2016-05-13T20:01:07-05:00 2015-06-30 470617373 CATHOLIC HEALTH INIATIVES 198 INVERNESS DRIVE WEST ENGLEWOOD CO 80112 990 2014-07-01 611029768 JEWISH HOSPITAL & ST MARY'S HEALTHCARE INC JEWI 5025403888 250 E LIBERTY ST STE 500 LOUISVILLE KY 40202 ROBERT STELTENPOHL VP-FINANCE 2016-05-13 true MARK STOCKI P00642127 3032989100 2014 2016-08-17 19:52:53Z RUTH WILLIAMS BRINKLEY 250 E LIBERTY ST STE 500 LOUISVILLE KY 40202 837391720 false X WWW.JHSMH.ORG X 1983 KY TO BE THE PREMIER, INTEGRATED, COMPREHENSIVE HEALTH SYSTEM IN THE COMMUNITY PROVIDING HIGH QUALITY CARE CLOSE TO HOME, REDUCING THE INCIDENCE OF DISEASE AND ELIMINATING INEQUITIES IN ACCESS TO CARE. 19 18 6019 894 1158072 261876 4776856 5274983 822226263 787866985 7688023 3951883 35357673 40098040 870048815 837191891 1144758 12311769 0 0 271040128 268311003 0 0 440211 651052266 592952753 923237152 873575525 -53188337 -36383634 1129076456 1541813350 728564823 1184241147 400511633 357572203 TO BRING HOPE, IMPROVE HEALTH AND CHANGE LIVES. INSPIRED BY OUR CATHOLIC AND JEWISH FAITH HERITAGE, WE SERVE WITH A SPIRIT OF INNOVATION AND COLLABORATION, TRANSFORM HEALTH CARE DELIVERY, PARTNER TO CREATE HEALTHY COMMUNITIES AND ADVOCATE FOR A JUST HEALTH SYSTEM. false false 722821884 12311769 786704242 For hospital program service accomplishments, SEE SCHEDULE H 0 0 0 All charitable contributions to the Jewish Hospital & St. Mary's Foundation are used primarily for the benefit and support of KentuckyOne Health's Louisville market. This past year the Foundation provided over $18 million in support to facilities including Jewish Hospital, St. Mary's & Elizabeth Hospital, Frazier Rehab Institute, James Graham Brown Cancer Center, University of Louisville Hospital, and Our Lady of Peace, as well as support to the Medical Centers and Jewish Hospital Shelbyville. The Foundation Board of 30 community volunteers, chaired by William E. Summers V, established four core areas of focus: Enhancing Patient Care - From supporting state-of-the-art neuroscience services at Jewish Hospital and Frazier Rehab Institute to expanding the emergency department at Sts. Mary & Elizabeth Hospital, our top objective is to ensure excellence in the organization's delivery of patient services. Funding Leading Edge Medical Research - Groundbreaking research conducted by Susan Harkema, Ph.D., benefiting patients with spinal cord impairment, and our internationally renowned hand transplant program simply would not be possible without grant funding. Supporting the Education of Health Caregivers - The Foundation manages 70 educational endowments. In 2015, awards totaling more than $335,000 were made to over 130 students pursuing degrees in nursing and other high-demand health care fields. Improving Access to Health Care - A pilot project is underway to provide people who have no insurance or Medicaid coverage with a nurse coach or "community care navigator" at discharge from Jewish Hospital. This is designed to help people with limited resources better manage chronic medical conditions - addressing problems before they escalate into a trip to the emergency room. 722821884 true true false true false false false false false true true true false true true true false true false false false true false false true true true true true true true false false false false false false false false true false false false true true true false false false true 2 15 true 6019 true true true false false false false true true false false false false X 19 18 false false false false true true true true true false false true true true true true true false true true true KY X ROBERT STELTENPOHL 5025874691 200 ABRAHAM FLEXNER WAY 1ST FL LOUISVILLE KY 40202 ROBERT HEWETT CHAIR 1.00 10.00 X X 0 0 0 Richard Schultz VICE CHAIR 1.00 5.00 X X 0 0 0 MIKE ADES DIRECTOR 1.00 5.00 X 0 0 0 Charles Blankenship DIRECTOR 1.00 4.00 X 0 0 0 RUSSELL WILLIAMS MD DIRECTOR 1.00 6.00 X 0 0 0 ROBERT W ROUNSAVALL III DIRECTOR 1.00 5.00 X 0 0 0 DAVID FENNELL DIRECTOR 1.00 6.00 X 0 0 0 MILLER HOFFMAN DIRECTOR 1.00 5.00 X 0 0 0 Martha Jones Director 1.00 5.00 X 0 0 0 MICHAEL ROWAN FACHE DIRECTOR/CHI EVP & COO 1.00 69.00 X 0 2500443 53656 SR ELIZABETH WENDELN DIRECTOR 1.00 6.00 X 0 0 0 Jane Burks Director 1.00 4.00 X 0 0 0 Jane J Chiles director 1.00 4.00 X 0 0 0 Gerald Temes MD director 1.00 4.00 X 0 0 0 David L Dunn director 1.00 4.00 X 0 0 0 louann atlas DIRECTOR 1.00 4.00 X 0 0 0 DOUG HALL DIRECTOR 1.00 4.00 X 0 0 0 JOHN D STEWART II MD DIRECTOR 1.00 4.00 X 0 0 0 LOUIS I WATERMAN DIRECTOR 1.00 4.00 X 0 0 0 Sherri Craig VICE PRESIDENT 45.00 16.00 X 191809 0 13290 SHARON HAGER SECRETARY/DIV VP SR COUNSEL 1.00 59.00 X 0 424955 32254 RUTH WILLIAMS BRINKLEY PRESIDENT/CEO KENTUCKYONE HEALTH 5.00 55.00 X 0 1208991 179113 randall combs TREASURER/CFO KOH 5.00 55.00 X 0 416042 36251 CHERYL FUGATTE VICE PRESIDENT/CNO 50.00 0 X 216752 0 7966 KIMBERLY HITE VICE PRESIDENT/CNO 50.00 0 X 160955 0 11939 KENNETH JOHNSON VP/COO 50.00 0 X 220049 0 18183 BRADLEY LINCKS VP-PATIENT CARE SVCS 50.00 0 X 181575 0 25958 MARK MILBURN VP ONCOLOGY SVC LINES 50.00 0 X 197924 0 11777 SHELLEY SHAUGHNESSY CEO-MARKET 50.00 0 X 184643 185408 59904 ROBERT SMITH FAMILY MEDICINE 50.00 0.00 X 275058 6548 25664 RUTH WHEATLEY PRES CEO/FRAZIER/TAYLOR C0 50.00 0 X 271403 0 10850 CARLOTTA RINKE VP-MEDICAL AFFAIRS 50.00 0 X 329333 0 4188 KHUDA KHAN HEMATOLOGIST-ONCOLOGIST 40.00 0 X 495124 0 28464 ROBERT STELTENPOHL VP-FINANCE 0.00 0 X 240470 0 27072 JENNIFER ANDERSON PHYS ASST-BEHAVIORAL HEALTH 40.00 0 X 256142 2623 18308 JEANETTA BOSLEY PHYSICIAN - FAM MED 40.00 0 X 241713 0 12159 JAMES KETTERHAGEN VICE PRESIDENT 45.00 0.00 X 117488 0 0 DAVID LAIRD VICE PRESIDENT 50.00 0 X 192307 0 0 DEBORAH MOLNAR VICE PRESIDENT 0.00 0.00 X 435156 0 12877 RANDY NAPIER VICE PRESIDENT 50.00 0 X 0 288953 69121 JENNIFER NOLAN VICE PRESIDENT 50.00 0.00 X 0 386560 73552 VAL SLAYTON VICE PRESIDENT 50.00 0 X 110449 0 4188 LISA DOLAN VP Nursing 40.00 0 X 100898 0 13332 GARY ERMERS Former Interim Chief Financial Officer 0.00 0.00 X 0 256665 41638 COLLEEN HOLTON DIV VP OPER FINANCE/INTERIM VP FIN REPORTING 0.00 50.00 X 0 336436 42454 TAMMY HOWELL Director Accounting 50.00 0.00 X 140870 0 19932 ronald farr SVP-CFO 0 X 199989 0 4004 4760107 6013624 858094 149 true true false ARAMARK HEALTHCARE SUPPORT SERVICES 24863 NETWORK PLACE CHICAGO IL 606731248 FOOD SERVICES/ENV. SERVICES 11226957 UNIVERSITY CARDIOTHORACIC SURGICAL ASSOCIATES 201 ABRAHAM FLEXNER WAY SUITE 1200 LOUISVILLE KY 40202 ON-CALL SURGEONS 5028866 Siemens Medical Solutions 51 Valley Stream Pkwy Malvern PA 19355 Health Services 4681526 Realm Construction Co Inc 620 S Third St Ste 600 LOUISVILLE KY 40202 Construction Service 4160534 MG CARROLL SP SHETH & V RATHAVAN PARTNERS 1460 BLUEGRASS AVENUE LOUISVILLE KY 40215 SPECIALISTS 3000000 94 0 0 277257 1130722 1817831 2049173 66644 5274983 Patient Services 900099 774748254 773585511 1162743 0 Rental Income 900099 11713790 11713790 0 0 Equity changes of unconsolidated orgs 900099 1404941 1404941 0 0 0 0 0 0 0 0 0 0 0 0 0 0 787866985 1672169 0 -4671 1676840 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 956669 1323046 0 0 956669 1323046 2279714 0 0 2279714 253878 277257 170756 83122 0 83122 30572 29073 1499 0 0 1499 0 0 0 0 0 0 Pharmacy Services 446110 32034361 0 0 32034361 Services Sold 900099 5006661 0 0 5006661 Other Miscellaneous Revenue 900099 2972397 0 0 2972397 0 0 0 0 40013419 837191891 786704242 1158072 44054594 X 1453510 1453510 10603584 10603584 254675 254675 1598032 516871 1081161 215752636 189227296 26392940 132400 8026009 7085360 935814 4835 26847630 22030753 4798029 18848 16086696 14106424 1980272 2278888 2278888 179341 179341 126721772 89323457 37131285 267030 3802 3802 15782937 11772493 3997818 12626 34439830 1821867 32617963 22423287 15622304 6800983 366584 243375 119214 3995 43806 29083 14246 477 18995497 18995497 22340100 22340100 33180610 25057997 8122613 6521947 5002986 1518961 State Provider Tax 13674298 13674298 Bad debts 74157494 74157494 Medical Supplies 178856500 178856500 Intercompany Allocations 29425089 29425089 13560971 13560971 0 0 873575525 722821884 150313430 440211 9440 9535 10919630 6924949 2257632 146648109 136810328 0 0 0 2000 15444528 15947194 2746474 2345816 658256715 135943610 425317655 522313105 20830863 17440967 118695133 122179058 0 392457305 711590085 1129076456 1541813350 126130027 207848161 10414892 2098906 0 2281248 1824497 589738656 972469583 728564823 1184241147 X 381587866 342765184 9997652 4848520 8926115 9958499 400511633 357572203 1129076456 1541813350 X -36383634 122725 1447969 -8126490 X false true X true true true X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED false true false false false true 54008 true 125333 false false 179341 false Schedule C, Part II-B, Line 1 DETAILED DESCRIPTION OF THE LOBBYING ACTIVITY THE PORTION OF ORGANIZATION DUES THAT ARE RELATED TO LOBBYING ARE AS FOLLOWS: AMERICAN HOSPITAL ASSOCIATION $11,302 CATHOLIC HEALTH ASSOCIATION $3,530 KENTUCKY HOSPITAL ASSOCIATION $39,176 ALLOCATED SALARY OF EMPLOYEES INVOLVED WITH ADVOCACY EFFORTS: $95,905 PAYMENTS TO ORGANIZATIONS FOR LOBBYING ASSISTANCE: CULL & HAYDEN - $21,802; MCCARTHY STRATEGIC SOLUTIONS - $7,626. 8926115 588974 443410 9958499 7651646 33216 1241253 8926115 7850412 73632 803398 1075796 7651646 7646829 17731 296477 110625 7850412 7542004 145533 158207 198915 7646829 0.0 1.0 0.0 false false 58624203 58624203 307232609 53273172 253959437 6725065 2399160 4325905 258551567 78602135 179949432 27123271 1669143 25454128 522313105 CHI OIP 122179058 F 122179058 Other assets 4366112 Investment in Unconsolidated Organizations 8299172 Intercompany Receivables 698924801 711590085 Pension Plan Liability 21250000 Intercompany payables 931215854 Other Liabilities 12234454 Minority Interest Deferred rent 7769275 972469583 X Schedule D, Part V, Line 4 Intended uses of endowment funds ENDOWED ASSETS ARE TO BE HELD IN PERPETUITY, THE INCOME FROM WHICH IS EXPENDABLE TO SUPPORT VARIOUS JHSMH PROGRAMS AS DESIGNATED BY THE DONOR. SIGNIFICANT PROGRAMS INCLUDE NURSING AND OTHER MEDICAL SCHOLARSHIPS AND RESEARCH PROGRAMS. Schedule D, Part X, Line 2 FIN 48 (ASC 740) footnote Jewish Hospital & St. Mary's Healthcare, Inc.'s financial information is included in the consolidated audited financial statements of Catholic Health Initiatives (CHI), a related organization. CHI's FIN 48 (ASC 740) footnote for the year ended June 30, 2015, reads as follows: "CHI is a tax-exempt Colorado corporation and has been granted an exemption from federal income tax under Section 501(c)(3) of the Internal Revenue Code. CHI owns certain taxable subsidiaries and engages in certain activities that are unrelated to its exempt purpose and therefore subject to income tax. Management reviews its tax positions annually and has determined that there are no material uncertain tax positions that require recognition in the accompanying consolidated financial statements." Sub-Saharan Africa Operational Support 254675 Equipment & Supplies Book 1 0 true false false false false false Circle of Care 389760 162757 227003 0 72536 5400 48413 Doctor's Ball 83275 59625 23650 304 13620 0 11383 2 58100 54875 3225 4150 11285 0 3665 531135 277257 253878 4454 97441 5400 63461 170756 83122 30572 29073 30572 29073 KY true false false false 1.0 jhsmh foundation 200 Abraham Flexner Way Louisville KY 40202 false CAROL WADE 0 MANAGEMENT X true 1499 Schedule G, Part III, Line 17 Distributions required under state law STATE=KENTUCKY,MANDATORY DISTRIBUTION AMOUNT=1499; true true X false false true true true false true true 7212 16509284 4094675 12414609 0.0155 149240365 127015126 22225239 0.0278 0 0 0 0.0 0 7212 165749649 131109801 34639848 0.0433 42 19118 1462900 1494 1461406 0.0018 7 1264 491163 0 491163 0.0006 0 0 0 0 0 0.0 1 0 744 0 744 0.0000 18 40291 466807 37541 429266 0.0005 68 60673 2421614 39035 2382579 0.0030 68 67885 168171263 131148836 37022427 0.0463 3 44 6589 0 6589 0.0000 0 0 0 0 0 0.0 2 550 1411 0 1411 0.0000 0 0 0 0 0 0.0 0 0 0 0 0 0.0 2 784 9742 0 9742 0.0000 1 0 3435 0 3435 0.0000 0 0 0 0 0 0.0 0 0 0 0 0 0.0 8 1378 21177 0 21177 0.0000 true 74157494 0 201155142 210856829 -9701687 X true true SCA PREM SURG CTR MANAGEMENT SERVICES 0.51 0.49 SURGERY CTR OF LOUI MANAGEMENT SERVICES 0.51 0.49 5 1 JEWISH HOSPITAL SHELBYVILLE www.kentuckyonehealth.org/jewish-hospital-shelbyville 100385 X X X A 2 FRAZIER REHABILITATION INSTITUE www.kentuckyonehealth.org/rehabilitationcarefrazier 100244 X X X A 3 STS MARY & ELIZABETH HOSPITAL www.kentuckyonehealth.org/st-mary-st-elizabeth-hospital 100254 X X X A 4 JEWISH HOSPITAL www.kyonehealth.org/jewishhospital 100215 X X X X X A 5 OUR LADY OF PEACE www.kentuckyonehealth.org/ourladyofpeace 100236 X X A A false false true X X X X X X X X X 12 true true true true X www.kentuckyonehealth.org/community-health-needs-assessment X true 13 true www.kentuckyonehealth.org/community-health-needs-assessment false false true X X X X X true true X X X true X http://www.kentuckyonehealth.org/financialassistance X http://www.kentuckyonehealth.org/financialassistance X X X true X false X X X X true X false false Schedule H, Part V, Section B, Line 5 Facility A, 1 Facility A, 1 - FACILITY REPORTING GROUP A. Jewish Hospital, Frazier Rehab Institute, Sts. Mary & Elizabeth Hospital & Our Lady of Peace: Four community forums were held in March 2012 at sites in each quadrant of Jefferson County. Members of the general public were asked to complete a survey on their perceptions of the city's health care needs. The survey was available in English and Spanish and covered a broad range of topics from access to health care to perception about the most pressing health care needs. After the forums, the same survey was made available online at the LMDPHW website from March 18 to June 1, again both in English and Spanish. A total of 1,871 individuals completed the survey with demographics that closely correspond to that of Jefferson County: 80 percent of respondents were white, 16 percent were African-American and the remainder were Asian, Native Hawaiian, Pacific Islander and American Indian, Alaskan Native or other. Three percent were ages 18-24, 18 percent were 25-34, 22 percent were 35-44, 28 percent were 45-54, 24 percent were 55-64 and 5 percent were age 65 or older. Respondents came from each of the city's zip codes, with most responses from southwest Louisville. A fifth forum was conducted by LMDPHW Director Dr. LaQuandra Nesbitt on March 29, 2012 at the Greater Louisville Medical Society tailored to gather input from community leaders, physicians and other health professionals. It was attended by 40 individuals representing a wide array of expertise including Bill Wagner, Executive Director of the Family Health Centers, Inc., Jay Davidson, Executive Director of The Healing Place, and leaders from an array of health and human service agencies that serve low-income and minority populations. Shelbyville Hospital: Jewish Hospital Shelbyville collaborated with the North Central District Health Department, Baptist Hospital Northeast and other community leaders to conduct the Community Health Needs Assessment. Members of the general public were asked to complete a survey on their perceptions of the community's health care needs. The survey was available in English and Spanish and covered a broad range of topics from access to health care to perception about the most pressing health care needs. Over 2,000 surveys were completed. The surveys were distributed online and through paper surveys, made available in both English and Spanish. A forum was conducted by NCDHD on August 23, 2012, tailored to gather input from community leaders and health professionals. It was attended by 30 individuals representing a wide array of expertise. Schedule H, Part V, Section B, Line 6a Facility A, 1 Facility A, 1 - FACILITY REPORTING GROUP A. Jewish Hospital, Frazier Rehab Institute, Sts. Mary & Elizabeth Hospital & Our Lady of Peace: Baptist Hospital East Norton Healthcare University of Louisville Hospital Shelbyville Hospital: Baptist Hospital Northeast Schedule H, Part V, Section B, Line 6b Facility A, 1 Facility A, 1 - Facility Reporting Group A. the Louisville Metro Department of Public Health and Wellness (LMDPHW), the Kentucky Hospital Association. Schedule H, Part V, Section B, Line 11 Facility A, 1 Facility A, 1 - Facility Reporting Group A. Jewish Hospital & St. Mary's Healthcare includes five hospitals, each of which prepared its own community health needs assessment and adopted an implementation plan to address the needs identified. Additional details on the approach taken by the individual hospitals are available in the implementation strategies posted to the website. In general, Tobacco Control and Prevention, Healthy Eating and Active Living, and Access to Services (Addressing Health Disparities) were the most significant needs identified. To address the Tobacco Control and Prevention need, the organization is working to enhance community education about the risks of smoking to promote early identification and intervention and ultimately improve outcomes and survival rates. To address the Health Eating and Active Living need, the organization is working to improve opportunities to participate in physical activities for residents, increasing community knowledge of the risks of obesity, and promoting access to good nutrition and exercise programs. To address the Access to Services need, the organization is working to increase access to services for underserved communities, improve the health status of patients with diabetes, and enhance community education about identification and intervention for cancer to improve outcomes and survival rates. Needs Not Addressed are presented below by hospital JEWISH HOSPITAL ---------------- MENTAL OR EMOTIONAL HEALTH, ADDICTION/SUBSTANCE ABUSE AND EXCESSIVE DRINKING: JEWISH HOSPITAL HAS ADOPTED NUMEROUS STRATEGIES IN THIS PLAN TO INTEGRATE MENTAL HEALTH AND SUBSTANCE USE DISORDERS WITH PHYSICAL HEALTH. WITHIN KENTUCKYONE HEALTH, THE PRIMARY RESOURCE FOR THIS AREA OF FOCUS IS OUR LADY OF PEACE WHICH HAS DEVELOPED AN IMPLEMENTATION PLAN TO ADDRESS THESE NEEDS COMPREHENSIVELY. IN ADDITION, SEVEN COUNTIES SERVICES, THE AREA'S COMMUNITY MENTAL HEALTH SERVICE, HAS THE EXPERTISE AND RESOURCES TO FOCUS IN THESE AREAS. FRAZIER REHAB INSITUTE: ----------------------- CHRONIC LOWER RESPIRATORY DISEASE INCREASED HEART DISEASE/STROKE AMONG AFRICAN AMERICANS: WHILE THIS PLAN DOES INCLUDE SOME INITIATIVES THAT ADDRESS COPD AND HEART DISEASE, THERE ARE MANY OTHER AREA ORGANIZATIONS PROVIDING RESOURCES TO SUPPORT EDUCATION, SUPPORT AND TREATMENT IN THIS AREA OF THESE ILLNESSES. THE MAYOR'S HEALTHY HOMETOWN MOVEMENT HAS MADE SMOKING CESSATION A PILLAR PRIORITY AND IS OFFERING FREE CLASSES AT LOCATIONS THROUGHOUT THE COMMUNITY YEAR-ROUND. IN ADDITION, THERE ARE NUMEROUS COMMUNITY SUPPORT GROUPS FOR PEOPLE WITH HEART DISEASE AND COPD AT MANY HOSPITALS AND OTHER FREE RESOURCES OFFERED THROUGH THE LOCAL CHAPTER OF THE AMERICAN HEART ASSOCIATION AND AMERICAN LUNG ASSOCIATION. CANCER: AS A REHABILITATION HOSPITAL, CANCER CARE IS NOT A PRIMARY AREA OF EMPHASIS OR EXPERTISE OF FRAZIER REHAB INSTITUTE. THERE ARE MANY PROVIDERS IN THE COMMUNITY ALREADY EFFECTIVELY ADDRESSING COMPREHENSIVE CANCER CARE INCLUDING THE JAMES GRAHAM BROWN CANCER CENTER, JEWISH HOSPITAL, AND NORTON HEALTHCARE. STS. MARY & ELIZABETH HOSPITAL -------------------------------- MENTAL OR EMOTIONAL HEALTH ADDICTION/SUBSTANCE ABUSE: STS. MARY & ELIZABETH HOSPITAL HAS ADOPTED NUMEROUS STRATEGIES IN THIS PLAN TO INTEGRATE MENTAL HEALTH AND SUBSTANCE USE DISORDERS WITH PHYSICAL HEALTH. WITHIN KENTUCKYONE HEALTH, THE PRIMARY RESOURCE FOR THIS AREA OF FOCUS IS OUR LADY OF PEACE WHICH HAS DEVELOPED AN IMPLEMENTATION PLAN TO ADDRESS THESE NEEDS COMPREHENSIVELY. IN ADDITION, SEVEN COUNTIES SERVICES, THE AREA'S COMMUNITY MENTAL HEALTH SERVICE, HAS THE EXPERTISE AND RESOURCES TO FOCUS IN THESE AREAS. OUR LADY OF PEACE ----------------------- COST OF MEDICATION: THERE ARE NUMEROUS COMMUNITY RESOURCES FOR FREE AND REDUCED-PRICE PRESCRIPTIONS WHICH ARE COMMUNICATED TO PATIENTS THROUGH CARE MANAGEMENT STAFF. THESE INCLUDE: - MEIJER PHARMACY COVERS LEADING, ORAL GENERIC ANTIBIOTICS WITH A SPECIAL FOCUS ON THE PRESCRIPTIONS MOST OFTEN FILLED FOR CHILDREN. - $4 PRESCRIPTIONS AT WALMART, TARGET AND KROGER - KENTUCKY PRESCRIPTION ASSISTANCE PROGRAM (KPAP) 1-800-633-8100 WHICH PROVIDES PUBLIC ACCESS TO PRESCRIPTION DRUG PROGRAMS OFFERED BY DRUG MANUFACTURERS, DISCOUNT DRUG PROGRAMS AND DISCOUNT PHARMACY PROGRAMS FOR QUALIFYING INDIVIDUALS AND/OR FAMILIES (INDIVIDUALS AT OR BELOW THE FEDERAL POVERTY LEVEL OR SENIOR CITIZENS IN THE MEDICARE DOUGHNUT HOLE MAY BE ELIGIBLE.) THOSE INELIGIBLE RECEIVE CONSULTATION ABOUT OTHER SOURCES OF LOW-COST PRESCRIPTIONS. - FAMILY HEALTH CENTERS AND PUBLIC HEALTH CENTERS - KENTUCKY PHYSICIANS CARE (KPC) 1-800-633-8100 - MEDICARE D DRUG PLAN - 1-800-633-4227 - SENIOR MEDICAL PATROL - 502-574-6960 (ASSIST WITH MEDICARE D) STROKE: EXTENSIVE STROKE SCREENING, TREATMENT, AND SUPPORT ARE PROVIDED BY MANY AREA HEALTH CARE PROVIDERS INCLUDING JEWISH HOSPITAL AND UNIVERSITY OF LOUISVILLE HOSPITAL RESPIRATORY ILLNESS: THERE ARE MANY OTHER AREA ORGANIZATIONS PROVIDING RESOURCES TO SUPPORT EDUCATION, SUPPORT AND TREATMENT IN THE AREA OF RESPIRATORY ILLNESS. THE MAYOR'S HEALTHY HOMETOWN MOVEMENT HAS MADE SMOKING CESSATION A PILLAR PRIORITY AND IS OFFERING FREE CLASSES AT LOCATIONS THROUGHOUT THE COMMUNITY YEAR-ROUND. THE HEALTH DEPARTMENT IS ALSO SPEARHEADING EXTENSIVE RESEARCH ON ASTHMA, TO INCLUDE A PROJECT CALLED "ASTHMAOLOGY" WHICH IS DOCUMENTING WHERE CHILDREN ARE EXPERIENCING ASTHMA ATTACKS. IN ADDITION, THERE ARE NUMEROUS COMMUNITY SUPPORT GROUPS FOR PEOPLE WITH COPD AT MANY HOSPITALS AND OTHER FREE RESOURCES OFFERED THROUGH THE LOCAL CHAPTER OF THE AMERICAN LUNG ASSOCIATION. SHELBYVILLE HOSPITAL ------------------- MENTAL OR EMOTIONAL HEALTH ADDICTION/SUBSTANCE ABUSE: JEWISH HOSPITAL SHELBYVILLE HAS ADOPTED NUMEROUS STRATEGIES IN THIS PLAN TO INTEGRATE MENTAL HEALTH AND SUBSTANCE USE DISORDERS WITH PHYSICAL HEALTH. WITHIN KENTUCKYONE HEALTH, THE PRIMARY RESOURCE FOR THIS AREA OF FOCUS IS OUR LADY OF PEACE WHICH HAS DEVELOPED AN IMPLEMENTATION PLAN TO ADDRESS THESE NEEDS COMPREHENSIVELY. IN ADDITION, SEVEN COUNTIES SERVICES, THE AREA'S COMMUNITY MENTAL HEALTH SERVICE, HAS THE EXPERTISE AND RESOURCES TO FOCUS IN THESE AREAS. Schedule H, Part V, Section B, Line 13 Facility A, 1 Facility A, 1 - Facility Reporting Group A. HUD low income guidelines used. 0 SPRINGHURST CORF - OUTPATIENT REHAB 4801 OLYMPIA PARK PLAZA 1600 LOUISVILLE KY 40241 OUTPATIENT REHAB FACILITY SOUTHWEST ORF - OUTPATIENT REHAB 6801 DIXIE HIGHWAY STE 129 LOUISVILLE KY 40258 OUTPATIENT REHAB FACILITY NORTHEAST OUTPATIENT REHAB 2401 TERRA CROSSING BLVD STE 204 LOUISVILLE KY 40245 OUTPATIENT REHAB FACILITY FERN VALLEY ORF AND OPS MEDICINE CENTER 100 HIGH RISE DRIVE STE 110 LOUISVILLE KY 40213 OUTPATIENT REHAB FACILITY MEDICAL PLAZA - DOCTORS OFFICE BUILDING 100 EAST LIBERTY STREET LOUISVILLE KY 40202 DOCTOR OFFICES JEWISH HOSPITAL MEDICAL CENTER SOUTH 1903 WEST HEBRON LANE SHEPHERDSVILLE KY 40165 AMBULATORY CARE CENTER EMERGENCY ROOM EAST CORF OUTPATIENT REHAB 4912 US HIGHWAY 42 LOUISVILLE KY 40222 OUTPATIENT REHAB FACILITY ST MARYS SURGICAL CENTER 4414 CHURCHMAN AVENUE LOUISVILLE KY 40215 OUTPATIENT SURGERY NEWBURG CORF - OUTPATIENT REHAB 3430 NEWBURG ROAD STE 111 LOUISVILLE KY 40218 OUTPATIENT REHAB FACILITY U OF L SPORT MEDICINE - OUPATIENT REHAB 201 ABRAHAM FLEXNER WAY STE 102 LOUISVILLE KY 40202 OUPATIENT REHAB FACILITY BULLITT COUNTY ORF - OUTPATIENT REHAB 1905 WEST HEBRON LANE SHEPHARDSVILLE KY 40165 OUTPATIENT REHAB FACILITY SOUTHERN INDIANA ORF - OUTPATIENT REHAB 2201 GREENTREE BOULEVARD NORTH CLARKSVILLE IN 47129 OUPATIENT REHAB FACILITY JEWISH HOSPITAL MEDICAL CENTER EAST 3920 DUTCHMANS LANE LOUISVILLE KY 40207 AMBULATORY CARE CENTER EMERGENCY ROOM CROSSROADS SOUTH 4606 HAZELWOOD AVE LOUISVILLE KY 40215 MENTAL HEALTH COUNSELING CTR MRI BUILDING 221 EAST CHESTNUT LOUISVILLE KY 40202 MRI CENTER ST MARYS & ELIZABETH HOSPITAL 4402 CHURCHMAN AVE STE 106 LOUISVILLE KY 40215 OUTPATIENT REHAB FACILITY OUTPATIENT CARE CENTER 225 ABRAHAM FLEXNER WAY LOUISVILLE KY 40202 AMBULATORY CARE CENTER DOCTOR OFFICES SOUTHWEST AMBULATORY CARE CENTER 9700 STONESTREET ROAD LOUISVILLE KY 40272 DIAGNOSTIC IMAGING AMBULATORY CARE EMERGENCY ROOM RUDD HEART AND LUNG CENTER 201 ABRAHAM FLEXNER WAY LOUISVILLE KY 40202 DOCTOR OFFICES/SUITES CATH LAB CORYDON CORF - OUTPATIENT REHAB 313 FEDERAL DRIVE NORTHWEST CORYDON KY 47112 OUTPATIENT REHAB FACILITY OWSLEY BROWN FRAZIER SPORTS MEDICINE 215 CENTRAL AVENUE STE 200 LOUISVILLE KY 40208 OUTPATIENT REHAB FACILITY JEWISH HOSPITAL HEALTH CENTER - MEADE CO 534 FAIRWAY DRIVE BRADENBURG KY 40108 DOCTOR OFFICE OPEN MRI & PT SCAN (SKYCARE) 200 EAST LIBERTY STREET LOUISVILLE KY 40202 MRI CENTER MOBILE PET MEADE COUNTY ORF - OUTPATIENT REHAB 534 HILLCREST DRIVE BRANDBURG KY 40108 OUTPATIENT REHAB FACILITY STONESTREET ORF - OUPATIENT REHAB 9700 STONESTREET ROAD LOUISVILLE KY 40272 OUTPATIENT REHAB FACILITY SOUTHERN INDIANA YMCA CORF 4812 HAMBURG PIKE JEFFERSONVILLE IN 47130 OUTPATIENT REHAB FACILITY MEDICAL CENTER EAST ORF - OUTPTNT REHAB 3920 DUTCHMANS LANE LOUISVILLE KY 40207 OUTPATIENT REHAB FACILITY VNA NAZARETH HOME CARE 5000 COMMERCE CROSSING DR STE 100A LOUISVILLE KY 40229 HOME INFUSION JEWISH HOSPITAL NORTHEAST 2401 TERRA CROSSING BLVD LOUISVILLE KY 40245 AMBULATORY CARE CENTER EMERGENCY ROOM CANCER BLOOD SPECIALIST 1460 BLUEGRASS AVE LOUISVILLE KY 40215 OUTPATIENT CANCER CARE MEDICAL PLAZA II 250 E LIBERTY ST LOUISVILLE KY 40202 Doctors offices; corporate offices Schedule H, Part VI Lines 2, 4 & 5 - Needs Assessment and Community Information Organization's Mission, Vision, and Tax-Exempt Purpose KentuckyOne Health, the largest and most comprehensive health system in the Commonwealth, has more than 200 locations including hospitals, physician groups, clinics, primary care centers, specialty institutes and home health agencies in Kentucky and southern Indiana. KentuckyOne Health is dedicated to bringing wellness, healing and hope to all, including the underserved. The system is made up of the former Jewish Hospital & St. Mary's HealthCare and Saint Joseph Health System, along with the University of Louisville Hospital and James Graham Brown Cancer Center. KentuckyOne Health is proud of and strengthened by its Catholic, Jewish and academic heritages. KentuckyOne Health was formed when two major Kentucky health care organizations came together in early 2012. KentuckyOne Health combines the Jewish and Catholic heritages of the two former systems- Jewish Hospital & St. Mary's HealthCare and Saint Joseph Health System. In late 2012, the organization formed a partnership with the University of Louisville Hospital | James Graham Brown Cancer Center. The nonprofit system is committed to improving the health of Kentuckians by integrating medical research, education, technology and health care services wherever patients receive care. An 18-member volunteer Board of Directors governs KentuckyOne health, its facilities and operations, with this mission: to bring wellness, healing, and hope to all. Our vision is to: * serve with a spirit of innovation and collaboration * transform health care delivery * partner to create healthy communities * advocate for a just health system Jewish Hospital, Jewish Hospital Shelbyville, and Sts. Mary and Elizabeth Hospital all operate 24-hour emergency rooms 365 days per year. All three emergency rooms are open to all individuals regardless of ability to pay. All facilities have an open medical staff, participate in Medicare and Medicaid, and have an active charity care program. The other two facilities considered part of JHSMH include Our Lady of Peace and Frazier Rehabilitation Institute. Community Benefit Approach Geographic Area Louisville is a major city-the largest in the state of Kentucky and the county seat of Jefferson County. As of 2010, the Louisville metropolitan area (MSA) had a population of 1,307,647 ranking it 42nd in size nationally. The metro area includes Louisville-Jefferson County and 12 surrounding counties, eight in Kentucky and four in Southern Indiana. Louisville is southeasterly situated along the border between Kentucky and Indiana, the Ohio River, in north-central Kentucky at the Falls of the Ohio. The Louisville metropolitan area is often referred to as Kentuckiana because it includes counties in Southern Indiana. A community is defined as the geographic area from which a significant number of the patients utilizing hospital services reside. While the community health needs assessment considers other types of healthcare providers, hospitals are the single largest provider of acute care services. For this reason, the utilization of hospital services provides the clearest definition of the community. The four Louisville hospitals define its service area for this community health needs assessment based on where the majority of its inpatients reside. Based on the patient origin of inpatient discharges from July 1, 2011 to June 30, 2012, management has identified the community as Jefferson, Bullitt, Nelson and Shelby Counties. We collaborated with the Louisville Metro Department of Public Health & Wellness in conducting the Louisville/Jefferson County community health needs assessment. Bullitt, Nelson, and Shelby Counties are served by Jewish Hospital Medical Center South, Jewish Hospital Shelbyville and Flaget Memorial Hospital, respectively. Jewish Hospital Shelbyville conducted their own community health needs assessments in conjunction with the North Central District Health Department and with input from area residents. Shelby County is located on Interstate 64 between Louisville and Lexington. Shelbyville is the largest city and county seat of Shelby County with population of just over 42,000. Because the community is 30 minutes from downtown Louisville, the county is considered part of Metro Louisville MSA. Besides Jefferson County, Shelby County is surrounded by Henry, Franklin, Anderson, Spencer and Oldham counties. Jewish Hospital Shelbyville defines its service area for this community health needs assessment based on where the majority of its inpatients reside. Based on the patient origin of inpatient discharges from January to December 30, 2011, management has identified almost 80 percent of Jewish Hospital Shelbyville's discharges originate in Shelby County. The North Central District Health Department, collaborating partner for Jewish Hospital Shelbyville's community health needs assessment, also serves populations in Henry and Spencer counties and plans are in place to expand the survey and needs assessment to those counties as soon as the Shelby County plan is complete. Jewish Hospital Shelbyville receives approximately 10% of admissions from both Spencer and Henry counties. They are considered to be a part of the hospital's primary service area. Demographics of Constituents in Community Served According to the 2010 census, 26% of the community is between the ages of 35 and 54 and 20% of the population is between 0-14 years old. The ethnicity breakdown is 68% white, 23% black, and 5% Hispanic. In total, the population breakdown for the community shows a higher percentage of black residents compared to the state of Kentucky and the United States. A review of specific zip code areas shows a relatively large percentage of black residents in several zip codes representing the highest discharges from Jewish Hospital. Median household incomes range from $25,000-$50,000. The average annual resident unemployment rates for counties in Jewish Hospital's defined community have risen in recent years. These counties have rates are similar to Kentucky's state average, which is slightly less favorable than national averages. In Jefferson County, residents obtain a bachelor's degree or higher at rates greater than state and national averages; in Bullitt County the rate is just 11.1percent, about half the state average. Schedule H, Part VI Lines 2, 4 & 5 - Needs Assessment and Community Information The overall population is projected to increase slightly over a five-year period from 577, 204 in 2013 to 595,540, a 3.2 percent increase. However, the people who utilize health care services the most, those ages 65 years and over, are projected to increase 16.7 percent, from 77,983 to 91,003. The projected change to the composition of the total community of males and females is projected to remain approximately the same over the five-year period. For the community served by Jewish Hospital Shelbyville, household incomes range from $42,506 to $61,921. Henry County has the highest level of population in poverty at 18.5%, which is just below the state percentage of 18.98. Community Benefit Process During 2012, a community health needs assessment (CHNA) was conducted to support the mission of enhancing the health of people in the communities served, to comply with the Patient Protection and Affordable Care Act of 2010 and federal tax-exemption requirements, and to identify health needs of the community to help prioritize the allocation of hospital resources to meet those needs. Based on current literature and other guidance from the Treasury and IRS, the following steps were completed as part of the community health needs assessment: 1. The "community" served was defined utilizing inpatient data on patient origin. 2. Population demographics and socioeconomic characteristics of the community were gathered and reported using various sources. The health status of the community was then reviewed. Information on the leading causes of death and morbidity was analyzed in conjunction with health outcomes and factors reported for the community by CountyHealthrankings.org. Health factors with significant opportunity for improvement were noted. 3. An inventory of health care facilities and resources was prepared. 4. Through a collaborative process conducted by the Louisville Metro Department of Public Health & Wellness(LMDPHW), the Kentucky Hospital Association and Louisville area hospitals, community input was obtained through a series of four public forums held across the county, and an additional forum for community leaders and medical professionals, and through an online survey. Information gathered in the steps above was analyzed and reviewed to identify health issues of uninsured persons, low-income persons, minority groups and the community as a whole. Health needs were prioritized utilizing a method that weighs: 1) the size of the problem; 2) the seriousness of the problem; 3) the impact of the problem on vulnerable populations; 4) how important the problem is to the community; 5) prevalence of common themes; 6) how closely the need aligns with the strategies and strengths of the hospital and KentuckyOne Health; and 7) an evaluation of existing hospital programs responding to the identified need. Information gaps were identified during the prioritization process and reported. Jewish Hospital Shelbyville has identified community health needs by undergoing an assessment process in collaboration with other community health partners. More than 1,800 residents provided input through a survey (paper and online, English and Spanish). Another 25 community leaders and health professionals shared their expertise at a special community forum. In addition, secondary data was compiled from demographic and socioeconomic sources as well as national, state and local sources of information on disease prevalence, health indicators, health equity and mortality. From a compilation of information, Jewish Hospital Shelbyville leaders entered into a dialogue with other key community partners to discuss the results of the evaluation/health priorities and consensus was reached. The process identified the issues with scores of 14 or more (on a scale of 28). With an understanding that collaborative efforts have the greatest opportunity for measurable, collective impact, Jewish Hospital Shelbyville has worked in partnership with the local North Central District Health Department through the implementation of the community's MAPP (Mobilizing for Action through Planning and Partnerships) assessment and plan. In addition, the hospital is partnering with the Kentuckiana Regional Planning & Development Agency (KIPDA) and the University of Louisville Kent School Of Social Work through their CDC funded Rural Diabetes Coalition grant. Summary of Assessment Findings After the CHNA was completed, the aforementioned facilities entered into a dialogue with other key community partners, including the LMDPHW, to discuss the results of the evaluation and select health priorities. Participants were given the opportunity to revise rankings and debate issues until a consensus was reached on a composite ranking of health issues. The process identified the following issues with scores of 14 or more (on a scale of 28): * stroke/cerebrovascular disease * chronic diseases in vulnerable neighborhoods/populations * chronic lower respiratory disease (COPD) * cancer * adult obesity * heart disease * physical inactivity * access to care * brain disorders (mental/emotional health) * violent crime * limited access to healthy foods * addiction/substance abuse * adult smoking * limited health knowledge and education * need for improved communication of available services * uninsured * Children in poverty These needs were then mapped to the health improvement efforts of the Mayor's Healthy Hometown Movement in order to increase collaborative efforts to have the greatest opportunity for measurable, collective impact. Community Benefit Process for the Future In accordance with the Patient Protection and Affordable Care Act of 2010 and in order to honor its commitment to the community, KentuckyOne Health is repeating this coordinated approach with the Louisville Metro Department of Public Health and Wellness and other area hospital systems to survey the community as part of the community health needs assessment for 2015. A report due in 2016 will capture these current community sentiments and guide community benefit work in FY2017-2019 through an implementation strategy. This implementation strategy will build upon the previous CHNA published in 2013 that guided community benefit work in FY2014-2016. Qualitative Description of Community Benefit These hospitals promote the community's health by responding to the four major pillars of community benefit activities: improving access, enhancing community health, advancing medical knowledge, and reducing government burden of care. Schedule H, Part VI Lines 2, 4 & 5 - Needs Assessment and Community Information Community Outreach for the Poor They provide additional access to health care services in underserved areas of Jefferson County. The hospitals also works to enhance the health of the community through violence prevention interventions, health fairs in underserved areas, and community collaboration with other nonprofits to address the issues around hospital super-utilizers, among other initiatives. Community Outreach for the Broader Community Most community outreach is open to the public, which serves the broader community. One initiative that simultaneously improves access to healthcare and promotes health living is Walk with a Doc, which is free, open to the public, and held in three separate geographic locations in the Louisville market. KentuckyOne Health completely absorbs the cost of this program, including fees and allocating staff time in order to provide this benefit to the whole community. Health Professions Education As teaching hospitals, they work to advance medical knowledge for many different specializations of health professionals. In FY2014, this included, but was not limited to, providing education to: medical students, physician residents and fellows, nursing students, pharmacy residents, mental health professionals, physical and occupational therapists, and laboratory technicians. This was done in collaboration with the University of Louisville, the University of Kentucky, Spalding University, Galen College of Nursing, Bellarmine University, and Jefferson Community and Technical College, among others. Community Building Activities The hospitals also work to enhance the health of the community through violence prevention interventions, health fairs in underserved areas, and community collaboration with other nonprofits to address the issues around hospital super-utilizers, among other initiatives. All hospitals also donate supplies to Supplies Overseas. Collaborating partners for community building activities include, but are not limited to: Jefferson County Public Schools, Louisville Metro government, Food Literacy Project, Walk with a Doc, University of Louisville, PACT in Action, and the Center for Women and Families, among others. List of Services Jewish Hospital * 24/7 emergency care * Cancer care * Clinical Lab * Critical Care * Diagnostic Imaging * General Surgery * Endoscopy * Hand and microsurgery * Heart care * Home care * Minimally invasive surgery * Neurology care * Orthopedic care * Palliative care * Pharmacy * Podiatry care * Rehabilitation care-Frazier Rehab * Sleep care * Sports medicine * Transplant care * Vascular care * Women's care * Wound care Jewish Hospital Shelbyville * 24/7 Emergency Care * Critical Care * Diagnostic Imaging * Cardiac & Pulmonary Rehabilitation * General Surgery, including Laser and Laparoscopy * Endoscopy * Gastroenterology * Comprehensive Gynecology * Orthopedic Care * Pain Management * Sleep Medicine * Wound Healing Center * Frazier Rehab Institute (Physical, Occupational & Speech Therapies) * Occupational Medicine * Clinical Laboratory and Pharmacy Our Lady of Peace * Mental Health Services for patients with emotional/behavioral, psychiatric disorders and/or chemical dependencies * Short-term acute/semi-acute inpatient care programs * Treatment alternatives such as partial hospitalization and intensive outpatient programs for children, adolescents and adults Frazier Rehabilitation Institute * Acute Care Rehab * Adaptive Sports Program * ALS Clinic * Amputee Rehab Program * Animal Assisted Therapy * Aquatic Therapy * Assistive Technology * Brain Injury Program * Community and Work Re-Entry * Community Based Rehab * Community Fitness and Wellness Facility * Driver's Education and Training Program * Frazier Water Protocol * Human Locomotion Research Center * Movement Disorders/Parkinson Disease Program * Neuropsychology/Psychology Services * NeuroRecovery Network * NeuroRehab Program * Neuroscience Collaborative Center * Pediatric Rehab Program * Pulmonary Rehab Program * Spinal Cord Medicine Program * Sports Medicine Program * Stroke Rehab Program * Women's Health - Pelvic Floor Therapy Schedule H, Part I, Line 3c Eligibility criteria for free or discounted care When Catholic Health Initiatives (the ultimate parent organization to Jewish Hospital & St Mary's Healthcare) established its financial assistance policy it was determined that establishing a household income scale based on the HUD very low income guidelines more accurately reflects the socioeconomic dispersions among urban and rural communities in 18 states served by CHI hospitals and health care facilities. In comparing HUD guidelines to the Federal Poverty Guidelines (FPG), we find that on average HUD guidelines compute to approximately 200% to 250% (and sometimes 300%) of FPG. Jewish Hospital & St Mary's Healthcare bases its financial assistance eligibility on HUD's 130% of Very Low Income Guidelines based on geography, and affords the uninsured and underinsured the ability to obtain financial assistance write-offs, based on a sliding scale, ranging from 25%-100% of charges. An individual's income under the HUD guidelines is a significant factor in determining eligibility for financial assistance. However, in determining whether to extend discounted or free care to a patient, the patient's assets may also be taken into consideration. For example, a patient suffering a catastrophic illness may have a reasonable level of income, but a low level of liquid assets such that the payment of medical bills would be seriously detrimental to the patient's basic financial (and ultimately physical) well-being and survival. Such a patient may be extended discounted or free care based upon the facts and circumstances. Schedule H, Part I, Line 6a Community benefit report prepared by related organization KentuckyOne Health, Inc. Schedule H, Part I, Line 7g Subsidized Health Services There are no physician clinics included in subsidized health services. Schedule H, Part I, Line 7 Bad Debt Expense excluded from financial assistance calculation 74157494 Schedule H, Part I, Line 7 Costing Methodology used to calculate financial assistance The cost-to-charge ratio for the year ended 6/30/15 was computed using the following formula: Operating expense (before restructuring, impairment and other losses) divided by gross patient revenue. Based on that formula, $627,609,325/$2,733,069,910 results in a 22.9635% cost-to-charge ratio. Worksheet 2 was not used to derive the cost-to-charge ratio. Schedule H, Part III, Line 2 Bad debt expense - methodology used to estimate amount Costing methodology for amounts reported on line 2 is determined using the organization's cost/charge ratio of 22.96%. When discounts are extended to self-pay patients, these patient account discounts are recorded as a reduction in revenue, not as bad debt expense. Schedule H, Part III, Line 3 Bad Debt Expense Methodology Jewish Hospital & St. Mary's Healthcare does not believe that any portion of bad debt expense could reasonably be attributed to patients who qualify for financial assistance since amounts due from those individuals' accounts will be reclassified from bad debt expense to charity care within 30 days following the date that the patient is determined to qualify for charity care. Schedule H, Part III, Line 4 Bad debt expense - financial statement footnote Jewish Hospital & St. Mary's Healthcare does not issue separate company audited financial statements. However, the organization is included in the consolidated financial statements of Catholic Health Initiatives. The consolidated footnote reads as follows: "The provision for bad debts is based upon management's assessment of historical and expected net collections, taking into consideration historical business and economic conditions, trends in health care coverage, and other collection indicators. Management routinely assesses the adequacy of the allowance for uncollectible accounts based upon historical write-off experience by payor category. The results of these reviews are used to modify, as necessary, the provision for bad debts and to establish appropriate allowances for uncollectible net patient accounts receivable. After satisfaction of amounts due from insurance, CHI follows established guidelines for placing certain balances with collection agencies, subject to the terms of certain restrictions on collection efforts as determined by each facility. The provision for bad debts is presented on the consolidated statements of operations as a deduction from patient services revenues (net of contractual allowances and discounts) since CHI accepts and treats substantially all patients without regard to the ability to pay." Schedule H, Part III, Line 8 Community benefit & methodology for determining medicare costs Using essentially the same Medicare cost report principles as to the allocation of general services costs and "apportionment" methods, the "CHI Workbook" calculates a payers' gross allowable costs by service (so as to facilitate a corresponding comparison between gross allowable costs and ultimate payments received). The term "gross allowable costs" means costs before any deductibles or co-insurance are subtracted. Jewish Hospital & St. Mary's Healthcare's ultimate reimbursement will be reduced by any applicable copayment/ deductible. Where Medicare is the secondary insurer, amounts due from the insured's primary payer were not subtracted from Medicare allowable costs because the amounts are typically immaterial. Although not presented on the Medicare cost report, in order to facilitate a more accurate understanding of the "true" cost of services (for "shortfall" purposes) the CHI Workbook allows a health care facility not to offset costs that Medicare considers to be non-allowable, but for which the facility can legitimately argue are related to the care of the facility's patients. In addition, although not reportable on the Medicare cost report, the CHI workbook includes the cost of services that are paid via a set fee-schedule rather than being reimbursed based on costs (e.g. outpatient clinical laboratory). Finally, the CHI Workbook allows a facility to include other health care services performed by a separate facility (such as a physician practice) that are maintained on separate books and records (as opposed to the main facility's books and records which has its costs of service included within a cost report). True costs of Medicare computed using this methodology: Total Medicare Revenue: $201,155,142 Total Medicare costs: $210,856,829 Surplus or Shortfall ($9,701,687) Jewish Hospital & St. Mary's Healthcare believes that excluding Medicare losses from community benefit makes the overall community benefit report more credible for these reasons: Unlike subsidized areas such as burn units or behavioral-health services, Medicare is not a differentiating feature of tax-exempt health care organizations. In fact, for-profit hospitals focus on attracting patients with Medicare coverage, especially in the case of well-paid services that include cardiac and orthopedics. Significant effort and resources are devoted to ensuring that hospitals are reimbursed appropriately by the Medicare program. The Medicare Payment Advisory Commission (MedPAC), an independent Congressional agency, carefully studies Medicare payment and the access to care that Medicare beneficiaries receive. The commission recommends payment adjustments to Congress accordingly. Though Medicare losses are not included by Catholic hospitals as community benefit, the Catholic Health Association guidelines allow hospitals to count as community benefit some programs that specifically serve the Medicare population. For instance, if hospitals operate programs for patients with Medicare benefits that respond to identified community needs, generate losses for the hospital, and meet other criteria, these programs can be included in the CHA framework in Category C as "subsidized health services." Medicare losses are different from Medicaid losses, which are counted in the CHA community benefit framework, because Medicaid reimbursements generally do not receive the level of attention paid to Medicare reimbursement. Medicaid payment is largely driven by what states can afford to pay, and is typically substantially less than what Medicare pays. Schedule H, Part III, Line 9b Collection practices for patients eligible for financial assistance Jewish Hospital & St. Mary's Healthcare's debt collection policy provides that Jewish Hospital & St. Mary's Healthcare will perform a reasonable review of each inpatient account prior to turning an account over to a third-party collection agent and prior to instituting any legal action for non-payment, to assure that the patient and patient guarantor are not eligible for any assistance program (e.g. Medicaid) and do not qualify for coverage through Jewish Hospital & St. Mary's Healthcare community assistance policy. After having been turned over to a third-party collection agent, any patient account that is subsequently determined to meet the Jewish Hospital & St. Mary's Healthcare community assistance policy is required to be returned immediately by the third-party collection agent to Jewish Hospital & St. Mary's Healthcare for appropriate follow-up. Jewish Hospital & St. Mary's Healthcare requires its third-party collection agents to include a message on all statements indicating that if a patient or patient guarantor meets certain stipulated income requirements, the patient or patient guarantor may be eligible for financial assistance. All of Catholic Health Initiatives' hospitals' contracts with third party collection agencies include the following standards: * Neither CHI hospitals nor their collection agencies will request bench or arrest warrants as a result of non-payment; * Neither CHI hospitals nor their collection agencies will seek liens that would require the sale or foreclosure of a primary residence; and * No Catholic Health Initiatives' collection agency may seek court action without hospital approval. Finally, collection agencies are trained on the Catholic Health Initiatives Mission, Core Values and Standard of Conduct to make sure all patients are treated with dignity and respect. Schedule H, Part V, Section B, Line 16a FAP website A - JEWISH HOSPITAL: Line 16a URL: http://www.kentuckyonehealth.org/financialassistance; Schedule H, Part V, Section B, Line 16b FAP Application website A - JEWISH HOSPITAL: Line 16b URL: http://www.kentuckyonehealth.org/financialassistance; Schedule H, Part VI, Line 3 Patient education of eligibility for assistance JEWISH HOSPITAL & ST. MARY'S HEALTHCARE includes information concerning its financial assistance policy on its website. In addition, JEWISH HOSPITAL & ST. MARY'S HEALTHCARE prominently displays its financial assistance policy in both English and Spanish in obvious locations throughout the hospitals, including the emergency rooms and other patient intake areas, as well as in JEWISH HOSPITAL & ST. MARY'S HEALTHCARE's outpatient facilities. In addition, JEWISH HOSPITAL & ST. MARY'S HEALTHCARE registration clerks are trained to provide consultation to those who have no insurance or potentially inadequate insurance concerning their financial options including application for Medicaid and for financial assistance under JEWISH HOSPITAL & ST. MARY'S HEALTHCARE's financial assistance policy. Upon registration (and once all EMTALA requirements are met), patients who are identified as uninsured (and not covered by Medicare or Medicaid) are provided with a packet of information that addresses the financial assistance policy and procedures including an application for assistance. JEWISH HOSPITAL & ST. MARY'S HEALTHCARE registration clerks read the organization's medical assistance policy to those who appear to be incapable of reading, and provide translators for non-English-speaking individuals. JEWISH HOSPITAL & ST. MARY'S HEALTHCARE's staff will also assist the patient/guarantor with applying for other available coverage (such as Medicaid), if necessary. Counselors assist Medicare eligible patients in enrollment by providing referrals to the appropriate government agencies. Schedule H, Part VI, Line 6 Affiliated health care system JEWISH HOSPITAL & ST. MARY'S HEALTHCARE, along with its affiliated outpatient facilities, are part of Catholic Health Initiatives. Catholic Health Initiatives (CHI) is a national faith-based nonprofit health care organization with headquarters in Englewood, Colorado. CHI's exempt purpose is to serve as an integral part of its national system of hospitals and other charitable entities, which are described as market-based organizations, or MBOs. An MBO is a direct provider of care or services within a defined market area that may be an integrated health system and/or a stand-alone hospital or other facility or service provider. CHI serves as the parent corporation of its MBOs which are comprised of 101 hospitals, including four academic medical centers, and 30 critical access facilities; community health service organizations; accredited nursing colleges; home health agencies; and other facilities that span the inpatient and outpatient continuum of care. Together, these facilities provided $981 million in charity care and community benefit in the 2015 fiscal year, including services for the poor, free clinics, education and research. CHI provides strategic planning and management services as well as centralized "shared services" for the MBOs. The provision of centralized management and shared services - including areas such as accounting, human resources, payroll and supply chain -- provides economies of scale and purchasing power to the MBOs. The cost savings achieved through CHI's centralization enable MBOs to dedicate additional resources to high-quality health care and community outreach services to the most vulnerable members of our society. JEWISH HOSPITAL & ST. MARY'S HEALTHCARE operates with its wholly owned affiliates and community partners, along with its fundraising arm, the Jewish Hospital & St. Mary's Foundation to serve the health care needs of the Louisville, Kentucky communities. Schedule H, Part VI, Line 7 State filing of community benefit report KY true St Joseph Health System 200 Abraham Flexner Way Louisville KY 40202 611334601 501(c)(3) 216271 General Support Flaget Healthcare Inc 4305 New Shepherdsville Rd Bardstown KY 40004 611345363 501(c)(3) 965585 General Support JEWISH HERITAGE FUND FOR EXCELLENCE 100 E Liberty St Suite 300 Louisville KY 40202 203805455 501(c)(3) 270000 General Support 3 0 Financial Assistance 7212 10603584 book Financial Assistance Schedule I, Part I, Line 2 Description Of Procedure For Monitoring Use Of Grant Funds WHEN COMMUNITY ORGANIZATIONS SEEK THE SUPPORT AND INVOLVEMENT OF JHSMH, WE WILL FOCUS ON OPPORTUNITIES THAT MEET ONE (AND PREFERABLY SEVERAL OF) THE FOLLOWING CRITERIA: -IMPROVE THE HEALTH OF OUR COMMUNITY -SUPPORT THE EDUCATION, DEVELOPMENT, RECRUITMENT AND RETENTION OF HIGH QUALITY HEALTH CARE PROFESSIONALS -COMPLEMENT AND ADVANCE AN AREA OF JHSMH CLINICAL EXCELLENCE -IMPROVE THE LIVES OF PEOPLE WHO ARE MEDICALLY UNDERSERVED -DEMONSTRATE CLEAR, MEASURABLE ANNUAL GOALS THAT BENEFIT THE COMMUNITY/TARGET POPULATION -DEMONSTRATE THE ACTIVE INVOLVEMENT OF JHSMH TEAM MEMBERS EXCLUDED FROM CONSIDERATION ARE: -REQUESTS FROM ORGANIZATIONS OUTSIDE AREAS IN WHICH JHSMH PROVIDES SERVICES -REQUESTS FROM RELIGIOUS ORGANIZATIONS FOR RELIGIOUS PURPOSES -REQUESTS FROM INDIVIDUALS -REQUESTS FROM PRIMARY OR SECONDARY SCHOOLS (UNLESS THE SCHOOL HAS A FORMAL PARTNERSHIP OR CONTRACTUAL RELATIONSHIP EXISTING WITH JHSMH) -REQUESTS FROM POLITICAL ORGANIZATIONS -REQUESTS FOR CAPITAL IMPROVEMENT PROJECTS -REQUESTS FOR ANNUAL OPERATING SUPPORT OR DEBT REDUCTION -GENERALLY, REQUESTS FOR MULTI-YEAR SPONSORSHIPS ARE ALSO EXCLUDED PROCEDURE ---------------- REQUESTS FOR SUPPORT MUST BE SUBMITTED IN WRITING TO THE COMMUNITY INVOLVEMENT COMMITTEE. IF A PERSONAL MEETING IS NEEDED, THE COMMITTEE WILL INITIATE IT AFTER A PRELIMINARY REVIEW. REQUESTS MUST BE SUBMITTED AT LEAST 6 WEEKS IN ADVANCE OF THE DATE OF THE EVENT OR PROJECT; THE COMMITTEE MEETS ONCE A MONTH TO REVIEW REQUESTS. REQUESTS SHOULD BE BRIEF AND INCLUDE: -A BRIEF INTRODUCTION OF THE ORGANIZATION, ITS MISSION AND HISTORY -A CONCISE EXPLANATION OF THE PROPOSED PARTNERSHIP AND HOW IT FURTHERS JHSMH'S MISSION AND/OR FUNDING PRIORITIES INCLUDING DETAILS ABOUT THE EVENT OR PROJECT DATE, LOCATION, ETC. -A CURRENT LISTING OF THE ORGANIZATION'S BOARD OF DIRECTORS RESPONSES WILL BE SENT TO REQUESTORS OF SUPPORT IN WRITING ABOUT THE NEXT STEP, IF ANY, IN THE APPLICATION PROCESS. Schedule I, Part III Financial Assistance Jewish Hospital and St. Mary's Healthcare RECOGNIZES THE RIGHT TO QUALITY HEALTHCARE REGARDLESS OF AGE, SEX, RACE, RELIGION, NATIONAL ORIGIN, OR ABILITY TO PAY. BUSINESS OFFICE STAFF HELPS PATIENTS SEEK LOCAL, STATE, AND FEDERAL REIMBURSEMENT AT NO CHARGE WHEN NO OTHER SOURCE OF PAYMENT IS AVAILABLE. CHARITY CARE IS PROVIDED TO PATIENTS WITH DEMONSTRATED INABILITY TO PAY FOR MEDICALLY NECESSARY SERVICES. THESE FUNDS ARE DIRECTLY USED TO OFFSET THE PATIENTS' ACCOUNTS RECEIVABLE. Schedule I, Part I, Line 2 Procedures for monitoring use of grant funds. WHEN COMMUNITY ORGANIZATIONS SEEK THE SUPPORT AND INVOLVEMENT OF JHSMH, WE WILL FOCUS ON OPPORTUNITIES THAT MEET ONE (AND PREFERABLY SEVERAL OF) THE FOLLOWING CRITERIA: -IMPROVE THE HEALTH OF OUR COMMUNITY -SUPPORT THE EDUCATION, DEVELOPMENT, RECRUITMENT AND RETENTION OF HIGH QUALITY HEALTH CARE PROFESSIONALS -COMPLEMENT AND ADVANCE AN AREA OF JHSMH CLINICAL EXCELLENCE -IMPROVE THE LIVES OF PEOPLE WHO ARE MEDICALLY UNDERSERVED -DEMONSTRATE CLEAR, MEASURABLE ANNUAL GOALS THAT BENEFIT THE COMMUNITY/TARGET POPULATION -DEMONSTRATE THE ACTIVE INVOLVEMENT OF JHSMH TEAM MEMBERS EXCLUDED FROM CONSIDERATION ARE: -REQUESTS FROM ORGANIZATIONS OUTSIDE AREAS IN WHICH JHSMH PROVIDES SERVICES -REQUESTS FROM RELIGIOUS ORGANIZATIONS FOR RELIGIOUS PURPOSES -REQUESTS FROM INDIVIDUALS -REQUESTS FROM PRIMARY OR SECONDARY SCHOOLS (UNLESS THE SCHOOL HAS A FORMAL PARTNERSHIP OR CONTRACTUAL RELATIONSHIP EXISTING WITH JHSMH) -REQUESTS FROM POLITICAL ORGANIZATIONS -REQUESTS FOR CAPITAL IMPROVEMENT PROJECTS -REQUESTS FOR ANNUAL OPERATING SUPPORT OR DEBT REDUCTION -GENERALLY, REQUESTS FOR MULTI-YEAR SPONSORSHIPS ARE ALSO EXCLUDED PROCEDURE ---------------- REQUESTS FOR SUPPORT MUST BE SUBMITTED IN WRITING TO THE COMMUNITY INVOLVEMENT COMMITTEE. IF A PERSONAL MEETING IS NEEDED, THE COMMITTEE WILL INITIATE IT AFTER A PRELIMINARY REVIEW. REQUESTS MUST BE SUBMITTED AT LEAST 6 WEEKS IN ADVANCE OF THE DATE OF THE EVENT OR PROJECT; THE COMMITTEE MEETS ONCE A MONTH TO REVIEW REQUESTS. REQUESTS SHOULD BE BRIEF AND INCLUDE: -A BRIEF INTRODUCTION OF THE ORGANIZATION, ITS MISSION AND HISTORY -A CONCISE EXPLANATION OF THE PROPOSED PARTNERSHIP AND HOW IT FURTHERS JHSMH'S MISSION AND/OR FUNDING PRIORITIES INCLUDING DETAILS ABOUT THE EVENT OR PROJECT DATE, LOCATION, ETC. -A CURRENT LISTING OF THE ORGANIZATION'S BOARD OF DIRECTORS RESPONSES WILL BE SENT TO REQUESTORS OF SUPPORT IN WRITING ABOUT THE NEXT STEP, IF ANY, IN THE APPLICATION PROCESS. true true false false false false false false false MICHAEL ROWAN FACHE DIRECTOR/CHI EVP & COO 0 1195620 0 788897 0 515926 0 32602 0 21054 0 2554099 0 224413 GARY ERMERS Former Interim Chief Financial Officer 0 22508 0 0 0 234157 0 28602 0 13036 0 298303 0 0 COLLEEN HOLTON DIV VP OPER FINANCE/INTERIM VP FIN REPORTING 0 326130 0 6365 0 3941 0 21219 0 21235 0 378890 0 0 TAMMY HOWELL Director Accounting 138792 0 1800 0 278 0 0 0 19932 0 160802 0 0 0 ronald farr SVP-CFO 1 0 0 0 199988 0 0 0 4004 0 203993 0 0 0 Sherri Craig VICE PRESIDENT 183130 0 5004 0 3675 0 0 0 13290 0 205099 0 0 0 SHARON HAGER SECRETARY/DIV VP SR COUNSEL 0 321576 0 54097 0 49282 0 23502 0 8752 0 457209 0 0 RUTH WILLIAMS BRINKLEY PRESIDENT/CEO KENTUCKYONE HEALTH 0 849132 0 332850 0 27009 0 170373 0 8740 0 1388104 0 0 randall combs TREASURER/CFO KOH 0 283938 0 75000 0 57104 0 27000 0 9251 0 452293 0 0 JAMES KETTERHAGEN VICE PRESIDENT 0 0 0 0 117488 0 0 0 0 0 117488 0 14287 0 DAVID LAIRD VICE PRESIDENT 0 0 0 0 192307 0 0 0 0 0 192307 0 0 0 DEBORAH MOLNAR VICE PRESIDENT -1 0 0 0 435157 0 0 0 12877 0 448033 0 78339 0 RANDY NAPIER VICE PRESIDENT 0 232097 0 33280 0 23576 0 54869 0 14252 0 358074 0 0 JENNIFER NOLAN VICE PRESIDENT 0 325519 0 38907 0 22134 0 50652 0 22900 0 460112 0 0 VAL SLAYTON VICE PRESIDENT 0 0 0 0 110449 0 0 0 4188 0 114637 0 0 0 LISA DOLAN VP Nursing 0 0 0 0 100898 0 0 0 13332 0 114230 0 0 0 CHERYL FUGATTE VICE PRESIDENT/CNO 209214 0 2592 0 4946 0 0 0 7966 0 224718 0 0 0 KIMBERLY HITE VICE PRESIDENT/CNO 153898 0 4266 0 2791 0 0 0 11939 0 172894 0 0 0 KENNETH JOHNSON VP/COO 49907 0 0 0 170142 0 0 0 18183 0 238232 0 0 0 BRADLEY LINCKS VP-PATIENT CARE SVCS 171024 0 8146 0 2405 0 6125 0 19833 0 207533 0 0 0 MARK MILBURN VP ONCOLOGY SVC LINES 189858 0 5138 0 2928 0 5874 0 5903 0 209701 0 0 0 SHELLEY SHAUGHNESSY CEO-MARKET 179562 158572 0 11773 5081 15063 9100 30272 11303 9229 205046 224909 0 0 ROBERT SMITH FAMILY MEDICINE 247914 4548 26676 2000 468 0 4093 0 21571 0 300722 6548 0 0 RUTH WHEATLEY PRES CEO/FRAZIER/TAYLOR C0 267554 0 0 0 3849 0 9004 0 1846 0 282253 0 0 0 CARLOTTA RINKE VP-MEDICAL AFFAIRS 30320 0 0 0 299013 0 1028 0 3160 0 333521 0 0 0 KHUDA KHAN HEMATOLOGIST-ONCOLOGIST 493879 0 0 0 1245 0 9100 0 19364 0 523588 0 0 0 ROBERT STELTENPOHL VP-FINANCE 234935 0 3062 0 2473 0 8529 0 18543 0 267542 0 0 0 JENNIFER ANDERSON PHYS ASST-BEHAVIORAL HEALTH 238945 1623 17000 1000 197 0 7076 0 11232 0 274450 2623 0 0 JEANETTA BOSLEY PHYSICIAN - FAM MED 218570 0 20181 0 2962 0 4487 0 7672 0 253872 0 0 0 Schedule J, Part I, Line 3 Arrangement used to establish the top management official's compensation Compensation for the top management official was established and paid by Catholic Health Initiatives (CHI), a related organization. CHI used the following to establish the top management official's compensation: (1) Compensation Committee; (2) Independent Compensation Consultant; (3) Written Employment Contracts; (4) Compensation Survey or Study; (5) Approval by the Board or Compensation Committee. Schedule J, Part I, Line 4a Severance or change-of-control payment Post-termination payments are addressed in executive employment agreements for Catholic Health Initiatives (CHI) and related organizations' employees at the level of Vice President and above, including the MBO CEOs. These employment agreements require that in order for the executive to receive post-termination payments, these individuals must execute a general release and settlement agreement. Post-termination payment arrangements are periodically reviewed for overall reasonableness in light of the executive's overall compensation package. The following reportable individuals received severance payments from Catholic Health Initiatives (a Related Organization) during the 2014 calendar year, and these severance payments were included in the individual's W-2 income and reportable compensation on Schedule J: Lisa Dolan - $103,061 Gary Ermers - $234,157 Ronald Farr - $200,182 Kenneth Johnson - $133,349 David Laird - $192,307 Deborah Molnar - $360,264 Carlotta Rinke - $278,167 Val Slayton - $111,218 Schedule J, Part I, Line 4b Supplemental nonqualified retirement plan During the 2014 calendar year Catholic Health Initiatives (CHI), a related organization, maintained a supplemental non-qualified deferred compensation plan for MBO CEOs/Presidents and other CHI employees at the level of Senior Vice President and above. The following reportable individuals were eligible to participate in that plan: Randall Combs, Randy Napier, Jennifer Nolan, Michael Rowan, Shelly Shaughnessy, Ruth Williams Brinkley During 2014 the following contributions were made by CHI to the deferred compensation plan: Randall Combs - $27,000 Randy Napier - $21,167 Jennifer Nolan - $29,700 Shelley Shaughnessy - $30,272 Ruth Williams Brinkley - $135,221 During 2014 the following distributions were made by CHI from the deferred compensation plan: Michael Rowan - $224,413 Due to the "super" vesting rules under the CHI deferred compensation plan, participants who have met certain requirements such as age, years of service or more than 5 years of plan participation are eligible to receive their 2014 contributions in cash. These cash payouts are included in the participant's reportable compensation in column (iii) Other Reportable Compensation on Schedule J Part II. During 2014, the following contributions that would have been made by CHI to the deferred compensation plan were paid in cash: Michael Rowan - $266,409 DURING THE 2014 CALENDAR YEAR JEWISH HOSPITAL AND ST. MARY'S HEALTHCARE ("JHSMH"), A RELATED ORGANIZATION, MAINTAINED A SUPPLEMENTAL NON-QUALIFIED DEFERRED COMPENSATION PLAN FOR EMPLOYEES AT THE LEVEL OF VICE PRESIDENT AND ABOVE. THE FOLLOWING REPORTABLE INDIVIDUALS WERE ELIGIBLE TO PARTICIPATE IN THAT PLAN: DEBORAH MOLNAR, JAMES KETTERHAGEN During 2014, the following distributions were made by JHSMH from the deferred compensation plan: James Ketterhagen - $32,184 Deborah Molnar - $655,362 X Silent Auction Items 75 66644 Market value 0 false false false Schedule M, Part I Explanations of reporting method for number of contributions Other: Column B is based off of the number of contributions Form 990, Part VI, Line 15a Top Management Official Compensation The organization's top management official's compensation is paid by Catholic Health Initiatives (CHI), a related organization. CHI has a defined compensation philosophy. Both the executive and non-executive compensation structures and ranges are reviewed annually in comparison to market data. CHI uses The Hay Group as the independent third party to assess executive compensation programs and to ensure the reasonableness of actual salaries and total compensation packages. Compensation of the senior most executives is reviewed annually. The Hay Group reviews both cash and total compensation for overall reasonableness, for adherence to CHI's compensation philosophy, and for comparability to the not-for-profit healthcare market. This independent review is delivered by Hay Group to the HR committee of the CHI Board of Stewardship Trustees annually at their September meeting and minutes are shared with the full board at the December meeting. The last review was September 14, 2015. In addition, Hay Group completed a comprehensive review of all positions at the level of vice president and above in the fall of 2014 to determine and validate appropriate compensation levels. These levels have been reviewed annually since and revised based on market data, where applicable. Form 990, Part VI, Line 6 Classes of members or stockholders THE SOLE CORPORATE MEMBER OF JEWISH HOSPITAL & ST. MARY'S HEALTHCARE, INC. IS KENTUCKYONE HEALTH, INC. Form 990, Part VI, Line 7a Members or stockholders electing members of governing body THE BOARD OF DIRECTORS SHALL BE APPOINTED BY THE CORPORATE MEMBER. Form 990, Part VI, Line 7b Decisions requiring approval by members or stockholders CERTAIN RIGHTS MAY BE RESERVED BY THE CORPORATE MEMBER IN ACCORDANCE WITH THE BYLAWS AND THE LAWS OF THE COMMONWEALTH OF KENTUCKY. THE BUSINESS, PROPERTY, AFFAIRS AND FUNDS OF THE CORPORATION SHALL BE MANAGED, SUPERVISED, AND CONTROLLED BY THE BOARD OF DIRECTORS, IN CORFORMITY WITH APPLICABLE POLICIES, PROCEDURES, AND THE MISSION OF THE CORPORATION AND THE CORPORATE MEMBER. Form 990, Part VI, Line 11b Review of form 990 by governing body ONCE THE RETURN IS PREPARED, THE RETURN IS REVIEWED BY the VP OF FINANCE AND AN ELECTRONIC COPY IS PROVIDED TO EACH MEMBER OF THE BOARD. AFTER THE RETURN IS REVIEWED BY THE VP OF FINANCE, THE TAX DEPARTMENT FILES THE RETURN WITH THE APPROPRIATE FEDERAL AND STATE AGENCIES, MAKING ANY NONSUBSTANTIVE CHANGES NECESSARY THAT EFFECT E-FILING. ANY SUCH CHANGES ARE NOT RESUBMITTED TO THE BOARD. SUBSEQUENT TO THE RETURN BEING FILED, THE PRESIDENT/CEO OF KENTUCKYONE HEALTH, INC., THE SOLE MEMBER OF THE ORGANIZATION, PRESENTS THE RETURN AT A JEWISH HOSPITAL & ST. MARY'S HEALTHCARE, INC. BOARD MEETING. Form 990, Part VI, Line 12c Conflict of interest policy Catholic Health Initiatives ("CHI") has a Conflicts of Interest ("COI") policy in place to maintain the integrity of all of its activities. The policy applies to CHI Board of Stewardship Trustees and members of its committees; all board and board committee members of CHI Entities; all CHI employees; all CHI physicians (both employed and non-employed) and all physician administrators and leaders; advanced practice clinicians (both employed and non-employed); and all CHI research personnel (both employed and non-employed). Disclosure, review and management of perceived, potential or actual conflicts of interest are accomplished through a defined COI disclosure process. Each person has a general ongoing obligation to promptly and fully report to his/her direct manager, supervisor, medical staff office, board or board committee chair any situation or circumstance that may create a conflict of interest. The person must report the actual or potential conflict as soon as she/he becomes aware of it. In any situation where the person may be in doubt, a full disclosure should be made to permit an impartial and objective determination. In addition to the general ongoing obligation, there are initial disclosure obligations. The board, board committee members, and new employees are required to make disclosures at the time of their initial hiring/appointment. All non-employed, credentialed or contracted physicians are required to make disclosures at the time of their credentialing and during any subsequent reappointment or recredentialing. All researchers are required to make disclosures upon consideration of affiliation with a research sponsor. In addition to the general ongoing and initial disclosure obligations, there is an annual disclosure obligation. All corporate officers, board and board committee members, employees at the level of manager and above, researchers, supply chain employees, employed physicians, physician administrators and leaders, and employed advanced practice clinicians must complete a new conflict of interest disclosure annually. Disclosures of perceived, potential or actual conflicts involving financial interests are forwarded to the Conflicts of Interest Review Committee ("C-CIRC") or Legal Services Group for review depending on the position of the person involved. The C-CIRC reviews COI questionnaires containing disclosures of perceived or possible conflicts for employees at a level of manager or above, supply chain employees, researchers and physicians, physician administrators and leaders, and advanced practice clinicians (both employed and non-employed). In the determination of a conflict, a COI management plan will be developed for that person. With respect to those audiences for which the C-CIRC has review responsibility, the C-CIRC will facilitate development of any such conflict of interest management plan in collaboration with local CRP staff. A designated CHI Entity staff will be responsible for monitoring the COI management plan and for documenting monitoring activities. At its sole discretion, a CHI Entity may reject a Person's request to enter into the relationship in question, or require the relationship be sufficiently altered to avoid a potential COI. If the C-CIRC determines that there is a potential or actual conflict of interest that does not currently have appropriate controls to address the conflict of interest, it may recommend that the disclosing person be allowed to participate in the activity or transaction subject to restrictions as outlined in the COI management plan. If a Person does not agree with a determination made by the C-CIRC, its interpretation of the Policy or Addenda, or seeks an exemption or exception, the following steps should be followed. The Employee disputing the review decision, interpretation of the Policy, or seeking exemption or exception must present the matter to the Employee's immediate direct manager or supervisor for review and determination. If the Employee and the manager do not agree with the review decision, interpretation of the Policy, or seek exemption or exception, the manager shall consult with the manager's Vice President (or higher if the manager is a Vice President) to reach a determination. If the matter remains unresolved, it shall be referred to the CHI Vice President of Human Resources and the CHI Corporate Responsibility Officer. If they are unable to reach agreement, the matter shall be referred to the CHI General Counsel, whose decision shall be final. Reviews and determinations involving board and board committee members and corporate officers will be the responsibility of the board, board executive committee, or board chair, with guidance from the Legal Services Group (LSG). Annual COI disclosures of all trustee and corporate officers will be reviewed by the CHI Senior Vice President, Legal Services, and General Counsel or his or her designee who will report potential conflicts to the applicable Board Chair. The Board Chair or designee shall make such further investigation of any conflict of interest disclosures as he or she may deem appropriate. If the conflict involves the Board Chair, the Vice Chair will assume the Chair's role. Based on review and evaluation of the relevant facts and circumstances, the Board Chair will make an initial determination as to whether a conflict of interest exists and whether, pursuant to the COI Policy, review and approval or other action by the Board is required. A written record of the Board Chair's determination, including relevant facts and circumstances, will be made. The Board Chair shall then make an appropriate report to the Executive Committee of the Board concerning such review, evaluation and determination. If a difference of opinion exists between the Board Chair and another Trustee as to whether the facts and circumstances of a given situation constitute a conflict of interest or whether Board review and approval or other action is required within the COI Policy, the matter shall be submitted to the Board's Executive Committee, which shall make a final determination as to the matter presented. Such determination, including relevant facts and circumstances, will be reflected in the Executive Committee minutes and will be reported to the Board. When any conflict of interest is considered by the board, the trustee or corporate officer, as appropriate, must disclose all of the material facts to the Board. The trustee shall not vote and the trustee or corporate officer shall not use his or her personal influence on the matter. The trustee or corporate officer shall be excused from the meeting during discussion and vote on the conflict of interest. In reviewing such transactions between CHI or CHI Entities and vendors or other contractors who are, or are affiliated with, Trustees or Corporate Officers, the Board will act as it would in reviewing transactions with unrelated third parties. The transaction is not be approved unless the Board determines that the transaction is fair to CHI or the CHI Entity. The Board must approve the transaction by a majority of the Trustees on the Board, without counting the vote of any individual who has an interest in the transaction. All determinations of conflicts of interest are reported as required by law, regulations, and CHI policy. Form 990, Part VI, Line 15b Process to establish compensation of other employees THE FOLLOWING REVIEW AND APPROVAL PROCESS IS USED BY JEWISH HOSPITAL & ST. MARY'S HEALTHCARE, INC. (JHSMH) FOR MOST DISQUALIFIED PERSONS, WHICH INCLUDES ALL OFFICERS AND KEY EMPLOYEES. THE MANAGEMENT REVIEW COMMITTEE IS RESPONSIBLE FOR REVIEW AND APPROVAL OF MANAGEMENT COMPENSATION. THE FULL COMMITTEE ADDRESSED THE OVERALL COMPENSATION PHILOSOPHY AND HOW THE ORGANIZATION'S GOALS CAN BE FURTHERED BY THE STRUCTURE OF COMPENSATION. THE INDEPENDENT MANAGEMENT REVIEW COMMITTEE AND ALL INDEPENDENT MEMBERS OF THE FULL BOARD APPROVED MAXIMUM COMPENSATION LEVELS FOR ALL DISQUALIFIED PERSONS. NON-INDEPENDENT DIRECTORS DID NOT PARTICIPATE IN THE DISCUSSION OR VOTE ON COMPENSATION LEVELS FOR INDIVIDUALS. THE MANAGEMENT REVIEW COMMITTEE RETAINED AN OUTSIDE COMPENSATION CONSULTANT FROM A NATIONAL FIRM TO ADVISE IT REGARDING REASONABLE COMPENSATION LEVELS, AND RELIED ON THE CONSULTANT'S OPINION THAT COMPENSATION LEVELS ARE REASONABLE. THE COMMITTEE RECEIVES A MARKET REVIEW ON EACH DISQUALIFIED PERSON FROM THE COMPENSATION CONSULTANT. THE MANAGEMENT REVIEW COMMITTEE APPROVED THE PEER GROUP OF SIMILAR ENTITLES USED TO MEASURE COMPARABLE COMPENSATION LEVELS. THE MANAGEMENT REVIEW COMMITTEE FOLLOWS THE PROCESS NECESSARY TO OBTAIN THE REBUTTABLE PRESUMPTION THAT COMPENSATION LEVELS ARE REASONABLE, INCLUDING CONTEMPORANEOUS DOCUMENTATION OF DECISIONS. Form 990, Part VI, Line 19 Required documents available to the public JEWISH HOSPITAL & ST. MARY'S HEALTHCARE, INC. DOES NOT MAKE ITS GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY OR FINANCIAL STATEMENTS AVAILABLE TO THE GENERAL PUBLIC. Form 990, Part IX, Line 11g Other Fees Purchased Services - Total Expense: 30778735, Program Service Expense: 21790844, Management and General Expenses: 8720861, Fundraising Expenses: 267030; Consulting - Total Expense: 1043648, Program Service Expense: 734605, Management and General Expenses: 309043, Fundraising Expenses: ; Contract Services - Total Expense: 94899389, Program Service Expense: 66798008, Management and General Expenses: 28101381, Fundraising Expenses: ; Form 990, Part XI, Line 9 Other changes in net assets or fund balances Pension liability adjustment - -3299619; Change in noncontrolling interest - 314195; Write-off prior year pledges not received - -5141066; JH AMUBLATORY IMAGING LLC 200 ABRAHAM FLEXNER WAY LOUISVILLE KY 40202 203301174 MEDICAL SERVICES KY 0 0 NA ALEGENT CREIGHTON CLINIC 12809 W DODGE RD OMAHA NE 68154 470765154 HEALTHCARE NE 501(c)(3 3 ACH true ALEGENT CREIGHTON HEALTH 12809 W DODGE RD OMAHA NE 68154 470757164 HEALTHCARE NE 501(c)(3 3 CHI NEBRASKA true ALEGENT CREIGHTON HEALTH FOUNDATION 12809 W DODGE RD OMAHA NE 68154 470648586 FUNDRAISING NE 501(c)(3 7 ACH true ALEGENT HEALTH - BERGAN MERCY HEALTH SYSTEM 7500 MERCY RD OMAHA NE 68124 470484764 HEALTHCARE NE 501(c)(3 3 CHI NEBRASKA true ALEGENT HEALTH - COMMUNITY MEMORIAL HOSPITAL OF MISSOURI VALLEY IA 631 N 8TH ST MISSOURI VALLEY IA 51555 420776568 HEALTHCARE IA 501(c)(3 3 CHI NEBRASKA true ALEGENT HEALTH - IMMANUEL MEDICAL CENTER 6901 N 72ND ST OMAHA NE 68122 470376615 HEALTHCARE NE 501(c)(3 3 CHI NEBRASKA true ALEGENT HEALTH - MEMORIAL HOSPITAL SCHUYLER 104 W 17TH ST SCHUYLER NE 68661 470399853 HEALTHCARE NE 501(c)(3 3 CHI NEBRASKA true ALEGENT HEALTH - MERCY HOSPITAL CORNING IOWA PO BOX 368 CORNING IA 50841 420782518 HEALTHCARE IA 501(c)(3 3 CHI NEBRASKA true ALVERNA APARTMENTS 300 SE 8TH AVE LITTLE FALLS MN 56345 411351177 LTERM CARE MN 501(c)(3 9 CHI true APPLETREE COURT 601 OAK ST BRECKENRIDGE MN 56520 411850500 SENIOR LIVING MN 501(c)(3 9 SFH true BELLEVILLE ST JOSEPH HEALTH CENTER 2801 FRANCISCAN DRIVE BRYAN TX 77802 274005511 HEALTHCARE TX 501(c)(3 3 SHSC true BISHOP DRUMM RETIREMENT CENTER 1111 6TH AVE DES MOINES IA 50314 420725196 LTERM CARE IA 501(c)(3 9 CHI-IA CORP true BORNEMANN HEALTHCARE CORPORATION 2500 BERNVILLE RD PO BOX 316 READING PA 19603 232187242 HEALTHCARE PA 501(c)(3 Type I CHI true BURLESON ST JOSEPH HEALTH CENTER 2801 FRANCISCAN DRIVE BRYAN TX 77802 742759890 HEALTHCARE TX 501(c)(3 3 SJSC true BURLESON ST JOSEPH MANOR 2801 FRANCISCAN DRIVE BRYAN TX 77802 742913931 HEALTHCARE TX 501(c)(3 9 SJSC true CARRINGTON HEALTH CENTER 800 N 4TH ST CARRINGTON ND 58421 450227311 HEALTHCARE ND 501(c)(3 3 CHI true CATHOLIC HEALTH INITIATIVES 198 INVERNESS DRIVE WEST ENGLEWOOD CO 80112 470617373 HEALTHCARE CO 501(c)(3 Type I NA true CATHOLIC HEALTH INITIATIVES - COLORADO 188 INVERNESS DRIVE WEST STE 500 ENGLEWOOD CO 80112 840405257 HEALTHCARE CO 501(c)(3 3 CHI true CATHOLIC HEALTH INITIATIVES - IOWA CORP 1111 6TH AVE DES MOINES IA 50314 420680448 HEALTHCARE IA 501(c)(3 3 CHI true CATHOLIC HEALTH INITIATIVES COLORADO FOUNDATION 6385 CORPORATE DR STE 301 COLORADO SPRINGS CO 80919 840902211 FUNDRAISING CO 501(c)(3 7 CHIC true CATHOLIC HEALTH INITIATIVES NATIONAL FOUNDATION 6385 CORPORATE DR COLORADO SPRINGS CO 80919 270930004 FUNDRAISING CO 501(c)(3 Type I CHI true CATHOLIC HEALTH INITIATIVES VIRTUAL HEALTH SERVICES 198 INVERNESS DRIVE WEST ENGLEWOOD CO 80112 460992796 HEALTHCARE CO 501(c)(3 Type I CHINS true CENTENNIAL MEDICAL GROUP INC 2700 STEWART PKWY ROSEBURG OR 97471 263946191 PHYSICIANS OR 501(c)(3 9 MMC true CENTRAL KANSAS MEDICAL CENTER 3515 BROADWAY GREAT BEND KS 67530 480543724 SURGERY CENTER KS 501(c)(3 3 CHI true CHI HEALTH CONNECT AT HOME - FARGO 4816 AMBER VALLEY PKWY S FARGO ND 58104 271966847 HEALTHCARE MN 501(c)(3 9 CHI true CHI INSTITUTE FOR RESEARCH AND INNOVATION 198 INVERNESS DRIVE WEST ENGLEWOOD CO 80112 271050565 HEALTHCARE CO 501(c)(3 Type I CHI true CHI KENTUCKY INC 3900 OLYMPIC BLVD STE 400 ERLANGER KY 41018 202741651 HEALTHCARE KY 501(c)(3 Type I CHI true CHI NATIONAL HOME CARE 198 INVERNESS DRIVE WEST ENGLEWOOD CO 80112 451261716 HEALTHCARE CO 501(c)(3 9 CHI NS true CHI NATIONAL SERVICES 198 INVERNESS DRIVE WEST ENGLEWOOD CO 80112 452532084 HEALTHCARE CO 501(c)(3 Type I CHI true CHI NEBRASKA 6940 O ST STE 200 LINCOLN NE 68510 363233121 HEALTHCARE NE 501(c)(3 Type I CHI true CHI ST JOSEPH'S CHILDREN 1516 5TH ST NW ALBUQUERQUE NM 87102 710897107 COMMUNITY NM 501(c)(3 Type I CHI true CHI ST LUKE'S HEALTH BAYLOR COLLEGE OF MEDICINE MEDICAL CENTER 6624 FANNIN ST HOUSTON TX 77030 741161938 HEALTHCARE TX 501(c)(3 3 SLHS true CHI ST VINCENT HOSPITAL HOT SPRINGS 300 WERNER ST HOT SPRINGS AR 71913 710236913 HEALTHCARE AR 501(c)(3 3 CHISVHS true CHI ST VINCENT HOT SPRINGS 300 WERNER ST HOT SPRINGS AR 71913 261125064 HOLDING CO AR 501(c)(3 Type II SVIMC true CHI ST VINCENT MEDICAL GROUP HOT SPRINGS 1 MERCY LANE STE 201 HOT SPRINGS AR 71913 261125131 HEALTHCARE AR 501(c)(3 3 CHISVHS 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