2015-05-14T12:47:23-05:00 2014-06-30 861065772 Deloitte Tax LLP 250 East Fifth Street Suite 1900 Cincinnati OH 45202 990 2013-07-01 860575938 Holy Cross Hospital Inc HOLY 5202853000 2202 N Forbes Blvd Tucson AZ 857451412 Alan Strauss Tax Director-Ascension Health 5202853000 2015-05-14 1 Rebecca Lyons P01487105 5137847100 2013 2016-02-25 16:41:14Z James K Beckmann Jr 2202 N Forbes Blvd Tucson AZ 857451412 20921563 0 0928 X www.carondelet.org X 1987 AZ Providing various types of advanced medical/surgical services to our patients. 8 7 204 13 19378 0 25742 79241 19376795 20033632 39179 64950 1202869 735609 20644585 20913432 0 0 0 0 10489752 10486334 0 0 0 12705690 11303523 23195442 21789857 -2550857 -876425 8861816 8866822 13721923 14593662 -4860107 -5726840 Provide for the healthcare needs of the community; to embrace the person in mind, body and spirit; and to serve all people with dignity. 0 0 17337668 20432790 Holy Cross Hospital is a cornerstone of the Nogales, Arizona community; providing much-needed emergency care, general surgery, labor and delivery services, and important health and wellness education for residents throughout Santa Cruz County. Holy Cross Hospital is a 25-bed facility that provides general medical/surgical services, 24-hour emergency care, rehabilitation, mammography, ultrasound, chemotherapy, and home health. We also offer advanced technology such as renal dialysis, teleradiology, and lithotripsy programs. Holy Cross Hospital's community benefit information is included in the community benefit report for Carondelet Health Network. See Schedule H. 17337668 1 1 0 1 0 0 0 0 0 0 1 0 0 0 1 0 0 1 0 0 0 0 0 0 0 0 1 1 0 0 1 0 0 0 1 0 0 0 0 0 0 0 0 0 1 1 1 0 0 1 X 0 0 204 1 1 1 0 0 0 0 0 0 0 0 0 0 X 8 7 0 0 0 0 1 1 1 1 1 0 0 0 1 1 1 1 1 0 0 0 AZ X Alan Strauss 5208727520 2202 N Forbes Blvd Tucson AZ 857451412 Mark Valenzuela Chairman 0.50 0.00 X 0 0 0 Amy Beiter MD Ex-Officio Pres/CEO-CSM;Dir-HCH 5.00 55.00 X 0 391715 61900 Imogene Juby Bell Director 0.50 0.00 X 0 0 0 Jose Duran MD Director 0.50 0.00 X 0 0 0 Joseph Impicciche start 1113 Director 0.50 55.00 X 0 3102348 115026 Jeffrey T Maudlin Director/Chief of Staff 1.00 0.00 X 24413 0 0 William Neubauer Director 0.50 0.00 X 0 0 0 Sr Irma Odabashian Director 0.50 0.00 X 0 0 0 James Ross Director 0.50 0.00 X 0 0 0 James K Beckmann Jr President/CEO-CHN 5.00 55.00 X 0 1605120 82174 Alan Strauss CFO-CHN 5.00 55.00 X 0 261402 50287 Roy Farrell CMO-HCH 5.00 55.00 X 0 192996 37639 Debra Knapheide VP COO/CNO-HCH 60.00 0.00 X 0 182699 41311 Celia Torres Dir-Pharmacy 40.00 0.00 X 139687 0 28720 Catherine Fairbanks Mgr-Perioperative Svcs 40.00 0.00 X 112323 0 11915 Albert Garcia Mgr Rehab Srvs 40.00 0.00 X 110622 0 15916 Roger Lucier Therapist-Phys-III 40.00 0.00 X 102847 0 23340 Dorothy Sawyer end 1012 Former CEO-CSM/HCH 0.00 0.00 X 0 239258 1020 Debra Mohesky Former CFO 0.00 0.00 X 0 342259 4825 489892 6317797 474073 4 1 1 0 Morrison Management Specialists 5801 Peachtree Dunwoody Rd Atlanta GA 30342 Nutritional Services 986089 TriMedx LLC PO Box 636129 Cincinnati OH 45263 Equipment Maintenance 556740 Quantum Plus Inc PO Box 634850 Cinncinnati OH 45263 Clinical Contract Labor 445234 Medefis Consolidated PO Box 5068 New York NY 10087 Clinical Contract Labor 393197 Alliance Healthcare Services FILE 55826 Los Angeles CA 90074 Health Services 304978 5 67241 12000 79241 Net Patient Revenue 621400 20033632 20033632 20033632 67419 67419 179861 5662 174199 174199 174199 2469 -2469 -2469 -2469 EHR Incentive Payment 900099 322323 322323 Cafeteria Revenue 722210 142874 142874 Reference Lab 621500 19378 19378 76835 76835 561410 20913432 20432790 19378 382023 X 9042537 7909058 1133479 358957 323061 35896 453356 408020 45336 631484 568336 63148 4286 4286 601 601 3796471 2713197 1083274 20809 20809 159235 158750 485 30374 27337 3037 391862 352676 39186 33039 18111 14928 603124 542812 60312 127087 114378 12709 Shared Svcs Allocation 4009285 2405571 1603714 0 Supplies 1644283 1554210 90073 0 Food Service 134308 110133 24175 0 Restructuring 95926 0 95926 0 252833 131417 121416 21789857 17337668 4452189 0 885 21309 2519930 3036980 41347 21180 694529 354359 331029 372694 70425 65168 10327499 5548980 4961724 4778519 15515 221523 221522 8861816 8866822 731716 674438 12990207 13919224 13721923 14593662 X -4880531 -5730355 20424 3515 0 -4860107 -5726840 8861816 8866822 X -876425 9692 X X 0 1 X 1 0 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 0 0 0 0 0 0 0 0 1 601 601 0 Part II-B, Line 1: Other activities represent the portion of dues paid to national and state hospital associations that is expended by the associations for lobbying and travel expenses to attend association lobbyist meetings. Holy Cross Hospital does not participate in or intervene in (including the publishing or distributing of statements) any political campaign on behalf of (or in opposition to) any candidate for public office. 815007 815007 6656316 3326529 3329787 2800392 2178337 622055 55784 44114 11670 4778519 Due to Affiliates 13238894 Estimated Settlements to Third Party Payors 154416 Other Current Liabilities 114784 Self Insurance Liability 297160 Other Non-Current Liabilities 113970 13919224 1 1 X 1 X 400.000000000000 1 X 1 1 0 1 1 600930 176477 424453 0.01950 9338879 7851632 1487247 0.06830 0.00000 9939809 8028109 1911700 0.08780 115863 1765 114098 0.00520 115742 115742 0.00530 2021185 597681 1423504 0.06530 0.00000 0.00000 2252790 599446 1653344 0.07580 12192599 8627555 3565044 0.16360 0.00000 2 1920 1920 0.00010 1 3360 3360 0.00020 0.00000 0.00000 1 5041 5041 0.00020 1 5911 5911 0.00030 2 2521 2521 0.00010 0.00000 7 18753 18753 0.00090 0 531423 382355 4894454 6503989 -1609535 X 1 1 1 1 Holy Cross Hospital Inc 1171 W Target Range Rd Nogales AZ 85621 www.carondelet.org h0090 X X X X Rural Holy Cross Hospital Inc 1 1 X X X X X X X X X 12 1 0 1 X www.carondelet.org/about/community-benefi X X X X X X X X 0 0 1 1 400.000000000000 1 400.000000000000 1 X X X X X X 1 1 X X 1 0 1 X 0 0 Holy Cross Hospital, Inc. Part V, Section B, Line 3: In addition to conducting surveys, the following key informants were consulted during the CHNA process:Santa Cruz County Community Health Needs Assessment Name Title Affiliation Role Special Knowledge and/or Expertise: -Marcelino Varona (Member Nogales Unified School District Governing Board), Santa Cruz Provisional Community College Governing Board; -Pat Trulock, Volunteer Santa Cruz Community Foundation Facilitate community events, binational cross border issues, grant writing, fundraising to support NGOs, capactity building for local NPOs, Identify currently emerging issues and strengthen community resources to address those issues; -Marcella Chavez Coordinator, Executive Director Rebuilding Together, United Way Grant writing & program coordination, campaign manager, 11 years with RBT, 6 years grant writing; -Kimberly Munoz Physical Therapist Carondelet Holy Cross Hospital, Self Contractor, Santa Cruz Valley Unified School District Resident of Santa Cruz County since 1995, 17 years as physical therapist, worked in home health, acute care, long term care, subacute care and outpation with pediatrics through adults/geriatrics; -Dina Sanchez, Director of Planning/Community Relations Carondelet Holy Cross Hospital Knowledge of local health care system and community affiliation; -Debra Knapheide, Site Administrator/CNO/COO Carondelet Holy Cross Hospital Overall healthcare needs of acute care patient population; -Michael Vetter, Executive Director Catholic Community Services of Southern AZ; -Suzanne David, Assistant Director South East Arizona Health Education Center (SEAHEC) Continuing education for health care providers; -Joyce Hospodar, Manager, Health Systems Development Center for Rural Health, MEZCOPH U of A Working with rural hospitals and first responders; -Alexa Bathe, Membership manager Arizona Lifeline Air Medical Care Paramedic, awareness manager of the membership program; -Yvonne Delgado, Executive Director Nogales Community Development Working with Mariposa Community Health Center and local partners on a Healthy Foods Intitiative, working with/provide support for the Southwest Rural Policy Network; -Cassalyn David, Network Director Mariposa Community Health Center, Santa Cruz County Adolescent Wellness Adolescent health and wellness, rural health networks, health equity; -Joyce LaTura, Maternal & Child Health Manager Mariposa CHC Maternal & Child health issues, community engagement, promotora (community health workers) training; -William Sanchez, Nogales Fire Department; -Gerry Castro, Nogales Fire Department; -Octavio Gradillas, Nogales Police Department; -Shane Dille, City Manager; -Nogales Christine Young, ADHS Office of Border; -Health Gail Emrick, Executive Director SEAHEC Public Health Administration/Planning/Management, health workforce development, border health issues, international health; -Jeffrey Maudlin, MD Carondelet Medical Group Community physician and chief of staff, Carondelet Holy Cross Hospital; -Christia Bridges-Jones, Breastfeeding Coordinator ADHS Maternal & child health nutrition, program coordinator/breastfeeding services; -Lisa Nieri, Director of Community Development and Special Populations Arizona Association of Community Health Centers Migrant & seasonal farmworker health, community health centers; -Kelly Watters, Project Coordinator Somos La Semilla, Community Food Bank of Southern AZ Community food systems development (farmers markets, food production and education); -William Neubauer, MD Chairman, Co-Chair, Trustee Santa Cruz Community Foundation, Arizona Mexico Commission, Carondelet Holy Cross Hospital Medical doctor Holy Cross Hospital, Inc. Part V, Section B, Line 7: Priorities Not Being Addressed Rationale Access to Healthcare1. Mental health services are lacking This priority will not be addressed. This need is being addressed in Santa Cruz County by a variety of organizations. Community resources include: 1. Community Intervention Associates 2. Community Connection 3. Mariposa Community Health Center 4. Southern Arizona Behavior Health Services 5. Corazon Behavior Health ServicesHealth Status (Leading Causes of Death)2. Cardiovascular Disease, Respiratory Disease, and Cancer This priority will not be addressed. Carondelet Medical Group routinely screens, treats, and educates patients on these diseases. Carondelet Holy Cross provides routine imaging services. Santa Cruz County is served by three cardiology groups (Pima Heart Physicians, The University of Arizona Medical Center Pediatric Cardiologists, and Tucson Heart Group) Mariposa Community Health Center offers cancer and cardiovascular prevention and education programs.Modifiable Risk Factors3. Obesity - Kids This priority will not be addressed. Carondelet Holy Cross will continue with its healthy eating program in its cafeteria. The Vivir Mejor! Consortium is working to educate families on healthy eating and physical activity. Numerous farmers markets are located throughout Santa Cruz County. Local school districts have begun to serve healthier foods during school and following after school programs.4. Adolescent Excessive Drinking This priority will not be addressed. This issue is best addressed by the Santa Cruz County Health Department and local school districts. 5. Smoking This priority will not be addressed. Carondelet Holy Cross does maintain a smoke free campus. Carondelet Medical Group routinely counsels patients on the adverse effects of smoking and provides resources, including ASHLine, to patients who wish to quit smoking. Mariposa Community Health Center provides school-based tobacco prevention education and other tobacco use prevention and cessation classes. Women and Children Services6. Highest Infant Mortality Rate in the State This priority will not be addressed. From 2000 to 2009 infant mortality rates in Santa Cruz County were above the state average only once (2004). In 2010, the infant mortality rate in Santa Cruz County was more than double that of the state. It is Carondelet Holy Cross's belief that 2010 represents an anomaly in which there was a rash of severe health issues with several babies born in Santa Cruz County. The infant mortality rate in 2011 (4.3/1,000) returned to a level below that of the state (5.9/1,000). 7. Fewer women receive pap smear and mammography screenings in Santa Cruz County than the StateThis priority will not be addressed. Carondelet Medical Group will continue to educate women on the benefits of routine pap smear and mammography screenings. Carondelet Holy Cross and Mariposa Community Health Center provide mammography screenings. Nogales Unified School District offers mobile mammography screening for eligible employees. 8. High rates of women who received no prenatal care or lower than average number of prenatal care visitsThis priority will not be addressed. Carondelet Medical Group will continue to educate patients on the benefits of early and regular prenatal care. Mariposa Community Health Center provides prenatal care and classes on prenatal education. 9. High Rates of Teen PregnancyThis priority will not be addressed. Mariposa Community Health Center offers Teen Maze, a program designed to help teens and preteens better understand potential outcomes to life decisions concerning sex, substance abuse, vocational and education issues.Reportable Diseases10. Campylobacteriosis, Shigellosis, Salmonellosis, Amebiasis, Meningococcal DiseaseThis priority will not be addressed. Relative to population, these numbers are not significantly high. Natural and Built Environment11. Air Quality - The number of particulate matter days in the Santa Cruz County is higher than the state and national benchmark. This priority will not be addressed. The city of Nogales Parks and Recreation Department has begun to fly air quality flags at the Fleischer Park flag pole in Nogales. This is part of an informational program by the Arizona Department of Environmental Quality. The flags help area residents make informed decisions about outdoor activities. Additionally, the Arizona Department of Environmental Quality sends out regular emails with projected air quality levels. 12. Access to Healthy Food This priority will not be addressed. Carondelet Holy Cross does maintain a healthy eating program in its cafeteria. Local school districts have begun to serve healthier foods during school and following after school programs. The Vivir Mejo! Consortium is working with the Community Food Bank of Southern Arizona to serve diabetic friendly food boxes. Social Environment13. Transportation This priority will not be addressed. This need is best addressed by Santa Cruz County and the cities and towns with in its boundary. 14. Domestic Violence This priority will not be addressed. Carondelet Holy Cross will explore starting a Domestic Violence screening program in the Emergency Department. Other community resources include: 1. Santa Cruz County Coordinated Response Team and Task Force Against Domestic Violence (CCRT and Task Force) 2. Our House/Nuestra Casa Domestic Violence Shelter15. Senior Care This priority will not be addressed. Carondelet Holy Cross will continue with its semi-monthly senior wellness clinic Centro De Salud Nogales Clinic. This clinic provides health screenings (including weight: blood pressure and blood glucose) medication review and education, health information, and referral. Other community resources include: 1. Santa Cruz council on Aging 2. Southeastern Arizona Governments Organization 3. Mariposa Community Health Center Holy Cross Hospital, Inc. Part V, Section B, Line 14g: In addition to being available upon request, a plain language summary is posted on the hospital facility's website, in the hospital facility's emergency rooms or waiting rooms, in the hospital facility's admissions offices, and in patients' financial statements when sent. Holy Cross Hospital, Inc. Part V, Section B, Line 20d: Per the Carondelet Health Network Financial Assistance Policy:Charges for emergency or other medically necessary care provided to persons who are eligible for financial assistance under this policy shall not exceed the amounts generally billed to individuals who have insurance coverage for such care. Part I, Line 6a: The organization prepares and files an annual Community Benefit Plan Report. This report is prepared on a consolidated basis and includes data for Carondelet Health Network, Holy Cross Hospital, and Carondelet Foundation. Part I, Line 7: The cost of providing charity care, means tested government programs, and community benefit programs is estimated using internal cost data, and is calculated in compliance with Catholic Health Association ("CHA") guidelines. The organization uses a costing accounting system that addresses all patient segments (for example: inpatient, outpatient, emergency room, private insurance, Medicaid, Medicare, uninsured, or self pay). The best available data was used to calculate the amounts reported in the table. Part I, Line 7g: The organization has not included costs attributable to a physician clinic as part of subsidized health services. Part II, Community Building Activities: Holy Cross Hospital's leadership team collaborates actively with a variety of community organizations in community building activities to advance the economic and overall growth and vitality of the region. This is done through active participation on economic development and chamber of commerce activities, through coalition building with community partners, and through advocacy for community health improvements around access to care and public health initiatives. This includes being members of the Southern AZ Coalition and Vivir Mejor!, a community coalition to improve the health of the community. Part III, Line 4: From the consolidated audited financial statements of Ascension Health Alliance (which includes the activity of Holy Cross Hospital, Inc.):The provision for doubtful accounts is based upon management's assessment of expected net collections considering economic conditions, historical experience, trends in healthcare coverage, and other collection indicators. Periodically throughout the year, management assesses the adequacy of the allowance for doubtful accounts based upon historical write-off experience by payor category, including those amounts not covered by insurance. The results of this review are then used to make any modifications to the provision for doubtful accounts to establish an appropriate allowance for doubtful accounts. After satisfaction of amounts due from insurance and reasonable efforts to collect from the patient have been exhausted, the System follows established guidelines for placing certain past-due patient balances with collection agencies, subject to the terms of certain restrictions on collection efforts as determined by the System. Accounts receivable are written off after collection efforts have been followed in accordance with the System's policies.The methodology for determining the allowance for doubtful accounts and related write-offs on uninsured patient accounts has remained consistent with the prior year. The System has not experienced material changes in write-off trends and has not materially changed its charity care policy in the current fiscal year.The organization's bad debt expense in 2012 was $2,132,675 at charges($531,423 at cost). Part III, Line 8: Holy Cross Hospital follows the Catholic Health Association ("CHA") guidelines for determining community benefit. CHA community benefit reporting guidelines suggest that Medicare shortfall is not treated as community benefit. Part III, Line 9b: The organization has a written debt collection policy that also includes a provision on the collection practices to be followed for patients who are known to qualify for charity care or financial assistance. Patients who are cooperating in good faith to resolve their hospital bills will not receive from Holy Cross Hospitalliens on primary residences or wage garnishments and unpaid bills will not be sent to collection agencies. Part VI, Line 2: Carondelet Holy Cross Hospital follows the Catholic Healthcare Association Guidelines which state that a Community Needs Assessment (CHNA) should be completed every three years. The Community Needs Assessment was commissioned in 2012 and delivered in February 2013 as a result of a collaboration with the the Arizona Department of Health Services. Carondelet engaged a graduate student from the UA College of Public health to lead the CHNA efforts. The Graduate Student worked with an internal committee for guidance of the needs assessment. The Student worked with her Public Health Professors and the ADHS to perform community focus groups and key informant surveys. Other internal and external strategic documents were used to identify community needs along with hospital data. Part VI, Line 3: Upon admission, patients are encouraged to apply for the state Medicaid program if they are uninsured as well as other public benefits such as TANF or SNAP if the patient has a need. If patients prove they meet at least one (1) of eight (8) criteria outlined in the policy, they will be eligible for charity care. The patient will be placed in pre-emptive charity care status and after all bills are finalized a request for the total amount with be made on the patient's behalf by their financial counselor. Trained financial counselors will work with patients if it is not easily determined that a patient qualifies for charity care or to what level of financial assistance a patient may qualify for. The Pre-emptive Charity Care Policy is posted in the Emergency Department, Admitting, hospital lobbies, other public areas as well as summarized on the Carondelet website and is to be included in a patient's financial statements when sent. The Network participates in "Tu Salud", a Southern AZ community Collaboration CHIPRA funded outreach program which provides a community outreach worker/financial counselor at community events to facilitate enrollment into government and community assistance programs. CHN led a Southern Arizona "Phonathon", which was a one day event, to increase awareness of state Medicaid eligibility requirements and other public funding resources as well as to facilitate enrollment of qualifying individuals and families. Part VI, Line 4: The primary and secondary service area includes Pima, Santa Cruz and Cochise Counties. The population is 1.29 million individuals based on 2014 projected from 2010 census data. This growth is 2.22% from 2000. The average household size is 2.52. The median age is 37.4 which is at the national average. 51.7% of the population earns less than $50,000 with the median household income at $48,879 and the per capita income at $26,267. 28.6% of the population is over the age of 55.The demographics of the area with regard to ethnicity are as follows: 36.6% of Hispanic origin, 2.0% two or more races, .1% some other race alone, 0.1% Pacific Islander alone, 2.4% Asian American, 2.3% American Indian alone, 3.2% Black and 53.3% White alone. Part VI, Line 5: Carondelet Holy Cross Hospital ("HCH") provides a wide variety of services to the communities where it has a presence. Activities include social service enrollment, support groups for patients, families and the community at large, chronic disease education to patients, families and outside medical professionals, spiritual care services and senior wellness services at the Santa Cruz Senior Nutrition Center. CHN works with community partners to provide border health outreach, promotion of state Medicaid enrollment, education on chronic diseases to schools, patients, churches and health and human service organizations.Associates serve on various Boards of Directors for local and regional organizations. Additional community outreach includes health screenings, health fairs and educational conferences and events throughout the year. The following are the organizations which Carondelet leadership is engaged in key community coalition building activities, community events, or initiatives: American Diabetes Association, American Heart Association, American Cancer Society, Lions Club, Catholic Foundation, United Way, American Red Cross. Part VI, Line 6: Carondelet Health Network is a member of Ascension Health Alliance. Ascension Health Alliance is a Missouri nonprofit corporation formed on September 13, 2011. Ascension Health Alliance is the sole corporate member and parent organization of Ascension Health, a Catholic national health system consisting primarily of nonprofit corporations that own and operate local healthcare facilities, or Health Ministries, located in 23 of the United States and the District of Columbia.Ascension is sponsored by Ascension Sponsor, a Public Juridic Person. The Participating Entities of Ascension Sponsor are the Daughters of Charity of St. Vincent de Paul, St. Louise Province; the Congregation of St. Joseph; the Congregation of the Sisters of St. Joseph of Carondelet; the Congregation of Alexian Brothers of the Immaculate Conception Province, Inc. American Province; and the Sisters of the Sorrowful Mother of the Third Order of St. Francis of Assisi US/Caribbean Province. As more fully described in the Organizational Changes note, Marian Health System, which was previously sponsored by the Sisters of the Sorrowful Mother of the Third Order of St. Francis of Assisi US/Caribbean Province, became part of Ascension Health on April 1, 2013.Carondelet Health Network consists of two nonprofit acute care hospitals in Tucson, Arizona and a critical access hospital in Nogales, Arizona. The hospitals within Carondelet Health Network provide inpatient, outpatient, and emergency care services for the residents of Tucson and Southern Arizona. Admitting physicians are primarily practitioners in the local area. Carondelet Health Network is related to Ascension Health's other sponsored organizations through common control. Substantially all expenses of Ascension Health and its sponsored organizations are related to providing health care services.Mission:The System directs its governance and management activities toward strong, vibrant, Catholic Health Ministries united in service and healing, and dedicates its resources to spiritually centered care which sustains and accordance with the System's mission of service to those persons living in poverty and other vulnerable persons, each Health Ministry accepts patients regardless of their ability to pay. The System uses four categories to identify the resources utilized for the care of persons living in poverty and community benefit programs:1. Traditional charity care includes the cost of services provided to persons who cannot afford healthcare because of inadequate resources and/or who are uninsured or underinsured.2. Unpaid cost of public programs represents the unpaid cost of services provided to persons covered by public programs for the persons living in poverty and other vulnerable persons.3. Cost of other programs for the persons living in poverty and other vulnerable persons includes programs intentionally designed to serve the persons living in poverty and other vulnerable persons of the community including substance abusers, the homeless, victims of child abuse andpersons with acquired immune deficiency syndrome.4. Community benefit consists of the unreimbursed costs of community benefit programs and services for the general community, not solely for persons living in poverty and other vulnerable persons, including health promotion and education, health clinics and screenings and medicalresearch.Discounts are provided to all uninsured patients, including those with the means to pay. Discounts provided to those patients who did not qualify for assistance under charity care guidelines are not included in the cost of providing care of persons living in poverty and community benefit programs. The cost of providing care to persons living in poverty and community benefit programs is estimated by reducing charges forgone by a factor derived from the ratio of each entity's total operating expenses to the entity's billed charges for patient care.Certain costs such as graduate medical education and certain other activities are excluded from total operating expenses for purposes of this computation.The amount of traditional charity care provided, determined on the basis of cost, was $424,453 and $770,003 for the years ended June 30, 2014 and 2013, respectively. The amount of unpaid cost of public programs, cost of other programs for persons living in poverty and other vulnerable persons, and community benefit cost is reported in the accompanying supplementary information. Community Benefit Report: Carondelet Health NetworkFiscal Year 2014Carondelet Health Network is Southern Arizona's leading faith-based provider of healthcare services, serving a region of 1.3 million residents.As the area's largest Catholic, nonprofit healthcare system, it is Carondelet's commitment to offer advanced quality, person-centered care, in a faith-based environment. Our vision, and that of our parent healthcare ministry, Ascension Health, is to ensure service that is committed to health and well-being for our communities and that responds to the needs of individuals throughout the life cycle. We are dedicated to Healthcare That Works, Healthcare That Is Safe, and Healthcare That Leaves No One Behind - for Life.Carondelet St. Mary's Hospital, Carondelet St. Joseph's Hospital, Carondelet Holy Cross Hospital, and Carondelet Foundation are nonprofit entities with a 501(c)(3) tax-exempt status.Carondelet Helps Insure over 6,200:Lack of health insurance can significantly impact an individual's health and the community at large; and last fall, roughly 147,000 Pima County residents were without a health insurance plan of any kind.To honor its mission to support the community's well-being - and encouraged by changes to healthcare laws on both the federal and state levels - Carondelet launched a grassroots campaign in 2013 to help the uninsured in Tucson get the health coverage they needed.The Campaign:The seven-month campaign targeted five groups, aiming to enroll 3,000 uninsured among them: current and former Carondelet patients; associates and their families; churches; those living below the poverty level; and the general public.Posters, pins, and business-sized cards were distributed across Carondelet's facilities and area organizations prompting people to call the Carondelet Help Center where a Patient Navigator could help enroll them in AHCCCS or the Federal Marketplace, if eligible. Additional help was provided by hospital Admitting staff and an Outreach Worker/Navigator in the Emergency Department (ED).Renee Perez, an ED Navigator at St. Mary's Hospital, was one of those who helped a number of patients get the coverage they need."Some people do not know how to navigate the system, and I have been doing this job for over 10 years. It's nice to have that help," she said. "I always get feedback, even now, from my patients thanking me because they were able to get on AHCCCS and get their medical issues taken care of. I love those calls!"Carondelet also partnered with area hospitals and Tucson Regional Economic Opportunities (TREO) on AZCares.org, a community-wide campaign focused on insuring the uninsured. The campaign earned national recognition from the White House and Centers for Medicaid and Medicare Services, declaring it a model community effort.Care Transitions Program Acknowledged as a National Best PracticeIn an effort to increase the quality and safety of patient care while reducing hospital readmissions, a collaborative program between Carondelet Health Network and the Pima Council on Aging (PCOA) is receiving national praise and an additional year of funding. The Centers for Medicaid and Medicare Services (CMS) call the Community-Based Care Transitions Program a "best practice" among the programs initiated nationwide to reduce hospital readmissions and lower the cost of healthcare.The program focuses on Medicare patients with multiple chronic illnesses who have been recently discharged from the hospital. Carondelet nurses and PCOA care coordinators partner on regular visits to the homes of patients who have joined the program, providing much-needed medical follow-up and a variety of other kinds of social support that help the patient manage their recuperation and maintain their health for 60 days post-hospitalization. It's clearly working. "We've seen some real success with this program. Patients are improving their health, their life status, and their well-being simply by receiving the support necessary to remain healthy and stay out of the hospital," says Donald Denmark, MD, Carondelet Health Network's Chief Medical Officer. To help facilitate visits with transitional team members, Carondelet is piloting a telehealth option. The nurse can be at the patient's home and connect real-time with the pharmacist or Pima Council on Aging coach via their laptops or tablets. Women's Health Hotline a big hit with callers: On May 10, 2014, Carondelet teamed up with KOLD News 13 to sponsor a day-long televised phone bank, answering women's questions about their health. The Carondelet KOLD Women's Health Hotline drew nearly 220 callers in the hours between 6 a.m. and 9 a.m. and again from 3 p.m. to 7 p.m., primetime viewing hours for local news on KOLD television. The broadcasts reaches over 40,000 viewers on any given day.Calls were answered by physicians and nurses in the area of obstetrics, gynecology, cardiac care, breast health, and family medicine. The event was held in conjunction with Carondelet's Mammograms & Massages Mother's Day promotion, a month-long initiative encouraging women to gift themselves the gift of health and get their annual screening mammogram in May.Diabetes:Diabetes continues to be an important area of focus for healthcare providers in Arizona where nearly 500,000 people have been diagnosed with the disease. However, diabetes can be controlled, and those living with it can lead active, fulfilling lives with the right care and self-management.Whether newly diagnosed or just getting around to doing something about it, individuals living with diabetes can attend any of the free, weeklydiabetes classes offered through Carondelet and led by Certified Diabetes Educators Gwen Gallegos, FNP, and Donna Heun, RN or nurse Ann McCurry.The weekly class includes an overview of diabetes, as well as instruction on healthy eating, safe exercise, symptoms and warning signs, and information on additional community resources and support. Last year, more than 240 people attended classes at one of the three Carondelet hospitals: St. Joseph's, St. Mary's or Holy Cross (Nogales). Carondelet also co-hosts classes at Mariposa Community Health Center and the Nogales Senior Center, both taught by Gwen.In Nogales, where she leads a youth diabetes support group at Carondelet Holy Cross Hospital every last Thursday of the month, Gwen meets with parents and their teens in a more interactive, playful environment. "They'll play games around the topic of diabetes. It's a lot of fun," said Maria Astorga, a nurse at Holy Cross who works with Gwen." She has seen those kids grow up, go to college, and they still keep in touch with her. Managing Diabetes Before Delivery:The American Diabetes Association estimates that many women will develop gestational diabetes (GD) during their pregnancy as a result of normal hormonal changes that make it harder to regulate blood sugar levels. Left untreated or uncontrolled, GD can harm the developing fetus and complicate delivery. For women diagnosed with GD, Carondelet Holy Cross and Carondelet St. Joseph's hospitals offer a specialized program to help.During a series of sessions with Certified Diabetes Educator and FamilyNurse Practitioner Gwen Gallegos, women at any stage of pregnancy learn how to manage their health (and that of their developing child) by focusing on meal planning, medication management, and monitoring their blood sugar levels."The whole reason for the Gestational Diabetes Management [program] is to reduce risks to the baby and the mother, such as a high birth weight and problems with delivery" says Gwen. "Of course [the women] are frightened. They come in here with preconceived notions about what it means to have diabetes. We help reduce their anxiety."In addition to educating the women on managing their condition, Gwen sends their physicians regular reports on what they've discussed. Additional follow-up sessions are offered until the baby is delivered, at which time they can choose to attend a community diabetes class for ongoing education.Last year, the program expanded to include women already living with diabetes prior to becoming pregnant. During that time, about 120 women attended the Gestational Diabetes Management/Diabetes in Pregnancy programs at Holy Cross and St. Joseph's hospitals.The benefit of such a program also extends to the hospital, which sees lower admissions of newborns to the Neonatal Intensive Care Unit (NICU) and a reduction in the length of hospital stays for the mother and baby, says Gwen. "It's a team effort between me, the physician and the patient. Our goal is he althy mothers and healthy babies." Associates Helping The Community: In FY14, associates donated items and time through a number of Carondelet-hosted drives. Highlights from the past year include:- Southern Arizona Community Food Bank - Associates gave more than 3,200 pounds of non-perishable food.- Wings for Women - associates filled a pick-up truck full of hygiene products for homeless and impoverished women in Tucson and Nogales.- O'Rielly Center at St. Joseph's Hospital - associates donated more than 50 bags of clothing to help patients at our inpatient behavioral health treatment facility.- Be the Match - associate volunteers organized and ran a bone marrow drive for the national registry drive. More than 190 associates and community members registered as potential donors.First Carondelet Heart & Vascular Institute Heart Academy:St. Mary's hosts hands-on experience for area high school studentsinside an operating room, alongside a surgical team performing open heart surgery, stood a small group of high school students. This definitely was not an ordinary field trip. The group was among 16 students from Sahuarita unified School District who were invited to Carondelet Health Network's first Heart Academy on Thursday, March 6 at Carondelet Heart & Vascular Institute (CHVI) at St. Mary's Hospital in Tucson.Upon arrival, students were whisked to a brief orientation where they met St. Mary's Chief Executive Officer, Amy Beiter, M.D., and other hospital leaders. Each student was issued scrubs to wear (and take home). They broke out into four groups and started the first of four interactive breakout sessions, which included tours of the hospital's new hybrid operating suite, Emergency Room and helipad, Catheterization Lab, and Imaging.The day was packed with hands-on learning. Students scrubbed up, donning booties and masks, and went into CHVI's new hybrid operating suite to observe segments of surgeries, from a heart valve replacement to hernia repair. Another session took place on the hospital's roof where an emergency helicopter pilot, flight nurse, and paramedic talked to them about the skills needed for a career in emergency transport. The kids took turns sitting inside the helicopter and orienting themselves to the equipment onboard.At the Cath Lab, students observed a physician replacing a patient's pacemaker battery while cardiovascular technologists explained the procedure in real time. The ED and imaging department were also part of the tour.Chaperone and Walden Grove science teacher Emily Bertelsen said during the tour, she saw in practice many of the medical skills she had learned in college."It was neat to see the different processes the surgeons go through during open heart surgery," Bertelsen said. "I think this type of exposure to real life medical situations is so valuable for the students."Planning for the Heart Academy began last fall. Program participation was limited to ensure students would have the most interactive, personalized experience possible. While programming focused on cardiology and vascular care, the academy ultimately aimed to expose students interested in healthcare to a wide array of professions within the medical field. Many participants already had an idea of the career they want to pursue - anesthesiologist, nurse, and radiologist among them. Others did not and hoped the experience would bring medical career options to light. Carondelet has plans to expand the program and open it to students in other districts across Southern Arizona.2014 Stroke Check- Carondelet Tucson Hospitals Screened Hundreds:According to the Centers for Disease Control and prevention, nearly 800,000 Americans suffer a stroke each year. Stroke is one of America's top killers, taking a life every four minutes in the US. Those who survive may have significant physical and mental deficiencies.In an effort to educate the Tucson community on stroke prevention, area hospitals partnered this spring to provide free stroke screenings to the public at an annual event called Stroke Check. In its eleventh year, Stroke Check took place on Saturday, April 12 at various facilities across town, including Carondelet St. Mary's Hospital and Carondelet St. Joseph's Hospital. Other partners included HealthSouth and the local chapter of the American Heart Association/American Stroke Association (AHA/ASA).Approximately 1,000 people were screened across Tucson in this community-wide event, including 92 at St. Mary's and 150 at St. Joseph's. Participants came in between 8:00 a.m. and 12:00 p.m. to receive a stroke screening, a 45-minute evaluation done on site that concluded with a private discussion with a clinician about the screening results.St. Mary's and St. Joseph's are Joint Commission-certified Primary Stroke Centers, and both earned the AHA/ASA Get with the Guidelines Stroke Gold Plus Quality Achievement Award for the third and fourth year in a row, respectively. It's a privilege to care for our community through Stroke Check. Carondelet looks forward to participating next year.Meditation Room at St. Joseph's offers a quiet space for all:In June 2014, St. Joseph's Hospital celebrated the opening of its newly finished meditation room. The room, nestled next to the hospital's chapel in the Fred & Olga Pace Spiritual Center, is available to all-associates, patients and guests-as a space for quiet contemplation or solace.The new meditation room includes several seating areas, a small library of inspirational books. A notepad left in the room has since become a guestbook of sorts in which visitors have shared their personal stories and offered words of comfort for others.The completion of the meditation room was made possible by a generous gift from the St. Joseph's Auxiliary. 1 1 0 0 0 0 0 0 0 Amy Beiter MD Ex-Officio Pres/CEO-CSM;Dir-HCH 0 337718 0 0 0 53997 0 38150 0 23750 0 453615 0 0 Joseph Impicciche start 1113 Director 0 758824 0 1988719 0 354805 0 81461 0 33565 0 3217374 0 0 James K Beckmann Jr President/CEO-CHN 0 637610 0 957522 0 9988 0 55650 0 26524 0 1687294 0 0 Alan Strauss CFO-CHN 0 40497 0 58000 0 162905 0 21675 0 28612 0 311689 0 0 Roy Farrell CMO-HCH 0 182313 0 0 0 10683 0 18624 0 19015 0 230635 0 0 Debra Knapheide VP COO/CNO-HCH 0 168360 0 9334 0 5005 0 32316 0 8995 0 224010 0 0 Celia Torres Dir-Pharmacy 138254 0 0 0 1433 0 9863 0 18857 0 168407 0 0 0 Dorothy Sawyer end 1012 Former CEO-CSM/HCH 0 0 0 4997 0 234261 0 0 0 1020 0 240278 0 0 Debra Mohesky Former CFO 0 0 0 0 0 342259 0 0 0 4825 0 347084 0 0 Part I, Line 3 Carondelet Health Network, a related organization of Holy Cross Hospital, Inc., uses the following to establish the compensation of the organization's CEO: -Compensation Committee, -Independent Compensation Committee, -Compensation Survey or Study, and -Approval by the Board or Compensation Committee. Part I, Lines 4a-b The following individuals received severance payments from CHN: - Former CFO-CHN Debra Mohesky, $302,776, severance to be paid out over 18 months, end date of 9/30/13 - Former CEO Dorothy Sawyer, $203,612, severance paid out over 9 months, ending 7/31/13. Part I, Line 4b: Eligible executives participate in a program that provides for supplemental retirement benefits. The payment of benefits under the program, if any, is entirely dependent upon the facts and circumstances under which the executive terminates employment with the organization. Benefits under the program are unfunded and non-vested. Due to the substantial risk of forfeiture provision, there is no guarantee that these executives will ever receive any benefit under the program. Any amount ultimately paid under the program to the executive is reported as compensation on Form 990, Schedule J, Part II, Column B in the year paid. The organization made payments from the supplemental nonqualified retirement plan in the amounts as noted: Debra K. Knapheide - $3,570 Roy Farrell - $6,923 Celia Torres - $4,009 Amy Elizabeth Beiter - $48,341 Jose Duran MD Board Member To purchase medical office building X 245735 21180 0 1 1 21180 Form 990, Part V, Line 1a: Number of Forms 1099 filed: Carondelet Health Network, a related organization of Holy Cross Hospital, uses a centralized accounting system to compensate all independent contractors used within the Health System. The number attributable to each hospital is not easily distinguishable. The total amount of Forms 1099 filed for the entire Health System appears on Part V, Line 1a of Carondelet Health Network's Form 990. Form 990, Part VI, Section A, line 6 Holy Cross Hospital, Inc. has a single corporate member, Carondelet Health Network. Form 990, Part VI, Section A, line 7a Holy Cross Hospital, Inc. has a single corporate member, Carondelet Health Network, who has the ability to elect members to the governing body of Holy Cross Hospital, Inc. Form 990, Part VI, Section A, line 7b All decisions that have a material impact to Holy Cross Hospital, Inc. financial information or corporation as a whole are subject to approval by its sole corporate member, Carondelet Health Network. Form 990, Part VI, Section B, line 11 Management, including certain officers, works diligently to complete the Form 990 and attached schedules in a thorough manner. Historically, Management has presented the Form to the Board, or a designated committee, to review and answer any questions. In addition, prior to filing the return all Board Members were provided the Form 990 and management team members were available to answer any Board Members' questions. Due to changes in organizational roles and responsibilities, system leadership reviewed the returns in lieu of the Board. Form 990, Part VI, Section B, line 12c The organization regularly and consistently monitors and enforces compliance with the conflict of interest policy in that any director, principal officer, or member of a committee with governing board delegated powers, who has a direct or indirect financial interest, must disclose the existence of the financial interest and be given the opportunity to disclose all material facts to the directors and members of the committees with governing board delegated powers considering the proposed transaction or arrangement. The remaining individuals on the governing board or committee meeting will decide if conflicts of interest exist. Each director, principal officer and member of a committee with governing board delegated powers annually signs a statement which affirms such person has received a copy of the Conflict of Interest Policy, has read and understands the policy, has agreed to comply with the policy, and understands that the organization is charitable and in order to maintain its federal tax exemption it must engage primarily in activities which accomplish its tax-exempt purpose. Form 990, Part VI, Section B, line 15 In determining compensation of the organization's CEO, the process, performed by Carondelet Health Network, a related organization, included a review and approval by independent persons, comparability data, and contemporaneous substantiation of the deliberation and decision. The Audit Committee reviewed and approved the compensation. In the review of the compensation, the CEO was compared to individuals at other hospitals in the area that hold the same title. During the review and approval of the compensation, documentation of the decision was recorded in the board minutes. The individual was not present when his compensation was decided. In determining compensation of other officers or key employees of the organization, the process, performed by Carondelet Health Network, a related organization, included a review and approval by independent persons, comparability data, and contemporaneous substantiation of the deliberation and decision. The Audit Committee reviewed and approved the compensation. In the review of the compensation, the other officers or key employees of the organization were compared to other hospitals' employees in the area that hold the same title. During the review and approval of the compensation, documentation of the decision was recorded in the board minutes. Form 990, Part VI, Section C, line 19 The organization will provide any documents open to public inspection upon request. Form 990, Part IX, line 11g Purch Svcs - Medical labor/supplies: Program service expenses 507,148. Management and general expenses 0. Fundraising expenses 0. Total expenses 507,148. Purch Svcs - TriMedex: Program service expenses 512,127. Management and general expenses 0. Fundraising expenses 0. Total expenses 512,127. Purch Svcs - Dietary, housekeeping, linen, laundry: Program service expenses 364,340. Management and general expenses 596,262. Fundraising expenses 0. Total expenses 960,602. Purch Svcs - All other: Program service expenses 108,938. Management and general expenses 399,060. Fundraising expenses 0. Total expenses 507,998. Professional/Consulting fees: Program service expenses 695,465. Management and general expenses 87,952. Fundraising expenses 0. Total expenses 783,417. Contract Personnel: Program service expenses 525,179. Management and general expenses 0. Fundraising expenses 0. Total expenses 525,179. Form 990, Part XI, line 9: Net Assets Released from Restriction -30,423. Transfers from Affiliates 40,115. Form 990, Part XII, Line 2: The financial statements of Carondelet Health Network (which include the activity of Holy Cross Hospital, Inc.) fall under the limited scope audit of Ascension Health Alliance. The activity of Carondelet Health Network and other members of the Carondelet Health Network are reported in the consolidated financial statements of Ascension Health Alliance. No individual audit report of Carondelet Health Network is completed. Ascension Health PO Box 45998 St Louis MO 63145 311662309 National Health System MO Section 501(c)(3)A Schedule A, Line 11a Ascension Health Alliance 0 Carondelet Health Network 2202 N Forbes Blvd Tucson AZ 85745 860455920 Hospital AZ Section 501(c)(3) Schedule A, Line 3 Ascension Health 0 Carondelet Heart & Vascular Institute 4888 N Stone Ave Tucson AZ 85704 561943271 Inactive Hospital AZ Section 501(c)(3) Schedule A, Line 3 Carondelet Health Network 1 Carondelet Foundation Inc 120 N Tucson Blvd Tuscon AZ 85716 860749574 Foundation AZ Section 501(c)(3) Schedule A, Line 11a Carondelet Health Network 1 Southwest Catholic Health Network (DBA Mercy Care Plan) 4350 E Cotton Center Blvd Bldg D Phoenix AZ 85040 860527381 Insurance AZ Section 501(c)(3) Schedule A, Line 11a Carondelet Health Network & Dignity Health 0 Chalon Living Inc 8553 E San Alberto Dr Scottsdale AZ 85258 860805615 Low Income Housing AZ Section 501(c)(3) Schedule A, Line 3 Holy Cross Hospital Inc 1 The Centurions 2202 N Forbes Blvd Tucson AZ 85745 854088322 Foundation AZ Section 501(c)(3) Schedule A, Line 11a Carondelet Foundation Inc 1 Carondelet Medical Group PC 2202 N Forbes Blvd Tucson AZ 85745 860836126 Medical Group AZ N/A C 0 Carondelet Specialist Group Inc 2202 N Forbes Blvd Tucson AZ 85745 281558773 Physician Practice AZ N/A C 0 0 0 1 0 0 0 0 0 1 0 0 0 0 0 0 0 1 0 0 Carondelet Health Network Q 13238894 Actual Amount Transferred Carondelet Foundation Inc C 67241 Actual Amount Transferred