2019-05-13T12:05:58-05:00 2018-06-30 430352985 KERBER ECK & BRAECKEL LLP 3401 OFFICE PARK DRIVE MARION IL 62959 990 2017-07-01 237246265 SAINT FRANCIS MEDICAL CENTER SAIN 5733313000 211 SAINT FRANCIS DRIVE CAPE GIRARDEAU MO 63703 DAVID C PRATHER CHIEF FINANCIAL OFFICER 5733313000 2019-05-10 1 AMBER HALSTEAD P01343727 6189938724 2019-05-10 66.220.95.27 2019-05-10 13:55:32 CD P 8FBDAAF724FD1D6222B37EDFD135E9DD0FF3B3E7 2B596217D46A1DF02F7DFC32C28E45542AFB7B54 2017 2019-02-21 02:37:17Z MARYANN REESE 211 SAINT FRANCIS DRIVE CAPE GIRARDEAU MO 63703 560544665 0 X WWW.SFMC.NET X 1972 MO THE MISSION OF SAINT FRANCIS MEDICAL CENTER IS TO PROVIDE A MINISTRY OF HEALING, WELLNESS, QUALITY AND LOVE INSPIRED BY OUR FAITH IN JESUS CHRIST. 11 6 3180 122 14931390 -1812972 1367089 670999 463829625 506652740 17212251 27789243 3335027 3164170 485743992 538277152 0 0 0 0 220309077 231838028 0 0 0 240131788 241383256 460440865 473221284 25303127 65055868 906679879 940849901 268159789 235299841 638520090 705550060 X SAINT FRANCIS MEDICAL CENTER IS A 308-BED FACILITY SERVING MORE THAN 650,000 PEOPLE THROUGHOUT MISSOURI, ILLINOIS, KENTUCKY, TENNESSEE, AND ARKANSAS. THE MEDICAL CENTER PROVIDES COMPREHENSIVE INPATIENT ACUTE CARE SERVICES FOR MEDICAL AND SURGICAL PATIENTS SPECIALIZING IN ORTHOPEDICS, NEUROSURGERY, CARDIOVASCULAR SERVICES, ONCOLOGY, DISEASE MANAGEMENT, GASTROENTEROLOGY, MATERNAL-CHILD HEALTH AND NEUROLOGY. 0 0 473221284 516741178 SINCE ITS FOUNDING IN 1875, SAINT FRANCIS MEDICAL CENTER'S (SFMC) MISSION HAS BEEN TO PROVIDE HEALTH CARE SERVICES TO EVERYONE, REGARDLESS OF RACE, CREED, GENDER, NATIONAL ORIGIN, HANDICAP, AGE OR ABILITY TO PAY. ALTHOUGH REIMBURSEMENT FOR SERVICES RENDERED IS CRITICAL TO THE OPERATION AND STABILITY OF SFMC, IT IS RECOGNIZED THAT NOT ALL INDIVIDUALS POSSESS THE ABILITY TO PURCHASE ESSENTIAL MEDICAL SERVICES. IN FULFILLING OUR MISSION TO SERVE RESIDENTS OF CAPE GIRARDEAU AND THE SURROUNDING REGION, SFMC PROVIDES: -FREE AND/OR SUBSIDIZED CARE WHEN NEED AND/OR AN INDIVIDUAL'S INABILITY TO PAY COEXIST. THIS PAST YEAR, SFMC PROVIDED OVER $59.2 MILLION IN FREE AND/OR SUBSIDIZED CARE.-CARE FOR PERSONS COVERED BY GOVERNMENTAL PROGRAMS THAT REIMBURSE BELOW ACTUAL COST.-HEALTH SCREENINGS AND EDUCATIONAL PROGRAMS TO SUPPORT THE HEALTHCARE NEEDS OF THE COMMUNITY. SFMC PROVIDES A VARIETY OF WELLNESS PROGRAMS, COMMUNITY HEALTH EDUCATION ACTIVITIES, SPECIAL PROGRAMS FOR THE ELDERLY, HANDICAPPED, MEDICALLY UNDER-SERVED AND PARTICIPATES IN A VARIETY OF BROAD COMMUNITY SUPPORT ACTIVITIES. SFMC SERVED 11,391 INPATIENTS, 43,353 EMERGENCY PATIENTS AND 150,198 OUTPATIENTS DURING THE FISCAL YEAR (FY) ENDING JUNE 30, 2018. DURING FY 2018, SFMC HAD A TOTAL OF 53,807 PATIENT DAYS IN ITS MEDICAL/SURGICAL, CRITICAL CARE, OBSTETRIC, AND REHABILITATION CARE UNITS. SFMC PROVIDES CARE TO PERSONS COVERED BY GOVERNMENTAL PROGRAMS, FOR WHICH IT IS REIMBURSED BELOW COST. RECOGNIZING ITS MISSION IN THE COMMUNITY, SFMC PROVIDES SERVICES TO BOTH MEDICARE AND MEDICAID PATIENTS. THE UNREIMBURSED VALUE OF PROVIDING CARE TO THESE PATIENTS WAS IN EXCESS OF $91.9 MILLION IN FY 2018. CHARITY CARE IS PROVIDED IN THE FORM OF MANY REDUCED-PRICE AND FREE SERVICES OFFERED THROUGHOUT THE YEAR. SFMC STRONGLY BELIEVES THESE PROGRAMS AND SERVICES FILL A REAL NEED IN THE COMMUNITY. THESE PROGRAMS AND SERVICES INCLUDE THE FOLLOWING: -PARTICIPATION IN AND/OR SPONSORSHIP OF MANY COMMUNITY HEALTH FAIRS. THESE EVENTS RANGE FROM CHILDREN'S SPECIAL EVENTS TO SENIOR HEALTH FAIRS. TOTAL ATTENDANCE AT THESE ACTIVITIES EXCEEDED 8,200 DURING FY 2018. -SFMC SPONSORS THE REGIONAL ARTHRITIS CENTER, OFFERING INFORMATION AND ASSISTANCE TO PEOPLE THROUGHOUT SOUTHEAST MISSOURI. -FREE OR DISCOUNTED HEALTH SCREENINGS (CHOLESTEROL, BLOOD PRESSURE, GLAUCOMA, BLOOD SUGAR, ETC.) PROVIDED AT HEALTH FAIRS AND COMMUNITY HEALTH EDUCATION PROGRAMS, AS WELL AS OUR WEEKLY WEDNESDAY MORNING HEART HEALTH SCREENINGS.-COMMUNITY HEALTH FORUMS WERE OFFERED ON TOPICS SUCH AS ARTHRITIS, DIABETES, CARDIOVASCULAR FITNESS, CHILDREN'S HEALTH AND SAFETY, NUTRITION, BREAST CANCER AND OSTEOPOROSIS. OTHER WELLNESS PROGRAMS SUCH AS WEIGHT MANAGEMENT AND SMOKING CESSATION ARE SUBSIDIZED BY SFMC AND OFFERED FOR A NOMINAL FEE.-CHILDBIRTH, SIBLINGS, BREASTFEEDING AND INFANT CARE CLASSES ARE PROVIDED FREE OF CHARGE TO EXPECTANT MOTHERS AND YOUNG FAMILIES.-SFMC SPONSORS HEALTHCARE SPEAKERS FOR COMMUNITY EVENTS AND CIVIC MEETINGS. SFMC STAFF PRESENTS FREE PROGRAMS ON A VARIETY OF HEALTH AND WELLNESS TOPICS TO VARIOUS COMMUNITY, SCHOOL AND CHURCH GROUPS THROUGHOUT THE YEAR. -SEVERAL SFMC OUTPATIENT CLINICS ARE OFFERED AT REDUCED FEE OR NO COST TO PATIENTS AND THEIR FAMILIES. THE CLINICS ADDRESS DIABETIC FOOT CARE, GENETICS, ORTHOPEDICS AND SPORTS INJURIES. -SFMC PROVIDES FREE FIRST AID SERVICES AT THE WEEKLONG SEMO DISTRICT FAIR IN CAPE GIRARDEAU. MEDICAL CENTER PERSONNEL STAFF THE FIRST AID STATION AND PROVIDE MINOR MEDICAL SERVICES TO HUNDREDS OF PEOPLE DURING THE COURSE OF THE WEEK. SFMC ALSO PROVIDES STAFF AND FIRST AID MATERIALS FOR OTHER CIVIC FUNCTIONS DURING THE FISCAL YEAR. -SFMC PROVIDES FREE MEETING ROOM SPACE AND RELATED ASSISTANCE TO MANY HEALTHCARE SUPPORT GROUPS. SEVERAL HUNDRED PEOPLE REGULARLY PARTICIPATE IN THESE SUPPORT GROUPS FOR DISEASES AND DISORDERS INCLUDING BREAST CANCER, MUSCULAR DYSTROPHY, SLEEP DISTURBANCE, HEAD INJURIES, LARYNGECTOMY, HEART SURGERY, DIGESTIVE DISEASES, PARKINSON'S, ARTHRITIS, MULTIPLE SCLEROSIS AND STROKES, AS WELL AS GRIEF SUPPORT FOR PEOPLE WHO HAVE LOST A LOVED ONE TO ILLNESS, INJURY OR DISEASE. -SFMC PROVIDES FINANCIAL AND IN-KIND SUPPORT FOR ACTIVITIES OF LOCAL CHARITIES SUCH AS THE AMERICAN CANCER SOCIETY, AMERICAN DIABETES ASSOCIATION, THE AMERICAN ARTHRITIS ASSOCIATION, THE MARCH OF DIMES, THE AMERICAN HEART ASSOCIATION AND THE AMERICAN LUNG ASSOCIATION. -SCHOLARSHIPS AND TUITION REIMBURSEMENT ARE AWARDED ANNUALLY BY SFMC TO UNDERGRADUATE AND GRADUATE STUDENTS ENROLLED IN VARIOUS HEALTHCARE CURRICULUMS. THE VALUE OF THIS INVESTMENT IN THE ADVANCEMENT OF EXISTING CARE PROVIDERS AND THE EDUCATION OF FUTURE CARE PROVIDERS WAS $155,422 IN FY 2018. -SFMC SPONSORS MEDICAL MINUTE. THESE WEEKLY EDUCATIONAL PROGRAMS, PRODUCED IN COOPERATION WITH MEMBERS OF THE MEDICAL COMMUNITY, PROVIDES INFORMATION ON NEW TECHNOLOGY AND PROCEDURES, TREATMENT FOR DISEASES AND DISORDERS, AND GENERAL MEDICAL EDUCATION TO AREA PATIENTS. -SFMC PROVIDES FREE INTERNET LIBRARY SEARCHES ON HEALTHCARE TOPICS TO AREA RESIDENTS WHO DO NOT HAVE OTHER ACCESS. HOSPITAL EDUCATION STAFF CONDUCTS THE SEARCH AND FAX OR EMAIL MATERIALS. -SFMC PROVIDES EMERGENCY CARE, CLOTHING AND PHARMACEUTICALS TO CHILDREN IN NEED THROUGH THE SAINT FRANCIS FOUNDATION CHILDREN HELPING CHILDREN FUND. -DURING FY 2018 SFMC VOLUNTEERS CONTRIBUTED APPROXIMATELY 27,862 HOURS OF SERVICE TO OUR PATIENTS, THEIR FAMILIES AND THE COMMUNITY. THE VALUE OF THIS CONTRIBUTION IS ESTIMATED AT OVER $214,000 AND IS GIVEN BACK TO THE COMMUNITY THROUGH LOWER COSTS IN PATIENT CARE SERVICES AND WELLNESS PROGRAMS SUCH AS THOSE DESCRIBED ELSEWHERE IN THIS DOCUMENT. -DURING FY 2018 SFMC PROVIDED 1,203 FREE MAMMOGRAMS AND ULTRASOUNDS TO AREA WOMEN WHO COULD NOT AFFORD THIS POTENTIALLY LIFESAVING SCREENING. THE VALUE OF THIS CONTRIBUTION IS ESTIMATED AT MORE THAN $101,234. 473221284 1 1 0 0 0 0 0 0 0 0 1 0 0 0 0 1 1 1 0 0 0 0 0 0 0 0 1 1 0 0 1 1 0 1 0 0 0 0 1 1 0 1 0 0 0 0 1 1 0 0 0 1 155 0 3180 1 1 1 0 0 0 0 0 0 0 0 0 X 11 6 1 1 0 0 1 1 1 1 1 0 0 1 1 1 1 1 1 1 1 0 X DAVID C PRATHER 5733313000 211 SAINT FRANCIS DRIVE CAPE GIRARDEAU MO 63703 KEVIN GOVERO VICE CHAIR OF BOARD 2.00 4.00 X 0 0 0 DONALD KAVERMAN CHAIR OF BOARD 2.00 4.00 X 0 0 0 MICHAEL TRUEBLOOD DIRECTOR 2.00 2.00 X 0 0 0 WILLIAM STAHR DIRECTOR 2.00 2.00 X 0 0 0 JANET VARNON DIRECTOR 2.00 2.00 X 0 0 0 JOEY MCLANE DIRECTOR 2.00 2.00 X 0 0 0 GINA RAFFETY DIRECTOR 2.00 2.00 X 0 0 0 DENNIS VOLLINK DIRECTOR 2.00 2.00 X 0 0 0 JAMES BOLLINGER JR DIRECTOR 2.00 2.00 X 0 0 0 PATRICIAS RAY DIRECTOR 2.00 2.00 X 0 0 0 STEVEN DIRNBERGER SECRETARY/TREASURER DIRECTOR 2.00 2.00 X 0 0 0 JULIE WOODRUFF CNO 40.00 X 173851 0 8253 MARYANN REESE PRESIDENT & CEO 40.00 6.00 X 649374 0 23272 STEVEN OGBURN VP AMBULATORY SERVICES 40.00 X 333782 0 39526 THOMAS S DIEMER MD CHIEF MEDICAL OFFICER 40.00 X 373773 0 32420 GERRY SALTER VP OF PROF SERVICES 40.00 X 240334 0 38179 STEPHANIE LAPIERRE CHIEF PERFORMANCE IMPROVEMENT OFFICER 40.00 X 203445 0 17191 JAMES WILFERTH VP FOUNDATION AND MARKETING 40.00 2.00 X 187340 0 34274 JAMES BURKE CHIEF ADMINISTRATIVE OFFICER 40.00 X 69359 0 1976 DAVID PRATHER CFO 40.00 2.00 X 211207 0 26561 STEVEN C BJELICH PRESIDENT & CEO 40.00 4.00 X 1751012 0 29795 JASON EWING CHIEF INFORMATION OFFICER 40.00 X 265024 0 17630 JEANNETTE FADLER VP PATIENT CARE 40.00 X 835432 0 23850 BARBARA THOMPSON VP OF MARKETING 20.00 X 0 0 0 WILLIAM A BALSANO VP OF FINANCE 40.00 2.00 X 690751 0 23401 MICHAEL FREEMAN MD GASTROENTEROLOGIST 40.00 X 1152453 0 39526 BRANDON SCOTT DO NEUROSURGEON 40.00 X 1202878 0 23387 KIMBERLY ROOS MD GYNECOLOGIST 40.00 X 880243 0 39526 KAYWAN GAMADIA DO NEUROSURGEON 40.00 X 1058288 0 30376 RONALD NEW MD CARDIOTHORACIC SURGEON 40.00 X 1645678 0 38078 JAMES A SCHELL MD FORMER VP MEDICAL AFFAIRS 40.00 X 792143 0 0 MARILYN K CURTIS FORMER VP OF PROF. SERVICE 40.00 X 248955 0 1193 TERI KREITZER FORMER VP OF HR 40.00 X 155083 0 5018 13120405 0 493432 280 1 1 0 CAPE ANESTHESIA GROUP INC PO BOX 1777 CAPE GIRARDEAU MO 637021777 ANESTHESIA SERV 7764751 THE ROBERTS GROUP 730 NORTH GRAND AVENUE WAUKESHA WI 53186 ADVERTISING 5338686 INTERNAL MEDICINE ASSOC OF SE MO LLC 225 PHYSICIANS PARK DRIVE POPLAR BLUFF MO 63901 PHYSCIAN SERVICES 4501481 HOSPITAL HOUSEKEEPING SERVICES LLC PO BOX 734367 DALLAS TX 75373 HOUSEKEEPING 3505416 EPIC SYSTEMS CORP PO BOX 88314 MILWAUKEE WI 532880314 EHR SYSTEM 2752017 203 667332 3667 670999 PATIENT SERVICE REVENUE 488322834 488322834 PHARMACY 446110 11897500 11897500 LAB FEES 621500 2944606 2944606 FITNESS CENTER 2339510 2339510 WELLNESS PROGRAMS 627602 627602 520688 431404 89284 506652740 16645260 13875845 2769415 699865 0 699865 699865 699865 33380000 31496 16742700 5524813 16637300 -5493317 11143983 11143983 CAFETERIA SALES 722514 1179969 1179969 ELECTRONIC HEALTH RECORDS 698695 698695 MEDICAL RECORDS 533603 533603 52038 52038 2464305 538277152 516741178 14931390 5933585 5984684 5984684 183822022 183822022 5892604 5892604 24787313 24787313 11351405 11351405 1395751 1395751 110001 110001 14057098 14057098 2784276 2784276 9457944 9457944 40151825 40151825 4247615 4247615 504076 504076 6656400 6656400 37458471 37458471 4444068 4444068 MEDICAL SUPPLIES 46547797 46547797 DRUGS 32621016 32621016 FRA TAX 19134456 19134456 OTHER EXP 13375725 13375725 8436737 8436737 473221284 473221284 0 0 43421665 21608918 23012308 10112861 63608065 68512596 508922 0 10787574 10881441 15835177 16879523 603845676 291847177 338974344 311998499 399391130 490989061 8855386 7765005 2285308 2101997 906679879 940849901 79368923 85068246 188790866 150231595 268159789 235299841 X 638520090 705550060 638520090 705550060 906679879 940849901 X 65055868 2157413 -183311 X X 0 1 X 1 0 X 8386950 8386950 242501866 96533966 145967900 336405578 187477239 148928339 16551282 7835972 8715310 311998499 X 540251254 2157413 -183311 1974102 538277152 0 538277152 473221284 0 473221284 0 473221284 PART X, LINE 2: THERE WERE NO UNCERTAIN TAX BENEFITS IDENTIFIED AND RECORDED AS A LIABILITY AT JUNE 30, 2018 OR 2017. PART XI, LINE 2D - OTHER ADJUSTMENTS: CHANGE IN INTEREST IN NET ASSETS OF SFF $(183,311) PART XIII - SUPPLEMENTAL FINANCIAL INFORMATION THE DIFFERENCE BETWEEN THE REVENUES AND THE NET ASSETS ON THE AUDITED FINANCIAL STATEMENTS AND THOSE REPORTED ON THE 990 REPRESENTS A DECREASE IN AUXILIARY FUNDS OF ($81,657) AND AN INCREASE OF AUXILIARY CASH OF $44,218. 1 1 1 X 0 1 1 1 0 1 1 27137104 8955213 18181891 0.03840 92911887 63477619 29434268 0.06220 120048991 72432832 47616159 0.10060 766164 766164 0.00160 1038909 1038909 0.00220 14121668 3594724 10526944 0.02220 746100 746100 0.00160 16672841 3594724 13078117 0.02760 136721832 76027556 60694276 0.12820 2067 2067 0.00000 13096 13096 0.00000 500 500 0.00000 8875 8875 0.00000 461343 461343 0.00100 485881 485881 0.00100 1 5527960 1713668 167518160 230039169 -62521009 X 1 1 1 1 SAINT FRANCIS MEDICAL CENTER 211 SAINT FRANCIS DRIVE CAPE GIRARDEAU IL 63703 X X X SAINT FRANCIS MEDICAL CENTER 1 0 0 1 X X X X X X X X X 16 1 0 0 1 X WWW.SFMC.NET X 1 16 1 WWW.SFMC.NET 0 1 X 200.000000000000 X 1 1 X X X 1 X WWW.SFMC.NET X WWW.SFMC.NET X WWW.SFMC.NET X X X X X X X 1 X 0 X X X X X 1 X 0 0 SAINT FRANCIS MEDICAL CENTER PART V, SECTION B, LINE 3J: THE IMPACT OF ANY ACTIONS TAKEN TO ADDRESS THE SIGNIFICANT HEALTH NEEDS IDENTIFIED IN THE HOSPITAL FACILITY'S PRIOR CHNA. SAINT FRANCIS MEDICAL CENTER PART V, SECTION B, LINE 5: INDIVIDUALS REPRESENTING THE BOARD INTERESTS OF BOLLINGER, CAPE GIRARDEAU, SCOTT, AND STODDARD COUNTIES INCLUDED PEOPLE INVOLVED IN SOME OF THE FOLLOWING ORGANIZATIONS: PUBLIC HEALTH DEPARTMENTS RURAL HEALTH CLINICS LOCAL SCHOOL DISTRICTS SOCIAL SERVICE ORGANIZATIONS OTHER HOSPITALS MINORITY ADVOCACY GROUPSFOUR FOCUS GROUPS WERE HELD IN THE FOUR DESIGNATED COUNTIES AND THE QUESTIONS ASKED CAN BE FOUND BELOW. 1. WHAT DO PEOPLE IN THIS COMMUNITY DO TO STAY HEALTHY? HOW DO PEOPLE GET INFORMATION ABOUT HEALTH? 2. IN THIS GROUP'S OPINION, WHAT ARE THE SERIOUS HEALTH PROBLEMS IN YOUR COMMUNITY? WHAT ARE SOME OF THE CAUSES OF THESE PROBLEMS? 3. WHAT KEEPS PEOPLE IN YOUR COMMUNITY FROM BEING HEALTHY? 4. WHAT COULD BE DONE TO SOLVE THESE PROBLEMS? 5. IS THERE ANY GROUP NOT RECEIVING ENOUGH HEALTH CARE? IF SO, WHY? 6. OF ALL THE ISSUES WE TALKED ABOUT TODAY, WHAT ISSUES DO YOU THINK ARE THE MOST IMPORTANT TO YOUR COMMUNITY TO ADDRESS? 161 SURVEYS WERE COMPLETED BY RESIDENTS OF THE FOUR DESIGNATED COUNTIES. THE SURVEY DEMOGRAPHICS WERE REPRESENTATIVE OF THE AREA'S POPULATION: 1. DEMOGRAPHICS: MULTIPLE-CHOICE QUESTIONS TO COLLECT INFORMATION ABOUT THE POPULATION OF THE COUNTY 2. SOCIAL AND ECONOMIC FACTORS: MULTIPLE-CHOICE QUESTIONS TO COLLECT INFORMATION REGARDING THE POPULATION'S EDUCATION, EMPLOYMENT AND INCOME STATUS. 3. HEALTH BEHAVIORS: QUESTIONS TO COLLECT INFORMATION ON THE BEHAVIORS CORRELATED TO HEALTH OF ADULTS AND CHILDREN IN THE COUNTRY. 4. MEDICAL CARE AND SERVICES: MULTIPLE-CHOICE, SHORT ANSWER AND RANKED QUESTIONS TO COLLECT INFORMATION REGARDING HEALTHCARE ACCESS, HEALTH STATUS, INSURANCE COVERAGE, AND OPINIONS ON HEALTH ISSUES. SAINT FRANCIS MEDICAL CENTER PART V, SECTION B, LINE 6A: SAINT FRANCIS MEDICAL CENTER WAS THE ONLY ENTITY CONDUCTING THIS COMMUNITY HEALTH NEEDS ASSESSMENT (CHNA). THERE WAS A COOPERATION ON THE FOCUS GROUP WITH MISSOURI DELTA MEDICAL CENTER IN SIKESTON, MISSOURI. SAINT FRANCIS MEDICAL CENTER PART V, SECTION B, LINE 7D: THE COMMUNITY HEALTH NEEDS ASSESSMENT WAS PLACED ON THE SAINT FRANCIS MEDICAL CENTER'S WEBSITE. THERE WERE NUMEROUS NEWS STORIES ON THE ASSESSMENT AND WHERE TO LOCATE THE INFORMATION. LOCAL HEALTH AND HUMAN SERVICES AGENCIES WERE INFORMED WHEN THE ASSESSMENT WAS COMPLETED AT LOCAL MEETINGS. PRESENTATION OF THE CHNA FINDINGS WERE PRESENTED TO ALL BOARDS OF SAINT FRANCIS HEALTHCARE SYSTEM. CHNA WAS SHARED WITH SOUTHEAST MISSOURI STATE UNIVERSITY, MISSOURI DELTA MEDICAL CENTER AND FERGUSON MEDICAL GROUP IN SIKESTON, MISSOURI. HTTPS://WWW.SFMC.NET/CHNA SAINT FRANCIS MEDICAL CENTER PART V, SECTION B, LINE 11: WHILE TREATMENT FOR SUBSTANCE ABUSE AND MENTAL HEALTH CONDITIONS ARE A SIGNIFICANT COMMUNITY HEALTH NEED IDENTIFIED BY THIS ASSESSMENT, SAINT FRANCIS HEALTHCARE SYSTEM WILL NOT BE ADDRESSING THIS NEED AS PART OF ITS 2016-2019 CHNA IMPLEMENTATION PLAN FOR THE FOLLOWING REASONS: 1. CONSIDERABLE RESOURCES ARE ALREADY ALLOCATED TO ADDRESS THE OTHER TOP-PRIORITY HEALTH NEEDS IDENTIFIED BY THE 2016 CHNA; 2. SOUTHEASTHEALTH, THE OTHER COMMUNITY HOSPITAL IN CAPE GIRARDEAU, ALREADY OFFERS INPATIENT PSYCHIATRIC TREATMENT, AND DUPLICATION OF SUCH SERVICES IN THE SAME COMMUNITY IS NOT THE BEST USE OF SFMC RESOURCES; 3. THE SIGNIFICANT RESOURCE REQUIREMENTS THAT WOULD BE NECESSARY FOR SAINT FRANCIS HEALTHCARE SYSTEM TO DEVELOP ITS OWN OUTPATIENT SUBSTANCE ABUSE AND/OR MENTAL HEALTH TREATMENT PROGRAMS FROM THE GROUND UP IS NOT FEASIBLE AT THIS TIME. SAINT FRANCIS WILL INSTEAD CONTINUE TO WORK WITH OTHER COMMUNITY PARTNERS THAT OFFER SUCH SERVICE IN THE COMMUNITY BY MAKING APPROPRIATE PATIENT REFERRALS. 4. SAINT FRANCIS RECENTLY ACQUIRED A MULTI-SPECIALTY CLINIC IN POPLAR BLUFF, MISSOURI, WHICH EMPLOYS A PSYCHIATRIST AND MENTAL HEALTH PROVIDERS. ALTHOUGH MENTAL HEALTH IS NOT BEING ADDRESSED CURRENTLY, FUTURE PLANS COULD INCLUDE MENTAL HEALTH OUTREACH TO NEARBY STODDARD COUNTY, MISSOURI. SAINT FRANCIS MEDICAL CENTER PART V, SECTION B, LINE 13H: ALL UNINSURED PATIENTS RECEIVING SERVICES AT SAINT FRANCIS MEDICAL CENTER WILL RECEIVE A 75% REDUCTION ON ALL GROSS CHARGES AT THE TIME OF BILLING (WITHOUT APPLICATION).ALL SELF-PAY ACCOUNTS WILL BE PROCESSED THROUGH A PRESUMPTIVE SCORING PROGRAM TO DETERMINE IF THEY QUALIFY FOR ASSISTANCE. IF THE PATIENT MEETS THE QUALIFICATIONS, THE PATIENT'S ACCOUNT WILL BE REDUCED TO ZERO. IF THE QUALIFICATIONS ARE NOT MET, COLLECTIONS WILL BE ESCALATED. SAINT FRANCIS MEDICAL CENTER PART V, SECTION B, LINE 16J: ALL PATIENTS ARE NOTIFIED OF THE FINANCIAL ASSISTANCE POLICY VIA THE CONSENT FORM UPON ADMISSION. UNINSURED PATIENTS ARE CONTACTED AFTER ADMISSION AND INFORMED OF THE FINANCIAL ASSISTANCE AVAILABLE THROUGH THE MEDICAL CENTER'S FINANCIAL ASSISTANCE POLICY. SAINT FRANCIS MEDICAL CENTER PART V, SECTION B, LINE 20E: IN-HOUSE AND THIRD PARTY REPRESENTATIVES WORK WITH UNINSURED PATIENTS TO HELP THEM QUALIFY FOR MEDICAID BENEFITS THROUGH THEIR STATE OF RESIDENCE. FINANCIAL ASSISTANCE APPLICATIONS ARE OFFERED FOR THOSE THAT DO NOT QUALIFY FOR MEDICAID AND EXPRESS THE INABILITY TO PAY FOR MEDICAL SERVICES. 32 1 - CAPE CARDIOLOGY GROUP 211 SAINT FRANCIS DRIVE CAPE GIRARDEAU MO 63703 PHYSICIAN PRACTICE 2 - KNEIBERT CLINIC 686 LESTER STREET POPLAR BLUFF MO 63901 PHYSICIAN PRACTICE 3 - PHYSICIANS PARK PRIMARY CARE 225 PHYSICIANS PARK DRIVE SUITE 40 POPLAR BLUFF MO 63901 PHYSICIAN PRACTICE 4 - CAPE CARE FOR WOMEN 211 SAINT FRANCIS DRIVE CAPE GIRARDEAU MO 63703 PHYSICIAN PRACTICE 5 - CAPE GASTROENTEROLOGY SPECIALISTS 28 S MOUNT AUBURN ROAD CAPE GIRARDEAU MO 63703 PHYSICIAN PRACTICE 6 - CAPE PHYSICIAN ASSOCIATES 3250 GORDONVILLE ROAD CAPE GIRARDEAU MO 63703 PHYSICIAN PRACTICE 7 - CAPE SPINE AND NEUROSURGERY 150 S MOUNT AUBURN ROAD CAPE GIRARDEAU MO 63703 PHYSICIAN PRACTICE 8 - FARMINGTON PHYSICIAN ASSOCIATES 515 MAPLE VALLEY DRIVE FARMINGTON MO 63640 PHYSICIAN PRACTICE 9 - CAPE ENT GROUP 150 S MOUNT AUBURN ROAD CAPE GIRARDEAU MO 63703 PHYSICIAN PRACTICE 10 - ADVANCED ORTHOPEADIC SPECIALISTS 48 DOCTORS PARK CAPE GIRARDEAU MO 63703 PHYSICIAN PRACTICE 11 - CAPE THORACIC & CARDIOVASCULAR SURGERY 3250 GORDONVILLE ROAD CAPE GIRARDEAU MO 63703 PHYSICIAN PRACTICE 12 - CAPE MEDICAL ONCOLOGY 211 SAINT FRANCIS DRIVE CAPE GIRARDEAU MO 63703 PHYSICIAN PRACTICE 13 - CAPE PRIMARY CARE 1702 N KINGSHIGHWAY CAPE GIRARDEAU MO 63701 PHYSICIAN PRACTICE 14 - PIEDMONT PHYSICIAN ASSOCIATES RT 4 BOX 4515 PIEDMONT MO 63957 PHYSICIAN PRACTICE 15 - CAPE NEUROLOGY SPECIALISTS 3004 GORDONVILLE ROAD CAPE GIRARDEAU MO 63703 PHYSICIAN PRACTICE 16 - IMMEDIATE CONVENIENT CARE - CAPE 1702 N KINGSHIGHWAY CAPE GIRARDEAU MO 63701 PHYSICIAN PRACTICE 17 - HOSPICE 14 C DOCTORS PARK CAPE GIRARDEAU MO 63703 HOSPICE 18 - CAPE NEUROSURGICAL ASSOCIATES 150 S MOUNT AUBURN ROAD CAPE GIRARDEAU MO 63703 PHYSICIAN PRACTICE 19 - CAPE PEDIATRIC GROUP 35 DOCTORS PARK CAPE GIRARDEAU MO 63703 PHYSICIAN PRACTICE 20 - CAPE PULMONOLOGY AND SLEEP MEDICINE 24 S MOUNT AUBURN ROAD CAPE GIRARDEAU MO 63703 PHYSICIAN PRACTICE 21 - JACKSON FAMILY CARE 545 BROADRIDGE DRIVE JACKSON MO 63755 PHYSICIAN PRACTICE 22 - POPLAR BLUFF NEUROLOGY SPECIALISTS 2210 BARRON ROAD SUITE 112 POPLAR BLUFF MO 63901 PHYSICIAN PRACTICE 23 - SAINT FRANCIS HOME HEALTH 14 DOCTORS PARK CAPE GIRARDEAU MO 63703 HOME HEALTH 24 - CAPE DIABETES & ENDOCRINOLOGY 211 SAINT FRANCIS DRIVE CAPE GIRARDEAU MO 63703 PHYSICIAN PRACTICE 25 - FITNESS PLUS 150 S MOUNT AUBURN ROAD CAPE GIRARDEAU MO 63703 FITNESS CENTER 26 - SAINT FRANCIS OUTPATIENT CENTER 1212 SAINT FRANCIS DRIVE CAPE GIRARDEAU MO 63703 PHYSICIAN PRACTICE 27 - JACKSON PHYSICIAN ASSOCIATES 2130 E JACKSON BLVD JACKSON MO 63755 PHYSICIAN PRACTICE 28 - CAPE GYNECOLOGIC ONCOLOGY 211 SAINT FRANCIS DRIVE CAPE GIRARDEAU MO 63703 PHYSICIAN PRACTICE 29 - CHARLESTON FAMILY CARE 400 S MAIN STREET CHARLESTON MO 63834 PHYSICIAN PRACTICE 30 - FITNESS PLUSS - DEXTER 1212 SAINT FRANCIS DRIVE CAPE GIRARDEAU MO 63841 FITNESS CENTER 31 - SAINT FRANCIS OUTPATIENT REHAB 150 S MOUNT AUBURN ROAD CAPE GIRARDEAU MO 63703 OUTPATIENT REHAB 32 - SIKESTON NEUROLOGY SPECIALISTS 807 N MAIN STREET SIKESTON MO 63801 PHYSICIAN PRACTICE PART I, LINE 3C: ALL UNINSURED PATIENTS RECEIVING SERVICES AT SAINT FRANCIS MEDICAL CENTER WILL RECEIVE A 75% REDUCTION ON ALL GROSS CHARGES AT THE TIME OF BILLING (WITHOUT APPLICATION). ALL SELF-PAY ACCOUNTS WILL BE PROCESSED THROUGH A PRESUMPTIVE SCORING PROGRAM TO DETERMINE IF THEY QUALIFY FOR ASSISTANCE. IF THE PATIENT MEETS THE QUALIFICATIONS, THE PATIENT'S ACCOUNT WILL BE REDUCED TO ZERO. IF THE QUALIFICATIONS ARE NOT MET, COLLECTIONS WILL BE ESCALATED. PART I, LINE 7: A COST-TO-CHARGE RATIO WAS USED IN ACCORDANCE WITH THE CALCULATION IN WORKSHEET 2, "RATIO OF PATIENT CARE COST TO CHARGES." PART I, LINE 7G: COSTS FOR SUBSIDIZED HEALTH SERVICES INCLUDE COSTS ASSOCIATED WITH PROVIDED NEONATOLOGY, TRAUMA, AND HOSPITALIST PHYSICIAN CLINICAL SERVICES WHERE OPERATIONS RESULT IN LOSSES. TOTAL EXPENSES IN THE AMOUNT OF $14,121,668 ARE INCLUDED. LINE 7, COLUMN (F) - EXCLUSIONS FROM PERCENT OF TOTAL EXPENSE BAD DEBTS WERE NOT EXCLUDED FROM THE CALCULATION IN COLUMN F. PART II, COMMUNITY BUILDING ACTIVITIES: SAINT FRANCIS MEDICAL CENTER'S COMMUNITY BUILDING ACTIVITIES ARE TARGETED TO KEEP GOOD HEALTH IN THE FOREFRONT THROUGH NON-TRADITIONAL CHANNELS. THESE ACTIVITIES ARE USED TO DELIVER HEALTHCARE INFORMATION AND EDUCATION DIRECTLY TO CITIZENS OF THE COMMUNITY. COMMUNITY FORUMS OR MEETINGS ALLOW REPRESENTATIVES OF THE MEDICAL CENTER TO PRESENT POTENTIALLY LIFE-SAVING INFORMATION TO AN AUDIENCE NOT TYPICALLY REACHED BY COMMUNITY HEALTH AGENCIES OR SCREENINGS. PART III, LINE 2: A COST-TO-CHARGE RATIO WAS USED IN ACCORDANCE WITH THE CALCULATION IN WORKSHEET 2, "RATIO OF PATIENT CARE COST TO CHARGES" TO DEVELOP COSTS ASSOCIATED WITH BAD DEBT EXPENSE. PATIENT PAYMENTS AND DISCOUNTS ARE APPLIED TO THE PATIENT'S ACCOUNT BEFORE BAD DEBT DETERMINATION IS MADE. PART III, LINE 3: AN ESTIMATE OF BAD DEBT EXPENSE AT COST ATTRIBUTABLE TO PATIENTS ELIGIBLE UNDER THE MEDICAL CENTER'S FINANCIAL ASSISTANCE POLICY WAS CALCULATED BASED ON A STUDY OF POVERTY RATES IN THE UNITED STATES BY THE UNITED STATES CENSUS BUREAU. THE PERCENTAGE OF THE POPULATION WITH INCOME LEVELS AT OR BELOW 200% OF THE FEDERAL POVERTY GUIDELINES WAS OBTAINED AND THAT PERCENTAGE WAS THEN APPLIED TO THE ESTIMATED BAD DEBT EXPENSE TO OBTAIN THE ESTIMATED AMOUNT IN BAD DEBT EXPENSE ATTRIBUTABLE TO PATIENTS ELIGIBLE UNDER THE FINANCIAL ASSITANCE POLICY. THE COST-TO-CHARGE RATIO WAS THEN APPLIED TO CONVERT TO COST. THE MEDICAL CENTER ESTIMATES THAT $1,713,668 AT COST IS FINANCIAL ASSISTANCE ELIGIBLE AND IS INCLUDED IN BAD DEBT EXPENSE. PART III, LINE 4: THE FOLLOWING IS FROM FOOTNOTE B OF THE AUDITED FINANCIAL STATEMENTS FOR SAINT FRANCIS MEDICAL CENTER FOR THE YEAR ENDED JUNE 30, 2018:THE MEDICAL CENTER ALSO PROVIDES A SIGNIFICANT AMOUNT OF UNCOMPENSATED CARE FOR PATIENTS WHICH IS NOT INCLUDED IN COMMUNITY BENEFIT EXPENSE BUT IS REPORTED ON THE STATEMENT OF OPERATIONS AS A PROVISION FOR UNCOLLECTIBLE ACCOUNTS. MANY OF THOSE PATIENTS ARE UNINSURED OR UNDERINSURED, BUT DID NOT APPLY FOR OR QUALIFY FOR CHARITY CARE. DURING THE YEAR ENDED JUNE 30, 2018, THE MEDICAL CENTER REPORTED BAD DEBT EXPENSE; AT COST, OF $5,528,000. PART III, LINE 8: THE COSTING METHODOLOGY USED FOR PART III, LINE 6, IS A COST-TO-CHARGE RATIO DERIVED FROM THE PRIOR YEAR'S MEDICARE COST REPORT WHICH USES ONLY MEDICARE ALLOWABLE COSTS.IRS REV. RUL. 69-545, WHICH ESTABLISHED THE COMMUNITY BENEFIT STANDARD FOR NONPROFIT HOSPITALS, STATES THAT IF A HOSPITAL SERVES PATIENTS WITH GOVERNMENT HEALTH BENEFITS, INCLUDING MEDICARE, THEN THIS IS AN INDICATION THAT THE HOSPITAL OPERATES TO PROMOTE THE HEALTH OF THE COMMUNITY. THIS IMPLIES THAT TREATING MEDICARE PATIENTS IS A COMMUNITY BENEFIT.**FOR-PROFIT SPECIALTY HOSPITALS HAVE BEEN CARVING OUT CERTAIN HIGH-MARGIN SERVICES (SUCH AS CARDIAC, ORTHOPEDICS, AND ONCOLOGY), LEAVING GENERAL ACUTE CARE HOSPITALS WITH LOWER-MARGIN MEDICARE SERVICES. THIS INDICATES THAT MEDICARE LOSSES CAN BE A RESULT OF RENDERING THESE LOWER-MARGIN SERVICES (WHICH BENEFIT THE COMMUNITY) RATHER THAN INEFFICIENT OPERATIONS.**IN SOME COMMUNITIES, MEDICARE IS THE LARGEST PAYER, AND HOSPITALS MUST ACCEPT THESE PATIENTS REGARDLESS OF WHETHER THEY MAKE A SURPLUS OR DEFICIT FROM PROVIDING SUCH SERVICES. IF THE MEDICARE PARTICIPATION IS PREMISED ON THIS FACT, THEN PROVIDING MEDICARE SERVICES PROMOTES ACCESS TO HEALTHCARE SERVICES WHICH IS A COMMUNITY BENEFIT.**THERE ARE A NUMBER OF LOW-INCOME CONSUMERS RECEIVING MEDICARE BENEFITS.**THE ELDERLY ARE OFTEN AN UNDERSERVED POPULATION WHO EXPERIENCE ISSUES WITH ACCESS TO HEALTHCARE SERVICES. WITHOUT TAX-EXEMPT HOSPITALS PROVIDING MEDICARE SERVICES, CMS WOULD BEAR THE BURDEN OF DIRECTLY PROVIDING SERVICES TO THE ELDERLY.**MEDICARE PAYMENT ANOMALIES MAY BE PRESENT IN SOME STATES SO EVEN VERY EFFICIENT HOSPITALS ARE UNABLE TO AVOID LOSSES. THUS, LOSSES MAY NOT BE INDICATIVE OF INEFFICIENCY BUT RATHER PROVISION OF A COMMUNITY BENEFIT. PART III, LINE 9B: IF A PATIENT EXPRESSES FINANCIAL INABILITY TO PAY, THE REPRESENTATIVE OF THE MEDICAL CENTER WILL OFFER A FINANCIAL ASSISTANCE APPLICATION TO THE PATIENT. THE PATIENT THEN RETURNS THE APPLICATION TO THE BUSINESS OFFICE FOR REVIEW. AFTER REVIEW, THE BUSINESS OFFICE WILL NOTIFY THE PATIENT IN WRITING OF THE DECISION. IF APPROVED, THE BUSINESS OFFICE WILL WRITE OFF THE REMAINING BALANCES. IF DENIED, THE BUSINESS OFFICE WILL CONTACT THE PATIENT TO MAKE PAYMENT ARRANGEMENTS. PART VI, LINE 2: SAINT FRANCIS IS PROACTIVE IN ASSESSING THE HEALTHCARE NEEDS OF ITS SERVICE AREA THROUGH GATHERING INFORMATION OR STUDIES FROM COMMUNITY HEALTHCARE AGENCIES, DEVELOPING AND SUPPORTING COMMUNITY HEALTH EDUCATORS, AND FOLLOWING UP ON INFORMATION FROM PATIENTS AND FAMILIES. SAINT FRANCIS IS REACTIVE IN ASSESSING THE HEALTHCARE NEEDS OF ITS SERVICE AREA BY PROVIDING SUPPORT AND ASSISTANCE THROUGH LOCAL AND NATIONAL AGENCIES, WHICH PROVIDE DIRECT HEALTHCARE SERVICES TO THE MEDICAL CENTER'S SERVICE AREA. PART VI, LINE 3: HOSPITAL PERSONNEL, INCLUDING NURSES, PHYSICIANS, SOCIAL WORKERS AND OTHERS, MAY IDENTIFY AND REQUEST AN APPLICATION FOR A PATIENT WHEN DEEMED APPROPRIATE. PATIENTS AND PERSONS WHO MAY BE BILLED RECEIVE AN APPLICATION FOR ASSISTANCE WHEN A NEED IS EXPRESSED. REQUEST FOR ASSISTANCE IS USUALLY MADE WHEN THE PATIENT RECEIVES THE BILL, OR WHEN THE CUSTOMER SERVICE REPRESENTATIVE CONTACTS THE PATIENT FOR PAYMENT OF ACCOUNT. AT THE TIME NEED IS EXPRESSED, THE APPLICATION IS GIVEN PERSONALLY OR MAILED TO THE PATIENT. CUSTOMER SERVICE REPRESENTATIVES THEN WORK WITH THE PATIENT TO COMPLETE ASSISTANCE REQUEST AND FORWARD APPLICATION FOR APPROVAL. ANY PATIENTS WHO RETURN TO THE MEDICAL CENTER TO PAY A BILL HAVE ACCESS TO ASSISTANCE EDUCATION DOCUMENTATION AT THE BILLING OFFICE. PART VI, LINE 4: SAINT FRANCIS MEDICAL CENTER IS A LEADING TERTIARY CARE PROVIDER SERVING PORTIONS OF A FIVE-STATE REGION - MISSOURI, ARKANSAS, TENNESSEE, KENTUCKY, AND ILLINOIS. THE SYSTEM PROVIDES TO A POPULATION OF MORE THAN 660,000 PEOPLE. THE PRIMARY SERVICE AREA CONSISTS OF CAPE GIRARDEAU COUNTY WITH AN ESTIMATED POPULATION OF 78,161 AS OF 2017. ACCORDING TO THE MISSOURI OFFICE OF ADMINISTRATION, BUDGET AND PLANNING, CAPE GIRARDEAU COUNTY'S POPULATION IS EXPECTED TO INCREASE TO 84,612 BY 2030. THE SECONDARY SERVICE AREA HAS A POPULATION OF NEARLY 175,000 ACCORDING TO THE UNITED STATES CENSUS BUREAU AND INCLUDES THE COUNTIES OF ALEXANDER (6,315), PULASKI (7,676), JOHNSON (12,900), AND UNION (17,000) IN ILLINOIS; AND BOLLINGER (12,306), MISSISSIPPI (13,586), NEW MADRID (17,582), PERRY (19,225), SCOTT (38,541), AND STODDARD (29,369) IN MISSOURI. THE TERTIARY SERVICE AREA HAS A TOTAL POPULATION OF MORE THAN 414,000 AND INCLUDES THE COUNTIES OF BUTLER (42,666), CARTER (27,144), DUNKLIN (30,119), IRON (10,226), MADISON (12,243), PEMISCOT (16,826), REYNOLDS (6,275), RIPLEY (13,564), ST. FRANCOIS (66,705), STE. GENEVIEVE (17,843), AND WAYNE (13,296) IN MISSOURI; AND JACKSON (58,284), RANDOLPH (32,423), AND WILLIAMSON (67,328) IN ILLINOIS.THE SOUTHEAST REGION OF MISSOURI IS GROWING SLOWLY AND HAS A HIGHER THAN AVERAGE PERCENTAGE OF RETIREE-AGED PEOPLE. OVER THE NEXT FIVE YEARS, THE POPULATION IS EXPECTED TO CONTINUE TO AGE. CURRENTLY, THE LARGEST POPULATION AGE GROUP IS AGES 45 TO 64. THIS REGION IS 85.9 PERCENT CAUCASIAN, 10.7 PERCENT AFRICAN AMERICAN, AND 2.0 PERCENT HISPANIC. TOTAL PERSONAL INCOME FOR CAPE GIRARDEAU COUNTY FOR 2016 WAS $3,254,791,000 OR $41,245 PER CAPITA. TOTAL PERSONAL INCOME FOR THE SOUTHEAST REGION WAS $12.8 BILLION WITH AN AVERAGE PER CAPITA INCOME OF $35,167. OF THE ENTIRE POPULATION 25 AND OLDER, 5.2 PERCENT DID NOT OBTAIN A HIGH SCHOOL DIPLOMA. APPROXIMATELY 84.7 PERCENT GRADUATED FROM HIGH SCHOOL OR HIGHER, 19.5 PERCENT EARNED A COLLEGE DEGREE OR HIGHER, AND 7.1 PERCENT COMPLETED A GRADUATE OR PROFESSIONAL DEGREE. ACCORDING TO EMPLOYEMENT STATISTICS IN FEBRUARY, 2018 DATA, CAPE GIRARDEAU COUNTY HAD AN UNEMPLOYEMENT RATE OF 3.7 PERCENT.STATISTICS ARE FROM MISSOURI ECONOMIC RESEARCH AND INFORMATION CENTER AND THE U.S. CENSUS BUREAU. PART VI, LINE 5: SAINT FRANCIS MEDICAL CENTER FURTHERS ITS EXEMPT PURPOSE BY PROVIDING FOR AN OPEN MEDICAL STAFF COMPRISED OF PHYSICIANS IN ITS PRIMARY SERVICE AREA. THE BOARD OF DIRECTORS IS COMPRISED OF LOCAL COMMUNITY MEMBERS WITH A VESTED INTEREST IN PROMOTING AND IMPROVING THE HEALTH OF THE POPULATION SERVED BY SAINT FRANCIS MEDICAL CENTER. IN ADDITION, SURPLUS FUNDS GENERATED BY THE OPERATINS OF THE MEDICAL CENTER ARE REINVESTED IN EQUIPMENT AND FACILITIES SO THAT SAINT FRANCIS MEDICAL CENTER CAN PROVIDE CUTTING EDGE HEALTHCARE TO THE RESIDENTS OF ITS COMMUNITY. PART VI, LINE 6: SAINT FRANCIS HEALTHCARE SYSTEM, INC. IS A HOLDING COMPANY WHICH OWNS SAINT FRANCIS MEDICAL CENTER. SAINT FRANCIS MEDICAL CENTER OPERATES A 308-BED ACUTE CARE HOSPITAL LOCATED IN CAPE GIRARDEAU, MISSOURI. ADMITTING PHYSICIANS ARE PRIMARILY PRACTITIONERS IN THE LOCAL AREA. SAINT FRANCIS MEDICAL CENTER WAS ORGANIZED BY SAINT FRANCIS HEALTHCARE SYSTEM. SAINT FRANCIS HEALTH DEVELOPMENT SERVICES, INC. FORMED IN 2002, OWNS A 51% INTEREST IN PHYSICIANS ALLIANCE SURGERY CENTER, LLC, A 30% INTEREST IN POPLAR BLUFF MEDICAL PARTNERS, LLC, A 30% INTEREST IN LANDMARK HOSPITAL OF CAPE GIRARDEAU, LLC, AND A 30% INTEREST IN AFC CLINIC 001, LLC, WHICH OPERATES A DOCTORS EXPRESS URGENT CARE CENTER. PART VI, LINE 7, REPORTS FILED WITH STATES MO X X X 1 1 X X X X X 1 1 0 0 0 1 0 0 0 JULIE WOODRUFF CNO 148854 0 0 0 24997 0 7173 0 1080 0 182104 0 0 0 MARYANN REESE PRESIDENT & CEO 583533 0 0 0 65841 0 13250 0 10022 0 672646 0 0 0 STEVEN OGBURN VP AMBULATORY SERVICES 298611 0 0 0 35171 0 13250 0 26276 0 373308 0 0 0 THOMAS S DIEMER MD CHIEF MEDICAL OFFICER 327800 0 0 0 45973 0 13250 0 19170 0 406193 0 0 0 GERRY SALTER VP OF PROF SERVICES 222686 0 0 0 17648 0 11927 0 26252 0 278513 0 0 0 STEPHANIE LAPIERRE CHIEF PERFORMANCE IMPROVEMENT OFFICE 181287 0 5000 0 17158 0 8667 0 8524 0 220636 0 0 0 JAMES WILFERTH VP FOUNDATION AND MARKETING 152793 0 0 0 34547 0 8778 0 25496 0 221614 0 0 0 DAVID PRATHER CFO 169693 0 8357 0 33157 0 9832 0 16729 0 237768 0 0 0 STEVEN C BJELICH PRESIDENT & CEO 678071 0 492334 0 580607 0 13250 0 16545 0 1780807 0 0 0 JASON EWING CHIEF INFORMATION OFFICER 236312 0 0 0 28712 0 754 0 16876 0 282654 0 0 0 JEANNETTE FADLER VP PATIENT CARE 335845 0 460329 0 39258 0 13250 0 10600 0 859282 0 0 0 WILLIAM A BALSANO VP OF FINANCE 615368 0 0 0 75383 0 13250 0 10151 0 714152 0 0 0 MICHAEL FREEMAN MD GASTROENTEROLOGIST 1106765 0 0 0 45688 0 13250 0 26276 0 1191979 0 0 0 BRANDON SCOTT DO NEUROSURGEON 687517 0 478941 0 36420 0 13250 0 10137 0 1226265 0 0 0 KIMBERLY ROOS MD GYNECOLOGIST 440751 0 396640 0 42852 0 13250 0 26276 0 919769 0 0 0 KAYWAN GAMADIA DO NEUROSURGEON 733829 0 323919 0 540 0 5300 0 25076 0 1088664 0 0 0 RONALD NEW MD CARDIOTHORACIC SURGEON 1627018 0 0 0 18660 0 13250 0 24828 0 1683756 0 0 0 JAMES A SCHELL MD FORMER VP MEDICAL AFFAIRS 792143 0 0 0 0 0 0 0 0 0 792143 0 0 0 MARILYN K CURTIS FORMER VP OF PROF. SERVICE 8490 0 0 0 240465 0 1048 0 145 0 250148 0 0 0 TERI KREITZER FORMER VP OF HR 28275 0 0 0 126808 0 2798 0 2220 0 160101 0 0 0 PART I, LINE 1A EXECUTIVE AND BOARD MEMBERS RECEIVE TRAVEL FOR THEIR SPOUSES. SPOUSAL TRAVEL IS ADDED TO W-2'S FOR EXECUTIVES AND 1099'S ARE ISSUED TO BOARD MEMBERS. THE FORMER CEO, STEVEN C. BJELICH, RECEIVED COUNTRY CLUB DUES, WHICH WAS INCLUDED ON THE W-2. PART I, LINES 4A-B MARYANN REESE - NONQUALIFIED - $60,017 STEVEN A OGBURN - NONQUALIFIED - $46,855 GERRY SALTER - NONQUALIFIED - $24,603 JAMES SCHELL MD - SEVERANCE - $792,143 PART I, LINE 6 ALL EXECUTIVE BONUSES ARE BASED ON FINANCIAL PERFORMANCE. PART III - OTHER ADDITIONAL INFORMATION BARBARA THOMPSON, FORMER VP OF MARKETING, IS THE OWNER OF THE ROBERTS GROUP. THE ROBERTS GROUP PROVIDED MARKETING AND ADVERTISING SERVICES FOR SAINT FRANCIS MEDICAL CENTER. BARBARA THOMPSON WAS NOT AN EMPLOYEE OF SAINT FRANCIS MEDICAL CENTER AND, THEREFORE, WAS NOT PAID A DIRECT SALARY FROM THE MEDICAL CENTER. HER COMPENSATION WAS PAID BY THE ROBERTS GROUP. SERVICES WITH THE ROBERTS GROUP WERE TERMINATED IN FY18. A IND DEV AUTH OF CAPE GIRARDEAU 431193901 139404FH5 2013-05-01 131833295 CAPITAL EXPENDITURES 0 0 0 B IND DEV AUTH OF CAPE GIRARDEAU 431193901 139404GB7 2016-11-16 34876270 ADVANCED REFUNDING 0 0 0 A 2465000 131833295 3393406 1380910 75003510 2015 1 1 1 1 B 34876270 35254267 178601 2016 0 1 1 1 A 0 0 0 0 0 0 0 B 0 0 0 0 0 0 0 A 0 0 0 0 0 0 0 0 0 B 0 0 0 0 1 0 0 0 0 A 0 B 0 DON KAVERMAN BOARD OF DIRECTORS 1629 DISCOUNTED HEAL PATRICIA RAY BOARD OF DIRECTORS 102 DISCOUNTED HEAL MICHAEL TRUEBLOOD BOARD OF DIRECTORS 98 DISCOUNTED HEAL JAMES BOLLINGER JR BOARD OF DIRECTORS 3936 DISCOUNTED HEAL JOEY MCLANE BOARD OF DIRECTORS 533 DISCOUNTED HEAL STEVE DIRNBERGER BOARD OF DIRECTORS 3578 DISCOUNTED HEAL B THOMPSON OWNS THE ROBERTS GROUP VP OF MARKETING 1678447 ADVERTISING FEES 0 P RAYS HUSBAND OWNER OF CNA DIRECTOR 1160118 PAID CNA UNDER PSA 0 D VOLLINK - DRURY SOUTHWEST PRES DIRECTOR 263446 SFMC LEASES BILLBOARD 0 A TRUEBLOOD ADVANCED ORTHOPEDIC ASSOCIATE DIRECTOR'S SON 3949355 SERVICES FOR SFMC 0 SCHEDULE L, PART V - ADDITIONAL INFORMATION BARBARA THOMPSON WAS THE FORMER VP OF MARKETING AT SAINT FRANCIS MEDICAL CENTER. SHE IS ALSO THE OWNER OF THE ROBERTS GROUP, WHICH PROVIDED MARKETING AND ADVERTISING SERVICES FOR SFMC. THE RELATIONSHIP WITH THE ROBERTS GROUP WAS TERMINATED IN FY 18. FORM 990, PART VI, SECTION A, LINE 2 A BUSINESS RELATIONSHIP IS CONSIDERED TO EXIST AMONGST OFFICERS AND/OR DIRECTORS OF SAINT FRANCIS MEDICAL CENTER (SFMC) WHO ALSO SERVE AS OFFICERS AND/OR DIRECTORS OF SAINT FRANCIS HEALTH DEVELOPMENT SERVICES, INC., WHICH IS A RELATED TAXABLE ENTITY OF SAINT FRANCIS MEDICAL CENTER. THE FOLLOWING OFFICERS AND/OR DIRECTORS SERVE ON BOTH THE SAINT FRANCIS MEDICAL CENTER AND SAINT FRANCIS HEALTH DEVELPMENT SERVICES, INC. BOARD OF DIRECTORS: MARYANN REESE - PRESIDENT AND CEO AT SFMC DON KAVERMAN - CHAIRMAN OF SFMC BOARD OF DIRECTORS KEVIN GOVERO - VICE CHAIRMAN OF SFMC BOARD OF DIRECTORS FORM 990, PART VI, SECTION A, LINE 3 THE ROBERTS GROUP PROVIDED MARKETING AND ADVERTISING SERVICES FOR SAINT FRANCIS MEDICAL CENTER. BARBARA THOMPSON IS THE OWNER OF THE ROBERTS GROUP AND WAS ALSO THE VICE PRESIDENT OF MARKETING AT SAINT FRANCIS MEDICAL CENTER. BARBARA THOMPSON WAS NOT AN EMPLOYEE OF THE MEDICAL CENTER AND, THEREFORE, WAS NOT PAID A DIRECT SALARY FROM THE MEDICAL CENTER. SERVICES WITH THE ROBERTS GROUP WERE TERMINATED IN FY18. FORM 990, PART VI, SECTION A, LINE 6 SAINT FRANCIS HEALTHCARE SYSTEM IS THE SOLE MEMBER OF THE SAINT FRANCIS MEDICAL CENTER. FORM 990, PART VI, SECTION A, LINE 7A SAINT FRANCIS HEALTHCARE SYSTEM, INC. AS THE SOLE MEMBER OF SAINT FRANCIS MEDICAL CENTER HAS THE POWER TO APPOINT AND REMOVE, WITH OR WITHOUT CAUSE, THE DIRECTORS, THE CHAIRMAN OF THE BOARD, THE VICE CHAIRMAN OF THE BOARD AND THE SECRETARY/TREASURER OF THE CORPORATION. FORM 990, PART VI, SECTION A, LINE 7B DECISIONS ARE SUBJECT TO THE BISHOP'S APPROVAL. FORM 990, PART VI, SECTION B, LINE 11B A COPY OF THE FORM 990 IS PROVIDED TO ALL THE MEMBERS OF THE BOARD OF DIRECTORS FOR REVIEW PRIOR TO BEING FILED WITH THE INTERNAL REVENUE SERVICE. FORM 990, PART VI, SECTION B, LINE 12C THE MEDICAL CENTER REQUIRES ALL OFFICERS, DIRECTORS, TRUSTEES AND KEY EMPLOYEES TO COMPLETE A CONFLICT OF INTEREST STATEMENT EACH YEAR. OFFICERS, DIRECTORS, TRUSTEES AND KEY EMPLOYEES ARE EDUCATED EACH YEAR ON THE DEFINITION OF A CONFLICT OF INTEREST AND HOW TO AVOID THEM. FORM 990, PART VI, SECTION B, LINE 15 AN OUTSIDE CONSULTANT IS ENGAGED TO PROVIDE BENCHMARK DATA FOR COMPARABLE POSITIONS IN COMPARABLY SIZED MEDICAL CENTERS. BASED ON THE DATA, THE CONSULTANT MAKES A RECOMMENDATION TO THE COMPENSATION COMMITTEE OF THE BOARD. THE BOARD DISCUSSES THE RECOMMENDATIONS AND MAKES A DECISION AS TO WHAT WILL BE PROVIDED FOR THE YEAR. THE PRESIDENT OF THE BOARD PROVIDES THE INFORMATION TO THE CHIEF FINANCIAL OFFICER TO IMPLEMENT. BASED ON DATA PROVIDED BY CONSULTANTS, THE BOARD OF DIRECTORS ESTABLISH PAY TARGETS FOR THE EXECUTIVE TEAM. THE PRESIDENT GRANTS THE VICE PRESIDENTS THEIR PAY INCREASES BASED ON PERFORMANCE IN THE PRECEEDING YEAR. FORM 990, PART VI, SECTION C, LINE 19 COPIES OF THE MEDICAL CENTERS GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, FINANCIAL STATEMENTS, AND FEDERAL FORM 990 ARE AVAILABLE AT THE ADMINISTRATIVE OFFICE UPON REQUEST. FORM 990, PART XI, LINE 9: CHANGE IN INTEREST IN NET ASSETS OF SFF -183,311. FORM 990, PART XII, LINE 2C: NO CHANGE IN PROCESS DURING FY18 MEDICAL PARTNERS OF CAPE GIRARDEAU 211 SAINT FRANCIS DRIVE CAPE GIRARDEAU MO 63703 431869973 PHYS. PRACTICE MO SFMC SAINT FRANCIS HEALTHCARE SYSTEM 211 SAINT FRANCIS DRIVE CAPE GIRARDEAU MO 63703 430662499 HOLDING COMPANY MO 501(C)(3) LINE 12B, II N/A 0 SAINT FRANCIS FOUNDATION 211 SAINT FRANCIS DRIVE CAPE GIRARDEAU MO 63703 431111276 FUND DEV. MO 501(C)(3) LINE 12B, II N/A 0 SAINT FRANCIS HEALTH DEVELOP SRVS 211 SAINT FRANCIS DRIVE CAPE GIRARDEAU MO 63703 470849798 HOLDING COMPANY MO N/A C 0 0 0 1 0 0 0 0 0 0 0 1 0 1 1 1 1 1 0 1