2016-05-12T12:59:42-05:00 2015-06-30 990 2014-07-01 590791028 HOLY CROSS HOSPITAL INC HOLY 9542676869 4725 NORTH FEDERAL HIGHWAY FT LAUDERDALE FL 333084603 LINDA WILFORD SVP & CFO 9542676869 2016-05-12 2014 2016-08-17 19:52:53Z SEE SCHEDULE O FOR LIST PATRICK A TAYLOR 4725 NORTH FEDERAL HIGHWAY FT LAUDERDALE FL 333084603 492839245 0 0928 X WWW.HOLY-CROSS.COM X 1952 FL TO PROVIDE HEALTHCARE AND HOSPITAL SERVICES. 15 9 3517 655 741685 85568 5476558 3542238 453894621 472502493 4123824 3076749 16713628 13617384 480208631 492738864 240908 245716 0 0 224196287 233689757 0 0 463830 234934222 253407265 459371417 487342738 20837214 5396126 466111195 468847594 243359847 245685734 222751348 223161860 X WE, HOLY CROSS HOSPITAL AND TRINITY HEALTH, SERVE TOGETHER IN THE SPIRIT OF THE GOSPEL AS A COMPASSIONATE AND TRANSFORMING HEALING PRESENCE WITHIN OUR COMMUNITIES. HOLY CROSS HOSPITAL IS A MEMBER OF TRINITY HEALTH. 0 0 465667817 245716 480904133 HOLY CROSS HOSPITAL IS A 557 BED COMMUNITY HOSPITAL LOCATED IN FT. LAUDERDALE, FLORIDA, IN OPERATION SINCE 1955. THE HOSPITAL SPECIALIZES IN HEART BYPASS SURGERY, HIP AND KNEE REPLACEMENT, HEART FAILURE, AND CHRONIC OBSTRUCTIVE PULMONARY DISEASE. THE HOSPITAL IS ALSO WELL-REGARDED IN THE SPECIALTIES OF GERIATRICS, GYNECOLOGY, ORTHOPEDICS AND UROLOGY. IT IS BROWARD COUNTY'S FIRST MAGNET HOSPITAL, ATTRACTING THE BEST NURSES AND FOSTERING AN ENVIRONMENT WHERE ALL PEOPLE ARE WELCOMED, VALUED AND CELEBRATED. IN FY15 THE HOSPITAL PROVIDED 82,599 PATIENT DAYS OF HEALTHCARE SERVICES TO THE COMMUNITY. HOLY CROSS ALSO OFFERS OUTPATIENT SERVICES IN BROWARD AND PALM BEACH COUNTIES.PLEASE VISIT SCHEDULE H AND THE WEBSITE FOR ADDITIONAL INFORMATION ABOUT SERVICES, RECOGNITIONS AND AWARDS: WWW.HOLY-CROSS.COM 465667817 1 1 0 1 0 0 0 0 0 0 1 1 0 1 1 0 0 1 0 0 0 0 0 0 1 0 1 1 1 0 1 0 0 0 0 0 0 1 1 0 0 0 0 1 1 1 1 0 0 1 616 0 1 3517 1 1 1 0 0 0 0 1 1 0 0 0 0 X 15 9 1 0 1 0 1 1 1 1 1 0 0 1 1 1 1 1 1 0 1 1 1 X MARLENE BERGER 9542676869 4725 N FEDERAL HIGHWAY FT LAUDERDALE FL 333084603 X PATRICK A TAYLOR MD DIRECTOR; PRESIDENT & CEO 53.00 2.00 X X 0 1032346 43461 REV MSGR TOMAS M MARIN DIRECTOR; CHAIR 1.00 1.00 X X 0 0 0 SR MARJORIE BOSSE RSM DIRECTOR; VICE CHAIR 1.00 0.00 X X 0 0 0 SR SUSAN WELSH RSM SCH O DIRECTOR; SECRETARY & TREASURER 1.00 44.00 X X 0 0 14864 RAUL TAPIA DIRECTOR THROUGH 12/14; PHYSICIAN 50.00 0.00 X 554402 0 10597 SR JOANNE COURNEEN RSM DIRECTOR 1.00 0.00 X 0 0 0 SR KATHLEEN ANN KOLB RSM DIRECTOR 1.00 0.00 X 0 0 0 GERMAINE SMITH-BAUGH DIRECTOR 1.00 0.00 X 0 0 0 KURT LANGSENKAMP DIRECTOR 1.00 0.00 X 0 0 0 JANICE MORAN DIRECTOR 1.00 0.00 X 0 0 0 MICHELE TAPIA DIRECTOR AS OF 1/15 1.00 0.00 X 0 0 0 JOSEPH CATANIA DIRECTOR 1.00 0.00 X 0 0 0 FATHER MICHAEL GREER DIRECTOR 1.00 0.00 X 0 0 0 ARISTIDES ZACHAROUDIS MD DIRECTOR; PHYSICIAN 50.00 0.00 X 277208 0 21207 LUIS BARRERAS MD DIRECTOR 1.00 0.00 X 0 0 0 NORA TRIOLA DIRECTOR AS OF 7/14;TRINITY SVP & CNO 1.00 49.00 X 0 1014669 32657 LINDA V WILFORD SVP & CFO 47.00 3.00 X 410688 0 73909 KENNETH HOMER MD CMO 50.00 0.00 X 452759 0 26155 MARK R DISSETTE SVP AND ADMINISTRATOR 50.00 0.00 X 347278 0 25002 TAREN RUGGIERO CNO 50.00 0.00 X 229184 0 24837 LUISA GUTMAN SVP & COO 50.00 0.00 X 371916 0 24474 DAVID TAUB MD CHIEF MEDICAL OFFICER, HCMG 50.00 0.00 X 530822 0 25525 JONATHAN C LEVY MD PHYSICIAN 50.00 0.00 X 1617245 0 23344 MARTIN ROCHE MD PHYSICIAN 50.00 0.00 X 1588757 0 17214 WILLIAM LEONE JR MD PHYSICIAN 50.00 0.00 X 1433032 0 29381 W PORTER MCROBERTS MD PHYSICIAN 50.00 0.00 X 1300495 0 16935 PAUL WU MD PHYSICIAN 50.00 0.00 X 1045695 0 27558 JAMES DESMARTEAU FORMER KEY EMPLOYEE 0.00 0.00 X 116058 0 15331 ANDREA J BRADLEY FORMER KEY EMPLOYEE 0.00 0.00 X 154818 0 0 10430357 2047015 452451 286 1 1 0 ACCRETIVE HEALTH INC 39918 TREASURY CENTER CHICAGO IL 606949900 CONSULTING SERVICES 14820212 SODEXO INC PO BOX 81049 WOBURN MA 018131049 MANAGEMENT SERVICES 6398861 SKANSKA USA BUILDING INC 2824 NE 25TH STREET FORT LAUDERDALE FL 33305 CONSTRUCTION SERVICES 2495706 SOUND PHYSICIANS PO BOX 742936 LOS ANGELES CA 900742936 PHYSICIAN SERVICES 2333209 LAUDERDALE CRITICAL CARE SVC 6278 N FEDERAL HWY UNIT 374 FORT LAUDERDALE FL 333081916 PHYSICIAN SERVICES 1543262 88 77117 71120 390899 3003102 16680 3542238 NET PATIENT SVC REV 622110 469007620 469007620 REFERENCE LAB 621500 86600 86600 3408273 3408273 472502493 1553427 1553427 3017957 0 3017957 3017957 3017957 1482505 88918 0 48101 1482505 40817 1523322 1523322 33090 71120 52280 -19190 -19190 GOV'T SUBSIDY - EHR 622110 3651944 3651944 CAFETERIA REVENUE 722514 1475292 1475292 WELLNESS CENTER REVENUE 713940 873445 218360 655085 4617936 4617936 10618617 492738864 480904133 741685 7550808 245716 245716 4431770 863414 3568356 535536 249329 286207 193166153 185512400 7313576 340177 4694057 4498814 195243 18671722 17764514 907208 12190519 11489573 674924 26022 912530 912530 245333 245333 266995 266995 36928026 35261512 1592213 74301 2218227 2095153 123074 7090761 6688288 392885 9588 13879772 13109679 770093 7295704 6890916 404788 459170 431838 25367 1965 14756 6040 355 8361 5242259 5242259 22892201 21622071 1270130 13993054 13216676 776378 MEDICAL SUPPLIES 83104931 83104931 BAD DEBT 33965191 33965191 EQUIPMENT MAINTENANCE 9836578 9290814 545764 UBI TAXES 110400 110400 14951377 14118689 829272 3416 487342738 465667817 21211091 463830 15993 6715378 30230785 0 3517881 1980957 80024201 88092554 42278 81722 9016407 8827523 2933157 4053539 555379497 326732561 228246487 228646936 76924661 53887293 49753082 100000 100000 35059345 26708610 466111195 468847594 81288358 91591587 32791434 33661715 129280055 120432432 243359847 245685734 X 205823007 204999793 14987589 16221315 1940752 1940752 222751348 223161860 466111195 468847594 X 5396126 -1846048 -3139566 X X 0 1 X 1 1 1 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 0 0 0 0 0 1 8141 0 0 0 8141 0 PART II-B, LINE 1: HOLY CROSS HOSPITAL, INC. HAS MADE GRANTS TO OTHER ORGANIZATIONS FOR LOBBYING PURPOSES. THESE GRANTS HAVE BEEN IN THE FORM OF MEMBERSHIP DUES PAID TO REGIONAL AND NATIONAL HEALTH CARE ORGANIZATIONS, WHERE THE ORGANIZATIONS HAVE PROVIDED HOLY CROSS HOSPITAL, INC. WITH AN ESTIMATED PERCENTAGE OF DUES PAYMENTS WHICH ARE USED FOR LOBBYING ACTIVITIES. HOLY CROSS HOSPITAL, INC. MADE NO CONTRIBUTIONS TO ANY LEGISLATORS OR CANDIDATES. 7419505 7419505 349284724 171045792 178238932 195017816 155686769 39331047 3657452 3657452 228646936 COMMINGLED FUNDS DIRECTLY HOLDING SECURITIES 13930863 F HEDGE FUNDS 16916048 F EQUITY METHOD INVESTMENTS 18906171 C 49753082 MISCELLANEOUS RECEIVABLES 1799806 INTERCOMPANY ACCOUNTS RECEIVABLE 175090 OTHER CURRENT ASSETS 12145500 OTHER LONG-TERM ASSETS 1004804 INVESTMENT IN UNCONSOL. AFFILIATES 2446296 INTERCOMPANY OTHER LONG-TERM ASSETS 9137114 26708610 INTERCOMPANY ACCOUNTS PAYABLE 6159918 INTERCOMPANY OTHER LIABILITIES 1002697 INTERCOMPANY NOTES PAYABLE 104568613 OTHER CURRENT LIABILITIES 794304 OTHER LONG-TERM LIABILITIES 5943962 ASSET RETIREMENT OBLIGATION(FIN47) 911441 DEFERRED COMPENSATION LIABILITY 120494 ANNUITIES PAYABLE 931003 120432432 GOLF TOURNAMENT 104210 71120 33090 7207 23293 21780 104210 71120 33090 7207 23293 21780 52280 -19190 1 1 X 1 X 1 X 1 1 0 1 1 422 7554145 7554145 0.01670 8973 20439109 5422787 15016322 0.03310 9395 27993254 5422787 22570467 0.04980 33 20863 1110250 209239 901011 0.00200 3 103 451608 451608 0.00100 2 48089 3147554 3147554 0.00690 1 11 11973 11973 0.00000 2 10005 273002 273002 0.00060 41 79071 4994387 209239 4785148 0.01050 41 88466 32987641 5632026 27355615 0.06030 1 33965191 0 134842474 156759574 -21917100 X 1 1 1 PHYSICIANS OUTPATIENT SURGERY CENTER LLC OUTPATIENT MULTI-SPECIALTY AMBULATORY SURGERY SERVICE 0.71000 0.01180 0.27820 1 1 HOLY CROSS HOSPITAL INC 4725 N FEDERAL HIGHWAY FORT LAUDERDALE FL 333084603 LICENSE # 4069 X X X HOLY CROSS HOSPITAL INC 1 0 0 1 X X X X X X X X X 13 1 0 0 1 X SEE SCHEDULE H, PART V, SECTION C X 1 13 1 SEE SCHEDULE H, PART V, SECTION C 0 0 1 X 200.000000000000 400.000000000000 X X X X X X 1 1 X X X 1 X HTTPS://WWW.HOLY-CROSS.COM/BILLING-INSURANCE X HTTPS://WWW.HOLY-CROSS.COM/BILLING-INSURANCE X HTTPS://WWW.HOLY-CROSS.COM/BILLING-INSURANCE X X X X X 1 X 1 X X X X 1 X 0 0 HOLY CROSS HOSPITAL, INC. PART V, SECTION B, LINE 5: THE COMMUNITY HEALTH NEEDS ASSESSMENT (CHNA) PROCESS INCLUDED A CHNA ADVISORY COUNCIL. THESE INDIVIDUALS ASSISTED IN: GUIDING THE ASSESSMENT PROCESS, ACTING AS A SOUNDING BOARD AND ASSISTING IN OBTAINING COMMUNITY INPUT, PARTICIPATING WITH THE PLANNING TEAM IN EVALUATING HEALTH ISSUES AND PRIORITIES ONCE THE ASSESSMENT WAS COMPLETED. THE CHNA ADVISORY COUNCIL MET TOGETHER FOR THIRTEEN MEETINGS. PARTICIPANTS INCLUDED REPRESENTATIVES OF: URBAN LEAGUE, HEALTHY MOTHERS HEALTHY BABIES, LIGHT OF THE WORLD CLINIC, DEPARTMENT OF CHILDREN & FAMILY SERVICES - MENTAL HEALTH, HOPE SOUTH FLORIDA, AND BROWARD REGIONAL HEALTH PLANNING COUNCIL. HOLY CROSS HOSPITAL, INC. PART V, SECTION B, LINE 11: THE HOLY CROSS HOSPITAL (HCH) COMMUNITY OUTREACH DEPARTMENT DEVELOPED A MULTI-PRONG APPROACH TO EFFECTIVELY RESPOND AND ADDRESS THE OUTSTANDING NEEDS IDENTIFIED: NAVIGATION AND WELLNESS. IN ORDER TO ACCOMPLISH OUTCOMES, THE DEPARTMENT FORMULATED INITIATIVES AND STRATEGIES, AND DETERMINED WHICH NEEDS HOLY CROSS HOSPITAL WOULD TAKE THE LEAD ON, PARTNER DIRECTLY WITH COMMUNITY PARTNERS OR PROVIDE IN-KIND, FINANCIAL OR ORGANIZATIONAL SERVICES OR SUPPORT. TO ADDRESS NAVIGATION, HCH IS IMPLEMENTING HEALTHCARE REFORM EDUCATION AND AN ENROLLMENT PLAN, A COMMUNITY BASED HOMELESS HEALTH ACCESS SITE, AND A FAITH COMMUNITY NURSING PROGRAM. TO ADDRESS WELLNESS, HCH IS WORKING TO PROVIDE SERVICES AT THE WELLNESS CENTER, HIRE A NURSE PRACTITIONER, AND PROVIDE HEALTH SCREENING AND WELLNESS PROMOTION SERVICES WITHIN THE COMMUNITY.THE OTHER NEEDS AND PRIORITY AREAS IDENTIFIED IN THE CHNA WERE NOT ADDRESSED BECAUSE IMPLEMENTATION DETAILS REVEALED THAT THE APPROACH WAS UNFEASIBLE, OR CERTAIN KEY INPUTS (SUCH AS SKILLED STAFF, TIME FRAMES, REQUIRED ORGANIZATIONAL/POLICY CHANGES, COMMUNITY SUPPORT) WERE NOT ATTAINABLE, OR WERE NOT ADDRESSED TO AVOID DUPLICATION OF SERVICES IN THE COMMUNITY.AN EXAMPLE OF UNFEASIBILITY WERE NEEDS RELATED TO AFFORDABILITY OF HEALTHCARE INCLUDING: HIGH COST OF CARE, LACK OF LOW COST OPTIONS, LACK OF INSURANCE AND ACCESS TO MEDICAID (ESPECIALLY 18-44 AGE RANGE), UNDERINSURED, ECONOMIC IMPACT AND PRESCRIPTIONS AND TREATMENT.AN EXAMPLE OF UNFEASIBILITY DUE TO SKILLED STAFF WAS BEHAVIORAL AND MENTAL HEALTH RELATED INTENDED AND UNINTENDED INJURIES, CONTINUITY OF CARE, BEHAVIORAL, MENTAL HEALTH FIRST AID.AN EXAMPLE OF AVOIDANCE OF DUPLICATION OF SERVICES WOULD BE DEDICATED EFFORTS RELATED TO LOW BIRTH WEIGHT AND INFANT MORTALITY. RATHER THAN FOCUS RESOURCES ON THIS PARTICULAR NEED, THE HOSPITAL IS SUPPORTIVE AND COLLABORATES WITH DEDICATED COMMUNITY ORGANIZATIONS, SUCH AS HEALTHY MOTHERS HEALTHY BABIES, HEALTHY START, AND THE MARCH OF DIMES AND THEIR EFFORTS. HOLY CROSS HOSPITAL, INC. PART V, SECTION B, LINE 13H: THE HOSPITAL RECOGNIZES THAT NOT ALL PATIENTS ARE ABLE TO PROVIDE COMPLETE FINANCIAL AND/OR SOCIAL INFORMATION. THEREFORE, APPROVAL FOR FINANCIAL SUPPORT MAY BE DETERMINED BASED ON AVAILABLE INFORMATION. EXAMPLES OF PRESUMPTIVE CASES INCLUDE: DECEASED PATIENTS WITH NO KNOWN ESTATE, THE HOMELESS, UNEMPLOYED PATIENTS, NON-COVERED MEDICALLY NECESSARY SERVICES PROVIDED TO PATIENTS QUALIFYING FOR PUBLIC ASSISTANCE PROGRAMS, PATIENT BANKRUPTCIES, AND MEMBERS OF RELIGIOUS ORGANIZATIONS WHO HAVE TAKEN A VOW OF POVERTY AND HAVE NO RESOURCES INDIVIDUALLY OR THROUGH THE RELIGIOUS ORDER.FOR THE PURPOSE OF HELPING FINANCIALLY NEEDY PATIENTS, A THIRD PARTY IS UTILIZED TO CONDUCT A REVIEW OF PATIENT INFORMATION TO ASSESS FINANCIAL NEED. THIS REVIEW UTILIZES A HEALTHCARE INDUSTRY-RECOGNIZED, PREDICTIVE MODEL THAT IS BASED ON PUBLIC RECORD DATABASES. THESE PUBLIC RECORDS ENABLE THE HOSPITAL TO ASSESS WHETHER THE PATIENT IS CHARACTERISTIC OF OTHER PATIENTS WHO HAVE HISTORICALLY QUALIFIED FOR FINANCIAL ASSISTANCE UNDER THE TRADITIONAL APPLICATION PROCESS. IN CASES WHERE THERE IS AN ABSENCE OF INFORMATION PROVIDED DIRECTLY BY THE PATIENT, AND AFTER EFFORTS TO CONFIRM COVERAGE AVAILABILITY, THE PREDICTIVE MODEL PROVIDES A SYSTEMATIC METHOD TO GRANT PRESUMPTIVE ELIGIBILITY TO FINANCIALLY NEEDY PATIENTS. HOLY CROSS HOSPITAL, INC. PART V, SECTION B, LINE 22D: PATIENTS WITH INCOME AT OR BELOW 200% OF THE FEDERAL POVERTY GUIDELINES (FPG) ARE ELIGIBLE FOR 100% CHARITY CARE WRITE OFF OF THE CHARGES FOR MEDICALLY NECESSARY SERVICES. ACUTE CARE PATIENTS WITH INCOME BETWEEN 201% AND 400% OF THE FPG RECEIVE A DISCOUNT OFF TOTAL CHARGES FOR MEDICALLY NECESSARY SERVICES EQUAL TO THE HOSPITAL'S AVERAGE ACUTE CARE CONTRACTUAL ADJUSTMENT FOR MEDICARE. AMBULATORY PATIENTS WITH INCOME BETWEEN 201% AND 400% OF THE FPG RECEIVE A DISCOUNT OFF TOTAL CHARGES FOR MEDICALLY NECESSARY SERVICES EQUAL TO THE HOSPITAL'S AVERAGE PHYSICIAN CONTRACTUAL ADJUSTMENT FOR MEDICARE. THE ACUTE AND PHYSICIAN AVERAGE CONTRACTUAL ADJUSTMENT AMOUNTS FOR MEDICARE ARE CALCULATED UTILIZING THE LOOK BACK METHODOLOGY OF CALCULATING THE SUM OF PAID CLAIMS DIVIDED BY THE TOTAL GROSS CHARGES FOR THOSE CLAIMS ANNUALLY USING TWELVE MONTHS OF PAID CLAIMS WITH A 30 DAY LAG FROM REPORT DATE TO THE MOST RECENT DISCHARGE DATE. HOLY CROSS HOSPITAL, INC. - PART V, SECTION B, LINE 7A: HTTPS://WWW.HOLY-CROSS.COM/COMMUNITY-OUTREACH HOLY CROSS HOSPITAL, INC. - PART V, SECTION B, LINE 10A: HTTPS://WWW.HOLY-CROSS.COM/COMMUNITY-OUTREACH PART V, SECTION B, LINE 16 FINANCIAL ASSISTANCE POLICY WEBSITE AVAILABILITY HOLY CROSS HOSPITAL, INC. PART V, SECTION B, LINE 16A WEBSITE: HTTPS://WWW.HOLY-CROSS.COM/BILLING-INSURANCE HOLY CROSS HOSPITAL, INC. PART V, SECTION B, LINE 16B WEBSITE: HTTPS://WWW.HOLY-CROSS.COM/BILLING-INSURANCE HOLY CROSS HOSPITAL, INC. PART V, SECTION B, LINE 16C WEBSITE: HTTPS://WWW.HOLY-CROSS.COM/BILLING-INSURANCE 38 HOLY CROSS ORTHOPEDIC INSTITUTE 5597 N DIXIE HIGHWAY FORT LAUDERDALE FL 33334 ORTHOPEDICS, SPINE, PODIATRY, REHABILITATION HOLY CROSS HEALTHPLEX 1000 NORTH EAST 56TH STREET OAKLAND PARK FL 33334 AMBULATORY SURG, ORTHOPEDICS, IMAGING AND LAB LIGHTHOUSE ORTHOPEDICS PRACTICE 1821 NE 25 ST LIGHTHOUSE POINT FL 33064 ORTHOPEDICS PRACTICE CARDIOLOGY ASSOCIATES OF BOCA RATON 9980 CENTRAL PARK BLVD 304 BOCA RATON FL 33428 CARDIOLOGY PRACTICE CARDIOLOGY ASSOCIATES OF BOYNTON BEACH 10151 ENTERPRISE CENTER 203 BOYNTON BEACH FL 33437 CARDIOLOGY PRACTICE HEART GROUP BOCA RATON 9980 CENTRAL PARK BLVD SUITE 210 BOCA RATON FL 33428 CARDIOLOGY PRACTICE GALLAGHER GASTROENTEROLOGY PRACTICE 1900 E COMMERCIAL BLVD 201 FORT LAUDERDALE FL 33308 GASTROENTEROLOGY PRACTICE GALLAGHER ADULT PRACTICE 1900 E COMMERCIAL BLVD 101 FORT LAUDERDALE FL 33308 INTERNAL MEDICINE OBSTETRICS AND GYNECOLOGY PRACTICE 4701 N FEDERAL HWY B BLDG FORT LAUDERDALE FL 33308 OB/GYN PRACTICE RIO VISTA URGENT CARE 1115 S FEDERAL HWY FORT LAUDERDALE FL 33316 URGENT CARE, IMAGING, OCCUPATIONAL MEDICINE HEART GROUP POMPANO 2 W SAMPLE RD SUITE 208 POMPANO BEACH FL 33064 CARDIOLOGY PRACTICE CARDIO PULMONARY PRACTICE 333 NW 70TH AVE 116 PLANTATION FL 33317 CARDIOLOGY PRACTICE GALLAGHER PEDIATRICS 1900 E COMMERCIAL BLVD 202 FORT LAUDERDALE FL 33308 PEDIATRICS PRACTICE COLORECTAL SURGERY PRACTICE 1940 NE 47TH ST SUITE 1 FORT LAUDERDALE FL 33308 COLORECTAL SURGERY PRACTICE HOLY CROSS MEDICAL PLAZA 5601 N DIXIE HIGHWAY FORT LAUDERDALE FL 33334 PAIN MANAGEMENT, INTERNAL MEDICINE, INFECTIOUS DISEASE PRACTICES ENDO AND INTERNAL MEDICINE PRACTICE 4701 N FEDERAL HWY A27 FORT LAUDERDALE FL 33308 INTERNAL MEDICINE RIO VISTA PRACTICE 1309 S FEDERAL HWY FORT LAUDERDALE FL 33316 INTERNAL MEDICINE, REHABILITATION MEDICAL MULTI-SPECIALTY GROUP 8391 W OAKLAND PARK BLVD SUNRISE FL 33351 INTERNAL MEDICINE POMPANO BEACH OFFICE 2700 NE 14TH ST CSWY SUITE 103 POMPANO BEACH FL 33062 FAMILY PRACTICE PULMONARY PRACTICE 1930 NE 47TH STREET 205 FORT LAUDERDALE FL 33308 PULMONARY PRACTICE NORTH BROWARD CARDIOLOGY 2800 N STATE RD 7 SUITE 101-102 POMPANO BEACH FL 33063 CARDIOLOGY PRACTICE BROWARD MEDICAL 1100 E BROWARD BLVD FORT LAUDERDALE FL 33301 FAMILY PRACTICE BOCA URGENT CARE 1799 S FEDERAL HWY FORT LAUDERDALE FL 33432 URGENT CARE, IMAGING, OCCUPATIONAL MEDICINE OFFICE OF RICKY SCHNEIDER MD 2901 CORAL HILLS DRIVE SUITE 240 CORAL SPRINGS FL 33065 CARDIOLOGY PRACTICE BARIATRICSGENERAL SURGERY PRACTICE 4800 NORTHEAST 20TH TERRACE SUITE 30 FORT LAUDERDALE FL 33308 BARIATRICS/GENERAL SURGERY PRACTICE BAYVIEW PRACTICE 1124 BAYVIEW DRIVE FORT LAUDERDALE FL 33308 INTERNAL MEDICINE GALT OCEAN MILE PRACTICE 4004 N OCEAN BLVD FORT LAUDERDALE FL 33308 FAMILY PRACTICE WILTON MANORS PRACTICE 1402 NE 26TH STREET FORT LAUDERDALE FL 33305 PEDIATRICS PRACTICE OFFICE OF ANIBAL LOZA MD 2000 NE 49TH STREET FORT LAUDERDALE FL 33308 FAMILY PRACTICE LIGHTHOUSE POINT PRACTICE 2100 E SAMPLE ROAD SUITE 101 POMPANO BEACH FL 33064 FAMILY PRACTICE COCONUT CREEK PRACTICE 4917 COCONUT CREEK PARKWAY POMPANO BEACH FL 33063 INTERNAL MEDICINE DR KARL CARDIOLOGY 880 NW 13TH STREET 1B BOCA RATON FL 33486 CARDIOLOGY PRACTICE DOROTHY MANGURIAN COMP WOMEN'S CENTER 1000 NE 56TH ST FORT LAUDERDALE FL 33334 FAMILY PRACTICE, REHABILITATION FAMILY LIFE CENTER PRACTICE 114 N FLAGLER AVE POMPANO BEACH FL 33060 FAMILY PRACTICE OFFICES OF MELLIN AND SCHWARTZ 4800 NE 20TH TERRACE SUITE 211 FORT LAUDERDALE FL 33308 INTERNAL MEDICINE BOCA RATON ORTHOPEDICS PRACTICE 9970 CENTRAL PARK BLVD 400 BOCA RATON FL 33428 ORTHOPEDICS PRACTICE, REHABILITATION FAMILY PHYSICIANS OF SOUTH FLORIDA 2001 N FEDERAL HWY 301 POMPANO BEACH FL 33062 FAMILY PRACTICE OFFICE OF ANGELA BUSCH DO 1930 NE 47TH STREET SUITE 104 FORT LAUDERDALE FL 33308 FAMILY PRACTICE PART I, LINE 3C: IN ADDITION TO LOOKING AT A MULTIPLE OF THE FEDERAL POVERTY GUIDELINES, OTHER FACTORS ARE CONSIDERED SUCH AS THE PATIENT'S FINANCIAL STATUS AND/OR ABILITY TO PAY AS DETERMINED THROUGH THE ASSESSMENT PROCESS. PART I, LINE 6A: HOLY CROSS HOSPITAL, INC. REPORTS ITS COMMUNITY BENEFIT INFORMATION AS PART OF THE CONSOLIDATED COMMUNITY BENEFIT INFORMATION REPORTED BY TRINITY HEALTH (EIN 35-1443425) IN ITS AUDITED FINANCIAL STATEMENTS, AVAILABLE AT WWW.TRINITY-HEALTH.ORG.IN ADDITION, HOLY CROSS HOSPITAL, INC. INCLUDES A COPY OF ITS MOST RECENTLY FILED SCHEDULE H ON BOTH ITS OWN WEBSITE AND TRINITY HEALTH'S WEBSITE. PART I, LINE 7: THE BEST AVAILABLE DATA WAS USED TO CALCULATE THE COST AMOUNTS REPORTED IN ITEM 7. FOR CERTAIN CATEGORIES, PRIMARILY TOTAL CHARITY CARE AND MEANS-TESTED GOVERNMENT PROGRAMS, SPECIFIC COST-TO-CHARGE RATIOS WERE CALCULATED AND APPLIED TO THOSE CATEGORIES. THE COST-TO-CHARGE RATIO WAS DERIVED FROM WORKSHEET 2, RATIO OF PATIENT CARE COST-TO-CHARGES. IN OTHER CATEGORIES, THE BEST AVAILABLE DATA WAS DERIVED FROM THE HOSPITAL'S COST ACCOUNTING SYSTEM. PART I, LN 7 COL(F): THE FOLLOWING NUMBER, $33,965,191, REPRESENTS THE AMOUNT OF BAD DEBT EXPENSE INCLUDED IN TOTAL FUNCTIONAL EXPENSES IN FORM 990, PART IX, LINE 25. PER IRS INSTRUCTIONS, THIS AMOUNT WAS EXCLUDED FROM THE DENOMINATOR WHEN CALCULATING THE PERCENT OF TOTAL EXPENSE FOR SCHEDULE H, PART I, LINE 7, COLUMN (F). PART III, LINE 2: METHODOLOGY USED FOR LINE 2 - ANY DISCOUNTS PROVIDED OR PAYMENTS MADE TO A PARTICULAR PATIENT ACCOUNT ARE APPLIED TO THAT PATIENT ACCOUNT PRIOR TO ANY BAD DEBT WRITE-OFF AND ARE THUS NOT INCLUDED IN BAD DEBT EXPENSE. AS A RESULT OF THE PAYMENT AND ADJUSTMENT ACTIVITY BEING POSTED TO BAD DEBT ACCOUNTS, WE ARE ABLE TO REPORT BAD DEBT EXPENSE NET OF THESE TRANSACTIONS. PART III, LINE 3: HOLY CROSS HOSPITAL, INC. USES A PREDICTIVE MODEL THAT INCORPORATES THREE DISTINCT VARIABLES IN COMBINATION TO PREDICT WHETHER A PATIENT QUALIFIES FOR CHARITY: (1) SOCIO-ECONOMIC SCORE, (2) ESTIMATED FEDERAL POVERTY LEVEL (FPL), AND (3) HOMEOWNERSHIP. BASED ON THE MODEL, CHARITY CARE CAN STILL BE EXTENDED TO PATIENTS EVEN IF THEY HAVE NOT RESPONDED TO FINANCIAL COUNSELING EFFORTS AND ALL OTHER FUNDING SOURCES HAVE BEEN EXHAUSTED. FOR FINANCIAL STATEMENT PURPOSES, HOLY CROSS HOSPITAL, INC. IS RECORDING AMOUNTS AS CHARITY CARE (INSTEAD OF BAD DEBT EXPENSE) BASED ON THE RESULTS OF THE PREDICTIVE MODEL. THEREFORE, HOLY CROSS HOSPITAL, INC. IS REPORTING ZERO ON LINE 3, SINCE THEORETICALLY ANY POTENTIAL CHARITY CARE SHOULD HAVE BEEN IDENTIFIED THROUGH THE PREDICTIVE MODEL. PART III, LINE 4: HOLY CROSS HOSPITAL, INC. IS INCLUDED IN THE CONSOLIDATED FINANCIAL STATEMENTS OF TRINITY HEALTH. THE FOLLOWING IS THE TEXT OF THE ALLOWANCE FOR DOUBTFUL ACCOUNTS FOOTNOTE FROM PAGE 15 OF THOSE STATEMENTS: "THE CORPORATION RECOGNIZES A SIGNIFICANT AMOUNT OF PATIENT SERVICE REVENUE AT THE TIME THE SERVICES ARE RENDERED EVEN THOUGH THE CORPORATION DOES NOT ASSESS THE PATIENT'S ABILITY TO PAY AT THAT TIME. AS A RESULT, THE PROVISION FOR BAD DEBTS IS PRESENTED AS A DEDUCTION FROM PATIENT SERVICE REVENUE (NET OF CONTRACTUAL PROVISIONS AND DISCOUNTS). FOR UNINSURED AND UNDERINSURED PATIENTS THAT DO NOT QUALIFY FOR CHARITY CARE, THE CORPORATION ESTABLISHES AN ALLOWANCE TO REDUCE THE CARRYING VALUE OF SUCH RECEIVABLES TO THEIR ESTIMATED NET REALIZABLE VALUE. THIS ALLOWANCE IS ESTABLISHED BASED ON THE AGING OF ACCOUNTS RECEIVABLE AND THE HISTORICAL COLLECTION EXPERIENCE BY THE HEALTH MINISTRIES AND FOR EACH TYPE OF PAYOR. A SIGNIFICANT PORTION OF THE CORPORATION'S PROVISION FOR DOUBTFUL ACCOUNTS RELATES TO SELF-PAY PATIENTS, AS WELL AS CO-PAYMENTS AND DEDUCTIBLES OWED TO THE CORPORATION BY PATIENTS WITH INSURANCE." PART III, LINE 8: HOLY CROSS HOSPITAL, INC. DOES NOT BELIEVE ANY MEDICARE SHORTFALL SHOULD BE TREATED AS COMMUNITY BENEFIT. THIS IS SIMILAR TO CATHOLIC HEALTH ASSOCIATION RECOMMENDATIONS, WHICH STATE THAT SERVING MEDICARE PATIENTS IS NOT A DIFFERENTIATING FEATURE OF TAX-EXEMPT HEALTHCARE ORGANIZATIONS AND THAT THE EXISTING COMMUNITY BENEFIT FRAMEWORK ALLOWS COMMUNITY BENEFIT PROGRAMS THAT SERVE THE MEDICARE POPULATION TO BE COUNTED IN OTHER COMMUNITY BENEFIT CATEGORIES.PART III, LINE 8: COSTING METHODOLOGY FOR LINE 6 - MEDICARE COSTS WERE OBTAINED FROM THE FILED MEDICARE COST REPORT. THE COSTS ARE BASED ON MEDICARE ALLOWABLE COSTS AS REPORTED ON WORKSHEET B, COLUMN 27, WHICH EXCLUDE DIRECT MEDICAL EDUCATION COSTS. INPATIENT MEDICARE COSTS ARE CALCULATED BASED ON A COMBINATION OF ALLOWABLE COST PER DAY TIMES MEDICARE DAYS FOR ROUTINE SERVICES AND COST TO CHARGE RATIO TIMES MEDICARE CHARGES FOR ANCILLARY SERVICES. OUTPATIENT MEDICARE COSTS ARE CALCULATED BASED ON COST TO CHARGE RATIO TIMES MEDICARE CHARGES BY ANCILLARY DEPARTMENT. PART III, LINE 9B: THE HOSPITAL'S COLLECTION POLICY CONTAINS PROVISIONS ON THE COLLECTION PRACTICES TO BE FOLLOWED FOR PATIENTS WHO ARE KNOWN TO QUALIFY FOR FINANCIAL ASSISTANCE. CHARITY DISCOUNTS ARE APPLIED TO THE AMOUNTS THAT QUALIFY FOR FINANCIAL ASSISTANCE. COLLECTION PRACTICES FOR THE REMAINING BALANCES ARE CLEARLY OUTLINED IN THE ORGANIZATION'S COLLECTION POLICY. THE HOSPITAL HAS IMPLEMENTED BILLING AND COLLECTION PRACTICES FOR PATIENT PAYMENT OBLIGATIONS THAT ARE FAIR, CONSISTENT AND COMPLIANT WITH STATE AND FEDERAL REGULATIONS. PART VI, LINE 2: NEEDS ASSESSMENT - THE FOLLOWING IS A SUMMARY OF THE QUANTITATIVE AND QUALITATIVE DATA SETS THAT WERE EXAMINED DURING THE COUNCIL MEETINGS:BROWARD COUNTY DEMOGRAPHICSMORTALITY AND MORBIDITYMATERNAL AND CHILD HEALTHBEHAVIORAL HEALTH RISKSSUICIDE AND SELF INFLICTED INJURYHOSPITAL UTILIZATIONPREVENTION QUALITY INDICATORSU.S. BUREAU OF THE CENSUSAMERICAN COMMUNITY SURVEYFLORIDA CHARTSYOUTH RISK BEHAVIOR SURVEYPROFESSIONAL RESEARCH CONSULTANTS, INC. PROFESSIONAL RESEARCH CONSULTANTS COMMUNITY QUALITY OF LIFE SURVEY (TELEPHONE SURVEY)BEHAVIORAL RISK FACTOR SURVEILLANCE SYSTEMCOMMUNITY HEALTH SURVEYBROWARD REGIONAL HEALTH PLANNING COUNCIL DATA WAREHOUSE:FLORIDA, BROWARD AND HOLY CROSS HOSPITAL DATAHOSPITAL UTILIZATIONCHRONIC DISEASESPREVENTION QUALITY INDICATORSDIAGNOSIS RELATED GROUPINGS PART VI, LINE 3: PATIENT EDUCATION OF ELIGIBILITY FOR ASSISTANCE- HOLY CROSS HOSPITAL, INC. IS COMMITTED TO:- PROVIDING ACCESS TO QUALITY HEALTHCARE SERVICES WITH COMPASSION, DIGNITY AND RESPECT FOR THOSE WE SERVE, PARTICULARLY THE POOR AND THE UNDERSERVED IN OUR COMMUNITIES- CARING FOR ALL PERSONS, REGARDLESS OF THEIR ABILITY TO PAY FOR SERVICES- ASSISTING PATIENTS WHO CANNOT PAY FOR PART OR ALL OF THE CARE THEY RECEIVE - BALANCING NEEDED FINANCIAL ASSISTANCE FOR SOME PATIENTS WITH BROADER FISCAL RESPONSIBILITIES IN ORDER TO SUSTAIN VIABILITY AND PROVIDE THE QUALITY AND QUANTITY OF SERVICES FOR ALL WHO MAY NEED CARE IN A COMMUNITYIN ACCORDANCE WITH AMERICAN HOSPITAL ASSOCIATION RECOMMENDATIONS, HOLY CROSS HOSPITAL, INC. HAS ADOPTED THE FOLLOWING GUIDING PRINCIPLES WHEN HANDLING THE BILLING, COLLECTION AND FINANCIAL SUPPORT FUNCTIONS FOR OUR PATIENTS: - PROVIDE EFFECTIVE COMMUNICATIONS WITH PATIENTS REGARDING HOSPITAL BILLS- MAKE AFFIRMATIVE EFFORTS TO HELP PATIENTS APPLY FOR PUBLIC AND PRIVATE FINANCIAL SUPPORT PROGRAMS- OFFER FINANCIAL SUPPORT TO PATIENTS WITH LIMITED MEANS- IMPLEMENT POLICIES FOR ASSISTING LOW-INCOME PATIENTS IN A CONSISTENT MANNER- IMPLEMENT FAIR AND CONSISTENT BILLING AND COLLECTION PRACTICES FOR ALL PATIENTS WITH PATIENT PAYMENT OBLIGATIONSHOLY CROSS HOSPITAL, INC. COMMUNICATES EFFECTIVELY WITH PATIENTS REGARDING PATIENT PAYMENT OBLIGATIONS. FINANCIAL COUNSELING IS PROVIDED TO PATIENTS ABOUT THEIR PAYMENT OBLIGATIONS AND HOSPITAL BILLS. INFORMATION ON HOSPITAL-BASED FINANCIAL SUPPORT POLICIES AND EXTERNAL PROGRAMS THAT PROVIDE COVERAGE FOR SERVICES ARE MADE AVAILABLE TO PATIENTS DURING THE PRE-REGISTRATION AND REGISTRATION PROCESSES AND/OR THROUGH COMMUNICATIONS WITH PATIENTS SEEKING FINANCIAL ASSISTANCE. FINANCIAL COUNSELORS MAKE AFFIRMATIVE EFFORTS TO HELP PATIENTS APPLY FOR PUBLIC AND PRIVATE PROGRAMS FOR WHICH THEY MAY QUALIFY AND THAT MAY ASSIST THEM IN OBTAINING AND PAYING FOR HEALTHCARE SERVICES. EVERY EFFORT IS MADE TO DETERMINE A PATIENT'S ELIGIBILITY PRIOR TO OR AT THE TIME OF ADMISSION OR SERVICE. FINANCIAL ASSISTANCE APPLICATIONS WILL BE ACCEPTED UNTIL ONE YEAR AFTER THE FIRST BILLING STATEMENT TO THE PATIENT. HOLY CROSS HOSPITAL, INC. OFFERS FINANCIAL SUPPORT TO PATIENTS WITH LIMITED MEANS. THIS SUPPORT IS AVAILABLE TO UNINSURED AND UNDERINSURED PATIENTS WHO DO NOT QUALIFY FOR PUBLIC PROGRAMS OR OTHER ASSISTANCE. NOTIFICATION ABOUT FINANCIAL ASSISTANCE, INCLUDING CONTACT INFORMATION, IS AVAILABLE THROUGH PATIENT BROCHURES, MESSAGES ON PATIENT BILLS, POSTED NOTICES IN PUBLIC REGISTRATION AREAS INCLUDING EMERGENCY ROOMS, ADMITTING AND REGISTRATION DEPARTMENTS, AND OTHER PATIENT FINANCIAL SERVICES OFFICES. SUMMARIES OF HOSPITAL PROGRAMS ARE MADE AVAILABLE TO APPROPRIATE COMMUNITY HEALTH AND HUMAN SERVICES AGENCIES AND OTHER ORGANIZATIONS THAT ASSIST PEOPLE IN NEED. INFORMATION REGARDING FINANCIAL ASSISTANCE PROGRAMS IS ALSO AVAILABLE ON HOSPITAL WEBSITES. IN ADDITION TO ENGLISH, THIS INFORMATION IS ALSO AVAILABLE IN SPANISH AND CREOLE, REFLECTING OTHER PRIMARY LANGUAGES SPOKEN BY THE POPULATION SERVICED BY OUR HOSPITAL. HOLY CROSS HOSPITAL, INC. HAS ESTABLISHED A WRITTEN POLICY FOR THE BILLING, COLLECTION AND SUPPORT FOR PATIENTS WITH PAYMENT OBLIGATIONS. HOLY CROSS HOSPITAL, INC. MAKES EVERY EFFORT TO ADHERE TO THE POLICY AND IS COMMITTED TO IMPLEMENTING AND APPLYING THE POLICY FOR ASSISTING PATIENTS WITH LIMITED MEANS IN A PROFESSIONAL, CONSISTENT MANNER. PART VI, LINE 4: COMMUNITY INFORMATION - BROWARD COUNTY IS THE SECOND MOST POPULATED COUNTY IN THE STATE AND RANKS HIGH IN DIVERSITY. 14.3% OF THE POPULATION IS 65 AND OVER, WHICH IS LESS THAN THE PERCENTAGE FOR THE ENTIRE STATE. FROM 2000-2010, THE GREATEST POPULATION INCREASE OCCURRED AMONG THE 45-69 AGE GROUPS; AND THE GREATEST DECREASE IN THE 30-44 AND THE 70 AND OVER AGE GROUPS. THE GROWING FORECLOSURE CRISIS AMONG FLORIDA HOMEOWNERS HAS CREATED A NEW GROUP OF HOMELESS INDIVIDUALS AND INCREASED THE DEMAND FOR AFFORDABLE RENTAL HOUSING. BROWARD COUNTY HAS ALSO BEEN SIGNIFICANTLY IMPACTED BY UNEMPLOYMENT (4.5% IN 2001 VS. 8.1% JULY 2012), REFLECTING THE ECONOMIC CRISIS. NEARLY 15% OF BROWARD RESIDENTS LIVE IN POVERTY. OF THESE, FAMILIES WITH CHILDREN UNDER THE AGE OF 18, 15.6% WERE REPORTED AT OR BELOW THE FEDERAL POVERTY LEVEL. THERE HAS BEEN A STEADY INCREASE IN THE NUMBER OF INDIVIDUALS AND FAMILIES RECEIVING PUBLIC ASSISTANCE (MEDICAID AND FOOD STAMPS). THE UNINSURED RATE INCREASED OVER TIME FOR BROWARD COUNTY AND IT IS ESTIMATED THAT 24% OF NON-INSTITUTIONALIZED CIVILIAN RESIDENTS ARE UNINSURED.THE HOLY CROSS SERVICE AREA (SA) IS DEFINED GEOGRAPHICALLY BY WHERE 80% OF ADMISSIONS ARE DERIVED, WITH 65% OF ADMISSIONS DEFINING THE PRIMARY SERVICE AREA (PSA) AND 15% DEFINING THE HCH SECONDARY SERVICE AREA (SSA); ADMISSIONS BEYOND THE HCH SA ARE DEFINED AS "OTHER". PART VI, LINE 5: OTHER INFORMATION - THE COMMUNITY OUTREACH DEPARTMENT IS DEVOTED TO IMPROVING THE HEALTH OUTCOMES OF THE POOR, DISENFRANCHISED, HOMELESS, MARGINALIZED, AND NEEDY WHO LIVE IN OUR BACKYARDS, NEIGHBORHOODS, AND COMMUNITY. COMMUNITY HEALTH EDUCATION: IMPACT ON OUR COMMUNITYHEALTH EDUCATION PROMOTES LEARNING IN OTHER SUBJECTS. HEALTHY STUDENTS LEARN BETTER AND TEND TO DO BETTER IN SCHOOL (HIGHER ATTENDANCE, HAVE BETTER GRADES, AND PERFORM BETTER ON TESTS). THE GOODSTART, SCHOOL HEALTH, AND GROWING HEALTHY KIDS PROGRAMS TARGET LOWER INCOME, TITLE X SCHOOLS SERVING PRE-K TO 8TH GRADE STUDENTS, PARENTS, AND FACULTY IN OUR PRIMARY AND SECONDARY SERVICE AREAS.GOODSTARTPROGRAM GOALS: INCREASE KNOWLEDGE AND INSTILL GOOD HEALTH BEHAVIORS FOR LIFE.OUTCOMES AND MEASUREMENT:- 100% OF ELEMENTARY AGE STUDENTS PARTICIPATING IN MISS VANESSA'S BOOK CLUB PASSED LANGUAGE ARTS WITH A GRADE OF C OR BETTER.- 100% OF CHILDREN ATTENDING GOODSTART TARGETED CHILDCARE CENTERS HAVE RECEIVED CHILDHOOD IMMUNIZATIONS IN ACCORDANCE WITH FL STATE GUIDELINES.- 100% OF DAYCARE PROVIDERS ATTENDING GOODSTART CAREGIVER WORKSHOPS RECEIVED THE IN-SERVICE POINTS NEEDED TO MAINTAIN THEIR EMPLOYMENT.SCHOOL HEALTHPROGRAM GOALS: IMPROVE HEALTH TO PROMOTE STUDENT HEALTH AND LEARNING.OUTCOMES AND MEASUREMENT:- 100% OF PAROCHIAL ELEMENTARY SCHOOLS SURVEYED BY THE SCHOOL NURSE WERE FOUND TO BE 100% IN COMPLIANCE WITH THE COMPULSORY SCHOOL IMMUNIZATION LAW, INDICATING THE STATUS OF THEIR KINDERGARTEN AND SEVENTH (7TH) GRADE STUDENTS, PURSUANT TO THE REQUIREMENTS OF SECTION 1003.22, FLORIDA STATUTES, AND SECTION 64D-3.011 (3), FLORIDA ADMINISTRATIVE CODE. - LOCAL PUBLIC SCHOOLS OUT OF COMPLIANCE ARE PROVIDED WITH ACCESS TO FREE ON-SITE 7TH GRADE VACCINATIONS. APPROXIMATELY 10% OF A SCHOOL'S INCOMING 7TH GRADE STUDENTS RECEIVE IMMUNIZATION VIA THIS SERVICE.- 100% OF BABIES BORN AT HOLY CROSS HOSPITAL WHO RECEIVE THEIR FIRST DOSAGE OF HEPATITIS B VACCINE IN THE HOSPITAL ARE ENTERED INTO THE FL SHOTS SYSTEM. HOLY CROSS HOSPITAL IS THE FIRST HOSPITAL IN BROWARD COUNTY TO ENSURE THAT ALL NEWBORN HBV VACCINES ARE ENTERED INTO THE STATE DATABASE.- 98% OF ELIGIBLE AND PARTICIPATING PAROCHIAL ELEMENTARY SCHOOL STUDENTS ARE SCREENED FOR VISION, HEARING AND SCOLIOSIS BY THE SCHOOL NURSE.GROWING HEALTHY KIDSPROGRAM GOALS: BUILD KNOWLEDGE, SKILLS, AND POSITIVE ATTITUDES REGARDING HEALTH. OUTCOMES AND MEASUREMENT:- 50% INCREASE IN KNOWLEDGE DEMONSTRATED BY STUDENTS WHO PARTICIPATED IN THE HEALTH ROCKS PROGRAMS (AS MEASURED BY SURVEY INSTRUMENTS / UNIVERSITY OF FLORIDA).- 100% OF YOUTH AND TEACHER/PRINCIPAL PARTICIPANTS IN PILATES FOR GIRLS PROGRAM COMPLETED THE PROGRAM.- ON AVERAGE, A 2% DECREASE IN BODY FAT WAS MEASURED AT THE CONCLUSION OF THE 3-MONTH PILATES PROGRAM.PARISH NURSEPROGRAM GOALS: MAINTAIN INDEPENDENCE AND OPTIMAL PHYSICAL, MENTAL AND EMOTIONAL HEALTH.OUTCOMES AND MEASUREMENT:- INCREASE ACCESS TO HOMELESS POPULATION: HOPE WELLNESS CENTER OPENED IN CONJUNCTION WITH HOPE SOUTH FLORIDA (LEADING HOMELESS FAMILY PROVIDER)- 1,417 HOMELESS CLIENTS SERVED.- 2,090 INDIVIDUALS PROVIDED WITH HEALTH EDUCATION, SCREENING, AND MONITORING REGARDING CHRONIC DISEASES: HYPERTENSION, DIABETES, AND/OR CONGESTIVE HEART FAILURE.CHRONIC DISEASE MANAGEMENTPROGRAM GOALS: IMPROVE HEALTH AND WELLNESS IN PATIENTS WITH CHRONIC DISEASES.OUTCOMES AND MEASUREMENT:- DESIGNATED LOCATIONS AND TIMES IDENTIFIED WITHIN THE COMMUNITY FOR A NURSE TO PROVIDE COMMUNITY BASED HEALTH COACHING AND SELF-MANAGEMENT CLASSES.- 150 DIABETIC CLIENTS SERVED THROUGH SCATTERED SITE COMMUNITY LOCATIONS.- 75% OF CLIENTS WHO CONSISTENTLY VISIT THE NURSE HAVE DEMONSTRATED DECREASES IN THEIR WEIGHT AND A1C LEVELS.HIV AND HEPATITIS-C COUNSELING, TESTING AND LINKAGE TO CAREPROGRAM GOAL: KNOW YOUR HIV STATUS.OUTCOMES AND MEASUREMENT:- 3,938 HIV RAPID TESTS PROVIDED TO TARGETED COMMUNITIES.- 100% OF HIV POSITIVE CLIENTS ARE LINKED INTO THE HEALTHCARE SYSTEM.- 551 HEPATITIS RAPID TESTS PROVIDED TO TARGETED COMMUNITIES.- 3% POSITIVITY RATE: 78% POSITIVE CLIENTS LINKED INTO THE HEALTHCARE SYSTEM.- 63% OF THE TIME, ACCESS TO SERVICES IS PROVIDED AT TARGETED COMMUNITY SITES THROUGHOUT THE COMMUNITY ABOARD A MOBILE HEALTH UNIT.PARTNERS IN BREAST HEALTHPROGRAM GOALS: DECREASE LATE STAGE BREAST CANCER DIAGNOSIS IN THE HOPE OF SAVING LIVES.OUTCOMES AND MEASUREMENT:- PROVIDE MAMMOGRAPHY AND DIAGNOSTIC SERVICES TO LOWER INCOME INDIVIDUALS WHO LACK ACCESS TO THE HEALTHCARE SYSTEM.- 100% OF NEWLY DIAGNOSED BREAST CANCER PATIENTS LINKED INTO THE HEALTHCARE SERVICES CONTINUUM.PRAYER, PRAISE AND PURPOSE - PARTNERS IN BREAST HEALTH PROGRAMGOAL: PROVIDE BREAST HEALTH EDUCATION TO 600 AFRICAN AMERICAN/BLACK INDIVIDUALS IN CHURCH SETTINGS IN BROWARD.OUTCOMES AND MEASUREMENT:- 600 AFRICAN AMERICAN/BLACK INDIVIDUALS PROVIDED WITH BREAST HEALTH EDUCATION.- 85% INDICATING EITHER HAVING HAD A MAMMOGRAM WITHIN THE PAST YEAR OR AGREED TO SCHEDULE A MAMMOGRAM.COMMUNITY: PROGRAMS FOR OUR ASSOCIATESPROGRAM GOAL: REMOVE BARRIERS TO SOCIAL DETERMINANTS BY PROVIDING ASSOCIATES WITH ASSISTANCE.OUTCOMES AND MEASUREMENT:- 563 BACKPACKS DISTRIBUTED FOR BACK TO SCHOOL FOR STUDENTS PRE-K THROUGH 12TH GRADE.- 365 THANKSGIVING BASKETS PROVIDED TO FAMILIES.- 650 ANGEL TREE GIFTS FOR CHILDREN.FOOD INSECURITYPROGRAM GOAL: COLLECT AND DISTRIBUTE DONATED DRY AND CANNED GOODS TO COMMUNITIES IN NEED.OUTCOMES AND MEASUREMENT:- 3 TONS OF FOOD DISTRIBUTED TO LOCAL FOOD PANTRIES. PART VI, LINE 6: HOLY CROSS HOSPITAL, INC. IS A MEMBER OF TRINITY HEALTH, ONE OF THE LARGEST CATHOLIC HEALTH CARE DELIVERY SYSTEMS IN THE COUNTRY. TRINITY HEALTH ANNUALLY REQUIRES THAT ALL REGIONAL HEALTH MINISTRIES DEFINE - AND ACHIEVE - COMMUNITY BENEFIT GOALS THAT INCLUDE IMPLEMENTING NEEDED SERVICES OR EXPANDING ACCESS TO SERVICES FOR LOW-INCOME INDIVIDUALS. AS A NOT-FOR-PROFIT HEALTH SYSTEM, TRINITY HEALTH REINVESTS ITS PROFITS BACK INTO THE COMMUNITY THROUGH PROGRAMS SERVING THOSE WHO ARE POOR AND UNINSURED, HELPING MANAGE CHRONIC CONDITIONS LIKE DIABETES, PROVIDING HEALTH EDUCATION, PROMOTING WELLNESS AND REACHING OUT TO UNDERSERVED POPULATIONS. ANNUALLY, THE ORGANIZATION INVESTS MORE THAN $800 MILLION IN SUCH COMMUNITY BENEFITS AND WORKS TO ENSURE THAT ITS MEMBER HOSPITALS AND OTHER ENTITIES/AFFILIATES ENHANCE THE OVERALL HEALTH OF THE COMMUNITIES THEY SERVE BY ADDRESSING EACH COMMUNITY'S SPECIFIC NEEDS. FOR MORE INFORMATION ABOUT TRINITY HEALTH, VISIT WWW.TRINITY-HEALTH.ORG. 0 HUMANE SOCIETY OF BROWARD COUNTY 2070 GRIFFIN ROAD FORT LAUDERDALE FL 33312 596002321 501(C) (3) 5000 DONATION FOR THE 16 ANNUAL PAWS ON THE GREEN WOMEN'S INVITATIONAL GOLF TOURN COVENANT HOUSE OF FLORIDA 733 BREAKERS AVENUE FORT LAUDERDALE FL 33304 592323607 501(C) (3) 5000 DONATION FOR A MEZZINE SPONSOSHIP FOR THE NIGHTS OF BROADWAY STARS HOPE SOUTH FLORIDA INC DBA THE SHEPHERD'S WAY 1232 NE 26TH STREET WILTON MANORS FL 33305 650670031 501(C) (3) 5000 DONATION FOR TASTE OF HOPE WAREHOUSE GALA-INVESTOR SPONSORSHIP BROWARD PARTNERSHIP FOR THE HOMELESS 920 NW 7TH AVENUE FORT LAUDERDALE FL 33311 650777033 501(C) (3) 26250 DONATION VARIOUS EVENTS INCLUDING GOLD SPONSORHIP TO LEADERSHIP GALA 2015 CATHOLIC HEALTH SERVICES FOUNDATION 4790 N STATE RD 7 LAUDERDALE LAKES FL 33319 650312041 501(C) (3) 6000 DONATION FOR CRYSTAL SPONSORSHIP HABITAT FOR HUMANITY BROWARD 3564 N OCEAN BLVD FORT LAUDERDALE FL 33308 592320573 501(C) (3) 5000 DONATION FOR SILVER SPONSOR FOR SPIRIT OF HUMANITY AWARDS JACK & JILL CHILDRENS CENTER 1315 W BROWARD BLVD FORT LAUDERDALE FL 33312 590637870 501(C) (3) 15000 DONATION -FOUNDER CIRCLE LEVEL LEADERSHIP BROWARD FOUNDATION 1415 E SUNRISE BLVD STE 401 FORT LAUDERDALE FL 33304 630387636 501(C) (3) 12500 DONATION WOMAN LEADING BROWARD PRESENTING SPONSORSHIP URBAN LEAGUE OF BROWARD COUNTY 11 NW 36TH AVENUE FORT LAUDERDALE FL 33311 591564384 501(C) (3) 5000 DONATION SUNSHINE HEALTH COMMUNITY CENTER WOMEN IN DISTRESS PO BOX 676 FORT LAUDERDALE FL 33302 591592524 501(C) (3) 5000 DONATION 9TH ANNUAL STARFISH LUNCHEON 10 0 PART I, LINE 2: DONATIONS MADE BY HOLY CROSS HOSPITAL, INC. TO CHARITABLE ORGANIZATIONS ARE MADE IN FURTHERANCE OF THE RECIPIENT ORGANIZATION'S EXEMPT PURPOSE. DONATIONS ARE INCLUDED IN COMMUNITY BENEFITS IN SCHEDULE H IF THE CONTRIBUTION HAS BEEN FORMALLY RESTRICTED TO A COMMUNITY BENEFIT ACTIVITY THAT MEETS THE CRITERIA TO BE REPORTED ON SCHEDULE H. 0 1 0 0 0 0 0 0 0 PATRICK A TAYLOR MD DIRECTOR; PRESIDENT & CEO 0 468386 0 218119 0 345841 0 19350 0 24111 0 1075807 0 0 RAUL TAPIA DIRECTOR THROUGH 12/14; PHYSICIAN 449568 0 103086 0 1748 0 0 0 10597 0 564999 0 0 0 ARISTIDES ZACHAROUDIS MD DIRECTOR; PHYSICIAN 275797 0 279 0 1132 0 0 0 21207 0 298415 0 0 0 NORA TRIOLA DIRECTOR AS OF 7/14;TRINITY SVP & CN 0 440272 0 359065 0 215332 0 19350 0 13307 0 1047326 0 0 LINDA V WILFORD SVP & CFO 332261 0 56031 0 22396 0 60300 0 13609 0 484597 0 0 0 KENNETH HOMER MD CMO 342266 0 39660 0 70833 0 10300 0 15855 0 478914 0 0 0 MARK R DISSETTE SVP AND ADMINISTRATOR 268870 0 39964 0 38444 0 5100 0 19902 0 372280 0 0 0 TAREN RUGGIERO CNO 204302 0 21265 0 3617 0 6450 0 18387 0 254021 0 0 0 LUISA GUTMAN SVP & COO 320898 0 42235 0 8783 0 11381 0 13093 0 396390 0 0 0 DAVID TAUB MD CHIEF MEDICAL OFFICER, HCMG 413186 0 116739 0 897 0 0 0 25525 0 556347 0 0 0 JONATHAN C LEVY MD PHYSICIAN 520202 0 1095147 0 1896 0 0 0 23344 0 1640589 0 0 0 MARTIN ROCHE MD PHYSICIAN 627844 0 958153 0 2760 0 0 0 17214 0 1605971 0 0 0 WILLIAM LEONE JR MD PHYSICIAN 759286 0 667016 0 6730 0 0 0 29381 0 1462413 0 0 0 W PORTER MCROBERTS MD PHYSICIAN 364765 0 933693 0 2037 0 0 0 16935 0 1317430 0 0 0 PAUL WU MD PHYSICIAN 489259 0 554705 0 1731 0 0 0 27558 0 1073253 0 0 0 JAMES DESMARTEAU FORMER KEY EMPLOYEE 115638 0 0 0 420 0 6258 0 9073 0 131389 0 0 0 ANDREA J BRADLEY FORMER KEY EMPLOYEE 0 0 0 0 154818 0 0 0 0 0 154818 0 0 0 PART I, LINE 3 HOLY CROSS HOSPITAL, INC. IS A SUBSIDIARY IN THE TRINITY HEALTH SYSTEM. HOLY CROSS HOSPITAL, INC.'S CEO IS PAID DIRECTLY BY THE SYSTEM'S PARENT ENTITY, TRINITY HEALTH CORPORATION. TRINITY HEALTH CORPORATION USED THE FOLLOWING METHODS TO ESTABLISH THE COMPENSATION OF HOLY CROSS HOSPITAL, INC.'S CEO: - COMPENSATION COMMITTEE - INDEPENDENT COMPENSATION CONSULTANT - FORM 990 OF OTHER ORGANIZATIONS - WRITTEN EMPLOYMENT CONTRACT - COMPENSATION SURVEY OR STUDY, AND - APPROVAL BY THE BOARD OR COMPENSATION COMMITTEE PART I, LINE 4B THE FOLLOWING INDIVIDUALS ARE VESTED IN THE CATHOLIC HEALTH EAST SUPPLEMENTAL EXECUTIVE RETIREMENT PLAN (SERP), A NONQUALIFED PLAN. THE PLAN WAS FROZEN DECEMBER 31, 2013. THE FOLLOWING VESTED SERP AMOUNTS ARE INCLUDED IN COLUMN B(III) OF SCHEDULE J, PART II: PATRICK A. TAYLOR, MD - $193,583 NORA TRIOLA - $175,431 THE FOLLOWING ARE PARTICIPANTS IN THE NEW TRINITY HEALTH SUPPLEMENTAL EXECUTIVE RETIREMENT PLAN (SERP) EFFECTIVE JANUARY 1, 2014. THE PLAN WILL PROVIDE RETIREMENT BENEFITS TO CERTAIN TRINITY HEALTH EXECUTIVES SUBJECT TO MEETING SPECIFIED VESTING AND EMPLOYMENT DATE REQUIREMENTS. THERE WERE NO PAYOUTS IN 2014. PATRICK A. TAYLOR, MD - $-0- NORA TRIOLA - $-0- SR. SUSAN WELSH, RSM - $-0- THE FOLLOWING INDIVIDUALS ARE PARTICIPANTS IN A NON-QUALIFIED DEFERRED COMPENSATION PLAN. THE FOLLOWING PAYOUTS ARE INCLUDED IN COLUMN (B)(III) OF SCHEDULE J, PART II: PATRICK A. TAYLOR, MD - $115,853 LINDA WILFORD - $470 KENNETH HOMER, MD - $-0- MARK DISSETTE - $28,606 TAREN RUGGIERO - $-0- LUISA GUTMAN - $-0- JAMES DESMARTEAU - $-0- ANDREA BRADLEY - $132,276 MARC TAUB FAMILY MEMBER OF DAVID TAUB, MD, KEY EMPLOYEE 210011 EMPLOYMENT ARRANGEMENT 0 MELISSA ZACHAROUDIS FAMILY MEMBER OF ARISTIDES ZACHAROUDIS, MD, TRUSTEE 39318 EMPLOYMENT ARRANGEMENT 0 JM FAMILY ENTERPRISES INC (JMFE) JANICE MORAN, TRUSTEE, AND HER FAMILY CONTROL MORE THAN 35% OF JMFE 974775 HOLY CROSS HOSPITAL, INC. PROVIDES MEDICAL CARE TO THE EMPLOYEES OF JM FAMILY ENTERPRISES, INC. 0 FORM 990, PART VI, SECTION A, LINE 2 RAUL TAPIA, DIRECTOR, AND MICHELE TAPIA, DIRECTOR, HAVE A FAMILY RELATIONSHIP. HOWEVER THEY DID NOT SERVE ON THE BOARD AT THE SAME TIME. FORM 990, PART VI, SECTION A, LINE 4 THE ARTICLES OF INCORPORATION AND BYLAWS OF HOLY CROSS HOSPITAL, INC. WERE AMENDED AND RESTATED TO CHANGE THE SOLE MEMBER OF THE CORPORATION. EFFECTIVE JULY 1, 2014, THE SOLE MEMBER IS TRINITY HEALTH CORPORATION. FORM 990, PART VI, SECTION A, LINE 6 THE SOLE MEMBER OF HOLY CROSS HOSPITAL, INC. IS TRINITY HEALTH CORPORATION. SEE LINE 7 FOR ADDITIONAL INFORMATION. FORM 990, PART VI, SECTION A, LINE 7A TRINITY HEALTH CORPORATION IS THE SOLE MEMBER OF HOLY CROSS HOSPITAL, INC. TRINITY HEALTH CORPORATION HAS THE RIGHT TO APPOINT ALL PERSONS TO THE BOARD OF DIRECTORS OF HOLY CROSS HOSPITAL, INC. FORM 990, PART VI, SECTION A, LINE 7B AS SOLE MEMBER, TRINITY HEALTH CORPORATION MUST APPROVE CERTAIN DECISIONS OF THE GOVERNING BODY, INCLUDING THE STRATEGIC PLAN, ANNUAL CAPITAL PLAN, AND ANNUAL OPERATING BUDGET. TRINITY HEALTH CORPORATION MUST ALSO APPROVE SIGNIFICANT CHANGES SUCH AS A MERGER, DISSOLUTION, SALE OF ASSETS IN EXCESS OF CERTAIN LIMITS AND MODIFICATIONS TO GOVERNING DOCUMENTS. FORM 990, PART VI, SECTION B, LINE 11 PRIOR TO FILING, THE FORM 990 FOR HOLY CROSS HOSPITAL, INC. IS REVIEWED BY SENIOR MANAGEMENT. IN ADDITION, CERTAIN KEY SECTIONS OF THE FORM ARE REVIEWED BY THE COMPENSATION COMMITTEE AS WELL AS THE BOARD OF DIRECTORS. THE BOARD RECEIVES A COPY OF THE RETURN IN ITS FINAL FORM BEFORE IT IS FILED WITH THE INTERNAL REVENUE SERVICE. FORM 990, PART VI, SECTION B, LINE 12C HOLY CROSS HOSPITAL HAS ADOPTED TRINITY HEALTH'S GOVERNANCE POLICY NO. 1, WHICH SETS FORTH THE ORGANIZATION'S CONFLICT OF INTEREST POLICY AND PROCESSES. IT APPLIES TO ALL "INTERESTED PERSONS" OF HOLY CROSS HOSPITAL WHICH INCLUDES DIRECTORS, PRINCIPAL OFFICERS, KEY EMPLOYEES, AND MEMBERS OF COMMITTEES WITH BOARD-DELEGATED POWERS. INTERESTED PERSONS ARE EXPECTED TO DISCHARGE THEIR DUTIES IN A MANNER THE PERSON REASONABLY BELIEVES TO BE IN THE BEST INTERESTS OF HOLY CROSS HOSPITAL AND TO AVOID SITUATIONS INVOLVING A CONFLICT OF INTEREST. ON AN ANNUAL BASIS, INTERESTED PERSONS ARE REQUIRED TO COMPLETE A CONFLICT OF INTEREST DISCLOSURE STATEMENT AND TO AFFIRM THEIR RECEIPT OF THE CONFLICT OF INTEREST POLICY, COMPLIANCE WITH ITS REQUIREMENTS, AND AGREE TO NOTIFY THE ORGANIZATION OF CHANGES IMPACTING THEIR ANNUAL DISCLOSURE IN ACCORDANCE WITH THE POLICY. THE ANNUAL DISCLOSURES ARE PROVIDED TO INTERNAL LEGAL COUNSEL AND THE INTEGRITY AND COMPLIANCE OFFICER, FROM WHICH LEGAL COUNSEL PREPARES A REPORT FOR THE BOARD CHAIR AND CEO. A SUMMARY OF POTENTIAL CONFLICTS IS REVIEWED WITH THE BOARD OF DIRECTORS OF HOLY CROSS HOSPITAL (OR A DELEGATED COMMITTEE OF THE BOARD) ON A YEARLY BASIS. INTERESTED PERSONS ARE REQUIRED TO MAKE FULL DISCLOSURE TO HOLY CROSS HOSPITAL OF ANY FINANCIAL OR BUSINESS INTERESTS THAT MIGHT RESULT IN OR HAVE THE APPEARANCE OF A CONFLICT OF INTEREST. THE BOARD OF DIRECTORS OF HOLY CROSS HOSPITAL (OR A DELEGATED COMMITTEE OF THE BOARD) IS RESPONSIBLE FOR THE REVIEW OF TRANSACTIONS TO DETERMINE WHETHER AN ACTUAL CONFLICT OF INTEREST EXISTS. IN THE EVENT OF AN ACTUAL CONFLICT, THE BOARD (OR A DELEGATED COMMITTEE OF THE BOARD) WILL EITHER AVOID THE CONFLICT OR APPROPRIATELY SCRUTINIZE THE TRANSACTION TO ENSURE IT IS IN THE BEST INTERESTS OF HOLY CROSS HOSPITAL. INTERESTED PERSONS ARE REQUIRED TO RECUSE THEMSELVES FROM DISCUSSION AND VOTING ON MATTERS INVOLVING A CONFLICT OF INTEREST. THE POLICY FURTHER ADDRESSES THE PROPER DOCUMENTATION OF THE PROCEEDINGS AND POTENTIAL DISCIPLINARY AND CORRECTIVE ACTION FOR VIOLATIONS OF THE POLICY. THE POLICY IS AVAILABLE TO THE PUBLIC UPON REQUEST. FORM 990, PART VI, SECTION B, LINE 15B QUESTION 15A IS ANSWERED "NO" BECAUSE THE COMPENSATION FOR HOLY CROSS HOSPITAL, INC.'S CEO IS ESTABLISHED AND PAID BY TRINITY HEALTH, A RELATED ORGANIZATION. IN ESTABLISHING CEO COMPENSATION, TRINITY HEALTH FOLLOWS A PROCESS AND POLICY THAT IS INTENDED TO MIRROR THE IRC SECTION 4958 GUIDELINES FOR OBTAINING A "REBUTTABLE PRESUMPTION OF REASONABLENESS" WITH REGARD TO COMPENSATION AND BENEFITS. AS PART OF THAT PROCESS, THE COMPENSATION AND BENEFITS OF THE CEO OF HOLY CROSS HOSPITAL, INC. ARE REVIEWED AT LEAST ANNUALLY BY THE TRINITY HEALTH BOARD OR THE TRINITY HEALTH HUMAN RESOURCES AND COMPENSATION COMMITTEE (HRCC) OF THE BOARD, AUTHORIZED TO ACT ON BEHALF OF THE BOARD WITH RESPECT TO CERTAIN COMPENSATION MATTERS. AS PART OF ITS REVIEW PROCESS, THE HRCC RETAINS AN INDEPENDENT FIRM EXPERIENCED IN COMPENSATION AND BENEFIT MATTERS FOR NOT-FOR-PROFIT HEALTHCARE ORGANIZATIONS TO ADVISE IT IN THE DETERMINATIONS IT MAKES ON THE REASONABLENESS OF PROPOSED COMPENSATION AND BENEFITS ARRANGEMENTS. FOR THE COMPENSATION OF OTHER EXECUTIVES, HOLY CROSS HOSPITAL, INC. HAS A PROCESS FOR DETERMINING COMPENSATION WHICH INCLUDES THE FOLLOWING: THE BOARD HAS AN INDEPENDENT COMMITTEE REVIEW AND APPROVE ALL ELEMENTS OF REMUNERATION FOR ALL DISQUALIFIED PARTIES, AS WELL AS OTHER KEY MANAGEMENT. THE BOARD/COMMITTEE HAS AN ESTABLISHED COMPENSATION PHILOSOPHY WHICH DETAILS THE OBJECTIVES OF MARKET POSITIONING AND PAY ELEMENTS. THE COMMITTEE ENGAGES WITH EXTERNAL CONSULTANTS TO PROVIDE MARKET DATA COMPARING THE ORGANIZATION'S ROLES TO SIMILARLY SIZED HEALTH SYSTEMS UTILIZING BOTH TITLE AND JOB CONTENT COMPARISONS. THE COMMITTEE REVIEWS THE MARKET ANALYSIS, APPROVES ANY SALARY ADJUSTMENTS FOR THE EXECUTIVE POPULATION, CONSIDERS BOTH REASONABLENESS AND EFFECTIVENESS OF ALL REMUNERATIVE PROGRAMS AND ESTABLISHES THE DETAILED PERFORMANCE EXPECTATIONS WHICH ARE INCORPORATED INTO THE INCENTIVE PLAN. ALL OF THESE DISCUSSIONS AND DECISIONS ARE DOCUMENTED THROUGH THE PROVISION OF MEETING MINUTES. FORM 990, PART VI, SECTION C, LINE 19 HOLY CROSS HOSPITAL, INC. IS A SUBSIDIARY ORGANIZATION IN THE TRINITY HEALTH SYSTEM. TRINITY HEALTH MAKES CERTAIN OF ITS KEY DOCUMENTS AVAILABLE TO THE PUBLIC ON ITS WEBSITE, WWW.TRINITY-HEALTH.ORG, IN THE "ABOUT US" SECTION. IN THIS SECTION, THE CONSOLIDATED AUDITED FINANCIAL STATEMENTS ARE PUBLICLY AVAILABLE. IN ADDITION, HOLY CROSS HOSPITAL, INC. INCLUDES A COPY OF ITS MOST RECENTLY FILED SCHEDULE H ON BOTH ITS OWN WEBSITE AND TRINITY HEALTH'S WEBSITE. HOLY CROSS HOSPITAL, INC.'S GOVERNING DOCUMENTS AND CONFLICT OF INTEREST POLICY ARE AVAILABLE UPON REQUEST. FORM 990, PART VII, LINE 1: SR. SUSAN WELSH, RSM, IS A MEMBER OF THE RELIGIOUS SISTERS OF MERCY. HAVING TAKEN A VOW OF POVERTY, SR. SUSAN WELSH DID NOT RECEIVE COMPENSATION FOR THE SERVICES SHE PROVIDED AS CEO TO PITTSBURGH MERCY HEALTH SYSTEM, A RELATED ENTITY, EXCEPT FOR INSURANCE BENEFITS OF $14,864. INSTEAD, A TOTAL OF $510,397 WAS PAID BY TRINITY HEALTH CORPORATION DIRECTLY TO THE RELIGIOUS SISTERS OF MERCY FOR SR. SUSAN WELSH'S SERVICES. FORM 990, PART XI, LINE 9: EQUITY TRANSFERS TO AFFILIATES -2,217,202. INCOME/LOSS FROM DISCONTINUED OPERATIONS -1,666,294. OTHER TRANSACTIONS 743,930. FORM 990, PART XII, LINE 2: HOLY CROSS HOSPITAL, INC.'S FINANCIAL STATEMENTS WERE INCLUDED IN THE FY15 CONSOLIDATED FINANCIAL STATEMENTS OF TRINITY HEALTH, WHICH WERE AUDITED BY AN INDEPENDENT PUBLIC ACCOUNTING FIRM. FORM 990, BOX C, DOING BUSINESS AS NAMES DOROTHY MANGURIAN COMPREHENSIVE WOMEN'S CENTER HARRY AND BEATRICE FELDMAN CENTER FOR OPTIMAL HEALTH HOLY CROSS HEALTH MINISTRIES HOLY CROSS CLINIC SERVICES HOLY CROSS HEALTHPLEX HOLY CROSS HOSPITAL HEALTHPLEX MEDICAL PLAZA HOLY CROSS HOSPITAL HOME HEALTH AGENCY HOLY CROSS MEDICAL GROUP HOLY CROSS ORTHOPEDIC INSTITUTE HOLY CROSS RESEARCH CENTER HOLY CROSS URGENT CARE AND IMAGING JIM MORAN HEART AND VASCULAR RESEARCH INSTITUTE MEDICAL PLAZA NORTH RIDGE MEDICAL CENTER THE MICHAEL AND DIANNE BIENES COMPREHENSIVE CANCER CENTER ZACHARIAH FAMILY WELLNESS PAVILION HOLY CROSS PHYSICIAN PARTNERS LLC 4725 N FEDERAL HWY FT LAUDERDALE FL 33308 364712116 MEDICAL SERVICES FL -591814 697957 HOLY CROSS HOSPITAL INC HOLY CROSS PHYSICIAN PARTNERS ACO LLC 4725 N FEDERAL HWY FT LAUDERDALE FL 33308 465530455 ACCOUNTABLE CARE ORGANIZATION FL 0 0 HOLY CROSS HOSPITAL INC ADVANTAGE HEALTHSAINT MARY'S MEDICAL GROUP 245 STATE ST SE GRAND RAPIDS MI 49503 272491974 HEALTHCARE SERVICES MI 501(C)(3) LINE 9 TRINITY HEALTH-MICHIGAN 1 ALBANY MEMORIAL HOSPITAL 600 NORTHERN BLVD ALBANY NY 12204 141338457 HEALTHCARE AND HOSPITAL SERVICES NY 501(C)(3) LINE 3 NORTHEAST HEALTH INC 1 ALLEGANY FRANCISCAN MINISTRIES INC 33920 US HIGHWAY 19 NORTH SUITE 269 PALM HARBOR FL 34684 581492325 HEALTHCARE SYSTEM MANAGEMENT AND SUPPORT FL 501(C)(3) LINE 11A, I TRINITY HEALTH CORPORATION 1 AMICARE HOSPICE SERVICES INC 20555 VICTOR PARKWAY LIVONIA MI 48152 382949053 HOSPICE SERVICES MI 501(C)(3) LINE 9 TRINITY HOME HEALTH SERVICES INC 1 AUXILIARY OF HOLY ROSARY HOSPITAL 351 SW 9TH STREET ONTARIO OR 97914 943059469 VOLUNTEER SERVICE AUXILIARY OR 501(C)(3) LINE 9 SAINT ALPHONSUS MEDICAL CENTER-ONTARIO 1 BAUM HARMON MERCY HOSPITAL 255 NORTH WELCH AVENUE PRIMGHAR IA 51245 421500277 HEALTHCARE AND HOSPITAL SERVICES IA 501(C)(3) LINE 3 MERCY HEALTH SERVICES-IOWA CORP 1 BAUM HARMON MERCY HOSPITAL AND CLINICS FOUNDATION 255 NORTH WELCH AVENUE PRIMGHAR IA 51245 262973307 FOUNDATION IA 501(C)(3) LINE 11A, I BAUM HARMON MERCY HOSPITAL 1 BEECHWOOD INC 2212 BURDETT AVE TROY NY 12180 141651563 TITLE HOLDING COMPANY NY 501(C)(2) N/A LTC (EDDY) INC 1 BEVERWYCK INC 40 AUTUMN DRIVE SLINGERLANDS NY 12159 141717028 SENIOR LIVING COMMUNITY NY 501(C)(3) LINE 9 LTC (EDDY) INC 1 BRIGHTSIDE INC C/O SPHS 1221 MAIN STREET SUITE 213 HOLYOKE MA 01040 042182395 HEALTHCARE SERVICES MA 501(C)(3) LINE 9 SISTERS OF PROVIDENCE HEALTH SYSTEM INC 1 CAPITAL REGION GERIATRIC CENTER INC 421 WEST COLUMBIA ST COHOES NY 12047 141701597 LONG TERM CARE NY 501(C)(3) LINE 9 LTC (EDDY) INC 1 CATHERINE MCAULEY HEALTH SERVICES CORP PO BOX 995 ANN ARBOR MI 48106 382507173 HEALTHCARE SERVICES (INACTIVE) MI 501(C)(3) LINE 3 TRINITY HEALTH-MICHIGAN 1 CATHOLIC HEALTH MINISTRIES 20555 VICTOR PARKWAY LIVONIA MI 48152 GOVERNANCE AND MANAGEMENT OF TRINITY HEALTH SYSTEM VT 501(C)(3) LINE 1 N/A 0 COLUMBUS ACQUISITION CORP 111 CENTRAL AVENUE NEWARK NJ 07102 262616342 INACTIVE ENTITY NJ 501(C)(3) LINE 9 SAINT MICHAEL'S MEDICAL CENTER 1 COMMUNITY HEALTH PARTNERS OF SOUTH BEND PO BOX 3998 SOUTH BEND IN 46619 263051440 HEALTHCARE SERVICES IN 501(C)(3) LINE 3 SAINT JOSEPH REGIONAL MEDICAL CENTER INC 1 CRANBROOK HOSPICE CARE 1111 W LONG LAKE RD STE 102 TROY MI 48098 383320699 HOSPICE SERVICES MI 501(C)(3) LINE 9 TRINITY HOME HEALTH SERVICES INC 1 DILEY RIDGE MEDICAL CENTER 7911 DILEY ROAD CANAL WINCHESTER OH 43110 342032340 HEALTHCARE AND HOSPITAL SERVICES OH 501(C)(3) LINE 3 MOUNT CARMEL HEALTH SYSTEM 1 DUBUQUE MERCY HEALTH FOUNDATION INC 250 MERCY DRIVE DUBUQUE IA 52001 262227941 FOUNDATION IA 501(C)(3) LINE 11A, I MERCY HEALTH SERVICES-IOWA CORP 1 DYERSVILLE HEALTH FOUNDATION INC 1111 3RD STREET SW DYERSVILLE IA 52040 205383271 FOUNDATION IA 501(C)(3) LINE 11A, I MERCY HEALTH SERVICES-IOWA CORP 1 EAST NORRITON PHYSICIAN SERVICES C/O ONE WEST ELM STREET CONSHOHOCKEN PA 19428 232515999 HEALTHCARE SERVICES PA 501(C)(3) LINE 3 MERCY PHYSICIAN NETWORK 1 EDDY LICENSED HOME CARE AGENCY 433 RIVER ST SUITE 3000 TROY NY 12180 141818568 HOME HEALTH SERVICES NY 501(C)(3) LINE 3 LTC (EDDY) INC 1 EMPIRE HOME INFUSION SERVICE INC 10 BLACKSMITH DRIVE MALTA NY 12020 141795732 HOME HEALTH SERVICES NY 501(C)(3) LINE 9 HOME AIDE SERVICE OF EASTERN NEW YORK INC 1 FARREN CARE CENTER INC C/O SPHS 1221 MAIN STREET SUITE 213 HOLYOKE MA 01040 042501711 LONG TERM CARE MA 501(C)(3) LINE 3 SISTERS OF PROVIDENCE HEALTH SYSTEM INC 1 FRANCISCAN ELDERCARE CORPORATION PO BOX 2500 WILMINGTON DE 19805 223008680 LONG TERM CARE (INACTIVE) DE 501(C)(3) LINE 9 ST FRANCIS HOSPITAL 1 GLEN EDDY INC ONE GLEN EDDY DRIVE NISKAYUNA NY 12309 141794150 SENIOR LIVING COMMUNITY NY 501(C)(3) LINE 9 LTC (EDDY) INC 1 GLOBAL HEALTH MINISTRY 3805 WEST CHESTER PIKE SUITE 100 NEWTOWN SQUARE PA 19073 233068656 HEALTHCARE SERVICES PA 501(C)(3) LINE 7 TRINITY HEALTH CORPORATION 1 GLOBAL HEALTH MINISTRY (FKA TRINITY HEALTH INTERNATIONAL) 20555 VICTOR PARKWAY LIVONIA MI 48152 421253527 HEALTHCARE SERVICES MI 501(C)(3) LINE 11A, I TRINITY HEALTH CORPORATION 1 GOOD SAMARITAN HOSPITAL INC 5401 LAKE OCONEE PARKWAY GREENSBORO GA 30642 261720984 HEALTHCARE AND HOSPITAL SERVICES GA 501(C)(3) LINE 3 ST MARY'S HEALTH CARE SYSTEM INC 1 GOTTLIEB COMMUNITY HEALTH SERVICES CORPORATION 701 W NORTH AVE MELROSE PARK IL 60160 363332852 COMMUNITY OUTREACH IL 501(C)(3) LINE 9 GOTTLIEB MEMORIAL HOSPITAL 1 GOTTLIEB MEMORIAL FOUNDATION 701 W NORTH AVE MELROSE PARK IL 60160 743260011 FOUNDATION IL 501(C)(3) LINE 11C, III-FI N/A 0 GOTTLIEB MEMORIAL HOSPITAL 701 W NORTH AVE MELROSE PARK IL 60160 362379649 HEALTHCARE AND HOSPITAL SERVICES IL 501(C)(3) LINE 3 LOYOLA UNIVERSITY HEALTH SYSTEM 1 GRAND RAPIDS MEDICAL EDUCATION PARTNERS INC 1000 MONROE AVENUE NW GRAND RAPIDS MI 49503 237270669 MEDICAL EDUCATION TRAINING PROGRAMS MI 501(C)(3) LINE 11A, I TRINITY HEALTH-MICHIGAN 1 HACKLEY HOSPITAL SELF INSURANCE PROFESSIONAL LIABILITY TRUST PO BOX 3302 MUSKEGON MI 49443 382299878 SELF INSURANCE MI 501(C)(3) LINE 11B, II MERCY HEALTH PARTNERS 1 HACKLEY LIFE COUNSELING 125 E SOUTHERN AVENUE MUSKEGON MI 49442 381386362 HEALTHCARE SERVICES MI 501(C)(3) LINE 9 MERCY HEALTH PARTNERS 1 HAWTHORNE RIDGE INC 30 COMMUNITY WAY EAST GREENBUSH NY 12061 800102840 SENIOR LIVING COMMUNITY NY 501(C)(3) LINE 9 LTC (EDDY) INC 1 HERITAGE HOUSE NURSING CENTER INC 2920 TIBBITS AVE TROY NY 12180 141725101 LONG TERM CARE NY 501(C)(3) LINE 9 LTC (EDDY) INC 1 HOLY CROSS CARENET INC PO BOX 9184 FARMINGTON HILLS MI 48152 521945054 LONG TERM CARE MD 501(C)(3) LINE 9 HOLY CROSS HEALTH INC 1 HOLY CROSS HEALTH FOUNDATION INC 11801 TECH ROAD SILVER SPRING MD 20904 208428450 FOUNDATION MD 501(C)(3) LINE 7 HOLY CROSS HEALTH INC 1 HOLY CROSS HEALTH INC 1500 FOREST GLEN RD SILVER SPRING MD 20910 520738041 HEALTHCARE AND HOSPITAL SERVICES MD 501(C)(3) LINE 3 TRINITY HEALTH CORPORATION 1 HOLY CROSS HOSPITAL INC 4725 NORTH FEDERAL HIGHWAY FT LAUDERDALE FL 33308 590791028 HEALTHCARE AND HOSPITAL SERVICES FL 501(C)(3) LINE 3 TRINITY HEALTH CORPORATION 0 HOLY CROSS MEDICAL PROPERTIES INC 4725 NORTH FEDERAL HIGHWAY FT LAUDERDALE FL 33308 650666283 BUILDING MANAGEMENT SERVICES FL 501(C)(2) N/A HOLY CROSS HOSPITAL INC 1 HOLY CROSS OUTPATIENT SERVICES INC 4725 NORTH FEDERAL HIGHWAY FT LAUDERDALE FL 33308 465421068 HEALTHCARE SERVICES FL 501(C)(3) LINE 9 HOLY CROSS HOSPITAL INC 1 HOME AIDE SERVICE OF EASTERN NEW YORK INC 433 RIVER ST SUITE 3000 TROY NY 12180 141514867 HOME HEALTH SERVICES NY 501(C)(3) LINE 9 LTC (EDDY) INC 1 HOSPICE OF NORTH IOWA 232 SECOND STREET SE MASON CITY IA 50401 421173708 HOSPICE SERVICES IA 501(C)(3) LINE 9 MERCY HEALTH SERVICES-IOWA CORP 1 HOSPICE OF SIOUXLAND 4300 HAMILTON BLVD SIOUX CITY IA 51104 383320710 HOSPICE SERVICES IA 501(C)(3) LINE 11A, I N/A 0 HOSPICE OF WASHTENAW II 806 AIRPORT BLVD ANN ARBOR MI 48108 383320707 HOSPICE SERVICES MI 501(C)(3) LINE 11A, I TRINITY HEALTH-MICHIGAN 1 IHA HEALTH SERVICES CORPORATION 24 FRANK LLOYD WRIGHT DR LOBBY J ANN ARBOR MI 48106 383316559 HEALTHCARE SERVICES MI 501(C)(3) LINE 9 TRINITY HEALTH-MICHIGAN 1 INTRACOASTAL HEALTH SYSTEMS INC 3805 WEST CHESTER PIKE SUITE 100 NEWTOWN SQUARE PA 19073 650556413 HEALTHCARE SYSTEM MANAGEMENT AND SUPPORT FL 501(C)(3) LINE 9 TRINITY HEALTH CORPORATION 1 JAMES A EDDY MEMORIAL GERIATRIC CENTER INC 2256 BURDETT AVE TROY NY 12180 222570478 LONG TERM CARE NY 501(C)(3) LINE 9 LTC (EDDY) INC 1 LANGHORNE MRI INC 1201 LANGHORNE-NEWTOWN ROAD LANGHORNE PA 19047 232519529 HEALTHCARE SERVICES (INACTIVE) PA 501(C)(3) LINE 9 ST MARY MEDICAL CENTER 1 LANGHORNE PHYSICIAN SERVICES INC 1201 LANGHORNE-NEWTOWN ROAD LANGHORNE PA 19047 232571699 HEALTHCARE SERVICES PA 501(C)(3) LINE 9 ST MARY MEDICAL CENTER 1 LIFE AT LOURDES INC 2475 MCCLELLAN AVENUE PENNSAUKEN NJ 08109 261854750 PACE PROGRAM NJ 501(C)(3) LINE 3 OUR LADY OF LOURDES HEALTH CARE SERVICES 1 LIFE AT ST FRANCIS HEALTHCARE INC 7TH CLAYTON STREETS WILMINGTON DE 19805 452569214 PACE PROGRAM DE 501(C)(3) LINE 9 ST FRANCIS HOSPITAL 1 LIFE ST FRANCIS CORPORATION 1435 LIBERTY STREET HAMILTON NJ 08629 222797282 PACE PROGRAM NJ 501(C)(3) LINE 11A, I ST FRANCIS MEDICAL CENTER TRENTON NJ 1 LIFE ST JOSEPH OF THE PINES INC 100 GOSSMAN DRIVE SOUTHERN PINES NC 28387 272159847 PACE PROGRAM NC 501(C)(3) LINE 3 ST JOSEPH OF THE PINES INC 1 LIFE ST MARY 1201 LANGHORNE-NEWTOWN ROAD LANGHORNE PA 19047 262976184 PACE PROGRAM PA 501(C)(3) LINE 9 ST MARY MEDICAL CENTER 1 LOURDES ANCILLARY SERVICES 1600 HADDON AVENUE CAMDEN NJ 08103 222568525 VOLUNTEER SERVICE AUXILIARY NJ 501(C)(3) LINE 11B, II OUR LADY OF LOURDES HEALTH CARE SERVICES 1 LOURDES CARDIOLOGY SERVICES PC 1600 HADDON AVENUE CAMDEN NJ 08103 274357794 HEALTHCARE SERVICES NJ 501(C)(3) LINE 3 OUR LADY OF LOURDES HEALTH CARE SERVICES 1 LOURDES DIALYSIS AT INNOVA INC 3716 CHURCH ROAD MT LAUREL NJ 08054 263237625 HEALTHCARE SERVICES (INACTIVE) NJ 501(C)(3) LINE 3 OUR LADY OF LOURDES HEALTH CARE SERVICES 1 LOURDES MEDICAL CENTER OF BURLINGTON COUNTY 218 SUNSET ROAD WILLINGBORO NJ 08046 223612265 HEALTHCARE AND HOSPITAL SERVICES NJ 501(C)(3) LINE 3 OUR LADY OF LOURDES HEALTH CARE SERVICES 1 LOYOLA UNIVERSITY HEALTH SYSTEM 2160 SOUTH FIRST AVENUE MAYWOOD IL 60153 363342448 HEALTHCARE SYSTEM MANAGEMENT AND SUPPORT IL 501(C)(3) LINE 11B, II TRINITY HEALTH CORPORATION 1 LOYOLA UNIVERSITY MEDICAL CENTER 2160 SOUTH FIRST AVENUE MAYWOOD IL 60153 364015560 HEALTHCARE AND HOSPITAL SERVICES IL 501(C)(3) LINE 3 LOYOLA UNIVERSITY HEALTH SYSTEM 1 LTC (EDDY) INC 2212 BURDETT AVE TROY NY 12180 222564710 MANAGEMENT SERVICES FOR LONG TERM CARE NY 501(C)(3) LINE 11B, II NORTHEAST HEALTH INC 1 MARIAN COMMUNITY HOSPITAL 3805 WEST CHESTER PIKE NO 100 NEWTOWN SQUARE PA 19073 240711230 HEALTHCARE SERVICES (INACTIVE) PA 501(C)(3) LINE 9 MAXIS HEALTH SYSTEM 1 MARIAN HOME HEALTHCARE 801 5TH STREET SIOUX CITY IA 51101 383320705 HOME HEALTH SERVICES (INACTIVE) IA 501(C)(3) LINE 11A, I MERCY HEALTH SERVICES-IOWA CORP 1 MARYCREST HEIGHTS PO BOX 9184 FARMINGTON HILLS MI 48333 270291722 SENIOR LIVING COMMUNITY MI 501(C)(3) LINE 11A, I TRINITY CONTINUING CARE SERVICES 1 MAXIS HEALTH SYSTEM 3805 WEST CHESTER PIKE NO 100 NEWTOWN SQUARE PA 19073 911940902 HEALTHCARE SYSTEM MANAGEMENT AND SUPPORT (INACTIVE) PA 501(C)(3) LINE 11A, I TRINITY HEALTH CORPORATION 1 MCAULEY CENTER INC 275 STEELE ROAD WEST HARTFORD CT 06117 061058086 SENIOR LIVING COMMUNITY CT 501(C)(3) LINE 9 MERCY COMMUNITY HEALTH INC 1 MCAULEY CLINIC CORPORATION PO BOX 992 ANN ARBOR MI 48106 382561013 HEALTHCARE SERVICES (INACTIVE) MI 501(C)(3) LINE 3 CATHERINE MCAULEY HEALTH SERVICES CORP 1 MCAULEY MINISTRIES 3333 FIFTH AVENUE PITTSBURGH PA 15213 943436142 GRANT MAKING PA 501(C)(3) LINE 11A, I PITTSBURGH MERCY HEALTH SYSTEM 1 MERCY AMICARE HOME HEALTHCARE OAKLAND 1111 W LONG LAKE RD STE 102 TROY MI 48098 383320698 HOME HEALTH SERVICES MI 501(C)(3) LINE 9 TRINITY HOME HEALTH SERVICES INC 1 MERCY AMICARE HOME HEALTHCARE PORT HURON 505 HURON AVENUE PORT HURON MI 48060 383320701 HOME HEALTH SERVICES MI 501(C)(3) LINE 9 TRINITY HOME HEALTH SERVICES INC 1 MERCY CARE FOUNDATION 424 DECATUR STREET ATLANTA GA 30312 581448522 FOUNDATION GA 501(C)(3) LINE 7 SAINT JOSEPH'S HEALTH SYSTEM INC 1 MERCY CATHOLIC MEDICAL CENTER OF SOUTHEASTERN PENNSYLVANIA ONE WEST ELM STREET CONSHOHOCKEN PA 19428 231352191 HEALTHCARE AND HOSPITAL SERVICES PA 501(C)(3) LINE 3 MERCY HEALTH SYSTEM OF SOUTHEASTERN PENNSYLVANIA 1 MERCY COMMUNITY HEALTH INC 2021 ALBANY AVENUE WEST HARTFORD CT 06117 061492707 HEALTHCARE SYSTEM MANAGEMENT AND SUPPORT CT 501(C)(3) LINE 11B, II TRINITY CONTINUING CARE SERVICES 1 MERCY COMMUNITY HOMECARE SERVICES 2021 ALBANY AVENUE WEST HARTFORD CT 06117 061488137 HOME HEALTH SERVICES CT 501(C)(3) LINE 9 MERCY COMMUNITY HEALTH INC 1 MERCY FAMILY SUPPORT 1001 BALTIMORE PIKE SUITE 310 SPRINGFIELD PA 19064 232325059 HOME HEALTH SERVICES PA 501(C)(3) LINE 9 MERCY HOME HEALTH SERVICES 1 MERCY FOUNDATION INC 2525 SOUTH MICHIGAN AVENUE CHICAGO IL 60616 363227350 FOUNDATION IL 501(C)(3) LINE 7 MERCY HEALTH SYSTEM OF CHICAGO 1 MERCY GENERAL 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