2018-05-09T14:10:42-05:00 2017-06-30 990 2016-07-01 630288864 St Vincent's Birmingham STVI 3147338000 810 St Vincents Drive Birmingham AL 35205 Tonya Mershon Tax Officer 2017-11-02 2016 2021-01-29 14:40:06Z Jason Alexander 810 St Vincents Drive Birmingham AL 35205 435885543 false 0928 X www.stvhs.com/birmingham X 1898 AL Provides essential health care services as well as community services to the Birmingham, AL metropolitan area and surrounding communities. X 13 12 2790 97 878671 314428 233078 421698 400708306 413361788 -269131 11899818 9615140 7248462 410287393 432931766 3101946 2710609 0 122219832 121494925 0 0 0 266238955 277777294 391560733 401982828 18726660 30948938 307596875 231317128 192773245 179661449 114823630 51655679 Rooted in the loving ministry of Jesus as healer, we commit ourselves to serving all persons with special attention to those who are poor and vulnerable. Our Catholic health ministry is dedicated to spiritually centered, holistic care which sustains and improves the health of individuals and communities. We are advocates for a compassionate and just society through our actions and our words. false false 374003394 2710609 412483117 THE HOSPITAL IS DEDICATED TO SPIRITUALLY CENTERED, HOLISTIC CARE THAT SUSTAINS AND IMPROVES THE HEALTH OF BIRMINGHAM, AL METROPOLITAN AREA AND SURROUNDING COMMUNITIES. IT FURTHERS THIS GOAL THROUGH DELIVERY OF PATIENT SERVICES, CARE TO THE ELDERLY AND INDIGENT, PATIENT EDUCATION AND HEALTH AWARENESS PROGRAMS FOR THE COMMUNITY. FOR DETAILED INFORMATION ON THE HOSPITAL'S PROGRAM SERVICE ACCOMPLISHMENTS AND STATISTICAL DATA. SEE SCHEDULE H. 374003394 true true false true false false false false false false true false false true true true false true false false false false false false false false true true true false true false false false false false false false true false false false true false true true true false false true 234 0 true 2790 true true true false false false false false false false false false X 13 12 false false false true true true true true false false false false true true true true true false false true true X Tina Lewis VP of Finance 2058383216 50 Medical Park East Drive Ste 310 Birmingham AL 35235 NEEYSA C BIDDLE SVP ASCENSION HEALTH/BIRMINGHAM MARKET EXECUTIVE/PRESIDENT CEO - STVHS 15.0 35.0 X X 0 1359832 26949 NENA F SANDERS CHAIR-HEALTH SYSTEM 0.5 4.0 X X 0 0 0 DANIEL F SANSONE VICE CHAIR-HEALTH SYSTEM 0.5 4.0 X X 0 0 0 JAMES D DAVIS SECRETARY/TREASURER-HEALTH SYSTEM 0.5 4.0 X X 0 0 0 JAMES CANTRELL MD board member-health system 0.5 4.0 X 0 0 0 SISTER MARY ELIZABETH CULLEN DC BOARD MEMBER-HEALTH SYSTEM 0.5 4.0 X 0 0 0 KENT J GRAEVE BOARD MEMBER-HEALTH SYSTEM 0.5 4.0 X 0 0 0 WILLIAM HORTON BOARD MEMBER-HEALTH SYSTEM (START 7/2016) 0.5 4.0 X 0 0 0 ELIZABETH HUNTLEY BOARD MEMBER-HEALTH SYSTEM (START 7/2016) 0.5 4.0 X 0 0 0 DENNIS JONES MD BOARD MEMBER-HEALTH SYSTEM 0.5 4.0 X 0 0 0 WILLIE H PARKER BOARD MEMBER-HEALTH SYSTEM 0.5 4.0 X 0 0 0 JOSEPH E WELDEN JR MD BOARD MEMBER-HEALTH SYSTEM 0.5 4.0 X 0 0 0 DELYNN ZELL CFP BOARD MEMBER-HEALTH SYSTEM 0.5 4.0 X 0 0 0 JASON ALEXANDER SVP ASCENSION HEALTH/BIRMINGHAM MARKET EXECUTIVE/PRESIDENT CEO - STVHS (START 3/2017) 15.0 35.0 X 0 0 0 WILLIAM A DAVIS CHIEF OPERATING OFFICER 5.0 45.0 X 0 642753 40414 STEPHANIE J DUGGAN MD CCO-Mnstry Mkt Brmnghm (START 7/2016) 15.0 35.0 X 0 562052 38679 JENNIFER L KINGRY CFO 15.0 35.0 X 0 336489 39301 NAN M PRIEST EVP/CHIEF STRATEGY OFFICER 5.0 38.0 X 0 576123 33768 JANITH GANNON VP SURGICAL SERVICES 50.0 0 X 301104 0 18957 ROBERT E RAY PRESIDENT - BIRMINGHAM 25.0 25.0 X 407882 0 36643 SHANNON SCATURRO VP-Clinical Operations (START 8/2016) 40.0 0.0 X 131887 138531 33290 AMY R SHELTON VP Nursing (START 7/2016) 40.0 10.0 X 213826 0 32304 Tessa R Bagala Physicist 40.0 0 X 154905 0 23067 Brian Kevin Mader Planning & Dvlpmnt Physicist 40.0 0 X 236217 0 36961 Jane Martin Mckinney Clinical Staff Pharmacist 40.0 0 X 156877 0 19286 Dianne Walters Norris Mgr-Medication Safety 40.0 0 X 157452 0 11561 Cheryl Rutledge Admin Dir-Nrsg Practice & Fin 40.0 0 X 162970 0 25378 SUZANNAH CAMPBELL FORMER KEY EMPLOYEE (END 11/2015) 0.0 50.0 X 0 215191 13589 DAVID A CAUBLE FORMER OFFICER (END 11/2015) 0.0 0.0 X 0 397069 10428 GREGORY L JAMES MD FORMER OFFICER (END 2/2016) 0.0 40.0 X 0 838319 33587 CAROL A MAIETTA FORMER OFFICER (END 1/2016) 0.0 0.0 X 0 292263 7498 JOHN D O'NEIL FORMER OFFICER (END 9/2014) 0.0 0.0 X 0 989122 9790 1923120 6347744 491450 60 true true false BRASFIELD & GORRIE LLC 3021 7TH AVE S BIRMINGHAM AL 35233 CONTRACTOR SERVICES 6803559 ST VINCENT OUTPATIENT SURGERY SERVICES LLC 810 ST VINCENTS DRIVE BIRMINGHAM AL 35205 SURGERY SERVICES 5556135 MED-SOUTH INC P O BOX 689 JASPER AL 355020689 MEDICAL SERVICES 1328155 FRESENIUS MANAGEMENT SERVICES 16343 COLLECTION CENTER DRIVE CHICAGO IL 606930163 MEDICAL SERVICES 1074166 STV ORTHOPEDICS CO-MANAGEMENT LLC 810 ST VINCENTS DRIVE BIRMINGHAM AL 35205 MEDICAL SERVICES 1062286 29 X 421698 421698 Net Patient Revenue 621990 408806035 408637559 168476 Investment - Joint Ventures 621990 1816077 1816077 Income from Affiliates 561000 1226427 1226427 Lab Revenue 621500 1513249 803054 710195 0 0 0 0 413361788 819461 819461 264335 70371 193964 0 193964 193964 11083698 3341 0 11080357 11080357 11080357 4206693 2880065 1326628 1326628 Parking Revenue 812930 2327067 2327067 Fitness Revenue 713940 204643 204643 Insurance Settlement 900099 2553518 2553518 642642 0 0 642642 5727870 432931766 412483117 878671 19148280 2710609 2710609 1154872 1039385 115487 100854970 90769473 10085497 155846 140261 15585 11957854 10762069 1195785 7371383 6634245 737138 988540 889686 98854 10189 10189 14872 13385 1487 3704298 3333868 370430 0 108111 97300 10811 1425663 1283097 142566 17931612 16138451 1793161 13984548 12586093 1398455 163899 147509 16390 126666 113999 12667 3909010 3518109 390901 17303017 15572715 1730302 1584131 1425718 158413 Medical Supplies 100051120 100051120 Corporate Overhead Allocation 40995235 36895711 4099524 Purchased Services 38370747 34533672 3837075 Provider TAx 19144801 19144801 17960835 16191929 1768906 0 401982828 374003394 27979434 0 10275 20801 47912239 46107526 0 0 0 5452088 5860391 699103 849791 489913833 352687052 173535799 137226781 0 2961644 3082212 1758978 1257768 75266749 36911858 307596875 231317128 25488268 23252365 3220680 1843 0 164064297 156407241 192773245 179661449 X 114823630 51655679 114823630 51655679 307596875 231317128 X 30948938 435874 -94552763 X false true X true false X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED false false false false false false false false true 10189 10189 false Schedule C, Part II-B, Line 1 DETAILED DESCRIPTION OF THE LOBBYING ACTIVITY LOBBYING EXPENSES REPRESENT THE PORTION OF DUES PAID TO NATIONAL AND STATE HOSPITAL ASSOCIATIONS THAT IS SPECIFICALLY ALLOCABLE TO LOBBYING. ST. VINCENT'S BIRMINGHAM DOES NOT PARTICIPATE IN OR INTERVENE IN (INCLUDING THE PUBLISHING OR DISTRIBUTING OR STATEMENTS) ANY POLITICAL CAMPAIGN ON BEHALF OF (OR IN OPPOSITION TO) ANY CANDIDATE FOR PUBLIC OFFICE. Schedule C, Part II-B, Line 1 DETAILED DESCRIPTION OF THE LOBBYING ACTIVITY LOBBYING EXPENSES REPRESENT THE PORTION OF DUES PAID TO NATIONAL AND STATE HOSPITAL ASSOCIATIONS THAT IS SPECIFICALLY ALLOCABLE TO LOBBYING. ST. VINCENT'S BIRMINGHAM DOES NOT PARTICIPATE IN OR INTERVENE IN (INCLUDING THE PUBLISHING OR DISTRIBUTING OR STATEMENTS) ANY POLITICAL CAMPAIGN ON BEHALF OF (OR IN OPPOSITION TO) ANY CANDIDATE FOR PUBLIC OFFICE. 8790157 8790157 255976771 164407530 91569241 356576 336214 20362 215600487 182600256 33000231 9189842 5343052 3846790 137226781 Interest in investments held by Ascension Health Alliance Due from Affiliates 33012582 Estimated Third Party Payor Settlement 2939900 Other Assets 266394 Other receivables 692982 36911858 Intercompany debt to Ascension Health 111173917 Other Liabilities 92973 Estimated third party payables 3190231 Post retirement benefits Other Nocurrent Liabilities Due to Affiliates 40071206 Accrued Tax Liability 240632 Recovery Tail Liability 1295119 Valuation Allowance 343163 156407241 X Schedule D, Part X, Line 2 FIN 48 (ASC 740) footnote THE SYSTEM ACCOUNTS FOR UNCERTAINTY IN INCOME TAX POSITIONS BY APPLYING A RECOGNITION THRESHOLD AND MEASUREMENT ATTRIBUTE FOR FINANCIAL STATEMENT RECOGNITION AND MEASUREMENT OF A TAX POSITION TAKEN OR EXPECTED TO BE TAKEN IN A TAX RETURN. THE SYSTEM HAS DETERMINED THAT NO MATERIAL UNRECOGNIZED TAX BENEFITS OR LIABILITIES EXIST AS OF JUNE 30, 2017. true true X true X 250 true X 327 true true true false true true 11582385 0 11582385 0.0288 36240556 34683555 1557001 0.0039 0 0 0 0.0 0 0 47822941 34683555 13139386 0.0327 37 123 986016 986016 0.0025 4 96 521266 139384 381882 0.0009 2 2263 2263 0.0000 3 173710 173710 0.0004 5 3 17778 17778 0.0000 51 222 1701033 139384 1561649 0.0039 51 222 49523974 34822939 14701035 0.0366 2 1137 1137 0.0000 3 5589 5589 0.0000 17 28351 28351 0.0001 0 0.0 5 17453 17453 0.0000 0 0.0 0 0.0 1 86578 86578 0.0002 1 3364 3364 0.0000 29 0 142472 0 142472 0.0004 false 3104098 0 154373032 164946234 -10573202 X true true 1 1 St Vincent's Birmingham 810 St Vincents Drive Birmingham AL 35205 http://www.stvhs.com/BIRMINGHAM/ H3714 X X X St Vincent's Birmingham 1 false false true X X X X X X X X 15 true true false true X http://www.stvhs.com/chassessment/CHNA_Jefferson_Shelby.pdf X true 15 true http://www.stvhs.com/chassessment/CHNA_Jefferson_Shelby.pdf false true X 250.0 327.0 X X X true true X X X X true X http://www.stvhs.com/financialpolicy.asp X http://www.stvhs.com/financialpolicy.asp X http://www.stvhs.com/financialpolicy.asp X X X X true X false X X X X true X false false Schedule H, Part V, Section B, Line 5 Facility , 1 Facility , 1 - St. Vincent's Birmingham. To prepare the CHNA report, data was gathered from multiple sources in an effort to construct a current and accurate snapshot of the health issues in Blount County, Alabama. Data was obtained from multiple public data bases and opinions were solicited from public health experts, community leaders and patients within the community served by St. Vincent's Birmingham Hospital. This information was summarized for final consideration by a CHNA team consisting of Hospital and System personnel as well as community leaders. Schedule H, Part V, Section B, Line 6a Facility , 1 Facility , 1 - St. Vincent's Birmingham. The hospital conducted its CHNA in conjunction with other St. Vincent Hospitals, St. Vincent's East, St. Vincent's Health System and St. Vincent's One Nineteen Health & Wellness. Schedule H, Part V, Section B, Line 11 Facility , 1 Facility , 1 - St Vincent's Birmingham. Community Health Needs Assessment Implementation Plan Narrative FY17 Update- St. Vincent's Birmingham Hospital The identified community health needs for the defined service area of St. Vincent's Birmingham for FY17 - FY19: 1. Access to Healthcare and Mental Healthcare 2. Cancer Awareness/Prevention/Education 3. Cardiovascular Disease Awareness/Prevention/Education Prioritized Need: Improved Access to Healthcare including Mental Healthcare GOAL 1: Increase proportion of persons with health insurance coverage St. Vincent's Birmingham has a long history of working with individuals who are uninsured to be able to provide healthcare and mental healthcare services. The Access to Care program is a primary care provider program for individuals living less than 200% income over the federal poverty level. In partnership with Enroll Alabama, St. Vincent's encouraged individuals to sign up for healthcare exchanges and publicized benefits of the Affordable Care Act. To address this need in FY17, STVHS heavily advocated for Medicaid expansion in the state of Alabama at the legislative level. Efforts were made to assist individuals in the community with connecting to coverage through the open enrollment period of healthcare exchange in collaboration with Enroll Alabama. Enrollment days were promoted and hosted at STVHS facility locations. GOAL 2: Increase proportion of persons reporting medical home (primary care provider) STVHS hosted community health screenings include documentation on primary care provider and follow up includes referral and assistance with locating appropriate services for the patient who is unattached. A document was developed and is being distributed to the community on the levels of care and importance of a primary care home. Follow up is being provided both inpatient and outpatient to assist individuals with connecting to a primary care provider. Transportation services have been established with Lyft to assist patients in getting to follow up and primary care appointments. Project Access, a community collaborative for specialty care, works with individuals who are in need of a primary care provider but also have specialty care needs. Preparations were made for a more formalized primary care connection program for unattached patients to be implemented in FY18. GOAL 3: Increase proportion of adults with mental health disorders who receive treatment. The addition of the Outpatient Bridge clinic at St. Vincent's East provides the entire region a quick linkage to individuals in need of urgent mental health services as they wait to be connected with a more permanent provider. In FY17, the Bridge Clinic provided services to 185 unique patients who did not have a mental healthcare provider. A mental healthcare provider roundtable of community organizations/agencies meets regularly to identify gaps in service and provide updates and information on services available in the community. A mental health provider resource is available to youth through the establishment of the referral center at Children's Hospital. Similar resource for adults is being coordinated through the state's 2-1-1 service at United Way. A SPOE (single point of entry) for mental health is being evaluated at the local and state level. A physician CME class was provided on psychiatric disorders as well as a session on substance abuse to assist medical staff in understanding and identifying mental health needs of patients. GOAL 4: Increase depression screening for adults by primary care providers All AMG physician practices have implemented the PHQ-9 depression/anxiety screening for new and annual patient visits. Individuals with a qualifying score are referred for services. Other affiliated practices are providing PHQ-9 screenings as well. Prioritized Need: Improve education/awareness/prevention of cancer GOAL 1: Increase proportion of adults who were counseled by their providers about cancer screenings based on current guidelines Plans are currently underway to provide more physician education regarding cancer screening guidelines. Clinical prompts are part of the Electronic Health Record. CME topics for education of physicians specific to cancer are upcoming for FY18 and FY19. GOAL 2: Increase proportion of adults who receive breast, lung, prostate, colorectal and skin cancer screening St. Vincent's clinic patients had a baseline colorectal cancer screening rate of 36.5% and this was increased in FY17 to 47.4%. Specifically for Medicaid patients, the baseline began at 43% and increased to 49.7% in FY17. In March of 2017, St. Vincent's East campus worked with East Family Resident Clinic to provide 100 FIT test kits (colorectal cancer) to the community. Of those, 21 were returned and as a result, 6 colonoscopies were performed. In CY 2015, approximately 59% of St. Vincent's clinic patients were screened for breast cancer. In CY2016, that number increased to 60%. GOAL 3: Increase mental and physical health-related quality of life indicators of cancer survivors. St. Vincent's participation and close partnership with Forge provides support and services to individuals who have experienced breast cancer. A 24 hour support line has been established to provide counseling and referrals, support groups and activities that promote healthy living have engaged survivors. Patient advocates/navigators assist patients with supportive services. A resource library is available to individuals in need of additional information. A clinician advisory committee provides clinical feedback to survivor network. Prioritized Need: Improve education/awareness/prevention of cardiovascular disease GOAL 1: Increase the proportion of adults with elevated LDL cholesterol who have been advised by a health care provider regarding cholesterol-lowering management, including lifestyle changes and, if indicated, medication In FY17, St. Vincent's Wellness department provided 383 free LDL level screenings to the community - especially focused on areas where healthcare access is a barrier. These individuals were provided counseling and abnormal results were called by a nurse from Dial-A-Nurse to discuss the results and assistance with locating a provider who could provide continued care and treatment. GOAL 2: Increase the proportion of adults who have had their blood pressure measured within the preceding 2 years and can state whether their blood pressure was normal or high In FY17, St. Vincent's Wellness department provided 1168 free blood pressure screenings in the community, focused on areas in which healthcare access is a barrier for care. All individuals screened for blood pressure were provided counseling and abnormal results were called by a nurse from Dial-A-Nurse to discuss the results and assistance with locating a provider who could provide continued care and treatment. GOAL 3: Increase the proportion of adults aged 20 years and older who are aware of the symptoms of and how to respond to a heart attack In FY17, St. Vincent's Wellness trained 1866 community members on bystander CPR hands only method. Schedule H, Part V, Section B, Line 11 Facility , 2 Facility , 2 - St. Vincent's Birmingham. *Proposed goals are taken from Healthy People 2020 goals **Proposed strategies are based on evidence based practices The CHNA for fiscal years 2017-2019 (beginning July 1, 2016) will continue efforts to address health needs of the greater Birmingham community and prioritize needs of the areas St. Vincent's Birmingham. The assessments of unmet health needs will provide a basis for addressing the health needs of the counties served and serve as a reference for each facility's implementation strategy, ensuring it is aligned with the community needs and the ministry goals of St. Vincent's Health System. The mission, vision, and values of St. Vincent's Health System are the key factors influencing the approach and commitment to addressing community health needs through community benefit activity. The objectives of the CHNA and subsequent facility specific implementation strategies are: 1.) To provide an unbiased comprehensive assessment of Jefferson and Shelby County's health needs; 2.) Use the CHNA to prioritize St. Vincent's Health System's Community Benefit Program strategy; and 3.) Fulfill Internal Revenue Service regulations related to 501 (c)(3) non-profit hospital status for federal income taxes. All Needs identified in the CHNA are actively being addressed. Blount/St. Clair/Chilton Prioritized Need: Improve education/awareness/prevention of diabetes GOAL 1: Increase proportion of persons with diabetes whose condition has been diagnosed. St. Vincent's Wellness services provides community and corporate glucose screenings. In FY17, St. Vincent's provided 483 free glucose screenings to the community, especially areas where access to healthcare is a barrier. Of individuals screened, all are provided counseling and abnormal results are referred to Dial-A-Nurse for follow-up. GOAL 2: Increase proportion of adults diagnosed with diabetes who receive formal diabetes education. Schedule H, Part V, Section B, Line 13 Facility , 1 Facility , 1 - St. Vincent's Birmingham. Partial financial assistance can be granted for those individuals that fall above the FPG. A sliding scale is used to determine the financial assistance amount. For instance if the income level is at 250% then the partial assistance is 90% of the total bill or Best Payor rate, whichever is less. 1 Access to Care Network 810 St Vincents Drive POB 1-Ste105 Birmingham AL 35205 Medical Clinic Schedule H, Part I, Line 3c OTHER CRITERIA FOR DETERMINING FREE OR DISCOUNTED CARE Partial financial assistance can be granted for those individuals that fall above the FPG. A sliding scale is used to determine the financial assistance amount. For instance if the income level is at 200% then the partial assistance is 90% of the total bill or Best Payor rate, whichever is less. Schedule H, Part VI, Line 5 CONTINUED Promotion of health and wellness is an integrated part of the St. Vincent's culture. Health screenings, education and follow-up in the broader community bring awareness and learning to individuals who might not otherwise receive care. In addition to community screenings, St. Vincent's has traditionally focused outreach on areas for systemic change such as the implementation of community vegetable gardens to promote healthy eating and collection of P.E. equipment for local schools. St. Vincent's associates volunteer as P.E. helpers to encourage the healthy habits of exercise for elementary school students. With the assistance of athletic trainers, St. Vincent's assists with the promotion of safe athletics to ensure students do not injure themselves at such a young age. Sports physicals for students who would not otherwise have access are also part of the community health outreach. In collaboration with the greater community, St. Vincent's provides medical care, pharmaceuticals, vaccines, wound care and foot care at Project Homeless Connect, a one-day blitz of services for individuals in the community experiencing homelessness. St. Vincent's also provides healthy snacks for participants and volunteers at the event. St. Vincent's East and Christ Health Center (a local Federally Qualified Health Center), created a high-level of clinical integration to improve health equity in 49 zip codes by increasing access to primary care and mental health services for almost 12,000 low to moderate income individuals. St. Vincent's continues to care for the community through extensive collaboration such as with the Forge initiative. This breast cancer survivorship program provides a 24/7 hotline for support, peer mentors, support groups and other resources to breast cancer survivors and their caregivers. Housed at St. Vincent's and led by the Health System, this initiative successfully brought together ALL the major healthcare providers in the region to rally around one cause. St. Vincent's provides in-kind office space and support for the Forge staff. We Are Called To: - Service of the Poor - Generosity of spirit, especially for persons most in need - Reverence - Respect and compassion for the dignity and diversity of life - Integrity-Inspiring trust through personal leadership - Wisdom-Integrating excellence and stewardship - Creativity -Courageous innovation - Dedication - Affirming the hope and joy of our ministry. St. Vincent's Health System is made up of six facilities: St. Vincent's Birmingham, St. Vincent's Blount, St. Vincent's East, St. Vincent's St. Clair, St. Vincent's Chilton and One Nineteen Health and Wellness. Together, we provide a special brand of high-touch, high-tech quality care to people in more than 40 different zip codes. Our healthcare family has an extensive network of skilled physicians and associates, as well as the most advanced technologies available. We are a part of Ascension Health, the nation's largest Catholic and non-profit health system, with more than 150,000 associates serving in 23 states and the District of Columbia. We are committed to providing healthcare that works, healthcare that is safe, and healthcare that leaves no one behind for life. Schedule H, Part V, Section B, Line 17 Billing and Collection Policy During tax year 2017, the organization learned via verbal comments of IRS agents at public events that the IRS intends that the "readily obtainable" standard in the 501(r) regulations for the AGB calculation and billing and collection policy is only met if those items are posted to the organization's web site. The organization had interpreted that web posting standard to be a safe harbor after consulting with external counsel and tax advisors, and timely took other steps to make the information readily obtainable. Consequently, the organization does not believe its decision to not post these documents to its web site rises to the level of a failure, nor does it believe the circumstances were either willful or egregious, having otherwise timely taken the steps necessary to attain and continue to maintain compliance with the other requirements related to the billing and collection policy and the AGB, as part of its policies and procedures for ensuring compliance with all aspects of 501(r). However, the organization is making this voluntary disclosure in order to communicate to the IRS the changes it is undertaking in response to the recent IRS informal guidance on this specific point concerning the "readily obtainable" standard, and the fact that the organization has started the work necessary to post its AGB information and billing and collection policy to its web site and will complete those additional postings as soon as reasonably possible. The other web postings required under 501(r) (i.e., those related to the community health needs assessment and the financial assistance policy) were timely completed and continue to remain in place as required. The organization believes its safeguards worked as intended in this case (i.e., the organization has regular communications with a number of external law firms and tax consultants and the timely attention to the recent guidance was supported by the framework of regular access to subject matter experts). These changes are in the process of being incorporated into corporate policies and procedures that apply to the organization. Schedule H, Part I, Line 7 Costing Methodology used to calculate financial assistance The cost of providing charity care, means tested government programs, and community benefit programs is estimated using internal cost data, and is calculated in compliance with Catholic Health Association ("CHA") guidelines. The Organization uses a cost accounting system that addresses all patient segments (for example: inpatient, outpatient, emergency room, private insurance, Medicaid, Medicare, uninsured, or self pay), The best available data was used to calculate the amounts reported in the table. For the information in the table, a cost-to-charge ratio were calculated and applied. Schedule H, Part II Community Building Activities RESEARCH SHOWS THAT SOCIAL DETERMINANTS AND QUALITY OF LIFE PLAY A MAJOR ROLE IN THE HEALTH STATUS OF INDIVIDUALS AND COMMUNITIES. COMMUNITY BUILDING ACTIVITIES, WHICH FOCUS ON IMPROVING THE QUALITY OF LIFE WITHIN A COMMUNITY, ULTIMATELY INFLUENCE AND IMPROVE HEALTH STATUS. Schedule H, Part III, Line 2 Bad debt expense - methodology used to estimate amount After satisfaction of amounts due from insurance and reasonable efforts to collect from the patient have been exhausted, the Corporation follows established guidelines for placing certain past-due patient balances within collection agencies, subject to the terms of certain restrictions on collection efforts as determined by Ascension Health. Accounts receivable are written off after collection efforts have been followed in accordance with the Corporation's policies. After applying the cost-to-charge ratio, the share of the bad debt expense in fiscal year 2017 was $16,520,906 at charges, ($3,104,098 at cost). Schedule H, Part III, Line 4 Bad debt expense - financial statement footnote The organization is part of the Ascension Health Alliance's consolidated audit in which the footnote that discusses the bad debt expense is located on page 19. Schedule H, Part III, Line 8 Community benefit & methodology for determining medicare costs A cost to charge ratio is applied to the organization's Medicare Expense to determine the Medicare allowable costs reported in the organization's Medicare Cost Report. Ascension Health and its related health ministries follow the Catholic Health Association (CHA) guidelines for determining community benefit. CHA community benefit reporting guidelines suggest that Medicare shortfall is not treated as community benefit. Schedule H, Part III, Line 9b Collection practices for patients eligible for financial assistance St. Vincent's Health System follows the Ascension guidelines for collection practices related to patients qualifying for charity or financial assistance. A patient can apply for charity or financial assistance at any time during the collection cycle. Once qualifying documentation is received the patient's account is adjusted. Patient accounts for the qualifying patient in the previous six months may also be considered for charity or financial assistance. Once a patient qualifies for charity or financial assistance, all collection activity is suspended. Schedule H, Part V, Section B, Line 16a FAP website - St. Vincent's Birmingham: Line 16a URL: http://www.stvhs.com/financialpolicy.asp; Schedule H, Part V, Section B, Line 16b FAP Application website - St. Vincent's Birmingham: Line 16b URL: http://www.stvhs.com/financialpolicy.asp; Schedule H, Part V, Section B, Line 16c FAP plain language summary website - St. Vincent's Birmingham: Line 16c URL: http://www.stvhs.com/financialpolicy.asp; Schedule H, Part VI, Line 2 Needs assessment Our most recent community needs assessment was conducted in June 2016 by our parent company St. Vincent's Health System and was limited geographically to the seven counties served by St. Vincent's Health System. The assessment was completed by interviewing key stakeholders both within St. Vincent's Health Care System and in the external community. The interviews were conducted as of June 2016. Interviewees included a range of CBO's and program managers from area health care organizations, and more than 50 interviews were completed. The needs assessment consists of census data, public health information, and findings from the interviews. These findings include an assessment of the local healthcare infrastructure and the service gaps, especially in regards to those in our community who lack access to basic healthcare services. Schedule H, Part VI, Line 3 Patient education of eligibility for assistance St. Vincent's Birmingham uses visual aids to inform patients of available financial assistance. The statement of Patient Financial Services Financial Assistance is displayed at all registration areas throughout the Hospital, including the Emergency Department, to make patients aware that assistance is available. our staff, when discussing collections with patients, also makes patients aware of the available assistance if they are unable to pay. Schedule H, Part VI, Line 4 Community information ST. VINCENT'S HEALTH SYSTEM PRIMARILY SERVICES RESIDENTS OF CENTRAL ALABAMA IN THE FOLLOWING SEVEN COUNTIES: BLOUNT, CULLMAN, JEFFERSON, SHELBY, ST. CLAIR, TALLADEGA, AND WALKER. - OUR PRIMARY SERVICE AREA CONSISTS OF BOTH RURAL AND URBAN COMMUNITIES WITH A POPULATION OF 1,247,848; MEDIAN INCOME OF $53,007; AND MEDIAN AGE OF 39.27. - AGE OF POPULATION: 26.5% AGE 0-19, 30.9% AGE 20-44, 26.2% AGE 45-64, 16.4% AGE 65+. - SEX: 51.9% FEMALE AND 48.1% MALE. - ETHNICITY: 66.0% WHITE NON-HISPANIC, 28.4% BLACK NON-HISPANIC, 4.3% HISPANIC, 1.3% ASIAN NON-HISPANIC. - LANGUAGE: ENGLISH SPEAKING 94.4%, NON-ENGLISH AGE 5+ 5.6%. (population by language spoken at home) - THERE ARE 89 FEDERALLY DESIGNATED MEDICALLY UNDERSERVED AREAS (MUA'S) IN THE STATE AND 19.7% OF THE POPULATION IS ELIGIBLE FOR MEDICAID INSIDE THE SEVEN COUNTY SERVICE AREAS (U.S. Census Bureau American Community Survey - % of defined population enrolled in Medicaid) - INSURANCE COVERAGE BREAKDOWN IS 54% PRIVATE, 16% MEDICARE, 16% MEDICAID, AND 14% UNINSURED. - POVERTY: 17.21% ON AVERAGE IN POVERTY. RANGE IN 7 COUNTIES 8.3% TO 23.05%. (U.S. Census Bureau American Community Survey) - HOSPITALS IN SERVICE AREA: 16 TOTAL, 5 NONPROFIT, 10 FOR PROFIT, 1 ACADEMIC MEDICAL CENTER. - HEALTH STATISTICS - OBESITY: 33%. - LEADING CAUSES OF DEATH: HEART DISEASE, CANCER, STROKE Schedule H, Part VI, Line 5 Promotion of community health This report illustrates the significant degree to which St. Vincent's Health System, through its five hospitals and Health & Wellness facilities, contributes to the positive health status of the communities we serve. The System's five hospitals include St. Vincent's Birmingham, St. Vincent's East, St. Vincent's Blount, St. Vincent's Chilton and St. Vincent's St. Clair. Each hospital has a separate Tax ID number. Each makes an important contribution to caring for their community, including those who are underserved. As a member of Ascension Health, St. Vincent's Health System continues to build and strengthen sustainable collaborative efforts that benefit the health of individuals, families and the community as a whole. The Health System's mission is to extend the healing ministry of Christ. The hospitals of the health system further the mission through the delivery of patient services, care to the elderly and indigent, patient education, and health awareness programs for the community. Our concern for all human life and commitment to the dignity of each person leads us to provide medical services to all people in the community without regard to race, creed, national origin, economic status, or ability to pay. Based on our Core Values and in the spirit of principles adopted by Ascension Health, our Health System has taken proactive steps to address those issues that affect accessibility, the financing, and the delivery of health care to all persons, especially the uninsured, underinsured, and the underserved. The following chart demonstrates the significant number of patient days and the estimated unreimbursed cost of services provide by our four hospitals to the uninsured or underserved. FY17 Number of Licensed Beds - Number of Patient Days - Estimated unreimbursed Cost: St, Vincent's Birmingham - 439 - 100,916 - $13,121,637 St. Vincent's East - 357 - 97,052 - $ 12,641,722 St, Vincent's Blount - 25 - 4,705 - $ 386,475 St. Vincent's St. Clair - 40 - 7,138 - $ 2,340,574 St. Vincent's Chilton - 30 -2,680 - $2,190,670 Total - 891 - 212,491 - $30,681,078. St. Vincent's Heath System has a deep commitment to serving the community. We earmark a certain percentage of our yearly profits for charitable donations. Through this charitable donation program, we are able to support local chapters of national organizations such as the American Cancer Society, the American Heart Association, March of Dimes, and Susan G. Komen for the Cure, among others. We also fund local programs and initiatives such as the United Way. Many of our executives serve on the boards of these and other charitable organizations. We provide essential medical services to the community, train and recruit healthcare professionals to serve the needs of the broader community, provide appropriate charity services to those unable to pay for their health care needs, and provide services to other organizations that allow them to provide quality services to their patients or constituents. Some of these services include Jeremiah's Hope Academy, Hispanic Outreach Ministry, Access to Care program and Clergy Wellness program. Each of these programs works to address root causes of poverty including health disparities, barriers to care, employment, and healthcare, as well as mental healthcare, coverage. St. Vincent's Birmingham Jeremiah's Hope Academy focuses on training at-risk individuals, particularly women, for entry level jobs in the healthcare industry. Today, more than 500 people have graduated from Jeremiah's Hope, and most are still working in the healthcare industry. Employment is one of the many systemic ways to assist individuals out of poverty and create an intergenerational impact for families that is sustainable into the future. Philanthropy allowed this revolutionary program to blossom and it has now become a model for other healthcare facilities nationwide. In 2003, St. Vincent's Birmingham initiated a Hispanic Outreach program. This program has now evolved into a congregational health worker training program and a high-risk pregnancy coach program. With infant mortality a significant need in the State of Alabama, the high-risk pregnancy coach aims to address barriers for expectant mothers to go above and beyond traditional case management and provide culturally appropriate and effective care and guidance as patients navigate pre and post-natal care. The Access to Care Program is a healthcare option for the "working poor" in the Birmingham area, serving individuals who are employed but lack health insurance. The Clinic treats up to 500 unique patients each year, providing for all of their healthcare needs with modest co-pays to engage the patient in responsibility for care. St. Vincent's works with patients to identify ways to acquire insurance and screens patients based on a willingness to make life changes conducive to good health and advancement to work towards coverage in the future. Patients in this program are integrated into the St. Vincent's clinic network and taught how to navigate healthcare effectively. An RN health coach works especially with patients who have chronic illness and need additional assistance understanding plans of care and medications. The St. Vincent's Clergy Wellness Program works with local clergy leaders to develop a personal health and wellness plan and also a congregational health improvement plan to integrate into their faith communities. Clergy are disproportionately at risk for chronic and mental illnesses (more than the general population) and yet they hold positions of significant influence in the community. By assisting these leaders in integrating health and wellness into their daily lives, they are then encouraged to identify and implement a strategy to improve the overall health of their congregations as well. This systemic approach allows the program to reach thousands of individuals by proxy. St. Vincent's facilitates community roundtable initiatives to improve the overall health of the community as well. The Healthcare Provider Roundtable consists of healthcare providers from around the region who serve uninsured or underinsured patients and meets six times a year. The Mental Healthcare Provider Roundtable is comprised of providers across the continuum who provide care to the community in the mental health sector. They also meet six times a year (on the alternate months of the healthcare group). A Low-Cost Dental Provider Roundtable now meets quarterly to discuss dental needs in the community and identify potential areas for collaboration. The goal of these groups is not only to coordinate care but also to identify gaps and needs in the community and come together to find solutions to the needs that arise. It is attended by clinics, social service providers, practitioners, educational facilities and major health system representatives. St. Vincent's representatives also serve on various community health initiatives such as Jefferson County Health Action Partnership, United Way's Bold Goals and the Birmingham Mayor's city improvement work groups. St. Vincent's and Ascension have a strong presence in advocacy on behalf of the poor and vulnerable as well. With a Chief Advocacy Officer for Alabama, Ascension and St. Vincent's are actively seeking opportunities for policy and procedure change that will expand coverage, assist those who are providing care to the uninsured as well as looking at other ways to promote the health of the community. Examples of advocacy in these areas includes working with navigators to enroll Marketplace participants; developing new and enhanced relationships with community care partners and working with our state and federal lawmakers to ensure adequate reimbursement for the uninsured and underinsured. When the need arises, St. Vincent's is also quick to respond to community issues involving natural disasters. This is evidenced by collection and donation of items for hurricane, flood and tornado survivors as well as volunteer efforts to assist with those affected. In the past, St. Vincent's has provided tetanus shots and basic medical care in areas of need. Schedule H, Part VI, Line 6 Affiliated health care system As part of St. Vincent's Health System (The Health Ministry), St. Vincent's Birmingham is a member of Ascension Health Alliance ("The System"). Ascension Health Alliance is a Missouri nonprofit corporation formed on September 13, 2011. Ascension Health Alliance is the sole corporate member and parent organization of Ascension Health, a Catholic national health system consisting primarily of nonprofit corporations that own and operate local healthcare facilities, or Health Ministries, located in 23 of the united States and the District of Columbia. ASCENSION IS SPONSORED BY A PUBLIC JURIDIC PERSON. THE PARTICIPATING ORGANIZATIONS/ENTITIES OF ASCENSION SPONSOR ARE: THE DAUGHTERS OF CHARITY OF ST. VINCENT DE PAUL ST. LOUISE PROVINCE THE CONGREGATION OF ST. JOSEPH THE CONGREGATION OF THE SISTERS OF ST. JOSEPH OF CARONDELET THE CONGREGATION OF ALEXIAN BROTHERS OF THE IMMACULATE CONCEPTION PROVINCE - AMERICAN PROVINCE THE SISTERS OF THE SORROWFUL MOTHER OF THE THIRD ORDER OF ST. FRANCIS OF ASSISI - U.S./CARIBBEAN PROVINCE ASCENSION AND ITS MEMBER ORGANIZATIONS ARE HEREAFTER REFERRED TO COLLECTIVELY AS THE SYSTEM. THE SYSTEM DIRECTS ITS GOVERNANCE AND MANAGEMENT ACTIVITIES TOWARD STRONG, VIBRANT, CATHOLIC HEALTH MINISTRIES UNITED IN SERVICE AND HEALING, AND DEDICATES ITS RESOURCES TO SPIRITUALLY CENTERED CARE WHICH SUSTAINS AND IMPROVES THE HEALTH OF THE INDIVIDUALS AND COMMUNITIES IT SERVES. IN ACCORDANCE WITH THE SYSTEM'S MISSION OF SERVICE TO THOSE PERSONS LIVING IN POVERTY AND OTHER VULNERABLE PERSONS, EACH HEALTH MINISTRY ACCEPTS PATIENTS REGARDLESS OF THEIR ABILITY TO PAY. THE SYSTEM USES FOUR CATEGORIES TO IDENTIFY THE RESOURCES UTILIZED FOR THE CARE OF PERSONS LIVING IN POVERTY AND COMMUNITY BENEFIT PROGRAMS: TRADITIONAL CHARITY CARE INCLUDES THE COST OF SERVICES PROVIDED TO PERSONS WHO CANNOT AFFORD HEALTHCARE BECAUSE OF INADEQUATE RESOURCES AND/OR WHO ARE UNINSURED OR UNDERINSURED. UNPAID COST OF PUBLIC PROGRAMS, EXCLUDING MEDICARE, REPRESENTS THE UNPAID COST OF SERVICES PROVIDED TO PERSONS COVERED BY PUBLIC PROGRAMS FOR PERSONS LIVING IN POVERTY AND OTHER VULNERABLE PERSONS. COST OF OTHER PROGRAMS FOR PERSONS LIVING IN POVERTY AND OTHER VULNERABLE PERSONS INCLUDES UNREIMBURSED COSTS OF PROGRAMS INTENTIONALLY DESIGNED TO SERVE THE PERSONS LIVING IN POVERTY AND OTHER VULNERABLE PERSONS OF THE COMMUNITY, INCLUDING SUBSTANCE ABUSERS, THE HOMELESS, VICTIMS OF CHILD ABUSE, AND PERSONS WITH ACQUIRED IMMUNE DEFICIENCY SYNDROME. COMMUNITY BENEFIT CONSISTS OF THE UNREIMBURSED COSTS OF COMMUNITY BENEFIT PROGRAMS AND SERVICES FOR THE GENERAL COMMUNITY NOT SOLELY FOR THE PERSONS LIVING IN POVERTY, INCLUDING HEALTH PROMOTION AND EDUCATION, HEALTH CLINICS AND SCREENINGS, AND MEDICAL RESEARCH. DISCOUNTS ARE PROVIDED TO ALL UNINSURED PATIENTS, INCLUDING THOSE WITH THE MEANS TO PAY. DISCOUNTS PROVIDED TO THOSE PATIENTS WHO DID NOT QUALIFY FOR ASSISTANCE UNDER CHARITY CARE GUIDELINES ARE NOT INCLUDED IN THE COST OF PROVIDING CARE OF PERSONS LIVING IN POVERTY AND OTHER COMMUNITY BENEFIT PROGRAMS. THE COST OF PROVIDING CARE TO PERSONS LIVING IN POVERTY AND OTHER COMMUNITY BENEFIT PROGRAMS IS ESTIMATED BY REDUCING CHARGES FORGONE BY A FACTOR DERIVED FROM THE RATIO OF EACH ENTITY'S TOTAL OPERATING EXPENSES TO THE ENTITY'S BILLED CHARGES FOR PATIENT CARE. true American Sports Medicine Institute 2660 10th Avenue South Birmingham AL 35205 630952490 501(C)(3) 2276893 OPERATING SUPPORT ALA EDU FOUND & INDIAN SPRINGS SCHOOL 190 Woodward Drive Pelham AL 35124 631000137 501(c)(3) 9000 OPERATING SUPPORT Vestavia Hills Board of Education 1204 Montgomery Hwy Birmingham AL 35216 630590762 GOV'T ENTITY 47000 OPERATING SUPPORT TRUSSVILLE CITY BOARD OF EDUCATION 113 N CHALKVILLE ROAD TRUSSVILLE AL 35178 630595540 GOV'T ENTITY 60500 OPERATING SUPPORT MOUNTAIN BROOK HIGH SCHOOL 3650 BETHUNE DRIVE BIRMINGHAM AL 35223 631076010 GOV'T ENTITY 59000 OPERATING SUPPORT AMERICAN CANCER SOCIETY MIDWEST DIVISION 1080 MONTREAL AVE SAINT PAUL MN 55116 410724036 501(C)(3) 10000 OPERATING SUPPORT BESSEMER ACADEMY 1705 5TH AVE SW BESSEMER AL 35022 630521463 501(C)(3) 13250 OPERATING SUPPORT BRIARWOOD PRESBYTERIAN CHURCH 400 OFFICE PARK DR STE 210 BIRMINGHAM AL 35223 630653634 501(C)(3) 43350 OPERATING SUPPORT CITY OF PELHAM BOARD OF EDUCATION 3113 CUMMINGS ST PELHAM AL 35124 636000764 GOV'T ENTITY 22000 OPERATING SUPPORT HOMEWOOD CITY BOARD OF EDUCATION 1901 S LAKESHORE DR BIRMINGHAM AL 35209 630586314 GOV'T ENTITY 35000 OPERATING SUPPORT JEFFERSON COUNTY BOARD OF EDUCATION 2100 18TH ST S BIRMINGHAM AL 35209 636000945 GOV'T ENTITY 26000 OPERATING SUPPORT MARCH OF DIMES FOUNDATION PO BOX 932852 ATLANTA GA 31193 131846366 501(C)(3) 7000 OPERATING SUPPORT PELL CITY SCHOOL SYSTEM 1300 COGWELL AVE PELL CITY AL 35125 630828429 GOV'T ENTITY 10000 OPERATING SUPPORT THE ALTAMONT SCHOOL 4801 ALTAMONT RD S BIRMINGHAM AL 35222 630302110 501(C)(3) 8500 OPERATING SUPPORT AMERICAN HEART ASSOCIATION INC 1449 Medical Park Dr Birmingham AL 35213 135613791 501(C)(3) 5000 OPERATING SUPPORT LEUKEMIA & LYMPHOMA SOCIETY INC 100 Chase Park S Suite 200 Birmingham AL 35244 135644916 501(C)(3) 5000 OPERATING SUPPORT THE SUSAN G KOMEN BREAST CANCER FOUNDATION 2323 Crestmoor Road Nashville TN 37215 751835298 501(C)(3) 5000 OPERATING SUPPORT 17 0 Schedule I, Part I, Line 2 Procedures for monitoring use of grant funds. The Associate Allocations Committee consists of 8-16 members who are appointed by the Chief Operating Officer (COO) of St. Vincent's Health system. The Committee is authorized to expend resources of the St. Louise/Help Fund, however expenditures will not exceed the budgeted amount. The Committee has the following allocation options: Award - Any part of the approved allocation will not be required to be paid back. Denial - Associate's request is denied. The Committee meets every two (2) weeks opposite payroll weeks unless otherwise necessary. X true true true true false false false false false false false NEEYSA C BIDDLE SVP ASCENSION HEALTH/BIRMINGHAM MARKET EXECUTIVE/PRESIDENT CEO - STVHS 0 593188 0 503787 0 262857 0 15900 0 11049 0 1386781 0 0 DAVID A CAUBLE FORMER OFFICER (END 11/2015) 0 0 0 0 0 397069 0 0 0 10428 0 407497 0 0 GREGORY L JAMES MD FORMER OFFICER (END 2/2016) 0 464632 0 273898 0 99789 0 14575 0 19012 0 871906 0 0 CAROL A MAIETTA FORMER OFFICER (END 1/2016) 0 13389 0 0 0 278874 0 1130 0 6368 0 299761 0 0 JOHN D O'NEIL FORMER OFFICER (END 9/2014) 0 0 0 0 0 989122 0 0 0 9790 0 998912 0 539012 WILLIAM A DAVIS CHIEF OPERATING OFFICER 0 387953 0 181073 0 73727 0 15900 0 24514 0 683167 0 0 STEPHANIE J DUGGAN MD CCO-Mnstry Mkt Brmnghm (START 7/2016) 0 421849 0 81654 0 58549 0 14576 0 24103 0 600731 0 0 JENNIFER L KINGRY CFO 0 256682 0 42821 0 36986 0 17225 0 22076 0 375790 0 0 NAN M PRIEST EVP/CHIEF STRATEGY OFFICER 0 296663 0 138073 0 141387 0 17225 0 16543 0 609891 0 43413 SUZANNAH CAMPBELL FORMER KEY EMPLOYEE (END 11/2015) 0 184965 0 12231 0 17995 0 11479 0 2110 0 228780 0 0 JANITH GANNON VP SURGICAL SERVICES 155074 0 16185 0 129845 0 9209 0 9748 0 320061 0 0 0 ROBERT E RAY PRESIDENT - BIRMINGHAM 320282 0 26859 0 60741 0 14575 0 22068 0 444525 0 0 0 SHANNON SCATURRO VP-Clinical Operations (START 8/2016) 68495 132109 50536 0 12856 6422 4973 6580 7296 14441 144156 159552 0 0 AMY R SHELTON VP Nursing (START 7/2016) 178937 0 11487 0 23402 0 9853 0 22451 0 246130 0 0 0 Tessa R Bagala Physicist 149787 0 5000 0 118 0 7331 0 15736 0 177972 0 0 0 Brian Kevin Mader Planning & Dvlpmnt Physicist 215425 0 8667 0 12125 0 14164 0 22797 0 273178 0 0 0 Jane Martin Mckinney Clinical Staff Pharmacist 149749 0 0 0 7128 0 6340 0 12946 0 176163 0 0 0 Dianne Walters Norris Mgr-Medication Safety 84550 0 8802 0 64100 0 5907 0 5654 0 169013 0 0 0 Cheryl Rutledge Admin Dir-Nrsg Practice & Fin 128326 0 5523 0 29121 0 9395 0 15983 0 188348 0 0 0 Schedule J, Part I, Line 1a Health or social club dues or initiation fees St. Vincent's Health System, a related organization, provides membership to The Summit Club and Vestavia Country Club for members of the executive team, as well as, Rotary and Kiwanis Club memberships for various members of the management team to facilitate networking and community benefit related to St. Vincent's Health System. Schedule J, Part I, Line 3 Arrangement used to establish the top management official's compensation Ascension Health, Inc., a related organization of St. Vincent's Birmingham uses the following to establish the compensation of the organization's CEO: - Compensation Committee - Independent Compensation Consultant - Compensation Survey or Study - Approval by the Board or Compensation Committee Schedule J, Part I, Line 4a Severance or change-of-control payment The following individual(s) received severance payments from the organization or a related organization: John O'Neil - $450,110 David Cauble - $397,069 Carol Maietta - $226,157 Schedule J, Part I, Line 4b Supplemental nonqualified retirement plan Eligible executives participate in a program that provides for supplemental retirement benefits. The payment of benefits under the program, if any, is entirely dependent upon the facts and circumstances under which the executive terminates employment with the organization. Benefits under the program are unfunded and non-vested. Due to the substantial risk of forfeiture provision, there is no guarantee that these executives will ever receive any benefit under the program. Any amount ultimately paid under the program to the executive is reported as compensation on Form 990, Schedule J, Part II, Column B in the year paid. The following individuals received payment from the supplemental nonqualified retirement plan in the amount as noted: John D. O'Neil - $539,012 Nan M. Priest - $43,413 SOUTHVIEW MEDICAL GROUP Dr. Joseph Weldon, Jr (Board Member) is PRESIDENT 149844 MEDICAL DIRECTOR FEES, CALL COVERAGE false CASH ACCOUNTS TRANSFERED TO PARENT'S BALANCE SHEET 2017-06-30 78697953 FMV 630931008 ST VINCENT'S HEALTH SYSTEM 810 ST VINCENTS DRIVE BIRMINGHAM AL 35205 501(C)(3) false false false false Schedule N, Part I, Line 2 CASH TRANSFER ST. VINCENT'S BIRMINGHAM TRANSFERED THEIR CASH BALANCES TO ST. VINCENT' S HEALTH SYSTEM (63-0931008) DURING FY 2017. Form 990, Part VI, Line 15a PROCESS TO ESTABLISH COMPENSATION OF TOP MANAGEMENT OFFICIAL IN DETERMINING THE COMPENSATION OF THE ORGANIZATION'S CEO, THE PROCESS, PERFORMED BY ASCENSION HEALTH, A RELATED ORGANIZATION OF ST. VINCENT'S BIRMINGHAM, INCLUDED A REVIEW AND APPROVAL BY INDEPENDENT PERSONS, COMPARABILITY DATA AND CONTEMPORANEOUS SUBSTANTIATION OF THE DELIBERATION AND DECISION. THE COMPENSATION COMMITTEE REVIEWED AND APPROVED THE COMPENSATION. IN THE REVIEW OF THE COMPENSATION, THE CEO WAS COMPARED TO INDIVIDUALS AT OTHER ORGANIZATIONS IN THE AREA WHO HOLD THE SAME TITLE. DURING THE REVIEW AND APPROVAL OF THE COMPENSATION, DOCUMENTATION OF THE DECISION WAS RECORDED IN THE COMMITTEE MINUTES. THE INDIVIDUAL WAS NOT PRESENT WHEN HIS COMPENSATION WAS DECIDED. Form 990, Part VI, Line 15b PROCESS TO ESTABLISH COMPENSATION OF OTHER OFFICERS OR KEY EMPLOYEES IN DETERMINING COMPENSATION OF THE ORGANIZATION'S OFFICERS, THE PROCESS PERFORMED BY ST. VINCENT'S HEALTH SYSTEM, A RELATED ORGANIZATION OF ST. VINCENT'S BIRMINGHAM, INCLUDED A REVIEW AND APPROVAL BY INDEPENDENT PERSONS, COMPARABILITY DATA, AND CONTEMPORANEOUS SUBSTANTIATION OF THE DELIBERATION AND DECISION. THE ST. VINCENT'S HEALTH SYSTEM EXECUTIVE COMPENSATION COMMITTEE REVIEWED AND APPROVED THE COMPENSATION. IN THE REVIEW OF THE COMPENSATION, THE OFFICERS' SALARIES WERE COMPARED TO INDIVIDUALS AT OTHER ORGANIZATIONS IN THE AREA WHO HOLD THE SAME TITLE. DURING THE REVIEW AND APPROVAL OF THE COMPENSATION, DOCUMENTATION OF THE DECISION WAS RECORDED IN THE MINUTES. INDIVIDUALS WERE NOT PRESENT WHEN THEIR COMPENSATION WAS DECIDED. Form 990, Part VI, Line 5 Diversion of organization assets In May 2017, a settlement from the Great American Insurance Company was received related to a theft in the Orthopedic Surgery location that spanned back to September 2013. The theft was an inventory based loss that resulted in $2,553,518 in additional expense related to shrinkage. Once the theft was investigated, the associate terminated and is no longer employed by the health system. Such theft would be easily identified going forward by unusual changes in inventory expense not associated with volumes. The Orthopedic Surgery location is on a perpetual inventory system and cycle counts occur daily in this area. Form 990, Part VI, Line 6 Classes of members or stockholders St. Vincent's Birmingham has a single corporate member, St. Vincent's Health System. Form 990, Part VI, Line 7a Members or stockholders electing members of governing body St. Vincent's Birmingham has a single corporate member, St. Vincent's Health System, who has the ability to elect members to the governing body of St. Vincent's Birmingham. Form 990, Part VI, Line 7b Decisions requiring approval by members or stockholders All decisions that have a material impact to St. Vincent's Birmingham's financial information or the corporation as a whole, are subject to approval by its sole corporate member, St. Vincent's Health System. Form 990, Part VI, Line 8b Documentation of meetings held by committees of governing body There are no separate committees that have the authority to act on behalf of the governing body for St. Vincent's Birmingham. Form 990, Part VI, Line 11b Review of form 990 by governing body DURING THE RETURN PREPARATION PROCESS, THE TAX DEPARTMENT WORKS WITH OTHER FUNCTIONAL AREAS INCLUDING FINANCE, ACCOUNTING, TREASURY, LEGAL, HUMAN RESOURCES, AND CORPORATE COMPLIANCE FOR ADVICE, INFORMATION AND ASSISTANCE IN ORDER TO PREPARE A COMPLETE AND ACCURATE RETURN. UPON COMPLETION, THE FORM 990 IS REVIEWED BY THE ORGANIZATION'S INTERNAL TAX DEPARTMENT WHICH CONSISTS OF ATTORNEYS AND CPAS. A COMPLETE FINAL COPY OF THE RETURN IS PROVIDED TO THE ORGANIZATION'S PRESIDENT, FINANCIAL OFFICER, AND/OR OTHER KEY OFFICERS IN LIEU OF THE FULL BOARD. Form 990, Part VI, Line 12c Conflict of interest policy The organization regularly and consistently monitors and enforces compliance with the conflict of interest policy in that any director, principal officer, or member of a committee with governing board delegated powers, who has a direct or indirect financial interest, must disclose the existence of the financial interest and be given the opportunity to disclose all material facts to the directors and members of the committees with governing board delegated powers considering the proposed transaction or arrangement. The remaining individuals on the governing board or committee will decide if conflicts of interest exist. Each director, principal officer and member of a committee with governing board delegated powers annually signs a statement which affirms such person has received a copy of the conflicts of interest policy, has read and understands the policy, has agreed to comply with the policy, and understands that the organization is charitable and in order to maintain its federal tax exemption it must engage primarily in activities which accomplish its tax-exempt purpose. Form 990, Part VI, Line 19 Required documents available to the public The Organization will provide any documents open to public inspection upon request. Form 990, Part VIII, Line 11d Other Miscellaneous Revenue Other Revenue - Total Revenue: 642642, Related or Exempt Function Revenue: , Unrelated Business Revenue: , Revenue Excluded from Tax Under Sections 512, 513, or 514: 642642; Form 990, Part XI, Line 9 Other changes in net assets or fund balances Transfers to/from affiliates - -94552763; Form 990, Part XII, Line 2b AUDITED FINANCIAL STATEMENTS The activity of St. Vincent's Birmingham is reported in the consolidated financial statements of Ascension Health Alliance. No individual audit of St. Vincent's Birmingham is completed. Therefore, the attached audited financial statements are of Ascension Health Alliance and Affiliates, which include the activity of St. Vincent's Birmingham. Form 990, Part XII, Line 2c AUDIT COMMITTEE St. Vincent's Birmingham is included in the consolidated financial statements of Ascension Health Alliance. The Finance and Audit committee of Ascension Health Alliance's Board assumes responsibility for the consolidated organization as a whole. 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