2018-07-03T08:52:40-05:00 2017-08-31 861065772 Deloitte Tax LLP 191 Peachtree Street Suite 2000 Atlanta GA 303031749 990 2016-09-01 582504530 St Francis Hospital Inc STFR 8642551000 One St Francis Drive Greenville SC 296013955 Ronnie Hyatt Treasurer/CFO-BSSFHS 8642551000 2018-07-03 1 John W Sadoff Jr P00540589 4042201500 2016 2022-09-23 18:48:47Z Craig McCoy One St Francis Drive Greenville SC 296013955 623086193 0 0928 X bonsecours.com X 1932 SC Provides acute care hospital services. 16 13 3364 279 562357 153723 3323606 3019879 555833916 607610127 1774586 1783305 9364392 10671484 570296500 623084795 338590744 69720134 0 0 186552277 198288608 0 0 0 310189130 331149674 835332151 599158416 -265035651 23926379 530105745 562242567 318453450 335966040 211652295 226276527 The mission is to bring compassion to health care and to be good help to those in need, especially those who are poor and dying. As a system of caregivers, we commit ourselves to help bring people and communities to health and wholeness. 0 0 560631199 69720134 611701379 Bon Secours St. Francis Health System (BSSFHS) primarily serves Greenville County, which is comprised of approximately 506,837 (2017) residents with a 12.3% population increase since 2010. 15% (2016) being over the age of 65 and 6.4% (2016) under the age of 5. Median household income is approximately $51,595 (2012-2016) and 10.9% (2016) persons in poverty in Greenville County. Currently, 12.4% (2016) of Greenville County residents under the age of 65 are considered medically uninsured. The three leading causes of death for Greenville County are cancer, heart disease and accidents (2016). See Community benefit information in Sch. H. The Community Benefit Report is available on the SFH website. 560631199 1 1 0 1 0 0 0 0 0 0 1 0 0 0 1 1 0 1 0 0 0 0 0 0 0 0 1 1 1 1 1 0 0 0 0 0 0 1 0 0 0 0 0 1 1 1 1 0 0 1 159 0 1 3364 1 1 1 0 0 0 0 0 0 0 0 0 X 16 13 1 0 0 0 1 1 1 1 1 0 0 1 1 1 1 1 1 0 1 1 0 X Ronnie Hyatt 8642551000 One St Francis Drive Greenville SC 296053955 X Katherine Arbuckle Board Member 2.00 0.00 X 0 0 0 Kenneth Baca Board Member (Jan-Aug) 2.00 0.00 X 0 0 0 Mills Gallivan Board Member 2.00 0.00 X 0 0 0 Gregory Haselden Board Member 2.00 0.00 X 0 0 0 Camilla Hertwig Chair (Sep-Dec) 3.50 0.00 X X 0 0 0 Laurence Hinsdale Board Member (Jan-Aug) 2.00 0.00 X 0 0 0 Henry Horowitz Board Member (Sep-Dec) 2.00 0.00 X 0 0 0 Fletcher Kirkland Jr Board Member 2.00 0.50 X 0 0 0 Raymond Lattimore Board Member (Jan-Aug) 2.00 0.00 X 0 0 0 Joanie Martin Board Member 2.00 0.00 X 0 0 0 Craig McCoy CEO 36.00 14.00 X X 0 602389 72041 Wayne McDonald MD BM (Sep-Dec)/Chair (Jan-Aug) 3.00 0.00 X X 0 0 0 Thomas Morris PhD President 3.50 46.50 X X 0 464396 82259 Jeffrey Oak PhD Board Member 2.00 48.00 X 0 519756 79835 Steven Owings Board Member (Jan-Aug) 2.00 0.50 X 0 0 0 Linton Puckett Board Member (Sep-Dec) 2.00 0.00 X 0 0 0 Carlos Quintero Board Member (Jan-Aug) 2.00 0.00 X 0 0 0 Joseph Sullivan Board Member 2.00 0.00 X 0 0 0 Angela Webb Board Member 2.00 0.00 X 0 0 0 Daniel Duggan COO (Sep-Nov) 45.00 5.00 X 0 479233 27871 Irene Holcombe Secretary 50.00 0.00 X 91689 0 16140 Ronnie Hyatt Treasurer/CFO - BSSFHS 36.00 14.00 X 492740 0 34364 Teresa Ficicchy EVP - CNO 50.00 0.00 X 374854 0 27498 Rose Leo VP - Surgical Services 50.00 0.00 X 249820 0 32157 Joseph Hartzog Emergency Physician 50.00 0.00 X 540054 0 42592 Sara Saccocio SVP Chief Med Officer (Sep-Apr) 50.00 0.00 X 452794 0 44192 Bruce Bourdon Emergency Physician 50.00 0.00 X 413846 0 44852 Gregory Hoffman Emergency Physician 50.00 0.00 X 411850 0 40737 Kurt Hoffert Emergency Physician 50.00 0.00 X 392905 0 42541 Mark Nantz Former CEO 0.00 50.00 X 0 938016 130212 3420552 3003790 717291 174 1 1 0 Spartanburg Regional Med Center 101 East Wood Street Spartanburg SC 29303 Oncology Clinical Services 2283008 Sleepworks LLC 556 Hall Road Thomasville GA 31757 Sleep Studies 957635 Invivo Molecular Imaging LLC PO Box 787442 Philadelphia PA 191787442 Imaging Services 716917 Clinical Services LLC 152 Belleford Ridge Rd Columbia SC 29233 ED Physician Services 584204 Upstate Carolina Radiology PA PO Box 27049 Greenville SC 29616 Radiology Readings 495206 26 2861328 158551 3019879 Patient Service Rev. 622110 607610127 607610127 607610127 1177549 1177549 1031006 45158 1398 0 1029608 45158 1074766 14048 1060718 550466 55290 0 0 550466 55290 605756 605756 Supplies/Pharmacy Reba 900099 2967578 2967578 Retail Pharmacy Sales 446110 2041625 2041625 Clinical Trial Researc 900099 1131972 1131972 3455543 917655 548309 1989579 9596718 623084795 611701379 562357 7801180 69712134 69712134 8000 8000 1338706 1204836 133870 153653739 138288365 15365374 5760193 5184174 576019 25159329 22643396 2515933 12376641 11138977 1237664 1010524 909472 101052 9721 8749 972 21136 19022 2114 13217585 13217585 3229763 2906787 322976 3316153 2984538 331615 1390480 1251432 139048 13877321 12489589 1387732 1047267 942540 104727 315232 283709 31523 8490059 8490059 18159943 16343949 1815994 1593389 1434050 159339 Medical Supplies 139408164 139408164 Corporate Dues 46095179 41485661 4609518 Purchased Services 34723029 31250726 3472303 Unrelated Business Inco 46358 46358 45198371 39025285 6173086 599158416 560631199 38527217 0 14073 12260 144932824 167158792 64553419 73374715 15781409 16912315 3052088 5644131 365386815 188054307 183760292 177332508 22609962 24646117 4038304 79474208 76430069 15927470 16693356 530105745 562242567 40930163 48724673 950767 635534 276572520 286605833 318453450 335966040 X 211652295 226276527 211652295 226276527 530105745 562242567 X 23926379 1281566 -10583713 X 0 1 X 1 0 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 0 0 0 0 0 0 0 0 1 21136 21136 0 Part II-B, Line 1: The filing organization maintains memberships to various professional healthcare associations. Portions of their membership dues are used for lobbying activities. The lobbying portion of such dues is included on line 1i. 13363668 13363668 179836129 65277474 114558655 1801948 1211473 590475 163557060 117641013 45916047 6828010 3924347 2903663 177332508 Due to Affiliates 260804884 Medicare/Medicaid Settlement 9163840 Hospice House Liability 7920278 HPL/GL Liability 4656399 Patient Credit Balances 2516598 FIN 47 Liability 972899 Deferred Rent 387161 Other Misc Liabilities 183774 286605833 X Part X, Line 2: Schedule D, Part X, Line 2 requires that the organization provide the text of the footnote to the organization's financial statements that reports the organization's liability for uncertain tax positions under ASC 740. ASC 740 addresses the accounting for uncertainty in income taxes recognized in an entity's financial statements and prescribes a threshold of more-likely-than-not for recognition and derecognition of tax positions taken or expected to be taken in a tax return. The adoption of ASC 740 by BSHSI on September 1, 2007 did not have a material impact on BSHSI's consolidated financial statements. As the organization does not conduct a separate audit of its financial statements, below is the related statement from the Bon Secours Health System, Inc. consolidated audited financial statements: The System and most of its subsidiaries (including certain joint venture entities) are exempt from federal income taxes under Section 501(c)(3) of the Internal Revenue Code of 1986, as amended. The System accounts for uncertain tax positions in accordance with ASC Topic 740, Income Taxes. Their related income is exempt from federal income tax under Section 501(A). 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 August 31, 2017 or 2016. Accounting for uncertainty in income taxes, ASC Topic 740-10 prescribes a comprehensive model for how an organization should measure, recognize, present, and disclose in its financial statements uncertain tax positions that an organization has taken or expects to take on a tax return. The System is subject to routine audits by taxing jurisdictions; however, there are currently no audits for any tax periods in progress. The System believes it is no longer subject to income tax examinations for years prior to 2013. As of August 31, 2017 and 2016, the System has no uncertain tax positions. The System's taxable subsidiaries had approximately $106,393 and $89,895 of net operating loss carryforwards as of August 31, 2017 and 2016, respectively, which expire in varying periods through 2037 and are available to offset future taxable income. The System accounts for income taxes under the asset and liability method. Under this method, deferred tax assets and liabilities are recognized for the estimated future tax consequences attributable to differences between the financial statement carrying amounts of existing assets and liabilities and their respective tax bases. Deferred tax assets and liabilities are measured using enacted tax rates expected to be in effect during the year in which those temporary differences are expected to be recovered or settled. The effect on deferred tax assets and liabilities of a change in tax rates is recognized in income in the period that includes the enactment date. Interest and penalties related to income taxes are accounted for as income tax expense. The System's deferred tax assets are fully reserved at August 31, 2017 and 2016 as the System considers it more likely than not that these amounts will not be recognized. 1 1 X 1 X 1 X 1 1 0 1 1 8295645 225113 8070532 0.01430 38450175 34590203 3859972 0.00680 46745820 34815316 11930504 0.02110 21 170977 3571753 3571753 0.00630 1 1243 675528 675528 0.00120 1 17404 17404 0.00000 3 1006 894467 894467 0.00160 26 173226 5159152 5159152 0.00910 26 173226 51904972 34815316 17089656 0.03020 6 3795 798442 798442 0.00140 1 1 155 155 0.00000 1 310 310 0.00000 743302 743302 0.00130 1 3 154371 154371 0.00030 1 14 10 3813 1696580 1696580 0.00300 1 32994988 0 145118410 160052623 -14934213 X 1 1 1 Upstate Surgery Center Ambulatory Surgery Center 0.58090 0.00000 0.11370 2 1 St Francis Hospital - Downtown One St Francis Drive Greenville SC 296013955 bonsecours.com HTL-0794 X X X X X A 2 St Francis Hospital - Eastside 125 Commonwealth Drive Greenville SC 296154812 bonsecours.com HTL-0793 X X X X A Facility Reporting Group - A 0 0 1 X X X X X X X X X 15 1 0 0 1 X See Section C X X 1 15 1 See Section C 0 1 X 200.000000000000 400.000000000000 1 1 X X X 1 X http://www.fa.bonsecours.com/ X http://www.fa.bonsecours.com/ X http://www.fa.bonsecours.com/ X X X X X X X 1 X 0 X X X X 1 X 0 0 Form 990, Schedule H, Part V, Section B, Line 14: Charges for patients who are eligible for financial assistance shall be limited to no more than amounts generally billed ("AGB") for such services. These charges are based on the average allowed amounts from Medicare and commercial payers for emergency and other medically necessary care. The allowed amounts include both the amount the insurer will pay and the amount, if any, the individual is personally responsible for paying. The AGB is calculated using a look back method. Because both Maryland law and Federal tax law limit the amounts that may be charged to patients, an FAP eligible individual or an uninsured individual will not be charged more than the lesser of the AGB or the regulated charge set by the Maryland Health Services Cost Review Commission for emergency or other medically necessary care. Form 990, Schedule H, Part V, Section B, Line 7a: https://bonsecours.com/greenville/community-commitment/community-health-needs-assessment Form 990, Schedule H, Part V, Section B, Line 10: https://bonsecours.com/greenville/community-commitment/community-health-needs-assessment Part V, Section B Facility Reporting Group A Facility Reporting Group A consists of: - Facility 1: St. Francis Hospital - Downtown, - Facility 2: St. Francis Hospital - Eastside Facility Reporting Group - A Part V, Section B, line 5: Specific groups were well-represented through the course of the assessment, including individuals representing the broad interests of the community, persons with special knowledge of the medically underserved, low-income, minority, and chronic disease populations. To do this, three primary data methods were used: focus groups, a town hall meeting, and a community questionnaire. The community questionnaire was collected through paper copies, an online version, and by phone. Additionally, the community questionnaire was available in Spanish. When soliciting feedback by all 3 methods of data gathering, specific people and organizations representing various populations of the community were targeted. Facility Reporting Group - A Part V, Section B, line 7d: In addition to having the CHNA available to the public on the web and paper copies available by request, key findings of the report were presented to the community on September 23, 2016. This event was held at the West End Community Center and was free and open to the public. Facility Reporting Group - A Part V, Section B, line 11: Nine health issues and conditions were identified by the community as being of greatest concern. Key findings from the survey, focus groups and town hall, as well as secondary data helped determine these results: behavioral health, transportation, community safety, homelessness, education, social environment and housing, adult obesity and nutrition and exercise, jobs and fair wages, and access to health care services for low income people (children, women, seniors). BSSFHS has developed a strategic three-year implementation plan to address the most paramount needs that were determined by the community: behavioral health, housing, and obesity/wellness. Due to limitations in capacity, resources and overall expertise, BSSFHS will work with other agencies and organizations to address remaining needs. A listing of these agencies and organizations has been included in the CHNA report. How significant needs are being addressed:BEHAVIORAL HEALTH: The Greenville Crisis Response Team (GCRT) was developed in order to provide a seamless and effective system of intervention for those with mental illness within our community. The GCRT, a multi-agency crisis intervention bureau is comprised of both individual community stakeholders and support organizations such as Greenville Mental Health, the Phoenix Center, Greenville Police Department, Greenville Health System, Bon Secours St. Francis Health System, Miracle Hill Ministries, Greenville Probate Court, and the City of Greenville. Currently the GCRT is developing a goal of an operational Crisis Stabilization Center in Greenville County. This endeavor is to provide citizens of Greenville that are in an applicable crisis, with a rapid, professionally coordinated response to their situation, instead of an individual experiencing crisis inappropriately and unnecessarily being placed in jail, a holding facility, hospital emergency room, or inpatient treatment program. Submission of The Robert Wood Johnson Foundation Clinical scholars Program grant in March 2017: The grant funding if obtained through the Robert Wood Johnson Foundation Clinical Scholars Program will have anticipated outcomes: Immediate, intermediate, and long-term outcomes will be appraised. The immediate outcomes include identifying seniors that should be completing AWVs, connecting with new seniors, and tracking seniors not enrolled with Medicare. The intermediate outcomes include engaging stakeholders, increasing the number of seniors completing the AWVs and preventive services, and connecting them to medical home teams. The long-term outcome is a transition of Greenville County seniors into a culture of health, rather than illness. We will also provide community-based educational experiences for future healthcare students. Evaluation will occur throughout the duration of the project. Baseline data will be obtained prior to launching the project, then quarterly to assess impact. AFFORDABLE HOUSING:The Sterling Land Trust will embark on its first initiative to build a house in 2017 on property it owns in the Sterling neighborhood. The Sterling Land Trust will work closely with the Nehemiah Community Revitalization Corporation a nonprofit developer located in Greenville County. Nehemiah has a history of building affordable housing in Greenville and surrounding counties in the Upstate.Funding Status:$25,000 grant from the Graham Foundation$10,000 ($5k received and $5k upon completion of house) from SC Assoc. for Community Economic Develop.$20,000 approved by Community Develop. Office of the City of Greenville.$19,000 approved by Bon Secours St. FrancisThe Sterling Land Trust was approved for a $50,000 loan through Community Works a community development finance organization.A grant application to Bank of America was declined. The Trust did not apply to TD Bank for a loan since a better loan rate was received from Community Works.The Sterling Land Trust did not begin the build in 2017 as the title was not cleared showing the Land Trust as the sole owner of the property. The Sterling Land Trust hired an attorney to clear the title. This work is being completed and the appropriate papers are being filed with County court. The Sterling Land Trust broke ground for the build on 4/4/2018. The hiring of an administrator has been put on hold as the building of the house is deemed a higher priority. The director Healthy Community Initiatives provides administrative support to the Land Trust and has written two grants which were funded as cited above. In March 2017 a member of the State Legislature introduced Bill S346 introducing inclusionary zoning which would give local municipalities the authority to carry out local regulations to increase the building of affordable housing units to address the shortage of housing in South Carolina. An advocacy letter was prepared by the director Healthy Community Initiatives on behalf of the Homeless Alliance supporting Bill S346. The letter was approved by the Alliance. In April 2017 the director Healthy Community Initiatives spoke before a Senate committee supporting Bill S346. A letter was drafted from Alex Garvey, SVP, Mission in support of Bill S346 which was sent to Greenville's state legislators indicating the Health System's support for inclusionary zoning.BSSFHS is to collaborate with AidJoy, a nonprofit capacity building organization, to address the needs of the homeless and residents via a community needs assessment, in which it will use the information from the community needs assessment to shape the housing agenda of Our Lady of the Rosary and the ARCUM churches. Due to AidJoy's projects, the organization decided it could not conduct a community needs assessment as originally planned for 2ndQ 2017. It anticipates being able to do so in 2018. BSSFHS' Healthy Community Initiatives will convene a meeting in summer 2017 with Pleasant Valley stakeholders: Our Lady of the Rosary, Westminster Presbyterian Church, The neighborhood association President and the executive director of the Pleasant Valley Connection and AidJoy to determine when a needs assessment can be completed. Bon Secours St. Francis Health System is represented on several housing groups including the Upstate Homeless Coalition, the Homeless Alliance, the Coalition of Downtown Churches, the City's affordable Housing Committee and United Ministries. The coalition of downtown churches has been meeting sporadically. The Upstate Homeless Coalition advocates for affordable housing in several ways. First, the Coalition connects organizations that have housing with homeless assistance providers. Second, some members of this Coalition are part of the Housing Determination Committee through the Continuum of Care. The Committee places chronically homeless people in HUD housing in the Housing First philosophy based on their vulnerability. Third, the Coalition collects data about homelessness through the Point in Time (PIT) Count, which can ultimately be used to advocate for services and resources. Data collected from the PIT Count helps the homeless assistance community understand the number and characteristics of persons who are homeless at one specific point in time. And fourth, some members of the Coalition are involved with the Greenville Homeless Alliance (GHA), which works on a systemic level to end homelessness. One of the GHA's current endeavors is studying housing models in other cities to assess what kind of system could be successful and replicated in Greenville. The director, Healthy Community Initiatives represents Bon Secours on the Homeless Alliance and sits on the advocacy committee. Best practice cities were identified and their community development directors were interviewed. Charlotte, NC, Seattle, Washington, San Antonio, TX, Arlington, VA, are some of the cities that made progress in reducing homelessness.Bon Secours St. Francis has been in discussions with Mercy Housing SE for 9 months. Bon Secours has leveraged its network to arrange meetings for Mercy officials to meet with County, City and the Housing Authority. Mercy Housing SE has identified a build site and expects to build about 66 units of affordable housing in Mauldin, SC located 10 miles from the City of Greenville. OBESITY: Partner with Greenville Free Medical Clinic to provide education and activities addressing nutrition, physical activity and behavioral health.An evidence-based curriculum identified: CDC Diabetes Prevention Program (DPP) which incorporates healthy eating, moderate exercise and behavior modification.Coordinated patient participant identification with BSSFHS HOP RN and Community Ministries Outreach RN. Pilot free weekly fresh produce market for patients underway, partnered with food rescue organization Loaves & Fishes Organization.Partnership with SC DHEC 'Eat Smart, Move More' for patient incentive giveaways for program participation. Facility Reporting Group - A Part V, Section B, line 16j: Information regarding the FAP is available on our websites, brochures are available at time of registration. We have on-site Financial Counselors who assist patients. We also have eligibility vendors who work with the patients and our statements indicate we have an FAP. We also provided local clinics in each market brochures regarding our FA program. 14 1 - St Francis Outpatient Center 3 St Francis Drive Greenville SC 29601 Outpatient Services 2 - St Francis ES Outpatient Lab 135 Commonwealth Dr Suite 255 Greenville SC 29615 Outpatient Lab 3 - St Francis Rehab 131 Commonwealth Drive Suite 200 Greenville SC 29615 Outpatient Rehab-Physical, Occupational, Speech, Massage Therapy 4 - St Francis Outpatient Rehab 120 Summer Street Greenville SC 29601 Outpatient Rehab 5 - St Francis Physical Therapy 712 Congaree Road Greenville SC 29607 Outpatient Rehab 6 - St Francis Powdersville Rehab 3407 Hwy 153 Piemont SC 29673 Outpatient Rehab 7 - St Francis Physical Therapy 209 Patewood Dr Ste 100 Greenville SC 29615 Outpatient Rehab 8 - St Francis Homecare 10 Patewood Drive Ste 300 Greenville SC 29615 Homecare Offices 9 - McCall Hospice House 1836 West Georgia Rd Simpsonville SC 29680 Hospice 10 - St Francis Sleep Disorder Center 3 St Francis Drive Ste 340 Greenville SC 29601 Sleep Disorder Center 11 - St Francis Wound Healing Center 131 Commonwealth Drive Suite 200 Greenville SC 29615 Wound Care Rehab 12 - St Francis Millennium 2 Innovation Dr Ste 110 Greenville SC 29607 Registration and Lab 13 - St Francis Pearlie Harris Breast Ctr 131 Commonwealth Drive Suite 220 Greenville SC 29615 Breast Cancer Treatment Facility 14 - St Francis Millennium Cancer Center 104 Innovation Dr Greenville SC 29607 Cancer Facility Part I, Line 7: Part I, line 7a: Charity Care at cost is computed by applying a cost-to-charge ratio to the aggregate charity adjustments recorded in the general ledger. Part I, line 7b: Unreimbursed Medicaid is computed by determining the cost of Medicaid services supplied less payments received for these services. To determine the cost of Medicaid services provided, a cost-to-charge ratio is applied to traditional and managed Medicaid gross charges captured in the patient accounting system and general ledger. Payments include payments for individual claims, payments from the Medicaid program paid outside the claim process (such as medical education payments) and expected or actual cost report settlements.Part I, line 7b(f): Prior to 2006, Medicaid in the state of South Carolina was reimbursed to hospitals on a fixed prospective basis (fixed rates not directly related to costs). For years 2006 - 2012, the State reimbursed Hospitals on a cost basis (actual costs to provide services). This reimbursement resulted in the hospitals receiving payments close to their costs. Starting is 2013 the State changed reimbursement methodologies to a fixed rate prospective basis (fixed rates not directly related to costs). For the first year the rates state wide were set to approximate the hospital's cost to provide service. For the subsequent years the fixed rate will be adjusted by a state wide inflationary factor and not related to an individual hospitals cost. The Hospital's unreimbursed Medicaid percentage for St. Francis Hospital, Inc. is fairly consistent with those of other hospitals in the state.Part I, line 7c: Unreimbursed costs from other means-tested government programs are computed by applying a cost-to-charge ratio to the total charges to patients covered under these programs. The charges are identified by the financial class assigned to the patient. For Part I, Line 7 a-c computations: The cost-to-charge ratio is derived using the suggested computation in Worksheet 2, Ratio of Patient Care Cost-to-Charges. Operating expenses and Gross patient charges are taken from the general ledger. Expenses for nonpatient care activities recorded in operating expenses are approximated as directly equaling other operating revenue, assuming these activities do not provide profit. Part I, line 7e: Community health improvement services and community benefit operations are accumulated throughout the year and reported at actual cost in a software program that specifically addresses this purpose.Part I, line 7f: Health professions education cost is determined as the direct and indirect cost of qualifying education activities as traditionally reported in columns 21-24 on Worksheet B of the Medicare cost report as a Medical Education program, nursing school or other allied health program. Part I, Ln 7 Col(f): Bad debt expense included in Part IX; line 25 and excluded from the "percent of total expense" calculation is: $32,994,988. Part II, Community Building Activities: The Healthy Community Initiatives Department focuses on revitalizing neighborhoods and systematically overcoming the social conditions in which people live. Using a grassroots strategy, Healthy Community Initiatives staff works closely with faith leaders, residents, local businesses and schools to address community concerns and to identify solutions to improve neighborhoods. With a focus on community development and community health our goal is to address a variety of social determinants. The department looks at the different variables affecting community health such as poverty rates, lack of access to health care, substance abuse, homelessness, affordable housing, public safety, etc. Each community is different, although there are some common themes amongst the communities; most of them have social challenges that impact negatively upon residents' health. We work to build trust and bring collaborations and partnerships into the community that can effect change. The staff team builds trust in these communities and Bon Secours St. Francis is a recognized name. Bon Secours St. Francis employs a Healthy Community Navigator who works with individuals who have chronic health conditions, the uninsured, the underinsured, and those who lack resources for good health. The Healthy Community Navigator is responsible for helping and supporting individuals and families to navigate and access healthcare services, educate on the importance of healthcare follow-ups, reinforce disease specific education, perform medication monitoring and case management and provide services to address barriers to health and social service resources. The Navigator works collaboratively with a team of healthcare professionals such as Bon Secours Saint Francis Community Wellness, Greenville Free Medical Clinic, New Horizon and other community agencies to provide patients with opportunities to stabilize and improve their health. Part III, Line 2: Bad debt expense on the general ledger includes: 1) actual write offs of discounted gross charges where it is determined an uninsured patient can pay and does not pay; and 2) the estimated write offs for uninsured patient accounts with outstanding balances after discount. Estimates are based on historical collection rates.When an uninsured patient is billed for patient care services, the charges are automatically discounted and the patient is requested to only pay the amount after discount. The discount is recorded as an adjustment to gross revenue and is not recorded in bad debt expense. If the balance after discount is not paid or not paid in full, the unpaid amount will be written off to bad debt expense. When a patient remits a payment on an account that has already been written off to bad debt expense, the payment is recorded as a recovery of bad debt, which reduces bad debt expense. Part III, Line 3: The organization does not report an estimate for the portion of bad debt expense that may have been likely to qualify for financial assistance under the hospital's charity care policy. The organization takes the position that ample opportunity and assistance is provided to the patient to qualify under the financial assistance policy. If sufficient information is not provided, the organization must assume the patient does not qualify. Part III, Line 4: Please see Footnote "(2d) Accounts Receivable, net" discussing "accounts receivable" on page 10 in the attached BSHSI consolidated audited financial statements ("AFS"). "Allowance for uncollectible accounts" is discussed in the second paragraph in Footnote "(10) Net Patient Service Revenue" on page 38-39 of the attached AFS. There is not a separate "bad debt expense" footnote in the AFS. Part III, Line 8: Medicare allowable costs reflected in Part III come directly from the facility's Medicare cost report. The cost report segregates the total facility actual expenses into costs for support departments, clinical departments (routine and ancillary) and non-reimbursable departments. The cost report uses appropriate statistical bases to "step down" support costs to allowable clinical and non-reimbursable departments. The charges for clinical departments are matched to the total cost for these departments for a cost-to-charge ratio. Medicare-specific allowable costs for in- and outpatient ancillary departments are computed by applying the department-specific cost-to-charge ratio to the Medicare program charges by department. For routine departments, a per diem total cost is computed and applied to Medicare program days for the Medicare routine program cost.The organization feels the total shortfall of Medicare reimbursement compared to computed Medicare allowable costs should be treated as community benefit. The hospital improves access to patient care by providing services regardless of a patient's ability to pay or the hospital's ability to receive full cost reimbursement for services. The hospital also relieves the government of a financial burden when it provides care to publicly insured patients where reimbursement is less than cost of providing the service.In addition to the costs reported above, the organization incurred additional costs relating to Medicare support that are not includable in the Medicare Cost Report in the amount of: $1,848,354. Part III, Line 9b: The hospital has a written policy that describes collection practices applying to patients who qualify for financial assistance. If full assistance is approved, no collection efforts are pursued on that patient's account(s). If partial assistance is approved, the patient is responsible for the adjusted account balance and collection efforts will follow the established practices for all patients where a self-pay balance exists. Collection efforts are not pursued on any pending FAP account.Specific criteria exists for how much financial assistance, partial or total, will be provided to the patient based on the assessed need. Criteria is based on Federal Poverty Guidelines and is reviewed and updated annually. Once a patient has been deemed eligible for the Patient Financial Assistance Program (FAP), the patient is notified by letter within 60 days after receipt of the application and supporting documentation. The patient retains eligibility for a period of eight months from the date of the application. This eligibility is identified by hospital admissions, billing and collection staff by the assignment of a specific financial class with accompanying eligibility dates. At the end of the eight months, the patient is responsible for reapplying for FAP eligibility. Part VI, Line 2: Under the Affordable Care Act of 2010, IRS requires 501 (c)(3) hospitals to conduct a Community Health Needs Assessment at least once every 3 years. Health systems are to ensure broad participation by residents of their service areas (Counties), Prioritize health needs and create an implementation plan to address any unmet needs. Local hospital boards approve the CHNA and implementation plan. The Healthy Community Initiatives Director is responsible for conducting the CHNA. An oversight team composed of diverse representatives from Bon Secours, the Health Department, the United Way, Piedmont Health Foundation, Furman University/LiveWell, the Greenville Free Medical and the SC Hospital Association provided guidance to the process. To assess community needs a data collection methodology was used to collect primary data via a survey, focus groups and a town hall meeting. Our health system collaborated with Greenville Health System (a local hospital) to conduct 2 focus groups. More than 850 residents in Greenville County gave their input and their opinions about the health needs of the community and perceptions about the quality of life. In addition, secondary data was collected - community demographics, mortality, maternal and infant health, access to health care and health behaviors and safety. The data from the survey, focus groups, was analyzed and discussed using a prioritization process and strategy grid. Three priority areas emerged as the focus of Bon Secours St. Francis Health System for 2017 - 2019. Outcomes, goals, strategies and action steps exist for each priority area and are contained in the implementation plan. The Board of Directors will receive an update of progress and achievements in the implementation twice per year.1. Obesity/Wellness2. Housing/Social Environment3. Access to Behavioral Health (including Homeless People) Part VI, Line 3: The Patient Financial Assistance program is communicated to patients verbally upon scheduling, registration, visible postings of the program are in common areas throughout the hospital, along with brochures and the program is detailed on our Bon Secours website. In addition, patient billing statements and letters inform patients regarding our financial assistance program. Bon Secours proactively screens patients to identify individuals and their families who may qualify for federal, state or local health insurance programs or the Bon Secours Patient Financial Assistance Program ("FAP") and assist the potential eligible patients through the qualification process. Potentially eligible patients that do not qualify for a federal or state health insurance program are referred to the Financial Assistance Coordinator located in Patient Financial Services for assistance in completing the documentation required to establish FAP eligibility. Bon Secours is also dedicated to meeting the needs of non-English speaking patients by having on-site Spanish translators, and other language translation services. In addition, Bon Secours employs a telephone language service which assists in meeting any language needs that arise. The translation services are offered to non-English speaking patients from admission to discharge, including the financial assistance process. Based on market need, our financial assistance policy and application are translated into multiple languages and placed on our Bon Secours website for patients to access. Part VI, Line 4: Approximately 482,752 residents reside in Greenville County. Greenville County is predominantly White (77.1%), with a large Black/African American population (18.5%). Compared to South Carolina, Greenville has a larger percentage of Hispanics/Latinos.Greenville has a similar age distribution compared to South Carolina, with slightly more children (age <18) and fewer older adults (age >65). The unemployment rate is lower in Greenville County than in South Carolina. Greenville has a higher median income and per capita income than South Carolina, but less than the nation. At 15.8%, Greenville has a lower percentage of people living below the poverty level than the state (18.3%); however, there are differences by race/ethnic group. Hispanic/Latinos, Black/African Americans, and those who identify as Other have twice the Greenville percentage.Similar to South Carolina and the U.S., 31.6% of Greenville County residents aged 25 or over have a Bachelor's degree or higher. Part VI, Line 5: BSSFHS has an open medical staff with privileges available to all qualified physicians. BSSFHS operates an emergency room at both of its hospitals which provide services 24 hours a day, seven days a week to ensure access to needed emergency care for all persons. In 2017, the health system was driven by the Bon Secours mission to serve the community by the leadership of a governing board that included sixteen members, thirteen of whom are representative of the community. BSSFHS supports several community programs through the Bon Secours mission to be "good help to those in need." As part of this mission, BSSFHS provides dedicated staff and services with the sole purpose of measuring needs, engaging partners, and addressing the needs of the community. Below gives examples of this commitment. Access to Oral Health Care Program The BSSFHS Oral Health Services program provides access to oral health care through an integrated service partnership providing a mutually beneficial relationship between businesses, funding agencies, a dental hygiene training program, and a college of dentistry. The St. Francis Mobile Dental Unit provides the opportunity to reach out to outlying portions of the county and reach populations that face multiple barriers to care, including transportation. The fixed sites at the Greenville Free Medical Clinic and the New Horizon Family Dental Care ensure that a range of comprehensive oral health services are available in the community on a sliding fee scale or at no cost for the underserved. During Fiscal Year 2016-2017 3,159 children and adults have received education and services through the Oral Health Program.Community OutreachCommunity Wellness (CW) is made up of a team of three nurses and one social workers, who bring their expansive experience to the community. Clients are treated holistically -- mind, body, and spirit. By fostering trusting relationships with community members, the health outreach team helps transform hurt into hope, promotes and defends human dignity, and fosters a healing and caring environment. CW provides the most vulnerable members of the community with opportunities to improve their health and quality of life, focusing on reaching those who are underserved and uninsured. Staff assist individuals and families with navigating the healthcare system and accessing community resources, including health education, personal safety, and basic life skills. Clients are able to establish a patient-primary care provider relationship, improve overall health, reduce unnecessary emergency department admissions, and decrease readmission to the healthcare system. CW assists clients with finding basic needs such as affordable health care, medications, medical supplies, transportation, and food/clothing. Additionally, CW provided individual and group presentations, screenings, and written literature in addition to annual flu clinics. In 2017, over 5,950 community members were served and 199 events/screenings in the community were offered.San Sebastian Catholic CommunitySan Sebastian Catholic Community is a mission of St. Mary's Catholic Church. The San Sebastian Catholic Community is located in the San Souci Community, and is predominately Spanish-speaking. A thriving and engaged community, the San Sebastian Catholic Community is committed to health and wholeness. Many in the community face the harshest impacts of poverty, and are in need of health and health-related services and resources. Community Health Outreach has a satellite office at San Sebastian Church where staff provide individuals and families resources and services. The St. Francis Mobile Dental Unit, Bon Secours mammography coach, and the IVAN Mobile, an eye screening van managed by Surgeons for Sight, all rotate through San Sebastian to bring services to this community. Center for Developmental ServicesBorn out of the vision of the Community Planning Council of the United Way of Greenville County, the Center for Developmental Services (CDS) is a unique collaboration that exists nowhere else in the United States. Visionaries recognized the need for an easier and more effective method for accessing developmental services in our area. Although quality services for children with developmental concerns existed all across the Upstate, the services were often geographically scattered, uncoordinated, and difficult to access. CDS is unique in that separate private and public nonprofit agencies are collaborating under one roof. CDS has existed to ensure that children with special developmental needs and their families are linked with appropriate interventions in as easy a manner as possible; and that parents, siblings, and caregivers are supported throughout their time in the service delivery system. Thousands of children from all over the Upstate benefit from the CDS each year receiving developmental evaluation, therapies, special education, family support and more. The Bilingual Support and Latina Outreach program at CDS continues to thrive in the partnership with Bon Secours St. Francis Health System through the Community Ministries department. Monthly an interpreter works side by side with an average of 45 families with partner agency clinicians, serving as the family's interpreter and offering advice and information regarding other resources to Spanish speaking families. In 2017, Bon Secours St. Francis Health System and CDS unveiled a new, state-of-the-art Bon Secours St. Francis Resource Center on the second floor of the CDS facilty. The new space the resource serves as a spot for families to have access to written materials and provides a child-friendly area for family meetings. Additionally, the resources center provides access to a bi-lingual kiosk, helping Spanish-speaking families connect to online health resources and information that might not otherwise be available to this community. On average 200 health-related sites are visited by users of the kiosk and the kiosk also contains important Spanish-language brochures and booklets providing healthcare information and a telephone providing a direct link to United Way 2-1-1, Greenville County's comprehensive source for information regarding human service agencies and community resources. Additionally, the resource room serves as a spot for families to have access to written materials and provides child-friendly space for family meetings. Finally, the Community Ministries Oral Health Team conducts "Tooth Times," an oral health prevention education program, in the resource center on a monthly basis. Part VI, Line 6: Bon Secours Health System, Inc., a Maryland nonprofit, nonstock membership corporation (BSHSI), and all of the other entities that are controlled directly or indirectly by Bon Secours, Inc., a Maryland nonprofit, nonstock membership corporation (BSI) are described collectively as the System. BSI, which is the sole corporate member of BSHSI, has no healthcare operations. The System was organized in June 1983 to fulfill the healthcare mission of the United States Province of the Congregation of the Sisters of Bon Secours of Paris, a congregation of religious women of the Roman Catholic Church founded in France in 1824. The System's activities are in the states of New York, Pennsylvania, Maryland, Virginia, Kentucky, South Carolina, and Florida, each referred to as a local system. The Ministry of BSHSI aids those in need, particularly those who are sick and dying, by offering services that include but are not limited to acute inpatient, outpatient, pastoral, palliative, home health, nursing home, rehabilitative, primary and secondary care and assisted living without regard to race, religion, color, gender, age, marital status, national origin, sexual orientation, or disability. As a member of the Catholic health ministry and a member of Bon Secours Health System, Inc. (BSHSI), this organization and its related entities are called to continue the healing ministry of Jesus. We exist to benefit the people living in the communities it serves. Through all of the services offered to the community, the mission is "to bring compassion to health care and to be good help to those in need, especially those who are poor and dying. As a System of caregivers, we commit ourselves to help bring people and communities to health and wholeness as part of the healing ministry of Jesus Christ and the Catholic Church." This organization and related organizations share the BSHSI Vision. BSHSI's vision to partner with communities to create a more humane world, build social justice for all and provide exceptional value for those served is implemented through its Strategic Quality Plan which provides focus in four goal areas for the current three year period (2016-2018). - Co-Create Healthy Communities: We recognize that the factors which drive health outcomes extend well beyond the scope of traditional health care services. Thus, we commit to improve the health of communities through partnership and collaboration with a broad range of constituencies including committed community residents - Be Person Centric: We recognize that those whom we serve are increasingly engaged in their own care and are seeking convenience, affordability and reliability. Thus, we commit to anticipate and respond to the changing expectations of health care consumers, and to ensure that we engage each person in an individualized plan for health with a focus on prevention and wellness. - Serve Those Who Are Vulnerable: We recognize, by our Catholic identity, that teh struggle for a more humane world is not an option, but an integral part of spreading the gospel. Thus, we commit to serve those who are vulnerable in many ways, addressing health disparities, sustaining global ministries, healing the environment and working to end violence and oppression.- Strengthen Our Culture and Capabilities: We recognize that the health care delivery system is undergoing rapid change with increasing complexity. Thus, we commit to liberate the potential of our people by strengthening individual and collective capabilities with respect to ministry leadership, knowledge, analytics, innovation and finances. Please see Schedule R for listings of the related organizations. Each of the reported entities play a role in achieving the vision of BSHSI and the SQP (Strategic Quality Plan). Part VI, Line 7, Reports Filed With States SC 1 Bon Secours - St Francis Health System Foundation Inc One St Francis Drive Greenville SC 29601 260012031 501(c)(3) 846528 Cost of administrative services provided to the Foundation St Francis Physician Services Inc One St Francis Drive Greenville SC 29601 134290167 501(c)(3) 68865606 General Support 2 0 Next Generation Scholarships 8 8000 Part I, Line 2: The organization complies with Bon Secours Health System, Inc.'s system-wide financial and accounting policies. Contributions are generally made as reimbursements for funds spent. In such cases, the donee/grantee organization must provide documentation to the filing organization before funds are approved for disbursement. 0 1 0 0 0 0 0 0 0 Craig McCoy CEO 0 456183 0 106067 0 40139 0 45400 0 26641 0 674430 0 0 Thomas Morris PhD President 0 336400 0 81600 0 46396 0 61346 0 20913 0 546655 0 21104 Jeffrey Oak PhD Board Member 0 366276 0 89262 0 64218 0 48426 0 31409 0 599591 0 19952 Daniel Duggan COO (Sep-Nov) 0 338708 0 79833 0 60692 0 15900 0 11971 0 507104 0 0 Ronnie Hyatt Treasurer/CFO - BSSFHS 349926 0 81142 0 61672 0 15900 0 18464 0 527104 0 0 0 Teresa Ficicchy EVP - CNO 263892 0 61291 0 49671 0 15900 0 11598 0 402352 0 0 0 Rose Leo VP - Surgical Services 196023 0 29142 0 24655 0 12764 0 19393 0 281977 0 0 0 Joseph Hartzog Emergency Physician 530899 0 6384 0 2771 0 15900 0 26692 0 582646 0 0 0 Sara Saccocio SVP Chief Med Officer (Sep-Apr) 334014 0 79311 0 39469 0 17000 0 27192 0 496986 0 0 0 Bruce Bourdon Emergency Physician 407186 0 4433 0 2227 0 15900 0 28952 0 458698 0 0 0 Gregory Hoffman Emergency Physician 279899 0 130935 0 1016 0 14045 0 26692 0 452587 0 0 0 Kurt Hoffert Emergency Physician 387400 0 4251 0 1254 0 15900 0 26641 0 435446 0 0 0 Mark Nantz Former CEO 0 666960 0 155881 0 115175 0 103665 0 26547 0 1068228 0 67200 Part I, Line 3 Bon Secours Health System, Inc., a related organization of the filing organization uses the following to establish the compensation of the organization's CEO/Executive Director: Compensation Committee Independent Compensation Consultant Written Employment Contract Compensation Survey or Study Approval by the Board or Compensation Committee Part I, Line 4b The filing organization participates in a BSHSI sponsored executive retirement program that allows for deposits into additional retirement plans and available only to key employees. The 457F plan is a non-qualified plan and is subject to a minimum three-year service requirement before vesting on deposits made into this plan. Individuals that received a distribution include: Thomas Morris, PhD, $22,519; Jeff Oak, PhD, $21,601; Mark Nantz, $71,441. Krista Coben Daughter of COO, Daniel Duggan 45819 Employment 0 Jason Coben Son-in-law of COO, Daniel Duggan 28008 Employment 0 Kyle Duggan Son of COO, Daniel Duggan 58540 Employment 0 Meagan Duggan Daughter-in-law of COO, Daniel Duggan 62460 Employment 0 Michael Haskell Brother of Key Employee, Teresa Ficicchy 79101 Employment 0 Form 990, Part VI, Section A, line 2 Daniel Duggan (COO) and Teresa Ficicchy (Key Employee) are married. Form 990, Part VI, Section A, line 6 Bon Secours Health System, Inc. is the sole member of Bon Secours St. Francis Health System, Inc., which in turn is the sole member of St. Francis Hospital, Inc. Form 990, Part VI, Section A, line 7a The governing body of St. Francis Hospital, Inc. is appointed by its member Bon Secours St. Francis Health System, Inc. and subject to approval by Bon Secours Health System, Inc. Form 990, Part VI, Section A, line 7b Certain authorities of St. Francis Hospital, Inc. are reserved to its member or to Bon Secours Health System, Inc. Form 990, Part VI, Section B, line 11b The process the organization uses to review the Form 990 consists of a review by the local system's audit and compliance board-committee and providing the form to the local system board of directors to allow for a thorough review by both before the filing date. The local system's audit and compliance committee and board of directors have reviewed the Form 990, scheduled time on meeting agendas, and asked questions regarding the Form 990 before the return is filed. Form 990, Part VI, Section B, line 12c The organization regularly and consistently monitors compliance with the conflict of interest policy. On an annual basis, all persons subject to the policy, including all officers, directors and key employees are required to make certain disclosures. These include disclosures related to certain personal, financial and organizational relationships that may present a conflict, or the appearance of a conflict of interest with the organization. All disclosures go through a three-part review process: (1) disclosures are reviewed first by the corporate responsibility officer (CRO); (2) a governance team comprised of the CEO, board president, board chair, CRO, and the BSHSI CRO participate in a second review of all disclosures during which recommendations are made as to the resolution of any conflicts or potential conflicts. Depending on the facts and circumstances, resolutions may include ongoing disclosure, recusal or removal of the conflict; and (3) all disclosures and recommendations are reviewed by a board committee (audit and compliance committee reviews the disclosures of management and the governance committee reviews the disclosures of the board and board committee members). Form 990, Part VI, Section B, line 15b The compensation committee of the board of Bon Secours Health System, Inc. (BSHSI) engages in a comprehensive process for the oversight and management of remuneration for executive employees and disqualified parties of BSHSI. The compensation committee consists of a group of independent board members and engages an independent external compensation consultant to ensure they receive appropriate analysis of market and follow the practices necessary to obtain full compliance with the IRS' rebuttable presumption of reasonableness. The committee establishes and maintains a compensation philosophy; reviews pay practices against local, regional and national healthcare organizations and approves all remunerative decisions for this group of individuals. The committee reviews and receives assurances that all levels of pay within the organization are reasonable based on performance and validates incentives are met. These decisions are documented in the BSHSI board of directors and compensation committee minutes. Compensation Process Other Officers/Key Employees: For those key employees and highest paid employees that are not reviewed by the BSHSI compensation committee, the process included a review and approval by independent persons, comparability data, and contemporaneous substantiation of the deliberation and decision. In the review, the other officers or key employees of the organization were compared to other hospitals' employees in the area that hold the same title. During the review and approval of the compensation, documentation of the decision was recorded in human resources. Form 990, Part VI, Section C, line 19 The filing organization makes all documents available to the general public upon request. Form 990, Part VII - Additional Disclosure: Board Member positions are generally voluntary in nature. Compensated employees of the filing organization and other related organizations who also hold board positions are compensated only in relation to their employment and do not receive additional compensation for their board responsibilities. Form 990, Part XI, line 9: Principal Payments to BSHSI -5,244,351. Swaps Allocation to BSHSI -2,295,222. Sale of BSNY - Writedown of Goodwill -3,044,140. Physicians' Surgery Center at St Francis LLC One St Francis Drive Greenville SC 29601 No Activity SC 0 0 St Francis Hospital Inc Health Partners of Bon Secours St Francis LLC One St Francis Drive Greenville SC 29601 814408628 No Activity SC 0 0 St Francis Hospital Inc Bon Secours Health System Inc 1505 Marriottsville Road Marriottsville MD 21104 521301088 Parent Org. - Management Services MD 501(c)(3) Line 12c, III-FI Bon Secours Inc 0 Bon Secours St Francis Health System Inc One St Francis Drive Greenville SC 29601 582504528 Local System Parent Org. SC 501(c)(3) Line 12c, III-FI Bon Secours Health System Inc 0 Bon Secours - St Francis Health System Foundation Inc One St Francis Drive Greenville SC 29601 260012031 Grant Making Foundation SC 501(c)(3) Line 7 St Francis Hospital Inc 1 St Francis Physician Services One St Francis Drive Greenville SC 29601 134290167 Physician Services SC 501(c)(3) Line 10 Bon Secours St Francis Health System Inc 0 Upstate Surgery Center One St Francis Drive Greenville SC 296013955 562186977 Ambulatory Surgery Center SC St Francis Hospital Inc Related 628215 1080084 0 0 0.58090 Optimum Health Network Inc One St Francis Drive Greenville SC 29601 570973524 Healthcare Services SC N/A C 0 0 1 1 0 0 0 0 0 0 1 0 1 1 0 0 1 1 1 1 Bon Secours - St Francis Health System Foundation Inc B 846528 Actual Bon Secours - St Francis Health System Foundation Inc C 2861028 Actual Upstate Surgery Center - SFH S 303765 Actual Upstate Surgery Center - PS Cost Transfers L 143808 Cost