2019-11-14T16:25:48-06:00 2018-12-31 PricewaterhouseCoopers LLP 2001 MARKET ST SUITE 1800 PHILADELPHIA PA 19103 990 2018-01-01 473825106 FRANCISCAN HEALTH RENSSELAER INC % JASON GEDDES FRAN 2198665141 1104 E GRACE ST RENSSELAER IN 47978 SISTER LETHIA MARIE LEVEILLE SECRETARY 5742563935 2019-11-11 true ERIC M MCNEIL P00460263 2673303000 167.68.125.77 23522320193185000103 2019-11-14 P 7C276736B1F8534619D83B6F2AADECD8007A5E58 7C276736B1F8534619D83B6F2AADECD8007A5E58 2018 2020-03-31 21:24:44Z KEVIN D LEAHY 1515 DRAGOON TRAIL MISHAWAKA IN 46544 29112616 false 0928 X WWWW.FRANCISCANALLIANCE.ORG X 2015 IN SEE SCHEDULE O 5 4 246 22 2532 -6867 101487 114254 31417153 28181587 0 -478527 335900 71238 31854540 27888552 0 0 0 0 16309712 17602250 0 0 0 23356034 17867425 39665746 35469675 -7811206 -7581123 29373235 27038944 41356169 48871199 -11982934 -21832255 X 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 false false 24205882 0 28198984 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. 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X X X true true X X X true X SEE SECTION C X SEE SECTION C X SEE SECTION C X X X X X true X false X X X X true X false false 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 A STATEWIDE FOCUS GROUP WAS HELD TO DISCUSS REGIONAL ISSUES WITH STATE PUBLIC HEALTH LEADERS. THE FOCUS GROUP WAS CO-SPONSORED BY INDIANA UNIVERSITY HEALTH, ST. VINCENT HEALTH, AND COMMUNITY HEALTH NETWORK. ATTENDEES INCLUDED: - HEALTH BY DESIGN/ALLIANCE FOR HEALTH PROMOTION - KIM IRWIN, EXECUTIVE DIRECTOR - HEALTH OCCUPATION STUDENT ASSOCIATION (INDIANA) - EDDIE ERICKSON, STATE COORDINATOR; HOLLI FRODGE, STATE PRESIDENT - HOOSIER ENVIRONMENTAL COUNCIL - INDRA FRANK, ENVIRONMENTAL HEALTH PROJECT DIRECTOR - INDIANA AREA HEALTH EDUCATION CENTERS - DR. JENNIFER TAYLOR, DIRECTOR OF EVALUATION - INDIANA ASSOCIATION OF AREA AGENCIES ON AGING - KRISTEN LAEACE, CEO; DAWNE LYON; AND ELVA JAMES, EXECUTIVE DIRECTOR, AREA 4 AGENCY OF AGING - LEADING AGE INDIANA - JIM LEICH, EXECUTIVE DIRECTOR; KATHY JOHNSON, DIRECTOR OF TRAINING - INDIANA CARDIOVASCULAR AND DIABETES COALITION - SHARA WESLEY, COALITION MANAGER; JENNIFER PFERRER, CHAIRPERSON - INDIANA COALITION AGAINST DOMESTIC VIOLENCE - COLLEEN YEAKLE, COORDINATOR OF PREVENTION INITIATIVES - INDIANA CANCER CONSORTIUM - KEYLEE WRIGHT, CANCER CONTROL SECTION DIRECTOR - INDIANA JOINT ASTHMA COALITION - KELLI MCCRARY, COALITION COORDINATOR - IU HEALTH - JOYCE HERTKO - INDIANA HEALTHY WEIGHT INITIATIVE - ERIC BEERS, COALITION COORDINATOR - INDIANA HOSPITAL ASSOCIATION - BERNIE ULRICH, VICE PRESIDENT - INDIANA IMMUNIZATION COALITION - LISA ROBERSON, DIRECTOR - INDIANA MINORITY HEALTH COALITION - ANITA OHMIT, DIRECTOR OF RESEARCH; CALVIN ROBERSON, VP OF PLANNING AND PROGRAM DEVELOPMENT - INDIANA NURSES ASSOCIATION - BLAYNE MILEY, DIRECTOR OF POLICY AND ADVOCACY - INDIANA PSYCHOLOGICAL ASSOCIATION - DR. KATHLEEN VOGLER, PAST PRESIDENT; TABITHA ARNETTE, EXECUTIVE DIRECTOR - INDIANA PRIMARY HEALTH CARE ASSOCIATION - PHIL MORPHEW, CEO; ELAINE WILLIAMS, RESOURCE DEVELOPMENT PROGRAM DIRECTOR - INDIANA SCHOOL NURSES ASSOCIATION - CAROLYN SNYDER, EXECUTIVE DIRECTOR - INDIANA STATE DEPARTMENT OF HEALTH - DR. JOAN DUWVE, CHIEF MEDICAL OFFICER; KATELIN RYAN, DIRECTOR OF PROGRAM EVALUATION; J. DAVID HOPPER, DIRECTOR, LOCAL HEALTH DEPARTMENT OUTREACH DIVISION - INDIANA SOCIETY FOR PUBLIC HEALTH EDUCATION - HEIDI HANCHER-RAUCH, ADVOCACY CHAIR; JENNIFER CONNER, PRESIDENT - IUPUI FAIRBANKS SCHOOL OF PUBLIC HEALTH - SULA HOOD; CYNTHIA STONE - IUPUI POLIS CENTER - KAREN COMER - YMCA OF GREATER INDIANA - CHELSY WINTERS, ASSOCIATE DIRECTOR OF HEALTH PARTNERSHIPS PROGRAMS; ANN GRAVES, DIRECTOR OF HEALTH INITIATIVES AND PARTNERSHIPS IN ADDITION, LOCAL PUBLIC HEALTH AND SOCIAL SERVICE LEADERS WERE CONSULTED ON THE COMMUNITY HEALTH ISSUES, PRIORITIZATION OF NEEDS, AND COMMUNITY STRENGTHS. COMMUNITY HEALTH NEEDS ASSESSMENT ATTENDEE LIST STEVE WOOD - MAYOR, CITY OF RENSSELAER KENDELL CULP - PRESIDENT, JASPER COUNTY COMMISSIONERS REIN BONTRAGER - MEMBER, JASPER COUNTY COUNCIL JOHN POTTER - JUDGE, JASPER COUNTY CIRCUIT COURT JAMES WAKEFIELD - PHYSICIAN, CHRISTIAN CLINIC NANCY BAILEY - NURSE, JASPER COUNTY HEALTH DEPARTMENT DOUG GUTWELN - REPRESENTATIVE, INDIANA GENERAL ASSEMBLY HARLEY HOUGTON - DENTIST KEVIN DEFRIES - CHIROPRACTOR CATHY TICEN - WABASH VALLEY HOSPITAL OUTPATIENT SERVICES WANDA GIFFORD - NURSE PRACTITIONER, WHEATFIELD HEALTH CENTRE CATHY LARSON - NURSE PRACTITIONER, BROCK HEALTH CENTRE SCOTT JAMES - ADMINISTRATOR, GEORGE ADE MEMORIAL HEALTH CENTER KEVIN KELLY - JASPER COUNTY ECONOMIC DEVELOPMENT OFFICE SHEILA SCHROEDER - JASPER COUNTY ECONOMIC DEVELOPMENT OFFICE KEN DOBIN - PLANT MANAGER, CON AGRA FOODS PAUL LADD - SEALY COMPONENT GROUP CRAIG WAGNER - STARK TRUSS COMPANY CHAR SHAW - FBI BUILDINGS INC. NED SPEICHER - SUPERINTENDENT, RENSSELAER CENTRAL SCHOOL CORPORATION AARON CASE - SUPERINTENDENT, KANKAKEE VALLEY SCHOOL CORPORATION ED HABROWSKI - ASST. SUPERINTENDENT, RENSSELAER CENTRAL SCHOOL CORPORATION KIM LOBSIGER - PRINCIPAL, KANKAKEE VALLEY HIGH SCHOOL ROBERT PASTOOR - PRESIDENT, SAINT JOSEPH'S COLLEGE WALT STANLEY - HOSPITAL BOARD OF TRUSTEES PATTY KERN - COOPERATIVE SCHOOL SERVICES DAVID VANDERLUGT - PHYSICIAN, DEMOTTE PHYSICIANS CHRISTINE HASEKELL - PROSECUTOR, JASPER COUNTY PROSECUTORS OFFICE GERRY WHITE - OFFICE OF COMMUNITY AND RURAL AFFAIRS SANDRA BEHRENS - NORTHWEST INDIANA AHEC JOHN MAGEE - AREA SPECIALIST, USDA RURAL DEVELOPMENT PAM HABROWSKI - PHARMACIST JODY MELTON - COMMUNITY MEMBER BILL HOLLERMAN - MEMBER, RENSSELAER CITY COUNCIL TIM SCHREEG - PRESIDENT/CEO, FRANCISCAN HEALTH RENSSELAER, INC. DEB ELLIS - ALTERNACARE DIRECTOR, FRANCISCAN HEALTH RENSSELAER, INC. STACIE KLINGER, VP PATIENT SERVICES, FRANCISCAN HEALTH RENSSELAER, INC. JEFF WEBB, VP FINANCIAL SERVICES, FRANCISCAN HEALTH RENSSELAER, INC. KAREN RIENTS, DIRECTOR - HOME HEALTH CARE AND HOSPICE LISA DECKER - VICE PRESIDENT, FRANCISCAN HEALTH LAFAYETTE JASON MIDDLETON - DIRECTOR, FRANCISCAN HEALTH - LAFAYETTE, CRAWFORDSVILLE, AND RENSSELAER JENNIFER HELTON - BELSTRA MILLING COMPANY PAT WILLIAMSON - CHIEF DEPUTY, JASPER COUNTY SHERIFF'S OFFICE JASON EASTLAND - DIRECTOR, RENSSELAER CARE CENTER CHERYL SPROWL - RENSSELAER CARE CENTER LINES 6A AND 6B ALL FRANCISCAN HEALTH FACILITIES COLLABORATED IN A STATEWIDE PARTNERSHIP WITH ST. VINCENT HEALTH, INDIANA UNIVERSITY HEALTH, COMMUNITY HEALTH NETWORK, INDIANA UNIVERSITY RICHARD M. FAIRBANKS SCHOOL OF PUBLIC HEALTH AT INDIANAPOLIS, 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 FRANCISCAN HEALTH PARTNERED WITH MULTIPLE COMMUNITY PARTNERSHIPS AND ADDITIONAL HEALTH SYSTEMS TO COMPLETE THIS ASSESSMENT. THESE ARE THE LARGEST HEALTH SYSTEMS IN INDIANA AND THE PARTNERSHIP ALLOWED FOR BETTER DATA COLLECTION, REDUCED BURDEN ON RESIDENTS TO COMPLETE SURVEYS, AND A PLATFORM TO COMBINE EFFORTS ON VARIOUS COMMUNITY HEALTH NEEDS THROUGHOUT THE STATE. READERS WILL FIND THAT CHNAS FROM THESE SYSTEMS ARE ALIGNED, THOUGH EACH MAY HAVE PARTICULAR AREAS OF EMPHASIS DEPENDING ON SPECIFIC POPULATION SERVED AND GEOGRAPHIC LOCATION OF HOSPITALS. BECAUSE INDIANA OPERATES AS A HOME RULE STATE, EACH COUNTY HAS A DIFFERENT PUBLIC HEALTH INFRASTRUCTURE AND RESOURCES IN ADDITION TO THE VARIATIONS BASED ON URBAN/RURAL STATUS, POPULATION, AND ECONOMIC MIX. DATA ON ZIP CODE OR CENSUS TRACK IS HIGHLY LACKING; THEREFORE THE DESIGN WAS BUILT ON A COUNTY BASIS. ELEVEN COUNTIES OF 28 INCLUDED IN THE ASSESSMENT ARE HOME TO MORE THAN ONE OF THE HEALTHY SYSTEMS IN THE COLLABORATIVE. IN THESE COUNTIES, A COUNTY 'CAPTAIN' WAS ELECTED TO COORDINATE THE CHNA PROCESS ON BEHALF OF THE PARTNERSHIP. IN THE REMAINING COUNTIES WHERE ONLY ONE HEALTH SYSTEM WAS REPRESENTED, THE HEALTH SYSTEM IN THE COUNTY USED THE COLLABORATIVE MATERIALS AND RESOURCES, BUT COMPLETED THE WORK INDEPENDENTLY. THE MOBILIZING FOR ACTION THROUGH PLANNING AND PARTNERSHIP (MAPP) MODEL, DEVELOPED BY THE NATIONAL ASSOCIATION OF COUNTY AND CITY HEALTH OFFICIALS (NACCHO), GUIDED THE ASSESSMENT PROCESS IN HENDRICKS AND MORGAN COUNTIES, AS BOTH COUNTY HEALTH DEPARTMENTS ARE WORKING ON ACCREDITATION THROUGH THE PUBLIC HEALTH ACCREDITATION BOARD (PHAB). THE MAPP MODEL INCLUDES SEVERAL COMPONENTS FOR COMMUNITY ASSESSMENT. FRANCISCAN PARTICIPATED IN ALL OF THE ASSESSMENT ACTIVITIES THAT WERE IN PROCESS DURING THE PERIOD OF THE HOSPITAL PARTNERSHIPS TIME FRAME. MARION COUNTY IS SEEKING ACCREDITATION, BUT HAD ALREADY COMPLETED THEIR COMMUNITY HEALTH ASSESSMENT PRIOR TO THE COLLABORATIVES TIME FRAME. INDIANA DOES NOT REQUIRE PHAB ACCREDITATION BY COUNTY HEALTH DEPARTMENTS AND A VAST MAJORITY OF HEALTH DEPARTMENTS ARE NOT SEEKING ACCREDITATION. IN REMAINING COUNTIES IDENTIFIED IN THIS ASSESSMENT, THE PRECEDE-PROCEDE METHOD WAS UTILIZED. THIS ASSESSMENT REFLECTS PHASES 1 THROUGH 5. COMMUNITY BENEFIT PROFESSIONALS FROM EACH SYSTEM WORKED TOGETHER ON DATA COLLECTED IN FOUR WAYS: 1. COMMUNITY HEALTH SURVEY: A CORE OF 20 MANDATORY QUESTIONS BASED ON PERCEPTION OF COMMUNITY AND PERSONAL NEEDS WAS CREATED. IN ADDITION, PROFESSIONALS ASSIGNED TO EACH COUNTY WORKED WITH ESTABLISHED COMMUNITY HEALTH COLLABORATIVES, LOCAL HOSPITALS, AND THE LOCAL HEALTH DEPARTMENT TO DEVELOP VOLUNTARY QUESTIONS SPECIFIC TO THE COUNTY. THIS RESULTED IN A SURVEY WITH 20 TO 29 QUESTIONS, DEPENDENT ON THE RESPONDENTS COUNTY OF RESIDENTS. 2. THE SURVEY WAS DISTRIBUTED ELECTRONICALLY AND ON PAPER. THE GOAL WAS TO ATTAIN A SAMPLE SIZE WITH A 95% CONFIDENCE LEVEL AND + OR 5% MARGIN OF ERROR. IN MOST COUNTIES, THE SAMPLE SIZE MET THIS GOAL; HOWEVER, PARTICULAR EMPHASIS ON VULNERABLE POPULATIONS MEANS THE SURVEY RESULTS ARE NOT A TRUE REPRESENTATION OF THE ENTIRE COUNTY POPULATION; BUT SKEWED TO REPRESENT THE MOST IN NEED. IN ADDITION TO THE QUANTITATIVE DATA, FREE TEXT RESPONSES WERE CODED AND CALCULATED TO PROVIDE FURTHER CLARIFICATION OF THE QUANTITATIVE DATA. 3. FOCUS GROUPS: BECAUSE FOCUS GROUPS ARE FACILITATED BASED ON THE CONVERSATION OF THE PARTICIPANTS, THE COLLABORATIVE DETERMINED OUTCOMES TO BE ACHIEVED DURING THE TWO-HOUR SESSIONS. MOST FOCUS GROUPS INCLUDED 15-60 COMMUNITY LEADERS FROM GOVERNMENTAL PUBLIC HEALTH, HEALTH CARE, SOCIAL SERVICE AGENCIES, RELATED NON-PROFITS, AND GRASSROOTS/NEIGHBORHOOD ORGANIZATIONS. IN LARGER FOCUS GROUPS, SUB-GROUPS WERE UTILIZED TO GIVE ALL PARTICIPANTS A VOICE. EACH FOCUS GROUP DETERMINED THE TOP FOUR TO SIX HEALTH NEEDS IN THE COMMUNITY; POTENTIAL RESOURCES OR PARTNERS; AND SOME ACTIONS/INTERVENTIONS THAT MIGHT WORK BEST. 4. SECONDARY DATA COLLECTION: WITH THE ASSISTANCE OF PUBLIC HEALTH UNDERGRADUATE AND GRADUATE STUDENTS, DATA ON HEALTH AND WELLNESS ISSUES WAS COLLECTED. SOURCES INCLUDE COUNTY HEALTH RANKINGS, CENSUS BUREAU DATA, VARIOUS REPORTS FROM THE INDIANA STATE DEPARTMENT OF HEALTH, AND OTHER NATIONAL REPORTS. INDIANA INDICATORS, COMMUNITY COMMONS, AND HEALTHY COMMUNITIES INSTITUTE DATA MANAGEMENT SYSTEMS ALSO CONTRIBUTED TO THE SECONDARY DATA USED. SOURCES OF THE SECONDARY DATA ARE IDENTIFIED THROUGHOUT THIS REPORT. IN ADVANCE OF THE FOCUS GROUPS, A FOCUS GROUP FOR STATE-WIDE ORGANIZATIONS WAS HELD. LEADERS FROM ORGANIZATIONS THAT SERVE THE ENTIRE STATE GATHERED TO DISCUSS TRENDS AND GROWING CONCERNS BY PREPAREDNESS DISTRICT AND BY AGE OF THE POPULATION. THE RESULTS WERE USED AS A PROBE IN THE REMAINING FOCUS GROUPS AND AS AREAS FOR FURTHER STUDY IN SECONDARY DATA. A FOCUS GROUP OF HIGH SCHOOL STUDENTS CONVENED BY THE INDIANA CHAPTER OF HEALTH OCCUPATION STUDENT ASSOCIATION DURING THEIR ANNUAL CONFERENCE ALSO OFFERED SOME INSIGHT, AS WE DID NOT PROMOTE THE SURVEY TO HIGH SCHOOL STUDENTS. THIS FOCUS GROUP YIELDED SOME INTERESTING INSIGHTS FROM THE TEEN PERSPECTIVE. IN DETERMINING COMMUNITY HEALTH INTERVENTIONS FOR THE SELECTED PRIORITY HEALTH NEEDS, HEALTH EQUITY, SUSTAINABILITY, AND CONSIDERATION OF THE SOCIAL DETERMINANTS OF HEALTH ARE KEY PRINICIPLES. WHILE MOST INTERVENTIONS FOCUS ON THE INDIVIDUAL LIFESTYLE FACTORS, KNOWLEDGE, SKILLS, AND BEHAVIORS, CONSIDERATION OF THE CULTURAL AND ENVIRONMENTAL CONTEXTS ARE JUST AS IMPORTANT. FRANCISCAN HEALTH 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 DETERMINANTS OF HEALTH. INTERVENTIONS IMPLEMENTED BY FRANCISCAN HEALTH ARE PERSON-CENTERED AND DESIGNED TO CREATE LASTING CHANGE. MALCOLM KNOWLES PRINCIPLES OF ANDRAGOGY PROVIDES THE FRAME WORK. 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 HEALTH USES EVIDENCE-BASED PRACTICES IN PLANNING INTERVENTIONS WHENEVER POSSIBLE, AS THESE PROGRAMS HAVE BEEN THOROUGHLY TESTED AND 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 KIRKPATRICKS MODEL 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 BEHAVIOR CHANGE, BIOMETRICS, POST-FOLLOW UP SURVEYS, AND OTHER METHODS WILL BE USED TO CAPTURE QUALITATIVE AND QUANTITATIVE DATA. THE HOSPITAL MADE THE FOLLOWING PROGRESS DURING 2018 IN ADDRESSING THE IDENTIFIED COMMUNITY HEALTH NEEDS FROM ITS MOST RECENT CHNA: - RECRUITMENT OF PRIMARY CARE PHYSICIANS - COMPLETED AS INDICATED - RECRUITMENT OF SPECIALISTS - COMPLETED AS INDICATED 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 2 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 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 nearly 86,000 people with an average household income close to $55,000 in 2018. For these communities, the percentage of residents below the federal poverty level was estimated at 10.7%. 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 4.8%. In comparison, the percentages of Medicaid and uninsured inpatients treated by Franciscan Health Rensselaer were 7.7% and 2.2% respectively in 2018. 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 (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 107,000 MEDICARE BENEFICIARIES AND APPROXIMATELY 82,000 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 DIR 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. UNCOLLECTIBLE PATIENT ACCOUNTS RECEIVABLE ARE WRITTEN OFF AGAINST THE ALLOWANCE FOR DOUBTFUL ACCOUNTS WITH ANY SUBSEQUENT RECOVERIES BEING RECORDED AGAINST THE PROVISION FOR DOUBTFUL ACCOUNTS. ----------------------------------------- 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 PATIENTS 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, 2018 AND 2017, THE CORPORATION INCURRED APPROXIMATELY $50.4 MILLION AND $34.6 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 false false false false false false false false false KEVIN D LEAHY PRESIDENT & DIRECTOR 0 1825836 0 0 0 108616 0 -17664 0 24996 0 1941784 0 0 TERRANCE WILSON FACILITY CEO/PRES OF HOSP DIV 0 797942 0 0 0 466707 0 -114277 0 29355 0 1179727 0 0 THOMAS GRYZBEK SR VP OF POST ACUTE SVCS DIV 0 627783 0 0 0 50884 0 -201975 0 21812 0 498504 0 0 DEBORAH M RILEY DIRECTOR PATIENT CARE SERVICES 128788 0 12097 0 25037 0 0 0 737 0 166659 0 0 0 SUSAN L HOOKER MANAGER PHARMACY SERVICES 102143 0 9548 0 22173 0 0 0 19162 0 153026 0 0 0 SCHEDULE J, PART I, LINE 3 FRANCISCAN HEALTH RENSSELAER, INC. DOES NOT COMPENSATE ITS PRESIDENT. SCHEDULE J, PART II, COLUMN (C) Deferred compensation reported in this column includes change in present value of the qualified defined benefit plan. Changes in the amount reflected between years is primarily a function of the fluctuation in the actuarial discount rate used to measure this future liability. 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 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, LINES 15A AND 15B FRANCISCAN HEALTH RENSSELAER, INC. DOES NOT COMPENSATE ITS OFFICERS OR KEY EMPLOYEES. FORM 990, PART XI, LINE 9 EQUITY TRANSFERS TO AFFILIATES $(2,320,579) OTHER CHANGES IN NET ASSETS 52,381 ------------------ TOTAL $(2,268,198) 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 FRANCISCAN SURGERY CENTER LLC 421 N EMERSON AVE BEECH GROVE IN 46107 352128334 MEDICAL SERVICES IN NA LAFAYETTE HEART PROGRAM HOLDINGS 1501 HARTFORD STREET LAFAYETTE IN 47904 383750811 MEDICAL SERVICES IN NA ST ANTHONY HEALTH NETWORK LLC PO BOX 310 MISHAWAKA IN 465460310 351985170 CLAIMS PROCESSING IN NA ST FRANCIS MOORESVILLE SURGERY CENTER 1215 HADLEY ROAD SUITE 100 MOORESVILLE IN 46158 202256900 MEDICAL SERVICES IN NA ST FRANCIS RADIATION THERAPY CENTERS 421 N EMERSON AVE BEECH GROVE IN 46107 770663631 MEDICAL SERVICES IN NA ST FRANCIS IMAGING CTR (GREENWOOD) 421 N EMERSON AVE GREENWOOD IN 46107 204607426 IMAGING SERVICES IN NA TONN AND BLANK CONST LLC 1623 GREENWOOD AVE MICHIGAN CITY IN 46360 263919039 CONSTRUCTION IN NA MAJOR HOSP CARDIAC DIAGNOSTICS LLC 2451 INTELLIPLEX DR SHELBYVILLE IL 46176 208715441 MEDICAL SERVICES IN NA FRANCISCAN HOLDING CORPORATION 1515 DRAGOON TRAIL MISHAWAKA IN 46544 363593505 HOLDING CO. IN NA C CORP ST JAMES PHO INC 30 E 11TH ST SUITE 402 CHICAGO HEIGHTS IL 60411 363945083 MANAGED CARE IL NA C CORP false false true false true false false false false false false false false false false false false false true