEVES IN THE DIGNITY, UNIQUENESS, AND WORTH OF EACH INDIVIDUAL AND, WITHIN THE LIMITS OF OUR RESOURCES, FRANCISCAN OFFERS A COMPREHENSIVE RANGE OF HEALTH CARE SERVICES TO ALL REGARDLESS OF RACE, CREED, COLOR, SEX, NATIONAL ORIGIN, HANDICAP OR AN INDIVIDUAL'S FINANCIAL CAPABILITY. IN LIGHT OF THIS BELIEF, WE CONSIDER OUR HEALTH CARE SERVICES TO BE REACHING OUT AND RESPONDING, IN A CHRIST-LIKE MANNER, TO THOSE WHO ARE PHYSICALLY, MATERIALLY, OR SPIRITUALLY IN NEED. FRANCISCAN IS COMMITTED TO PROVIDING FINANCIAL ASSISTANCE, IN THE FORM OF CHARITY CARE OR UNINSURED DISCOUNTS, TO PERSONS WHO ARE UNINSURED OR UNDERINSURED, WHO ARE INELIGIBLE FOR GOVERNMENTAL OR SOCIAL SERVICE PROGRAMS, AND WHO OTHERWISE ARE UNABLE TO PAY FOR EMERGENCY SERVICES OR MEDICALLY NECESSARY CARE BASED ON THEIR INDIVIDUAL FINANCIAL SITUATION. CONSISTENT WITH OUR MISSION TO DELIVER COMPASSIONATE, HIGH QUALITY, AFFORDABLE HEALTH CARE AND TO ADVOCATE FOR THOSE WHO ARE POOR AND DISENFRANCHISED, FRANCISCAN STRIVES TO ENSURE THE FINANCIAL CAPACITY OF PEOPLE WHO NEED MEDICALLY NECESSARY HEALTH CARE SERVICES DOES NOT PREVENT THEM FROM SEEKING OR RECEIVING THAT CARE. FRANCISCAN'S FINANCIAL ASSISTANCE POLICY IS DESIGNED TO ALLOW RELIEF FROM ALL OR PART OF THE CHARGES RELATED TO EMERGENCY OR MEDICALLY NECESSARY HEALTH CARE SERVICES THAT EXCEED A PATIENT'S REASONABLE ABILITY TO PAY. IN ORDER TO ENSURE TRANSPARENCY, CONSISTENCY AND FAIRNESS, WE ASK PATIENTS TO COOPERATE BY PROVIDING NECESSARY INFORMATION TO DETERMINE THEIR ELIGIBILITY FOR FINANCIAL ASSISTANCE. FOR PATIENTS NOT INITIALLY IDENTIFIED AS QUALIFYING FOR FINANCIAL ASSISTANCE, FRANCISCAN COMMUNICATES THE AVAILABILITY OF CHARITY CARE AND FINANCIAL ASSISTANCE IN THE APPLICABLE LANGUAGES OF THE HOSPITAL COMMUNITY THROUGH THE FOLLOWING MEANS: 1. FRANCISCAN COMMUNICATES THE AVAILABILITY OF FINANCIAL ASSISTANCE IN APPROPRIATE CARE SETTINGS SUCH AS EMERGENCY DEPARTMENTS, ADMITTING/REGISTRATION AREAS, BILLING OFFICES, OUTPATIENT SERVICE SETTINGS, AND ON OUR HOSPITALS' WEBSITES. SIGNS/POSTINGS INFORM PATIENTS THAT FREE OR REDUCED COST CARE MAY BE AVAILABLE TO QUALIFYING PATIENTS WHO COMPLETE A FINANCIAL ASSISTANCE APPLICATION. 2. BROCHURES SUMMARIZING OUR FINANCIAL ASSISTANCE PROGRAMS ARE AVAILABLE THROUGHOUT EACH FRANCISCAN HOSPITAL. 3. FINANCIAL COUNSELORS AND BUSINESS OFFICE PERSONNEL ARE AVAILABLE TO HELP PATIENTS UNDERSTAND AND APPLY FOR LOCAL, STATE, FEDERAL HEALTH CARE, AND HEALTH INSURANCE EXCHANGE PROGRAMS AND FRANCISCAN'S FINANCIAL ASSISTANCE PROGRAMS. 4. ALL BILLS AND STATEMENTS FOR SERVICES INFORM UNINSURED PATIENTS THAT FINANCIAL ASSISTANCE IS AVAILABLE. 5. PATIENTS/GUARANTORS MAY REQUEST A COPY OF THE FINANCIAL ASSISTANCE APPLICATION BY CALLING THE FRANCISCAN BILLING OFFICE OR DOWNLOADING A COPY AT NO COST FROM FRANCISCAN HOSPITAL'S WEBSITES. 6. PATIENTS/GUARANTORS CAN REQUEST FINANCIAL ASSISTANCE INFORMATION BY CALLING FRANCISCAN'S BILLING OFFICE PHONE LINE ON A 24-HOUR BASIS. 7. INDIVIDUALS OTHER THAN THE PATIENT, SUCH AS THE PATIENT'S PHYSICIAN, FAMIHLY MEMBERS, COMMUNITY OR RELIGIOUS GROUPS, SOCIAL SERVICES, OR HOSPITAL PERSONNEL MAY MAKE REQUESTS FOR FINANCIAL ASSISTANCE ON THE PATIENT'S BEHALF, SUBJECT TO APPLICABLE PRIVACY LAWS. 8. PRIOR TO TRANSFER TO A COLLECTION AGENCY, FRANCISCAN SENDS A MINIMUM OF 4 STATEMENTS AND MAKES 6 PHONE CALL ATTEMPTS TO CONTACT THE PATIENT/GUARANTOR AT THE ADDRESS AND PHONE NUMBER PROVIDED BY THE PATIENT/GUARANTOR. STATEMENTS AND COMMUNICATIONS INFORM THE PATIENT OF THE AMOUNT DUE AND IF THEY CANNOT PAY THEIR BALANCE THE AVAILABILITY OF FINANCIAL ASSISTANCE. A PATIENT'S QUALIFICATION FOR CHARITY CARE IS DETERMINED THROUGH A FINANCIAL ASSISTANCE APPLICATION AND SCREENING PROCESS. PATIENTS WHO MAY QUALIFY FOR MEDICAID OR ANY OTHER GOVERNMENTAL ASSISTANCE MUST BE DENIED COVERAGE OR ASSISTANCE FROM THOSE GOVERNMENTAL PROGRAMS PRIOR TO RECEIVING APPROVAL FOR CHARITY CARE. AS SUCH, FRANCISCAN OFFERS PATIENTS ASSISTANCE IN APPLYING OR ENROLLING IN SUCH PROGRAMS. A PATIENT WILL NEED TO FILL OUT, SIGN, AND SUBMIT THE FINANCIAL ASSISTANCE APPLICATION ALONG WITH ALL REQUESTED DOCUMENTATION OF INCOME, EXPENSES, ASSETS, AND LIABILITIES. FRANCISCAN'S BILLING OFFICE WILL PLACE THE PATIENT'S ACCOUNT ON HOLD ONCE A FINANCIAL ASSISTANCE APPLICATION HAS BEEN REQUESTED AND UNTIL A FINANCIAL ASSISTANCE DETERMINATION IS MADE. APPLICANTS ARE TREATED WITH DIGNITY AND RESPECT THROUGHOUT THE FINANCIAL ASSISTANCE PROCESS AND ALL INFORMATION/MATERIALS RECEIVED ARE CONFIDENTIALLY MAINTAINED. FRANCISCAN ALSO UTILIZES AN EXTERNAL VENDOR, SERVICE, OR DATA SOURCE THAT PROVIDES INFORMATION ON A PATIENT'S OR GUARANTOR'S ABILITY TO PAY (I.E. CREDIT SCORING). ELIGIBILITY FOR CHARITY CARE MAY BE DETERMINED AT ANY POINT IN THE COLLECTIONS CYCLE (I.E. PRIOR TO THE PROVISION OF SERVICES, DURING THE NORMAL COLLECTIONS CYCLE, OR MAY BE USED TO RE-CLASSIFY ACCOUNTS AFTER THEY HAVE BEEN DEEMED UNCOLLECTIBLE AND SUBSEQUENTLY RETURNED FROM A THIRD PARTY COLLECTION AGENCY). ONCE APPROVED, THE PATIENT WILL REMAIN ELIGIBLE FOR CHARITY CARE FOR A MAXIMUM OF FOUR MONTHS. THE ELIGIBILITY PERIOD WILL BEGIN FROM THE DATE OF THE PATIENT'S APPROVAL OF CHARITY CARE. CHARITY CARE DISCOUNTS WILL BE GIVEN FOR CURRENT OPEN ACCOUNTS AND THE FOLLOWING FOUR MONTHS OF EMERGENCY SERVICES OR MEDICALLY NECESSARY CARE. AFTER THE ELIGIBILITY PERIOD HAS ELAPSED, THE PATIENT MUST REAPPLY FOR FINANCIAL ASSISTANCE.
LINES 16A, 16B, AND 16C	THE FAP, FAP APPLICATION FORM, AND PLAIN LANGUAGE SUMMARY OF THE FAP ARE AVAILABLE AT THE FOLLOWING ADDRESS: HTTPS://STATEMENTS.FRANCISCANALLIANCE.ORG/INFO/FINANCIALASSISTANCE.ASPX

Field	Value	IRS element (for citing)
Facility	2	FacilityNum

Oth Hlth Care Fclts Not Hospital OthHlthCareFcltsNotHospitalGrp

Oth Hlth Care Fclts OthHlthCareFcltsGrp (2 entries)

Address Line1USAddress/AddressLine1Txt	CityUSAddress/CityNm	State AbbreviationUSAddress/StateAbbreviationCd	ZIPUSAddress/ZIPCd	FacilityFacilityTxt
FRANCISCAN BROOK HEALTH CENTER
420 E MAIN STREET	BROOK	IN	47922	RURAL HEALTH CENTER
FRANCISCAN WHEATFIELD HEALTH CENTER
429 SOUTH BIERMA ST	WHEATFIELD	IN	463926004	RURAL HEALTH CENTER

Supplemental Information Detail SupplementalInformationDetail (13 entries)

Form And Line ReferenceFormAndLineReferenceDesc	ExplanationExplanationTxt
SCHEDULE H, PART VI, LINE 2	NEEDS ASSESSMENT RENSSELAER IS A HOSPITAL AFFILIATE OF FRANCISCAN ALLIANCE, INC. RENSSELAER ASSESSES THE HEALTH CARE NEEDS OF THE COMMUNITIES WE SERVE BY COLLABORATING WITH PUBLIC AND PRIVATE AGENCIES TO DETERMINE COMMUNITY HEALTH NEEDS AND HOW BEST TO ADDRESS THEM. FRANCISCAN ALLIANCE, INC.'S CORPORATE COMMUNITY BENEFIT COMMITTEE, AS WELL AS COMMITTEES IN THE LOCAL FACILITIES, COMMITTED TO AN ONGOING ASSESSMENT OF COMMUNITY HEALTH NEEDS AND PRIORITIES BASED UPON HEALTH INITIATIVES OF THE MUNICIPAL, COUNTY, AND STATE HEALTH DEPARTMENTS, COMMUNITY-BASED ASSESSMENTS BY OTHER PUBLIC SECTOR PARTNERS, PROFESSIONAL RESEARCH CONSULTANT REPORTS, AND FAITH-BASED PARTNERS WITHIN THE COMMUNITIES SERVED. IN ADDITION, OUR HOSPITALS ADDRESS PUBLIC AGENCY AND COMMUNITY GROUP REQUESTS TO PROVIDE COMMUNITY BENEFIT ACTIVITIES AND PROGRAMS THAT MEET CERTAIN SPECIALTY OR HYBRID NEEDS OR POPULATIONS.
SCHEDULE H, PART VI, ITEM 3	FINANCIAL ASSISTANCE POLICY RENSSELAER INFORMS AND EDUCATES PATIENTS AND PERSONS WHO MAY BE BILLED FOR PATIENT CARE ABOUT THEIR ELIGIBILITY FOR ASSISTANCE UNDER FEDERAL, STATE, OR LOCAL GOVERNMENT PROGRAMS OR UNDER RENSSELAER'S FINANCIAL ASSISTANCE AND CHARITY CARE POLICY. FOR PATIENTS NOT INITIALLY IDENTIFIED AS QUALIFYING FOR FINANCIAL ASSISTANCE, RENSSELAER COMMUNICATES THE AVAILABILITY OF CHARITY CARE AND FINANCIAL ASSISTANCE IN THE APPLICABLE LANGUAGES OF THE HOSPITAL COMMUNITY THROUGH THE FOLLOWING MEANS: 1. RENSSELAER COMMUNICATES THE AVAILABILITY OF FINANCIAL ASSISTANCE IN APPROPRIATE CARE SETTINGS SUCH AS EMERGENCY DEPARTMENTS, ADMITTING/REGISTRATION AREAS, BILLING OFFICES, OUTPATIENT SERVICE SETTINGS, AND ON OUR HOSPITALS' WEBSITES. SIGNS/POSTINGS INFORM PATIENTS THAT FREE OR REDUCED COST CARE MAY BE AVAILABLE TO QUALIFYING PATIENTS WHO COMPLETE A FINANCIAL ASSISTANCE APPLICATION. 2. BROCHURES SUMMARIZING OUR FINANCIAL ASSISTANCE PROGRAMS ARE AVAILABLE THROUGHOUT THE HOSPITAL. 3. FINANCIAL COUNSELORS AND BUSINESS OFFICE PERSONNEL ARE AVAILABLE TO HELP PATIENTS UNDERSTAND AND APPLY FOR LOCAL, STATE, FEDERAL HEALTH CARE PROGRAMS; HEALTH INSURANCE EXCHANGES; AND RENSSELAER'S FINANCIAL ASSISTANCE PROGRAMS. 4. ALL BILLS AND STATEMENTS FOR SERVICES INFORM UNINSURED PATIENTS THAT FINANCIAL ASSISTANCE IS AVAILABLE. 5. PATIENTS/GUARANTORS MAY REQUEST A COPY OF THE FINANCIAL ASSISTANCE APPLICATION BY CALLING THE RENSSELAER'S BILLING OFFICE OR DOWNLOADING A COPY AT NO COST FROM RENSSELAER'S WEBSITE. 6. INDIVIDUALS OTHER THAN THE PATIENT, SUCH AS THE PATIENT'S PHYSICIAN, FAMILY MEMBERS, COMMUNITY OR RELIGIOUS GROUPS, SOCIAL SERVICES, OR HOSPITAL PERSONNEL MAY MAKE REQUESTS FOR FINANCIAL ASSISTANCE ON THE PATIENT'S BEHALF, SUBJECT TO APPLICABLE PRIVACY LAWS. 7. RENSSELAER SENDS 4 STATEMENTS AND MAKES 7 PHONE CALL ATTEMPTS TO CONTACT THE PATIENT/GUARANTOR AT THE ADDRESS AND PHONE NUMBER PROVIDED BY THE PATIENT/GUARANTOR. STATEMENTS AND COMMUNICATIONS INFORM THE PATIENT OF THE AMOUNT DUE AND IF THEY CANNOT PAY THEIR BALANCE THE AVAILABILITY OF FINANCIAL ASSISTANCE.
SCHEDULE H, PART VI, ITEM 4	COMMUNITY INFORMATION FRANCISCAN HEALTH RENSSELAER SERVES A LARGE GEOGRAPHIC AREA WHICH INCLUDES 4 COUNTIES IN INDIANA (JASPER, NEWTON, PULASKI, AND WHITE). THE POPULATION OF THE COMMUNITIES THAT WE SERVE WAS ESTIMATED AT OVER 85,800 PEOPLE WITH AN AVERAGE HOUSEHOLD INCOME JUST ABOVE $65,800 IN 2022. FOR THESE COMMUNITIES, THE PERCENTAGE OF RESIDENTS BELOW THE FEDERAL POVERTY LEVEL WAS ESTIMATED AT 10%. THE PERCENTAGE OF INPATIENTS FROM THESE COMMUNITIES WHO WERE SERVED BY MEDICAID WAS 17%. AND THE PERCENTAGE OF INPATIENTS FROM THESE COMMUNITIES WHO WERE UNINSURED WAS APPROXIMATELY 2.3%. IN COMPARISON, THE PERCENTAGES OF MEDICAID AND UNINSURED INPATIENTS TREATED BY FRANCISCAN HEALTH RENSSELAER WERE 5.9% AND 1.1% RESPECTIVELY IN 2022. THERE ARE 2 OTHER HOSPITALS THAT SERVE WITHIN THESE COMMUNITIES AS WELL.
SCHEDULE H, PART VI, ITEM 5 & PART 1, LINE 6A	OTHER INFORMATION WWW.FRANCISCANHEALTH.ORG/COMMUNITYHEALTH REFLECTS RENSSELAER'S MISSION OF "CONTINUING CHRIST'S MINISTRY IN OUR FRANCISCAN TRADITION." ALTHOUGH IT IS NOT ALL INCLUSIVE OF THE MANY BENEFITS PROVIDED BY RENSSELAER IT DOES PORTRAY THE SIGNIFICANT BENEFITS THAT REFLECT OUR COMMITMENT TO HEALTHCARE AND THE COMMUNITIES WE ARE PRIVILEGED TO SERVE. THE FOLLOWING IS A SUBSET OF THE MANY CLINICAL SERVICES AS WELL AS POPULATION HEALTH IMPROVEMENT AND COMMUNITY OUTREACH ACTIVITIES OFFERED BY ONE OR MORE OF RENSSELAER'S HEALTHCARE FACILITIES: - INPATIENT HOSPITAL SERVICES INCLUDING: MEDICAL SERVICES, SURGICAL SERVICES, INTENSIVE CARE SERVICES, TELEMETRY SERVICES, ONCOLOGY SERVICES, GENERAL SURGERY SERVICES, CARDIOLOGY SERVICES, VASCULAR SERVICES, ORTHOPEDICS, ENDOSCOPY SERVICES, ANESTHESIA SERVICES, AND EXTENDED CARE. - EMERGENCY SERVICES INCLUDING: 24 HOUR EMERGENCY ROOM SERVICES. - OUTPATIENT SERVICES INCLUDING: LABORATORY SERVICES, PHYSICAL THERAPY SERVICES, OCCUPATIONAL THERAPY SERVICES, SPEECH THERAPY SERVICES, GENERAL RADIOLOGY SERVICES, COMPUTED TOMOGRAPHY SERVICES, MAGNETIC RESONANCE IMAGING (MRI), NUCLEAR MEDICINE SERVICES, MAMMOGRAPHY SERVICES, GASTROINTESTINAL SERVICES, SLEEP LABORATORY, OUTPATIENT SURGERY, ELECTROCARDIOGRAM (EKG) SERVICES, MEDICAL ONCOLOGY SERVICES, PHARMACY, OCCUPATIONAL MEDICINE SERVICES, CARDIAC REHABILITATION SERVICES, WOUND HEALING AND PREVENTION, NUTRITIONAL COUNSELING, DIABETES MANAGEMENT, SOCIAL SERVICES, PALLIATIVE CARE, BEHAVIORAL HEALTH, STROKE SERVICES, HOME HEALTH SERVICES, SKILLED NURSING SERVICES, AND SOCIAL SERVICES. - SUBSIDIZED HEALTHCARE SERVICES OFFERED BY RENSSELAER: - RENSSELAER HAS NEIGHBORHOOD HEALTH CLINICS THAT OFFER FAMILY PRACTICE SERVICES DESIGNED FOR FAMILIES WITHOUT ACCESS TO AFFORDABLE HEALTH CARE. THE FOCUS IS ON PROVIDING PRIMARY AND PREVENTIVE CARE AS WELL AS HEALTH EDUCATION. THESE CLINICS OFFER FREE IMMUNIZATIONS. - RENSSELAER'S SEXUAL ASSAULT CLINICS THAT PROVIDE MEDICAL AND FORENSIC ASSISTANCE THAT IS SENSITIVE TO THE SPECIAL NEEDS OF THE VICTIM AS WELL AS A VICTIM ADVOCATE PROGRAM AND CRISIS INTERVENTION COUNSELORS. - RENSSELAER'S DIABETES EDUCATION CENTERS OFFER A NUMBER OF DIABETES CLASSES AND INDIVIDUALIZED SESSIONS TO HELP PATIENTS TAKE CONTROL OF THEIR HEALTH WITH A FOCUS ON NUTRITIONAL, EXERCISE, MEDICATIONS, CHRONIC CONDITIONS, PRECONCEPTION AND PREGNANCY, BLOOD GLUCOSE MONITORING, GOAL SETTING, PROBLEM SOLVING, PSYCHOSOCIAL ADJUSTMENT, DETECTION/TREATMENT OF HIGH AND LOW BLOOD SUGAR, AND INSULIN ADMINISTRATION. - PALLIATIVE CARE SERVICES ASSIST PATIENTS AND FAMILIES IN MAKING COMPLEX MEDICAL DECISIONS BY PROVIDING A GOOD UNDERSTANDING OF THE PATIENT'S PRESENT CONDITION, COORDINATING AND COMMUNICATING CARE WITH PHYSICIANS, ADVOCATING FOR PATIENTS' WISHES, AND HELPING THEM TO ACHIEVE A SENSE OF CONTROL OVER THEIR MEDICAL CARE. PALLIATIVE CARE IS OFFERED REGARDLESS OF THE STAGE OF DISEASE OR THE NEED FOR OTHER THERAPIES AND CAN BE PROVIDED CONCURRENTLY WITH LIFE-PROLONGING CARE OR AS THE MAIN FOCUS OF CARE. - EMERGENCY SERVICES PROVIDE OUR COMMUNITIES WITH STATE-OF-THE-ART EMERGENCY FACILITIES, OPEN 24-HOURS A DAY, SEVEN DAYS A WEEK. EQUIPPED WITH ADVANCED MEDICAL TECHNOLOGY, OUR EMERGENCY TEAM OF SPECIALLY TRAINED PHYSICIANS AND NURSES TREAT THEIR PATIENTS FOR TRAUMA, STROKE, CARDIAC, AND OTHER LIFE-THREATENING CONDITIONS IN ADULTS AND CHILDREN. - INDIGENT HEALTH CARE CLINICS. - HEALTH AND WELLNESS CENTERS AND HEALTHY LIVING EDUCATION CENTERS. - COMMUNITY OUTREACH AND EDUCATION PROGRAMS INCLUDING: HEALTH FAIRS, FREE HEALTH SCREENINGS, FREE IMMUNIZATIONS, FREE BREAST HEALTH SCREENING SERVICES, FREE PROSTRATE SCREENINGS, FREE SKIN CANCER SCREENINGS, FREE CERVICAL CANCER SCREENINGS, FREE GLUCOSE SCREENINGS, FREE CHOLESTEROL SCREENINGS, FREE BONE DENSITY SCREENINGS, FREE LUNG SCREENINGS, FREE SPA SERVICES FOR CANCER PATIENTS, ONLINE HEALTH CONDITION ASSESSMENT TOOLS, CANCER PREVENTION ACTIVITIES, SENIOR HEALTH EDUCATION, DIABETES MANAGEMENT EDUCATION AND ACTIVITIES, CARDIAC RISK FACTORS EDUCATIONAL SESSIONS AND ONLINE TOOLS, HOSPICE AND PALLIATIVE CARE COUNSELING AND EDUCATION SERVICES, SMOKING CESSATION PROGRAMS, BASIC LIFE-SAVING SKILLS PROGRAMS, CHILDREN'S HEALTH NEEDS ACTIVITIES, CHILDHOOD OBESITY ACTIVITIES, WEIGHT LOSS EDUCATION, ORGAN AND TISSUE DONATION FAIRS, VOLUNTEER ADVOCATES FOR SENIORS, PARENTING PROGRAMS, ATHLETIC TRAINING (FOR SCHOOLS AND VARIOUS MARATHONS), FLU VACCINATIONS, CHILD SEAT SAFETY PROGRAMS, BEREAVEMENT SUPPORT GROUPS, COMMUNITY EDUCATION LECTURES, CAREGIVERS EDUCATION SYMPOSIUMS, HEALTH CAREER DAYS, BABYSITTING COURSE, FOOD SHARE PROGRAMS, NUTRITIONAL COUNSELING FOR GRADE SCHOOLS AND SENIORS, ETC. - SOCIAL SERVICES INCLUDING: PASTORAL CARE, EUCHARISTIC MINISTRY PROGRAM, NO ONE DIES ALONE PROGRAMS, GRIEVANCE SUPPORT PROGRAMS FOR CHILDREN, LANGUAGE INTERPRETER SERVICES, DEAF INTERPRETER SERVICES, TRANSPORTATION FOR THE INDIGENT, ENROLLMENT ASSISTANCE IN MEDICAID AND HEALTH INSURANCE EXCHANGES, CHRISTIAN LEGAL CLINIC, TRANSPORTATION SERVICE FOR INDIGENT PATIENTS, ETC. THE WEB SITE HAS HEALTHY LIVING SECTIONS THAT OFFER TIPS AND SUGGESTIONS ON BEGINNING AND MAINTAINING DIET AND EXERCISE REGIMENTS TO OPTIMIZE HEALTHY LIFESTYLES. RENSSELAER'S GOVERNING BODY IS COMPOSED OF INDEPENDENT MEMBERS REPRESENTING THE BROAD COMMUNITY SERVED BY FRANCISCAN HEALTH RENSSELAER. MEDICAL STAFF PRIVILEGES ARE AVAILABLE TO QUALIFIED PHYSICIANS. FRANCISCAN HEALTH RENSSELAER ALSO USES ITS SURPLUS FOR IMPROVEMENT IN PATIENT CARE, TO EXPAND AND REPLACE FACILITIES AND EQUIPMENT, AMORTIZATION OF INDEBTEDNESS, AND MEDICAL TRAINING, EDUCATION, AND RESEARCH. FRANCISCAN ALLIANCE, INC. AND ITS ACCOUNTABLE CARE ORGANIZATION ("ACO") WAS THE FIRST AND ONLY PIONEER ACO IN INDIANA AND AMONG THE FIRST IN THE COUNTRY TO PARTNER WITH MEDICARE AS AN ACO. RENSSELAER ALSO PARTICIPATES IN VARIOUS MEDICARE SHARED SAVINGS ACO PROGRAMS AND NONGOVERNMENTAL ACO PROGRAMS. FORMED IN 2011, FRANCISCAN ACOS PROVIDE COORDINATED, COMPREHENSIVE CARE ACROSS HOSPITALS, PHYSICIAN PRACTICES, AND OTHER HEALTHCARE PROVIDERS, WITH THE AIM OF BRINGING DOWN THE OVERALL COSTS OF MEDICAL CARE AND IMPROVING THE HEALTH OF PATIENTS ATTRIBUTED TO THE ACOS. UNDER THE ACO MODEL, ATTRIBUTED BENEFICIARIES MAINTAIN THE ABILITY TO SEE ANY DOCTOR OR HEALTHCARE PROVIDER, AS WELL AS THE FULL BENEFITS ASSOCIATED WITH TRADITIONAL MEDICARE, BUT WITH THE ADDED BENEFIT OF A MORE COORDINATED CARE EXPERIENCE. THIS INCLUDES COORDINATION OF PREVENTIVE HEALTH SERVICES, THE ASSIGNMENT OF CARE MANAGERS, THE PROVISION OF SOCIAL SUPPORT SERVICES, AND SUPPORT FOR PERSONS WITH CHRONIC HEALTH CONDITIONS, SUCH AS DIABETES AND CONGESTIVE HEART FAILURE. FRANCISCAN ACOS SERVE APPROXIMATELY 90,000 MEDICARE BENEFICIARIES AND APPROXIMATELY 97,000 NONGOVERNMENTAL ACO BENEFICIARIES. RENSSELAER'S ACO EFFORTS INCLUDE IMPROVED COMMUNICATION AND INFORMATION SHARING AMONG AFFILIATED AND NONAFFILIATED HEALTHCARE PROVIDERS REGARDING ACO PATIENTS, ALONG WITH THE EXPANSION OF ACO CASE MANAGEMENT RESOURCES, THE ASSIGNMENT OF DEDICATED CHRONIC DISEASE CASE ADVOCATES TO PATIENTS, EVALUATING THE QUALITY AND CAPABILITIES OF LONG-TERM CARE FACILITIES THAT ACO PATIENTS MAY TRANSITION TO, AND WORKING WITH POST-ACUTE CARE PROVIDERS TO IMPROVE THEIR CONTINUING CARE CAPABILITIES. THE SUPPORTING RESOURCES AND TECHNOLOGY OF FRANCISCAN ACOS ARE FUNDAMENTAL FOR IMPROVING POPULATION HEALTH AND MAKING HEALTHCARE COSTS MORE AFFORDABLE TO THE PATIENTS IN OUR COMMUNITIES WE ARE PRIVILEGED TO SERVE. RENSSELAER AND ITS EMPLOYEES SPONSOR AND PARTICIPATE IN MANY COMMUNITY HEALTH IMPROVEMENT INITIATIVES AND ACTIVITIES. COMMUNITY HEALTH FAIRS, EDUCATION SESSIONS AND SUPPORT GROUPS ARE MADE AVAILABLE THROUGH PROGRAMS SUCH AS THE ORTHOPEDIC ROAD SHOW, ASK-THE-DOC SEMINARS, DAY OF DANCE, HEART HEALTH CLASSES, SENIOR CITIZENS DAY AT THE FAIR, SPIRIT OF WOMEN, PERINATAL EDUCATION, BEREAVEMENT SUPPORT GROUPS, CANCER SCREENING CLINICS, ARTHRITIS EXERCISE GROUP, SMOKING CESSATION CLASSES, PROSTATE SCREENINGS, CANCER SURVIVORS DAY, NUTRITIONAL COUNSELING SERVICES TO NAME A FEW.
SCHEDULE H, PART VI, ITEM 6	ROLE OF AFFILIATES EVERY HOSPITAL WITHIN OUR SYSTEM HAS THE DEGREE OF AUTONOMY AND FLEXIBILITY TO MEET THE NEEDS OF THE COMMUNITIES IT SERVES. THE CORPORATE COMMUNITY HEALTH IMPROVEMENT DIRECTOR PROVIDES COMMUNITY HEALTH DATA, INCLUDING INFORMATION RELATED TO SOCIAL DETERMINANTS OF HEALTH AND EMERGING PUBLIC HEALTH NEEDS TO LOCAL FACILITY STAFF ON A REGULAR BASIS FOR CONSIDERATION OF LOCAL ACTIVITY. THE CORPORATE DIRECTOR ALSO ORGANIZES A THOROUGH COMMUNITY HEALTH NEEDS ASSESSMENT AND PROVIDES CONSULTATION TO LOCAL STAFF ON THE IMPLEMENTATION PLAN. THE INDIVIDUAL AND REGIONAL COMMUNITY BENEFIT PLANS ARE DESIGNED TO BE PART OF AN OVERALL FRANCISCAN SYSTEM VISION TO PROVIDE FOR THE ONGOING HEALTHCARE NEEDS OF THE COMMUNITIES WE ARE PRIVILEGED TO SERVE.
SCHEDULE H, PART I, LINE 3B	IN ADDITION TO USING FEDERAL POVERTY GUIDELINES AS A FACTOR IN DETERMINING ELIGIBILITY FOR DISCOUNTED CARE, FOR UNINSURED PATIENTS, RENSSELAER WILL PROVIDE AN UNINSURED PATIENT DISCOUNT FOR EMERGENCY SERVICES OR MEDICALLY NECESSARY SERVICES PERFORMED AT ITS HOSPITAL LOCATIONS. THE UNINSURED PATIENT DISCOUNT IS BASED ON THE AVERAGE RATE OF THE THREE BEST NEGOTIATED MANAGED CARE CONTRACTS WHICH WILL BE CALCULATED ON AN ANNUAL BASIS. RENSSELAER MAY OFFER ADDITIONAL DISCOUNTS BASED ON THE FACTS AND CIRCUMSTANCES UNIQUE TO THEIR LOCAL MARKETS. THIS DISCOUNT SHALL NOT BE COMBINED WITH OTHER FACILITY DISCOUNTS, EXCEPT FOR A PROMPT PAY DISCOUNT, IF AVAILABLE. NO DISCOUNT SHALL BE PROVIDED THAT VIOLATES ANY LAWS OR GOVERNMENT REGULATIONS. RENSSELAER WILL IDENTIFY UNINSURED PATIENTS DURING THE REGISTRATION AND/OR ADMISSIONS PROCESS. THE UNINSURED DISCOUNT IS APPLIED AUTOMATICALLY BY THE RECEIVABLE SYSTEM AT THE TIME OF INITIAL BILL. ALL STATEMENTS TO PATIENTS WILL INDICATE THE ADJUSTMENT AND THE REVISED PATIENT BALANCE. THE UNINSURED DISCOUNT IS A CONTRACTUAL DISCOUNT AND IS NOT CONSIDERED A CHARITY CARE WRITE OFF UNLESS THE PATIENT ALSO QUALIFIES FOR CHARITY CARE. UNINSURED PATIENT DISCOUNTS WILL NOT BE REVERSED DUE TO NONPAYMENT OF AN ACCOUNT. IF, AT ANY TIME, RENSSELAER BECOMES AWARE THAT A PREVIOUSLY IDENTIFIED UNINSURED PATIENT WAS IN FACT COVERED BY INSURANCE AT THE TIME OF SERVICE, RENSSELAER WILL REVOKE THE UNINSURED DISCOUNT AND ISSUE A REVISED STATEMENT TO THE PATIENT AND THE ASSOCIATED INSURANCE PROVIDER. PATIENTS THAT ARE STILL NOT ABLE TO PAY THE BALANCE AFTER THE UNINSURED DISCOUNT ARE ABLE TO APPLY FOR A CHARITY CARE WRITE OFF OR A MEDICAL FINANCIAL HARDSHIP ADJUSTMENT.
SCHEDULE H, PART II	COMMUNITY BUILDING ACTIVITIES FOLLOWING NATIONAL GUIDANCE ON COMMUNITY BUILDING, ACTIVITIES RELATED TO SOCIAL DETERMINANTS ARE REPRESENTED IN OTHER CATEGORIES. FRANCISCAN ALLIANCE DOES ENGAGE IN COMMUNITY BUILDING THROUGH VARIOUS PARTNERSHIP EFFORTS. FRANCISCAN ALLIANCE DOES ENGAGE IN REDUCING BARRIERS TO HEALTH CARE ACCESS, THOUGH MOST ACTIVITIES IN THIS AREA ARE INCLUDED IN THE FINANCIAL ASSISTANCE AND OTHER COMMUNITY BENEFIT CATEGORIES. EXAMPLES INCLUDE: FREE OR LOW COST HEALTH SCREENING IN SPECIFIC NEIGHBORHOODS, IMMUNIZATION SERVICES, PRESCRIPTION MEDICATION ASSISTANCE PROGRAMS, ENROLLMENT ASSISTANCE IN MEDICAID, FOOD ASSISTANCE, TRANSPORTATION ASSISTANCE, AND REFERRAL ASSISTANCE. ADDITIONALLY, SEVERAL OF OUR HOSPITALS HAVE BEEN IDENTIFIED BY THE FEDERAL GOVERNMENT AS DESIGNATED REGIONAL MEDICATION DISTRIBUTION SITES IN THE EVENT OF A NATIONAL DISASTER OR EPIDEMIC/PANDEMIC. RESPONDING TO FEDERAL, STATE AND LOCAL NEEDS IN THE EVENT OF NATIONAL OR LOCAL DISASTERS OR EPIDEMIC/PANDEMICS, WE COLLABORATE AND COORDINATE OUR EFFORTS WITH MANY CIVIC AND OTHER AGENCIES TO ENSURE THAT THOSE NEEDS WILL BE MET SHOULD DISASTER STRIKE. EVENT OF NATIONAL OR LOCAL DISASTERS OR EPIDEMIC/PANDEMICS, WE COLLABORATE AND COORDINATE OUR EFFORTS WITH MANY CIVIC AND OTHER AGENCIES TO ENSURE THAT THOSE NEEDS WILL BE MET SHOULD DISASTER STRIKE.
SCHEDULE H, PART III, LINE 2	THROUGHOUT THE YEAR, THE CORPORATION ESTIMATES THIS ALLOWANCE BASED ON THE AGING OF ITS PATIENT ACCOUNTS RECEIVABLE, HISTORICAL COLLECTION EXPERIENCE, AND OTHER RELEVANT FACTORS. THESE FACTORS INCLUDE CHANGES IN THE ECONOMY AND UNEMPLOYMENT RATES, WHICH HAS AN IMPACT ON THE NUMBER OF UNINSURED AND UNDERINSURED PATIENTS, AS WELL AS TRENDS IN HEALTH CARE COVERAGE, SUCH AS THE INCREASED BURDEN OF DEDUCTIBLES, COPAYMENTS, AND COINSURANCE PAYMENTS TO BE MADE BY PATIENTS WITH INSURANCE. AFTER SATISFACTION OF AMOUNTS DUE FROM INSURANCE AND REASONABLE EFFORTS TO COLLECT FROM THE PATIENT HAVE BEEN EXHAUSTED, THE CORPORATION FOLLOWS ESTABLISHED PROCEDURES FOR PLACING CERTAIN PAST DUE PATIENT BALANCES WITH COLLECTION AGENCIES, SUBJECT TO THE TERMS AND CERTAIN RESTRICTIONS ON COLLECTION EFFORTS AS DETERMINED BY THE CORPORATION.
SCHEDULE H, PART III, LINE 3	THE CORPORATION HAS A SYSTEM-WIDE CHARITY CARE AND UNINSURED DISCOUNT POLICY; HAS DETAILED ADMINISTRATIVE PROCEDURES ESTABLISHED FOR QUALIFYING AND ENROLLING PATIENTS FOR CHARITY CARE OR UNINSURED/UNDERINSURED DISCOUNTS; USES VARIOUS ANALYTICAL PROGRAMS INCLUDING SOFT CREDIT INQUIRIES THAT DO NOT AFFECT CREDIT SCORES TO HELP ASSESS A PATIENT'S ABILITY TO PAY; AND UTILIZES NUMEROUS MECHANISMS TO INFORM AND EDUCATE PATIENTS ABOUT THEIR ELIGIBILITY FOR ASSISTANCE WHICH ARE DETAILED UNDER SCHEDULE H, PART VI, ITEM 3. DESPITE THESE RIGOROUS EFFORTS, PATIENTS WHO NEED SUBSIDIZED CARE MAY NOT SEEK THIS ASSISTANCE OR CHOOSE TO ENROLL IN THE STATE'S MEDICAID PROGRAM. ALSO, AS FURTHER DESCRIBED IN HFMA STATEMENT NO. 15, THE APPROPRIATE CLASSIFICATION OF CHARITY CARE AND BAD DEBT IS OFTEN DIFFICULT. THE URGENCY OF SOME TREATMENTS, AS WELL AS CERTAIN FEDERAL REGULATIONS, OFTEN REQUIRES THE PROVISION OF SERVICE WITHOUT CONSIDERATION OF THE PATIENT'S ABILITY TO PAY. SOME PATIENTS HAVE COMPLEX MEDICAL CONDITIONS WITH UNPREDICTABLE TREATMENT NEEDS. FOR THESE AND OTHER REASONS, RENSSELAER BELIEVES, A PORTION OF ITS BAD DEBT EXPENSE AS REPORTED ON LINE 3 OF PART III REPRESENTS CHARITY CARE DELIVERED TO INDIVIDUALS IN THE COMMUNITIES IT SERVES CONSISTENT WITH ITS CHARITABLE HEALTHCARE MISSION. IT SERVES CONSISTENT WITH ITS CHARITABLE HEALTHCARE MISSION.
SCHEDULE H, PART III, LINE 4	RENSSELAER IS INCLUDED IN THE CONSOLIDATED AUDITED FINANCIAL STATEMENTS OF FRANCISCAN ALLIANCE, INC. THE CORPORATION'S ALLOWANCE FOR DOUBTFUL ACCOUNTS FOOTNOTE FROM ITS AUDITED FINANCIAL STATEMENTS IS AS FOLLOWS: FRANCISCAN ALSO PROVIDES A SIGNIFICANT AMOUNT OF UNCOMPENSATED CARE TO PATIENTS WHICH IS NOT REPORTED IN THE SUMMARY OF QUANTIFIABLE COMMUNITY BENEFITS. IN ACCORDANCE WITH FINANCIAL ACCOUNTING STANDARDS BOARD ("FASB") ACCOUNTING STANDARD UPDATE ("ASU") 2014-9, REVENUE FROM CONTRACTS WITH CUSTOMERS (TOPIC 606), FRANCISCAN RECOGNIZES REVENUE IN AN AMOUNT THAT REFLECTS THE CONSIDERATION THE ENTITY EXPECTS TO BE ENTITLED TO IN AN EXCHANGE FOR GOODS OR SERVICES. ADOPTION OF THIS ASU DOES NOT ALLOW THE SEPARATE REPORTING OF THE UNCOLLECTIBLE AMOUNTS DUE FROM PATIENTS; HOWEVER, THE IDENTIFICATION OF THIS AMOUNT IS NEEDED FOR OTHER PURPOSES INCLUDING GOVERNMENTAL REPORTING AND REIMBURSEMENT CALCULATIONS. FRANCISCAN HAS A SYSTEM-WIDE CHARITY CARE AND UNINSURED DISCOUNT POLICY THAT INCLUDES ADMINISTRATIVE PROCEDURES FOR QUALIFYING AND ENROLLING PATIENTS FOR CHARITY CARE OR UNINSURED/UNDERINSURED DISCOUNTS. FRANCISCAN ALSO USES VARIOUS ANALYTICAL PROGRAMS TO ASSESS A PATIENT'S ABILITY TO PAY AND IT UTILIZES NUMEROUS MECHANISMS TO INFORM AND EDUCATE PATIENTS ABOUT FINANCIAL ASSISTANCE. DESPITE THESE RIGOROUS EFFORTS, PATIENTS WHO NEED SUBSIDIZED CARE MAY NOT SEEK THIS ASSISTANCE NOR CHOOSE TO ENROLL IN MEDICAID OR OTHER FINANCIAL ASSISTANCE PROGRAMS. FOR THESE AND OTHER REASONS, FRANCISCAN BELIEVES A PORTION OF ITS UNCOLLECTIBLE AMOUNTS DUE FROM PATIENTS REPRESENTS CHARITY CARE DELIVERED TO INDIVIDUALS IN THE COMMUNITIES IT SERVES CONSISTENT WITH ITS CHARITABLE HEALTH CARE MISSION. DURING THE YEARS ENDED DECEMBER 31, 2022 AND 2021, FRANCISCAN INCURRED APPROXIMATELY $7.8 MILLION AND $34.5 MILLION, RESPECTIVELY, AS UNCOLLECTIBLE AMOUNTS DUE FROM PATIENTS BASED ON ACCUMULATED CHARGES.
SCHEDULE H, PART III, LINE 8	CONSISTENT WITH THE CHARITABLE HEALTHCARE MISSION OF RENSSELAER AND THE COMMUNITY BENEFIT STANDARD SET FORTH IN IRS REVENUE RULING 69-545 AND THE REQUIREMENTS OF IRC SECTION 501(R), RENSSELAER PROVIDES CARE FOR ALL PATIENTS COVERED BY MEDICARE SEEKING MEDICAL CARE AT RENSSELAER. SUCH CARE IS PROVIDED REGARDLESS OF WHETHER THE REIMBURSEMENT PROVIDED FOR SUCH SERVICES MEETS OR EXCEEDS THE COSTS INCURRED BY RENSSELAER TO PROVIDE SUCH SERVICES. LIKE MEDICAID, PAYMENT RATES FOR MEDICARE ARE SET BY LAW RATHER THAN THROUGH A NEGOTIATION PROCESS AS WITH PRIVATE INSURERS. THESE PAYMENT RATES ARE CURRENTLY SET BELOW THE COSTS OF PROVIDING CARE RESULTING IN UNDERPAYMENTS. MEDICARE RATES ARE DETERMINED WITHIN THE CONTEXT OF ALL THE BUDGETARY NEEDS OF THE FEDERAL GOVERNMENT AND MEDICARE PAYMENTS HAVE HISTORICALLY BEEN SET BELOW THE COSTS OF PROVIDING CARE TO MEDICARE PATIENTS THOUGH HOW FAR BELOW VARIES OVER TIME AND BY SERVICE. EACH YEAR MEDICARE IS SUPPOSED TO PROVIDE HOSPITALS AN INCREASE IN BOTH INPATIENT AND OUTPATIENT PAYMENTS TO ACCOUNT FOR INFLATION IN THE PRICES FOR GOODS AND SERVICES HOSPITALS MUST PURCHASE IN ORDER TO PROVIDE PATIENT CARE. HOWEVER INPATIENT UPDATES HAVE BEEN SET BELOW THE RATE OF INFLATION AND ACTUALLY NEGATIVE IN RECENT YEARS RESULTING IN A SHORTFALL THAT HAS GROWN OVER TIME. THE COMPOUNDING ISSUE THAT OCCURS IS THAT THIS SHORTFALL JEOPARDIZES HOSPITAL'S ABILITY TO SERVE THEIR COMMUNITIES BECAUSE THEY ARE NOT REIMBURSED THEIR INCURRED COSTS. PROVIDERS MAKE THE DECISION TO ELIMINATE OR SIGNIFICANTLY REDUCE NECESSARY CLINICAL SERVICES WITHIN THE MARKETPLACE PLACING THE MEDICARE SHORTFALL BURDEN ON OTHERS THAT DO, SUCH AS RENSSELAER. GIVEN THAT RENSSELAER PROVIDES SUCH SERVICES TO MEDICARE PATIENTS KNOWING THAT THEY WILL RESULT IN A LOSS, AND GIVEN THAT RENSSELAER BELIEVES THAT IT PROVIDES THESE SERVICES IN AN EFFICIENT AND COST EFFECTIVE MANNER, THE SHORTFALL REPORTED ON LINE 7 OF PART III SHOULD BE VIEWED AS COMMUNITY BENEFIT PROVIDED BY RENSSELAER. ------------------------------------------------
SCHEDULE H, PART III, LINE 9B	RENSSELAER'S WRITTEN CHARITY CARE AND UNINSURED PATIENT DISCOUNT POLICY AND PATIENT COLLECTION PROCEDURE INCLUDE VARIOUS PROVISIONS ON THE COLLECTION PRACTICES TO BE FOLLOWED FOR PATIENTS WHO ARE KNOWN TO QUALIFY FOR CHARITY OR FINANCIAL ASSISTANCE. IF A PATIENT QUALIFIES FOR CHARITY OR FINANCIAL ASSISTANCE CERTAIN COLLECTION PRACTICES DO NOT APPLY.
STATE FILING OF COMMUNITY BENEFIT REPORT	IN

Schedule J IRS990ScheduleJ

Field	Value	IRS element (for citing)
Severance Payment	false	SeverancePaymentInd
Supplemental Nonqual Rtr Plan	false	SupplementalNonqualRtrPlanInd
Equity Based Comp Arrngm	false	EquityBasedCompArrngmInd
Comp Based On Revenue Of Flng Org	false	CompBasedOnRevenueOfFlngOrgInd
Comp Bsd On Rev Related Orgs	false	CompBsdOnRevRelatedOrgsInd
Comp Bsd Net Earns Flng Org	false	CompBsdNetEarnsFlngOrgInd
Comp Bsd Net Earns Rltd Orgs	false	CompBsdNetEarnsRltdOrgsInd
Any Non Fixed Payments	false	AnyNonFixedPaymentsInd
Initial Contract Exception	false	InitialContractExceptionInd

Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp (4 entries)

TitleTitleTxt	Base Compensation Filing OrgBaseCompensationFilingOrgAmt	Compensation Based On Rltd OrgsCompensationBasedOnRltdOrgsAmt	Bonus Filing OrganizationBonusFilingOrganizationAmount	Bonus Related OrganizationsBonusRelatedOrganizationsAmt	Other Compensation Filing OrgOtherCompensationFilingOrgAmt	Other Compensation Rltd OrgsOtherCompensationRltdOrgsAmt	Deferred Compensation Flng OrgDeferredCompensationFlngOrgAmt	Deferred Comp Rltd OrgsDeferredCompRltdOrgsAmt	Nontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgAmt	Nontaxable Benefits Rltd OrgsNontaxableBenefitsRltdOrgsAmt	Total Compensation Filing OrgTotalCompensationFilingOrgAmt	Total Compensation Rltd OrgsTotalCompensationRltdOrgsAmt	Comp Report Prior990 Filing OrgCompReportPrior990FilingOrgAmt	Comp Report Prior990 Rltd OrgsCompReportPrior990RltdOrgsAmt
KEVIN D LEAHY
PRESIDENT & TRUSTEE	$0	$2,044,355	$0	$0	$0	$41,000	$0	-$115,737	$0	$14,921	$0	$1,984,539	$0	$0
TERRANCE WILSON
FACILITY CEO/PRES OF HOSP DIV	$0	$804,800	$0	$0	$0	$27,000	$0	-$32,728	$0	$20,605	$0	$819,677	$0	$0
KARI L GOODMAN
DIRECTOR PATIENT CARE SERVICES	$137,807	$0	$0	$0	$0	$0	$0	$0	$14,333	$0	$152,140	$0	$0	$0
AGNES THERADY
SENIOR VICE PRESIDENT CNO	$0	$458,984	$0	$0	$0	$14,194	$0	$18,300	$0	$14,921	$0	$506,399	$0	$0

Supplemental Information Detail SupplementalInformationDetail

Field	Value	IRS element (for citing)
Form And Line Reference	SCHEDULE J, PART I, LINE 3	FormAndLineReferenceDesc
Explanation	FRANCISCAN HEALTH RENSSELAER, INC. DOES NOT COMPENSATE ITS PRESIDENT.	ExplanationTxt

Schedule O IRS990ScheduleO

Supplemental Information Detail SupplementalInformationDetail (8 entries)

Form And Line ReferenceFormAndLineReferenceDesc	ExplanationExplanationTxt
FORM 990, PART I, LINE 1	THE MISSION OF FRANCISCAN HEALTH RENSSELAER ("FH RENSSELAER") IS TO PROVIDE THE HIGHEST QUALITY OF HEALTHCARE IN A COMPASSIONATE MANNER TO OUR PATIENTS AND TO THOSE IN THE LOCAL COMMUNITY WE SERVE.
FORM 990, PART III, LINE 1	THE PURPOSES FOR WHICH FRANCISCAN HEALTH RENSSELAER IS FORMED ARE: TO CONTINUE THE HEALING MINISTRY OF CHRIST IN ACCORDANCE WITH THE TEACHINGS OF THE ROMAN CATHOLIC CHURCH AND, IN PARTNERSHIP WITH OTHERS, TO PROVIDE A FULL CONTINUUM OF HEALTH CARE SERVICES; TO CARRY ON EDUCATIONAL ACTIVITIES RELATED TO THE PROMOTION OF HEALTH; TO PROMOTE AND CARRY ON SCIENTIFIC RESEARCH RELATED TO HEALTH CARE; AND TO PARTICIPATE IN ANY ACTIVITY DESIGNED AND CONDUCTED TO PROMOTE THE GENERAL HEALTH OF THOSE SERVED BY FRANCISCAN HEALTH RENSSELAER. THE REVENUES OF FRANCISCAN HEALTH RENSSELAER ALLOW FOR THE OPERATION OF HEALTH CARE FACILITIES WHERE THE PURPOSE IS TO RESPECT LIFE AND TO PRESERVE HEALTH AS WELL AS TREAT ILLNESS AND INJURY. THIS ALLOWS FOR THE ACCOMPLISHMENT OF THE CORPORATE MINISTRY WHICH HAS THE FOLLOWING CENTRAL CONCERNS: COMPASSION FOR THOSE IN NEED, RESPECT FOR LIFE AND THE DIGNITY OF PERSONS, WELLNESS AND THE PREVENTION OF ILLNESS, RESTORATION TO HEALTH, AND THE ACCEPTANCE OF DEATH AS THE FINAL STEP TOWARDS WHOLENESS. WWW.FRANCISCANHEALTH.ORG/COMMUNITYHEALTH REFLECTS OUR MISSION OF "CONTINUING CHRIST'S MINISTRY IN OUR FRANCISCAN TRADITION."
FORM 990, PART VI, LINE 6	FRANCISCAN ALLIANCE, INC. IS THE SOLE MEMBER OF FRANCISCAN HEALTH RENSSELAER, INC.
FORM 990, PART VI, LINE 7B	CERTAIN POWERS HAVE BEEN RESERVED TO THE MEMBER. THOSE POWERS INCLUDE: - THE ADOPTION, AMENDMENT, RESTATEMENT OR REPEAL OF THE MISSION STATEMENT OF FH RENSSELAER; - THE EXPANSION OF SERVICES OF FH RENSSELAER TO PROMOTE THE HEALTH OF A BROAD CROSS-SECTION OF THE COMMUNITY SERVED BASED ON MEDICAL NECESSITY REGARDLESS OF THE PATIENT'S RACE, CREED, NATIONAL ORIGIN, GENDER, PAYOR SOURCE OR ABILITY TO PAY CONSISTENT WITH THE REQUIREMENTS OF SECTIONS 501(C)(3) AND 501(R) OF THE CODE AND APPLICABLE IRS REVENUE RULINGS AND SIMILAR GUIDANCE ISSUED BY THE INTERNAL REVENUE SERVICE FROM TIME TO TIME; - ASSURING THAT FH RENSSELAER IS IN COMPLIANCE WITH THE OPERATING COVENANTS REGARDING PROTECTION OF THE CHARITABLE MISSION OF THE SOLE MEMBER AND ITS CHARITY CARE AND COMMUNITY BENEFIT POLICIES, AS AMENDED FROM TIME TO TIME AND IS ACTING EXCLUSIVELY IN FURTHERANCE OF ITS TAX EXEMPT PURPOSES AND IN A MANNER THAT WILL NOT ADVERSELY AFFECT THE TAX EXEMPT STATUS OF FH RENSSELAER OR THE SOLE MEMBER; AND - ASSURING THAT FH RENSSELAER IS IN COMPLIANCE WITH THE ETHICAL AND RELIGIOUS DIRECTIVES FOR CATHOLIC HEALTH CARE SERVICES, AS PROMULGATED FROM TIME TO TIME BY THE UNITED STATES CONFERENCE OF CATHOLIC BISHOPS, OR ITS SUCCESSOR, AND AS INTERPRETED BY THE LOCAL BISHOP FROM TIME TO TIME, INCLUDING, WITHOUT LIMITATION, THE EXCLUSIVE RIGHT TO DETERMINE AND MAINTAIN THE RELIGIOUS IDENTITY, PHILOSOPHY, MISSION, AND PURPOSE OF FH RENSSELAER, AND TO APPROVE ANY CHANGE IN THE FUNDAMENTAL PURPOSES, MISSION OR OPERATION OF FH RENSSELAER AS WELL AS THE RIGHT TO APPROVE ANY SALE, PURCHASE, MORTGAGE OR ENCUMBRANCE OF ANY REAL PROPERTY OF THE CORPORATION, WHERE SUCH APPROVAL IS REQUIRED BY CANON LAW. - AMEND, RESTATE OR REPEAL THE ARTICLES OF INCORPORATION OR BYLAWS OF FH RENSSELAER AFTER CONSULTATION WITH THE BOARD; - APPROVE A PLAN OF DISSOLUTION OF FH RENSSELAER, DISSOLVE FH RENSSELAER, AND WIND UP AND LIQUIDATE FH RENSSELAER'S BUSINESS AND AFFAIRS; - APPROVE A PLAN OF MERGER OR CONSOLIDATION OF FH RENSSELAER INTO OR WITH ANOTHER ENTITY, OR THE ORGANIZATION OF OR AFFILIATION WITH ANOTHER ENTITY, OR THE ACQUISITION OF THE ASSETS, MEMBERSHIP INTERESTS, STOCK OR OTHER OWNERSHIP INTERESTS OF ANOTHER ENTITY; - APPROVE THE SALE, LEASE OR OTHER TRANSFER OF ANY ASSETS OF FH RENSSELAER OTHER THAN IN THE ORDINARY AND USUAL COURSE OF FH RENSSELAER'S BUSINESS AND IN EXCESS OF AN AMOUNT ESTABLISHED FROM TIME TO TIME BY THE SOLE MEMBER; - VOLUNTARILY DECLARE THE BANKRUPTCY OF FH RENSSELAER; - APPROVE THE ADMISSION OR REMOVAL OF A MEMBER; - APPROVE A STRATEGIC PLAN OF FH RENSSELAER AND ANY MODIFICATIONS THERETO OR REPLACEMENTS THEREOF DEVELOPED AND RECOMMENDED BY THE BOARD IN CONJUNCTION WITH THE HOSPITAL, WITH SUCH MODIFICATIONS THERETO AS THE MEMBER MAY DEEM NECESSARY OR APPROPRIATE; - APPROVE ANNUAL AND LONG-TERM CAPITAL AND OPERATING BUDGETS DEVELOPED AND RECOMMENDED BY THE BOARD IN CONJUNCTION WITH THE HOSPITAL, WITH SUCH MODIFICATIONS AS SOLE MEMBER MAY DEEM NECESSARY OR APPROPRIATE, OR APPROVE ANY CHANGES THEREIN OR DEVIATIONS THEREFROM; - APPROVE THE INCURRENCE OF DEBT BY FH RENSSELAER OR ANY ORGANIZATION CONTROLLED BY FH RENSSELAER (OTHER THAN ACCOUNTS PAYABLE INCURRED FOR THE ACQUISITION OF GOODS AND SERVICES IN THE ORDINARY AND USUAL COURSE OF FH RENSSELAER'S BUSINESS) AND TO GRANT ANY SECURITY INTERESTS, PLACE ANY ENCUMBRANCES OR ENTER INTO ANY COVENANTS IN CONNECTION WITH THE INCURRENCE OF SUCH DEBT; - CHANGE THE STATUS OF FH RENSSELAER FOR FEDERAL TAX PURPOSES, MAKE ANY STATE OR FEDERAL TAX ELECTION ON BEHALF OF FH RENSSELAER AND SELECT OR DISMISS THE INDEPENDENT PUBLIC ACCOUNTANTS FOR FH RENSSELAER; - APPROVE AND ENTER INTO, IN THE NAME OF OR ON BEHALF OF FH RENSSELAER, MANAGED CARE AND OTHER THIRD PARTY PAYOR CONTRACTS, AMENDMENTS THERETO OR THE TERMINATION THEREOF BY THE COMPANY HEALTH INSURANCE PLANS; - APPROVE PROGRAMS AND FH RENSSELAER'S PARTICIPATION THEREIN TO SUPPORT CLINICAL INTEGRATION INITIATIVES (INCLUDING, WITHOUT LIMITATION, ACCOUNTABLE CARE ORGANIZATIONS AND MEDICAL HOMES); - PROMULGATE POLICIES BINDING ON FH RENSSELAER. - ADOPT, AMEND AND TERMINATE EMPLOYEE BENEFITS AND EMPLOYEE BENEFIT PLANS, INCLUDING, BUT NOT LIMITED TO RETIREMENT PLANS, DEFERRED COMPENSATION PLANS, AND EMPLOYEE WELFARE PLANS PROVIDING FOR HEALTH, DENTAL AND VISION BENEFITS, DISABILITY BENEFITS, DEATH BENEFITS, PAID TIME OFF BENEFITS, PREPAID LEGAL SERVICES, DAY CARE CENTERS, SCHOLARSHIP FUNDS, APPRENTICESHIP AND TRAINING BENEFITS, OR OTHER BENEFITS; - APPOINT AND REMOVE FH RENSSELAER'S OFFICERS, WITH OR WITHOUT CAUSE, AFTER CONSULTATION WITH THE BOARD; - CHOOSE OR DISMISS THE INDEPENDENT PUBLIC ACCOUNTS FOR FH RENSSELAER; AND - REVIEW AND APPROVE FH RENSSELAER'S COMPLIANCE PLAN. - MONITORING MISSION INTEGRATION ENDEAVORS OF FH RENSSELAER AND THE HOSPITAL; - THE QUALITY AND SAFETY PLANS FOR FH RENSSELAER AND THE HOSPITAL; - ALL MEDICAL STAFF AFFAIRS FOR FH RENSSELAER AND THE HOSPITAL INCLUDING BUT NOT LIMITED TO ACTING AS THE BOARD FOR THE APPROVAL OF THE APPOINTMENTS AND RE-APPOINTMENTS AND THE GRANTING OF CLINICAL PRIVILEGES TO PHYSICIANS TO THE MEDICAL STAFF AS RECOMMENDED BY THE MEDICAL STAFF AFFAIRS/QUALITY IMPROVEMENT COMMITTEE OF THE HOSPITAL; - ACTING AS THE BOARD FOR THE CREDENTIALING AND RE-CREDENTIALING OF ALLIED HEALTH PERSONNEL AS RECOMMENDED BY THE MEDICAL STAFF AFFAIRS/QUALITY IMPROVEMENT COMMITTEE OF THE HOSPITAL; - THE DEVELOPMENT AND RECOMMENDATION OF THE ANNUAL BUDGET OF FH RENSSELAER INCLUDING STAFFING, APPROPRIATE FOR THE SCOPE AND COMPLEXITY FOR SERVICES OFFERED AT THE HOSPITAL AND OTHER FACILITIES OF FH RENSSELAER; - THE DEVELOPMENT AND RECOMMENDATION OF FH RENSSELAER'S STRATEGIC PLAN IN ACCORD WITH THE MISSION, VISION, VALUES, AND STRATEGIC PLAN OF THE SOLE MEMBER; - ACTIVE PARTICIPATION IN RELEVANT PROGRAMS OF RESEARCH, EDUCATION, AND HEALTH - PROJECTS, ALL IN THE FURTHERANCE OF THE PROMOTION OF HEALTH; - PROVISION FOR THE ADEQUACY OF THE PHYSICAL PLANT OF THE HOSPITAL AND OTHER FACILITIES OF FH RENSSELAER; AND - ASSISTING THE SOLE MEMBER AND OTHER ENTITIES IN WHICH THE SOLE MEMBER HAS AN OWNERSHIP INTEREST, WITH RESPECT TO THE MANAGEMENT AND OPERATION OF THEIR HEALTH CARE FACILITIES AND OPERATIONS WITHIN THE WESTERN INDIAN REGION. THE NATURE OF THEIR VOTING RIGHTS: ON MATTERS RESERVED TO EITHER FRANCISCAN ALLIANCE, INC. OR ITS BOARD, MAJORITY VOTE AT WHICH A QUORUM IS PRESENT.
FORM 990, PART VI, SECTION B, LINE 11B	THE INFORMATION TO PREPARE THE FORM 990 IS GATHERED BY FINANCE STAFF AND MISSION REPRESENTATIVES AND PROVIDED TO ITS ACCOUNTING FIRM WHO PREPARES THE RETURN. SENIOR MANAGEMENT THEN REVIEWS THE RETURN PRIOR TO FILING. THE FORM 990 IS ALSO MADE AVAILABLE TO FRANCISCAN HEALTH RENSSELAER'S BOARD OF TRUSTEES AND BOARD FINANCE COMMITTEE PRIOR FILING.
FORM 990, PART VI, SECTION B, LINE 12C	FH RENSSELAER REQUIRES ANNUAL CONFLICT OF INTEREST STATEMENTS FROM EACH DIRECTOR, PRINCIPAL OFFICER, MEMBERS OF COMMITTEES WITH BOARD DESIGNATED POWERS, KEY EMPLOYEES, AND EXECUTIVE LEADERSHIP COMMITTEE MEMBERS WHICH AFFIRMS THAT THEY HAVE RECEIVED, READ, AND UNDERSTAND THE CONFLICT OF INTEREST POLICY AND HAVE AGREED TO COMPLY WITH THE POLICY. IN CONNECTION WITH ANY ACTUAL OR POSSIBLE CONFLICT OF INTEREST, A DIRECTOR, PRINCIPAL OFFICER OR MEMBER OF A COMMITTEE WITH BOARD DESIGNATED POWERS MUST DISCLOSE THE EXISTENCE AND NATURE OF THE FINANCIAL INTEREST TO THE DIRECTORS AND MEMBERS OF COMMITTEES WITH BOARD DELEGATED POWERS CONSIDERING THE PROPOSED TRANSACTION OR ARRANGEMENTS. AFTER DISCLOSURES OF THE FINANCIAL INTEREST, THE DIRECTOR, PRINCIPAL OR COMMITTEE MEMBER SHALL LEAVE THE BOARD OR COMMITTEE MEETING WHILE THE FINANCIAL INTEREST IS DISCUSSED AND VOTE TAKEN. IN ADDITION, ONGOING REVIEWS AND ASSESSMENTS ARE MADE TO MAKE CERTAIN THAT FH RENSSELAER OPERATES IN A MANNER CONSISTENT WITH ITS CHARITABLE PURPOSES. IN CONDUCTING THE ONGOING REVIEWS AND ASSESSMENTS, FH RENSSELAER USES INTERNAL AND EXTERNAL ADVISORS. REVIEWS INCLUDE COMPENSATION ARRANGEMENTS, ACQUISITIONS, PARTNERSHIPS, JOINT VENTURE ARRANGEMENTS, AND AGREEMENTS TO PROVIDE HEALTH CARE PRODUCTS/SERVICES, ETC.
FORM 990, PART VI, SECTION B, LINE 15	FRANCISCAN HEALTH RENSSELAER, INC. DOES NOT COMPENSATE ITS OFFICERS OR KEY EMPLOYEES.
FORM 990, PART VI, SECTION C, LINE 19	FRANCISCAN HEALTH RENNSELAER, INC.'S ARTICLES OF INCORPORATION ARE AVAILABLE ON THE INDIANA SECRETARY OF STATE WEBSITE. THE BYLAWS AND CONFLICTS OF INTEREST POLICY ARE AVAILABLE UPON WRITTEN REQUEST. THE AUDITED FINANCIAL STATEMENTS ARE AVAILABLE ON THE ELECTRONIC MUNICIPAL MARKET ACCESS (EMMA) WEBSITE.

Schedule R IRS990ScheduleR

Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp (7 entries)

Address Line1USAddress/AddressLine1Txt	CityUSAddress/CityNm	State AbbreviationUSAddress/StateAbbreviationCd	ZIPUSAddress/ZIPCd	EINEIN	Primary ActivitiesPrimaryActivitiesTxt	Legal Domicile StateLegalDomicileStateCd	Exempt Code SectionExemptCodeSectionTxt	Public Charity StatusPublicCharityStatusTxt	Business Name Line1DirectControllingEntityName/BusinessNameLine1Txt	Controlled OrganizationControlledOrganizationInd
FRANCISCAN ALLIANCE INC
1515 DRAGOON TRAIL	MISHAWAKA	IN	46544	351330472	HEALTH SRVCS	IN	501(C)(3)	3	NA	false
HILLS INSURANCE COMPANY INC
1515 DRAGOON TRAIL	MISHAWAKA	IN	46544	030372512	CAPTIVE INS	VT	501(C)(3)	12 - TYPE 1	FRANCISCAN	false
SISTERS OF ST FRANCIS OF PERPETUAL ADOR
PO BOX 766	MISHAWAKA	IN	46546	351328145	RELIGIOUS	IN	501(C)(3)	1	NA	false
ST ALEXIS HOSPITAL ASSOCIATION
PO BOX 1290	MISHAWAKA	IN	46546	340714485	SUPPORT ALEXA	OH	501(C)(3)	3	FRANCISCAN	false
FRANCISCAN VNS HOME CARE INC
4701 N KEYSTONE AVE S418	INDIANAPOLIS	IN	46205	350868199	HOME HEALTH	IN	501(C)(3)	10	FRANCISCAN	false
FRANCISCAN HEALTH FOUNDATION INC
1515 DRAGOON TRAIL	MISHAWAKA	IN	46544	351955283	FUNDRAISING	IN	501(C)(3)	7	FRANCISCAN	false
FRANCISCAN ACO INC
700 E SOUTHPORT ROAD	INDIANAPOLIS	IN	46227	351904455	HEALTHCARE	IN	501(C)(3)	12 - TYPE I	FRANCISCAN	false

Id Related Org Txbl Partnership IdRelatedOrgTxblPartnershipGrp (8 entries)

Address Line1USAddress/AddressLine1Txt	CityUSAddress/CityNm	State AbbreviationUSAddress/StateAbbreviationCd	ZIPUSAddress/ZIPCd	EINEIN	Primary ActivitiesPrimaryActivitiesTxt	Legal Domicile StateLegalDomicileStateCd	Business Name Line1DirectControllingEntityName/BusinessNameLine1Txt	Predominant Income TypePredominantIncomeTypeTxt
FRANCISCAN SURGERY CENTER LLC
421 N EMERSON AVE	BEECH GROVE	IN	46107	352128334	MEDICAL SERVICES	IN	NA	N/A
ST FRANCIS RADIATION THERAPY CENTERS
421 N EMERSON AVE	BEECH GROVE	IN	46107	770663631	MEDICAL SERVICES	IN	NA	N/A
ST FRANCIS IMAGING CTR (GREENWOOD)
421 N EMERSON AVE	GREENWOOD	IN	46107	204607426	IMAGING SERVICES	IN	NA	N/A
TONN AND BLANK CONSTRUCTION LLC
1623 GREENWOOD AVE	MICHIGAN CITY	IN	46360	263919039	CONSTRUCTION	IN	NA	N/A
MAJOR HOSP CARDIAC DIAGNOSTICS LLC
2451 INTELLIPLEX DR	SHELBYVILLE	IL	46176	208715441	MEDICAL SERVICES	IN	NA	N/A
ST FRANCIS MOORESVILLE SURGERY CENTER
1215 HADLEY ROAD SUITE 100	MOORESVILLE	IN	46158	202256900	MEDICAL SERVICES	IN	NA	N/A
FRANCISCAN ORTHOPEDIC SURGERY CENTER
10777 ILLINOIS ST STE H300 H4000	CARMEL	IN	46032	845101253	MEDICAL SERVICES	IN	NA	N/A
MOORESEVILLE ENDOSCOPY CENTER LLC
1215 HADLEY ROAD SUITE 101	MOORESVILLE	IN	46158	412116930	MEDICAL SERVICES	IN	NA	N/A

Id Related Org Txbl Corp Tr IdRelatedOrgTxblCorpTrGrp (2 entries)

Address Line1USAddress/AddressLine1Txt	CityUSAddress/CityNm	State AbbreviationUSAddress/StateAbbreviationCd	ZIPUSAddress/ZIPCd	EINEIN	Primary ActivitiesPrimaryActivitiesTxt	Legal Domicile StateLegalDomicileStateCd	Business Name Line1DirectControllingEntityName/BusinessNameLine1Txt	Entity TypeEntityTypeTxt
FRANCISCAN HOLDING CORPORATION
1515 DRAGOON TRAIL	MISHAWAKA	IN	46544	363593505	HOLDING CO.	IN	NA	C CORP
SAGAMORE SURGICAL SERVICES INC
2320 CONCORD ROAD SUITE B	LAFAYETTE	IN	479092708	351850819	MEDICAL SERVICES	IN	NA	S CORP

Field	Value	IRS element (for citing)
Receipt Of Int Annts Rnts Rylts	false	ReceiptOfIntAnntsRntsRyltsInd
Gift Grnt Or Cap Contri To Oth Org	false	GiftGrntOrCapContriToOthOrgInd
Gift Grnt Cap Contri From Oth Org	Yes (true)	GiftGrntCapContriFromOthOrgInd
Loans Or Guarantees To Other Org	false	LoansOrGuaranteesToOtherOrgInd
Loans Or Guarantees From Oth Org	Yes (true)	LoansOrGuaranteesFromOthOrgInd
Div Related Organization	false	DivRelatedOrganizationInd
Asset Sale To Other Org	false	AssetSaleToOtherOrgInd
Asset Purchase From Other Org	false	AssetPurchaseFromOtherOrgInd
Asset Exchange	false	AssetExchangeInd
Rental Of Facilities To Oth Org	false	RentalOfFacilitiesToOthOrgInd
Rental Of Fclts From Oth Org	false	RentalOfFcltsFromOthOrgInd
Perform Of Services For Oth Org	false	PerformOfServicesForOthOrgInd
Perform Of Services By Other Org	false	PerformOfServicesByOtherOrgInd
Sharing Of Facilities	false	SharingOfFacilitiesInd
Paid Employees Sharing	false	PaidEmployeesSharingInd
Reimbursement Paid To Other Org	false	ReimbursementPaidToOtherOrgInd
Reimbursement Paid By Other Org	false	ReimbursementPaidByOtherOrgInd
Transfer To Other Org	false	TransferToOtherOrgInd
Transfer From Other Org	Yes (true)	TransferFromOtherOrgInd