2017-05-15T18:02:14-05:00 2016-06-30 990 2015-07-01 592292041 St Vincent's Ambulatory Care Inc STVI 9043087300 4205 Belfort Road 4020 Jacksonville FL 32216 Pamela Hess CFO - HEALTH SYSTEM 2017-05-15 2015 2021-01-29 14:40:06Z Tom VanOsdol 4205 Belfort Road Jacksonville FL 32216 73097002 false 0928 X WWW.JAXHEALTH.COM X 1983 FL Rooted in the loving ministry of Jesus as healer, we commit ourselves to serving all persons with special attention to those who are poor and vulnerable. 9 9 775 1 0 1063420 1138466 65707399 67763992 36392 -208358 3077272 3874973 69884483 72569073 0 0 79290932 89040637 0 0 23450874 20579897 102741806 109620534 -32857323 -37051461 46879116 21620930 78804097 24073217 -31924981 -2452287 Rooted in the loving ministry of Jesus as healer, we commit ourselves to serving all persons with special attention to those who are poor and vulnerable. Our Catholic health ministry is dedicated to spiritually centered, holistic care, which sustains and improves the health of individuals and communities. We are advocates for a compassionate and just society through our actions and our words. false false 100231613 70090291 ST. VINCENT'S AMBULATORY CARE, INC. PROVIDES QUALITY OUT-PATIENT CARE IN THE FIELDS OF NEUROSCIENCE, CARDIOLOGY, OBSTETRICS/GYNECOLOGY, AND GENERAL SURGERY TO THE RESIDENTS OF NE FLORIDA AND SE GEORGIA. ST. VINCENT'S AMBULATORY CARE, INC. HAS TAKEN PROACTIVE STEPS TO ADDRESS THOSE ISSUES THAT WILL AFFECT ACCESSIBIILITY, THE FINANCING, AND THE DELIVERY OF HEALTHCARE TO ALL PERSONS, ESPECIALLY THE UNINSURED AND THE UNDERSERVED. APPROXIMATELY 54% OF THE VALUE OF SERVICES WERE RENDERED TO PATIENTS UNDER THE MEDICARE PROGRAM AND APPROXIMATELY 5% OF THE SERVICES PROVIDED TO PATIENTS UNDER THE MEDICAID PROGRAM. 1545201 1545201 MOBILE HEALTH OUTREACH PROVIDES QUALITY OUT-PATIENT CARE TO THE RESIDENTS OF NE FLORIDA AND SE GEORGIA. MOBILE HEALTH OUTREACH HAS TAKEN PROACTIVE STEPS TO ADDRESS THOSE ISSUES THAT WILL AFFECT ACCESSIBILITY, THE FINANCING, AND THE DELIVERY OF HEALTHCARE TO ALL PERSONS, ESPECIALLY THE INDIGENT AND MIGRANT POPULATION. 21489 21489 ST. VINCENT'S ("SV") P.A.T.H. PROGRAM PROVIDES QUALITY OUT-PATIENT CARE TO THE RESIDENTS OF NE FLORIDA AND SE GEORGIA. SV'S P.A.T.H. HAS TAKEN PROACTIVE STEPS TO ADDRESS THOSE ISSUES THAT WILL AFFECT ACCESSIBILITY, THE FINANCING, AND THE DELIVERY OF HEALTHCARE TO ALL PERSONS, ESPECIALLY THE UNINSURED AND UNDERSERVED. SV'S P.A.T.H. SERVICES INCLUDE PRIMARY CARE, PRESCRIPTION ASSISTANCE, RN HEALTH COACHING/EDUCATION, CASE MANAGEMENT, AND PREVENTIVE CARE SCREENINGS. 101798303 true true false false false false false false false false true false false true true true false true false false false false false false false false false false false true false false false false false false false false false false false false false true true true false false true 50 0 true 775 true false false false false false false false false false false X 9 9 false false false false true true true true true false false true true true true true true false false false X MAUREEN P MARTIN 9043087300 4205 BELFORT ROAD SUITE 4020 JACKSONVILLE FL 32216 KAREN F DARNELL VP/ CHIEF AMBULATORY SERVICE OFFICER (THRU 3/27/15) 10.0 41.0 X X 0 138819 16238 DAVID G KULIK VICE CHAIRMAN 1.0 5.0 X X 0 0 0 RICARDO MORALES JR SECRETARY/TREASURER 1.0 4.0 X X 0 0 0 DONNIE ROMINE JR COO/ACUTE CARE HOSPITALS (THRU 10/30/2015) 3.0 51.0 X X 0 492198 35098 SIDNEY S SIMMONS II CHAIRMAN 1.0 12.0 X X 0 0 0 PAUL J CHAPPANO MD MEMBER 1.0 4.0 X 0 0 0 CARLA HARRIS MEMBER 1.0 4.0 X 0 0 0 RICHARD JONES MEMBER 1.0 4.0 X 0 0 0 SISTER JEAN D RHOADES MEMBER 1.0 4.0 X 0 0 0 HELEN D ROWAN MEMBER 1.0 4.0 X 0 0 0 VAN D ROYAL MEMBER 1.0 4.0 X 0 0 0 KIMBERLY HODGKINSON CFO (THRU 6.8.2016) 3.0 51.0 X 0 371824 32068 MICHAEL SCHATZLEIN MD REGIONAL CEO 1.0 63.5 X 0 2906062 39144 THOMAS J VANOSDOL COO - MINISTRY MARKET JACKSONVILLE (STARTED 12/6/2015) 3.0 57.0 X 0 465623 46560 JON DEBARDELEBEN Assoc. General Counsel 3.0 49.0 X 0 208908 27005 JANICE G LIPSKY SR. VP HR/OD/CHRO (THRU 12/4/2015) 3.0 49.0 X 0 272949 35171 DENISE MCKROW SVP - SUPPORT SERVICES (THRU 10/30/2015) 3.0 51.0 X 0 197861 29012 JOHN MEYER III CSMO - MINISTRY MARKET JACKSONVILLE 3.0 49.0 X 0 246285 20869 JEFFREY MIDDLEBROOKS GENERAL COUNSEL 3.0 49.0 X 0 157060 6626 KYLE SANDERS PRESIDENT POPULATION HEALTH & CARE CONTINUUM 3.0 40.0 X 0 333149 31085 MICHELLE ADAMOLEKUN CHIEF HUMAN RESOURCES OFFICER REGIONAL VP 3.0 23.0 X 0 249594 14528 ESTRELLITA HOWARD REDMON MD VP - CLINICAL INTEGRATION 20.0 23.0 X 0 289349 30027 JOHN CASSANI PRESIDENT - CLINICAL LEAD (THRU 3/28/2016) 3.0 40.0 X 0 296916 37160 TERESA LOFTIS VP MSN-CMIO MNSTRY MKT JAX 3.0 49.0 X 0 172010 27443 William Mayher SVP - Reg Dev & Corp Resp 3.0 49.0 X 0 190977 27313 ALI CHAHLAVI MD PHYSICIAN 40.0 1.0 X 2858063 0 29901 ERIC GABRIEL MD PHYSICIAN 40.0 0 X 1826888 0 29472 SAMER GARAS MD PHYSICIAN 40.0 0 X 1552458 0 34886 MARIANO MIKULIC MD PHYSICIAN 40.0 0 X 1470718 0 30233 ASHUTOSH PRADHAN MD PHYSICIAN 40.0 0 X 1397317 0 35916 MOODY CHISHOLM FORMER OFFICER (THRU 3/20/15) 0.0 0.0 X 0 680696 26723 9105444 7670278 642478 134 true true false BRASFIELD & GORRIE LLC 3021 7th Ave S Birmingham AL 35233 Construction Services 676522 Joseph David Ruggiero 2035 Professional Center Dr Orange Park FL 32073 Medical Services 79104 Theraic Enterprises of Jacksonville LLC 6321 Daniels Parkway Ste 200 Fort Myers FL 33912 Investment Fees 56054 3 X 1138466 1138466 Medicaid/Medicare 621990 39527618 39527618 Net Patient Services 621990 27772793 27772793 SV PATH 621990 21097 21097 Mobile Health Outreach 621990 390884 390884 EKG Reading Revenue 621990 51600 51600 0 0 0 0 67763992 -1355 -1355 71788 320926 -249138 0 -249138 -249138 207003 0 -207003 -207003 -207003 Incentive Payments 621990 3098333 3098333 MEDICAL RECORDS 621990 231122 231122 On-Call/Medical Director Income 621990 794656 794656 0 0 0 0 4124111 72569073 71656981 0 -226374 79430669 75935720 3494949 2164961 2069703 95258 3863402 3693412 169990 3581605 3424014 157591 141864 135622 6242 4573 4372 201 173 173 3869182 3096724 772458 0 39537 39537 382396 148656 233740 -480747 -336523 -144224 2104094 1194392 909702 146653 109990 36663 240266 180199 60067 685410 658942 26468 2683647 2683647 Medical Supplies 3271674 3255316 16358 Rental & Maintenance 2978759 2803012 175747 System Allocation 1700698 826539 874159 Shared Services 1182851 574866 607985 1628867 1300163 328704 0 109620534 101798303 7822231 0 12090228 3130626 6256286 5149092 0 0 224767 133018 12497549 7035909 4078752 5461640 0 0 1319141 1615881 22909942 6130673 46879116 21620930 8333607 8468092 39518 2103227 70430972 13501898 78804097 24073217 -31924981 -2452287 -31924981 -2452287 46879116 21620930 X -37051461 -8725 -760769 67293649 X false true X true false X 402000 1544933 1161998 1063420 1138466 5310817 45373306 43739102 46281581 68710618 71656981 275761588 0 0 0 45775306 45284035 47443579 69774038 72795447 281072405 402000 0 0 0 0 402000 0 0 0 0 0 0 402000 0 0 0 0 402000 280670405 329739 336387 436579 168771 70433 1341909 0 329739 336387 436579 168771 70433 1341909 0 51666 344622 178865 149416 231122 955691 46156711 45965044 48059023 70092225 73097002 283370005 0.9905 0.9869 0.0047 0.0077 X Schedule A, Part III, Line 12 Other Income DESCRIPTION - MISCELLANEOUS INCOME / MEDICAL RECORDS, COLUMN A - 51666.0, COLUMN B - 344622.0, COLUMN C - 178865.0, COLUMN D - 149416.0, COLUMN E - 231122.0, COLUMN F - 955691.0; RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 140000 2038154 2178154 3171744 1807421 1364323 2052350 1141691 910659 2378290 1735632 642658 2717011 2351165 365846 5461640 deposits 7691 AH deferred compensation 5329740 Interest in Investments Held by Ascension Health Alliance FICA Recoup AR IntraCompany with HM and with System Office 632434 Other Assets 58205 Other Receivables 102603 6130673 AP InterCompany Between HMs 2651248 Ascension deferred compensation liabiliity 5329740 General Professional Liability payable 2463601 AH Savings Plan Liability 873741 Current Portion General Professional Liability Current Portion Workers Comp 47231 Accrued Real Estate Tax 27802 Accrued Sales Tax 220 Pension Plan Liability 2104623 Deposit Liability 3692 13501898 X Schedule D, Part X, Line 2 FIN 48 (ASC 740) footnote FROM THE CONSOLIDATED FINANCIAL STATEMENTS OF ST. VINCENT'S HEALTH SYSTEM, INC. ( WHICH INCLUDE THE ACTIVITY OF ST. VINCENT'S AMBULATORY CARE, INC.) The member healthcare entities of the System are primarily tax-exempt organizations under Internal Revenue Code Section 501(c)(3) or Section 501(c)(2), and their related income is exempt from federal income tax under Section 501(a). The System accounts for uncertainty in income tax positions by applying a recognition threshold and measurement attribute for financial statement recognition and measurement of a tax position taken or expected to be taken in a tax return. The System has determined that no material unrecognized tax benefits or liabilities exist as of June 30, 2016. At June 30, 2015, the System has deferred tax assets of approximately $354,000 and $326,000 for federal and state income tax purposes primarily related to net operating loss carryforwards for the years ended June 30, 2015 and 2014, respectively. A valuation allowance of approximately $344,000 and $322,000 was recorded due to the uncertainty regarding use of the deferred tax assets for the years ended June 30, 2016 and 2015, respectively. true true false false false false false false false MOODY CHISHOLM FORMER OFFICER (THRU 3/20/15) 0 144240 0 0 0 536455 0 3231 0 23492 0 707419 0 0 KAREN F DARNELL VP/ CHIEF AMBULATORY SERVICE OFFICER (THRU 3/27/15) 0 116233 0 0 0 22587 0 3455 0 12783 0 155057 0 0 DONNIE ROMINE JR COO/ACUTE CARE HOSPITALS (THRU 10/30/2015) 0 430630 0 0 0 61568 0 10153 0 24945 0 527296 0 0 KIMBERLY HODGKINSON CFO (THRU 6.8.2016) 0 367829 0 0 0 3995 0 10446 0 21622 0 403891 0 0 MICHAEL SCHATZLEIN MD REGIONAL CEO 0 960751 0 1660416 0 284896 0 7950 0 31194 0 2945206 0 0 THOMAS J VANOSDOL COO - MINISTRY MARKET JACKSONVILLE (STARTED 12/6/2015) 0 336754 0 125195 0 3674 0 16041 0 30519 0 512183 0 0 JON DEBARDELEBEN Assoc. General Counsel 0 208571 0 0 0 337 0 6148 0 20857 0 235913 0 0 JANICE G LIPSKY SR. VP HR/OD/CHRO (THRU 12/4/2015) 0 234493 0 0 0 38456 0 7124 0 28047 0 308119 0 5079 DENISE MCKROW SVP - SUPPORT SERVICES (THRU 10/30/2015) 0 148713 0 0 0 49147 0 4692 0 24320 0 226873 0 0 JOHN MEYER III CSMO - MINISTRY MARKET JACKSONVILLE 0 244961 0 0 0 1323 0 2068 0 18801 0 267154 0 0 JEFFREY MIDDLEBROOKS GENERAL COUNSEL 0 109960 0 11240 0 35859 0 4544 0 2082 0 163686 0 0 KYLE SANDERS PRESIDENT POPULATION HEALTH & CARE CONTINUUM 0 330823 0 0 0 2326 0 8286 0 22799 0 364234 0 0 MICHELLE ADAMOLEKUN CHIEF HUMAN RESOURCES OFFICER REGIONAL VP 0 186433 0 34617 0 28545 0 11086 0 3443 0 264122 0 0 ESTRELLITA HOWARD REDMON MD VP - CLINICAL INTEGRATION 0 283621 0 0 0 5728 0 6357 0 23670 0 319377 0 0 JOHN CASSANI PRESIDENT - CLINICAL LEAD (THRU 3/28/2016) 0 264771 0 25000 0 7145 0 6663 0 30497 0 334076 0 0 TERESA LOFTIS VP MSN-CMIO MNSTRY MKT JAX 0 170818 0 0 0 1191 0 4983 0 22460 0 199452 0 0 William Mayher SVP - Reg Dev & Corp Resp 0 189478 0 0 0 1499 0 5625 0 21688 0 218290 0 0 ALI CHAHLAVI MD PHYSICIAN 2021442 0 835351 0 1269 0 6500 0 23401 0 2887963 0 0 0 ERIC GABRIEL MD PHYSICIAN 1468803 0 355334 0 2751 0 6625 0 22847 0 1856361 0 0 0 SAMER GARAS MD PHYSICIAN 544007 0 1007546 0 905 0 6625 0 28261 0 1587344 0 0 0 MARIANO MIKULIC MD PHYSICIAN 556212 0 913187 0 1319 0 6500 0 23733 0 1500950 0 0 0 ASHUTOSH PRADHAN MD PHYSICIAN 1000919 0 395172 0 1227 0 6625 0 29291 0 1433233 0 0 0 Schedule J, Part I, Line 3 Arrangement used to establish the top management official's compensation ASCENSION HEALTH, A RELATED ORGANIZATION OF ST. VINCENT'S AMBULATORY CARE, INC. USES THE FOLLOWING METHODS TO ESTABLISH THE COMPENSATION OF THE ORGANIZATION'S PRESIDENT: -COMPENSATION COMMITTEE, -INDEPENDENT COMPENSATION CONSULTANT -COMPENSATION SURVEY OR STUDY, AND -APPROVAL BY THE BOARD OR COMPENSATION COMMITTEE Schedule J, Part I, Line 4a Severance or change-of-control payment THE FOLLOWING INDIVIDUALS RECEIVED SEVERENCE PAYMENTS FROM THE ORGANIZATION OR A RELATED ORGANIZATION DURING THE CALENDAR YEAR 2015: MOODY CHISHOLM - $455,785 JANICE G LIPSKY - $9,769 DENISE MCKROW - $24,884 DONNIE ROMINE, JR - $56,808 Schedule J, Part I, Line 4b Supplemental nonqualified retirement plan Eligible executives participate in a program that provides for supplemental retirement benefits. The payment of benefits under the program, if any, is entirely dependent upon the facts and circumstances under which the executive terminates employment with the organization. Benefits under the program are unfunded and non-vested. Due to the substantial risk of forfeiture provision, there is no guarantee that these executives will ever receive any benefit under the program. Any amount ultimately paid under the program to the executives is reported as compensation on Form 990 Schedule J Part II Column B in the year paid. The following individual received a payout from Ascension Health's nonqualified retirement plan in the amount as noted: Janice G Lipsky- $5,079 Form 990, Part VI, Line 15 CEO COMPENSATION IN DETERMINING THE COMPENSATION OF THE ORGANIZATION'S CEO, THE PROCESS, PERFORMED BY ASCENSION HEALTH, A RELATED ORGANIZATION OF ST. VINCENT'S AMBULATORY CARE, INC., INCLUDED A REVIEW AND APPROVAL BY INDEPENDENT PERSONS, COMPARABILITY DATA AND CONTEMPORANEOUS SUBSTANTIATION OF THE DELIBERATION AND DECISION. THE COMPENSATION COMMITTEE REVIEWED AND APPROVED THE COMPENSATION. IN THE REVIEW OF THE COMPENSATION, THE CEO WAS COMPARED TO INDIVIDUALS AT OTHER ORGANIZATIONS IN THE AREA WHO HOLD THE SAME TITLE. DURING THE REVIEW AND APPROVAL OF THE COMPENSATION, DOCUMENTATION OF THE DECISION WAS RECORDED IN THE COMMITTEE MINUTES. THE INDIVIDUAL WAS NOT PRESENT WHEN HIS COMPENSATION WAS DECIDED. IN DETERMINING THE COMPENSATION OF OTHER OFFICERS OF THE ORGANIZATION, THE PROCESS, PERFORMED BY ST. VINCENT'S HEALTH SYSTEM, INC., A RELATED ORGANIZATION WHO PAID THE OTHER OFFICERS, INCLUDED A REVIEW AND APPROVAL BY INDEPENDENT PERSONS, COMPARABILITY DATA, AND CONTEMPORANEOUS SUBSTANTIATION OF THE DELIBERATION AND DECISION. THE AUDIT COMMITTEE REVIEWED AND APPROVED THE COMPENSATION. IN THE REVIEW OF THE COMPENSATION, THE OTHER OFFICERS WERE COMPARED TO INDIVIDUALS AT OTHER ORGANIZATIONS IN THE AREA WHO HOLD THE SAME TITLE. DURING THE REVIEW AND APPROVAL OF THE COMPENSATION, DOCUMENTATION OF THE DECISION WAS RECORDED IN THE BOARD MINUTES. Form 990, Part VI, Line 6 Classes of members or stockholders ST. VINCENT'S AMBULATORY CARE, INC. HAS A SINGLE CORPORATE MEMBER, ST. VINCENT'S HEALTH SYSTEM, INC. Form 990, Part VI, Line 7a Members or stockholders electing members of governing body ST. VINCENT'S AMBULATORY CARE, INC. HAS A SINGLE CORPORATE MEMBER, ST VINCENT'S HEALTH SYSTEM, INC. WHO HAS THE ABILITY TO ELECT MEMBERS TO THE GOVERNING BODY OF ST. VINCENT'S AMBULATORY CARE, INC. Form 990, Part VI, Line 7b Decisions requiring approval by members or stockholders ALL DECISIONS THAT HAVE A MATERIAL IMPACT TO ST. VINCENT'S AMBULATORY CARE, INC. FINANCIAL INFORMATION OR CORPORATION AS A WHOLE ARE SUBJECT TO APPROVAL BY ITS SOLE CORPORATE MEMBER, ST. VINCENT'S HEALTH SYSTEM, INC. Form 990, Part VI, Line 11b Review of form 990 by governing body MANAGEMENT, INCLUDING CERTAIN OFFICERS, WORKS DILIGENTLY TO COMPLETE THE FORM 990 AND ATTACHED SCHEDULES IN A THOROUGH MANNER. MANAGEMENT PRESENTS THE FORM TO THE BOARD, OR A DESIGNATED COMMITTEE, TO REVIEW. PRIOR TO FILING THE RETURN, ALL BOARD MEMBERS ARE PROVIDED THE FORM 990 AND MANAGEMENT TEAM MEMBERS ARE AVAILABLE TO ANSWER ANY BOARD MEMBERS QUESTIONS. Form 990, Part VI, Line 12c Conflict of interest policy OFFICERS, DIRECTORS OR TRUSTEES, AND KEY EMPLOYEES ARE REQUIRED TO COMPLETE A CONFLICT OF INTEREST ATTESTATION STATEMENT AT THE TIME OF HIRING OR WHEN THEIR SERVICE BEGINS. ANNUALLY, THE CORPORATE RESPONSIBILITY OFFICER SENDS THE CONFLICT OF INTEREST POLICY AND ATTESTATION STATEMENT TO ALL OFFICERS, DIRECTORS, TRUSTEES, AND KEY EMPLOYEES FOR COMPLETION AND RETURN WITHIN TWO WEEKS. THREE SEPARATE MAILINGS ARE SENT OUT WITH TWO WEEK DEADLINES TO RECEIVE A MAXIMUM RESPONSE. THE RESPONSE FROM THE RETURNED ATTESTATION STATEMENT ARE ORGANIZED IN A SPREADSHEET AND ARE CAREFULLY REVIEWED BY THE CORPORATE RESPONSIBILITY OFFICER, THE CHIEF LEGAL OFFICER, AND THE CHIEF EXECUTIVE OFFICER. A FULL REPORT IS PRESENTED TO THE AUDIT COMMITTEE AND ANY POTENTIAL CONFLICTS OF INTEREST ARE HANDLED BY THE COMMITTEE IN AN APPROPRIATE MANNER. Form 990, Part VI, Line 19 Required documents available to the public THE ORGANIZATION WILL PROVIDE ANY DOCUMENTS OPEN TO PUBLIC INSPECTION UPON REQUEST. Form 990, Part VIII, Line 11d Other Miscellaneous Revenue - Total Revenue: , Related or Exempt Function Revenue: , Unrelated Business Revenue: , Revenue Excluded from Tax Under Sections 512, 513, or 514: ; Form 990, Part XI, Line 9 Other changes in net assets or fund balances Deferred Pension Costs - -1874307; Transfer from Affiliates - 69167956; FROM 990 PART III COMMUNITY BENEFIT REPORT This report illustrates the significant degree St. Vincent's Ambulatory Care Inc., ("ACI"), positively contributes to the health status of its' patients and their families in the Northeast Florida and Southeast Georgia communities. ACI is a subsidiary of St. Vincent's HealthCare, a multi-entity health care network that provides essential health services to its community. As a member of Ascension Health, the nation's largest not-for-profit Catholic healthcare system, St. Vincent's HealthCare continues to build and strengthen sustainable collaborative efforts that benefit the health of individuals, families, and society as a whole. The goal of St. Vincent's HealthCare is to perpetuate the healing mission of the Catholic Church. St. Vincent's HealthCare furthers this goal through delivery of patient services, care to the elderly and indigent, and patient education and health awareness programs for the community. Our concern for all human life and dignity of each person leads the organization to provide medical services to all people in the community without regard to the patient's race, creed, national origin, economic status, or ability to pay. In order to fully portray the breadth of our contribution, ACI's community benefit information is described below: Organizational Commitment to Providing Community Benefit: ACI is comprised of three main branches, the Ambulatory Care Specialty practices, the Primary Care practices and the Mobile Health Outreach Ministry (MHOM). ACI contains over 200 physicians specializing in Cardiology, Neurosurgery, Neurology, Infectious Disease, Obstetrics & Gynecology, General Surgery, ENT, Pulmonology/Critical Care, Sleep Medicine and Rheumatology. These providers see patients in 50 different locations, many of them rural markets with limited access to health care. Furthermore, physicians travel 1 to 2 hours to outlying clinics in Georgia daily to serve these patients. Additionally, ACI offers Cardiac Research opportunities providing free medical care to patients who are eligible for study. The Mobile Health Outreach Ministry (MHOM) utilizes five mobile medical clinics that deliver medical care to neighborhoods and communities that lack access to medical care. These fully staffed doctors' offices-on-wheels provide acute and preventive services that include pediatric care, dentistry, and adult medical services. Their unique delivery model is the only one of its kind in the Northeast Florida region that provides free medical care to the area's poor and vulnerable. The MHOM regularly visits middle and high schools located in the lower socioeconomic areas to provide physicals and screenings to children. Additionally, the MHOM vehicles in partnership with local Departments of Health, make scheduled visits to the outlying rural communities to provide primary care and secondary care, to those who lack access to medical care. As a direct result of poor access to care these rural markets experience a higher risk of heart disease high blood pressure, diabetes, and obesity, as well as transforming minor health issues into degenerative more complicated and costly diseases. ACI provides these services to support St. Vincent's HealthCare's mission of service to all persons with special attention to those who are poor and vulnerable. Operations and governance: - St. Vincent's Ambulatory Care has an extensive operations and support team. - ACI recently formed a physician governance council which provides monthly reports to St. Vincent's HealthCare Board of Directors. - ACI is subject to all federal and state regulations including CMS, OBRA and OSHA. - ACI participates in Medicaid Medicare CHAMPUS, Tricare, and/or other government-based health care sponsored health care programs Unreimbursed Services Provided to the Elderly and the Poor: In the spirit of principles adopted by Ascension Health, St. Vincent's ACI has taken proactive steps to address those issues that will affect accessibility, the financing, and the delivery of ambulatory specialty care to all persons, especially the uninsured and the underserved. During the fiscal year ending June 30, 2016, approximately 54% of the values of services rendered were to elderly patients under the Medicare program, and approximately 5% of the services were provided to patients under the Medicaid or Charity program. The data below indicates the importance of success to critically needed free medical care provided by St. Vincent's MHOM between July 2015 and June 2016. - More than 16,000 free adult and pediatric patient services were provided, including patient visits health screenings, and case management, as well as outreach services such as delivering food, clothing and critically important medications to the needy. Included among those services are: - Over 2,000 patient visits and case management were completed through our Rural Outreach Ministry. - Over 3,700 patient visits and case management were provided by the Urban Outreach Ministry (Duval, Clay and Nassau counties). - Almost 10,000 patient visits and case management were provided through the Pediatric Outreach Ministry, which includes over 3,040 school and sports physicals and 472 immunizations. - More than 1,800 nutritional and dietary services that include classes, counseling and fitness training have been provided to children helping to reduce obesity and chronic diseases such as diabetes and heart disease associated. Patient Services: ACI Specialty Practices offer outpatient clinics, surgery, procedures, neurological testing, specialized surgeries aimed to treat cancer patients, sleep studies, radiology, infusions, pulmonary function testing, hearing assessments, obstetric care and deliveries, non- invasive cardiac testing and inpatient care. Additionally, ACI offers Cardiac Research, which provides procedures, tests, medications and care to patients at no charge. Cardiology offers specialized programs aimed at reducing hospital re-admissions. The physicians have learned innovative medical procedures, often the first in the country that will extend patient's lives or their ability to function in their day to day activities. The MHOM also provides the community with valuable health screenings, education, referrals and medications. If a patient is diagnosed or needs additional screening or follow-up care, the MHOM connects that patient with charity services within St. Vincent's HealthCare or other local non-profits to provide additional specialty services. Summary: St. Vincent's Ambulatory Care Inc., furthers its charitable purposes by providing a broad array of medical services with an innovative delivery method to those who are in need of healthcare education and outreach services. ACI provides essential care to the community and offers appropriate charity services to those eligible residents who are unable to pay for their own care. ACI provides care and education to the elderly and infirm that has challenges accessing services in order to improve the overall status of our patients and our community. The care of these people who are so in need of support is the founding mission of the Daughters of Charity. 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