2021-10-27T10:19:09-05:00 2020-12-31 990 2020-01-01 810232124 SCL HEALTH - MONTANA SCLH 4062377000 1233 NORTH 30TH STREET BILLINGS MT 59101 PAM PALAGI VP FINANCE & CFO 4062377000 2021-10-26 PAM PALAGI XXX-XX-XXXX 2 AAL1 IAL1 2020 2022-09-23 18:48:47Z X ST VINCENT HEALTHCARE MICHAEL SKEHAN 1233 NORTH 30TH STREET BILLINGS MT 59101 506480713 0 0928 X SEE SCHEDULE O X 1972 MT WE REVEAL AND FOSTER GOD'S HEALING LOVE BY IMPROVING THE HEALTH OF THE PEOPLE AND COMMUNITIES WE SERVE, ESPECIALLY THOSE WHO ARE POOR AND VULNERABLE. 18 15 2257 239 3361652 0 9391367 32291010 479265713 447988685 23320532 20731901 2368756 1286877 514346368 502298473 12602017 11397398 0 0 133592430 139888412 0 0 0 276976805 298470486 423171252 449756296 91175116 52542177 833718085 939194566 44301866 97236170 789416219 841958396 X WE REVEAL AND FOSTER GOD'S HEALING LOVE BY IMPROVING THE HEALTH OF THE PEOPLE AND COMMUNITIES WE SERVE, ESPECIALLY THOSE WHO ARE POOR AND VULNERABLE. 0 0 388879223 11397398 448996210 MOTHER XAVIER ROSS LED THE SISTERS OF CHARITY INTO THE INDIAN TERRITORY OF KANSAS IN 1858. IN 1869, THE SISTERS EXTENDED THEIR CHARITABLE WORKS INTO MONTANA TERRITORY AT THE REQUEST OF FATHER PIERRE JEAN DESMET. SAINT VINCENT HOSPITAL IN BILLINGS WAS FOUNDED BY THE SISTERS OF CHARITY OF LEAVENWORTH IN 1898. THE HOSPITAL OFFICIALLY OPENED ON FEBRUARY 1, 1899. THE CITY AND REGION GREW QUICKLY AND THE DEMAND FOR HEALTHCARE INCREASED DRAMATICALLY. BY 1915, THE SISTERS AND AREA MEDICAL PERSONNEL HAD CARED FOR MORE THAN 20,000 PATIENTS.DURING THE NEXT THIRTY YEARS, RAPID MEDICAL ADVANCEMENTS AND THE AREA'S GROWING POPULATION KEPT THE HOSPITAL IN A CONSTANT STATE OF CHANGE AND GROWTH, BUT TRUE TO ITS MISSION, COMPASSION AND CHARITY REMAINED AT THE FOREFRONT OF THE HOSPITAL'S ENDEAVORS. DURING THE GREAT DEPRESSION OF THE 1930S, THE SISTERS AT SAINT VINCENT HOSPITAL HELPED FEED THE HUNGRY. WITH THE ADVENT OF WORLD WAR II, VOLUNTEER SERVICES BECAME ESSENTIAL TO THE OPERATION OF THE HOSPITAL.ADAPTING TO THE CHANGES IN HEALTHCARE MEANT A NEW NAME FOR SAINT VINCENT HOSPITAL. IN NOVEMBER 2000, WE BECAME ST. VINCENT HEALTHCARE. FROM ITS MODEST BEGINNINGS OVER 100 YEARS AGO, ST. VINCENT HEALTHCARE HAS GROWN INTO ONE OF MONTANA'S LARGEST COMPREHENSIVE HOSPITALS, SERVING THE HEALTHCARE NEEDS OF OVER 400,000 PEOPLE IN A FOUR-STATE AREA. RENOWNED FOR A MISSION OF COMPASSIONATE CARE AND SERVICE TO THE POOR, THE ST. VINCENT HEALTHCARE TEAM IS CONTINUALLY RECOGNIZED AS A TECHNOLOGICAL LEADER IN THE HEALTHCARE INDUSTRY.DURING 2019, THE FOLLOWING STATISTICAL DATA WAS GATHERED:- 10,945 ADMISSIONS- 203,023 OUTPATIENT, CLINIC, AND HOME HEALTH VISTS- 31,708 EMERGENCY DEPARTMENT VISITS- 1,457 BIRTHS- 7,494 SURGERIES- 991,106 LABORATORY TESTSMISSION, VISION & VALUES MISSIONWE REVEAL AND FOSTER GOD'S HEALING LOVE BY IMPROVING THE HEALTH OF THE PEOPLE AND COMMUNITIES WE SERVE, ESPECIALLY THOSE WHO ARE POOR AND VULNERABLE.VISIONINSPIRED BY OUR FAITH, WE WILL PARTNER WITH OUR PATIENTS AND COMMUNITIES TO EXCEED THEIR EXPECTATIONS FOR HEALTH.VALUESCARING SPIRIT - WE HONOR THE SACRED DIGNITY OF EACH PERSON.EXCELLENCE - WE SET AND SURPASS HIGH STANDARDS.GOOD HUMOR - WE CREATE JOYFUL AND WELCOMING ENVIRONMENTS.INTEGRITY - WE DO THE RIGHT THING WITH OPENNESS AND PRIDE.SAFETY - WE DELIVER CARE THAT SEEKS TO ELIMINATE ALL HARM FOR PATIENTS AND ASSOCIATES. STEWARDSHIP - WE ARE ACCOUNTABLE FOR THE RESOURCES ENTRUSTED TO US.ST. VINCENT HEALTHCARE OFFERS A WIDE VARIETY OF SERVICES TO THE COMMUNITY:- BARIATRIC SURGERY - BEHAVIORAL HEALTH- BLOOD CONSERVATION PROGRAM- CANCER CARE- CARDIOLOGY- DERMATOLOGY- DIABETES CENTER- EMERGENCY SERVICES- GI DIAGNOSTIC CENTER- INTENSIVE CARE SERVICES- JOINT REPLACEMENT CENTER- KIDS HEALTH- LAB SERVICES- MAMMOGRAPHY- MANSFIELD HEALTH EDUCATION CENTER- WOMEN'S HEALTH- MS CLINIC- NEUROSCIENCE- NURSE ADVISOR- OCCUPATIONAL HEALTH SERVICES- ORTHOPEDIC SERVICES- OTOLARYNGOLOGY - OUTREACH- PAIN CENTER- PEDIATRICS- PRIMARY CARE- RADIOLOGY AND IMAGING SERVICES- REHABILITATION- RESPIRATORY- SENIOR SERVICES- SLEEP CENTER- SPORTS MEDICINE- STROKE- SURGERY SERVICES- TELEHEALTH- TRAUMA OUTREACH- UROLOGY- VASCULAR CENTER- WALK IN CARE- WEIGHT MANAGEMENT- WOUND HEALING CENTERST. VINCENT HEALTHCARE IS RELATED TO SCL HEALTH MEDICAL GROUP - BILLINGS, LLC, A SINGLE MEMBER LIMITED LIABILITY COMPANY OWNED BY A RELATED ORGANIZATION, SISTERS OF CHARITY OF LEAVENWORTH HEALTH SYSTEM, INC. SCL HEALTH MEDICAL GROUP - BILLINGS, LLC IS A GROUP OF PHYSICIAN CLINICS THAT PROVIDE PROFESSIONAL SERVICES TO THE ST. VINCENT HEALTHCARE COMMUNITY AND SUPPORTS THE MISSION OF ST. VINCENT HEALTHCARE.ALTHOUGH SCL HEALTH MEDICAL GROUP - BILLINGS, LLC IS NOT OWNED DIRECTLY BY ST. VINCENT HEALTHCARE, ST. VINCENT HEALTHCARE IS REQUIRED TO FUND ALL OPERATING LOSSES OF SCL HEALTH MEDICAL GROUP - BILLINGS, LLC. IN 2020, THE HOSPITAL PROVIDED $24,226,981 IN SUPPORT OF THE LOSSES OF THE PHYSICIAN CLINICS. 388879223 1 1 0 1 0 0 0 0 0 1 1 0 0 1 1 0 0 1 0 0 0 0 0 0 0 0 1 1 1 0 1 0 0 0 0 0 0 1 0 1 0 0 0 0 1 1 1 0 0 1 188 0 1 2257 1 1 1 0 0 0 0 0 0 0 0 0 0 0 X 18 15 0 0 1 0 1 1 1 1 1 0 0 1 1 1 1 1 1 0 0 1 1 X KYLE ENGMAN 3038135543 500 ELDORADO BLVD SUITE 4200 BROOMFIELD CO 80021 JAMES VALIN MD DIRECTOR 1.00 50.00 X 0 1105337 152887 STEVE LOVELESS PRESIDENT AND CEO 37.00 13.00 X X 0 861702 119902 STUART GOODMAN MD FORMER HIGHEST PAID 0.00 50.00 X 0 869999 28932 WILLIAM SPIRE MD FORMER HIGHEST PAID 0.00 50.00 X 0 775102 48245 JEFFREY ZAVALA FORMER KEY EMPLOYEE 0.00 50.00 X 0 546648 86058 MICHAEL SKEHAN VP CHIEF OPERATING OFFICER REGION MT 37.00 13.00 X 0 533071 79308 MICHAEL BUSH MD VP CHIEF MEDICAL OFFICER SVB 47.00 3.00 X 0 518685 84827 FRANK LAMM MD PHYSICIAN 50.00 0.00 X 512451 0 47116 TRENT MIHALICK MD PHYSICIAN 50.00 0.00 X 510439 0 47885 RONALD SNYDER MD PHYSICIAN 50.00 0.00 X 506066 0 48316 RICHARD LAMMERS MD PHYSICIAN 50.00 0.00 X 498452 0 42316 DANIEL LEWIS MD PHYSICIAN 50.00 0.00 X 475056 0 47479 PAMELA PALAGI VP FINANCE REGION MT 37.00 13.00 X 0 384989 42823 JAMES RITCHEY VP HR MT REGION 1/1-2/24 37.00 13.00 X 0 305811 65859 MICHAEL HAMILTON VP STRATEGY & BUS DEVELOPMENT SVB 50.00 0.00 X 0 293285 64229 BLANCHE GILMORE VP CHIEF NURSING OFFICER SVB 50.00 0.00 X 0 328521 26801 JESSE LASLOVICH VP NETWORK DEVELOPMENT REGION MT 37.00 13.00 X 0 289874 59356 TRACY NEARY VP MISSION INTEGRATION REGION MT 37.00 13.00 X 0 203955 50517 SUSAN PETERSEN MD DIRECTOR 1.00 50.00 X 0 198458 13547 JOHN ELLIOTT VP HR MT REGION 2/24-10/2 37.00 13.00 X 0 189566 18358 NGUYEN-VU PHAM DIRECTOR 1.00 0.00 X 0 6500 0 SHAWN COFFIN SECRETARY 2.00 0.00 X X 0 0 0 CHRIS EDWARDS DIRECTOR 1.00 0.00 X 0 0 0 KAREN FAGG CHAIR 2.00 0.00 X X 0 0 0 DANETTE GLEASON VICE CHAIR 2.00 0.00 X X 0 0 0 EILEEN HURLEY DIRECTOR 1.00 0.00 X 0 0 0 JUDITH JACKSON DIRECTOR 1.00 0.00 X 0 0 0 DEBRA JONES MD DIRECTOR 1.00 0.00 X 0 0 0 BERNARD MCCARTHY DIRECTOR 1.00 0.00 X 0 0 0 CHARLES NOTBOHM DIRECTOR 1.00 0.00 X 0 0 0 COLLEEN O'LEARY DIRECTOR 1.00 0.00 X 0 0 0 CYNTHIA REID DIRECTOR 1.00 0.00 X 0 0 0 MAJEL RUSSELL DIRECTOR 1.00 0.00 X 0 0 0 CINDY SORICH DIRECTOR 1.00 0.00 X 0 0 0 MISTY STEADMAN DIRECTOR 1.00 0.00 X 0 0 0 2502464 7411503 1174761 202 1 1 0 SAUNDERS EXPRESS LLC 6950 SOUTH JORDAN ROAD CENTENNIAL CO 80112 CONSTRUCTION 14133740 MONTANA FAMILY MEDICAL RESIDENCY 123 S 27TH ST BILLINGS MT 59101 MEDICAL SERVICES 3761810 ORTHO MONTANA PSC 2900 12TH AVE N BILLINGS MT 59101 MEDICAL SERVICES 3112190 HEMATOLOGY ONCOLOGY CENTERS OF TH 1315 GOLDEN VALLEY CIRCLE BILLINGS MT 59102 ONCOLOGY PHYSICIANS 2724867 ECHO LOCUMS TENENS INC PO BOX 742936 LOS ANGELES CA 90074 MEDICAL CONTRACT LABOR 2440693 42 7588465 24702545 160296 32291010 PATIENT SERVICE REVENUE 622110 446261479 443142437 3119042 MISSION UNITED - JV 623300 1382465 1382465 BIG HORN BSN RAC ONC - JV 621990 455753 455753 ROCKY MTN HEATLH - JV 621400 86868 86868 JOINT VENTURE OTHER 621400 -197880 -197880 447988685 22992432 22992432 1155988 5099 1119246 0 36742 5099 41841 5099 36742 802463 3062994 -2260531 -2260531 -2260531 CAFETERIA SALES 722514 986205 748694 237511 PARKING LOT FEES 531190 180411 180411 LAUNDRY SERVICE - JV 812300 75047 75047 3373 3373 1245036 502298473 445877168 3361652 20768643 X 11396189 11396189 1209 1209 3645872 3532463 113409 110158463 106731872 3426591 4183652 4183652 13418616 12945469 473147 8481809 8360248 121561 111886 111886 14 14 78263431 77646821 616610 2335400 20098 2315302 1536162 1486561 49601 30329515 3849361 26480154 8109241 7931678 177563 380090 261885 118205 218670 150148 68522 2282 2282 17794369 17778899 15470 2864829 2864829 MEDICAL SUPPLIES 92769531 92769531 BAD DEBT 10291293 10291293 SHARED SERVICES - BILLI 9935130 9935130 MAINTENANCE SERVICES 9733252 9422049 311203 33795391 17140786 16654605 449756296 388879223 60877073 0 7104 7230 69495642 52406341 132631 98262 8467579 9637045 4461705 4519657 433499485 221346855 196597340 212152630 5677416 6963677 548878668 653409724 833718085 939194566 38544421 75475457 57860 59219 5699585 21701494 44301866 97236170 X 789416219 841958396 789416219 841958396 833718085 939194566 52542177 0 X 0 1 X 1 1 1 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 0 0 0 0 0 0 0 0 1 14 14 0 PART II-B, LINE 1: ST VINCENT HEALTHCARE PAID MEMBERSHIP DUES TO THE MONTANA HOSPITAL ASSOCIATION OF WHICH $14 IS ATTRIBUTED TO LOBBYING. 30025283 2041401 4256990 1498781 34824893 25452842 867340 4621764 916663 30025283 24954332 1675842 -1177332 25452842 43040009 654720 18740397 24954332 42470513 7159174 441785 3861558 3169905 43040009 0.46645 0.53354 0.00000 0 1 1 21433828 21433828 235476829 118853432 116623397 14430129 10740253 3689876 149200217 91753170 57447047 12958482 12958482 212152630 INTERCOMPANY RECEIVABLE 591516044 RIGHT OF USE ASSETS 21509751 OTHER ACCT RECEIVABLE 2937773 3RD PARTY SETTLEMENTS 35815491 JOINT VENTURE RECEIVABLES 120877 DEFERRED TAXES 707811 RENT RECIEVABLE 801977 653409724 OPERATING LEASE 21358475 FINANCING LEASE 343019 21701494 PART V, LINE 4: THE TWO LARGEST ENDOWMENTS SUPPORT THE MT PEDIATRICS PROJECT AND NURSE EDUCATION. THE REMAINING ENDOWMENTS SUPPORT VARIOUS DEPARTMENTS IN THE HOSPITAL. 1 1 X 1 X 1 X 1 1 1 0 1 1 5636854 5636854 0.01250 70231703 71158629 0 0.00000 1008023 1718272 0 0.00000 76876580 72876901 5636854 0.01250 1672850 1672850 0.00370 320233 320233 0.00070 38635646 26166220 12469426 0.02770 9862873 9862873 0.02190 50491602 26166220 24325382 0.05400 127368182 99043121 29962236 0.06650 2482 2482 0.00000 32893 32893 0.00010 2034 2034 0.00000 37409 37409 0.00010 1 10291293 128012895 154526908 -26514013 X 1 1 1 ATHLETIC MEDICINE & PERFORMANCE LLC PHYSICAL THERAPY 0.33330 0.47410 2 ROCKY MOUNTAIN HEALTH NETWORK INC PHO - ADMINISTRATIVE SERVICES 0.50000 0.50000 3 ROCKY MOUNTAIN ACCOUNTABLE HEALTH NETWORK INC ACCOUNTABLE CARE ORGANIZATION 0.50000 0.50000 1 1 ST VINCENT HEALTHCARE 1233 NORTH 30TH STREET BILLINGS MT 59101 SEE PART VI SUPP INFO 13258 X X X X ST VINCENT HEALTHCARE 1 0 0 1 X X X X X X X X X 20 1 1 1 1 X SEE PART V, SECTION C X SEE PART V, SECTION C X X 1 20 1 SEE PART V, SECTION C 0 1 X 200.000000000000 400.000000000000 X X X 1 1 X X X X 1 X SEE PART V, SECTION C X SEE PART V, SECTION C X SEE PART V, SECTION C X X X X X X 1 X 0 X X X X 1 X 0 0 ST. VINCENT HEALTHCARE PART V, SECTION B, LINE 5: THE 2020 CHNA WAS CONDUCTED BY ST. VINCENT HEALTHCARE IN PARTNERSHIP WITH BILLINGS CLINIC, A HOSPITAL LOCATED IN BILLINGS, MT, THE CITY-COUNTY HEALTH DEPARTMENT AND RIVERSTONE HEALTH UTILIZING PRC, A NATIONALLY RECOGNIZED HEALTHCARE CONSULTING FIRM. THE CHNA ADVISORY COMMITTEE INCLUDED AREA RESIDENTS AND ORGANIZATIONAL REPRESENTATIVES EITHER IDENTIFYING AS OR SERVING LOW-INCOME, MINORITY, OR OTHER MEDICALLY UNDERSERVED POPULATIONS. THE ADVISORY GROUP PROVIDED INPUT THROUGHOUT THE CHNA/CHIP PROCESS INCLUDING MAJOR ACTIVITIES SUCH AS THE QUESTIONNAIRE, STAKEHOLDERS INVOLVED IN THE KEY INFORMANT SURVEY AND INVITEES FOR THE PRIORITIZATION PROCESS. THE CHNA INCORPORATED: 1) PRIMARY QUANTITATIVE DATA (A 400 HOUSEHOLD TELEPHONE COMMUNITY HEALTH SURVEY), 2) SECONDARY QUANTITATIVE DATA (EXISTING PUBLIC HEALTH DATA) AND 3) PRIMARY QUALITATIVE DATA (ONLINE KEY INFORMANT SURVEYS). THE SAMPLE DRAWN FOR THE 400 HOUSEHOLD TELEPHONE SURVEY IS REPRESENTATIVE OF THE ADULT YELLOWSTONE COUNTY POPULATION IN TERMS OF DEMOGRAPHIC AND SOCIOECONOMIC CHARACTERISTICS, AS WELL AS GEOGRAPHIC LOCATION. THE 2020 CHNA WAS A FOLLOW-UP TO SIMILAR SURVEYS CONDUCTED IN 2017, 2014, 2011, AND 2006 WHICH ALLOWED FOR TRENDING OVER TIME.TO SOLICIT INPUT FOR KEY INFORMANTS, AN ONLINE KEY INFORMANT SURVEY WAS IMPLEMENTED. 154 COMMUNITY STAKEHOLDERS TOOK PART IN THE ONLINE KEY INFORMANT SURVEY INCLUDING REPRESENTATIVES OF COMMUNITY BASED ORGANIZATIONS, EDUCATION, GOVERNMENT, BUSINESS, HEALTHCARE AND PUBLIC HEALTH. THROUGHOUT THE PROCESS, INPUT WAS GATHERED FROM INDIVIDUALS WHOSE ORGANIZATIONS WORK WITH LOW-INCOME, MINORITY POPULATIONS, OR OTHER MEDICALLY UNDERSERVED POPULATIONS. MINORITY/MEDICALLY UNDERSERVED POPULATIONS REPRESENTED BY KEY INFORMANTS INCLUDED: AMERICAN INDIANS, CHILDREN, COLLEGE STUDENTS, THOSE WITH CO-OCCURRING DISORDERS, CRIMINAL OFFENDERS, THOSE WITH DISABILITIES, THE ELDERLY, ENGLISH AS A SECOND LANGUAGE, HISPANICS, HOMELESS INDIVIDUALS, HUTTERITES, IMMIGRANTS, LGBTQ+, LOW INCOME, THE MENTALLY ILL, MULTI-RACIAL INDIVIDUALS, PREGNANT TEENS, RUNAWAYS, RURAL RESIDENTS, SINGLE PARENTS, SUBSTANCE ABUSERS, UNINSURED/UNDERINSURED RESIDENTS, VETERANS, VICTIMS OF VIOLENCE, WOMEN, AND INDIVIDUALS WITH CHRONIC DISEASE SUCH AS CANCER, DIABETES, HIGH BLOOD PRESSURE, AND HIV/AIDS. IN ADDITION, FEEDBACK FROM DIVERSE GROUPS WAS COLLECTED USING STREETWYZE/ISEEED, AN ONLINE COMMUNITY ENGAGEMENT PLATFORM. STREETWYZE PROVIDED THE OPPORTUNITY FOR COMMUNITY MEMBERS TO SHARE FIRST-HAND PERCEPTIONS AND EXPERIENCES OF THEIR COMMUNITY. A PROJECT SPECIFIC PROMPT WAS CREATED TO SOLICIT FEEDBACK SPECIFICALLY RELATED TO COMMUNITY HEALTH BARRIERS AND OPPORTUNITIES. A TOTAL OF 428 DATA POINTS WERE COLLECTED THROUGH 120 UNIQUE USER ACCOUNTS. ST. VINCENT HEALTHCARE PART V, SECTION B, LINE 6A: THE 2020 CHNA WAS CONDUCTED IN PARTNERSHIP WITH BILLINGS CLINIC, A HOSPITAL LOCATED IN BILLINGS, MT. ST. VINCENT HEALTHCARE PART V, SECTION B, LINE 6B: THE CHNA WAS CONDUCTED WITH THE CITY-COUNTY HEALTH DEPARTMENT, AND RIVERSTONE HEALTH. IN ADDITION, 93 REPRESENTATIVES FROM BUSINESS, COMMUNITY, EDUCATION, FAITH-BASED ORGANIZATIONS, SOCIAL SERVICE, AND GOVERNMENT WERE INVOLVED IN THE CHNA PROCESS AS MEMBERS OF THE CHNA ADVISORY GROUP WHICH PROVIDED OVERSIGHT TO THE CHNA PROCESS.ST. VINCENT HEALTHCARE:PART V, SECTION B, LINE 7A: HTTPS://WWW.SCLHEALTH.ORG/LOCATIONS/ST-VINCENT-HEALTHCARE/ABOUT/COMMUNITY-BENEFIT/COMMUNITY-HEALTH-NEEDS-ASSESSMENT/ ST. VINCENT HEALTHCARE:PART V, SECTION B, LINE 7B: HTTPS://WWW.HEALTHYBYDESIGNYELLOWSTONE.ORG/WP-CONTENT/UPLOADS/2020-PRC-CHNA-REPORT-YELLOWSTONE-COUNTY-MT-FINAL-2020.02.07.PDF ST. VINCENT HEALTHCARE PART V, SECTION B, LINE 7D: A PRESS CONFERENCE WAS HELD ON FEBRUARY 7, 2020, TO PUBLICIZE THE CHNA. PRINTED COPIES OF THE CHNA SUMMARY REPORT WERE DISTRIBUTED TO LOCAL NON-PROFIT ORGANIZATIONS. THE CHNA IS ALSO AVAILABLE ELECTRONICALLY ON THE HEALTHY BY DESIGN COALITION WEBSITE: HTTP://WWW.HEALTHYBYDESIGNYELLOWSTONE.ORGST. VINCENT HEALTHCARE:PART V, SECTION B, LINE 10A:HTTPS://WWW.SCLHEALTH.ORG/LOCATIONS/ST-VINCENT-HEALTHCARE/ABOUT/COMMUNITY-BENEFIT/COMMUNITY-HEALTH-IMPROVEMENT-PLAN/ ST. VINCENT HEALTHCARE PART V, SECTION B, LINE 11: THE 2020 CHNA IDENTIFIED 13 AREAS OF OPPORTUNITY AFTER CONSIDERATION OF VARIOUS CRITERIA, INCLUDING: STANDING IN COMPARISON WITH BENCHMARK DATA (PARTICULARLY NATIONAL DATA); IDENTIFIED TRENDS; THE PREPONDERANCE OF SIGNIFICANT FINDINGS WITHIN TOPIC AREAS; THE MAGNITUDE OF THE ISSUE IN TERMS OF NUMBER OF PERSONS AFFECTED; AND THE POTENTIAL HEALTH IMPACT OF A GIVEN ISSUE. IN ALPHABETICAL ORDER, THEY ARE:1. ACCESS TO HEALTHCARE SERVICES2. CANCER3. DIABETES4. HEART DISEASE AND STROKE5. INFANT HEALTH 6. INJURY AND VIOLENCE7. MENTAL HEALTH8. NUTRITION, PHYSICAL ACTIVITY AND WEIGHT9. POTENTIALLY DISABLING CONDITIONS10. RESPIRATORY DISEASES11. SEXUAL HEALTH12. SUBSTANCE ABUSE13. TOBACCO USEA GROUP OF COMMUNITY STAKEHOLDERS, REPRESENTING A CROSS-SECTION OF COMMUNITY-BASED AGENCIES AND ORGANIZATIONS, WAS CONVENED TO EVALUATE, DISCUSS, AND PRIORITIZE HEALTH ISSUES FOR THE COMMUNITY. PARTICIPANTS EVALUATED EACH OF THE 13 IDENTIFIED AREAS OF OPPORTUNITY ALONG TWO CRITERIA: SCOPE AND SEVERITY, AND ABILITY TO IMPACT. THIS PROCESS YIELDED A PRIORITIZED LIST OF COMMUNITY NEEDS WITH THE TOP THREE IDENTIFIED NEEDS AS: 1. MENTAL HEALTH2. SUBSTANCE ABUSE 3. NUTRITION, PHYSICAL ACTIVITY, AND WEIGHTST. VINCENT HEALTHCARE'S COMMUNITY BENEFIT COMMITTEE OF THE BOARD REVIEWED THE RESULTS OF THE CHNA AND RECOMMENDED THREE PRIORITY FOCUS AREAS:- ACCESS TO HEALTHCARE SERVICES- BEHAVIORAL HEALTH (MENTAL HEALTH AND SUBSTANCE USE) - HEALTHY WEIGHT STATUS ST. VINCENT HEALTHCARE IS ADDRESSING THESE IDENTIFIED HEALTH NEEDS THROUGH BOTH COLLABORATIVE COMMUNITY EFFORTS AND SPECIFIC HOSPITAL EFFORTS.ACCESS TO HEALTHCARE SERVICES:IN THE 2020 CHNA, 32.1% OF YELLOWSTONE COUNTY ADULTS REPORTED SOME TYPE OF DIFFICULTY OR DELAY IN OBTAINING HEALTHCARE SERVICES IN THE PAST YEAR. RATES OF ROUTINE CHECKUPS (67.2%) WERE LOWER THAN MONTANA OVERALL (73%). YELLOWSTONE COUNTY IS SURROUNDED BY HEALTHCARE PROVIDER SHORTAGE AREAS BASED ON GEOGRAPHIES AND LOW-INCOME. TO ENHANCE ACCESS TO HEALTHCARE SERVICES, ESPECIALLY FOR RESIDENTS IN RURAL AND TRIBAL COMMUNITIES, ST. VINCENT HEALTHCARE PROVIDES OUTREACH SERVICES SUCH AS MOBILE MAMMOGRAPHY, VISITING CLINICS, PEDIATRIC OUTREACH, AND VIRTUAL HEALTH SERVICES. IN 2020, PRIMARY CARE CLINICS WERE OPENED IN BOZEMAN AND LEWISTOWN. MOBILE MAMMOGRAPHY SCREENINGS WERE PROVIDED TO 2,592 WOMEN AT 64 LOCATIONS, INCLUDING OUTREACH TO AMERICAN INDIAN WOMEN ON THE CROW AND NORTHERN CHEYENNE RESERVATIONS AND THE MONTANA STATE WOMEN'S PRISON. MIDWIFERY CLINICS PROVIDED ADDITIONAL OUTREACH TO WOMEN IN THE NORTHERN CHEYENNE COMMUNITY, INCREASING ACCESS TO EARLY PRENATAL CARE. TO INCREASE WORKFORCE CAPACITY TO PROVIDE HEALTHCARE SERVICES, ST. VINCENT HEALTHCARE PROVIDES CLINICAL ROTATIONS FOR NURSING, DIETITIAN, PHYSICAL THERAPY, AND PHARMACY STUDENTS. ST. VINCENT HEALTHCARE OFFERS THE ONLY ACCREDITED CLINICAL PASTORAL EDUCATION (CPE) PROGRAM IN THE STATE. IN 2020, 74 NURSING STUDENTS, 19 PHYSICAL THERAPY STUDENTS, 4 DIETETIC INTERNS AND 9 CPE STUDENTS COMPLETED CLINICAL ROTATIONS. TO TRAIN FUTURE PHYSICIANS, ST. VINCENT HEALTHCARE PROVIDED LEADERSHIP AND FINANCIAL SUPPORT TO THE MONTANA FAMILY PRACTICE RESIDENCY PROGRAM. IN ADDITION, ST. VINCENT HEALTHCARE OFFERS A MEDICATION ASSISTANCE PROGRAM AND PROVIDES FINANCIAL SUPPORT FOR THE MEDICATION ASSISTANCE PROGRAM AT RIVERSTONE HEALTH AND THE CITY-COUNTY HEALTH DEPARTMENT. THE MEDICATION ASSISTANCE PROGRAM (MAP) PROVIDES ASSISTANCE TO LOW INCOME, UNINSURED INDIVIDUALS TO OBTAIN FREE OR DISCOUNTED PRESCRIPTION MEDICATIONS DIRECTLY FROM PHARMACEUTICAL COMPANIES. IN 2020, RIVERSTONE MAP HELPED 380 PATIENTS TO OBTAIN 913 MEDICATIONS THEY OTHERWISE MAY HAVE GONE WITHOUT.BEHAVIORAL HEALTH (MENTAL HEALTH AND SUBSTANCE USE):YELLOWSTONE COUNTY ADULTS REPORTED HIGHER RATES OF DEPRESSIVE DISORDER (32.2%) THAN THE STATE OF MONTANA AND THE US. THE PERCENTAGE OF ADULTS REPORTING THEIR OVERALL MENTAL HEALTH AS FAIR OR POOR WAS 20.2% WHICH HAS INCREASED SIGNIFICANTLY SINCE 2005. IN THE 2020 CHNA, 36.1% OF LOW-INCOME RESIDENTS REPORTED CONSIDERING SUICIDE. OVER HALF OF YELLOWSTONE COUNTY ADULTS (53.8%) REPORTED THEIR LIVES HAD BEEN NEGATIVELY IMPACTED BY SUBSTANCE USE. ST. VINCENT HEALTHCARE HAS INTEGRATED BEHAVIORAL HEALTH INTO OUR PRIMARY CARE CLINICS AND MIDWIFERY CLINIC. EMBEDDED MENTAL HEALTH SPECIALISTS PROVIDE INCREASED ACCESS TO MENTAL HEALTH TREATMENTS AND REDUCE BARRIERS RELATED TO STIGMA. IN 2020 1,168 INDIVIDUALS WERE REFERRED TO BEHAVIORAL HEALTH SPECIALISTS WITH 8,347 IN-PERSON, TELEPHONE, OR TELEVIDEO VISITS COMPLETED. WE CONTINUE TO PROVIDE SUPPORT TO THE COMMUNITY CRISIS CENTER. THE COMMUNITY CRISIS CENTER PROVIDES ASSESSMENTS, CASE MANAGEMENT, GROUPS, ADDICTIONS COUNSELING, REFERRALS, AND STABILIZATION SERVICES TO PEOPLE 24 HOURS PER DAY 365 DAYS PER YEAR. THESE SERVICES ARE PROVIDED FOR PERSONS IN CRISIS WHO NEED ACCESS TO INTEGRATED MENTAL HEALTH, CHEMICAL DEPENDENCY AND SOCIAL SERVICES, REGARDLESS OF ABILITY TO PAY FOR THESE SERVICES. THIS INCLUDES A 24-HOUR STABILIZATION AREA FOR THOSE MOST AT RISK THAT DO NOT NEED HOSPITALIZATION. THE COMMUNITY CRISIS CENTER ALSO PROVIDES CRISIS INTERVENTION TEAM TRAINING FOR LAW ENFORCEMENT. IN 2020, 11,895 RESOLVED CLIENT VISITS WERE MADE TO THE COMMUNITY CRISIS CENTER. ST. VINCENT HEALTHCARE ALSO PROVIDED FINANCIAL SUPPORT TO A STUDENT RUN MENTAL HEALTH CLINIC AT WALLA WALLA UNIVERSITY-BILLINGS. SINCE ITS INCEPTION, THIS CLINIC HAS PROVIDED NO-COST MENTAL HEALTH SERVICES TO OVER 378 INDIVIDUALS WITHOUT INSURANCE COVERAGE WHILE AT THE SAME TIME PROVIDING CLINICAL HOURS NEEDED FOR STUDENTS TO COMPLETE THEIR MSW DEGREES, INCREASING ACCESS TO MENTAL HEALTH SERVICES. WE CONTINUE SUPPORT TO COMMUNITY COLLABORATIONS ADDRESSING SUICIDE AND MENTAL HEALTH INCLUDING THE YELLOWSTONE VALLEY SUICIDE PREVENTION COALITION. IN 2020, A VIRTUAL SUICIDE PREVENTION CONFERENCE WAS HOSTED BY ST. VINCENT HEALTHCARE WITH THE YELLOWSTONE VALLEY SUICIDE PREVENTION COALITION. THROUGH COLLABORATION WITH THE COALITION, 198 COMMUNITY MEMBERS WERE TRAINED IN QPR, A SUICIDE PREVENTION TRAINING. ALSO IN 2020, ONE OF ST. VINCENT HEALTHCARE'S STAFF MEMBERS RECEIVED CERTIFICATION AS A YOUTH MENTAL HEALTH FIRST AID TRAINER WHICH WILL ENABLE US TO PROVIDE ADDITIONAL COMMUNITY MENTAL HEALTH TRAININGS. ST. VINCENT HEALTHCARE IS ADDRESSING PRENATAL SUBSTANCE USE THROUGH MIDWIFERY CLINICS WHICH INCLUDE CARE COORDINATORS TO FOCUS ON SOCIAL NEEDS AND SCREENINGS FOR MENTAL HEALTH NEEDS AND SUBSTANCE USE. THE HEALTHY SPARK COALITION IS PROVIDING TWO-WAY COMMUNICATION VIA A TEXTING APPLICATION FOR HIGH-RISK NEW MOTHERS. ST. VINCENT HEALTHCARE IS AN ACTIVE MEMBER OF THE SUBSTANCE ABUSE CONNECT COALITION, FOCUSED ON DECREASING METH USE IN OUR COMMUNITY, WITH STAFF SERVING ON THE EXECUTIVE COMMITTEE, TREATMENT AND DIVERSION, AND PREVENTION TASK GROUPS. ST. VINCENT HEALTHCARE COLLABORATES WITH COMMUNITY PARTNERS IN THE HEALTHY BY DESIGN COALITION ON A COLLECTIVE COMMUNITY HEALTH IMPROVEMENT PLAN TO ADDRESS BEHAVIORAL HEALTH CONCERNS THROUGH AN UPSTREAM APPROACH. THESE COLLECTIVE EFFORTS INCLUDE THE CREATION OF HEALTHY NEIGHBORHOODS, HEALTHY CONNECTIONS TO DECREASE SOCIAL ISOLATION, AND HEALTHY INVESTMENTS TO IMPROVE QUALITY OF LIFE AND LIVABILITY THROUGHOUT THE COMMUNITY. CONTINUED IN SCHED H PART V SUPPLEMENTAL INFORMATION PART V, SECTION B, LINE 11 CONTINUED NUTRITION, PHYSICAL ACTIVITY & WEIGHT: THE 2020 CHNA REPORTED 72.7% OF YELLOWSTONE COUNTY ADULTS AS OVERWEIGHT OR OBESE, 27.7% OF ADULTS CONSUMING 5 OR MORE SERVINGS OF FRUITS OR VEGETABLES, AND 23.3% OF ADULTS MEETING PHYSICAL ACTIVITY RECOMMENDATIONS. IN ADDITION, 24.3% OF CHILDREN IN YELLOWSTONE COUNTY ARE OVERWEIGHT OR OBESE. ST. VINCENT HEALTHCARE OFFERS THE EVIDENCE-BASED DIABETES AND HEART DISEASE PREVENTION PROGRAM. LOCATED AT THE BILLINGS FAMILY YMCA, THE PROGRAM IS OFFERED TWICE A YEAR. IN 2020, 95 INDIVIDUALS PARTICIPATED IN THE PROGRAM WHICH FOCUSES ON NUTRITION EDUCATION AND PHYSICAL ACTIVITY, SUPPORTING HEALTH LIFESTYLE CHANGES FOR ADULTS WHO ARE AT RISK FOR DEVELOPING TYPE 2 DIABETES OR HEART DISEASE. AS PRESENTING SPONSOR OF KIDS IN MOTION, ST. VINCENT HEALTHCARE COLLABORATES WITH THE CITY OF BILLINGS AND SCHOOL DISTRICT 2 TO PROVIDE BICYCLE TUNE-UP CLINICS AND IN-CLASS EDUCATION TO EMPOWER YOUTH WITH SKILLS AND CONFIDENCE NEEDED TO RIDE THEIR BICYCLES EVERY DAY. IN 2020 THE PANDEMIC LIMITED REPAIR CLINICS FOR KIDS IN MOTION, A TOTAL OF 24 STUDENT BICYCLES WERE INSPECTED AND, IF NEEDED, REPAIRED AT 2 SCHOOLS. AS A SPONSORING ENTITY AND MEMBER OF THE HEALTHY BY DESIGN COALITION, ST. VINCENT HEALTHCARE IS COLLABORATING TO INCREASE THE PROPORTION OF RESIDENTS WHO ARE AT A HEALTHY WEIGHT IN YELLOWSTONE COUNTY THROUGH POLICY, SYSTEMS AND ENVIRONMENTAL CHANGE EFFORTS. THIS INCLUDES THE HEALTHY BY DESIGN COALITION'S GARDENERS' MARKET. LOCATED IN A FEDERALLY IDENTIFIED FOOD DESERT WITHIN A LOW-INCOME NEIGHBORHOOD AND ACCEPTING SNAP AND WIC BENEFITS TO INCREASE ACCESS TO AFFORDABLE FRUITS AND VEGETABLES, THE GARDENERS' MARKET SERVED AN AVERAGE OF 211 RESIDENTS EACH WEEK FROM JUNE TO OCTOBER. OTHER COLLECTIVE EFFORTS OF THE HEALTHY BY DESIGN COALITION INCLUDE THE CREATION OF HEALTHY NEIGHBORHOODS, HEALTHY CONNECTIONS TO DECREASE SOCIAL ISOLATION, AND HEALTHY INVESTMENTS TO IMPROVE QUALITY OF LIFE AND LIVABILITY THROUGHOUT THE COMMUNITY. OTHER SIGNIFICANT NEEDS NOT PRIORITIZED: ST. VINCENT HEALTHCARE CONTINUES TO COLLABORATE WITH COMMUNITY ORGANIZATIONS TO ENSURE THESE HEALTH NEEDS ARE ADDRESSED.CANCER: ST. VINCENT HEALTHCARE SCREENED 328 PATIENTS FOR LUNG CANCER USING LOW-DOSE CT SCANS AND DETECTED 5 CANCERS AS A RESULT OF SCREENING IN 2020. THE MOBILE MAMMOGRAPHY COACH PROVIDED MAMMOGRAMS TO 2,592 WOMEN AT 64 LOCATIONS THROUGHOUT THE REGION, INCLUDING TRIBAL RESERVATIONS. ST. VINCENT HEALTHCARE SPONSORS THE LIVESTRONG PROGRAM FOR CANCER SURVIVORS AT THE BILLINGS YMCA. NUTRITION EDUCATION FOR CANCER PREVENTION WAS PROVIDED TO 100 ATTENDEES AT THE HEALTHY BY DESIGN GARDENERS' MARKET. ST. VINCENT HEALTHCARE OFFERS VIRTUAL HEALTH OUTREACH SERVICES FOR CANCER TREATMENT TO RURAL COMMUNITIES. DIABETES: ST. VINCENT HEALTHCARE OFFERS TWO SESSIONS OF THE DIABETES HEART DISEASE AND PREVENTION AT THE BILLINGS FAMILY YMCA EACH YEAR. FREE DIABETES SCREENINGS ARE OFFERED AT EVENTS INCLUDING THE MATE SHOW AND POWWOWS TO SCREEN AT-RISK POPULATIONS. IN 2020, SCREENINGS WERE NOT CONDUCTED AT THE POWWOWS DUE TO THE COVID-19 PANDEMIC. DIABETES IS ALSO ADDRESSED THROUGH OUR HEALTHY WEIGHT STATUS PRIORITY. HEART DISEASE AND STROKE: ST. VINCENT HEALTHCARE OFFERS A BROAD ARRAY OF SERVICES INCLUDING CARDIOLOGY, INTERVENTIONAL CARDIOLOGY, AND CARDIAC REHABILITATION. A STROKE CAMP AND MONTHLY SUPPORT GROUP IS PROVIDED FOR AREA RESIDENTS. PREVENTION OF HEART DISEASE IS ADDRESSED THROUGH OUR HEALTHY WEIGHT STATUS PRIORITY.INFANT HEALTH AND SEXUAL HEALTH: ST. VINCENT HEALTHCARE OFFERS MATERNAL FETAL MEDICINE WITH OUTREACH TO RURAL COMMUNITIES VIA TELEHEALTH. OUR MIDWIFERY CLINIC PROVIDES OUTREACH TO TRIBAL COMMUNITIES. BEHAVIORAL HEALTH SCREENINGS ARE PROVIDED AT PRENATAL APPOINTMENTS AND TARGETED INTERVENTIONS HAVE BEEN DEVELOPED FOR HIGH RISK PARENTS. INJURY AND VIOLENCE: ST. VINCENT HEALTHCARE PROVIDES FINANCIAL SUPPORT FOR THE BILLINGS YWCA'S REACHING EVERY WOMAN DOMESTIC VIOLENCE AWARENESS CAMPAIGN. POTENTIAL DISABLING CONDITIONS: ST. VINCENT HEALTHCARE IS A MEMBER OF THE DEMENTIA FRIENDLY BILLINGS COALITION. RESPIRATORY DISEASE AND TOBACCO USE: ST. VINCENT HEALTHCARE PROVIDES FREEDOM FROM SMOKING TOBACCO CESSATION CLASSES FOR THE COMMUNITY. DUE TO THE PANDEMIC, NO CLASSES WERE ABLE TO BE OFFERED TO THE COMMUNITY IN 2020. LOW-DOSE CT SCANS WERE OFFERED TO 328 CURRENT AND FORMER HEAVY SMOKERS TO SCREEN FOR LUNG CANCER AND TOBACCO CESSATION INFORMATION WAS PROVIDED IN CONJUNCTION WITH THESE SCREENINGS.ST. VINCENT HEALTHCARE:PART V, SECTION B, LINE 16A, 16B, 16C: WWW.SCLHEALTH.ORG/LOCATIONS/ST-VINCENT-HEALTHCARE/PATIENTS-VISITORS/BILLING-INSURANCE/FINANCIAL-ASSISTANCE/ 17 1 - ATHLETIC MEDICINE & PREFORMANCE LLC 1144 NORTH 28TH STREET BILLINGS MT 59101 PHYSICAL THERAPY 2 - ST VINCENT MULTIPLE SCLEROSIS CENTER 1041 N 29TH ST BILLINGS MT 59101 OUTPATIENT PHYSICIAN CLINIC 3 - ST VINCENT HEALTHCARE - NEUROSCIENCE 1041 N 29TH ST BILLINGS MT 59101 OUTPATIENT PHYSICIAN CLINIC 4 - ST VINCENT EMERGENCY MEDICINE 1233 N 30TH ST BILLINGS MT 59101 OUTPATIENT PHYSICIAN CLINIC 5 - ST VINCENT HEALTHCARE - NEUROSCIENCE 1041 N 29TH ST BILLINGS MT 59101 OUTPATIENT PHYSICIAN CLINIC 6 - ST VINCENT ORTHO MONTANA 2900 12TH AVE N STE 140W BILLINGS MT 59101 OUTPATIENT PHYSICIAN CLINIC 7 - ST VINCENT RHEUMATOLOGY 2900 12TH AVE N STE 503E BILLINGS MT 59101 OUTPATIENT PHYSICIAN CLINIC 8 - FRONTIER CANCER CENTER 1315 GOLDEN VALLEY CIR BILLINGS MT 59102 OUTPATIENT PHYSICIAN CLINIC 9 - ST VINCENT NEONATOLOGY 1233 N 30TH ST BILLINGS MT 59101 OUTPATIENT PHYSICIAN CLINIC 10 - FRONTIER CANCER CENTER 1315 GOLDEN VALLEY CIR BILLINGS MT 59102 OUTPATIENT PHYSICIAN CLINIC 11 - ST VINCENT PALLIATIVE CARE 1233 N 30TH ST BILLINGS MT 59101 OUTPATIENT PHYSICIAN CLINIC 12 - ST VINCENT HOSPITALIST NEUROLOGIST 1233 N 30TH ST BILLINGS MT 59101 OUTPATIENT PHYSICIAN CLINIC 13 - SCL HEALTH MEDICAL GROUP-BILLINGS-RED 810 N BROADWAY REDLODGE MT 59086 OUTPATIENT PHYSICIAN CLINIC 14 - ST VINCENT HOSPITALISTS 1233 N 30TH ST BILLINGS MT 59107 OUTPATIENT PHYSICIAN CLINIC 15 - ST VINCENT HOSPITALISTS 1233 N 30TH ST BILLINGS MT 59101 OUTPATIENT PHYSICIAN CLINIC 16 - FRONTIER CANCER CENTER 1315 GOLDEN VALLEY CIR BILLINGS MT 59102 OUTPATIENT PHYSICIAN CLINIC 17 - FRONTIER CANCER CENTER 2600 WILSON STREET MILES CITY MT 59301 OUTPATIENT PHYSICIAN CLINIC PART I, LINE 6A: THIS ORGANIZATION IS PART OF SCL HEALTH SYSTEM WHICH PREPARES AN ANNUAL COMMUNITY BENEFIT REPORT ON A CONSOLIDATED BASIS. THE REPORT IS PREPARED BY THE PARENT COMPANY, SISTERS OF CHARITY OF LEAVENWORTH HEALTH SYSTEM, INC. PART I, LINE 7: THE AMOUNTS REPORTED ON FORM 990, SCHEDULE H, PART I, LINE 7A, 7B AND 7C WERE DETERMINED USING THE COST TO CHARGE RATIO DERIVED FROM WORKSHEET 2, IN THE SCHEDULE H, FORM 990 INSTRUCTIONS. FORM 990, SCHEDULE H, PART I, LINES 7E, 7F, 7G, 7H AND 7I ARE REPORTED AT COST AS REPORTED IN THE ORGANIZATION'S FINANCIAL STATEMENTS.PART I, LINE 7, COLUMN (F): THE BAD DEBT EXPENSE INCLUDED ON FORM 990,PART IX, LINE 25, COLUMN (A), BUT SUBTRACTED FOR PURPOSES OF CALCULATING THE PERCENTAGE ON SCHEDULE H, PART I, LINE 7 COLUMN (F) IS $10,291,293. PART II, COMMUNITY BUILDING ACTIVITIES: ST. VINCENT HEALTHCARE RECOGNIZES THE NEED TO ADDRESS UNDERLYING FACTORS WHICH INFLUENCE HEALTH IN OUR COMMUNITY SUCH AS EDUCATION, HOUSING, EARLY CHILDHOOD DEVELOPMENT AND ECONOMIC SECURITY. WE SPONSOR THE FOSTER GRANDPARENT PROGRAM WITH 34 LOW-INCOME SENIORS MENTORING STUDENTS IN NEED AT SCHOOLS AND HEAD START CENTERS IN SIX COUNTIES AND ON THREE RESERVATIONS, RESULTING IN IMPROVED ACADEMIC SCORES. MISSION FUND GRANTS SUPPORTED INITIATIVES INCLUDING HOUSING FOR INDIVIDUALS EXPERIENCING HOMELESSNESS, EMERGENCY SHELTER FOR VICTIMS OF SEX TRAFFICKING, SUPPORT FOR FOOD BANKS AND FOOD PANTRIES, AND SUPPORT OF CASE MANAGEMENT SERVICES FOR AT-RISK INDIVIDUALS. SCHEDULE H, PART III, LINE 1THE ORGANIZATION REPORTS BAD DEBT IN ACCORDANCE TO HEALTHCARE FINANCIAL MANAGEMENT ASSOCIATION (HFMA) STATEMENT NO. 15 TO THE EXTENT THAT HFMA STATEMENT NO. 15 FOLLOWS THE GENERALLY ACCEPTED ACCOUNTING PRINCIPLES (GAAP) FOR THE REPORTING OF BAD DEBT. PART III, LINE 2: THE BAD DEBT EXPENSE REPORTED ON PART III, LINE 2 IS AT CHARGES AS RECORDED IN THE ORGANIZATION'S FINANCIAL STATEMENTS. THE ALLOWANCE FOR BAD DEBT IS BASED UPON MANAGEMENT'S ASSESSMENT OF HISTORICAL AND EXPECTED NET COLLECTIONS CONSIDERING THE BUSINESS AND GENERAL ECONOMIC CONDITIONS IN ITS SERVICE AREA, TRENDS IN HEALTH CARE COVERAGE, AND OTHER COLLECTION INDICATORS.THE BAD DEBT ALLOWANCE IS CALCULATED AS A PERCENTAGE OF PATIENT RECEIVABLES AFTER DEDUCTIONS FOR ESTIMATED PROVISIONS FOR CONTRACTUAL ADJUSTMENTS (DISCOUNTS) ON SERVICES PROVIDED TO ENROLLEES OF MEDICARE, MEDICAID, THIRD-PARTY PAYOR PROGRAMS, CHARITY CARE, UNINSURED DISCOUNTS, AND OTHER ADMINISTRATIVE ADJUSTMENTS. PART III, LINE 4: THE ALLOWANCE FOR BAD DEBT IS BASED UPON MANAGEMENT'S ASSESSMENT OF HISTORICAL AND EXPECTED NET COLLECTIONS CONSIDERING THE BUSINESS AND GENERAL ECONOMIC CONDITIONS IN ITS SERVICE AREA, TRENDS IN HEALTH CARE COVERAGE, AND OTHER COLLECTION INDICATORS.THE BAD DEBT ALLOWANCE IS CALCULATED AS A PERCENTAGE OF PATIENT RECEIVABLES AFTER DEDUCTIONS FOR ESTIMATED PROVISIONS FOR CONTRACTUAL ADJUSTMENTS (DISCOUNTS) ON SERVICES PROVIDED TO ENROLLEES OF MEDICARE, MEDICAID, THIRD-PARTY PAYOR PROGRAMS, CHARITY CARE, UNINSURED DISCOUNTS, AND OTHER ADMINISTRATIVE ADJUSTMENTS.THE ORGANIZATION HAS A FINANCIAL ASSISTANCE PROGRAM THAT PROVIDES PATIENTS OPPORTUNITIES TO APPLY FOR FREE OR DISCOUNTED CARE AND/OR TO BE ENROLLED IN A GOVERNMENT SPONSORED MEDICAL CARE PROGRAM. THE PROCESS INCLUDES IDENTIFYING PATIENTS WITH A FINANCIAL CONCERN AND PROVIDING FINANCIAL COUNSELING AND ASSISTANCE IN APPLYING FOR THE ORGANIZATION'S CHARITY CARE AND OTHER FINANCIAL ASSISTANCE PROGRAMS.CERTAIN PATIENT ACCOUNTS ARE WRITTEN OFF TO BAD DEBT BECAUSE THE ORGANIZATION DOES NOT HAVE SUFFICIENT INFORMATION TO DETERMINE IF THE PATIENT WOULD QUALIFY FOR FREE CARE OR FINANCIAL AID. THEREFORE, IT IS POSSIBLE THAT SOME BAD DEBT IS ACTUALLY CHARITY CARE. HOWEVER, IF A PATIENT ACCOUNT IS WRITTEN OFF TO BAD DEBT AND THE COLLECTION AGENCY LATER DETERMINES THAT THE PATIENT WOULD HAVE QUALIFIED FOR FREE CARE OR FINANCIAL AID, THEN THE BAD DEBT EXPENSE IS RECLASSIFIED TO CHARITY CARE. THE FOLLOWING IS THE TEXT OF THE FOOTNOTE IN THE ORGANIZATION'S FINANCIAL STATEMENTS THAT DESCRIBES THE BAD DEBT ALLOWANCE AND BAD DEBT EXPENSE: NET PATIENT SERVICE REVENUE GENERALLY RELATES TO CONTRACTS WITH PATIENTS IN WHICH THE PERFORMANCE OBLIGATIONS ARE TO PROVIDE HEALTH CARE SERVICES TO PATIENTS OVER A PERIOD OF TIME. REVENUE IS ESTIMATED FOR PATIENTS WHO HAVE NOT BEEN DISCHARGED AS OF THE REPORTING PERIOD BASED ON ACTUAL CHARGES INCURRED TO DATE IN RELATION TO TOTAL EXPECTED CHARGES. SCL HEALTH BELIEVES THIS METHOD PROVIDES A FAITHFUL DEPICTION OF THE TRANSFER OF SERVICES OVER THE TERM OF THE PERFORMANCE OBLIGATION BASED ON THE INPUTS NEEDED TO SATISFY THE OBLIGATION. THE CONTRACTUAL RELATIONSHIP WITH PATIENTS ALSO TYPICALLY INVOLVES A THIRD-PARTY PAYER (MEDICARE, MEDICAID, MANAGED CARE PLANS, AND COMMERCIAL INSURANCE COMPANIES), AND THE TRANSACTION PRICES FOR THE SERVICES PROVIDED ARE DEPENDENT UPON THE TERMS PROVIDED BY OR NEGOTIATED WITH THE THIRD-PARTY PAYERS. THE PAYMENT ARRANGEMENTS WITH THIRD-PARTY PAYERS FOR THE SERVICES PROVIDED TO THE RELATED PATIENTS TYPICALLY SPECIFY PAYMENT OR REIMBURSEMENT TO SCL HEALTH AT OTHER-THAN-STANDARD CHARGES.BECAUSE ALL OF ITS PERFORMANCE OBLIGATIONS RELATE TO CONTRACTS WITH A DURATION OF LESS THAN ONE YEAR, SCL HEALTH HAS ELECTED TO APPLY THE OPTION EXEMPTION, AND THEREFORE, IS NOT REQUIRED TO DISCLOSE THE AGGREGATE AMOUNT OF THE TRANSACTION PRICE ALLOCATED TO PERFORMANCE OBLIGATIONS THAT ARE UNSATISFIED OR PARTIALLY SATISFIED AT THE END OF THE REPORTING PERIOD. THE UNSATISFIED OR PARTIALLY SATISFIED PERFORMANCE OBLIGATIONS REFERRED TO ABOVE ARE PRIMARILY RELATED TO INPATIENT SERVICES AT THE END OF THE REPORTING PERIOD. THE PERFORMANCE OBLIGATIONS FOR THESE CONTRACTS ARE GENERALLY COMPLETED WHEN PATIENTS ARE DISCHARGED, WHICH GENERALLY OCCURS WITHIN DAYS OR WEEKS OF THE END OF THE REPORTING PERIOD.NET PATIENT SERVICE REVENUE IS REPORTED AT ESTIMATED AMOUNTS FROM PATIENTS, THIRD-PARTY PAYERS, AND OTHERS FOR SERVICES RENDERED AND INCLUDES ESTIMATES OF IMPLICIT PRICE CONCESSIONS AND RETROACTIVE REVENUE ADJUSTMENTS DUE TO AUDITS, REVIEWS, AND INVESTIGATIONS. IMPLICIT PRICE CONCESSIONS RELATE PRIMARILY TO UNINSURED PATIENTS AND PATIENTS WITH CO-PAYS, CO-INSURANCE AND DEDUCTIBLES AND ARE ESTIMATED BASED ON HISTORICAL COLLECTION DATA. RETROACTIVE ADJUSTMENTS ARE CONSIDERED IN THE RECOGNITION OF REVENUE ON AN ESTIMATED BASIS IN THE PERIOD THE RELATED SERVICES ARE RENDERED, AND SUCH AMOUNTS ARE ADJUSTED IN FUTURE PERIODS AS ADJUSTMENTS BECOME KNOWN OR AS YEARS ARE NO LONGER SUBJECT TO SUCH AUDITS, REVIEWS, OR INVESTIGATIONS. PART III, LINE 8: THE ORGANIZATION BELIEVES THAT AT LEAST SOME PORTION OF THE COSTS WE INCUR IN EXCESS OF PAYMENTS RECEIVED FROM THE FEDERAL GOVERNMENT FOR PROVIDING MEDICAL SERVICES TO MEDICARE ENROLLEES AND BENEFICIARIES UNDER THE FEDERAL MEDICARE PROGRAM (SHORTFALL OR MEDICARE SHORTFALL) CONSTITUTES A COMMUNITY BENEFIT. PROVIDING THESE SERVICES CLEARLY LESSENS THE BURDENS OF THE GOVERNMENT BY ALLEVIATING THE FEDERAL GOVERNMENT FROM HAVING TO DIRECTLY PROVIDE THESE MEDICAL SERVICES. AS DEMONSTRATED AND CALCULATED ON FORM 990, SCHEDULE H, PART III, LINES 5, 6 AND 7, OUR MEDICARE "ALLOWABLE COSTS" CLEARLY EXCEED THE PAYMENTS WE RECEIVE FOR PROVIDING THESE MEDICAL SERVICES UNDER THE MEDICARE PROGRAM. BY ABSORBING THE MEDICARE SHORTFALL COSTS WE ARE PROVIDING A COMMUNITY BENEFIT AS WELL AS EASING THE BURDEN OF THE FEDERAL GOVERNMENT HAVING TO COVER THESE COSTS.TO ARRIVE AT THE FORM 990, SCHEDULE H, PART III, LINE 6 AMOUNT, WE USED ACTUAL MEDICARE CHARGES FROM INTERNAL RECORDS AND APPLIED AN ESTIMATED COST TO CHARGE RATIO TO DETERMINE THE MEDICARE ALLOWABLE COSTS. THE ESTIMATED MEDICARE COST TO CHARGE RATIO IS THE PRIOR PERIOD MEDICARE COST REPORT COST TO CHARGE RATIO. PART III, LINE 9B: AN INTEGRAL COMPONENT OF OUR MISSION IS TO BE GOOD FINANCIAL STEWARDS. THIS REQUIRES US TO DETERMINE WHICH PATIENTS ARE IN NEED OF CHARITY CARE AND WHICH ARE ABLE TO CONTRIBUTE SOME PAYMENT FOR CARE RECEIVED. WEMAINTAIN A BALANCE THAT ENABLES US TO CONTINUE TO PROVIDE CHARITY CARE TOTHOSE WHO NEED IT MOST AND ENSURE THAT WE MANAGE OUR RESOURCES SOWE CAN CONTINUE TO BE HERE WHEN PEOPLE NEED US MOST. THE ORGANIZATION NOTIFIES PATIENTS OF FINANCIAL ASSISTANCE POLICY UPON ADMISSION AND DISCHARGE. IN ADDITION, THE PATIENTS RECEIVE INFORMATION ABOUT THE FINANCIAL ASSISTANCE POLICY WITH THEIR PATIENT BILLS. PATIENTS ARE CONTACTED MULTIPLE TIMES ABOUT UNPAID BALANCES PRIOR TO INITIATING ANY COLLECTION ACTION. IF A PATIENT IS DETERMINED TO BE ELIGIBLE FOR FINANCIAL ASSISTANCE AT ANY TIME DURING THE COLLECTION PROCESS, THE ACCOUNT IS RECLASSIFIED AS FINANCIAL ASSISTANCE AND DEBT COLLECTION EFFORTS ARE CEASED. PART V, SECTION A WEBSITE: WWW.SCLHEALTH.ORG/LOCATIONS/ST-VINCENT-HEALTHCARE/ PART VI, LINE 2: IN ADDITION TO THE CHNA, ST. VINCENT HEALTHCARE USES SECONDARY DATA SUCH AS COUNTY HEALTH RANKINGS AND THE BEHAVIOR RISK FACTOR SURVEILLANCE SYSTEM (BRFSS) TO DETERMINE HEALTH NEEDS FOR COUNTIES BEYOND OUR PRIMARY SERVICE AREA. WE ALSO UTILIZE OTHER LOCAL NEEDS ASSESSMENTS AND REPORTS FROM COMMUNITY ORGANIZATIONS SUCH AS UNITED WAY OF YELLOWSTONE COUNTY AND HRDC.ST. VINCENT HEALTHCARE LEADERS SERVE ON VARIOUS COMMUNITY BOARDS TO UNDERSTAND SPECIFIC NEEDS. OUTREACH AND RELATIONSHIPS WITH OTHER HOSPITALS AND CLINICS ALSO ENABLES ST. VINCENT TO BETTER ASSESS HEALTH CARE NEEDS OF OUR RURAL MONTANA COMMUNITIES. PART VI, LINE 3: THE ORGANIZATION NOTIFIES PATIENTS ABOUT THE FINANCIAL ASSISTANCE POLICY UPON ADMISSION AND PRIOR TO DISCHARGE. NOTICES ABOUT THE FINANCIAL ASSISTANCE POLICY ARE DISPLAYED THROUGHOUT THE HOSPITAL. IN ADDITION, PATIENTS RECEIVE INFORMATION ABOUT THE FINANCIAL ASSISTANCE POLICY WITH THEIR PATIENT BILLS. THE FINANCIAL ASSISTANCE POLICY AND APPLICATION ARE POSTED ON THE HOSPITAL'S WEBSITE. THE POLICY AND APPLICATION ARE ALSO AVAILABLE UPON REQUEST. THE ORGANIZATION HAS A FINANCIAL ASSISTANCE PROGRAM THAT PROVIDES PATIENTS OPPORTUNITIES TO APPLY FOR FREE OR DISCOUNTED CARE AND/OR TO BE ENROLLED IN A GOVERNMENT SPONSORED MEDICAL CARE PROGRAM. THE PROCESS INCLUDES IDENTIFYING PATIENTS WITH A FINANCIAL CONCERN, PROVIDING FINANCIAL COUNSELING AND ASSISTANCE IN APPLYING FOR THE ORGANIZATION'S CHARITY CARE AND OTHER FINANCIAL ASSISTANCE PROGRAMS. PART VI, LINE 4: POPULATION AND GEOGRAPHY: ST. VINCENT HEALTHCARE'S PRIMARY SERVICE AREA INCLUDES YELLOWSTONE COUNTY. YELLOWSTONE COUNTY ENCOMPASES 2,633 SQUARE MILES AND INCLUDES A POPULATION OF 156,332 RESIDENTS. BETWEEN THE 2000 AND 2010 US CENSUSES, THE POPULATION OF YELLOWSTONE COUNTY INCREASED BY 14.4%, A GREATER PROPORTIONAL INCREASE THAN SEEN ACROSS BOTH MONTANA AND THE NATION OVERALL. YELLOWSTONE COUNTY IS PREDOMINANTLY URBAN WITH 83.3% OF THE POPULATION LIVING IN AREAS DESIGNATED AS URBAN AND IS SURROUNDED BY RURAL AND FRONTIER COUNTIES.AGE: IN YELLOWSTONE COUNTY, 23.6% OF THE POPULATION ARE CHILDREN AGE 0-17; 60.7% ARE AGE 18 TO 64, WHILE 15.7% ARE AGE 65 AND OLDER. RACE AND ETHNICITY: THE MAJORITY OF YELLOWSTONE COUNTY RESIDENTS ARE WHITE (90.9%), 4.3% ARE NATIVE AMERICAN, 0.7% ARE BLACK, 0.6% ARE ASIAN, AND 2.8% MULTIPLE RACES . A TOTAL OF 5.4% OF YELLOWSTONE COUNTY RESIDENTS ARE HISPANIC OR LATINO WHICH IS HIGHER THAN THE STATE OF MONTANA PREVALENCE. POVERTY AND ECONOMICS: THE LATEST CENSUS ESTIMATE SHOWS 10.1% OF THE YELLOWSTONE COUNTY POPULATION LIVING BELOW THE FEDERAL POVERTY LEVEL, INCLUDING 4,222 CHILDREN LIVING BELOW THE FEDERAL POVERTY LEVEL. AN ESTIMATED 7.1% OF YELLOWSTONE COUNTY ADULTS OVER AGE 25 DO NOT HAVE A HIGH SCHOOL EDUCATION. THE UNEMPLOYMENT RATE WAS 2.9% AND HAS DECREASED SINCE 2010. 27.8% OF ADULTS REPORTED BEING WORRIED OR STRESSED ABOUT HAVING ENOUGH MONEY TO PAY THEIR RENT OR MORTGAGE IN THE PAST YEAR. APPROXIMATELY 33,651 RESIDENTS HAVE LOW FOOD ACCESS AND 17.1% OF ADULTS FOUND IT DIFFICULT TO ACCESS AFFORDABLE FRESH FRUITS AND VEGETABLES. HEALTH STATUS: MOST YELLOWSTONE COUNTY RESIDENTS RATE THEIR OVERALL HEALTH FAVORABLY WITH 83.3% RATING IT AS EXCELLENT, VERY GOOD, OR GOOD. HOWEVER, 16.7% OF ADULTS BELIEVE THEIR HEALTH IS FAIR OR POOR. IN 2020, COUNTY HEALTH RANKINGS AND ROADMAPS PROGRAM RANKED YELLOWSTONE COUNTY 24 OF 48 COUNTIES FOR HEALTH OUTCOMES AND 15 OF 48 COUNTIES FOR HEALTH FACTORS. PART VI, LINE 5: ST. VINCENT HEALTHCARE WAS ACTIVELY INVOLVED IN THE COMMUNITY-WIDE RESPONSE TO THE COVID-19 PANDEMIC. ST. VINCENT HEALTHCARE ESTABLISHED A DRIVE-UP COVID-19 TESTING STATION. WORKING WITH PARTNERS FROM THE COMMUNITY UNIFIED HEALTH COMMAND, ST. VINCENT HEALTHCARE ASSISTED WITH STAFFING FOR COMMUNITY COVID-19 TESTING. IN 2020, ST. VINCENT HEALTHCARE VACCINATED COMMUNITY RESPONDERS AND HEALTHCARE PERSONNEL. ST. VINCENT HEALTHCARE ADHERES TO COMMUNITY BENEFIT GUIDELINES OUTLINED IN THE CATHOLIC HEALTH ASSOCIATION'S PUBLICATION, "A GUIDE TO PLANNING AND REPORTING COMMUNITY BENEFIT". ST. VINCENT HEALTHCARE'S COMMUNITY BENEFIT WORK IS DRIVEN BY IDENTIFIED COMMUNITY HEALTH NEEDS AND DIRECTED IN COLLABORATION WITH OTHER HEALTHCARE ORGANIZATIONS AND THE BROADER COMMUNITY. COMMUNITY BENEFIT STRATEGIES ARE INTEGRATED IN THE ORGANIZATIONAL STRATEGIC PLAN. PROGRAMS ARE LOCATED THROUGHOUT THE ORGANIZATION AND STAFF AND BOARD EDUCATION IS CONDUCTED. ST. VINCENT HEALTHCARE HAS DEDICATED STAFF COMMITTED TO COMMUNITY BENEFIT EFFORTS. HOSPITAL LEADERS, MANAGERS, AND SUPERVISORS ARE REQUIRED TO PARTICIPATE ANNUALLY IN COMMUNITY BENEFIT SERVICE EVENTS WITH NON-PROFIT ORGANIZATIONS TO IMPROVE THE HEALTH OF THE COMMUNITIES WE SERVE. IN 2020, OUR LEADERS PERFORMED OVER 1,285 HOURS OF SERVICE IN THE COMMUNITY, BENEFITING MORE THAN 77 ORGANIZATIONS FOCUSED ON BEHAVIORAL HEALTH, INJURY PREVENTION, EDUCATION, HOMELESSNESS, PHYSICAL ACTIVITY, NUTRITION, ECONOMIC DEVELOPMENT, SENIORS, EMERGENCY RESPONSE, AND HEALTHCARE PROVIDER TRAINING. SCL HEALTH MONTANA REGION'S BOARD OF DIRECTORS IS A VOLUNTEER GOVERNING BODY WHICH INCLUDE INDEPENDENT PERSONS THAT REPRESENT THE COMMUNITY. WITHIN THE BOARD OF DIRECTORS, THERE IS A SPECIFIC COMMUNITY BENEFIT BOARD LEVEL COMMITTEE. THIS COMMITTEE IS DEEPLY INVOLVED IN THE COMMUNITY HEALTH NEEDS ASSESSMENT PROCESS AND PROVIDES DIRECTION TO DEVELOPMENT OF THE ORGANIZATION'S IMPROVEMENT PLAN IN RESPONSE TO RESULTS OF COMMUNITY HEALTH NEEDS ASSESSMENT. THE HOSPITAL'S COMMUNITY BENEFIT BOARD COMMITTEE MONITORS IMPLEMENTATION OF COMMUNITY BENEFIT PROGRAMS AND PROVIDES REPORTS BACK TO THE FULL REGIONAL BOARD. ST. VINCENT HEALTHCARE OPERATES AN EMERGENCY ROOM THAT IS OPEN TO ALL PERSONS REGARDLESS OF ABILITY TO PAY AND HAS AN OPEN MEDICAL STAFF WITH PRIVILEGES AVAILABLE TO ALL QUALIFIED PHYSICIANS IN THE AREA. ST. VINCENT HEALTHCARE ENGAGES IN MEDICAL AND SCIENTIFIC RESEARCH PROGRAMS; ENGAGES IN THE TRAINING AND EDUCATION OF HEALTHCARE PROFESSIONALS AND PARTICIPATES IN MEDICAID, MEDICARE AND OTHER GOVERNMENT SPONSORED HEALTH PROGRAMS. ST. VINCENT HEALTHCARE EMPLOYS THE STAFF OF THE ST. VINCENT HEALTHCARE FOUNDATION, A NON-PROFIT ORGANIZATION THAT PROVIDES FUNDRAISING FOR BOTH ST. VINCENT HEALTHCARE PROGRAMS AND FOR COMMUNITY BENEFIT PROGRAMS THAT REACH BOTH THE POOR AND BROADER COMMUNITY. OPERATIONS OF THE ST. VINCENT HEALTHCARE FOUNDATION ARE GOVERNED BY A SEPARATE FOUNDATION BOARD WITH VOLUNTARY MEMBERSHIPS FROM THE LOCAL COMMUNITY. WHEN ST. VINCENT HEALTHCARE HAS EXCESS REVENUE OVER OPERATING EXPENSES, WE USE THOSE FUNDS TO OBTAIN CURRENT HEALTHCARE TECHNOLOGIES AND EQUIPMENT, IMPROVE PATIENT CARE, PROVIDE MEDICAL TRAINING EDUCATION AND RESEARCH, AND TO EXPAND ACCESS TO POINTS OF CARE. THESE INVESTMENTS ENSURE WE WILL BE ABLE TO CARE FOR FUTURE GENERATIONS. ST. VINCENT HEALTHCARE CO-LEADS COMMUNITY HEALTH IMPROVEMENT EFFORTS AS PART OF THE ALLIANCE, A COLLABORATIVE WITH BILLINGS CLINIC AND RIVERSTONE HEALTH, AND COMMITS TIME AND FINANCIAL RESOURCES TO FULFILLING GOALS OUTLINED IN THE COLLABORATIVE COMMUNITY HEALTH IMPROVEMENT PLAN FOR YELLOWSTONE COUNTY. PART VI, LINE 6: THE ORGANIZATION IS A CONTROLLED ENTITY OF THE SISTERS OF CHARITY OF LEAVENWORTH HEALTH SYSTEM, INC. (SCLHS). SCLHS AND ITS AFFILIATED ENTITIES HAVE A COMMON CALLING AND MISSION: "WE REVEAL AND FOSTER GOD'S HEALING LOVE BY IMPROVING THE HEALTH OF THE PEOPLE AND COMMUNITIES WE SERVE, ESPECIALLY THOSE WHO ARE POOR AND VULNERABLE." WE STRIVE TO PROVIDE HIGH-QUALITY, COMPASSIONATE AND AFFORDABLE HEALTHCARE IN EACH OF OUR HOSPITAL SITES AND THEIR RESPECTIVE COMMUNITIES, AS WELL AS IN A VARIETY OF OUTPATIENT SETTINGS AND IN THE HOME. SCLHS IS A FAITH-BASED, NONPROFIT HEALTHCARE ORGANIZATION THAT OPERATES EIGHT HOSPITALS, TWO SAFETY NET CLINICS, ONE CHILDREN'S MENTAL HEALTH CENTER, HOME HEALTH AND MORE THAN 200 PHYSICIAN CLINICS IN THREE STATES - COLORADO, KANSAS AND MONTANA. THE HEALTH SYSTEM INCLUDES MORE THAN 15,900 EMPLOYEES AND MORE THAN 800 EMPLOYED PROVIDERS.AS OUR HEALTH SYSTEM GROWS, WE'RE LEVERAGING THAT GROWTH TO ACHIEVE BENEFITS OF SCALE - IDENTIFYING COST AND OTHER ADVANTAGES THAT WE GAIN DUE TO OUR SIZE. WE'RE ALSO WORKING TO STREAMLINE AND UNIFY OUR SYSTEM-WIDE PROCESSES TO ELIMINATE COSTLY DUPLICATION OF EFFORT. WE ACTIVELY ENCOURAGE OUR PEOPLE TO PURSUE CREATIVE IDEAS THAT IMPROVE EFFICIENCY, SERVICE AND THE OVERALL CARE EXPERIENCE. WHEN OUR ASSOCIATES OR LEADERSHIP TEAMS IDENTIFY BEST PRACTICES IN ANY AREA OF CARE, WE RAPIDLY REPLICATE THOSE ACROSS ALL CARE SITES.THE ORGANIZATION PROMOTES THE HEALTH OF THE COMMUNITY BY DELIVERING DIRECT HIGH QUALITY HEALTHCARE SERVICES THAT ARE RESPONSIVE TO THE NEEDS OF ITS PATIENTS AND THEIR FAMILIES. THIS INCLUDES COORDINATING COMMUNITY BENEFIT PROCESSES, PROVIDING GUIDANCE WITH COMMUNITY NEEDS ASSESSMENTS, AND ESTABLISHING CONSISTENT FINANCIAL ASSISTANCE AND CHARITY CARE POLICIES AND PROCEDURES. ADDITIONALLY, SCLHS BENEFITS AFFILIATES THROUGH QUALITY IMPROVEMENT AND PERFORMANCE EXCELLENCE INITIATIVES; SYSTEM-WIDE INFORMATION TECHNOLOGY IMPLEMENTATION AND INFRASTRUCTURE; STRATEGIC AND OPERATIONS DIRECTION AND OVERSIGHT; SUPPLY CHAIN MANAGEMENT AND PURCHASING; FINANCE ADMINISTRATION, REVENUE CYCLE SUPPORT, BENEFITS ADMINISTRATION, RISK MANAGEMENT; DISASTER PLANNING AND CRISIS ASSISTANCE, CENTRAL CASH MANAGEMENT AND INVESTMENT, INTERNAL AUDIT, LEGAL SERVICES, TAX SERVICES AND MISSION INTEGRATION. 1 SISTERS OF CHARITY OF LEAVENWORTH HEALTH SYSTEM INC 500 ELDORADO BLVD SUITE 4300 BROOMFIELD CO 80021 237379161 501(C)(3) 9820665 SUPPORT MONTANA CLINICS ST VINCENT HEALTHCARE FOUNDATION 1106 NORTH 30TH STREET BILLINGS MT 59101 810468034 501(C)(3) 1572973 SUPPORT OPERATIONS 2 0 PART I, LINE 2: MISSION FUND POLICIES ST VINCENT HEALTHCARE PROVIDES A LIMITED NUMBER OF GRANTS TO IMPROVE THE HEALTH AND WELL-BEING OF THE PEOPLE IN OUR COMMUNITY. GUIDED BY HOSPITAL POLICY, MISSION FUND AWARD PROJECTS MUST: (1) DEMONSTRATE A COMMITTMENT TO THE ST VINCENT HEALTHCARE MISSION, VISION, AND VALUES; (2) MEET CRITERIA FOR INCLUSION IN THE COMMUNITY BENEFIT REPORT; AND (3) DOCUMENT MEASURABLE OUTCOMES THAT DEMONSTRATE THE SUCCESS OF THE PROJECT. PREFERENCE WILL BE GIVEN WHEN THE PROJECT CAN: (1) ADDRESS CREATIVELY THE UNMET NEEDS OF THE ECONOMICALLY DISADVANTAGED; (2) FORM COLLABORATIVE PARTNERSHIPS THAT IMPROVE THE HEALTH OF THE COMMUNITY; (3) AID A SIGNIFICANT POPULATION OF THE POOR, UNDERSERVED AND/OR UNINSURED; (4) REFLECT ST VINCENT HEALTHCARE'S ANNUAL AND STRATEGIC GOALS; AND (5) DEMONSTRATE THE POSSIBILITY FOR SUSTAINABILITY BEYOND THE GRANT PERIOD. APPLICATIONS ARE REVIEWED ON AN ANNUAL BASIS BY COMMITTEE. GRANTEES ARE REQUIRED TO PROVIDE A 6-MONTH AND 1-YEAR REPORT TO ST VINCENT HEALTHCARE AND PROVIDE FOR AN ON-SITE VISIT OF THE PROGRAM. AS NOTED IN THE MISSION FUND APPLICATION, IF FUNDS ARE USED OUTSIDE OF PROJECT GUIDELINES THE GRANTEE MAY BE ASKED TO REIMBURSE ST VINCENT HEALTHCARE FOR FUNDS ALREADY DISTRIBUTED FOR THE PROJECT. X 0 1 0 1 0 0 0 0 0 1 0 JAMES VALIN MD DIRECTOR 0 718908 0 260299 0 126130 0 124200 0 28687 0 1258224 0 107316 STEVE LOVELESS PRESIDENT AND CEO 0 539530 0 201615 0 120557 0 93629 0 26273 0 981604 0 79197 STUART GOODMAN MD FORMER HIGHEST PAID 0 844321 0 15900 0 9778 0 12943 0 15989 0 898931 0 0 WILLIAM SPIRE MD FORMER HIGHEST PAID 0 756707 0 15900 0 2495 0 16807 0 31438 0 823347 0 0 JEFFREY ZAVALA FORMER KEY EMPLOYEE 0 379294 0 97801 0 69553 0 64720 0 21338 0 632706 0 42752 MICHAEL SKEHAN VP CHIEF OPERATING OFFICER REGION MT 0 389657 0 92332 0 51082 0 60741 0 18567 0 612379 0 45098 MICHAEL BUSH MD VP CHIEF MEDICAL OFFICER SVB 0 366377 0 92793 0 59515 0 61101 0 23726 0 603512 0 43638 FRANK LAMM MD PHYSICIAN 506977 0 0 0 5474 0 17100 0 30016 0 559567 0 0 0 TRENT MIHALICK MD PHYSICIAN 504278 0 0 0 6161 0 15170 0 32715 0 558324 0 0 0 RONALD SNYDER MD PHYSICIAN 480453 0 20000 0 5613 0 17100 0 31216 0 554382 0 0 0 RICHARD LAMMERS MD PHYSICIAN 399117 0 75983 0 23352 0 15364 0 26952 0 540768 0 0 0 DANIEL LEWIS MD PHYSICIAN 455753 0 12289 0 7014 0 17100 0 30379 0 522535 0 0 0 PAMELA PALAGI VP FINANCE REGION MT 0 279345 0 68550 0 37094 0 32910 0 9913 0 427812 0 23084 JAMES RITCHEY VP HR MT REGION 1/1-2/24 0 243950 0 58606 0 3255 0 37720 0 28139 0 371670 0 0 MICHAEL HAMILTON VP STRATEGY & BUS DEVELOPMENT SVB 0 229384 0 58894 0 5007 0 37423 0 26806 0 357514 0 0 BLANCHE GILMORE VP CHIEF NURSING OFFICER SVB 0 236330 0 59725 0 32466 0 13323 0 13478 0 355322 0 0 JESSE LASLOVICH VP NETWORK DEVELOPMENT REGION MT 0 234036 0 54316 0 1522 0 32542 0 26814 0 349230 0 0 TRACY NEARY VP MISSION INTEGRATION REGION MT 0 154775 0 34743 0 14437 0 23380 0 27137 0 254472 0 13729 SUSAN PETERSEN MD DIRECTOR 0 143507 0 52238 0 2713 0 10614 0 2933 0 212005 0 0 JOHN ELLIOTT VP HR MT REGION 2/24-10/2 0 155791 0 0 0 33775 0 0 0 18358 0 207924 0 0 PART I, LINE 1A TAX INDEMNIFICATION AND GROSS-UP PAYMENTS THE ORGANIZATION AND RELATED ORGANIZATIONS ALLOW FOR CERTAIN TAX INDEMNIFICATION AND GROSS-UP PAYMENTS IN THE INSTANCES OF RELOCATION. THESE AMOUNTS ARE TREATED AS TAXABLE COMPENSATION. THE INDIVIDUALS THAT RECEIVED TAX GROSS-UP PAYMENTS IN 2020 WERE: JOHN ELLIOTT - $2,615 PART I, LINE 1B: TAX INDEMNIFICATION AND GROSS-UP PAYMENTS - WRITTEN POLICY THE ORGANIZATION AND RELATED ORGANIZATIONS DO NOT HAVE A FORMAL WRITTEN POLICY FOR TAX INDEMNIFICATION AND GROSS-UP PAYMENTS. HOWEVER, BEFORE ANY TAX INDEMNIFICATION AND GROSS-UP PAYMENTS ARE MADE; PROPER APPROVAL FROM THE EMPLOYEE'S MANAGER IS REQUIRED. IN ADDITION, APPROVAL IS ALSO REQUIRED FROM HUMAN RESOURCES. PART I, LINE 3 THE ORGANIZATION'S OFFICERS AND SENIOR MANAGEMENT ARE PAID BY A RELATED ORGANIZATION, SISTERS OF CHARITY OF LEAVENWORTH HEALTH SYSTEM, INC. (SCL HEALTH). COMPENSATION FOR THE OFFICERS AND SENIOR MANAGEMENT IS MANAGED BY THE SCL HEALTH BOARD COMPENSATION COMMITTEE (COMMITTEE) ON BEHALF OF SCL HEALTH AND ALL OF ITS AFFILIATES. THE COMMITTEE REVIEWS AND APPROVES COMPENSATION ARRANGEMENTS OF THE OFFICERS AND SENIOR MANAGEMENT AND MAKES RECOMMENDATIONS TO SCL HEALTH'S BOARD FOR APPROVAL OF ANY CHANGES TO COMPENSATION FOR THE OFFICERS AND SENIOR MANAGEMENT. THE COMMITTEE'S REVIEW IS CONDUCTED IN A MANNER THAT IS INTENDED TO QUALIFY FOR THE REBUTTABLE PRESUMPTION OF REASONABLENESS UNDER THE INTERMEDIATE SANCTIONS RULES OF INTERNAL REVENUE CODE SECTION 4958. THE COMMITTEE CONDUCTS THE REVIEW WITH THE ASSISTANCE OF AN EXPERIENCED AND INDEPENDENT COMPENSATION CONSULTING FIRM THAT HAS DEEP NATIONAL EXPERTISE IN HEALTH SYSTEMS' EXECUTIVE COMPENSATION PROGRAMS AND LEVELS. THE COMMITTEE OBTAINS AND RELIES UPON CURRENT, COMPARABLE MARKET DATA FOR PEER ORGANIZATIONS PRIOR TO MAKING COMPENSATION RELATED DECISIONS. THE INFORMATION REVIEWED INCLUDES COMPENSATION LEVELS PAID BY SIMILARLY SITUATED ORGANIZATIONS FOR FUNCTIONALLY COMPARABLE POSITIONS, THE AVAILABILITY OF SIMILAR SERVICES IN THE GEOGRAPHIC AREA SERVED BY SCL HEALTH AND CURRENT COMPENSATION SURVEYS COMPILED BY AN INDEPENDENT FIRM. CONSISTENT WITH THE PAY PHILOSOPHY SET BY SCL HEALTH'S BOARD, THE COMMITTEE EMPHASIZES THE IMPORTANCE OF ENSURING TOTAL REMUNERATION IS REASONABLE AND APPROPRIATE WHEN REVIEWING AND MAKING RECOMMENDATIONS WITH RESPECT TO COMPENSATION PACKAGES FOR THE OFFICERS AND SENIOR MANAGEMENT. AS PART OF THE REVIEW PROCESS, SCL HEALTH USES THE FOLLOWING IN ESTABLISHING THE COMPENSATION OF OFFICERS AND SENIOR MANAGEMENT. 1) COMPENSATION COMMITTEE 2) INDEPENDENT COMPENSATION CONSULTANT 3) FORM 990 OF OTHER ORGANIZATIONS 4) WRITTEN EMPLOYMENT CONTRACTS 5) COMPENSATION SURVEYS AND STUDIES 6) APPROVAL BY THE BOARD OR COMPENSATION COMMITTEE THE ITEMS LISTED ABOVE SUPPORT THE COMPENSATION COMMITTEE'S EFFORTS TO ENSURE THAT THE LEVEL OF COMPENSATION PROVIDED TO ITS OFFICERS AND SENIOR MANAGEMENT IS REASONABLE, APPROPRIATE AND CONSISTENT WITH THE PAY PHILOSOPHY SET BY THE BOARD. PART I, LINE 4B PAYMENTS FROM A SUPPLEMENTAL NONQUALIFIED RETIREMENT PLAN A RELATED ORGANIZATION PROVIDES NONQUALIFIED DEFERRED COMPENSATION PLANS (NQDC) KNOWN AS SUPPLEMENTAL EXECUTIVE RETIREMENT PROGRAM (SERP) FOR EXECUTIVES (SENIOR MANAGEMENT) TO COMPENSATE FOR REGULATORY IMPOSED LIMITATIONS IN QUALIFIED RETIREMENT PLANS AND TO PROVIDE A BENEFIT CONSISTENT WITH OTHER NOT FOR PROFIT HEALTH SYSTEMS. THESE PLANS ENABLE THE EXECUTIVE TO EARN BENEFITS DURING EACH YEAR THAT THEY PARTICIPATE. IN 2014, IN AN EFFORT TO REDUCE LONG-TERM COST AND HAVE GREATER CONTROL OVER FINANCIAL RISK, THE SERP WAS CONVERTED FROM A DEFINED BENEFIT (DB) TO A DEFINED CONTRIBUTION (DC) DESIGN. CERTAIN MEMBERS OF SENIOR MANAGEMENT WHOSE BENEFITS WERE CONVERTED FROM DB TO DC WOULD HAVE BEEN DISPROPORTIONATELY AND NEGATIVELY AFFECTED BY THE CHANGE, SO THE COMMITTEE DETERMINED IT WOULD BE APPROPRIATE TO GRANT "TRANSITION CREDITS" IN ORDER TO MITIGATE THE NEGATIVE IMPACT OF THE CHANGE ON THEIR RETIREMENT BENEFITS. THIS IS A COMMON APPROACH EMPLOYED BY OTHER ORGANIZATIONS UNDERGOING A SIMILAR TRANSITION. THE TRANSITION CREDITS VEST IN ACCORDANCE WITH THE TERMS OF THE DC SERP (I.E., AFTER THREE YEARS) AND ARE PAID TO THE EXECUTIVE UPON VESTING. NQDC SERP PLANS PRIOR TO 2014 PRIOR TO 2014, THE RELATED ORGANIZATION'S NQDC SERP PLAN PROVIDED A BENEFIT TO ELIGIBLE PARTICIPANTS BASED ON A PERCENTAGE OF THEIR BASE COMPENSATION. THE VESTING PERIOD IS 5 YEARS OR WHEN THE PARTICIPANT IS AGE 65 OR OLDER. THERE WERE NO CONTRIBUTIONS TO THIS PLAN AFTER DECEMBER 31, 2013. FOR AMOUNTS CONTRIBUTED TO THE NQDC SERP PLAN PRIOR TO 2014, VESTED AMOUNTS ARE PAYABLE UPON THE END OF EMPLOYMENT. THE VESTED AMOUNTS WITHDRAWN INCLUDE AMOUNTS PREVIOUSLY TAXED TO THE RECIPIENT AND AMOUNTS TAXABLE TO THE RECIPIENT IN THE CURRENT YEAR. THE TAXABLE AMOUNTS ARE INCLUDED ON THE RECIPIENT'S W-2. ANY DISTRIBUTIONS FROM THIS PLAN ARE REPORTED BELOW. IN 2019, THE RELATED ORGANIZATION CONSOLIDATED FOUR NON QUALIFED DEFERRED COMPENSATION PLANS INTO ONE PLAN. AS PART OF THIS EFFORT, ALL VESTED BALANCES FROM THE SERP PLANS PRIOR TO 2014 WERE PAID TO THE PARTICIPANTS IN 2020. THERE ARE NO REMAINING PARTICIPANTS IN THE LEGACY PLANS. NQDC SERP PLANS STARTING IN 2014 STARTING IN 2014, THE RELATED ORGANIZATION'S NQDC SERP PLAN PROVIDED A BENEFIT TO ELIGIBLE PARTICIPANTS BASED ON A PERCENTAGE OF THEIR BASE COMPENSATION. THE VESTING PERIOD IS ROLLING 3 YEARS OR WHEN THE PARTICIPANT IS AGE 65 OR OLDER. THERE WERE NO CONTRIBUTIONS TO THIS PLAN BEFORE JANUARY 1, 2014. ANY DISTRIBUTIONS FROM THIS PLAN ARE REPORTED BELOW. STARTING IN 2014, FOR CONTRIBUTIONS TO THE NQDC SERP PLAN, CERTAIN PARTICIPANTS ARE VESTED OR BECAME VESTED IN THE PLAN DURING 2020. VESTED AMOUNTS ARE PAYABLE TO THE RECIPIENT. THE VESTED AMOUNTS ARE TAXABLE TO THE RECIPIENT IN THE CURRENT YEAR. THE TAXABLE AMOUNTS ARE INCLUDED ON THE RECIPIENT'S W-2. THE AMOUNTS WITHDRAWN FROM THE NQDC SERP PLANS IN 2020 WERE:STEVE LOVELESS - $149,690, JAMES VALIN - $107,316, PAMELA PALAGI - $23,084, MICHAEL BUSH - $73,561, BLANCHE GILMORE - $25,044, TRACY NEARY - $13,729, MICHAEL SKEHAN - $45,098, JEFFREY ZAVALA - $63,607 IN ACCORDANCE WITH THE REQUIREMENTS OF SCHEDULE J, DEFERRED COMPENSATION EARNED OVER THE VESTING PERIOD IS REPORTED IN COLUMN C AND ANY AMOUNTS VESTED/PAID FROM A DEFERRED COMPENSATION PLAN ARE REPORTED IN COLUMN B(III). THUS, THE SAME AMOUNT WOULD BE REPORTED TWICE (FIRST WHEN IT ACCRUED DURING THE VESTING PERIOD AND AGAIN WHEN IT IS VESTED/PAID). THIS RESULTS IN THE APPEARANCE OF CERTAIN EXECUTIVES RECEIVING MORE THAN THEY ARE ACTUALLY PAID FROM THE DEFERRED COMPENSATION PLANS. COLUMN F IS INTENDED TO RECONCILE THIS DUPLICATION (BY REPORTING AMOUNTS INCLUDED IN COLUMN B(III) THAT HAD BEEN REPORTED AS DEFERRED COMPENSATION ON A SCHEDULE J FOR A PREVIOUS YEAR). HOWEVER, THE SIGNIFICANCE OF THE AMOUNTS LISTED IN COLUMN F IS OFTEN OVERLOOKED AND GIVEN THE COMPLEXITY OF THE SCHEDULE J REPORTING REQUIREMENTS, THE AMOUNTS SHOWN ARE EASILY MISUNDERSTOOD. TO DETERMINE TOTAL AMOUNT EARNED (RATHER THAN THE AMOUNT VESTED/PAID OUT) DURING THE YEAR, SUBTRACT THE AMOUNT IN COLUMN F FROM COLUMN E. PART I, LINE 7 THE AT-RISK COMPENSATION (ARC) PLAN WAS ESTABLISHED TO ENABLE SCL HEALTH TO ATTRACT AND ENGAGE QUALIFIED LEADERS AND TO PROVIDE SUCH LEADERS WITH AN ADDITIONAL PERFORMANCE COMPENSATION OPPORTUNITY TO PROMOTE AND FURTHER ITS CHARITABLE MISSION AND STRATEGIC IMPERATIVES. THE PLAN OPERATES ON A CALENDAR-YEAR BASIS AND AWARD OPPORTUNITIES ARE A PERCENTAGE OF LEADERS' BASE PAY AS DETERMINED BY THEIR MANAGEMENT LEVEL AT SCL HEALTH. ACTUAL AWARDS WILL BE PAID OUT BASED ON ATTAINMENT OF SELECTED SCL HEALTH BOARD-APPROVED GOALS, INCLUDING OPERATING INCOME, STEWARDSHIP, QUALITY, PATIENT AND ASSOCIATE SAFETY AND PATIENT EXPERIENCE AND FULFILLMENT OF OUR MISSION. AWARDS ARE BASED ON THE BOARD'S DETERMINATION ON HOW WELL THE HEALTH CARE SYSTEM PERFORMS RELATIVE TO THE PLAN'S STATED PERFORMANCE STANDARDS AND THE WEIGHT GIVEN TO EACH OF THE PERFORMANCE MEASURES AS DEFINED FOR THAT PLAN YEAR. THE AT RISK COMPENSATION PLAN SHALL BE INTERPRETED, APPLIED AND ADMINISTERED AT ALL TIMES IN ACCORDANCE WITH CODE SECTION 409A AND GUIDANCE ISSUED THEREUNDER. THE HEALTH CARE SYSTEM RESERVES THE RIGHT TO AMEND OR TERMINATE THIS PLAN AT ANY TIME FOR ANY REASON. ADDITIONAL OFFICER AND BOARD DISCLOSURES THE SISTERS OF CHARITY OF LEAVENWORTH HEALTH SYSTEM, INC. (SCL HEALTH) AND RELATED TAX EXEMPT ORGANIZATIONS CONSISTS OF EIGHT HOSPITALS, NINE FOUNDATIONS, TWO SAFETY-NET CLINICS, ONE CHILDREN'S MENTAL HEALTH CENTER, HOME HEALTH AND MORE THAN 200 PHYSICIAN CLINICS IN THREE STATES - COLORADO, KANSAS AND MONTANA. THE HEALTH SYSTEM INCLUDES MORE THAN 15,900 FULL-TIME ASSOCIATES AND MORE THAN 800 EMPLOYED PROVIDERS. SCL HEALTH AND RELATED TAX EXEMPT ORGANIZATIONS ADHERE TO GOVERNANCE EXCELLENCE STANDARDS INCLUDING TRANSPARENCY AND ACCOUNTABILITY. IN KEEPING WITH SCL HEALTH'S CORE VALUE OF STEWARDSHIP, SCL HEALTH'S BOARD COMPENSATION COMMITTEE (COMMITTEE) HAS RETAINED THE SERVICES OF AN INDEPENDENT COMPENSATION ADVISOR. THE COMPENSATION ADVISOR IS RESPONSIBLE FOR ADVISING THE COMMITTEE ON ALL MATTERS RELATING TO EXECUTIVE COMPENSATION INCLUDING SUPPORTING THE COMMITTEE'S EFFORTS TO ENSURE THAT THE LEVEL OF COMPENSATION PROVIDED OFFICERS AND SENIOR MANAGEMENT IS REASONABLE, APPROPRIATE AND CONSISTENT WITH THE PAY PHILOSOPHY SET BY THE BOARD. THE SISTERS WHO SERVE AS OFFICERS AND/OR BOARD MEMBERS ARE MEMBERS OF THE SISTERS OF CHARITY OF LEAVENWORTH (A RELIGIOUS ORDER OF WOMEN). THE SISTERS HAVE TAKEN VOWS OF POVERTY AND RECEIVE NO COMPENSATION, EXPENSE ACCOUNT ALLOWANCE, OR CONTRIBUTIONS TO BENEFIT PLANS FOR THEIR SERVICES TO THE HEALTH CARE SYSTEM. HOWEVER, A PAYMENT IS MADE DIRECTLY TO THE SISTERS OF CHARITY OF LEAVENWORTH FOR THE SERVICES OF THOSE WHO PERFORM PROFESSIONAL, ADMINISTRATIVE, AND OTHER SUCH SERVICES. GREGORY BUSH SEE PART V 17562 EMPLOYMENT 0 SCH L, PART IV, BUSINESS TRANSACTIONS INVOLVING INTERESTED PERSONS: MICHAEL BUSH (KEY EMPLOYEE), IS THE FATHER OF GREGORY BUSH, AN EMPLOYEE OF ST. VINCENT HEALTHCARE X 25 9200 FMV X 15 44740 FMV X OTHER SUPPLIES 12 106356 FMV 0 1 0 FORM 990, LINE J WEBSITE: HTTPS://WWW.SCLHEALTH.ORG/LOCATIONS/ST-VINCENT-HEALTHCARE/ FORM 990, PART VI, SECTION A, LINE 4 FORM 990, PART VI, LINE 4 SIGNIFICANT CHANGES TO THE GOVERNING DOCUMENTS NAME CHANGE ST. VINCENT HEALTHCARE CHANGED ITS NAME TO SCL HEALTH - MONTANA EFFECTIVE JANUARY 1, 2020 CHANGES TO THE ARTICLES OF INCORPORATION AND BY-LAWS SISTERS OF CHARITY OF LEAVENWORTH HEALTH SYSTEM, INC. (SCL HEALTH) AND THE MONTANA CARE SITES, ST. VINCENT HEALTHCARE, ST. JAMES HEALTHCARE AND HOLY ROSARY HEALTHCARE CREATED A REGIONAL GOVERNANCE STRUCTURE FOR ITS MONTANA CARE SITES CONSISTENT WITH THE OPERATIONAL ALIGNMENT AMONG ITS CARE SITES. THIS NEW STRUCTURE WAS IMPLEMENTED ON JANUARY 1, 2020. THE SCL HEALTH - MONTANA MANAGEMENT STRUCTURE FURTHER ALIGNS THE ORGANIZATION'S REGIONAL FOCUS AND ACTIVITY. MONTANA CARE SITES - INCLUDING THE AFFILIATES NAMED ABOVE - WILL CONTINUE TO BE RESPONSIBLE FOR KEY LOCAL FUNCTIONS. THE REGIONAL GOVERNANCE STRUCTURE WILL BRING GREATER FOCUS TO THE FIDUCIARY RESPONSIBILITIES OF THE REGIONAL BOARD OF DIRECTORS AROUND QUALITY, SAFETY AND PATIENT EXPERIENCE AND THE COMPOSITION OF THE REGIONAL BOARD WILL ENSURE ALL MONTANA CARE SITES AND THEIR COMMUNITIES ARE WELL REPRESENTED. THIS REGIONAL GOVERNANCE STRUCTURE, DEVELOPED WITH INPUT FROM BOTH SCL HEALTH LEADERSHIP AND THE MONTANA CARE SITE BOARD LEADERSHIP, WILL: - ENHANCE AND STREAMLINE INDIVIDUAL BOARD MEMBER EFFECTIVENESS WITHIN THEIR GOVERNANCE ROLES - ALLOW THE SCL HEALTH - MONTANA BOARD TO DRAW UPON THE EXTENSIVE EXPERTISE EXISTING THROUGHOUT THE REGION FOR THE BENEFIT OF ALL CARE SITES - ADVANCE REGIONAL STRATEGIES WHILE ADDRESSING INDIVIDUAL CARE SITE NEEDS - CREATE ORGANIZATIONAL EFFICIENCIES - EMBRACE AND HONOR THE HISTORY OF EACH SCL HEALTH - MONTANA CARE SITE AND THEN SHARE HOW EACH CAN MOVE FORWARD - DEMONSTRATE THE BETTERMENT OF PATIENTS - PROVIDE A MORE IMPACTFUL PRESENCE WITH PAYERS AND EMPLOYERS - IMPROVE GROWTH OPPORTUNITIES ACROSS THE REGION - FOSTER A UNIFIED MEDICAL STAFF CULTURE - LEVERAGE ADVOCACY AND NEGOTIATION STRENGTHS - GROW AWARENESS OF THE SCL HEALTH BRAND SCL HEALTH - MONTANA WILL BE GOVERNED BY ONE UNIFIED REGIONAL BOARD OF DIRECTORS UNDER THE ST. VINCENT HEALTHCARE LEGAL ENTITY, WHICH HAS BEEN RENAMED SCL HEALTH - MONTANA, AND WILL HAVE REPRESENTATION FROM ALL THREE MONTANA CARE SITES. THE SCL HEALTH - MONTANA BOARD OF DIRECTORS WILL BE COMPRISED OF INDIVIDUALS APPOINTED BY THE SCL HEALTH BOARD OF DIRECTORS BASED ON GEOGRAPHIC LOCATION AND CORE COMPETENCIES. EXISTING MEMBERS OF MONTANA CARE SITE BOARDS OF DIRECTORS WHO ARE NOT APPOINTED TO THE REGIONAL BOARD MAY BE APPOINTED TO SERVE ON REGIONAL COMMITTEES OR CARE SITE FOUNDATION BOARDS OF DIRECTORS. THE PRIMARY CHANGES TO THE AFFILIATES' ARTICLES OF INCORPORATION AND BYLAWS ARE AS FOLLOWS: ST. VINCENT HEALTHCARE - CHANGE THE NAME TO SCL HEALTH - MONTANA - REFLECT THAT THE BOARD OF SCL HEALTH - MONTANA IS RESPONSIBLE FOR MANAGEMENT OF THE BUSINESS AND AFFAIRS OF ST. VINCENT HEALTHCARE, HOLY ROSARY HEALTHCARE, AND ST. JAMES HEALTHCARE - CLARIFY SCL HEALTH - MONTANA BOARD MEMBER DUTIES TO ALIGN WITH CURRENT ROLES - STREAMLINE COMMITTEES AND COMMITTEE FUNCTION FOR A REGIONAL BOARD OF DIRECTORS AND CONSISTENT WITH OTHER GOVERNANCE CONSTRUCTS WITHIN SCL HEALTH - CHANGE THE TERMS OF DIRECTORS FROM TWO CONSECUTIVE THREE-YEAR TERMS TO ONE INITIAL ONE-YEAR TERM WITH ELIGIBILITY FOR REAPPOINTMENT FOR THREE ADDITIONAL CONSECUTIVE THREE-YEAR TERMS, FOR A TOTAL OF NO MORE THAN TEN CONSECUTIVE YEARS HOLY ROSARY HEALTHCARE AND ST. JAMES HEALTHCARE - INCORPORATE CERTAIN CONCEPTS AND LANGUAGE TO DELEGATE THE REQUIRED AUTHORITY TO THE SCL HEALTH - MONTANA BOARD OF DIRECTORS ST. VINCENT HEALTHCARE, HOLY ROSARY HEALTHCARE, ST. JAMES HEALTHCARE: - ALIGN THE DOCUMENTS WITH THE MODEL ARTICLES OF INCORPORATION AND BYLAWS FOR OTHER AFFILIATES. - ROUTINE UPDATING OF LANGUAGE, GRAMMAR, AND IDENTIFIERS FORM 990, PART VI, SECTION A, LINE 6 SISTERS OF CHARITY OF LEAVENWORTH HEALTH SYSTEM, INC. (SCLHS) IS THE SOLE MEMBER OF SCL HEALTH - MONTANA. FORM 990, PART VI, SECTION A, LINE 7A SISTERS OF CHARITY OF LEAVENWORTH HEALTH SYSTEM, INC., THE SOLE MEMBER OF SCL HEALTH - MONTANA, APPROVES MEMBERS OF SCL HEALTH - MONTANA BOARD OF DIRECTORS. FORM 990, PART VI, SECTION A, LINE 7B SISTERS OF CHARITY OF LEAVENWORTH HEALTH SYSTEM, INC. (SCLHS) HAS CERTAIN RESERVE POWERS TO APPROVE CHANGES TO THE ARTICLES OF INCORPORATION AND THE BYLAWS INCLUDING THE APPOINTMENT OR REMOVAL OF BOARD MEMBERS AND THE PRESIDENT/CEO. SCLHS ALSO HAS CERTAIN RESERVE POWERS OVER ANY CHANGE IN OWNERSHIP OF THE CORPORATION, CHANGE IN MISSION, ACQUISITION OF ASSETS, DISPOSAL OF ASSETS, LEASING OF ASSETS, INCURRENCE OF DEBT, MERGER OR DISSOLUTION, APPROVAL OF STRATEGIC PLANS AND BUDGETS, APPOINTMENT OF AUDITORS AND OVERSIGHT AND APPROVAL OF COMPENSATION AND BENEFITS FOR DIRECTORS, OFFICERS, KEY EMPLOYEES AND PHYSICIANS. FORM 990, PART VI, SECTION B, LINE 11B THE FORM 990 IS PREPARED BY THE TAX DEPARTMENT OF THE PARENT ORGANIZATION, SISTERS OF CHARITY OF LEAVENWORTH HEALTH SYSTEM, INC. (SCLHS). THE FORM 990 IS REVIEWED BY CERTAIN MEMBERS OF SENIOR MANAGEMENT. A COPY OF THE FORM 990 IS PROVIDED TO THE BOARD OF DIRECTORS PRIOR TO THE FILING OF THE FORM 990 WITH THE INTERNAL REVENUE SERVICE. ANY QUESTIONS ARE ADDRESSED TO THE TAX DIRECTOR OF SCLHS PRIOR TO FILING THE FORM 990 WITH THE INTERNAL REVENUE SERVICE. FORM 990, PART VI, SECTION B, LINE 12C MONITORING AND ENFORCEMENT OF COMPLIANCE WITH CONFLICT OF INTEREST POLICY SCL HEALTH - MONTANA AND THE PARENT ORGANIZATION, SISTERS OF CHARITY OF LEAVENWORTH HEALTH SYSTEM, INC. (COLLECTIVELY REFERRED TO AS SCL HEALTH), REGULARLY AND CONSISTENTLY MONITORS AND ENFORCES ITS CONFLICT OF INTEREST POLICY BY PROVIDING EDUCATION AND TRAINING FOR ITS EMPLOYEES, STAFF, OFFICERS AND DIRECTORS. PERSONS CONSIDERED TO BE IN AN INFLUENTIAL POSITION, SUCH AS BOARD MEMBERS, OFFICERS, PHYSICIANS, EXECUTIVES AND DIRECTOR LEVEL MANAGERS ARE ALL REQUIRED TO COMPLETE A CONFLICT OF INTEREST STATEMENT UPON HIRE/APPOINTMENT AND ON AN ANNUAL BASIS TO DISCLOSE ANY POTENTIAL CONFLICT ISSUES. THESE STATEMENTS ARE CAREFULLY REVIEWED BY THE SCL HEALTH INTEGRITY AND COMPLIANCE DEPARTMENT AND APPROPRIATE LEADERSHIP. A REPORT IS PROVIDED TO SCL HEALTH'S PRESIDENT/CEO AND THE BOARD OF DIRECTORS. THE BUSINESS AND AFFAIRS OF SCL HEALTH WILL AT ALL TIMES BE CONDUCTED IN A MANNER THAT IS SOLELY IN THE BEST INTERESTS OF SCL HEALTH AND NOT BE INFLUENCED BY CONFLICTING INTERESTS OF PERSONS RESPONSIBLE FOR ADMINISTERING THOSE AFFAIRS. THE EXISTENCE OF ANY CONFLICTS OF INTEREST WILL BE DISCLOSED AND THE PROCEDURES SET FORTH HEREIN WILL BE FOLLOWED. CERTAIN TRANSACTIONS DETERMINED TO CONSTITUTE A CONFLICT OF INTEREST ARE PROHIBITED. ANY PERSON IN A POSITION TO EXERCISE SUBSTANTIAL INFLUENCE OVER SCL HEALTH IS CONSIDERED AN INTERESTED PERSON. THIS TERM INCLUDES, BUT IS NOT LIMITED TO THE FOLLOWING: - BOARD MEMBERS, BOARD COMMITTEE MEMBERS, OFFICERS AND DIRECTORS; - SENIOR LEADERS AND EXECUTIVES (CEO, PRESIDENT, SVP, VP, EXECUTIVE DIRECTORS); - EMPLOYED PHYSICIANS AND PHYSICIANS IN MEDICAL STAFF LEADERSHIP ROLES (E.G., DEPARTMENT CHAIRS, MEMBERS OF MEDICAL STAFF COMMITTEES); - MEDICAL DIRECTORS OF CLINICAL PROGRAMS THAT ASSESS, REVIEW, RECOMMEND OR REQUEST PURCHASE OF ANY SPECIFIC PHARMACEUTICAL PRODUCTS, MEDICAL DEVICES, SUPPLIES AND/OR EQUIPMENT; - DEPARTMENT DIRECTORS; AND - OTHER SELECT INDIVIDUALS IDENTIFIED BY LEADERSHIP WHICH MAY INCLUDE, BUT IS NOT LIMITED TO, SUPPLY CHAIN AND FINANCE. UPON BECOMING AN INTERESTED PERSON AND ON AN ANNUAL BASIS, INTERESTED PERSONS ARE REQUIRED TO DISCLOSE ANY RELATIONSHIPS THAT CONSTITUTE OR MIGHT LEAD TO A CONFLICT OF INTEREST BY COMPLETING THE CURRENT CONFLICT OF INTEREST AND GIFT DISCLOSURE STATEMENT ("STATEMENT") AS APPROVED BY THE CHIEF INTEGRITY AND COMPLIANCE OFFICER. THE CHIEF INTEGRITY AND COMPLIANCE OFFICER WILL OVERSEE THE REVIEW OF THE STATEMENTS AND THE RESOLUTION OF ANY IDENTIFIED CONFLICTS OF INTEREST AND ALERT THE SCL HEALTH CEO AND/OR THE CHAIR OF THE SCL HEALTH BOARD OF DIRECTORS TO ANY ITEMS OF CONCERN. WHEN AN INTERESTED PERSON BECOMES AWARE OF A CONFLICT OF INTEREST WHICH HAS NOT BEEN DISCLOSED ON A STATEMENT, HE OR SHE SHALL CONTACT THE LOCAL COMPLIANCE AND PRIVACY OFFICER OR THE CHIEF INTEGRITY AND COMPLIANCE OFFICER, OBTAIN A STATEMENT FORM, COMPLETE AND RETURN IT TO THE SCL HEALTH INTEGRITY AND COMPLIANCE DEPARTMENT. WHENEVER AN INTERESTED PERSON BECOMES AWARE THAT AN ARRANGEMENT WITH RESPECT TO WHICH HE OR SHE HAS A CONFLICT OF INTEREST IS BEING CONSIDERED, THE INTERESTED PERSON MUST DISCLOSE ALL MATERIAL FACTS CONCERNING THE EXISTENCE AND NATURE OF THE CONFLICT OF INTEREST TO HIS OR HER SUPERVISOR (IF AN EMPLOYEE OTHER THAN THE ORGANIZATIONS SCL HEALTH CEO) OR TO THE APPLICABLE BOARD OR COMMITTEE CHAIR (IF THE SCL HEALTH CEO OR A BOARD OR COMMITTEE MEMBER), EVEN IF THE CONFLICT OF INTEREST HAS BEEN PREVIOUSLY DISCLOSED. WITH REGARD TO EMPLOYEES OTHER THAN THE SCL HEALTH CEO, THE INTERESTED PERSON'S SUPERVISOR WILL DETERMINE WHETHER A CONFLICT OF INTEREST EXISTS. WITH REGARD TO THE SCL HEALTH CEO AND BOARD OR COMMITTEE MEMBERS, THE REMAINING MEMBERS OF THE BOARD OR COMMITTEE WILL DETERMINE WHETHER A CONFLICT OF INTEREST EXISTS. PERSON(S) RESPONSIBLE FOR THE DETERMINATION SHOULD OBTAIN FURTHER GUIDANCE FROM THE SCL HEALTH INTEGRITY AND COMPLIANCE OR LEGAL DEPARTMENTS. UPON MAKING HIS OR HER DISCLOSURE, THE INTERESTED PERSON WILL LEAVE THE MEETING OR OTHERWISE REMOVE HIM OR HERSELF FROM THE DELIBERATIONS OR OTHER DECISION-MAKING PROCESS UNTIL SUCH TIME AS A DETERMINATION IS REACHED. IF A DETERMINATION HAS BEEN MADE THAT NO CONFLICT OF INTEREST EXISTS, THE INTERESTED PERSON MAY BE PRESENT AND PARTICIPATE IN THE DELIBERATION REGARDING THE TRANSACTION OR ARRANGEMENT. HOWEVER, IF AN INTERESTED PERSON HAS BEEN DETERMINED TO HAVE A CONFLICT OF INTEREST, HE OR SHE MAY NOT PARTICIPATE IN THE DELIBERATION OR DECISION REGARDING THE TRANSACTION OR ARRANGEMENT; BE PRESENT DURING THE DELIBERATION OR DECISION-MAKING; OR BE ALLOWED TO MAKE A PRESENTATION PRIOR TO THE DELIBERATION AND DECISION-MAKING ACTIVITIES. WHEN AN INTERESTED PERSON HAS A CONFLICT OF INTEREST, THE DECISION-MAKER/DECISION-MAKING BODY CONSIDERING THE TRANSACTION OR ARRANGEMENT WILL TAKE REASONABLE MEASURES, PRIOR TO APPROVING OR ENTERING INTO THE TRANSACTION OR ARRANGEMENT, TO ENSURE THAT THE PROPOSAL IS IN SCL HEALTH'S BEST INTERESTS. THE PROPOSED TRANSACTION OR ARRANGEMENT MAY PROCEED IF THE DECISION-MAKER/DECISION-MAKING BODY, AFTER HAVING BEEN FULLY INFORMED OF THE MATERIAL FACTS ESTABLISHING THE CONFLICT OF INTEREST, DETERMINES THAT THE TRANSACTION OR ARRANGEMENT IS IN SCL HEALTH'S BEST INTERESTS AND IS FAIR AND REASONABLE. A MAJORITY VOTE OF THE DISINTERESTED DECISION-MAKERS IS REQUIRED WHEN A DETERMINATION IS MADE BY A BOARD, COMMITTEE OR OTHER DECISION-MAKING BODY. MANAGEMENT OF POTENTIAL CONFLICTS IS DONE BY THE CHIEF INTEGRITY AND COMPLIANCE OFFICER AND/OR CARE SITE COMPLIANCE AND PRIVACY OFFICERS AND REPORTED ANNUALLY TO THE CARE SITE LEADERSHIP COMMITTEES AND/OR SYSTEM INTEGRITY AND COMPLIANCE COMMITTEE AND TO THE AUDIT COMMITTEE, ORGANIZATIONAL INTEGRITY AND COMPLIANCE COMMITTEE OF THE SCL HEALTH BOARD OF DIRECTORS. ANY REPORTED CONFLICTS OR POTENTIAL CONFLICTS WILL ALSO BE REPORTED TO AND REVIEWED BY THE SCL HEALTH TAX DIRECTOR FOR COMPLIANCE WITH THE FORM 990 TAX RETURN. FORM 990, PART VI, SECTION B, LINE 15 THE ORGANIZATION'S OFFICERS AND SENIOR MANAGEMENT ARE PAID BY A RELATED ORGANIZATION, SISTERS OF CHARITY OF LEAVENWORTH HEALTH SYSTEM, INC. (SCL HEALTH). COMPENSATION FOR THE OFFICERS AND SENIOR MANAGEMENT IS MANAGED BY THE SCL HEALTH BOARD COMPENSATION COMMITTEE (COMMITTEE) ON BEHALF OF SCL HEALTH AND ALL OF ITS AFFILIATES. THE COMMITTEE REVIEWS AND APPROVES COMPENSATION ARRANGEMENTS OF THE OFFICERS AND SENIOR MANAGEMENT AND MAKES RECOMMENDATIONS TO SCL HEALTH'S BOARD FOR APPROVAL OF ANY CHANGES TO COMPENSATION FOR THE OFFICERS AND SENIOR MANAGEMENT. THE COMMITTEE'S REVIEW IS CONDUCTED IN A MANNER THAT IS INTENDED TO QUALIFY FOR THE REBUTTABLE PRESUMPTION OF REASONABLENESS UNDER THE INTERMEDIATE SANCTIONS RULES OF INTERNAL REVENUE CODE SECTION 4958. THE COMMITTEE CONDUCTS THE REVIEW WITH THE ASSISTANCE OF AN EXPERIENCED AND INDEPENDENT COMPENSATION CONSULTING FIRM THAT HAS DEEP NATIONAL EXPERTISE IN HEALTH SYSTEMS' EXECUTIVE COMPENSATION PROGRAMS AND LEVELS. THE COMMITTEE OBTAINS AND RELIES UPON CURRENT, COMPARABLE MARKET DATA FOR PEER ORGANIZATIONS PRIOR TO MAKING COMPENSATION RELATED DECISIONS. THE INFORMATION REVIEWED INCLUDES COMPENSATION LEVELS PAID BY SIMILARLY SITUATED ORGANIZATIONS FOR FUNCTIONALLY COMPARABLE POSITIONS, THE AVAILABILITY OF SIMILAR SERVICES IN THE GEOGRAPHIC AREA SERVED BY SCL HEALTH AND CURRENT COMPENSATION SURVEYS COMPILED BY AN INDEPENDENT FIRM. CONSISTENT WITH THE PAY PHILOSOPHY SET BY SCL HEALTH'S BOARD, THE COMMITTEE EMPHASIZES THE IMPORTANCE OF ENSURING TOTAL REMUNERATION IS REASONABLE AND APPROPRIATE WHEN REVIEWING AND MAKING RECOMMENDATIONS WITH RESPECT TO COMPENSATION PACKAGES FOR THE OFFICERS AND SENIOR MANAGEMENT. AS PART OF THE REVIEW PROCESS, SCL HEALTH USES THE FOLLOWING IN ESTABLISHING THE COMPENSATION OF OFFICERS AND SENIOR MANAGEMENT. 1) COMPENSATION COMMITTEE 2) INDEPENDENT COMPENSATION CONSULTANT 3) FORM 990 OF OTHER ORGANIZATIONS 4) WRITTEN EMPLOYMENT CONTRACTS 5) COMPENSATION SURVEYS AND STUDIES 6) APPROVAL BY THE BOARD OR COMPENSATION COMMITTEE THE ITEMS LISTED ABOVE SUPPORT THE COMPENSATION COMMITTEE'S EFFORTS TO ENSURE THAT THE LEVEL OF COMPENSATION PROVIDED TO ITS OFFICERS AND SENIOR MANAGEMENT IS REASONABLE, APPROPRIATE AND CONSISTENT WITH THE PAY PHILOSOPHY SET BY THE BOARD. FORM 990, PART VI, SECTION C, LINE 19 THE ORGANIZATION MAKES ITS CONFLICT OF INTEREST POLICY, FINANCIAL STATEMENTS, AND GOVERNING DOCUMENTS AVAILABLE UPON REQUEST. FORM 990, PART IX, LINE 11G PROFESSIONAL MEDICAL SERVICES: PROGRAM SERVICE EXPENSES 48,740,911. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 48,740,911. PHYSICIAN MANAGEMENT SERVICES: PROGRAM SERVICE EXPENSES 24,408,285. MANAGEMENT AND GENERAL EXPENSES 616,610. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 25,024,895. OUTSIDE LABORATORY FEES: PROGRAM SERVICE EXPENSES 4,054,349. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 4,054,349. PROFESSIONAL CONSULTING SERVICES: PROGRAM SERVICE EXPENSES 443,276. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 443,276. 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