2018-05-15T13:00:52-05:00 2017-06-30 990 2016-07-01 941437713 SAINT AGNES MEDICAL CENTER SAIN 5594503559 1303 EAST HERNDON AVENUE FRESNO CA 93720 STEPHEN KALOMIRIS CONTROLLER 5594503559 2018-05-15 2016 2022-09-23 18:48:47Z SEE SCHEDULE O NANCY HOLLINGSWORTH 1303 EAST HERNDON AVENUE FRESNO CA 93720 496575702 0 0928 X WWW.SAMC.COM X 1958 CA TO PROVIDE HEALTH CARE AND HOSPITAL SERVICES. 15 12 2943 676 291035 74427 1414713 1760966 495200891 478005740 424949 9580924 5251502 3468198 502292055 492815828 422243 2811480 0 0 205895076 212695714 56458 61275 877543 274515462 263875093 480889239 479443562 21402816 13372266 722075419 746368363 182127065 183581545 539948354 562786818 X WE, SAINT AGNES MEDICAL CENTER AND TRINITY HEALTH, SERVE TOGETHER IN THE SPIRIT OF THE GOSPEL AS A COMPASSIONATE AND TRANSFORMING HEALING PRESENCE WITHIN OUR COMMUNITIES. SAINT AGNES MEDICAL CENTER IS A MEMBER OF TRINITY HEALTH. 0 0 394873313 2811480 478812226 SAINT AGNES MEDICAL CENTER, LOCATED IN FRESNO, CALIFORNIA, IS AN ACUTE-CARE HOSPITAL SERVING THE RESIDENTS IN FOUR LOCAL COUNTIES; FRESNO, MADERA, KINGS, AND TULARE. SAINT AGNES MEDICAL CENTER OPERATES A 436-BED, STATE-OF-THE-ART MEDICAL CENTER CAMPUS, BRINGING TOGETHER THE MOST ADVANCED EQUIPMENT AND FACILITIES, AND THE EXPERTISE OF TOP-RANKED PHYSICIANS AND STAFF. FOR OVER 80 YEARS, SAINT AGNES MEDICAL CENTER HAS PROMISED TO PROVIDE THE HIGHEST QUALITY, MOST COMPASSIONATE HEALTH CARE TO THE PEOPLE IN THE SAN JOAQUIN VALLEY. FROM EMERGENCY, DIAGNOSTIC AND REHABILITATIVE SERVICES TO CARDIAC, CANCER, NEUROLOGICAL AND ORTHOPEDIC CARE, SAINT AGNES MEDICAL CENTER CAN BE TRUSTED TO BE THERE TO SERVE THE PEOPLE OF THESE COMMUNITIES FOR YEARS TO COME. IN FY17 THE HOSPITAL PROVIDED 98,855 PATIENT DAYS OF HEALTHCARE SERVICES TO THE COMMUNITY.PLEASE VISIT SCHEDULE H AND OUR WEBSITE FOR ADDITIONAL INFORMATION ABOUT OUR SERVICES, RECOGNITIONS AND AWARDS: WWW.SAMC.COM 394873313 1 1 0 1 0 0 0 0 0 1 1 1 0 0 1 0 0 1 0 0 0 0 0 1 1 1 1 1 1 1 1 0 0 0 0 0 0 1 1 1 0 0 0 0 1 1 1 0 0 1 517 1 1 2943 1 1 1 0 0 0 0 1 1 0 0 0 0 X 15 12 0 1 0 0 1 1 1 1 1 0 0 1 1 1 1 1 1 0 0 1 1 CA X STEPHEN KALOMIRIS CONTROLLER 5594503559 1303 E HERNDON AVENUE FRESNO CA 93720 NANCY HOLLINGSWORTH DIRECTOR; PRESIDENT & CEO 54.00 1.00 X X 0 759805 48260 A THOMAS FERDINANDI JR DIRECTOR; CHAIR 3.00 0.00 X X 0 0 0 DIANNE NURY DIRECTOR; VICE CHAIR 2.00 0.00 X X 0 0 0 SHERRY DOLAN RSM DIRECTOR 2.00 0.00 X 0 0 0 CAROLYN DRAKE DIRECTOR 2.00 0.00 X 0 0 0 ALLEN EVANS MD DIRECTOR 2.00 0.00 X 0 0 0 WILLIAM HADCOCK MD DIRECTOR; PHYSICIAN 4.00 0.00 X 40236 0 0 DEBORAH IKEDA DIRECTOR 2.00 1.00 X 0 0 0 NEIL KOENIG DIRECTOR THROUGH 10/16 2.00 0.00 X 0 0 0 JULIE MALDONADO DIRECTOR 2.00 0.00 X 0 0 0 KATHLEEN MORONEYCSC DIRECTOR 2.00 0.00 X 0 0 0 P TERRENCE O'ROURKE MD DIRECTOR 2.00 0.00 X 0 0 0 LUIS SANTANA DIRECTOR AS OF 1/17 2.00 0.00 X 0 0 0 SHERI SHAPIRO DIR AS OF 1/17; SVP MKG/ACQUISITION 2.00 48.00 X 0 321177 90009 MIKE TOLLADAY DIRECTOR 2.00 0.00 X 0 0 0 O JAMES WOODWARD III DIRECTOR 2.00 0.00 X 0 0 0 RICK WOLF SECRETARY; GENERAL COUNSEL 49.00 1.00 X 0 279941 33900 MICHAEL PRUSAITIS CFO & TREASURER 49.00 1.00 X 0 344823 34781 JONATHAN FELTON CHIEF OPERATING OFFICER 50.00 0.00 X 0 348070 30941 STACY VAILLANCOURT CHIEF ADMINISTRATIVE OFFICER 50.00 0.00 X 0 340612 28962 TONI KAZARIAN INT CNO 7/16 - 1/17; SR ADMIN DIR 50.00 0.00 X 217928 0 30542 W EUGENE EGERTON MD CHIEF MEDICAL OFFICER AS OF 8/16 49.00 1.00 X 0 173289 2553 MICHAEL FREUDIGER CHARGE PHARMACIST 50.00 0.00 X 376247 0 20023 GERALD MARGOSIAN COORD. PHARMACY OPERATIONS 50.00 0.00 X 350726 0 44555 GARRY SEVEL CHIEF MEDINFO/PHYSICIAN ADVISOR 50.00 0.00 X 315208 0 20776 BRENDA REED CHARGE PHARMACIST 50.00 0.00 X 232974 0 22084 SHERMAN KONG PHARMACIST 50.00 0.00 X 229785 0 19186 MARK BATEMAN FORMER OFFICER; SAMF PRES THR 10/16 0.00 50.00 X 108129 0 0 DEBORA CHAPPELL FORMER KEY EMP; VP CLINICAL SERVICES 50.00 0.00 X 206982 0 33171 RICHARD O'CONNELL FORMER KE; TRINITY EVP THR 11/16 0.00 55.00 X 0 1545409 47362 STEPHEN SOLDO MD FORMER KEY EMP; SERVICE LINE LEADER 49.00 1.00 X 149753 0 23869 JARRELL WILLIAMSON FORMER OFFICER; STAFF ATTORNEY 50.00 0.00 X 0 180355 28055 JOHN FRYE JR FORMER KE; DIR ORG PERFORMANCE 50.00 0.00 X 264334 0 34207 2492302 4293481 593236 571 1 1 0 STRATEGIC STAFFING SOLUTIONS 645 GRISWOLD ST 2900 DETROIT MI 48226 TEMPORARY HEALTHCARE STAFFING 13178984 ALL SERVICE ELECTRIC CO INC 7222 S MAPLE AVE FRESNO CA 93725 CONSTRUCTION SERVICES 2734795 SEALS BIEHLE INC 9410 W PLACER AVE VISALIA CA 93291 CONSTRUCTION SERVICES 2619451 NEW ENGLAND SHEET METAL WORKS 2731 S CHERRY AVE FRESNO CA 93706 CONSTRUCTION SERVICES 2158262 DVA HLTHCARE RENAL CARE INC PO BOX 8500-1607 PHILADELPHIA PA 191781607 DIALYSIS SERVICES 1940090 89 206872 31986 1522108 118839 1760966 ACUTE INPATIENT SVCS 622110 331516996 331516996 ACUTE OUTPATIENT SVCS 622110 146488744 146197709 291035 478005740 3972563 3972563 3191864 3308312 -116448 -116448 -116448 4249977 1477851 0 119467 4249977 1358384 5608361 5608361 311417 206872 297104 14313 14313 84801 34991 49810 49810 CAFETERIA REVENUE 722514 2423002 2423002 OTHER REVENUE 622110 1053603 1053603 GOV'T SUBSIDY - EHR 622110 43918 43918 3520523 492815828 478812226 291035 11951601 2687494 2687494 123986 123986 3080344 40236 3040108 1043577 14723 1028854 179807064 169685325 9558636 563103 6946969 6552584 372640 21745 9160745 8673433 458532 28780 12657015 11588322 1030240 38453 214751 49393 165358 497266 497266 61275 61275 503221 503221 44038848 37045103 6979607 14138 1757483 23374 1710235 23874 3680567 2470298 1173782 36487 19814675 141321 19673354 6555413 5547609 1007804 9820 2073 7116 631 392084 278226 94647 19211 3516006 3516006 28078693 9867041 18203926 7726 2204645 2204645 MEDICAL SUPPLIES EXP 76361051 76361051 HOSPITAL PROVIDER TAX 42716461 42716461 I/C PURCHASED SERVICES 12465105 12465105 UBI TAXES 8825 8825 21060179 17489254 3508805 62120 479443562 394873313 83692706 877543 1880920 1795145 52947 230993 220974 156608401 168269092 24300000 276141 1182313 7459410 7815041 1246082 1240917 524025025 327495020 190722997 196530005 171970382 182432770 164622931 161465187 2704215 25416919 722075419 746368363 77760171 79091736 220950 2012159 1818462 102133785 102671347 182127065 183581545 X 533539929 555588530 1816920 2616601 4591505 4581687 539948354 562786818 722075419 746368363 X 13372266 30980069 -21513871 X X 0 1 X 1 0 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 0 0 0 0 0 1 36039 1 1104 0 0 37143 0 PART II-B, LINE 1: SAINT AGNES MEDICAL CENTER HAS HAD DIRECT CONTACT WITH AND SENT MAILINGS TO LEGISLATORS DURING THE YEAR. THIS CONTACT INCLUDED DISCUSSIONS OF HEALTH CARE AND MEDICARE ISSUES. SAINT AGNES MEDICAL CENTER HAS ALSO MADE GRANTS TO OTHER ORGANIZATIONS FOR LOBBYING PURPOSES. THESE GRANTS HAVE BEEN IN THE FORM OF MEMBERSHIP DUES PAID TO REGIONAL AND NATIONAL HEALTH CARE ORGANIZATIONS, WHERE THE ORGANIZATIONS HAVE PROVIDED SAINT AGNES MEDICAL CENTER WITH AN ESTIMATED PERCENTAGE OF DUES PAYMENTS WHICH ARE USED FOR LOBBYING ACTIVITIES. ORGANIZATION EMPLOYEES ALSO ENGAGE IN ADVOCACY ON ISSUES RELATED TO HEALTH CARE AND HEALTH CARE PROVIDERS. SUCH ACTIVITIES CONSIST OF WRITTEN AND VERBAL COMMUNICATIONS WITH FEDERAL, STATE AND LOCAL ELECTED OFFICIALS AND GOVERNMENT AGENCIES. 4591505 999 -10817 4581687 4625707 22189 -4591 51800 4591505 15902528 1000 -13083 11264738 4625707 14896841 32790 1484915 512018 15902528 13673937 38630 1184274 14896841 1.00000 0 0 2185927 8949544 11135471 337682707 190513582 147169125 161890444 136701566 25188878 13316403 279872 13036531 196530005 COMMINGLED FUNDS DIRECTLY HOLDING SECURITIES 72144020 F EQUITY METHOD INVESTMENTS 54966872 C HEDGE FUNDS 34354295 F 161465187 INTERCOMPANY ACCOUNTS PAYABLE 5569006 ASSET RETIREMENT OBLIGATION (FIN 47) 1974582 INTERCOMPANY NOTES PAYABLE 94526777 OTHER LONG-TERM LIABILITIES 169176 OTHER CURRENT LIABILITIES 431806 102671347 PART V, LINE 4: SAINT AGNES MEDICAL CENTER'S ENDOWMENT FUNDS ARE USED FOR CAPITAL ACQUISITIONS AND NURSING EDUCATION. X 1 THE GAVEL GROUP 26439 RANCHO PARKWAY SOUTH SUITE 1 LAKE FOREST CA 92630 SOLICITED AUCTION ITEMS FOR FOUNDATION EVENT 0 185889 61275 124614 185889 61275 124614 CA DINNER DANCE 204805 46927 157878 42994 33397 9703 60032 LUNCHEON & FASHION SHOW 149465 60131 89334 39466 19168 7166 27454 5 164019 99814 64205 13343 32229 911 11241 518289 206872 311417 95803 84794 17780 98727 297104 14313 84801 1750 32374 867 1 0.10000 84801 1750 32374 867 34991 49810 CA 0 ORGANIZATION IS EXEMPT AND DOES NOT REQUIRE A LICENSE. 0 0 0 1.00000 STEPHEN KALOMIRIS 1111 E SPRUCE AVENUE FRESNO CA 93720 0 TERI AMERINE 1733 THE GAMING ACTIVITIES AT SAINT AGNES MEDICAL CENTER PRIMARILY RELATE TO RAFFLE TICKET SALES AT FUNDRAISING EVENTS. TERI AMERINE, VP - FOUNDATION, MANAGES THE OVERALL GAMING ACTIVITIES INCLUDING THE RECORDKEEPING, HIRING AND FIRING OF WORKERS, AND MAKING THE BANK DEPOSITS FOR THE GAMING ACTIVITIES. TERI AMERINE'S COMPENSATION ALLOCATED TO GAMING ACTIVITIES IS APPROXIMATELY $1,733 X 0 SCHEDULE G, PART I, LINE 2B, COLUMN (V) THE AGREEMENT SPECIFIES THAT SAINT AGNES MEDICAL CENTER WILL COMPENSATE THE GAVEL GROUP 50% OF AUCTION AND SILENT AUCTION NET PROFIT 1 1 X 1 X 1 X 1 1 1 0 1 1 2815452 24108 2791344 0.00590 164696115 150915189 13780926 0.02930 167511567 150939297 16572270 0.03520 15 46065 1550906 113610 1437296 0.00310 2 1121 912990 912990 0.00190 5 449128 449128 0.00100 22 47186 2913024 113610 2799414 0.00600 22 47186 170424591 151052907 19371684 0.04120 1 8975456 0 158237626 161542589 -3304963 X 1 1 1 SAINT AGNES HEALTH PARTNERS LLC MANAGED CARE SERVICES 0.50000 0.50000 1 1 SAINT AGNES MEDICAL CENTER 1303 E HERNDON AVE FRESNO CA 93720 WWW.SAMC.COM HOSPITAL LICENSE # 040000173 X X X SAINT AGNES MEDICAL CENTER 1 0 0 1 X X X X X X X X X 15 1 1 1 1 X WWW.SAMC.COM/COMMUNITY-BENEFITS X 1 15 1 WWW.SAMC.COM/COMMUNITY-BENEFITS 0 1 X 200.000000000000 400.000000000000 X X X X X X 1 1 X X X X 1 X WWW.SAMC.COM/FINANCIAL-SUPPORT X WWW.SAMC.COM/FINANCIAL-SUPPORT X WWW.SAMC.COM/FINANCIAL-SUPPORT X X X X X X X 1 X 0 X X X X 1 X 0 0 SAINT AGNES MEDICAL CENTER PART V, SECTION B, LINE 5: THE 2016 CHNA ASSESSED FRESNO, KINGS, MADERA AND TULARE COUNTIES, WHICH TOGETHER COMPRISE A MAJOR PORTION OF SAN JOAQUIN OR CENTRAL VALLEY OF CALIFORNIA. COMMUNITY INPUT IDENTIFIED COMMUNITY HEALTH NEEDS AND SECONDARY DATA CONFIRMED THE NEEDS RANK BELOW STATE AVERAGES. FURTHER REVIEW OF THE HEALTH NEEDS DETERMINED THE EXTENT TO WHICH HEALTH INEQUITIES MAY EXIST AND WHICH SEGMENTS OF THE POPULATION ARE MORE NEGATIVELY IMPACTED. IN ADDITION TO PRIMARY DATA SOURCES, A STRONG EMPHASIS WAS PLACED ON ADMINISTERING A COMMUNITY SURVEY, CONDUCTING FOCUS GROUPS, AND INTERVIEWING KEY STAKEHOLDERS IN EACH COUNTY.IN ORDER TO LEVERAGE THE OPPORTUNITY TO USE A CONSISTENT SET OF QUESTIONS ACROSS ALL FOUR COUNTIES, A CHNA SURVEY THAT WAS DEVELOPED BY THE MADERA COUNTY DEPARTMENT OF PUBLIC HEALTH WAS RECOMMENDED BY THE WORKGROUP FOR USE IN THIS PROCESS. THIS CHNA SURVEY WAS DESIGNED BY THE HEALTHY MADERA COALITION WITH THE COUNTY PUBLIC HEALTH DEPARTMENT STAFF. THIRTY-SIX QUESTIONS FOCUSED ON DEMOGRAPHIC INFORMATION AND CENTERED ON KEY HEALTH CONCERNS AND FACTORS THAT INFLUENCE THE HEALTH OF THE COMMUNITY.THE CHNA SURVEY, WHICH WAS ADMINISTERED BETWEEN JULY AND DECEMBER 2015, CENTERED ON SOLICITING PERSPECTIVES ON HEALTH NEEDS, PERCEPTIONS ON WHAT ENVIRONMENTAL FACTORS INFLUENCE THE HEALTH OF THE COMMUNITY, BEHAVIORS THAT IMPACT HEALTH, AND WHAT MAKES IT HARD TO GET HEALTH CARE IN THEIR COUNTY. OTHER QUESTIONS FOCUSED ON WHAT PARTICIPANTS CONSIDER TO BE INDICATORS OF A HEALTHY COMMUNITY AND WHAT FACTORS IN THEIR COMMUNITY MOST NEED IMPROVEMENT. THREE QUESTIONS WERE USED TO DETERMINE IF THE RESPONDENT WAS A HOSPITAL STAFF MEMBER AND WHAT HOSPITAL THEY WORKED AT IN ORDER TO DISTINGUISH HEALTH CARE WORKERS VERSUS RESIDENTS TAKING THE SURVEY. HEALTH CARE WORKERS WERE ALSO ASKED TO COMPLETE A QUESTION ABOUT WHAT PATIENT ISSUES THEY MOST OFTEN SEE IN THEIR DEPARTMENT.A TOTAL OF 15 FOCUS GROUPS WERE CONDUCTED BETWEEN AUGUST AND OCTOBER, AND RANGED IN SIZE FROM 3 TO 28 PARTICIPANTS. THE FOCUS GROUPS WERE COORDINATED IN PARTNERSHIP WITH THE FOLLOWING COMMUNITY ORGANIZATIONS: FRESNO METRO MINISTRY, A NONPROFIT ESTABLISHED IN 1970 WITH A MISSION TO ADVOCATE FOR THE HEALTH AND WELL-BEING OF THE COMMUNITY; CENTRO LA FAMILIA ADVOCACY SERVICES, A NONPROFIT WORKING TO EMPOWER LOW INCOME PEOPLE TO ACCESS LIFE SUSTAINING RESOURCES THROUGH EDUCATION, TRAINING AND SOCIAL SERVICES; THE KINGS COUNTY ACTION ORGANIZATION, A COALITION THAT SEEKS TO PROVIDE PROGRAMS THAT DEVELOP SELF-SUFFICIENCY IN INDIVIDUALS, FAMILIES, AND COMMUNITIES WITHIN KINGS COUNTY; AND THE TULE RIVER TRIBE LOCATED APPROXIMATELY 18 MILES FROM PORTERVILLE. IN ADDITION, THE MADERA COUNTY DEPARTMENT OF PUBLIC HEALTH AND CAMARENA HEALTH, A FEDERALLY QUALIFIED HEALTH CENTER, ASSISTED WITH THE OUTREACH EFFORTS IN THEIR OWN COUNTY AND PROVIDED THE COMMUNITY SURVEY USED FOR THE CHNA. THE FOCUS GROUPS WERE ATTENDED BY HOSPITAL AND FACILITY STAFF, COMMUNITY LEADERS FROM NONPROFIT AND FAITH-BASED ORGANIZATIONS, ELECTED OFFICIALS, AND RESIDENTS. THESE SESSIONS WERE CONDUCTED PRIMARILY IN ENGLISH. FOCUS GROUPS COMPRISED OF PRIMARILY RESIDENTS, INCLUDING MOTHERS AND YOUTH, WERE CONDUCTED IN ENGLISH AND SPANISH. CHILDCARE WAS PROVIDED AT TWO OF THE FOCUS GROUPS.THE WORKGROUP IDENTIFIED APPROXIMATELY 95 INDIVIDUALS CONSIDERED TO BE KEY STAKEHOLDERS IN THE REGION THAT COULD PROVIDE A UNIQUE PERSPECTIVE ON THE HEALTH OF THE COMMUNITY, HEALTH CARE DELIVERY SYSTEMS IN PLACE, AND OVERALL CONDITIONS THAT INFLUENCE HEALTH BEHAVIORS. THEIR ORGANIZATIONS REPRESENTED CONSTITUENTS INCLUDING MEMBERS OF MEDICALLY UNDERSERVED POPULATIONS EXPERIENCING HEALTH DISPARITIES, OR THOSE AT RISK OF NOT RECEIVING ADEQUATE MEDICAL CARE AS A RESULT OF BEING UNINSURED OR UNDERINSURED, OR DUE TO GEOGRAPHIC, LANGUAGE, FINANCIAL OR OTHER BARRIERS.CONSULTANTS CONTACTED EACH STAKEHOLDER OFFERING TO CONDUCT PHONE OR IN-PERSON INTERVIEWS. THIRTY-SIX STAKEHOLDER INTERVIEWS WERE CONDUCTED BETWEEN JULY 20 AND SEPTEMBER 10, 2015. THEY INCLUDED LEADERS FROM THE FRESNO COUNTY HOUSING AUTHORITY, FRESNO COUNTY BEHAVIORAL HEALTH, CENTRAL CALIFORNIA CHILDREN'S INSTITUTE, STONE SOUP, KINGS COUNTY ACTION ORGANIZATION, PORTERVILLE HIGH SCHOOL, TULARE COUNTY HEALTH AND HUMAN SERVICES AGENCY, FRESNO CENTER FOR NEW AMERICANS, EVERY NEIGHBORHOOD PARTNERSHIP, VISALIA UNIFIED SCHOOL DISTRICT, POVERELLO HOUSE, YOUTH LEADERSHIP INSTITUTE, FRESNO DEPARTMENT OF PUBLIC HEALTH, CAMARENA HEALTH, AND MADERA PUBLIC HEALTH DEPARTMENT. THE FORMAT FOR THE INTERVIEWS WAS IDENTICAL TO THE FOCUS GROUP PROCESS. SAINT AGNES MEDICAL CENTER PART V, SECTION B, LINE 6A: THE HOSPITAL'S CHNA WAS CONDUCTED IN COLLABORATION WITH:1. ADVENTIST HEALTH/ADVENTIST MEDICAL CENTER - HANFORD2. ADVENTIST MEDICAL CENTER - REEDLEY3. ADVENTIST MEDICAL CENTER - SELMA4. ADVENTIST MEDICAL CENTER - CENTRAL VALLEY GENERAL HOSPITAL5. CLOVIS COMMUNITY MEDICAL CENTER6. COALINGA REGIONAL MEDICAL CENTER7. COMMUNITY REGIONAL MEDICAL CENTER (INCLUDES COMMUNITY BEHAVIORAL HEALTH CENTER)8. FRESNO HEART & SURGICAL HOSPITAL9. KAISER PERMANENTE FRESNO MEDICAL CENTER10. KAWEAH DELTA HEALTH CARE DISTRICT11. MADERA COMMUNITY HOSPITAL12. SIERRA VIEW DISTRICT HOSPITAL13. VALLEY CHILDREN'S HEALTHCARE SAINT AGNES MEDICAL CENTER PART V, SECTION B, LINE 6B: IN ORDER TO CONDUCT THE REGIONAL CHNA FOR FRESNO, KINGS, MADERA AND TULARE COUNTIES, HOSPITAL LEADERS FROM EACH COUNTY ENGAGED WITH THE HOSPITAL COUNCIL OF NORTHERN AND CENTRAL CALIFORNIA TO FORM THE HOSPITAL COUNCIL COMMUNITY BENEFIT WORKGROUP. SAINT AGNES MEDICAL CENTER PART V, SECTION B, LINE 11: SAINT AGNES MEDICAL CENTER IS ADDRESSING FOUR OF THE SIGNIFICANT NEEDS IDENTIFIED IN THE CHNA AS FOLLOWS:ACCESS TO CARE - PART OF SAINT AGNES MEDICAL CENTER'S MISSION IS TO PROVIDE QUALITY HEALTH CARE SERVICES WITH COMPASSION AND RESPECT, REGARDLESS OF RACE, CREED, SEX, AGE OR FINANCIAL STATUS. IN FY17 THIS INCLUDED A CONTINUED COMMITMENT TO PROVIDE ACCESSIBLE SERVICES TO PATIENTS WHO HAD LIMITED OR NO RESOURCES TO PAY FOR CARE. SAINT AGNES MEDICAL CENTER'S FINANCIAL SUPPORT PROGRAM CONTINUED TO BE A RESOURCE TO ELIGIBLE PATIENTS WHO MET FINANCIAL GUIDELINES. STAFF WERE ALSO AVAILABLE TO ASSIST PATIENTS IN APPLYING FOR PUBLIC ASSISTANCE PROGRAMS OR TO ESTABLISH A MANAGEABLE MONTHLY PAYMENT PLAN. TO ADDRESS ACCESS TO CARE FOR THE AREA'S MOST VULNERABLE POPULATION, SAINT AGNES MEDICAL CENTER CONTINUED TO COLLABORATE WITH AND PROVIDE FINANCIAL SUPPORT FOR COMMUNITY CLINICS AND OTHER SAFETY NET PROVIDERS. EXAMPLES INCLUDE: - ONGOING SUPPORT OF FULLY SUBSIDIZED HEALTH AND DENTAL SERVICES AT THE HOLY CROSS CLINIC,- CONTINUED SUPPORT FOR PROGRAMS SERVING HOMELESS PATIENTS, INCLUDING THE RESCUE MISSION RESPITE CARE PROGRAM AND THE MULTI-AGENCY PARTNERSHIP AT THE POVERELLO HOUSE, - CONTINUED SUPPORT OF THE VISION MOBILE UNIT PROGRAM TO PROVIDE NO-COST EXAMS AND GLASSES TO STUDENTS IN FOUR SCHOOL DISTRICTS RESULTING IN MORE THAN 1800 CHILDREN SERVED, AND- PARTICIPATION ON THE FRESNO UNIFIED SCHOOL DISTRICT (FUSD) HEALTH CARE PARTNERSHIP ADVISORY COUNCIL TO IMPROVE THE INFRASTRUCTURE FOR PROVIDING HEALTH SERVICES TO LOW-INCOME STUDENTS. SAINT AGNES MEDICAL CENTER'S COLLABORATION WITH COMMUNITY BENEFIT ORGANIZATIONS WITHIN THE FRESNO SERVICE AREA CONTINUED TO BE AN IMPORTANT ELEMENT TO REDUCING BARRIERS FOR HEALTH CARE. IN FY17 SAINT AGNES MEDICAL CENTER CONTINUED TO: - PARTICIPATE IN THE HEALTHCARE CAREERS PATHWAY INITIATIVE WITH THE FUSD CAREER TECHNICAL EDUCATION PROGRAM, - FACILITATE THE HEALTH PROFESSIONS EDUCATIONAL SUPPORT PROGRAM IN PARTNERSHIP WITH HIGHER EDUCATION INSTITUTIONS, - PARTICIPATE ON THE STEERING COMMITTEE FOR THE FRESNO COUNTY HEALTH IMPROVEMENT PARTNERSHIP (FCHIP), - ACT AS AN ADVISORY MEMBER OF THE CHILDREN'S MOVEMENT HEALTHCARE WORKGROUP, AND- CHAIR THE FCHIP'S HEALTH LITERACY WORKGROUP. SUPPORTING PATIENTS IN THE MANAGEMENT OF THEIR OWN HEALTH WAS ANOTHER KEY COMPONENT FOR SAINT AGNES MEDICAL CENTER'S ACCESS TO CARE STRATEGY. THESE EFFORTS INCLUDED: - OFFERING NO-COST PROGRAMS LIKE THE BETTER BREATHERS PROGRAM, SICKLE CELL PROGRAM, CANCER SUPPORT GROUPS, AND CHRONIC DISEASE MANAGEMENT AND PREVENTION WORKSHOPS TO PATIENTS, THEIR FAMILIES AND COMMUNITY MEMBERS, - PROVIDING NO-COST BLOOD PRESSURE SCREENINGS AND DIABETES SCREENINGS IN THE COMMUNITY, AND- PROVIDING PATIENTS AND COMMUNITY MEMBERS LINKAGES TO SUPPORTIVE SERVICES THROUGH THE SAINT AGNES MEDICAL CENTER HEALTH HUB.DIABETES AND OBESITY - THE OCCURRENCE RATES OF DIABETES AND OBESITY IN SAINT AGNES MEDICAL CENTER'S PRIMARY FRESNO SERVICE AREA ARE HIGHER THAN THE CALIFORNIA STATE AVERAGE. MEDICARE BENEFICIARIES WITH DIABETES ARE 4.8% HIGHER ON AVERAGE AS COMPARED TO THE STATE, AND OBESITY RATES ARE 4.25% HIGHER. SAINT AGNES MEDICAL CENTER CONTINUED ITS INVOLVEMENT AND SUPPORT FOR A COMMUNITY-CENTERED AND INTEGRATED FOCUS ON HEALTH, HEALTHY CHOICES, AND WELLNESS AND PREVENTION. THROUGH THESE INITIATIVES, SAINT AGNES MEDICAL CENTER ENGAGED RESIDENTS AND COLLABORATED WITH NEIGHBORHOOD-BASED ORGANIZATIONS, HEALTH CARE PROVIDERS, PUBLIC HEALTH, SAFETY-NET CLINICS, HEALTH EDUCATORS AND HEALTH PLANS. IN FY17 SAINT AGNES MEDICAL CENTER: - SUPPORTED COMMUNITY HEALTH ORGANIZATIONS TO EXPAND EXISTING DIABETES PREVENTION AND MANAGEMENT PROGRAMS, INCLUDING THE IMPLEMENTATION OF THE NATIONAL DIABETES PREVENTION PROGRAM, - PARTICIPATED AS ADVISORY MEMBERS OF THE FRESNO DIABETES COLLABORATIVE, WHICH PROVIDED TOOLS FOR DIABETES RISK ASSESSMENTS AND COORDINATED HEALTH SYMPOSIUMS FOR HEALTH PROFESSIONALS AND COMMUNITY MEMBERS, AND- PROVIDED MARKET INSIGHT TO THE PARTNERSHIP FOR A HEALTHIER AMERICA TO INCREASE MARKET EFFECTIVENESS OF THE NATIONAL "FNV" (FRUITS AND VEGGIES) CAMPAIGN. SEVERAL FACTORS CONTRIBUTE TO THE HIGH RATES OF DIABETES AND OBESITY IN SAINT AGNES MEDICAL CENTER'S SERVICE AREA: POOR NUTRITION AND/OR LACK OF PHYSICAL ACTIVITY, POOR ACCESS TO CARE, AND POOR HEALTH LITERACY. SAINT AGNES MEDICAL CENTER INCREASED ACCESS TO CULTURALLY COMPETENT, HIGH-QUALITY DIABETES MANAGEMENT EDUCATION FOR LOW-INCOME INDIVIDUALS. THESE EFFORTS INCLUDED: - CONTINUED SUPPORT AND OFFERINGS OF HEALTHIER YOU WORKSHOPS TO PROVIDE CHRONIC DISEASE SELF-MANAGEMENT HEALTH EDUCATION IN BOTH ENGLISH AND SPANISH LANGUAGES TO COMMUNITY MEMBERS AT NO COST, - CONTINUED CROSS-TRAINING FOR COMMUNITY PARTNER ORGANIZATIONS AND COMMUNITY RESIDENTS AS "LAY LEADER" FACILITATORS OF THE HEALTHIER YOU PROGRAM, - EXPANDING THE USE OF CARE COORDINATORS AND COMMUNITY HEALTH WORKERS TO PROVIDE ASSISTANCE IN GUIDING INDIVIDUALS THROUGH SOCIAL SUPPORT SYSTEMS AND AVAILABLE RESOURCES TO INCREASE CONSUMPTION OF FRESH FRUITS AND VEGETABLES, AND- OFFERING THE HOLY CROSS CENTER FOR WOMEN'S "JUNIOR VOLUNTEER PROGRAM" DURING SUMMER VACATION MONTHS TO KEEP CHILDREN AND FAMILIES ENGAGED IN HEALTHY ACTIVITIES. ORAL HEALTH - SAINT AGNES MEDICAL CENTER'S SERVICE AREA RANKS BELOW THE STATE OF CALIFORNIA AVERAGES IN SEVERAL AREAS RELATED TO ORAL HEALTH. THE PERCENT OF ADULTS WITH POOR DENTAL HEALTH IS 13.1% AS COMPARED TO 11.3% FOR THE STATE OF CALIFORNIA; THE PERCENT OF ADULTS WITH NO DENTAL EXAM IS 35.27% AS COMPARED TO 30.5% FOR THE STATE OF CALIFORNIA; AND THE PERCENT OF CHILDREN AGED 2-11 WHO SAW A DENTIST 6-12 MONTHS AGO IS 16.6% AS COMPARED TO 3.9% FOR THE STATE OF CALIFORNIA.ACTIONS TAKEN BY SAINT AGNES MEDICAL CENTER TO ADDRESS ORAL HEALTH INCLUDED:- PROMOTING AND STAFFING THE HOLY CROSS CLINIC DENTAL CLINIC TO PROVIDE ACCESS TO CARE TO LOW INCOME, UNINSURED, AND UNDERINSURED POPULATIONS,- PROVIDING ORAL HEALTH EDUCATION, AND - OFFERING PREVENTATIVE ORAL HEALTH SERVICES TO ALL IN NEED REGARDLESS OF ABILITY TO PAY.SAINT AGNES MEDICAL CENTER ACKNOWLEDGES THE WIDE RANGE OF PRIORITY HEALTH ISSUES THAT EMERGED FROM THE CHNA PROCESS, AND DETERMINED THAT IT COULD EFFECTIVELY FOCUS ON ONLY THOSE HEALTH NEEDS WHICH IT DEEMED MOST PRESSING, UNDER-ADDRESSED, AND/OR WITHIN ITS ABILITY TO INFLUENCE. SAINT AGNES MEDICAL CENTER WILL REMAIN ENGAGED IN COMMUNITY COALITIONS, COLLABORATIVE WORK AND INITIATIVES TO OFFER INSIGHT AND SUPPORT AS APPROPRIATE. ADDITIONALLY, SAINT AGNES MEDICAL CENTER WILL CONTINUE TO ANALYZE AND IMPLEMENT BEST PRACTICES AND WILL CONTINUE TO PROVIDE RESOURCES FOR PATIENTS, BUT DUE TO COMPETING PRIORITIES WHICH SAINT AGNES MEDICAL CENTER HAS THE EXPERTISE TO INFLUENCE, THE FOLLOWING NEEDS WILL NOT BE SPECIFICALLY ADDRESSED: - BREATHING PROBLEMS (ASTHMA) - MENTAL HEALTH- MATERNAL AND INFANT HEALTH - INFANT MORTALITY & PREMATURE BIRTHS OR TEEN/UNWANTED PREGNANCY - SUBSTANCE ABUSE - CARDIO VASCULAR DISEASE (CVD)/STROKE (HYPERTENSION) - VIOLENCE/INJURY PREVENTION SAINT AGNES MEDICAL CENTER PART V, SECTION B, LINE 13H: THE HOSPITAL RECOGNIZES THAT NOT ALL PATIENTS ARE ABLE TO PROVIDE COMPLETE FINANCIAL AND/OR SOCIAL INFORMATION. THEREFORE, APPROVAL FOR FINANCIAL SUPPORT MAY BE DETERMINED BASED ON AVAILABLE INFORMATION. EXAMPLES OF PRESUMPTIVE CASES INCLUDE: DECEASED PATIENTS WITH NO KNOWN ESTATE, THE HOMELESS, UNEMPLOYED PATIENTS, NON-COVERED MEDICALLY NECESSARY SERVICES PROVIDED TO PATIENTS QUALIFYING FOR PUBLIC ASSISTANCE PROGRAMS, PATIENT BANKRUPTCIES, AND MEMBERS OF RELIGIOUS ORGANIZATIONS WHO HAVE TAKEN A VOW OF POVERTY AND HAVE NO RESOURCES INDIVIDUALLY OR THROUGH THE RELIGIOUS ORDER.FOR THE PURPOSE OF HELPING FINANCIALLY NEEDY PATIENTS, A THIRD PARTY IS UTILIZED TO CONDUCT A REVIEW OF PATIENT INFORMATION TO ASSESS FINANCIAL NEED. THIS REVIEW UTILIZES A HEALTH CARE INDUSTRY-RECOGNIZED, PREDICTIVE MODEL THAT IS BASED ON PUBLIC RECORD DATABASES. THESE PUBLIC RECORDS ENABLE THE HOSPITAL TO ASSESS WHETHER THE PATIENT IS CHARACTERISTIC OF OTHER PATIENTS WHO HAVE HISTORICALLY QUALIFIED FOR FINANCIAL ASSISTANCE UNDER THE TRADITIONAL APPLICATION PROCESS. IN CASES WHERE THERE IS AN ABSENCE OF INFORMATION PROVIDED DIRECTLY BY THE PATIENT, AND AFTER EFFORTS TO CONFIRM COVERAGE AVAILABILITY, THE PREDICTIVE MODEL PROVIDES A SYSTEMATIC METHOD TO GRANT PRESUMPTIVE ELIGIBILITY TO FINANCIALLY NEEDY PATIENTS. SAINT AGNES MEDICAL CENTER PART V, SECTION B, LINE 16J: THE FOLLOWING ORGANIZATIONS RECEIVED THE PLAIN LANGUAGE SUMMARY OF THE FAP: POVERELLO HOUSE, THE MEXICAN CONSULATE, READING AND BEYOND, THE UNITED WAY, CENTRO LA FAMILIA, FIRST 5 FRESNO COUNTY, FRESNO RESCUE MISSION, FRESNO COMMUNITY FOOD BANK. SAINT AGNES MEDICAL CENTER: PART V, SECTION B, LINE 9: AS PERMITTED IN THE FINAL SECTION 501(R) REGULATIONS, THE HOSPITAL'S IMPLEMENTATION STRATEGY WAS ADOPTED WITHIN 4 1/2 MONTHS AFTER THE FISCAL YEAR END THAT THE CHNA WAS COMPLETED AND MADE WIDELY AVAILABLE TO THE PUBLIC. 4 1 - SAINT AGNES PEACHWOOD LABORATORY 275 W HERNDON AVE CLOVIS CA 93612 LAB 2 - SAINT AGNES NORTHWEST LABORATORY 4770 W HERNDON AVE FRESNO CA 93722 LAB 3 - HOLY CROSS CENTER FOR WOMEN 421 F STREET FRESNO CA 93706 DAYTIME SHELTER FOR WOMEN AND CHILDREN 4 - HOLY CROSS CLINIC AT POVERELLO HOUSE 412 F STREET FRESNO CA 93706 MEDICAL/DENTAL FOR THE INDIGENT PART I, LINE 3C: IN ADDITION TO LOOKING AT A MULTIPLE OF THE FEDERAL POVERTY GUIDELINES, OTHER FACTORS ARE CONSIDERED SUCH AS THE PATIENT'S FINANCIAL STATUS AND/OR ABILITY TO PAY AS DETERMINED THROUGH THE ASSESSMENT PROCESS. PART I, LINE 6A: SAINT AGNES MEDICAL CENTER PREPARES AN ANNUAL COMMUNITY BENEFIT REPORT, WHICH IT SUBMITS TO THE STATE OF CALIFORNIA. IN ADDITION, SAINT AGNES MEDICAL CENTER REPORTS ITS COMMUNITY BENEFIT INFORMATION AS PART OF THE CONSOLIDATED COMMUNITY BENEFIT INFORMATION REPORTED BY TRINITY HEALTH (EIN 35-1443425) IN ITS AUDITED FINANCIAL STATEMENTS, AVAILABLE AT WWW.TRINITY-HEALTH.ORG.IN ADDITION, SAINT AGNES MEDICAL CENTER INCLUDES A COPY OF ITS MOST RECENTLY FILED SCHEDULE H ON BOTH ITS OWN WEBSITE AND TRINITY HEALTH'S WEBSITE. PART I, LINE 7: THE BEST AVAILABLE DATA WAS USED TO CALCULATE THE COST AMOUNTS REPORTED IN ITEM 7. FOR CERTAIN CATEGORIES, PRIMARILY TOTAL CHARITY CARE AND MEANS-TESTED GOVERNMENT PROGRAMS, SPECIFIC COST-TO-CHARGE RATIOS WERE CALCULATED AND APPLIED TO THOSE CATEGORIES. THE COST-TO-CHARGE RATIO WAS DERIVED FROM WORKSHEET 2, RATIO OF PATIENT CARE COST-TO-CHARGES. IN OTHER CATEGORIES, THE BEST AVAILABLE DATA WAS DERIVED FROM THE HOSPITAL'S COST ACCOUNTING SYSTEM. PART I, LN 7 COL(F): THE FOLLOWING NUMBER, $8,975,456, REPRESENTS THE AMOUNT OF BAD DEBT EXPENSE INCLUDED IN TOTAL FUNCTIONAL EXPENSES IN FORM 990, PART IX, LINE 25. PER IRS INSTRUCTIONS, THIS AMOUNT WAS EXCLUDED FROM THE DENOMINATOR WHEN CALCULATING THE PERCENT OF TOTAL EXPENSE FOR SCHEDULE H, PART I, LINE 7, COLUMN (F). PART III, LINE 2: METHODOLOGY USED FOR LINE 2 - ANY DISCOUNTS PROVIDED OR PAYMENTS MADE TO A PARTICULAR PATIENT ACCOUNT ARE APPLIED TO THAT PATIENT ACCOUNT PRIOR TO ANY BAD DEBT WRITE-OFF AND ARE THUS NOT INCLUDED IN BAD DEBT EXPENSE. AS A RESULT OF THE PAYMENT AND ADJUSTMENT ACTIVITY BEING POSTED TO BAD DEBT ACCOUNTS, WE ARE ABLE TO REPORT BAD DEBT EXPENSE NET OF THESE TRANSACTIONS. PART III, LINE 3: SAINT AGNES MEDICAL CENTER USES A PREDICTIVE MODEL THAT INCORPORATES THREE DISTINCT VARIABLES IN COMBINATION TO PREDICT WHETHER A PATIENT QUALIFIES FOR FINANCIAL ASSISTANCE: (1) SOCIO-ECONOMIC SCORE, (2) ESTIMATED FEDERAL POVERTY LEVEL (FPL), AND (3) HOMEOWNERSHIP. BASED ON THE MODEL, CHARITY CARE CAN STILL BE EXTENDED TO PATIENTS EVEN IF THEY HAVE NOT RESPONDED TO FINANCIAL COUNSELING EFFORTS AND ALL OTHER FUNDING SOURCES HAVE BEEN EXHAUSTED. FOR FINANCIAL STATEMENT PURPOSES, SAINT AGNES MEDICAL CENTER IS RECORDING AMOUNTS AS CHARITY CARE (INSTEAD OF BAD DEBT EXPENSE) BASED ON THE RESULTS OF THE PREDICTIVE MODEL. THEREFORE, SAINT AGNES MEDICAL CENTER IS REPORTING ZERO ON LINE 3, SINCE THEORETICALLY ANY POTENTIAL CHARITY CARE SHOULD HAVE BEEN IDENTIFIED THROUGH THE PREDICTIVE MODEL. PART III, LINE 4: SAINT AGNES MEDICAL CENTER IS INCLUDED IN THE CONSOLIDATED FINANCIAL STATEMENTS OF TRINITY HEALTH. THE FOLLOWING IS THE TEXT OF THE ALLOWANCE FOR DOUBTFUL ACCOUNTS FOOTNOTE FROM PAGE 14 OF THOSE STATEMENTS: "THE CORPORATION RECOGNIZES A SIGNIFICANT AMOUNT OF PATIENT SERVICE REVENUE AT THE TIME THE SERVICES ARE RENDERED EVEN THOUGH THE CORPORATION DOES NOT ASSESS THE PATIENT'S ABILITY TO PAY AT THAT TIME. AS A RESULT, THE PROVISION FOR BAD DEBTS IS PRESENTED AS A DEDUCTION FROM PATIENT SERVICE REVENUE (NET OF CONTRACTUAL PROVISIONS AND DISCOUNTS). FOR UNINSURED AND UNDERINSURED PATIENTS THAT DO NOT QUALIFY FOR CHARITY CARE, THE CORPORATION ESTABLISHES AN ALLOWANCE TO REDUCE THE CARRYING VALUE OF SUCH RECEIVABLES TO THEIR ESTIMATED NET REALIZABLE VALUE. THIS ALLOWANCE IS ESTABLISHED BASED ON THE AGING OF ACCOUNTS RECEIVABLE AND THE HISTORICAL COLLECTION EXPERIENCE BY THE HEALTH MINISTRIES AND FOR EACH TYPE OF PAYOR. A SIGNIFICANT PORTION OF THE CORPORATION'S PROVISION FOR DOUBTFUL ACCOUNTS RELATES TO SELF-PAY PATIENTS, AS WELL AS CO-PAYMENTS AND DEDUCTIBLES OWED TO THE CORPORATION BY PATIENTS WITH INSURANCE."PART III, LINE 5:TOTAL MEDICARE REVENUE REPORTED IN PART III, LINE 5 HAS BEEN REDUCED BY THE TWO PERCENT SEQUESTRATION REDUCTION. PART III, LINE 8: SAINT AGNES MEDICAL CENTER DOES NOT BELIEVE ANY MEDICARE SHORTFALL SHOULD BE TREATED AS COMMUNITY BENEFIT. THIS IS SIMILAR TO CATHOLIC HEALTH ASSOCIATION RECOMMENDATIONS, WHICH STATE THAT SERVING MEDICARE PATIENTS IS NOT A DIFFERENTIATING FEATURE OF TAX-EXEMPT HEALTH CARE ORGANIZATIONS AND THAT THE EXISTING COMMUNITY BENEFIT FRAMEWORK ALLOWS COMMUNITY BENEFIT PROGRAMS THAT SERVE THE MEDICARE POPULATION TO BE COUNTED IN OTHER COMMUNITY BENEFIT CATEGORIES.PART III, LINE 8: COSTING METHODOLOGY FOR LINE 6 - MEDICARE COSTS WERE OBTAINED FROM THE FILED MEDICARE COST REPORT. THE COSTS ARE BASED ON MEDICARE ALLOWABLE COSTS AS REPORTED ON WORKSHEET B, COLUMN 27, WHICH EXCLUDE DIRECT MEDICAL EDUCATION COSTS. INPATIENT MEDICARE COSTS ARE CALCULATED BASED ON A COMBINATION OF ALLOWABLE COST PER DAY TIMES MEDICARE DAYS FOR ROUTINE SERVICES AND COST TO CHARGE RATIO TIMES MEDICARE CHARGES FOR ANCILLARY SERVICES. OUTPATIENT MEDICARE COSTS ARE CALCULATED BASED ON COST TO CHARGE RATIO TIMES MEDICARE CHARGES BY ANCILLARY DEPARTMENT. PART III, LINE 9B: THE HOSPITAL'S COLLECTION POLICY CONTAINS PROVISIONS ON THE COLLECTION PRACTICES TO BE FOLLOWED FOR PATIENTS WHO ARE KNOWN TO QUALIFY FOR FINANCIAL ASSISTANCE. CHARITY DISCOUNTS ARE APPLIED TO THE AMOUNTS THAT QUALIFY FOR FINANCIAL ASSISTANCE. COLLECTION PRACTICES FOR THE REMAINING BALANCES ARE CLEARLY OUTLINED IN THE ORGANIZATION'S COLLECTION POLICY. THE HOSPITAL HAS IMPLEMENTED BILLING AND COLLECTION PRACTICES FOR PATIENT PAYMENT OBLIGATIONS THAT ARE FAIR, CONSISTENT AND COMPLIANT WITH STATE AND FEDERAL REGULATIONS. PART VI, LINE 2: NEEDS ASSESSMENT - IN ADDITION TO THE CHNA, SAINT AGNES MEDICAL CENTER CONTINUALLY ASSESSES THE HEALTH STATUS OF ITS COMMUNITY, IN PARTNERSHIP WITH COMMUNITY COALITIONS. AS PART OF THE NORMAL COURSE OF OPERATIONS AND IN THE CONTINUOUS EFFORTS TO IMPROVE PATIENT CARE AND THE HEALTH OF THE OVERALL COMMUNITY, PATIENT DATA, PUBLIC HEALTH DATA, PUBLISHED COUNTY HEALTH RANKINGS, MARKET STUDIES AND OTHER REPORTS ARE ANALYZED ON A REGULAR BASIS TO HELP DETERMINE TRENDS AND EMERGING HEALTH NEEDS FOR THE SERVICE AREA. ONGOING PARTICIPATION IN LOCAL AREA STAKEHOLDER MEETINGS, COMMUNITY ROUNDTABLES AND HEALTH STRATEGY FORUMS ALLOW FOR ALIGNMENT WITH LOCAL COMMUNITY BASED ORGANIZATIONS AND STRATEGIES. PART VI, LINE 3: PATIENT EDUCATION OF ELIGIBILITY FOR ASSISTANCE - SAINT AGNES MEDICAL CENTER IS COMMITTED TO:- PROVIDING ACCESS TO QUALITY HEALTH CARE SERVICES WITH COMPASSION, DIGNITY AND RESPECT FOR THOSE WE SERVE, PARTICULARLY THE POOR AND THE UNDERSERVED IN OUR COMMUNITIES- CARING FOR ALL PERSONS, REGARDLESS OF THEIR ABILITY TO PAY FOR SERVICES- ASSISTING PATIENTS WHO CANNOT PAY FOR PART OR ALL OF THE CARE THEY RECEIVE - BALANCING NEEDED FINANCIAL ASSISTANCE FOR SOME PATIENTS WITH BROADER FISCAL RESPONSIBILITIES IN ORDER TO SUSTAIN VIABILITY AND PROVIDE THE QUALITY AND QUANTITY OF SERVICES FOR ALL WHO MAY NEED CARE IN A COMMUNITYIN ACCORDANCE WITH AMERICAN HOSPITAL ASSOCIATION RECOMMENDATIONS, SAINT AGNES MEDICAL CENTER HAS ADOPTED THE FOLLOWING GUIDING PRINCIPLES WHEN HANDLING THE BILLING, COLLECTION AND FINANCIAL SUPPORT FUNCTIONS FOR OUR PATIENTS: - PROVIDE EFFECTIVE COMMUNICATIONS WITH PATIENTS REGARDING HOSPITAL BILLS- MAKE AFFIRMATIVE EFFORTS TO HELP PATIENTS APPLY FOR PUBLIC AND PRIVATE FINANCIAL SUPPORT PROGRAMS- OFFER FINANCIAL SUPPORT TO PATIENTS WITH LIMITED MEANS- IMPLEMENT POLICIES FOR ASSISTING LOW-INCOME PATIENTS IN A CONSISTENT MANNER- IMPLEMENT FAIR AND CONSISTENT BILLING AND COLLECTION PRACTICES FOR ALL PATIENTS WITH PATIENT PAYMENT OBLIGATIONSSAINT AGNES MEDICAL CENTER COMMUNICATES EFFECTIVELY WITH PATIENTS REGARDING PATIENT PAYMENT OBLIGATIONS. FINANCIAL COUNSELING IS PROVIDED TO PATIENTS ABOUT THEIR PAYMENT OBLIGATIONS AND HOSPITAL BILLS. INFORMATION ON HOSPITAL-BASED FINANCIAL SUPPORT POLICIES AND EXTERNAL PROGRAMS THAT PROVIDE COVERAGE FOR SERVICES ARE MADE AVAILABLE TO PATIENTS DURING THE PRE-REGISTRATION AND REGISTRATION PROCESSES AND/OR THROUGH COMMUNICATIONS WITH PATIENTS SEEKING FINANCIAL ASSISTANCE. FINANCIAL COUNSELORS MAKE AFFIRMATIVE EFFORTS TO HELP PATIENTS APPLY FOR PUBLIC AND PRIVATE PROGRAMS FOR WHICH THEY MAY QUALIFY AND THAT MAY ASSIST THEM IN OBTAINING AND PAYING FOR HEALTH CARE SERVICES. EVERY EFFORT IS MADE TO DETERMINE A PATIENT'S ELIGIBILITY PRIOR TO OR AT THE TIME OF ADMISSION OR SERVICE. FINANCIAL ASSISTANCE APPLICATIONS WILL BE ACCEPTED UNTIL ONE YEAR AFTER THE FIRST BILLING STATEMENT TO THE PATIENT. SAINT AGNES MEDICAL CENTER OFFERS FINANCIAL SUPPORT TO PATIENTS WITH LIMITED MEANS. THIS SUPPORT IS AVAILABLE TO UNINSURED AND UNDERINSURED PATIENTS WHO DO NOT QUALIFY FOR PUBLIC PROGRAMS OR OTHER ASSISTANCE. NOTIFICATION ABOUT FINANCIAL ASSISTANCE, INCLUDING CONTACT INFORMATION, IS AVAILABLE THROUGH PATIENT BROCHURES, MESSAGES ON PATIENT BILLS, POSTED NOTICES IN PUBLIC REGISTRATION AREAS INCLUDING EMERGENCY ROOMS, ADMITTING AND REGISTRATION DEPARTMENTS, AND OTHER PATIENT FINANCIAL SERVICES OFFICES. SUMMARIES OF HOSPITAL PROGRAMS ARE MADE AVAILABLE TO APPROPRIATE COMMUNITY HEALTH AND HUMAN SERVICES AGENCIES AND OTHER ORGANIZATIONS THAT ASSIST PEOPLE IN NEED. INFORMATION REGARDING FINANCIAL ASSISTANCE PROGRAMS IS ALSO AVAILABLE ON HOSPITAL WEBSITES. IN ADDITION TO ENGLISH, THIS INFORMATION IS ALSO AVAILABLE IN OTHER LANGUAGES AS REQUIRED BY INTERNAL REVENUE CODE SECTION 501(R), REFLECTING OTHER PRIMARY LANGUAGES SPOKEN BY THE POPULATION SERVICED BY OUR HOSPITAL. SAINT AGNES MEDICAL CENTER HAS ESTABLISHED A WRITTEN POLICY FOR THE BILLING, COLLECTION AND SUPPORT FOR PATIENTS WITH PAYMENT OBLIGATIONS. SAINT AGNES MEDICAL CENTER MAKES EVERY EFFORT TO ADHERE TO THE POLICY AND IS COMMITTED TO IMPLEMENTING AND APPLYING THE POLICY FOR ASSISTING PATIENTS WITH LIMITED MEANS IN A PROFESSIONAL, CONSISTENT MANNER. PART VI, LINE 4: COMMUNITY INFORMATION - SAINT AGNES MEDICAL CENTER DEFINES THE COMMUNITY SERVED AS THOSE INDIVIDUALS RESIDING WITHIN ITS HOSPITAL SERVICE AREA WITHOUT EXCLUSION OF LOW-INCOME OR UNDERSERVED POPULATIONS. SAINT AGNES MEDICAL CENTER'S PRIMARY SERVICE AREA INCLUDES THE MAJORITY OF FRESNO AND PORTIONS OF MADERA COUNTIES. THE REMAINDER OF FRESNO AND MADERA COUNTIES, AS WELL AS PORTIONS OF KINGS AND TULARE COUNTIES, COMPRISES THE SECONDARY SERVICE AREA OF SAINT AGNES MEDICAL CENTER. A TOTAL OF 1,109,936 PEOPLE LIVE WITHIN SAINT AGNES MEDICAL CENTER'S PRIMARY FRESNO AND MADERA SERVICE AREA, WHICH COVERS 8,095.92 SQUARE MILES ACCORDING TO THE U.S. CENSUS BUREAU AMERICAN COMMUNITY SURVEY 2011-15 5-YEAR ESTIMATES. THE CITY OF FRESNO IS THE LARGEST OF THE CITIES IN FRESNO COUNTY. MADERA COUNTY IS THE FURTHEST NORTH OF ALL FOUR COUNTIES WITH THE LARGEST CITY BEING MADERA. A TOTAL OF 605,031 PEOPLE LIVE IN KINGS AND TULARE COUNTIES. THE COUNTIES FACE MANY CHALLENGES. AMONG 58 CALIFORNIA COUNTIES, FRESNO COUNTY RANKED 52ND, MADERA RANKED 45TH, TULARE RANKED 50TH, AND KINGS COUNTY RANKED 37TH IN HEALTH OUTCOMES, AS REPORTED BY THE UNIVERSITY OF WISCONSIN POPULATION HEALTH INSTITUTE. THE DATA INCLUDES PREMATURE BIRTHS AND DEATHS, LOW BIRTH WEIGHTS, ACCESS TO EXERCISE ACTIVITIES, OBESITY, PHYSICIAN-TO-RESIDENT RATIO, RATE OF UNINSURED RESIDENTS, AND NUMEROUS OTHER FACTORS. ECONOMIC AND SOCIAL INSECURITY OFTEN ARE ASSOCIATED WITH POOR HEALTH. POVERTY, UNEMPLOYMENT, AND LACK OF EDUCATIONAL ACHIEVEMENT AFFECT ACCESS TO CARE AND A COMMUNITY'S ABILITY TO ENGAGE IN HEALTHY BEHAVIORS.POVERTY IS A SIGNIFICANT SOCIAL DETERMINANT OF HEALTH BECAUSE THE ABSENCE OF ECONOMIC RESOURCES IMPACTS HOUSING CHOICES, FOOD OPTIONS, AND OVERALL LIFESTYLE CHOICES. WITHIN SAINT AGNES MEDICAL CENTER'S PRIMARY SERVICE AREA NEARLY 51% OF RESIDENTS ARE LIVING IN HOUSEHOLDS WITH INCOME BELOW 200% OF THE FEDERAL POVERTY LEVEL (FPL) AND SLIGHTLY MORE THAN 54% OF TULARE AND KINGS LIVE BELOW 200% FPL. THE AREA'S UNEMPLOYMENT RATE IS CONSISTENTLY ABOVE THE NATIONAL AND STATE RATES. TOTAL UNEMPLOYMENT WITHIN THE PRIMARY SERVICE AREA FOR THE CURRENT MONTH WAS 46,407, OR 9.1% OF THE CIVILIAN NON-INSTITUTIONALIZED POPULATION AGE 16 AND OLDER (NON-SEASONALLY ADJUSTED). TULARE AND KINGS UNEMPLOYMENT RATE IS SLIGHTLY HIGHER, AT 10.5%. PER CAPITA INCOME RANGES FROM $17,970 IN MADERA COUNTY TO $20,408 IN FRESNO COUNTY, WHICH IS SUBSTANTIALLY LOWER THAN THE CALIFORNIA AVERAGE OF $30,318. SAINT AGNES MEDICAL CENTER'S SERVICE AREA AS A WHOLE IS AN AREA OF IMMENSE NEED, WITH FEWER HEALTH RESOURCES THAN THE REST OF THE STATE. IT IS A REGION OF GREAT DIVERSITY, WITH BOTH URBAN AND RURAL POPULATIONS, AND MANY IMMIGRANTS. THE ESTIMATED POPULATION THAT IS OF HISPANIC, LATINO, OR SPANISH ORIGIN IS 942,307. THIS REPRESENTS 54.95% OF THE TOTAL REPORT AREA POPULATION, WHICH IS GREATER THAN THE NATIONAL RATE OF 17.13%.THE DIVERSITY OF THE REGION IS REFLECTED IN THE WIDE RANGE OF LANGUAGES SPOKEN IN EACH COUNTY. LESS THAN 20% OF THE POPULATION OVER AGE 5 HAS A LIMITED ENGLISH PROFICIENCY, AND NEARLY 10% IS LINGUISTICALLY ISOLATED. WITHIN SAINT AGNES MEDICAL CENTER'S SERVICE AREA, NEARLY 84% OF RESIDENTS WITH LIMITED ENGLISH PROFICIENCY SPEAK SPANISH; 10.35% SPEAK ASIAN OR PACIFIC ISLAND LANGUAGES, AND 4.86% SPEAK INDO-EUROPEAN LANGUAGES. EDUCATION OR EDUCATIONAL ATTAINMENT IS STRONGLY LINKED TO HEALTH OUTCOMES; A 25 YEAR OLD IN THE UNITED STATES WITHOUT A HIGH SCHOOL DIPLOMA TODAY WILL DIE 9 YEARS SOONER THAN COLLEGE GRADUATES. PEOPLE WITH MORE EDUCATION LIVE LONGER, EXPERIENCE BETTER HEALTH OUTCOMES AND TEND TO PRACTICE HEALTH-PROMOTING BEHAVIORS (I.E. GETTING REGULAR EXERCISE, REFRAINING FROM SMOKING, OR GETTING TIMELY MEDICAL CHECKUPS, IMMUNIZATIONS OR SCREENINGS). UNFORTUNATELY, OVER A QUARTER OF THE POPULATION IN MADERA AND FRESNO, AND MORE THAN 30% IN TULARE AND KINGS COUNTIES, LACKS A HIGH SCHOOL DIPLOMA. WITHIN EACH COUNTY, LESS THAN 20% OF THE POPULATION HAS A BACHELOR'S DEGREE COMPARED TO 31.43% OF CALIFORNIA AS A WHOLE. MADERA COUNTY'S BACHELOR'S DEGREE RATE IS 13.34%, WHICH IS SUBSTANTIALLY LOWER THAN THE STATE'S RATE. ANOTHER FACTOR IMPACTING SAINT AGNES MEDICAL CENTER'S PRIMARY SERVICE AREA AS A WHOLE IS THE LOW RATE OF PRIMARY CARE PHYSICIANS IN THE REGION AND CONSEQUENTLY, THE HIGH RANGE OF THE POPULATION THAT LIVES WITHIN A HEALTH PROFESSIONAL SHORTAGE AREA (HPSA). ANOTHER FACTOR THAT EXACERBATES ACCESS TO CARE IS THE HIGH RATE OF ADULTS AND CHILDREN THAT LACK INSURANCE. THESE FACTORS IMPACT RATES OF PREVENTABLE HOSPITALIZATIONS, POTENTIAL YEARS OF LIFE LOST, AND THE NUMBER OF PEOPLE WHO DO NOT RECEIVE PREVENTATIVE CARE. THE NUMBER OF PRIMARY CARE PHYSICIANS PER 100,000 POPULATION IN FRESNO AND MADERA COUNTIES IS 67.9, WHICH IS LOWER THAN THE STATE'S RATE OF 86.7. TULARE AND KINGS COUNTIES ARE EVEN LOWER AT 47.2 PER 100,000. MORE THAN 16% OF FRESNO AND MADERA AND 14.79% OF TULARE AND KINGS COUNTY RESIDENTS ARE UNINSURED, HIGHER THAN CALIFORNIA'S RATE OF 14.7%. A COMMUNITY'S HEALTH IS ALSO AFFECTED BY THE PHYSICAL ENVIRONMENT. A SAFE, CLEAN ENVIRONMENT THAT PROVIDES ACCESS TO HEALTHY FOOD AND RECREATIONAL OPPORTUNITIES IS IMPORTANT TO MAINTAINING AND IMPROVING COMMUNITY HEALTH. ACCORDING TO THE CENTERS FOR DISEASE CONTROL, THE PERCENTAGE OF DAYS WITH PARTICULATE MATTER 2.5 LEVELS ABOVE THE NATIONAL AMBIENT AIR QUALITY STANDARD (35 MICROGRAMS PER CUBIC METER) PER YEAR IN THE SERVICE AREA AS A WHOLE WAS NEARLY FOUR TIMES HIGHER THAN THE STATE. ADDITIONALLY, MORE THAN 500,000 RESIDENTS HAVE LIMITED ACCESS TO SUPERMARKETS, SUPERCENTERS, GROCERY STORES, OR OTHER SOURCES OF HEALTHY AND AFFORDABLE FOOD. PART VI, LINE 5: OTHER INFORMATION - IN FY17, SAINT AGNES MEDICAL CENTER CONTINUED TO PROMOTE HEALTH IN THE COMMUNITY THROUGH A VARIETY OF ACTIVITIES AND INVOLVEMENT. THEY INCLUDED THE FOLLOWING: WORKFORCE DEVELOPMENT - SAINT AGNES MEDICAL CENTER'S CONTINUING MEDICAL EDUCATION (CME) PROGRAM STRIVED TO IMPROVE PATIENT CARE BY PROVIDING HIGH QUALITY EDUCATIONAL ACTIVITIES WITH THE GOAL OF PROMOTING LIFELONG LEARNING AND ENHANCING HEALTH CARE PROFESSIONALS' KNOWLEDGE AND SKILLS. PHYSICIANS WHO ATTENDED SAINT AGNES MEDICAL CENTER'S CME ACTIVITIES EARNED CREDITS TO SUPPORT THEIR STATE LICENSES AND BOARD CERTIFICATIONS.SAINT AGNES MEDICAL CENTER IS LOCATED IN A HEALTH PROFESSIONS SHORTAGE AREA AND THEREFORE 100% OF ITS SERVICE AREA IS DEFINED AS "MEDICALLY UNDERSERVED." AS A RESULT, THE HOSPITAL MADE IT A PRIORITY TO SUPPORT HEALTH PROFESSION EDUCATION FOR NURSING STUDENTS AND OTHER PROFESSIONS INCLUDING, BUT NOT LIMITED TO, RADIOLOGY TECHNICIANS, SURGERY TECHNICIANS, PARAMEDICS, AND SOCIAL WORKERS. ADDITIONALLY, SAINT AGNES MEDICAL CENTER PARTICIPATED IN THE HEALTH CARE CAREER PATHWAY INITIATIVE AND PROVIDED EXPERTISE TO FRESNO UNIFIED SCHOOL DISTRICT'S CAREER TECHNICAL EDUCATION PROGRAM. HOMELESSNESS - SAINT AGNES MEDICAL CENTER CONTINUED TO PLAY A CRITICAL ROLE IN EFFORTS TO END HOMELESSNESS BY FINANCIALLY SUPPORTING AND SERVING ON THE BOARD OF FRESNO FIRST STEPS HOME, A HOUSING FIRST MODEL THAT LAUNCHED IN 2011 AND IS CHAMPIONED BY FRESNO MAYOR LEE BRAND. SAINT AGNES MEDICAL CENTER CONTINUED ITS SUPPORT OF THE MULTI-AGENCY PARTNERSHIP (MAP) PROGRAM WITH STAFF AND THROUGH PARTICIPATION ON ITS ADVISORY COUNCIL. MAP IS DESIGNED TO PROVIDE HOUSING ASSISTANCE, MENTAL HEALTH AND SUBSTANCE USE DISORDER SERVICES AND OTHER SOCIAL NEEDS THROUGH ONE COORDINATED ENTRY POINT. COMMUNITY TRANSFORMATION - THE FRESNO COUNTY HEALTH IMPROVEMENT PARTNERSHIP (FCHIP) IS A COUNTY-WIDE EFFORT TO IMPLEMENT POLICIES, SYSTEMS, AND ENVIRONMENTS TO IMPROVE HEALTH. IN ADDITION TO PROVIDING STAFF FOR ITS STEERING COMMITTEE AND TO PARTICIPATE IN THE DIABETES WORKGROUP AND LEAD THE HEALTH LITERACY WORKGROUP, THE INITIATIVE RECEIVED FINANCIAL SUPPORT FOR INFRASTRUCTURE DEVELOPMENT AND TO ASSIST WITH THE HIRING OF A PROGRAM DIRECTOR TO FACILITATE THE WORK OF THE PARTNERSHIP. PARTNERED WITH THE DEPARTMENT OF PUBLIC HEALTH, FCHIP SUCCESSFULLY DEVELOPED AND MADE AVAILABLE TO THE PUBLIC A WEB-BASED HEALTH PRIORITY INDEX (HPI) PLATFORM TO HELP INFORM INTERVENTIONS, INFRASTRUCTURE PLANNING, AND RESOURCE ALLOCATION WITHIN FRESNO COUNTY. FRESNO UNIFIED SCHOOL DISTRICT UTILIZED THE HPI AS ONE CRITERIA IN CHOOSING FUTURE SCHOOL BASED HEALTH CLINICS. THE FCHIP STEERING COMMITTEE ALSO PARTNERED WITH THE PUBLIC HEALTH INSTITUTE AND THE CALIFORNIA ACCOUNTABLE COMMUNITIES FOR HEALTH (CACHI) TO BUILD ITS CAPACITY TO COLLABORATE, ALIGN, AND LEVERAGE RESOURCES. A STRATEGIC PLAN PROCESS FOCUSED FCHIP'S EFFORTS ON INFRASTRUCTURE AND FOUR WORK GROUPS: DIABETES COLLABORATIVE, LAND USE AND PLANNING, HEALTH LITERACY AND EMPOWERMENT, AND PRE TO 3. TOBACCO - SMOKE FREE - SAINT AGNES MEDICAL CENTER IS DEDICATED TO POLICY AND SYSTEMS CHANGE EFFORTS THAT POSITIVELY IMPACT THE HEALTH AND WELL-BEING OF RESIDENTS WITHIN OUR SERVICE AREA. AS A MEMBER OF TRINITY HEALTH, ONE OF THE LARGEST HEALTH CARE SYSTEMS IN THE UNITED STATES, SAINT AGNES MEDICAL CENTER PARTICIPATED IN A REVIEW OF ITS EXISTING TOBACCO-FREE CAMPUS AND HEALTHY VENDING MACHINE POLICIES AND PRACTICES. THE OBJECTIVE OF THESE EFFORTS WAS TO STRENGTHEN THE EXISTING POLICY TO KEEP UP WITH NEW PRODUCT CREATIONS AFFECTING POPULATIONS THAT NEEDED TO BE ADDRESSED (E-CIGARETTES, VAPORIZERS, ETC.). SAINT AGNES MEDICAL CENTER'S EFFORTS EXTENDED BEYOND ITS OWN CAMPUS WITH A CHALLENGE TO CALIFORNIA STATE UNIVERSITY IN FRESNO (CSUF) PRESIDENT CASTRO TO REVIEW AND UPDATE ORGANIZATIONAL POLICIES RELATED TO HAVING A TOBACCO-FREE CAMPUS. THE CHALLENGE HELPED SUPPORT CSUF'S ADOPTION OF A SMOKE-FREE, TOBACCO-FREE, VAPOR-FREE CAMPUS POLICY. SAINT AGNES MEDICAL CENTER ALSO PROVIDED FINANCIAL SUPPORT TO THE YOUTH LEADERSHIP INSTITUTE TO ACTIVATE YOUTH ADVOCATES TO MAKE SIGNIFICANT IMPACTS ON LOCAL TOBACCO ISSUES RELATED TO STOREFRONT ADVERTISING AND SMOKE-FREE PARKS. AS A RESULT OF THEIR WORK, THE CITIES OF FRESNO AND SELMA ADOPTED A NEW, MORE RESTRICTIVE CODE RELATED TO STOREFRONT ADVERTISING; THE CITY OF KERMAN ADOPTED A NEW SMOKE-FREE PARK ORDINANCE, AND SIGNAGE WAS INSTALLED AT 12 PARKS. COMMUNITY SUPPORT - THE LEADERSHIP TEAM AT SAINT AGNES MEDICAL CENTER CONTINUED TO PROVIDE TIME AND EXPERTISE TO SUPPORT NEARLY 30 LOCAL COMMUNITY BOARDS. SAINT AGNES MEDICAL CENTER ALSO CONTINUED TO SPONSOR COMMUNITY BASED ORGANIZATIONS' MISSION TO HEALTH AND WELLNESS. PART VI, LINE 6: SAINT AGNES MEDICAL CENTER IS A MEMBER OF TRINITY HEALTH, ONE OF THE LARGEST CATHOLIC HEALTH CARE DELIVERY SYSTEMS IN THE COUNTRY. TRINITY HEALTH ANNUALLY REQUIRES THAT ALL MEMBER ORGANIZATIONS DEFINE - AND ACHIEVE - SPECIFIC COMMUNITY HEALTH AND WELL-BEING GOALS. IN FISCAL YEAR 2017, GOALS INCLUDED 1) PARTICIPATING IN LOCAL COALITION AND ADVOCACY EFFORTS AIMED AT CURBING TOBACCO USE AND PREVENTING OBESITY, AND 2) ASSESSING CAPACITY TO IDENTIFY AND SUPPORT INDIVIDUALS THAT ARE HOUSING INSECURE AND ACKNOWLEDGING OTHER BARRIERS INDIVIDUALS HAVE ACCESSING HEALTH CARE AND 3) EXPANDING ACCESS AND DELIVERY OF DIABETES PREVENTION PROGRAM. TRINITY HEALTH ACKNOWLEDGES THE IMPACT SOCIAL DETERMINANTS SUCH AS ADEQUATE HOUSING, SAFETY, ACCESS TO FOOD, EDUCATION, INCOME, AND HEALTH COVERAGE HAVE ON THE HEALTH OF THE COMMUNITY. IN FISCAL YEAR 2016, TRINITY HEALTH LAUNCHED THE TRANSFORMING COMMUNITIES INITIATIVE (TCI), AWARDING EIGHT COMMUNITIES FUNDING TO IMPROVE THE HEALTH AND WELL-BEING OF THEIR COMMUNITIES IN PARTNERSHIP WITH THE LOCAL TRINITY HEALTH MEMBER HOSPITAL. THE AWARDED COMMUNITIES FOCUS ON POLICY, SYSTEM, AND ENVIRONMENTAL CHANGES THAT SPECIFICALLY IMPACT COMMUNITY IDENTIFIED NEEDS AND THAT WILL REDUCE CHILDHOOD OBESITY AND YOUTH TOBACCO USE. IN FISCAL YEAR 2017, TRINITY HEALTH INVESTED $2.7 MILLION IN TCI.AS A NOT-FOR-PROFIT HEALTH SYSTEM, TRINITY HEALTH REINVESTS ITS PROFITS BACK INTO OUR COMMUNITIES THROUGH PROGRAMS SERVING THOSE WHO ARE POOR AND VULNERABLE, HELPING MANAGE CHRONIC CONDITIONS LIKE DIABETES, PROVIDING HEALTH EDUCATION, PROMOTING WELLNESS AND DEVELOPING PROGRAMS AND POLICIES TO SPECIFICALLY SUPPORT VULNERABLE POPULATIONS. ANNUALLY, THE ORGANIZATION INVESTS OVER $1.1 BILLION IN SUCH COMMUNITY BENEFITS AND WORKS TO ENSURE THAT ITS MEMBER HOSPITALS AND OTHER ENTITIES/AFFILIATES ENHANCE THE OVERALL HEALTH OF THE COMMUNITIES THEY SERVE BY ADDRESSING THE SPECIFIC NEEDS OF EACH COMMUNITY.FOR MORE INFORMATION ABOUT TRINITY HEALTH, VISIT WWW.TRINITY-HEALTH.ORG. PART VI, LINE 7, REPORTS FILED WITH STATES CA 1 AMERICAN HEART ASSOCATION 7425 N PALM BLUFFS AVE 101 FRESNO CA 93711 135613797 501(C)(3) 15000 SPONSORSHIP/DONATION ART OF LIFE CANCER FOUNDATION 6121 N THESTA 204 FRESNO CA 93710 462645524 501(C)(3) 5000 SPONSORSHIP/DONATION CALIFORNIA HEALTH COLLABORATIVE 1680 W SHAW AVE FRESNO CA 93711 942862660 501(C)(3) 55000 SPONSORSHIP/DONATION CENTRAL CALIFORNIA WOMEN'S CONFERENCE PO BOX 3187 TURLOCK CA 95381 770178140 501(C)(3) 17000 SPONSORSHIP/DONATION CLINICAL PASTORAL EDUCATION OF CENTRAL CALIFORNIA 1303 E HERNDON AVE 965 FRESNO CA 93720 262859810 501(C)(3) 46664 SPONSORSHIP/DONATION FOUNDATION FOR CLOVIS SCHOOLS 1450 HERNDON AVE CLOVIS CA 93612 770140576 501(C)(3) 10000 SPONSORSHIP/DONATION FRESNO FIRST STEPS HOME 2600 FRESNO ST FRESNO CA 93721 272531998 501(C)(3) 25000 SPONSORSHIP/DONATION FRESNO MADERA MEDICAL SOCIETY 255 W FALLBROOK AVE 104 FRESNO CA 93711 941115551 501(C)(6) 5000 SPONSORSHIP/DONATION FRESNO METROPOLITAN MINISTRY 4270 N BLACKSTONE AVE FRESNO CA 93726 942181848 501(C)(3) 26919 SPONSORSHIP/DONATION FRESNO PHILHARMONIC ASSOCIATION 2377 W SHAW AVE 101 FRESNO CA 93711 941309738 501(C)(3) 5000 SPONSORSHIP/DONATION POVERELLO HOUSE 412 F STREET FRESNO CA 93706 770007985 501(C)(3) 16649 SPONSORSHIP/DONATION SUSAN G KOMEN BREAST CANCER FOUNDATION INC 5730 N FRESNO ST 105 FRESNO CA 93710 751835298 501(C)(3) 7500 SPONSORSHIP/DONATION TURNING POINT OF CENTRAL CALIFORNIA INC PO BOX 7447 VISALIA CA 932907447 941719862 501(C)(3) 5000 SPONSORSHIP/DONATION YOUTH LEADERSHIP INSTITUTE 940 HOWARD ST SAN FRANCISCO CA 94103 680184712 501(C)(3) 7500 SPONSORSHIP/DONATION MEDICAL MINISTRIES INTERNATIONAL 1004 SAN JOSE AVE 122 CLOVIS CA 93612 770498274 501(C)(3) 325459 COST MEDICAL SUPPLIES & EQUIPMENT MEDICAL SUPPLIES AND EQUIPMENT TRINITY HOME HEALTH SERVICES 17410 COLLEGE PARKWAY SUITE 150 LIVONIA MI 48152 382621935 501(C)(3) 1611553 COMMUNITY WELFARE CALIFORNIA STATE UNIVERSITY FRESNO FOUNDATION 4910 N CHESTNUT AVE FRESNO CA 93726 946003272 501(C)(3) 128250 SUPPORT NURSING MOBILE UNIT AND SPONSORSHIP WESTCARE CALIFORNIA INC PO BOX 94738 LAS VEGAS NV 89193 237368450 501(C)(3) 125000 SUPPORT AND EXPAND MENTAL HEALTH SERVICES CAMARENA HEALTH PO BOX 299 MADERA CA 93639 942503904 501(C)(3) 125000 SUPPORT HEALTH AND WELLNESS PROGRAMS CLINICA SIERRA VISTA 1430 TRUXTUN AVE BAKERSFIELD CA 93301 952707101 501(C)(3) 125000 COMMUNITY WELFARE 19 1 HOUSING/IN HOME CARE 4 7525 COST TEMPORARY HOUSING & ASSISTED LIVING PHARMACEUTICALS 22 6833 COST PRESCRIPTION DRUGS FUNERAL EXPENSES 9 1779 COST FUNERAL EXPENSES MEDICAL EQUIPMENT & SUPPLIES 22 5458 COST MEDICAL EQUIPMENT & SUPPLIES HEALTH INSURANCE/COBRA 5 4391 COST HEALTH INSURANACE / COBRA FOOD VOUCHERS 572 38500 COST FOOD VOUCHERS TRANSPORTATION VOUCHERS 1387 59154 COST TRANSPORTATION VOUCHERS OTHER 3 346 COST OTHER PART I, LINE 2: DONATIONS MADE BY SAINT AGNES MEDICAL CENTER TO CHARITABLE ORGANIZATIONS ARE MADE IN FURTHERANCE OF THE RECIPIENT ORGANIZATION'S EXEMPT PURPOSE. DONATIONS ARE INCLUDED IN COMMUNITY BENEFITS IN SCHEDULE H IF THE CONTRIBUTION HAS BEEN FORMALLY RESTRICTED TO A COMMUNITY BENEFIT ACTIVITY THAT MEETS THE CRITERIA TO BE REPORTED ON SCHEDULE H. 0 1 0 0 0 0 0 0 0 NANCY HOLLINGSWORTH DIRECTOR; PRESIDENT & CEO 0 474927 0 112474 0 172404 0 19875 0 28385 0 808065 0 23083 SHERI SHAPIRO DIR AS OF 1/17; SVP MKG/ACQUISITION 0 284936 0 27230 0 9011 0 71032 0 18977 0 411186 0 0 RICK WOLF SECRETARY; GENERAL COUNSEL 0 259615 0 19935 0 391 0 11925 0 21975 0 313841 0 0 MICHAEL PRUSAITIS CFO & TREASURER 0 302839 0 41267 0 717 0 11925 0 22856 0 379604 0 0 JONATHAN FELTON CHIEF OPERATING OFFICER 0 306154 0 41602 0 314 0 9775 0 21166 0 379011 0 0 STACY VAILLANCOURT CHIEF ADMINISTRATIVE OFFICER 0 284765 0 38593 0 17254 0 11925 0 17037 0 369574 0 0 TONI KAZARIAN INT CNO 7/16 - 1/17; SR ADMIN DIR 201658 0 918 0 15352 0 15370 0 15172 0 248470 0 0 0 W EUGENE EGERTON MD CHIEF MEDICAL OFFICER AS OF 8/16 0 137190 0 10000 0 26099 0 1938 0 615 0 175842 0 0 MICHAEL FREUDIGER CHARGE PHARMACIST 361553 0 0 0 14694 0 11925 0 8098 0 396270 0 0 0 GERALD MARGOSIAN COORD. PHARMACY OPERATIONS 313735 0 3609 0 33382 0 19875 0 24680 0 395281 0 0 0 GARRY SEVEL CHIEF MEDINFO/PHYSICIAN ADVISOR 313206 0 0 0 2002 0 11925 0 8851 0 335984 0 0 0 BRENDA REED CHARGE PHARMACIST 232288 0 0 0 686 0 14042 0 8042 0 255058 0 0 0 SHERMAN KONG PHARMACIST 222091 0 0 0 7694 0 16717 0 2469 0 248971 0 0 0 MARK BATEMAN FORMER OFFICER; SAMF PRES THR 10/16 101000 0 0 0 7129 0 0 0 0 0 108129 0 0 0 DEBORA CHAPPELL FORMER KEY EMP; VP CLINICAL SERVICES 205723 0 0 0 1259 0 15825 0 17346 0 240153 0 0 0 RICHARD O'CONNELL FORMER KE; TRINITY EVP THR 11/16 0 878773 0 258051 0 408585 0 11925 0 35437 0 1592771 0 112018 STEPHEN SOLDO MD FORMER KEY EMP; SERVICE LINE LEADER 148913 0 0 0 840 0 6895 0 16974 0 173622 0 0 0 JARRELL WILLIAMSON FORMER OFFICER; STAFF ATTORNEY 0 171238 0 0 0 9117 0 5827 0 22228 0 208410 0 0 JOHN FRYE JR FORMER KE; DIR ORG PERFORMANCE 262480 0 0 0 1854 0 15498 0 18709 0 298541 0 0 0 PART I, LINE 3 SAINT AGNES MEDICAL CENTER IS A SUBSIDIARY IN THE TRINITY HEALTH SYSTEM. SAINT AGNES MEDICAL CENTER'S CEO IS PAID DIRECTLY BY THE SYSTEM'S PARENT ENTITY, TRINITY HEALTH CORPORATION. TRINITY HEALTH CORPORATION USED THE FOLLOWING METHODS TO ESTABLISH THE COMPENSATION OF SAINT AGNES MEDICAL CENTER'S CEO: - COMPENSATION COMMITTEE - INDEPENDENT COMPENSATION CONSULTANT - FORM 990 OF OTHER ORGANIZATIONS - WRITTEN EMPLOYMENT CONTRACT - COMPENSATION SURVEY OR STUDY, AND - APPROVAL BY THE BOARD OR COMPENSATION COMMITTEE PART I, LINE 4B THE FOLLOWING ARE PARTICIPANTS IN A TRINITY HEALTH SUPPLEMENTAL EXECUTIVE RETIREMENT PLAN (SERP) IN 2016. THE PLAN PROVIDES RETIREMENT BENEFITS TO CERTAIN TRINITY HEALTH EXECUTIVES SUBJECT TO MEETING SPECIFIED VESTING AND EMPLOYMENT DATE REQUIREMENTS. BENEFITS FOR PARTICIPANTS VESTED IN A PLAN WERE PAID OUT IN 2016, AND BENEFITS FOR PARTICIPANTS NOT YET VESTED IN A PLAN WERE ACCRUED IN 2016. THE FOLLOWING PAYOUTS FOR 2016 FOR THE PLAN ARE INCLUDED IN COLUMN B(III) OF SCHEDULE J, PART II: NANCY HOLLINGSWORTH - $111,475 RICHARD O'CONNELL - $221,949 THE FOLLOWING ACCRUALS FOR 2016 ARE INCLUDED IN COLUMN C OF SCHEDULE J, PART II: SHERI SHAPIRO - $61,623 THE FOLLOWING ARE PARTICIPANTS IN A TRINITY HEALTH RESTORATION OR RETENTION PLAN. THE RESTORATION PLAN PROVIDES RETIREMENT BENEFITS FOR CERTAIN TRINITY HEALTH SYSTEM OFFICE EXECUTIVES WITH EARNINGS ABOVE THE IRS PAY CAP FOR QUALIFIED PLANS ($265,000 FOR 2016). THE FOLLOWING PAYOUTS FOR 2016 FOR THESE PLANS ARE INCLUDED IN COLUMN B(III) OF SCHEDULE J, PART II: NANCY HOLLINGSWORTH - $23,083 RICHARD O'CONNELL - $121,018 COLUMN (F) OF SCHEDULE J, PART II INCLUDES THE PORTION OF THESE AMOUNTS THAT WERE REPORTED AS DEFERRED COMPENSATION IN PRIOR YEARS. SAINT AGNES MEDICAL PROVIDERS INC (SAMP) S. SOLDO, FORMER KE & W.E. EGERTON, KE, WERE STOCKHOLDERS OF SAMP IN FY17 25216955 DEBT FORGIVENESS 0 SAINT AGNES MEDICAL PROVIDERS INC (SAMP) S. SOLDO, FORMER KE & W.E. EGERTON, KE, WERE STOCKHOLDERS OF SAMP IN FY17 842355 PAYMENTS MADE BY SAINT AGNES MEDICAL CENTER TO SAMP FOR PHYSICIAN SERVICES. 0 2374795 0 165000 0 TAYLOR PRUSAITIS FAMILY MEMEMBER OF MICHAEL PRUSAITIS, OFFICER 14723 EMPLOYMENT 0 X AUCTION ITEMS 241 118839 DONOR VALUED 0 0 1 PART I, LINE 32B: SAINT AGNES MEDICAL CENTER ENTERED INTO AN AGREEMENT WITH THE GAVEL GROUP TO SOLICIT AUCTION ITEMS FOR FOUNDATION EVENTS. PART I, LINE 33: SAINT AGNES MEDICAL CENTER RECEIVED GIFT-IN-KIND DONATIONS IN SUPPORT OF FUNDRAISING EVENTS. THESE DONATIONS ARE PRIMARILY AUCTION ITEMS, AND THE REVENUE FOR THESE ITEMS IS NOT RECORDED UNLESS THE ITEMS ARE SOLD DURING THE AUCTION. ITEMS THAT DO NOT SELL AT THE AUCTION ARE RETURNED TO THE DONOR. DONATED SUPPLIES ARE ALSO RECEIVED FOR THE FUNDRAISING EVENTS AND ARE RECORDED AT FAIR MARKET VALUE. FORM 990, PART VI, SECTION A, LINE 3 SAINT AGNES MEDICAL CENTER HAS CONTRACTED WITH B.E. SMITH, INC. FOR THE PROVISION OF INTERIM CHIEF MEDICAL OFFICER (CMO) SERVICES. IN CALENDAR YEAR 2016 SAINT AGNES MEDICAL CENTER PAID $365,700 TO B.E. SMITH, INC. FOR THE INTERIM CMO SERVICES PROVIDED. FORM 990, PART VI, SECTION A, LINE 6 THE SOLE MEMBER OF SAINT AGNES MEDICAL CENTER IS TRINITY HEALTH CORPORATION. SEE LINE 7 FOR ADDITIONAL INFORMATION. FORM 990, PART VI, SECTION A, LINE 7A TRINITY HEALTH CORPORATION IS THE SOLE MEMBER OF SAINT AGNES MEDICAL CENTER. TRINITY HEALTH CORPORATION HAS THE RIGHT TO APPOINT ALL PERSONS TO THE BOARD OF DIRECTORS OF SAINT AGNES MEDICAL CENTER. FORM 990, PART VI, SECTION A, LINE 7B AS SOLE MEMBER, TRINITY HEALTH CORPORATION MUST APPROVE CERTAIN DECISIONS OF THE GOVERNING BODY, INCLUDING THE STRATEGIC PLAN, ANNUAL CAPITAL PLAN, AND ANNUAL OPERATING BUDGET. TRINITY HEALTH CORPORATION MUST ALSO APPROVE SIGNIFICANT CHANGES SUCH AS A MERGER, DISSOLUTION, SALE OF ASSETS IN EXCESS OF CERTAIN LIMITS, AND MODIFICATIONS TO GOVERNING DOCUMENTS. FORM 990, PART VI, SECTION B, LINE 11B PRIOR TO FILING, THE FORM 990 FOR SAINT AGNES MEDICAL CENTER IS REVIEWED BY SENIOR MANAGEMENT. IN ADDITION, CERTAIN KEY SECTIONS OF THE FORM ARE REVIEWED BY THE BOARD. EACH MEMBER OF THE BOARD RECEIVES A COPY OF THE RETURN IN ITS FINAL FORM BEFORE IT IS FILED WITH THE INTERNAL REVENUE SERVICE. FORM 990, PART VI, SECTION B, LINE 12C SAINT AGNES MEDICAL CENTER HAS ADOPTED TRINITY HEALTH'S GOVERNANCE POLICY NO. 1, WHICH SETS FORTH THE ORGANIZATION'S CONFLICT OF INTEREST POLICY AND PROCESSES. IT APPLIES TO ALL "INTERESTED PERSONS" OF SAINT AGNES MEDICAL CENTER, WHICH INCLUDES DIRECTORS, PRINCIPAL OFFICERS, KEY EMPLOYEES, AND MEMBERS OF COMMITTEES WITH BOARD-DELEGATED POWERS. INTERESTED PERSONS ARE EXPECTED TO DISCHARGE THEIR DUTIES IN A MANNER THE PERSON REASONABLY BELIEVES TO BE IN THE BEST INTERESTS OF SAINT AGNES MEDICAL CENTER AND TO AVOID SITUATIONS INVOLVING A CONFLICT OF INTEREST. ON AN ANNUAL BASIS, INTERESTED PERSONS ARE REQUIRED TO COMPLETE A CONFLICT OF INTEREST DISCLOSURE STATEMENT AND TO AFFIRM THEIR RECEIPT OF THE CONFLICT OF INTEREST POLICY, COMPLIANCE WITH ITS REQUIREMENTS, AND AGREE TO NOTIFY THE ORGANIZATION OF CHANGES IMPACTING THEIR ANNUAL DISCLOSURE IN ACCORDANCE WITH THE POLICY. THE ANNUAL DISCLOSURES ARE PROVIDED TO INTERNAL LEGAL COUNSEL AND THE INTEGRITY AND COMPLIANCE OFFICER, FROM WHICH LEGAL COUNSEL PREPARES A REPORT FOR THE BOARD CHAIR AND CEO. A SUMMARY OF POTENTIAL CONFLICTS IS REVIEWED WITH THE BOARD OF DIRECTORS OF SAINT AGNES MEDICAL CENTER (OR A DELEGATED COMMITTEE OF THE BOARD) ON A YEARLY BASIS. INTERESTED PERSONS ARE REQUIRED TO MAKE FULL DISCLOSURE TO SAINT AGNES MEDICAL CENTER OF ANY FINANCIAL OR BUSINESS INTERESTS THAT MIGHT RESULT IN OR HAVE THE APPEARANCE OF A CONFLICT OF INTEREST. THE BOARD OF DIRECTORS OF SAINT AGNES MEDICAL CENTER (OR A DELEGATED COMMITTEE OF THE BOARD) IS RESPONSIBLE FOR THE REVIEW OF TRANSACTIONS TO DETERMINE WHETHER AN ACTUAL CONFLICT OF INTEREST EXISTS. IN THE EVENT OF AN ACTUAL CONFLICT, THE BOARD (OR A DELEGATED COMMITTEE OF THE BOARD) WILL EITHER AVOID THE CONFLICT OR APPROPRIATELY SCRUTINIZE THE TRANSACTION TO ENSURE IT IS IN THE BEST INTERESTS OF SAINT AGNES MEDICAL CENTER. INTERESTED PERSONS ARE REQUIRED TO RECUSE THEMSELVES FROM DISCUSSION AND VOTING ON MATTERS INVOLVING A CONFLICT OF INTEREST. THE POLICY FURTHER ADDRESSES THE PROPER DOCUMENTATION OF THE PROCEEDINGS AND POTENTIAL DISCIPLINARY AND CORRECTIVE ACTION FOR VIOLATIONS OF THE POLICY. THE POLICY IS AVAILABLE TO THE PUBLIC UPON REQUEST. FORM 990, PART VI, SECTION B, LINE 15 QUESTIONS 15A AND 15B ARE ANSWERED "NO" BECAUSE THE COMPENSATION FOR CERTAIN OFFICERS AND KEY MANAGEMENT OFFICIALS OF SAINT AGNES MEDICAL CENTER IS ESTABLISHED BY TRINITY HEALTH, A RELATED ORGANIZATION. IN ESTABLISHING CEO AND CFO COMPENSATION, TRINITY HEALTH FOLLOWS A PROCESS AND POLICY THAT IS INTENDED TO MIRROR THE IRC SECTION 4958 GUIDELINES FOR OBTAINING A "REBUTTABLE PRESUMPTION OF REASONABLENESS" WITH REGARD TO COMPENSATION AND BENEFITS. AS PART OF THAT PROCESS, THE COMPENSATION AND BENEFITS OF THE CEO AND CFO OF SAINT AGNES MEDICAL CENTER ARE REVIEWED AT LEAST ANNUALLY BY THE TRINITY HEALTH BOARD OR THE TRINITY HEALTH HUMAN RESOURCES AND COMPENSATION COMMITTEE (HRCC) OF THE BOARD, AUTHORIZED TO ACT ON BEHALF OF THE BOARD WITH RESPECT TO CERTAIN COMPENSATION MATTERS. AS PART OF ITS REVIEW PROCESS, THE HRCC RETAINS AN INDEPENDENT FIRM EXPERIENCED IN COMPENSATION AND BENEFIT MATTERS FOR NOT-FOR-PROFIT HEALTH CARE ORGANIZATIONS TO ADVISE IT IN THE DETERMINATIONS IT MAKES ON THE REASONABLENESS OF PROPOSED COMPENSATION AND BENEFITS ARRANGEMENTS. FORM 990, PART VI, SECTION C, LINE 19 SAINT AGNES MEDICAL CENTER IS A SUBSIDIARY ORGANIZATION IN THE TRINITY HEALTH SYSTEM. TRINITY HEALTH MAKES CERTAIN OF ITS KEY DOCUMENTS AVAILABLE TO THE PUBLIC ON ITS WEBSITE, WWW.TRINITY-HEALTH.ORG, IN THE "ABOUT US" SECTION. IN THIS SECTION, THE CONSOLIDATED AUDITED FINANCIAL STATEMENTS ARE PUBLICLY AVAILABLE. IN ADDITION, SAINT AGNES MEDICAL CENTER INCLUDES A COPY OF ITS MOST RECENTLY FILED SCHEDULE H ON BOTH ITS OWN WEBSITE AND TRINITY HEALTH'S WEBSITE. SAINT AGNES MEDICAL CENTER'S GOVERNING DOCUMENTS AND CONFLICT OF INTEREST POLICY ARE AVAILABLE UPON REQUEST. FORM 990, PART XI, LINE 9: EQUITY TRANSFER TO AFFILIATE -14,823,355. NET ASSET TRANSFER TO AFFILIATE -6,165,116. ASSET IMPAIRMENT -525,000. CHANGE IN EQUITY OF UNCONSOLIDATED AFFILIATES -400. FORM 990, PART XII, LINE 2: SAINT AGNES MEDICAL CENTER'S FINANCIAL STATEMENTS WERE INCLUDED IN THE FY17 CONSOLIDATED FINANCIAL STATEMENTS OF TRINITY HEALTH, WHICH WERE AUDITED BY AN INDEPENDENT PUBLIC ACCOUNTING FIRM. FORM 990, PAGE 1, PART C, DOING BUSINESS AS NAMES: ST. AGNES HOME INFUSION PHARMACY ADVANTAGE HEALTHSAINT MARY'S MEDICAL GROUP 245 STATE ST SE GRAND RAPIDS MI 49503 272491974 HEALTH CARE SERVICES MI 501(C)(3) LINE 10 TRINITY HEALTH-MICHIGAN 1 ALLEGANY FRANCISCAN MINISTRIES INC 33920 US HIGHWAY 19 NORTH SUITE 269 PALM HARBOR FL 34684 581492325 GRANT MAKING FL 501(C)(3) LINE 12A, I TRINITY HEALTH CORPORATION 1 ASYLUM HILL FAMILY MEDICINE CENTER INC 114 WOODLAND STREET HARTFORD CT 06105 061450170 HEALTH CARE SERVICES CT 501(C)(3) LINE 3 TRINITY HEALTH OF NEW ENGLAND CORP INC 1 BAUM HARMON MERCY HOSPITAL 255 NORTH WELCH AVENUE PRIMGHAR IA 51245 421500277 HEALTH CARE AND HOSPITAL SERVICES IA 501(C)(3) LINE 3 MERCY HEALTH SERVICES-IOWA CORP 1 BAUM HARMON MERCY HOSPITAL AND CLINICS FOUNDATION 255 NORTH WELCH AVENUE PRIMGHAR IA 51245 262973307 FOUNDATION IA 501(C)(3) LINE 12A, I BAUM HARMON MERCY HOSPITAL 1 BEECHWOOD INC 2212 BURDETT AVE TROY NY 12180 141651563 TITLE HOLDING COMPANY NY 501(C)(2) N/A LTC (EDDY) INC 1 BETHLEHEM HAVEN OF PITTSBURGH 905 WATSON STREET PITTSBURGH PA 15219 251436685 HOMELESS SHELTER PA 501(C)(3) LINE 7 PITTSBURGH MERCY HEALTH SYSTEM INC 1 BEVERWYCK INC 40 AUTUMN DRIVE SLINGERLANDS NY 12159 141717028 SENIOR LIVING COMMUNITY NY 501(C)(3) LINE 10 LTC (EDDY) INC 1 BRIGHTSIDE INC 1221 MAIN STREET SUITE 213 HOLYOKE MA 01040 042182395 HEALTH CARE SERVICES MA 501(C)(3) LINE 10 THE MERCY HOSPITAL INC 1 CAPITAL REGION GERIATRIC CENTER INC 421 WEST COLUMBIA ST COHOES NY 12047 141701597 LONG TERM CARE NY 501(C)(3) LINE 10 LTC (EDDY) INC 1 CARING PARTNERS HOME HEALTH INC 1200 EARHART RD ANN ARBOR MI 48105 201681131 HOME HEALTH SERVICES MI 501(C)(3) LINE 10 GLACIER HILLS INC 1 CATHERINE MCAULEY HEALTH SERVICES CORP PO BOX 995 ANN ARBOR MI 48106 382507173 HEALTH CARE SERVICES MI 501(C)(3) LINE 3 TRINITY HEALTH-MICHIGAN 1 CATHOLIC HEALTH MINISTRIES 20555 VICTOR PARKWAY LIVONIA MI 48152 GOVERNANCE AND MANAGEMENT OF TRINITY HEALTH SYSTEM VT 501(C)(3) LINE 1 N/A 0 COLUMBUS ACQUISITION CORP 111 CENTRAL AVENUE NEWARK NJ 07102 262616342 INACTIVE ENTITY NJ 501(C)(3) LINE 10 SAINT MICHAEL'S MEDICAL CENTER 1 CRANBROOK HOSPICE CARE 1111 W LONG LAKE RD STE 102 TROY MI 48098 383320699 HOSPICE SERVICES MI 501(C)(3) LINE 10 TRINITY HOME HEALTH SERVICES 1 DILEY RIDGE MEDICAL CENTER 6150 EAST BROAD STREET COLUMBUS OH 43213 342032340 HEALTH CARE AND HOSPITAL SERVICES OH 501(C)(3) LINE 3 MOUNT CARMEL HEALTH SYSTEM 1 DUBUQUE MERCY HEALTH FOUNDATION 250 MERCY DRIVE DUBUQUE IA 52001 262227941 FOUNDATION IA 501(C)(3) LINE 12A, I MERCY HEALTH SERVICES-IOWA CORP 1 DYERSVILLE HEALTH FOUNDATION INC 1111 3RD STREET SW DYERSVILLE IA 52040 205383271 FOUNDATION IA 501(C)(3) LINE 12A, I MERCY HEALTH SERVICES-IOWA CORP 1 EAST NORRITON PHYSICIANS SERVICES INC ONE WEST ELM STREET SUITE 100 CONSHOHOCKEN PA 19428 232515999 HEALTH CARE SERVICES PA 501(C)(3) LINE 3 MERCY PHYSICIAN NETWORK 1 EDDY LICENSED HOME CARE AGENCY 433 RIVER ST SUITE 3000 TROY NY 12180 141818568 HOME HEALTH SERVICES NY 501(C)(3) LINE 3 LTC (EDDY) INC 1 EMBRACING AGE INC 333 BUTTERNUT DRIVE SUITE 100 DEWITT NY 13214 461051881 PACE PROGRAM NY 501(C)(3) LINE 10 ST JOSEPH'S HEALTH INC 1 EMPIRE HOME INFUSION SERVICE INC 10 BLACKSMITH DRIVE MALTA NY 12020 141795732 HOME HEALTH SERVICES NY 501(C)(3) LINE 10 LTC (EDDY) INC 1 FARREN CARE CENTER INC 1221 MAIN STREET SUITE 213 HOLYOKE MA 01040 042501711 LONG TERM CARE MA 501(C)(3) LINE 3 THE MERCY HOSPITAL INC 1 FRANCISCAN ELDERCARE CORPORATION PO BOX 2500 WILMINGTON DE 19805 223008680 LONG TERM CARE (INACTIVE) DE 501(C)(3) LINE 10 ST FRANCIS HOSPITAL 1 GLACIER HILLS FOUNDATION 1200 EARHART RD ANN ARBOR MI 48105 208072723 FOUNDATION MI 501(C)(3) LINE 12A, I GLACIER HILLS INC 1 GLACIER HILLS INC 1200 EARHART RD ANN ARBOR MI 48105 381891500 SENIOR LIVING COMMUNITY MI 501(C)(3) LINE 10 TRINITY CONTINUING CARE SERVICES 1 GLEN EDDY INC 1 GLEN EDDY DRIVE NISKAYUNA NY 12309 141794150 SENIOR LIVING COMMUNITY NY 501(C)(3) LINE 10 LTC (EDDY) INC 1 GLOBAL HEALTH MINISTRY 20555 VICTOR PARKWAY LIVONIA MI 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