ST FRANCIS HOSPITAL OF THE HOSPITAL SISTERS OF THE THIRD ORDER OF ST F: Form 990, tax year 2014
View the entire original 990 at ProPublica ↗
- Organization
- ST FRANCIS HOSPITAL OF THE HOSPITAL SISTERS OF THE THIRD ORDER OF ST F (EIN 37-0661236)
- Tax period
- 2014-07-01 to 2015-06-30
- Filed
- 2016-05-13
- IRS object ID
- 201601349349306010
- Schema version
- 2014v6.0
- 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 O
- Schedule R
Return header ReturnHeader
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return | 2016-05-13T14:57:33-05:00 | ReturnTs |
| Tax Period End | 2015-06-30 | 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 | 2014-07-01 | TaxPeriodBeginDt |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 370661236 | EIN |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | St Francis Hospital Sisters of the Third Order of St Francis | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Control | STFR | BusinessNameControlTxt |
| Phone | 2173242191 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1215 FRANCISCAN DRIVE | AddressLine1Txt |
| City | Litchfield | CityNm |
| State Abbreviation | IL | StateAbbreviationCd |
| ZIP | 62056 | ZIPCd |
Business Officer BusinessOfficerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | PATTI FISCHER | PersonNm |
| Person Title | CEO | PersonTitleTxt |
| Signature | 2016-05-13 | 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 | 2014 | TaxYr |
| Build TS | 2016-08-17 19:52:53Z | BuildTS |
Form 990 IRS990
Principal Ofcr Business Name PrincipalOfcrBusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Patti Fischer | BusinessNameLine1Txt |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1215 FRANCISCAN DRIVE | AddressLine1Txt |
| City | Litchfield | CityNm |
| State Abbreviation | IL | StateAbbreviationCd |
| ZIP | 62056 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | $42,181,481 | GrossReceiptsAmt |
| Group Return For Affiliates | false | GroupReturnForAffiliatesInd |
| Group Exemption | 0928 | GroupExemptionNum |
| Organization501c3 | Yes (X) | Organization501c3Ind |
| Website Address | WWW.STFRANCIS-LITCHFIELD.ORG | WebsiteAddressTxt |
| Type Of Organization Corp | Yes (X) | TypeOfOrganizationCorpInd |
| Formation | 1955 | 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 | 11 | VotingMembersGoverningBodyCnt |
| Voting Members Independent | 9 | VotingMembersIndependentCnt |
| Total Employee | 265 | TotalEmployeeCnt |
| Total Volunteers | 75 | TotalVolunteersCnt |
| Total Gross UBI | $13,521 | TotalGrossUBIAmt |
| Net Unrelated Bus Txbl Incm | $0 | NetUnrelatedBusTxblIncmAmt |
| PY Contributions Grants | $846,297 | PYContributionsGrantsAmt |
| CY Contributions Grants | $174,854 | CYContributionsGrantsAmt |
| PY Program Service Revenue | $36,126,500 | PYProgramServiceRevenueAmt |
| CY Program Service Revenue | $40,210,518 | CYProgramServiceRevenueAmt |
| PY Investment Income | $1,280,473 | PYInvestmentIncomeAmt |
| CY Investment Income | $1,003,666 | CYInvestmentIncomeAmt |
| PY Other Revenue | $476,857 | PYOtherRevenueAmt |
| CY Other Revenue | $678,753 | CYOtherRevenueAmt |
| PY Total Revenue | $38,730,127 | PYTotalRevenueAmt |
| CY Total Revenue | $42,067,791 | CYTotalRevenueAmt |
| PY Grants And Similar Paid | $2,000 | PYGrantsAndSimilarPaidAmt |
| CY Grants And Similar Paid | $2,000 | CYGrantsAndSimilarPaidAmt |
| PY Benefits Paid To Members | $0 | PYBenefitsPaidToMembersAmt |
| CY Benefits Paid To Members | $0 | CYBenefitsPaidToMembersAmt |
| PY Salaries Comp Emp Bnft Paid | $14,627,960 | PYSalariesCompEmpBnftPaidAmt |
| CY Salaries Comp Emp Bnft Paid | $15,220,247 | CYSalariesCompEmpBnftPaidAmt |
| PY Total Prof Fndrsng Expns | $0 | PYTotalProfFndrsngExpnsAmt |
| CY Total Prof Fndrsng Expns | $0 | CYTotalProfFndrsngExpnsAmt |
| CY Total Fundraising Expense | $0 | CYTotalFundraisingExpenseAmt |
| PY Other Expenses | $19,063,311 | PYOtherExpensesAmt |
| CY Other Expenses | $19,089,949 | CYOtherExpensesAmt |
| PY Total Expenses | $33,693,271 | PYTotalExpensesAmt |
| CY Total Expenses | $34,312,196 | CYTotalExpensesAmt |
| PY Revenues Less Expenses | $5,036,856 | PYRevenuesLessExpensesAmt |
| CY Revenues Less Expenses | $7,755,595 | CYRevenuesLessExpensesAmt |
| Total Assets BOY | $57,970,019 | TotalAssetsBOYAmt |
| Total Assets EOY | $69,340,931 | TotalAssetsEOYAmt |
| Total Liabilities BOY | $23,820,160 | TotalLiabilitiesBOYAmt |
| Total Liabilities EOY | $31,449,607 | TotalLiabilitiesEOYAmt |
| Net Assets Or Fund Balances BOY | $34,149,859 | NetAssetsOrFundBalancesBOYAmt |
| Net Assets Or Fund Balances EOY | $37,891,324 | NetAssetsOrFundBalancesEOYAmt |
| Mission | TO REVEAL AND EMBODY CHRIST'S HEALING LOVE FOR ALL PEOPLE THROUGH OUR HIGH QUALITY FRANCISCAN HEALTH CARE MINISTRY. | MissionDesc |
| Significant New Program Srvc | false | SignificantNewProgramSrvcInd |
| Significant Change | false | SignificantChangeInd |
| Expense | $17,122,409 | ExpenseAmt |
| Grant | $0 | GrantAmt |
| Revenue | $32,040,760 | RevenueAmt |
| Desc | SEE SCHEDULE O - OUTPATIENT ACUTE CARE | Desc |
Prog Srvc Accom Acty2 ProgSrvcAccomActy2Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Expense | $5,183,866 | ExpenseAmt |
| Grant | $0 | GrantAmt |
| Revenue | $7,273,937 | RevenueAmt |
| Desc | SEE SCHEDULE O - INPATIENT MEDICAL/SURGICAL | Desc |
Prog Srvc Accom Acty3 ProgSrvcAccomActy3Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Expense | $765,681 | ExpenseAmt |
| Revenue | $882,300 | RevenueAmt |
| Desc | SEE SCHEDULE O - MATERNITY/GYNECOLOGY SERVICES | Desc |
Prog Srvc Accom Acty Other ProgSrvcAccomActyOtherGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Expense | $42,944 | ExpenseAmt |
| Grant | $0 | GrantAmt |
| Revenue | $0 | RevenueAmt |
| Desc | OTHER PROGRAM SERVICES CONDUCTED IN FURTHERANCE OF THE HOSPITAL'S MISSION AND TAX-EXEMPT PURPOSE. | Desc |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Other Prog Srvc Expense | $42,944 | TotalOtherProgSrvcExpenseAmt |
| Total Program Service Expenses | $23,114,900 | 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 | false | 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 | false | DeductibleNonCashContriInd |
| Deductible Art Contribution | false | 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 | 55 | IRPDocumentCnt |
| IRP Document W2 G | 0 | IRPDocumentW2GCnt |
| Backup Wthld Compliance | Yes (true) | BackupWthldComplianceInd |
| Employee | 265 | 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 | 11 | GoverningBodyVotingMembersCnt |
| Independent Voting Member | 9 | 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 | false | InvestmentInJointVentureInd |
| States Where Copy Of Return Is Fld | IL | StatesWhereCopyOfReturnIsFldCd |
| Upon Request | Yes (X) | UponRequestInd |
Books In Care Of Detail BooksInCareOfDetail
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Patrick Nudo | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Phone | 2173248510 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1215 FRANCISCAN DRIVE | AddressLine1Txt |
| City | LITCHFIELD | CityNm |
| State Abbreviation | IL | StateAbbreviationCd |
| ZIP | 62056 | ZIPCd |
Form990 Part VII Section A Form990PartVIISectionAGrp (23 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 | Highest Compensated EmployeeHighestCompensatedEmployeeInd | Former Ofcr Director TrusteeFormerOfcrDirectorTrusteeInd |
|---|---|---|---|---|---|---|---|---|---|
| PATRICIA FISCHER | |||||||||
| Chief Executive Officer | 60.00 | 0 | Yes (X) | Yes (X) | $0 | $172,717 | $1,083 | ||
| DONA MCGRAW | |||||||||
| VICE CHAIRMAN | 1.00 | 2.00 | Yes (X) | Yes (X) | $0 | $0 | $0 | ||
| JOHN FASSERO | |||||||||
| SECRETARY | 1.00 | 0 | Yes (X) | Yes (X) | $0 | $0 | $0 | ||
| TOM FRANZEN | |||||||||
| CHAIRMAN | 1.00 | 0 | Yes (X) | Yes (X) | $0 | $0 | $0 | ||
| ROGER WUJEK MD | |||||||||
| BOARD MEMBER | 1.00 | 0 | Yes (X) | $0 | $0 | $0 | |||
| SISTER JANICE SCHNIEDER OSF | |||||||||
| BOARD MEMBER | 1.00 | 1.00 | Yes (X) | $0 | $0 | $0 | |||
| PETER MANNIX | |||||||||
| BOARD MEMBER | 1.00 | 59.00 | Yes (X) | $0 | $518,241 | $137,838 | |||
| MIKE FLEMING | |||||||||
| BOARD MEMBER | 1.00 | 0 | Yes (X) | $0 | $0 | $0 | |||
| PAUL KAY MD | |||||||||
| BOARD MEMBER | 1.00 | 0 | Yes (X) | $0 | $0 | $0 | |||
| Jerry Williams | |||||||||
| Board Member | 1.00 | 0 | Yes (X) | $0 | $0 | $0 | |||
| Tom Baker | |||||||||
| Board Member | 1.00 | 0 | Yes (X) | $0 | $0 | $0 | |||
| ANN M CARR | |||||||||
| TREASURER | 0.25 | 59.25 | Yes (X) | $0 | $335,735 | $228,208 | |||
| LARRY J RAGEL | |||||||||
| DIVISIONAL CFO | 3.75 | 0.00 | Yes (X) | $0 | $435,539 | $98,854 | |||
| DIANE LINDSAY | |||||||||
| CFO | 50.00 | 0 | Yes (X) | $181,510 | $0 | $119,352 | |||
| DAVID OLEJNICZAK | |||||||||
| Interim CEO | 10.00 | 75.00 | Yes (X) | $0 | $462,282 | $101,258 | |||
| SHERRI A GREENWOOD | |||||||||
| DIVISION CHIEF NURSING OFFICER | 5.00 | 55.00 | Yes (X) | $0 | $270,464 | $72,900 | |||
| REBECCA PUCLIK | |||||||||
| DIVISIONAL CHIEF PEOPLE OFFICER | 10.00 | 65.00 | Yes (X) | $0 | $208,196 | $52,400 | |||
| GERALD PAULE | |||||||||
| DIVISION CHIEF FINANCIAL OFFICER | 10.00 | 65.00 | Yes (X) | $0 | $255,914 | $22,175 | |||
| EVERT J KUIPER | |||||||||
| Central Illinois Division CEO | 16.00 | 59.00 | Yes (X) | $0 | $620,933 | $114,739 | |||
| KATHRYN KNOBLOCH | |||||||||
| DIRECTOR OF ANCILLARY SERVICES | 45.00 | 0 | $114,560 | $0 | $67,614 | Yes (X) | |||
| JILL MOUTRIA | |||||||||
| PHARMACIST | 40.00 | 0 | $130,737 | $0 | $40,491 | Yes (X) | |||
| Brian Strader | |||||||||
| Director - Pharmacy | 40.00 | 0 | $127,308 | $0 | $15,731 | Yes (X) | |||
| DANIEL PERRYMAN | |||||||||
| FORMER BOARD PRESIDENT/HOSPITAL CEO | 0.00 | 40.00 | $0 | $547,721 | $104,169 | Yes (X) | |||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | $554,115 | TotalReportableCompFromOrgAmt |
| Tot Reportable Comp Rltd Org | $3,827,742 | TotReportableCompRltdOrgAmt |
| Total Other Compensation | $1,176,812 | TotalOtherCompensationAmt |
| Indiv Rcvd Greater Than100 K | 4 | IndivRcvdGreaterThan100KCnt |
| Former Ofcr Employees Listed | Yes (true) | FormerOfcrEmployeesListedInd |
| Total Comp Greater Than150 K | Yes (true) | TotalCompGreaterThan150KInd |
| Compensation From Other Srcs | false | CompensationFromOtherSrcsInd |
Contractor Compensation ContractorCompensationGrp (5 entries)
| Address Line1ContractorAddress/USAddress/AddressLine1Txt | Address Line2ContractorAddress/USAddress/AddressLine2Txt | CityContractorAddress/USAddress/CityNm | State AbbreviationContractorAddress/USAddress/StateAbbreviationCd | ZIPContractorAddress/USAddress/ZIPCd | ServicesServicesDesc | CompensationCompensationAmt |
|---|---|---|---|---|---|---|
| SIEMENS MEDICAL SOLUTIONS | ||||||
| 3663 NORTH SAM HOUSTON | SUITE 400 | HOUSTON | TX | 77032 | DIAGNOSTIC EQUIPMENT CONTRACTS | $11,888,590 |
| HELMCAMP CONSTRUCTION CO | ||||||
| 707 BERKSHIRE BLVD | EAST ALTON | IL | 62024 | CONST CONTRACTOR | $1,032,262 | |
| ORTHOPAEDIC CENTER OF IL | ||||||
| 1301 S KOKE MILL RD | SPRINGFIELD | IL | 62711 | ORTHO SURGEON | $756,954 | |
| CARDINAL HEALTHPHARMACY SOLUTIONS | ||||||
| 21377 NETWORK PLACE | CHICAGO | IL | 60673 | MEDICATION ORDER MGT SYSTEM | $608,124 | |
| AMSOL ANESTHETISTS OF LITCHFIELD LLC | ||||||
| PO BOX 6633 | HIGH POINT | NC | 27262 | CRNA SERVICES | $599,748 | |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cntrct Rcvd Greater Than100 K | 20 | CntrctRcvdGreaterThan100KCnt |
| Info In Schedule O Part VIII | Yes (X) | InfoInScheduleOPartVIIIInd |
| Related Organizations | $71,433 | RelatedOrganizationsAmt |
| Government Grants | $95,896 | GovernmentGrantsAmt |
| All Other Contributions | $7,525 | AllOtherContributionsAmt |
| Total Contributions | $174,854 | TotalContributionsAmt |
Program Service Revenue ProgramServiceRevenueGrp (2 entries)
| DescDesc | BusinessBusinessCd | Total Revenue ColumnTotalRevenueColumnAmt | Related Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt | Unrelated Business RevenueUnrelatedBusinessRevenueAmt |
|---|---|---|---|---|
| NET PATIENT SERVICE REVENUE | 900099 | $40,196,997 | $40,196,997 | |
| LAB | 621500 | $13,521 | $13,521 |
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 | $40,210,518 | TotalProgramServiceRevenueAmt |
Investment Income InvestmentIncomeGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $110,812 | TotalRevenueColumnAmt |
| Exclusion | $110,812 | ExclusionAmt |
Gross Rents GrossRentsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $73,940 | RealAmt |
Less Rental Expenses LessRentalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $113,690 | RealAmt |
Rental Income Or Loss RentalIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | -$39,750 | RealAmt |
| Personal | $0 | PersonalAmt |
Net Rental Income Or Loss NetRentalIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | -$39,750 | TotalRevenueColumnAmt |
| Exclusion | -$39,750 | ExclusionAmt |
Gross Amount Sales Assets GrossAmountSalesAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | $892,854 | SecuritiesAmt |
Less Cost Oth Basis Sales Expnss LessCostOthBasisSalesExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | $0 | SecuritiesAmt |
Gain Or Loss GainOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | $892,854 | SecuritiesAmt |
| Other | $0 | OtherAmt |
Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $892,854 | TotalRevenueColumnAmt |
| Exclusion | $892,854 | ExclusionAmt |
Other Revenue Misc OtherRevenueMiscGrp (3 entries)
| DescDesc | BusinessBusinessCd | Total Revenue ColumnTotalRevenueColumnAmt | ExclusionExclusionAmt |
|---|---|---|---|
| SPECIALTY PHYSICIAN PMTS FOR STAFF | 900099 | $649,145 | $649,145 |
| Cafeteria Revenue | 900099 | $3,591 | $3,591 |
| Loss on early extinguishment of debt | 900099 | -$6,417 | -$6,417 |
Miscellaneous Revenue MiscellaneousRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $72,184 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $0 | RelatedOrExemptFuncIncomeAmt |
| Unrelated Business Revenue | $0 | UnrelatedBusinessRevenueAmt |
| Exclusion | $72,184 | ExclusionAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Revenue Total | $718,503 | OtherRevenueTotalAmt |
Total Revenue TotalRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $42,067,791 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $40,196,997 | RelatedOrExemptFuncIncomeAmt |
| Unrelated Business Revenue | $13,521 | UnrelatedBusinessRevenueAmt |
| Exclusion | $1,682,419 | ExclusionAmt |
Grants To Domestic Orgs GrantsToDomesticOrgsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
| Program Services | $0 | ProgramServicesAmt |
Grants To Domestic Individuals GrantsToDomesticIndividualsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $2,000 | TotalAmt |
| Program Services | $2,000 | ProgramServicesAmt |
Foreign Grants ForeignGrantsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
| Program Services | $0 | ProgramServicesAmt |
Benefits To Members BenefitsToMembersGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
| Program Services | $0 | ProgramServicesAmt |
Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $184,450 | TotalAmt |
| Program Services | $184,450 | ProgramServicesAmt |
| Management And General | $0 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Comp Disqual Persons CompDisqualPersonsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
| Program Services | $0 | ProgramServicesAmt |
| Management And General | $0 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Other Salaries And Wages OtherSalariesAndWagesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $10,780,368 | TotalAmt |
| Program Services | $8,801,954 | ProgramServicesAmt |
| Management And General | $1,978,414 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Pension Plan Contributions PensionPlanContributionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $959,353 | TotalAmt |
| Program Services | $770,098 | ProgramServicesAmt |
| Management And General | $189,255 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Other Employee Benefits OtherEmployeeBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $2,559,761 | TotalAmt |
| Program Services | $2,054,787 | ProgramServicesAmt |
| Management And General | $504,974 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Payroll Taxes PayrollTaxesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $736,315 | TotalAmt |
| Program Services | $591,059 | ProgramServicesAmt |
| Management And General | $145,256 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Fees For Services Management FeesForServicesManagementGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $67,830 | TotalAmt |
| Program Services | $0 | ProgramServicesAmt |
| Management And General | $67,830 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Fees For Services Legal FeesForServicesLegalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $4,230 | TotalAmt |
| Program Services | $0 | ProgramServicesAmt |
| Management And General | $4,230 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Fees For Services Accounting FeesForServicesAccountingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $42,167 | TotalAmt |
| Program Services | $0 | ProgramServicesAmt |
| Management And General | $42,167 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Fees For Services Lobbying FeesForServicesLobbyingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
| Program Services | $0 | ProgramServicesAmt |
| Management And General | $0 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Fees For Services Prof Fundraising FeesForServicesProfFundraising
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
| Fundraising | $0 | FundraisingAmt |
Fees For Srvc Invst Mgmnt Fees FeesForSrvcInvstMgmntFeesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
| Program Services | $0 | ProgramServicesAmt |
| Management And General | $0 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Fees For Services Other FeesForServicesOtherGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $3,008,533 | TotalAmt |
| Program Services | $1,220,361 | ProgramServicesAmt |
| Management And General | $1,788,172 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Advertising AdvertisingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $45,802 | TotalAmt |
| Program Services | $0 | ProgramServicesAmt |
| Management And General | $45,802 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Office Expenses OfficeExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $101,544 | TotalAmt |
| Program Services | $50,772 | ProgramServicesAmt |
| Management And General | $50,772 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Information Technology InformationTechnologyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,376,820 | TotalAmt |
| Program Services | $1,032,615 | ProgramServicesAmt |
| Management And General | $344,205 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Royalties RoyaltiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
| Program Services | $0 | ProgramServicesAmt |
| Management And General | $0 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Travel TravelGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $26,344 | TotalAmt |
| Program Services | $11,208 | ProgramServicesAmt |
| Management And General | $15,136 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Pymt Travel Entrtnmnt Pub Ofcl PymtTravelEntrtnmntPubOfclGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
| Program Services | $0 | ProgramServicesAmt |
| Management And General | $0 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Conferences Meetings ConferencesMeetingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $62,666 | TotalAmt |
| Program Services | $23,607 | ProgramServicesAmt |
| Management And General | $39,059 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Interest InterestGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $473,057 | TotalAmt |
| Program Services | $473,057 | ProgramServicesAmt |
| Management And General | $0 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Payments To Affiliates PaymentsToAffiliatesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
| Program Services | $0 | ProgramServicesAmt |
| Management And General | $0 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Depreciation Depletion DepreciationDepletionGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $2,404,637 | TotalAmt |
| Program Services | $2,119,283 | ProgramServicesAmt |
| Management And General | $285,354 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Insurance InsuranceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $453,117 | TotalAmt |
| Program Services | $339,838 | ProgramServicesAmt |
| Management And General | $113,279 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Other Expenses OtherExpensesGrp (4 entries)
| DescDesc | TotalTotalAmt | Program ServicesProgramServicesAmt | Management And GeneralManagementAndGeneralAmt | FundraisingFundraisingAmt |
|---|---|---|---|---|
| SUPPLIES (Medical & Office) | $3,086,690 | $195,151 | $2,891,539 | $0 |
| PROVISION FOR BAD DEBT | $1,817,224 | $1,817,224 | $0 | $0 |
| MAINTENANCE AND REPAIRS | $1,086,805 | $947,710 | $139,095 | $0 |
| MEDICAL PROFESSIONAL FEES | $2,479,726 | $2,479,726 |
All Other Expenses AllOtherExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $2,552,757 | TotalAmt |
| Program Services | $0 | ProgramServicesAmt |
| Management And General | $2,552,757 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Total Functional Expenses TotalFunctionalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $34,312,196 | TotalAmt |
| Program Services | $23,114,900 | ProgramServicesAmt |
| Management And General | $11,197,296 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Total Joint Costs TotalJointCostsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
| Program Services | $0 | ProgramServicesAmt |
| Management And General | $0 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Cash Non Interest Bearing CashNonInterestBearingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $6,694,146 | BOYAmt |
| EOY | $4,431,352 | EOYAmt |
Pledges And Grants Receivable PledgesAndGrantsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $37 | BOYAmt |
Accounts Receivable AccountsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $756,408 | BOYAmt |
| EOY | $2,653,868 | EOYAmt |
Receivables From Officers Etc ReceivablesFromOfficersEtcGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Rcvbl From Disqualified Prsn RcvblFromDisqualifiedPrsnGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
Oth Notes Loans Receivable Net OthNotesLoansReceivableNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $60,992 | BOYAmt |
| EOY | $201,154 | EOYAmt |
Inventories For Sale Or Use InventoriesForSaleOrUseGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $384,208 | BOYAmt |
| EOY | $377,727 | EOYAmt |
Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $226,370 | BOYAmt |
| EOY | $235,300 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Bldg Equip Cost Or Other Bss | $57,050,395 | LandBldgEquipCostOrOtherBssAmt |
| Land Bldg Equip Accum Deprec | $32,591,039 | LandBldgEquipAccumDeprecAmt |
Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $23,600,952 | BOYAmt |
| EOY | $24,459,356 | EOYAmt |
Investments Pub Traded Sec InvestmentsPubTradedSecGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $26,150,927 | BOYAmt |
| EOY | $36,937,914 | 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 | $0 | BOYAmt |
Other Assets Total OtherAssetsTotalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $95,979 | BOYAmt |
| EOY | $44,260 | EOYAmt |
Total Assets TotalAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $57,970,019 | BOYAmt |
| EOY | $69,340,931 | EOYAmt |
Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $6,217,597 | BOYAmt |
| EOY | $6,667,586 | EOYAmt |
Deferred Revenue DeferredRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $12,167 | BOYAmt |
| EOY | $4,578,750 | EOYAmt |
Tax Exempt Bond Liabilities TaxExemptBondLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $10,077,568 | BOYAmt |
| EOY | $9,953,660 | EOYAmt |
Loans From Officers Directors LoansFromOfficersDirectorsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
Other Liabilities OtherLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $7,512,828 | BOYAmt |
| EOY | $10,249,611 | EOYAmt |
Total Liabilities TotalLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $23,820,160 | BOYAmt |
| EOY | $31,449,607 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Organization Follows SFAS117 | Yes (X) | OrganizationFollowsSFAS117Ind |
Unrestricted Net Assets UnrestrictedNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $30,823,712 | BOYAmt |
| EOY | $34,568,483 | EOYAmt |
Temporarily Rstr Net Assets TemporarilyRstrNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $2,077,966 | BOYAmt |
| EOY | $2,074,660 | EOYAmt |
Permanently Rstr Net Assets PermanentlyRstrNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,248,181 | BOYAmt |
| EOY | $1,248,181 | EOYAmt |
Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $34,149,859 | BOYAmt |
| EOY | $37,891,324 | EOYAmt |
Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $57,970,019 | BOYAmt |
| EOY | $69,340,931 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part XI | Yes (X) | InfoInScheduleOPartXIInd |
| Reconcilation Revenue Expnss | $7,755,595 | ReconcilationRevenueExpnssAmt |
| Net Unrlzd Gains Losses Invst | -$433,793 | NetUnrlzdGainsLossesInvstAmt |
| Other Changes In Net Assets | -$3,580,337 | 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 | Yes (true) | FederalGrantAuditRequiredInd |
| Federal Grant Audit Performed | Yes (true) | FederalGrantAuditPerformedInd |
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 | $18,656 | OtherActivitiesAmt |
| Total Lobbying Expenditures | $18,656 | TotalLobbyingExpendituresAmt |
| Not Described Section501c3 | false | NotDescribedSection501c3Ind |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | Schedule C, Part II-B, Line 1 DETAILED DESCRIPTION OF THE LOBBYING ACTIVITY | FormAndLineReferenceDesc |
| Explanation | THE HOSPITAL PAYS MEMBERSHIP DUES TO DIFFERENT ASSOCIATIONS AND A PERCENTAGE OF THOSE DUES ARE DEDICATED TO LOBBYING EXPENSES. THE ASSOCIATIONS ST FRANCIS PAYS ARE AS FOLLOWS: - AMERICAN HOSPITAL ASSOCIATION ("AHA") AT 22.80% LOBBYING EXPENSE - CATHOLIC HEALTH ASSOCIATION ("CHA") AT 2.98% LOBBYING EXPENSE - ILLINOIS HOSPITAL ASSOCIATION ("IHA") AT 39.00% LOBBYING EXPENSE - NATIONAL ASSOCIATION FOR HOME CARE & HOSPICE AT 15.00% LOBBYING EXPENSE THE TOTAL AMOUNT OF ANNUAL DUES PAID TO EACH ASSOCIATION IS MULTIPLIED BY THE PERCENTAGE OF DUES ALLOCATED TO LOBBYING EXPENSE TO CALCULATE THE TOTAL LOBBYING EXPENDITURES PAID. | ExplanationTxt |
Schedule D IRS990ScheduleD
Land LandGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $99,383 | OtherCostOrOtherBasisAmt |
| Book Value | $99,383 | BookValueAmt |
Buildings BuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $34,855,466 | OtherCostOrOtherBasisAmt |
| Depreciation | $15,811,554 | DepreciationAmt |
| Book Value | $19,043,912 | BookValueAmt |
Leasehold Improvements LeaseholdImprovementsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $1,824,801 | OtherCostOrOtherBasisAmt |
| Depreciation | $1,180,148 | DepreciationAmt |
| Book Value | $644,653 | BookValueAmt |
Equipment EquipmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $20,197,647 | OtherCostOrOtherBasisAmt |
| Depreciation | $15,595,940 | DepreciationAmt |
| Book Value | $4,601,707 | BookValueAmt |
Other Land Buildings OtherLandBuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $73,098 | OtherCostOrOtherBasisAmt |
| Depreciation | $3,397 | DepreciationAmt |
| Book Value | $69,701 | BookValueAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Land Buildings | $24,459,356 | TotalBookValueLandBuildingsAmt |
Other Liabilities Org OtherLiabilitiesOrgGrp (3 entries)
| DescDesc | AmtAmt |
|---|---|
| SETTLEMENT VALUE OF INTEREST RATE SWAP PROGRAM | $800,038 |
| RETIRE OBLIGATION - ASBESTOS | $902,595 |
| ACCRUED BENEFIT LIABILITY | $8,546,978 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Liability | $10,249,611 | TotalLiabilityAmt |
| Footnote Text | Yes (X) | FootnoteTextInd |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | Schedule D, Part X, Line 2 FIN 48 (ASC 740) footnote | FormAndLineReferenceDesc |
| Explanation | 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. 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 that Kiara, Inc. will not realize the majority of the benefits of these deductible differences. The deferred tax assets attributable to the net operating loss carryforwards not realized as of June 30, 2015 and 2014 have been fully reserved 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 that the tax position will be sustained on examination by the taxing authorities, based on the technical merits of the position. As of June 30, 2015 and 2014, HSHS does not have any liabilities for unrecognized tax benefits. | ExplanationTxt |
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 | 0 | 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) |
|---|---|---|
| Total Community Benefit Expns | $687,574 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $687,574 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.0212 | TotalExpensePct |
Unreimbursed Medicaid UnreimbursedMedicaidGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $9,493,265 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $8,250,137 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $1,243,128 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.0383 | TotalExpensePct |
Unreimbursed Costs UnreimbursedCostsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| 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 | 0 | PersonsServedCnt |
| Total Community Benefit Expns | $10,180,839 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $8,250,137 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $1,930,702 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.0594 | TotalExpensePct |
Community Health Services CommunityHealthServicesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $162,748 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $162,748 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.0050 | TotalExpensePct |
Health Professions Education HealthProfessionsEducationGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Net Community Benefit Expns | $0 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.0 | TotalExpensePct |
Subsidized Health Services SubsidizedHealthServicesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Net Community Benefit Expns | $0 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.0 | TotalExpensePct |
Research ResearchGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Net Community Benefit Expns | $0 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.0 | TotalExpensePct |
Cash And In Kind Contributions CashAndInKindContributionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $125,504 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $125,504 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.0039 | TotalExpensePct |
Total Other Benefits TotalOtherBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Activities Or Programs | 0 | ActivitiesOrProgramsCnt |
| Persons Served | 0 | PersonsServedCnt |
| Total Community Benefit Expns | $288,252 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $0 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $288,252 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.0089 | TotalExpensePct |
Total Community Benefits TotalCommunityBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Activities Or Programs | 0 | ActivitiesOrProgramsCnt |
| Persons Served | 0 | PersonsServedCnt |
| Total Community Benefit Expns | $10,469,091 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $8,250,137 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $2,218,954 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.0683 | 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) |
|---|---|---|
| Net Community Benefit Expns | $0 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.0 | 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) |
|---|---|---|
| Net Community Benefit Expns | $0 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.0 | TotalExpensePct |
Workforce Development WorkforceDevelopmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Net Community Benefit Expns | $0 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.0 | 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 | 0 | PersonsServedCnt |
| Total Community Benefit Expns | $0 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $0 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $0 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.0 | TotalExpensePct |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bad Debt Expense Reported | Yes (true) | BadDebtExpenseReportedInd |
| Bad Debt Expense | $1,817,224 | BadDebtExpenseAmt |
| Bad Debt Expense Attributable | $56,503 | BadDebtExpenseAttributableAmt |
| Reimbursed By Medicare | $11,709,789 | ReimbursedByMedicareAmt |
| Cost Of Care Reimbursed By Medcr | $11,918,626 | CostOfCareReimbursedByMedcrAmt |
| Medicare Surplus Or Shortfall | -$208,837 | 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 |
| 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 FRANCIS HOSPITAL OF THE HOSPITAL SISTERS OF THE THIRD ORDER OF ST FRANCI | BusinessNameLine1Txt |
| Business Name Line2 | S | BusinessNameLine2Txt |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1215 FRANCISCAN DRIVE | AddressLine1Txt |
| City | LITCHFIELD | CityNm |
| State Abbreviation | IL | StateAbbreviationCd |
| ZIP | 62056 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Website Address | http://www.stfrancis-litchfield.org/ | WebsiteAddressTxt |
| State License | 2336 | StateLicenseNum |
| Licensed Hospital | Yes (X) | LicensedHospitalInd |
| Critical Access Hospital | Yes (X) | CriticalAccessHospitalInd |
| 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 FRANCIS HOSPITAL OF THE HOSPITAL SISTERS OF THE THIRD ORDER OF ST FRANCI | BusinessNameLine1Txt |
| Business Name Line2 | S | BusinessNameLine2Txt |
| 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 |
| 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.stfrancis-litchfield.org/sfl/Needs-Assessment.aspx | 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.stfrancis-litchfield.org/sfl/Needs-Assessment.aspx | 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 | 2.0 | FPGFamilyIncmLmtFreeCarePct |
| FPG Family Incm Lmt Dscnt Care | 6.0 | 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 App Available On Website | Yes (X) | FAPAppAvailableOnWebsiteInd |
| FAP App Available On Website URL | http://www.stfrancis-litchfield.org/sfl/financial_assistance.aspx | FAPAppAvailableOnWebsiteURLTxt |
| FAP Summary On Website | Yes (X) | FAPSummaryOnWebsiteInd |
| FAP Summary On Website URL | http://www.stfrancis-litchfield.org/sfl/financial_assistance.aspx | 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 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 |
| Medicare Rates | Yes (X) | MedicareRatesInd |
| Amounts Generally Billed | false | AmountsGenerallyBilledInd |
| Gross Charges | false | GrossChargesInd |
Supplemental Information SupplementalInformationGrp (3 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| Schedule H, Part V, Section B, Line 5 Facility , 1 | Facility , 1 - ST. FRANCIS HOSPITAL. The hospital took into account input from persons who represent the broad interests of the community served by the hospital, including those with special knowledge of, or expertise in public health (local, regional, state and/or tribal). Members of medically underserved, low-income, and minority populations served by the hospital or individuals or organizations representing the interests of such populations also provided input. The medically underserved are members of a population who experience health disparities, are at risk of not receiving adequate medical care as a result of being uninsured or underinsured, and/or experiencing barriers to health care due to geographic, language, financial, or other barriers. Members of the CHNA Steering Committee, those who both participated in focus groups and the needs identification and prioritization process, were chosen based on their unique expertise and experience, informed perspectives, and involvement with the community. The CHNA Steering Committee members included Lee Johns, community activist, business leader, and deacon at Holy Family Catholic Church; Dr. Chris Poirot, Physician with certifications in family and geriatric medicine, Chief Medical Officer at St. Francis Hospital; Rick Robbins, Montgomery County Undersheriff; Kent Tarro, Public Health Administrator Macoupin County; Patti Fischer, CEO St. Francis Hospital; Vicky Fuller, Community Outreach Facilitator, St. Francis Hospital. Others providing input through community focus groups included a local optometrist, a representative from Montgomery County Health Department, a local administrator and director of nursing from a long term care facility, a director of an assisted living facility, the director of the Macoupin County public health clinic, a county board member who is also engaged in long term care, the regional superintendent of schools, an aide from a state representative's office, a local high school student, a director of a local social service agency, and a representative from the local ambulance service. |
| Schedule H, Part V, Section B, Line 6b Facility , 1 | Facility , 1 - St. Francis Hospital. In order to provide representation of all aspects of our community, a cross section of community members were identified by the St. Francis Hospital CHNA Steering Committee and invited to participate in the community health needs assessment process. Representatives from law enforcement, education, public health, religious organizations, the medical, dental, and optometry fields, long term care, service organizations, as well as state senator and state representative offices were invited to participate in focus groups. Participating organizations included Heritage Health, Evergreen Place, Maple St. Clinic, Hearts United, Almost Home, Representative Wayne Rosenthal's office, Litchfield High School, the Regional Superintendent of Schools, and both the Montgomery and Macoupin county health departments. The directors of both county health departments, Macoupin county health department and Montgomery county health department, are very aware of the needs of the uninsured and low income or minority populations as these are the target populations that they serve. Both county health department directors were fully engaged with the needs assessment process and provided valuable insight into the primary and chronic disease needs of the uninsured and low income populations. |
| Schedule H, Part V, Section B, Line 11 Facility , 1 | Facility , 1 - St. Francis Hospital. As part of the identification and prioritization of health needs, 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 placed 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. The following needs were identified as significant health needs and prioritized: 1. MENTAL HEALTH * A unified, countywide process for intake and post-intake handling of criminal and non-criminal mental health needs introduced to the system by law enforcement and others. * Continued improvement in access to psychiatrists for youth and adults Both focus groups raised issues surrounding intake and post-intake resources for persons with mental health issues. Medical professionals and law enforcement agreed that this issue created particular problems with persons brought to the facility by law enforcement. Finding local counseling and inpatent transfer options are extremely difficult on a regular basis. The need for mental health care was also raised in the focus groups. St. Francis Hospital is located in a designated Mental Health Professional Shortage Area (MH-HPSA score - 16). Mental illness, mental health needs, depression, eating disorders, substance abuse issues, juvenile suicide, and mental health services, prevention and management for all ages were all mentioned in the focus groups. Although the Macoupin County Health Department has begun providing psychiatric services at its clinic, the entire prioritization group agreed that the effort was insufficient to fully address the needs for services for persons of all ages. 2. HYPERTENSION-CARDIOVASCULAR (TOBACCO USE) * Education about risk and prevention * Self-management and self-engagement education Mortality information from the Illinois Department of Public Health highlighted the impact of hypertension and cardiovascular diseases on the area. Hypertension was identified as a health concern by both focus groups. The identification and prioritization group felt that tobacco was a central issue requiring continued attention in addition to self-management and self-engagement of cardiovascular diseases. 3. OBESITY * Education about risk and prevention * Low income access to recreation and physical activity Obesity, and the often related condition of diabetes and other illnesses, was concerns of both focus groups. Specific mention was made in the community focus group of the absence of opportunities for recreation and physical activities for low income and elderly residents. The identification and prioritization group believed this to be centered on issues surrounding the need for better education and better access to recreation and physical activity, especially for persons with low income and the elderly. 4. WELLNESS * Nutrition (access to healthy foods and education for youth, young adults, and the elderly about nutrition) * Low income access to recreation and physical activity * Life skills education * Self-management education Wellness, and its many components, was discussed by both focus groups. Secondary data concerning food access and choices, obesity, and healthy living indicators, particularly from Community Commons and County Health Rankings, supported many of those concerns. The identification and prioritization group identified the above needs as significant and also as inclusive of the various concerns seen. 5. CANCER * Local infusion services * Prevention information and testing * Better understanding of types of cancer and frequency of cancer seen locally Cancer, in various forms, was a concern of both focus groups and that concern were supported by the mortality tables and the National Cancer Institute ranking for Montgomery County. The identification and prioritization group identified absence of local infusion services (reflecting concerns over transportation and absence of local services in the focus groups) and the need for better prevention information and testing and a better understanding of the types and frequency of cancer seen locally as significant needs. 6. EDUCATION * About available health-related services for youth and adults * For grandparents raising grandchildren * About safety for all ages Access to information and education about many topics was raised in the focus groups and identified as a significant need. 7. DENTAL * Better access to services for low income St. Francis Hospital is located in a dental professional shortage area with a HPSA score of 12. The Medical Professionals and Partners focus group identified access to dental care as a need. The identification and prioritization group felt that although this situation seemed to be improving, it remained a significant need. The Implementation Strategy was developed through a facilitated meeting involving key administrative staff at St. Francis Hospital and a member of the Board of Directors, followed by a subsequent working meeting of the same group without the facilitator. The group reviewed the needs assessment process completed to that point and considered the prioritized significant needs and supporting documents along with the immediate past Implementation Strategy, a summary of the activities and impacts flowing from that strategy over the past two years, and internal and external resources potentially available to address the current prioritized needs. The group then considered each of the prioritized needs and regrouped the similar or related needs to align into four categories. Under the resulting alignment, health needs and issues regarding hypertension, cardiovascular health, and wellness are addressed through the focus on obesity. Education is addressed across the continuum of all needs and is incorporated into the approach for each. For each of the four categories, actions the hospital intends to take were identified along with the anticipated impact of the actions, the resources the hospital intends to commit to the actions, and the external collaborators the hospital plans to cooperate with to address the need. The plan will be evaluated by periodic review of measurable outcome indicators in conjunction with annual review and reporting. Process by which needs will be addressed: 1. MENTAL HEALTH Actions the hospital intends to take to address the health need: * Collaborate with local health providers to identify current resources, assess needs, and identify opportunities to improve access * Explore tele-psychiatry * Explore development of local behavioral health evaluation services * Identify or generate three data sets surrounding this need 2. CANCER Actions the hospital intends to take to address the health need: * Collaborate with local partners to identify current activities and efforts regarding education and prevention, identify gaps, and develop plan to address those gaps * Work with physicians for screening education * Create a screening information campaign with handouts and posters * Assess available screenings and needs and create a screening calendar * Explore a navigator program for cancer within the service area to work with all available physicians * Explore development of local infusion services * Participate with the local American Cancer Association and other potential resources to explore local incidence of cancer * Identify or generate three data sets surrounding this need 3. DENTAL Actions the hospital intends to take to address the health need: * Continue to develop and expand programs launched over the past two years in response to the FY2012 CHNA Anticipated impact of these actions: * It is anticipated that the number of patients receiving dental care will continue to improve as a result of this program and that the impact will continue to be significant to low income and elderly members of the community. * Measurable outcomes to support evaluation will be the number of patients served and the number of EmergencyDepartment visits related to dental issues 4. OBESITY Actions the hospital intends to take to address the health need: * Collaborate with the Litchfield Park District to develop and offer expanded physical activity programs At the community center, the pool, and in the parks * Collaborate with schools to provide curriculum regarding wellness, nutrition, and health * Working with businesses to provide access for indoor walking and possibly, other activities * Expand the role of the dietitian who was employed as a result of the FY 2012 CHNA to include community engagement |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Facility | 0 | FacilityNum |
Supplemental Information Detail SupplementalInformationDetail (18 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| Schedule H, Part VI, Line 5 Promotion of community health (continued) | The hospital partnered with the dental hygiene program at Lewis and Clark Community College to bring their mobile dental van to the Litchfield area. This pilot program provided free or low cost dental exams and cleanings to the uninsured in the spring of 2012 and continues. This service has expanded with the addition of multiple visits several times per year. 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. This portion of the program was expanded in 2012 to the Hillsboro area and partnerships were established with Hillsboro Area Hospital and a dental provider in Hillsboro. The percentage of total emergency department visits related to dental issues have decreased from 2.2% in 2011 to 1.27% in 2014 as a result of these collaborative efforts. . A Medication Collection Program was established across two counties and in seven municipalities to collect unused medications from the home to reduce teen access to prescription medications which have been directly linked to teen substance abuse. School administrators and local law enforcement officers were very vocal about the issue of teen substance abuse in our area during the CHNA FY2012. They advised that it is common for teens to access unused medications in the home for "pharm parties" to which they bring pills from home and share with others. St. Francis Hospital recognized the need to reduce teen access to medications in the home and obtained grant funds from ICAHN to establish a medication take back program across two counties. The funds were used to provide secure drop boxes in 7 different communities which were installed at those local police departments. Community members can drop off any unused /unwanted medications at a secure and safe location, and community education was provided via the media as well as partnerships with 5 school districts which sent home information with all students. The program has been very successful with positive reports from all local pharmacies and law enforcement agencies. Other Community Benefit Activities and Services In response to multiple request received from the community, St. Francis Hospital also partnered with several local social service agencies and the Montgomery County Health department to provide an annual community health fair since 2012. Laboratory tests to check for infection, anemia, electrolyte levels, diabetes, cholesterol levels and thyroid and kidney function are available at greatly reduced rates. In addition a variety of other free health screenings are provided including balance, flexibility, and hand grip, oral cancer screenings, hearing and vision screenings, and pulmonary health screenings. St. Francis Hospital partnered with Macoupin County Health Department to provide the oral cancer screenings and Montgomery County Health Department to provide the bone density screenings. A variety of informational displays also provided health related information regarding cholesterol levels, heart health, blood pressure, and colon cancer. Enrollment Outreach and Assistance In FY2015, Hospital Sisters Health System (HSHS) and our 13 Local Systems invested considerable Community Benefit resources to educate the uninsured about historic new opportunities to enroll in affordable health insurance coverage and to facilitate the enrollment process. St. Francis Hospital played a vital role in educating eligible people in their local communities by partnering with the Macoupin County Health Department to provide office space for an enrollment advisor to be on site at the hospital on a regular basis. The advisor was able to assist individuals from a four county area with the open enrollment process. Communication about this service was achieved through newspaper ads, radio, and distribution of brochures to medical offices, emergency departments, and public health venues. |
| Schedule H, Part VI, Line 6 Description of affiliated group (continued A) | Enhance community health As part of our mission to embody Christ's healing love, 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. HSHS hospitals also understand we need to listen closely to the residents of the communities we serve to ensure the health care needs of all are being met. To that end, 13 of our hospitals completed Community Health Needs Assessments (CHNAs) in FY2015 and in FY2012. HSHS St. Clare Memorial Hospital in Oconto Falls, Wisconsin, who affiliated with HSHS in September 2015, completed their CHNA in FY2014. The information gathered from these assessments is being used to develop new, and enhance existing, programs and services that best address the needs of the community. Several priority needs were identified in the FY2015 CHNAs including mental health; chronic disease prevention and management; alcohol, tobacco and other drug abuse; nutrition/wellness; access to care; oral health; and domestic abuse. 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 are providing community education sessions on QPR (Question, Persuade and Refer), an evidence-based suicide prevention program. In addition, the hospitals hosted sessions to train community members to become Certified QPR Trainers. In southern Illinois, HSHS St Elizabeth's Hospital in Belleville also identified suicide as a priority community health need. In response, the hospital in cooperation with the local county mental board offered QPR to educate the community about how to identify and talk to someone who may be considering suicide. In addition, St Elizabeth's mental health counselors provided free evaluations to assess for services or referred individuals to other local agencies for assistance. They also provided telephone assistance to individuals with mental health questions. In FY2015, the counselors screened more than 300 clients and fielded more than 1,000 calls. HSHS St. Vincent Hospital in Green Bay developed the Sexual Assault Nurse Examiner (SANE) program comprised of 11 nurses and a medical director to provide care for anyone who has been sexually assaulted. Begun in 1992, St. Vincent's SANE program is the regional site for such care, one where all the hospitals in Green Bay and the surrounding communities send sexual assault victims. St. Vincent's SANE nurses have been properly trained to conduct the medical examination, collect evidence, treat injury and provide courtroom testimony. In FY2015, SANE served more than 185 individuals at a vulnerable and devastating time of their lives. HSHS St. Mary's Hospital in Streator, Illinois teamed up with the Streator YMCA to offer a 12-week weight loss program - Healthy You - to motivate more than 284 participants. The program included aerobics classes, cooking classes, and a maintenance program to encourage participants to weigh in monthly. Surveys were collected at registration to quantify progress for repeat participants - 14 percent returned with a further weight loss and 9 percent within 5 pounds of their 2014 weight. In FY2015, Healthy You participants collectively lost 2,982 pounds. In FY2015, HSHS St. Mary's Hospital in Decatur, Illinois partnered with Macon County Care Coordination (MCCC) comprised of the Macon County Health Board, Community Health Improvement Center, Decatur Memorial Hospital, Heritage Behavioral Health Center, and Macon County Health Department to provide a team approach to health care and behavioral health services for Medicaid recipients with chronic health conditions. In FY2015, a nurse practitioner was hired to lead the program and recruit physicians. Three teams consisting of a Registered Nurse, Care Navigator and Care Coordinator were hired to provide services. St. Mary's is in the final stages of the development of an interface with the Electronic Medical Record, and is working on fully integrating MCCC services into their Emergency Department and exploring possibilities of integrating MCCC within the HSHS Medical Group to provide care coordination for Medicaid recipients with chronic health conditions. According to the National Assessment of Adult Literacy, only 12 percent of adults have "proficient" health literacy, i.e. nine out of 10 adults lack the skills needed to manage their health. Health literacy was identified in the CHNA completed by HSHS St. Nicholas Hospital in Sheboygan and the Department of Public Health in FY2012. In FY2014, the Healthy Sheboygan County 2020 Health Literacy Committee hosted five focus groups (Hispanic, Hmong, low-income, senior citizens and young adults) and an Executive Briefing for health care leaders to share the results of the community survey and focus groups. In FY2015, with the support of St. Nicholas Hospital, a health literacy community awareness campaign was launched - Okay2Ask - to encourage people to build strong relationships with their health care providers and pharmacists. |
| Schedule H, Part VI, Line 6 Description of affiliated group (continued B) | Advance medical knowledge HSHS works to advance medical knowledge by supporting research initiatives and educational opportunities. In FY2015, HSHS hospitals and affiliated physician groups contributed more than $19 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 FY2015, 73 students were served by the program. In FY2015, HSHS St. Mary's Hospital Medical Center and HSHS St. Vincent Hospital in Green Bay invested more than $450,000 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 FY2015. 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. In response to its FY2012 CHNA, HSHS St. John's Hospital in Springfield, Illinois convened a team of health care providers in FY2015 to identify the practice gaps around metabolic syndrome in children and adults and to research best practices and evidence-based protocols to reduce the progression of metabolic syndrome. The team developed and implemented a three-part multidisciplinary discussion on preventing childhood obesity entitled "Childhood Obesity in Central Illinois: Weighing in on the Problem," which was offered during grand rounds. In addition, the team hosted a Continuing Medical Education program for the community entitled "Restoring Healthy Families and Communities in an Obesongenic Environment: A Tool Kit for Health Care Professionals." 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 FY2015. 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 I, Line 7 Bad Debt Expense excluded from financial assistance calculation | 1817224 |
| Schedule H, Part I, Line 7 Costing Methodology used to calculate financial assistance | Charity care is calculated by determining the total amount from patient billing that is written off to charity care charge codes or allowances. This amount matches the number that is reported on our fiscal year ending 2015 audited financial statements. The total charity care dollar amount is then reduced to cost by applying the hospital's cost to charge ratio as calculated on IRS Schedule H - worksheet 2. The percent of charity care and certain other benefits at cost as a percent of total expenses less bad debt is 6.83%. The amount of bad debt expense removed when calculating the percentages in Part I, Line 7, Column F was $1,817,224. |
| 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 who 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 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 a historical matrix, using collectability percentages by payer 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. St. Francis Hospital reports bad debt in accordance with Healthcare Financial Management Association Statement 15, as modified by and consistent with Generally Accepted Accounting Principles (GAAP). |
| 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 20 of the HSHS Consolidated Audit Report. |
| Schedule H, Part III, Line 8 Community benefit & methodology for determining medicare costs | The 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, St. Francis Hospital is relieving the burdens of the government. Accordingly, this shortfall restricts St. Francis Hospital ability to make funds available to provide for charity care and other community benefits. The hospital Medicare shortfall at cost for fiscal year 2015 was $208,837. |
| Schedule H, Part III, Line 9b Collection practices for patients eligible for financial assistance | St. Francis Hospital makes all reasonable efforts to determine whether an individual is eligible for assistance. The account is placed with the early out vendor who attempts to collect for 120 days. If no payment arrangement is made, the accounts are returned to St. Francis and placed with an outside collection agency. If an account that has been sent to a collection agency is determined to be uncollectible, attempts to collect payment will cease and the account will be returned to the hospital. St. Francis will then consider the account to be uncollectible. |
| Schedule H, Part V, Section B, Line 16b FAP Application website | - ST. FRANCIS HOSPITAL OF THE HOSPITAL SISTERS OF THE THIRD ORDER OF ST. FRANCIS: Line 16b URL: http://www.stfrancis-litchfield.org/sfl/financial_assistance.aspx; |
| Schedule H, Part V, Section B, Line 16c FAP plain language summary website | - ST. FRANCIS HOSPITAL OF THE HOSPITAL SISTERS OF THE THIRD ORDER OF ST. FRANCIS: Line 16c URL: http://www.stfrancis-litchfield.org/sfl/financial_assistance.aspx; |
| Schedule H, Part VI, Line 2 Needs assessment | As indicated in Part V, Section B, St. Francis Hospital conducted a Community Health Needs Assessment in our FY2015 (July 1, 2014 through June 30, 2015) through partnership with the Illinois Critical Access Hospital Network. In previous years, a Community Health Needs Assessment was also completed in 2009 in partnership with the Illinois Institute of Rural Affairs and Western Illinois University and in 2012 through an outside vendor. Sources of data included the U.S. Census and subsequent updates and estimates from the U.S. Census Bureau, the Illinois Behavioral Risk Factor Surveillance System (IBRFSS), official websites of the City of Litchfield and Macoupin and Montgomery counties health departments, and a statewide report on poverty in Illinois. County Health Rankings obtained from the Robert Wood Johnson Foundation and the University of Wisconsin Population Health Institute were utilized as well as information from Community Commons, the Illinois Department of Employment Security, and the National Cancer Institute. Other data sources include the U.S. Health Resources and Services Administration data, the Illinois State Board of Education, and the U.S. Department of Agriculture. The hospital's awareness of the healthcare needs of our community continues through phone calls, inquiries, and requests received by the Community Outreach Facilitator from the community for health related services. Evaluations of community outreach programs also provide a mechanism for feedback from the community regarding health care and health related education needs. 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, St. Francis Hospital 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 provides brochures to patients upon registration regarding the Payment Assistance Program available to them at St. Francis Hospital. The brochures are also supplied in waiting and ancillary areas for easy access by the patient. 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. One-on-one conversations to educate patients about financial assistance often stem from patients receiving a statement or a pre-collection letter. At that point, the customer service representative or cashier, or other qualified staff, will inform/educate the caller about financial assistance options. The first pre-collection letter reminds the patient their account is in delinquent status. It also informs them they may be eligible for financial assistance through the organization's charity care program. The letter provides direct contact information to begin the application process for charity care and lists the Internet address where the policy can be obtained. A system called PayNav (Passport) is now being utilized after failed attempts made by the hospital to work out payment arrangements. 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. |
| Schedule H, Part VI, Line 4 Community information | More than 94% of the inpatients treated at St. Francis Hospital reside in Montgomery and Macoupin Counties. 59% of the inpatients live in Montgomery County and 35% live in the neighboring Macoupin County. Both of the counties are located in central Illinois, between the cities of Springfield, Illinois and St. Louis, Missouri. Combined population is 75,812 and the median household income is around $46,000 per year. The percentage of people living below the poverty level averages 12.4% in Macoupin County and 14.1% in Montgomery County and the current unemployment rate is 5.7% and 6.7% respectively. Persons eligible for Medicare account for 44% of the patient revenue generated at the hospital and Medicaid-eligible patients generate 27% of revenue. Likewise, 26% of the revenue is derived from patients who have managed care/commercial insurance coverage. The remaining 3% of the patient revenue comes from patients with no insurance. Most of the Medicaid revenue originates in the Maternity unit. Over 67.0% of the Maternity unit revenue came from treating patients eligible for Medicaid. Provision of maternity services is financially detrimental to the hospital, since the hospital is a Critical Access Hospital (CAH) and is reimbursed by Medicare based on the Medicare-eligible costs incurred. Maintaining a maternity unit limits the number of Medicare patients who can be admitted to the hospital, as a CAH is allowed only 25 inpatients at a time, including maternity patients. Also, the maternity unit absorbs hospital overhead costs that would otherwise be eligible for Medicare cost-based reimbursement. In FY 2015, over $1,317,000 of the hospital's total operating cost was allocated to maternity services and was excluded from the computation of Medicare reimbursement. But since St. Francis is the only hospital offering maternity services between Springfield and Maryville, IL, maternity services continue to be provided as a service to the community. |
| Schedule H, Part VI, Line 5 Promotion of community health | St. Francis Hospital offers hope to our community in the tradition of the Hospital Sisters of St. Francis. As a healing ministry of the Catholic Church and an affiliate of the Hospital Sisters Health System (HSHS), St. Francis is committed to delivering high quality, compassionate, and cost-effective health care services to all. The hospital was founded 140 years ago to bring a healing presence and improve the health of our community, especially for people who are sick, poor, and disadvantaged. Because of the hospital's purpose and tradition, it is organized to promote the health of Litchfield and surrounding areas. The hospital is governed by a Board of Directors, the majority of whom reside in the organization's primary service area and who are neither employees nor contractors of the hospital (nor family members thereof). The Board ensures that St. Francis is responding to community need. During FY2015, the Board was actively involved in the CHNA process by providing input, review, and approval of the Community Health Needs Assessment and approved an implementation strategy for addressing selected needs. The Friends of St. Francis Leadership Council and the St. Francis Hospital Auxiliary are two additional groups that help the hospital connect with the community. The Leadership Council is comprised of 12 community leaders who volunteer their time in furthering the hospital's philanthropic mission. The hospital auxiliary has 250 volunteers who raise awareness of the hospital in the community, raise funds for scholarships that are given to students pursuing health related careers, and needed equipment for the hospital. Also consistent with its exempt purpose, St. Francis has an open medical staff with privileges available to all qualified physicians in the area. In addition, the hospital operates an emergency department that is open 24 hours to all persons regardless of their ability to pay. As a not-for-profit hospital, St. Francis reinvests surplus funds into the mission of the organization and health of the community rather than distributing them 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. St. Francis also devotes significant resources to access for patients who cannot afford care, along with other community benefits. In fiscal year 2015, St. Francis provided over $2.2 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, during this period, St. Francis provided $581,000 (at cost) in uncompensated care to patients that did not qualify for charity care or public assistance. The range of benefits provided by St. Francis flows from our mission and long-standing commitment to our community. In many cases, these programs would be unlikely to exist without the leadership role played by St. Francis, and they often relieve a burden that would otherwise be carried by government. Several of these programs and activities are designed to respond to our identified needs from the Community Health Needs Assessment and are in collaboration with other community partners. Diabetes Self-Management Courses continue as well as low cost Hemoglobin A1C checks provided at the 2014 and 2015 Community Health Fair. As a part of the Macoupin County Diabetes Coalition, Diabetes Self-Management Program courses are provided biannually. These courses are facilitated by the Community Outreach Facilitator of St. Francis Hospital and a lay instructor. This evidence based course, which was developed by Stanford University, consists of six weekly classes, which meet for 3 hours. The hospital also collaborates with the Illinois Kidney Mobile and the Montgomery County Health Department to provide free screenings for diabetes and renal disease. This free service provides a large mobile van full of diabetic and renal disease education displays in addition to a health screening process. The health screenings consist of free urinalysis, blood glucose testing, hemoglobin A1C testing if appropriate, height, weight, body mass index, and additional chemistry testing for those meeting specific criteria. Once all screenings are completed, a nurse practitioner reviews results with each individual and referrals for care are arranged if needed. A team of four individuals with the Kidney Mobile is assisted by staff from the Montgomery County Health Department and St. Francis Hospital, which sponsor this free day of screening and education. Many individuals who normally would not be able to afford these tests have been able to obtain much needed testing and screening through this program. In 2012, St. Francis Hospital also collaborated with Carlinville Area Hospital and the Macoupin County Health Department to bring the Kidney Mobile to the Carlinville area. The Community Wide Dental Program continues to provide care through the mobile Health Unit of Lewis & Clark Community College and local dental providers who provide free services to the uninsured. Dental care was identified as an area of need through the Community Health Needs Assessment. As a result of this need, St. Francis Hospital has coordinated free or low cost dental services for the uninsured in our community since 2011. |
| Schedule H, Part VI, Line 6 Affiliated health care system | St. Francis Hospital in Litchfield is an affiliate of Hospital Sisters Health System (HSHS), a health care ministry that includes 14 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. Working collaboratively with others in the communities we serve, our Community Benefit initiatives are strategically and successfully expanding access to care, improving the health status of residents, and increasing medical education and knowledge. In FY2015, our hospitals responded to needs identified in each of their most recent Community Health Needs Assessments (CHNAs) completed in FY2012. 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 many priority needs identified in our CHNAs were chronic disease prevention and management, obesity, adequate food and nutrition, mental health, and access to health care services. 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. System-wide, HSHS collectively provided $195.3 million in Community Benefit (9.9% of total hospital expenses) in FY2015. This amount included $25.2 million provided for Financial Assistance (i.e. Charity Care) and $132.3 million for unreimbursed care provided as part of the Medicaid program. In addition, HSHS hospitals committed significant resources to care for 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 $183.7 million. HSHS hospitals also recorded $61.5 million in uncollectible accounts. While HSHS does not count the latter two amounts as Community Benefit, they nonetheless reflect our commitment to 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. As the U.S. health care delivery model continues to evolve, HSHS remains focused on implementing our Care Integration strategy. Care Integration coordinates the delivery of care across the continuum to meet the needs of each patient. During FY2015, HSHS made significant progress with this strategy as we implemented additional interoperable health information technologies and strengthened our alignment with physicians. 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 often involve partnering with others to achieve this goal. Across our two-state System, there are numerous examples of HSHS collaborating with other organizations to enhance access to care for those in need. In FY2015, HSHS and our 14 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 coverage are more likely than their insured counterparts to postpone care and to develop more severe and expensive conditions. 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 14 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. Of the eight states with the highest concentration of uninsured, Illinois was among 25 states that adopted Medicaid expansion under the Affordable Care Act. HSHS St. Mary's Hospital Medical Center in Green Bay supports the NEW Community Clinic, a 38-year-old free health center for the uninsured and underinsured, and also provides free and discounted laboratory and radiology services to the clinic. More than 70 percent of patients indicate the care they received at the clinic prevented a trip to the emergency department. This year St. Mary's Hospital, along with sister hospital HSHS St. Vincent Hospital in Green Bay, provided more than $100,000 to support acute care clinic operations at their Northeast Wisconsin Technical College location, as well as funds to support operating costs associated with the oral surgeon's services at the dental clinic. HSHS St. Francis Hospital in Litchfield, Illinois partnered 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. The percentage of total emergency department visits related to dental issues has decreased from 2.2 percent in 2011 to 1.27 percent in 2014 as a result of these collaborative efforts to provide the right care in the right setting. 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 FY2015, St. Anthony's helped underwrite the cost of prescription medications for 312 residents. St. Anthony's and Catholic Charities believe that no one should be without prescription medications because of the inability to pay. 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. All charges are waived 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. |
| Schedule H, Part VI, Line 7 State filing of community benefit report | IL |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Compensation Committee | Yes (X) | CompensationCommitteeInd |
| Independent Consultant | Yes (X) | IndependentConsultantInd |
| Form990 Of Other Organizations | Yes (X) | Form990OfOtherOrganizationsInd |
| Written Employment Contract | Yes (X) | WrittenEmploymentContractInd |
| 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 (13 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 |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| DANIEL PERRYMAN | ||||||||||||||
| FORMER BOARD PRESIDENT/HOSPITAL CEO | $0 | $310,136 | $0 | $127,460 | $0 | $110,125 | $0 | $85,106 | $0 | $19,063 | $0 | $651,890 | $0 | $36,390 |
| PATRICIA FISCHER | ||||||||||||||
| Chief Executive Officer | $0 | $63,019 | $0 | $50,000 | $0 | $59,698 | $0 | $0 | $0 | $1,083 | $0 | $173,800 | $0 | $0 |
| PETER MANNIX | ||||||||||||||
| BOARD MEMBER | $0 | $324,413 | $0 | $55,597 | $0 | $138,231 | $0 | $108,382 | $0 | $29,456 | $0 | $656,079 | $0 | $96,110 |
| ANN M CARR | ||||||||||||||
| TREASURER | $0 | $238,965 | $0 | $34,985 | $0 | $61,785 | $0 | $207,994 | $0 | $20,214 | $0 | $563,943 | $0 | $28,503 |
| LARRY J RAGEL | ||||||||||||||
| DIVISIONAL CFO | $0 | $170,253 | $0 | $17,185 | $0 | $248,101 | $0 | $74,572 | $0 | $24,282 | $0 | $534,393 | $0 | $0 |
| DIANE LINDSAY | ||||||||||||||
| CFO | $163,528 | $0 | $17,982 | $0 | $0 | $0 | $102,034 | $0 | $17,318 | $0 | $300,862 | $0 | $0 | $0 |
| DAVID OLEJNICZAK | ||||||||||||||
| Interim CEO | $0 | $410,056 | $0 | $33,902 | $0 | $18,324 | $0 | $71,698 | $0 | $29,560 | $0 | $563,540 | $0 | $0 |
| SHERRI A GREENWOOD | ||||||||||||||
| DIVISION CHIEF NURSING OFFICER | $0 | $256,675 | $0 | $12,965 | $0 | $824 | $0 | $44,097 | $0 | $28,803 | $0 | $343,364 | $0 | $0 |
| REBECCA PUCLIK | ||||||||||||||
| DIVISIONAL CHIEF PEOPLE OFFICER | $0 | $197,873 | $0 | $9,889 | $0 | $434 | $0 | $33,133 | $0 | $19,267 | $0 | $260,596 | $0 | $0 |
| GERALD PAULE | ||||||||||||||
| DIVISION CHIEF FINANCIAL OFFICER | $0 | $111,282 | $0 | $0 | $0 | $144,632 | $0 | $0 | $0 | $22,175 | $0 | $278,089 | $0 | $0 |
| EVERT J KUIPER | ||||||||||||||
| Central Illinois Division CEO | $0 | $534,817 | $0 | $43,384 | $0 | $42,732 | $0 | $86,617 | $0 | $28,122 | $0 | $735,672 | $0 | $0 |
| KATHRYN KNOBLOCH | ||||||||||||||
| DIRECTOR OF ANCILLARY SERVICES | $112,082 | $0 | $2,478 | $0 | $0 | $0 | $66,404 | $0 | $1,210 | $0 | $182,174 | $0 | $0 | $0 |
| JILL MOUTRIA | ||||||||||||||
| PHARMACIST | $129,404 | $0 | $1,333 | $0 | $0 | $0 | $31,486 | $0 | $9,005 | $0 | $171,228 | $0 | $0 | $0 |
Supplemental Information Detail SupplementalInformationDetail (3 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| 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 | GERALD PAULE, DIVISION CFO, RECEIVED A SEVERANCE PAYOUT IN THE AMOUNT OF $99,000 DURING CALENDAR YEAR 2014. LARRY J. RAGEL, DIVISIONAL CFO, RECEIVED A SEVERANCE PAYOUT IN THE AMOUNT OF $142,140 DURING CALENDAR YEAR 2014. |
| Schedule J, Part I, Line 4b Supplemental nonqualified retirement plan | 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 2014; THESE DEFERRALS ARE INCLUDED IN SCHEDULE J, PART II, COLUMN (C). Ann Carr -- $29,789 Evert Kuiper -- $60,554 Peter Mannix -- $38,985 Daniel Perryman -- $44,162 THE FOLLOWING INTERESTED PERSONS RECEIVED DISTRIBUTIONS FROM THE SUPPLEMENTAL EXECUTIVE RETIREMENT PLAN (SERP) IN 2014; THESE PAYMENTS ARE INCLUDED IN SCHEDULE J, PART II, COLUMN (B)(III) AND SCHEDULE J, PART II, COLUMN (F), AS APPLICABLE. Ann Carr -- $28,503 Peter Mannix -- $123,918 Daniel Perryman -- $41,614 |
Schedule O IRS990ScheduleO
Supplemental Information Detail SupplementalInformationDetail (15 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| Form 990, Part III, Line 4 PROGRAM SERVICE ACCOMPLISHMENTS | THE COMMUNITY BENEFIT CONTRIBUTION OF ST. FRANCIS HOSPITAL INCLUDES PROGRAMS AND ACTIVITIES THAT IMPROVE ACCESS TO HEALTH CARE AND IMPROVE HEALTH IN OUR COMMUNITIES. IN ORDER TO PORTRAY THE FULL BREADTH OF OUR CONTRIBUTION, OUR COMMUNITY BENEFIT INFORMATION IS DESCRIBED BELOW: SECTION 1 - QUALITATIVE DESCRIPTION OF COMMUNITY BENEFIT: DURING THE FISCAL YEAR ENDED JUNE 30, 2015 ST. FRANCIS HOSPITAL OPERATED AS A CRITICAL ACCESS HOSPITAL. THE HOSPITAL PROVIDED 4,620 ADULT, PEDIATRIC, AND SKILLED NURSING DAYS OF CARE AND ACCOMMODATED 52,709 OUTPATIENT VISITS DURING THE FISCAL YEAR. QUALITY MEDICAL SERVICES WERE PROVIDED TO ALL PATIENTS REGARDLESS OF RACE, CREED, SEX, NATIONAL ORIGIN, HANDICAP, AGE OR FINANCIAL STATUS. ALTHOUGH REIMBURSEMENT FOR SERVICES RENDERED IS CRITICAL TO THE OPERATION AND STABILITY OF THE HOSPITAL, IT IS RECOGNIZED THAT NOT ALL INDIVIDUALS POSSESS THE ABILITY TO PURCHASE ESSENTIAL MEDICAL SERVICES. ST. FRANCIS HOSPITAL'S MISSION IS TO REVEAL AND EMBODY CHRIST'S HEALING LOVE FOR ALL PEOPLE THROUGH OUR HIGH QUALITY FRANCISCAN HEALTH CARE MINISTRY. TO ACCOMPLISH THE MISSION, THE HOSPITAL PROVIDES CARE TO THE POOR, ELDERLY, AND THE NEEDY OF THE COMMUNITY THROUGH VARIOUS PROGRAMS AND SERVICES. THESE ACTIVITIES INCLUDE WELLNESS PROGRAMS, COMMUNITY EDUCATION, COMMUNITY SUPPORT ACTIVITIES, AND PROGRAMS SPECIFICALLY DESIGNED FOR THE ELDERLY, HANDICAPPED AND MEDICALLY UNDERSERVED. BENEFITS FOR THE POOR INCLUDE SERVICES PROVIDED TO PERSONS WHO CANNOT AFFORD HEALTH CARE BECAUSE OF INADEQUATE RESOURCES AND WHO ARE UNINSURED OR UNDERINSURED. THESE BENEFITS ARE PROVIDED IN THE FORM OF CHARITY CARE FOR THOSE WHO CANNOT AFFORD TO PAY THROUGH THE HOSPITAL'S UNINSURED DISCOUNT PROGRAM AND THROUGH PUBLIC PROGRAMS SUCH AS MEDICAID. ST. FRANCIS PROVIDES CHARITY CARE THROUGH ITS CHRISTIAN CARE PROGRAM. THE CHRISTIAN CARE PROGRAM IS DESIGNED TO ENSURE THAT THE RESOURCES USED TO ASSIST PATIENTS ARE PROVIDED FOR THOSE WHO ARE UNABLE TO PAY FOR THEIR MEDICAL CARE. FINANCIAL ASSISTANCE IS DETERMINED BY COMPARING THE APPLICANT'S GROSS FAMILY INCOME TO THE MOST RECENT FEDERAL POVERTY GUIDELINES. IN ORDER TO QUALIFY FOR ASSISTANCE APPLICANTS MUST COMPLETE AN APPLICATION FORM, PROVIDE DOCUMENTATION OF CURRENT FAMILY INCOME, DOCUMENTATION OF MEDICAL EXPENSES AND AVAILABLE ASSETS, AND PROVIDE EVIDENCE OF INVESTIGATION OF ALL OTHER MEANS OF ASSISTANCE. APPLICATIONS ARE REVIEWED BY THE HOSPITAL'S CHRISTIAN CARE COMMITTEE AND SELECTION FOR ASSISTANCE IS DETERMINED BY THE HOSPITAL'S AVAILABLE FUNDS AND THE ELIGIBILITY OF THE APPLICANT. ALL UNINSURED PATIENTS ARE ALLOWED A DISCOUNT OF AT LEAST 10% FROM THE CHARGES BILLED FOR THE PATIENTS' HOSPITAL SERVICES. IN ACCORDANCE WITH THE STATE OF ILLINOIS PUBLIC ACT 095-0965, ST. FRANCIS PROVIDES UNINSURED PATIENTS THE ABILITY TO APPLY FOR FURTHER DISCOUNTS. UNDER THE HOSPITAL UNINSURED PATIENT DISCOUNT ACT, UNINSURED PATIENTS MAY BE ELIGIBLE FOR DISCOUNTS ENSURING THAT THEY PAY NO MORE THAN 135% OF THE COST OF THE SERVICES PROVIDED. BENEFITS FOR THE BROADER COMMUNITY INCLUDE SERVICES PROVIDED TO NEEDY POPULATIONS THAT MAY NOT QUALIFY AS POOR BUT NEED SPECIAL SERVICES AND SUPPORT. ST. FRANCIS PROVIDES THESE BENEFITS THROUGH THE PROVISION OF UNBILLED SERVICES FOR COMMUNITY MEMBERS. NON-BILLED COMMUNITY SERVICES INCLUDE THE COST OF HEALTH EDUCATION AND COMMUNITY HEALTH CLINICS AND SCREENINGS. SPECIFIC SERVICES PROVIDED BY ST. FRANCIS INCLUDE: - ASSISTANCE WITH COMMUNITY BLOOD DRIVES, KIDNEY MOBILE, DENTAL CARE, AND FRESH FRUIT PROGRAM - EMPLOYEE SPEAKERS AT HEALTH FAIRS, SCHOOLS, AND OTHER COMMUNITY ORGANIZATIONS - NUTRITIONAL MANAGEMENT CONSULTING SERVICES AND EDUCATIONAL MATERIALS - EDUCATIONAL SEMINARS FOR THE GENERAL PUBLIC ON SENIOR FITNESS PROGRAMS, BREAST CANCER AWARENESS, DIABETES, CARDIAC REHABILITATION, CONGESTIVE HEART FAILURE, ELDER ABUSE, STROKE, AND DRUG PREVENTION - SCREENINGS FOR COLORECTAL CANCER, HYPERTENSION, CHOLESTEROL, AND OBESITY - DONATION OF MEDICAL SUPPLIES AND USED EQUIPMENT TO MISSIONS IN UNDERDEVELOPED COUNTRIES - DONATION OF CASH AND SUPPLIES TO LOCAL AGENCIES - EDUCATIONAL SESSIONS FOR HEALTHCARE PROVIDERS ON BLOOD BORNE PATHOGENS, STRESS MANAGEMENT, AND CPR - ST. CLARE FOOD PANTRY TO PROVIDE FOOD FOR NEEDY FAMILIES QUANTIFIABLE COMMUNITY BENEFIT: THE FINANCIAL INFORMATION IN THIS REPORT WAS PREPARED IN ACCORDANCE WITH THE CATHOLIC HEALTH ASSOCIATIONS (CHA) COMMUNITY BENEFIT REPORTING GUIDELINES. THESE GUIDELINES RECOMMEND THE FOLLOWING: - REPORT CHARITY CARE AT COST, NOT CHARGES - DO NOT INCLUDE BAD DEBT, CONTRACTUAL ALLOWANCES, AND PROMPT PAY DISCOUNTS AS PART OF CHARITY CARE EXPENSE - DO NOT COUNT A MEDICARE SHORTFALL AS A COMMUNITY BENEFIT - REPORT THE NET EXPENSE FOR COMMUNITY SERVICES, I.E. THE TOTAL COMMUNITY BENEFIT EXPENSE MINUS ANY ASSOCIATED REVENUE FROM PATIENTS, PAYERS, AND EXTERNAL SOURCES THE CHA REPORTING GUIDELINES REFLECT A CONSERVATIVE APPROACH TO REPORTING QUANTIFIABLE COMMUNITY BENEFIT. THE GOAL OF THE GUIDELINES IS TO PRODUCE COMMUNITY BENEFIT FINANCIAL REPORTS THAT REFLECT TRUE COSTS AND THAT DESCRIBE COMMUNITY BENEFIT ACTIVITIES THAT INCREASE ACCESS AND AWARENESS TO HEALTH CARE AND IMPROVE COMMUNITY HEALTH. IN ADDITION, THE HOSPITAL COMMITTED SIGNIFICANT RESOURCES TO SERVING THE MEDICARE POPULATION. THE COST (DETERMINED USING THE COST REPORT) OF PROVIDING SERVICES TO PRIMARILY ELDERLY BENEFICIARIES OF THE MEDICARE PROGRAM, IN EXCESS OF GOVERNMENTAL PAYMENTS, WAS $208,837 FOR THE YEAR ENDED JUNE 30, 2015. THE HOSPITAL ALSO COMMITTED SIGNIFICANT RESOURCES TO SERVING THE MEDICAID POPULATION. THE COST OF PROVIDING SERVICES TO PREGNANT WOMEN AND THEIR NEWBORNS WAS $1,449,444 FOR THE YEAR ENDED JUNE 30, 2015. ST. FRANCIS HOSPITAL IS THE ONLY HOSPITAL BETWEEN SPRINGFIELD AND MARYVILLE THAT OFFERS MATERNITY SERVICES. THE STATE OF ILLINOIS (THE STATE) RENEWED AN ASSESSMENT PROGRAM TO ASSIST IN FINANCING OF ITS MEDICAID PROGRAM IN DECEMBER OF 2006 FOR THE STATE'S FISCAL YEARS ENDED JUNE 30, 2006, 2007, 2008, 2009, 2010, 2011 AND 2012. THE PROGRAM WAS APPROVED IN 2008 AND HAS BEEN RENEWED EACH YEAR SINCE. PURSUANT TO THIS PROGRAM, HOSPITALS WITHIN THE STATE ARE REQUIRED TO REMIT PAYMENT TO THE STATE OF ILLINOIS MEDICAID PROGRAM UNDER AN ASSESSMENT FORMULA APPROVED BY THE CENTERS FOR MEDICARE AND MEDICAID SERVICES (CMS). THE ASSESSMENT PROGRAM ALSO PROVIDES HOSPITALS WITHIN THE STATE WITH ADDITIONAL MEDICAID REIMBURSEMENT BASED ON FUNDING FORMULAS, ALSO APPROVED BY CMS. THE NET EFFECT OF THE 2015 ASSESSMENT AND REIMBURSEMENT INCLUDED IN THE HOSPITAL'S 2015 STATEMENT OF OPERATIONS IS $3 MILLION. |
| Form 990, Part III, Line 4d Description of other program services | (Expenses $ 42,944 including grants of $ 0)(Revenue $ 0) OTHER PROGRAM SERVICES CONDUCTED IN FURTHERANCE OF THE HOSPITAL'S MISSION AND TAX-EXEMPT PURPOSE. |
| Form 990, Part VI, Line 13 WHISTLEBLOWER POLICY | PROVISIONS WITHIN THE CORPORATE COMPLIANCE PROGRAM 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. FRANCIS 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. FRANCIS HOSPITAL, AND ALL HSHS HOSPITALS, TO EVALUATE THEIR PARTICIPATION IN JOINT VENTURE ARRANGEMENTS, INCLUDING UNDER APPLICABLE FEDERAL TAX LAWS, AND TO SAFEGUARD ST. FRANCIS 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 ST. FRANCIS 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 ST. FRANCIS 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 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 CFO 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 | THE ORGANIZATION IS SUBJECT TO THE CORPORATE COMPLIANCE PROGRAM AND CONFLICT OF INTEREST POLICY ("POLICY") OF HOSPITAL SISTERS HEALTH SYSTEM, AN ILLINOIS NOT FOR PROFIT CORPORATION EXEMPT FROM FEDERAL TAXATION UNDER SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE. A REVISED CORPORATE COMPLIANCE PROGRAM AND CONFLICT OF INTEREST POLICY HAVE BEEN IMPLEMENTED SINCE JANUARY 2009 TO MANAGE CONFLICTS OF INTEREST USING A SYSTEM-WIDE PROTOCOL FOR DISCLOSURE STATEMENTS. IN ACCORDANCE WITH THE ORGANIZATON'S 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 OR ITS AFFILIATES. THE POLICY DEFINES COVERED PERSONS AS BOARD MEMBERS, BOARD COMMITTEE MEMBERS, OFFICERS, BOARD DESIGNEES, SENIOR MANAGEMENT, MEMBERS OF ANY COMMITTEE THAT OVERSEES THE APPROVAL OF PHARMACEUTICALS AND MEDICAL DEVICES, AND ANY OTHER INDIVIDUAL WHO HOLDS A POSITION OF TRUST. 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. 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 IS REQUIRED PROMPTLY TO DISCLOSE THE INTEREST TO THE COMMITTEE USING THE HSHS CONFLICT OF INTEREST DISCLOSURE STATEMENT. COMPLETED CONFLICT OF INTEREST STATEMENTS ARE SUBMITTED TO THE COMMITTEE, WHICH IS RESPONSIBLE FOR IDENTIFYING, ASSESSING, AND MANAGING CONFLICTS OF INTEREST THAT ARISE IN THE COURSE OF CONDUCTING THE AFFAIRS OF HSHS AND ITS AFFILIATES. IF THE COMMITTEE DETERMINES THAT A CONFLICT OF INTEREST EXISTS, THE CONFLICT OF INTEREST POLICY REQUIRES HSHS NOT TO 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 COVERED PERSON 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 VIII, Line 11d Other Miscellaneous Revenue | Other Revenue - Total Revenue: 72184, Related or Exempt Function Revenue: , Unrelated Business Revenue: , Revenue Excluded from Tax Under Sections 512, 513, or 514: 72184; - Total Revenue: , Related or Exempt Function Revenue: , Unrelated Business Revenue: , Revenue Excluded from Tax Under Sections 512, 513, or 514: ; - Total Revenue: , Related or Exempt Function Revenue: , Unrelated Business Revenue: , Revenue Excluded from Tax Under Sections 512, 513, or 514: ; |
| Form 990, Part X, Line 11 POOLED INVESTMENT ACCOUNT | ST. FRANCIS HOSPITAL'S CASH RESERVES ARE INVESTED IN A POOLED INVESTMENT ACCOUNT. PARTICIPATION IN THE POOLED FUND IS LIMITED TO THE 501(C)(3) HOSPITALS AND RELATED HEALTH SERVICES ORGANIZATIONS SPONSORED BY THE HOSPITAL SISTERS HEALTH SYSTEM. THE POOLED ACCOUNT CONSISTS OF CASH, AND 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 | Change in fair value of interest rate swap - -239949; Swap payments - -104413; Change in temporarily restricted net assets - 118832; Transfers to/from affiliates - -883421; Pension-related changes other than net periodic benefit cost - -2471386; |
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 | -$2,181,245 | $7,140,533 | HSSI |
| PHYSICIAN CLINICAL INTEGRATION NETWORK LLC | |||||||||
| 4936 LAVERNA ROAD | SPRINGFIELD | IL | 62707 | 371668647 | HEALTHCARE | IL | -$487,125 | $5,630,644 | KCIN |
| HSHS ACO LLC | |||||||||
| 4936 LAVERNA ROAD | SPRINGFIELD | IL | 62749 | 320465666 | HEALTHCARE | IL | $0 | $0 | KCIN |
Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp (26 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 III-FI | 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 ELIZABETH'S HOSPITAL | ||||||||||
| 211 SOUTH THIRD STREET | BELLEVILLE | IL | 62220 | 370663567 | 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) |
| 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) |
| WISCONSIN UPPER PENINSULA ONCOLOGY MANAGEMENT | ||||||||||
| 835 S VAN BUREN | GREEN BAY | WI | 54301 | 391677100 | HEALTHCARE | WI | 501(c)(3 | 3 | ST VINCENT | 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) |
| COMMUNITY HEALTHCARE FOUNDATION | ||||||||||
| 855 SOUTH MAIN STREET | OCONTO FALLS | WI | 54154 | 391700944 | FUNDRAISING (DISSOLVED 8/25/14) | WI | 501(c)(3 | 7 | ST CLARE | Yes (true) |
Id Related Org Txbl Partnership IdRelatedOrgTxblPartnershipGrp (8 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 | $1,009,386 | $4,940,657 | false | false | 0.005 |
| PRAIRIE HEART INSTITUTE ST JOHN'S | |||||||||||||
| 800 EAST CARPENTER STREET | SPRINGFIELD | IL | 62769 | 371321197 | HEALTHCARE | IL | HSHS | Related | -$874 | $46,181 | false | false | 0.01 |
| NORTHEAST WISCONSIN RADIATION THERAPY SERVICES LLC | |||||||||||||
| 1726 SHAWANO AVE | GREEN BAY | WI | 543079047 | 263749065 | HEALTHCARE (Disolved 6/1/15) | WI | SMGB | Related | $0 | $0 | false | Yes (true) | 0.005 |
| PAIN CENTER OF WISCONSIN | |||||||||||||
| 4131 W LOOMIS ROAD SUITE 300 | GREENFIELD | WI | 53221 | 263155343 | HEALTHCARE | WI | ST VINCENT | Related | $1,121,849 | $1,119,039 | false | false | 0.005 |
| PAIN CENTER OF WISCONSIN - OCONTO FALLS LLC | |||||||||||||
| 4131 W LOOMIS ROAD SUITE 300 | GREENFIELD | WI | 53221 | 364717036 | HEALTHCARE | WI | ST CLARE | Related | -$68,999 | $194,065 | false | false | 0.005 |
| CARPENTER STREET HOTEL LLC | |||||||||||||
| 525 NORTH SIXTH STREET | SPRINGFIELD | IL | 62702 | 364128127 | HOTEL | IL | LASANTE INC | N/A | |||||
| SPRINGFIELD URGENT CARE REAL ESTATE LLC | |||||||||||||
| PO BOX 19456 | SPRINGFIELD | IL | 727949456 | 030413258 | RENTAL REAL ESTATE | IL | LASANTE INC | N/A | |||||
| PRAIRIE HEART INSTITUTE MANAGEMENT COMPANY LLC | |||||||||||||
| 4936 LAVERNA ROAD | SPRINGFIELD | IL | 62707 | 261479945 | MEDICAL | IL | HSHS | Related | -$7,920 | $21,158 | false | Yes (true) | 0.01 |
Id Related Org Txbl Corp Tr IdRelatedOrgTxblCorpTrGrp (9 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 | -$27,121,195 | $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 | $315,933 | $46,398,032 | 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 | $103,291,372 | 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) | ||||||||
| STREATORLAND QUALITY CARE PHO LLC | |||||||||||||||||
| 111 SPRING STREET | STREATOR | IL | 61364 | 364105007 | HEALTHCARE | IL | ST MARY'S STREATOR | C Corporation | -$3,116 | $17,486 | 0.005 | 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 | false | RentalOfFacilitiesToOthOrgInd |
| Rental Of Fclts From Oth Org | Yes (true) | RentalOfFcltsFromOthOrgInd |
| Perform Of Services For Oth Org | false | PerformOfServicesForOthOrgInd |
| Perform Of Services By Other Org | Yes (true) | PerformOfServicesByOtherOrgInd |
| 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 | ANY TRANSACTIONS LISTED ON SCHEDULE R, PART V, LINE 1 AND NOT ON SCHEDULE R, PART V, LINE 2 ARE BETWEEN RELATED 501(C)(3) ORAGNIZATIONS AND DO NOT REQUIRE REPORTING ON THIS SECTION. | ExplanationTxt |