ST ELIZABETHS HOSPITAL OF THE HOSPITAL SISTERS OF THE THIRD ORDE: Form 990, tax year 2015
View the entire original 990 at ProPublica ↗
- Organization
- ST ELIZABETHS HOSPITAL OF THE HOSPITAL SISTERS OF THE THIRD ORDE (EIN 37-0663567)
- Tax period
- 2015-07-01 to 2016-06-30
- Filed
- 2017-05-12
- IRS object ID
- 201711329349300511
- Schema version
- 2015v3.0
- Source
- Download XML · Original 990 at ProPublica
Every field in the e-filed return. Faint text is the IRS element name, for citing.
- Return header
- Form 990
- Schedule A
- Schedule B
- Schedule C
- Schedule D
- Schedule H
- Schedule J
- Schedule M
- Schedule O
- Schedule R
Return header ReturnHeader
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return | 2017-05-12T07:01:25-05:00 | ReturnTs |
| Tax Period End | 2016-06-30 | TaxPeriodEndDt |
Preparer Firm PreparerFirmGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Firm EIN | 350921680 | PreparerFirmEIN |
Preparer Firm Name PreparerFirmName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | CROWE HORWATH LLP | BusinessNameLine1Txt |
Preparer US Address PreparerUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 225 West Wacker Drive | AddressLine1Txt |
| Address Line2 | Suite 2600 | AddressLine2Txt |
| City | Chicago | CityNm |
| State Abbreviation | IL | StateAbbreviationCd |
| ZIP | 606061224 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990 | ReturnTypeCd |
| Tax Period Begin | 2015-07-01 | TaxPeriodBeginDt |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 370663567 | EIN |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | St Elizabeth's Hospital of the Hospital Sisters of the Third Order of St Fr | BusinessNameLine1Txt |
| Business Name Line2 | ancis | BusinessNameLine2Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Control | STEL | BusinessNameControlTxt |
| Phone | 6182342120 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 211 SOUTH THIRD STREET | AddressLine1Txt |
| City | Belleville | CityNm |
| State Abbreviation | IL | StateAbbreviationCd |
| ZIP | 622201998 | ZIPCd |
Business Officer BusinessOfficerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | Peggy Sebastian | PersonNm |
| Person Title | CEO | PersonTitleTxt |
| Signature | 2017-05-11 | SignatureDt |
| Discuss With Paid Preparer | Yes (true) | DiscussWithPaidPreparerInd |
Preparer Person PreparerPersonGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Person | John V Woodhull | PreparerPersonNm |
| PTIN | P01305268 | PTIN |
| Phone | 3128997000 | PhoneNum |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax | 2015 | TaxYr |
| Build TS | 2021-01-29 14:40:06Z | BuildTS |
Form 990 IRS990
Principal Ofcr Business Name PrincipalOfcrBusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | PEGGY SEBASTIAN CEO | BusinessNameLine1Txt |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 211 SOUTH THIRD STREET | AddressLine1Txt |
| City | Belleville | CityNm |
| State Abbreviation | IL | StateAbbreviationCd |
| ZIP | 622201998 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | $160,289,172 | GrossReceiptsAmt |
| Group Return For Affiliates | false | GroupReturnForAffiliatesInd |
| Group Exemption | 0928 | GroupExemptionNum |
| Organization501c3 | Yes (X) | Organization501c3Ind |
| Website Address | WWW.STELIZ.ORG | WebsiteAddressTxt |
| Type Of Organization Corp | Yes (X) | TypeOfOrganizationCorpInd |
| Formation | 1875 | FormationYr |
| Legal Domicile State | IL | LegalDomicileStateCd |
| Activity Or Mission | TO REVEAL AND EMBODY CHRIST'S HEALING LOVE FOR ALL PEOPLE THROUGH OUR HIGH QUALITY FRANCISCAN HEALTH CARE MINISTRY. | ActivityOrMissionDesc |
| Voting Members Governing Body | 13 | VotingMembersGoverningBodyCnt |
| Voting Members Independent | 11 | VotingMembersIndependentCnt |
| Total Employee | 1625 | TotalEmployeeCnt |
| Total Volunteers | 185 | TotalVolunteersCnt |
| Total Gross UBI | $18,618 | TotalGrossUBIAmt |
| Net Unrelated Bus Txbl Incm | -$196,646 | NetUnrelatedBusTxblIncmAmt |
| PY Contributions Grants | $864,867 | PYContributionsGrantsAmt |
| CY Contributions Grants | $200,229 | CYContributionsGrantsAmt |
| PY Program Service Revenue | $172,258,960 | PYProgramServiceRevenueAmt |
| CY Program Service Revenue | $157,855,479 | CYProgramServiceRevenueAmt |
| PY Investment Income | $1,471,021 | PYInvestmentIncomeAmt |
| CY Investment Income | $259,068 | CYInvestmentIncomeAmt |
| PY Other Revenue | $696,434 | PYOtherRevenueAmt |
| CY Other Revenue | $636,056 | CYOtherRevenueAmt |
| PY Total Revenue | $175,291,282 | PYTotalRevenueAmt |
| CY Total Revenue | $158,950,832 | CYTotalRevenueAmt |
| CY Grants And Similar Paid | $0 | CYGrantsAndSimilarPaidAmt |
| CY Benefits Paid To Members | $0 | CYBenefitsPaidToMembersAmt |
| PY Salaries Comp Emp Bnft Paid | $74,077,391 | PYSalariesCompEmpBnftPaidAmt |
| CY Salaries Comp Emp Bnft Paid | $71,193,590 | CYSalariesCompEmpBnftPaidAmt |
| CY Total Prof Fndrsng Expns | $0 | CYTotalProfFndrsngExpnsAmt |
| CY Total Fundraising Expense | $0 | CYTotalFundraisingExpenseAmt |
| PY Other Expenses | $114,725,172 | PYOtherExpensesAmt |
| CY Other Expenses | $115,563,187 | CYOtherExpensesAmt |
| PY Total Expenses | $188,802,563 | PYTotalExpensesAmt |
| CY Total Expenses | $186,756,777 | CYTotalExpensesAmt |
| PY Revenues Less Expenses | -$13,511,281 | PYRevenuesLessExpensesAmt |
| CY Revenues Less Expenses | -$27,805,945 | CYRevenuesLessExpensesAmt |
| Total Assets BOY | $128,900,746 | TotalAssetsBOYAmt |
| Total Assets EOY | $183,543,621 | TotalAssetsEOYAmt |
| Total Liabilities BOY | $179,340,287 | TotalLiabilitiesBOYAmt |
| Total Liabilities EOY | $294,165,437 | TotalLiabilitiesEOYAmt |
| Net Assets Or Fund Balances BOY | -$50,439,541 | NetAssetsOrFundBalancesBOYAmt |
| Net Assets Or Fund Balances EOY | -$110,621,816 | NetAssetsOrFundBalancesEOYAmt |
| Info In Schedule O Part III | Yes (X) | InfoInScheduleOPartIIIInd |
| Mission | SEE SCHEDULE O | MissionDesc |
| Significant New Program Srvc | false | SignificantNewProgramSrvcInd |
| Significant Change | false | SignificantChangeInd |
| Expense | $43,483,259 | ExpenseAmt |
| Grant | $0 | GrantAmt |
| Revenue | $33,032,901 | RevenueAmt |
| Desc | Surgical Services HSHS St. Elizabeth's Hospital's highly trained and experienced surgeons perform surgical and non-surgical procedures in a variety of areas and represent a wide range of specialties, including: cardiothoracic, orthopedic, plastic surgery, neurosurgery, podiatry and more. Your surgical team will perform your surgery using the latest technology and least invasive procedures possible in one of our 16 surgery suites. Our board certified anesthesiologists and certified nurse anesthetists provide excellent anesthesia care. During FY 2016, HSHS St. Elizabeth's Hospital had 4,608 surgical cases. | Desc |
Prog Srvc Accom Acty2 ProgSrvcAccomActy2Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Expense | $28,718,150 | ExpenseAmt |
| Grant | $0 | GrantAmt |
| Revenue | $26,623,395 | RevenueAmt |
| Desc | Cardiac Services HSHS St. Elizabeth's Hospital provides comprehensive cardiovascular services from diagnosis to surgery to rehabilitation and wellness. HSHS St. Elizabeth's is accredited by the Society of Chest Pain Centers, a professional organization focused on improving care for patients with acute coronary syndromes and teaching the public to recognize and react to the early symptoms of a possible heart attack. This accreditation attests that HSHS St. Elizabeth's meets strict criteria for recognizing and treating patients who come to the emergency room with heart attack symptoms. We are also a heart attack receiving center. Our patients benefit from our highly credentialed physicians and state-of-the-art technologies, as well as our commitment to superior patient outcomes. Services provided include cardiac catheterization, stent placement, stress testing, pacemaker, implantable cardioverter defibrillator (ICD), electrocardiography, coronary artery bypass graft (open heart) surgery and cardiac rehabilitation. During FY 2016, HSHS St. Elizabeth's Hospital had 12,662 cardiac cases. | Desc |
Prog Srvc Accom Acty3 ProgSrvcAccomActy3Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Expense | $8,942,910 | ExpenseAmt |
| Revenue | $5,585,090 | RevenueAmt |
| Desc | Mother Child/Obstetric Services HSHS St. Elizabeth's Hospital has been delivering babies for more than 140 years and continues to serve as the hospital of choice for families seeking a family-centered, high quality, maternity experience. At HSHS St. Elizabeth's, we consider it a privilege to be able to assist families with one of the most memorable and intimate moments of their lives. That's why we hold ourselves to higher standards, guided by our Core Values of RESPECT, CARE, COMPETENCE and JOY to give patients region leading, high-quality obstetric care. From the individualized care we provide for mother and baby, to the educational programs we offer expecting families, we offer a wide range of resources, services and special touches to celebrate deliveries including the Delivering Miracles Program This program provides personalized individual counseling sessions, a private facility tour and post-delivery support. For labor and delivery, the Mother-Child Services department provides quality care to pregnant women and their families throughout the birthing process. Our anesthesia providers are available 24 hours a day to provide epidural placement and other pain management, as needed. A hydrotherapy tub is also available for mothers-to-be as a pain relief alternative to epidural treatment. After you and your closest loved ones have welcomed your new baby in your private labor, delivery and recovery room, you will be transferred to your Mother-Child post-partum room. A diverse team, including a childbirth educator and a clinical resource nurse, are available to you after the birth of your baby. Our maternity nurses are skilled at helping new moms and babies learn how to breastfeed, and our lactation counselors provide extra support. We smooth the transition to home with individualized instruction and a customized education program. In FY16, HSHS St. Elizabeth's Hospital had 1,035 Births and 5,319 Gynecologic and Obstetric cases | Desc |
Prog Srvc Accom Acty Other ProgSrvcAccomActyOtherGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Expense | $65,520,293 | ExpenseAmt |
| Revenue | $92,614,093 | RevenueAmt |
| Desc | Other Health Care Services HSHS St. Elizabeth's Hospital delivers a comprehensive array of healthcare services to both inpatients and outpatients. Our accredited programs have consistently demonstrated quality outcomes that positively impact our patients, their families and the entire community. We provide quality medical healthcare regardless of race, creed, sex, national origin, handicap, age, or ability to pay. Although reimbursement for services rendered is critical to the operation and stability of HSHS St. Elizabeth's Hospital, it is recognized that not all individuals possess the ability to purchase essential medical services. It is our mission to serve the sick, especially the poor, with quality healthcare services and healthcare education. We have further defined our mission of identifying those who are at greatest health risk, the elderly, children, those coping with mental illness, and those with less means who are dependent on quality healthcare. HSHS St. Elizabeth's Hospital currently staffs 260 inpatient beds. The hospital employs 1,625 colleagues. Inpatient admissions for Fiscal Year 2016 were 8,556. The Emergency Department had 38,832 visits and admitted 5,113 to inpatient services. The Urgicare Center in O'Fallon, an offsite facility, had 29,786 visits. Total Outpatient visits for the hospital were 201,750. | Desc |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Other Prog Srvc Expense | $65,520,293 | TotalOtherProgSrvcExpenseAmt |
| Total Other Prog Srvc Revenue | $92,614,093 | TotalOtherProgSrvcRevenueAmt |
| Total Program Service Expenses | $146,664,612 | TotalProgramServiceExpensesAmt |
| Described In Section501c3 | Yes (true) | DescribedInSection501c3Ind |
| Schedule B Required | Yes (true) | ScheduleBRequiredInd |
| Political Campaign Acty | false | PoliticalCampaignActyInd |
| Lobbying Activities | Yes (true) | LobbyingActivitiesInd |
| Subject To Proxy Tax | false | SubjectToProxyTaxInd |
| Donor Advised Fund | false | DonorAdvisedFundInd |
| Conservation Easements | false | ConservationEasementsInd |
| Collections Of Art | Yes (true) | CollectionsOfArtInd |
| Credit Counseling | false | CreditCounselingInd |
| Temp Or Permanent Endowments | false | TempOrPermanentEndowmentsInd |
| Report Land Building Equipment | Yes (true) | ReportLandBuildingEquipmentInd |
| Report Investments Other Sec | false | ReportInvestmentsOtherSecInd |
| Report Program Related Invst | false | ReportProgramRelatedInvstInd |
| Report Other Assets | false | ReportOtherAssetsInd |
| Report Other Liabilities | Yes (true) | ReportOtherLiabilitiesInd |
| Include FIN48 Footnote | Yes (true) | IncludeFIN48FootnoteInd |
| Independent Audit Fincl Stmt | false | IndependentAuditFinclStmtInd |
| Consolidated Audit Fincl Stmt | Yes (true) | ConsolidatedAuditFinclStmtInd |
| School Operating | false | SchoolOperatingInd |
| Foreign Office | false | ForeignOfficeInd |
| Foreign Activities | false | ForeignActivitiesInd |
| More Than5000 K To Org | false | MoreThan5000KToOrgInd |
| More Than5000 K To Individuals | false | MoreThan5000KToIndividualsInd |
| Professional Fundraising | false | ProfessionalFundraisingInd |
| Fundraising Activities | false | FundraisingActivitiesInd |
| Gaming Activities | false | GamingActivitiesInd |
| Operate Hospital | Yes (true) | OperateHospitalInd |
| Audited Financial Stmt Att | Yes (true) | AuditedFinancialStmtAttInd |
| Grants To Organizations | false | GrantsToOrganizationsInd |
| Grants To Individuals | false | GrantsToIndividualsInd |
| Schedule J Required | Yes (true) | ScheduleJRequiredInd |
| Tax Exempt Bonds | false | TaxExemptBondsInd |
| Engaged In Excess Benefit Trans | false | EngagedInExcessBenefitTransInd |
| PY Excess Benefit Trans | false | PYExcessBenefitTransInd |
| Loan Outstanding | false | LoanOutstandingInd |
| Grant To Related Person | false | GrantToRelatedPersonInd |
| Business Rln With Org Mem | false | BusinessRlnWithOrgMemInd |
| Business Rln With Fam Mem | false | BusinessRlnWithFamMemInd |
| Business Rln With Officer Ent | false | BusinessRlnWithOfficerEntInd |
| Deductible Non Cash Contri | Yes (true) | DeductibleNonCashContriInd |
| Deductible Art Contribution | Yes (true) | DeductibleArtContributionInd |
| Terminate Operations | false | TerminateOperationsInd |
| Partial Liquidation | false | PartialLiquidationInd |
| Disregarded Entity | Yes (true) | DisregardedEntityInd |
| Related Entity | Yes (true) | RelatedEntityInd |
| Related Organization Ctrl Ent | false | RelatedOrganizationCtrlEntInd |
| Trnsfr Exmpt Non Chrtbl Rltd Org | false | TrnsfrExmptNonChrtblRltdOrgInd |
| Activities Conducted Prtshp | false | ActivitiesConductedPrtshpInd |
| Schedule O Required | Yes (true) | ScheduleORequiredInd |
| IRP Document | 153 | IRPDocumentCnt |
| IRP Document W2 G | 0 | IRPDocumentW2GCnt |
| Backup Wthld Compliance | Yes (true) | BackupWthldComplianceInd |
| Employee | 1625 | EmployeeCnt |
| Employment Tax Returns Filed | Yes (true) | EmploymentTaxReturnsFiledInd |
| Unrelated Bus Incm Over Limit | Yes (true) | UnrelatedBusIncmOverLimitInd |
| Form990 T Filed | Yes (true) | Form990TFiledInd |
| Foreign Financial Account | false | ForeignFinancialAccountInd |
| Prohibited Tax Shelter Trans | false | ProhibitedTaxShelterTransInd |
| Taxable Party Notification | false | TaxablePartyNotificationInd |
| Nondeductible Contributions | false | NondeductibleContributionsInd |
| Quid Pro Quo Contributions | false | QuidProQuoContributionsInd |
| Form8282 Property Disposed Of | false | Form8282PropertyDisposedOfInd |
| Rcv Fnds To Pay Prsnl Bnft Cntrct | false | RcvFndsToPayPrsnlBnftCntrctInd |
| Pay Premiums Prsnl Bnft Cntrct | false | PayPremiumsPrsnlBnftCntrctInd |
| Indoor Tanning Services | false | IndoorTanningServicesInd |
| Info In Schedule O Part VI | Yes (X) | InfoInScheduleOPartVIInd |
| Governing Body Voting Members | 13 | GoverningBodyVotingMembersCnt |
| Independent Voting Member | 11 | IndependentVotingMemberCnt |
| Family Or Business Rln | false | FamilyOrBusinessRlnInd |
| Delegation Of Mgmt Duties | false | DelegationOfMgmtDutiesInd |
| Change To Org Documents | false | ChangeToOrgDocumentsInd |
| Material Diversion Or Misuse | false | MaterialDiversionOrMisuseInd |
| Members Or Stockholders | Yes (true) | MembersOrStockholdersInd |
| Election Of Board Members | Yes (true) | ElectionOfBoardMembersInd |
| Decisions Subject To Approva | Yes (true) | DecisionsSubjectToApprovaInd |
| Minutes Of Governing Body | Yes (true) | MinutesOfGoverningBodyInd |
| Minutes Of Committees | Yes (true) | MinutesOfCommitteesInd |
| Officer Mailing Address | false | OfficerMailingAddressInd |
| Local Chapters | false | LocalChaptersInd |
| Form990 Provided To Gvrn Body | Yes (true) | Form990ProvidedToGvrnBodyInd |
| Conflict Of Interest Policy | Yes (true) | ConflictOfInterestPolicyInd |
| Annual Disclosure Covered Prsn | Yes (true) | AnnualDisclosureCoveredPrsnInd |
| Regular Monitoring Enfrc | Yes (true) | RegularMonitoringEnfrcInd |
| Whistleblower Policy | Yes (true) | WhistleblowerPolicyInd |
| Document Retention Policy | Yes (true) | DocumentRetentionPolicyInd |
| Compensation Process CEO | Yes (true) | CompensationProcessCEOInd |
| Compensation Process Other | Yes (true) | CompensationProcessOtherInd |
| Investment In Joint Venture | Yes (true) | InvestmentInJointVentureInd |
| Written Policy Or Procedure | Yes (true) | WrittenPolicyOrProcedureInd |
| Upon Request | Yes (X) | UponRequestInd |
Books In Care Of Detail BooksInCareOfDetail
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | David Nosacka | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Phone | 6182342120 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 211 SOUTH THIRD STREET | AddressLine1Txt |
| City | BELLEVILLE | CityNm |
| State Abbreviation | IL | StateAbbreviationCd |
| ZIP | 622201998 | ZIPCd |
Form990 Part VII Section A Form990PartVIISectionAGrp (28 entries)
| TitleTitleTxt | Average Hours Per WeekAverageHoursPerWeekRt | Average Hours Per Week Rltd OrgAverageHoursPerWeekRltdOrgRt | Individual Trustee Or DirectorIndividualTrusteeOrDirectorInd | OfficerOfficerInd | Reportable Comp From OrgReportableCompFromOrgAmt | Reportable Comp From Rltd OrgReportableCompFromRltdOrgAmt | Other CompensationOtherCompensationAmt | Key EmployeeKeyEmployeeInd | Highest Compensated EmployeeHighestCompensatedEmployeeInd | Former Ofcr Director TrusteeFormerOfcrDirectorTrusteeInd |
|---|---|---|---|---|---|---|---|---|---|---|
| THOMAS M EGAN | ||||||||||
| BOARD SECRETARY | 1.0 | 0 | Yes (X) | Yes (X) | $0 | $0 | $0 | |||
| MARYANN REESE | ||||||||||
| PRESIDENT & CEO | 60.0 | 0 | Yes (X) | Yes (X) | $0 | $329,399 | $63,490 | |||
| SHELLEY HARRIS | ||||||||||
| CHIEF NURSING OFFICER & INTERIM PRESIDENT & CEO | 60.0 | 0 | Yes (X) | Yes (X) | $276,267 | $0 | $188,574 | |||
| WILLIAM S LYKE | ||||||||||
| BOARD CHAIRPERSON | 1.0 | 0 | Yes (X) | Yes (X) | $0 | $0 | $0 | |||
| SISTER JANICE SCHNIEDER OSF | ||||||||||
| Board Vice Chair - Part Year | 1.0 | 1.0 | Yes (X) | Yes (X) | $0 | $0 | $0 | |||
| RICHARD J THOMAN | ||||||||||
| Board Vice Chair - Part Year | 1.0 | 0 | Yes (X) | Yes (X) | $0 | $0 | $0 | |||
| JIM CLANAHAN MD | ||||||||||
| BOARD MEMBER | 1.0 | 0 | Yes (X) | $0 | $0 | $0 | ||||
| JACQUELYN M CLEMENT PHD | ||||||||||
| BOARD MEMBER | 1.0 | 0 | Yes (X) | $0 | $0 | $0 | ||||
| SR MARYBETH CULNAN OSF | ||||||||||
| BOARD MEMBER | 1.0 | 9.0 | Yes (X) | $0 | $0 | $0 | ||||
| REVEREND JAMES E DEITERS | ||||||||||
| BOARD MEMBER | 1.0 | 0 | Yes (X) | $0 | $0 | $0 | ||||
| THOMAS DINGES | ||||||||||
| BOARD MEMBER | 1.0 | 0 | Yes (X) | $0 | $0 | $0 | ||||
| SR Helen Marie Plummer OSF | ||||||||||
| BOARD MEMBER | 1.0 | 1.0 | Yes (X) | $0 | $0 | $0 | ||||
| STEPHANIE STRANO-MAINE | ||||||||||
| BOARD MEMBER | 1.0 | 0 | Yes (X) | $0 | $0 | $0 | ||||
| ANN M CARR | ||||||||||
| TREASURER | 0.3 | 59.8 | Yes (X) | $0 | $354,305 | $222,661 | ||||
| SHELLY HARKINS MD | ||||||||||
| CHIEF MEDICAL OFFICER | 60.0 | 0 | Yes (X) | $229,375 | $0 | $38,295 | ||||
| DAVID NOSACKA | ||||||||||
| DIVISION CFO | 29.0 | 30.8 | Yes (X) | $372,312 | $0 | $49,022 | ||||
| PEGGY SEBASTIAN | ||||||||||
| President and CEO - Part Year | 60.0 | 60.0 | Yes (X) | $0 | $353,354 | $120,126 | ||||
| MARY LOU TATE | ||||||||||
| DIRECTOR OF FINANCE | 60.0 | 0 | Yes (X) | $143,975 | $0 | $34,147 | ||||
| AMY BALLANCE | ||||||||||
| DIVISION VICE PRESIDENT BUSINESS DEVELOPMENT | 29.0 | 7.8 | $215,023 | $0 | $59,439 | Yes (X) | ||||
| SUSAN BEELER | ||||||||||
| PROJECT MANAGER, NEW CONSTRUCTION | 60.0 | 0 | $178,456 | $0 | $106,957 | Yes (X) | ||||
| JAMES DOVER | ||||||||||
| CEO SOUTHERN ILLINOIS DIV | 24.0 | 36.0 | $0 | $373,442 | $72,819 | Yes (X) | ||||
| MARGARET LUNA | ||||||||||
| DIVISION CPO | 29.0 | 4.2 | $237,382 | $0 | $95,464 | Yes (X) | ||||
| CHELLIE BUTEL | ||||||||||
| EXECUTIVE DIRECTOR OF RISK & PCU | 60.0 | 0 | $180,304 | $0 | $20,879 | Yes (X) | ||||
| JACQUELYNNE N HOLST | ||||||||||
| DIVISION VICE PRESIDENT LEGAL AFFAIRS / HSHS ASSOCIATE GENERAL COUNSEL | 29.0 | 7.8 | $181,457 | $0 | $36,915 | Yes (X) | ||||
| BRIAN D JOHNSON | ||||||||||
| EXECUTIVE DIRECTOR OF SURGICAL SERVICES | 60.0 | 0 | $171,045 | $0 | $47,702 | Yes (X) | ||||
| JULIA SCHIMMELPFENNIG | ||||||||||
| DIRECTOR OF PHARMACY | 60.0 | 0 | $159,781 | $0 | $22,644 | Yes (X) | ||||
| PETER WONG | ||||||||||
| CHIEF PERFORMANCE IMPROVEMENT OFFICER | 10.0 | 0 | $297,050 | $0 | $60,043 | Yes (X) | ||||
| LAWRENCE SCHUMACHER | ||||||||||
| Former DIVISION CEO - INTERIM | 0.0 | $0 | $1,460,120 | $72,705 | Yes (X) | |||||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | $2,642,427 | TotalReportableCompFromOrgAmt |
| Tot Reportable Comp Rltd Org | $2,870,620 | TotReportableCompRltdOrgAmt |
| Total Other Compensation | $1,311,882 | TotalOtherCompensationAmt |
| Indiv Rcvd Greater Than100 K | 49 | IndivRcvdGreaterThan100KCnt |
| Former Ofcr Employees Listed | false | FormerOfcrEmployeesListedInd |
| Total Comp Greater Than150 K | Yes (true) | TotalCompGreaterThan150KInd |
| Compensation From Other Srcs | false | CompensationFromOtherSrcsInd |
Contractor Compensation ContractorCompensationGrp (5 entries)
| Address Line1ContractorAddress/USAddress/AddressLine1Txt | CityContractorAddress/USAddress/CityNm | State AbbreviationContractorAddress/USAddress/StateAbbreviationCd | ZIPContractorAddress/USAddress/ZIPCd | ServicesServicesDesc | CompensationCompensationAmt |
|---|---|---|---|---|---|
| ALBERICI HEALTHCARE | |||||
| 8800 PAGE AVE | ST LOUIS | MO | 63114 | CONSTRUCTION SERVICES FOR NEW HOSPITAL CONSTRUCTION | $19,189,649 |
| HOWARD CONCRETE PUMPING CO | |||||
| 701 MILLERS RUN ROAD | CUDDY | PA | 15031 | CONCRETE PUMPING WORK FOR NEW HOSPITAL | $4,608,840 |
| PROFESSIONAL THERAPY SERVICES INC | |||||
| 2810 FRANK SCOTT PKWY WEST STE 824 | BELLEVILLE | IL | 62223 | PHYSICAL THERAPY | $3,230,162 |
| KAHLER SLATER INC | |||||
| 111 WEST WISCONSIN AVENUE | MILWAUKEE | WI | 532032501 | ARCHITECTURAL SERVICES | $2,504,967 |
| SODEXO OPERATIONS LLC | |||||
| 4880 PAYSHERE CIRCLE | CHICAGO | IL | 60674 | FOOD SERVICE | $1,640,161 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cntrct Rcvd Greater Than100 K | 44 | CntrctRcvdGreaterThan100KCnt |
| Related Organizations | $146,120 | RelatedOrganizationsAmt |
| Government Grants | $54,109 | GovernmentGrantsAmt |
| Noncash Contributions | $26,751 | NoncashContributionsAmt |
| Total Contributions | $200,229 | TotalContributionsAmt |
Program Service Revenue ProgramServiceRevenueGrp (4 entries)
| DescDesc | BusinessBusinessCd | Total Revenue ColumnTotalRevenueColumnAmt | Related Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt |
|---|---|---|---|
| Net Patient Revenue | 622110 | $155,482,664 | $155,482,664 |
| Oncology Center | 621999 | $848,922 | $848,922 |
| Health Programs | 621999 | $525,452 | $525,452 |
| Rental Income-Affiliates | 531120 | $998,441 | $998,441 |
Total Oth Program Service Rev TotalOthProgramServiceRevGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $0 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $0 | RelatedOrExemptFuncIncomeAmt |
| Unrelated Business Revenue | $0 | UnrelatedBusinessRevenueAmt |
| Exclusion | $0 | ExclusionAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | $157,855,479 | TotalProgramServiceRevenueAmt |
Investment Income InvestmentIncomeGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $309,290 | TotalRevenueColumnAmt |
| Exclusion | $309,290 | ExclusionAmt |
Gross Rents GrossRentsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $1,197,623 | RealAmt |
Less Rental Expenses LessRentalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $1,236,083 | RealAmt |
Rental Income Or Loss RentalIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | -$38,460 | RealAmt |
| Personal | $0 | PersonalAmt |
Net Rental Income Or Loss NetRentalIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | -$38,461 | TotalRevenueColumnAmt |
| Exclusion | -$38,461 | ExclusionAmt |
Gross Amount Sales Assets GrossAmountSalesAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | $52,035 | SecuritiesAmt |
Less Cost Oth Basis Sales Expnss LessCostOthBasisSalesExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | $102,257 | SecuritiesAmt |
Gain Or Loss GainOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | -$50,222 | SecuritiesAmt |
| Other | $0 | OtherAmt |
Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | -$50,222 | TotalRevenueColumnAmt |
| Exclusion | -$50,222 | ExclusionAmt |
Other Revenue Misc OtherRevenueMiscGrp (3 entries)
| DescDesc | BusinessBusinessCd | Total Revenue ColumnTotalRevenueColumnAmt | ExclusionExclusionAmt | Unrelated Business RevenueUnrelatedBusinessRevenueAmt |
|---|---|---|---|---|
| Outside Services | 900099 | $633,493 | $633,493 | |
| Cafeteria Sales | 722210 | $22,406 | $22,406 | |
| Laundry Services | 812300 | $18,618 | $18,618 |
Miscellaneous Revenue MiscellaneousRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $0 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $0 | RelatedOrExemptFuncIncomeAmt |
| Unrelated Business Revenue | $0 | UnrelatedBusinessRevenueAmt |
| Exclusion | $0 | ExclusionAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Revenue Total | $674,517 | OtherRevenueTotalAmt |
Total Revenue TotalRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $158,950,832 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $157,855,479 | RelatedOrExemptFuncIncomeAmt |
| Unrelated Business Revenue | $18,618 | UnrelatedBusinessRevenueAmt |
| Exclusion | $876,506 | ExclusionAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part IX | Yes (X) | InfoInScheduleOPartIXInd |
Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $2,154,831 | TotalAmt |
| Program Services | $625,835 | ProgramServicesAmt |
| Management And General | $1,528,996 | ManagementAndGeneralAmt |
Other Salaries And Wages OtherSalariesAndWagesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $53,408,196 | TotalAmt |
| Program Services | $46,409,132 | ProgramServicesAmt |
| Management And General | $6,999,064 | ManagementAndGeneralAmt |
Pension Plan Contributions PensionPlanContributionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,822,247 | TotalAmt |
| Program Services | $1,735,163 | ProgramServicesAmt |
| Management And General | $87,084 | ManagementAndGeneralAmt |
Other Employee Benefits OtherEmployeeBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $9,291,487 | TotalAmt |
| Program Services | $7,302,843 | ProgramServicesAmt |
| Management And General | $1,988,644 | ManagementAndGeneralAmt |
Payroll Taxes PayrollTaxesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $4,516,829 | TotalAmt |
| Program Services | $3,844,079 | ProgramServicesAmt |
| Management And General | $672,750 | ManagementAndGeneralAmt |
Fees For Services Legal FeesForServicesLegalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $246,324 | TotalAmt |
| Program Services | $23,397 | ProgramServicesAmt |
| Management And General | $222,927 | ManagementAndGeneralAmt |
Fees For Services Other FeesForServicesOtherGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $39,134,740 | TotalAmt |
| Program Services | $32,096,970 | ProgramServicesAmt |
| Management And General | $7,037,770 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Advertising AdvertisingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $332,766 | TotalAmt |
| Program Services | $127,894 | ProgramServicesAmt |
| Management And General | $204,872 | ManagementAndGeneralAmt |
Office Expenses OfficeExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,070,979 | TotalAmt |
| Program Services | $688,514 | ProgramServicesAmt |
| Management And General | $382,465 | ManagementAndGeneralAmt |
Information Technology InformationTechnologyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $11,472,490 | TotalAmt |
| Program Services | -$474 | ProgramServicesAmt |
| Management And General | $11,472,964 | ManagementAndGeneralAmt |
Occupancy OccupancyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $4,021,235 | TotalAmt |
| Program Services | $4,021,235 | ProgramServicesAmt |
Travel TravelGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $412,149 | TotalAmt |
| Program Services | $107,564 | ProgramServicesAmt |
| Management And General | $304,585 | ManagementAndGeneralAmt |
Conferences Meetings ConferencesMeetingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $33,679 | TotalAmt |
| Program Services | $8,337 | ProgramServicesAmt |
| Management And General | $25,342 | ManagementAndGeneralAmt |
Interest InterestGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $2,400,139 | TotalAmt |
| Program Services | $2,400,139 | ProgramServicesAmt |
Depreciation Depletion DepreciationDepletionGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $15,363,343 | TotalAmt |
| Program Services | $6,843,382 | ProgramServicesAmt |
| Management And General | $8,519,961 | ManagementAndGeneralAmt |
Insurance InsuranceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $3,039,323 | TotalAmt |
| Program Services | $3,039,323 | ProgramServicesAmt |
Other Expenses OtherExpensesGrp (4 entries)
| DescDesc | TotalTotalAmt | Program ServicesProgramServicesAmt | Management And GeneralManagementAndGeneralAmt |
|---|---|---|---|
| Medical Supplies | $22,389,964 | $22,389,964 | |
| Provision for uncollectible accounts | $3,072,599 | $3,072,599 | |
| License & Taxes | $9,009,277 | $8,840,252 | $169,025 |
| Maintenance & Repairs | $2,756,307 | $2,714,692 | $41,615 |
All Other Expenses AllOtherExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $807,873 | TotalAmt |
| Program Services | $373,772 | ProgramServicesAmt |
| Management And General | $434,101 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Total Functional Expenses TotalFunctionalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $186,756,777 | TotalAmt |
| Program Services | $146,664,612 | ProgramServicesAmt |
| Management And General | $40,092,165 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Cash Non Interest Bearing CashNonInterestBearingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Savings And Temp Cash Invst SavingsAndTempCashInvstGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $3,351,330 | BOYAmt |
| EOY | $0 | EOYAmt |
Pledges And Grants Receivable PledgesAndGrantsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $2,068,924 | BOYAmt |
| EOY | $4,338,244 | EOYAmt |
Accounts Receivable AccountsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $39,570,735 | BOYAmt |
| EOY | $33,975,904 | EOYAmt |
Receivables From Officers Etc ReceivablesFromOfficersEtcGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| EOY | $0 | EOYAmt |
Rcvbl From Disqualified Prsn RcvblFromDisqualifiedPrsnGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| EOY | $0 | EOYAmt |
Oth Notes Loans Receivable Net OthNotesLoansReceivableNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $273,113 | BOYAmt |
| EOY | $56,202 | EOYAmt |
Inventories For Sale Or Use InventoriesForSaleOrUseGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $3,162,069 | BOYAmt |
| EOY | $3,336,841 | EOYAmt |
Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,024,020 | BOYAmt |
| EOY | $964,758 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Bldg Equip Cost Or Other Bss | $289,970,137 | LandBldgEquipCostOrOtherBssAmt |
| Land Bldg Equip Accum Deprec | $159,884,632 | LandBldgEquipAccumDeprecAmt |
Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $69,429,621 | BOYAmt |
| EOY | $130,085,505 | EOYAmt |
Investments Pub Traded Sec InvestmentsPubTradedSecGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $4,837,999 | BOYAmt |
| EOY | $5,776,312 | EOYAmt |
Investments Other Securities InvestmentsOtherSecuritiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
Investments Program Related InvestmentsProgramRelatedGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $4,940,656 | BOYAmt |
| EOY | $4,789,579 | EOYAmt |
Other Assets Total OtherAssetsTotalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $242,279 | BOYAmt |
| EOY | $220,276 | EOYAmt |
Total Assets TotalAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $128,900,746 | BOYAmt |
| EOY | $183,543,621 | EOYAmt |
Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $22,826,597 | BOYAmt |
| EOY | $17,484,778 | EOYAmt |
Tax Exempt Bond Liabilities TaxExemptBondLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $122,325,736 | BOYAmt |
| EOY | $219,569,894 | EOYAmt |
Other Liabilities OtherLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $34,187,954 | BOYAmt |
| EOY | $57,110,765 | EOYAmt |
Total Liabilities TotalLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $179,340,287 | BOYAmt |
| EOY | $294,165,437 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Organization Follows SFAS117 | Yes (X) | OrganizationFollowsSFAS117Ind |
Unrestricted Net Assets UnrestrictedNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | -$57,317,862 | BOYAmt |
| EOY | -$119,041,455 | EOYAmt |
Temporarily Rstr Net Assets TemporarilyRstrNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $6,744,478 | BOYAmt |
| EOY | $7,995,477 | EOYAmt |
Permanently Rstr Net Assets PermanentlyRstrNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $133,843 | BOYAmt |
| EOY | $424,162 | EOYAmt |
Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | -$50,439,541 | BOYAmt |
| EOY | -$110,621,816 | EOYAmt |
Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $128,900,746 | BOYAmt |
| EOY | $183,543,621 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part XI | Yes (X) | InfoInScheduleOPartXIInd |
| Reconcilation Revenue Expnss | -$27,805,945 | ReconcilationRevenueExpnssAmt |
| Net Unrlzd Gains Losses Invst | -$2,144,421 | NetUnrlzdGainsLossesInvstAmt |
| Other Changes In Net Assets | -$30,231,909 | OtherChangesInNetAssetsAmt |
| Method Of Accounting Accrual | Yes (X) | MethodOfAccountingAccrualInd |
| Accountant Compile Or Review | false | AccountantCompileOrReviewInd |
| FS Audited | Yes (true) | FSAuditedInd |
FS Audited Basis FSAuditedBasisGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Consolidated Basis Fincl Stmt | Yes (X) | ConsolidatedBasisFinclStmtInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Audit Committee | Yes (true) | AuditCommitteeInd |
| Federal Grant Audit Required | false | FederalGrantAuditRequiredInd |
Schedule A IRS990ScheduleA
| Field | Value | IRS element (for citing) |
|---|---|---|
| Hospital | Yes (X) | HospitalInd |
Schedule B IRS990ScheduleB
Contributor Information ContributorInformationGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Contributor | RESTRICTED | ContributorNum |
Contributor Business Name ContributorBusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | RESTRICTED | BusinessNameLine1 |
Contributor US Address ContributorUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | RESTRICTED | AddressLine1 |
| Address Line2 | RESTRICTED | AddressLine2 |
| City | RESTRICTED | City |
| State | RESTRICTED | State |
| ZIP Code | RESTRICTED | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Contributions | RESTRICTED | TotalContributionsAmt |
Schedule C IRS990ScheduleC
| Field | Value | IRS element (for citing) |
|---|---|---|
| Volunteers | false | VolunteersInd |
| Paid Staff Or Management | false | PaidStaffOrManagementInd |
| Media Advertisements | false | MediaAdvertisementsInd |
| Mailings Members | false | MailingsMembersInd |
| Publications Or Broadcast | false | PublicationsOrBroadcastInd |
| Grants Other Organizations | false | GrantsOtherOrganizationsInd |
| Direct Contact Legislators | false | DirectContactLegislatorsInd |
| Rallies Demonstrations | false | RalliesDemonstrationsInd |
| Other Activities | Yes (true) | OtherActivitiesInd |
| Other Activities | $36,953 | OtherActivitiesAmt |
| Total Lobbying Expenditures | $36,953 | TotalLobbyingExpendituresAmt |
| Not Described Section501c3 | false | NotDescribedSection501c3Ind |
Supplemental Information Detail SupplementalInformationDetail (2 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| Schedule C, Part II-B, Line 1 DETAILED DESCRIPTION OF THE LOBBYING ACTIVITY | ST. ELIZABETH'S HOSPITAL ("THE HOSPITAL") IS A MEMBER OF THE CATHOLIC HEALTH ASSOCIATION ("CHA"), THE ILLINOIS HEALTH ASSOCIATION ("IHA"), THE NATIONAL ASSOCIATION FOR HOME CARE AND HOSPICE, AND THE AMERICAN HEALTH ASSOCIATION ("AHA"). AS A MEMBER OF THESE ORGANIZATIONS, THE HOSPITAL PAYS DUES, PART OF WHICH ARE ATTRIBUTABLE TO LOBBYING FEES PAID BY THE ORGANIZATIONS. THE AMOUNT LISTED IS THE AMOUNT ATTRIBUTABLE TO THE HOSPITAL FROM ITS DUES PAID. |
| Schedule C, Part II-B, Line 1 DETAILED DESCRIPTION OF THE LOBBYING ACTIVITY | ST. ELIZABETH'S HOSPITAL ("THE HOSPITAL") IS A MEMBER OF THE CATHOLIC HEALTH ASSOCIATION ("CHA"), THE ILLINOIS HEALTH ASSOCIATION ("IHA"), THE NATIONAL ASSOCIATION FOR HOME CARE AND HOSPICE, AND THE AMERICAN HEALTH ASSOCIATION ("AHA"). AS A MEMBER OF THESE ORGANIZATIONS, THE HOSPITAL PAYS DUES, PART OF WHICH ARE ATTRIBUTABLE TO LOBBYING FEES PAID BY THE ORGANIZATIONS. THE AMOUNT LISTED IS THE AMOUNT ATTRIBUTABLE TO THE HOSPITAL FROM ITS DUES PAID. |
Schedule D IRS990ScheduleD
Art Public Exhibition Amounts ArtPublicExhibitionAmountsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Revenues Included | $0 | RevenuesIncludedAmt |
| Assets Included | $160,850 | AssetsIncludedAmt |
Collection Used Other Purposes CollectionUsedOtherPurposesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Collection Used Other Purposes | Yes (X) | CollectionUsedOtherPurposesInd |
| Other Purposes | See Part III, Line 4 | OtherPurposesDesc |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Solicited Assets Sale | false | SolicitedAssetsSaleInd |
Land LandGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $22,952,115 | OtherCostOrOtherBasisAmt |
| Book Value | $22,952,115 | BookValueAmt |
Buildings BuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $122,732,445 | OtherCostOrOtherBasisAmt |
| Depreciation | $100,283,258 | DepreciationAmt |
| Book Value | $22,449,187 | BookValueAmt |
Leasehold Improvements LeaseholdImprovementsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $73,174 | OtherCostOrOtherBasisAmt |
| Depreciation | $12,806 | DepreciationAmt |
| Book Value | $60,368 | BookValueAmt |
Equipment EquipmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $70,376,464 | OtherCostOrOtherBasisAmt |
| Depreciation | $53,827,119 | DepreciationAmt |
| Book Value | $16,549,345 | BookValueAmt |
Other Land Buildings OtherLandBuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $73,835,939 | OtherCostOrOtherBasisAmt |
| Depreciation | $5,761,449 | DepreciationAmt |
| Book Value | $68,074,490 | BookValueAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Land Buildings | $130,085,505 | TotalBookValueLandBuildingsAmt |
Other Liabilities Org OtherLiabilitiesOrgGrp (3 entries)
| DescDesc | AmtAmt |
|---|---|
| Retire Obligation Asbestos | $9,243,523 |
| Accrued Pension Benefit | $43,695,583 |
| Cash Balance-negative | $4,171,659 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Liability | $57,110,765 | TotalLiabilityAmt |
| Footnote Text | Yes (X) | FootnoteTextInd |
Supplemental Information Detail SupplementalInformationDetail (2 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| Schedule D, Part III, Line 4 Collections of art - description of collections | The hospital has received various donations of artwork, which are held and displayed throughout the facility to beautify the hospital and promote healing. |
| Schedule D, Part X, Line 2 FIN 48 (ASC 740) footnote | HSHS and the Foundation are Illinois not-for-profit organizations as described in Section 501(c)(3) of the Internal Revenue Code (the Code} and are exempt from federal income taxes on related income pursuant to Section 501 (a) of the Code. Kiara, Inc. is an Illinois for-profit corporation that recognizes income taxes under the asset- and-liability method. Deferred tax assets and liabilities are recognized for the future tax consequences attributable to differences between the consolidated financial statement carrying amounts of existing assets-and-liabilities and their respective tax basis and operating loss and tax credit carryforwards. Deferred tax assets and liabilities are measured using the enacted tax rates expected to apply to taxable income in the years in which those temporary differences are expected to be recovered or settled. The effect on deferred tax assets and liabilities of a change in tax rates is recognized in income in the period that includes the enactment date. In assessing the realizability of deferred tax assets, management considers whether it is more likely than not that some portion or all of the deferred tax assets will not be realized. The ultimate realization of deferred tax assets is dependent upon the generation of future taxable income during the periods in which those temporary differences become deductible. Management considers projected future taxable income and tax planning strategies in making this assessment. Based upon the level of historical taxable losses and projections for future taxable losses over the periods for which the deferred tax assets are deductible, management believes it is more likely than not Kiara, Inc. will not realize the majority of the benefits of these deductible differences. Full valuation allowances have been applied against the deferred tax assets attributable to the net operating loss carryforwards not realized as of June 30, 2016 and 2015 in the accompanying consolidated financial statements due to the uncertainty of realization. HSHS recognizes the tax benefit from an uncertain tax position only if it is more likely than not the tax position will be sustained on examination by the taxing authorities, based on the technical merits of the position. As of June 30, 2016 and 2015, HSHS does not have any liabilities for unrecognized tax benefits. |
Schedule H IRS990ScheduleH
| Field | Value | IRS element (for citing) |
|---|---|---|
| Financial Assistance Policy | Yes (true) | FinancialAssistancePolicyInd |
| Written Policy | Yes (true) | WrittenPolicyInd |
| All Hospitals Policy | Yes (X) | AllHospitalsPolicyInd |
| FPG Reference Free Care | Yes (true) | FPGReferenceFreeCareInd |
| Percent200 | Yes (X) | Percent200Ind |
| FPG Reference Discounted Care | Yes (true) | FPGReferenceDiscountedCareInd |
Discounted Care Oth Percentage DiscountedCareOthPercentageGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | Yes (X) | OtherInd |
| Discounted Care Other | 600 | DiscountedCareOtherPct |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Free Care Medically Indigent | Yes (true) | FreeCareMedicallyIndigentInd |
| Financial Assistance Budget | Yes (true) | FinancialAssistanceBudgetInd |
| Expenses Exceed Budget | Yes (true) | ExpensesExceedBudgetInd |
| Unable To Provide Care | false | UnableToProvideCareInd |
| Annual Community Bnft Report | Yes (true) | AnnualCommunityBnftReportInd |
| Report Publically Available | Yes (true) | ReportPublicallyAvailableInd |
Financial Assistance At Cost Typ FinancialAssistanceAtCostTyp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Persons Served | 5249 | PersonsServedCnt |
| Total Community Benefit Expns | $3,898,732 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $0 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $3,898,732 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.0212 | TotalExpensePct |
Unreimbursed Medicaid UnreimbursedMedicaidGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Persons Served | 20556 | PersonsServedCnt |
| Total Community Benefit Expns | $47,687,783 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $30,732,013 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $16,955,770 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.0923 | TotalExpensePct |
Unreimbursed Costs UnreimbursedCostsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $0 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $0 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $0 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.0 | TotalExpensePct |
Total Financial Assistance Typ TotalFinancialAssistanceTyp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Activities Or Programs | 0 | ActivitiesOrProgramsCnt |
| Persons Served | 25805 | PersonsServedCnt |
| Total Community Benefit Expns | $51,586,515 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $30,732,013 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $20,854,502 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.1135 | TotalExpensePct |
Community Health Services CommunityHealthServicesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Persons Served | 8910 | PersonsServedCnt |
| Total Community Benefit Expns | $487,052 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $1,714 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $485,338 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.0026 | TotalExpensePct |
Health Professions Education HealthProfessionsEducationGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Persons Served | 1983 | PersonsServedCnt |
| Total Community Benefit Expns | $2,359,853 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $652,871 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $1,706,982 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.0093 | TotalExpensePct |
Subsidized Health Services SubsidizedHealthServicesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Persons Served | 0 | PersonsServedCnt |
| Total Community Benefit Expns | $0 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $0 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $0 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.0 | TotalExpensePct |
Research ResearchGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Persons Served | 0 | PersonsServedCnt |
| Total Community Benefit Expns | $76 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $0 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $76 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.0000 | TotalExpensePct |
Cash And In Kind Contributions CashAndInKindContributionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Persons Served | 4336 | PersonsServedCnt |
| Total Community Benefit Expns | $165,532 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $0 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $165,532 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.0009 | TotalExpensePct |
Total Other Benefits TotalOtherBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Activities Or Programs | 0 | ActivitiesOrProgramsCnt |
| Persons Served | 15229 | PersonsServedCnt |
| Total Community Benefit Expns | $3,012,513 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $654,585 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $2,357,928 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.0128 | TotalExpensePct |
Total Community Benefits TotalCommunityBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Activities Or Programs | 0 | ActivitiesOrProgramsCnt |
| Persons Served | 41034 | PersonsServedCnt |
| Total Community Benefit Expns | $54,599,028 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $31,386,598 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $23,212,430 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.1264 | TotalExpensePct |
Physical Imprv And Housing PhysicalImprvAndHousingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Net Community Benefit Expns | $0 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.0 | TotalExpensePct |
Economic Development EconomicDevelopmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Net Community Benefit Expns | $0 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.0 | TotalExpensePct |
Community Support CommunitySupportGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Persons Served | 200 | PersonsServedCnt |
| Total Community Benefit Expns | $23,748 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $0 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $23,748 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.0001 | TotalExpensePct |
Environmental Improvements EnvironmentalImprovementsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Net Community Benefit Expns | $0 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.0 | TotalExpensePct |
Leadership Development LeadershipDevelopmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Net Community Benefit Expns | $0 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.0 | TotalExpensePct |
Coalition Building CoalitionBuildingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Net Community Benefit Expns | $0 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.0 | TotalExpensePct |
Health Improvement Advocacy HealthImprovementAdvocacyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Persons Served | 13 | PersonsServedCnt |
| Total Community Benefit Expns | $159 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $0 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $159 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.0000 | TotalExpensePct |
Workforce Development WorkforceDevelopmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Persons Served | 925 | PersonsServedCnt |
| Total Community Benefit Expns | $2,428 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $0 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $2,428 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.0000 | TotalExpensePct |
Other Communtity Building Acty OtherCommuntityBuildingActyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Net Community Benefit Expns | $0 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.0 | TotalExpensePct |
Total Communtity Building Acty TotalCommuntityBuildingActyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Activities Or Programs | 0 | ActivitiesOrProgramsCnt |
| Persons Served | 1138 | PersonsServedCnt |
| Total Community Benefit Expns | $26,335 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $0 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $26,335 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.0001 | TotalExpensePct |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bad Debt Expense Reported | Yes (true) | BadDebtExpenseReportedInd |
| Bad Debt Expense | $3,072,599 | BadDebtExpenseAmt |
| Bad Debt Expense Attributable | $0 | BadDebtExpenseAttributableAmt |
| Reimbursed By Medicare | $44,248,743 | ReimbursedByMedicareAmt |
| Cost Of Care Reimbursed By Medcr | $50,808,390 | CostOfCareReimbursedByMedcrAmt |
| Medicare Surplus Or Shortfall | -$6,559,647 | MedicareSurplusOrShortfallAmt |
Costing Methodology Used CostingMethodologyUsedGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cost To Charge Ratio | Yes (X) | CostToChargeRatioInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Written Debt Collection Policy | Yes (true) | WrittenDebtCollectionPolicyInd |
| Financial Assistance Prvsn | Yes (true) | FinancialAssistancePrvsnInd |
Management Co And Jnt Ventures ManagementCoAndJntVenturesGrp (2 entries)
| Primary ActivitiesPrimaryActivitiesTxt | Org Profit Or OwnershipOrgProfitOrOwnershipPct |
|---|---|
| MEMORIAL & ST ELIZABETH'S HEALTHCARE SERVICES | |
| HEALTHCARE | 0.5 |
| SOUTHERN ILLINOIS CARDIOVASCULAR FACILITY | |
| FACILITATE CARDIOVASCULAR SERVICES | 0.5 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Hospital Facilities | 1 | HospitalFacilitiesCnt |
Hospital Facilities HospitalFacilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Facility | 1 | FacilityNum |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | ST ELIZABETH'S HOSPITAL | BusinessNameLine1Txt |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 211 SOUTH 3RD STREET | AddressLine1Txt |
| City | BELLEVILLE | CityNm |
| State Abbreviation | IL | StateAbbreviationCd |
| ZIP | 62220 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Website Address | http://www.steliz.org/ | WebsiteAddressTxt |
| State License | 00002345 | StateLicenseNum |
| Licensed Hospital | Yes (X) | LicensedHospitalInd |
| General Medical And Surgical | Yes (X) | GeneralMedicalAndSurgicalInd |
| Teaching Hospital | Yes (X) | TeachingHospitalInd |
| Emergency Room24 Hrs | Yes (X) | EmergencyRoom24HrsInd |
Hospital Fclty Policies Prctc HospitalFcltyPoliciesPrctcGrp
Hospital Facility Name HospitalFacilityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | ST ELIZABETH'S HOSPITAL | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Facility | 1 | FacilityNum |
| First Licensed CY Or PY | false | FirstLicensedCYOrPYInd |
| Tax Exempt Hospital CY Or PY | false | TaxExemptHospitalCYOrPYInd |
| CHNA Conducted | Yes (true) | CHNAConductedInd |
| Community Definition | Yes (X) | CommunityDefinitionInd |
| Community Demographics | Yes (X) | CommunityDemographicsInd |
| Existing Resources | Yes (X) | ExistingResourcesInd |
| How Data Obtained | Yes (X) | HowDataObtainedInd |
| Community Health Needs | Yes (X) | CommunityHealthNeedsInd |
| Other Health Issues | Yes (X) | OtherHealthIssuesInd |
| Community Hlth Needs Id Process | Yes (X) | CommunityHlthNeedsIdProcessInd |
| Consulting Process | Yes (X) | ConsultingProcessInd |
| Information Gaps | Yes (X) | InformationGapsInd |
| CHNA Conducted | 14 | CHNAConductedYr |
| Take Into Account Others Input | Yes (true) | TakeIntoAccountOthersInputInd |
| CHNA Conducted With Other Fclts | false | CHNAConductedWithOtherFcltsInd |
| CHNA Conducted With Non Fclts | Yes (true) | CHNAConductedWithNonFcltsInd |
| CHNA Report Widely Available | Yes (true) | CHNAReportWidelyAvailableInd |
| Rpt Available On Own Website | Yes (X) | RptAvailableOnOwnWebsiteInd |
| Own Website URL | http://www.steliz.org/www-seb/media/SEB-PDF-Documents/Community-Health-Needs-Assessment-(CHNA)_St_El | OwnWebsiteURLTxt |
| Paper Copy Public Inspection | Yes (X) | PaperCopyPublicInspectionInd |
| Implementation Strategy Adopt | Yes (true) | ImplementationStrategyAdoptInd |
| Implementation Strategy Adpt | 14 | ImplementationStrategyAdptYr |
| Strategy Posted Website | Yes (true) | StrategyPostedWebsiteInd |
| Strategy Website URL | http://www.steliz.org/www-seb/media/SEB-PDF-Documents/Community-Health-Needs-Assessment-(CHNA)_St_El | StrategyWebsiteURLTxt |
| Strategy Attached | false | StrategyAttachedInd |
| Organization Incur Excise Tax | false | OrganizationIncurExciseTaxInd |
| Elig Criteria Explained | Yes (true) | EligCriteriaExplainedInd |
| FPG Family Incm Lmt Free Dscnt | Yes (X) | FPGFamilyIncmLmtFreeDscntInd |
| FPG Family Incm Lmt Free Care | 200.0 | FPGFamilyIncmLmtFreeCarePct |
| FPG Family Incm Lmt Dscnt Care | 600.0 | FPGFamilyIncmLmtDscntCarePct |
| Asset Level Criteria | Yes (X) | AssetLevelCriteriaInd |
| Medical Indigency Criteria | Yes (X) | MedicalIndigencyCriteriaInd |
| Insurance Status Criteria | Yes (X) | InsuranceStatusCriteriaInd |
| Underinsurance Stat Criteria | Yes (X) | UnderinsuranceStatCriteriaInd |
| Explained Basis | Yes (true) | ExplainedBasisInd |
| App Financial Asst Expln | Yes (true) | AppFinancialAsstExplnInd |
| Described Info | Yes (X) | DescribedInfoInd |
| Described Suprt Doc | Yes (X) | DescribedSuprtDocInd |
| Provided Hospital Contact | Yes (X) | ProvidedHospitalContactInd |
| Provided Nonprofit Contact | Yes (X) | ProvidedNonprofitContactInd |
| Includes Publicity Measures | Yes (true) | IncludesPublicityMeasuresInd |
| FAP Available On Website | Yes (X) | FAPAvailableOnWebsiteInd |
| FAP Available On Website URL | http://www.steliz.org/Patient-Guest/Financial-Assistance | FAPAvailableOnWebsiteURLTxt |
| FAP App Available On Website | Yes (X) | FAPAppAvailableOnWebsiteInd |
| FAP App Available On Website URL | http://www.steliz.org/Patient-Guest/Financial-Assistance | FAPAppAvailableOnWebsiteURLTxt |
| FAP Summary On Website | Yes (X) | FAPSummaryOnWebsiteInd |
| FAP Summary On Website URL | http://www.steliz.org/Patient-Guest/Financial-Assistance | FAPSummaryOnWebsiteURLTxt |
| FAP Avlbl On Request No Charge | Yes (X) | FAPAvlblOnRequestNoChargeInd |
| FAP App Avlbl On Request No Chrg | Yes (X) | FAPAppAvlblOnRequestNoChrgInd |
| FAP Sum Avlbl On Request No Chrg | Yes (X) | FAPSumAvlblOnRequestNoChrgInd |
| FAP Notice Displayed | Yes (X) | FAPNoticeDisplayedInd |
| Communtity Notified FAP | Yes (X) | CommuntityNotifiedFAPInd |
| FAP Actions On Nonpayment | Yes (true) | FAPActionsOnNonpaymentInd |
| Permit No Actions | Yes (X) | PermitNoActionsInd |
| Collection Activities | false | CollectionActivitiesInd |
| FAP Notified Upon Admission | Yes (X) | FAPNotifiedUponAdmissionInd |
| FAP Notified Before Discharge | Yes (X) | FAPNotifiedBeforeDischargeInd |
| FAP Notified All Patients | Yes (X) | FAPNotifiedAllPatientsInd |
| Documented Elig Determination | Yes (X) | DocumentedEligDeterminationInd |
| Nondis Emergency Care Policy | Yes (true) | NondisEmergencyCarePolicyInd |
| Average Negotiated Rates | Yes (X) | AverageNegotiatedRatesInd |
| Amounts Generally Billed | false | AmountsGenerallyBilledInd |
| Gross Charges | false | GrossChargesInd |
Supplemental Information SupplementalInformationGrp (4 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| Schedule H, Part V, Section B, Line 5 Facility , 1 | Facility , 1 - HSHS St. Elizabeth's Hospital. HSHS St. Elizabeth's senior leadership engaged Southern Illinois School of Medicine's Center for Clinical Research and Office of Community Health and Service to provide quantitative and secondary data and community health data on the four county service areas. In addition the team along with members of the community benefits committee identified additional data sets to review and discuss with focus groups. Internal data collected consisted of the top 10 diagnosis of patients admitted to the hospital from the Emergency Department and the top 10 diagnosis of patients discharged from the Emergency Department. The FY12 Community Health Needs Assessment was also included in the data review. A core group of St. Elizabeth's colleagues along with our physician partners provided valuable input for this CHNA. This focus group discussed the data, shared insights from their perspective vantage point and identified their top three health care focus areas. HSHS St. Elizabeth Hospital also leveraged existing relationships that provided diverse input for a comprehensive review and analysis of community health needs in the hospital's service area. These external component steps included conducting a survey at the Regional Health Policy Summit, leading focus groups, and utilizing the expertise of the existing Community Benefits Committee members. Community members were invited based on their awareness and expertise in the needs of our community. There was particular attention afforded to those who work with the underserved, low income, and minority populations as well as populations with chronic disease. In addition a special focus group was conducted with the homeless in their environment. Local focus groups were sponsored by community partners, which further demonstrate St Elizabeth's integration with the community. Such members include the director of St. Clair County Public Health Commission, retired nurse, St. Clair Mental Health Board(mental health), the Carla Smith Foundation (families of the mentally ill), USAF Nurse from Scott Air Force Base (Population Health), members of the clergy, community based hospice, BEACON ministries (social services agency for the poor and underserved), Health Visions East social worker for low income, medically underserved, and the elderly, local mental health agencies, representatives from senior living, a university professor, agency for domestic violence prevention, legal and financial services that represent low income population, and a member for the local Federally Quantified Healthcare Agency. |
| Schedule H, Part V, Section B, Line 6b Facility , 1 | Facility , 1 - HSHS St. Elizabeth's Hospital. St. Clair County Public Health Commission, Southern Illinois Health Foundation, Health Visions East, Lindenwood University, Southern Illinois University School of Medicine Office of Community Health and Service, Eastside Health District and BEACON Ministries. |
| Schedule H, Part V, Section B, Line 11 Facility , 1 | Facility , 1 - HSHS St. Elizabeth's Hospital. Identifying and prioritizing the areas of focus was completed using LEAN Principles. The charter, the first step in the LEAN process, consisted of identifying the primary customers, the scope of the project, the primary goal and the metrics selected for the CHNA. We listened to the voice of the customer as St Elizabeth's collaborated with our community partners. Individuals included the community benefits team, social agencies such as BEACON ministries, the executive medical staff, and SIU School of Medicine. The key drivers selected included the SIU secondary data analysis, focus groups, surveys, and Emergency Department(ED) data. These key drivers were further delineated into critical to quality requirements that provided measureable specifications. Data collected and measured included focus group members top three health needs, survey results of the top three health needs, and the top 10 ED diagnosis for both admitted and discharged patients. The data was collected and analyzed using a pareto chart. A pareto chart measures data in decreasing order of occurrence. The pareto chart identified poverty as the largest area of need followed by access to healthcare, obesity, food scarcity, and diabetes and then substance abuse as the tops six. As a health care organization St. Elizabeth's expertise and resources are best used addressing a health care need with measureable outcomes. Noting the association among some of the topics the data was categorized using an Affinity Diagram. An Affinity Diagram organizes a large amount of data into natural relationships. Using the data in the Affinity Diagram a new pareto chart was created. The priority areas that rose to the top were nutrition, followed by mental health/substance abuse, access to care, and cardiac disease. As part of the identification and prioritization of health needs, HSHS St. Elizabeth's senior leadership team and the CHNA Steering Committee considered the estimated feasibility and effectiveness of possible interventions by the hospital to impact these health priorities; the burden, scope, severity, or urgency of the health need; the health disparities associated with the health needs; the importance the community places on addressing the health need; and other community assets and resources that could be leveraged through strategic collaboration in the hospital's service area to address the health need. Based on the CHNA planning and development process described, the following community health needs were identified: 1. Nutrition and Wellness 2. Access to Care 3. Cardiac Disease Implementation Plan to Address Identified Needs HSHS St. Elizabeth Hospital partnered with other organizations to develop, implement, monitor and evaluate both new and ongoing initiatives that address the identified priority community health needs. The set of implementation strategies and interventions are contained in the Implementation Plan, which was approved and adopted by an authorized body of the hospital. The implementation strategies and interventions will include, but are not limited to, the following initiatives: 1. Wellness related to Nutrition a. Goal: To partner with the local soup kitchen to provide a series of education classes on nutrition. Measure: Conduct quarterly classes at the soup kitchen. b. Goal: Partner with the Eastside Health District and provide customers with samples of healthy food and recipes at the farmer's market. Measure: Assess customer's feedback. c. Goal: Cultivate and support a community garden and donate the produce to the local food pantries. Measure: Weigh the amount of produce donated to the food pantry and encourage colleagues to donate surplus produce from their personal gardens. d. Goal: To provide support and information to individuals with diabetes that will help with diabetes self-management. Measure: Continue to conduct the Diabetes support Group and complete annual survey related to knowledge and behavioral changes. Measure: Provide health screenings/glucose test and education to the community on a quarterly basis. Measure: Refer and track pre-diabetes patients for classes to our partner, the YMCA. Measure: Enroll eligible patients in the DSME program and track their referral source. Measure: Participate in a division wide diabetes campaign in partnership with Walmart and create a cohort of patients that we can measure and track physical behavioral changes. e. Goal: To provide the services of a dietitian to organizations free of charge for education about nutrition and healthy eating. Measure: Dietitian will make three presentations during the year, which may include a grocery store tour and/or cooking demonstration to teach individuals how to shop and cook for healthy foods. 2. Access to Health Care To provide access to medical care for those in need a. Goal: To continue providing financial assistance programs for patients who do not have the ability to pay for services received. To determine eligibility, a scale based upon the Federal Poverty Guidelines (FPG) will be used. Measure: Information about financial assistance programs will be communicated in registration areas and through patient accounting representatives. Eligibility will be based upon the Federal Poverty Guidelines (FPG) established by the U.S. Department of Health & Human Service b. Goal: to increase enrollment in the Health insurance exchange. Measure: During the period of open enrollment on the HIE, November 1, 2015 and end January 31, 2016, St. Elizabeth's Hospital will distribute one news release to the local media about open enrollment and place information on the hospital's website. The services of an enrollment counselor will be funded by the hospital as the level of need is determined for the county and in coordination with the local/regional public health departments. c. Goal: To further assess the need for non-emergency medical transportation and identify other organizations for possible collaboration. Measure: Assessment will be completed and one action taken as identified to improve transportation access and/or reduce costs for low income residents. Collaboration will be completed with current public transportation provider, as appropriate. d. Goal: To address to the needs of eligible patients that require medications and services to safely transition patients to an appropriate level of care. Measure: Collaborate with other organizations that support the continuum of care for eligible patients and can provide needed services. 3. Heart Disease/Cerebrovascular Disease and further evaluated until we reached sufficient detailed information that enabled us to measure the information. For example, the key drivers: a. Goal: To promote heart health awareness, education about cardiovascular disease as well as eating and lifestyle choices. Measure: During the month of February, nationally recognized as Heart Health month, one activity will be held for community health education. Measure: Conduct/participate in quarterly community health programs Measure: Meet with outside agencies and hospitals and provide cardiac and stroke education. Measure: Conduct quarterly classes at the soup kitchen on cardiac and stroke awareness. Measure: Participate in a division wide diabetes/cardiac campaign in partnership with Walmart and create a cohort of patients that we can measure and track physical behavioral changes. In addition to the above activities HSHS St. Elizabeth's continues to engage the community in many other activities that provide support to the poor and underserved. As a teaching institute the hospital, colleagues mentor students in a variety of disciplines to include a family practice residency program, pharmacy, nursing and multiple ancillary departments. |
| Schedule H, Part V, Section B, Line 11 Facility , 2 | Facility , 2 - HSHS St. Elizabeth's Hospital. As an outcome of the prioritization process, the following community health needs were also identified and will not be addressed directly by the hospital for the reasons indicated: * Mental Health and Substance Abuse- this category is listed as the second health care priority. St. Elizabeth's will continue to partner with local and state agencies to assist when feasible with mental health and substance abuse. St. Elizabeth's is in the process of transitioning the majority of our mental health resources and expertise to a local community partner and St Elizabeth's lacks necessary resources to pursue this priority. * Tobacco Use - The hospital did not take the lead on this issue. It is best addressed through the County Health Department smoking cessation classes. * Poverty- due the complexity of this issue the hospital will not take lead. There are several agencies that are addressing this issue. St. Elizabeth's partners with agencies such as East-Side Aligned, Catholic Urban Programs, St. Vincent DePaul, and BEACON ministries, where we can provide support. * Violent Crimes- The hospital will not take lead in this because it is not an area of expertise for St. Elizabeth's, however an active partnership exists with the Violence Prevention Center. * Sexually Transmitted Diseases-the local health department takes lead for this focus area. * Lack of available healthy food and food scarcity. The hospital did not take the lead on this issue. It is addressed by groups including local food pantries, East Side Health District, and East Side Aligned. The hospital supports these efforts by donating community garden proceeds to the local food pantry and conducting food drives. * Maternal and Infant Health as it relates to infant mortality and teen pregnancy; the hospital has a special care nursery and a pediatrician on staff but the hospital lacks the resources to further enhance programs for maternal and child health at this time. It is part of the St Clair County IPLAN. * Lung Cancer - This is issue is being addressed in the IPLAN and additionally St. Elizabeth's does offer new technology to screen for lung cancer. |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Facility | 0 | FacilityNum |
Supplemental Information Detail SupplementalInformationDetail (21 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| Schedule H, Part VI, Line 5 Promotion of community health (continued A) | Access to health care: Enrollment: To improve access to care the hospital, St. Elizabeth's took a proactive approach and enlisted Cardon Outreach to assist patients and the community with enrollment in ACA plans, both during the open enrollment period and throughout the year to continue Medicaid enrollment assistance. Cardon's contract began in October of 2014 and they continue to screen inpatients and outpatients, specifically the Emergency Department patients for Medicaid eligibility. Cardon continued to assess patients post enrollment. St. Elizabeth's two prong approach; assessing inpatients and Emergency Department patients and also providing a resource for the community yielded very favorable results. These very deliberate efforts to increase our community's access to healthcare were very successful. Cardon continues to make a significant impact on Medicaid enrollment. Enrollment increased by 39% going from 1280 to 3,291 patients placed. In addition we had 17% or 740 individuals who were not eligible for Medicaid screened for St Elizabeth's Financial Aid Program. Community Resource Fairs Working in collaboration with our physician partners, we learned that there was an education gap with our patients. Although they now have health care coverage, they are not familiar with how to use it and are not aware of the many benefits that come with the different plans. To help bridge this gap HSHS St Elizabeth's planned quarterly resources fairs in collaboration with other social agencies. Community agencies participate and create an environment that not only educates the community about health insurance benefits but also informs patients about other resources that can help improve their overall health and quality of life. This collaboration resulted in three community resource fairs impacting over 100 persons. After the first resource fair offered at the hospital we learned that we would capturing our desired audience which were those individuals who has access for fewer resources. Therefore we moved the following events in the community and every effort is made to meet the people where they were. Every participant received a gift of a healthy snack or hygiene kit; both are much appreciated. Nutrition and Wellness Cardiac/Cardivascular Disease Make Health Happen The East St. Louis Make Health Happen partnership consists of local community organizations working together to improve healthy food access in East St. Louis, Illinois. The Corner Store initiative works to increase access to healthy food while building demand in the community through education and promotion of healthy food options. Community partners work to improve access to nutrition information by providing healthy cooking demonstrations and direct and series based nutrition education. St. Elizabeth's provided fruit and healthy snacks and education at the Corner Store Trick or Treat Day. We toured a local store noted the increased visibility of signs that identifies healthy choices with anticipation of conducting a health fair in the parking area. One of our nurses joined the Bond Ave Fish Market and provided education about diabetes to 75 members in the community. On another occasion we offered food sampling of common food found at a food pantry. People were pleasantly surprised of the different ways to serve food. Cosgrove's Kitchen Cosgrove's Soup Kitchen was established more than 30 years ago and has been an important ministry serving those suffering from the effects of poverty. It is the only facility in the East St. Louis area that offers a free noon meal six days a week. During the FY156 CHNA, St Elizabeth's conducted a focus group with members of the Cosgrove's Kitchen community. Members of the focus group shared their concerns about their community and made requests about education and health. On a monthly basis, the nurses provide education and screening. Over the course of the past year our consistent presence allowed us to be accepted and they look forward to our visit. Besides establishing relationships some members of the community showed some improvement in their health status. When asked if we could check one gentleman's blood pressure, he commented, "because of you I now have a doctor's appointment." He shared that after our last visit he decided he needed to seek follow-up care for his hypertension. All clients who allow us to interact with them are given a hygiene kit. The nurses provide, on average, 20 screens per month and may include glucose and cholesterol screens, blood pressure, height and weight. The clients are given a small card to track their progress. The most effective method of education is 1:1 with each person, providing some individual attention and answering questions in a respectful manner. The director of St. Vincent DePaul feels our presence is value added for this often homeless and transient community. LifeFit Partnership with the YMCA St. Elizabeth's collaborated with the YCMA and designed a program to bridge the gap between complex needs of 15 YMCA underserved families and resources available in the community. Through monthly meetings, educational offerings, and bi-weekly check-ins, Lifefit provides families with opportunity, connections and information. After completing a needs assessment, six topics were identified. St. Elizabeth's developed presentations around these 6 topics, which included stress management, nutritional planning, diabetes, emergency/disaster preparedness, cardiac disease with cholesterol panel interpretation. These topics validated the community health needs assessment. Along with the monthly education St Elizabeth's provided a healthy low cost meal and the recipes. Ten families completed the program. During a focus group families commented that with the added education and support of the YMCA and St Elizabeth's they are ready to make some behavior changes related to health such as increase in activity and minor changes in diet, specifically addressing salt and fried food. Cardiovascular/Cardiac Education HSHS St Elizabeth's, a TRUVEN TOP 50 Cardiac Hospital for the fourth consecutive year, offers year round cardiac and cardiovascular education for all age groups. Cardiac education begins in the schools and HSHS St Elizabeth's interacts with students and educated on the importance of calling 911 and how to perform Hands Only CPR. One 11 year old student saved her father's life by calling 911 against his will. The patient experienced a cardiac arrest in the ambulance on the way to the hospital. Had he remained at home or had he been driven in buy a family member, he would have died. Cardiac education occurs at all health fairs for the community and in the senior centers. Over the course of the year more than 1,000 persons received education about heart disease and stroke. Other Community Benefit Activities and Programs Breast Health Awareness October is Breast Health Awareness month. Annually, HSHS St. Elizabeth's Hospital works to enhance community awareness and connect with the community in an effort to educate and raise awareness of the importance of breast health. In FY2016, O'Fallon "dressed in pink" by wearing pink bows on all the downtown light poles to raise awareness for Breast Health Awareness month. The hospital partnered with the local newspaper, our regional FQHC, a local business, and the HSHS Southern Illinois Division to host a community Health Fair at the large local mall. A member of the Illinois Breast and Cervical Cancer program was present to share information about their programs for qualified individuals. Nearly 100 women participated in the events. The community Health Fair included Breast Health Information, Mammography scheduling, Bone Density screenings, Cardiac and stroke information, Blood Pressure and BMI screenings, Diabetes Information with a Diabetes Risk Assessment, and an on demand Glucose Screening. |
| Schedule H, Part VI, Line 6 Description of affiliated group (continued A) | In southwest Illinois, HSHS St. Joseph's Hospital in Highland enhanced their offerings to their senior population based on their CHNA. "Senior Renewal" is an outpatient counseling program for senior adults who may be facing emotional and physical problems unique to the aging process such as feelings of loneliness, isolation and anxiety. Clients receive a comprehensive level of treatment without inpatient hospitalization through counseling strategies and education. In addition, St. Joseph's Hospital in collaboration with the Illinois Department of Insurance participates in the Senior Health Insurance Program (SHIP), a free health insurance counseling service for Medicare beneficiaries and their caregivers. In addition to programs designed to increase access to care, HSHS makes sure that those who need financial assistance receive it. HSHS's Financial Assistance (Charity Care) policy was modified effective January 1, 2014 to offer a 25 percent self-pay discount to all patients who register without insurance. HSHS Financial Assistance programs have a sliding scale, in some instances providing up to a 55 percent reduction off billed charges if an uninsured patient's family income level is determined to be above 500 percent but equal to our less than 600 percent of the current Federal Poverty Guidelines. HSHS hospitals waive all charges for patients below 200 percent of the Federal Poverty Levels. Counselors are available in our hospitals to explain our financial assistance policy to patients, provide them with assistance in filling out a simple application form, or help them enroll in publicly funded health care programs. Enhance community health As part of our mission to embody Christ's healing love for all people, we understand that we have a responsibility to improve the overall quality of life in our communities by supporting initiatives that promote health and wellness. We recognize we are most successful when we work together with a wide array of public and private organizations that share our commitment to improving lives. By doing so, we maximize our efforts and reduce the duplication of services. To ensure the health care needs of all are being met, HSHS hospitals also understand we need to listen closely to the residents of the communities we serve. In turn, 13 of our 15 hospitals completed Community Health Needs Assessments (CHNAs) in FY2015. HSHS St. Clare Memorial Hospital in Oconto Falls, Wisconsin, who affiliated with HSHS in September 2015, and HSHS Holy Family Hospital in Greenville, Illinois, who affiliated with HSHS in May 2016, both completed their CHNAs in FY2014. HSHS hospitals are using the information gathered from their most recent CHNAs to develop new, and enhance existing, programs and services that best address the needs of the community. Several priority areas were identified in the FY2015 CHNAs including access to health care services; alcohol, tobacco, and other drug abuse; chronic disease prevention and management; nutrition/wellness; mental health; and oral health. HSHS hospitals are addressing these and other needs by proactively offering educational opportunities, preventative screenings, and new or enhanced clinical services. In many cases, the hospitals collaborate with other hospital facilities, local departments of public health and community organizations to address identified needs. In western Wisconsin, HSHS Sacred Heart Hospital in Eau Claire and HSHS St. Joseph's Hospital in Chippewa Falls are taking the lead on programming to educate the public about mental health issues and treatment, the stigma associated with mental health, and the recognition of mental health issues. To combat the rising rate of suicides in the area, both hospitals under the umbrella of 3D Community Health are providing community education on QPR (Question, Persuade and Refer), an evidence-based suicide prevention program. In FY2016, 3D Community Health provided 37 adult QPR programs for 1,046 persons and 44 youth QPR programs for 1,161 high school students. In addition, 3D Community Health hosted a community forum to discuss the CHNA results and introduce QPR to 192 community members. HSHS St. Vincent Hospital in Green Bay collaborated with Prevea Health to implement the TIPS program, a program for non-violent opioid abusers that provides treatment and deferred/dismissed prosecution upon successful completion of the treatment program. St. Vincent Hospital also subsidized scholarships for a residential treatment program and arranged to have the first dose of Vivitrol donated; Vivitrol prevents relapse to opioid dependence after opioid detox by attaching to opioid receptors and blocking feelings of pain relief and wellbeing. HSHS St. Mary's Hospital in Decatur, Illinois joined the Macon County Mental Health Board to collaborate on existing programs and to provide resources to meet identified gaps. While other communities are cutting back on mental health services, St. Mary's Hospital remains committed to providing a full spectrum of behavioral health services for adolescents, adults and senior. For example, the hospital collaborates with the Decatur Public School District to provide school teachers for two hours per day for children in the adolescent behavioral health unit. The partnership limits the amount of schoolwork missed during hospitalization. The hospital also has substance abuse counselors who provide educational programs on alcohol and other drug abuse in county schools for students and faculty. HSHS St. Nicholas Hospital in Sheboygan identified nutrition and physical activity as a priority health need in its FY2015 CHNA. In response, St. Nicholas Hospital coordinated and supported the development of the "Double Your Bucks" program at the Sheboygan Farmers Market in FY2016 to enable EBT recipients to double the amount of fresh fruits and vegetables they can purchase. The hospital is also a sponsor of the Sheboygan Farmers Market to promote healthy eating in the community. Additionally, St. Nicholas subsidized the cost of additional bike helmets at the Early Learning Center to increase the physical activity levels of Head Start students and purchased culinary equipment for South High School nutrition and fitness classes to increase opportunities for students to learn how to prepare healthy food. HSHS St. Mary's Hospital in Streator, Illinois collaborated with two local schools to establish community gardens on each of their campuses to address childhood obesity in addition to the community garden on the hospital campus. Students, their families, and hospital colleagues planted, tended and harvested the gardens. Math and science teachers incorporated the gardens into their curricula. Neither school offered Home Economics classes, so St. Mary's Hospital provided the produce and colleagues to offer cooking demonstrations in the classrooms to encourage students to prepare fresh fruit and vegetables snacks. The three gardens produced more than 1,713 pounds of produce in three years, which was donated to the local food pantry, Salvation Army, students and local churches providing healthy food to the poor and vulnerable. Advance medical knowledge HSHS works to advance medical knowledge by supporting research initiatives and educational opportunities. In FY2016, HSHS hospitals and affiliated physician groups contributed more than $19.1 million toward research and education. Highlights of this commitment include subsidizing medical school residency programs, offering ongoing medical education to physicians and clinicians, and providing job shadowing programs for high school students. In southern Illinois, HSHS St. Joseph's Hospital in Breese, hosted members of the Health Occupations Students of America onsite to learn about job opportunities in health care from health care professionals. St. Joseph's also provided clinical experience for Kaskaskia College students enrolled in nursing, physical therapy and radiology programs. Pharmacy students have also completed their clinical training at St. Joseph's Hospital. In FY2016, the program served more than 100 students. In FY2016, HSHS St. Mary's Hospital Medical Center and HSHS St. Vincent Hospital in Green Bay invested more than $311,000 to provide onsite training and education of nurses and allied health professionals. In addition, the hospitals have been collaborating with the Medical College of Wisconsin to establish a community medical education program in Green Bay and to provide financial support to offset operating costs in FY2016. Also in eastern Wisconsin, HSHS St. Clare Memorial Hospital in Oconto Falls provided training for local paramedics and emergency response personnel through the hospital's EMS liaison program. |
| Schedule H, Part VI, Line 6 Description of affiliated group (continued B) | Mission-driven and strategically implemented Community Benefit is an integral part of Hospital Sisters Health System's Mission. Our commitment to Community Benefit arises from our Catholic identity, Mission and Core Values shared by 14,000 colleagues across Illinois and Wisconsin. Through our work to improve access to health care services, enhance community health, advance medical knowledge, and relieve or reduce the burden of government, we believe we have made a positive difference in the quality of lives of tens of thousands of people in Illinois and Wisconsin in FY2016. As a Catholic health care ministry, HSHS is concerned with the dignity of all persons, the common good, and the stewardship of resources. We advocate for health care for all and work to improve social conditions that lead to improved health and well-being. We engage partners in our communities to improve health and quality of life and to reduce duplication. Working side by side with many faith communities, HSHS remains dedicated to our common purpose of compassionate care for all people. |
| Schedule H, Part VI, Line 5 HSHS St. Elizabeth's Hospital (continued B) | Pregnancy Loss Support Group: The Share Program Pregnancy loss affects families of all races, all socioeconomic groups, and all ages. It is important to for those who experience pregnancy or infant loss to be supported and surrounded by those who understand the devastating emotional, physical, and long lasting effects pregnancy loss creates. Unfortunately, in the community served by St. Elizabeth's Hospital, support for grieving families has been limited. Share is a pregnancy and infant loss program dedicated to supporting mothers and families experiencing this heartbreaking tragedy. Two colleagues on the Obstetrics unit, embraced the challenge of establishing a Share Chapter at St. Elizabeth's to help support those facing loss during a period of life that is usually exciting and celebrated-the birth of a child. HSHS St Elizabeth's continues to serve as the chapter leader for this organization in our community. Mothers interact with our Share leader both in person and through social media. She makes accommodations to meet the needs of the mother through the bi-monthly meetings or through email. This year she interacted with 15 different mothers who experienced fetal loss. In- Kind donations for the community, the poor, and the vulnerable HSHS St Elizabeth's provides and donates a plethora of donations to various social and educational agencies. For example seven agencies received 137 computer devices to support students in the classroom and computers to facilitate and manage social agencies. Conference room space is donated to a variety of organizations that are aligned with our mission and principles. An example of such space includes providing meeting space for support groups, blood drives, and also housing the county morgue. HSHS St Elizabeth's provides printing services for two small small local non-profit organizations. Education HSHS St Elizabeth's is a strong supporter of education and provides mentoring to individuals in the clinical disciples as well those outside of the clinical setting. In conjunction with St Louis University, Southern Illinois Health Foundation (FQHC), and Scott Air Force Base, the hospital supports a Family Practice Residency. Other disciplines that receive on site education and mentoring include nursing, pharmacy, pharmacy informatics, respiratory, radiology, occupational, physical, and speech therapies. Non clinical education includes administrative secretary, medical records, and a master of health administration to name a few. |
| Schedule H, Part I, Line 7 Bad Debt Expense excluded from financial assistance calculation | 3072599 |
| Schedule H, Part I, Line 7 Costing Methodology used to calculate financial assistance | To determine the actual cost of these services, the hospital uses a cost-to-charge ratio based on our audited financial statements to calculate the amounts reported on Lines 7a through 7i. The bad debt expense included on Form 990, Part IX, Line 25, column (A) was subtracted prior to and for the purpose of calculating the percentage in Part I, Line 7, column (f) is $3,072,599. |
| Schedule H, Part II Community Building Activities | HSHS St. Elizabeth's Hospital engages in Community Building activities that focus on the root causes of health problems and how the activity sustains or improves infrastructure in such a way that it supports a healthier community. SEB utilizes a discernment process to prioritize the allocation of human, material and/or financial resources to support Community Building. Allocation of Human Resources As a trusted health care organization in the community, SEB receives numerous requests for free screenings, educational presentations and sponsorship donations throughout the year. To be good stewards of our human and financial resources, the hospital's marketing department developed a process flowchart and a "Health Fair Request Form" to manage requests. Marketing reviews the request and recommends whether SEB should participate. The request and discernment is presented to senior leadership for approval. If approved, the marketing department confirms participation, secures staff and compiles all materials for the event. Events are tracked and Post Event Survey responses are collected and compiled future event requests. Allocation of Material and Financial Resources The hospital's stewardship committee assesses resources for operational, community benefit, and community building activities in light of our mission and as we prepare to complete the replacement hospital in November 2017. SEB seeks opportunities that will allow us to be good stewards of our resources. 1. Workforce (non-hospital) development: SEB has planned a very careful utilization of its financial resources in the construction and planning of the replacement hospital and medical office building in O'Fallon. SEB has made a commitment to ensure representation on the project from minority and women owned businesses in the construction of the building. In addition, local subcontractors are used whenever possible to support the local community and continue the partnership between the hospital and community. 2. Workforce (non-hospital) development: Bridges Connections District 201 is designed to help special needs students learn marketable skills through on the job training. Up to three students receive two hours of supervised job training for each day during the school year. The hospital absorbs an increasing percentage of the cost as participant's progress through the program. Bridges enhances this high-risk population's ability to be productive members of our community. 3. Environmental improvements: When the hospital construction team identified the need for a new sanitary pump station on the campus, the hospital built the pump station in a location that would also serve the Misty Valley neighborhood, which demonstrated our commitment to work with the community, improve the environment and be good stewards of our resources. 4. Leadership Development: Partnerships with community business leaders is an important part of demonstrating SEB's commitment to the community. In January, the hospital hosted the Greater Belleville Chamber of Commerce's Leadership Belleville 25 member class for their educational program on "Health care, aging and community service." Leadership Belleville is a 9-month commitment and unique training program for individuals who have demonstrated high leadership qualities. SEB also sponsored a colleague to take part in this professional development program and she completed the program in May. 5. Coalition Building: BASIC Initiative (Belleville Achieves Strength in Character) is a partnership of schools, the City of Belleville and the business community to strengthen character in our youth and in the community. BASIC encourages youth and adults to be productive citizens in our community. 6. Coalition Building: SEB initiated practices that later became part of the health department when they formed in 1985. A SEB colleague participates in the Health Care Commission, a 20 plus member commission which was founded in 1991 that serves as a public health system to establish priority health issues, mobilize resources to meet identified needs, and promote the health and well-being of the all-county residents. SEB is actively involved in the IPLAN process. 7. Coalition Building: East Side Aligned is a collective impact model to serve children and youth within the Greater East St Louis that is led by the United Way. SEB is part of two teams - career pathways and health care. As a member of the health care strategy team, SEB partners with other agencies that have similar goals as our CHNA. For example, Eastside Health District received CDC grant and WIC to focus on policy change and increasing healthy foods in the area - a coalition called Make Health Happen of which SEB is an active member. 8. Community Support: SEB is a community leader for emergency management and disaster preparedness. SEB's EMS coordinator serves on the Advisory Council for two counties, and is certified in National Incident Management System (NIMS) and Incident Command Structure (ICS). In FY2016, SEB was the only hospital involved in a five county, 22 agency railroad derailment drill and involved a hazardous chemical exposure; the coordination of events occurred at SEB. ED nurses who communicate with EMS must be attend the licensed class approved by IDPH. SEB colleagues trained 25 nurses on this process and 85% were from outside agencies. SEB continues as an assessing hospital for EBOLA. 9. Community Support : Pregnancy Care Center: SEB's Mother Child Department hosted the first Annual "Bundles for Babies" Community Baby Shower and collected baby items including clothing, bottles, diapers, baby wash and lotion, and crib sheets. Larger, gently used pieces of furniture and strollers were also donated. The Pregnancy Care Center is located on the Belleville campus in free space provided by the hospital. It provides free services including pregnancy tests, referrals for medical care, WIC and other resource information. The Pregnancy Care Center also provides clothing and supplies to those with financial needs. 10. Community Support: Social Agency Donations: The hospital conducts food, clothing, and school supply drives, and electronics recycling in collaboration with many local social agencies such as St Vincent DePaul, Catholic Urban Programs, BEACON ministries and local food pantries to meet the needs of the underserved and reduce the burden of government. In FY2016, colleagues donated 73 baskets (for colleagues) and 500 pounds of food for Mt Zion Baptist Church in East St Louis, more than 752 pounds of clothing, 230 pounds of shoes for Waterman Project, and backpacks and school supplies to East St Louis St Vincent DePaul. Computers were donated to a number of schools and social agencies. SEB partners with local blood centers, provides a donation location for blood drives and contributes to incentives to encourage colleagues and the public to participate. Colleagues participate on the board for the Center of Autism. 11. Community Health improvement and advocacy: Over the past two years SEB worked with Touchette Regional Hospital to establish a Mental Health Center of Excellence for behavioral health patients in our region. In the best interest of our patients, establishing a Regional Mental Health Center of Excellence at Touchette was the best solution. In January 2016, the Behavioral Healthcare Unit at SEB closed its inpatient and outpatient treatment programs. SEB worked with Touchette in the development and construction of their state-of-the-art facility. Monthly meetings continue with Touchette to ensure our patients are referred and transferred appropriately. Both hospitals are members of the Metro-east Behavioral Health Network Council, a group of agencies within our community that share resources and implement new treatment strategies for our patients with psychiatric needs. |
| Schedule H, Part III, Line 2 Bad debt expense - methodology used to estimate amount | Self-pay patients are screened for verification of no insurance coverage. Once verification of no coverage has been completed, the guarantors will be screened for charity or uninsured discounts based on income levels. Those guarantors that do not qualify for charity through the screening process will be asked to provide proof of income in the form of a recent pay stub and/or recent tax return to determine the level of uninsured discounting. If no proof of income is provided or a guarantor's income is greater than 201% of the federal poverty level, the appropriate discount according to the established criteria up to 600% of the federal poverty level will be applied. The amount of money not collected from those self-pay patients who are not eligible for charity care is reported as bad debt. Allowances for Doubtful Accounts have been recorded based on an historical matrix, using collectability percentages by payor and aging category in accordance with HSHS Executive Policy #F-23, Valuation of Net Accounts Receivable. Percentages are based on historical experience at the hospital and adjusted for known limitations. |
| Schedule H, Part III, Line 3 Bad Debt Expense Methodology | The hospital strongly believes that its charity care, and the related community benefit obtained from such care, is understated because of those patients who potentially qualify for charity care but do not wish to apply for it. In addition, some care is not classified as charity because of missing documentation on patient resources. Thus, the hospital's bad debt includes a portion that could be classified as charity care if application for such care was sought and/or completed. Currently, the hospital is implementing processes, procedures and systems to more effectively determine charity care that will reduce a patient's documentation requirements and ease the patient's emotional burden in applying for charity care. This will provide a more accurate reporting of charity care services provided by the hospital. |
| Schedule H, Part III, Line 4 Bad debt expense - financial statement footnote | The text of the footnote to the organization's financial statements that describes bad debt expense can be found on page 21 of the HSHS Consolidated Audit Report. |
| Schedule H, Part III, Line 8 Community benefit & methodology for determining medicare costs | HSHS St. Elizabeth's Hospital continually strives to provide excellent patient care in the most cost effective fashion. Nonetheless, the Medicare program, in many cases, does not provide payment that covers the full cost of the care provided. Since it is the mission of the hospital to respond to community need, hospital management continually advocates for improved Medicare payment so that the cost of quality care to those patients who are not able to afford it is not compromised and is fairly subsidized by all payers. While this shortfall in Medicare payments is not classified as community benefit by the IRS, we nonetheless believe it is an important contribution made by the hospital to the health and well-being of the community. If the Medicare program did not exist, many Medicare patients would be eligible for charity care or other means-tested government programs. Further, by absorbing this payment shortfall and providing care below cost to these individuals, HSHS St Elizabeth's is relieving the burdens of the government. Accordingly, this shortfall restricts HSHS St Elizabeth's ability to make funds available to provide for charity care and other community benefits. The hospital Medicare shortfall at cost for fiscal year 2016 was $6.559,647. |
| Schedule H, Part III, Line 9b Collection practices for patients eligible for financial assistance | The hospital makes reasonable efforts to determine a patient's eligibility for the Financial Assistance Program before utilizing any extraordinary collection actions. Upon admission, a patient receives information about the Financial Assistance Program and how to fill out an application, along with a phone number to contact for further help. Inpatients that are uninsured and not eligible for Medicaid are given a Financial Assistance Application. Each patient will then receive a minimum of three bills with information on how to apply for Financial Assistance. Accounts of patients who have not responded to any of these inquiries will be recommended for bad debt. However, before submitting accounts to a collection agency, the guarantor is screened (using an external program) for charity qualification. If the guarantor qualifies for a full adjustment, the account is settled. We do offer a sliding scale discount for charity. If they qualify for less than 100%, the discount will be posted and the account transferred to the collection agency. The collection agency will do further screening based on their credit score and propensity to pay. Based on this screening, the collection agency may return the account with a recommendation of charity. |
| Schedule H, Part V, Section B, Line 16a FAP website | - ST. ELIZABETH'S HOSPITAL: Line 16a URL: http://www.steliz.org/Patient-Guest/Financial-Assistance; |
| Schedule H, Part V, Section B, Line 16b FAP Application website | - ST. ELIZABETH'S HOSPITAL: Line 16b URL: http://www.steliz.org/Patient-Guest/Financial-Assistance; |
| Schedule H, Part V, Section B, Line 16c FAP plain language summary website | - ST. ELIZABETH'S HOSPITAL: Line 16c URL: http://www.steliz.org/Patient-Guest/Financial-Assistance; |
| Schedule H, Part VI, Line 2 Needs assessment | As indicated in Part V, Section C, HSHS St Elizabeth's conducted a Community Health Needs Assessment in FY2015 (July 1, 2014 through June 30, 2015). In FY2012 HSHS St Elizabeth's conducted its first formal CHNA. Engagement sessions were held and participants were invited based on their expertise and in their awareness of health care needs in the community. In previous years, the hospital assessed community need by working closely with the Health Department. Social accountability has always been a part of the hospital's mission. St. Elizabeth's assessed our top ten diagnoses and evaluated how we can impact care for these patient populations. Due to St. Elizabeth's close relationship with the St. Clair County Health Department, information and data were shared and addressed collectively. Provisions in the Affordable Care Act require charitable hospitals to conduct a CHNA and adopt implementation strategies to meet the needs identified. To comply with these requirements, HSHS St Elizabeth's led a collaborative approach to conduct its CHNA and adopt an Implementation Plan in FY2015 (July 1, 2014 through June 30, 2015), a process we undertake every three years. |
| Schedule H, Part VI, Line 3 Patient education of eligibility for assistance | The Registration Department informs all patients about the Financial assistance policy and provides applications and brochures upon request. They are printed and readily available. This packet contains a letter identifying financial assistance opportunities offered to our patients as well as a financial assistance application, plain language summary of the financial assistance policy and financial assistance contact information. At the time of registration, a brochure is provided to self-pay patients upon registration regarding the Financial Assistance Program available to them at HSHS St Elizabeth's. The brochures are also supplied in waiting and ancillary areas for easy access by the patient. The hospital has onsite advocates to assist patients with enrollment in several federal, state and local government programs. These Advocates visit patients while in the hospital or contact them by phone once discharged. The advocates will also make home visits as needed in order to assist patient with enrollment as well as gathering necessary documents for application. We also offer an online business office portal that provides information on how to read and understand HSHS St Elizabeth's billing information. HSHS St Elizabeth's website provides an explanation of Medicare forms at www.steliz.org. Each statement that a patient receives contains information about our financial assistance program and a phone number for assistance with applying. Any patient visiting the onsite financial counselor as well as contacting us via phone are given information about payment options including our financial assistance options. Even after an account is sent to a collection agency and/or anytime in the process they believe a patient may be eligible for Financial Assistance, the account is returned to the hospital for evaluation. HSHS St. Elizabeth's makes their financial assistance application and standard response letters available in Spanish, as well as English. Patients are also provided a Fair Billing Act notification at the point of registration regarding separate physician billing they can expect to receive, plus information about the patient's financial responsibility if their insurance plan is out of network. A system called Payment Navigator is now being utilized after failed attempts made by the hospital, but before sending to a collection agency. That system accesses credit and other information and allows us to see the probability of a patient being able to pay their bill. After assessing that information, the hospital makes a determination whether to grant charity care or continue collection efforts. St Elizabeth's assessed its community and it does not require the FAP to be translated into the primary language of any population with limited English proficiency. |
| Schedule H, Part VI, Line 4 Community information | HSHS St. Elizabeth Hospital service area is comprised of approximately 1955 square miles with a population of approximately 610,057 and a population density of 312 per square mile. The service area consists of the following communities: St Clair, Monroe, Madison, and Clinton counties. The population of these counties is 270,056, 32,957, 269,282, and 37,762 respectively. The population increased in the service area by 5.51% between 2000 and 2010. The population in St Elizabeth's service area had a similar age distribution as the state as a whole. Belleville, the county seat of St. Clair county, has median household income is $49,634 compared to the national median income of $53,271.More than 85,000 residents (14.0%) of residents in the service area live below poverty. Thirty percent of the area's population lives below 200% of the poverty level. The population in Clinton County that is uninsured is 6.9%, Madison County is 9.5%, Monroe County is 5.9%, and St Clair County is 11.4%. Hospital that also provide service include 5 hospitals in Madison County, one hospital in Clinton county, three hospitals in St Clair county with one being a FQHC, and no hospitals in Monroe county. The hospital does not exclude Medically Underserved Areas (MUAs), low income or minority populations from its service area. |
| Schedule H, Part VI, Line 5 Promotion of community health | As a healing ministry of the Catholic Church and an affiliate of Hospital Sisters Health System (HSHS), HSHS St Elizabeth's is committed to delivering high quality, compassionate, and cost-effective health care services to all. The hospital was founded more than 140 years ago to bring a healing presence and improve the health of our community, especially for those persons who are sick, poor, and disadvantaged. Because of the hospital's purpose and tradition, it is organized to promote the health of St Clair County and the surrounding counties of Madison, Clinton, and Monroe. The hospital is governed by a Board of Directors, at least a majority of whom reside in the hospital's primary service area and who are neither employees nor independent contractors of the hospital (nor family members thereof). The Board ensures that HSHS St Elizabeth's is responding to community need. In FY2016, for example, the board reviewed the Community Benefit implementation plan and are especially impressed by the work at Cosgrove's Kitchen. In addition the Hospital Advisory/Community Benefit Committee sought new members that complement the CHNA priority needs. Along with this committee, the Foundation and our volunteer auxiliary group advocate on behalf of the hospital in the community Also consistent with its exempt purpose, HSHS St Elizabeth's has an open medical staff with privileges available to all qualified physicians in the area. The hospital also operates an emergency department that is open 24 hours to all persons regardless of their ability to pay. As a not-for-profit hospital, HSHS St Elizabeth's reinvests surplus funds to support the mission of the organization and health of the community rather than distributing surplus funds as profits to shareholders or individuals. Funds not committed to ongoing operations are generally used to upgrade facilities, secure new technologies, improve patient care, and support initiatives designed to promote health and ensure access for all along with providing medical education and research. Replacement Hospital For example, St. Elizabeth's has a long history of assessing the sign of the times and strategically planned for the future of healthcare in southern Illinois. On April 21, 2015, HSHS St. Elizabeth's Hospital received unanimous approval from the Illinois Health Facilities and Services Review Board (HFSRB) to begin construction on a new $300 million medical campus along Interstate 64 and Green Mount Road in St. Clair County. The Certificate of Need allows St. Elizabeth's to replace its current hospital, which was built in the 1950s, with a modern hospital that will be built on a 114-acre campus with an adjoining ambulatory care center. The new campus will enhance St. Elizabeth's ability to develop an integrated care delivery model that will serve residents from across Southwestern Illinois. The new St. Elizabeth's is designed for the future of health care delivery. The facility will include 144 private patient rooms, an emergency department, state-of-the art operating rooms, modern birthing suites, an advanced intensive care unit, and inpatient rehabilitation. The adjacent ambulatory care center will offer various outpatient services such as lab, imaging and therapy, and include medical office space for more than 100 physicians. The location of St. Elizabeth's replacement hospital will be centrally located for the patients of the southwestern Illinois region that it serves. It will also be closer to Scott Air Force Base and the community hospitals that refer patients to St. Elizabeth's. Construction began in June of 2015 with estimated completion and transfer of services in November of 2017. Capital Purchasing This past year, St. Elizabeth's implemented a multi-disciplinary task force to prioritize capital projects. The team reviewed every desired asset and prioritized the list, both clinical and non-clinical to determine which assets to purchase during the year. The criteria used in the evaluation process include: patient and colleague safety, regulatory requirements, infection prevention, equipment age and usage, physician needs and financial information. For example, our Intensive Care Unit needed new Temperature Management Systems for patient safety. The committee reviewed the requirement and cost of replacing the old units and updating them with purchasing new state of the art technology and will be used in the new hospital. Given the infection prevention concerns, end of useful life issues and physician desires, the committee worked within budget to obtain these needed units. The Davinci Program Based on input from our physician community and the increased adoption of robotics technology throughout the nation, St. Elizabeth's Surgical Services program identified the need to evaluate the acquisition of a Davinci XI robotics device. Specialists in General Surgery, Gynecology, and Urology are currently being trained in their respective medical school residency programs to perform minimally-invasive laparoscopic surgical procedures with the Davinci. Additionally, many of our local surgeons adopted robotics surgery into their provision of surgical procedures. A multi-disciplinary steering committee included surgeons, nursing leadership and administrative representatives. Medical staff quality metrics and program oversight were discussed and formulated. A block scheduling system was designed, which allocated access to the Davinci robotics device for the identified specialties. The committee addressed training and implementation for our robotics team. Nursing colleagues enrolled in a defined curriculum that consisted of a combination of self-study and hands on practicum. Simulated surgical procedures were completed by nursing staff utilizing a robotics simulator. A staff physician and a surgical nurse attended an advanced robotics course hosted by Intuitive Surgical. This advanced course provided significant training and knowledge in laparoscopic surgical procedures utilizing the Davinci robotics device. This advanced course augmented and reinforced device utilization. Our Central Sterile Processing colleagues also required special training. Once the Davinci equipment and instrumentation was installed, it required several new advanced sterilization and disinfection devices to reprocess the equipment. Final stage of the implementation was scheduling and performing our first robotics surgical procedure. It was accomplished the week of April 18, 2016. The entire team performed their responsibilities in perfect form. The patient did extremely well. Our hospital and community benefits from the addition of this highly advanced, state of the art, minimally invasive Davinci XI robotics device. It allows our team of dedicated caregivers to offer our patients advanced technology right here in our local community. HSHS St Elizabeth's also devotes significant resources to access for patients who cannot afford care, along with other community benefits. In FY 2016, HSHS St Elizabeth's provided more than $23 million in Community Benefit services, including charity care at cost, unpaid costs of Medicaid and other public programs, and a range of diverse programs designed to enhance access and improve community health. Additionally, in FY2016, HSHS St Elizabeth's provided $20.8 million (at cost) in uncompensated care to patients who did not qualify for charity care or public assistance and more than $6.5 million (at cost) in excess of Medicare payment for health care services. HSHS St Elizabeth's provides a range of Community Benefit activities and programs that furthers our mission and long-standing commitment to our community. In many cases, these Community Benefit initiatives would not exist without the leadership role played by HSHS St Elizabeth's and they often relieve a burden that would otherwise be carried by government. The hospital's FY2015 Community Health Needs Assessment (CHNA) surfaced the following health focus areas to be addressed by the hospital in collaboration with other hospitals and community organizations: Based on the CHNA planning and development process the community health needs identified include nutrition and wellness, access to care and cardiac disease. Strategies were created to maximize resources and impact the community. |
| Schedule H, Part VI, Line 6 Affiliated health care system | HSHS St. Elizabeth's Hospital in Belleville is an affiliate of Hospital Sisters Health System (HSHS), a health care ministry that includes 15 hospitals, numerous community-based health centers and clinics, and hundreds of physician partners across Illinois and Wisconsin. The mission of HSHS is "to reveal and embody Christ's healing love for all people through our high quality Franciscan health care ministry." We live our mission by providing holistic healing to all who seek our care, as well as through Community Benefit. In tandem with others in the communities we serve, our Community Benefit initiatives are strategically increasing access to care, improving the health status of residents, and increasing medical education and knowledge. In FY2016, our hospitals responded to the top needs identified in each of their most recent Community Health Needs Assessments (CHNAs). The information gathered from these assessments was used to develop or enhance Community Benefit programs and services to best address community health needs. Among the priority needs identified in the most recent CHNA process were access to care; alcohol, tobacco, and other drug abuse; chronic disease prevention and management; nutrition/wellness; mental health; and oral health. HSHS hospitals are proactively addressing these and other needs through patient, provider and community education, preventative screenings, self-management classes, and new or enhanced clinical services. In FY2016, HSHS collectively provided $203.8 million in Community Benefit (10.0% of total hospital expenses). This amount included $28.1 million provided for Financial Assistance (i.e. Charity Care) and $134.3 million for unreimbursed care provided as part of the Medicaid program. In addition, HSHS hospitals committed significant resources to treat Medicare patients. The cost of providing services to primarily elderly beneficiaries of the Medicare program - in excess of governmental and managed care contract payments - was $221.3 million. HSHS hospitals also recorded $31.4 million in uncollectible accounts. While HSHS does not count the latter two amounts as Community Benefit, they nonetheless reflect our commitment to serving all persons in need of care. In addition to the dollars invested in our Community Benefit programs, HSHS continues to reinvest any surplus revenue from operations and investments into new medical technology, facility infrastructure and health care services in our communities. By doing so, we ensure our ability to meet the ongoing demand for high quality, efficient and easily accessible health care. Improve access to health services As a Franciscan health care ministry, HSHS is deeply committed to serving those who are most in need with a special focus on the poor and vulnerable. We not only provide care to every patient who walks through our doors, but also reach out beyond the walls of our hospitals and clinics to care for those in our communities. Our efforts to ensure residents in the communities we serve receive the right care, at the right time, and in the right setting involve collaborating with others to achieve this goal. Across our two-state System, there are numerous examples of partnerships with departments of public health, other health care facilities and community and social service organizations to enhance access to care for those in need. In FY2016, HSHS and our 15 hospitals invested Community Benefit resources to educate the uninsured about new enrollment opportunities in affordable health care coverage and to facilitate the process. Studies have shown that people without insurance are more likely to postpone care and develop more severe and expensive conditions than their insured counterparts. It is for this reason that the Catholic Church, Catholic health care and HSHS have long promoted "coverage and access for all." HSHS and our 15 hospitals in partnership with local health departments, social service agencies and other health care providers played a vital role in educating eligible people in their local communities, by referring people to Certified Application Counselors and/or in enrolling them in the health insurance exchanges, or in securing coverage through Medicaid expansion. In southern Illinois, HSHS St. Elizabeth's Hospital in Belleville identified an education gap among newly insured patients. Although these patients now had health insurance, they did not know how to use insurance nor did they understand the many benefits that come with different plans. To bridge the gap, St. Elizabeth's Hospital hosted quarterly resource fairs in collaboration with other social service agencies in the community to not only educate the public about their health insurance benefits but also about other resources in the community that can improve their overall health and quality of life. More than 100 persons participated in the resource fairs and each received a healthy snack or hygiene kit. In response to its FY2015 CHNA, HSHS St. John's Hospital in Springfield, Illinois established a community health worker program to increase access to health care and coordination of care for residents of the Enos Park Neighborhood. The hospital also helped establish an Enos Park Neighborhood Advisory Council and Providers Alliance as part of the access collaborative to drive behavior changes and improve health outcomes. In the first year of the program, 103 clients were 100% engaged. Services provided included basic needs (70%) and health care access (30%). The access collaborative also placed 12 homeless individuals or families in affordable, safe housing in Enos Park. Of the 27 parolees we worked with, we realized an 18% recidivism rate compared to the national rate of 60% due to lack of housing or employment. One hundred percent of our clients visited a primary care provider and 84% connected to a medical home. Due to the program's initial success, it is being replicated in Sangamon County's eastside where our most poor and vulnerable populations live. HSHS St. Mary's Hospital Medical Center in Green Bay led the activities of the community Oral Health Task Force, which focuses on prevention, intervention and policy modification strategies to improve oral health in Brown County. In FY2016, St. Mary's Hospital helped to expand the services at NEW Community Clinic dental clinic by supporting their efforts to secure a HRSA grant for expansion by subsidizing the rent guarantee necessary and by assisting with the design cost for the center. The hospital also subsidized the cost of a staff person to obtain the necessary medical clearances and consent forms for patients, many of whom are elderly and/or disabled and need consent from guardians - thus supporting the oral surgeons who are providing their services free of charge. St. Mary's Hospital expanded oral health services for children by covering the costs of a dental hygienist employed by the Brown County Oral Health Partnership to offer oral health services in the Ashwaubenon school district. Through this new alliance, 79 students received oral health care that otherwise would have been difficult to obtain, including care for dental caries and abscesses. HSHS St. Francis Hospital in Litchfield, Illinois collaborated with Lewis & Clark Community College and local dental providers to bring the College's mobile dental health unit to the Litchfield area; the unit provides free or low cost dental exams and screenings, x-rays and hygiene services. In addition, three local dental providers also participated by opening their offices and donating time, staff and supplies to provide either a free filling, extraction or hygiene services. Beginning in 2015, the hospital collaborated with Catholic Charities to launch a dental voucher program. Five dentists in Macoupin and Montgomery counties participate in the program, which covers an initial exam and x-rays, one tooth extraction and up to three fillings per year per individual. The percentage of total emergency department visits related to dental issues decreased from 2.2 percent in 2011 to 1.27 percent in 2014 because of this collaboration. In southeast Illinois, area residents can get help filling a prescription through the long-term collaboration between HSHS St. Anthony's Memorial Hospital in Effingham and Catholic Charities. In FY2016, St. Anthony's Memorial Hospital helped to underwrite the cost of prescription medications for 518 residents. St. Anthony's Memorial Hospital and Catholic Charities believe no one should be without prescriptions because of the inability to pay. |
| Schedule H, Part VI, Line 7 State filing of community benefit report | IL |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Idemnification Gross Up Pmts | Yes (X) | IdemnificationGrossUpPmtsInd |
| Club Dues Or Fees | Yes (X) | ClubDuesOrFeesInd |
| Written Policy Ref T And E Expnss | Yes (true) | WrittenPolicyRefTAndEExpnssInd |
| Substantiation Required | Yes (true) | SubstantiationRequiredInd |
| Compensation Committee | Yes (X) | CompensationCommitteeInd |
| Independent Consultant | Yes (X) | IndependentConsultantInd |
| Form990 Of Other Organizations | Yes (X) | Form990OfOtherOrganizationsInd |
| Compensation Survey | Yes (X) | CompensationSurveyInd |
| Board Or Committee Approval | Yes (X) | BoardOrCommitteeApprovalInd |
| Severance Payment | Yes (true) | SeverancePaymentInd |
| Supplemental Nonqual Rtr Plan | Yes (true) | SupplementalNonqualRtrPlanInd |
| Equity Based Comp Arrngm | false | EquityBasedCompArrngmInd |
| Comp Based On Revenue Of Flng Org | false | CompBasedOnRevenueOfFlngOrgInd |
| Comp Bsd On Rev Related Orgs | false | CompBsdOnRevRelatedOrgsInd |
| Comp Bsd Net Earns Flng Org | false | CompBsdNetEarnsFlngOrgInd |
| Comp Bsd Net Earns Rltd Orgs | false | CompBsdNetEarnsRltdOrgsInd |
| Any Non Fixed Payments | false | AnyNonFixedPaymentsInd |
| Initial Contract Exception | false | InitialContractExceptionInd |
Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp (17 entries)
| TitleTitleTxt | Base Compensation Filing OrgBaseCompensationFilingOrgAmt | Compensation Based On Rltd OrgsCompensationBasedOnRltdOrgsAmt | Bonus Filing OrganizationBonusFilingOrganizationAmount | Bonus Related OrganizationsBonusRelatedOrganizationsAmt | Other Compensation Filing OrgOtherCompensationFilingOrgAmt | Other Compensation Rltd OrgsOtherCompensationRltdOrgsAmt | Deferred Compensation Flng OrgDeferredCompensationFlngOrgAmt | Deferred Comp Rltd OrgsDeferredCompRltdOrgsAmt | Nontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgAmt | Nontaxable Benefits Rltd OrgsNontaxableBenefitsRltdOrgsAmt | Total Compensation Filing OrgTotalCompensationFilingOrgAmt | Total Compensation Rltd OrgsTotalCompensationRltdOrgsAmt | Comp Report Prior990 Filing OrgCompReportPrior990FilingOrgAmt | Comp Report Prior990 Rltd OrgsCompReportPrior990RltdOrgsAmt |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| MARYANN REESE | ||||||||||||||
| PRESIDENT & CEO | $0 | $220,325 | $0 | $75,000 | $0 | $34,074 | $0 | $50,716 | $0 | $12,774 | $0 | $392,889 | $0 | $0 |
| SHELLEY HARRIS | ||||||||||||||
| CHIEF NURSING OFFICER & INTERIM PRESIDENT & CEO | $244,741 | $0 | $30,716 | $0 | $810 | $0 | $165,036 | $0 | $23,538 | $0 | $464,841 | $0 | $0 | $0 |
| LAWRENCE SCHUMACHER | ||||||||||||||
| Former DIVISION CEO - INTERIM | $0 | $255,552 | $0 | $152,120 | $0 | $1,052,448 | $0 | $63,423 | $0 | $9,282 | $0 | $1,532,825 | $0 | $342,101 |
| ANN M CARR | ||||||||||||||
| TREASURER | $0 | $253,980 | $0 | $36,527 | $0 | $63,798 | $0 | $201,780 | $0 | $20,881 | $0 | $576,966 | $0 | $29,789 |
| SHELLY HARKINS MD | ||||||||||||||
| CHIEF MEDICAL OFFICER | $216,509 | $0 | $0 | $0 | $12,866 | $0 | $29,927 | $0 | $8,368 | $0 | $267,670 | $0 | $38,295 | $0 |
| DAVID NOSACKA | ||||||||||||||
| DIVISION CFO | $328,673 | $0 | $40,696 | $0 | $2,943 | $0 | $25,484 | $0 | $23,538 | $0 | $421,334 | $0 | $0 | $0 |
| PEGGY SEBASTIAN | ||||||||||||||
| President and CEO - Part Year | $0 | $231,214 | $0 | $41,278 | $0 | $80,862 | $0 | $108,795 | $0 | $11,331 | $0 | $473,480 | $0 | $66,903 |
| MARY LOU TATE | ||||||||||||||
| DIRECTOR OF FINANCE | $143,165 | $0 | $0 | $0 | $810 | $0 | $10,916 | $0 | $23,231 | $0 | $178,122 | $0 | $0 | $0 |
| AMY BALLANCE | ||||||||||||||
| DIVISION VICE PRESIDENT BUSINESS DEVELOPMENT | $197,666 | $0 | $16,547 | $0 | $810 | $0 | $38,534 | $0 | $20,905 | $0 | $274,462 | $0 | $0 | $0 |
| SUSAN BEELER | ||||||||||||||
| PROJECT MANAGER, NEW CONSTRUCTION | $178,051 | $0 | $0 | $0 | $405 | $0 | $98,214 | $0 | $8,743 | $0 | $285,413 | $0 | $0 | $0 |
| JAMES DOVER | ||||||||||||||
| CEO SOUTHERN ILLINOIS DIV | $0 | $321,705 | $0 | $0 | $0 | $51,737 | $0 | $50,332 | $0 | $22,487 | $0 | $446,261 | $0 | $0 |
| MARGARET LUNA | ||||||||||||||
| DIVISION CPO | $218,886 | $0 | $18,091 | $0 | $405 | $0 | $77,558 | $0 | $17,906 | $0 | $332,846 | $0 | $0 | $0 |
| CHELLIE BUTEL | ||||||||||||||
| EXECUTIVE DIRECTOR OF RISK & PCU | $169,920 | $0 | $10,384 | $0 | $0 | $0 | $18,215 | $0 | $2,664 | $0 | $201,183 | $0 | $0 | $0 |
| JACQUELYNNE N HOLST | ||||||||||||||
| DIVISION VICE PRESIDENT LEGAL AFFAIRS / HSHS ASSOCIATE GENERAL COUNSEL | $180,973 | $0 | $0 | $0 | $484 | $0 | $16,106 | $0 | $20,809 | $0 | $218,372 | $0 | $0 | $0 |
| BRIAN D JOHNSON | ||||||||||||||
| EXECUTIVE DIRECTOR OF SURGICAL SERVICES | $170,235 | $0 | $0 | $0 | $810 | $0 | $26,837 | $0 | $20,865 | $0 | $218,747 | $0 | $0 | $0 |
| JULIA SCHIMMELPFENNIG | ||||||||||||||
| DIRECTOR OF PHARMACY | $159,702 | $0 | $0 | $0 | $79 | $0 | $21,808 | $0 | $836 | $0 | $182,425 | $0 | $0 | $0 |
| PETER WONG | ||||||||||||||
| CHIEF PERFORMANCE IMPROVEMENT OFFICER | $277,449 | $0 | $18,791 | $0 | $810 | $0 | $41,725 | $0 | $18,318 | $0 | $357,093 | $0 | $0 | $0 |
Supplemental Information Detail SupplementalInformationDetail (5 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| Schedule J, Part I, Line 1a Tax indemnification and gross-up payments | TAX GROSS-UPS WERE PAID TO THE FOLLOWING: SHELLY HARKINS IN THE AMOUNT OF $29.00. JULIA SCHIMMELPFENNIG IN THE AMOUNT OF $29.00. JACQUELYNNE NICOLE HOLST IN THE AMOUNT OF $29.00. THE FAIR VALUE OF THESE BENEFITS WAS INCLUDED IN THE INDIVIDUALS' ANNUAL REPORTED INCOME. |
| Schedule J, Part I, Line 1a Health or social club dues or initiation fees | Social club dues were provided to Peggy Sebastian IN THE AMOUNT OF $1,373.00 OF TAXABLE COMPENSATION. |
| Schedule J, Part I, Line 3 Arrangement used to establish the top management official's compensation | PLEASE SEE RESPONSE TO FORM 990, PART VI, LINE 15A IN SCHEDULE O. |
| Schedule J, Part I, Line 4a Severance or change-of-control payment | Organization: Hospital Sisters Health System, Inc. EIN: 37-1058692 Interested Person: Lawrence Schumacher Amount: $476,419 Terms: Compensation paid as a result of a severance from the position of COO. |
| Schedule J, Part I, Line 4b Supplemental nonqualified retirement plan | Schedule J, Part I, Line 4b - Disclosure HSHS EXECUTIVES ELIGIBLE TO PARTICIPATE IN SUPPLEMENTAL EXECUTIVE RETIREMENT PLAN (SERP) ARE DEFINED IN THE SERP PLAN DOCUMENTS. THE SERP WAS ESTABLISHED TO PROVIDE ADDITIONAL RETIREMENT BENEFITS TO ENSURE REASONABLE MARKET COMPETITIVE BENEFITS IN ACCORDANCE WITH THE HSHS EXECUTIVE COMPENSATION PHILOSOPHY ESTABLISHED BY THE HSHS COMPENSATION COMMITTEE. THE PLAN PROVIDES A DEFINED RETIREMENT CONTRIBUTION TO PARTICIPANTS COMMENCING ON JANUARY 1, 2008, EQUAL TO A PERCENTAGE OF COMPENSATION AS DEFINED IN THE SERP PLAN DOCUENTS FOR THE PLAN YEAR. PARTICIPANTS CONSTRUCTIVELY RECEIVE A DISTRIBUTION FROM THE PLAN NO LATER THAN MARCH 15TH OF THE CALENDAR YEAR FOLLOWING THE CALENDAR YEAR IN WHICH AN AMOUNT IS VESTED AND TAXABLE PURSUANT TO A VESTING SCHEDULE AS SPECIFIED IN THE PLAN DOCUMENT. THE ACTUAL DISTRIBUTION OF THE VESTED BENEFIT UNDER THE PLAN IS PAID IN A SINGLE LUMP SUM TO THE PARTICIPANT OR THE PARTICIPANT'S BENEFICIARY UPON THE EARLIER OF THE PARTICIPANT'S TERMINATION OF EMPLOYMENT, DEATH, OR TOTAL AND PERMANENT DISABILITY. THE FOLLOWING INTERESTED PERSONS CONSTRUCTIVELY RECEIVED DEFERRALS TO THE SUPPLEMENTAL EXECUTIVE RETIREMENT PLAN (SERP) IN 2015 THESE DEFERRALS ARE INCLUDED IN SCHEDULE J, PART II, COLUMN (C). Ann Carr -- $31,485 Dover - $42,546 Peggy Sebastian -- $27,476 THE FOLLOWING INTERESTED PERSONS RECEIVED DISTRIBUTIONS FROM THE SUPPLEMENTAL EXECUTIVE RETIREMENT PLAN (SERP) IN 2015 THESE PAYMENTS ARE INCLUDED IN SCHEDULE J, PART II, COLUMN (B)(III) AND SCHEDULE J, PART II, COLUMN (F), AS APPLICABLE. Ann Carr -- $29,789 Lawrence Schumacher -- $342,101 Peggy Sebastian -- $66,903 |
Schedule M IRS990ScheduleM
Other Non Cash Contri Table OtherNonCashContriTableGrp (2 entries)
| Non Cash CheckboxNonCashCheckboxInd | DescDesc | ContributionContributionCnt | Noncash Contributions Rpt F990NoncashContributionsRptF990Amt | Method Of Determining RevenuesMethodOfDeterminingRevenuesTxt |
|---|---|---|---|---|
| Yes (X) | Patient Items-Baby Blankets/Hats/Booties, Stuffed Animals, Eyeglass Cases, Prayer Shawls | 22 | $22,772 | Market value |
| Yes (X) | Items for Colleagues/Giveaways | 7 | $3,979 | Market value |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form8283 Received | 0 | Form8283ReceivedCnt |
| Any Property That Must Be Held | false | AnyPropertyThatMustBeHeldInd |
| Review Process Unusual NC Gifts | Yes (true) | ReviewProcessUnusualNCGiftsInd |
| Third Parties Used | false | ThirdPartiesUsedInd |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | Schedule M, Part I Explanations of reporting method for number of contributions | FormAndLineReferenceDesc |
| Explanation | Other - Patient Items-Baby Blankets/Hats/Booties, Stuffed Animals, Eyeglass Cases, Prayer Shawls: OTHER: THE NUMBER OF CONTRIBUTIONS IS BEING REPORTED. Other - Items for Colleagues/Giveaways: OTHER: THE NUMBER OF CONTRIBUTIONS IS BEING REPORTED. | ExplanationTxt |
Schedule O IRS990ScheduleO
Supplemental Information Detail SupplementalInformationDetail (16 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| Form 990, Part III, Line 1 ORGANIZATION'S MISSION | THE MISSION OF HSHS ST. ELIZABETH'S HOSPITAL IS TO REVEAL AND EMBODY CHRIST'S HEALING LOVE FOR ALL PEOPLE THROUGH OUR HIGH QUALITY FRANCISCAN HEALTH CARE MINISTRY. IN THE PERFORMANCE OF ITS MISSION, HSHS ST. ELIZABETH'S HOSPITAL WILL FOSTER THE VALUES OF RESPECT, CARE, COMPETENCE AND JOY. RESPECT IS THE FRANCISCAN RESPECT FOR LIFE FROM CONCEPTION TO DEATH AND FOR THE DIGNITY OF EACH INDIVIDUAL PERSON. IT IS A COMMITMENT TO FREEING AND EMPOWERING EACH PERSON TO DEVELOP TO HIS OR FULL POTENTIAL. CARE EMBODIES THE CONCERN, COMPASSION, AND SENSITIVITY WITH WHICH WE CARE FOR PATIENTS, CLIENTS, EMPLOYEES AND CO-WORKERS. MANY TIMES IT IS THOUGHT OF AS BEDSIDE BEHAVIOR, BUT IT BELONGS IN BUSINESS OFFICES, CAFETERIAS AND BOARDROOMS. COMPETENCE MEANS THAT OUR WORK IS PERFORMED AND ST. ELIZABETH'S IS MANAGED WITH THE HIGHEST LEVEL OF SKILL AND ABILITY. WE ARE COMMITTED TO RECRUITING AND DEVELOPING PEOPLE WHO ARE COMPETENT IN THEIR WORK AND WHOSE VALUES REFLECT OUR OWN. OUR VALUES ARE AN INTEGRAL PART OF OUR SYSTEM'S STRATEGIC PLAN, WHICH PROVIDES THE OVERALL FRAMEWORK FOR LOCAL ACTIVITIES. JOY IS THE MANNER IN WHICH OUR EMPLOYEES AND ALL WHO JOIN US IN OUR MINISTRY SEEK TO PERFORM THEIR WORK -- THE PERSONAL FULFILLMENT OF CARING FOR OTHERS. IT IS AN ESSENTIAL INGREDIENT IN BRINGING A SENSE OF HOPE TO THOSE WHO SUFFER. |
| Form 990, Part III, Line 4d Description of other program services | (Expenses $ 65,520,293 including grants of $)(Revenue $ 92,614,093) Other Health Care Services HSHS St. Elizabeth's Hospital delivers a comprehensive array of healthcare services to both inpatients and outpatients. Our accredited programs have consistently demonstrated quality outcomes that positively impact our patients, their families and the entire community. We provide quality medical healthcare regardless of race, creed, sex, national origin, handicap, age, or ability to pay. Although reimbursement for services rendered is critical to the operation and stability of HSHS St. Elizabeth's Hospital, it is recognized that not all individuals possess the ability to purchase essential medical services. It is our mission to serve the sick, especially the poor, with quality healthcare services and healthcare education. We have further defined our mission of identifying those who are at greatest health risk, the elderly, children, those coping with mental illness, and those with less means who are dependent on quality healthcare. HSHS St. Elizabeth's Hospital currently staffs 260 inpatient beds. The hospital employs 1,625 colleagues. Inpatient admissions for Fiscal Year 2016 were 8,556. The Emergency Department had 38,832 visits and admitted 5,113 to inpatient services. The Urgicare Center in O'Fallon, an offsite facility, had 29,786 visits. Total Outpatient visits for the hospital were 201,750. |
| Form 990, Part IV, Line 24a TAX EXEMPT BONDS | ST. ELIZABETH'S HOSPITAL HOLDS A LIABILITY ON ITS BOOKS FOR TAX-EXEMPT BONDS, WHICH IS AN ALLOCATION FROM ITS SOLE CORPORATE MEMBER, HOSPITAL SISTERS SERVICES, INC. AS A RESULT, THIS QUESTION WAS ANSWERED NO, AND SCHEDULE K WILL BE COMPLETED ON THE HOSPITAL SISTERS SERVICES, INC. FORM 990. |
| Form 990, Part VI, Line 13 WHISTLEBLOWER POLICY | PROVISIONS WITHIN THE CORPORATE COMPLIANCE HOTLINE AND CONFLICT OF INTEREST POLICY PROVIDE PROTECTIONS FOR WHISTLEBLOWER TYPE ACTIVITIES. |
| Form 990, Part VI, Line 16b JOINT VENTURES | HOSPITAL SISTERS HEALTH SYSTEM ADOPTED A JOINT VENTURE COMPLIANCE PROGRAM POLICY EFFECTIVE ON JANUARY 1, 2012 FOR ALL SYSTEM HOSPITALS, INCLUDING ST. ELIZABETH'S HOSPITAL. THE OVERALL PURPOSE OF THE POLICY IS TO PROVIDE PRACTICAL GUIDELINES FOR ETHICAL BUSINESS CONDUCT, TO ACHIEVE COMPLIANCE, AND TO DETECT AND PREVENT VIOLATIONS OF APPLICABLE LAWS. THE POLICY REQUIRES ST. ELIZABETH'S HOSPITAL, AND ALL HSHS HOSPITALS, TO EVALUATE THEIR PARTICIPATION IN JOINT VENTURE ARRANGEMENTS, INCLUDING UNDER APPLICABLE FEDERAL TAX LAWS, AND TO SAFEGUARD ST. ELIZABETH'S HOSPITAL'S TAX EXEMPT STATUS WITH RESPECT TO ANY JOINT VENTURE ARRANGEMENTS. |
| Form 990, Part VI, Line 6 Classes of members or stockholders | THE SENIOR GOVERNING BODY OF HSHS ST. ELIZABETH'S HOSPITAL (THE CORPORATION) IS THE MEMBER OF THE CORPORATION, WHICH IS HOSPITAL SISTERS SERVICES, INC. ("HSSI"), AN ILLINOIS NOT FOR PROFIT CORPORATION EXEMPT FROM FEDERAL TAXATION UNDER SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE. |
| Form 990, Part VI, Line 7a Members or stockholders electing members of governing body | PURSUANT TO SECTION 2.3 OF THE CORPORATION'S BYLAWS, THE ORGANIZATION'S MEMBER, HOSPITAL SISTERS SERVICES, INC. ("HSSI"), AN ILLINOIS NOT FOR PROFIT CORPORATION EXEMPT FROM FEDERAL TAXATION UNDER SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE, HAS THE RIGHT TO APPOINT AND REMOVE THE CORPORATION'S BOARD OF DIRECTORS, CHAIRPERSON OF THE BOARD AND PRESIDENT. |
| Form 990, Part VI, Line 7b Decisions requiring approval by members or stockholders | RESPONSIBILITY FOR THE POLICY AND OPERATIONS OF HSHS ST. ELIZABETH'S HOSPITAL (THE "CORPORATION") IS VESTED IN ITS BOARD OF DIRECTORS, EXCEPT WITH RESPECT TO SPECIFIC POWERS RESERVED IN THE CORPORATION'S BYLAWS TO THE CORPORATION'S MEMBER, HOSPITAL SISTERS SERVICES, INC. ("HSSI"), AN ILLINOIS NOT FOR PROFIT CORPORATION EXEMPT FROM FEDERAL TAXATION UNDER SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE. THE MEMBER OF HSSI IS HOSPITAL SISTERS HEALTH SYSTEM ("HSHS"), AN ILLINOIS NOT FOR PROFIT CORPORATION EXEMPT FROM FEDERAL TAXATION UNDER SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE. THE MEMBERS OF HSHS ARE THE INDIVIDUAL SISTERS WHO FROM TIME TO TIME ARE THE DULY ELECTED PROVINCIAL SUPERIOR AND PROVINCIAL COUNCILORS, RESPECTIVELY OF THE AMERICAN PROVINCE OF THE HOSPITAL SISTERS OF ST. FRANCIS ("AMERICAN PROVINCE"). THE AMERICAN PROVINCE IS THE UNITED STATES ORGANIZATION OF THE CONGREGATION OF THE HOSPITAL SISTERS OF THE THIRD ORDER REGULAR OF ST. FRANCIS, A RELIGIOUS INSTITUTE OF THE ROMAN CATHOLIC CHURCH. THE GOVERNANCE AND OPERATIONS OF THE CORPORATION ARE SUBJECT TO HSSI'S RIGHT TO EXERCISE THESE RESERVED POWERS WITH RESPECT TO THE CORPORATION AND ORGANIZATIONS OF WHICH THE CORPORATION IS EITHER, DIRECTLY OR INDIRECTLY, A CONTROLLING MEMBER OR A CONTROLLING SHAREHOLDER ("AFFILIATES"). HSSI'S RIGHT TO EXERCISE CERTAIN OF THESE RESERVED POWERS IS, IN TURN, SUBJECT TO THE APPROVAL OF HSHS AND HSHS' MEMBERS. THE RESERVED POWERS INCLUDE ALL RIGHTS GRANTED TO HSSI BY LAW AND THE RIGHT TO: (A) ADOPT, APPROVE AMENDMENTS TO, OR AMEND ANY STATEMENT OF PHILOSOPHY, MISSION, MISSION INTEGRATION OR VALUES OR ANY NAME, LOGO, OR MARK OF THE CORPORATION OR OF ANY AFFILIATE; (B) ADOPT, APPROVE AMENDMENTS TO, OR AMEND THE ARTICLES OF INCORPORATION OF THE CORPORATION OR OF ANY AFFILIATE; (C) ADOPT, APPROVE AMENDMENTS TO, OR AMEND THE BYLAWS OF THE CORPORATION OR OF ANY AFFILIATE; (D) APPOINT AND REMOVE THE BOARD OF DIRECTORS, ANY ONE OR MORE OF THE DIRECTORS OF THE CORPORATION OR OF ANY AFFILIATE, AND THE CHAIRPERSON AND PRESIDENT OF THE CORPORATION OR OF ANY AFFILIATE; (E) APPROVE THE RECOMMENDATION OF THE BOARD OF DIRECTORS TO APPOINT OR REMOVE THE BOARD OF DIRECTORS, ANY ONE OR MORE DIRECTORS OF THE CORPORATION OR OF ANY AFFILIATE, OR THE CHAIRPERSON AND PRESIDENT OF THE CORPORATION OR OF ANY AFFILIATE. (F) WITH RESPECT TO THE CORPORATION OR ANY AFFILIATE, APPROVE THE PURCHASE, SALE, ALIENATION, EXCHANGE, LEASE OR ENCUMBRANCE OF ANY REAL PROPERTY OF THE CORPORATION OR OF ANY AFFILIATE, WHICH PROPERTY HAS A VALUE IN EXCESS OF LIMITS SET FROM TIME TO TIME BY HSSI; (G) APPROVE THE OPERATING AND CAPITAL BUDGETS OF THE CORPORATION OR OF ANY AFFILIATE, AND ANY DEVIATIONS BY THE CORPORATION OR OF ANY AFFILIATE FROM SUCH BUDGETS IN AN AMOUNT OR PERCENTAGE SPECIFIED BY HSSI FROM TIME TO TIME; (H) APPROVE THE STRATEGIC PLAN AND GOALS OF THE CORPORATION OR OF ANY AFFILIATE; (I) APPROVE THE SALE OF SUBSTANTIALLY ALL OF THE ASSETS OF THE (II) CORPORATION OR OF ANY AFFILIATE; (J) APPROVE THE MERGER OR DISSOLUTION OF THE CORPORATION OR OF ANY AFFILIATE; (K) ADOPT OR AMEND THE PLAN FOR MINISTRY EDUCATION AND GOVERNANCE FOR THE CORPORATION AND ITS AFFILIATES; (L) APPROVE THE CORPORATION'S MISSION ACCOUNTABILITY REPORTS AND THOSE OF ANY AFFILIATE; (M) APPROVE THE FINANCIAL POLICIES AND PROCEDURES OF THE CORPORATION OR OF ANY AFFILIATE AND APPROVE ANY DEVIATIONS FROM SUCH POLICIES AND PROCEDURES BY THE CORPORATION OR ANY AFFILIATE; AND (N) ADOPT POLICIES TO IMPLEMENT THE RESERVED POWERS OF HSSI. |
| Form 990, Part VI, Line 11b Review of form 990 by governing body | THE HOSPITAL EMPLOYS CROWE HORWATH TO ASSIST IN THE OVERALL PREPARATION, REVIEW AND ELECTRONIC SUBMISSION OF ITS FORM 990. CROWE HORWATH PROVIDES GUIDANCE IN IDENTIFYING CRITICAL ERRORS IN THE RETURN SUBMISSION AND FEEDBACK ON QUANTITATIVE AND QUALITATIVE RESPONSES. ADDITIONALLY, THE HOSPITAL DIRECTOR OF FINANCE PERFORMS A THOROUGH REVIEW OF THE RETURN AND REVIEWS IT WITH THE HOSPITAL CEO AND/OR SENIOR LEADERS BEFORE PRESENTING IT IN ITS ENTIRETY TO THE HOSPITAL BOARD FOR QUESTIONING AND REVIEW PRIOR TO THE RETURN'S SIGNING AND SUBMISSION TO THE IRS. |
| Form 990, Part VI, Line 12c Conflict of interest policy | A REVISED CORPORATE COMPLIANCE PROGRAM AND CONFLICT OF INTEREST POLICY HAS BEEN USED SINCE JANUARY, 2009 TO ESTABLISH THE PRACTICE OF MANAGING CONFLICTS OF INTEREST USING A SYSTEM-WIDE PROTOCOL FOR DISCLOSURE STATEMENTS. IN ACCORDANCE WITH OUR CONFLICT OF INTEREST POLICY ALL COVERED PERSONS HAVE A DUTY TO COMPLY WITH THE CONFLICT OF INTEREST POLICY FOR ANY CONTRACT, TRANSACTION, RELATIONSHIP OR ACTIVITY CONTEMPLATED, ENTERED INTO OR CONDUCTED AT HSHS. THE POLICY DEFINES COVERED PERSONS AS A.) BOARD MEMBERS, BOARD COMMITTEE MEMBERS, OFFICERS, BOARD DESIGNEES, SENIOR MANAGEMENT, MEMBERS OF ANY COMMITTEE THAT OVERSEES THE APPROVAL OF PHARMACEUTICALS AND MEDICAL DEVICES, ANY OTHER INDIVIDUAL WHO HOLDS A POSITION OF TRUST AND B.) NON-EMPLOYED MEMBERS OF THE MEDICAL STAFF WHO ALSO EITHER: 1) HOLD PAID OR UNPAID MEDICAL ADMINISTRATIVE POSITIONS, SUCH AS CHAIRS OF CLINICAL DEPARTMENTS, SECTION AND DIVISION CHIEFS, DIRECTORS OF SPECIAL CARE UNITS, DIRECTORS OF RESEARCH OR INDIVIDUALS WHO OTHERWISE DIRECT OR MATERIALLY INFLUENCE RESEARCH; OR 2) HAVE PROCUREMENT RESPONSIBILITY, OR THE AUTHORITY EFFECTIVELY TO RECOMMEND SUCH PROCUREMENT. ON AN ANNUAL BASIS HSHS DISCLOSES A COPY OF THE CONFLICT OF INTEREST POLICY (AND ALL CORRESPONDING PROCEDURES, GUIDELINES, FORMS AND TOOLS), TO ALL COVERED PERSONS AND ADVISES ALL COVERED PERSONS IN WRITING OF ANY SUBSTANTIVE CHANGES TO THIS POLICY AND SUCH RELATED MATERIALS. THE COVERED PERSONS ARE REQUIRED TO REVIEW AND COMPLETE THE CORRESPONDING CONFLICT OF INTEREST STATEMENT. THE SYSTEM OFFICE VICE PRESIDENT, SYSTEM RESPONSIBILITY, VICE PRESIDENT, RISK & COMPLIANCE OR MEMBERS OF THE AUDIT AND INTEGRITY COMMITTEE ("COMMITTEE") ARE AVAILABLE TO ANSWER ANY QUESTIONS A COVERED PERSON MAY HAVE. IN ADDITION, IF, AT ANY TIME AFTER SUBMITTING AN ANNUAL CONFLICT OF INTEREST STATEMENT, A COVERED PERSON BECOMES AWARE OF AN INTEREST THAT HE OR SHE WOULD HAVE HAD TO DISCLOSE AT THE ANNUAL INTERVAL, THE COVERED PERSON SHALL PROMPTLY DISCLOSE THE INTEREST TO THE COMMITTEE USING THE HSHS CONFLICT OF INTEREST DISCLOSURE STATEMENT. COMPLETED CONFLICT OF INTEREST STATEMENTS ARE SUBMITTED TO THE COMMITTEE OF HSHS WHICH IS RESPONSIBLE FOR IDENTIFYING, ASSESSING, AND MANAGING CONFLICTS OF INTEREST THAT ARISE IN THE COURSE OF CONDUCTING THE AFFAIRS OF HSHS. IF THE COMMITTEE DETERMINES THAT A CONFLICT OF INTEREST EXISTS, HSHS SHALL NOT ENGAGE IN OR ENTER INTO A PROPOSED CONTRACT, TRANSACTION, RELATIONSHIP, ARRANGEMENT OR ACTIVITY UNLESS THE COMMITTEE OR, WHERE NECESSARY, THE BOARD OF DIRECTORS (ACTING THROUGH ITS DISINTERESTED MEMBERS), HAS INVESTIGATED ALTERNATIVES TO THE PROPOSED CONTRACT, TRANSACTION, RELATIONSHIP, ARRANGEMENT OR ACTIVITY AND, IN THE ABSENCE OF ALTERNATIVES THAT ARE IN THE BEST INTERESTS OF HSHS, HAS DETERMINED: 1. THAT, REGARDLESS OF WHETHER THE COVERED PERSON PARTICIPATES IN THE IMPLEMENTATION OF THE PROPOSED CONTRACT, TRANSACTION, RELATIONSHIP, ARRANGEMENT, OR ACTIVITY; 2. THE CONTRACT, TRANSACTION, ARRANGEMENT OR ACTIVITY IS IN THE BEST INTERESTS OF HSHS; 3. THE CONTRACT, TRANSACTION, ARRANGEMENT OR ACTIVITY IS FAIR AND REASONABLE FROM THE PERSPECTIVE OF HSHS; AND 4. HSHS CANNOT OBTAIN A MORE ADVANTAGEOUS CONTRACT, TRANSACTION, ARRANGEMENT OR ACTIVITY WITH REASONABLE EFFORTS UNDER THE CIRCUMSTANCES. IN DETERMINING WHETHER A CONTRACT, TRANSACTION OR ARRANGEMENT IS FAIR AND REASONABLE TO HSHS, THE COMMITTEE SHALL CONSIDER, WHERE APPLICABLE: 1. APPRAISALS OR OTHER INDEPENDENT VALUATIONS OF THE FAIR MARKET VALUE OF THE CONTRACT, TRANSACTION OR ARRANGEMENT; 2. INFORMATION REGARDING COMPARABLE CONTRACTS, TRANSACTIONS OR ARRANGEMENTS BETWEEN UNRELATED PARTIES; 3. OFFERS FROM COMPARABLE COMPETING ENTITIES; AND/OR 4. STUDIES OF COMPARABLE COMPENSATION ARRANGEMENTS. IN ANY CASE IN WHICH THE COMMITTEE FINDS, AFTER TAKING THE STEPS DESCRIBED ABOVE, THAT HSHS SHOULD PARTICIPATE IN A PROPOSED TRANSACTION OR ARRANGEMENT DESPITE THE EXISTENCE OF A CONFLICT OF INTEREST, THE COMMITTEE SHALL DEVELOP, IMPLEMENT, MONITOR, AND ENFORCE COMPLIANCE WITH, A CONFLICT MANAGEMENT PLAN FOR MANAGING THE CONFLICT OF INTEREST AS IT CONSIDERS NECESSARY FOR SUCH FINDINGS TO REMAIN VALID THROUGHOUT THE LIFE OF THE CONTRACT, TRANSACTION, RELATIONSHIP, ARRANGEMENT OR ACTIVITY. ALL CONFLICT MANAGEMENT PLANS SHALL: 1. STATE THAT THE COMMITTEE WILL OVERSEE, MONITOR AND ENFORCE COMPLIANCE WITH THE PLAN THROUGHOUT THE COURSE OF THE STUDY AND SPECIFY MEANS FOR DOING SO, INCLUDING, WITHOUT LIMITATION, THAT THE APPROPRIATE INDIVIDUALS MUST PROVIDE THE COMMITTEE WITH WRITTEN REPORTS PERTAINING TO COMPLIANCE WITH THE CONFLICT MANAGEMENT PLAN, THAT THE COMMITTEE SHALL HAVE THE RIGHT TO AUDIT THE STUDY FOR SUCH COMPLIANCE AND THE RIGHT TO IMPOSE SANCTIONS FOR NON-COMPLIANCE; 2. STATE THAT THE PLAN MUST BE SHARED WITH THE COVERED PERSON OR PERSONS WHOSE INTERESTS IT WAS DEVELOPED TO MANAGE; 3. STATE THAT THE PLAN MUST BE SHARED WITH, AND PERIODIC REPORTS ON COMPLIANCE WITH THE PLAN MUST BE PROVIDED TO, THE BOARD, SENIOR MANAGEMENT AND/OR GOVERNMENT AGENCIES; AND 4. PROVIDE FOR SUCH OTHER MANAGEMENT STEPS AND MECHANISMS THE COMMITTEE CONSIDERS NECESSARY AND APPROPRIATE. IN ADDITION TO THE COMMITTEE, THE SYSTEM OFFICE VICE PRESIDENTS OF SYSTEM RESPONSIBILITY AND RISK & COMPLIANCE MAY RETAIN SUCH INDEPENDENT ADVISORS OR EXPERTS AS DEEMED NECESSARY TO ASSIST IN MAKING ITS DETERMINATIONS AND DECISIONS. IF THE COMMITTEE DETERMINES THAT THE CONTEMPLATED TRANSACTION, RELATIONSHIP ARRANGEMENT OR ACTIVITY CANNOT PROCEED DUE TO A CONFLICT OF INTEREST, THE COMMITTEE SHALL INFORM THE APPLICABLE COVERED PERSON OR DECISION-MAKING BODY OF SUCH DETERMINATION WITHIN ONE WEEK OF THE COMMITTEE MEETING AT WHICH THE CONTEMPLATED TRANSACTION WAS DISCUSSED. THE COMMITTEE SHALL DOCUMENT ITS REJECTION OF THE CONTEMPLATED TRANSACTION IN THE COMMITTEE'S MEETING MINUTES. |
| Form 990, Part VI, Line 15a Process to establish compensation of top management official | THE COMPENSATION COMMITTEE (COMMITTEE) IS COMPRISED OF INDEPENDENT MEMBERS OF THE BOARD OF DIRECTORS. THE COMMITTEE DEVELOPS A COMPENSATION PHILOSOPHY FOR THE SYSTEM AND ALL AFFILIATES. THE COMMITTEE SELECTS AND HIRES THE INDEPENDENT COMPENSATION CONSULTANT TO DEVELOP COMPARABILITY DATA AND ADVISE THE COMMITTEE DURING ITS DELIBERATIONS REGARDING ALL ELEMENTS OF TOTAL COMPENSATION FOR ALL DISQUALIFIED INDIVIDUALS. INTEGRATED HEALTHCARE STRATEGIES ("IHS"), THE CONSULTANTS UTILIZED BY THE COMMITTEE, USE DATA FROM MULTIPLE TAX-EXEMPT PEER GROUP SOURCES TO DETERMINE SALARY RANGES, INCENTIVE OPPORTUNITY RANGES AND BENEFITS FOR THE DISQUALIFIED INDIVIDUALS. IHS THEN ASSISTS THE COMMITTEE IN PREPARING CONTEMPORANEOUS DOCUMENTATION OF ALL ACTIONS. EACH COMMITTEE MEETING IS CONDUCTED WITH THE INTENT TO CREATE A REBUTTABLE PRESUMPTION OF REASONABLENESS FOR ALL ELEMENTS OF EXECUTIVE TOTAL COMPENSATION FOR THE DISQUALIFIED INDIVIDUALS. THE CHAIRMAN MAKES THIS DECLARATION AND ALSO INQUIRES IF THERE ARE ANY CONFLICTS OF INTEREST BY ANY ATTENDEES. ANY CONFLICTS ARE DISCLOSED AND THE COMMITTEE THEN ACTS IN A MANNER TO AVOID ANY CONFLICTED INDIVIDUAL PARTICIPATING IN ANY MANNER WHERE A CONFLICT MIGHT EXIST. AT THE END OF THE MEETING, THE COMMITTEE PREPARES CONTEMPORANEOUS MINUTES THAT RECORD ALL ACTIONS TAKEN DURING THE MEETING. |
| Form 990, Part VI, Line 15b Process to establish compensation of other employees | PLEASE SEE RESPONSE TO FORM 990, PART VI, LINE 15a. |
| Form 990, Part VI, Line 19 Required documents available to the public | BOARD-APPROVED FINANCIAL STATEMENTS ARE MADE AVAILABLE TO THE PUBLIC UPON REQUEST. THE GOVERNING DOCUMENTS AND CONFLICT OF INTEREST POLICY ARE NOT MADE AVAILABLE TO THE GENERAL PUBLIC AT THIS TIME. |
| Form 990, Part IX, Line 11g Other Fees | Purchased Services - Total Expense: 27946096, Program Service Expense: 25093553, Management and General Expenses: 2852543, Fundraising Expenses: ; Professional Fees - Total Expense: 5712914, Program Service Expense: 3124952, Management and General Expenses: 2587962, Fundraising Expenses: ; Contract Labor - Total Expense: 3930952, Program Service Expense: 3878465, Management and General Expenses: 52487, Fundraising Expenses: ; HSHS Shared Service Fee - Total Expense: 1544778, Program Service Expense: , Management and General Expenses: 1544778, Fundraising Expenses: ; |
| Form 990, Part X, Line 11 POOLED INVESTMENT ACCOUNT | PARTICIPATION IN THE POOLED FUND IS LIMITED TO THE 501(C)(3) HOSPITALS AND RELATED HEALTH SERVICES ORGANIZATIONS SPONSORED BY HOSPITAL SISTERS HEALTH SYSTEM. THE POOLED ACCOUNT CONSISTS OF CASH, EQUITY AND DEBT SECURITIES THAT ARE PUBLICLY TRADED. IN ACCORDANCE WITH THE PROVISIONS OF SFAS NO. 124 "ACCOUNTING FOR CERTAIN INVESTMENTS HELD BY NOT-FOR-PROFIT ORGANIZATIONS", INVESTMENTS IN EQUITY SECURITIES WITH READILY DETERMINABLE VALUES AND ALL INVESTMENTS IN DEBT SECURITIES ARE REPORTED AT FAIR VALUE ON THE BALANCE SHEET. INCOME, REALIZED AND UNREALIZED GAINS AND LOSSES ARE POOLED AND ALLOCATED TO THE PARTICIPANTS. INDIVIDUAL COMPONENTS OF ASSETS AND REVENUE ARE NOT IDENTIFIED TO THE PARTICIPANTS. |
| Form 990, Part XI, Line 9 Other changes in net assets or fund balances | Pension - -24008759; Affiliate Transfer - -9870256; Change in Fair Value Interest Rate Swaps - -70184; Foundation Grants - -146120; Unrestricted Foundation - 656613; Temp Restricted Foundation - 736508; Perm Restricted Foundation - 290318; Unrealized Gains/Losses Foundation - 2175971; Foundation Grants-Prairie Cardio - 4000; |
Schedule R IRS990ScheduleR
Id Disregarded Entities IdDisregardedEntitiesGrp (3 entries)
| Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | EINEIN | Primary ActivitiesPrimaryActivitiesTxt | Legal Domicile StateLegalDomicileStateCd | Total IncomeTotalIncomeAmt | End Of Year AssetsEndOfYearAssetsAmt | Business Name Line1DirectControllingEntityName/BusinessNameLine1Txt |
|---|---|---|---|---|---|---|---|---|---|
| KIARA CLINICAL INTEGRATION NETWORK LLC | |||||||||
| 4936 LAVERNA ROAD | SPRINGFIELD | IL | 62707 | 261417684 | HEALTHCARE | IL | -$3,126,361 | $6,209,010 | HSSI |
| PHYSICIAN CLINICAL INTEGRATION NETWORK LLC | |||||||||
| 4936 LAVERNA ROAD | SPRINGFIELD | IL | 62707 | 371668647 | HEALTHCARE | IL | -$127,884 | $6,099,730 | KCIN |
| HSHS ACO LLC | |||||||||
| 4937 LAVERNA ROAD | SPRINGFIELD | IL | 62707 | 320465666 | HEALTHCARE & SOCIAL ASSISTANCE | IL | -$35 | $0 | KCIN |
Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp (27 entries)
| Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | EINEIN | Primary ActivitiesPrimaryActivitiesTxt | Legal Domicile StateLegalDomicileStateCd | Exempt Code SectionExemptCodeSectionTxt | Public Charity StatusPublicCharityStatusTxt | Business Name Line1DirectControllingEntityName/BusinessNameLine1Txt | Controlled OrganizationControlledOrganizationInd |
|---|---|---|---|---|---|---|---|---|---|---|
| HOSPITAL SISTERS HEALTH SYSTEM | ||||||||||
| 4936 LAVERNA ROAD | SPRINGFIELD | IL | 62707 | 371058692 | HEALTHCARE | IL | 501(c)(3 | Type III-FI | NA | false |
| HOSPITAL SISTERS OF ST FRANCIS FOUNDATION | ||||||||||
| 4936 LAVERNA ROAD | SPRINGFIELD | IL | 62707 | 371186514 | HEALTHCARE | IL | 501(c)(3 | 7 | HSHS | Yes (true) |
| HSHS HEALTHCARE PLAN TRUST FUND | ||||||||||
| 4936 LAVERNA ROAD | SPRINGFIELD | IL | 62707 | 371137724 | HEALTHCARE | IL | 501(c)(9 | HSHS | Yes (true) | |
| HSHS SELF INSURANCE TRUST | ||||||||||
| 4936 LAVERNA ROAD | SPRINGFIELD | IL | 62707 | 371120626 | INSURANCE | IL | 501(c)(3 | Type I | HSHS | Yes (true) |
| HOSPITAL SISTERS HEALTHCARE WEST INC | ||||||||||
| 2661 COUNTY HIGHWAY 1 | CHIPPEWA FALLS | WI | 54729 | 510157933 | HEALTHCARE | WI | 501(c)(3 | Type I | HSSI | Yes (true) |
| SACRED HEART HOSPITAL | ||||||||||
| 990 WEST CLAIREMONT AVENUE | EAU CLAIRE | WI | 54701 | 390807060 | HEALTHCARE | WI | 501(c)(3 | 3 | HSSI | Yes (true) |
| ST ANTHONY'S HOSPITAL | ||||||||||
| 503 N MAPLE STREET | EFFINGHAM | IL | 62401 | 370661233 | HEALTHCARE | IL | 501(c)(3 | 3 | HSSI | Yes (true) |
| ST NICHOLAS HOSPITAL | ||||||||||
| 3100 SUPERIOR AVENUE | SHEBOYGAN | WI | 53081 | 390808480 | HEALTHCARE | WI | 501(c)(3 | 3 | HSSI | Yes (true) |
| ST JOHN'S HOSPITAL | ||||||||||
| 800 EAST CARPENTER STREET | SPRINGFIELD | IL | 62769 | 370661238 | HEALTHCARE | IL | 501(c)(3 | 3 | HSSI | Yes (true) |
| ST JOSEPH'S HOSPITAL | ||||||||||
| 9515 HOLY CROSS LANE | BREESE | IL | 62230 | 371208459 | HEALTHCARE | IL | 501(c)(3 | 3 | HSSI | Yes (true) |
| ST JOSEPH'S HOSPITAL | ||||||||||
| 2661 COUNTY HIGHWAY 1 | CHIPPEWA FALLS | WI | 54729 | 390810545 | HEALTHCARE | WI | 501(c)(3 | 3 | HSSI | Yes (true) |
| ST MARY'S HOSPITAL | ||||||||||
| 1800 E LAKE SHORE DRIVE | DECATUR | IL | 62521 | 370661244 | HEALTHCARE | IL | 501(c)(3 | 3 | HSSI | Yes (true) |
| ST MARY'S HOSPITAL | ||||||||||
| 111 Spring Street | Streator | IL | 61364 | 362169181 | HEALTHCARE | IL | 501(c)(3 | 3 | HSSI | Yes (true) |
| ST MARY'S MEDICAL CENTER | ||||||||||
| 1762 SHAWANO AVENUE | GREEN BAY | WI | 54303 | 390818682 | HEALTHCARE | WI | 501(c)(3 | 3 | HSSI | Yes (true) |
| ST VINCENT HOSPITAL | ||||||||||
| 835 S VAN BUREN | GREEN BAY | WI | 51301 | 390817529 | HEALTHCARE | WI | 501(c)(3 | 3 | HSSI | Yes (true) |
| ST JOSEPH'S HOSPITAL | ||||||||||
| 12866 TROXLER AVENUE | HIGHLAND | IL | 62249 | 370663568 | HEALTHCARE | IL | 501(c)(3 | 3 | HSSI | Yes (true) |
| ST FRANCIS HOSPITAL | ||||||||||
| 1215 FRANCISCAN DRIVE | LITCHFIELD | IL | 62056 | 370661236 | HEALTHCARE | IL | 501(c)(3 | 3 | HSSI | Yes (true) |
| HOSPITAL SISTERS SERVICES INC | ||||||||||
| 4936 LAVERNA ROAD | SPRINGFIELD | IL | 62707 | 371163402 | HEALTHCARE | IL | 501(c)(3 | Type III-FI | HSHS | Yes (true) |
| HSHS MEDICAL GROUP INC | ||||||||||
| 3215 EXECUTIVE PARK DRIVE | SPRINGFIELD | IL | 62703 | 263956318 | HEALTHCARE | IL | 501(c)(3 | Type III-FI | HSSI | Yes (true) |
| HSHS WISCONSIN MEDICAL GROUP INC | ||||||||||
| 3215 EXECUTIVE PARK DRIVE | SPRINGFIELD | IL | 62703 | 264515959 | HEALTHCARE | WI | 501(c)(3 | Type III-FI | HSSI | Yes (true) |
| ORANGE CROSS AMBULANCE INC | ||||||||||
| 919 ASHLAND AVENUE | SHEBOYGAN | WI | 53081 | 391860942 | HEALTHCARE | WI | 501(c)(3 | 9 | ST NICHOLAS | Yes (true) |
| UNITY LIMITED PARTNERSHIP | ||||||||||
| 2366 OAK RIDGE CIRCLE | DE PERE | WI | 54115 | 391750729 | HEALTHCARE | WI | 501(c)(3 | 9 | HSSI | Yes (true) |
| PRAIRIE EDUCATION & RESEARCH COOPERATIVE | ||||||||||
| 317 NORTH 5TH STREET | SPRINGFIELD | IL | 62701 | 371157915 | HEALTHCARE | IL | 501(c)(3 | 4 | HSSI | Yes (true) |
| ST CLARE MEMORIAL HOSPITAL | ||||||||||
| 855 S MAIN STREET | OCONTO FALLS | WI | 54154 | 390848401 | HEALTHCARE | WI | 501(c)(3 | 3 | HSSI | Yes (true) |
| HSHS HOLY FAMILY HOSPITAL | ||||||||||
| 200 HEALTHCARE DRIVE | GREENVILLE | IL | 62246 | 370792770 | HEALTHCARE | IL | 501(c)(3 | 3 | HSSI | Yes (true) |
| UTLAUT MEMORIAL FOUNDATION | ||||||||||
| 200 HEALTHCARE DRIVE | GREENVILLE | IL | 62246 | 371140166 | FUNDRAISING | IL | 501(c)(3 | Type II | HSSI | Yes (true) |
| GREENVILLE REGIONAL HEALTHCARE | ||||||||||
| 200 HEALTHCARE DRIVE | GREENVILLE | IL | 62246 | 371139987 | HEALTHCARE | IL | 501(c)(3 | Type II | HSSI | Yes (true) |
Id Related Org Txbl Partnership IdRelatedOrgTxblPartnershipGrp (7 entries)
| Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | EINEIN | Primary ActivitiesPrimaryActivitiesTxt | Legal Domicile StateLegalDomicileStateCd | Business Name Line1DirectControllingEntityName/BusinessNameLine1Txt | Predominant Income TypePredominantIncomeTypeTxt | Share Of Total IncomeShareOfTotalIncomeAmt | Share Of EOY AssetsShareOfEOYAssetsAmt | Disproportionate AllocationsDisproportionateAllocationsInd | General Or Managing PartnerGeneralOrManagingPartnerInd | OwnershipOwnershipPct |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| MEMORIAL AND ST ELIZABETH'S HEALTHCARE CANCER TREATMENT CENTER | |||||||||||||
| 4000 NORTH ILLINOIS STREET | SWANSEA | IL | 62226 | 371312961 | HEALTHCARE | IL | ST ELIZABETH'S | Related | $848,922 | $4,789,579 | false | false | 0.5 |
| PRAIRIE HEART INSTITUTE ST JOHN'S | |||||||||||||
| 800 EAST CARPENTER STREET | SPRINGFIELD | IL | 62769 | 371321197 | HEALTHCARE | IL | HSHS | Related | -$596 | $8,000 | false | false | 1.0 |
| PAIN CENTER OF WISCONSIN | |||||||||||||
| 4131 W LOOMIS ROAD SUITE 300 | GREENFIELD | WI | 53221 | 263155343 | HEALTHCARE | WI | ST VINCENT | Related | $606,068 | $807,898 | false | false | 0.5 |
| PAIN CENTER OF WISCONSIN - OCONTO FALLS LLC | |||||||||||||
| 4131 W LOOMIS ROAD SUITE 300 | GREENFIELD | WI | 53221 | 364717036 | HEALTHCARE | WI | ST CLARE | Related | -$79,535 | $206,472 | false | false | 0.5 |
| CARPENTER STREET HOTEL LLC | |||||||||||||
| 525 NORTH SIXTH STREET | SPRINGFIELD | IL | 62702 | 364128127 | HOTEL | IL | LASANTE INC | N/A | 0 | ||||
| SPRINGFIELD URGENT CARE REAL ESTATE LLC | |||||||||||||
| PO BOX 19456 | SPRINGFIELD | IL | 727949456 | 030413258 | RENTAL REAL ESTATE | IL | LASANTE INC | N/A | 0 | ||||
| PRAIRIE HEART INSTITUTE MANAGEMENT COMPANY LLC | |||||||||||||
| 4936 LAVERNA ROAD | SPRINGFIELD | IL | 62707 | 261479945 | MEDICAL | IL | HSHS | Related | -$7,435 | $17,725 | false | Yes (true) | 1.0 |
Id Related Org Txbl Corp Tr IdRelatedOrgTxblCorpTrGrp (8 entries)
| Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | EINEIN | Primary ActivitiesPrimaryActivitiesTxt | Legal Domicile StateLegalDomicileStateCd | Business Name Line1DirectControllingEntityName/BusinessNameLine1Txt | Entity TypeEntityTypeTxt | Share Of Total IncomeShareOfTotalIncomeAmt | Share Of EOY AssetsShareOfEOYAssetsAmt | OwnershipOwnershipPct | Controlled OrganizationControlledOrganizationInd | Address Line1ForeignAddress/AddressLine1Txt | Province Or StateForeignAddress/ProvinceOrStateNm | CountryForeignAddress/CountryCd | Foreign PostalForeignAddress/ForeignPostalCd | Legal Domicile Foreign CountryLegalDomicileForeignCountryCd |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| KIARA INC | |||||||||||||||||
| 4936 LAVERNA ROAD | SPRINGFIELD | IL | 62707 | 371163401 | HEALTHCARE | IL | HSHS | C Corporation | -$36,664,461 | $46,374,438 | 0.01 | Yes (true) | |||||
| LASANTE WISCONSIN INC | |||||||||||||||||
| 4936 LAVERNA ROAD | SPRINGFIELD | IL | 62707 | 391572196 | HEALTHCARE | IL | KIARA INC | C Corporation | Yes (true) | ||||||||
| LASANTE INC | |||||||||||||||||
| 4936 LAVERNA ROAD | SPRINGFIELD | IL | 62707 | 371163400 | HEALTHCARE | IL | KIARA INC | C Corporation | Yes (true) | ||||||||
| PRAIRIE CARDIOVASCULAR | |||||||||||||||||
| 619 EAST MASON SUITE 4P57 | SPRINGFIELD | IL | 62701 | 371071858 | HEALTHCARE | IL | KIARA INC | C Corporation | Yes (true) | ||||||||
| PREVEA HEALTH SERVICES INC | |||||||||||||||||
| 2710 EXECUTIVE DRIVE | GREEN BAY | WI | 54304 | 391839351 | HEALTHCARE | WI | HSSI | C Corporation | $174,464 | $47,208,492 | 0.005 | Yes (true) | |||||
| PREVEA CLINIC INC | |||||||||||||||||
| 2710 EXECUTVE DRIVE | GREEN BAY | WI | 54304 | 391839349 | HEALTHCARE | WI | PHSI | C Corporation | Yes (true) | ||||||||
| RENAISSANCE QUALITY INSURANCE LTD | |||||||||||||||||
| 980669953 | INSURANCE | HSSI | C Corporation | $0 | $105,014,533 | 0.01 | Yes (true) | PO BOX 1159 | GRAND CAYMAN | CJ | KY11102 | CJ | |||||
| OJV INC | |||||||||||||||||
| 4936 LAVERNA ROAD | SPRINGFIELD | IL | 62707 | 460873384 | HEALTHCARE | IL | LASANTE INC | C Corporation | Yes (true) | ||||||||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Receipt Of Int Annts Rnts Rylts | false | ReceiptOfIntAnntsRntsRyltsInd |
| Gift Grnt Or Cap Contri To Oth Org | false | GiftGrntOrCapContriToOthOrgInd |
| Gift Grnt Cap Contri From Oth Org | Yes (true) | GiftGrntCapContriFromOthOrgInd |
| Loans Or Guarantees To Other Org | false | LoansOrGuaranteesToOtherOrgInd |
| Loans Or Guarantees From Oth Org | false | LoansOrGuaranteesFromOthOrgInd |
| Div Related Organization | false | DivRelatedOrganizationInd |
| Asset Sale To Other Org | false | AssetSaleToOtherOrgInd |
| Asset Purchase From Other Org | false | AssetPurchaseFromOtherOrgInd |
| Asset Exchange | false | AssetExchangeInd |
| Rental Of Facilities To Oth Org | Yes (true) | RentalOfFacilitiesToOthOrgInd |
| Rental Of Fclts From Oth Org | false | RentalOfFcltsFromOthOrgInd |
| Perform Of Services For Oth Org | false | PerformOfServicesForOthOrgInd |
| Perform Of Services By Other Org | false | PerformOfServicesByOtherOrgInd |
| Sharing Of Facilities | false | SharingOfFacilitiesInd |
| Paid Employees Sharing | Yes (true) | PaidEmployeesSharingInd |
| Reimbursement Paid To Other Org | Yes (true) | ReimbursementPaidToOtherOrgInd |
| Reimbursement Paid By Other Org | Yes (true) | ReimbursementPaidByOtherOrgInd |
| Transfer To Other Org | Yes (true) | TransferToOtherOrgInd |
| Transfer From Other Org | false | TransferFromOtherOrgInd |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | Schedule R, Part V, Line 2 TRANSACTIONS WITH RELATED ENTITIES | FormAndLineReferenceDesc |
| Explanation | THE TRANSACTIONS REPORTED IN QUESTION 1 ARE BETWEEN RELATED 501(C)(3) PUBLIC CHARITIES AND ARE NOT REPORTED IN THIS SECTION. | ExplanationTxt |