2020-11-04T10:37:31-06:00 2019-12-31 990 2019-01-01 810232124 ST VINCENT HEALTHCARE STVI 4062377000 1233 NORTH 30TH STREET BILLINGS MT 59101 PAM PALAGI VP FINANCE & CFO 4062377000 2020-10-23 170.188.5.33 2020-10-23 11:54:58 MD P 3DE5F749A1903F95D50F7F754F5516E476789552 3DE5F749A1903F95D50F7F754F5516E476789552 2019 2021-01-29 14:40:06Z STEVE LOVELESS 1233 NORTH 30TH STREET BILLINGS MT 59101 515517787 0 0928 X SEE SCHEDULE O X 1972 MT WE REVEAL AND FOSTER GOD'S HEALING LOVE BY IMPROVING THE HEALTH OF THE PEOPLE AND COMMUNITIES WE SERVE, ESPECIALLY THOSE WHO ARE POOR AND VULNERABLE. 13 10 2141 349 6601679 0 10058110 9391367 448827323 479265713 17242468 23320532 2191210 2368756 478319111 514346368 2801840 12602017 0 0 131480934 133592430 0 0 0 257451389 276976805 391734163 423171252 86584948 91175116 737506879 833718085 39726409 44301866 697780470 789416219 X WE REVEAL AND FOSTER GOD'S HEALING LOVE BY IMPROVING THE HEALTH OF THE PEOPLE AND COMMUNITIES WE SERVE, ESPECIALLY THOSE WHO ARE POOR AND VULNERABLE. 0 0 387677287 12602017 480789400 MOTHER XAVIER ROSS LED THE SISTERS OF CHARITY INTO THE INDIAN TERRITORY OF KANSAS IN 1858. IN 1869, THE SISTERS EXTENDED THEIR CHARITABLE WORKS INTO MONTANA TERRITORY AT THE REQUEST OF FATHER PIERRE JEAN DESMET. SAINT VINCENT HOSPITAL IN BILLINGS WAS FOUNDED BY THE SISTERS OF CHARITY OF LEAVENWORTH IN 1898. THE HOSPITAL OFFICIALLY OPENED ON FEBRUARY 1, 1899. THE CITY AND REGION GREW QUICKLY AND THE DEMAND FOR HEALTHCARE INCREASED DRAMATICALLY. BY 1915, THE SISTERS AND AREA MEDICAL PERSONNEL HAD CARED FOR MORE THAN 20,000 PATIENTS.DURING THE NEXT THIRTY YEARS, RAPID MEDICAL ADVANCEMENTS AND THE AREA'S GROWING POPULATION KEPT THE HOSPITAL IN A CONSTANT STATE OF CHANGE AND GROWTH, BUT TRUE TO ITS MISSION, COMPASSION AND CHARITY REMAINED AT THE FOREFRONT OF THE HOSPITAL'S ENDEAVORS. DURING THE GREAT DEPRESSION OF THE 1930S, THE SISTERS AT SAINT VINCENT HOSPITAL HELPED FEED THE HUNGRY. WITH THE ADVENT OF WORLD WAR II, VOLUNTEER SERVICES BECAME ESSENTIAL TO THE OPERATION OF THE HOSPITAL.ADAPTING TO THE CHANGES IN HEALTHCARE MEANT A NEW NAME FOR SAINT VINCENT HOSPITAL. IN NOVEMBER 2000, WE BECAME ST. VINCENT HEALTHCARE. FROM ITS MODEST BEGINNINGS OVER 100 YEARS AGO, ST. VINCENT HEALTHCARE HAS GROWN INTO ONE OF MONTANA'S LARGEST COMPREHENSIVE HOSPITALS, SERVING THE HEALTHCARE NEEDS OF OVER 400,000 PEOPLE IN A FOUR-STATE AREA. RENOWNED FOR A MISSION OF COMPASSIONATE CARE AND SERVICE TO THE POOR, THE ST. VINCENT HEALTHCARE TEAM IS CONTINUALLY RECOGNIZED AS A TECHNOLOGICAL LEADER IN THE HEALTHCARE INDUSTRY.DURING 2019, THE FOLLOWING STATISTICAL DATA WAS GATHERED:- 12,184 ADMISSIONS- 231,611 OUTPATIENT, CLINIC, AND HOME HEALTH VISTS- 37,142 EMERGENCY DEPARTMENT VISITS- 1,464 BIRTHS- 8,382 SURGERIES- 912,697 LABORATORY TESTSMISSION, VISION & VALUES MISSIONWE REVEAL AND FOSTER GOD'S HEALING LOVE BY IMPROVING THE HEALTH OF THE PEOPLE AND COMMUNITIES WE SERVE, ESPECIALLY THOSE WHO ARE POOR AND VULNERABLE.VISIONINSPIRED BY OUR FAITH, WE WILL PARTNER WITH OUR PATIENTS AND COMMUNITIES TO EXCEED THEIR EXPECTATIONS FOR HEALTH.VALUESCARING SPIRIT - WE HONOR THE SACRED DIGNITY OF EACH PERSON.EXCELLENCE - WE SET AND SURPASS HIGH STANDARDS.GOOD HUMOR - WE CREATE JOYFUL AND WELCOMING ENVIRONMENTS.INTEGRITY - WE DO THE RIGHT THING WITH OPENNESS AND PRIDE.SAFETY - WE DELIVER CARE THAT SEEKS TO ELIMINATE ALL HARM FOR PATIENTS AND ASSOCIATES. STEWARDSHIP - WE ARE ACCOUNTABLE FOR THE RESOURCES ENTRUSTED TO US.ST. VINCENT HEALTHCARE OFFERS A WIDE VARIETY OF SERVICES TO THE COMMUNITY:- BARIATRIC SURGERY - BEHAVIORAL HEALTH- BLOOD CONSERVATION PROGRAM- CANCER CARE- CARDIOLOGY- DERMATOLOGY- DIABETES CENTER- EMERGENCY SERVICES- GI DIAGNOSTIC CENTER- INTENSIVE CARE SERVICES- JOINT REPLACEMENT CENTER- KIDS HEALTH- LAB SERVICES- MAMMOGRAPHY- MANSFIELD HEALTH EDUCATION CENTER- WOMEN'S HEALTH- MS CLINIC- NEUROSCIENCE- NURSE ADVISOR- OCCUPATIONAL HEALTH SERVICES- ORTHOPEDIC SERVICES- OTOLARYNGOLOGY - OUTREACH- PAIN CENTER- PEDIATRICS- PRIMARY CARE- RADIOLOGY AND IMAGING SERVICES- REHABILITATION- RESPIRATORY- SENIOR SERVICES- SLEEP CENTER- SPORTS MEDICINE- STROKE- SURGERY SERVICES- TELEHEALTH- TRAUMA OUTREACH- UROLOGY- VASCULAR CENTER- WALK IN CARE- WEIGHT MANAGEMENT- WOUND HEALING CENTERST. VINCENT HEALTHCARE IS RELATED TO SCL HEALTH MEDICAL GROUP - BILLINGS, LLC, A SINGLE MEMBER LIMITED LIABILITY COMPANY OWNED BY A RELATED ORGANIZATION, SISTERS OF CHARITY OF LEAVENWORTH HEALTH SYSTEM, INC. SCL HEALTH MEDICAL GROUP - BILLINGS, LLC IS A GROUP OF PHYSICIAN CLINICS THAT PROVIDE PROFESSIONAL SERVICES TO THE ST. VINCENT HEALTHCARE COMMUNITY AND SUPPORTS THE MISSION OF ST. VINCENT HEALTHCARE.ALTHOUGH SCL HEALTH MEDICAL GROUP - BILLINGS, LLC IS NOT OWNED DIRECTLY BY ST. VINCENT HEALTHCARE, ST. VINCENT HEALTHCARE IS REQUIRED TO FUND ALL OPERATING LOSSES OF SCL HEALTH MEDICAL GROUP - BILLINGS, LLC THROUGH EQUITY TRANSFERS TO SISTERS OF CHARITY OF LEAVENWORTH HEALTH SYSTEM, INC. IN 2019, THE HOSPITAL PROVIDED $18,244,178 IN SUPPORT OF THE LOSSES OF THE PHYSICIAN CLINICS. 387677287 1 1 0 1 0 0 0 0 0 1 1 0 0 1 1 0 0 1 0 0 0 0 0 0 0 0 1 1 1 0 1 0 0 0 0 0 0 1 0 0 0 0 0 0 1 1 1 0 0 1 189 0 1 2141 1 1 1 0 0 0 0 0 0 0 0 0 0 0 X 13 10 0 0 0 0 1 1 1 1 1 0 0 1 1 1 1 1 1 0 0 1 1 X KYLE ENGMAN 3038135543 500 ELDORADO BLVD SUITE 4200 BROOMFIELD CO 80021 STEVE LOVELESS PRESIDENT AND CEO 37.00 13.00 X X 0 798757 121286 STUART GOODMAN MD FORMER HIGHEST PAID 0.00 50.00 X 0 858470 39572 WILLIAM SPIRE MD FORMER HIGHEST PAID 0.00 50.00 X 0 763787 49135 JEFFREY ZAVALA FORMER KEY EMPLOYEE 50.00 0.00 X 0 519886 91225 KEVIN BRUEN MD DIRECTOR 1.00 50.00 X 0 553372 51153 MICHAEL BUSH MD VP CHIEF MEDICAL OFFICER SVB 47.00 3.00 X 0 494446 90081 MICHAEL SKEHAN VP COO MONTANA REGION 37.00 13.00 X 0 484030 78435 FRANK LAMM MD PHYSICIAN 50.00 0.00 X 492757 0 43996 RONALD SNYDER MD PHYSICIAN 50.00 0.00 X 481255 0 52927 TRENT MIHALICK MD PHYSICIAN 50.00 0.00 X 485328 0 32764 SHELDON NELSON MD PHYSICIAN 50.00 0.00 X 438779 0 51753 MICHAEL HICKMAN MD PHYSICIAN 50.00 0.00 X 437137 0 34293 PAMELA PALAGI VP FINANCE MT REGION 37.00 13.00 X 0 327869 45644 MICHAEL HAMILTON VP STRATEGY & BUSINESS DEVELOPMENT SVB 50.00 0.00 X 0 272877 72667 BLANCHE GILMORE VP CHIEF NURSING OFFICER SVB 50.00 0.00 X 0 316034 28517 JAMES RITCHEY VP HUMAN RESOURCES MONTANA REGION 37.00 13.00 X 0 257233 66639 JESSE LASLOVICH VP NETWORK DEVELOPMENT MONTANA REGION 37.00 13.00 X 0 257588 58999 TRACY NEARY VP MISSION INTEGRATION MONTANA REGION 37.00 13.00 X 0 178730 48257 SUSAN PETERSEN MD DIRECTOR 1.00 50.00 X 0 189468 14597 JOHN BEDFORD TREASURER 2.00 0.00 X X 0 0 0 CORI COOK DIRECTOR 1/1-8/1 1.00 0.00 X 0 0 0 CHRIS EDWARDS DIRECTOR 1.00 0.00 X 0 0 0 KAREN FAGG VICE CHAIR 2.00 0.00 X X 0 0 0 SHAUN HARRINGTON DIRECTOR 1.00 0.00 X 0 0 0 KATHRYN HATCH MD DIRECTOR 1.00 0.00 X 0 0 0 SISTER BERNADETTE HELFERT DIRECTOR 1.00 0.00 X 0 0 0 CARL JACKSON DIRECTOR 1/1-6/23 1.00 0.00 X 0 0 0 DEBRA JONES MD SECRETARY 2.00 0.00 X X 0 0 0 VU PHAM CHAIR 2.00 0.00 X X 0 0 0 REBECCA RENO DIRECTOR 1.00 0.00 X 0 0 0 MAJEL RUSSELL DIRECTOR 1.00 0.00 X 0 0 0 2335256 6272547 1071940 186 1 1 0 SAUNDERS EXPRESS LLC 6950 SOUTH JORDAN ROAD CENTENNIAL CO 80112 CONSTRUCTION 16903743 ORTHO MONTANA PSC 2900 12TH AVE N BILLINGS MT 59101 MEDICAL SERVICES 2907465 HEMATOLOGY ONCOLOGY CENTERS OF TH 1315 GOLDEN VALLEY CIRCLE BILLINGS MT 59102 ONCOLOGY PHYSICIANS 2823067 MONTANA FAMILY MEDICAL RESIDENCY 123 S 237TH ST BILLINGS MT 59101 MEDICAL SERVICES 2772275 YELLOWSTONE PATHOLOGY INSTITUTE 2900 12TH AVE N STE 295W BILLINGS MT 59101 PATHOLOGY SERVICES 2014810 37 9391367 9391367 PATIENT SERVICE REVENUE 622110 478660464 472459151 6201313 MISSION UNITED - JV 623300 521023 521023 COMMUNITY CRISIS - JV 621420 236403 236403 ROCKY MTN HEATLH - JV 621999 134041 134041 JOINT VENTURE OTHER 621400 -286218 -286218 479265713 19993525 19993525 1127294 5498 682591 0 444703 5498 450201 5498 444703 3815835 488828 3327007 3327007 3327007 CAFETERIA SALES 722514 1611996 1217128 394868 PARKING LOT FEES 531190 171990 171990 LAUNDRY SERVICE - JV 812300 127420 127420 7149 7149 1918555 514346368 474588087 6601679 23765235 X 12602017 12602017 3249070 3145546 103524 105892213 102518217 3373996 4308011 3908535 399476 12515817 12304489 211328 7627319 7402370 224949 19347 19347 6951 6951 66953070 66247568 705502 2470664 2345128 125536 1879125 1816091 63034 25712222 25712222 7917698 7568183 349515 779374 587896 191478 489387 361816 127571 2831 2831 15080942 15078990 1952 2761193 2761193 MEDICAL SUPPLIES 94188439 94188439 SHARED SERVICES - BILLI 10061802 10061802 MAINTENANCE SERVICES 8799962 8446102 353860 3RD PARTY PROVIDER FEES 8500536 8500536 31353262 12152820 19200442 423171252 387677287 35493965 0 14832 7104 65412443 69495642 565924 132631 8366524 8467579 4273137 4461705 448808428 252211088 177111793 196597340 5001184 5677416 476761042 548878668 737506879 833718085 39667001 38544421 59408 57860 0 5699585 39726409 44301866 X 697780470 789416219 697780470 789416219 737506879 833718085 X 91175116 460633 X 0 1 X 1 0 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 0 0 0 0 0 1 5000 0 0 1 1951 6951 0 PART II-B, LINE 1: AS PART OF THEIR MISSION TO IMPROVE THE HEALTH OF THE PEOPLE AND COMMUNITIES WE SERVE ST VINCENT HEALTHCARE PAID $5,000 TO GREAT SCHOOLS BILLINGS TO SUPPORT THE PUBLIC SCHOOLS LEVY CAMPAIGN. ST VINCENT HEALTHCARE HAS ALSO PAID MEMBERSHIP DUES TO THE MONTANA HOSPITAL ASSOCIATION OF WHICH $1,951 IS ATTRIBUTED TO LOBBYING. 25452842 867340 4621764 916663 30025283 24954332 1675842 -1177332 25452842 43040009 654720 18740397 24954332 42470513 7159174 441785 3861558 3169905 43040009 40639150 7967355 -188066 4693288 1254638 42470513 0.53710 0.46290 0.00000 0 1 1 21882850 21882850 237796873 129432240 108364633 15193085 11311606 3881479 165862138 111467242 54394896 8073482 8073482 196597340 INTERCOMPANY RECEIVABLE 505868534 OTHER ACCT RECEIVABLE 8740493 3RD PARTY SETTLEMENTS 34037371 JOINT VENTURE RECEIVABLES 232270 548878668 OPERATING LEASE 5599412 FINANCING LEASE 100173 5699585 PART V, LINE 4: THE TWO LARGEST ENDOWMENTS SUPPORT THE MT PEDIATRICS PROJECT AND NURSE EDUCATION. THE REMAINING ENDOWMENTS SUPPORT VARIOUS DEPARTMENTS IN THE HOSPITAL. 1 1 X 1 X 1 X 1 1 0 1 1 3785966 3785966 0.00890 65591473 77218802 0 0.00000 1141845 1829830 0 0.00000 70519284 79048632 3785966 0.00890 1085701 1085701 0.00260 244101 244101 0.00060 28261287 19562183 8699104 0.02060 24964 24964 0.00010 10314538 10314538 0.02440 39930591 19562183 20368408 0.04830 110449875 98610815 24154374 0.05720 34619 34619 0.00010 92605 92605 0.00020 4648 4648 0.00000 110 110 0.00000 647180 647180 0.00150 779162 779162 0.00180 1 2978694 138134216 165254695 -27120479 X 1 1 1 ATHLETIC MEDICINE & PERFORMANCE LLC PHYSICAL THERAPY 0.33330 0.47410 2 ROCKY MOUNTAIN HEALTH NETWORK INC PHO - ADMINISTRATIVE SERVICES 0.50000 0.50000 3 ROCKY MOUNTAIN ACCOUNTABLE HEALTH NETWORK INC ACCOUNTABLE CARE ORGANIZATION 0.50000 0.50000 1 1 ST VINCENT HEALTHCARE 1233 NORTH 30TH STREET BILLINGS MT 59101 SEE PART VI SUPP INFO 13258 X X X X ST VINCENT HEALTHCARE 1 0 0 1 X X X X X X X X X 17 1 1 1 1 X SEE PART V, SECTION C X SEE PART V, SECTION C X X 1 18 1 SEE PART V, SECTION C 0 1 X 200.000000000000 400.000000000000 X X X 1 1 X X X X 1 X SEE PART V, SECTION C X SEE PART V, SECTION C X SEE PART V, SECTION C X X X X X X 1 X 0 X X X X 1 X 0 0 ST. VINCENT HEALTHCARE PART V, SECTION B, LINE 5: THE 2017 CHNA WAS CONDUCTED BY ST. VINCENT HEALTHCARE IN PARTNERSHIP WITH BILLINGS CLINIC, A HOSPITAL LOCATED IN BILLINGS, MT, AND THE CITY-COUNTY HEALTH DEPARTMENT, RIVERSTONE HEALTH. THE CHNA ADVISORY GROUP CONSISTED OF 71 INDIVIDUALS REPRESENTING 58 ORGANIZATIONS ACROSS THE COMMUNITY. THE ADVISORY GROUP PROVIDED INPUT THROUGHOUT THE CHNA/CHIP PROCESS AND APPROVED MAJOR ACTIVITIES SUCH AS THE QUESTIONNAIRE, STAKEHOLDERS INVOLVED IN THE KEY INFORMANT SURVEY AND AGENDA ITEMS AND INVITEES FOR THE PRIORITIZATION PROCESS. THE CHNA INCORPORATED: 1) PRIMARY QUANTITATIVE DATA (A 404 HOUSEHOLD TELEPHONE COMMUNITY HEALTH SURVEY), 2) SECONDARY QUANTITATIVE DATA (EXISTING PUBLIC HEALTH DATA) AND 3) PRIMARY QUALITATIVE DATA (KEY INFORMANT SURVEYS). THE SAMPLE DRAWN FOR THE 404 HOUSEHOLD TELEPHONE SURVEY IS REPRESENTATIVE OF THE ADULT YELLOWSTONE COUNTY POPULATION IN TERMS OF DEMOGRAPHIC AND SOCIOECONOMIC CHARACTERISTICS, AS WELL AS GEOGRAPHIC LOCATION. THE 2017 CHNA WAS A FOLLOW-UP TO SIMILAR SURVEYS CONDUCTED IN 2006, 2011, AND 2014 WHICH ALLOWED FOR TRENDING OVER TIME.TO SOLICIT INPUT FOR KEY INFORMANTS, AN ONLINE KEY INFORMANT SURVEY WAS IMPLEMENTED. 194 COMMUNITY STAKEHOLDERS TOOK PART IN THE ONLINE KEY INFORMANT SURVEY INCLUDING REPRESENTATIVES OF COMMUNITY BASED ORGANIZATIONS, EDUCATION, GOVERNMENT, BUSINESS, HEALTHCARE AND PUBLIC HEALTH. THROUGHOUT THE PROCESS, INPUT WAS GATHERED FROM INDIVIDUALS WHOSE ORGANIZATIONS WORK WITH LOW-INCOME, MINORITY POPULATIONS, OR OTHER MEDICALLY UNDERSERVED POPULATIONS. MINORITY/MEDICALLY UNDERSERVED POPULATIONS REPRESENTED BY KEY INFORMANTS INCLUDED: AFRICAN-AMERICANS, AGRICULTURAL WORKERS, AMERICAN INDIANS, ASIANS, CHILDREN, COLLEGE STUDENTS, THOSE WITH CO-OCCURRING DISORDERS, CRIMINAL OFFENDERS, THOSE WITH DISABILITIES, THE ELDERLY, ENGLISH AS A SECOND LANGUAGE, HISPANICS, HOMELESS INDIVIDUALS, HUTTERITES, IMMIGRANTS, LGBT, LOW INCOME, THE MENTALLY ILL, MULTI-RACIAL INDIVIDUALS, PREGNANT TEENS, RUNAWAYS, RURAL RESIDENTS, SAMOANS, SINGLE PARENTS, SUBSTANCE ABUSERS, UNINSURED/UNDERINSURED RESIDENTS, VETERANS, VICTIMS OF VIOLENCE, WOMEN, AND INDIVIDUALS WITH CHRONIC DISEASE SUCH AS CANCER, DIABETES, HIGH BLOOD PRESSURE, AND HIV/AIDS. ST. VINCENT HEALTHCARE PART V, SECTION B, LINE 6A: THE 2017 CHNA WAS CONDUCTED IN PARTNERSHIP WITH BILLINGS CLINIC, A HOSPITAL LOCATED IN BILLINGS, MT. ST. VINCENT HEALTHCARE PART V, SECTION B, LINE 6B: THE CHNA WAS CONDUCTED WITH THE CITY-COUNTY HEALTH DEPARTMENT, RIVERSTONE HEALTH. IN ADDITION, 71 REPRESENTATIVES FROM BUSINESS, COMMUNITY, EDUCATION, FAITH-BASED ORGANIZATIONS, AND GOVERNMENT WERE INVOLVED IN THE CHNA PROCESS AS MEMBERS OF THE CHNA ADVISORY GROUP WHICH PROVIDED OVERSIGHT TO THE CHNA PROCESS.ST. VINCENT HEALTHCARE:PART V, SECTION B, LINE 7A: HTTPS://WWW.SCLHEALTH.ORG/LOCATIONS/ST-VINCENT-HEALTHCARE/ABOUT/COMMUNITY-BENEFIT/COMMUNITY-HEALTH-NEEDS-ASSESSMENT/ ST. VINCENT HEALTHCARE:PART V, SECTION B, LINE 7B: HTTP://WWW.HEALTHYBYDESIGNYELLOWSTONE.ORG/WP-CONTENT/UPLOADS/2016-17-PRC-CHNA-REPORT-FINAL-YELLOWSTONE-COUNTY-MT.PDF ST. VINCENT HEALTHCARE PART V, SECTION B, LINE 7D: A PRESS CONFERENCE WAS HELD ON FEBRUARY 6, 2017, TO PUBLICIZE THE CHNA. PRINTED COPIES OF THE CHNA REPORT WERE DISTRIBUTED TO LOCAL NON-PROFIT ORGANIZATIONS. THE CHNA IS ALSO AVAILABLE ELECTRONICALLY ON THE HEALTHY BY DESIGN COALITION WEBSITE: HTTP://WWW.HEALTHYBYDESIGNYELLOWSTONE.ORGST. VINCENT HEALTHCARE:PART V, SECTION B, LINE 10A:HTTPS://WWW.SCLHEALTH.ORG/LOCATIONS/ST-VINCENT-HEALTHCARE/ABOUT/COMMUNITY-BENEFIT/COMMUNITY-HEALTH-IMPROVEMENT-PLAN/ ST. VINCENT HEALTHCARE PART V, SECTION B, LINE 11: THE 2017 CHNA IDENTIFIED 13 AREAS OF OPPORTUNITY AFTER CONSIDERATION OF VARIOUS CRITERIA, INCLUDING: STANDING IN COMPARISON WITH BENCHMARK DATA (PARTICULARLY NATIONAL DATA); IDENTIFIED TRENDS; THE PREPONDERANCE OF SIGNIFICANT FINDINGS WITHIN TOPIC AREAS; THE MAGNITUDE OF THE ISSUE IN TERMS OF NUMBER OF PERSONS AFFECTED; AND THE POTENTIAL HEALTH IMPACT OF A GIVEN ISSUE. IN ALPHABETICAL ORDER, THEY ARE:1. ACCESS TO HEALTHCARE SERVICES2. CANCER3. DEMENTIA, INCLUDING ALZHEIMER'S DISEASE4. DIABETES5. HEART DISEASE AND STROKE6. INFANT HEALTH AND FAMILY PLANNING7. INJURY AND VIOLENCE8. MENTAL HEALTH9. NUTRITION, PHYSICAL ACTIVITY AND WEIGHT10. POTENTIALLY DISABLING CONDITIONS11. RESPIRATORY DISEASES12. SUBSTANCE ABUSE13. TOBACCO USEA GROUP OF COMMUNITY STAKEHOLDERS, REPRESENTING A CROSS-SECTION OF COMMUNITY-BASED AGENCIES AND ORGANIZATIONS, WAS CONVENED TO EVALUATE, DISCUSS, AND PRIORITIZE HEALTH ISSUES FOR THE COMMUNITY. PARTICIPANTS EVALUATED EACH OF THE 13 IDENTIFIED AREAS OF OPPORTUNITY ALONG TWO CRITERIA: SCOPE AND SEVERITY, AND ABILITY TO IMPACT. THIS PROCESS YIELDED A PRIORITIZED LIST OF COMMUNITY NEEDS WITH THE TOP THREE IDENTIFIED NEEDS AS: 1. NUTRITION, PHYSICAL ACTIVITY & WEIGHT2. MENTAL HEALTH3. SUBSTANCE ABUSE ST. VINCENT HEALTHCARE IS ADDRESSING THESE IDENTIFIED HEALTH NEEDS THROUGH BOTH COLLABORATIVE COMMUNITY EFFORTS AND SPECIFIC HOSPITAL EFFORTS.NUTRITION, PHYSICAL ACTIVITY & WEIGHT: 34.4% OF YELLOWSTONE COUNTY ADULTS ARE OBESE, HIGHER THAN MONTANA FINDINGS AND SIMILAR TO RATES IN THE U.S. (CHNA, 2017). AS A SPONSORING ENTITY AND MEMBER OF THE HEALTHY BY DESIGN COALITION, ST. VINCENT HEALTHCARE IS COLLABORATING TO INCREASE THE PROPORTION OF RESIDENTS WHO ARE AT A HEALTHY WEIGHT IN YELLOWSTONE COUNTY THROUGH POLICY, SYSTEMS AND ENVIRONMENTAL CHANGE EFFORTS INCLUDING STRATEGIES FOR HEALTHY FOOD RETAIL AND PROCUREMENT, IMPROVING ACCESS TO PLACES FOR PHYSICAL ACTIVITY, COMMUNITY-SCALE URBAN DESIGN AND LAND USE POLICIES, AND PROVIDING SPACE FOR ORGANIZED ACTIVITIES THAT ENCOURAGE SOCIAL PARTICIPATION AND INCLUSION. THE HEALTHY BY DESIGN COALITION'S GARDENERS' MARKET, LOCATED IN A FEDERALLY IDENTIFIED FOOD DESERT WITHIN A LOW-INCOME NEIGHBORHOOD, SERVED 216 RESIDENTS EACH WEEK FROM JUNE TO OCTOBER, ACCEPTING SNAP AND WIC BENEFITS TO INCREASE ACCESS TO AFFORDABLE FRUITS AND VEGETABLES. THE COALITION DISTRIBUTED MAPS OF WALKING ROUTES AT TWO LOCAL PARKS. THESE MAPS WERE DISTRIBUTED AT OUR PRIMARY CARE CLINICS AND IN THE COMMUNITY.ST. VINCENT HEALTHCARE CONTINUES TO OFFER THE EVIDENCE-BASED DIABETES AND HEART DISEASE PREVENTION PROGRAM. LOCATED AT THE BILLINGS FAMILY YMCA, THIS PROGRAM IS OFFERED TWICE PER YEAR. IN 2019, 122 INDIVIDUALS PARTICIPATED IN THE PROGRAM WHICH FOCUSES ON NUTRITION EDUCATION AND PHYSICAL ACTIVITY, SUPPORTING HEALTHY LIFESTYLE CHANGES FOR ADULTS WHO ARE AT RISK FOR DEVELOPING TYPE 2 DIABETES. 28.8% OF CHILDREN AGES 5-17 ARE OVERWEIGHT OR OBESE (CHNA, 2017). ST. VINCENT HEALTHCARE COLLABORATES WITH AND PROVIDES SUPPORT TO KIDS IN MOTION, AN ACTIVE TRANSPORTATION PROGRAM FACILITATED BY SCHOOL DISTRICT #2, EDUCATION FOUNDATION FOR BILLINGS PUBLIC SCHOOLS, THE CITY OF BILLINGS, AND OTHER COMMUNITY PARTNERS THAT COMBINES VOLUNTEER-COORDINATED EVENTS SUCH AS BICYCLE TUNE-UP CLINICS, WITH IN-CLASS EDUCATION TO EMPOWER YOUTH WITH THE SKILLS AND CONFIDENCE NEEDED TO WALK AND RIDE THEIR BICYCLE EVERY DAY. IN 2019, 169 STUDENT BICYCLES WERE INSPECTED AND, IF NEEDED, REPAIRED AT 7 SCHOOLS. IN-CLASS EDUCATION WAS PROVIDED TO OVER 400 4TH AND 5TH GRADE STUDENTS AT SEVEN SCHOOLS. ST. VINCENT HEALTHCARE MANAGES THE KOHL'S CARES FOR KIDS GRANT PARTNERSHIP WITH PRIORITY TITLE ONE SCHOOLS, PROVIDING PHYSICAL ACTIVITY AND NUTRITION EDUCATION AND OUTREACH. IN 2019, 1,522 STUDENTS IN FIVE TITLE ONE SCHOOLS WERE SERVED BY PROGRAM THROUGH RUNNING PROGRAMS, HIP HOP PROGRAMS, AND SHOE DISTRIBUTION. IN ADDITION, SVH PROVIDED IN-KIND SUPPORT TO THE BILLINGS SCHOOL DISTRICT #2 SCHOOL HEALTH ADVISORY COMMITTEE AND BILLINGS ACTION FOR HEALTHY KIDS. ST. VINCENT HEALTHCARE PROVIDED FINANCIAL SUPPORT AND LEADERSHIP FOR LOCAL NON-PROFITS FOCUSED ON OBESITY PREVENTION, NUTRITION AND PHYSICAL ACTIVITY PROMOTION. THESE ORGANIZATIONS INCLUDED TRAILNET, A LOCAL TRAIL ADVOCACY ORGANIZATION; BIG SKY STATE GAMES, A LOCAL ORGANIZATION WHICH PROVIDES COMMUNITY PHYSICAL ACTIVITY OPPORTUNITIES; SPECIAL OLYMPICS, FOCUSED ON PHYSICAL ACTIVITY FOR INDIVIDUALS WITH DEVELOPMENTAL DISABILITY; AND EAGLE MOUNT, FOCUSED ON PHYSICAL ACTIVITY FOR INDIVIDUALS WITH PHYSICAL DISABILITIES. WE ADVOCATE FOR ACCESS TO HEALTHY FOODS FOR LOW-INCOME INDIVIDUALS AND FAMILIES, INCLUDING SERVING AS A DISTRIBUTION SITE FOR BOUNTIFUL BASKETS AND PROVIDING FOOD DONATIONS TO COMMUNITY-BASED ORGANIZATIONS SERVING VULNERABLE POPULATIONS INCLUDING MEALS FOR INDIVIDUALS WITH AIDS.BEHAVIORAL HEALTH:13.4% OF ADULTS IN YELLOWSTONE COUNTY REPORT THEIR OVERALL MENTAL HEALTH AS FAIR OR POOR WHICH HAS SIGNIFICANTLY INCREASED SINCE 2005 AND 25.3% OF ADULTS HAVE BEEN DIAGNOSED WITH A DEPRESSIVE DISORDER WHICH IS HIGHER THAN RATES IN MONTANA AND THE U.S. (CHNA 2017). ST. VINCENT HEALTHCARE HAS PROVIDED FINANCIAL SUPPORT TO ORGANIZATIONS FOCUSED ON IMPROVING ACCESS TO MENTAL HEALTH RESOURCES IN OUR COMMUNITY AND HAVE INTEGRATED BEHAVIORAL HEALTH INTO OUR PRIMARY CARE CLINICS. EMBEDDED MENTAL HEALTH SPECIALISTS PROVIDE INCREASED ACCESS TO MENTAL HEALTH TREATMENTS AND REDUCE BARRIERS RELATED TO STIGMA. IN ONE YEAR, 54,852 INDIVIDUALS WERE SCREENED FOR MENTAL HEALTH OR SUBSTANCE ABUSE. 679 OF THOSE INDIVIDUALS WERE IDENTIFIED AS NEEDING BEHAVIORAL HEALTH SUPPORTS AND WERE PROVIDED WITH A WARM HANDOFF TO A BEHAVIORAL HEALTH SPECIALIST. AN ADDITIONAL 55 INDIVIDUALS WERE REFERRED FOR A HIGHER LEVEL OF BEHAVIORAL HEALTH CARE. WE CONTINUE TO PROVIDE FINANCIAL SUPPORT TO THE COMMUNITY CRISIS CENTER AND OUR CHIEF MEDICAL OFFICER SERVES ON THE BOARD OF DIRECTORS. THE COMMUNITY CRISIS CENTER PROVIDES ASSESSMENTS, CASE MANAGEMENT, GROUPS, ADDICTIONS COUNSELING, REFERRALS, AND STABILIZATION SERVICES TO PEOPLE 24 HOURS PER DAY 365 DAYS PER YEAR. THESE SERVICES ARE PROVIDED FOR PERSONS IN CRISIS WHO NEED ACCESS TO INTEGRATED MENTAL HEALTH, CHEMICAL DEPENDENCY AND SOCIAL SERVICES, REGARDLESS OF ABILITY TO PAY FOR THESE SERVICES. THIS INCLUDES A 24-HOUR STABILIZATION AREA FOR THOSE MOST AT RISK THAT DO NOT NEED HOSPITALIZATION. THE COMMUNITY CRISIS CENTER ALSO PROVIDES CRISIS INTERVENTION TEAM TRAINING FOR LAW ENFORCEMENT. IN 2019, OVER 11,000 CLIENT VISITS WERE MADE TO THE COMMUNITY CRISIS CENTER. ST. VINCENT HEALTHCARE ALSO PROVIDED FINANCIAL SUPPORT TO A STUDENT RUN MENTAL HEALTH CLINIC AT WALLA WALLA UNIVERSITY-BILLINGS. SINCE ITS INCEPTION, THIS CLINIC PROVIDED NO-COST MENTAL HEALTH SERVICES TO OVER 320 INDIVIDUALS WITHOUT INSURANCE COVERAGE WHILE AT THE SAME TIME PROVIDING CLINICAL HOURS NEEDED FOR STUDENTS TO COMPLETE THEIR MSW DEGREES, INCREASING ACCESS TO MENTAL HEALTH SERVICES. TO ADDRESS MENTAL HEALTH NEEDS OF VETERANS, WE'VE PROVIDED FINANCIAL AND LEADERSHIP SUPPORT TO HORSES SPIRITS HEALING, INC., A NON-PROFIT PROVIDING EQUINE THERAPY TO 267 VETERANS MANY OF WHOM HAD PTSD OR OTHER MENTAL HEALTH NEEDS. WE CONTINUE TO PROVIDE FINANCIAL AND IN-KIND SUPPORT TO COMMUNITY ORGANIZATIONS AND COLLABORATIONS ADDRESSING SUICIDE AND MENTAL HEALTH INCLUDING THE YELLOWSTONE VALLEY SUICIDE PREVENTION COALITION, AMERICAN FOUNDATION FOR SUICIDE PREVENTION. THROUGH THIS PARTNERSHIP, 190 COMMUNITY MEMBERS WERE TRAINED IN QPR THROUGH 8 TRAININGS AND AN ADDITIONAL 85 WERE TRAINED IN TRAUMA INFORMED CARE. 45.5% OF ADULTS IN YELLOWSTONE COUNTY REPORT THEIR LIVES HAVE BEEN NEGATIVELY AFFECTED BY SUBSTANCE USE, HIGHER THAN THE NATIONAL AVERAGE (CHNA, 2017). ST. VINCENT HEALTHCARE IS ADDRESSING PRENATAL SUBSTANCE USE THROUGH MIDWIFERY CLINICS WHICH INCLUDE CARE COORDINATORS TO FOCUS ON SOCIAL NEEDS. ST. VINCENT HEALTHCARE IS AN ACTIVE MEMBER OF THE SUBSTANCE ABUSE CONNECT COALITION, FOCUSED ON DECREASING METH USE IN OUR COMMUNITY, WITH STAFF SERVING ON THE EXECUTIVE COMMITTEE AND PREVENTION TASK GROUPS. WE PROVIDED FINANCIAL AND IN-KIND SUPPORT FOR THE COMMUNITY INNOVATIONS INITIATIVE WHICH ADDRESSES ISSUES OF CHRONIC, PUBLIC INTOXICATION. ST. VINCENT HEALTHCARE ALSO PARTICIPATED IN COLLABORATIVES TO ADDRESS OPIOID USE.ACCESS TO HEALTHCARE SERVICES: 42% OF ADULTS REPORT SOME TYPE OF DIFFICULTY OR DELAY IN OBTAINING HEALTHCARE SERVICES IN THE PAST YEAR (CHNA, 2017). YELLOWSTONE COUNTY IS SURROUNDED BY HEALTHCARE PROVIDER SHORTAGE AREAS BASED ON GEOGRAPHIES AND LOW-INCOME (MONTANA PRIMARY CARE NEEDS ASSESSMENT, 2016). CONTINUED IN SCHED H PART V SUPPLEMENTAL INFORMATION PART V, SECTION B, LINE 11 CONTINUED TO ENHANCE ACCESS TO HEALTHCARE SERVICES, ESPECIALLY FOR RESIDENTS IN RURAL AND TRIBAL COMMUNITIES, ST. VINCENT HEALTHCARE PROVIDES OUTREACH SERVICES SUCH AS MOBILE MAMMOGRAPHY, VISITING CLINICS, PEDIATRIC OUTREACH, AND VIRTUAL HEALTH SERVICES. MOBILE MAMMOGRAPHY SCREENINGS WERE PROVIDED TO 3,224 WOMEN AT 60 LOCATIONS, INCLUDING OUTREACH TO AMERICAN INDIAN WOMEN ON THE CROW AND NORTHERN CHEYENNE RESERVATIONS AND THE MONTANA STATE WOMEN'S PRISON. MIDWIFERY CLINICS PROVIDED ADDITIONAL OUTREACH TO WOMEN IN THE NORTHERN CHEYENNE COMMUNITY, INCREASING ACCESS TO EARLY PRENATAL CARE. TO INCREASE WORKFORCE CAPACITY TO PROVIDE HEALTHCARE SERVICES, ST. VINCENT HEALTHCARE PROVIDES CLINICAL ROTATIONS FOR NURSING, DIETITIAN, PHYSICAL THERAPY, AND PHARMACY STUDENTS. ST. VINCENT HEALTHCARE OFFERS THE ONLY ACCREDITED CLINICAL PASTORAL EDUCATION (CPE) PROGRAM IN THE STATE. IN 2019, APPROXIMATELY 109 NURSING STUDENTS, 18 PHYSICAL THERAPY STUDENTS, 2 DIETETIC INTERNS AND 8 CPE STUDENTS COMPLETED CLINICAL ROTATIONS. TO TRAIN FUTURE PHYSICIANS, ST. VINCENT HEALTHCARE PROVIDED LEADERSHIP AND FINANCIAL SUPPORT TO THE MONTANA FAMILY PRACTICE RESIDENCY PROGRAM. IN ADDITION, ST. VINCENT HEALTHCARE OFFERS A MEDICATION ASSISTANCE PROGRAM AND PROVIDED FINANCIAL SUPPORT FOR THE MEDICATION ASSISTANCE PROGRAM AT RIVERSTONE HEALTH, THE CITY-COUNTY HEALTH DEPARTMENT. THE MEDICATION ASSISTANCE PROGRAM (MAP) PROVIDES ASSISTANCE TO LOW INCOME, UNINSURED INDIVIDUALS TO OBTAIN FREE OR DISCOUNTED PRESCRIPTION MEDICATIONS DIRECTLY FROM PHARMACEUTICAL COMPANIES. IN 2019, RIVERSTONE MAP HELPED 1,034 PATIENTS TO OBTAIN 1,498 MEDICATIONS THEY OTHERWISE MAY HAVE GONE WITHOUT.OTHER SIGNIFICANT NEEDS NOT PRIORITIZED: ST. VINCENT HEALTHCARE CONTINUES TO COLLABORATE WITH COMMUNITY ORGANIZATIONS TO ENSURE THESE HEALTH NEEDS ARE ADDRESSED.CANCER: ST. VINCENT HEALTHCARE PROVIDES A MOBILE MAMMOGRAPHY COACH, FINANCIAL AND IN-KIND SUPPORT FOR THE AMERICAN CANCER SOCIETY, FINANCIAL SUPPORT OF THE LIVESTRONG PHYSICAL ACTIVITY PROGRAM AT THE BILLINGS YMCA; LUNG CANCER SCREENINGS, HEAD AND NECK CANCER SCREENINGS, AND CANCER NAVIGATORS FOR PATIENTS.DEMENTIAS, INCLUDING ALZHEIMER'S DISEASE: ST. VINCENT HEALTHCARE PROVIDES FINANCIAL AND IN-KIND SUPPORT, INCLUDING OFFICE SPACE FOR THE ALZHEIMER'S SOCIETY AND IS A MEMBER OF DEMENTIA-FRIENDLY BILLINGS COALITION.DIABETES: ST. VINCENT HEALTHCARE MANAGES THE DIABETES PREVENTION PROGRAM AT THE BILLINGS YMCA. BLOOD GLUCOSE SCREENINGS WERE CONDUCTED AT LOCAL EVENTS INCLUDING THE MATE SHOW AND MONTANA-STATE UNIVERSITY POWWOW. FINANCIAL AND IN-KIND SUPPORT WAS PROVIDED TO THE AMERICAN DIABETES ASSOCIATION.HEART DISEASE AND STROKE: ST. VINCENT HEALTHCARE OFFERS A STROKE CAMP AND MONTHLY SUPPORT GROUP FOR AREA RESIDENTS. FINANCIAL AND IN-KIND SUPPORT WAS OFFERED FOR COMMUNITY CPR TRAINING AT CPR SATURDAY. CARDIAC REHABILITATION PROGRAMS ARE PROVIDED. FINANCIAL AND IN-KIND SUPPORT WAS PROVIDED TO THE AMERICAN HEART ASSOCIATION.INJURY AND VIOLENCE: ST. VINCENT HEALTHCARE PROVIDED FINANCIAL SUPPORT FOR THE YWCA INCLUDING VIOLENCE AWARENESS CAMPAIGNS AND A CRISIS PHONE LINE WHICH RECEIVED 3,113 CALLS IN 2019. OTHER INJURY PREVENTION EFFORTS INCLUDED A DISTRACTED DRIVING PRESENTATION TO REGIONAL SCHOOLS, INJURY PREVENTION EDUCATION AT PEDIATRIC FOCUSED EVENTS, AND A SENIOR FOCUSED FALLS PREVENTION PROGRAM, STEPPING ON.POTENTIAL DISABLING CONDITIONS: NOT ADDRESSED IN 2018 DUE TO RESOURCE LIMITATIONS.RESPIRATORY DISEASE AND TOBACCO USE: ST. VINCENT HEALTHCARE PROVIDES TOBACCO CESSATION CLASSES FOR THE COMMUNITY. THE 7-WEEK EVIDENCE-BASED AMERICAN LUNG ASSOCIATION FREEDOM FROM SMOKING CLASS WAS OFFERED ONCE IN 2019. LOW-DOSE CT SCANS WERE PROVIDED TO 300 CURRENT AND FORMER HEAVY SMOKERS TO SCREEN FOR LUNG CANCER AND TOBACCO CESSATION INFORMATION WAS PROVIDED IN CONJUNCTION WITH THESE SCREENINGS. ST. VINCENT HEALTHCARE:PART V, SECTION B, LINE 16A, 16B, 16C: WWW.SCLHEALTH.ORG/LOCATIONS/ST-VINCENT-HEALTHCARE/PATIENTS-VISITORS/BILLING-INSURANCE/FINANCIAL-ASSISTANCE/ 26 1 - ST VINCENT MULTIPLE SCLEROSIS CENTER 1041 N 29TH ST BILLINGS MT 59101 OUTPATIENT PHYSICIAN CLINIC 2 - ST VINCENT EMERGENCY MEDICINE 1233 N 30TH ST BILLINGS MT 59101 OUTPATIENT PHYSICIAN CLINIC 3 - ST VINCENT HEALTHCARE - NEUROSCIENCES 1041 N 29TH ST BILLINGS MT 59101 OUTPATIENT PHYSICIAN CLINIC 4 - ST VINCENT HEALTHCARE - NEUROSCIENCES 1041 N 29TH ST BILLINGS MT 59101 OUTPATIENT PHYSICIAN CLINIC 5 - ST VINCENT UROLOGY 2900 12TH AVE N STE 160W BILLINGS MT 59101 OUTPATIENT PHYSICIAN CLINIC 6 - ST VINCENT ORTHO MONTANA 2900 12TH AVE N STE 140W BILLINGS MT 59101 OUTPATIENT PHYSICIAN CLINIC 7 - ST VINCENT RHEUMATOLOGY 2900 12TH AVE N STE 503E BILLINGS MT 59101 OUTPATIENT PHYSICIAN CLINIC 8 - FRONTIER CANCER CENTER 1315 GOLDEN VALLEY CIR BILLINGS MT 59102 OUTPATIENT PHYSICIAN CLINIC 9 - ST VINCENT NEONATOLOGY 1233 N 30TH ST BILLINGS MT 59101 OUTPATIENT PHYSICIAN CLINIC 10 - FRONTIER CANCER CENTER 1315 GOLDEN VALLEY CIR BILLINGS MT 59102 OUTPATIENT PHYSICIAN CLINIC 11 - ST VINCENT PALLIATIVE CARE 1233 N 30TH ST BILLINGS MT 59101 OUTPATIENT PHYSICIAN CLINIC 12 - ST VINCENT HOSPITALIST NEUROLOGIST 1233 N 30TH ST BILLINGS MT 59101 OUTPATIENT PHYSICIAN CLINIC 13 - SCL HEALTH MEDICAL GROUP-BILLINGS-RED LO 810 N BROADWAY REDLODGE MT 59086 OUTPATIENT PHYSICIAN CLINIC 14 - ST VINCENT UROLOGY MILES CITY 2600 WILSON ST MILES CITY MT 59301 OUTPATIENT PHYSICIAN CLINIC 15 - ST VINCENT HOSPITALISTS 1233 N 30TH ST BILLINGS MT 59101 OUTPATIENT PHYSICIAN CLINIC 16 - FRONTIER CANCER CENTER 2600 WILSON STREET MILES CITY MT 59301 OUTPATIENT PHYSICIAN CLINIC 17 - ST VINCENT UROLOGY GLENDIVE 202 PROSPECT GLENDIVE MT 59330 OUTPATIENT PHYSICIAN CLINIC 18 - ST VINCENT HOSPITALISTS 1233 N 30TH ST BILLINGS MT 59107 OUTPATIENT PHYSICIAN CLINIC 19 - FRONTIER CANCER CENTER 1315 GOLDEN VALLEY CIR BILLINGS MT 59102 OUTPATIENT PHYSICIAN CLINIC 20 - ST VINCENT UROLOGY WORLAND 1106 BIGHORN AVE WORLAND WY 82401 OUTPATIENT PHYSICIAN CLINIC 21 - ST VINCENT UROLOGY CODY 720 LINDSAY LN STE A CODY WY 82414 OUTPATIENT PHYSICIAN CLINIC 22 - SCL HEALTH MEDICAL GROUP - BILLINGS - HE 408 WENDELL AVE STE 7 LEWISTOWN MT 59457 OUTPATIENT PHYSICIAN CLINIC 23 - ST VINCENT UROLOGY SIDNEY 216 14TH AVE SW SIDNEY MT 59270 OUTPATIENT PHYSICIAN CLINIC 24 - ST VINCENT UROLOGY LEWISTOWN 408 WENDELL AVE STE 7 LEWISTOWN MT 59457 OUTPATIENT PHYSICIAN CLINIC 25 - SCL HEALTH MEDICAL GROUP - BILLINGS - HE 2600 WILSON ST MILES CITY MT 59301 PHYSICAL THERAPY 26 - ATHLETIC MEDICINE & PERFORMANCE LLC 1144 NORTH 28TH STREET BILLINGS MT 59101 PHYSICAL THERAPY PART I, LINE 6A: THIS ORGANIZATION IS PART OF SCL HEALTH SYSTEM WHICH PREPARES AN ANNUAL COMMUNITY BENEFIT REPORT ON A CONSOLIDATED BASIS. THE REPORT IS PREPARED BY THE PARENT COMPANY, SISTERS OF CHARITY OF LEAVENWORTH HEALTH SYSTEM, INC. PART I, LINE 7: THE AMOUNTS REPORTED ON FORM 990, SCHEDULE H, PART I, LINE 7A, 7B AND 7C WERE DETERMINED USING THE COST TO CHARGE RATIO DERIVED FROM WORKSHEET 2, IN THE SCHEDULE H, FORM 990 INSTRUCTIONS. FORM 990, SCHEDULE H, PART I, LINES 7E, 7F, 7G, 7H AND 7I ARE REPORTED AT COST AS REPORTED IN THE ORGANIZATION'S FINANCIAL STATEMENTS.PART I, LINE 7, COLUMN (F): THE BAD DEBT EXPENSE INCLUDED ON FORM 990,PART IX, LINE 25, COLUMN (A), BUT SUBTRACTED FOR PURPOSES OF CALCULATING THE PERCENTAGE ON SCHEDULE H, PART I, LINE 7 COLUMN (F) IS $2,978,694. PART II, COMMUNITY BUILDING ACTIVITIES: ST. VINCENT HEALTHCARE RECOGNIZES THE NEED TO ADDRESS UNDERLYING FACTORS WHICH INFLUENCE HEALTH IN OUR COMMUNITY SUCH AS EDUCATION, HOUSING, EARLY CHILDHOOD DEVELOPMENT AND ECONOMIC SECURITY. WE SPONSOR THE FOSTER GRANDPARENT PROGRAM WITH 45 LOW-INCOME SENIORS MENTORING STUDENTS IN NEED AT SCHOOLS AND HEADSTART CENTERS RESULTING IN IMPROVED ACADEMIC SCORES. WE PROVIDED FINANCIAL SUPPORT TO CLDI TO DEVELOP EMPLOYMENT AND LEADERSHIP DEVELOPMENT FOR AT-RISK YOUTH AND WOMEN IN CRISIS; ST. VINCENT DE PAUL FOR SOBER LIVING SCHOLARSHIPS; AND NATIVE AMERICAN DEVELOPMENT CORPORATION FOR AN URBAN INDIAN SELF-SUFFICIENCY PILOT. SCHEDULE H, PART III, LINE 1THE ORGANIZATION REPORTS BAD DEBT IN ACCORDANCE TO HEALTHCARE FINANCIAL MANAGEMENT ASSOCIATION (HFMA) STATEMENT NO. 15 TO THE EXTENT THAT HFMA STATEMENT NO. 15 FOLLOWS THE GENERALLY ACCEPTED ACCOUNTING PRINCIPLES (GAAP) FOR THE REPORTING OF BAD DEBT. PART III, LINE 2: THE BAD DEBT EXPENSE REPORTED ON PART III, LINE 2 IS AT CHARGES AS RECORDED IN THE ORGANIZATION'S FINANCIAL STATEMENTS. THE ALLOWANCE FOR BAD DEBT IS BASED UPON MANAGEMENT'S ASSESSMENT OF HISTORICAL AND EXPECTED NET COLLECTIONS CONSIDERING THE BUSINESS AND GENERAL ECONOMIC CONDITIONS IN ITS SERVICE AREA, TRENDS IN HEALTH CARE COVERAGE, AND OTHER COLLECTION INDICATORS.THE BAD DEBT ALLOWANCE IS CALCULATED AS A PERCENTAGE OF PATIENT RECEIVABLES AFTER DEDUCTIONS FOR ESTIMATED PROVISIONS FOR CONTRACTUAL ADJUSTMENTS (DISCOUNTS) ON SERVICES PROVIDED TO ENROLLEES OF MEDICARE, MEDICAID, THIRD-PARTY PAYOR PROGRAMS, CHARITY CARE, UNINSURED DISCOUNTS, AND OTHER ADMINISTRATIVE ADJUSTMENTS. PART III, LINE 4: THE ALLOWANCE FOR BAD DEBT IS BASED UPON MANAGEMENT'S ASSESSMENT OF HISTORICAL AND EXPECTED NET COLLECTIONS CONSIDERING THE BUSINESS AND GENERAL ECONOMIC CONDITIONS IN ITS SERVICE AREA, TRENDS IN HEALTH CARE COVERAGE, AND OTHER COLLECTION INDICATORS.THE BAD DEBT ALLOWANCE IS CALCULATED AS A PERCENTAGE OF PATIENT RECEIVABLES AFTER DEDUCTIONS FOR ESTIMATED PROVISIONS FOR CONTRACTUAL ADJUSTMENTS (DISCOUNTS) ON SERVICES PROVIDED TO ENROLLEES OF MEDICARE, MEDICAID, THIRD-PARTY PAYOR PROGRAMS, CHARITY CARE, UNINSURED DISCOUNTS, AND OTHER ADMINISTRATIVE ADJUSTMENTS.THE ORGANIZATION HAS A FINANCIAL ASSISTANCE PROGRAM THAT PROVIDES PATIENTS OPPORTUNITIES TO APPLY FOR FREE OR DISCOUNTED CARE AND/OR TO BE ENROLLED IN A GOVERNMENT SPONSORED MEDICAL CARE PROGRAM. THE PROCESS INCLUDES IDENTIFYING PATIENTS WITH A FINANCIAL CONCERN AND PROVIDING FINANCIAL COUNSELING AND ASSISTANCE IN APPLYING FOR THE ORGANIZATION'S CHARITY CARE AND OTHER FINANCIAL ASSISTANCE PROGRAMS.CERTAIN PATIENT ACCOUNTS ARE WRITTEN OFF TO BAD DEBT BECAUSE THE ORGANIZATION DOES NOT HAVE SUFFICIENT INFORMATION TO DETERMINE IF THE PATIENT WOULD QUALIFY FOR FREE CARE OR FINANCIAL AID. THEREFORE, IT IS POSSIBLE THAT SOME BAD DEBT IS ACTUALLY CHARITY CARE. HOWEVER, IF A PATIENT ACCOUNT IS WRITTEN OFF TO BAD DEBT AND THE COLLECTION AGENCY LATER DETERMINES THAT THE PATIENT WOULD HAVE QUALIFIED FOR FREE CARE OR FINANCIAL AID, THEN THE BAD DEBT EXPENSE IS RECLASSIFIED TO CHARITY CARE. THE FOLLOWING IS THE TEXT OF THE FOOTNOTE IN THE ORGANIZATION'S FINANCIAL STATEMENTS THAT DESCRIBES THE BAD DEBT ALLOWANCE AND BAD DEBT EXPENSE:NET PATIENT SERVICE REVENUE GENERALLY RELATES TO CONTRACTS WITH PATIENTS IN WHICH THE PERFORMANCE OBLIGATIONS ARE TO PROVIDE HEALTH CARE SERVICES TO PATIENTS OVER A PERIOD OF TIME. REVENUE IS ESTIMATED FOR PATIENTS WHO HAVE NOT BEEN DISCHARGED AS OF THE REPORTING PERIOD BASED ON ACTUAL CHARGES INCURRED TO DATE IN RELATION TO TOTAL EXPECTED CHARGES. SCL HEALTH BELIEVES THIS METHOD PROVIDES A FAITHFUL DEPICTION OF THE TRANSFER OF SERVICES OVER THE TERM OF THE PERFORMANCE OBLIGATION BASED ON THE INPUTS NEEDED TO SATISFY THE OBLIGATION. THE CONTRACTUAL RELATIONSHIP WITH PATIENTS ALSO TYPICALLY INVOLVES A THIRD-PARTY PAYER (MEDICARE, MEDICAID, MANAGED CARE PLANS, AND COMMERCIAL INSURANCE COMPANIES), AND THE TRANSACTION PRICES FOR THE SERVICES PROVIDED ARE DEPENDENT UPON THE TERMS PROVIDED BY OR NEGOTIATED WITH THE THIRD-PARTY PAYERS. THE PAYMENT ARRANGEMENTS WITH THIRD-PARTY PAYERS FOR THE SERVICES PROVIDED TO THE RELATED PATIENTS TYPICALLY SPECIFY PAYMENT OR REIMBURSEMENT TO SCL HEALTH AT OTHER-THAN-STANDARD CHARGES.BECAUSE ALL OF ITS PERFORMANCE OBLIGATIONS RELATE TO CONTRACTS WITH A DURATION OF LESS THAN ONE YEAR, SCL HEALTH HAS ELECTED TO APPLY THE OPTION EXEMPTION, AND THEREFORE, IS NOT REQUIRED TO DISCLOSE THE AGGREGATE AMOUNT OF THE TRANSACTION PRICE ALLOCATED TO PERFORMANCE OBLIGATIONS THAT ARE UNSATISFIED OR PARTIALLY SATISFIED AT THE END OF THE REPORTING PERIOD. THE UNSATISFIED OR PARTIALLY SATISFIED PERFORMANCE OBLIGATIONS REFERRED TO ABOVE ARE PRIMARILY RELATED TO INPATIENT SERVICES AT THE END OF THE REPORTING PERIOD. THE PERFORMANCE OBLIGATIONS FOR THESE CONTRACTS ARE GENERALLY COMPLETED WHEN PATIENTS ARE DISCHARGED, WHICH GENERALLY OCCURS WITHIN DAYS OR WEEKS OF THE END OF THE REPORTING PERIOD.NET PATIENT SERVICE REVENUE IS REPORTED AT ESTIMATED AMOUNTS FROM PATIENTS, THIRD-PARTY PAYERS, AND OTHERS FOR SERVICES RENDERED AND INCLUDES ESTIMATES OF IMPLICIT PRICE CONCESSIONS AND RETROACTIVE REVENUE ADJUSTMENTS DUE TO AUDITS, REVIEWS, AND INVESTIGATIONS. IMPLICIT PRICE CONCESSIONS RELATE PRIMARILY TO UNINSURED PATIENTS AND PATIENTS WITH CO-PAYS, CO-INSURANCE AND DEDUCTIBLES AND ARE ESTIMATED BASED ON HISTORICAL COLLECTION DATA. RETROACTIVE ADJUSTMENTS ARE CONSIDERED IN THE RECOGNITION OF REVENUE ON AN ESTIMATED BASIS IN THE PERIOD THE RELATED SERVICES ARE RENDERED, AND SUCH AMOUNTS ARE ADJUSTED IN FUTURE PERIODS AS ADJUSTMENTS BECOME KNOWN OR AS YEARS ARE NO LONGER SUBJECT TO SUCH AUDITS, REVIEWS, OR INVESTIGATIONS. PART III, LINE 8: THE ORGANIZATION BELIEVES THAT AT LEAST SOME PORTION OF THE COSTS WE INCUR IN EXCESS OF PAYMENTS RECEIVED FROM THE FEDERAL GOVERNMENT FOR PROVIDING MEDICAL SERVICES TO MEDICARE ENROLLEES AND BENEFICIARIES UNDER THE FEDERAL MEDICARE PROGRAM (SHORTFALL OR MEDICARE SHORTFALL) CONSTITUTES A COMMUNITY BENEFIT. PROVIDING THESE SERVICES CLEARLY LESSENS THE BURDENS OF THE GOVERNMENT BY ALLEVIATING THE FEDERAL GOVERNMENT FROM HAVING TO DIRECTLY PROVIDE THESE MEDICAL SERVICES. AS DEMONSTRATED AND CALCULATED ON FORM 990, SCHEDULE H, PART III, LINES 5, 6 AND 7, OUR MEDICARE "ALLOWABLE COSTS" CLEARLY EXCEED THE PAYMENTS WE RECEIVE FOR PROVIDING THESE MEDICAL SERVICES UNDER THE MEDICARE PROGRAM. BY ABSORBING THE MEDICARE SHORTFALL COSTS WE ARE PROVIDING A COMMUNITY BENEFIT AS WELL AS EASING THE BURDEN OF THE FEDERAL GOVERNMENT HAVING TO COVER THESE COSTS.TO ARRIVE AT THE FORM 990, SCHEDULE H, PART III, LINE 6 AMOUNT, WE USED ACTUAL MEDICARE CHARGES FROM INTERNAL RECORDS AND APPLIED AN ESTIMATED COST TO CHARGE RATIO TO DETERMINE THE MEDICARE ALLOWABLE COSTS. THE ESTIMATED MEDICARE COST TO CHARGE RATIO IS THE PRIOR PERIOD MEDICARE COST REPORT COST TO CHARGE RATIO. PART III, LINE 9B: AN INTEGRAL COMPONENT OF OUR MISSION IS TO BE GOOD FINANCIAL STEWARDS. THIS REQUIRES US TO DETERMINE WHICH PATIENTS ARE IN NEED OF CHARITY CARE AND WHICH ARE ABLE TO CONTRIBUTE SOME PAYMENT FOR CARE RECEIVED. WEMAINTAIN A BALANCE THAT ENABLES US TO CONTINUE TO PROVIDE CHARITY CARE TOTHOSE WHO NEED IT MOST AND ENSURE THAT WE MANAGE OUR RESOURCES SOWE CAN CONTINUE TO BE HERE WHEN PEOPLE NEED US MOST. THE ORGANIZATION NOTIFIES PATIENTS OF FINANCIAL ASSISTANCE POLICY UPON ADMISSION AND DISCHARGE. IN ADDITION, THE PATIENTS RECEIVE INFORMATION ABOUT THE FINANCIAL ASSISTANCE POLICY WITH THEIR PATIENT BILLS. PATIENTS ARE CONTACTED MULTIPLE TIMES ABOUT UNPAID BALANCES PRIOR TO INITIATING ANY COLLECTION ACTION. IF A PATIENT IS DETERMINED TO BE ELIGIBLE FOR FINANCIAL ASSISTANCE AT ANY TIME DURING THE COLLECTION PROCESS, THE ACCOUNT IS RECLASSIFIED AS FINANCIAL ASSISTANCE AND DEBT COLLECTION EFFORTS ARE CEASED. PART V, SECTION A WEBSITE: WWW.SCLHEALTH.ORG/LOCATIONS/ST-VINCENT-HEALTHCARE/ PART VI, LINE 2: IN ADDITION TO THE CHNA, ST. VINCENT HEALTHCARE USES SECONDARY DATA SUCH AS COUNTY HEALTH RANKINGS AND THE BEHAVIOR RISK FACTOR SURVEILLANCE SYSTEM (BRFSS) TO DETERMINE HEALTH NEEDS FOR COUNTIES BEYOND OUR PRIMARY SERVICE AREA. WE ALSO UTILIZE OTHER LOCAL NEEDS ASSESSMENTS AND REPORTS FROM UNITED WAY.ST. VINCENT HEALTHCARE LEADERS SERVE ON VARIOUS COMMUNITY BOARDS TO UNDERSTAND SPECIFIC NEEDS. OUTREACH AND RELATIONSHIPS WITH OTHER HOSPITALS AND CLINICS ALSO ENABLES ST. VINCENT TO BETTER ASSESS HEALTH CARE NEEDS OF OUR RURAL MONTANA COMMUNITIES. PART VI, LINE 3: THE ORGANIZATION NOTIFIES PATIENTS ABOUT THE FINANCIAL ASSISTANCE POLICY UPON ADMISSION AND PRIOR TO DISCHARGE. NOTICES ABOUT THE FINANCIAL ASSISTANCE POLICY ARE DISPLAYED THROUGHOUT THE HOSPITAL. IN ADDITION, PATIENTS RECEIVE INFORMATION ABOUT THE FINANCIAL ASSISTANCE POLICY WITH THEIR PATIENT BILLS. THE FINANCIAL ASSISTANCE POLICY AND APPLICATION ARE POSTED ON THE HOSPITAL'S WEBSITE. THE POLICY AND APPLICATION ARE ALSO AVAILABLE UPON REQUEST. THE ORGANIZATION HAS A FINANCIAL ASSISTANCE PROGRAM THAT PROVIDES PATIENTS OPPORTUNITIES TO APPLY FOR FREE OR DISCOUNTED CARE AND/OR TO BE ENROLLED IN A GOVERNMENT SPONSORED MEDICAL CARE PROGRAM. THE PROCESS INCLUDES IDENTIFYING PATIENTS WITH A FINANCIAL CONCERN, PROVIDING FINANCIAL COUNSELING AND ASSISTANCE IN APPLYING FOR THE ORGANIZATION'S CHARITY CARE AND OTHER FINANCIAL ASSISTANCE PROGRAMS. PART VI, LINE 4: POPULATION AND GEOGRAPHY: ST. VINCENT HEALTHCARE'S PRIMARY SERVICE AREA INCLUDES YELLOWSTONE COUNTY. YELLOWSTONE COUNTY ENCOMPASSES 2,633 SQUARE MILES AND INCLUDES A POPULATION OF 151,965 RESIDENTS. BETWEEN THE 2000 AND 2010 US CENSUSES, THE POPULATION OF YELLOWSTONE COUNTY INCREASED BY 14.4%, A GREATER PROPORTIONAL INCREASE THAN SEEN ACROSS BOTH MONTANA AND THE NATION OVERALL. YELLOWSTONE COUNTY IS PREDOMINATELY URBAN WITH 83.3% OF THE POPULATION LIVING IN AREAS DESIGNATED AS URBAN AND IS SURROUNDED BY RURAL AND FRONTIER COUNTIES.RACE AND ETHNICITY: THE MAJORITY OF YELLOWSTONE COUNTY RESIDENTS ARE WHITE (90.6%), 4.3% ARE NATIVE AMERICAN, AND 0.7% ARE BLACK. A TOTAL OF 5% OF YELLOWSTONE COUNTY RESIDENTS ARE HISPANIC OR LATINO. YELLOWSTONE COUNTY HAS A SMALL PERCENTAGE OF LINGUISTICALLY ISOLATED RESIDENTS AT 0.6%.POVERTY: THE LATEST CENSUS ESTIMATE SHOWS 12.5% OF THE YELLOWSTONE COUNTY POPULATION LIVING BELOW THE FEDERAL POVERTY LEVEL. IN ALL, 31.2% OF YELLOWSTONE COUNTY RESIDENTS (AN ESTIMATED 46,236 INDIVIDUALS) LIVE BELOW 200% OF THE FEDERAL POVERTY LEVEL. ADDITIONALLY, 40.5% OF YELLOWSTONE COUNTY CHILDREN LIVE BELOW THE 200% POVERTY THRESHOLD. ECONOMICS: THE UNEMPLOYMENT RATE IN YELLOWSTONE COUNTY IN 2015 WAS 3.3% (US DEPARTMENT OF LABOR), MORE FAVORABLE THAN THE STATEWIDE AND NATIONAL UNEMPLOYMENT RATES. AMONG THE ADULT POPULATION, AN ESTIMATED 7.6% OF RESIDENTS DO NOT HAVE A HIGH SCHOOL EDUCATION, IDENTICAL TO MONTANA RATES AND MORE FAVORABLE THAN NATIONAL RATES. SIMILAR TO NATIONAL RATES, NEARLY A THIRD OF ADULTS REPORTED HOUSING INSECURITY (2017 CHNA). ADDITIONALLY, 14.4% OF ADULTS REPORTED FOOD INSECURITY, ALSO SIMILAR TO RATES FOUND NATIONALLY (2017 CHNA). HEALTH STATUS: JUST OVER ONE-HALF (50.5%) OF YELLOWSTONE COUNTY ADULTS RATE THEIR OVERALL HEALTH AS "EXCELLENT OR "VERY GOOD" WHILE 15.4% OF ADULTS RATED THEIR HEALTH AS "FAIR OR "POOR" (2017 CHNA), SIMILAR TO STATEWIDE AND NATIONAL FINDINGS. A TOTAL OF 29.6% OF YELLOWSTONE COUNTY ADULTS ARE LIMITED IN SOME WAY DUE A PHYSICAL, MENTAL, OR EMOTIONAL PROBLEM, LESS FAVORABLE THAN STATE AND NATIONAL PREVALENCE RATES. IN 2017, COUNTY HEALTH RANKINGS & ROADMAPS PROGRAM RANKED YELLOWSTONE COUNTY 19 OF 47 COUNTIES IN MONTANA. PART VI, LINE 5: ST. VINCENT HEALTHCARE ADHERES TO COMMUNITY BENEFIT GUIDELINES OUTLINED IN THE CATHOLIC HEALTH ASSOCIATION'S PUBLICATION, "A GUIDE TO PLANNING AND REPORTING COMMUNITY BENEFIT". ST. VINCENT HEALTHCARE'S COMMUNITY BENEFIT WORK IS DRIVEN BY IDENTIFIED COMMUNITY HEALTH NEEDS AND DIRECTED IN COLLABORATION WITH OTHER HEALTHCARE ORGANIZATIONS AND THE BROADER COMMUNITY. COMMUNITY BENEFIT STRATEGIES ARE INTEGRATED IN THE ORGANIZATIONAL STRATEGIC PLAN. PROGRAMS ARE LOCATED THROUGHOUT THE ORGANIZATION AND STAFF AND BOARD EDUCATION IS CONDUCTED. ST. VINCENT HEALTHCARE HAS DEDICATED STAFF COMMITTED TO COMMUNITY BENEFIT EFFORTS. HOSPITAL LEADERS, MANAGERS, AND SUPERVISORS ARE REQUIRED TO PARTICIPATE ANNUALLY IN COMMUNITY BENEFIT SERVICE EVENTS WITH NON-PROFIT ORGANIZATIONS TO IMPROVE THE HEALTH OF THE COMMUNITIES WE SERVE. IN 2017, OUR LEADERS PERFORMED OVER 2,700 HOURS OF SERVICE IN THE COMMUNITY, BENEFITING MORE THAN 78 ORGANIZATIONS. ST. VINCENT HEALTHCARE'S BOARD OF DIRECTORS IS A VOLUNTEER GOVERNING BODY WHICH INCLUDES INDEPENDENT PERSONS THAT REPRESENT THE COMMUNITY. WITHIN THE BOARD OF DIRECTORS, THERE IS A SPECIFIC COMMUNITY BENEFIT BOARD LEVEL COMMITTEE. THIS COMMITTEE IS DEEPLY INVOLVED IN THE COMMUNITY HEALTH NEEDS ASSESSMENT PROCESS AND PROVIDES DIRECTION TO DEVELOPMENT OF THE ORGANIZATION'S IMPROVEMENT PLAN IN RESPONSE TO RESULTS OF COMMUNITY HEALTH NEEDS ASSESSMENT. THE HOSPITAL'S COMMUNITY BENEFIT BOARD COMMITTEE MONITORS IMPLEMENTATION OF COMMUNITY BENEFIT PROGRAMS AND PROVIDES REPORTS BACK TO THE FULL HOSPITAL BOARD. ST. VINCENT HEALTHCARE OPERATES AN EMERGENCY ROOM THAT IS OPEN TO ALL PERSONS REGARDLESS OF ABILITY TO PAY AND HAS AN OPEN MEDICAL STAFF WITH PRIVILEGES AVAILABLE TO ALL QUALIFIED PHYSICIANS IN THE AREA. ST. VINCENT HEALTHCARE ENGAGES IN MEDICAL AND SCIENTIFIC RESEARCH PROGRAMS; ENGAGES IN THE TRAINING AND EDUCATION OF HEALTHCARE PROFESSIONALS AND PARTICIPATES IN MEDICAID, MEDICARE AND OTHER GOVERNMENT SPONSORED HEALTH PROGRAMS. ST. VINCENT HEALTHCARE EMPLOYS THE STAFF OF THE ST. VINCENT HEALTHCARE FOUNDATION, A NON-PROFIT ORGANIZATION THAT PROVIDES FUNDRAISING FOR BOTH ST. VINCENT HEALTHCARE PROGRAMS AND FOR COMMUNITY BENEFIT PROGRAMS THAT REACH BOTH THE POOR AND BROADER COMMUNITY. OPERATIONS OF THE ST. VINCENT HEALTHCARE FOUNDATION ARE GOVERNED BY A SEPARATE FOUNDATION BOARD WITH VOLUNTARY MEMBERSHIPS FROM THE LOCAL COMMUNITY. WHEN ST. VINCENT HEALTHCARE HAS EXCESS REVENUE OVER OPERATING EXPENSES, WE USE THOSE FUNDS TO OBTAIN CURRENT HEALTHCARE TECHNOLOGIES AND EQUIPMENT, IMPROVE PATIENT CARE, PROVIDE MEDICAL TRAINING EDUCATION AND RESEARCH, AND TO EXPAND ACCESS TO POINTS OF CARE. THESE INVESTMENTS ENSURE WE WILL BE ABLE TO CARE FOR FUTURE GENERATIONS. ST. VINCENT CO-LEADS COMMUNITY HEALTH IMPROVEMENT EFFORTS AS PART OF THE ALLIANCE, A COLLABORATIVE WITH BILLINGS CLINIC AND RIVERSTONE HEALTH, AND COMMITS TIME AND FINANCIAL RESOURCES TO FULFILLING GOALS OUTLINED IN THE COLLABORATIVE COMMUNITY HEALTH IMPROVEMENT PLAN FOR YELLOWSTONE COUNTY. IN 2019, WE PROVIDED $1,506,201 IN MISSION FUND GRANT AWARDS TO BIG HORN HOSPITAL ASSOCIATION, BILLINGS CHAMBER OF COMMERCE, CLDI, COMMUNITY CRISIS CENTER, EDUCATION FOUNDATION FOR BILLINGS PUBLIC SCHOOLS, HORSES SPIRITS HEALING, MONTANA COMMUNITY FOUNDATION, NATIVE AMERICAN DEVELOPMENT CORPORATION, NO KID HUNGRY MONTANA, RIVERSTONE HEALTH, ROCKY MOUNTAIN COLLEGE, ST. VINCENT DE PAUL, WALLA WALLA UNIVERSITY BILLINGS MENTAL HEALTH CLINIC, AND YWCA BILLINGS. ST. VINCENT HEALTHCARE VALUES THESE COMMUNITY PARTNERSHIPS AND COLLABORATIONS AS AN INTEGRAL PART OF OUR COMMUNITY HEALTH IMPROVEMENT EFFORTS. PART VI, LINE 6: THE ORGANIZATION IS A CONTROLLED ENTITY OF THE SISTERS OF CHARITY OF LEAVENWORTH HEALTH SYSTEM, INC. (SCLHS). SCLHS AND ITS AFFILIATED ENTITIES HAVE A COMMON CALLING AND MISSION: "WE REVEAL AND FOSTER GOD'S HEALING LOVE BY IMPROVING THE HEALTH OF THE PEOPLE AND COMMUNITIES WE SERVE, ESPECIALLY THOSE WHO ARE POOR AND VULNERABLE." WE STRIVE TO PROVIDE HIGH-QUALITY, COMPASSIONATE AND AFFORDABLE HEALTHCARE IN EACH OF OUR HOSPITAL SITES AND THEIR RESPECTIVE COMMUNITIES, AS WELL AS IN A VARIETY OF OUTPATIENT SETTINGS AND IN THE HOME. SCLHS IS A FAITH-BASED, NONPROFIT HEALTHCARE ORGANIZATION THAT OPERATES EIGHT HOSPITALS, TWO SAFETY NET CLINICS, ONE CHILDREN'S MENTAL HEALTH CENTER, HOME HEALTH AND MORE THAN 200 PHYSICIAN CLINICS IN THREE STATES - COLORADO, KANSAS AND MONTANA. THE HEALTH SYSTEM INCLUDES MORE THAN 15,900 EMPLOYEES AND MORE THAN 800 EMPLOYED PROVIDERS.AS OUR HEALTH SYSTEM GROWS, WE'RE LEVERAGING THAT GROWTH TO ACHIEVE BENEFITS OF SCALE - IDENTIFYING COST AND OTHER ADVANTAGES THAT WE GAIN DUE TO OUR SIZE. WE'RE ALSO WORKING TO STREAMLINE AND UNIFY OUR SYSTEM-WIDE PROCESSES TO ELIMINATE COSTLY DUPLICATION OF EFFORT. WE ACTIVELY ENCOURAGE OUR PEOPLE TO PURSUE CREATIVE IDEAS THAT IMPROVE EFFICIENCY, SERVICE AND THE OVERALL CARE EXPERIENCE. WHEN OUR ASSOCIATES OR LEADERSHIP TEAMS IDENTIFY BEST PRACTICES IN ANY AREA OF CARE, WE RAPIDLY REPLICATE THOSE ACROSS ALL CARE SITES.THE ORGANIZATION PROMOTES THE HEALTH OF THE COMMUNITY BY DELIVERING DIRECT HIGH QUALITY HEALTHCARE SERVICES THAT ARE RESPONSIVE TO THE NEEDS OF ITS PATIENTS AND THEIR FAMILIES. THIS INCLUDES COORDINATING COMMUNITY BENEFIT PROCESSES, PROVIDING GUIDANCE WITH COMMUNITY NEEDS ASSESSMENTS, AND ESTABLISHING CONSISTENT FINANCIAL ASSISTANCE AND CHARITY CARE POLICIES AND PROCEDURES. ADDITIONALLY, SCLHS BENEFITS AFFILIATES THROUGH QUALITY IMPROVEMENT AND PERFORMANCE EXCELLENCE INITIATIVES; SYSTEM-WIDE INFORMATION TECHNOLOGY IMPLEMENTATION AND INFRASTRUCTURE; STRATEGIC AND OPERATIONS DIRECTION AND OVERSIGHT; SUPPLY CHAIN MANAGEMENT AND PURCHASING; FINANCE ADMINISTRATION, REVENUE CYCLE SUPPORT, BENEFITS ADMINISTRATION, RISK MANAGEMENT; DISASTER PLANNING AND CRISIS ASSISTANCE, CENTRAL CASH MANAGEMENT AND INVESTMENT, INTERNAL AUDIT, LEGAL SERVICES, TAX SERVICES AND MISSION INTEGRATION. 1 SISTERS OF CHARITY OF LEAVENWORTH HEALTH SYSTEM INC 500 ELDORADO BLVD SUITE 4300 BROOMFIELD CO 80021 237379161 501(C)(3) 8747984 SUPPORT MONTANA CLINICS ST VINCENT HEALTHCARE FOUNDATION 1106 NORTH 30TH STREET BILLINGS MT 59101 810468034 501(C)(3) 1921669 SUPPORT OPERATIONS MONTANA COMMUNITY FOUNDATION 33S LAST CHANCE GULCH SUITE 2A HELENA MT 59601 810450150 501(C)(3) 1000000 SUPPORT COMMUNITY HEALTH RIVERSTONE HEALTH 123 S 27TH STREET BILLINGS MT 59101 352332179 501(C)(3) 164300 PROGRAM SUPPORT, SCHOLARSHIPS AND, SPONSORSHIP COMMUNITY CRISIS CENTER 704 N 30TH ST BILLINGS MT 59101 203231164 501(C)(3) 164000 SUPPORT OPERATIONS WALLA WALLA UNIVERSITY 204 S COLLEGE AVE COLLEGE PLACE WA 99324 910617727 501(C)(3) 89020 STUDENT CLINIC OPERATIONAL SUPPORT ROCKY MOUNTAIN COLLEGE 1511 POLY DR BILLINGS MT 59102 810235407 501(C)(3) 53000 EVENT SPONSORSHIP THE SOCIETY OF ST VINCENT DE PAUL 3005 1ST AVENUE S BILLINGS MT 59101 910879988 501(C)(3) 50000 SCHOLARSHIPS AND RENT ASSISTANCE SHARE OUR STRENGTH 1030 15TH STREET NW WASHINTON DC 20005 521367538 501(C)(3) 50000 MEAL PROGRAMS FOR KIDS EDUCATION FOUNDATION FOR BILLINGS PUBLIC SCHOOLS 415 N 30TH ST BILLINGS MT 59010 810452904 501(C)(3) 29500 SUPPORT COMMUNITY HEALTH NATIVE AMERICAN DEVELOPMENT CORPORATION 17 N 26TH STREET BILLINGS MT 59101 810512124 501(C)(3) 28773 SUPPORT COMMUNITY HEALTH YWCA 909 WYOMING AVENUE BILLINGS MT 59101 810534954 501(C)(3) 26500 REACHING EVERY WOMAN PROGRAM AND EVENT SPONSORSHIP BILLINGS CHAMBER OF COMMERCE 815 S 27TH ST BILLINGS MT 59101 810111570 501(C)(6) 25500 PUBLIC SAFTEY INITIATIVE SUPPORT COMMUNITY LEADERSHIP AND DEVELOPMENT INC 24 S 29TH SREET BILLINGS MT 59101 810397424 501(C)(3) 25000 SUPPORT COMMUNITY HEALTH HOLY ROSARY HEALTHCARE FOUNDATION INC 2600 WLSON STREET MILES CITY MT 59301 202270238 501(C)(3) 20000 SUPPORT OPERATIONS ST JAMES HEALTHCARE FOUNDATION INC 404 SOUTH CLARK ST BUTTE MT 59701 651202190 501(C)(3) 20000 SUPPORT OPERATIONS MONTANA AMATEUR SPORTS INC PO BOX 7136 BILLINGS MT 59103 810431595 501(C)(3) 17500 EVENT SPONSORSHIP BILLINGS CATHOLIC SCHOOLS FOUNDATION 215 N 31ST STREET BILLINGS MT 59101 383819006 501(C)(3) 16000 EVENT SPONSORSHIP AMERICAN CANCER SOCIETY 1903 CENTRAL AVE BILLINGS MT 59102 131788491 501(C)(3) 13000 EVENT SPONSORSHIP YMCA 402 NORTH 32ND STREET BILLINGS MT 59101 810229386 501(C)(3) 10500 LIVESTRONG SPONSORSHIP BIG HORN HOSPITAL ASSOCIATION 17 N MILES AVE HARDIN MT 59034 810384618 501(C)(3) 10000 SUPPORT COMMUNITY HEALTH HORSES SPIRIT HEALING INC 7256 HIGHWAY 3 BILLINGS MT 59106 471915118 501(C)(3) 10000 VETERAN INTEGRATION ACTIVITIES AND THERAPIES MONTANA STATE UNIVERSITY FOUNDATION PO BOX 172750 BOZEMAN MT 59717 816001649 501(C)(3) 10000 TUITION AND SCHOLARSHIPS LEADERSHIP MONTANA PO BOX 5155 BOZEMAN MT 59717 208571151 501(C)(3) 7750 LMT PROGRAM SPONSORSHIP ST JOHNS LUTHERAN MINISTRIES FOUNDATION 2429 MISISON WAY BILLINGS MT 59102 810459472 501(C)(3) 7500 EVENT SPONSORSHIP RONALD MCDONALD HOUSE OF EASTERN MONTANA 1144N 30TH ST BILLINGS MT 59101 810400667 501(C)(3) 6100 EVENT SPONSORSHIP UNITED WAY OF YELLOWSTONE COUNTY 2173 OVERLAND AVE BILLINGS MT 59102 810287507 501(C)(3) 5525 READER TUTOR PROGRAM & DAY OF CARING BILLINGS SYMPHONY ORCHESTRA AND CHORALE 2721 2ND AVE N STE 350 BILLINGS MT 59101 237083873 501(C)(3) 5500 SPONSORSHIP 28 0 PART I, LINE 2: MISSION FUND POLICIES ST VINCENT HEALTHCARE PROVIDES A LIMITED NUMBER OF GRANTS TO IMPROVE THE HEALTH AND WELL-BEING OF THE PEOPLE IN OUR COMMUNITY. GUIDED BY HOSPITAL POLICY, MISSION FUND AWARD PROJECTS MUST: (1) DEMONSTRATE A COMMITTMENT TO THE ST VINCENT HEALTHCARE MISSION, VISION, AND VALUES; (2) MEET CRITERIA FOR INCLUSION IN THE COMMUNITY BENEFIT REPORT; AND (3) DOCUMENT MEASURABLE OUTCOMES THAT DEMONSTRATE THE SUCCESS OF THE PROJECT. PREFERENCE WILL BE GIVEN WHEN THE PROJECT CAN: (1) ADDRESS CREATIVELY THE UNMET NEEDS OF THE ECONOMICALLY DISADVANTAGED; (2) FORM COLLABORATIVE PARTNERSHIPS THAT IMPROVE THE HEALTH OF THE COMMUNITY; (3) AID A SIGNIFICANT POPULATION OF THE POOR, UNDERSERVED AND/OR UNINSURED; (4) REFLECT ST VINCENT HEALTHCARE'S ANNUAL AND STRATEGIC GOALS; AND (5) DEMONSTRATE THE POSSIBILITY FOR SUSTAINABILITY BEYOND THE GRANT PERIOD. APPLICATIONS ARE REVIEWED ON AN ANNUAL BASIS BY COMMITTEE. GRANTEES ARE REQUIRED TO PROVIDE A 6-MONTH AND 1-YEAR REPORT TO ST VINCENT HEALTHCARE AND PROVIDE FOR AN ON-SITE VISIT OF THE PROGRAM. AS NOTED IN THE MISSION FUND APPLICATION, IF FUNDS ARE USED OUTSIDE OF PROJECT GUIDELINES THE GRANTEE MAY BE ASKED TO REIMBURSE ST VINCENT HEALTHCARE FOR FUNDS ALREADY DISTRIBUTED FOR THE PROJECT. 0 1 0 0 0 0 0 1 0 STEVE LOVELESS PRESIDENT AND CEO 0 511967 0 202410 0 84380 0 95993 0 25293 0 920043 0 69735 STUART GOODMAN MD FORMER HIGHEST PAID 0 822967 0 25725 0 9778 0 20016 0 19556 0 898042 0 0 WILLIAM SPIRE MD FORMER HIGHEST PAID 0 735567 0 25725 0 2495 0 22219 0 26916 0 812922 0 0 JEFFREY ZAVALA FORMER KEY EMPLOYEE 0 368429 0 100803 0 50654 0 66725 0 24500 0 611111 0 41586 KEVIN BRUEN MD DIRECTOR 0 520106 0 24000 0 9266 0 22161 0 28992 0 604525 0 0 MICHAEL BUSH MD VP CHIEF MEDICAL OFFICER SVB 0 346101 0 93125 0 55220 0 64872 0 25209 0 584527 0 43364 MICHAEL SKEHAN VP COO MONTANA REGION 0 350415 0 92663 0 40952 0 60746 0 17689 0 562465 0 35146 FRANK LAMM MD PHYSICIAN 487283 0 0 0 5474 0 15830 0 28166 0 536753 0 0 0 RONALD SNYDER MD PHYSICIAN 457098 0 20000 0 4157 0 23611 0 29316 0 534182 0 0 0 TRENT MIHALICK MD PHYSICIAN 474325 0 0 0 11003 0 1140 0 31624 0 518092 0 0 0 SHELDON NELSON MD PHYSICIAN 315779 0 118122 0 4878 0 23137 0 28616 0 490532 0 0 0 MICHAEL HICKMAN MD PHYSICIAN 412909 0 0 0 24228 0 14751 0 19542 0 471430 0 0 0 PAMELA PALAGI VP FINANCE MT REGION 0 256870 0 68796 0 2203 0 36600 0 9044 0 373513 0 0 MICHAEL HAMILTON VP STRATEGY & BUSINESS DEVELOPMENT S 0 223344 0 44654 0 4879 0 46529 0 26138 0 345544 0 0 BLANCHE GILMORE VP CHIEF NURSING OFFICER SVB 0 223864 0 60526 0 31644 0 15432 0 13085 0 344551 0 0 JAMES RITCHEY VP HUMAN RESOURCES MONTANA REGION 0 220051 0 34731 0 2451 0 40274 0 26365 0 323872 0 0 JESSE LASLOVICH VP NETWORK DEVELOPMENT MONTANA REGIO 0 200878 0 54511 0 2199 0 31533 0 27466 0 316587 0 0 TRACY NEARY VP MISSION INTEGRATION MONTANA REGIO 0 126493 0 34868 0 17369 0 22100 0 26157 0 226987 0 16738 SUSAN PETERSEN MD DIRECTOR 0 132264 0 54687 0 2517 0 12047 0 2550 0 204065 0 0 PART I, LINE 3 THE ORGANIZATION'S OFFICERS AND SENIOR MANAGEMENT ARE PAID BY A RELATED ORGANIZATION, SISTERS OF CHARITY OF LEAVENWORTH HEALTH SYSTEM, INC. (SCL HEALTH). COMPENSATION FOR THE OFFICERS AND SENIOR MANAGEMENT IS MANAGED BY THE SCL HEALTH BOARD COMPENSATION COMMITTEE (COMMITTEE) ON BEHALF OF SCL HEALTH AND ALL OF ITS AFFILIATES. THE COMMITTEE REVIEWS AND APPROVES COMPENSATION ARRANGEMENTS OF THE OFFICERS AND SENIOR MANAGEMENT AND MAKES RECOMMENDATIONS TO SCL HEALTH'S BOARD FOR APPROVAL OF ANY CHANGES TO COMPENSATION FOR THE OFFICERS AND SENIOR MANAGEMENT. THE COMMITTEE'S REVIEW IS CONDUCTED IN A MANNER THAT IS INTENDED TO QUALIFY FOR THE REBUTTABLE PRESUMPTION OF REASONABLENESS UNDER THE INTERMEDIATE SANCTIONS RULES OF INTERNAL REVENUE CODE SECTION 4958. THE COMMITTEE CONDUCTS THE REVIEW WITH THE ASSISTANCE OF AN EXPERIENCED AND INDEPENDENT COMPENSATION CONSULTING FIRM THAT HAS DEEP NATIONAL EXPERTISE IN HEALTH SYSTEMS' EXECUTIVE COMPENSATION PROGRAMS AND LEVELS. THE COMMITTEE OBTAINS AND RELIES UPON CURRENT, COMPARABLE MARKET DATA FOR PEER ORGANIZATIONS PRIOR TO MAKING COMPENSATION RELATED DECISIONS. THE INFORMATION REVIEWED INCLUDES COMPENSATION LEVELS PAID BY SIMILARLY SITUATED ORGANIZATIONS FOR FUNCTIONALLY COMPARABLE POSITIONS, THE AVAILABILITY OF SIMILAR SERVICES IN THE GEOGRAPHIC AREA SERVED BY SCL HEALTH AND CURRENT COMPENSATION SURVEYS COMPILED BY AN INDEPENDENT FIRM. CONSISTENT WITH THE PAY PHILOSOPHY SET BY SCL HEALTH'S BOARD, THE COMMITTEE EMPHASIZES THE IMPORTANCE OF ENSURING TOTAL REMUNERATION IS REASONABLE AND APPROPRIATE WHEN REVIEWING AND MAKING RECOMMENDATIONS WITH RESPECT TO COMPENSATION PACKAGES FOR THE OFFICERS AND SENIOR MANAGEMENT. AS PART OF THE REVIEW PROCESS, SCL HEALTH USES THE FOLLOWING IN ESTABLISHING THE COMPENSATION OF OFFICERS AND SENIOR MANAGEMENT. 1) COMPENSATION COMMITTEE 2) INDEPENDENT COMPENSATION CONSULTANT 3) FORM 990 OF OTHER ORGANIZATIONS 4) WRITTEN EMPLOYMENT CONTRACTS 5) COMPENSATION SURVEYS AND STUDIES 6) APPROVAL BY THE BOARD OR COMPENSATION COMMITTEE THE ITEMS LISTED ABOVE SUPPORT THE COMPENSATION COMMITTEE'S EFFORTS TO ENSURE THAT THE LEVEL OF COMPENSATION PROVIDED TO ITS OFFICERS AND SENIOR MANAGEMENT IS REASONABLE, APPROPRIATE AND CONSISTENT WITH THE PAY PHILOSOPHY SET BY THE BOARD. PART I, LINE 4B PAYMENTS FROM A SUPPLEMENTAL NONQUALIFIED RETIREMENT PLAN A RELATED ORGANIZATION PROVIDES NONQUALIFIED DEFERRED COMPENSATION PLANS (NQDC) KNOWN AS SUPPLEMENTAL EXECUTIVE RETIREMENT PROGRAM (SERP) FOR EXECUTIVES (SENIOR MANAGEMENT) TO COMPENSATE FOR REGULATORY IMPOSED LIMITATIONS IN QUALIFIED RETIREMENT PLANS AND TO PROVIDE A BENEFIT CONSISTENT WITH OTHER NOT FOR PROFIT HEALTH SYSTEMS. THESE PLANS ENABLE THE EXECUTIVE TO EARN BENEFITS DURING EACH YEAR THAT THEY PARTICIPATE. IN 2014, IN AN EFFORT TO REDUCE LONG-TERM COST AND HAVE GREATER CONTROL OVER FINANCIAL RISK, THE SERP WAS CONVERTED FROM A DEFINED BENEFIT (DB) TO A DEFINED CONTRIBUTION (DC) DESIGN. CERTAIN MEMBERS OF SENIOR MANAGEMENT WHOSE BENEFITS WERE CONVERTED FROM DB TO DC WOULD HAVE BEEN DISPROPORTIONATELY AND NEGATIVELY AFFECTED BY THE CHANGE, SO THE COMMITTEE DETERMINED IT WOULD BE APPROPRIATE TO GRANT "TRANSITION CREDITS" IN ORDER TO MITIGATE THE NEGATIVE IMPACT OF THE CHANGE ON THEIR RETIREMENT BENEFITS. THIS IS A COMMON APPROACH EMPLOYED BY OTHER ORGANIZATIONS UNDERGOING A SIMILAR TRANSITION. THE TRANSITION CREDITS VEST IN ACCORDANCE WITH THE TERMS OF THE DC SERP (I.E., AFTER THREE YEARS) AND ARE PAID TO THE EXECUTIVE UPON VESTING. NQDC SERP PLANS PRIOR TO 2014 PRIOR TO 2014, THE RELATED ORGANIZATION'S NQDC SERP PLAN PROVIDED A BENEFIT TO ELIGIBLE PARTICIPANTS BASED ON A PERCENTAGE OF THEIR BASE COMPENSATION. THE VESTING PERIOD IS 5 YEARS OR WHEN THE PARTICIPANT IS AGE 65 OR OLDER. THERE WERE NO CONTRIBUTIONS TO THIS PLAN AFTER DECEMBER 31, 2013. THE RELATED ORGANIZATION HAS DETERMINED THAT THESE BENEFITS SHOULD BE SUBJECT TO TAXATION AS THE AMOUNTS ARE VESTED RATHER THAN WHEN THEY ARE RECEIVED. AS A RESULT, THE TOTAL NONQUALIFIED RETIREMENT PLAN BENEFITS, WHICH WERE VESTED IN THE CURRENT YEAR, ARE CONSIDERED TAXABLE AND THUS WERE TAXED TO THE PARTICIPANTS. FOR SOME OF THE PARTICIPANTS, AN AMOUNT EQUAL TO THE PARTICIPANT'S EXPECTED INCOME TAX LIABILITY WAS WITHDRAWN FROM THE PARTICIPANT'S ACCOUNT AND REMITTED TO THE FEDERAL AND STATE GOVERNMENTS AS WITHHOLDING ON THE TAXABLE BENEFIT. NO CASH PAYMENT IS MADE DIRECTLY TO THE PARTICIPANT AND THE REMAINING BENFIT AMOUNT STAYS IN THE RETIREMENT PLAN. THE AMOUNTS WITHDRAWN FROM THE PLAN FOR TAXES IN 2019 WERE: NONE. FOR AMOUNTS CONTRIBUTED TO THE NQDC SERP PLAN PRIOR TO 2014, VESTED AMOUNTS ARE PAYABLE UPON THE END OF EMPLOYMENT. THE VESTED AMOUNTS WITHDRAWN INCLUDE AMOUNTS PREVIOUSLY TAXED TO THE RECIPIENT AND AMOUNTS TAXABLE TO THE RECIPIENT IN THE CURRENT YEAR. THE TAXABLE AMOUNTS ARE INCLUDED ON THE RECIPIENT'S W-2. ANY DISTRIBUTIONS FROM THIS PLAN ARE REPORTED BELOW. NQDC SERP PLANS STARTING IN 2014 STARTING IN 2014, THE RELATED ORGANIZATION'S NQDC SERP PLAN PROVIDED A BENEFIT TO ELIGIBLE PARTICIPANTS BASED ON A PERCENTAGE OF THEIR BASE COMPENSATION. THE VESTING PERIOD IS ROLLING 3 YEARS OR WHEN THE PARTICIPANT IS AGE 65 OR OLDER. THERE WERE NO CONTRIBUTIONS TO THIS PLAN BEFORE JANUARY 1, 2014. ANY DISTRIBUTIONS FROM THIS PLAN ARE REPORTED BELOW. STARTING IN 2014, FOR CONTRIBUTIONS TO THE NQDC SERP PLAN, CERTAIN PARTICIPANTS ARE VESTED OR BECAME VESTED IN THE PLAN DURING 2019. VESTED AMOUNTS ARE PAYABLE TO THE RECIPIENT. THE VESTED AMOUNTS ARE TAXABLE TO THE RECIPIENT IN THE CURRENT YEAR. THE TAXABLE AMOUNTS ARE INCLUDED ON THE RECIPIENT'S W-2. THE AMOUNTS WITHDRAWN FROM THE NQDC SERP PLANS IN 2019 WERE: STEVE LOVELESS - $69,735, MICHAEL BUSH - $43,364, BLANCHE GILMORE - $22,875, TRACY NEARY - $16,738, MICHAEL SKEHAN - 35,146, JEFFREY ZAVALA - $41,586. IN ACCORDANCE WITH THE REQUIREMENTS OF SCHEDULE J, DEFERRED COMPENSATION EARNED OVER THE VESTING PERIOD IS REPORTED IN COLUMN C AND ANY AMOUNTS VESTED/PAID FROM A DEFERRED COMPENSATION PLAN ARE REPORTED IN COLUMN B(III). THUS, THE SAME AMOUNT WOULD BE REPORTED TWICE (FIRST WHEN IT ACCRUED DURING THE VESTING PERIOD AND AGAIN WHEN IT IS VESTED/PAID). THIS RESULTS IN THE APPEARANCE OF CERTAIN EXECUTIVES RECEIVING MORE THAN THEY ARE ACTUALLY PAID FROM THE DEFERRED COMPENSATION PLANS. COLUMN F IS INTENDED TO RECONCILE THIS DUPLICATION (BY REPORTING AMOUNTS INCLUDED IN COLUMN B(III) THAT HAD BEEN REPORTED AS DEFERRED COMPENSATION ON A SCHEDULE J FOR A PREVIOUS YEAR). HOWEVER, THE SIGNIFICANCE OF THE AMOUNTS LISTED IN COLUMN F IS OFTEN OVERLOOKED AND GIVEN THE COMPLEXITY OF THE SCHEDULE J REPORTING REQUIREMENTS, THE AMOUNTS SHOWN ARE EASILY MISUNDERSTOOD. TO DETERMINE TOTAL AMOUNT EARNED (RATHER THAN THE AMOUNT VESTED/PAID OUT) DURING THE YEAR, SUBTRACT THE AMOUNT IN COLUMN F FROM COLUMN E. PART I, LINE 7 THE AT-RISK COMPENSATION (ARC) PLAN WAS ESTABLISHED TO ENABLE SCL HEALTH TO ATTRACT AND ENGAGE QUALIFIED LEADERS AND TO PROVIDE SUCH LEADERS WITH AN ADDITIONAL PERFORMANCE COMPENSATION OPPORTUNITY TO PROMOTE AND FURTHER ITS CHARITABLE MISSION AND STRATEGIC IMPERATIVES. THE PLAN OPERATES ON A CALENDAR-YEAR BASIS AND AWARD OPPORTUNITIES ARE A PERCENTAGE OF LEADERS' BASE PAY AS DETERMINED BY THEIR MANAGEMENT LEVEL AT SCL HEALTH. ACTUAL AWARDS WILL BE PAID OUT BASED ON ATTAINMENT OF SELECTED SCL HEALTH BOARD-APPROVED GOALS, INCLUDING OPERATING INCOME, STEWARDSHIP, PATIENT AND ASSOCIATE SAFETY AND PATIENT EXPERIENCE AND TARGETS AND FULFILLMENT OF OUR MISSION. AWARDS ARE BASED ON THE BOARD'S DETERMINATION ON HOW WELL THE HEALTH CARE SYSTEM PERFORMS RELATIVE TO THE PLAN'S STATED PERFORMANCE STANDARDS AND THE WEIGHT GIVEN TO EACH OF THE PERFORMANCE MEASURES AS DEFINED FOR THAT PLAN YEAR. THE AT RISK COMPENSATION PLAN SHALL BE INTERPRETED, APPLIED AND ADMINISTERED AT ALL TIMES IN ACCORDANCE WITH CODE SECTION 409A AND GUIDANCE ISSUED THEREUNDER. THE HEALTH CARE SYSTEM RESERVES THE RIGHT TO AMEND OR TERMINATE THIS PLAN AT ANY TIME FOR ANY REASON. ADDITIONAL OFFICER AND BOARD DISCLOSURES THE SISTERS OF CHARITY OF LEAVENWORTH HEALTH SYSTEM, INC. (SCL HEALTH) AND RELATED TAX EXEMPT ORGANIZATIONS CONSISTS OF EIGHT HOSPITALS, NINE FOUNDATIONS, TWO SAFETY-NET CLINICS, ONE CHILDREN'S MENTAL HEALTH CENTER, HOME HEALTH AND MORE THAN 200 PHYSICIAN CLINICS IN THREE STATES - COLORADO, KANSAS AND MONTANA. THE HEALTH SYSTEM INCLUDES MORE THAN 15,900 FULL-TIME ASSOCIATES AND MORE THAN 800 EMPLOYED PROVIDERS. SCL HEALTH AND RELATED TAX EXEMPT ORGANIZATIONS ADHERE TO GOVERNANCE EXCELLENCE STANDARDS INCLUDING TRANSPARENCY AND ACCOUNTABILITY. IN KEEPING WITH SCL HEALTH'S CORE VALUE OF STEWARDSHIP, SCL HEALTH'S BOARD COMPENSATION COMMITTEE (COMMITTEE) HAS RETAINED THE SERVICES OF AN INDEPENDENT COMPENSATION ADVISOR. THE COMPENSATION ADVISOR IS RESPONSIBLE FOR ADVISING THE COMMITTEE ON ALL MATTERS RELATING TO EXECUTIVE COMPENSATION INCLUDING SUPPORTING THE COMMITTEE'S EFFORTS TO ENSURE THAT THE LEVEL OF COMPENSATION PROVIDED OFFICERS AND SENIOR MANAGEMENT IS REASONABLE, APPROPRIATE AND CONSISTENT WITH THE PAY PHILOSOPHY SET BY THE BOARD. THE SISTERS WHO SERVE AS OFFICERS AND/OR BOARD MEMBERS ARE MEMBERS OF THE SISTERS OF CHARITY OF LEAVENWORTH (A RELIGIOUS ORDER OF WOMEN). THE SISTERS HAVE TAKEN VOWS OF POVERTY AND RECEIVE NO COMPENSATION, EXPENSE ACCOUNT ALLOWANCE, OR CONTRIBUTIONS TO BENEFIT PLANS FOR THEIR SERVICES TO THE HEALTH CARE SYSTEM. HOWEVER, A PAYMENT IS MADE DIRECTLY TO THE SISTERS OF CHARITY OF LEAVENWORTH FOR THE SERVICES OF THOSE WHO PERFORM PROFESSIONAL, ADMINISTRATIVE, AND OTHER SUCH SERVICES. GREGORY BUSH SEE PART V 23687 EMPLOYMENT 0 SCH L, PART IV, BUSINESS TRANSACTIONS INVOLVING INTERESTED PERSONS: MICHAEL BUSH (KEY EMPLOYEE), IS THE FATHER OF GREGORY BUSH, AN EMPLOYEE OF ST. VINCENT HEALTHCARE FORM 990, LINE J WEBSITE: HTTPS://WWW.SCLHEALTH.ORG/LOCATIONS/ST-VINCENT-HEALTHCARE/ FORM 990, PART VI, SECTION A, LINE 6 SISTERS OF CHARITY OF LEAVENWORTH HEALTH SYSTEM, INC. (SCLHS) IS THE SOLE MEMBER OF ST. VINCENT HEALTHCARE. FORM 990, PART VI, SECTION A, LINE 7A SISTERS OF CHARITY OF LEAVENWORTH HEALTH SYSTEM, INC., THE SOLE MEMBER OF ST. VINCENT HEALTHCARE, APPROVES MEMBERS OF ST. VINCENT HEALTHCARE BOARD OF DIRECTORS. FORM 990, PART VI, SECTION A, LINE 7B SISTERS OF CHARITY OF LEAVENWORTH HEALTH SYSTEM, INC. (SCLHS) HAS CERTAIN RESERVE POWERS TO APPROVE CHANGES TO THE ARTICLES OF INCORPORATION AND THE BYLAWS INCLUDING THE APPOINTMENT OR REMOVAL OF BOARD MEMBERS AND THE PRESIDENT/CEO. SCLHS ALSO HAS CERTAIN RESERVE POWERS OVER ANY CHANGE IN OWNERSHIP OF THE CORPORATION, CHANGE IN MISSION, ACQUISITION OF ASSETS, DISPOSAL OF ASSETS, LEASING OF ASSETS, INCURRENCE OF DEBT, MERGER OR DISSOLUTION, APPROVAL OF STRATEGIC PLANS AND BUDGETS, APPOINTMENT OF AUDITORS AND OVERSIGHT AND APPROVAL OF COMPENSATION AND BENEFITS FOR DIRECTORS, OFFICERS, KEY EMPLOYEES AND PHYSICIANS. FORM 990, PART VI, SECTION B, LINE 11B THE FORM 990 IS PREPARED BY THE TAX DEPARTMENT OF THE PARENT ORGANIZATION, SISTERS OF CHARITY OF LEAVENWORTH HEALTH SYSTEM, INC. (SCLHS). THE FORM 990 IS REVIEWED BY CERTAIN MEMBERS OF SENIOR MANAGEMENT. A COPY OF THE FORM 990 IS PROVIDED TO THE BOARD OF DIRECTORS PRIOR TO THE FILING OF THE FORM 990 WITH THE INTERNAL REVENUE SERVICE. ANY QUESTIONS ARE ADDRESSED TO THE TAX DIRECTOR OF SCLHS PRIOR TO FILING THE FORM 990 WITH THE INTERNAL REVENUE SERVICE. FORM 990, PART VI, SECTION B, LINE 12C MONITORING AND ENFORCEMENT OF COMPLIANCE WITH CONFLICT OF INTEREST POLICY ST. VINCENT HEALTHCARE AND THE PARENT ORGANIZATION, SISTERS OF CHARITY OF LEAVENWORTH HEALTH SYSTEM, INC. (COLLECTIVELY REFERRED TO AS SCL HEALTH), REGULARLY AND CONSISTENTLY MONITORS AND ENFORCES ITS CONFLICT OF INTEREST POLICY BY PROVIDING EDUCATION AND TRAINING FOR ITS EMPLOYEES, STAFF, OFFICERS AND DIRECTORS. PERSONS CONSIDERED TO BE IN AN INFLUENTIAL POSITION, SUCH AS BOARD MEMBERS, OFFICERS, PHYSICIANS, EXECUTIVES AND DIRECTOR LEVEL MANAGERS ARE ALL REQUIRED TO COMPLETE A CONFLICT OF INTEREST STATEMENT UPON HIRE/APPOINTMENT AND ON AN ANNUAL BASIS TO DISCLOSE ANY POTENTIAL CONFLICT ISSUES. THESE STATEMENTS ARE CAREFULLY REVIEWED BY THE SCL HEALTH INTEGRITY AND COMPLIANCE DEPARTMENT AND APPROPRIATE LEADERSHIP. A REPORT IS PROVIDED TO SCL HEALTH'S PRESIDENT/CEO AND THE BOARD OF DIRECTORS. THE BUSINESS AND AFFAIRS OF SCL HEALTH WILL AT ALL TIMES BE CONDUCTED IN A MANNER THAT IS SOLELY IN THE BEST INTERESTS OF SCL HEALTH AND NOT BE INFLUENCED BY CONFLICTING INTERESTS OF PERSONS RESPONSIBLE FOR ADMINISTERING THOSE AFFAIRS. THE EXISTENCE OF ANY CONFLICTS OF INTEREST WILL BE DISCLOSED AND THE PROCEDURES SET FORTH HEREIN WILL BE FOLLOWED. CERTAIN TRANSACTIONS DETERMINED TO CONSTITUTE A CONFLICT OF INTEREST ARE PROHIBITED. ANY PERSON IN A POSITION TO EXERCISE SUBSTANTIAL INFLUENCE OVER SCL HEALTH IS CONSIDERED AN INTERESTED PERSON. THIS TERM INCLUDES, BUT IS NOT LIMITED TO THE FOLLOWING: - BOARD MEMBERS, BOARD COMMITTEE MEMBERS, OFFICERS AND DIRECTORS; - SENIOR LEADERS AND EXECUTIVES (CEO, PRESIDENT, SVP, VP, EXECUTIVE DIRECTORS); - EMPLOYED PHYSICIANS AND PHYSICIANS IN MEDICAL STAFF LEADERSHIP ROLES (E.G., DEPARTMENT CHAIRS, MEMBERS OF MEDICAL STAFF COMMITTEES); - MEDICAL DIRECTORS OF CLINICAL PROGRAMS THAT ASSESS, REVIEW, RECOMMEND OR REQUEST PURCHASE OF ANY SPECIFIC PHARMACEUTICAL PRODUCTS, MEDICAL DEVICES, SUPPLIES AND/OR EQUIPMENT; - DEPARTMENT DIRECTORS; AND - OTHER SELECT INDIVIDUALS IDENTIFIED BY LEADERSHIP WHICH MAY INCLUDE, BUT IS NOT LIMITED TO, SUPPLY CHAIN AND FINANCE. UPON BECOMING AN INTERESTED PERSON AND ON AN ANNUAL BASIS, INTERESTED PERSONS ARE REQUIRED TO DISCLOSE ANY RELATIONSHIPS THAT CONSTITUTE OR MIGHT LEAD TO A CONFLICT OF INTEREST BY COMPLETING THE CURRENT CONFLICT OF INTEREST AND GIFT DISCLOSURE STATEMENT ("STATEMENT") AS APPROVED BY THE CHIEF INTEGRITY AND COMPLIANCE OFFICER. THE CHIEF INTEGRITY AND COMPLIANCE OFFICER WILL OVERSEE THE REVIEW OF THE STATEMENTS AND THE RESOLUTION OF ANY IDENTIFIED CONFLICTS OF INTEREST AND ALERT THE SCL HEALTH CEO AND/OR THE CHAIR OF THE SCL HEALTH BOARD OF DIRECTORS TO ANY ITEMS OF CONCERN. WHEN AN INTERESTED PERSON BECOMES AWARE OF A CONFLICT OF INTEREST WHICH HAS NOT BEEN DISCLOSED ON A STATEMENT, HE OR SHE SHALL CONTACT THE LOCAL COMPLIANCE AND PRIVACY OFFICER OR THE CHIEF INTEGRITY AND COMPLIANCE OFFICER, OBTAIN A STATEMENT FORM, COMPLETE AND RETURN IT TO THE SCL HEALTH INTEGRITY AND COMPLIANCE DEPARTMENT. WHENEVER AN INTERESTED PERSON BECOMES AWARE THAT AN ARRANGEMENT WITH RESPECT TO WHICH HE OR SHE HAS A CONFLICT OF INTEREST IS BEING CONSIDERED, THE INTERESTED PERSON MUST DISCLOSE ALL MATERIAL FACTS CONCERNING THE EXISTENCE AND NATURE OF THE CONFLICT OF INTEREST TO HIS OR HER SUPERVISOR (IF AN EMPLOYEE OTHER THAN THE ORGANIZATIONS SCL HEALTH CEO) OR TO THE APPLICABLE BOARD OR COMMITTEE CHAIR (IF THE SCL HEALTH CEO OR A BOARD OR COMMITTEE MEMBER), EVEN IF THE CONFLICT OF INTEREST HAS BEEN PREVIOUSLY DISCLOSED. WITH REGARD TO EMPLOYEES OTHER THAN THE SCL HEALTH CEO, THE INTERESTED PERSON'S SUPERVISOR WILL DETERMINE WHETHER A CONFLICT OF INTEREST EXISTS. WITH REGARD TO THE SCL HEALTH CEO AND BOARD OR COMMITTEE MEMBERS, THE REMAINING MEMBERS OF THE BOARD OR COMMITTEE WILL DETERMINE WHETHER A CONFLICT OF INTEREST EXISTS. PERSON(S) RESPONSIBLE FOR THE DETERMINATION SHOULD OBTAIN FURTHER GUIDANCE FROM THE SCL HEALTH INTEGRITY AND COMPLIANCE OR LEGAL DEPARTMENTS. UPON MAKING HIS OR HER DISCLOSURE, THE INTERESTED PERSON WILL LEAVE THE MEETING OR OTHERWISE REMOVE HIM OR HERSELF FROM THE DELIBERATIONS OR OTHER DECISION-MAKING PROCESS UNTIL SUCH TIME AS A DETERMINATION IS REACHED. IF A DETERMINATION HAS BEEN MADE THAT NO CONFLICT OF INTEREST EXISTS, THE INTERESTED PERSON MAY BE PRESENT AND PARTICIPATE IN THE DELIBERATION REGARDING THE TRANSACTION OR ARRANGEMENT. HOWEVER, IF AN INTERESTED PERSON HAS BEEN DETERMINED TO HAVE A CONFLICT OF INTEREST, HE OR SHE MAY NOT PARTICIPATE IN THE DELIBERATION OR DECISION REGARDING THE TRANSACTION OR ARRANGEMENT; BE PRESENT DURING THE DELIBERATION OR DECISION-MAKING; OR BE ALLOWED TO MAKE A PRESENTATION PRIOR TO THE DELIBERATION AND DECISION-MAKING ACTIVITIES. WHEN AN INTERESTED PERSON HAS A CONFLICT OF INTEREST, THE DECISION-MAKER/DECISION-MAKING BODY CONSIDERING THE TRANSACTION OR ARRANGEMENT WILL TAKE REASONABLE MEASURES, PRIOR TO APPROVING OR ENTERING INTO THE TRANSACTION OR ARRANGEMENT, TO ENSURE THAT THE PROPOSAL IS IN SCL HEALTH'S BEST INTERESTS. THE PROPOSED TRANSACTION OR ARRANGEMENT MAY PROCEED IF THE DECISION-MAKER/DECISION-MAKING BODY, AFTER HAVING BEEN FULLY INFORMED OF THE MATERIAL FACTS ESTABLISHING THE CONFLICT OF INTEREST, DETERMINES THAT THE TRANSACTION OR ARRANGEMENT IS IN SCL HEALTH'S BEST INTERESTS AND IS FAIR AND REASONABLE. A MAJORITY VOTE OF THE DISINTERESTED DECISION-MAKERS IS REQUIRED WHEN A DETERMINATION IS MADE BY A BOARD, COMMITTEE OR OTHER DECISION-MAKING BODY. MANAGEMENT OF POTENTIAL CONFLICTS IS DONE BY THE CHIEF INTEGRITY AND COMPLIANCE OFFICER AND/OR CARE SITE COMPLIANCE AND PRIVACY OFFICERS AND REPORTED ANNUALLY TO THE CARE SITE LEADERSHIP COMMITTEES AND/OR SYSTEM INTEGRITY AND COMPLIANCE COMMITTEE AND TO THE AUDIT COMMITTEE, ORGANIZATIONAL INTEGRITY AND COMPLIANCE COMMITTEE OF THE SCL HEALTH BOARD OF DIRECTORS. ANY REPORTED CONFLICTS OR POTENTIAL CONFLICTS WILL ALSO BE REPORTED TO AND REVIEWED BY THE SCL HEALTH TAX DIRECTOR FOR COMPLIANCE WITH THE FORM 990 TAX RETURN. FORM 990, PART VI, SECTION B, LINE 15 THE ORGANIZATION'S OFFICERS AND SENIOR MANAGEMENT ARE PAID BY A RELATED ORGANIZATION, SISTERS OF CHARITY OF LEAVENWORTH HEALTH SYSTEM, INC. (SCL HEALTH). COMPENSATION FOR THE OFFICERS AND SENIOR MANAGEMENT IS MANAGED BY THE SCL HEALTH BOARD COMPENSATION COMMITTEE (COMMITTEE) ON BEHALF OF SCL HEALTH AND ALL OF ITS AFFILIATES. THE COMMITTEE REVIEWS AND APPROVES COMPENSATION ARRANGEMENTS OF THE OFFICERS AND SENIOR MANAGEMENT AND MAKES RECOMMENDATIONS TO SCL HEALTH'S BOARD FOR APPROVAL OF ANY CHANGES TO COMPENSATION FOR THE OFFICERS AND SENIOR MANAGEMENT. THE COMMITTEE'S REVIEW IS CONDUCTED IN A MANNER THAT IS INTENDED TO QUALIFY FOR THE REBUTTABLE PRESUMPTION OF REASONABLENESS UNDER THE INTERMEDIATE SANCTIONS RULES OF INTERNAL REVENUE CODE SECTION 4958. THE COMMITTEE CONDUCTS THE REVIEW WITH THE ASSISTANCE OF AN EXPERIENCED AND INDEPENDENT COMPENSATION CONSULTING FIRM THAT HAS DEEP NATIONAL EXPERTISE IN HEALTH SYSTEMS' EXECUTIVE COMPENSATION PROGRAMS AND LEVELS. THE COMMITTEE OBTAINS AND RELIES UPON CURRENT, COMPARABLE MARKET DATA FOR PEER ORGANIZATIONS PRIOR TO MAKING COMPENSATION RELATED DECISIONS. THE INFORMATION REVIEWED INCLUDES COMPENSATION LEVELS PAID BY SIMILARLY SITUATED ORGANIZATIONS FOR FUNCTIONALLY COMPARABLE POSITIONS, THE AVAILABILITY OF SIMILAR SERVICES IN THE GEOGRAPHIC AREA SERVED BY SCL HEALTH AND CURRENT COMPENSATION SURVEYS COMPILED BY AN INDEPENDENT FIRM. CONSISTENT WITH THE PAY PHILOSOPHY SET BY SCL HEALTH'S BOARD, THE COMMITTEE EMPHASIZES THE IMPORTANCE OF ENSURING TOTAL REMUNERATION IS REASONABLE AND APPROPRIATE WHEN REVIEWING AND MAKING RECOMMENDATIONS WITH RESPECT TO COMPENSATION PACKAGES FOR THE OFFICERS AND SENIOR MANAGEMENT. AS PART OF THE REVIEW PROCESS, SCL HEALTH USES THE FOLLOWING IN ESTABLISHING THE COMPENSATION OF OFFICERS AND SENIOR MANAGEMENT. 1) COMPENSATION COMMITTEE 2) INDEPENDENT COMPENSATION CONSULTANT 3) FORM 990 OF OTHER ORGANIZATIONS 4) WRITTEN EMPLOYMENT CONTRACTS 5) COMPENSATION SURVEYS AND STUDIES 6) APPROVAL BY THE BOARD OR COMPENSATION COMMITTEE THE ITEMS LISTED ABOVE SUPPORT THE COMPENSATION COMMITTEE'S EFFORTS TO ENSURE THAT THE LEVEL OF COMPENSATION PROVIDED TO ITS OFFICERS AND SENIOR MANAGEMENT IS REASONABLE, APPROPRIATE AND CONSISTENT WITH THE PAY PHILOSOPHY SET BY THE BOARD. FORM 990, PART VI, SECTION C, LINE 19 THE ORGANIZATION MAKES ITS CONFLICT OF INTEREST POLICY, FINANCIAL STATEMENTS, AND GOVERNING DOCUMENTS AVAILABLE UPON REQUEST. FORM 990, PART IX, LINE 11G PROFESSIONAL MEDICAL SERVICES: PROGRAM SERVICE EXPENSES 39,037,230. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 39,037,230. PHYSICIAN MANAGEMENT SERVICES: PROGRAM SERVICE EXPENSES 23,670,372. MANAGEMENT AND GENERAL EXPENSES 705,502. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 24,375,874. OUTSIDE LABORATORY FEES: PROGRAM SERVICE EXPENSES 3,442,586. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 3,442,586. PROFESSIONAL CONSULTING SERVICES: PROGRAM SERVICE EXPENSES 97,380. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 97,380. FORM 990, PART XI, LINE 9: EQUITY TRANSFER-TRANSFER OF LAND DONATED TO ST. VINCENT FOUNDATION 460,633. 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