2019-05-11T10:04:40-05:00 2018-06-30 990 2017-07-01 630931008 St Vincent's Health System STVI 3147338000 810 St Vincents Drive Birmingham AL 35205 Tonya Mershon Tax Officer 2019-05-11 2017 2019-02-21 02:37:17Z JASON ALEXANDER 810 St Vincents Drive Birmingham AL 35205 146800329 false 0928 X www.stvhs.com X 1986 AL We provide high-tech, quality care to the people in more than 40 different zip codes. 13 13 887 13 133187 223561 15356593 1141967 172407672 139648721 1820489 559776 1276278 4843901 190861032 146194365 104260 211000 0 52371321 54031045 0 0 0 134202117 102664605 186677698 156906650 4183334 -10712285 219639839 290026638 95579424 89256169 124060415 200770469 Our Catholic health ministry is dedicated to spiritually centered, holistic care, which sustains and improves the health of individuals and communities. In furtherance of its mission and in an effort to reduce the government's financial burden, St. Vincent's Health System supports the efforts of its hospitals and health facilities providing care to individuals and communities. false false 145203980 211000 143090898 St. Vincent's Health System is a 66-bed hospital campus providing services without regard to patient race, creed, national origin, economic status, or ability to pay. During fiscal year 2018, St. Vincent's Health System treated 2,600 adults and children for a total of 9,263 patient days of service. The hospital also provided services for 78,924 outpatient visits, which included 2,616 outpatient surgeries and 42,976 Emergency Room Visits. See Schedule H for a non-exhaustive list of community benefit programs and descriptions. 145203980 true true false true false false false false false true false false true true true false true false false false false false false false false true true true false true false false false false false false false false false false false false true true true true true false true 223 0 true 887 true true true false false false false false true false false false X 13 13 false false false false true true true true true false true true false true true true true true false true true true X SARA OBRIEN 3147338070 11775 BORMAN DRIVE MARYLAND HEIGHTS MO 63146 NENA F SANDERS CHAIRMAN 2.0 5.0 X X 0 0 0 JOSEPH E WELDEN JR MD VICE-CHAIRMAN 2.0 5.0 X X 0 0 0 WILLIAM HORTON SECRETARY/TREASURER 2.0 5.0 X X 0 0 0 JAMES CANTRELL MD BOARD MEMBER 2.0 5.0 X 0 0 0 MATT CARRINGTON BOARD MEMBER (START 7/2017) 2.0 5.0 X 0 0 0 LEIGH DAVIS BOARD MEMBER (START 7/2017) 2.0 5.0 X 0 0 0 KENT J GRAEVE BOARD MEMBER 2.0 5.0 X 0 0 0 ELIZABETH HUNTLEY BOARD MEMBER 2.0 5.0 X 0 0 0 DENNIS JONES MD BOARD MEMBER 2.0 5.0 X 0 0 0 CATHERINE MARIE LOWE SISTER BOARD MEMBER (START 7/2017) 2.0 5.0 X 0 0 0 MICHAEL MILLS BOARD MEMBER (START 7/2017) 2.0 5.0 X 0 0 0 DAVID SILVERSTEIN BOARD MEMBER (START 7/2017) 2.0 5.0 X 0 0 0 DELYNN ZELL CFP BOARD MEMBER 2.0 5.0 X 0 0 0 JASON P ALEXANDER FACHE CEO, MINISTRY MARKET 0.0 50.0 X 0 472184 27767 JENNIFER L KINGRY CFO, MINISTRY MARKET (END 8/2017) 15.0 35.0 X 293400 0 19390 ROBERT E RAY PRESIDENT BIRMINGHAM 25.0 25.0 X 0 392773 35848 BRANDON M WILLIAMS CFO, MINISTRY MARKET (START 8/2017) 15.0 39.0 X 152113 0 9142 SUZANNAH CAMPBELL Administrator-STV CHILTON 50.0 0.0 X 212199 0 13478 WAYNE CARMELLO-HARPER SVP MISSION INTEGRATION & PHILANTHROPY 40.0 0.0 X 429151 0 35285 WILLIAM A DAVIS COO, MINISTRY MARKET (END 11/2017) 0.0 51.0 X 677383 35426 39389 STEPHANIE J DUGGAN MD CCO, MINISTRY MARKET 14.0 36.0 X 705629 0 39794 JAMES FLYNN AMG Administrative Dyad Leader 50.0 0 X 224906 0 31704 STEPHANIE HOLDERBY VP-Ambulatory HC Network 50.0 0 X 221679 0 25586 DON E KING COO, MINISTRY MARKET (START 1/2018) 7.0 43.0 X 0 782385 41936 JEFFREY H MIDDLEBROOK CLO, MINISTRY MARKET (START 1/2018) 5.0 50.0 X 0 537561 35064 LIZ MOORE CCMO, MINISTRY MARKET 5.0 0.0 X 111707 196370 37693 CHRISTOPHER L MOORE CNO, MINISTRY MARKET 14.0 36.0 X 317997 0 39438 LISA NICHOLS Administrator-STV ST CLAIR 50.0 0 X 180066 0 31546 PEGGY PANOS VP-Corporate Responsibility 50.0 0.0 X 157902 20994 20220 BRENNA POWELL VP-Strategic Integration 50.0 0 X 181726 0 14532 ANDREW TAYLOR VP-Regional Growth 50.0 0 X 159667 0 15539 LYDIA ANN EDWARDS DIRECTOR, PHARMACY 50.0 0 X 185812 0 23263 KRISTY GUNTHER VP, FINANCIAL PLANNING 50.0 0 X 182671 0 2676 JERRY L KITCHENS JR EXECUTIVE DIRECTOR 50.0 0 X 175215 0 30364 JACK WARREN VINES JR DIRECTOR, ORTHOPEDIC SERVICE LINE 50.0 0 X 202652 0 26560 GORDON BRIAN WESLEY ADMINISTRATIVE SYSTEM DIRECTOR, CARDIOVASCULAR 50.0 0 X 174637 0 20987 FRANK MALENSEK FORMER KEY EMPLOYEE (END 6/2017) 0.0 0.0 X 0 328658 38281 DAVID A CAUBLE FORMER OFFICER (END 11/2015) 0.0 0.0 X 375532 0 0 GREGORY L JAMES MD FORMER OFFICER (END 2/2016) 0.0 51.0 X 0 1026984 35414 MICHAEL R KORPIEL FORMER OFFICER (END 4/2017) 0.0 0.0 X 0 116259 1983 CAROL A MAIETTA FORMER OFFICER (END 1/2016) 0.0 0.0 X 247266 0 1854 NAN M PRIEST FORMER OFFICER (END 6/2017) 0.0 0.0 X 810477 0 32427 NEEYSA C BIDDLE FORMER OFFICER (END 6/2017) 0.0 0.0 X 1114745 111067 21512 7494531 4020662 748672 63 true true false SOUTHERN PERIOPERATIVE SERVICES PC 405 RIVERDALE DRIVE TUSCALOOSA AL 35406 HEALTHCARE SERVICES 646495 MEDSPEED LLC 665 W GRAND AVE SUITE 320 ELMHURST IL 601261043 COURIER SERVICES 327724 ACCENTURE LLP 161 N CLARK STREET CHICAGO IL 60601 CONSULTING SERVICES 308230 MEDPARTNERS HIM LLC 5810 CORAL RIDGE DR SUITE 250 CORAL SPRINGS FL 33076 HEALTHCARE SERVICES 260895 SIGNATURE HEALTH PC 2700 ROGERS DRIVE STE 102 BIRMINGHAM AL 35209 HEALTHCARE SERVICES 207130 10 X 1119920 22047 1141967 Net Patient Service Revenue 621990 66313862 66180713 133149 Services to Affiliates 561000 75962931 75962931 Shared Savings Revenue 900099 333598 333598 Lab Services 621500 -27835 -27873 38 Income from Joint Ventures 621990 298 298 -2934133 -2934133 0 0 139648721 1165740 1165740 194394 194394 0 194394 194394 605964 0 -605964 -605964 -605964 20037 20037 20037 Community Service 900099 3548324 3548324 Cafeteria/Vending Revenue 722514 259345 259345 Education Revenue 616000 27040 27040 794761 0 0 794761 4629470 146194365 143090898 133187 1828313 211000 211000 4873989 4386590 487399 38019348 34217413 3801935 1652649 1487384 165265 6547701 5892931 654770 2937358 2643622 293736 100319 90287 10032 15575 14018 1557 1070 963 107 5747 5172 575 -50000 -45000 -5000 4474709 4027239 447470 0 208210 187389 20821 1356672 1221005 135667 352098 316888 35210 3379641 3041677 337964 419907 377916 41991 215246 193721 21525 -603 -543 -60 10036080 9032473 1003607 497991 448192 49799 Purchased Services 34913751 31422376 3491375 Management Fee to Affiliate 17459711 17459711 Capitation Claims Expense 17032806 17032806 Medical Supplies 5176389 5176389 7069286 6362361 706925 0 156906650 145203980 11702670 0 30920137 1990 37692517 27349894 1859871 0 5954261 5286330 0 0 0 0 0 1109444 1282689 1262010 639765 479581 78536071 24366180 51549812 54169891 0 149072 95429 36462057 40774239 53129658 159497830 219639839 290026638 18156263 5893901 145387 242226 0 0 77277774 83120042 95579424 89256169 X 122158333 200718468 1902082 52001 124060415 200770469 219639839 290026638 X -10712285 336845 87085494 X false true X true false X X 5 ST VINCENT'S BIRMINGHAM 630288864 3 true 41913422 0 ST VINCENT'S EAST 630578923 3 true 22057373 0 ST VINCENT'S BLOUNT 630909073 3 true 2024274 0 AMERICAN SPORTS MEDICINE INSTITUTE 630952490 7 true 112576 0 ST VINCENT'S FOUNDATION OF ALABAMA INC 630868066 7 true 0 0 5 66107645 0 true false false false false false false false false false false false false false false true true false X true true Schedule A, Part IV, Section E, Line 3a Power To Appoint/Elect Majority of Officer/Director/Trustee Section 4.1-d-f of the current By Laws of St. Vincent's Health System details the power of the Board which includes but is not limited to recommending, appointing or removing of the governing board of it's subsidiaries. Schedule A, Part IV, Section E, Line 3b Substantial Direction Over Policies/Programs/Activities Section 1.4-h of the By Laws states St. Vincent's Health System "shall serve as the controlling entity of its subisidiaries. Organizations that conduct health related and other activity, and limit the powers, duties and responsibilities of the governing bodies of such Subsidiary Organizations, all in accordance with requirements established by Ascension Health." false false false false false false false false true 5747 5747 false Schedule C, Part II-B, Line 1 DETAILED DESCRIPTION OF THE LOBBYING ACTIVITY Lobbying expenses represent the portion of dues paid to national and state hospital associations that is specifically allocable to lobbying. St. Vincent's Health System does not participate or intervene in (including the publishing or distributing of statements), any political campaign on behalf of (or in opposition to) any candidate for public office. Schedule C, Part II-B, Line 1 DETAILED DESCRIPTION OF THE LOBBYING ACTIVITY Lobbying expenses represent the portion of dues paid to national and state hospital associations that is specifically allocable to lobbying. St. Vincent's Health System does not participate or intervene in (including the publishing or distributing of statements), any political campaign on behalf of (or in opposition to) any candidate for public office. 3250000 3250000 33661563 5303641 28357922 0 0 0 37376569 19050291 18326278 4247939 12248 4235691 54169891 Other MIscellaneous Assets 301434 Due from Affiliates 104405472 Other Receivables 13230192 Deferred Compensation/Retirement/Pension Asset Physician Guarantee Asset 1091920 Security Deposit 139064 Estimated 3rd Party Payor Settlements 1124856 Donor Restricted Non HSD 52001 Funded Depreciation 39152891 159497830 At Risk Compensation LIability Other LIabilities 1036171 Valuation ALlowance 924000 Due to Affiliates 68717257 Deferred Compensation/Retirement/Pension Liability Savings Plan Liability Estimated 3rd Party Payor Settlement 2417170 Physician Guarantee Liability 589273 Recovery Tail Liability 107222 Accrued Tax Liability 17287 IBNR Capitation Claims 9311662 83120042 X Schedule D, Part X, Line 2 FIN 48 (ASC 740) footnote THE SYSTEM ACCOUNTS FOR UNCERTAINTY IN INCOME TAX POSITIONS BY APPLYING A RECOGNITION THRESHOLD AND MEASUREMENT ATTRIBUTE FOR FINANCIAL STATEMENT RECOGNITION AND MEASUREMENT OF A TAX POSITION TAKEN OR EXPECTED TO BE TAKEN IN A TAX RETURN. THE SYSTEM HAS DETERMINED THAT NO MATERIAL UNRECOGNIZED TAX BENEFITS OR LIABILITIES EXIST AS OF JUNE 30, 2018. true true X true X 250 true X 327 true true true false true true 3011682 0 3011682 0.0192 7492632 6528471 964161 0.0061 0 0.0 0 0 10504314 6528471 3975843 0.0253 52 8342 351206 351206 0.0022 8 5 68682 68682 0.0004 2 480 1728 1728 0.0000 0 0.0 0 0.0 62 8827 421616 0 421616 0.0027 62 8827 10925930 6528471 4397459 0.0280 0 0.0 4 12155 12155 0.0001 17 52446 52446 0.0003 0 0.0 5 157701 157701 0.0010 2 7318 7318 0.0000 5 97423 97423 0.0006 5 355 7181 7181 0.0000 0 0.0 38 355 334224 0 334224 0.0021 false 3093327 0 18966224 19957959 -991735 X true true 2 1 St Vincent's St Clair 7063 Veterans Parkway Pell City AL 35125 https://healthcare.ascension.org/Locations/Alabama/ALBIR/Pell-City-St-Vincents-St-Clair H5801 X X X 2 St Vincent's Chilton 2030 Lay Dam Road Clanton AL 35046 https://healthcare.ascension.org/Locations/Alabama/ALBIR/Clanton-St-Vincents-Chilton H1102 X X X St Vincent's St Clair 1 false false true X X X X X X X X 15 true false false true X https://healthcare.ascension.org/Locations/Alabama/ALBIR/Pell-City-St-Vincents-St-Clair/Community-Be X true 15 true https://healthcare.ascension.org/Locations/Alabama/ALBIR/Pell-City-St-Vincents-St-Clair/Community-Be false true X 250.0 327.0 X X X true true X X X X true X https://healthcare.ascension.org/Financial-Assistance/Alabama X https://healthcare.ascension.org/Financial-Assistance/Alabama X https://healthcare.ascension.org/Financial-Assistance/Alabama X X X X X X true X false X X X X true X false false St Vincent's Chilton 2 true true true X X X X X X X X X 15 true false false true X https://healthcare.ascension.org/Locations/Alabama/ALBIR/Clanton-St-Vincents-Chilton/Community-Benef X true 15 true https://healthcare.ascension.org/Locations/Alabama/ALBIR/Clanton-St-Vincents-Chilton/Community-Benef false true X 250.0 327.0 X X X true true X X X X true X https://healthcare.ascension.org/Financial-Assistance/Alabama X https://healthcare.ascension.org/Financial-Assistance/Alabama X https://healthcare.ascension.org/Financial-Assistance/Alabama X X X X X X true X false X X X X true X false false Schedule H, Part V, Section B, Line 3E To better target community resources on the service area's most pressing health needs, the hospital participated in a group discussion with organizational decision makers and community leaders to prioritize the significant community health needs while considering several criteria: alignment with Ascension Health strategies of healthcare that leaves no one behind; care for the poor and vulnerable; opportunities for partnership; availability of existing programs and resources; addressing disparities of subgroups; availability of evidence-based practices; and community input. The significant health needs are a prioritized description of the significant health needs of the community as identified through the CHNA. See Schedule H, Part V, Line 7 for the link to the CHNA and Schedule H, Part V, Line 11 for how those needs are being addressed. Schedule H, Part V, Section B, Line 5 Facility , 1 Facility , 1 - St. Vincent's St. Clair. The CHNA process for St. Vincent's St. Clair was a collaborative project with representation from all areas of the Health System which included Senior Leadership, Corporate Development, Mission Integration, Finance, and leadership from each of the facilities. The process included a review of publically available secondary health data for the following health indicator topics recommended by the Catholic Health Association: demographics and socioeconomic status, access to health care, health status, risk factor behaviors, child health, infectious diseases, natural environment, and social environment. Input was also received by conducting interviews with individuals who represented broad interests of the community and local/state health leaders; a paper survey distributed and collected at community events; and focus groups were conducted within the community, with special attention to the vulnerable populations in the area served. * Interviews Interviews were conducted with a former CEO of a local community bank in St. Clair County, and a board member of the St. Clair County Healthcare Authority. * Paper Survey - simple paper pencil survey (attachment included in appendix) distributed at various events and locations, including: - Clergy Wellness 5K event - Various health fairs through STVHS Wellness Services - Access to Care patients - Jeremiah's Hope students * Focus Groups - Two focus groups were held at St. Vincent's St. Clair and open to the community in September of 2015. The focus groups were conducted to obtain more detailed information about resident perceptions of quality of life, including the assets, strengths, and weaknesses of St. Clair County. Schedule H, Part V, Section B, Line 11 Facility , 1 Facility , 1 - St Vincent's St. Clair - Part 1. ST. VINCENT'S ST. CLAIR COMMUNITY HEALTH NEEDS ASSESSMENT IMPLEMENTATION PLAN NARRATIVE FY17 UPDATE- ST. VINCENT'S BIRMINGHAM HOSPITAL THE IDENTIFIED COMMUNITY HEALTH NEEDS FOR THE DEFINED SERVICE AREA OF ST. VINCENT'S BIRMINGHAM FOR FY17 - FY19: 1. ACCESS TO HEALTHCARE AND MENTAL HEALTHCARE 2. CANCER AWARENESS/PREVENTION/EDUCATION 3. DIABETES AWARENESS/PREVENTION/EDUCATION PRIORITIZED NEED: IMPROVED ACCESS TO HEALTHCARE INCLUDING MENTAL HEALTHCARE GOAL 1: INCREASE PROPORTION OF PERSONS WITH HEALTH INSURANCE COVERAGE ST. VINCENT'S HEALTH SYSTEM HAS A LONG HISTORY OF WORKING WITH INDIVIDUALS WHO ARE UNINSURED TO BE ABLE TO PROVIDE HEALTHCARE AND MENTAL HEALTHCARE SERVICES. THE ACCESS TO CARE PROGRAM IS A PRIMARY CARE PROVIDER PROGRAM FOR INDIVIDUALS LIVING LESS THAN 200% INCOME OVER THE FEDERAL POVERTY LEVEL WHO HAVE NO OTHER ACCESS TO HEALTH COVERAGE. IN PARTNERSHIP WITH ENROLL ALABAMA, ST. VINCENT'S ENCOURAGED INDIVIDUALS TO SIGN UP FOR HEALTHCARE EXCHANGES AND PUBLICIZED BENEFITS OF THE AFFORDABLE CARE ACT. TO ADDRESS THIS NEED IN FY18, STVHS HEAVILY ADVOCATED FOR MEDICAID EXPANSION IN THE STATE OF ALABAMA AT THE LEGISLATIVE LEVEL. EFFORTS WERE MADE TO ASSIST INDIVIDUALS IN THE COMMUNITY WITH CONNECTING TO COVERAGE THROUGH THE OPEN ENROLLMENT PERIOD OF HEALTHCARE EXCHANGE IN COLLABORATION WITH ENROLL ALABAMA. GOAL 2: INCREASE PROPORTION OF PERSONS REPORTING MEDICAL HOME (PRIMARY CARE PROVIDER) STVHS HOSTED COMMUNITY HEALTH SCREENINGS INCLUDING DOCUMENTATION ON PRIMARY CARE PROVIDER AND FOLLOW UP INCLUDES REFERRAL AND ASSISTANCE WITH LOCATING APPROPRIATE SERVICES FOR THE PATIENT WHO IS UNATTACHED. A DOCUMENT WAS DEVELOPED AND IS BEING DISTRIBUTED TO THE COMMUNITY ON THE LEVELS OF CARE AND IMPORTANCE OF A PRIMARY CARE HOME. DURING A MEDICAL MISSION EVENT WITH PROJECT HOMELESS CONNECT, PATIENTS WERE GIVEN PCP APPOINTMENTS TO FOLLOW UP WITH A LOCAL FREE CLINIC. FOLLOW UP IS BEING PROVIDED BOTH INPATIENT AND OUTPATIENT TO ASSIST INDIVIDUALS WITH CONNECTING TO A PRIMARY CARE PROVIDER. TRANSPORTATION SERVICES HAVE BEEN ESTABLISHED WITH LYFT TO ASSIST PATIENTS IN GETTING TO FOLLOW UP AND PRIMARY CARE APPOINTMENTS. PROJECT ACCESS, A COMMUNITY COLLABORATIVE FOR SPECIALTY CARE, WORKS WITH INDIVIDUALS WHO ARE IN NEED OF A PRIMARY CARE PROVIDER BUT ALSO HAVE SPECIALTY CARE NEEDS. PATIENT NAVIGATORS HAVE BEEN ACTIVELY CONNECTING PATIENTS WITHOUT A PCP TO POSSIBLE PRIMARY CARE. UNATTACHED PATIENTS AT STVHS URGENT CARE ARE BEING FOLLOWED UP BY DIAL-A-NURSE TO ENSURE THEY ARE GIVEN APPROPRIATE OPTIONS FOR A MEDICAL HOME. GOAL 3: INCREASE PROPORTION OF ADULTS WITH MENTAL HEALTH DISORDERS WHO RECEIVE TREATMENT THE ADDITION OF THE OUTPATIENT BRIDGE CLINIC AT ST. VINCENT'S EAST PROVIDES THE ENTIRE REGION A QUICK LINKAGE TO INDIVIDUALS IN NEED OF URGENT MENTAL HEALTH SERVICES AS THEY WAIT TO BE CONNECTED WITH A MORE PERMANENT PROVIDER. IN FY18, THE BRIDGE CLINIC PROVIDED SERVICES TO 172 UNIQUE PATIENTS WHO DID NOT HAVE A MENTAL HEALTHCARE PROVIDER. A MENTAL HEALTHCARE PROVIDER ROUNDTABLE OF COMMUNITY ORGANIZATIONS/AGENCIES MEETS REGULARLY TO IDENTIFY GAPS IN SERVICE AND PROVIDE UPDATES AND INFORMATION ON SERVICES AVAILABLE IN THE COMMUNITY. A MENTAL HEALTH PROVIDER RESOURCE IS AVAILABLE TO YOUTH THROUGH THE ESTABLISHMENT OF THE REFERRAL CENTER AT CHILDREN'S HOSPITAL. SIMILAR RESOURCE FOR ADULTS IS BEING COORDINATED THROUGH THE STATE'S 2-1-1 SERVICE AT UNITED WAY. A SPOE (SINGLE POINT OF ENTRY) FOR MENTAL HEALTH IS BEING EVALUATED AT THE LOCAL AND STATE LEVEL. A PHYSICIAN CME CLASS WAS PROVIDED ON DEPRESSION AND SUICIDE TO RECOGNIZE SIGNS AND SYMPTOMS IN PATIENTS AS WELL AS PRACTITIONERS. A CME ON OPIOID ABUSE WAS HELD IN FY18 AS WELL. TWO CME OFFERINGS COVERED ISSUES AROUND WORKPLACE VIOLENCE AND MENTAL HEALTH. A PHARMACY CONFERENCE WAS HELD INCLUDING SESSIONS RELATED TO MENTAL HEALTH AND MEDICATION. IN MARCH OF 2017, ST. VINCENT'S ST. CLAIR IMPLEMENTED TELEPSYCH EVALUATION ABILITY TO ITS CAMPUS AND WAS ABLE TO CONNECT WITH PSYCHIATRISTS FOR CONSULTS WHERE THIS WAS NOT PREVIOUSLY POSSIBLE. GOAL 4: INCREASE DEPRESSION SCREENING FOR ADULTS BY PRIMARY CARE PROVIDERS ALL AMG PHYSICIAN PRACTICES HAVE IMPLEMENTED THE PHQ-9 DEPRESSION/ANXIETY SCREENING FOR NEW AND ANNUAL PATIENT VISITS. INDIVIDUALS WITH A QUALIFYING SCORE ARE REFERRED FOR SERVICES. OTHER AFFILIATED PRACTICES ARE PROVIDING PHQ-9 SCREENINGS AS WELL. IN CY17 AND 18, THIS RESULTED IN 1290 NEW SCREENINGS AND EDUCATION REGARDING DEPRESSION AND ANXIETY. PRIORITIZED NEED: IMPROVE EDUCATION/AWARENESS/PREVENTION OF CANCER GOAL 1: INCREASE PROPORTION OF ADULTS WHO WERE COUNSELED BY THEIR PROVIDERS ABOUT CANCER SCREENINGS BASED ON CURRENT GUIDELINES CANCER SCREENINGS BASED ON CURRENT GUIDELINES PLANS ARE CURRENTLY UNDERWAY TO PROVIDE MORE PHYSICIAN EDUCATION REGARDING CANCER SCREENING GUIDELINES. CLINICAL PROMPTS ARE PART OF THE ELECTRONIC HEALTH RECORD. CME TOPICS FOR EDUCATION OF PHYSICIANS SPECIFIC TO CANCER ARE UPCOMING FOR FY19. GOAL 2: INCREASE PROPORTION OF ADULTS WHO RECEIVE BREAST, LUNG, PROSTATE, COLORECTAL AND SKIN CANCER SCREENING ST. VINCENT'S CLINIC PATIENTS HAD A BASELINE COLORECTAL CANCER SCREENING RATE OF 36.5% AND THIS WAS INCREASED IN FY17 TO 47.4%. SPECIFICALLY, FOR MEDICAID PATIENTS, THE BASELINE BEGAN AT 43% AND INCREASED TO 49.7% IN FY17. IN 2018, ST. VINCENT'S OSE PROVIDED FREE COLORECTAL CANCER SCREENINGS TO THE UNINSURED COMMUNITY. OF THOSE, 39 COLONOSCOPIES WERE PERFORMED. GOAL 3: INCREASE MENTAL AND PHYSICAL HEALTH-RELATED QUALITY OF LIFE INDICATORS OF CANCER SURVIVORS ST. VINCENT'S PARTICIPATION AND CLOSE PARTNERSHIP WITH FORGE PROVIDES SUPPORT AND SERVICES TO INDIVIDUALS WHO HAVE EXPERIENCED BREAST CANCER. A 24-HOUR SUPPORT LINE HAS BEEN ESTABLISHED TO PROVIDE COUNSELING AND REFERRALS, SUPPORT GROUPS AND ACTIVITIES THAT PROMOTE HEALTHY LIVING HAVE ENGAGED SURVIVORS. PATIENT ADVOCATES/NAVIGATORS ASSIST PATIENTS WITH SUPPORTIVE SERVICES. A RESOURCE LIBRARY IS AVAILABLE TO INDIVIDUALS IN NEED OF ADDITIONAL INFORMATION. A CLINICIAN ADVISORY COMMITTEE PROVIDES CLINICAL FEEDBACK TO SURVIVOR NETWORK. PRIORITIZED NEED: IMPROVE EDUCATION/AWARENESS/PREVENTION OF DIABETES GOAL 1: INCREASE PROPORTION OF PERSONS WITH DIABETES WHOSE CONDITION HAS BEEN DIAGNOSED THROUGH EARLY SCREENING AND RISK FACTORS IN FY18, ST. VINCENT'S WELLNESS DEPARTMENT PROVIDED FREE GLUCOSE SCREENINGS TO THE COMMUNITY - ESPECIALLY FOCUSED ON AREAS WHERE HEALTHCARE ACCESS IS A BARRIER. THESE INDIVIDUALS WERE PROVIDED COUNSELING AND ABNORMAL RESULTS WERE CALLED BY A NURSE FROM DIAL-A-NURSE TO DISCUSS THE RESULTS AND ASSISTANCE WITH LOCATING A PROVIDER WHO COULD PROVIDE CONTINUED CARE AND TREATMENT. GOAL 2: INCREASE PROPORTION OF ADULTS DIAGNOSED WITH DIABETES WHO RECEIVE FORMAL DIABETES EDUCATION IN FY18, ST. VINCENT'S HEALTH SYSTEM PROVIDED 4,688 DIABETES EDUCATION PATIENT ENCOUNTERS. THIS IS UP APPROXIMATELY 12% FROM THE PREVIOUS YEAR WHERE FY 17 RECORDED 4185 ENCOUNTERS. Schedule H, Part V, Section B, Line 11 Facility , 2 Facility , 2 - St. Vincent's St. Clair - Part 2. *PROPOSED GOALS ARE TAKEN FROM HEALTHY PEOPLE 2020 GOALS **PROPOSED STRATEGIES ARE BASED ON EVIDENCE BASED PRACTICES THE CHNA FOR FISCAL YEARS 2017-2019 (BEGINNING JULY 1, 2016) WILL CONTINUE EFFORTS TO ADDRESS HEALTH NEEDS OF THE GREATER BIRMINGHAM COMMUNITY AND PRIORITIZE NEEDS OF THE AREAS ST. VINCENT'S BIRMINGHAM. THE ASSESSMENTS OF UNMET HEALTH NEEDS WILL PROVIDE A BASIS FOR ADDRESSING THE HEALTH NEEDS OF THE COUNTIES SERVED AND SERVE AS A REFERENCE FOR EACH FACILITY'S IMPLEMENTATION STRATEGY, ENSURING IT IS ALIGNED WITH THE COMMUNITY NEEDS AND THE MINISTRY GOALS OF ST. VINCENT'S HEALTH SYSTEM. THE MISSION, VISION, AND VALUES OF ST. VINCENT'S HEALTH SYSTEM ARE THE KEY FACTORS INFLUENCING THE APPROACH AND COMMITMENT TO ADDRESSING COMMUNITY HEALTH NEEDS THROUGH COMMUNITY BENEFIT ACTIVITY. THE OBJECTIVES OF THE CHNA AND SUBSEQUENT FACILITY SPECIFIC IMPLEMENTATION STRATEGIES ARE: 1.) TO PROVIDE AN UNBIASED COMPREHENSIVE ASSESSMENT OF ST. CLAIR COUNTY'S HEALTH NEEDS; 2.) USE THE CHNA TO PRIORITIZE ST. VINCENT'S HEALTH SYSTEM'S COMMUNITY BENEFIT PROGRAM STRATEGY; AND 3.) FULFILL INTERNAL REVENUE SERVICE REGULATIONS RELATED TO 501 (C)(3) NON-PROFIT HOSPITAL STATUS FOR FEDERAL INCOME TAXES. ALL NEEDS IDENTIFIED IN THE CHNA ARE ACTIVELY BEING ADDRESSED. Schedule H, Part V, Section B, Line 13 Facility , 1 Facility , 1 - ST. VINCENT'S ST. CLAIR. At a minimum, Patients with incomes above 250% of the FPL, but not exceeding 327% of the FPL, will receive a sliding scale discount on that portion of the charges for services provided for which the Patient is responsible following payment by an insurer, if any. A Patient eligible for the sliding scale discount will not be charged more than the calculated AGB charges. Patients with demonstrated financial needs with income greater than 327% of the FPL may be eligible for consideration under a "Means Test" for some discount of their charges for services from the Organization based on a substantive assessment of their ability to pay. A Patient who is not eligible for FAP under presumptive eligibility will be able to complete a FAP application for consideration of qualifying for Charity under the "Means Test". The Means Test shall be applied in individual cases of hardship under particular circumstances of patients with income greater than the FPL base. A Patient eligible for the "Means Test" discount will not be charged more than the calculated AGB charges for the care provided. Schedule H, Part V, Section B, Line 2 St Vincent's Chilton was a newly constructed facility that opened in August 2016. It is licensed for 30 beds. Schedule H, Part V, Section B, Line 3E To better target community resources on the service area's most pressing health needs, the hospital participated in a group discussion with organizational decision makers and community leaders to prioritize the significant community health needs while considering several criteria: alignment with Ascension Health strategies of healthcare that leaves no one behind; care for the poor and vulnerable; opportunities for partnership; availability of existing programs and resources; opportunities for partnership; addressing disparities of subgroups; availability of evidence-based practices; and community input. The significant health needs are a prioritized description of the significant health needs of the community as identified through the CHNA. See Schedule H, Part V, Line 7 for the link to the CHNA and Schedule H, Part V, Line 11 for how those needs are being addressed. Schedule H, Part V, Section B, Line 5 Facility , 1 Facility , 1 - St Vincent's Chilton. The CHNA process for St. Vincent's Chilton was a collaborative project with representation from all areas of the Health System which included Senior Leadership, Corporate Development, Mission Integration, Finance, and leadership from each of the facilities. The process included a review of publicly available secondary health data for the following health indicator topics recommended by the Catholic Health Association: demographics and socioeconomic status, access to health care, health status, risk factor behaviors, child health, infectious diseases, natural environment, and social environment. Input was also received by conducting interviews with individuals who represented broad interests of the community and local/state health leaders; and a paper survey was distributed and collected at community events. * Interviews - Interviews were conducted with city mayors within Chilton County, county commissioner, city council members and a member of the Chilton County Healthcare Authority Board. * Paper Survey - simple paper pencil survey (attachment included in appendix) distributed at various events and locations, including: - Clergy Wellness 5K event - Various health fairs through STVHS Wellness Services - Access to Care patients -Jeremiah's Hope students Schedule H, Part V, Section B, Line 11 Facility , 1 Facility , 1 - St Vincent's Chilton - Part 1. COMMUNITY HEALTH NEEDS ASSESSMENT IMPLEMENTATION PLAN NARRATIVE FY17 UPDATE- ST. VINCENT'S CHILTON HOSPITAL THE IDENTIFIED COMMUNITY HEALTH NEEDS FOR THE DEFINED SERVICE AREA OF ST. VINCENT'S BIRMINGHAM FOR FY17 - FY19: 1. ACCESS TO HEALTHCARE AND MENTAL HEALTHCARE 2. CANCER AWARENESS/PREVENTION/EDUCATION 3. DIABETES AWARENESS/PREVENTION/EDUCATION PRIORITIZED NEED: IMPROVED ACCESS TO HEALTHCARE INCLUDING MENTAL HEALTHCARE GOAL 1: INCREASE PROPORTION OF PERSONS WITH HEALTH INSURANCE COVERAGE ST. VINCENT'S HEALTH SYSTEM HAS A LONG HISTORY OF WORKING WITH INDIVIDUALS WHO ARE UNINSURED TO BE ABLE TO PROVIDE HEALTHCARE AND MENTAL HEALTHCARE SERVICES. THE ACCESS TO CARE PROGRAM IS A PRIMARY CARE PROVIDER PROGRAM FOR INDIVIDUALS LIVING LESS THAN 200% INCOME OVER THE FEDERAL POVERTY LEVEL WHO HAVE NO OTHER ACCESS TO HEALTH COVERAGE. IN PARTNERSHIP WITH ENROLL ALABAMA, ST. VINCENT'S ENCOURAGED INDIVIDUALS TO SIGN UP FOR HEALTHCARE EXCHANGES AND PUBLICIZED BENEFITS OF THE AFFORDABLE CARE ACT. TO ADDRESS THIS NEED IN FY18, STVHS HEAVILY ADVOCATED FOR MEDICAID EXPANSION IN THE STATE OF ALABAMA AT THE LEGISLATIVE LEVEL. EFFORTS WERE MADE TO ASSIST INDIVIDUALS IN THE COMMUNITY WITH CONNECTING TO COVERAGE THROUGH THE OPEN ENROLLMENT PERIOD OF HEALTHCARE EXCHANGE IN COLLABORATION WITH ENROLL ALABAMA. GOAL 2: INCREASE PROPORTION OF PERSONS REPORTING MEDICAL HOME (PRIMARY CARE PROVIDER) STVHS HOSTED COMMUNITY HEALTH SCREENINGS INCLUDING DOCUMENTATION ON PRIMARY CARE PROVIDER AND FOLLOW UP INCLUDES REFERRAL AND ASSISTANCE WITH LOCATING APPROPRIATE SERVICES FOR THE PATIENT WHO IS UNATTACHED. A DOCUMENT WAS DEVELOPED AND IS BEING DISTRIBUTED TO THE COMMUNITY ON THE LEVELS OF CARE AND IMPORTANCE OF A PRIMARY CARE HOME. DURING A MEDICAL MISSION EVENT WITH PROJECT HOMELESS CONNECT, PATIENTS WERE GIVEN PCP APPOINTMENTS TO FOLLOW UP WITH A LOCAL FREE CLINIC. FOLLOW UP IS BEING PROVIDED BOTH INPATIENT AND OUTPATIENT TO ASSIST INDIVIDUALS WITH CONNECTING TO A PRIMARY CARE PROVIDER. TRANSPORTATION SERVICES HAVE BEEN ESTABLISHED WITH LYFT TO ASSIST PATIENTS IN GETTING TO FOLLOW UP AND PRIMARY CARE APPOINTMENTS. PROJECT ACCESS, A COMMUNITY COLLABORATIVE FOR SPECIALTY CARE, WORKS WITH INDIVIDUALS WHO ARE IN NEED OF A PRIMARY CARE PROVIDER BUT ALSO HAVE SPECIALTY CARE NEEDS. PATIENT NAVIGATORS HAVE BEEN ACTIVELY CONNECTING PATIENTS WITHOUT A PCP TO POSSIBLE PRIMARY CARE. UNATTACHED PATIENTS AT STVHS URGENT CARE ARE BEING FOLLOWED UP BY DIAL-A-NURSE TO ENSURE THEY ARE GIVEN APPROPRIATE OPTIONS FOR A MEDICAL HOME. GOAL 3: INCREASE PROPORTION OF ADULTS WITH MENTAL HEALTH DISORDERS WHO RECEIVE TREATMENT THE ADDITION OF THE OUTPATIENT BRIDGE CLINIC AT ST. VINCENT'S EAST PROVIDES THE ENTIRE REGION A QUICK LINKAGE TO INDIVIDUALS IN NEED OF URGENT MENTAL HEALTH SERVICES AS THEY WAIT TO BE CONNECTED WITH A MORE PERMANENT PROVIDER. IN FY18, THE BRIDGE CLINIC PROVIDED SERVICES TO 172 UNIQUE PATIENTS WHO DID NOT HAVE A MENTAL HEALTHCARE PROVIDER. A MENTAL HEALTHCARE PROVIDER ROUNDTABLE OF COMMUNITY ORGANIZATIONS/AGENCIES MEETS REGULARLY TO IDENTIFY GAPS IN SERVICE AND PROVIDE UPDATES AND INFORMATION ON SERVICES AVAILABLE IN THE COMMUNITY. A MENTAL HEALTH PROVIDER RESOURCE IS AVAILABLE TO YOUTH THROUGH THE ESTABLISHMENT OF THE REFERRAL CENTER AT CHILDREN'S HOSPITAL. SIMILAR RESOURCE FOR ADULTS IS BEING COORDINATED THROUGH THE STATE'S 2-1-1 SERVICE AT UNITED WAY. A SPOE (SINGLE POINT OF ENTRY) FOR MENTAL HEALTH IS BEING EVALUATED AT THE LOCAL AND STATE LEVEL. A PHYSICIAN CME CLASS WAS PROVIDED ON DEPRESSION AND SUICIDE TO RECOGNIZE SIGNS AND SYMPTOMS IN PATIENTS AS WELL AS PRACTITIONERS. A CME ON OPIOID ABUSE WAS HELD IN FY18 AS WELL. TWO CME OFFERINGS COVERED ISSUES AROUND WORKPLACE VIOLENCE AND MENTAL HEALTH. A PHARMACY CONFERENCE WAS HELD INCLUDING SESSIONS RELATED TO MENTAL HEALTH AND MEDICATION. IN MARCH OF 2017, ST. VINCENT'S CHILTON IMPLEMENTED TELEPSYCH EVALUATION ABILITY TO ITS CAMPUS AND WAS ABLE TO CONNECT WITH PSYCHIATRISTS FOR CONSULTS WHERE THIS WAS NOT PREVIOUSLY POSSIBLE. GOAL 4: INCREASE DEPRESSION SCREENING FOR ADULTS BY PRIMARY CARE PROVIDERS ALL AMG PHYSICIAN PRACTICES HAVE IMPLEMENTED THE PHQ-9 DEPRESSION/ANXIETY SCREENING FOR NEW AND ANNUAL PATIENT VISITS. INDIVIDUALS WITH A QUALIFYING SCORE ARE REFERRED FOR SERVICES. OTHER AFFILIATED PRACTICES ARE PROVIDING PHQ-9 SCREENINGS AS WELL. IN CY17 AND 18, THIS RESULTED IN 1290 NEW SCREENINGS AND EDUCATION REGARDING DEPRESSION AND ANXIETY. PRIORITIZED NEED: IMPROVE EDUCATION/AWARENESS/PREVENTION OF CANCER GOAL 1: INCREASE PROPORTION OF ADULTS WHO WERE COUNSELED BY THEIR PROVIDERS ABOUT CANCER SCREENINGS BASED ON CURRENT GUIDELINES CANCER SCREENINGS BASED ON CURRENT GUIDELINES PLANS ARE CURRENTLY UNDERWAY TO PROVIDE MORE PHYSICIAN EDUCATION REGARDING CANCER SCREENING GUIDELINES. CLINICAL PROMPTS ARE PART OF THE ELECTRONIC HEALTH RECORD. CME TOPICS FOR EDUCATION OF PHYSICIANS SPECIFIC TO CANCER ARE UPCOMING FOR FY19. GOAL 2: INCREASE PROPORTION OF ADULTS WHO RECEIVE BREAST, LUNG, PROSTATE, COLORECTAL AND SKIN CANCER SCREENING ST. VINCENT'S CLINIC PATIENTS HAD A BASELINE COLORECTAL CANCER SCREENING RATE OF 36.5% AND THIS WAS INCREASED IN FY17 TO 47.4%. SPECIFICALLY, FOR MEDICAID PATIENTS, THE BASELINE BEGAN AT 43% AND INCREASED TO 49.7% IN FY17. IN 2018, ST. VINCENT'S OSE PROVIDED FREE COLORECTAL CANCER SCREENINGS TO THE UNINSURED COMMUNITY. OF THOSE, 39 COLONOSCOPIES WERE PERFORMED. GOAL 3: INCREASE MENTAL AND PHYSICAL HEALTH-RELATED QUALITY OF LIFE INDICATORS OF CANCER SURVIVORS ST. VINCENT'S PARTICIPATION AND CLOSE PARTNERSHIP WITH FORGE PROVIDES SUPPORT AND SERVICES TO INDIVIDUALS WHO HAVE EXPERIENCED BREAST CANCER. A 24-HOUR SUPPORT LINE HAS BEEN ESTABLISHED TO PROVIDE COUNSELING AND REFERRALS, SUPPORT GROUPS AND ACTIVITIES THAT PROMOTE HEALTHY LIVING HAVE ENGAGED SURVIVORS. PATIENT ADVOCATES/NAVIGATORS ASSIST PATIENTS WITH SUPPORTIVE SERVICES. A RESOURCE LIBRARY IS AVAILABLE TO INDIVIDUALS IN NEED OF ADDITIONAL INFORMATION. A CLINICIAN ADVISORY COMMITTEE PROVIDES CLINICAL FEEDBACK TO SURVIVOR NETWORK. PRIORITIZED NEED: IMPROVE EDUCATION/AWARENESS/PREVENTION OF DIABETES GOAL 1: INCREASE PROPORTION OF PERSONS WITH DIABETES WHOSE CONDITION HAS BEEN DIAGNOSED THROUGH EARLY SCREENING AND RISK FACTORS IN FY18, ST. VINCENT'S WELLNESS DEPARTMENT PROVIDED FREE GLUCOSE SCREENINGS TO THE COMMUNITY - ESPECIALLY FOCUSED ON AREAS WHERE HEALTHCARE ACCESS IS A BARRIER. THESE INDIVIDUALS WERE PROVIDED COUNSELING AND ABNORMAL RESULTS WERE CALLED BY A NURSE FROM DIAL-A-NURSE TO DISCUSS THE RESULTS AND ASSISTANCE WITH LOCATING A PROVIDER WHO COULD PROVIDE CONTINUED CARE AND TREATMENT. GOAL 2: INCREASE PROPORTION OF ADULTS DIAGNOSED WITH DIABETES WHO RECEIVE FORMAL DIABETES EDUCATION IN FY18, ST. VINCENT'S HEALTH SYSTEM PROVIDED 4,688 DIABETES EDUCATION PATIENT ENCOUNTERS. THIS IS UP APPROXIMATELY 12% FROM THE PREVIOUS YEAR WHERE FY 17 RECORDED 4185 ENCOUNTERS. Schedule H, Part V, Section B, Line 11 Facility , 2 Facility , 2 - St. Vincent's Chilton - Part II. *PROPOSED GOALS ARE TAKEN FROM HEALTHY PEOPLE 2020 GOALS **PROPOSED STRATEGIES ARE BASED ON EVIDENCE BASED PRACTICES THE CHNA FOR FISCAL YEARS 2017-2019 (BEGINNING JULY 1, 2016) WILL CONTINUE EFFORTS TO ADDRESS HEALTH NEEDS OF THE GREATER BIRMINGHAM COMMUNITY AND PRIORITIZE NEEDS OF THE AREAS ST. VINCENT'S HEALTH SYSTEM. THE ASSESSMENTS OF UNMET HEALTH NEEDS WILL PROVIDE A BASIS FOR ADDRESSING THE HEALTH NEEDS OF THE COUNTIES SERVED AND SERVE AS A REFERENCE FOR EACH FACILITY'S IMPLEMENTATION STRATEGY, ENSURING IT IS ALIGNED WITH THE COMMUNITY NEEDS AND THE MINISTRY GOALS OF ST. VINCENT'S HEALTH SYSTEM. THE MISSION, VISION, AND VALUES OF ST. VINCENT'S HEALTH SYSTEM ARE THE KEY FACTORS INFLUENCING THE APPROACH AND COMMITMENT TO ADDRESSING COMMUNITY HEALTH NEEDS THROUGH COMMUNITY BENEFIT ACTIVITY. THE OBJECTIVES OF THE CHNA AND SUBSEQUENT FACILITY SPECIFIC IMPLEMENTATION STRATEGIES ARE: 1.) TO PROVIDE AN UNBIASED COMPREHENSIVE ASSESSMENT OF CHILTON COUNTY'S HEALTH NEEDS; 2.) USE THE CHNA TO PRIORITIZE ST. VINCENT'S HEALTH SYSTEM'S COMMUNITY BENEFIT PROGRAM STRATEGY; AND 3.) FULFILL INTERNAL REVENUE SERVICE REGULATIONS RELATED TO 501 (C)(3) NON-PROFIT HOSPITAL STATUS FOR FEDERAL INCOME TAXES. ALL NEEDS IDENTIFIED IN THE CHNA ARE ACTIVELY BEING ADDRESSED. Schedule H, Part V, Section B, Line 13 Facility , 1 Facility , 1 - ST. VINCENT'S CHILTON. At a minimum, Patients with incomes above 250% of the FPL, but not exceeding 327% of the FPL, will receive a sliding scale discount on that portion of the charges for services provided for which the Patient is responsible following payment by an insurer, if any. A Patient eligible for the sliding scale discount will not be charged more than the calculated AGB charges. Patients with demonstrated financial needs with income greater than 327% of the FPL may be eligible for consideration under a "Means Test" for some discount of their charges for services from the Organization based on a substantive assessment of their ability to pay. A Patient who is not eligible for FAP under presumptive eligibility will be able to complete a FAP application for consideration of qualifying for Charity under the "Means Test". The Means Test shall be applied in individual cases of hardship under particular circumstances of patients with income greater than the FPL base. A Patient eligible for the "Means Test" discount will not be charged more than the calculated AGB charges for the care provided. 0 Schedule H, Part VI, Line 5 Promotion of Community Health - Part 2 PROMOTION OF HEALTH AND WELLNESS IS AN INTEGRATED PART OF THE ST. VINCENT'S CULTURE. HEALTH SCREENINGS, EDUCATION AND FOLLOW-UP IN THE BROADER COMMUNITY BRING AWARENESS AND LEARNING TO INDIVIDUALS WHO MIGHT NOT OTHERWISE RECEIVE CARE. IN ADDITION TO COMMUNITY SCREENINGS, ST. VINCENT'S HAS TRADITIONALLY FOCUSED OUTREACH ON AREAS FOR SYSTEMIC CHANGE SUCH AS THE IMPLEMENTATION OF COMMUNITY VEGETABLE GARDENS TO PROMOTE HEALTHY EATING AND COLLECTION OF P.E. EQUIPMENT FOR LOCAL SCHOOLS. ST. VINCENT'S ASSOCIATES VOLUNTEER AS P.E. HELPERS TO ENCOURAGE THE HEALTHY HABITS OF EXERCISE FOR ELEMENTARY SCHOOL STUDENTS. WITH THE ASSISTANCE OF ATHLETIC TRAINERS, ST. VINCENT'S ASSISTS WITH THE PROMOTION OF SAFE ATHLETICS TO ENSURE STUDENTS DO NOT INJURE THEMSELVES AT SUCH A YOUNG AGE. SPORTS PHYSICALS FOR STUDENTS WHO WOULD NOT OTHERWISE HAVE ACCESS ARE ALSO PART OF THE COMMUNITY HEALTH OUTREACH. IN COLLABORATION WITH THE GREATER COMMUNITY, ST. VINCENT'S PROVIDES MEDICAL CARE, PHARMACEUTICALS, VACCINES, WOUND CARE AND FOOT CARE AT PROJECT HOMELESS CONNECT, A ONE-DAY BLITZ OF SERVICES FOR INDIVIDUALS IN THE COMMUNITY EXPERIENCING HOMELESSNESS. ST. VINCENT'S ALSO PROVIDES HEALTHY SNACKS FOR PARTICIPANTS AND VOLUNTEERS AT THE EVENT. ST. VINCENT'S EAST AND CHRIST HEALTH CENTER (A LOCAL FEDERALLY QUALIFIED HEALTH CENTER), CREATED A HIGH-LEVEL OF CLINICAL INTEGRATION TO IMPROVE HEALTH EQUITY IN 49 ZIP CODES BY INCREASING ACCESS TO PRIMARY CARE AND MENTAL HEALTH SERVICES FOR ALMOST 12,000 LOW TO MODERATE INCOME INDIVIDUALS. ST. VINCENT'S CONTINUES TO CARE FOR THE COMMUNITY THROUGH EXTENSIVE COLLABORATION SUCH AS WITH THE FORGE INITIATIVE. THIS BREAST CANCER SURVIVORSHIP PROGRAM PROVIDES A 24/7 HOTLINE FOR SUPPORT, PEER MENTORS, SUPPORT GROUPS AND OTHER RESOURCES TO BREAST CANCER SURVIVORS AND THEIR CAREGIVERS. HOUSED AT ST. VINCENT'S AND LED BY THE HEALTH SYSTEM, THIS INITIATIVE SUCCESSFULLY BROUGHT TOGETHER ALL THE MAJOR HEALTHCARE PROVIDERS IN THE REGION TO RALLY AROUND ONE CAUSE. ST. VINCENT'S PROVIDES IN-KIND OFFICE SPACE AND SUPPORT FOR THE FORGE STAFF. WE ARE CALLED TO: - SERVICE OF THE POOR - GENEROSITY OF SPIRIT, ESPECIALLY FOR PERSONS MOST IN NEED - REVERENCE - RESPECT AND COMPASSION FOR THE DIGNITY AND DIVERSITY OF LIFE - INTEGRITY-INSPIRING TRUST THROUGH PERSONAL LEADERSHIP - WISDOM-INTEGRATING EXCELLENCE AND STEWARDSHIP - CREATIVITY -COURAGEOUS INNOVATION - DEDICATION - AFFIRMING THE HOPE AND JOY OF OUR MINISTRY. ST. VINCENT'S HEALTH SYSTEM IS MADE UP OF SIX FACILITIES: ST. VINCENT'S BIRMINGHAM, ST. VINCENT'S BLOUNT, ST. VINCENT'S EAST, ST. VINCENT'S ST. CLAIR, ST. VINCENT'S CHILTON AND ONE NINETEEN HEALTH AND WELLNESS. TOGETHER, WE PROVIDE A SPECIAL BRAND OF HIGH-TOUCH, HIGH-TECH QUALITY CARE TO PEOPLE IN MORE THAN 40 DIFFERENT ZIP CODES. OUR HEALTHCARE FAMILY HAS AN EXTENSIVE NETWORK OF SKILLED PHYSICIANS AND ASSOCIATES, AS WELL AS THE MOST ADVANCED TECHNOLOGIES AVAILABLE. WE ARE A PART OF ASCENSION HEALTH, THE NATION'S LARGEST CATHOLIC AND NON-PROFIT HEALTH SYSTEM, WITH MORE THAN 150,000 ASSOCIATES SERVING IN 23 STATES AND THE DISTRICT OF COLUMBIA. WE ARE COMMITTED TO PROVIDING HEALTHCARE THAT WORKS, HEALTHCARE THAT IS SAFE, AND HEALTHCARE THAT LEAVES NO ONE BEHIND FOR LIFE. Schedule H, Part I, Line 7 Costing Methodology used to calculate financial assistance The cost of providing charity care, means-tested government programs, and other community benefit programs is estimated using internal cost data, and is calculated in compliance with Catholic Health Association ("CHA") guidelines. The organization uses a cost accounting system that addresses all patient segments (for example, inpatient, outpatient, emergency room, private insurance, Medicaid, Medicare, uninsured, or self pay). The best available data was used to calculate the amounts reported in the table. For the information in the table, a cost-to-charge ratio was calculated and applied. Schedule H, Part II Community Building Activities RESEARCH SHOWS THAT SOCIAL DETERMINANTS AND QUALITY OF LIFE PLAY A MAJOR ROLE IN THE HEALTH STATUS OF INDIVIDUALS AND COMMUNITIES. COMMUNITY BUILDING ACTIVITIES, WHICH FOCUS ON IMPROVING THE QUALITY OF LIFE WITHIN A COMMUNITY, ULTIMATELY INFLUENCE AND IMPROVE HEALTH STATUS. Schedule H, Part III, Line 2 Bad debt expense - methodology used to estimate amount After satisfaction of amounts due from insurance and reasonable efforts to collect from the patient have been exhausted, the Corporation follows established guidelines for placing certain past-due patient balances within collection agencies, subject to the terms of certain restrictions on collection efforts as determined by Ascension Health. Accounts receivable are written off after collection efforts have been followed in accordance with the Corporation's policies. After applying the cost-to-charge ratio, the share of the bad debt expense in fiscal year 2018 was $7,951,697 at charges, ($3,093,327 at cost). Schedule H, Part III, Line 3 Bad Debt Expense Methodology The provision for doubtful accounts is based upon management's assessment of expected net collections considering historical experience, economic conditions, trends in healthcare coverage, and other collection indicators. Periodically throughout the year, management assesses the adequacy of the allowance for doubtful accounts based upon historical write-off experience by payor category, including those amounts not covered by insurance. The results of this review are then used to make any modifications to the provision for doubtful accounts to establish an appropriate allowance for doubtful accounts. Schedule H, Part III, Line 4 Bad debt expense - financial statement footnote The organization is part of the Ascension Health Alliance's consolidated audit in which the footnote that discusses the bad debt expense is located on page 21. Schedule H, Part III, Line 8 Community benefit & methodology for determining medicare costs A cost to charge ratio is applied to the organization's Medicare Expense to determine the Medicare allowable costs reported in the organization's Medicare Cost Report. Ascension Health and its related health ministries follow the Catholic Health Association (CHA) guidelines for determining community benefit. CHA community benefit reporting guidelines suggest that Medicare shortfall is not treated as community benefit. Schedule H, Part III, Line 9b Collection practices for patients eligible for financial assistance St. Vincent's Health System follows the Ascension guidelines for collection practices related to patients qualifying for charity or financial assistance. A patient can apply for charity or financial assistance at any time during the collection cycle. Once qualifying documentation is received the patient's account is adjusted. Patient accounts for the qualifying patient in the previous six months may also be considered for charity or financial assistance. Once a patient qualifies for charity or financial assistance, all collection activity is suspended. Schedule H, Part V, Section B, Line 16a FAP website - St. Vincent's St. Clair: Line 16a URL: https://healthcare.ascension.org/Financial-Assistance/Alabama; - St. Vincent's Chilton: Line 16a URL: https://healthcare.ascension.org/Financial-Assistance/Alabama; Schedule H, Part V, Section B, Line 16b FAP Application website - St. Vincent's St. Clair: Line 16b URL: https://healthcare.ascension.org/Financial-Assistance/Alabama; - St. Vincent's Chilton: Line 16b URL: https://healthcare.ascension.org/Financial-Assistance/Alabama; Schedule H, Part V, Section B, Line 16c FAP plain language summary website - St. Vincent's St. Clair: Line 16c URL: https://healthcare.ascension.org/Financial-Assistance/Alabama; - St. Vincent's Chilton: Line 16c URL: https://healthcare.ascension.org/Financial-Assistance/Alabama; Schedule H, Part VI, Line 3 Patient education of eligibility for assistance St. Vincent's Health System uses visual aids to inform patients of available financial assistance. The statement of Patient Financial Services Financial Assistance is displayed at all registration areas throughout the Hospital, including the Emergency Department to make patients aware that assistance is available. Our staff when discussing collections with patients, also makes patients aware of the available assistance if they are unable to pay. Schedule H, Part VI, Line 4 Community information ST. VINCENT'S HEALTH SYSTEM PRIMARILY SERVICES RESIDENTS OF CENTRAL ALABAMA IN THE FOLLOWING SEVEN COUNTIES: BLOUNT, CULLMAN, JEFFERSON, SHELBY, ST. CLAIR, TALLADEGA, AND WALKER. - OUR PRIMARY SERVICE AREA CONSISTS OF BOTH RURAL AND URBAN COMMUNITIES WITH A POPULATION OF 1,247,848; MEDIAN INCOME OF $53,007; AND MEDIAN AGE OF 39.27. - AGE OF POPULATION: 26.5% AGE 0-19, 30.9% AGE 20-44, 26.2% AGE 45-64, 16.4% AGE 65+. - SEX: 51.9% FEMALE AND 48.1% MALE. - ETHNICITY: 66.0% WHITE NON-HISPANIC, 28.4% BLACK NON-HISPANIC, 4.3% HISPANIC, 1.3% ASIAN NON-HISPANIC. - LANGUAGE: ENGLISH SPEAKING 94.4%, NON-ENGLISH AGE 5+ 5.6%. (population by language spoken at home) - THERE ARE 89 FEDERALLY DESIGNATED MEDICALLY UNDERSERVED AREAS (MUA'S) IN THE STATE AND 19.7% OF THE POPULATION IS ELIGIBLE FOR MEDICAID INSIDE THE SEVEN COUNTY SERVICE AREAS (U.S. Census Bureau American Community Survey - % of defined population enrolled in Medicaid) - INSURANCE COVERAGE BREAKDOWN IS 54% PRIVATE, 16% MEDICARE, 16% MEDICAID, AND 14% UNINSURED. - POVERTY: 17.21% ON AVERAGE IN POVERTY. RANGE IN 7 COUNTIES 8.3% TO 23.05%. (U.S. Census Bureau American Community Survey) - HOSPITALS IN SERVICE AREA: 16 TOTAL, 5 NONPROFIT, 10 FOR PROFIT, 1 ACADEMIC MEDICAL CENTER. - HEALTH STATISTICS - OBESITY: 33%. - LEADING CAUSES OF DEATH: HEART DISEASE, CANCER, STROKE Schedule H, Part VI, Line 5 Promotion of community health THIS REPORT ILLUSTRATES THE SIGNIFICANT DEGREE TO WHICH ST. VINCENT'S HEALTH SYSTEM, THROUGH ITS FIVE HOSPITALS AND HEALTH & WELLNESS FACILITIES, CONTRIBUTES TO THE POSITIVE HEALTH STATUS OF THE COMMUNITIES WE SERVE. THE SYSTEM'S FIVE HOSPITALS INCLUDE ST. VINCENT'S BIRMINGHAM, ST. VINCENT'S EAST, ST. VINCENT'S BLOUNT, ST. VINCENT'S CHILTON AND ST. VINCENT'S ST. CLAIR. EACH HOSPITAL HAS A SEPARATE TAX ID NUMBER. EACH MAKES AN IMPORTANT CONTRIBUTION TO CARING FOR THEIR COMMUNITY, INCLUDING THOSE WHO ARE UNDERSERVED. EACH YEAR, ST. VINCENT'S HEALTH SYSTEM FACILITIES SPONSOR A SCHOOL TO ASSIST WITH COLLECTING PHYSICAL EDUCATION EQUIPMENT AS WELL AS PARTICIPATING IN SEVERAL PE CLASSES TO FOSTER HEALTHY HABITS FOR LOCAL SCHOOL CHILDREN. THIS IS ONE WAY IN WHICH STVHS PROMOTES A HEALTHY LIFESTYLE ACROSS THE SERVICE AREA. AS A MEMBER OF ASCENSION HEALTH, ST. VINCENT'S HEALTH SYSTEM CONTINUES TO BUILD AND STRENGTHEN SUSTAINABLE COLLABORATIVE EFFORTS THAT BENEFIT THE HEALTH OF INDIVIDUALS, FAMILIES AND THE COMMUNITY AS A WHOLE. THE HEALTH SYSTEM'S MISSION IS TO EXTEND THE HEALING MINISTRY OF CHRIST. THE HOSPITALS OF THE HEALTH SYSTEM FURTHER THE MISSION THROUGH THE DELIVERY OF PATIENT SERVICES, CARE TO THE ELDERLY AND INDIGENT, PATIENT EDUCATION, AND HEALTH AWARENESS PROGRAMS FOR THE COMMUNITY. OUR CONCERN FOR ALL HUMAN LIFE AND COMMITMENT TO THE DIGNITY OF EACH PERSON LEADS US TO PROVIDE MEDICAL SERVICES TO ALL PEOPLE IN THE COMMUNITY WITHOUT REGARD TO RACE, CREED, NATIONAL ORIGIN, ECONOMIC STATUS, OR ABILITY TO PAY. BASED ON OUR CORE VALUES AND IN THE SPIRIT OF PRINCIPLES ADOPTED BY ASCENSION HEALTH, OUR HEALTH SYSTEM HAS TAKEN PROACTIVE STEPS TO ADDRESS THOSE ISSUES THAT AFFECT ACCESSIBILITY, THE FINANCING, AND THE DELIVERY OF HEALTH CARE TO ALL PERSONS, ESPECIALLY THE UNINSURED, UNDERINSURED, AND THE UNDERSERVED. THE FOLLOWING CHART DEMONSTRATES THE SIGNIFICANT NUMBER OF PATIENT DAYS AND THE ESTIMATED UNREIMBURSED COST OF SERVICES PROVIDE BY OUR FOUR HOSPITALS TO THE UNINSURED OR UNDERSERVED. FY18 NUMBER OF LICENSED BEDS - NUMBER OF PATIENT DAYS - ESTIMATED UNREIMBURSED COST: St. Vincent's Birmingham - 439 - 96,110 - $7,784,766 St. Vincent's East - 357 - 94,667 - $ 5,616,145 St, Vincent's Blount - 25 - 5,022- $ 743,720 St. Vincent's St. Clair - 40 - 6,834 - $ 468,986 St. Vincent's Chilton - 26 -2,429 - $3,506,857 Total - 887 - 205,062 - $18,120,474 ST. VINCENT'S HEATH SYSTEM HAS A DEEP COMMITMENT TO SERVING THE COMMUNITY. WE EARMARK A CERTAIN PERCENTAGE OF OUR YEARLY PROFITS FOR CHARITABLE DONATIONS. THROUGH THIS CHARITABLE DONATION PROGRAM, WE ARE ABLE TO SUPPORT LOCAL CHAPTERS OF NATIONAL ORGANIZATIONS SUCH AS THE AMERICAN CANCER SOCIETY, THE AMERICAN HEART ASSOCIATION, MARCH OF DIMES, AND SUSAN G. KOMEN FOR THE CURE, AMONG OTHERS. WE ALSO FUND LOCAL PROGRAMS AND INITIATIVES SUCH AS THE UNITED WAY. MANY OF OUR EXECUTIVES SERVE ON THE BOARDS OF THESE AND OTHER CHARITABLE ORGANIZATIONS. WE PROVIDE ESSENTIAL MEDICAL SERVICES TO THE COMMUNITY, TRAIN AND RECRUIT HEALTHCARE PROFESSIONALS TO SERVE THE NEEDS OF THE BROADER COMMUNITY, PROVIDE APPROPRIATE CHARITY SERVICES TO THOSE UNABLE TO PAY FOR THEIR HEALTH CARE NEEDS, AND PROVIDE SERVICES TO OTHER ORGANIZATIONS THAT ALLOW THEM TO PROVIDE QUALITY SERVICES TO THEIR PATIENTS OR CONSTITUENTS. SOME OF THESE SERVICES INCLUDE JEREMIAH'S HOPE ACADEMY, HISPANIC OUTREACH MINISTRY, ACCESS TO CARE PROGRAM AND CLERGY WELLNESS PROGRAM. EACH OF THESE PROGRAMS WORKS TO ADDRESS ROOT CAUSES OF POVERTY INCLUDING HEALTH DISPARITIES, BARRIERS TO CARE, EMPLOYMENT, AND HEALTHCARE, AS WELL AS MENTAL HEALTHCARE, COVERAGE. ST. VINCENT'S JEREMIAH'S HOPE ACADEMY FOCUSES ON TRAINING AT-RISK INDIVIDUALS, PARTICULARLY WOMEN, FOR ENTRY LEVEL JOBS IN THE HEALTHCARE INDUSTRY. TODAY, MORE THAN 500 PEOPLE HAVE GRADUATED FROM JEREMIAH'S HOPE, AND MOST ARE STILL WORKING IN THE HEALTHCARE INDUSTRY. EMPLOYMENT IS ONE OF THE MANY SYSTEMIC WAYS TO ASSIST INDIVIDUALS OUT OF POVERTY AND CREATE AN INTERGENERATIONAL IMPACT FOR FAMILIES THAT IS SUSTAINABLE INTO THE FUTURE. PHILANTHROPY ALLOWED THIS REVOLUTIONARY PROGRAM TO BLOSSOM AND IT HAS NOW BECOME A MODEL FOR OTHER HEALTHCARE FACILITIES NATIONWIDE. IN 2003, ST. VINCENT'S INITIATED A HISPANIC OUTREACH PROGRAM. THIS PROGRAM HAS NOW EVOLVED INTO A HIGH-RISK PREGNANCY COACH PROGRAM. WITH INFANT MORTALITY A SIGNIFICANT NEED IN THE STATE OF ALABAMA, THE HIGH-RISK PREGNANCY COACH AIMS TO ADDRESS BARRIERS FOR EXPECTANT MOTHERS TO GO ABOVE AND BEYOND TRADITIONAL CASE MANAGEMENT AND PROVIDE CULTURALLY APPROPRIATE AND EFFECTIVE CARE AND GUIDANCE AS PATIENTS NAVIGATE PRE AND POST-NATAL CARE. THE ACCESS TO CARE PROGRAM IS A HEALTHCARE OPTION FOR THE "WORKING POOR" IN THE BIRMINGHAM AREA, SERVING INDIVIDUALS WHO ARE EMPLOYED BUT LACK HEALTH INSURANCE. THE CLINIC TREATS UP TO 500 UNIQUE PATIENTS EACH YEAR, PROVIDING FOR ALL OF THEIR HEALTHCARE NEEDS WITH MODEST CO-PAYS TO ENGAGE THE PATIENT IN RESPONSIBILITY FOR CARE. ST. VINCENT'S WORKS WITH PATIENTS TO IDENTIFY WAYS TO ACQUIRE INSURANCE AND SCREENS PATIENTS BASED ON A WILLINGNESS TO MAKE LIFE CHANGES CONDUCIVE TO GOOD HEALTH AND ADVANCEMENT TO WORK TOWARDS COVERAGE IN THE FUTURE. PATIENTS IN THIS PROGRAM ARE INTEGRATED INTO THE ST. VINCENT'S CLINIC NETWORK AND TAUGHT HOW TO NAVIGATE HEALTHCARE EFFECTIVELY. AN RN HEALTH COACH WORKS ESPECIALLY WITH PATIENTS WHO HAVE CHRONIC ILLNESS AND NEED ADDITIONAL ASSISTANCE UNDERSTANDING PLANS OF CARE AND MEDICATIONS. THE ST. VINCENT'S CLERGY WELLNESS PROGRAM WORKS WITH LOCAL CLERGY LEADERS TO DEVELOP A PERSONAL HEALTH AND WELLNESS PLAN AND ALSO A CONGREGATIONAL HEALTH IMPROVEMENT PLAN TO INTEGRATE INTO THEIR FAITH COMMUNITIES. CLERGY ARE DISPROPORTIONATELY AT RISK FOR CHRONIC AND MENTAL ILLNESSES (MORE THAN THE GENERAL POPULATION) AND YET THEY HOLD POSITIONS OF SIGNIFICANT INFLUENCE IN THE COMMUNITY. BY ASSISTING THESE LEADERS IN INTEGRATING HEALTH AND WELLNESS INTO THEIR DAILY LIVES, THEY ARE THEN ENCOURAGED TO IDENTIFY AND IMPLEMENT A STRATEGY TO IMPROVE THE OVERALL HEALTH OF THEIR CONGREGATIONS AS WELL. THIS SYSTEMIC APPROACH ALLOWS THE PROGRAM TO REACH THOUSANDS OF INDIVIDUALS BY PROXY. ST. VINCENT'S FACILITATES COMMUNITY ROUNDTABLE INITIATIVES TO IMPROVE THE OVERALL HEALTH OF THE COMMUNITY AS WELL. THE HEALTHCARE PROVIDER ROUNDTABLE CONSISTS OF HEALTHCARE PROVIDERS FROM AROUND THE REGION WHO SERVE UNINSURED OR UNDERINSURED PATIENTS AND MEETS SIX TIMES A YEAR. THE MENTAL HEALTHCARE PROVIDER ROUNDTABLE IS COMPRISED OF PROVIDERS ACROSS THE CONTINUUM WHO PROVIDE CARE TO THE COMMUNITY IN THE MENTAL HEALTH SECTOR. THEY ALSO MEET SIX TIMES A YEAR (ON THE ALTERNATE MONTHS OF THE HEALTHCARE GROUP). A LOW-COST DENTAL PROVIDER ROUNDTABLE NOW MEETS QUARTERLY TO DISCUSS DENTAL NEEDS IN THE COMMUNITY AND IDENTIFY POTENTIAL AREAS FOR COLLABORATION. THE GOAL OF THESE GROUPS IS NOT ONLY TO COORDINATE CARE BUT ALSO TO IDENTIFY GAPS AND NEEDS IN THE COMMUNITY AND COME TOGETHER TO FIND SOLUTIONS TO THE NEEDS THAT ARISE. IT IS ATTENDED BY CLINICS, SOCIAL SERVICE PROVIDERS, PRACTITIONERS, EDUCATIONAL FACILITIES AND MAJOR HEALTH SYSTEM REPRESENTATIVES. ST. VINCENT'S REPRESENTATIVES ALSO SERVE ON VARIOUS COMMUNITY HEALTH INITIATIVES SUCH AS JEFFERSON COUNTY HEALTH ACTION PARTNERSHIP, UNITED WAY'S BOLD GOALS AND THE BIRMINGHAM MAYOR'S CITY IMPROVEMENT WORK GROUPS. ST. VINCENT'S AND ASCENSION HAVE A STRONG PRESENCE IN ADVOCACY ON BEHALF OF THE POOR AND VULNERABLE AS WELL. WITH A CHIEF ADVOCACY OFFICER FOR ALABAMA, ASCENSION AND ST. VINCENT'S ARE ACTIVELY SEEKING OPPORTUNITIES FOR POLICY AND PROCEDURE CHANGE THAT WILL EXPAND COVERAGE, ASSIST THOSE WHO ARE PROVIDING CARE TO THE UNINSURED AS WELL AS LOOKING AT OTHER WAYS TO PROMOTE THE HEALTH OF THE COMMUNITY. EXAMPLES OF ADVOCACY IN THESE AREAS INCLUDES WORKING WITH NAVIGATORS TO ENROLL MARKETPLACE PARTICIPANTS; DEVELOPING NEW AND ENHANCED RELATIONSHIPS WITH COMMUNITY CARE PARTNERS AND WORKING WITH OUR STATE AND FEDERAL LAWMAKERS TO ENSURE ADEQUATE REIMBURSEMENT FOR THE UNINSURED AND UNDERINSURED. WHEN THE NEED ARISES, ST. VINCENT'S IS ALSO QUICK TO RESPOND TO COMMUNITY ISSUES INVOLVING NATURAL DISASTERS. THIS IS EVIDENCED BY COLLECTION AND DONATION OF ITEMS FOR HURRICANE, FLOOD AND TORNADO SURVIVORS AS WELL AS VOLUNTEER EFFORTS TO ASSIST WITH THOSE AFFECTED. IN THE PAST, ST. VINCENT'S HAS PROVIDED TETANUS SHOTS AND BASIC MEDICAL CARE IN AREAS OF NEED. Schedule H, Part VI, Line 6 Affiliated health care system AS PART OF ST. VINCENT'S HEALTH SYSTEM (THE HEALTH MINISTRY IS A MEMBER OF ASCENSION HEALTH ALLIANCE ("THE SYSTEM"). ASCENSION HEALTH ALLIANCE IS A MISSOURI NONPROFIT CORPORATION FORMED ON SEPTEMBER 13, 2011. ASCENSION HEALTH ALLIANCE IS THE SOLE CORPORATE MEMBER AND PARENT ORGANIZATION OF ASCENSION HEALTH, A CATHOLIC NATIONAL HEALTH SYSTEM CONSISTING PRIMARILY OF NONPROFIT CORPORATIONS THAT OWN AND OPERATE LOCAL HEALTHCARE FACILITIES, OR HEALTH MINISTRIES, LOCATED IN 23 OF THE UNITED STATES AND THE DISTRICT OF COLUMBIA. ASCENSION IS SPONSORED BY A PUBLIC JURIDIC PERSON. THE PARTICIPATING ORGANIZATIONS/ENTITIES OF ASCENSION SPONSOR ARE: THE DAUGHTERS OF CHARITY OF ST. VINCENT DE PAUL ST. LOUISE PROVINCE THE CONGREGATION OF ST. JOSEPH THE CONGREGATION OF THE SISTERS OF ST. JOSEPH OF CARONDELET THE CONGREGATION OF ALEXIAN BROTHERS OF THE IMMACULATE CONCEPTION PROVINCE - AMERICAN PROVINCE THE SISTERS OF THE SORROWFUL MOTHER OF THE THIRD ORDER OF ST. FRANCIS OF ASSISI - U.S./CARIBBEAN PROVINCE MISSION: THE SYSTEM DIRECTS ITS GOVERNANCE AND MANAGEMENT ACTIVITIES TOWARD STRONG, VIBRANT, CATHOLIC HEALTH MINISTRIES UNITED IN SERVICE AND HEALING, AND DEDICATES ITS RESOURCES TO SPIRITUALLY CENTERED CARE WHICH SUSTAINS IN ACCORDANCE WITH THE SYSTEM'S MISSION OF SERVICE TO THOSE PERSONS LIVING IN POVERTY AND OTHER VULNERABLE PERSONS, EACH HEALTH MINISTRY ACCEPTS PATIENTS REGARDLESS OF THEIR ABILITY TO PAY. THE SYSTEM USES FOUR CATEGORIES TO IDENTIFY THE RESOURCES UTILIZED FOR THE CARE OF PERSONS LIVING IN POVERTY AND COMMUNITY BENEFIT PROGRAMS: 1. TRADITIONAL CHARITY CARE INCLUDES THE COST OF SERVICES PROVIDED TO PERSONS WHO CANNOT AFFORD HEALTHCARE BECAUSE OF INADEQUATE RESOURCES AND/OR WHO ARE UNINSURED OR UNDERINSURED. 2. UNPAID COST OF PUBLIC PROGRAMS, EXCLUDING MEDICARE, REPRESENTS THE UNPAID COST OF SERVICES PROVIDED TO PERSONS COVERED BY PUBLIC PROGRAMS FOR THE PERSONS LIVING IN POVERTY AND OTHER VULNERABLE PERSONS. 3. COST OF OTHER PROGRAMS FOR THE PERSONS LIVING IN POVERTY AND OTHER VULNERABLE PERSONS INCLUDES PROGRAMS INTENTIONALLY DESIGNED TO SERVE THE PERSONS LIVING IN POVERTY AND OTHER VULNERABLE PERSONS OF THE COMMUNITY INCLUDING SUBSTANCE ABUSERS, THE HOMELESS VICTIMS OF CHILD ABUSE AND PERSONS WITH ACQUIRED IMMUNE DEFICIENCY SYNDROME. 4. COMMUNITY BENEFIT CONSISTS OF THE UNREIMBURSED COSTS OF COMMUNITY BENEFIT PROGRAMS AND SERVICES FOR THE GENERAL COMMUNITY, NOT SOLELY FOR PERSONS LIVING IN POVERTY AND OTHER VULNERABLE PERSONS, INCLUDING HEALTH PROMOTION AND EDUCATION, HEALTH CLINICS AND SCREENINGS AND MEDICAL RESEARCH. DISCOUNTS ARE PROVIDED TO ALL UNINSURED PATIENTS, INCLUDING THOSE WITH THE MEANS TO PAY. DISCOUNTS PROVIDED TO THOSE PATIENTS WHO DID NOT QUALIFY FOR ASSISTANCE UNDER CHARITY CARE GUIDELINES ARE NOT INCLUDED IN THE COST OF PROVIDING CARE OF PERSONS LIVING IN POVERTY AND COMMUNITY BENEFIT PROGRAMS. THE COST OF PROVIDING CARE TO PERSONS LIVING IN POVERTY AND COMMUNITY BENEFIT PROGRAMS IS ESTIMATED BY REDUCING CHARGES FORGONE BY A FACTOR DERIVED FROM THE RATIO OF EACH ENTITY'S TOTAL OPERATING EXPENSES TO THE ENTITY'S BILLED CHARGES FOR PATIENT CARE. true UNITED WAY 3600 8TH AVE S BIRMINGHAM AL 35232 630288846 501(C)(3) 75000 GENERAL SUPPORT HOLY FAMILY CRISTO REY HIGH SCHOOL 2001 19TH ST ENSLEY BIRMINGHAM AL 35218 134341859 501(C)(3) 136000 GENERAL SUPPORT 2 0 Schedule I, Part I, Line 2 Procedures for monitoring use of grant funds. The Associate Allocations Committee consists of 8-16 members who are appointed by the Chief Operating Officer (COO) of St. Vincent's Health system. The Committee is authorized to expend resources of the St. Louise/Help Fund, however expenditures will not exceed the budgeted amount. The Committee has the following allocation options: Award - Any part of the approved allocation will not be required to be paid back. Denial - Associate's request is denied. The Committee meets every two (2) weeks opposite payroll weeks unless otherwise necessary. true true false false false false false false false NEEYSA C BIDDLE FORMER OFFICER (END 6/2017) 319307 111067 673278 0 122159 0 16050 0 5462 0 1136257 111067 0 0 DAVID A CAUBLE FORMER OFFICER (END 11/2015) 0 0 0 0 375532 0 0 0 0 0 375532 0 13989 0 GREGORY L JAMES MD FORMER OFFICER (END 2/2016) 0 474354 0 458209 0 94421 0 14850 0 20564 0 1062398 0 0 MICHAEL R KORPIEL FORMER OFFICER (END 4/2017) 0 0 0 0 0 116259 0 0 0 1983 0 118242 0 0 CAROL A MAIETTA FORMER OFFICER (END 1/2016) 0 0 0 0 247266 0 0 0 1854 0 249120 0 0 0 NAN M PRIEST FORMER OFFICER (END 6/2017) 262306 0 194199 0 353972 0 17550 0 14877 0 842904 0 90593 0 JASON P ALEXANDER FACHE CEO, MINISTRY MARKET 0 414474 0 0 0 57710 0 11406 0 16361 0 499951 0 0 JENNIFER L KINGRY CFO, MINISTRY MARKET (END 8/2017) 170280 0 98122 0 24999 0 5319 0 14071 0 312790 0 0 0 ROBERT E RAY PRESIDENT BIRMINGHAM 0 320045 0 25827 0 46901 0 14850 0 20998 0 428621 0 0 BRANDON M WILLIAMS CFO, MINISTRY MARKET (START 8/2017) 119738 0 30000 0 2376 0 3231 0 5911 0 161255 0 0 0 FRANK MALENSEK FORMER KEY EMPLOYEE (END 6/2017) 0 296426 0 12629 0 19603 0 14850 0 23431 0 366939 0 0 SUZANNAH CAMPBELL Administrator-STV CHILTON 184972 0 11761 0 15466 0 11453 0 2025 0 225677 0 0 0 WAYNE CARMELLO-HARPER SVP MISSION INTEGRATION & PHILANTHROPY 272397 0 123400 0 33354 0 14850 0 20435 0 464436 0 0 0 WILLIAM A DAVIS COO, MINISTRY MARKET (END 11/2017) 365843 29225 246807 0 64732 6202 15606 594 21356 1832 714345 37853 0 0 STEPHANIE J DUGGAN MD CCO, MINISTRY MARKET 457147 0 190157 0 58326 0 14850 0 24944 0 745424 0 0 0 JAMES FLYNN AMG Administrative Dyad Leader 194529 0 12715 0 17661 0 11318 0 20386 0 256610 0 0 0 STEPHANIE HOLDERBY VP-Ambulatory HC Network 195435 0 12715 0 13529 0 13826 0 11760 0 247265 0 0 0 DON E KING COO, MINISTRY MARKET (START 1/2018) 0 456783 0 276549 0 49054 0 14850 0 27086 0 824321 0 0 JEFFREY H MIDDLEBROOK CLO, MINISTRY MARKET (START 1/2018) 0 333538 0 138824 0 65198 0 9658 0 25406 0 572625 0 0 LIZ MOORE CCMO, MINISTRY MARKET 105901 92388 0 97073 5806 6909 7191 8939 11208 10354 130106 215664 0 0 CHRISTOPHER L MOORE CNO, MINISTRY MARKET 278646 0 18119 0 21232 0 17550 0 21888 0 357435 0 0 0 LISA NICHOLS Administrator-STV ST CLAIR 161985 0 10375 0 7705 0 11916 0 19629 0 211611 0 0 0 PEGGY PANOS VP-Corporate Responsibility 131249 20513 18330 0 8323 481 9554 1356 8163 1147 175619 23497 0 0 BRENNA POWELL VP-Strategic Integration 160930 0 10051 0 10744 0 10379 0 4153 0 196258 0 0 0 ANDREW TAYLOR VP-Regional Growth 142702 0 9218 0 7748 0 7051 0 8488 0 175206 0 0 0 LYDIA ANN EDWARDS DIRECTOR, PHARMACY 177222 0 7304 0 1287 0 10230 0 13033 0 209075 0 0 0 KRISTY GUNTHER VP, FINANCIAL PLANNING 1877 0 0 0 180794 0 0 0 2676 0 185347 0 0 0 JERRY L KITCHENS JR EXECUTIVE DIRECTOR 166102 0 6809 0 2304 0 9323 0 21041 0 205579 0 0 0 JACK WARREN VINES JR DIRECTOR, ORTHOPEDIC SERVICE LINE 191349 0 7782 0 3521 0 10481 0 16079 0 229212 0 0 0 GORDON BRIAN WESLEY ADMINISTRATIVE SYSTEM DIRECTOR, CARDIOVASCULAR 144131 0 30000 0 506 0 6480 0 14507 0 195624 0 0 0 Schedule J, Part I, Line 3 Arrangement used to establish the top management official's compensation Ascension Health, Inc., a related organization of St. Vincent's Health System uses the following to establish the compensation of the organization's CEO: -Compensation Committee -Independent Compensation Consultant -Compensation Survey or Study -Approval by the Board or Compensation Committee Schedule J, Part I, Line 4a Severance or change-of-control payment The following individual(s) received severance payments from the organization or a related organization: David A Cauble - $361,543 Carol A Marietta - $243,757 Nan M Priest - $35,194 Michael R Korpiel - $112,788 Schedule J, Part I, Line 4b Supplemental nonqualified retirement plan Eligible executives participate in a program that provides for supplemental retirement benefits. The payment of benefits under the program, if any, is entirely dependent upon the facts and circumstances under which the executive terminates employment with the organization. Benefits under the program are unfunded and non-vested. Due to the substantial risk of forfeiture provision, there is no guarantee that these executives will ever receive any benefit under the program. Any amount ultimately paid under the program to the executive is reported as compensation on Form 990, Schedule J, Part II, Column B in the year paid. The following individuals received payment from the supplemental nonqualified retirement plan in the amount as noted: David A Cauble - $13,989 Nan M Priest - $90,593 Form 990, Part IV, Line 20b Audited Financial Statements The activity of St. Vincent's Health System is reported in the consolidated financial statements of Ascension Health Alliance. No individual audit of St. Vincent's Health System is completed. Therefore, the attached audited financial statements are of Ascension Health Alliance and Affiliates, which include the activity of St. Vincent's Health System. Form 990, Part VI, Line 15a process to establish executive compensation In determining the compensation of the organization's President & CEO, the process, performed by Ascension Health, a related organization of St. Vincent's Health System, included a review and approval by independent persons, comparability data and contemporaneous substantiation of the deliberation and decision. The Compensation Committee reviewed and approved the compensation. In the review of the compensation, the President & CEO was compared to individuals at other organizations in the area who hold the same title. During the review and approval of the compensation, documentation of the decision was recorded in the committee minutes. The individual was not present when his compensation was decided. Form 990, Part VI, Line 6 Classes of members or stockholders St. Vincent's Health System has a single corporate member, Ascension Health. Form 990, Part VI, Line 7a Members or stockholders electing members of governing body St. Vincent's Health System has a single corporate member, Ascension Health, who has the ability to elect members to the governing board of St. Vincent's Health System. Form 990, Part VI, Line 7b Decisions requiring approval by members or stockholders Ascension Health has designed a system authority matrix which assigns authority for key decisions that are necessary in the operation of the system. Specific areas that are identified in the authority matrix are: new organizations & major transactions; governing documents; appointments/removals; evaluation; debt limits; strategic & financial plans; assets; system policies & procedures. These areas are subject to certain levels of approval by Ascension per the system authority matrix. Form 990, Part VI, Line 11b Review of form 990 by governing body DURING THE RETURN PREPARATION PROCESS, THE TAX DEPARTMENT WORKS WITH OTHER FUNCTIONAL AREAS INCLUDING FINANCE, ACCOUNTING, TREASURY, LEGAL, HUMAN RESOURCES, AND CORPORATE COMPLIANCE FOR ADVICE, INFORMATION AND ASSISTANCE IN ORDER TO PREPARE A COMPLETE AND ACCURATE RETURN. UPON COMPLETION, THE FORM 990 IS REVIEWED BY THE ORGANIZATION'S INTERNAL TAX DEPARTMENT WHICH CONSISTS OF ATTORNEYS AND CPAS. A COMPLETE FINAL COPY OF THE RETURN IS PROVIDED TO THE ORGANIZATION'S PRESIDENT, FINANCIAL OFFICER, AND/OR OTHER KEY OFFICERS IN LIEU OF THE FULL BOARD. Form 990, Part VI, Line 12c Conflict of interest policy The organization regularly and consistently monitors and enforces compliance with the conflict of interest policy in that any director, principal officer, or member of a committee with governing board delegated powers, who has a direct or indirect financial interest, must disclose the existence of the financial interest and be given the opportunity to disclose all material facts to the directors and members of the committees with governing board delegated powers considering the proposed transaction or arrangement. The remaining individuals on the governing board or committee will decide if conflicts of interest exist. Each director, principal officer and member of a committee with governing board delegated powers annually signs a statement which affirms such person has received a copy of the conflicts of interest policy, has read and understands the policy, has agreed to comply with the policy, and understands that the organization is charitable and in order to maintain its federal tax exemption it must engage primarily in activities which accomplish its tax-exempt purpose. Form 990, Part VI, Line 15b Process to establish compensation of other employees IN DETERMINING COMPENSATION OF THE ORGANIZATION'S OFFICERS, THE PROCESS INCLUDED A REVIEW AND APPROVAL BY INDEPENDENT PERSONS, COMPARABILITY DATA, AND CONTEMPORANEOUS SUBSTANTIATION OF THE DELIBERATION AND DECISION. THE EXECUTIVE COMPENSATION COMMITTEE REVIEWED AND APPROVED THE COMPENSATION. IN THE REVIEW OF THE COMPENSATION, THE OFFICERS' SALARIES WERE COMPARED TO INDIVIDUALS AT OTHER ORGANIZATIONS IN THE AREA WHO HOLD THE SAME TITLE. DURING THE REVIEW AND APPROVAL OF THE COMPENSATION, DOCUMENTATION OF THE DECISION WAS RECORDED IN THE MINUTES. INDIVIDUALS WERE NOT PRESENT WHEN THEIR COMPENSATION WAS DECIDED. Form 990, Part VI, Line 19 Required documents available to the public The organization will provide any documents open to public inspection upon request. Form 990, Part VII, Section A Related Entities The organization utilizes an affiliate as the common pay agent. Employees reported in Part VII may have duties that impact multiple related entities. Total average hours worked and compensation and benefits paid are reported. In doing so, if available, a common law employer analysis is used to determine whether the hours and compensation/benefits are reportable as attributable directly to the filing organization or another entity; otherwise, the best available information has been used as the basis for allocations utilized in the reporting. Form 990, Part VIII, Line 2f Other Program Service Revenue Subsidy - Total Revenue: -2934133, Related or Exempt Function Revenue: -2934133, Unrelated Business Revenue: , Revenue Excluded from Tax Under Sections 512, 513, or 514: ; Form 990, Part VIII, Line 11d Other Miscellaneous Revenue Escheatment Revenue - Total Revenue: 1751, Related or Exempt Function Revenue: , Unrelated Business Revenue: , Revenue Excluded from Tax Under Sections 512, 513, or 514: 1751; Fitness Club Revenue - Total Revenue: -40, Related or Exempt Function Revenue: , Unrelated Business Revenue: , Revenue Excluded from Tax Under Sections 512, 513, or 514: -40; Miscellaneous Revenue - Total Revenue: 792839, Related or Exempt Function Revenue: , Unrelated Business Revenue: , Revenue Excluded from Tax Under Sections 512, 513, or 514: 792839; Medical Staff Dues - Total Revenue: 211, Related or Exempt Function Revenue: , Unrelated Business Revenue: , Revenue Excluded from Tax Under Sections 512, 513, or 514: 211; Form 990, Part XI, Line 9 Other changes in net assets or fund balances Net Asset Transfers with Affiliates - -82909; Write-off of pledge - -1775494; Transfers to Alpha Fund - 88943897; Form 990, Part XII, Line 2c Audit Committee St. Vincent's Health System is included in the consolidated financial statements of Ascension Health Alliance. The Finance and Audit committee of Ascension Health Alliance's Board assumes responsibility for the consolidated organization as a whole. 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