2017-11-06T16:42:02-06:00 2016-12-31 346565596 ERNST & YOUNG US LLP 370 17TH STREET 3300 DENVER CO 80202 990 2016-01-01 237379161 SISTERS OF CHARITY OF LEAVENWORTH HEALTH SYSTEM INC SIST 3038135190 500 ELDORADO BLVD SUITE 4300 BROOMFIELD CO 80021 LYDIA JUMONVILLE PRESIDENT & CEO/CFO 3038135190 2017-11-06 0 KELLEY SIMON P00791436 7209314000 170.188.5.33 2017-11-06 15:41:18 MS P D592015B8FE208EA5042194ABEAF8E5B275B46FB D592015B8FE208EA5042194ABEAF8E5B275B46FB 2016 2017-02-10 21:41:12Z LYDIA JUMONVILLE 500 ELDORADO BLVD SUITE 4300 BROOMFIELD CO 80021 464201432 0 X WWW.SCLHEALTH.ORG X 1972 KS WE REVEAL AND FOSTER GOD'S HEALING LOVE BY IMPROVING THE HEALTH OF THE PEOPLE AND COMMUNITIES WE SERVE, ESPECIALLY THOSE WHO ARE POOR AND VULNERABLE. 20 19 2954 0 -1688251 -1962849 1844653 2510868 374990782 423557861 65683477 27121930 8549478 8554927 451068390 461745586 15517172 5917019 0 0 223489307 261229095 0 0 0 297828263 324602026 536834742 591748140 -85766352 -130002554 2439912230 2405899688 2972946859 2302998525 -533034629 102901163 X WE REVEAL AND FOSTER GOD'S HEALING LOVE BY IMPROVING THE HEALTH OF THE PEOPLE AND COMMUNITIES WE SERVE, ESPECIALLY THOSE WHO ARE POOR AND VULNERABLE. 0 0 575582607 5917019 431973750 SISTERS OF CHARITY OF LEAVENWORTH HEALTH SYSTEM, INC. (SCL HEALTH) IS A FAITH-BASED, NONPROFIT HEALTHCARE ORGANIZATION THAT OPERATES NINE HOSPITALS, TWO SAFETY NET CLINICS, ONE CHILDREN'S MENTAL HEALTH CENTER AND MORE THAN 190 AMBULATORY SERVICE CENTERS IN THREE STATES - COLORADO, KANSAS AND MONTANA. THE HEALTH SYSTEM INCLUDES 15,000 FULL-TIME ASSOCIATES AND MORE THAN 500 EMPLOYED PROVIDERS.BASED IN DENVER, THE HEALTH NETWORK IS DEDICATED TO IMPROVING THE HEALTH OF THE COMMUNITIES AND INDIVIDUALS IT SERVES, ESPECIALLY THOSE WHO ARE POOR AND VULNERABLE. IN 2016, SCL HEALTH CONTRIBUTED $257 MILLION IN COMMUNITY BENEFIT, INCLUDING SERVICES FOR THE POOR, HEALTH SCREENINGS, EDUCATIONAL PROGRAMS, COMMUNITY DONATIONS AND RESEARCH.SCL HEALTH WAS FOUNDED BY THE SISTERS OF CHARITY OF LEAVENWORTH (SCL), WHO TRACE THEIR ORIGIN AS A RELIGIOUS COMMUNITY TO THE 1600S IN FRANCE, WHERE VINCENT DE PAUL AND LOUISE DE MARILLAC ESTABLISHED THE DAUGHTERS OF CHARITY. THESE WOMEN WERE DEDICATED TO SERVING THE SICK AND POOR THROUGH AN ACTIVE MINISTRY.IN 1857, A SMALL CONGREGATION OF SISTERS FROM NASHVILLE, TENN., LED BY MOTHER XAVIER ROSS, VENTURED TO THE EDGE OF AN EXPANDING FRONTIER IN THE THEN-INDIAN TERRITORY OF KANSAS. THEY OPENED THE FIRST PRIVATE HOSPITAL IN THE STATE IN 1864, WITH THE FIRST TRAINED NURSE IN THE STATE AND SURELY THE FIRST WOMAN IN THE WESTERN TERRITORY TO RUN A HOSPITAL. IN 1873, THE SISTERS FOUNDED WHAT IS NOW SAINT JOSEPH HOSPITAL IN DENVER, THE OLDEST PRIVATE TEACHING HOSPITAL IN COLORADO, AND ONE OF THE FIVE COLORADO HOSPITALS OF SCL HEALTH.SCL HEALTH WAS FORMED IN 1972 TO STRENGTHEN AND UNIFY THE HEALTHCARE FACILITIES SPONSORED BY SCL. IN 2011, THE SISTERS TRANSFERRED SPONSORSHIP OF SCL HEALTH TO LEAVEN MINISTRIES. OUR ORGANIZATION'S RICH HERITAGE AND ENDURING LEGACY SERVE AS THE FOUNDATION FOR OUR HEALTH MINISTRY TODAY, AND OUR MISSION, VISION AND VALUES SERVE AS THE FRAMEWORK FOR OUR SUCCESS.SISTERS OF CHARITY OF LEAVENWORTH HEALTH SYSTEM, INC. (SCLHS) IS THE PARENT CORPORATION OF A LARGE HOSPITAL AND HEALTHCARE SYSTEM. SCLHS IS THE MANAGEMENT COMPANY PROVIDING CENTRALIZED SERVICES FOR ALL SCL HEALTH SUBSIDIARIES.SCLHS PERFORMS NUMEROUS COORDINATED AND CENTRALIZED SERVICES FOR THE ENTITIES & CARE SITES THAT COMPRISE ITS SYSTEM, SUCH AS ADMINISTERING FINANCING & CAPITAL FORMATION PROGRAMS, ETHICAL & RELIGIOUS DIRECTION, FINANCIAL REPORTING, TAX SERVICES, HUMAN RESOURCES FUNCTIONS INCLUDING EXECUTIVE RECRUITING & ADMINISTERING & MAINTAINING WELFARE, BENEFIT & RETIREMENT PLANS, INFORMATION TECHNOLOGY SERVICES INCLUDING ELECTRONIC MEDICAL RECORD SYSTEMS, BUSINESS MANAGEMENT SYSTEMS, EQUIPMENT & CONNECTIVITY, INTERNAL AUDIT FUNCTIONS, LEGAL SERVICES, PHYSICIAN NETWORK DEVELOPMENT, PROCUREMENT & SUPPLY CHAIN MANAGEMENT, INCLUDING MEDICAL DEVICES, SUPPLIES & EQUIPMENT, PROFESSIONAL LIABILITY INSURANCE THROUGH A CAPTIVE PROVIDER INCLUDING GROUP EXCESS COVERAGE AND REINSURANCE AND LITIGATION MANAGEMENT, PUBLIC RELATIONS, COMMUNICATIONS & LEGISLATIVE AFFAIRS, REAL ESTATE MANAGEMENT SERVICES, INCLUDING LEASING & CONSTRUCTION, PURCHASE & SALE, REGULATORY COMPLIANCE SERVICES, REVENUE CYCLE MANAGEMENT SERVICES INCLUDING BILLING & COLLECTIONS, RISK MANAGEMENT SERVICES INCLUDING SELF-INSURANCE, GROUP EXCESS COVERAGE & REINSURANCE, LITIGATION MANAGEMENT, INSPECTION & CONTROLS.THE CENTRALIZATION OF MANAGEMENT SERVICES PROVIDES FOR HIGH QUALITY, COST EFFECTIVE AND COMPASSIONATE HEALTH CARE MANAGEMENT AND MEDICAL SERVICES FOR THE COMMUNITIES WE SERVE. THEREFORE, THESE MANAGEMENT SERVICES RELATE DIRECTLY TO THE EXEMPT PURPOSE OF OWNING AND MANAGING PUBLIC HOSPITALS AND A HEALTHCARE SYSTEM. OUR MISSION, VISION AND VALUES ARE LISTED BELOW. MISSIONWE REVEAL AND FOSTER GOD'S HEALING LOVE BY IMPROVING THE HEALTH OF THE PEOPLE AND COMMUNITIES WE SERVE, ESPECIALLY THOSE WHO ARE POOR AND VULNERABLE.VISIONINSPIRED BY OUR FAITH,WE WILL BE DISTINGUISHED AS THE TRUSTED PERSON-CENTERED PARTNER TO THOSE WHO ENGAGE WITH US IN THEIR PHYSICAL, MENTAL AND SPIRITUAL HEALTH DECISIONS.WE WILL SHARE ACCOUNTABILITY WITH OUR CLINICIANS, ASSOCIATES AND AFFILIATED STAKEHOLDERS TO DELIVER EXCEPTIONAL CARE THAT IS WELL-COORDINATED, ACCESSIBLE, AFFORDABLE, SAFE, AND RESULTS IN OPTIMAL OUTCOMES FOR INDIVIDUALS AND POPULATIONS.WE WILL GROW AS COMMUNITY-BASED HEALTH NETWORKS IN PARTNERSHIP WITH OTHERS WHO SHARE OUR VISION AND VALUES AND ALIGN WITH US TO BE AN ESSENTIAL PROVIDER TO THOSE WE SERVE.VALUESCARING SPIRIT - WE HONOR THE SACRED DIGNITY OF EACH PERSON.EXCELLENCE - WE SET AND SURPASS HIGH STANDARDS.GOOD HUMOR - WE CREATE JOYFUL AND WELCOMING ENVIRONMENTS.INTEGRITY - WE DO THE RIGHT THING WITH OPENNESS AND PRIDE.SAFETY - WE DELIVER CARE THAT SEEKS TO ELIMINATE ALL HARM FOR PATIENTS AND ASSOCIATES. STEWARDSHIP - WE ARE ACCOUNTABLE FOR THE RESOURCES ENTRUSTED TO US. 575582607 1 1 0 1 0 0 0 0 0 1 1 1 1 0 1 0 0 1 0 0 1 0 0 0 0 0 1 1 1 1 1 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 1 1 1 0 0 1 490 0 1 2954 1 1 1 1 CJ EI 0 0 0 0 0 0 0 0 X 20 19 0 0 0 0 1 1 1 1 1 0 1 1 1 1 1 1 1 1 1 1 1 1 X KYLE ENGMAN 3038135543 500 ELDORADO BLVD SUITE 4200 BROOMFIELD CO 80021 JERRY BELL JR MEMBER 1.00 0.00 X 0 0 0 SISTER LYNN CASEY SCL PAST CHAIR 2.00 0.00 X X 0 0 0 SISTER MAUREEN HALL SCL MEMBER 1.00 0.00 X 0 0 0 C GORDON HOWIE MEMBER 1.00 0.00 X 0 0 0 STEVEN HUEBNER MEMBER 1.00 0.00 X 0 0 0 PAUL HUGHES-CROMWICK MEMBER 1.00 0.00 X 0 0 0 SISTER EILEEN HURLEY SCL MEMBER 1.00 0.00 X 0 0 0 SCOTT KELLER MEMBER 1.00 0.00 X 0 0 0 DONNA KING MEMBER 1.00 0.00 X 0 0 0 KNUTE KNUDSON CHAIR 2.00 0.00 X X 0 0 0 MAUREEN MAHONEY MEMBER 1.00 0.00 X 0 0 0 KATHRYN PAUL VICE CHAIR 2.00 0.00 X X 0 0 0 SISTER CONSTANCE PHELPS SCL MEMBER 1.00 0.00 X 0 0 0 KENT RUSSELL MEMBER 1.00 0.00 X 0 0 0 VINOD SAHNEY PHD MEMBER 1.00 0.00 X 0 0 0 MICHAEL SALEM MD MEMBER 1.00 0.00 X 0 0 0 MICHAEL SLUBOWSKI SYSTEM PRESIDENT AND CEO 50.00 0.00 X X 1951205 0 38596 J PAUL SOLVERSON MEMBER 1.00 0.00 X 0 0 0 MARLA WILLIAMS MEMBER 1.00 0.00 X 0 0 0 ALAN YORDY MEMBER 1.00 0.00 X 0 0 0 LYDIA JUMONVILLE TREASURER & CFO/EVP 50.00 0.00 X 1012271 0 238836 ROSLAND MCLEOD SECRETARY/SVP CHIEF LEGAL OFFICER 50.00 0.00 X 570645 0 168979 LYNN SMITH ASSISTANT SECRETARY/EXEC ASST-CEO 50.00 0.00 X 108004 0 17545 MICHAEL TAYLOR CHIEF OPERATING OFF-HOSP OPS 50.00 0.00 X 849356 0 156505 WILLIAM ANDERSON SVP-CHIEF HUMAN RESOURCES OFCR 50.00 0.00 X 549453 0 39826 STEVEN CHYUNG CHIEF STEWARDSHP & TRNFMTN OFC 50.00 0.00 X 529038 0 96488 SHAWN DUFFORD SVP CHIEF MEDICAL OFFICER SYS 50.00 0.00 X 557563 0 109394 TAJQUAH HUDSON SVP-CHIEF STRAT-BUS DEV OFCR 50.00 0.00 X 534535 0 143874 KERRY KOHNEN SVP PAYER & POP HEALTH STRAT 50.00 0.00 X 317041 0 201 WILLIAM PACK VP FINANCE OPERATIONS 1/1-5/6 50.00 0.00 X 192388 0 66404 DAVID PECORARO SVP-CHIEF INFORMATION OFFICER 50.00 0.00 X 599562 0 37290 DAVID PRINGLE SVP MISSION INTEGRATION 50.00 0.00 X 378720 0 68345 KAREN SCREMIN VP FINANCE OPERATIONS 50.00 0.00 X 342779 0 54820 TROY SPRING VP REVENUE CYCLE 50.00 0.00 X 276110 0 61406 GERALDINE TOWNDROW SVP CHIEF NURSING OFFICER SYS 50.00 0.00 X 402244 0 22315 MARK WILKINSON VP TREASURER 50.00 0.00 X 355496 0 53651 CHRISTINE WOOLSEY SVP AND CHIEF COMM-MKTG OFCR 50.00 0.00 X 384431 0 97819 J GRANT WICKLUND PRESIDENT-CEO LMC 0.00 50.00 X 555162 0 263703 WILLIAM ANDERSON MEDICAL DIRECTOR 0.00 50.00 X 724399 0 42035 DAVID HAMM PRESIDENT-CEO EGSM 0.00 50.00 X 530418 0 208359 STEVE LOVELESS PRESIDENT CEO SVH-MT REG 0.00 50.00 X 628244 0 97110 THOMAS PETERSON CHIEF SAFETY OFFICER 1/1-9/9 50.00 0.00 X 513397 0 35018 ROBERT LADENBURGER FORMER KEY EMPLOYEE 0.00 0.00 X 323002 0 6893 13185463 0 2125412 500 1 1 0 CHG COMPANIES INC PO BOX 972651 DALLAS TX 75397 CONTRACT LABOR 6263510 DENTONS US LLP 233 S WACKER DRIVE STE 7800 CHICAGO IL 60606 LEGAL SERVICES 4412055 WEATHERBY LOCUMS INC PO BOX 972633 DALLAS TX 75397 CONTRACT LABOR 3109805 ERNST & YOUNG US LLP 200 PLAZA DR SECAUCUS NJ 07094 AUDIT SERVICES 1861566 CONTINUUM HEALTH SOLUTIONS LLC 8100 E ARPAHOE ROAD CENTENNIAL CO 80112 CONSULTING SERVICES 1804808 100 2077223 433645 2510868 MANAGEMENT SERVICES 541900 340416425 340386425 30000 PATIENT SERVICE REVENUE 622110 66785597 66753807 31790 PROGRAM RELATED INVESTMENTS 900099 22587374 22587374 JOINT VENTURES - MEDICAL SERVICE 622110 -6231535 -6231535 423557861 18581842 -1750041 20331883 67929 67929 71109 0 71109 71109 71109 10950934 45000 0 2455846 10950934 -2410846 8540088 8540088 VENDOR ADMINISTRATION REBATE 900099 8415889 8415889 8415889 461745586 431911960 -1688251 29011009 5846739 5846739 70280 70280 11383131 7402598 3980533 201274936 201274936 9652276 9652276 23248009 23248009 15670743 15670743 10124272 10124272 1672422 1672422 164802 164802 223504 223504 23808816 23808816 6780981 6780981 25654781 25654781 9724231 9724231 12214874 12214874 4174728 4174728 1746608 1746608 126516709 126516709 38942855 38942855 1471503 1471503 MAINTENANCE CONTRACTS 34208922 34208922 BANK FEES 8302946 8302946 COLLECTION AGENCIES 5244674 5244674 MEDICAL SUPPLIES 4963845 4963845 8660553 8660553 591748140 575582607 16165533 0 44421354 128199906 150227 47906 5947634 5777838 304508 404056 6127 14432452 21834032 430747212 211237735 225949295 219509477 1117812707 1056299971 506412767 483727675 510330252 488574692 1417333 195072 12733701 1322936 2439912230 2405899688 127128973 123530581 94412 609742 1487706042 1296666898 1358017432 882191304 2972946859 2302998525 X -549999666 84640146 14965037 16261017 2000000 2000000 -533034629 102901163 2439912230 2405899688 X -130002554 63425630 702512716 X 0 1 X 1 1 1 X X 11 ST FRANCIS HEALTH CENTER INC 480547719 3 0 0 0 ST JAMES HEALTHCARE 810231785 3 0 0 0 SAINT JOSEPH HOSPITAL INC 840417134 3 0 0 0 SCL HEALTH - FRONT RANGE INC 841103606 3 0 0 0 ST MARY'S HOSPITAL AND MEDICAL CENTER INC 840425720 3 0 0 0 ST VINCENT HEALTHCARE 810232124 3 0 0 0 HOLY ROSARY HEALTHCARE 810231792 3 0 0 0 CARITAS CLINICS INC 481009910 3 0 64929 0 MARIAN CLINIC INC 481046905 3 0 92411 0 MOUNT ST VINCENT HOME 840405260 10 0 627849 0 BRIGHTON COMMUNITY HOSPITAL ASSOCIATION 840482695 3 0 0 0 11 785189 0 0 0 0 0 1 1 0 0 0 0 0 0 0 0 0 1 1 0 X 1 1 SCHEDULE A, PART IV, SECTION A, LINE 1 THE SISTERS OF CHARITY OF LEAVENWORTH HEALTH SYSTEM, INC. IS THE PARENT OF EACH OF ITS SUPPORTED ORGANIZATIONS AND CONTROLS THEM AS PART OF AN INTEGRATED HEALTH SYSTEM. EACH SUPPORTED ORGANIZATION IS CONTROLLED BY THE SISTERS OF CHARITY OF LEAVENWORTH HEALTH SYSTEM, INC. A CLOSE AND HISTORIC ORGANIZATIONAL RELATIONSHIP ENSURES THAT SISTERS OF CHARITY OF LEAVENWORTH HEALTH SYSTEM, INC. AND ITS SUPPORTED ORGANIZATIONS SHARE A SUBSTANTIAL IDENTITY OF INTERESTS. SCHEDULE A, PART IV, SECTION A, LINE 5A ORGANIZATION ADDED: BRIGHTON COMMUNITY HOSPITAL ASSOCIATION 84-0482695 BRIGHTON COMMUNITY HOSPITAL ASSOCIATION WAS ACQUIRED IN LATE 2015. SISTERS OF CHARITY OF LEAVENWORTH HEALTH SYSTEM, INC. CONSIDERS BRIGHTON COMMUNITY HOSPITAL ASSOCIATION A SUPPORTED ORGANIZATION STARTING IN 2016. SCHEDULE A, PART IV, SECTION A, LINE 6 SUPPORT WAS PROVIDED TO MEDICAL AND OTHER CHARITABLE ORGANIZATIONS NOT CONSIDERED SUPPORTED ORGANIZATIONS. HOWEVER, THESE INSTITUTIONS ARE SUPPORTING MEDICAL AND OTHER ACTIVITIES BENEFITING THE COMMUNITIES SERVED BY SUPPORTED ORGANIZATIONS. AMOUNTS GRANTED ARE INSIGNIFICANT TO THE OVERALL OPERATIONS OF SISTERS OF CHARITY OF LEAVENWORTH HEALTH SYSTEM, INC. SCHEDULE A, PART IV, SECTION E, LINE 3A SISTERS OF CHARITY OF LEAVENWORTH HEALTH SYSTEM, INC. (SCLHS) IS THE SOLE MEMBER OF THE SUPPORTED ORGANIZATIONS. SCLHS APPOINTS MEMBERS OF THE SUPPORTED ORGANIZATIONS' BOARD OF DIRECTORS. SCHEDULE A, PART IV, SECTION E, LINE 3B SISTERS OF CHARITY OF LEAVENWORTH HEALTH SYSTEM, INC. (SCLHS) HAS CERTAIN RESERVE POWERS TO APPROVE CHANGES TO THE ARTICLES OF INCORPORATION AND THE BYLAWS INCLUDING THE APPOINTMENT OR REMOVAL OF BOARD MEMBERS AND THE PRESIDENT/CEO. SCLHS ALSO HAS CERTAIN RESERVE POWERS OVER ANY CHANGE IN OWNERSHIP OF THE CORPORATION, CHANGE IN MISSION, ACQUISITION OF ASSETS, DISPOSAL OF ASSETS, LEASING OF ASSETS, INCURRENCE OF DEBT, MERGER OR DISSOLUTION, APPROVAL OF STRATEGIC PLANS AND BUDGETS, APPOINTMENT OF AUDITORS AND OVERSIGHT AND APPROVAL OF COMPENSATION AND BENEFITS FOR DIRECTORS, OFFICERS, KEY EMPLOYEES AND PHYSICIANS. RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 0 0 0 0 0 0 0 0 1 164802 164802 0 PART II-B, LINE 1: LOBBYING EXPENSES OF $64,802 WERE DERIVED AS A PERCENTAGE OF DUES PAID TO THE AMERICAN HOSPITAL ASSOCIATION. ADDITIONAL LOBBYING EXPENSES OF $100,000 WERE DERIVED FROM FEES FOR ADVOCACY SERVICES TO DEFEAT COLORADO AMENDMENT 69. 2000000 2000000 3813121 25463 1838584 2000000 3663849 149272 3813121 3521063 142786 3663849 3524552 140511 144000 3521063 1.00000 0 0 37697596 37697596 16533199 9428286 7104913 15511278 6573306 8937972 338216369 195236143 142980226 22788770 22788770 219509477 VHA STOCK INVESTMENT 621978 F ABSOLUTE RETURN INVESTMENTS 7317967 F TACTICAL - PINEBRIDGE 92106252 F OPPORTUNISTIC INVESTMENTS 40815125 F EXECUTIVE DB PLAN INVESTMENTS 19360345 F JOINT VENTURE - LUTHERAN CAMPUS ASC, LLC 814283 F JOINT VENTURE - DENVER WEST ENDOSCOPY CTR, LLC 786374 F JOINT VENTURE - E + PET IMAGING X, LP 251077 F JOINT VENTURE - SCL HEALTH - EMERUS, LLC 4917015 F JOINT VENTURE - NORTHERN ROCKIES HEALTHCARE ALLIANCE, LLC 426217 F JOINT VENTURE - SCLTDI JV, LLC 6469839 F JOINT VENTURE - SCLH-GI ENDOSCOPY CENTER HOLDINGS, LLC 1305000 F REAL RETURN INVESTMENTS 273656510 F SWEEP ACCOUNTS 34879693 F 483727675 NOTES REC - ST. JOSEPH HOSPITAL, INC. 193659180 C NOTES REC - SCL HEALTH - FRONT RANGE, INC. 274650000 C NOTES REC - ST. JAMES HEALTHCARE 5637379 C NOTES REC - ST. MARY'S HOSPITAL & MEDICAL CENTER, INC. 14628133 C 488574692 INTERCOMPANY PAYABLE 819760694 DEFERRED COMPENSATION PLAN PAYABLE 43741875 INTEREST RATE SWAP PAYABLE 18496758 INFORMATION TECHNOLOGY SERVICES PAYABLE 191977 882191304 PART V, LINE 4: SCLHS HAS A PERMANENT ENDOWMENT IN THE AMOUNT OF $2,000,000. THE EARNINGS FROM THE PERMANENT ENDOWMENT ARE A TERM ENDOWMENT TO BE USED FOR EDUCATIONAL PURPOSES AS DETERMINED BY SCLHS MANAGEMENT. CENTRAL AMERICA/CARIBBEAN 0 0 PROGRAM SERVICES CAPTIVE INSURANCE PREMIUM 12823650 CENTRAL AMERICA/CARIBBEAN 0 0 INVESTMENTS, PROGRAM-RELATED 58542 EUROPE 0 0 INVESTMENTS, PROGRAM-RELATED 1976715 0 0 0 0 0 0 14858907 0 14858907 1 0 1 1 1 0 SCHEDULE F, PART I, LINE 3 INVESTMENTS REPORTED IN SCHEDULE F ARE ACCOUNTED FOR ON THE ACCRUAL BASIS OF ACCOUNTING. SCLHS' EXPENDITURES (PREMIUMS PAID) FOR ITS CAPTIVE INSURANCE PREMIUMS WERE $12,823,650 NET OF PREMIUM DISCOUNTS. 1 1 X 1 X 1 X 500.000000000000 1 0 1 1 541881 0 541881 0.00090 11075893 5876161 5199732 0.00880 11617774 5876161 5741613 0.00970 9451079 5898066 3553013 0.00600 785189 0 785189 0.00130 10236268 5898066 4338202 0.00730 21854042 11774227 10079815 0.01700 1 1607661 0 17849465 35897252 -18047787 X 1 1 1 DENVER WEST ENDOSCOPY CENTER LLC OUTPATIENT ENDOSCOPY SERVICES 0.51000 0.00000 0.49000 2 LUTHERAN CAMPUS ASC LLC OUTPATIENT SURGERY 0.52520 0.00000 0.47480 3 SCLH-GI ENDOSCOPY CENTER HOLDINGS LLC ENDOSCOPY SERVICES 0.51000 0.00000 0.49000 4 NORTHGLENN ENDOSCOPY CENTER LLC ENDOSCOPY SERVICES 0.51000 0.00000 0.49000 2 1 SCL HEALTH WESTMINSTER LLC 6500 WEST 104TH AVENUE SUITE 100 WESTMINSTER CO 80020 WWW.SCLHEALTHCOMMUNITY.ORG/WESTMINSTER 01A413 X X X A 2 SCL HEALTH SOUTHWEST LLC 8515 W COAL MINE AVENUE LITTLETON CO 80123 WWW.SCLHEALTHCOMMUNITY.ORG/SOUTHWEST 01U326 X X X A FACILITY REPORTING GROUP - A 1 1 0 0 1 X 200.000000000000 500.000000000000 X 1 1 X X X 1 X WWW.SCLHEALTHCOMMUNITY.ORG/HELPINGHANDS X WWW.SCLHEALTHCOMMUNITY.ORG/HELPINGHANDS X WWW.SCLHEALTHCOMMUNITY.ORG/HELPINGHANDS X X X X X X 1 X 0 X X X 1 X 0 0 PART V, SECTION B FACILITY REPORTING GROUP A FACILITY REPORTING GROUP A CONSISTS OF: - FACILITY 1: SCL HEALTH WESTMINSTER, LLC, - FACILITY 2: SCL HEALTH SOUTHWEST, LLC PART V, SECTION B, LINE 2: SCL HEALTH WESTMINSTER COMMUNITY HOSPITAL WAS PLACED INTO SERVICE IN NOVEMBER 2015. SCL HEALTH SOUTHWEST COMMUNITY HOSPITAL WAS PLACED INTO SERVICE IN JUNE 2016. THE HOSPITALS ARE OWNED THROUGH A JOINT VENTURE, SCL HEALTH - EMERUS, LLC. 105 1 - DENVER WEST ENDOSCOPY CENTER LLC 382 S ARTHUR AVENUE LOUISVILLE CO 80027 OUTPATIENT ENDOSCOPY SERVICES 2 - LUTHERAN CAMPUS ASC LLC 3455 LUTHERAN PKWY STE 150 WHEATRIDGE CO 80033 OUTPATIENT SURGERY 3 - NORTHGLENN ENDOSCOPY CENTER LLC 11900 GRANT STREET NORTHGLENN CO 80233 ENDOSCOPY SERVICES 4 - TOUCHSTONE MEDICAL IMAGING - AURORA 3055 SOUTH PARKER RD BLDG A STE 103 AURORA CO 80014 RADIOLOGY SERVICES 5 - TOUCHSTONE MEDICAL IMAGING - DRY CREEK 125 INVERNESS DR EAST STE 140 ENGLEWOOD CO 80112 RADIOLOGY SERVICES 6 - TOUCHSTONE MEDICAL IMAGING - HIGHLINE 26 WEST DRY CREEK CIR STE 160 LITTLETON CO 80120 RADIOLOGY SERVICES 7 - TOUCHSTONE MEDICAL IMAGING - LAFAYETTE 390 EMPIRE ROAD STE 102 LAFAYETTE CO 80026 RADIOLOGY SERVICES 8 - TOUCHSTONE MEDICAL IMAGING - LAKEWOOD 14062 DENVER WEST PKWY BLDG 52 STE 180 LAKEWOOD CO 80401 RADIOLOGY SERVICES 9 - TOUCHSTONE MEDICAL IMAGING - THORNTON 12021 PENNSYLVANIA ST STE 106 THORNTON CO 80241 RADIOLOGY SERVICES 10 - TOUCHSTONE IMAGING MAMMOGRAPHY AND BONE 3455 N LUTHERAN PKWY 110 WHEAT RIDGE CO 80033 RADIOLOGY SERVICES 11 - TOUCHSTONE MEDICAL IMAGING - UPTOWN 1007 E COLFAX AVE DENVER CO 80218 RADIOLOGY SERVICES 12 - TOUCHSTONE MEDICAL IMAGING - WHEAT RIDGE 7615 WEST 38TH AVENUE STE B115 WHEAT RIDGE CO 80033 RADIOLOGY SERVICES 13 - SCL FRONT RANGE HOME HEALTH LLC 3980 QUEBEC STREET SUITE 100 DENVER CO 80207 HOME HEALTH 14 - ROCKY MOUNTAIN CLINIC FAM PRAC & INT MED 435 S CRYSTAL ST STE 300 BUTTE MT 59701 OUTPATIENT PHYSICIAN CLINIC 15 - ROCKY MTN CLINIC FAM PRAC & INT MED - BE 400 S CLARK ST BUTTE MT 597012328 OUTPATIENT PHYSICIAN CLINIC 16 - ROCKY MOUNTAIN CLINIC NEUROLOGY 435 S CRYSTAL ST STE 300 BUTTE MT 59701 OUTPATIENT PHYSICIAN CLINIC 17 - ST JAMES CARDIAC & THORACIC SURG- CVTS 435 S CRYSTAL ST BUTTE MT 59701 OUTPATIENT PHYSICIAN CLINIC 18 - ST JAMES CARDIAC & THORACIC SURG - SURGI 400 W PORPHYRY ST BUTTE MT 59701 OUTPATIENT PHYSICIAN CLINIC 19 - ST JAMES CARDIAC INTERPRETATIONS 400 S CLARK ST BUTTE MT 59701 OUTPATIENT PHYSICIAN CLINIC 20 - ST JAMES CARDIOLOGY 435 S CRYSTAL ST STE 220 BUTTE MT 59701 OUTPATIENT PHYSICIAN CLINIC 21 - ST JAMES EMERGENCY PHYSICIANS 400 S CLARK ST BUTTE MT 59701 OUTPATIENT PHYSICIAN CLINIC 22 - ST JAMES HEALTHCARE REHAB - BOULDER 214 S MAIN BOULDER MT 59632 OUTPATIENT PHYSICIAN CLINIC 23 - ST JAMES HEALTHCARE REHAB - WHITEHALL 309 EAST LEGION WHITEHALL MT 59759 OUTPATIENT PHYSICIAN CLINIC 24 - ST JAMES OBSTETRICS & GYNECOLOGY 305 W PORPHYRY STE 200 BUTTE MT 59701 OUTPATIENT PHYSICIAN CLINIC 25 - ST JAMES RADIATION ONCOLOGY 400 S CLARK ST BUTTE MT 59701 OUTPATIENT PHYSICIAN CLINIC 26 - ST JAMES SUMMIT LAB 435 S CIRYSTAL ST STE 300 BUTTE MT 597011506 OUTPATIENT PHYSICIAN CLINIC 27 - ST JAMES UROLOGY 305 W PORPHYRY STE 100 BUTTE MT 59701 OUTPATIENT PHYSICIAN CLINIC 28 - ST JAMES WMMH OUTREACH 106 W BROADWAY ST BUTTE MT 59701 OUTPATIENT PHYSICIAN CLINIC 29 - ST VINCENT HEALTH CENTER CCBDC 1233 N 30TH ST BILLINGS MT 59101 OUTPATIENT PHYSICIAN CLINIC 30 - SVP - ABSAROKEE FAMILY MEDICINE 55 N MONTANA ABSAROKEE MT 590010425 OUTPATIENT PHYSICIAN CLINIC 31 - SVP - BEHAVIORAL HEALTH 2900 12TH AVE N STE 280W BILLINGS MT 591017516 OUTPATIENT PHYSICIAN CLINIC 32 - SVP - BIG HORN BASIN REG CANCER CTR 1025 9TH ST CODY WY 824143441 OUTPATIENT PHYSICIAN CLINIC 33 - SVP - BROADWATER FAMILY MEDICINE 2019 BROADWATER AVE BILLINGS MT 591024810 OUTPATIENT PHYSICIAN CLINIC 34 - SVP - BROADWATER WALK-IN CLINIC 2019 BROADWATER AVE BILLINGS MT 591024810 OUTPATIENT PHYSICIAN CLINIC 35 - SVP - CODY FAMILY MEDICINE 720 LINDSAY LN STE A CODY WY 824144103 OUTPATIENT PHYSICIAN CLINIC 36 - SVP - DERMATOLOGY 2900 12TH AVE N STE 265W BILLINGS MT 591017513 OUTPATIENT PHYSICIAN CLINIC 37 - SVP - DIABETES CENTER 2900 12TH AVE N STE 160W BILLINGS MT 591017588 OUTPATIENT PHYSICIAN CLINIC 38 - SVP - FORTIN PED SPEC CLINIC - CARDIO 2600 WILSON ST MILES CITY MT 59301 OUTPATIENT PHYSICIAN CLINIC 39 - SVP - FORTIN PED SPEC CLINIC - CARDIO - 935 HIGHLAND PARK BLVD STE 2200 BOZEMAN MT 59718 OUTPATIENT PHYSICIAN CLINIC 40 - SVP - FORTIN PED SPEC CLINIC - CARDIO BU 435 S CRYSTAL ST STE 300 BUTTE MT 59701 OUTPATIENT PHYSICIAN CLINIC 41 - SVP - FORTIN PED SPEC CLINIC - FORTIN PE 1232 N 30TH STE 300 BILLINGS MT 59101 OUTPATIENT PHYSICIAN CLINIC 42 - SVP - FORTIN PED SPEC CLINIC - FORTIN PE 1232 N 30TH STE 200 BILLINGS MT 591010128 OUTPATIENT PHYSICIAN CLINIC 43 - SVP - FORTIN PED SPEC CLINIC - GI BOZEMA 935 HIGHLAND PARK BLVD STE 2200 BOZEMAN MT 59718 OUTPATIENT PHYSICIAN CLINIC 44 - SVP - FORTIN PED SPEC CLINIC - MILES CIT 2600 WILSON ST MILES CITY MT 59301 OUTPATIENT PHYSICIAN CLINIC 45 - SVP - FORTIN PED SPEC CLINIC - ONC BOZEM 935 HIGHLAND PARK BLVD STE 2200 BOZEMAN MT 59718 OUTPATIENT PHYSICIAN CLINIC 46 - SVP - FORTIN PED SPEC CLINIC - ONC G FAL 1300 28TH ST S STE 4 GREAT FALLS MT 59405 OUTPATIENT PHYSICIAN CLINIC 47 - SVP - FORTIN PED SPEC CLINIC - PED BOZEM 120 N 19TH ST BOZEMAN MT 59718 OUTPATIENT PHYSICIAN CLINIC 48 - SVP - FORTIN PED SPEC CLINIC - PED BUTTE 435 S CRYSTAL ST BUTTE MT 59701 OUTPATIENT PHYSICIAN CLINIC 49 - SVP - FORTIN PED SPEC CLINIC - PED G FAL 1300 28TH ST S STE 4 GREAT FALLS MT 59405 OUTPATIENT PHYSICIAN CLINIC 50 - SVP - FORTIN PED SPEC CLINIC - PED GI 1232 N 30TH STE 200 BILLINGS MT 591010128 OUTPATIENT PHYSICIAN CLINIC 51 - SVP - FORTIN PED SPEC CLINIC - PED GI BU 435 S CRYSTAL ST BUTTE MT 59701 OUTPATIENT PHYSICIAN CLINIC 52 - SVP - FORTIN PED SPEC CLINIC - PED GI G 1300 28TH ST S STE 4 GREAT FALLS MT 59405 OUTPATIENT PHYSICIAN CLINIC 53 - SVP - FORTIN PED SPEC CLINIC - PED GI HE 3330 PTARMIGAN LN HELENA MT 59602 OUTPATIENT PHYSICIAN CLINIC 54 - SVP - FORTIN PED SPEC CLINIC - PED HELEN 3330 PTARMIGAN LN HELENA MT 59602 OUTPATIENT PHYSICIAN CLINIC 55 - SVP - FORTIN PED SPEC CLINIC PED CARDIO 707 SHERIDAN AVE CODY WY 82414 OUTPATIENT PHYSICIAN CLINIC 56 - SVP - GASTROENTEROLOGY 1144 N BROADWAY STE C BILLINGS MT 591010110 OUTPATIENT PHYSICIAN CLINIC 57 - SVP - HARDIN FAMILY MEDICINE 16 N MILES STE 101 HARDIN MT 590342356 OUTPATIENT PHYSICIAN CLINIC 59 - SVP - HEART & VASCULAR CTR - CODY 720 LINDSEY LANE STE A CODY WY 824144103 OUTPATIENT PHYSICIAN CLINIC 60 - SVP - HEART & VASCULAR CTR - GLASGO 621 3RD ST SOUTH GLASGOW MT 592301111 OUTPATIENT PHYSICIAN CLINIC 61 - SVP - HEART & VASCULAR CTR - MILES CITY 2600 WILSON ST MILES CITY MT 59301 OUTPATIENT PHYSICIAN CLINIC 62 - SVP - HEART & VASCULAR CTR - VASCULAR 2900 12TH AVE N STE 400E BILLINGS MT 591017504 OUTPATIENT PHYSICIAN CLINIC 63 - SVP - HEIGHTS FAMILY MEDICINE 32 WICKS LN BILLINGS MT 591053810 OUTPATIENT PHYSICIAN CLINIC 64 - SVP - INTERNAL MEDICINE ASSOCIATES 2900 12TH AVE N STE 310W BILLINGS MT 591017588 OUTPATIENT PHYSICIAN CLINIC 65 - SVP - LAUREL FAMILY MEDICINE 1035 1ST AVE LAUREL MT 590442119 OUTPATIENT PHYSICIAN CLINIC 66 - SVP - LONG TERM CARE 1101 N 27TH ST STE 101 BILLINGS MT 591010100 OUTPATIENT PHYSICIAN CLINIC 67 - SVP - MATERNAL FETAL MED - FETAL MED 2900 12TH AVE N STE 130W BILLINGS MT 591017504 OUTPATIENT PHYSICIAN CLINIC 68 - SVP - MATERNAL FETAL MED - GREAT PLAINS 1700 11TH ST W WILLISTON ND 58801 OUTPATIENT PHYSICIAN CLINIC 69 - SVP - MIDWIFERY & WOMEN'S HEALTH 2900 12TH AVE N STE 245W BILLINGS MT 59101 OUTPATIENT PHYSICIAN CLINIC 70 - SVP - MONTANA HEART 2900 12TH AVE N STE 204E BILLINGS MT 59101 OUTPATIENT PHYSICIAN CLINIC 71 - SVP - MONTANA HEART - ABSAROKEE 55 N MONTANA ABSAROKEE MT 590016331 OUTPATIENT PHYSICIAN CLINIC 72 - SVP - MONTANA HEART - CODY 720 LINDSAY LANE STE A CODY WY 824144103 OUTPATIENT PHYSICIAN CLINIC 73 - SVP - MONTANA HEART - HARDIN 16 N MILES AVE STE 101 HARDIN MT 590342356 OUTPATIENT PHYSICIAN CLINIC 74 - SVP - MONTANA HEART - LAUREL 1035 1ST AVE LAUREL MT 590442120 OUTPATIENT PHYSICIAN CLINIC 75 - SVP - MONTANA HEART - MTN VIEW 10 ROBINSON LANE RED LODGE MT 590689010 OUTPATIENT PHYSICIAN CLINIC 76 - SVP - MOUNTAIN VIEW FAMILY MEDICINE 10 ROBINSON LN RED LODGE MT 590680070 OUTPATIENT PHYSICIAN CLINIC 77 - SVP - NEPHROLOGY 2900 12TH AVE STE 160W BILLINGS MT 591017508 OUTPATIENT PHYSICIAN CLINIC 78 - SVP - NEPHROLOGY - CODY 720 LINDSAY LN STE A CODY WY 824144103 OUTPATIENT PHYSICIAN CLINIC 79 - SVP - NEPHROLOGY - LEWISTON 310 WENDELL AVE STE 5 LEWISTOWN MT 59457 OUTPATIENT PHYSICIAN CLINIC 80 - SVP - NEPHROLOGY - MILES CITY 2600 WILSON ST MILES CITY MT 59301 OUTPATIENT PHYSICIAN CLINIC 81 - SVP - NEPHROLOGY - WORLAND 1106 BIG HORN AVE WORLAND WY 824012803 OUTPATIENT PHYSICIAN CLINIC 82 - SVP - NEUROSURGERY 1041 N 29TH ST BILLINGS MT 59101 OUTPATIENT PHYSICIAN CLINIC 83 - SVP - NORTH SHILOH FAMILY MEDICINE 2223 MISSION WAY BILLINGS MT 591020160 OUTPATIENT PHYSICIAN CLINIC 84 - SVP - OCCUPATIONAL HEALTH 2019 BROADWATER AVE BILLINGS MT 591024810 OUTPATIENT PHYSICIAN CLINIC 85 - SVP - OP NEURO CLINIC & MS CTR - BOZEMAN 650 FERGUSON STE 1 BOZEMAN MT 59715 OUTPATIENT PHYSICIAN CLINIC 86 - SVP - OP NEURO CLINIC & MS CTR - BUTTE 435 S CRYSTAL ST BUTTE MT 59701 OUTPATIENT PHYSICIAN CLINIC 87 - SVP - OP NEURO CLINIC & MS CTR - CODY 720 LINDSAY LN CODY WY 82414 OUTPATIENT PHYSICIAN CLINIC 88 - SVP - OP NEURO CLINIC & MS CTR - FM GLAS 621 3RD STREET SOUTH GLASGOW MT 59230 OUTPATIENT PHYSICIAN CLINIC 89 - SVP - OP NEURO CLINIC & MS CTR - GI FM G 621 3RD ST S GLASGOW MT 59230 OUTPATIENT PHYSICIAN CLINIC 90 - SVP - OP NEURO CLINIC & MS CTR - HELENA 2550 BROADWAY HELENA MT 59602 OUTPATIENT PHYSICIAN CLINIC 91 - SVP - OP NEURO CLINIC & MS CTR - LEWISTO 310 WENDELL STE 5 LEWISTOWN MT 59457 OUTPATIENT PHYSICIAN CLINIC 92 - SVP - OP NEURO CLINIC & MS CTR - MILES C 2600 WILSON ST MILES CITY MT 59301 OUTPATIENT PHYSICIAN CLINIC 93 - SVP - OP NEURO CLINIC & MS CTR - MILES C 2600 WILSON MILES CITY MT 59301 OUTPATIENT PHYSICIAN CLINIC 94 - SVP - OP NEURO CLINIC & MS CTR - NEURO 1041 N 29TH ST BILLINGS MT 59101 OUTPATIENT PHYSICIAN CLINIC 95 - SVP - OP NEURO CLINIC & MS CTR - NEURO G 621 3RD ST S GLASGOW MT 59230 OUTPATIENT PHYSICIAN CLINIC 96 - SVP - OP NEURO CLINIC & MS CTR - NSGY BO 650 FERGUSON STE 1 BOZEMAN MT 59715 OUTPATIENT PHYSICIAN CLINIC 97 - SVP - OP NEURO CLINIC & MS CTR - NSGY SI 216 14TH AVE SW SIDNEY MT 59270 OUTPATIENT PHYSICIAN CLINIC 98 - SVP - OP NEURO CLINIC & MS CTR - OP NEUR 1041 N 29TH ST BILLINGS MT 59101 OUTPATIENT PHYSICIAN CLINIC 99 - SVP - OP NEURO CLINIC & MS CTR - SIDNEY 216 14TH AVE SW SIDNEY MT 59270 OUTPATIENT PHYSICIAN CLINIC 100 - SVP - OP NEURO CLINIC & MS CTR - SNSGY W 1213 15TH AVENUE WEST WILLISTON ND 58801 OUTPATIENT PHYSICIAN CLINIC 101 - SVP - OP NEURO CLINIC & MS CTR - WILLIST 1213 15TH AVE W WILLISTON ND 58801 OUTPATIENT PHYSICIAN CLINIC 102 - SVP - PAIN CENTER 2900 12TH AVE N STE 335W BILLINGS MT 591017506 OUTPATIENT PHYSICIAN CLINIC 103 - SVP - PHYSIATRY & INFECTIOUS DISEASE 2900 12TH AVE N STE 201E BILLINGS MT 591010136 OUTPATIENT PHYSICIAN CLINIC 104 - SVP - SLEEP & RESPIRATORY 2900 12TH AVE N STE 300 E BILLINGS MT 591010127 OUTPATIENT PHYSICIAN CLINIC 105 - SVP - WEIGHT MANAGEMENT 2900 12TH AVE N STE 160W BILLINGS MT 591017588 OUTPATIENT PHYSICIAN CLINIC 106 - SVP - WEST GRAND FAMILY MEDICINE 2750 GRAND AVE BILLINGS MT 591022629 OUTPATIENT PHYSICIAN CLINIC PART I, LINE 6A: THIS ORGANIZATION IS PART OF SCL HEALTH SYSTEM WHICH PREPARES AN ANNUAL COMMUNITY BENEFIT REPORT ON A CONSOLIDATED BASIS. THE REPORT IS PREPARED BY THE PARENT COMPANY, SISTERS OF CHARITY OF LEAVENWORTH HEALTH SYSTEM, INC. PART I, LINE 7: THE AMOUNTS REPORTED ON FORM 990, SCHEDULE H, PART I, LINE 7A, 7B AND 7C WERE DETERMINED USING THE COST TO CHARGE RATIO DERIVED FROM WORKSHEET 2, IN THE SCHEDULE H, FORM 990 INSTRUCTIONS. FORM 990, SCHEDULE H, PART I, LINES 7E, 7F, 7G, 7H AND 7I ARE REPORTED AT COST AS REPORTED IN THE ORGANIZATION'S FINANCIAL STATEMENTS.PART I, LINE 7, COLUMN (A) - (F): THE SCL HEALTH WESTMINSTER, LLC HOSPITAL OPENED IN LATE NOVEMBER 2015 AND THE SCL HEALTH SOUTHWEST, LLC HOSPITAL OPENED IN JUNE 2016. THE HOSPITALS WERE NOT CERTIFIED FOR MEDICARE AND MEDICAID UNTIL DECEMBER 2016. BECAUSE THE HOSPITALS WERE NOT CERTIFIED FOR MEDICARE AND MEDICAID UNTIL DECEMBER 2016, THERE WERE NO UNREIMBURSED COSTS FOR MEDICAID AND OTHER MEANS-TESTED GOVERNMENT PROGRAMS FOR THESE TWO HOSPITALS REPORTED ON SCHEDULE H, PART I, LINES 7B AND 7C. DUE TO LIMITED FINANCIAL RESOURCES AND THE SHORT PERIOD OF TIME THE TWO HOSPITAL FACILITIES HAVE BEEN OPERATIONAL, THERE WERE NO COMMUNITY BENEFIT EXPENSES FOR THESE TWO HOSPITALS REPORTED ON SCHEDULE H, PART I, LINES 7E-7H. PART I, LINE 7, COLUMN (F): THE BAD DEBT EXPENSE INCLUDED ON FORM 990, PART IX, LINE 25, COLUMN (A), BUT SUBTRACTED FOR PURPOSES OF CALCULATING THE PERCENTAGE IN THIS COLUMN IS $ 1,607,661. PART II, COMMUNITY BUILDING ACTIVITIES: DUE TO LIMITED FINANCIAL RESOURCES AND THE SHORT PERIOD OF TIME THE TWO HOSPITAL FACILITIES HAVE BEEN OPERATIONAL, THERE WERE NO COMMUNITY BUILDING ACTIVITIES EXPENSE TO REPORT ON SCHEDULE H, PART II.PART III, LINE 1:THE ORGANIZATION REPORTS BAD DEBT IN ACCORDANCE WITH HEALTHCARE FINANCIAL MANAGEMENT ASSOCIATION (HFMA) STATEMENT NO. 15 TO THE EXTENT THAT HFMA STATEMENT NO. 15 FOLLOWS THE GENERALLY ACCEPTED ACCOUNTING PRINCIPLES (GAAP) FOR THE REPORTING OF BAD DEBT. PART III, LINE 2: THE BAD DEBT EXPENSE REPORTED ON PART III, LINE 2 IS AT CHARGES AS RECORDED IN THE ORGANIZATION'S FINANCIAL STATEMENTS. THE ALLOWANCE FOR BAD DEBT IS BASED UPON MANAGEMENT'S ASSESSMENT OF HISTORICAL AND EXPECTED NET COLLECTIONS CONSIDERING THE BUSINESS AND GENERAL ECONOMIC CONDITIONS IN ITS SERVICE AREA, TRENDS IN HEALTH CARE COVERAGE, AND OTHER COLLECTION INDICATORS.THE BAD DEBT ALLOWANCE IS CALCULATED AS A PERCENTAGE OF PATIENT RECEIVABLES AFTER DEDUCTIONS FOR ESTIMATED PROVISIONS FOR CONTRACTUAL ADJUSTMENTS (DISCOUNTS) ON SERVICES PROVIDED TO ENROLLEES OF MEDICARE, MEDICAID, THIRD-PARTY PAYOR PROGRAMS, CHARITY CARE, UNINSURED DISCOUNTS, AND OTHER ADMINISTRATIVE ADJUSTMENTS. PART III, LINE 4: THE ALLOWANCE FOR BAD DEBT IS BASED UPON MANAGEMENT'S ASSESSMENT OF HISTORICAL AND EXPECTED NET COLLECTIONS CONSIDERING THE BUSINESS AND GENERAL ECONOMIC CONDITIONS IN ITS SERVICE AREA, TRENDS IN HEALTH CARE COVERAGE, AND OTHER COLLECTION INDICATORS.THE BAD DEBT ALLOWANCE IS CALCULATED AS A PERCENTAGE OF PATIENT RECEIVABLES AFTER DEDUCTIONS FOR ESTIMATED PROVISIONS FOR CONTRACTUAL ADJUSTMENTS (DISCOUNTS) ON SERVICES PROVIDED TO ENROLLEES OF MEDICARE, MEDICAID, THIRD-PARTY PAYOR PROGRAMS, CHARITY CARE, UNINSURED DISCOUNTS, AND OTHER ADMINISTRATIVE ADJUSTMENTS.THE ORGANIZATION HAS A FINANCIAL ASSISTANCE PROGRAM THAT PROVIDES PATIENTS OPPORTUNITIES TO APPLY FOR FREE OR DISCOUNTED CARE OR TO BE ENROLLED IN A GOVERNMENT SPONSORED MEDICAL CARE PROGRAM. THE PROCESS INCLUDES IDENTIFYING PATIENTS WITH A FINANCIAL CONCERN AND PROVIDING FINANCIAL COUNSELING AND ASSISTANCE IN APPLYING FOR THE ORGANIZATION'S CHARITY CARE AND OTHER FINANCIAL ASSISTANCE PROGRAMS.CERTAIN PATIENT ACCOUNTS ARE WRITTEN OFF TO BAD DEBT BECAUSE THE ORGANIZATION DOES NOT HAVE SUFFICIENT INFORMATION TO DETERMINE IF THE PATIENT WOULD QUALIFY FOR FREE CARE OR FINANCIAL AID. THEREFORE, IT IS POSSIBLE THAT SOME BAD DEBT IS ACTUALLY CHARITY CARE. HOWEVER, IF A PATIENT ACCOUNT IS WRITTEN OFF TO BAD DEBT AND THE COLLECTION AGENCY LATER DETERMINES THAT THE PATIENT WOULD HAVE QUALIFIED FOR FREE CARE OR FINANCIAL AID, THEN THE BAD DEBT EXPENSE IS RECLASSIFIED TO CHARITY CARE. THE FOLLOWING IS THE TEXT OF THE FOOTNOTE TO THE ORGANIZATIONS FINANCIAL STATEMENTS THAT DESCRIBE THE BAD DEBT ALLOWANCE AND BAD DEBT EXPENSE: THE ALLOWANCE FOR UNCOLLECTIBLE ACCOUNTS IS BASED UPON MANAGEMENT'S ASSESSMENT OF HISTORICAL AND EXPECTED NET COLLECTIONS CONSIDERING THE BUSINESS AND GENERAL ECONOMIC CONDITION IN ITS SERVICE AREA, TRENDS IN HEALTH CARE COVERAGE, AND OTHER COLLECTION INDICATORS. THROUGHOUT THE YEAR, MANAGEMENT ASSESSES THE ADEQUACY OF THE ALLOWANCE FOR UNCOLLECTIBLE ACCOUNTS BASED UPON HISTORICAL COLLECTION EXPERIENCE BY PAYOR CATEGORY AND OTHER FACTORS. THE RESULTS OF THESE REVIEWS ARE THEN USED TO MAKE MODIFICATIONS TO THE ALLOWANCE FOR UNCOLLECTIBLE ACCOUNTS. THE ALLOWANCE FOR UNCOLLECTIBLE ACCOUNTS INCLUDES A RESERVE FOR BOTH UNINSURED PATIENTS AND BALANCES DUE FROM PATIENTS AFTER INSURANCE. PART III, LINE 8: THE SCL HEALTH WESTMINSTER, LLC HOSPITAL OPENED IN LATE NOVEMBER 2015 AND THE SCL HEALTH SOUTHWEST, LLC HOSPITAL OPENED IN JUNE 2016. THE HOSPITALS WERE NOT CERTIFIED FOR MEDICARE AND MEDICAID UNTIL DECEMBER 2016. BECAUSE THE HOSPITALS WERE NOT CERTIFIED FOR MEDICARE AND MEDICAID UNTIL DECEMBER 2016, THERE WERE NO UNREIMBURSED COSTS FOR MEDICARE FOR THESE TWO HOSPITALS REPORTED ON SCHEDULE H, PART III, LINES 5, 6 AND 7. THE ORGANIZATION BELIEVES THAT AT LEAST SOME PORTION OF THE COSTS WE INCUR IN EXCESS OF PAYMENTS RECEIVED FROM THE FEDERAL GOVERNMENT FOR PROVIDING MEDICAL SERVICES TO MEDICARE ENROLLEES AND BENEFICIARIES UNDER THE FEDERAL MEDICARE PROGRAM (SHORTFALL OR MEDICARE SHORTFALL) CONSTITUTES A COMMUNITY BENEFIT. PROVIDING THESE SERVICES CLEARLY LESSENS THE BURDENS OF THE GOVERNMENT BY ALLEVIATING THE FEDERAL GOVERNMENT FROM HAVING TO DIRECTLY PROVIDE THESE MEDICAL SERVICES. AS DEMONSTRATED AND CALCULATED ON FORM 990, SCHEDULE H, PART III, LINES 5, 6 AND 7, OUR MEDICARE "ALLOWABLE COSTS" CLEARLY EXCEED THE PAYMENTS WE RECEIVE FOR PROVIDING THESE MEDICAL SERVICES UNDER THE MEDICARE PROGRAM. BY ABSORBING THE MEDICARE SHORTFALL COSTS WE ARE PROVIDING A COMMUNITY BENEFIT AS WELL AS EASING THE BURDEN OF THE FEDERAL GOVERNMENT HAVING TO COVER THESE COSTS.TO ARRIVE AT THE FORM 990, SCHEDULE H, PART III, LINE 6 AMOUNT, WE USED ACTUAL MEDICARE CHARGES FROM INTERNAL RECORDS AND APPLIED AN ESTIMATED COST TO CHARGE RATIO TO DETERMINE THE MEDICARE ALLOWABLE COSTS. THE ESTIMATED MEDICARE COST TO CHARGE RATIO IS THE PRIOR PERIOD MEDICARE COST REPORT COST TO CHARGE RATIO. PART III, LINE 9B: AN INTEGRAL COMPONENT OF OUR MISSION IS TO BE GOOD FINANCIAL STEWARDS. THIS REQUIRES US TO DETERMINE WHICH PATIENTS ARE IN NEED OF CHARITY CARE AND WHICH ARE ABLE TO CONTRIBUTE SOME PAYMENT FOR CARE RECEIVED. WE MAINTAIN A BALANCE THAT ENABLES US TO CONTINUE TO PROVIDE CHARITY CARE TOTHOSE WHO NEED IT MOST AND ENSURE THAT WE MANAGE OUR RESOURCES SO WE CAN CONTINUE TO BE HERE WHEN PEOPLE NEED US MOST. THE ORGANIZATION NOTIFIES PATIENTS ABOUT THE FINANCIAL ASSISTANCE POLICY BY PROVIDING A PLAIN LANGUAGE SUMMARY OF THE FINANCIAL ASSISTANCE POLICY TO ALL PATIENTS. NOTICES ABOUT THE FINANCIAL ASSISTANCE POLICY ARE DISPLAYED IN THE HOSPITAL. IN ADDITION, THE PATIENTS RECEIVES INFORMATION ABOUT THE FINANCIAL ASSISTANCE POLICY WITH THEIR PATIENT BILLS. UNINSURED/UNDERINSURED PATIENTS WHO QUALIFY FOR FINANCIAL ASSISTANCE WILL HAVE DISCOUNTS APPLIED TO OUTSTANDING BALANCES BASED ON THE CORRESPONDING DISCOUNT GUIDELINES PROVIDED WITHIN THE FINANCIAL ASSISTANCE POLICY. REASONABLE EFFORT TO QUALIFY PATIENTS FOR FINANCIAL ASSISTANCE THROUGH THE PRESUMPTIVE ELIGIBILITY PROCESS WILL BE MADE IN ACCORDANCE WITH THE FINANCIAL ASSISTANCE POLICY. IF PATIENTS DO NOT QUALIFY UNDER THIS PROCESS, THEY MAY INITIATE AND SUBMIT A FINANCIAL APPLICATION FOR FURTHER CONSIDERATION. PATIENTS ARE CONTACTED MULTIPLE TIMES ABOUT UNPAID BALANCES PRIOR TO INITIATING ANY COLLECTION ACTION. IF A PATIENT IS DETERMINED TO BE ELIGIBLE FOR FINANCIAL ASSISTANCE AT ANY TIME DURING THE COLLECTION PROCESS, THE ACCOUNT IS RECLASSIFIED AS FINANCIAL ASSISTANCE AND DEBT COLLECTION EFFORTS ARE CEASED. PART VI, LINE 2: SCL COMMUNITY HOSPITAL (SCLCH) OPENED ITS DOORS IN NOVEMBER OF 2015 AND WILL COMPLETE THE COMMUNITY HEALTH NEEDS ASSESSMENT PROCESS PER THE COMPLIANCE TIMELINES. THE MISSION OF SCL HEALTH COMMUNITY HOSPITALS IS TO INCREASE THE COMMUNITY'S ACCESS TO HIGH-QUALITY HEALTH CARE THROUGH AN EXPERIENCED STAFF AND STATE-OF-THE-ART RESOURCES. SERVICES INCLUDE EMERGENCY CARE, INPATIENT CARE, DIAGNOSTIC AND SURGICAL SERVICES OFFERED WITH A PATIENT-CENTERED APPROACH. SCL COMMUNITY HOSPITAL - SOUTHWEST OPENED ITS DOORS IN JUNE OF 2016 AND WILL COMPLETE THE COMMUNITY HEALTH NEEDS ASSESSMENT PROCESS PER THE COMPLIANCE TIMELINES. THE MISSION OF SCL HEALTH COMMUNITY HOSPITALS IS TO INCREASE THE COMMUNITY'S ACCESS TO HIGH-QUALITY HEALTH CARE THROUGH AN EXPERIENCED STAFF AND STATE-OF-THE-ART RESOURCES. SERVICES INCLUDE EMERGENCY CARE, INPATIENT CARE, DIAGNOSTIC AND SURGICAL SERVICES OFFERED WITH A PATIENT-CENTERED APPROACH.OUR APPROACH TO COMPLETE THE COMMUNITY HEALTH NEEDS ASSESSMENT WILL INCLUDE A COLLABORATIVE PROCESS WITH PUBLIC HEALTH DEPARTMENTS, COMMUNITY BASED ORGANIZATIONS AND COMMUNITY RESIDENTS TO GATHER THE BROADEST REPRESENTATION OF INPUT ON KEY HEALTH INDICATORS. WE WILL RELY ON BOTH QUANTITATIVE AND QUALITATIVE DATA TO IDENTIFY EMERGENT HEALTH NEEDS, SERVICE GAPS AND DISPARITIES. AS A PART OF THE ASSESSMENT PROCESS, WE WILL PRESENT FINDINGS IN A PUBLIC MEETING TO INVITE PARTICIPATION IN THE PRIORITY SELECTION PROCESS. FOLLOWING THE ASSESSMENT PROCESS, A COMMUNITY HEALTH IMPROVEMENT PLAN WILL BE DEVELOPED TO INDICATE SPECIFIC PRIORITIES AND EXPECTED IMPACT. IMPROVEMENT PLAN ACTIVITIES WILL LEVERAGE EVIDENCE BASED STRATEGIES AROUND PREVENTION, DISEASE MANAGEMENT AND HEALTHY LIVING. ACTIVITY EXAMPLES COULD INCLUDE COMMUNITY HEALTH AND SAFETY CLINICS, CANCER SCREENINGS, CHRONIC DISEASE MANAGEMENT, AND HEALTH LITERACY SEMINARS. IN ADDITION, A FOCUS ON PREVENTATIVE INTERVENTIONS WITH OUTREACH TO UNDERSERVED COMMUNITIES WILL BE ESSENTIAL TO ADDRESSING SUCH AREAS AS ANNUAL YOUTH PHYSICALS, SENIOR FALL PREVENTION, AND ASSISTING COMMUNITY MEMBERS IN CONNECTING TO OTHER COMMUNITY HEALTH SUPPORT RESOURCES (E.G. TRANSPORTATION, HOME HEALTH, HOUSING, AND OTHER SOCIAL SERVICES). PART VI, LINE 3: THE ORGANIZATION NOTIFIES PATIENTS ABOUT THE FINANCIAL ASSISTANCE POLICY BY PROVIDING A PLAIN LANGUAGE SUMMARY OF THE FINANCIAL ASSISTANCE POLICY TO ALL PATIENTS. NOTICES ABOUT THE FINANCIAL ASSISTANCE POLICY ARE DISPLAYED IN THE HOSPITAL. IN ADDITION, PATIENTS RECEIVE INFORMATION ABOUT THE FINANCIAL ASSISTANCE POLICY WITH THEIR PATIENT BILLS. THE FINANCIAL ASSISTANCE POLICY AND APPLICATION ARE POSTED ON THE HOSPITAL'S WEBSITE. THE POLICY AND APPLICATION ARE ALSO AVAILABLE UPON REQUEST. THE ORGANIZATION HAS A FINANCIAL ASSISTANCE PROGRAM THAT PROVIDES PATIENTS OPPORTUNITIES TO APPLY FOR FREE OR DISCOUNTED CARE OR TO BE ENROLLED IN A GOVERNMENT SPONSORED MEDICAL CARE PROGRAM. THE PROCESS INCLUDES IDENTIFYING PATIENTS WITH A FINANCIAL CONCERN, PROVIDING FINANCIAL COUNSELING AND ASSISTANCE IN APPLYING FOR THE ORGANIZATION'S CHARITY CARE AND OTHER FINANCIAL ASSISTANCE PROGRAMS. PART VI, LINE 4: SCL COMMUNITY HOSPITAL (SCLCH) IS LOCATED IN THE CITY OF WESTMINSTER, COLORADO. WESTMINSTER IS LOCATED IN JEFFERSON COUNTY, BUT INCLUDES A UNIQUE SERVICE AREA OF THREE INTERSECTING COUNTIES (ADAMS, BROOMFIELD AND JEFFERSON). WITH THE POSITIONING OF THE COMMUNITY HOSPITAL, ALONG A MAJOR TRANSPORTATION CORRIDOR, THE PRIMARY SERVICE AREA IS DEFINED BY A GEOGRAPHIC RADIUS OF 50 MILES FOR HEALTH DATA REVIEW.DATA SHARED BELOW REPRESENTS A COMBINATION OF COUNTY AND SERVICE MARKET DATA AS OF 2010-2012 GATHERED AS A CHNA PRECURSOR FROM MULTIPLE PUBLIC HEALTH DEPARTMENTS - (JEFFERSON COUNTY PUBLIC HEALTH, BOULDER COUNTY PUBLIC HEALTH, TRI-COUNTY PUBLIC HEALTH AND GOOD SAM MEDICAL CENTER).DEMOGRAPHICS OF THE COMMUNITY (U.S. CENSUS BUREAU 2010)JEFFERSON COUNTY'S POPULATION AS OF 2010 WAS 534,543; ADAM'S COUNTY 441,603; AND BROOMFIELD 55,889. PRIMARY SERVICE AREA POPULATION FOR SCLCH IS 302,901 WHICH REPRESENTS APPROXIMATELY 115,911 HOUSEHOLDS.GENDER: THE POPULATION OF MALES AND FEMALES IS NEARLY EQUAL - 49.7% (MALE) AND 50.3% (FEMALE)AGE: SERVICE AREA SHOWS A DOMINANCE OF PERSONS BETWEEN THE AGES OF 18 AND 64 (53.4%) WITH A MEDIAN AGE OF 36.1RACIAL AND ETHNIC DIVERSITY: THE POPULATION IN JEFFERSON AND BROOMFIELD COUNTIES IS PREDOMINANTLY WHITE, WITH HISPANIC ORIGIN FOLLOWING. PRIMARY SERVICE AREA PERCENTAGES SHOW 78.4% (WHITE) AND 15.1% (HISPANIC). OTHER RACES (ASIAN, BLACKS/AFRICAN AMERICAN AND AMERICAN INDIAN/ALASKA NATIVES) HAVE RELATIVELY SMALL PERCENTAGES. EDUCATION: WITHIN SERVICE AREA, 40,207 HOLD HIGH SCHOOL DIPLOMAS AND 43,464 HOLD BACHELOR'S DEGREES. 23,183 REPRESENT A GRADUATE DEGREE OR HIGHER. ADAMS COUNTY HAS ONE OF THE LOWEST EDUCATION LEVELS IN THE STATE WITH ONLY 81% HAVING A HIGH SCHOOL EDUCATION AND 20% WITH A BACHELOR DEGREE OR HIGHER. BY COMPARISON, JEFFERSON COUNTY HAD THE HIGHEST HIGH SCHOOL COMPLETION RATE AT 84.5% AND THE HIGHEST PORTION OF THE POPULATION AGE 25 AND OLDER WHO HAVE COMPLETED HIGH SCHOOL AT 94.0%. JEFFERSON ALSO HAD THE HIGHEST PORTION OF THE POPULATION AGE 25 AND OLDER WITH A BACHELOR'S DEGREE OR HIGHER AT 41.6%.LANGUAGE: FOR JEFFERSON COUNTY 10.5% OF PERSONS AGE 5 YEARS AND OVER SPEAK A LANGUAGE OTHER THAN ENGLISH IN THE HOME; FOR BROOMFIELD THAT PERCENTAGE IS 12.2 AND ADAMS 26.2.ECONOMICS: THE MEDIAN HOUSEHOLD INCOME IS $62,890 FOR SERVICE AREA, COMPARED TO $61,303 FOR THE STATE. HOWEVER ADAMS COUNTY HAS ONE OF THE HIGHEST POVERTY RATES IN THE STATE AT 13.3% AND BROOMFIELD IS ONE OF THE LOWEST LEVELS IN THE STATE AT 4.9%.OVERALL HEALTH RANK: THIS MEASURE RANKS THE OVERALL HEALTH OF COUNTY CITIZENS FOR ALL COUNTIES IN COLORADO. THE RANKINGS ARE BASED ON A MODEL OF POPULATION HEALTH THAT EMPHASIZES THE MANY FACTORS THAT, IF IMPROVED, CAN HELP TO MAKE COMMUNITIES HEALTHIER PLACES TO LIVE, LEARN, WORK AND PLAY. FACTORS INCLUDED IN THE RANKING ARE HEALTH OUTCOMES, HEALTH FACTORS, POLICIES/PROGRAMS AND SOCIAL DETERMINANTS OF HEALTH. JEFFERSON RANKS 14TH; BROOMFIELD RANKS 2ND AND ADAMS RANKS 37TH.HEALTH BEHAVIORS: ADULT OBESITY IS 20% IN BROOMFIELD COUNTY; COMMUNITY HEALTH NEEDS SHOWING PREVALENCE:JEFFERSON COUNTY- ACCESS TO CARE- OBESITY- BEHAVIORAL HEALTH- FALLS PREVENTIONBROOMFIELD COUNTY- ACCESS TO CARE- BEHAVIORAL HEALTH- OBESITY- CANCERADAMS COUNTY- ACCESS TO CARE- BEHAVIORAL HEALTH- SMOKINGSCL COMMUNITY HOSPITAL (SCLCH) IS LOCATED IN THE CITY OF LITTLETON, COLORADO. LITTLETON IS LOCATED IN JEFFERSON COUNTY, BUT INCLUDES A SERVICE AREA THAT INTERSECTS WITH DOUGLASS COUNTY. WITH THE POSITIONING OF THE COMMUNITY HOSPITAL, ALONG A MAJOR TRANSPORTATION CORRIDOR, THE PRIMARY SERVICE AREA IS DEFINED BY A GEOGRAPHIC RADIUS OF 50 MILES FOR HEALTH DATA REVIEW.DATA SHARED BELOW REPRESENTS A COMBINATION OF AVAILABLE PUBLIC HEALTH DATA AS OF 2010-2015 GATHERED AS A CHNA PRECURSOR. COMMUNITY HEALTH NEEDS ASSESSMENT RESULTS FROM OUR NEAREST ACUTE CARE FACILITY LOCATED IN THE LAKEWOOD/WHEAT RIDGE AREA WAS REVIEWED AS DATA SUPPORT AS WELL.DEMOGRAPHICS OF THE COMMUNITY (U.S. CENSUS BUREAU 2010)JEFFERSON COUNTY'S POPULATION AS OF 2010 WAS 534,543. 2016 ESTIMATED GROWTH SHOWS A 7% CHANGE BETWEEN 2010 AND 2016 FOR A TOTAL OF 571,837 COMPARED TO A 10% GROWTH CHANGE FOR THE STATE.GENDER: THE POPULATION OF MALES AND FEMALES IS NEARLY EQUAL - 49.7% (MALE) AND 50.3% (FEMALE)AGE: SERVICE AREA SHOWS A DOMINANCE OF PERSONS BETWEEN THE AGES OF 18 AND 64 (64.3%) WITH A MEDIAN AGE OF 36.1. JEFFERSON COUNTY ALSO SHOWS A STRIKING REPRESENTATION OF ADULTS WHO ARE AGE 65 AND OLDER (15.1%) COMPARED TO (13%) FOR THE STATE. RACIAL AND ETHNIC DIVERSITY: THE POPULATION IN JEFFERSON COUNTY IS PREDOMINANTLY WHITE, WITH HISPANIC ORIGIN FOLLOWING. PRIMARY SERVICE AREA PERCENTAGES SHOW 78.5% (WHITE) AND 15.1% (HISPANIC). OTHER RACES (ASIAN, BLACKS/AFRICAN AMERICAN AND AMERICAN INDIAN/ALASKA NATIVES) HAVE RELATIVELY SMALL PERCENTAGES. EDUCATION: WITHIN THE SERVICE AREA, JEFFERSON HAD THE HIGHEST HIGH SCHOOL COMPLETION RATE AT 84.5% AND THE HIGHEST PORTION OF THE POPULATION AGE 25 AND OLDER WHO HAVE COMPLETED HIGH SCHOOL AT 94.0%. JEFFERSON ALSO HAD THE HIGHEST PORTION OF THE POPULATION AGE 25 AND OLDER WITH A BACHELOR'S DEGREE OR HIGHER AT 41.6%.LANGUAGE: FOR JEFFERSON COUNTY 89.6% OF HOUSEHOLDS SPEAK "ONLY" ENGLISH. APPROXIMATELY 10 % OF HOUSEHOLDS SPEAK A LANGUAGE OTHER THAN ENGLISH (E.G. SPANISH, ASIAN & PACIFIC ISLANDER, OR OTHER INDO EUROPEAN LANGUAGES)ECONOMICS: THE MEDIAN HOUSEHOLD INCOME IS $70,164 FOR SERVICE AREA, COMPARED TO $60,629 FOR THE STATE. PERCENT OF PERSONS IN POVERTY IS 7.9% COMPARED TO 11.5% FOR THE STATE. OVERALL HEALTH RANK: THIS MEASURE RANKS THE OVERALL HEALTH OF COUNTY CITIZENS FOR ALL COUNTIES IN COLORADO. THE RANKINGS ARE BASED ON A MODEL OF POPULATION HEALTH THAT EMPHASIZES THE MANY FACTORS THAT, IF IMPROVED, CAN HELP TO MAKE COMMUNITIES HEALTHIER PLACES TO LIVE, LEARN, WORK AND PLAY. FACTORS INCLUDED IN THE RANKING ARE HEALTH OUTCOMES, HEALTH FACTORS, POLICIES/PROGRAMS AND SOCIAL DETERMINANTS OF HEALTH. JEFFERSON COUNTY RANKS 14TH OUT OF 60.COMMUNITY HEALTH NEEDS SHOWING PREVALENCE:JEFFERSON COUNTY- CARDIOVASCULAR DISEASE- CANCER- UNINTENTIONAL INJURIES- CHRONIC LOWER RESPIRATORY DISEASE- MENTAL HEALTH/SUICIDE- DIABETES PART VI, LINE 5: SCL HEALTH COMMUNITY HOSPITALS IS A NATIONALLY RECOGNIZED INNOVATIVE LEADER IN THE DELIVERY OF EMERGENCY, INPATIENT AND DIAGNOSTIC MEDICAL HEALTH CARE THAT STRIVES TO BE THERE FOR ANYONE, ANYWHERE, ANYTIME.WE UNDERSTAND THAT SUPPORTING OUR PATIENTS AND THEIR FAMILIES AS THEY HEAL IS AN IMPORTANT PART OF HEALTH AND WELL-BEING. WE STRIVE TO OFFER PATIENT-CENTERED CARE AND OPERATIONALLY EFFICIENT FACILITIES THAT ARE STAFFED BY MEDICAL PROFESSIONALS WHO TREAT YOU LIKE THEIR OWN FAMILY. OUR COMMUNITY HOSPITALS PRIORITIZE LIMITED INPATIENT STAYS, EFFICIENT EMERGENCY ROOMS AND COST-EFFECTIVE PRICING IN A SMALLER-CAMPUS SETTING.AS PART OF THE SISTERS OF CHARITY OF LEAVENWORTH HEALTH SYSTEM (SCL HEALTH), OUR NEW SCL HEALTH COMMUNITY HOSPITALS SHARE OUR MISSION TO REVEAL AND FOSTER GOD'S HEALING LOVE BY IMPROVING THE HEALTH OF THE PEOPLE AND COMMUNITIES WE SERVE, ESPECIALLY THOSE WHO ARE POOR AND VULNERABLE. WITH OUR INITIAL OUTREACH FOR OUR SERVICE MARKETS, GREAT FOCUS HAS BEEN PLACED ON CONNECTING WITH PRIMARY DEMOGRAPHIC AREAS SUCH AS YOUNG FAMILIES, SENIORS AND THOSE HAVING LOW SOCIO-ECONOMIC STATUS. OUR COMMUNITY BENEFIT INITIATIVES HAVE FAVORED GENERAL HEALTH AND WELLNESS APPROACHES LIKE PREVENTIVE EDUCATION, HEALTH SCREENINGS, EVENT SPONSORSHIP IN SUPPORT OF COMMUNITY BASED ORGANIZATIONS AND HEALTH CAUSES. WHEN THE COMMUNITY HEALTH NEEDS ASSESSMENT IS COMPLETED, A MORE ROBUST STRATEGY AND IMPLEMENTATION PLAN WILL BE CREATED TO ADDRESS HEALTH PRIORITIES HAVING THE GREATEST NEED AND THAT REPRESENT MEANINGFUL IMPACT OPPORTUNITIES FOR OUR COMMUNITY HOSPITALS.THE FOLLOWING REPRESENTS SOME SPECIFIC EXAMPLES OF OUR SUPPORT FOR COMMUNITY HEALTH IMPROVEMENT: - ACCESS TO CARE - HOST PARTNER WITH SENIOR LIVING FACILITY TO OFFER A HEALTH LITERACY EVENT. EVENT WELCOMED OVER 100 SENIOR RESIDENTS TO MEET PROVIDERS, ASK-THE-DOC, TOUR AND PRESENTATION ON UNDERSTANDING APPROPRIATE ACCESS TO CARE POINTS IN THE COMMUNITY (E.G. URGENT, PRIMARY CARE, AMBULATORY, ETC.).- COMMUNITY PARTNER WITH BONFILS BLOOD CENTERS TO HOST BLOOD DRIVES. PROVIDE SPACE, STAFF AND MATERIALS. EACH COMMUNITY HOSPITAL PARTICIPATES IN A ROTATING SCHEDULE FOR THE DRIVES.- HOSTED A SENIOR HEALTH FAIR, OFFERING VARIOUS HEALTH SCREENINGS INCLUDING BLOOD PRESSURE, BONE DENSITY, MEDICATION REVIEW, BODY MASS INDEX, AND OTHERS.- GENERAL WELLNESS AND PREVENTION - EVENT SPONSOR AND HOST FOR THE HOME RUN AGAINST DRUGS PROGRAM WHICH PARTNERS WITH (5) LOCAL ELEMENTARY SCHOOLS. PROGRAM ADDRESSES PRESCRIPTION DRUGS, MARIJUANA, AND OVER-THE-COUNTER DRUG USE.- SAFETY-PALOOSA - EVENT SPONSOR AND HOST FOR A BROAD SERVING COMMUNITY EVENT THAT PROVIDES MATERIALS, EDUCATION AND EXPERT INTERACTION AROUND EVIDENCE BASED INJURY PREVENTION INTERVENTIONS (E.G. BABY'S FIRST RIDE, SEAT BELT CAR FITTINGS, SAFE DISPOSAL OF PRESCRIPTION DRUGS, BIKE SAFETY, AND OTHERS)- WESTYFEST - JEFFERSON COUNTY COMMUNITY HEALTH AND WELLNESS EVENT FOR FAMILIES THAT DRAWS ATTENDANCE FROM MULTIPLE COUNTIES. PARTNER TO OFFER FREE HEALTH IMPROVEMENT RESOURCES FOR CHILDHOOD OBESITY PREVENTION, MENTAL HEALTH FIRST AID CLASSES, CHRONIC DISEASE SELF-MANAGEMENT, AND SOCIAL SERVICES RESOURCE MATERIALS. PART VI, LINE 6: SCL HEALTH COMMUNITY HOSPITALS ARE AFFILIATED WITH SISTERS OF CHARITY OF LEAVENWORTH HEALTH SYSTEM, INC. (SCLHS). SCLHS AND ITS AFFILIATED ENTITIES HAVE A COMMON CALLING AND MISSION: "WE REVEAL AND FOSTER GOD'S HEALING LOVE BY IMPROVING THE HEALTH OF THE PEOPLE AND COMMUNITIES WE SERVE, ESPECIALLY THOSE WHO ARE POOR AND VULNERABLE." WE STRIVE TO PROVIDE HIGH-QUALITY, COMPASSIONATE AND AFFORDABLE HEALTHCARE IN EACH OF OUR HOSPITAL SITES AND THEIR RESPECTIVE COMMUNITY, AS WELL AS IN A VARIETY OF OUTPATIENT SETTINGS AND IN THE HOME. SCLHS IS A FAITH-BASED, NONPROFIT HEALTHCARE ORGANIZATION THAT OPERATES NINE HOSPITALS, TWO SAFETY NET CLINICS, ONE CHILDREN'S MENTAL HEALTH CENTER AND MORE THAN 190 AMBULATORY SERVICE CENTERS IN THREE STATES - COLORADO, KANSAS AND MONTANA. THE HEALTH SYSTEM INCLUDES MORE THAN 15,000 FULL-TIME ASSOCIATES AND MORE THAN 500 EMPLOYED PROVIDERS.AS OUR HEALTH SYSTEM GROWS, WE'RE LEVERAGING THAT GROWTH TO ACHIEVE BENEFITS OF SCALE - IDENTIFYING COST AND OTHER ADVANTAGES THAT WE GAIN DUE TO OUR SIZE. WE'RE ALSO WORKING TO STREAMLINE AND UNIFY OUR SYSTEM-WIDE PROCESSES TO ELIMINATE COSTLY DUPLICATION OF EFFORT. WE ACTIVELY ENCOURAGE OUR PEOPLE TO PURSUE CREATIVE IDEAS THAT IMPROVE EFFICIENCY, SERVICE AND THE OVERALL CARE EXPERIENCE. WHEN OUR ASSOCIATES OR LEADERSHIP TEAMS IDENTIFY BEST PRACTICES IN ANY AREA OF CARE, WE RAPIDLY REPLICATE THOSE ACROSS ALL CARE SITES.SCLHS AND ITS AFFILIATED ENTITIES PROMOTE THE HEALTH OF THE COMMUNITY BY DELIVERING DIRECT HIGH QUALITY HEALTHCARE SERVICES THAT ARE RESPONSIVE TO THE NEEDS OF ITS PATIENTS AND THEIR FAMILIES. THIS INCLUDES COORDINATING COMMUNITY BENEFIT PROCESSES, PROVIDING GUIDANCE WITH COMMUNITY NEEDS ASSESSMENTS, AND ESTABLISHING CONSISTENT FINANCIAL ASSISTANCE AND CHARITY CARE POLICIES AND PROCEDURES. ADDITIONALLY, SCLHS BENEFITS AFFILIATES THROUGH QUALITY IMPROVEMENT AND PERFORMANCE EXCELLENCE INITIATIVES; SYSTEM-WIDE INFORMATION TECHNOLOGY IMPLEMENTATION AND INFRASTRUCTURE; STRATEGIC AND OPERATIONS DIRECTION AND OVERSIGHT; SUPPLY CHAIN MANAGEMENT AND PURCHASING; FINANCE ADMINISTRATION AND REVENUE CYCLE SUPPORT, BENEFITS ADMINISTRATION, RISK MANAGEMENT; DISASTER PLANNING AND CRISIS ASSISTANCE, CENTRAL CASH MANAGEMENT AND INVESTMENT, INTERNAL AUDIT, LEGAL SERVICES, TAX SERVICES AND MISSION INTEGRATION. 1 INTEGRITY HEALTH 500 ELDORADO BLVD SUITE 4300 BROOMFIELD CO 80021 474520350 501(C)(3) 5000000 SUPPORT MISSION MOUNT SAINT VINCENT HOME 4159 LOWELL BOULEVARD DENVER CO 80211 840405260 501(C)(3) 627849 SUPPORT MISSION MARIAN CLINIC 1001 SW GARFIELD AVE TOPEKA KS 66604 481046905 501(C)(3) 92411 SUPPORT MISSION CARITAS CLINICS 818 NORTH 7TH STREET LEAVENWORTH KS 66048 481009910 501(C)(3) 64929 SUPPORT MISSION LUTHERAN MEDICAL CENTER FOUNDATION 8300 WEST 38TH AVENUE WHEAT RIDGE CO 80033 208846152 501(C)(3) 56000 SUPPORT MISSION 5 0 SECONDARY EDUCATION SCHOLARSHIP 27 70280 PART I, LINE 2: SCLHS' MISSION DEPARTMENT REQUIRES WRITTEN STATEMENTS THREE TIMES A YEAR REGARDING THE PROGRESS AND STATUS OF THE GRANT. X 0 1 X X X X X X 1 1 0 0 0 0 0 1 0 MICHAEL SLUBOWSKI SYSTEM PRESIDENT AND CEO 1132496 0 220576 0 598133 0 19080 0 19516 0 1989801 0 0 0 LYDIA JUMONVILLE TREASURER & CFO/EVP 706515 0 97092 0 208664 0 220478 0 18358 0 1251107 0 190203 0 ROSLAND MCLEOD SECRETARY/SVP CHIEF LEGAL OFFICER 476267 0 76875 0 17503 0 141090 0 27889 0 739624 0 0 0 MICHAEL TAYLOR CHIEF OPERATING OFF-HOSP OPS 700141 0 112079 0 37136 0 129931 0 26574 0 1005861 0 0 0 WILLIAM ANDERSON SVP-CHIEF HUMAN RESOURCES OFCR 367647 0 61436 0 120370 0 18240 0 21586 0 589279 0 0 0 STEVEN CHYUNG CHIEF STEWARDSHP & TRNFMTN OFC 365105 0 61181 0 102752 0 66652 0 29836 0 625526 0 85581 0 SHAWN DUFFORD SVP CHIEF MEDICAL OFFICER SYS 476834 0 65891 0 14838 0 87580 0 21814 0 666957 0 0 0 TAJQUAH HUDSON SVP-CHIEF STRAT-BUS DEV OFCR 445804 0 71036 0 17695 0 137057 0 6817 0 678409 0 0 0 KERRY KOHNEN SVP PAYER & POP HEALTH STRAT 269667 0 0 0 47374 0 0 0 201 0 317242 0 0 0 WILLIAM PACK VP FINANCE OPERATIONS 1/1-5/6 147546 0 42624 0 2218 0 56393 0 10011 0 258792 0 0 0 DAVID PECORARO SVP-CHIEF INFORMATION OFFICER 417839 0 68142 0 113581 0 19080 0 18210 0 636852 0 0 0 DAVID PRINGLE SVP MISSION INTEGRATION 285518 0 47097 0 46105 0 49930 0 18415 0 447065 0 0 0 KAREN SCREMIN VP FINANCE OPERATIONS 312819 0 28524 0 1436 0 45080 0 9740 0 397599 0 0 0 TROY SPRING VP REVENUE CYCLE 249373 0 23773 0 2964 0 32629 0 28777 0 337516 0 0 0 GERALDINE TOWNDROW SVP CHIEF NURSING OFFICER SYS 307717 0 40664 0 53863 0 14617 0 7698 0 424559 0 0 0 MARK WILKINSON VP TREASURER 266163 0 30586 0 58747 0 44119 0 9532 0 409147 0 57309 0 CHRISTINE WOOLSEY SVP AND CHIEF COMM-MKTG OFCR 319297 0 51614 0 13520 0 82402 0 15417 0 482250 0 0 0 J GRANT WICKLUND PRESIDENT-CEO LMC 451185 0 74595 0 29382 0 241737 0 21966 0 818865 0 0 0 WILLIAM ANDERSON MEDICAL DIRECTOR 686101 0 27160 0 11138 0 16430 0 25605 0 766434 0 0 0 DAVID HAMM PRESIDENT-CEO EGSM 428582 0 71471 0 30365 0 189399 0 18960 0 738777 0 0 0 STEVE LOVELESS PRESIDENT CEO SVH-MT REG 461919 0 71543 0 94782 0 75503 0 21607 0 725354 0 80560 0 THOMAS PETERSON CHIEF SAFETY OFFICER 1/1-9/9 229046 0 36417 0 247934 0 14095 0 20923 0 548415 0 0 0 ROBERT LADENBURGER FORMER KEY EMPLOYEE 0 0 0 0 323002 0 0 0 6893 0 329895 0 0 0 PART I, LINE 1A TAX INDEMNIFICATION AND GROSS-UP PAYMENTS THE ORGANIZATION AND RELATED ORGANIZATIONS ALLOW FOR CERTAIN TAX INDEMNIFICATION AND GROSS-UP PAYMENTS IN THE INSTANCES OF RELOCATION. THESE AMOUNTS ARE TREATED AS TAXABLE COMPENSATION. THE INDIVIDUALS THAT RECEIVED TAX GROSS-UP PAYMENTS IN 2016 WERE: MICHAEL TAYLOR - $2,141, KERRY KOHNEN - $1,477. PART I, LINE 1B TAX INDEMNIFICATION AND GROSS-UP PAYMENTS - WRITTEN POLICY THE ORGANIZATION AND RELATED ORGANIZATIONS DO NOT HAVE A FORMAL WRITTEN POLICY FOR TAX INDEMNIFICATION AND GROSS-UP PAYMENTS. HOWEVER, BEFORE ANY TAX INDEMNIFICATION AND GROSS-UP PAYMENTS ARE MADE; PROPER APPROVAL FROM THE EMPLOYEE'S MANAGER IS REQUIRED. IN ADDITION, APPROVAL IS ALSO REQUIRED FROM HUMAN RESOURCES. PART I, LINE 3 COMPENSATION OF THE ORGANIZATION'S CEO/EXECUTIVE DIRECTOR COMPENSATION FOR THE OFFICERS AND SENIOR MANAGEMENT IS MANAGED BY THE SISTERS OF CHARITY OF LEAVENWORTH HEALTH SYSTEM, INC. (SCL HEALTH) BOARD COMPENSATION COMMITTEE (COMMITTEE) ON BEHALF OF SCL HEALTH AND ALL OF ITS AFFILIATES. THE COMMITTEE REVIEWS AND APPROVES COMPENSATION ARRANGEMENTS OF THE OFFICERS AND SENIOR MANAGEMENT AND MAKES RECOMMENDATIONS TO SCL HEALTH'S BOARD FOR APPROVAL OF ANY CHANGES TO COMPENSATION FOR THE OFFICERS AND SENIOR MANAGEMENT. THE COMMITTEE'S REVIEW IS CONDUCTED IN A MANNER THAT IS INTENDED TO QUALIFY FOR THE REBUTTABLE PRESUMPTION OF REASONABLENESS UNDER THE INTERMEDIATE SANCTIONS RULES OF INTERNAL REVENUE CODE SECTION 4958. THE COMMITTEE CONDUCTS THE REVIEW WITH THE ASSISTANCE OF AN EXPERIENCED AND INDEPENDENT COMPENSATION CONSULTING FIRM THAT HAS DEEP NATIONAL EXPERTISE IN HEALTH SYSTEMS' EXECUTIVE COMPENSATION PROGRAMS AND LEVELS. THE COMMITTEE OBTAINS AND RELIES UPON CURRENT, COMPARABLE MARKET DATA FOR PEER ORGANIZATIONS PRIOR TO MAKING COMPENSATION RELATED DECISIONS. THE INFORMATION REVIEWED INCLUDES COMPENSATION LEVELS PAID BY SIMILARLY SITUATED ORGANIZATIONS FOR FUNCTIONALLY COMPARABLE POSITIONS, THE AVAILABILITY OF SIMILAR SERVICES IN THE GEOGRAPHIC AREA SERVED BY SCL HEALTH AND CURRENT COMPENSATION SURVEYS COMPILED BY AN INDEPENDENT FIRM. CONSISTENT WITH THE PAY PHILOSOPHY SET BY SCL HEALTH'S BOARD, THE COMMITTEE EMPHASIZES THE IMPORTANCE OF ENSURING TOTAL REMUNERATION IS REASONABLE AND APPROPRIATE WHEN REVIEWING AND MAKING RECOMMENDATIONS WITH RESPECT TO COMPENSATION PACKAGES FOR THE OFFICERS AND SENIOR MANAGEMENT. AS PART OF THE REVIEW PROCESS, SCL HEALTH USES THE FOLLOWING IN ESTABLISHING THE COMPENSATION OF OFFICERS AND SENIOR MANAGEMENT. 1) COMPENSATION COMMITTEE 2) INDEPENDENT COMPENSATION CONSULTANT 3) FORM 990 OF OTHER ORGANIZATIONS 4) WRITTEN EMPLOYMENT CONTRACTS 5) COMPENSATION SURVEYS AND STUDIES 6) APPROVAL BY THE BOARD OR COMPENSATION COMMITTEE THE ITEMS LISTED ABOVE SUPPORT THE COMPENSATION COMMITTEE'S EFFORTS TO ENSURE THAT THE LEVEL OF COMPENSATION PROVIDED TO ITS OFFICERS AND SENIOR MANAGEMENT IS REASONABLE, APPROPRIATE AND CONSISTENT WITH THE PAY PHILOSOPHY SET BY THE BOARD. PART I, LINES 4A-B SCHEDULE J, PART I, LINE 4A THE ORGANIZATION AND RELATED ORGANIZATIONS PERIODICALLY INCUR SEVERANCE PAYMENTS TO FORMER EMPLOYEES. THE INDIVIDUALS AND THE AMOUNTS PAID FOR SEVERANCE IN 2016 WERE: ROBERT LADENBURGER - $318,682, THOMAS PETERSON - $100,522. SCHEDULE J, PART I, LINE 4B PAYMENTS FROM NONQUALIFIED SUPPLEMENTAL EXECUTIVE RETIREMENT PLAN THE ORGANIZATION PROVIDES NONQUALIFIED DEFERRED COMPENSATION PLANS (NQDC) KNOWN AS SUPPLEMENTAL EXECUTIVE RETIREMENT PROGRAM (SERP) FOR EXECUTIVES (SENIOR MANAGEMENT) TO COMPENSATE FOR REGULATORY IMPOSED LIMITATIONS IN QUALIFIED RETIREMENT PLANS AND TO PROVIDE A BENEFIT CONSISTENT WITH OTHER NOT FOR PROFIT HEALTH SYSTEMS. THESE PLANS ENABLE THE EXECUTIVE TO EARN BENEFITS DURING EACH YEAR THAT THEY PARTICIPATE. IN 2014, IN AN EFFORT TO REDUCE LONG-TERM COST AND HAVE GREATER CONTROL OVER FINANCIAL RISK, THE SERP WAS CONVERTED FROM A DEFINED BENEFIT (DB) TO A DEFINED CONTRIBUTION (DC) DESIGN. CERTAIN MEMBERS OF SENIOR MANAGEMENT WHOSE BENEFITS WERE CONVERTED FROM DB TO DC WOULD HAVE BEEN DISPROPORTIONATELY AND NEGATIVELY AFFECTED BY THE CHANGE, SO THE COMMITTEE DETERMINED IT WOULD BE APPROPRIATE TO GRANT "TRANSITION CREDITS" IN ORDER TO MITIGATE THE NEGATIVE IMPACT OF THE CHANGE ON THEIR RETIREMENT BENEFITS. THIS IS A COMMON APPROACH EMPLOYED BY OTHER ORGANIZATIONS UNDERGOING A SIMILAR TRANSITION. THE TRANSITION CREDITS VEST IN ACCORDANCE WITH THE TERMS OF THE DC SERP (I.E., AFTER THREE YEARS) AND ARE PAID TO THE EXECUTIVE UPON VESTING. NQDC SERP PLANS PRIOR TO 2014 PRIOR TO 2014, THE ORGANIZATION'S NQDC SERP PLAN PROVIDED A BENEFIT TO ELIGIBLE PARTICIPANTS BASED ON A PERCENTAGE OF THEIR BASE COMPENSATION. THE VESTING PERIOD IS 5 YEARS OR WHEN THE PARTICIPANT IS AGE 65 OR OLDER. THERE WERE NO CONTRIBUTIONS TO THIS PLAN AFTER DECEMBER 31, 2013. THE ORGANIZATION HAS DETERMINED THAT THESE BENEFITS SHOULD BE SUBJECT TO TAXATION AS THE AMOUNTS ARE VESTED RATHER THAN WHEN THEY ARE RECEIVED. AS A RESULT, THE TOTAL NONQUALIFIED RETIREMENT PLAN BENEFITS, WHICH WERE VESTED IN THE CURRENT YEAR, ARE CONSIDERED TAXABLE AND THUS WERE TAXED TO THE PARTICIPANTS. FOR SOME OF THE PARTICIPANTS, AN AMOUNT EQUAL TO THE PARTICIPANT'S EXPECTED INCOME TAX LIABILITY WAS WITHDRAWN FROM THE PARTICIPANT'S ACCOUNT AND REMITTED TO THE FEDERAL AND STATE GOVERNMENTS AS WITHHOLDING ON THE TAXABLE BENEFIT. NO CASH PAYMENT IS MADE DIRECTLY TO THE PARTICIPANT AND THE REMAINING BENEFIT AMOUNT STAYS IN THE RETIREMENT PLAN. THE AMOUNTS WITHDRAWN FROM THE PLAN FOR TAXES IN 2016 WERE: LYDIA JUMONVILLE - $86,105, STEVEN CHYUNG - $37,071, MARK WILKINSON - $24,970, STEVE LOVELESS - $36,382. FOR AMOUNTS CONTRIBUTED TO THE NQDC SERP PLAN PRIOR TO 2014, VESTED AMOUNTS ARE PAYABLE UPON THE END OF EMPLOYMENT. THE VESTED AMOUNTS WITHDRAWN INCLUDE AMOUNTS PREVIOUSLY TAXED TO THE RECIPIENT AND AMOUNTS TAXABLE TO THE RECIPIENT IN THE CURRENT YEAR. THE TAXABLE AMOUNTS ARE INCLUDED ON THE RECIPIENT'S W-2. ANY DISTRIBUTIONS FROM THIS PLAN ARE REPORTED BELOW. NQDC SERP PLANS STARTING IN 2014 STARTING IN 2014, THE ORGANIZATION'S NQDC SERP PLAN PROVIDED A BENEFIT TO ELIGIBLE PARTICIPANTS BASED ON A PERCENTAGE OF THEIR BASE COMPENSATION. THE VESTING PERIOD IS ROLLING 3 YEARS OR WHEN THE PARTICIPANT IS AGE 65 OR OLDER. THERE WERE NO CONTRIBUTIONS TO THIS PLAN BEFORE JANUARY 1, 2014. ANY DISTRIBUTIONS FROM THIS PLAN ARE REPORTED BELOW. STARTING IN 2014, FOR CONTRIBUTIONS TO THE NQDC SERP PLAN, CERTAIN PARTICIPANTS ARE VESTED OR BECAME VESTED IN THE PLAN DURING 2016. VESTED AMOUNTS ARE PAYABLE TO THE RECIPIENT. THE VESTED AMOUNTS ARE TAXABLE TO THE RECIPIENT IN THE CURRENT YEAR. THE TAXABLE AMOUNTS ARE INCLUDED ON THE RECIPIENT'S W-2. THE AMOUNTS WITHDRAWN FROM THE NQDC SERP PLANS IN 2016 WERE: MICHAEL SLUBOWSKI - $566,716, WILLIAM ANDERSON - $77,197, DAVID PECORARO - $90,679, GERALDINE TOWNDROW - $34,500, THOMAS PETERSON - $114,483. IN ACCORDANCE WITH THE REQUIREMENTS OF SCHEDULE J, DEFERRED COMPENSATION EARNED OVER THE VESTING PERIOD IS REPORTED IN COLUMN C AND ANY AMOUNTS VESTED/PAID FROM A DEFERRED COMPENSATION PLAN ARE REPORTED IN COLUMN B(III). THUS, THE SAME AMOUNT WOULD BE REPORTED TWICE (FIRST WHEN IT ACCRUED DURING THE VESTING PERIOD AND AGAIN WHEN IT IS VESTED/PAID). THIS RESULTS IN THE APPEARANCE OF CERTAIN EXECUTIVES RECEIVING MORE THAN THEY ARE ACTUALLY PAID FROM THE DEFERRED COMPENSATION PLANS. COLUMN F IS INTENDED TO RECONCILE THIS DUPLICATION (BY REPORTING AMOUNTS INCLUDED IN COLUMN B(III) THAT HAD BEEN REPORTED AS DEFERRED COMPENSATION ON A SCHEDULE J FOR A PREVIOUS YEAR). HOWEVER, THE SIGNIFICANCE OF THE AMOUNTS LISTED IN COLUMN F IS OFTEN OVERLOOKED AND GIVEN THE COMPLEXITY OF THE SCHEDULE J REPORTING REQUIREMENTS, THE AMOUNTS SHOWN ARE EASILY MISUNDERSTOOD. TO DETERMINE TOTAL AMOUNT EARNED (RATHER THAN THE AMOUNT VESTED/PAID OUT) DURING THE YEAR, SUBTRACT THE AMOUNT IN COLUMN F FROM COLUMN E. PART I, LINE 7 OTHER NON-FIXED PAYMENTS THE AT RISK COMPENSATION PLAN WAS ESTABLISHED TO ENABLE THE HEALTH CARE SYSTEM AND ITS CARE SITES TO ATTRACT AND ENGAGE QUALIFIED LEADERS AND TO PROVIDE SUCH LEADERS WITH AN ADDITIONAL PERFORMANCE COMPENSATION OPPORTUNITY TO PROMOTE AND FURTHER ITS CHARITABLE MISSION, VISION, STRATEGIC PRIORITIES AND KEY INITIATIVES. THE PLAN OPERATES ON A CALENDAR-YEAR BASIS AND IS FUNDED EACH YEAR BY MEETING THRESHOLD LEVELS OF OPERATING INCOME. TARGET AWARD AMOUNTS ARE A PERCENTAGE OF LEADERS' BASE PAY AS DETERMINED BY THEIR SPECIFIC ROLE AT THE HEALTH CARE SYSTEM. ACTUAL AWARDS ARE PAID OUT BASED ON ATTAINMENT OF BOARD APPROVED GOALS, INCLUDING OPERATING INCOME, STEWARDSHIP, PATIENT EXPERIENCE, EMPLOYEE SAFETY AND COMMUNITY BENEFIT/MISSION TARGETS. AWARDS ARE BASED ON THE BOARD'S DETERMINATION ON HOW WELL THE HEALTH CARE SYSTEM PERFORMS RELATIVE TO THE PLAN'S STATED PERFORMANCE STANDARDS AND THE WEIGHT GIVEN TO EACH OF THE PERFORMANCE MEASURES AS DEFINED FOR THAT PLAN YEAR. THE AT RISK COMPENSATION PLANS ARE BASED ON A COMBINATION OF PERFORMANCE MEASURES. PERFORMANCE MEASURES INCLUDE OPERATING INCOME, STEWARDSHIP, PATIENT EXPERIENCE, EMPLOYEE SAFETY AND COMMUNITY BENEFIT/MISSION TARGETS. THE AT RISK COMPENSATION PLAN SHALL BE INTERPRETED, APPLIED AND ADMINISTERED AT ALL TIMES IN ACCORDANCE WITH CODE SECTION 409A AND GUIDANCE ISSUED THEREUNDER. THE HEALTH CARE SYSTEM RESERVES THE RIGHT TO AMEND OR TERMINATE THIS PLAN AT ANY TIME FOR ANY REASON. ADDITIONAL OFFICER AND BOARD DISCLOSURES THE SISTERS OF CHARITY OF LEAVENWORTH HEALTH SYSTEM, INC. (SCLHS) AND RELATED TAX EXEMPT ORGANIZATIONS CONSISTS OF NINE HOSPITALS, NINE FOUNDATIONS, TWO SAFETY-NET CLINICS, ONE CHILDREN'S MENTAL HEALTH CENTER AND MORE THAN 190 AMBULATORY SERVICE CENTERS IN THREE STATES. SCLHS AND RELATED TAX EXEMPT ORGANIZATIONS ADHERE TO GOVERNANCE EXCELLENCE STANDARDS INCLUDING TRANSPARENCY AND ACCOUNTABILITY. IN KEEPING WITH SCLHS' CORE VALUE OF STEWARDSHIP, NO BOARD MEMBER SERVING ON THE BOARD OF DIRECTORS (BOARD) IS COMPENSATED FOR THAT SERVICE. SCLHS' BOARD COMPENSATION COMMITTEE (COMMITTEE) HAS RETAINED THE SERVICES OF AN INDEPENDENT COMPENSATION ADVISOR. THE COMPENSATION ADVISOR IS RESPONSIBLE FOR ADVISING THE COMMITTEE ON ALL MATTERS RELATING TO EXECUTIVE COMPENSATION INCLUDING SUPPORTING THE COMMITTEE'S EFFORTS TO ENSURE THAT THE LEVEL OF COMPENSATION PROVIDED OFFICERS AND SENIOR MANAGEMENT IS REASONABLE, APPROPRIATE AND CONSISTENT WITH THE PAY PHILOSOPHY SET BY THE BOARD. THE SISTERS WHO SERVE AS OFFICERS AND/OR BOARD MEMBERS ARE MEMBERS OF THE SISTERS OF CHARITY OF LEAVENWORTH (A RELIGIOUS ORDER OF WOMEN). THE SISTERS HAVE TAKEN VOWS OF POVERTY AND RECEIVE NO COMPENSATION, EXPENSE ACCOUNT ALLOWANCE, OR CONTRIBUTIONS TO BENEFIT PLANS FOR THEIR SERVICES TO THE HEALTH CARE SYSTEM. HOWEVER, A PAYMENT IS MADE DIRECTLY TO THE SISTERS OF CHARITY OF LEAVENWORTH FOR THE SERVICES OF THOSE WHO PERFORM PROFESSIONAL, ADMINISTRATIVE, AND OTHER SUCH SERVICES. A COLORADO HEALTH FACILITIES AUTHORITY 840752932 19648AST3 2010-05-20 605460143 3/24/98,11/13/02,7/18/02 REFI+HOSP FA 0 0 0 B MONTANA FACILITY FINANCE AUTHORITY 810302402 61204KHV6 2010-05-20 217535868 3/24/98 & 5/25/00 REFI+HOSP FAC 0 0 0 C KANSAS DEVELOPMENT FINANCE AUTHORITY 481066589 48542K5N5 2010-05-20 202625401 3/24/98 & 5/25/00 REFI+HOSP FAC 1 0 0 D COLORADO HEALTH FACILITIES AUTHORITY 840752932 NONEAVAIL 2011-06-15 62620000 7/18/02 & 2/4/09 REFI 0 0 0 A 74170000 605500535 6836215 310650923 288013397 2010 1 1 1 1 B 32180000 217665906 2529281 94781550 120355075 2010 1 0 1 1 C 29745000 135375000 202625401 2488006 77008019 123129376 2010 1 0 1 1 D 5105000 62620000 420000 62200000 2011 1 0 1 1 A 0 1 1 1 0 0 0 1 B 0 1 1 1 0 0.01300 0.00100 0.01400 0 0 1 C 0 1 1 1 0 1 1 0.64520 1 1 D 0 1 1 1 0 0 0 1 A 0 0 0 1 0 0 0 0 1 B 0 0 0 1 0 0 0 0 1 C 0 0 0 1 0 0 0 0 1 D 0 0 0 1 1 0 0 0 1 A 1 B 1 C 1 D 1 PART IV, LINE 2C REBATE COMPLETION DATES: A - COLORADO HEALTH FACILITIES AUTHORITY 2010 - 5/20/16 B - MONTANA FACILITY FINANCE AUTHORITY 2010 - 5/20/16 C - KANSAS DEVELOPMENT FINANCE AUTHORITY 2010 - 5/20/16 D - COLORADO HEALTH FACILITIES AUTHORITY 2011 - 6/15/16 A - COLORADO HEALTH FACILITIES AUTHORITY 2013 - 11/12/16 B - KANSAS DEVELOPMENT FINANCE AUTHORITY 2013 - 5/20/16 PART I COLUMN (E) & PART II LINE 3 ANY DIFFERENCE BETWEEN ISSUES PRICE REPORTED ON PART I, COLUMN (E) AND TOTAL PROCEEDS REPORTED ON PART II, LINE 3 IS DUE TO INVESTMENT EARNINGS. PART III, LINE 8B PROVIDENCE MEDICAL CENTER (KANSAS CITY, KS) AND SAINT JOHN HOSPITAL (LEAVENWORTH, KS) WERE SOLD APRIL 2013 AND REMEDIAL ACTIONS (REISSUANCE AND REDEMPTION) WERE TAKEN WITH RESPECT TO THE OUTSTANDING BONDS. A COLORADO HEALTH FACILITY AUTHORITY 840752932 19648AN84 2013-11-12 302719375 CONSTRUCT HOSPITAL FACILITY 0 0 0 B KANSAS DEVELOPMENT FINANCE AUTHORITY 481066589 48542K5N5 2013-04-01 32775000 REISSUANCE OF KANSAS 2010 1 0 0 C COLORADO HEALTH FACILITY AUTHORITY 840752932 19648A5S0 2016-05-12 221970000 CONSTRUCT HOSPITAL FACILITY 0 0 0 A 302719375 3005563 299713812 2013 0 0 1 1 B 3170000 7805000 32775000 32775000 2013 0 0 1 1 C 221976622 1908538 219956622 111462 2016 0 0 0 1 A 0 1 1 1 0 0 0 1 B 0 1 1 1 0 0 0 1 C 0 1 1 1 0 0 0 1 A 0 0 0 1 0 0 0 0 1 B 0 0 0 1 0 0 0 0 1 C 0 1 0 0 1 0 0 0 1 A 1 B 1 C 1 FORM 990, PART VI, SECTION A, LINE 6 THE MEMBERS OF SISTERS OF CHARITY OF LEAVENWORTH HEALTH SYSTEM, INC. (SCLHS) SHALL BE THE MEMBERS OF LEAVEN MINISTRIES. THE MEMBERS OF LEAVEN MINISTRIES SHALL SERVE AS MEMBERS OF SCLHS DURING THEIR TERMS OF OFFICE AS MEMBERS OF LEAVEN MINISTRIES. FORM 990, PART VI, SECTION A, LINE 7A THE PRESIDENT/CHIEF EXECUTIVE OFFICER OF THE CORPORATION AND THE CHAIR OF LEAVEN MINISTRIES, OR HIS/HER DESIGNEE, SHALL BE EX-OFFICIO MEMBERS OF THE BOARD WITH FULL VOTING RIGHTS. THE CHAIR OF LEAVEN MINISTRIES SHALL APPOINT AN ADDITIONAL MEMBER OF THE CORPORATION TO SERVE ON THE BOARD OF DIRECTORS OF THE CORPORATION. THE BOARD OF DIRECTORS SHALL ENSURE THE PRESENCE OF REPRESENTATIVES NOMINATED BY THE PARTICIPATING ENTITIES ON THIS BOARD AND ON THE BOARD OF ANY CORPORATION OF WHICH THIS CORPORATION IS A CONTROLLING MEMBER. EXCEPT FOR EX-OFFICIO MEMBERS OF THE BOARD OF DIRECTORS, THE MEMBERS SHALL APPOINT DIRECTORS AT THE ANNUAL MEETING OF THE MEMBERS. A SLATE OF NAMES PROPOSED BY A NOMINATING COMMITTEE OF THE BOARD OF DIRECTORS FOR APPOINTMENT AS DIRECTORS SHALL BE SUBMITTED TO THE MEMBERS BY THE CHAIRPERSON OF THE BOARD, PROVIDED, HOWEVER, THAT THE MEMBERS MAY APPOINT INDIVIDUALS AS DIRECTORS WHO HAVE NOT BEEN NOMINATED BY THE NOMINATING COMMITTEE. FORM 990, PART VI, SECTION A, LINE 7B THE MEMBERS OF THE CORPORATION SHALL BE THE MEMBERS OF LEAVEN MINISTRIES. THE MEMBERS OF LEAVEN MINISTRIES SHALL SERVE AS MEMBERS OF THE CORPORATION DURING THEIR TERM OF OFFICE AS MEMBERS OF LEAVEN MINISTRIES. IN ADDITION TO ALL MATTERS REQUIRED BY LAW OR BY THE ARTICLES OF INCORPORATION OR OTHER PROVISIONS OF THESE BYLAWS WHICH ARE REQUIRED TO BE PERFORMED BY THE MEMBERS, THE MEMBERS SHALL HAVE THE SOLE PREROGATIVE TO ACT UPON ANY OF THE FOLLOWING MATTERS AND, IF ANY ACTION WITH RESPECT TO ANY OF THE FOLLOWING IS INITIATED BY A BODY OTHER THAN THE MEMBERS, IT SHALL NOT BECOME EFFECTIVE UNTIL APPROVED BY AN AFFIRMATIVE VOTE OF THE MEMBERS: TO ESTABLISH/APPROVE THE MISSION/PHILOSOPHY OF THIS CORPORATION AND ANY CORPORATION OF WHICH THIS CORPORATION IS THE CONTROLLING MEMBER; TO ADOPT, AMEND OR REPEAL THE ARTICLES OF INCORPORATION OR BYLAWS OF THIS CORPORATION AND THE ARTICLES AND BYLAWS OF ANY CORPORATION OF WHICH THIS CORPORATION IS THE CONTROLLING MEMBER; TO FIX THE NUMBER OF DIRECTORS OF THIS CORPORATION AND APPOINT THE CORPORATION'S BOARD OF DIRECTORS, AFTER RECEIVING RECOMMENDATIONS FROM THE BOARD, PROVIDED THAT THE MEMBERS' APPOINTMENT AUTHORITY SHALL NOT BE LIMITED TO THE NOMINATIONS RECEIVED; TO REMOVE, WITH OR WITHOUT CAUSE, AFTER CONSULTATION WITH THE BOARD OF DIRECTORS, ANY MEMBER OF THE BOARD OF THIS CORPORATION; TO APPOINT AND REMOVE, WITH OR WITHOUT CAUSE, AFTER CONSULTATION WITH THE BOARD OF DIRECTORS, THE PRESIDENT/CHIEF EXECUTIVE OFFICER OF THIS CORPORATION; TO APPROVE FOR THIS CORPORATION, OR FOR ANY CORPORATION OF WHICH THIS CORPORATION IS THE CONTROLLING MEMBER, THE INCURRENCE OF INDEBTEDNESS OR THE SALE, TRANSFER, ASSIGNMENT, OR ENCUMBERING OF THE ASSETS, PURSUANT TO POLICIES ESTABLISHED FROM TIME TO TIME BY THE MEMBERS OF THIS CORPORATION; TO APPROVE THE MERGER, DISSOLUTION OR CORPORATE RESTRUCTURING OF THIS CORPORATION OR ANY CORPORATION OF WHICH THIS CORPORATION IS THE CONTROLLING MEMBER. FORM 990, PART VI, SECTION B, LINE 11B THE FORM 990 IS PREPARED BY THE TAX DEPARTMENT. THE FORM 990 IS REVIEWED BY SENIOR MANAGEMENT. A COPY OF THE FORM 990 IS PROVIDED TO THE BOARD OF DIRECTORS PRIOR TO THE FILING OF THE FORM 990 WITH THE INTERNAL REVENUE SERVICE. ANY QUESTIONS ARE ADDRESSED TO THE TAX DIRECTOR OF SCLHS PRIOR TO FILING THE FORM 990 WITH THE INTERNAL REVENUE SERVICE. THE FORM 990 WAS ALSO REVIEWED BY AN OUTSIDE ACCOUNTING FIRM. FORM 990, PART VI, SECTION B, LINE 12C MONITORING AND ENFORCEMENT OF COMPLIANCE WITH CONFLICT OF INTEREST POLICY SISTERS OF CHARITY OF LEAVENWORTH HEALTH SYSTEM, INC. (SCL HEALTH) REGULARLY AND CONSISTENTLY MONITORS AND ENFORCES ITS CONFLICT OF INTEREST POLICY BY PROVIDING EDUCATION AND TRAINING FOR ITS EMPLOYEES, STAFF, OFFICERS AND DIRECTORS. PERSONS CONSIDERED TO BE IN AN INFLUENTIAL POSITION, SUCH AS BOARD MEMBERS, OFFICERS, PHYSICIANS, EXECUTIVES AND MANAGERS ARE ALL REQUIRED TO COMPLETE A CONFLICT OF INTEREST STATEMENT ON AN ANNUAL BASIS TO DISCLOSE ANY POTENTIAL CONFLICT ISSUES. THESE STATEMENTS ARE CAREFULLY REVIEWED BY THE SCL HEALTH INTEGRITY AND COMPLIANCE DEPARTMENT AND APPROPRIATE LEADERSHIP. A REPORT IS PROVIDED TO SCLHS' PRESIDENT/CEO AND THE BOARD OF DIRECTORS. THE BUSINESS AND AFFAIRS OF SCL HEALTH WILL AT ALL TIMES BE CONDUCTED IN A MANNER THAT IS SOLELY IN THE BEST INTERESTS OF SCL HEALTH AND NOT BE INFLUENCED BY CONFLICTING INTERESTS OF PERSONS RESPONSIBLE FOR ADMINISTERING THOSE AFFAIRS. THE EXISTENCE OF ANY CONFLICTS OF INTEREST WILL BE DISCLOSED AND THE PROCEDURES SET FORTH HEREIN WILL BE FOLLOWED. CERTAIN TRANSACTIONS SUGGESTIVE OF A CONFLICT OF INTEREST ARE PROHIBITED. ANY PERSON IN A POSITION TO EXERCISE SUBSTANTIAL INFLUENCE OVER SCL HEALTH IS CONSIDERED AN INTERESTED PERSON. THIS TERM INCLUDES, BUT IS NOT LIMITED TO THE FOLLOWING: - BOARD MEMBERS, BOARD COMMITTEE MEMBERS, OFFICERS AND DIRECTORS; - SENIOR LEADERS AND EXECUTIVES (CEO, PRESIDENT, SVP, VP, EXECUTIVE DIRECTORS); - EMPLOYED PHYSICIANS AND PHYSICIANS IN MEDICAL STAFF LEADERSHIP ROLES (E.G., DEPARTMENT CHAIRS, MEMBERS OF MEDICAL STAFF COMMITTEES); - MEDICAL DIRECTORS OF CLINICAL PROGRAMS THAT ASSESS, REVIEW, RECOMMEND OR REQUEST PURCHASE OF ANY SPECIFIC PHARMACEUTICAL PRODUCTS, MEDICAL DEVICES, SUPPLIES AND/OR EQUIPMENT; - DEPARTMENT DIRECTORS AND MANAGERS; AND - OTHER SELECT INDIVIDUALS IDENTIFIED BY LEADERSHIP WHICH MAY INCLUDE, BUT IS NOT LIMITED TO, SUPPLY CHAIN AND FINANCE. UPON BECOMING AN INTERESTED PERSON AND ON AN ANNUAL BASIS, INTERESTED PERSONS ARE REQUIRED TO DISCLOSE ANY RELATIONSHIPS THAT CONSTITUTE OR MIGHT LEAD TO A CONFLICT OF INTEREST BY COMPLETING THE CURRENT CONFLICT OF INTEREST AND GIFT DISCLOSURE STATEMENT ("STATEMENT") AS APPROVED BY THE CHIEF INTEGRITY AND COMPLIANCE OFFICER. THE CHIEF INTEGRITY AND COMPLIANCE OFFICER WILL OVERSEE THE REVIEW OF THE STATEMENTS AND THE RESOLUTION OF ANY IDENTIFIED CONFLICTS OF INTEREST AND ALERT THE SCL HEALTH CEO AND/OR THE CHAIR OF THE SCL HEALTH BOARD OF DIRECTORS TO ANY ITEMS OF CONCERN. WHEN AN INTERESTED PERSON BECOMES AWARE OF A CONFLICT OF INTEREST WHICH HAS NOT BEEN DISCLOSED ON A STATEMENT, HE OR SHE SHALL CONTACT THE LOCAL COMPLIANCE AND PRIVACY OFFICER OR THE CHIEF INTEGRITY AND COMPLIANCE OFFICER, OBTAIN A STATEMENT FORM, COMPLETE AND RETURN IT TO THE SCL HEALTH INTEGRITY AND COMPLIANCE DEPARTMENT. WHENEVER AN INTERESTED PERSON BECOMES AWARE THAT AN ARRANGEMENT WITH RESPECT TO WHICH HE OR SHE HAS A CONFLICT OF INTEREST IS BEING CONSIDERED, THE INTERESTED PERSON MUST DISCLOSE ALL MATERIAL FACTS CONCERNING THE EXISTENCE AND NATURE OF THE CONFLICT OF INTEREST TO HIS OR HER SUPERVISOR (IF AN EMPLOYEE OTHER THAN THE ORGANIZATIONS SCL HEALTH CEO) OR TO THE APPLICABLE BOARD OR COMMITTEE CHAIR (IF THE SCL HEALTH CEO OR A BOARD OR COMMITTEE MEMBER), EVEN IF THE CONFLICT OF INTEREST HAS BEEN PREVIOUSLY DISCLOSED. WITH REGARD TO EMPLOYEES OTHER THAN THE SCL HEALTH CEO, THE INTERESTED PERSON'S SUPERVISOR WILL DETERMINE WHETHER A CONFLICT OF INTEREST EXISTS. WITH REGARD TO THE SCL HEALTH CEO AND BOARD OR COMMITTEE MEMBERS, THE REMAINING MEMBERS OF THE BOARD OR COMMITTEE WILL DETERMINE WHETHER A CONFLICT OF INTEREST EXISTS. PERSON(S) RESPONSIBLE FOR THE DETERMINATION SHOULD OBTAIN FURTHER GUIDANCE FROM THE SCL HEALTH INTEGRITY AND COMPLIANCE OR LEGAL DEPARTMENTS. UPON MAKING HIS OR HER DISCLOSURE, THE INTERESTED PERSON WILL LEAVE THE MEETING OR OTHERWISE REMOVE HIM OR HERSELF FROM THE DELIBERATIONS OR OTHER DECISION-MAKING PROCESS UNTIL SUCH TIME AS A DETERMINATION IS REACHED. IF A DETERMINATION HAS BEEN MADE THAT NO CONFLICT OF INTEREST EXISTS, THE INTERESTED PERSON MAY BE PRESENT AND PARTICIPATE IN THE DELIBERATION REGARDING THE TRANSACTION OR ARRANGEMENT. HOWEVER, IF AN INTERESTED PERSON HAS BEEN DETERMINED TO HAVE A CONFLICT OF INTEREST, HE OR SHE MAY NOT PARTICIPATE IN THE DELIBERATION OR DECISION REGARDING THE TRANSACTION OR ARRANGEMENT; BE PRESENT DURING THE DELIBERATION OR DECISION-MAKING; OR BE ALLOWED TO MAKE A PRESENTATION PRIOR TO THE DELIBERATION AND DECISION-MAKING ACTIVITIES. WHEN AN INTERESTED PERSON HAS A CONFLICT OF INTEREST, THE DECISION-MAKER/DECISION-MAKING BODY CONSIDERING THE TRANSACTION OR ARRANGEMENT WILL TAKE REASONABLE MEASURES, PRIOR TO APPROVING OR ENTERING INTO THE TRANSACTION OR ARRANGEMENT, TO ENSURE THAT THE PROPOSAL IS IN SCL HEALTH'S BEST INTERESTS. THE PROPOSED TRANSACTION OR ARRANGEMENT MAY PROCEED IF THE DECISION-MAKER/DECISION-MAKING BODY, AFTER HAVING BEEN FULLY INFORMED OF THE MATERIAL FACTS ESTABLISHING THE CONFLICT OF INTEREST, DETERMINES THAT THE TRANSACTION OR ARRANGEMENT IS IN SCL HEALTH'S BEST INTERESTS AND IS FAIR AND REASONABLE. A MAJORITY VOTE OF THE DISINTERESTED DECISION-MAKERS IS REQUIRED WHEN A DETERMINATION IS MADE BY A BOARD, COMMITTEE OR OTHER DECISION-MAKING BODY. MANAGEMENT OF POTENTIAL CONFLICTS IS DONE BY THE CHIEF INTEGRITY AND COMPLIANCE OFFICER AND/OR CARE SITE COMPLIANCE AND PRIVACY OFFICERS AND REPORTED ANNUALLY TO THE CARE SITE LEADERSHIP COMMITTEES AND/OR EXECUTIVE INTEGRITY AND COMPLIANCE COMMITTEE, THE AUDIT COMMITTEE, ORGANIZATIONAL INTEGRITY AND COMPLIANCE COMMITTEE OF THE SCL HEALTH BOARD OF DIRECTORS. ANY REPORTED CONFLICTS OR POTENTIAL CONFLICTS WILL ALSO BE REPORTED TO AND REVIEWED BY THE SCL HEALTH TAX DIRECTOR FOR COMPLIANCE WITH THE FORM 990 TAX RETURN. FORM 990, PART VI, SECTION B, LINE 15 SISTERS OF CHARITY OF LEAVENWORTH HEALTH SYSTEM, INC. (SCL HEALTH) PROCESS FOR DETERMINING COMPENSATION FOR THE OFFICERS AND SENIOR MANAGEMENT IS THE RESPONSIBILITY OF THE COMPENSATION COMMITTEE. COMPENSATION FOR THE OFFICERS AND SENIOR MANAGEMENT IS MANAGED BY THE SCL HEALTH BOARD COMPENSATION COMMITTEE (COMMITTEE) ON BEHALF OF SCL HEALTH AND ALL OF ITS AFFILIATES. THE COMMITTEE REVIEWS AND APPROVES COMPENSATION ARRANGEMENTS OF THE OFFICERS AND SENIOR MANAGEMENT AND MAKES RECOMMENDATIONS TO SCL HEALTH'S BOARD FOR APPROVAL OF ANY CHANGES TO COMPENSATION FOR THE OFFICERS AND SENIOR MANAGEMENT. THE COMMITTEE'S REVIEW IS CONDUCTED IN A MANNER THAT IS INTENDED TO QUALIFY FOR THE REBUTTABLE PRESUMPTION OF REASONABLENESS UNDER THE INTERMEDIATE SANCTIONS RULES OF INTERNAL REVENUE CODE SECTION 4958. THE COMMITTEE CONDUCTS THE REVIEW WITH THE ASSISTANCE OF AN EXPERIENCED AND INDEPENDENT COMPENSATION CONSULTING FIRM THAT HAS DEEP NATIONAL EXPERTISE IN HEALTH SYSTEMS' EXECUTIVE COMPENSATION PROGRAMS AND LEVELS. THE COMMITTEE OBTAINS AND RELIES UPON CURRENT, COMPARABLE MARKET DATA FOR PEER ORGANIZATIONS PRIOR TO MAKING COMPENSATION RELATED DECISIONS. THE INFORMATION REVIEWED INCLUDES COMPENSATION LEVELS PAID BY SIMILARLY SITUATED ORGANIZATIONS FOR FUNCTIONALLY COMPARABLE POSITIONS, THE AVAILABILITY OF SIMILAR SERVICES IN THE GEOGRAPHIC AREA SERVED BY SCL HEALTH AND CURRENT COMPENSATION SURVEYS COMPILED BY AN INDEPENDENT FIRM. CONSISTENT WITH THE PAY PHILOSOPHY SET BY SCL HEALTH'S BOARD, THE COMMITTEE EMPHASIZES THE IMPORTANCE OF ENSURING TOTAL REMUNERATION IS REASONABLE AND APPROPRIATE WHEN REVIEWING AND MAKING RECOMMENDATIONS WITH RESPECT TO COMPENSATION PACKAGES FOR THE OFFICERS AND SENIOR MANAGEMENT. AS PART OF THE REVIEW PROCESS, SCL HEALTH USES THE FOLLOWING IN ESTABLISHING THE COMPENSATION OF OFFICERS AND SENIOR MANAGEMENT. 1) COMPENSATION COMMITTEE 2) INDEPENDENT COMPENSATION CONSULTANT 3) FORM 990 OF OTHER ORGANIZATIONS 4) WRITTEN EMPLOYMENT CONTRACTS 5) COMPENSATION SURVEYS AND STUDIES 6) APPROVAL BY THE BOARD OR COMPENSATION COMMITTEE THE ITEMS LISTED ABOVE SUPPORT THE COMPENSATION COMMITTEE'S EFFORTS TO ENSURE THAT THE LEVEL OF COMPENSATION PROVIDED TO ITS OFFICERS AND SENIOR MANAGEMENT IS REASONABLE, APPROPRIATE AND CONSISTENT WITH THE PAY PHILOSOPHY SET BY THE BOARD. FORM 990, PART VI, SECTION C, LINE 19 THE ORGANIZATION MAKES ITS CONFLICT OF INTEREST POLICY, FINANCIAL STATEMENTS, AND GOVERNING DOCUMENTS AVAILABLE UPON REQUEST. FORM 990, PART XI, LINE 9: CHANGE IN SELF INSURED LIABILITY 1,577,654. EQUITY TRANSFER - FUND NEGATIVE CASH BALANCES IN PHYSICIAN CLINICS 72,900,000. EQUITY TRANSFER - INTEREST EXPENSE IN EXCESS OF INTEREST INCOME 99,091,862. EQUITY TRANSFER - MARIAN CLINIC 649,000. EQUITY TRANSFER - MOUNT SAINT VINCENT HOME 3,800,000. EQUITY TRANSFER - REFUNDING OF KANSAS 2010 BOND ISSUE 163,662,319. EQUITY TRANSFER - REFUNDING OF KANSAS 2012 BOND ISSUE 32,467,007. EQUITY TRANSFER - SYSTEM ACQUISITION COST 280,000,000. EQUITY TRANSFER - UNRECOGNIZED LOSSES NOT EXPENSED TO PENSION PLAN 14,670,430. EQUITY TRANSFER - UNRECOVERED COST OF SYSTEM OFFICE FIXED ASSETS 20,558,442. FAS 157 CREDIT RISK ADJUSTMENT -46,756. FAS 158 UNRECOGNIZED FROZEN DB PLAN -2,317,242. LEAVEN INSURANCE DIVIDEND 15,500,000. SCL HEALTH MEDICAL GROUP - MONTANA LLC 500 ELDORADO BLVD SUITE 4300 BROOMFIELD CO 80021 471888400 PHYSICIAN SERVICES MT 0 0 SCLHS SCL HEALTH MEDICAL GROUP - BILLINGS LLC 1233 NORTH 30TH STREET BILLINGS MT 59101 464056262 PHYSICIAN SERVICES MT 54519851 16439581 SCL HEALTH MEDICAL GROUP - MONTANA LLC ST JAMES HEALTHCARE PHYSICIAN BILLING LLC 400 SOUTH CLARK STREET BUTTE MT 59701 273193107 PHYSICIAN SERVICES MT 6390530 1624994 SCL HEALTH MEDICAL GROUP - MONTANA LLC SCL HEALTH MEDICAL GROUP - MILES CITY LLC 2600 WILSON STREET MILES CITY MT 59301 464056338 PHYSICIAN SERVICES MT 0 0 SCL HEALTH MEDICAL GROUP - MONTANA LLC SCL HEALTH PARTNERS LLC 8300 WEST 38TH AVENUE WHEAT RIDGE CO 80033 020749530 HEALTHCARE SERVICES CO -6231535 14969805 SCLHS SCL HOME HEALTH SOLUTIONS LLC 500 ELDORADO BLVD SUITE 4300 BROOMFIELD CO 80021 462418729 HOME CARE DE 0 0 SCL HEALTH PARTNERS LLC SCL FRONT RANGE HOME HEALTH LLC 3980 QUEBEC STREET SUITE 100 DENVER CO 80207 841195134 HOME HEALTH SERVICES CO 3810338 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