2015-05-12T13:22:18-05:00 2014-06-30 990 2013-07-01 580566223 ST MARY'S HEALTH CARE SYSTEM INC STMA 7063893939 1230 BAXTER STREET ATHENS GA 306063791 MARTIN HUTSON CFO 7063893939 2015-05-12 2013 2016-02-25 16:41:14Z DONALD MCKENNA 1230 BAXTER STREET ATHENS GA 306063791 178043232 0 0928 X WWW.STMARYSATHENS.ORG X 1938 GA THE MISSION OF ST. MARY'S HEALTH CARE SYSTEM, INC. ("ST. MARY'S") IS TO BE A COMPASSIONATE HEALING PRESENCE IN OUR COMMUNITY, COMMITTED TO THE SACREDNESS OF HUMAN LIFE AND THE DIGNITY OF EACH PERSON WE SERVE. 17 16 1561 350 0 0 217300 295272 80412598 171461624 781082 2248557 788678 3891067 82199658 177896520 258610 48820 0 0 34753807 71464378 0 0 0 44790947 95256839 79803364 166770037 2396294 11126483 188917825 191149096 62985589 42888417 125932236 148260679 THE MISSION OF ST. MARY'S HEALTH CARE SYSTEM, INC. ("ST. MARY'S") IS TO BE A COMPASSIONATE HEALING PRESENCE IN OUR COMMUNITY, COMMITTED TO THE SACREDNESS OF HUMAN LIFE AND THE DIGNITY OF EACH PERSON WE SERVE. 0 0 152725581 48820 173671910 ST. MARY'S HEALTH CARE SYSTEM, INC. WAS ESTABLISHED TO MEET THE HEALTH CARE NEEDS OF THE PEOPLE OF NORTHEAST GEORGIA. THE SYSTEM OPERATES AN ACUTE CARE HOSPITAL, HOME HEALTH CARE AGENCY, AND HOSPICE. ADDITIONALLY, THE SYSTEM OFFERS MANY WELLNESS AND EDUCATIONAL SERVICES TO THE COMMUNITY AT LOW, OR IN SOME CASES, AT NO CHARGE. 152725581 1 1 0 1 0 0 0 0 0 0 1 1 0 1 1 0 0 1 0 0 0 0 0 0 0 0 1 1 1 0 1 0 0 0 0 0 0 0 1 0 0 0 0 0 1 1 1 0 0 1 113 0 1 1561 1 0 0 0 0 0 0 0 0 0 0 X 17 16 0 0 0 0 1 1 1 1 1 0 0 1 1 1 1 1 1 0 1 0 GA X MARTIN HUTSON 7063893938 1230 BAXTER STREET ATHENS GA 30606 DONALD MCKENNA PRESIDENT; CEO 48.00 7.00 X X 0 621654 54240 MARTIN HUTSON VICE PRESIDENT; CFO 43.00 7.00 X X 255598 0 32403 JEAN CHIN MD VICE CHAIR 1.00 0.00 X X 0 0 0 BOBBY SNIPES CHAIR 1.00 0.00 X X 0 0 0 TIM BURGESS DIRECTOR 1.00 0.00 X 0 0 0 RUTH M CLINE MD DIRECTOR 1.00 0.00 X 0 0 0 CHRIS CALDWELL DIRECTOR 1.00 1.00 X 0 0 0 JOHN CUFF MD DIRECTOR 1.00 0.00 X 0 0 0 JOE GORMAN DIRECTOR 1.00 2.00 X 0 0 0 DAWN GRIFFIN DIRECTOR 1.00 0.00 X 0 0 0 THOMAS F HOLLINGSWORTH III DIRECTOR 1.00 0.00 X 0 0 0 ROBBIE P HOOKER DIRECTOR 1.00 0.00 X 0 0 0 LEON HUBRICH MD DIRECTOR 1.00 0.00 X 0 0 0 LOUIS A PERNO DIRECTOR 1.00 0.00 X 0 0 0 FATHER ROBERT SALAMONE DIRECTOR 1.00 0.00 X 0 0 0 RALPH JOHNSON DIRECTOR 1.00 0.00 X 0 0 0 KATHY WILBANKS DIRECTOR 1.00 0.00 X 0 0 0 MIXON ROBINSON MD DIRECTOR; CHIEF OF STAFF 1.00 0.00 X 0 0 0 BRUCE F MIDDENDORF CHIEF MEDICAL OFFICER 50.00 0.00 X 352229 0 24247 MONTEZ D CARTER VP OF OPERATIONS 16.00 34.00 X 274151 0 37302 KAREN D SCHULLER VP & GENERAL COUNSEL 49.00 1.00 X 242744 0 13703 ELENA A EVANS VP NURSING 50.00 0.00 X 226852 0 14191 JEFFREY K ENGLISH VP HUMAN RESOURCES 50.00 0.00 X 216983 0 31524 KERRY J VAUGHN CHIEF INFORMATION OFFICER 50.00 0.00 X 0 156269 38008 STEVEN CAMP PHARMACIST 50.00 0.00 X 194490 0 30658 GARY A WRIGHT DIRECTOR OF PHARMACY 50.00 0.00 X 159239 0 16478 ROBERT B SHUTT RN 50.00 0.00 X 147389 0 22395 BLAKE WATTS VP OF PHYSICIAN & PROFESSIONAL SERV. 50.00 0.00 X 144098 0 19429 PATRICIA LOOME VP OF MISSION SERVICES 50.00 0.00 X 148014 0 9859 2361787 777923 344437 52 0 1 0 SKANSKA USA BUILDING INC 55 IVAN ALLEN JR BOULEVARD SUITE ATLANTA GA 30308 CONSTRUCTION SERVICES 4248405 ATHENS HOSPITALIST SERVICES PC PO BOX 7695 ATHENS GA 30606 HOSPITALIST (PHYSICIAN) SERVICES 2748824 REHABCARE GROUP INC PO BOX 502096 ST LOUIS MO 631502096 MANAGEMENT AND CLINICAL SERVICES 1782983 ANESTHESIA CONSULTANTS OF ATHENS PO BOX 7127 ATHENS GA 30604 ANESTHESIOLOGY (PHYSICIAN) COVERAGE 1594355 SODEXO INC PO BOX 536922 ATLANTA GA 303536922 DIETARY SERVICES 1458470 33 295272 295272 NET PATIENT SVC REV 622110 171461624 171461624 171461624 1962111 1962111 111051 78398 32653 32653 32653 283062 4424 0 1040 283062 3384 286446 286446 112240 67274 44966 44966 GOV'T SUBSIDY -EHR 622110 2210286 2210286 WELLNESS PROGRAM REV 621999 473174 473174 CAFETERIA REVENUE 722514 71647 71647 1058341 1058341 3813448 177896520 173671910 0 3929338 X 48820 48820 2280645 2280645 55689606 51099504 4590102 2830365 2592445 237920 6584489 5920760 663729 4079273 3608758 470515 215131 215131 30870 27309 3561 17501387 15482726 2018661 884622 782587 102035 3138548 2776539 362009 1713012 1515428 197584 3712620 3284392 428228 535012 473302 61710 149 132 17 710308 628379 81929 10567849 9348922 1218927 1333047 1179289 153758 MEDICAL SUPPLIES EXP 35083440 35083440 BAD DEBT EXPENSE 9424737 9424737 I/C PURCHASED SERVICES 6729514 5953312 776202 HOSPITAL PROVIDER TAX 2149304 2149304 0 1527289 1345496 181793 166770037 152725581 14044456 0 1922261 21203048 21431878 21734140 3490226 3061140 2954851 2134099 1343516 219048021 150283792 67094652 68764229 33029866 30698752 27223421 277405 21417 37195511 36486509 188917825 191149096 24766062 22808189 47975 17582788 1340000 757360 531994 19831404 18208234 62985589 42888417 X 127007503 149335946 -1075267 -1075267 125932236 148260679 188917825 191149096 X 11126483 1928519 9273441 X X 0 1 X 1 0 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 0 0 0 0 0 1 17582 0 0 0 17582 0 PART II-B, LINE 1: ST. MARY'S HEALTH CARE SYSTEM, 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 ST. MARY'S HEALTH CARE SYSTEM, INC. WITH AN ESTIMATED PERCENTAGE OF DUES PAYMENTS WHICH ARE USED FOR LOBBYING ACTIVITIES. ST. MARY'S HEALTH CARE SYSTEM, INC. MADE NO CONTRIBUTIONS TO ANY LEGISLATORS OR CANDIDATES. 2536947 2536947 81551251 47414929 34136322 343430 181927 161503 132944830 102686936 30257894 1671563 1671563 68764229 COMMINGLED FUNDS DIRECTLY HOLDING SECURITIES 5792217 F HEDGE FUNDS 8688326 F EQUITY METHOD INVESTMENTS 12742878 C 27223421 INTERCOMPANY ACCOUNTS RECEIVABLE 29194268 OTHER LONG-TERM ASSETS 1122387 INVESTMENT IN UNCONSOL. AFFILIATES 6169854 36486509 INTERCOMPANY ACCOUNTS PAYABLE 512689 INTERCOMPANY OTHER LIABILITIES 881762 INTERCOMPANY NOTES PAYABLE 15655853 OTHER CURRENT LIABILITIES 1157930 18208234 1 1 X 1 X 1 X 1 1 1 0 1 1 7163200 7163200 0.04550 23050280 18786771 4263509 0.02710 30213480 18786771 11426709 0.07260 191965 5089 186876 0.00120 1822446 4320 1818126 0.01160 365059 202104 162955 0.00100 3921 3921 0.00000 116365 116365 0.00070 2499756 211513 2288243 0.01450 32713236 18998284 13714952 0.08710 1 0 4974 4974 0.00000 1 0 2141 2141 0.00000 3 279 23923 23923 0.00020 0 0 1 870 7709 7709 0.00000 0 0 0 0 0 0 6 1149 38747 38747 0.00020 1 2494674 0 52699880 52464361 235519 X 1 1 1 1 ST MARY'S HEALTH CARE SYSTEM 1230 BAXTER STREET ATHENS GA 30606 WWW.STMARYSATHENS.ORG LICENSE #02 X X X HOME HEALTH HOSPICE, AND OTHER OP CENTERS ST MARY'S HEALTH CARE SYSTEM INC 1 X X X X X X X X 13 1 0 1 X SEE SCHEDULE H, PART V, SECTION C X X X X X X X 0 0 1 1 200.000000000000 1 400.000000000000 1 X X X X X X X X X 1 1 X X X 1 0 X X X X 1 X 0 0 ST. MARY'S HEALTH CARE SYSTEM, INC. PART V, SECTION B, LINE 3: FOCUSED INTERVIEWS WERE CONDUCTED WITH KEY INFORMANTS FROM THE CHNA SERVICE AREA TO COLLECT PRIMARY, QUALITATIVE DATA FOR THE ASSESSMENT. ST. MARY'S RECEIVED INPUT FROM A DIVERSE GROUP OF LEADERS THAT REPRESENT THE BROAD INTERESTS OF OUR COMMUNITY, INCLUDING: DIRECTORS AND STAFF FROM COMMUNITY HEALTH CENTERS, EDUCATIONAL LEADERS AND MEMBERS FROM SOCIAL SERVICE ORGANIZATIONS. THE FOLLOWING ORGANIZATIONS AND GROUPS WERE CONSULTED IN CONDUCTING ST. MARY'S MOST RECENT CHNA:NORTHEAST GEORGIA HOMELESS & POVERTY COALITION ATHENS HEALTH NETWORK ATHENS NURSES CLINIC ST. MARY'S HEALTH CARE SYSTEM CLARKE CENTRAL HIGH SCHOOL OASIS CATOLICO SANTA RAFAELA CLARKE COUNTY HEALTH DEPARTMENT ATHENS AREA COMMUNITY FOUNDATION MERCY HEALTH CENTER THE UNIVERSITY OF GEORGIA COLLEGE OF PHARMACYKEY INFORMANTS PROVIDED KNOWLEDGE ABOUT THE COMMUNITY'S HEALTH STATUS, RISK FACTORS, SERVICE UTILIZATION, AND COMMUNITY RESOURCE NEEDS, AS WELL AS GAPS AND SERVICE SUGGESTIONS.IN TOTAL, 11 FACE-TO-FACE INTERVIEWS WERE CONDUCTED BY A SINGLE INTERVIEWER FROM ST. MARY'S HEALTH CARE SYSTEM BETWEEN FEBRUARY AND APRIL 2013. KEY INFORMANTS WERE IDENTIFIED AND RECRUITED BY THE ASSESSMENT TEAM WORKING IN COLLABORATION WITH ST. MARY'S LEADERSHIP COMMITTEE. ST. MARY'S HEALTH CARE SYSTEM, INC. PART V, SECTION B, LINE 7: ST. MARY'S HEALTH CARE SYSTEM (STMH) ACKNOWLEDGES THE WIDE RANGE OF PRIORITY HEALTH ISSUES THAT EMERGED FROM THE CHNA PROCESS, AND DETERMINED THAT IT COULD EFFECTIVELY FOCUS ON ONLY THOSE HEALTH NEEDS WHICH IT DEEMED MOST PRESSING, UNDER-ADDRESSED, AND WITHIN ITS ABILITY TO INFLUENCE. STMH WILL NOT TAKE ACTION ON THE FOLLOWING HEALTH NEEDS:MENTAL HEALTH - THIS PRIORITY AREA IS BEING ADDRESSED BY ADVANTAGE BEHAVIORAL HEALTH SYSTEMS, NUCI'S SPACE AND PALM HOUSE RECOVERY CENTERS. THE NUMBER OF EXISTING PROGRAMS ADDRESSING THIS ISSUE EXCLUDED THIS AS AN AREA CHOSEN FOR ACTION; HOWEVER, STMH RECOGNIZES THAT ADDITIONAL SERVICES ARE STILL NEEDED.ORAL HEALTH - STMH BELIEVES THAT THIS PRIORITY AREA FALLS OUT OF THE SCOPE OF EXPERTISE AND RESOURCES OF THE HOSPITAL. ST. MARY'S WILL CONTINUE TO WORK WITH EXISTING COMMUNITY HEALTH PARTNERS AND SEEK OUT INNOVATIVE METHODS TO ADDRESS THIS NEED IN THE FUTURE AS RESOURCES BECOME AVAILABLE.REPRODUCTIVE & SEXUAL HEALTH - STMH BELIEVES THAT THIS PRIORITY AREA FALLS MORE WITHIN THE PURVIEW OF THE COUNTY HEALTH DEPARTMENT AND OTHER COMMUNITY ORGANIZATIONS. LIMITED RESOURCES AND LOWER PRIORITY EXCLUDED THIS AS AN AREA CHOSEN FOR ACTION. ST. MARY'S HEALTH CARE SYSTEM, INC. PART V, SECTION B, LINE 12I: 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. ST. MARY'S HEALTH CARE SYSTEM, INC. PART V, SECTION B, LINE 14G: DUE TO THE COMPLEXITY OF THE POLICY, COPIES OF THE FULL POLICY ARE ONLY PROVIDED ON REQUEST. STATEMENTS PROVIDING THE AVAILABILITY OF FINANCIAL ASSISTANCE AND THE NUMBER(S) TO CALL ARE PROVIDED TO PATIENTS AT PRE-REGISTRATION, REGISTRATION, AND ADMISSIONS OFFICES. FAP INFORMATION IS ALSO PLACED ON THE BEDSIDE TABLES IN ALL INPATIENT ROOMS. FINANCIAL ASSISTANCE POLICY INFORMATION IS PROVIDED IN THE PATIENT INFORMATION BOOKLET AND ON ALL BILLING STATEMENTS. ST. MARY'S HEALTH CARE SYSTEM, INC. PART V, SECTION B, LINE 20D: 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. PATIENTS WITH INCOME BETWEEN 201% AND 400% OF THE FPG RECEIVE A WRITE OFF OF HOSPITAL CHARGES FOR MEDICALLY NECESSARY SERVICES EQUAL TO THE HOSPITAL'S AVERAGE MANAGED CARE PLAN DISCOUNT. ST. MARY'S HEALTH CARE SYSTEM, INC.- PART V, SECTION B, LINE 5A: WWW.STMARYSATHENS.ORG/ABOUT-US/COMMUNITY-BENEFIT/ 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: ST. MARY'S HEALTH CARE SYSTEM, 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, ST. MARY'S HEALTH CARE SYSTEM, 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, $9,424,737, 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 II, COMMUNITY BUILDING ACTIVITIES: ST. MARY'S HEALTH CARE SYSTEM PARTICIPATES IN SEVERAL COMMUNITY BUILDING ACTIVITIES THAT PROMOTE THE HEALTH OF THE COMMUNITIES SERVED BY IMPROVING ACCESS TO HEALTH SERVICES, ENHANCING PUBLIC HEALTH, AND ADVANCING KNOWLEDGE. ST. MARY'S HEALTH CARE SYSTEM HOSTS MANY VOLUNTEERS THROUGHOUT THE YEAR INCLUDING HIGH SCHOOL AND COLLEGE STUDENTS AS WELL AS COMMUNITY MEMBERS OF ALL AGES. SEVERAL DEPARTMENTS WITHIN THE HOSPITAL ARE INVOLVED IN MENTORING STUDENTS INTERESTED IN HEALTHCARE CAREERS. THE VOLUNTEERS NOT ONLY SERVE THE HOSPITAL IN VITAL WAYS, BUT ALSO RECEIVE EXPERIENTIAL TRAINING IN HEALTH CARE IN A HOSPITAL SETTING; INCREASED EDUCATION AND TRAINING CORRELATES WITH INCREASED HEALTH STATUS. ST. MARY'S IS A LEAD FACILITATOR IN LOCAL AND REGIONAL PREPAREDNESS ACTIVITIES, ENSURING THAT ATHENS-CLARKE COUNTY IS PREPARED SHOULD A DISASTER STRIKE. THE DIRECTOR OF SECURITY ATTENDS AND PARTICIPATES IN DISASTER MANAGEMENT AND EMERGENCY PREPAREDNESS MEETINGS THROUGHOUT THE YEAR. THE PLANNING ALLOWS COLLABORATION OF STATE AND LOCAL AGENCIES AND ORGANIZATIONS IN ORDER TO PREPARE FOR A LOCAL OR STATEWIDE EMERGENCY. PLANNING IS A VITAL STEP IN DISASTER MANAGEMENT AND WILL CERTAINLY INCREASE COMMUNITY HEALTH IN THE CASE OF AN EMERGENCY. ST. MARY'S HEALTH CARE SYSTEM COLLABORATES WITH COMMUNITIES, CHURCHES, BUSINESSES, AND OTHER HEALTH CARE ORGANIZATIONS TO FACILITATE AND STRENGTHEN ACCESSIBILITY OF QUALITY COMPREHENSIVE HEALTH CARE SERVICES FOR ALL, PARTICULARLY THE VULNERABLE AND UNDERSERVED POPULATIONS. STAFF MEMBERS DONATE THEIR TIME AND EXPERTISE TO A VARIETY OF ORGANIZATIONS THAT STRIVE TO IMPROVE COMMUNITY HEALTH. ST. MARY'S MANAGER OF COMMUNITY BENEFITS AND OUTREACH SERVED ON THE ATHENS HEALTH NETWORK BOARD OF DIRECTORS IN FISCAL YEAR 2014. THE ATHENS HEALTH NETWORK IS AN UMBRELLA ORGANIZATION THAT SERVES AS A SAFETY NET FOR THOSE IN NEED OF HEALTHCARE, PROMOTING THE EXISTING INFRASTRUCTURE OF THE ATHENS-CLARKE COUNTY HEALTHCARE SYSTEM AND IDENTIFYING THE PRESENCE OF SERVICE GAPS AND WAYS OF FILLING THOSE GAPS. THE NETWORK CONNECTS HEALTHCARE AND COMMUNITY LEADERS, EQUIPPING THEM WITH RESOURCES AND INFORMATION TO PROVIDE HEALTHCARE TO THE UNINSURED AND UNDERINSURED OF ATHENS-CLARKE COUNTY. ST. MARY'S CONTINUES TO INVEST IN INITIATIVES THAT SUPPORT ECONOMIC DEVELOPMENT IN OUR COMMUNITY. THE DIRECTOR OF MARKETING AND PUBLIC RELATIONS SERVES ON THE OCONEE COUNTY CHAMBER OF COMMERCE BOARD OF DIRECTORS AND ST. MARY'S FOUNDATION DIRECTOR SERVES ON THE ATHENS AREA CHAMBER OF COMMERCE BOARD. ADDITIONALLY, THE DIRECTOR OF CORPORATE HEALTH SERVICES SERVES ON THE STEERING COMMITTEE/BOARD OF LEAD ATHENS. LEAD ATHENS IS A LEADERSHIP DEVELOPMENT PROGRAM FOR ATHENS-CLARKE COUNTY LEADERS TO FURTHER THEIR UNDERSTANDING OF THE COMMUNITY. LEAD PARTICIPANTS LEARN ABOUT THE RESOURCES, OPPORTUNITIES AND CHALLENGES THAT FACE OUR COMMUNITY AND COME AWAY WITH INSIGHT ON HOW THEY CAN MAKE A DIFFERENCE. THE MANAGER OF PHYSICIAN RELATIONS SERVES ON THE LEADERSHIP OCONEE STEERING COMMITTEE. THE LEADERSHIP OCONEE PROGRAM DEVELOPS LEADERS FROM WITHIN OCONEE COUNTY. THE PRIMARY PURPOSE IS TO EDUCATE THESE LEADERS WITH A WELL-ROUNDED APPROACH TO ALL THAT IS AVAILABLE AND HAPPENING WITHIN OUR COUNTY. MEMBERS OF EACH CLASS LEARN ABOUT CURRENT PROGRAMS/SERVICES AVAILABLE, CHALLENGES WE STILL FACE AS A COMMUNITY AND HOW THEY CAN CONTRIBUTE TO IMPROVE AS A COUNTY. ST. MARY'S ALSO PARTICIPATES IN THE YOUTH APPRENTICESHIP PROGRAM (YAP). YAP IS A CAREER DEVELOPMENT PROGRAM FOR HIGH SCHOOL STUDENTS THAT HELPS THEM TO BE BETTER EQUIPPED FOR THE WORKPLACE. PART III, LINE 2: METHODOLOGY USED FOR LINE 2 - BAD DEBT EXPENSE REPORTED ON LINE 2 IS SHOWN AT COST AND WAS CALCULATED USING A COST TO CHARGE RATIO METHODOLOGY.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: ST. MARY'S HEALTH CARE SYSTEM, 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. ST. MARY'S HEALTH CARE SYSTEM, INC. IS RECORDING AMOUNTS AS CHARITY CARE (INSTEAD OF BAD DEBT EXPENSE) BASED ON THE RESULTS OF THE PREDICTIVE MODEL. THEREFORE, ST. MARY'S HEALTH CARE SYSTEM, 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: ST. MARY'S HEALTH CARE SYSTEM, 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 14 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 REGIONAL HEALTH MINISTRY 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: ST. MARY'S HEALTH CARE SYSTEM, INC. DOES NOT BELIEVE ANY MEDICARE SHORTFALL SHOULD BE TREATED AS COMMUNITY BENEFIT. THIS IS SIMILAR TO CHA 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 - IN ADDITION TO CONDUCTING A COMPREHENSIVE NEEDS ASSESSMENT EVERY THREE YEARS, ST. MARY'S HEALTH CARE SYSTEM CONTINUOUSLY GATHERS AND REVIEWS DATA RELATED TO COMMUNITY HEALTH NEEDS UTILIZING FOCUS AND ADVISORY GROUPS, COMMUNITY STUDIES, AS WELL AS SERVING ON LOCAL BOARDS AND SUBCOMMITTEES TO ENSURE THAT THE COMMUNITY HEALTH NEEDS ARE APPROPRIATELY IDENTIFIED AND ADDRESSED. ST. MARY'S ALSO COLLABORATES WITH COMMUNITY ORGANIZATIONS, CHURCHES, BUSINESSES, AGENCIES, LOCAL COLLEGES AND UNIVERSITIES, AND STATE INDIGENT PROGRAMS TO DETERMINE HEALTH NEEDS. PART VI, LINE 3: PATIENT EDUCATION OF ELIGIBILITY FOR ASSISTANCE-ST. MARY'S HEALTH CARE SYSTEM, 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, ST. MARY'S HEALTH CARE SYSTEM, 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 OBLIGATIONSST. MARY'S HEALTH CARE SYSTEM, 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. HOWEVER, DETERMINATION FOR FINANCIAL SUPPORT CAN BE MADE DURING ANY STAGE OF THE PATIENT'S STAY AFTER STABILIZATION OR COLLECTION CYCLE. ST. MARY'S HEALTH CARE SYSTEM, 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, REFLECTING OTHER PRIMARY LANGUAGES SPOKEN BY THE POPULATION SERVICED BY OUR HOSPITAL. ST. MARY'S HEALTH CARE SYSTEM, INC. HAS ESTABLISHED A WRITTEN POLICY FOR THE BILLING, COLLECTION AND SUPPORT FOR PATIENTS WITH PAYMENT OBLIGATIONS. ST. MARY'S HEALTH CARE SYSTEM, 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 - ST. MARY'S HOSPITAL IS LOCATED IN ATHENS-CLARKE COUNTY AND SERVES A MULTI-COUNTY AREA IN NORTHEAST GEORGIA. ATHENS-CLARKE COUNTY, COMPRISED OF 121 SQUARE MILES, IS THE SMALLEST IN LAND AREA OF GEORGIA'S 159 COUNTIES. IT IS LOCATED APPROXIMATELY 65 MILES NORTHEAST OF ATLANTA AND IS 94 PERCENT URBAN. THE U.S. CENSUS BUREAU ESTIMATES THE 2010 POPULATION OF ATHENS-CLARKE COUNTY TO BE 116,714, MAKING IT THE 19TH MOST POPULOUS COUNTY IN THE STATE. AMONG COUNTIES WITH A POPULATION OF AT LEAST 100,000, ATHENS-CLARKE COUNTY HAS THE THIRD LOWEST MEDIAN AGE IN THE UNITED STATES (25.9). OF THE 2010 CENSUS POPULATION: 17.5 PERCENT OF THE POPULATION WAS UNDER 18 YEARS OF AGE; 74.0 PERCENT WERE BETWEEN THE AGES OF 18 AND 64; AND 8.5 PERCENT WERE AGE 65 OR OLDER. THE GENDER DISTRIBUTION OF THE COUNTY WAS 52.5 PERCENT FEMALE AND 47.5 PERCENT MALE.THE RESIDENTS OF ATHENS-CLARKE COUNTY COME FROM A MYRIAD OF ETHNIC, CULTURAL AND SOCIOECONOMIC BACKGROUNDS. THE MAJORITY OF THE POPULATION IS WHITE (61.9%), FOLLOWED BY BLACK OR AFRICAN-AMERICAN (26.6%). FROM 2000 TO 2010, THE HISPANIC POPULATION IN THE COUNTY INCREASED 4.1 PERCENT. THE RESIDENTS OF ATHENS-CLARKE COUNTY EXCEED THE STATE AVERAGE IN EDUCATION ATTAINMENT LEVELS, BOTH IN TERMS OF HIGH SCHOOL COMPLETION AND FOUR OR MORE YEARS OF COLLEGE EDUCATION. OF THE POPULATION AGE 25 YEARS AND OVER IN ATHENS-CLARKE COUNTY, 41.2 PERCENT HAVE AT LEAST A BACHELOR'S DEGREE COMPARED TO 15.8 PERCENT IN THE AVERAGE COUNTY IN GEORGIA. ACCORDING TO THE GEORGIA DEPARTMENT OF LABOR, THE AVERAGE UNEMPLOYMENT RATE IN THE COUNTY FELL TO 6.5 PERCENT IN 2012. DESPITE THE HIGH NUMBER OF EDUCATED CITIZENS IN THE LOCAL WORKFORCE AND A RELATIVELY LOW UNEMPLOYMENT RATE, ATHENS-CLARKE COUNTY HAS A VERY HIGH POVERTY RATE. IN 2010, THE PER CAPITA INCOME IN ATHENS-CLARKE COUNTY WAS $25,309 AND THE MEDIAN HOUSEHOLD INCOME WAS $34,000. AT 33.3 PERCENT, THE POVERTY RATE IN ATHENS-CLARKE COUNTY IS NEARLY DOUBLE THE GEORGIA AVERAGE OF 18.0 PERCENT. POVERTY LEVELS ARE PARTICULARLY STRIKING FOR CHILDREN IN THE COUNTY; 35.5 PERCENT OF THE POPULATION UNDER AGE 17 LIVES BELOW THE POVERTY LEVEL. PART VI, LINE 5: PROMOTION OF COMMUNITY HEALTH - ST. MARY'S HEALTH CARE SYSTEM'S OVERALL RESPONSIVENESS TO THE NEEDS OF OUR COMMUNITY IS EVIDENCED BY OUR WILLINGNESS TO PARTICIPATE IN A RANGE OF COMMITTEES, COALITIONS, PANELS, ADVISORY GROUPS, COMMISSIONS, AND BOARDS. FOR EXAMPLE, IN FY14, MANY OF ST. MARY'S SENIOR LEADERSHIP DONATED THEIR TIME AND EXPERTISE TO ORGANIZATIONS THAT STRIVE TO IMPROVE COMMUNITY HEALTH. THESE ORGANIZATIONS INCLUDE THE ATHENS HEALTH NETWORK, UNITED WAY OF NORTHEAST GEORGIA, AND PREVENT CHILD ABUSE ATHENS (PCAA).ST. MARY'S IS ADVANCING HEALTHCARE BY IMPROVING ACCESS TO EDUCATION AND TRAINING. EACH YEAR ST. MARY'S WELCOMES HUNDREDS OF STUDENTS FROM LOCAL COLLEGES AND UNIVERSITIES WHO ARE STUDYING TO BECOME THE NEXT GENERATION OF HEALTH CARE PROFESSIONALS. ST. MARY'S IS WORKING WITH THE GRU/UGA MEDICAL PARTNERSHIP TO CREATE A GRADUATE MEDICAL EDUCATION PROGRAM WITH 30 INTERNAL MEDICINE RESIDENCY POSITIONS STARTING IN 2015. CREATING A QUALITY RESIDENCY PROGRAM AT ST. MARY'S IS VITAL TO THE FUTURE OF HEALTHCARE IN NORTHEAST GEORGIA. ST. MARY'S IS ACTIVELY INVOLVED IN NUMEROUS COMMUNITY EVENTS THAT BENEFIT EVERYONE FROM NEWBORNS (MARCH OF DIMES WALK) TO PEOPLE WITH LIFE-LIMITING ILLNESSES (HOSPICE EVENTS). IN FISCAL YEAR 2014, ST. MARY'S HOSTED OR PARTICIPATED IN NUMEROUS COMMUNITY EVENTS TO PROVIDE FREE HEALTH SCREENINGS AND INFORMATION TO AREA RESIDENTS, INCLUDING THE NEXT STEP 5K AGAINST STROKE, WALTON EMC HEALTH FAIR, AND THE ATHENS-CLARKE COUNTY GOVERNMENT EMPLOYEE HEALTH FAIR. ST. MARY'S HEALTH CARE SYSTEM HAS A VIBRANT VOLUNTEER PROGRAM, OFFERING VARIED OPPORTUNITIES TO MEMBERS OF THE COMMUNITY TO VOLUNTEER. ST. MARY'S IS HONORED THAT APPROXIMATELY 350 PEOPLE CHOSE TO DONATE THEIR TIME, TALENTS AND ENERGY TO ST. MARY'S AS VOLUNTEERS IN FISCAL YEAR 2014. WE ESPECIALLY WANT TO HIGHLIGHT THE WORK OF OUR HOSPICE VOLUNTEERS. MORE THAN 100 STRONG, THESE CARING PEOPLE ASSIST IN ALL ASPECTS OF OUR HOSPICE PROGRAM, FROM FUND-RAISING TO ENSURING THAT HOMELESS PERSONS IN OUR HOSPICE HOUSE DO NOT DIE ALONE.ST. MARY'S HEALTH CARE SYSTEM IS GOVERNED BY A BOARD OF DIRECTORS COMMITTED TO THE VALUES OF THE SYSTEM AND TO ENSURING THAT ST. MARY'S CONTINUES ITS MISSION OF BEING A COMPASSIONATE, HEALING PRESENCE IN OUR COMMUNITY. ST. MARY'S HAS A 17-MEMBER BOARD COMPRISED OF A MAJORITY OF COMMUNITY MEMBERS. IN ADDITION, ST. MARY'S OPERATES A 24-HOUR EMERGENCY DEPARTMENT THAT IS ACCESSIBLE TO ANYONE NEEDING CARE REGARDLESS OF ABILITY TO PAY AND MAINTAINS AN OPEN MEDICAL STAFF. PART VI, LINE 6: ST. MARY'S HEALTH CARE SYSTEM, 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 MEMBER ORGANIZATIONS 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. OVERALL, 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. 1 CATHOLIC RELIEF SERVICES PO BOX 17090 BALTIMORE MD 212970303 135563422 501(C)(3) 5000 DISASTER RELIEF SERVICES - TYPHOON HAIYAN RESPONSE ATHENS AREA CHAMBER OF COMMERCE 246 WEST HANCOCK AVENUE ATHENS GA 30601 580144673 501(C)(6) 6000 SPONSORSHIP OF ANNUAL MEETING AND LEAD ATHENS PROGRAM UNITED WAY OF NORTHEAST GEORGIA 1 HUNTINGTON ROAD SUITE 805 ATHENS GA 30606 586008133 501(C)(3) 7670 SPONSORSHIP OF WEE READ PROGRAM AND FISHING TOURNAMENT FUNDRAISER OCONEE COUNTY CHAMBER OF COMMERCE PO BOX 348 WATKINSVILLE GA 30677 581516645 501(C)(6) 5150 SPONSORSHIP OF PROGRAMS AND GOLF TOURNAMENT ATHENS AREA CANCER AUXILIARY PO BOX 48763 ATHENS GA 30604 582555731 501(C)(3) 5000 SPONSORSHIP OF PROGRAMS UGA CATHOLIC CENTER 1344 SOUTH LUMPKIN STREET ATHENS GA 30606 580903505 501(C)(3) 5000 SPONSORSHIP OF 5K RACE FESTIVAL HALL INC 201 NORTH MAIN STREET GREENSBORO GA 30642 272365249 501(C)(3) 5000 SPONSORSHIP OF GREENE COUNTY PLAYERS ATHENS AREA COMMUNITY FOUNDATION 1240 SOUTH LUMPKIN STREET ATHENS GA 30602 261838979 501(C)(3) 10000 SPONSORSHIP OF VARIOUS COMMUNITY PROGRAMS 6 2 PART I, LINE 2: DONATIONS MADE BY ST. MARY'S HEALTH CARE SYSTEM, 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 DONALD MCKENNA PRESIDENT; CEO 0 354103 0 163214 0 104337 0 18975 0 35265 0 675894 0 0 MARTIN HUTSON VICE PRESIDENT; CFO 202699 0 52458 0 441 0 16793 0 15610 0 288001 0 0 0 BRUCE F MIDDENDORF CHIEF MEDICAL OFFICER 294762 0 53764 0 3703 0 12725 0 11522 0 376476 0 0 0 MONTEZ D CARTER VP OF OPERATIONS 225709 0 48253 0 189 0 12725 0 24577 0 311453 0 0 0 KAREN D SCHULLER VP & GENERAL COUNSEL 194969 0 47377 0 398 0 12042 0 1661 0 256447 0 0 0 ELENA A EVANS VP NURSING 197891 0 28694 0 267 0 12494 0 1697 0 241043 0 0 0 JEFFREY K ENGLISH VP HUMAN RESOURCES 177325 0 39497 0 161 0 14845 0 16679 0 248507 0 0 0 KERRY J VAUGHN CHIEF INFORMATION OFFICER 0 131776 0 20307 0 4186 0 12213 0 25795 0 194277 0 0 STEVEN CAMP PHARMACIST 191765 0 0 0 2725 0 14222 0 16436 0 225148 0 0 0 GARY A WRIGHT DIRECTOR OF PHARMACY 149560 0 8740 0 939 0 1690 0 14788 0 175717 0 0 0 ROBERT B SHUTT RN 147350 0 0 0 39 0 8587 0 13808 0 169784 0 0 0 BLAKE WATTS VP OF PHYSICIAN & PROFESSIONAL SERV. 143990 0 0 0 108 0 6568 0 12861 0 163527 0 0 0 PATRICIA LOOME VP OF MISSION SERVICES 117459 0 30118 0 437 0 2197 0 7662 0 157873 0 0 0 PART I, LINE 3 ST. MARY'S HEALTH CARE SYSTEM'S CEO IS PAID DIRECTLY BY A RELATED ORGANIZATION, CATHOLIC HEALTH EAST. CATHOLIC HEALTH EAST USED ONE OR MORE OF THE METHODS DESCRIBED BELOW TO ESTABLISH THE COMPENSATION OF ST. MARY'S HEALTH CARE SYSTEM'S CEO: - COMPENSATION COMMITTEE - INDEPENDENT COMPENSATION CONSULTANT - WRITTEN EMPLOYMENT CONTRACT - COMPENSATION SURVEY OR STUDY - APPROVAL BY THE BOARD OR COMPENSATION COMMITTEE PART I, LINE 4B PART II: THE FOLLOWING INDIVIDUAL IS VESTED IN A SUPPLEMENTAL EXECUTIVE RETIREMENT PLAN (SERP). THE FOLLOWING VESTED SERP AMOUNT IS INCLUDED IN COLUMN B(III) OF SCHEDULE J, PART II: DONALD MCKENNA - $76,937 ATHENS HOSPITALIST SERVICES BRUCE MIDDENDORF, MD, KEY EMPLOYEE, IS THE PRES. OF ATHENS HOSPITALIST SVCS 2748824 PAYMENTS MADE BY ST. MARY'S HEALTH CARE SYSTEM, INC. TO ATHENS HOSPITALIST SERVICES FOR PHYSICIAN SERVICES. 0 FORM 990, PART VI, SECTION A, LINE 6 THE SOLE MEMBER OF ST. MARY'S HEALTH CARE SYSTEM, INC. IS CATHOLIC HEALTH EAST. SEE LINE 7 FOR ADDITIONAL INFORMATION. FORM 990, PART VI, SECTION A, LINE 7A CATHOLIC HEALTH EAST IS THE SOLE MEMBER OF ST. MARY'S HEALTH CARE SYSTEM, INC. CATHOLIC HEALTH EAST HAS THE RIGHT TO APPOINT ALL PERSONS TO THE BOARD OF DIRECTORS OF ST. MARY'S HEALTH CARE SYSTEM, INC. FORM 990, PART VI, SECTION A, LINE 7B AS SOLE MEMBER, CATHOLIC HEALTH EAST MUST APPROVE CERTAIN DECISIONS OF THE GOVERNING BODY, INCLUDING THE STRATEGIC PLAN, ANNUAL CAPITAL PLAN, AND ANNUAL OPERATING BUDGET. CATHOLIC HEALTH EAST MUST ALSO APPROVE SIGNIFICANT CHANGES SUCH AS A MERGER, DISSOLUTION, SALE OF ASSETS IN EXCESS OF CERTAIN LIMITS, A MATERIAL CHANGE IN MISSION, AND MODIFICATIONS TO GOVERNING DOCUMENTS. FORM 990, PART VI, SECTION B, LINE 11 PRIOR TO FILING, THE FORM 990 FOR ST. MARY'S HEALTH CARE SYSTEM, INC. IS REVIEWED BY SENIOR MANAGEMENT. IN ADDITION, CERTAIN KEY SECTIONS OF THE FORM ARE REVIEWED BY 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 ST. MARY'S HEALTH CARE SYSTEM, INC. HAS ADOPTED CATHOLIC HEALTH EAST'S POLICY 103, WHICH SETS FORTH THE ORGANIZATION'S CONFLICT OF INTEREST POLICY AND PROCESSES. ANNUALLY, ALL THOSE SERVING ST. MARY'S HEALTH CARE SYSTEM, INC. IN A FIDUCIARY CAPACITY, INCLUDING DIRECTORS, OFFICERS, AND KEY EMPLOYEES RECEIVE A COPY OF THE POLICY AND ANNUAL DISCLOSURE STATEMENT TO BE COMPLETED. DISCLOSURES OF FINANCIAL INTEREST OR OTHER REPORTABLE CIRCUMSTANCES AS DEFINED IN THE POLICY ARE SUBMITTED AND REVIEWED BY THE ORGANIZATION'S CEO AND BOARD CHAIR. SUMMARY INFORMATION IS REPORTED TO THE ENTIRE BOARD AND IS AVAILABLE TO THE BOARD THROUGHOUT THE YEAR AS BUSINESS COMES BEFORE THE BOARD OR MANAGEMENT FOR ACTION. THE POLICY CONTAINS A CONTINUING AFFIRMATIVE OBLIGATION ON ALL AFFECTED INDIVIDUALS TO DISCLOSE COMPENSATION OR OTHER CIRCUMSTANCES THROUGHOUT THE YEAR WHICH MAY RISE TO THE LEVEL OF AN ACTUAL OR APPARENT CONFLICT. THE DETERMINATION OF WHETHER A DISCLOSED FINANCIAL OR OTHER INTEREST CONSTITUTES A CONFLICT OF INTEREST IS MADE BY THE BOARD OR AN APPROPRIATE COMMITTEE THEREOF COMPRISED OF DISINTERESTED PERSONS AND WITHOUT THE PARTICIPATION OF THE AFFECTED INDIVIDUAL EXCEPT TO RESPOND TO QUESTIONS ABOUT THE DISCLOSURE. THE POLICY FURTHER ADDRESSES THE PROCEDURE FOR THE BOARD'S FURTHER CONSIDERATION OF THE PROPOSED TRANSACTION/MATTER WITHOUT THE PARTICIPATION OF THE AFFECTED PERSON AND THE DOCUMENTATION OF THE PROCEEDINGS. LASTLY, THE POLICY ADDRESSES POTENTIAL DISCIPLINARY ACTION FOR VIOLATIONS OF THE POLICY. THE POLICY IS AVAILABLE TO THE PUBLIC UPON REQUEST. FORM 990, PART VI, SECTION B, LINE 15B THE COMPENSATION FOR ST. MARY'S HEALTH CARE SYSTEM, INC.'S CHIEF EXECUTIVE OFFICER AND CHIEF INFORMATION OFFICER IS ESTABLISHED BY CATHOLIC HEALTH EAST'S COMPENSATION COMMITTEE USING ONE OR MORE OF THE METHODS DESCRIBED IN SCHEDULE J, PART III. FOR OTHER EMPLOYEES, ST. MARY'S HEALTH CARE SYSTEM, INC. HAS ADOPTED CATHOLIC HEALTH EAST'S 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 ST. MARY'S HEALTH CARE SYSTEM, 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, ST. MARY'S HEALTH CARE SYSTEM, INC. INCLUDES A COPY OF ITS MOST RECENTLY FILED SCHEDULE H ON BOTH ITS OWN WEBSITE AND TRINITY HEALTH'S WEBSITE. ST. MARY'S HEALTH CARE SYSTEM, INC.'S GOVERNING DOCUMENTS AND CONFLICT OF INTEREST POLICY ARE AVAILABLE UPON REQUEST. FORM 990, PART IX, LINE 11G MEDICAL SPECIALIST FEES : PROGRAM SERVICE EXPENSES 4,885,208. MANAGEMENT AND GENERAL EXPENSES 636,941. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 5,522,149. COLLECTION SERVICES : PROGRAM SERVICE EXPENSES 886,149. MANAGEMENT AND GENERAL EXPENSES 115,537. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 1,001,686. MISC. PURCHASED SERVICES : PROGRAM SERVICE EXPENSES 9,628,228. MANAGEMENT AND GENERAL EXPENSES 1,255,343. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 10,883,571. RECRUITMENT : PROGRAM SERVICE EXPENSES 83,141. MANAGEMENT AND GENERAL EXPENSES 10,840. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 93,981. FORM 990, PART XI, LINE 9: POOLING OF INTEREST 5,194,021. EQUITY TRANSFERS TO/FROM AFFILIATES 4,079,420. FORM 990, PART XII, LINE 2: ST. MARY'S HEALTH CARE SYSTEM, INC.'S FINANCIAL STATEMENTS WERE INCLUDED IN THE FY14 CONSOLIDATED FINANCIAL STATEMENTS OF TRINITY HEALTH, WHICH WERE AUDITED BY AN INDEPENDENT PUBLIC ACCOUNTING FIRM. 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 ALLEGANY FRANCISCAN MINISTRIES INC 33920 US HIGHWAY 19 NORTH SUITE 269 PALM HARBOR FL 34684 581492325 MANAGEMENT & SUPPORT SERVICES FL 501(C)(3) LINE 11A, I CATHOLIC HEALTH EAST 1 AMICARE HOSPICE SERVICES INC 20555 VICTOR PARKWAY LIVONIA MI 48152 382949053 PROVIDE 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 SUPPORTS SERVICES OF RELATED HOSPITAL OR 501(C)(3) LINE 9 SAINT ALPHONSUS MEDICAL CENTER-ONTARIO 1 BAUM HARMON MERCY HOSPITAL 255 NORTH WELCH AVENUE PRIMGHAR IA 51245 421500277 ACUTE/AMBULATORY HEALTHCARE SERVICES IA 501(C)(3) LINE 3 MERCY HEALTH SERVICES-IOWA CORP 1 BAUM HARMON MERCY HOSPITAL & CLINICS FOUNDATION 255 NORTH WELCH AVENUE PRIMGHAR IA 51245 262973307 SUPPORT THE SERVICES OF RELATED HOSPITAL IA 501(C)(3) LINE 11A, I BAUM HARMON MERCY HOSPITAL 1 BEECHWOOD INC 2212 BURDETT AVE TROY NY 12180 141651563 REAL ESTATE HOLDING NY 501(C)(2) N/A LTC (EDDY) INC 1 BEVERWYCK INC 40 AUTUMN DRIVE SLINGERLANDS NY 12159 141717028 INDEPENDENT/ASSISTED LIVING RETIREMENT 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 BEHAVIORAL CARE 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 NURSING HOME NY 501(C)(3) LINE 9 LTC (EDDY) INC 1 CATHERINE MCAULEY HEALTH SERVICES CORP PO BOX 995 ANN ARBOR MI 48106 382507173 FURTHER TRINITY HEALTH ACTIVITIES, ORGANIZE AND DEVELOP MEDICAL SERVICES MI 501(C)(3) LINE 11B, II TRINITY HEALTH-MICHIGAN 1 CATHOLIC HEALTH EAST 3805 WEST CHESTER PIKE SUITE 100 NEWTOWN SQUARE PA 19073 232929748 MANAGEMENT SERVICES PA 501(C)(3) LINE 11C, III-FI CHE TRINITY INC 1 CHE TRINITY INC 20555 VICTOR PARKWAY LIVONIA MI 48152 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