FRANCISCAN HEALTH RENSSELAER: Form 990, tax year 2019
View the entire original 990 at ProPublica ↗
- Organization
- FRANCISCAN HEALTH RENSSELAER (EIN 47-3825106)
- Tax period
- 2019-01-01 to 2019-12-31
- Filed
- 2020-11-16
- IRS object ID
- 202043219349314254
- Schema version
- 2019v5.1
- 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 ReturnHeader
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return | 2020-11-16T13:52:59-06:00 | ReturnTs |
| Tax Period End | 2019-12-31 | TaxPeriodEndDt |
Preparer Firm PreparerFirmGrp
Preparer Firm Name PreparerFirmName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | PricewaterhouseCoopers 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 | 2019-01-01 | 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 | PersonTitleTxt |
| Phone | 5742563935 | PhoneNum |
| Signature | 2020-11-16 | SignatureDt |
| Discuss With Paid Preparer | Yes (true) | DiscussWithPaidPreparerInd |
Preparer Person PreparerPersonGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Person | ERIC M MCNEIL | PreparerPersonNm |
| PTIN | P00460263 | PTIN |
| Phone | 2673303000 | PhoneNum |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax | 2019 | TaxYr |
| Build TS | 2022-09-23 18:48:47Z | 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 | $32,867,450 | 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 | 225 | TotalEmployeeCnt |
| Total Volunteers | 14 | TotalVolunteersCnt |
| Total Gross UBI | $12,841 | TotalGrossUBIAmt |
| Net Unrelated Bus Txbl Incm | -$18,134 | NetUnrelatedBusTxblIncmAmt |
| PY Contributions Grants | $114,254 | PYContributionsGrantsAmt |
| CY Contributions Grants | $338,155 | CYContributionsGrantsAmt |
| PY Program Service Revenue | $28,181,587 | PYProgramServiceRevenueAmt |
| CY Program Service Revenue | $32,432,118 | CYProgramServiceRevenueAmt |
| PY Investment Income | -$478,527 | PYInvestmentIncomeAmt |
| CY Investment Income | $4,686 | CYInvestmentIncomeAmt |
| PY Other Revenue | $71,238 | PYOtherRevenueAmt |
| CY Other Revenue | $92,491 | CYOtherRevenueAmt |
| PY Total Revenue | $27,888,552 | PYTotalRevenueAmt |
| CY Total Revenue | $32,867,450 | 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 | $17,602,250 | PYSalariesCompEmpBnftPaidAmt |
| CY Salaries Comp Emp Bnft Paid | $17,667,101 | CYSalariesCompEmpBnftPaidAmt |
| PY Total Prof Fndrsng Expns | $0 | PYTotalProfFndrsngExpnsAmt |
| CY Total Prof Fndrsng Expns | $0 | CYTotalProfFndrsngExpnsAmt |
| CY Total Fundraising Expense | $0 | CYTotalFundraisingExpenseAmt |
| PY Other Expenses | $17,867,425 | PYOtherExpensesAmt |
| CY Other Expenses | $19,120,772 | CYOtherExpensesAmt |
| PY Total Expenses | $35,469,675 | PYTotalExpensesAmt |
| CY Total Expenses | $36,787,873 | CYTotalExpensesAmt |
| PY Revenues Less Expenses | -$7,581,123 | PYRevenuesLessExpensesAmt |
| CY Revenues Less Expenses | -$3,920,423 | CYRevenuesLessExpensesAmt |
| Total Assets BOY | $27,038,944 | TotalAssetsBOYAmt |
| Total Assets EOY | $27,884,259 | TotalAssetsEOYAmt |
| Total Liabilities BOY | $48,871,199 | TotalLiabilitiesBOYAmt |
| Total Liabilities EOY | $48,946,674 | TotalLiabilitiesEOYAmt |
| Net Assets Or Fund Balances BOY | -$21,832,255 | NetAssetsOrFundBalancesBOYAmt |
| Net Assets Or Fund Balances EOY | -$21,062,415 | NetAssetsOrFundBalancesEOYAmt |
| Info In Schedule O Part III | Yes (X) | InfoInScheduleOPartIIIInd |
| Mission | 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 TH | MissionDesc |
| Significant New Program Srvc | false | SignificantNewProgramSrvcInd |
| Significant Change | false | SignificantChangeInd |
| Expense | $25,120,727 | ExpenseAmt |
| Grant | $0 | GrantAmt |
| Revenue | $32,442,462 | RevenueAmt |
| Desc | FRANCISCAN HEALTH RENSSELAER, INC. IS A TWENTY FIVE BED CRITICAL CARE HOSPITAL LOCATED IN RENSSELAER, INDIANA PROVIDING HEALTH CARE 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 | $25,120,727 | 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 | 57 | IRPDocumentCnt |
| IRP Document W2 G | 0 | IRPDocumentW2GCnt |
| Backup Wthld Compliance | Yes (true) | BackupWthldComplianceInd |
| Employee | 225 | 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 | 5742546268 | 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 |
Form990 Part VII Section A Form990PartVIISectionAGrp (13 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 & DIRECTOR | 5.0 | 56.0 | Yes (X) | Yes (X) | $0 | $1,976,570 | $26,152 | |
| TERRANCE WILSON | ||||||||
| FACILITY CEO/PRES OF HOSP DIV | 5.0 | 40.0 | Yes (X) | $0 | $1,266,683 | $29,651 | ||
| THOMAS GRYZBEK | ||||||||
| SR VP OF POST ACUTE SVCS DIV | 0.0 | 40.0 | Yes (X) | $0 | $711,823 | $22,970 | ||
| DEBORAH M RILEY | ||||||||
| DIRECTOR PATIENT CARE SERVICES | 40.0 | 0.0 | $165,817 | $0 | $743 | Yes (X) | ||
| SUSAN L HOOKER | ||||||||
| MANAGER PHARMACY SERVICES | 40.0 | 0.0 | $122,482 | $0 | $17,231 | Yes (X) | ||
| CHRISTINA M HOAKS | ||||||||
| DIRECTOR NURSING | 40.0 | 0.0 | $110,981 | $0 | $23,378 | Yes (X) | ||
| CHRISTINE M SCHEURICH | ||||||||
| DIRECTOR REHAB SERVICES | 40.0 | 0.0 | $130,187 | $0 | $640 | Yes (X) | ||
| KARI L GOODMAN | ||||||||
| DIRECTOR NURSING | 40.0 | 0.0 | $112,453 | $0 | $16,194 | Yes (X) | ||
| SISTER JANE MARIE KLEI | ||||||||
| CHAIR & DIRECTOR | 5.0 | 56.0 | Yes (X) | $0 | $0 | $0 | ||
| SISTER M ANN KATHLEEN | ||||||||
| TREASURER & DIRECTOR | 5.0 | 51.0 | Yes (X) | Yes (X) | $0 | $0 | $0 | |
| SISTER M MADONNA ROUGE | ||||||||
| DIRECTOR | 5.0 | 50.0 | Yes (X) | $0 | $0 | $0 | ||
| SISTER ROSE AGNES PFAU | ||||||||
| DIRECTOR (THROUGH 1/2019) | 5.0 | 15.0 | Yes (X) | $0 | $0 | $0 | ||
| SISTER LETHIA MARIE LE | ||||||||
| SEC'Y/DIRECTOR (AS OF 2/2019) | 5.0 | 51.0 | Yes (X) | Yes (X) | $0 | $0 | $0 | |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | $641,920 | TotalReportableCompFromOrgAmt |
| Tot Reportable Comp Rltd Org | $3,955,076 | TotReportableCompRltdOrgAmt |
| Total Other Compensation | $136,959 | TotalOtherCompensationAmt |
| Indiv Rcvd Greater Than100 K | 8 | 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 |
|---|---|---|---|---|---|
| EMCARE INC | |||||
| 7032 COLLECTIONS CENTER DRIVE | CHICAGO | IL | 60693 | PHYSICIAN SERVICES | $1,320,719 |
| WABASH EM I MEDICAL SERVICES PC | |||||
| 7032 COLLECTIONS CENTER DRIVE | CHICAGO | IL | 60693 | PHYSICIAN SERVICES | $1,048,099 |
| SURGICAL CONSULTANTS INTL PC | |||||
| PO BOX 846 | CROWN POINT | IN | 463080846 | PHYSICIAN SERVICES | $254,000 |
| INDIANA AMS LLC | |||||
| 28 N PALAFOX STREET | PENSACOLA | FL | 32502 | PHYSICIAN SERVICES | $182,500 |
| MEDICAL INFORMATION TECHNOLOGY INC | |||||
| PO BOX 74569 | CHICAGO | IL | 60696 | IS SERVICES | $166,963 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cntrct Rcvd Greater Than100 K | 7 | CntrctRcvdGreaterThan100KCnt |
| Related Organizations | $291,575 | RelatedOrganizationsAmt |
| All Other Contributions | $46,580 | AllOtherContributionsAmt |
| Total Contributions | $338,155 | TotalContributionsAmt |
Program Service Revenue ProgramServiceRevenueGrp (2 entries)
| DescDesc | BusinessBusinessCd | Total Revenue ColumnTotalRevenueColumnAmt | Related Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt | ExclusionExclusionAmt |
|---|---|---|---|---|
| PATIENT SERVICE AND OTHER REVENUES | 622110 | $32,369,232 | $32,369,232 | |
| CAFETERIA | 622110 | $62,886 | $62,886 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | $32,432,118 | 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 | $6,420 | RealAmt |
Rental Income Or Loss RentalIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $6,420 | RealAmt |
| Personal | $0 | PersonalAmt |
Net Rental Income Or Loss NetRentalIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $6,420 | TotalRevenueColumnAmt |
| Exclusion | $6,420 | ExclusionAmt |
Gross Amount Sales Assets GrossAmountSalesAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | $4,686 | OtherAmt |
Gain Or Loss GainOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | $4,686 | OtherAmt |
Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $4,686 | TotalRevenueColumnAmt |
| Exclusion | $4,686 | ExclusionAmt |
| 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 (2 entries)
| DescDesc | BusinessBusinessCd | Total Revenue ColumnTotalRevenueColumnAmt | Related Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt | Unrelated Business RevenueUnrelatedBusinessRevenueAmt |
|---|---|---|---|---|
| OTHER REVENUE | 900099 | $73,230 | $73,230 | |
| LABORATORY | 621500 | $12,841 | $12,841 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Revenue Total | $86,071 | OtherRevenueTotalAmt |
Total Revenue TotalRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $32,867,450 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $32,442,462 | RelatedOrExemptFuncIncomeAmt |
| Unrelated Business Revenue | $12,841 | UnrelatedBusinessRevenueAmt |
| Exclusion | $73,992 | ExclusionAmt |
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 | $13,726,703 | TotalAmt |
| Program Services | $8,700,291 | ProgramServicesAmt |
| Management And General | $5,026,412 | ManagementAndGeneralAmt |
Pension Plan Contributions PensionPlanContributionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $448,087 | TotalAmt |
| Program Services | $281,130 | ProgramServicesAmt |
| Management And General | $166,957 | ManagementAndGeneralAmt |
Other Employee Benefits OtherEmployeeBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $2,744,211 | TotalAmt |
| Program Services | $1,721,717 | ProgramServicesAmt |
| Management And General | $1,022,494 | ManagementAndGeneralAmt |
Payroll Taxes PayrollTaxesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $748,100 | TotalAmt |
| Program Services | $469,358 | ProgramServicesAmt |
| Management And General | $278,742 | 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 | $2,710,486 | TotalAmt |
| Program Services | $1,845,428 | ProgramServicesAmt |
| Management And General | $865,058 | ManagementAndGeneralAmt |
Advertising AdvertisingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,693 | TotalAmt |
| Program Services | $54 | ProgramServicesAmt |
| Management And General | $1,639 | ManagementAndGeneralAmt |
Office Expenses OfficeExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,321,065 | TotalAmt |
| Program Services | $344,080 | ProgramServicesAmt |
| Management And General | $976,985 | ManagementAndGeneralAmt |
Information Technology InformationTechnologyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $28,035 | TotalAmt |
| Program Services | $28,035 | ProgramServicesAmt |
Royalties RoyaltiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Occupancy OccupancyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,724,830 | TotalAmt |
| Program Services | $550,214 | ProgramServicesAmt |
| Management And General | $1,174,616 | ManagementAndGeneralAmt |
Travel TravelGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $52,341 | TotalAmt |
| Program Services | $35,446 | ProgramServicesAmt |
| Management And General | $16,895 | 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 | $6,010 | TotalAmt |
| Program Services | $3,496 | ProgramServicesAmt |
| Management And General | $2,514 | ManagementAndGeneralAmt |
Interest InterestGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $799,988 | TotalAmt |
| Program Services | $799,988 | ProgramServicesAmt |
Payments To Affiliates PaymentsToAffiliatesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Depreciation Depletion DepreciationDepletionGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $3,435,988 | TotalAmt |
| Program Services | $2,806,203 | ProgramServicesAmt |
| Management And General | $629,785 | ManagementAndGeneralAmt |
Insurance InsuranceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $153,915 | TotalAmt |
| Program Services | $153,580 | ProgramServicesAmt |
| Management And General | $335 | ManagementAndGeneralAmt |
Other Expenses OtherExpensesGrp (4 entries)
| DescDesc | TotalTotalAmt | Program ServicesProgramServicesAmt | Management And GeneralManagementAndGeneralAmt | FundraisingFundraisingAmt |
|---|---|---|---|---|
| PURCHASED SERVICES | $3,958,996 | $2,619,956 | $1,339,040 | |
| MEDICAL SUPPLIES/DRUGS | $3,060,070 | $3,052,087 | $7,983 | $0 |
| MEDICAID ASSESSMENT | $1,698,869 | $1,698,869 | ||
| FEDERAL & STATE UBI TAXES | $3,121 | $3,121 |
All Other Expenses AllOtherExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $165,365 | TotalAmt |
| Program Services | $10,795 | ProgramServicesAmt |
| Management And General | $154,570 | ManagementAndGeneralAmt |
Total Functional Expenses TotalFunctionalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $36,787,873 | TotalAmt |
| Program Services | $25,120,727 | ProgramServicesAmt |
| Management And General | $11,667,146 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Cash Non Interest Bearing CashNonInterestBearingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $67,625 | EOYAmt |
Savings And Temp Cash Invst SavingsAndTempCashInvstGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $647,399 | 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 | $3,758,475 | BOYAmt |
| EOY | $4,734,988 | 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 | $947,297 | BOYAmt |
| EOY | $825,472 | EOYAmt |
Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Bldg Equip Cost Or Other Bss | $32,274,168 | LandBldgEquipCostOrOtherBssAmt |
| Land Bldg Equip Accum Deprec | $11,272,925 | LandBldgEquipAccumDeprecAmt |
Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $22,047,428 | BOYAmt |
| EOY | $21,001,243 | 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 | $202,331 | BOYAmt |
| EOY | $524,119 | EOYAmt |
Total Assets TotalAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $27,038,944 | BOYAmt |
| EOY | $27,884,259 | EOYAmt |
Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $3,439,223 | BOYAmt |
| EOY | $1,843,322 | 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 | $21,700,319 | BOYAmt |
| EOY | $22,500,023 | EOYAmt |
Other Liabilities OtherLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $23,731,657 | BOYAmt |
| EOY | $24,603,329 | EOYAmt |
Total Liabilities TotalLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $48,871,199 | BOYAmt |
| EOY | $48,946,674 | 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 | -$21,915,668 | BOYAmt |
| EOY | -$21,145,828 | 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 | -$21,832,255 | BOYAmt |
| EOY | -$21,062,415 | EOYAmt |
Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $27,038,944 | BOYAmt |
| EOY | $27,884,259 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part XI | Yes (X) | InfoInScheduleOPartXIInd |
| Reconcilation Revenue Expnss | -$3,920,423 | ReconcilationRevenueExpnssAmt |
| Other Changes In Net Assets | $4,690,263 | 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 | $18,619,964 | OtherCostOrOtherBasisAmt |
| Depreciation | $4,555,498 | DepreciationAmt |
| Book Value | $14,064,466 | BookValueAmt |
Leasehold Improvements LeaseholdImprovementsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $484,426 | OtherCostOrOtherBasisAmt |
| Depreciation | $133,212 | DepreciationAmt |
| Book Value | $351,214 | BookValueAmt |
Equipment EquipmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $11,634,322 | OtherCostOrOtherBasisAmt |
| Depreciation | $6,584,215 | DepreciationAmt |
| Book Value | $5,050,107 | BookValueAmt |
Other Land Buildings OtherLandBuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $859,665 | OtherCostOrOtherBasisAmt |
| Book Value | $859,665 | BookValueAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Land Buildings | $21,001,243 | TotalBookValueLandBuildingsAmt |
| Federal Income Tax Liability | $0 | FederalIncomeTaxLiabilityAmt |
Other Liabilities Org OtherLiabilitiesOrgGrp (5 entries)
| DescDesc | AmtAmt |
|---|---|
| DUE TO THIRD PARTY PAYORS | $2,349,163 |
| ACCRUED PAYROLL | $1,282,004 |
| OTHER SHORT TERM LIABILITY | $20,573,545 |
| ESTIMATED INSURANCE LIABILITY | $85,019 |
| LEASE LIABILITIES | $313,598 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Liability | $24,603,329 | 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 | $1,422,091 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $1,422,091 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.03870 | TotalExpensePct |
Unreimbursed Medicaid UnreimbursedMedicaidGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $7,506,659 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $4,331,017 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $3,175,642 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.08630 | TotalExpensePct |
Total Financial Assistance Typ TotalFinancialAssistanceTyp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $8,928,750 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $4,331,017 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $4,597,733 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.12500 | TotalExpensePct |
Community Health Services CommunityHealthServicesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $80,595 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $13,306 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $67,289 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00180 | TotalExpensePct |
Subsidized Health Services SubsidizedHealthServicesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $1,140,780 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $796,132 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $344,648 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00940 | TotalExpensePct |
Cash And In Kind Contributions CashAndInKindContributionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $12,505 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $12,505 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00030 | TotalExpensePct |
Total Other Benefits TotalOtherBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $1,233,880 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $809,438 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $424,442 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.01150 | TotalExpensePct |
Total Community Benefits TotalCommunityBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $10,162,630 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $5,140,455 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $5,022,175 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.13650 | TotalExpensePct |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bad Debt Expense Reported | Yes (true) | BadDebtExpenseReportedInd |
| Bad Debt Expense | $416,028 | BadDebtExpenseAmt |
| Reimbursed By Medicare | $17,443,996 | ReimbursedByMedicareAmt |
| Cost Of Care Reimbursed By Medcr | $18,529,447 | CostOfCareReimbursedByMedcrAmt |
| Medicare Surplus Or Shortfall | -$1,085,451 | 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 | 19 | CHNAConductedYr |
| Take Into Account Others Input | Yes (true) | TakeIntoAccountOthersInputInd |
| CHNA Conducted With Other Fclts | Yes (true) | CHNAConductedWithOtherFcltsInd |
| CHNA Conducted With Non Fclts | Yes (true) | CHNAConductedWithNonFcltsInd |
| CHNA Report Widely Available | Yes (true) | CHNAReportWidelyAvailableInd |
| Rpt Available On Own Website | Yes (X) | RptAvailableOnOwnWebsiteInd |
| Own Website URL | SEE PART V-C | OwnWebsiteURLTxt |
| Implementation Strategy Adopt | Yes (true) | ImplementationStrategyAdoptInd |
| Implementation Strategy Adpt | 19 | 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 (7 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| LINE 3E - SIGNIFICANT HEALTH NEEDS OF THE COMMUNITY | PLEASE SEE THE RESPONSE TO SCHEDULE H, PART V, LINE 11 BELOW FOR AN EXPLANATION OF THE HOW THE HEALTH NEEDS IDENTIFIED IN THE CHNA WERE PRIORITIZED. LINE 5 - INPUT FROM THE COMMUNITY 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 COVERAGE OF 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. THREE TYPES OF FOCUS GROUPS WERE CONDUCTED: - PROFESSIONAL: REPRESENTATIVES FROM ORGANIZATIONS, SERVICES, AND BUSINESSES THAT CONTRIBUTE TO YOUTH AND BEHAVIORAL HEALTH. THESE MEETINGS MAP COMMUNITY ASSETS AND NEEDS IN ADDITION TO DETERMINING POTENTIAL PARTNERS. - INTERNAL: FRANCISCAN HEALTH STAFF FROM ALL DIVISIONS ARE INVITED TO LEARN ABOUT POTENTIAL INTERVENTIONS AND PROVIDE FEEDBACK. - RESIDENT: SMALL GROUPS OF RESIDENTS BROUGHT TOGETHER BY A PARTNER AGENCY WERE ASKED ABOUT STRENGTHS AND CHALLENGES IN COMMUNITIES AS WELL AS THE LIKELIHOOD OF PARTICIPATING IN INTERVENTIONS. INTERNAL FOCUS GROUP-RENSSELAER - REHABILITATION (2) - CARE MANAGEMENT - ONCOLOGY - ADMINISTRATION (3) - FRANCISCAN ALLIANCE MISSION - OPERATING ROOM - FRANCISCAN HOME HEALTH PROFESSIONAL FOCUS GROUP-RENSSELAER - 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) RESIDENT FOCUS GROUPS FROM THE FOLLOWING ZIP CODES - FH RENSSELAER - 47978 (4) |
| LINES 6A AND 6B | IN INDIANA, ALL FRANCISCAN ALLIANCE HOSPITAL FACILITIES COLLABORATED IN A STATEWIDE PARTNERSHIP WITH ASCENSION ST. VINCENT HEALTH, INDIANA UNIVERSITY HEALTH, COMMUNITY HEALTH NETWORK, DECONESS HOSPITAL, METHODIST HOSPITAL, COMMUNITY HOSPITAL, GIBSON GENERAL HOSPITAL, HENDRICKS REGIONAL HEALTH, ST. MARYS HOSPITAL AND WITH EACH FACILITY WITHIN THE FRANCISCAN HEALTH SYSTEM. |
| LINE 7A | THE CHNA REPORT IS AVAILABLE ON FRANCISCAN ALLIANCES WEBSITE AT HTTPS://WWW.FRANCISCANHEALTH.ORG/COMMUNITYHEALTH. |
| LINE 10 | THE IMPLEMENTATION PLAN IS AVAILABLE ON FRANCISCAN ALLIANCES WEBSITE AT HTTPS://WWW.FRANCISCANHEALTH.ORG/COMMUNITYHEALTH. |
| LINE 11 | 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 MEETING INPUT. A CORE TEAM OF SIX STAFF MEMBERS WITH EDUCATION AND EXPERIENCE IN PUBLIC HEALTH WORKED WITH STAFF IN EACH COMMUNITY TO COME TO 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 RELATIONSHIP TO ADVERSE CHILDHOOD EXPERIENCES (ACES), 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 EMPHASES 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. CHILDHOOD TRAUMA SPURS TOXIC STRESS RESPONSES THAT CAUSE BOTH IMMEDIATE AND LONG-TERM PHYSICAL AND EMOTIONAL HARMS AND CAN POTENTIALLY BE FATAL. AN ANALYSIS BY THE CENTERS FOR DISEASE CONTROL AND PREVENTION HAS FOUND THAT AT LEAST FIVE OF THE TOP 10 LEADING CAUSES OF DEATH ARE ASSOCIATED WITH ADVERSE CHILDHOOD EXPERIENCES (ACES) SUCH AS EXPERIENCING ABUSE, WITNESSING VIOLENCE OR SUBSTANCE ABUSE IN THE HOME AND HAVING A PARENT IN JAIL. PREVENTING ACES CAN REDUCE HEART DISEASE, CANCER, RESPIRATORY DISEASE, DIABETES AND SUICIDE. FRANCISCAN ALLIANCE HAS PARTNERED WITH AN ONLINE COMMUNITY PLATFORM, ACES CONNECTION, TO GENERATE AWARENESS, ENGAGEMENT, AND DISCUSSION REGARDING CHILDHOOD ADVERSITY. THIS PARTNERSHIP IS A COMPONENT OF FRANCISCAN ALLIANCE'S AWARENESS INITIATIVE TO PROVIDE COMMUNITY MEMBERS WITH FREE RESOURCES TO BUILD A SELF-HEALING, TRAUMA-INFORMED COMMUNITY. FRANCISCAN ALLIANCE'S HOPES TO EDUCATE COMMUNITY MEMBERS TO: "GET DATA. GET TRAINED. GET INVOLVED." FRANCISCAN ALLIANCE HAS ALSO PARTNERED WITH BROADSTREET TO CREATE NATIONALLY AVAILABLE DASHBOARDS FOR ACES RISK IN CHILDREN. THE ACES RISK IN CHILDREN DASHBOARDS WILL PROVIDE DATA THAT PERTAINS TO ACE FOR A SELECTED LOCATION. DASHBOARD INSIGHTS INCLUDE THINGS LIKE MENTAL HEALTH OR INCARCERATION RISKS IN A GIVEN COMMUNITY WHICH AIDS IN CULTIVATING A STORY ABOUT EACH COMMUNITY TO SEE RISK FACTORS AND SOCIAL DETERMINANTS. THE HOPE IS THAT COMMUNITIES WILL BE ABLE TO USE THESE DASHBOARD TO PROVIDE GUIDANCE IN THE DIRECTION OF WHAT PUBLIC HEALTH AREAS TO ADDRESS. FRANCISCAN ALLIANCE IS ALSO A FOUNDING PARTNER OF THE ACES INDIANA COALITION, A TEAM OF AGENCIES, ORGANIZATIONS, AND INDIVIDUALS WORKING TOGETHER TO REDUCE ADVERSE OUTCOMES OF ACES. FRANCISCAN ALLIANCE HAS MADE THE INVESTMENT TO HAVE SEVEN TEAM MEMBERS CERTIFIED AS ACE INTERFACE MASTERS ALLOWS THEM TO CONDUCT ACES TRAINING AND PRESENTATIONS ON THE RESEARCH WITHIN ITS COMMUNITIES. ACCORDING TO ACE STUDY RESEARCH, PREVENTION IS THE GREATEST OPPORTUNITY TO IMPROVE THE OVERALL WELL-BEING OF POPULATIONS. OUR TRAINING PROGRAMS ARE DESIGNED TO PROMOTE UNDERSTANDING AND IMPROVE COMMUNITY OUTCOMES THROUGH HEALING PROCESSES, INTERVENTIONS, AND EDUCATION AND FRANCISCAN ALLIANCE IS COMMITTED TO ADVANCING THIS EDUCATION THROUGHOUT ITS COMMUNITIES. THE FRANCISCAN ALLIANCE HOSPITALS MADE THE FOLLOWING PROGRESS DURING 2019 IN ADDRESSING THE IDENTIFIED COMMUNITY HEALTH NEEDS FROM ITS MOST RECENT CHNA: FRANCISCAN HEALTH RENSSELAER: TOP HEALTH NEEDS INCLUDE (TOP NEEDS FIRST): - YOUTH MENTAL HEALTH - SUBSTANCE ABUSE - INFANT MORTALITY - ACCESS TO HEALTH SERVICES - UNINTENTIONAL INJURY - LOW TEEN SUPPORT SERVICES - PHYSICAL ACTIVITY AND NUTRITION - TOBACCO - TRANSPORTATION - HEART DISEASE THERE IS A SIGNIFICANT LINK BETWEEN EIGHT OF THESE ISSUES AND ADVERSE CHILDHOOD EXPERIENCES ("ACES"). THEREFORE, THE FOLLOWING IMPLEMENTATION STRATEGIES WILL BE USED (WITH 2019 PROGRESS INDICATED): - FACILITATE ACES CONNECTION COMMUNITY PAGES: ACHIEVED IN 2019 - PROVIDE FACT SHEETS, ARTICLES, AND OTHER FREE RESOURCES: ACHIEVED IN 2019 - OFFER FREE SCREENINGS OF RESILIENCE FILM: SOMEWHAT ACHIEVED IN 2019 - COORDINATE TRAINING OPPORTUNITIES FOR PROFESSIONALS: ACHIEVED IN 2019 - DEVELOP COMMUNITY RESILIENCY COALITION: INCOMLETE IN 2019 DUE TO HEALTH COALITION CHANGES - PROVIDE HEALING ACTIVITIES: DEVELOPED IN 2019 - LOCAL PROJECT: PARTNERSHIP WITH RENSSELAER SCHOOLS TO PROVIDE MENTAL HEALTH SUPPORT: DELAYED DUE TO CHANGE IN STAFF |
| LINES 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, 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, PHYSICIAN OFFICES, 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 RENSSELAER. 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 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 BILLING OFFICE OR DOWNLOADING A COPY AT NO COST FROM THE RENSSELAER WEBSITE. 6. PATIENTS/GUARANTORS CAN REQUEST FINANCIAL ASSISTANCE INFORMATION BY CALLING RENSSELAER'S BILLING OFFICE PHONE LINE ON A 24-HOUR BASIS. 7. 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. 8. PRIOR TO TRANSFER TO A COLLECTION AGENCY, RENSSELAER SENDS A MINIMUM OF 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. 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, RENSSELAER 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. RENSSELAER'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. RENSSELAER 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 AVAILBALE AT THE FOLLOWING ADDRESS: HTTPS://WWW.FRANCISCANHEALTH.ORG/PATIENTS-AND-VISITORS/BILLING-INSURANCE/F INANCIAL-ASSISTANCE |
| 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 (5 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 86,000 people with an average household income close to $57,000 in 2019. For these communities, the percentage of residents below the federal poverty level was estimated at 9.7%. The percentage of inpatients from these communities who were served by Medicaid was 17.1%. The percentage of inpatients from these communities who were uninsured was approximately 3.4%. In comparison, the percentages of Medicaid and uninsured inpatients treated by Franciscan Health Rensselaer were 7.6% and 1.2% respectively in 2019. 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, HOSPICE 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, GASTRO/INTESTINAL 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. - RENSSELAER'S HOSPICE CARE SERVICES PROVIDE A SENSE OF DIGNITY AND COMPASSION TO BOTH THE PATIENT AND THEIR FAMILY IN CARING FOR PATIENTS WITH A LIFE EXPECTANCY OF SIX MONTHS OR LESS. OUR PROGRAMS AFFIRM AND CELEBRATE LIFE AND REGARD DYING AS A NATURAL PROCESS, RECOGNIZING THAT EVERY PERSON HAS THE RIGHT TO DIE WITH DIGNITY, PEACE, AND COMFORT REGARDLESS OF THEIR ETHNIC, FAITH BACKGROUND, OR ABILITY TO PAY. - 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 |
| 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. -------------------------------------- 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: "THE CORPORATION ALSO PROVIDES A SIGNIFICANT AMOUNT OF UNCOMPENSATED CARE TO PATIENTS WHICH IS NOT REPORTED IN THE SUMMARY OF QUANTIFIABLE COMMUNITY BENEFITS. EFFECTIVE JANUARY 1, 2018, THE CORPORATION ADOPTED THE FINANCIAL ACCOUNTING STANDARDS BOARD ("FASB") ACCOUNTING STANDARD UPDATE ("ASU") 2014-9, REVENUE FROM CONTRACTS WITH CUSTOMERS (TOPIC 606) WHICH REQUIRES REVENUE TO BE RECOGNIZED 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. THE CORPORATION 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. THE CORPORATION 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, THE CORPORATION 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, 2019 AND 2018, THE CORPORATION INCURRED APPROXIMATELY $52.5 MILLION AND $50.4 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 & DIRECTOR | $0 | $1,916,501 | $0 | $0 | $0 | $60,069 | $0 | $0 | $0 | $26,152 | $0 | $2,002,722 | $0 | $0 |
| TERRANCE WILSON | ||||||||||||||
| FACILITY CEO/PRES OF HOSP DIV | $0 | $1,231,702 | $0 | $0 | $0 | $34,981 | $0 | $0 | $0 | $29,651 | $0 | $1,296,334 | $0 | $0 |
| THOMAS GRYZBEK | ||||||||||||||
| SR VP OF POST ACUTE SVCS DIV | $0 | $660,231 | $0 | $0 | $0 | $51,592 | $0 | $0 | $0 | $22,970 | $0 | $734,793 | $0 | $0 |
| DEBORAH M RILEY | ||||||||||||||
| DIRECTOR PATIENT CARE SERVICES | $132,252 | $0 | $7,712 | $0 | $25,853 | $0 | $0 | $0 | $743 | $0 | $166,560 | $0 | $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 (5 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| FORM 990, PART I, LINE 1 | THE MISSION OF FRANCISCAN HEALTH 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 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 THE CORPORATION; - THE EXPANSION OF SERVICES OF THE CORPORATION 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 THE CORPORATION 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 THE CORPORATION OR THE SOLE MEMBER; AND - ASSURING THAT THE CORPORATION 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 THE CORPORATION, AND TO APPROVE ANY CHANGE IN THE FUNDAMENTAL PURPOSES, MISSION OR OPERATION OF THE CORPORATION 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 THE CORPORATION AFTER CONSULTATION WITH THE BOARD; - APPROVE A PLAN OF DISSOLUTION OF THE CORPORATION, DISSOLVE THE CORPORATION, AND WIND UP AND LIQUIDATE THE CORPORATION'S BUSINESS AND AFFAIRS; - APPROVE A PLAN OF MERGER OR CONSOLIDATION OF THE CORPORATION 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 THE CORPORATION OTHER THAN IN THE ORDINARY AND USUAL COURSE OF THE CORPORATION'S BUSINESS AND IN EXCESS OF AN AMOUNT ESTABLISHED FROM TIME TO TIME BY THE SOLE MEMBER; - VOLUNTARILY DECLARE THE BANKRUPTCY OF THE CORPORATION; - APPROVE THE ADMISSION OR REMOVAL OF A MEMBER; - APPROVE A STRATEGIC PLAN OF THE CORPORATION 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 THE CORPORATION OR ANY ORGANIZATION CONTROLLED BY THE CORPORATION (OTHER THAN ACCOUNTS PAYABLE INCURRED FOR THE ACQUISITION OF GOODS AND SERVICES IN THE ORDINARY AND USUAL COURSE OF THE CORPORATION'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 THE CORPORATION FOR FEDERAL TAX PURPOSES, MAKE ANY STATE OR FEDERAL TAX ELECTION ON BEHALF OF THE CORPORATION AND SELECT OR DISMISS THE INDEPENDENT PUBLIC ACCOUNTANTS FOR THE CORPORATION; - APPROVE AND ENTER INTO, IN THE NAME OF OR ON BEHALF OF THE CORPORATION, MANAGED CARE AND OTHER THIRD PARTY PAYOR CONTRACTS, AMENDMENTS THERETO OR THE TERMINATION THEREOF BY THE COMPANY HEALTH INSURANCE PLANS; - APPROVE PROGRAMS AND THE CORPORATION'S PARTICIPATION THEREIN TO SUPPORT CLINICAL INTEGRATION INITIATIVES (INCLUDING, WITHOUT LIMITATION, ACCOUNTABLE CARE ORGANIZATIONS AND MEDICAL HOMES); - PROMULGATE POLICIES BINDING ON THE CORPORATION. - 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 THE CORPORATION'S OFFICERS, WITH OR WITHOUT CAUSE, AFTER CONSULTATION WITH THE BOARD; - CHOOSE OR DISMISS THE INDEPENDENT PUBLIC ACCOUNTS FOR THE CORPORATION; AND - REVIEW AND APPROVE THE CORPORATION'S COMPLIANCE PLAN. - MONITORING MISSION INTEGRATION ENDEAVORS OF THE CORPORATION AND THE HOSPITAL; - THE QUALITY AND SAFETY PLANS FOR THE CORPORATION AND THE HOSPITAL; - ALL MEDICAL STAFF AFFAIRS FOR THE CORPORATION 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 THE CORPORATION INCLUDING STAFFING, APPROPRIATE FOR THE SCOPE AND COMPLEXITY FOR SERVICES OFFERED AT THE HOSPITAL AND OTHER FACILITIES OF THE CORPORATION; - THE DEVELOPMENT AND RECOMMENDATION OF THE CORPORATION'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 THE CORPORATION; 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 THE MEMBER OR THE MEMBER'S FRANCISCAN ALLIANCE, INC. 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 TO FILING. |
| FORM 990, PART VI, SECTION B, LINE 12C | THE CORPORATION 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 THE CORPORATION OPERATES IN A MANNER CONSISTENT WITH ITS CHARITABLE PURPOSES. IN CONDUCTING THE ONGOING REVIEWS AND ASSESSMENTS, THE CORPORATION 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. |
| FORM 990, PART XI, LINE 9 | EQUITY TRANSFERS FROM AFFILIATES $4,668,378 OTHER CHANGES IN NET ASSETS 21,885 ------------------ TOTAL $4,690,263 |
Schedule R IRS990ScheduleR
Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp (8 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 PERSONAL CARE INC | ||||||||||
| 4701 N KEYSTONE AVE S418 | INDIANAPOLIS | IN | 46205 | 352107306 | HEALTHCARE | IN | 501(C)(3) | 10 | 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 |
| LAFAYETTE HEART PROGRAM HOLDINGS | ||||||||
| 1501 HARTFORD STREET | LAFAYETTE | IN | 47904 | 383750811 | MEDICAL SERVICES | IN | NA | N/A |
| ST ANTHONY HEALTH NETWORK LLC | ||||||||
| PO BOX 310 | MISHAWAKA | IN | 465460310 | 351985170 | CLAIMS PROCESSING | IN | NA | N/A |
| ST FRANCIS MOORESVILLE SURGERY CENTER | ||||||||
| 1215 HADLEY ROAD SUITE 100 | MOORESVILLE | IN | 46158 | 202256900 | 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 CONST 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 |
Id Related Org Txbl Corp Tr IdRelatedOrgTxblCorpTrGrp
Related Organization Name RelatedOrganizationName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | FRANCISCAN HOLDING CORPORATION | BusinessNameLine1Txt |
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) |
|---|---|---|
| EIN | 363593505 | EIN |
| Primary Activities | HOLDING CO. | PrimaryActivitiesTxt |
| Legal Domicile State | IN | LegalDomicileStateCd |
Direct Controlling Entity Name DirectControllingEntityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | NA | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Entity Type | C CORP | EntityTypeTxt |
| 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 |
| 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 |