2015-11-09T16:30:21-06:00 2014-12-31 990 2014-01-01 480547719 ST FRANCIS HEALTH CENTER INC STFR 7852958000 1700 SW 7TH STREET TOPEKA KS 66606 ESSENCE MONTGOMERY CFO 7852958000 2015-11-06 2014 2016-03-07 17:11:31Z DAVID SETCHEL 1700 SW 7TH STREET TOPEKA KS 66606 275552953 0 0928 X WWW.STFRANCISTOPEKA.ORG X 1975 KS WE REVEAL AND FOSTER GOD'S HEALING LOVE BY IMPROVING THE HEALTH OF THE PEOPLE AND COMMUNITIES WE SERVE, ESPECIALLY THOSE WHO ARE POOR AND VULNERABLE. 15 13 1935 165 645011 0 6820933 2488787 242140067 250280730 7501189 20772166 3323913 1810115 259786102 275351798 623345 774605 0 0 120681494 129358057 0 0 0 139946769 151413204 261251608 281545866 -1465506 -6194068 394809481 381476675 19093608 19807462 375715873 361669213 X WE REVEAL AND FOSTER GOD'S HEALING LOVE BY IMPROVING THE HEALTH OF THE PEOPLE AND COMMUNITIES WE SERVE, ESPECIALLY THOSE WHO ARE POOR AND VULNERABLE. 0 0 238869888 774605 250931790 ST. FRANCIS HEALTH HAS SERVED THE HEALTHCARE NEEDS OF TOPEKA, KAN., AND SURROUNDING COMMUNITIES SINCE 1909. AS PART OF SCL HEALTH, A FAITH-BASED, NONPROFIT HEALTH SYSTEM, ST. FRANCIS WORKS TO IMPROVE NOT ONLY THE HEALTH OF THOSE WE SERVE, BUT PEOPLE'S LIVES. WE BRING COMPASSIONATE CARE AND THE MOST ADVANCED TECHNOLOGY TO OUR PATIENTS BY WAY OF OUR ACUTE-CARE HOSPITAL AND MORE THAN 20 PHYSICIAN CLINICS THROUGHOUT THE REGION.ST. FRANCIS HEALTH EMBODIES A DIVERSE AND CARING COMMUNITY DEDICATED TO IMPROVING THE HEALTH AND WELFARE OF OTHERS. ST. FRANCIS EMPLOYEES HAVE PROVIDED INNOVATIVE, INSPIRED SERVICE FOR MORE THAN A CENTURY. WE CARE FOR THOUSANDS OF PATIENTS AND THEIR FAMILIES WITH THE SAME SPIRIT AND RESOLVE DEMONSTRATED BY THE RESOURCEFUL SISTERS WHO OPENED THE FACILITY. ST. FRANCIS HEALTH CENTER OPENED ON OCT. 17, 1909, WITH 40 BEDS. ASSEMBLING SCRAPS OF FABRIC AND FASHIONING THEM INTO COLORFUL QUILTS FOR PATIENTS WAS ONE OF THE FIRST ASPECTS OF BUSINESS THE SISTERS OF CHARITY OF LEAVENWORTH PURSUED. EVER MINDFUL OF THE COST OF THINGS, THEY WERE PRUDENT IN THEIR APPROACHES TO ENSURE THAT WHATEVER RESOURCES THEY HAD AVAILABLE COULD BE STRETCHED TO ACCOMMODATE THE NEEDS OF EVERYONE WHO SOUGHT ASSISTANCE FOR THEIR AILMENTS. TODAY, THE HOSPITAL HAS 378 LICENSED BEDS, A MEDICAL STAFF REPRESENTING NEARLY ALL SPECIALTIES, ADULT AND YOUTH VOLUNTEERS AND A THRIVING AUXILIARY. SKILLFULLY INTEGRATING TECHNOLOGY WITH TENDERNESS, ST. FRANCIS AND ITS EMPLOYEES HAVE FOSTERED A PREMIER REGIONAL HOSPITAL FEATURING THE NEWEST MEDICAL INNOVATIONS AND STATE-OF-THE-ART EQUIPMENT. ST. FRANCIS WAS THE FIRST IN THE AREA TO PURCHASE AN X-RAY MACHINE, ESTABLISH AN INTENSIVE CARE UNIT, INSTALL DIAGNOSTIC ULTRASOUND EQUIPMENT, CONDUCT A HEART TRANSPLANT, USE BEDSIDE COMPUTERS TO PROVIDE POINT OF SERVICE DOCUMENTATION AND PURCHASE A POSITRON EMISSION TOMOGRAPHY (PET) SCANNER. THE HOSPITAL IS ALSO ONE OF ONLY TWO NON-VETERANS ADMINISTRATION HOSPITALS IN KANSAS TO BAR CODE PHARMACEUTICALS TO PREVENT MEDICATION ERRORS FOR PATIENT SAFETY AND PEACE OF MIND. THE HEALING TOUCH OF ST. FRANCIS EXTENDS BEYOND THE WALLS OF THE HOSPITAL TO INCLUDE PROGRAMS FOCUSED ON PREVENTIVE MEDICINE, SUCH AS THE BREAST CENTER AND ITS SPIRIT OF WOMEN HEALTH IMPROVEMENT EVENTS AND PROGRAMS. THROUGH THE MARIAN CLINIC AND THE MARIAN DENTAL CLINIC, BOTH OWNED AND OPERATED BY SCL HEALTH, ST. FRANCIS HELPS THE WORKING POOR AND THE UNINSURED SECURE THE TREATMENT THEY NEED, FROM IMMUNIZATIONS AND ROUTINE TEETH CLEANING TO SURGICAL PROCEDURES AND CROWN AND DENTURE WORK.DURING 2014, ST. FRANCIS HAD THE FOLLOWING RESULTS:8,900 ADMISSIONS 524,305 OUTPATIENT VISITS33,614 EMERGENCY DEPARTMENT VISITS987 BIRTHS7,072 SURGERIES797,679 LABORATORY TESTSMISSIONWE REVEAL AND FOSTER GOD'S HEALING LOVE BY IMPROVING THE HEALTH OF THE PEOPLE AND COMMUNITIES WE SERVE, ESPECIALLY THOSE WHO ARE POOR AND VULNERABLE. VISIONINSPIRED BY OUR FAITH:WE WILL BE DISTINGUISHED AS THE PREMIER PERSON-CENTERED HEALTH SYSTEM AND TRUSTED PARTNER. WE WILL SHARE ACCOUNTABILITY WITH CLINICIANS AND OTHER STAKEHOLDERS TO COORDINATE CARE ACROSS ALL SETTINGS AND IMPROVE ACCESS, QUALITY, HEALTH OUTCOMES, AND AFFORDABILITY. WE WILL GROW AS COMMUNITY-BASED HEALTH NETWORKS TO SERVE MORE PEOPLE IN PARTNERSHIPS WITH OTHERS WHO SHARE OUR VISION AND VALUES.VALUES CARING SPIRIT WE HONOR THE SACRED DIGNITY OF EACH PERSON. EXCELLENCE WE SET AND SURPASS HIGH STANDARDS. GOOD HUMOR WE CREATE JOYFUL AND WELCOMING ENVIRONMENTS. INTEGRITY WE DO THE RIGHT THING WITH OPENNESS AND PRIDE. SAFETY WE DELIVER CARE THAT SEEKS TO ELIMINATE ALL HARM FOR PATIENTS AND ASSOCIATES. STEWARDSHIP WE ARE ACCOUNTABLE FOR THE RESOURCES ENTRUSTED TO US.ST. FRANCIS HEALTH CENTER IS A FULL-SERVICE HOSPITAL WITH A VARIETY OF HEALTHCARE SERVICES TO CARE FOR AND KEEP OUR COMMUNITY HEALTHY:ANTICOAGULATION CLINIC, CARDIOLOGY SERVICES, CENTER FOR INFANT AND CHILD HEALTH, COMPREHENSIVE CANCER CENTER, DA VINCI SURGICAL ROBOT SERVICES, DIABETES CENTER, DIAGNOSTIC SERVICES, EMERGENCY SERVICES, FAMILY MEDICINE, HOME CARE, IMAGING CENTER, JOINT REPLACEMENT CENTER, LABORATORY SERVICES, NEUROLOGY SERVICES, NEW LIFE CENTER, OCCUPATIONAL MEDICINE, PEDIATRICS, REHABILITATION SERVICES, SPINE CENTER, VEIN CLINIC, WOMEN'S SERVICES, WOUND CENTER. 238869888 1 1 0 1 0 0 0 0 0 1 1 0 0 1 0 0 0 1 0 0 1 1 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 1 185 0 1 1935 1 1 1 0 0 0 0 1 1 0 0 0 0 X 15 13 0 0 0 0 1 1 1 1 1 0 0 1 1 1 1 1 1 0 0 0 X KYLE ENGMAN 3038135543 500 ELDORADO BLVD SUITE 4200 BROOMFIELD CO 80021 CARLYLE DUNSHEE BOARD MEMBER 1.00 0.00 X 0 0 0 CYNTHIA HORNBERGER SECRETARY 2.00 0.00 X X 0 0 0 GREG SCHWERDT CHAIR 2.00 0.00 X X 0 0 0 JAMES OWEN BOARD MEMBER 1.00 0.00 X 0 0 0 JEFF WIETHARN BOARD MEMBER 1.00 0.00 X 0 0 0 JIM KLAUSMAN BOARD MEMBER 1.00 0.00 X 0 0 0 JOEL HUTCHINS BOARD MEMBER 1.00 0.00 X 0 0 0 JULIANN MAZACHEK VICE CHAIR 2.00 0.00 X X 0 0 0 KATHLEEN TULIPANA BOARD MEMBER 1.00 50.00 X 0 229930 42223 MAL ROBINSON BOARD MEMBER 1.00 0.00 X 0 0 0 MARK YOUNG BOARD MEMBER 1.00 0.00 X 0 0 0 MARVIN SPEES BOARD MEMBER 1.00 0.00 X 0 0 0 NEIL DOBLER BOARD MEMBER 1.00 0.00 X 0 0 0 ROBERT ERICKSON CEO 50.00 0.00 X X 0 503250 125299 SISTER JENNIFER GORDON BOARD MEMBER 1.00 0.00 X 0 0 0 SISTER MARIANNA BAUDER BOARD MEMBER 1.00 0.00 X 0 0 0 WAYNE BASSO BOARD MEMBER 1.00 0.00 X 0 0 0 DEBRA CARTWRIGHT VP & CFO 1/14 - 10/14 50.00 0.00 X 0 315970 26828 THOMAS HAMILTON CHIEF MEDICAL OFFICER 50.00 0.00 X 0 374571 79540 DAVID SETCHEL COO 50.00 0.00 X 0 311647 62319 SCOTT WELLS VP PATIENT CARE SERVICES 50.00 0.00 X 0 276003 58529 ERIC BARNABY VP STRAT & BUS DVPMT 1/14 - 10/14 50.00 0.00 X 0 288998 36126 FLORIN NICOLAE PAIN MGMT PHYSICIAN CLINIC 50.00 0.00 X 1259535 0 44380 JOHN JOLIFF PHYSICIAN CCT 50.00 0.00 X 981528 0 39284 SUMER DHIR PHYSICIAN CCT 50.00 0.00 X 914853 0 40480 BERNITA BERNTSEN PHYSICIAN CLINIC TALLGRASS 50.00 0.00 X 919180 0 44220 DAVID FRITZ PHYSICIAN - NEURO 50.00 0.00 X 821189 0 46360 GWEN HELLER FORMER KEY EMPLOYEE 1/14 0.00 50.00 X 0 208598 43245 4896285 2508967 688833 133 1 1 0 TOPEKA ANESTHESIA & PAIN TREAT 1700 SW 7TH ST TOPEKA KS 66606 MEDICAL SERVICES 2674450 JOHN MULLER & COMPANY INC 11610 ASH ST STE 200 LEAWOOD KS 66211 ADVERTISING SERVICES 1187357 WEATHERBY LOCUMS INC PO BOX 972633 DALLAS TX 75397 CONTRACT LABOR 1020715 MISSION WOODS MED & OFF P 2238 SW VILLAGE HALL ROAD TOPEKA KS 66614 MEDICAL SERVICES 670178 TOTAL RENAL CARE INC 634 SW MULVANE ST STE 300 TOPEKA KS 66608 MEDICAL SERVICES 663964 37 625000 1784366 79421 2488787 PATIENT SERVICE REVENUE 622110 250052855 249420215 632640 PATIENT REV - LIFESTAR 622110 227875 227875 250280730 5215491 5215491 656803 199731 457072 457072 457072 15556486 189 0 0 15556486 189 15556675 15556675 10396 1424 8972 8972 CAFETERIA SALES 722310 1040988 1028617 12371 HOSPITAL MGMT SERVICES 900099 248463 248463 MEDICAL STAFF FEES 900099 48000 48000 6620 6620 1344071 275351798 250931790 645011 21286210 696146 696146 300 300 78159 78159 2459080 2459080 102274962 99853396 2421566 4509364 4247398 261966 13560227 13503418 56809 6554424 6291139 263285 55463 23209 32254 11754 11754 12575 12575 9907891 7817063 2090828 74837 73890 947 1046687 1021317 25370 6924752 6829709 95043 284548 198798 85750 66269 44107 22162 10443563 10443563 2052066 2052066 MEDICAL SUPPLIES 47549294 47487876 61418 SYSTEM ALLOCATION 33604426 33604426 BAD DEBT EXPENSE 18680360 18680360 MAINTENANCE SERVICES 8406503 8249946 156557 12292216 11266274 1025942 281545866 238869888 42675978 0 2451922 8481671 38864234 34346552 4834608 4623076 4259163 4643409 278370525 201506063 72432792 76864462 2580145 2845042 269386617 249672463 394809481 381476675 19093608 19807462 19093608 19807462 X 375715873 361669213 375715873 361669213 394809481 381476675 -6194068 -7852592 0 X 0 1 X 1 1 1 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 0 0 0 0 0 0 0 0 1 12575 12575 0 PART II-B, LINE 1: PART II-B, LINE (1I): LOBBYING EXPENSES WERE DERIVED AS A PERCENTAGE OF DUES PAID TO THE KANSAS HOSPITAL ASSOCIATION. 5834197 109242 244925 1404608 13616 4770140 5142433 705491 2475 11252 5834197 4592958 563648 8013 6160 5142433 4540982 89819 24684 13159 4592958 4081439 544019 72096 12380 4540982 1.00000 0 1 1 16143758 16143758 137818318 98975273 38843045 7754563 4891708 2862855 114795741 97639082 17156659 1858145 1858145 76864462 INTERCOMPANY RECEIVABLES 244619842 OTHER RECEIVABLES 397804 3RD PARTY SETTLEMENTS 4654817 249672463 PART V, LINE 4: THE ORIGINAL ENDOWMENT FUNDS ARE NEVER USED. THE INVESTMENT EARNINGS ARE USED AS DESIGNATED BY THE DONOR AT THE TIME OF THEIR DONATION FOR VARIOUS USES INCLUDING; SCHOLARSHIPS, HEALTHCARE FOR THE POOR, HEALTH CENTER EYE SURGERY EQUIPMENT, MEDICAL EDUCATION, FACILITY IMPROVEMENT, RADIOLOGY SERVICES, ONCOLOGY AND DIABETES DEPARTMENT EXPENSES. ENDOWMENT FUNDS ARE HELD BY THE ST. FRANCIS HEALTH CENTER FOUNDATION. 1 SUB-SAHARAN AFRICA 0 0 GRANTS TO HOSPITALS IN REGION 78159 0 0 0 0 0 0 78159 0 78159 SUB-SAHARAN AFRICA PROVIDE SURGICAL SUPPLIES TO MEDICAL PROFESSIONALS IN AFRICA 78159 SURGICAL SUPPLIES FMV 1 0 0 0 0 0 0 PART I, LINE 2: GRANTS RECEIVED FROM ST. FRANCIS HEALTH CENTER MISSION FUNDS MUST ADDRESS ONE OF THE IDENTIFIED COMMUNITY HEALTH NEEDS IN THE ASSESSMENT REPORT FOR TOPEKA/SHAWNEE COUNTY SPONSORED BY THE UNITED WAY OF GREATER TOPEKA. ONLY ONE GRANT APPLICATION PER ORGANIZATION WILL BE ACCEPTED EACH YEAR. GRANTS CAN BE RENEWED AND FUNDED FOR A MAXIMUM OF THREE YEARS BASED ON THE PREVIOUS YEAR'S OUTCOMES AS DETERMINED BY THE MISSION FUND COMMITTEE. THE GRANT CANNOT BE THE SOLE FUNDING SOURCE FOR ANY PROJECT REQUEST THAT EXCEEDS $1,000. THE ORGANIZATION RECEIVING THE GRANT IS REQUIRED TO SUBMIT AN INTERIM REPORT SIX MONTHS INTO THE GRANT YEAR. AT THE END OF THE GRANT YEAR A FINAL ACCOUNTING AND EVALUATION MUST BE SUBMITTED. BOTH REPORTS INCLUDE FINANCIAL INFORMATION AND A NARRATIVE REPORT DISCUSSING GOALS, OUTCOMES, FINANCIAL VARIANCES, AND PLANS TO OVERCOME VARIANCES. 1 1 X 1 X 1 X 1 1 1 0 1 1 6201945 6201945 0.02360 18945575 12625091 6320484 0.02400 19 13 6 0.00000 25147539 12625104 12522435 0.04760 60912 1335 59577 0.00020 148648 148648 0.00060 7183823 2318439 4865384 0.01850 135991 135991 0.00050 209843 209843 0.00080 7739217 2319774 5419443 0.02060 32886756 14944878 17941878 0.06820 1214 1214 0.00000 5727 5727 0.00000 733 733 0.00000 11250 11250 0.00000 18924 18924 1 18680361 0 81319612 92395664 -11076052 X 1 1 1 1 ST FRANCIS HEALTH CENTER INC 1700 SW 7TH STREET TOPEKA KS 66606 WWW.STFRANCISTOPEKA.ORG H-087-002 X X X X ST FRANCIS HEALTH CENTER INC 1 0 0 1 X X X X X X X X X 13 1 1 1 1 X HTTPS://WWW.STFRANCISTOPEKA.ORG/ABOUT-US X 1 14 1 HTTPS://WWW.STFRANCISTOPEKA.ORG/ABOUT-US 0 0 1 X 200.000000000000 400.000000000000 X X X 1 1 X X X X 1 X X X X X X X X 1 X 0 X X X X 1 X 0 0 ST. FRANCIS HEALTH CENTER, INC. PART V, SECTION B, LINE 5: THE ASSOCIATION FOR COMMUNITY HEALTH IMPROVEMENT (ACHI) COMMUNITY HEALTH ASSESSMENT TOOLKIT WAS UTILIZED AS THE FRAMEWORK TO COMPLETE THE CHNA. THIS APPROACH TO THE CHNA REQUIRES SIGNIFICANT INPUT FROM THE COMMUNITY AND DELIBERATE EFFORTS AT COMMUNITY BUILDING; THE APPROACH FOCUSES ON THE CHNA AS AN OPPORTUNITY TO DEMONSTRATE TO THE COMMUNITY OUR SHARED, CONSISTENT COMMITMENT TO THE HEALTH OF OUR RESIDENTS. THE LEAD ENTITY IN THIS COMMUNITY HEALTH NEEDS ASSESSMENT WAS THE HEALTHY SHAWNEE COUNTY TASK FORCE. THE TASK FORCE HAD AN ASSESSMENT ADVISORY COMMITTEE TO PROVIDE DIRECTION AND FEEDBACK DURING THIS PROCESS INCLUDING THE SHAWNEE COUNTY HEALTH AGENCY, ST. FRANCIS HEALTH CENTER, AND STORMONT-VAIL HEALTHCARE. HEALTHY SHAWNEE COUNTY ASSESSMENT ADVISORY COMMITTEE INCLUDED COMMUNITY REPRESENTATIVES FROM TOPEKA PUBLIC SCHOOLS FOUNDATION, KANSAS CHILDREN'S SERVICE LEAGUE, COMMUNITY RESOURCES COUNCIL, UNITED WAY OF GREATER TOPEKA, AND A COMMUNITY VOLUNTEER.TO OBTAIN COMMUNITY INPUT, A HEALTHY SHAWNEE COUNTY COMMUNITY PERCEPTION SURVEY WAS MADE AVAILABLE ON-LINE TO RESIDENTS OF SHAWNEE COUNTY. A TOTAL OF 548 COMMUNITY INDIVIDUALS AND 229 ORGANIZATION MEMBERS COMPLETED THE SURVEY. INSIGHT INTO SHAWNEE COUNTY'S HEALTH-RELATED NEEDS WAS ALSO PROVIDED BY THREE FOCUS GROUPS. EACH GROUP HAD A DIFFERENT SET OF PARTICIPANTS - HEALTH CARE PROFESSIONALS, SOCIAL SERVICE PROFESSIONALS AND NEIGHBORHOOD LEADERS. FOCUS GROUPS WERE CONDUCTED AUGUST 15 AND 16, 2012 AT THE TOPEKA-SHAWNEE COUNTY PUBLIC LIBRARY. ADDITIONALLY, THIRTY-FIVE TARGETED COMMUNITY STAKEHOLDERS WITH PUBLIC HEALTH EXPERTISE WERE SENT AN E-MAIL SURVEY. RESPONDING TO THE SURVEY WERE REPRESENTATIVES FROM: BREWSTER PLACE RETIREMENT COMMUNITY, KANSAS CHILDREN'S SERVICE LEAGUE, POSITIVE CONNECTIONS, INC., KANSAS ASSOCIATION FOR THE MEDICALLY UNDERSERVED, COMMUNITY ACTION, INC., UNITED WAY OF GREATER TOPEKA, SHAWNEE COUNTY HEALTH AGENCY - COMMUNITY HEALTH CENTER, AND A RETIRED NON-PROFIT EXECUTIVE DIRECTOR. ST. FRANCIS HEALTH CENTER, INC. PART V, SECTION B, LINE 6A: STORMONT-VAIL HEALTHCARE, TOPEKA, KS ST. FRANCIS HEALTH CENTER, INC. PART V, SECTION B, LINE 11: THE HEALTHY SHAWNEE COUNTY TASK FORCE COMPILED THE COLLECTIVE DATA AND 14 COMMUNITY ISSUES EMERGED: 1) ADULTS WHO ARE OVERWEIGHT OR OBESE; 2)ADULTS CONSUMING FRUITS AND VEGETABLES FIVE OR MORE TIMES PER DAY; 3)ADULTS PARTICIPATING IN RECOMMENDED LEVEL OF PHYSICAL ACTIVITY; 4) ADULT CIGARETTE SMOKING; 5) ADULTS WHO REPORTED THEIR MENTAL HEALTH WAS NOT GOOD ON 14 OR MORE DAYS, PAST 30 DAYS; 6) BIRTHS OCCURRING TO TEENS (15-19); 7) ADULTS WITH DIAGNOSED DIABETES; 8) ADULTS WITH AND AT RISK FOR HEART DISEASE AND STROKE; 9) INFANT MORTALITY; 10) INFANTS FULLY IMMUNIZED AT 24 MONTHS; 11) CHILDREN WITHOUT ADEQUATE ORAL HEALTH; 12) ACCESS TO HEALTH SERVICES; 13) KNOWLEDGE OF AVAILABLE HEALTH/SOCIAL SERVICES AND 14) TRANSPORTATION CONNECTING PERSONS TO SERVICES AND RECREATION. BASED ON THIS LIST, ST. FRANCIS IDENTIFIED THREE FOCUS AREAS FOR IMPACTING THE HEALTH OF ITS COMMUNITY: HEALTHY EATING AND ACTIVE LIVING IMPROVING ACCESS TO HEALTHCARE SERVICES HEALTHY BABIESEACH OF THE HEALTH NEEDS IDENTIFIED IN THE SHAWNEE COUNTY CHNA IS IMPORTANT AND NUMEROUS PARTNERS THROUGHOUT THE COMMUNITY ARE ADDRESSING THESE NEEDS THROUGH INNOVATIVE PROGRAMS AND INITIATIVES. THE ST. FRANCIS HEALTH CHIP WILL ADDRESS ONLY THE PRIORITY AREAS LISTED ABOVE IN ORDER TO ALLOCATE APPROPRIATE TIME AND RESOURCES TO SUCCESSFUL TACTICS AND ACTIONS. AREAS IDENTIFIED, BUT NOT SPECIFICALLY ADDRESSED INCLUDE: 1. ADULT CIGARETTE SMOKING (OTHER THAN PREGNANT WOMEN) 2. ADULT WHO REPORTED THEIR MENTAL HEALTH WAS NOT GOOD ON 14 OR MORE DAYS IN THE PAST 30 DAYS 3. CHILDREN WITHOUT ADEQUATE ORAL HEALTH. 24 ST FRANCIS FAMILY MEDICAL MISSION WOODS 2835 SW MISSION WOODS DR TOPEKA KS 66614 FAMILY MEDICINE GYNECOLOGY 601 CORPORATE VIEW DRIVE STE 100 TOPEKA KS 66615 GYNECOLOGY SERVICES ST FRANCIS ADVANCED WOUND CARE CENTER 634 SW MULVANE STE 100 TOPEKA KS 66606 WOUND SERVICES ST FRANCIS CARDIO & THORACIC SURGERY 600 SW COLLEGE AVE TOPEKA KS 66606 CARDIOLOGY SERVICES ST FRANCIS COMPREHENSIVE CANCER CENTER 1700 SW 7TH ST TOPEKA KS 66606 CANCER SERVICES ST FRANCIS FAMILY MED & READYCARE 1101 SW 29TH ST TOPEKA KS 66611 FAMILY MEDICINE ST FRANCIS FAMILY MED AT VALLEY FALLS 2835 SW MISSION WOODS DR TOPEKA KS 66614 FAMILY MEDICINE ST FRANCIS FAMILY MED HUNTER'S RIDGE 4646 NW FIELDING RD TOPEKA KS 66618 FAMILY MEDICINE ST FRANCIS FAMILY MED JEWELL CLINIC 600 SW JEWELL AVE TOPEKA KS 66606 FAMILY MEDICINE ST FRANCIS FAMILY MEDICINE MISSION WOODS 2835 SW MISSION WOODS DR TOPEKA KS 66614 FAMILY MEDICINE SFT FAM MED MISS WOODSLAKE SHAWEE 2835 SW MISSION WOODS DR TOPEKA KS 66614 FAMILY MEDICINE ST FRANCIS HEALTH CTR HOSPITALIST SVC 1700 SW 7TH STREET TOPEKA KS 66606 HOSPITALIST SERVICE ST FRANCIS HEART AND VASCULAR CENTER 600 SW COLLEGE AVE TOPEKA KS 66606 CARDIOLOGY SERVICES ST FRANCIS MEDICAL CLINIC AT RIVER HILL 6001 SW 6TH AVE STE 320 TOPEKA KS 66615 CLINIC SERVICES ST FRANCIS OCCUPATIONAL MEDICINE 1700 SW 7TH STREET TOPEKA KS 66606 OCCUPATIONAL MEDICINE ST FRANCIS PAIN MANAGEMENT CENTER 634 MULVANE STE 104 TOPEKA KS 66606 PAIN MANAGEMENT ST FRANCIS HEART & VASCULAR CENTER 600 SW COLLEGE TOPEKA KS 66606 CARDIOLOGY SERVICES ST FRANCIS SPECIALTY CLINIC 1700 SW 7TH ST TOPEKA KS 66606 SPECIALTY CLINIC SFT ENDOCRIN & DIABETES MGMT CTR 6730 SW 29TH ST TOPEKA KS 66614 ENDOCRINOLOGY SERVICES TOPEKA NEUROLOGY 631 SW HORNE ST STE 420 TOPEKA KS 66606 NEUROLOGY SERVICES TOPEKA NEUROSURGERY 634 SW MULVANE STE 202 TOPEKA KS 66606 NEUROLOGY SERVICES TOPEKA OBGYN ASSOCIATES 634 SW MULVANE STE 202 TOPEKA KS 66606 OB/GYN SERVICES TOPEKA UROLOGY 1516 SW 6TH AVE STE 1 TOPEKA KS 66606 UROLOGY SERVICES ST FRANCIS HOME HEALTH HOME 1501 SW 6TH ST TOPEKA KS 66606 HOME HEALTH SERVICES PART I, LINE 6A: THIS ORGANIZATION IS PART OF SCL HEALTH SYSTEM WHICH PREAPRES AN ANNUAL COMMUNITY BENEFIT REPORT ON A CONSOLIDATED BASIS. THE REPORT IS PREPARED BY THE PARENT COMPANY, SISTERS OF CHARITY OF LEAVENWORTH HEALTH SYSTEM, INC. PART I, LINE 7: THE AMOUNTS REPORTED ON FORM 990, SCHEDULE H, PART I, LINE 7A, 7B AND 7C WERE DETERMINED USING THE COST TO CHARGE RATIO DERIVED FROM WORKSHEET 2, IN THE SCHEDULE H, FORM 990 INSTRUCTIONS. FORM 990, SCHEDULE H, PART I, LINES 7E, 7F, 7G, 7H AND 7I ARE REPORTED AT COST AS REPORTED IN THE ORGANIZATION'S FINANCIAL STATEMENTS. PART I, LINE 7, COLUMN (F): THE BAD DEBT EXPENSE INCLUDED ON FORM 990, PART IX, LINE 25, COLUMN (A), BUT SUBTRACTED FOR PURPOSES OF CALCULATING THE PERCENTAGE IN THIS COLUMN IS $ 18,680,361. PART II, COMMUNITY BUILDING ACTIVITIES: COMMUNITY BUILDING ACTIVITIES, THOSE THAT ENHANCE EXISTING EFFORTS OR FILL GAPS OF COMMUNITY NEED, INCLUDE PROGRAMS THAT SUPPORT THOSE IN THE COMMUNITY WHO ARE LIVING AT OR BELOW POVERTY. ADMINISTRATIVE LEADERSHIP AND ITS EMPLOYEES PERFORMED CIVIC ACTIVITIES IN WHICH THE SOCIAL AND PHYSICAL HEALTH OF THE COMMUNITY WAS ADVOCATED AS A PRIORITY BY THE HOSPITAL. IN 2014, SFT ADMINISTRATION AND EMPLOYEES PARTICIPATED IN THE FOLLOWING COMMUNITY MEETINGS: BOYS AND GIRLS CLUB OF TOPEKA BOARD, TOPEKA CHAMBER OF COMMERCE, YMCA BOARD, WASHBURN UNIVERSITY, STEERING COMMITTEE OF SHAWNEE COUNTY HEALTH NET, AND HEALTHY SHAWNEE COUNTY.PART III, LINE 1THE ORGANIZATION REPORTS BAD DEBT IN ACCORDANCE TO HEALTHCARE FINANCIAL MANAGEMENT ASSOCIATION (HFMA) STATEMENT NO. 15 TO THE EXTENT THAT HFMA STATEMENT NO. 15 FOLLOWS THE GENERALLY ACCEPTED ACCOUNTING PRINCIPLES (GAAP) FOR THE REPORTING OF BAD DEBT. PART III, LINE 2: THE BAD DEBT EXPENSE REPORTED ON PART III, LINE 2 IS AT CHARGES AS RECORDED IN THE ORGANIZATION'S FINANCIAL STATEMENTS. THE ALLOWANCE FOR BAD DEBT IS BASED UPON MANAGEMENT'S ASSESSMENT OF HISTORICAL AND EXPECTED NET COLLECTIONS CONSIDERING THE BUSINESS AND GENERAL ECONOMIC CONDITIONS IN ITS SERVICE AREA, TRENDS IN HEALTH CARE COVERAGE, AND OTHER COLLECTION INDICATORS.THE BAD DEBT ALLOWANCE IS CALCULATED AS A PERCENTAGE OF PATIENT RECEIVABLES AFTER DEDUCTIONS FOR ESTIMATED PROVISIONS FOR CONTRACTUAL ADJUSTMENTS (DISCOUNTS) ON SERVICES PROVIDED TO ENROLLEES OF MEDICARE, MEDICAID, THIRD-PARTY PAYOR PROGRAMS, CHARITY CARE, UNINSURED DISCOUNTS, AND OTHER ADMINISTRATIVE ADJUSTMENTS. PART III, LINE 4: THE ALLOWANCE FOR BAD DEBT IS BASED UPON MANAGEMENT'S ASSESSMENT OF HISTORICAL AND EXPECTED NET COLLECTIONS CONSIDERING THE BUSINESS AND GENERAL ECONOMIC CONDITIONS IN ITS SERVICE AREA, TRENDS IN HEALTH CARE COVERAGE, AND OTHER COLLECTION INDICATORS.THE BAD DEBT ALLOWANCE IS CALCULATED AS A PERCENTAGE OF PATIENT RECEIVABLES AFTER DEDUCTIONS FOR ESTIMATED PROVISIONS FOR CONTRACTUAL ADJUSTMENTS (DISCOUNTS) ON SERVICES PROVIDED TO ENROLLEES OF MEDICARE, MEDICAID, THIRD-PARTY PAYOR PROGRAMS, CHARITY CARE, UNINSURED DISCOUNTS, AND OTHER ADMINISTRATIVE ADJUSTMENTS.THE ORGANIZATION HAS A FINANCIAL ASSISTANCE PROGRAM THAT PROVIDES PATIENTS OPPORTUNITIES TO APPLY FOR FREE OR DISCOUNTED CARE OR TO BE ENROLLED IN A GOVERNMENT SPONSORED MEDICAL CARE PROGRAM. THE PROCESS INCLUDES IDENTIFYING PATIENTS WITH A FINANCIAL CONCERN AND PROVIDING FINANCIAL COUNSELING AND ASSISTANCE IN APPLYING FOR THE ORGANIZATION'S CHARITY CARE AND OTHER FINANCIAL ASSISTANCE PROGRAMS.CERTAIN PATIENT ACCOUNTS ARE WRITTEN OFF TO BAD DEBT BECAUSE THE ORGANIZATION DOES NOT HAVE SUFFICIENT INFORMATION TO DETERMINE IF THE PATIENT WOULD QUALIFY FOR FREE CARE OR FINANCIAL AID. THEREFORE, IT IS POSSIBLE THAT SOME BAD DEBT IS ACTUALLY CHARITY CARE. HOWEVER, IF A PATIENT ACCOUNT IS WRITTEN OFF TO BAD DEBT AND THE COLLECTION AGENCY LATER DETERMINES THAT THE PATIENT WOULD HAVE QUALIFIED FOR FREE CARE OR FINANCIAL AID, THEN THE BAD DEBT EXPENSE IS RECLASSIFIED TO CHARITY CARE. THE FOLLOWING IS THE TEXT OF THE FOOTNOTE TO THE ORGANIZATIONS FINANCIAL STATEMENTS THAT DESCRIBE THE BAD DEBT ALLOWANCE AND BAD DEBT EXPENSE: THE ALLOWANCE FOR UNCOLLECTIBLE ACCOUNTS IS BASED UPON MANAGEMENT'S ASSESSMENT OF HISTORICAL AND EXPECTED NET COLLECTIONS CONSIDERING THE BUSINESS AND GENERAL ECONOMIC CONDITION IN ITS SERVICE AREA, TRENDS IN HEALTH CARE COVERAGE, AND OTHER COLLECTION INDICATORS. THROUGHOUT THE YEAR, MANAGEMENT ASSESSES THE ADEQUACY OF THE ALLOWANCE FOR UNCOLLECTIBLE ACCOUNTS BASED UPON HISTORICAL COLLECTION EXPERIENCE BY PAYOR CATEGORY AND OTHER FACTORS. THE RESULTS OF THESE REVIEWS ARE THEN USED TO MAKE MODIFICATIONS TO THE ALLOWANCE FOR UNCOLLECTIBLE ACCOUNTS. THE ALLOWANCE FOR UNCOLLECTIBLE ACCOUNTS INCLUDES A RESERVE FOR BOTH UNINSURED PATIENTS AND BALANCES DUE FROM PATIENTS AFTER INSURANCE. PART III, LINE 8: THE ORGANIZATION BELIEVES THAT AT LEAST SOME PORTION OF THE COSTS WE INCUR IN EXCESS OF PAYMENTS RECEIVED FROM THE FEDERAL GOVERNMENT FOR PROVIDING MEDICAL SERVICES TO MEDICARE ENROLLEES AND BENEFICIARIES UNDER THE FEDERAL MEDICARE PROGRAM (SHORTFALL OR MEDICARE SHORTFALL) CONSTITUTES A COMMUNITY BENEFIT. PROVIDING THESE SERVICES CLEARLY LESSENS THE BURDENS OF THE GOVERNMENT BY ALLEVIATING THE FEDERAL GOVERNMENT FROM HAVING TO DIRECTLY PROVIDE THESE MEDICAL SERVICES. AS DEMONSTRATED AND CALCULATED ON FORM 990, SCHEDULE H, PART III, LINES 5, 6 AND 7, OUR MEDICARE "ALLOWABLE COSTS" CLEARLY EXCEED THE PAYMENTS WE RECEIVE FOR PROVIDING THESE MEDICAL SERVICES UNDER THE MEDICARE PROGRAM. BY ABSORBING THE MEDICARE SHORTFALL COSTS WE ARE PROVIDING A COMMUNITY BENEFIT AS WELL AS EASING THE BURDEN OF THE FEDERAL GOVERNMENT HAVING TO COVER THESE COSTS.TO ARRIVE AT THE FORM 990, SCHEDULE H, PART III, LINE 6 AMOUNT, WE USED ACTUAL MEDICARE CHARGES FROM INTERNAL RECORDS AND APPLIED AN ESTIMATED COST TO CHARGE RATIO TO DETERMINE THE MEDICARE ALLOWABLE COSTS. THE ESTIMATED MEDICARE COST TO CHARGE RATIO IS THE PRIOR PERIOD MEDICARE COST REPORT COST TO CHARGE RATIO. PART III, LINE 9B: AN INTEGRAL COMPONENT OF OUR MISSION IS TO BE GOOD FINANCIAL STEWARDS.THIS REQUIRES US TO DETERMINE WHICH PATIENTS ARE IN NEED OF CHARITY CARE AND WHICH ARE ABLE TO CONTRIBUTE SOME PAYMENT FOR CARE RECEIVED. WEMAINTAIN A BALANCE THAT ENABLES US TO CONTINUE TO PROVIDE CHARITY CARE TOTHOSE WHO NEED IT MOST AND ENSURE THAT WE MANAGE OUR RESOURCES SOWE CAN CONTINUE TO BE HERE WHEN PEOPLE NEED US MOST. THE ORGANIZATION NOTIFIES PATIENTS OF FINANCIAL ASSISTANCE POLICY UPON ADMISSION AND DISCHARGE. IN ADDITION, THE PATIENTS RECEIVES INFORMATION ABOUT THE FINANCIAL ASSISTANCE POLICY WITH THEIR PATIENT BILLS. PATIENTS ARE CONTACTED MULTIPLE TIMES ABOUT UNPAID BALANCES PRIOR TO INITIATING ANY COLLECTION ACTION. IF A PATIENT IS DETERMINED TO BE ELIGIBLE FOR FINANCIAL ASSISTANCE AT ANY TIME DURING THE COLLECTION PROCESS, THE ACCOUNT IS RECLASSIFIED AS FINANCIAL ASSISTANCE AND DEBT COLLECTION EFFORTS ARE CEASED. PART VI, LINE 2: THE ASSOCIATION FOR COMMUNITY HEALTH IMPROVEMENT (ACHI) COMMUNITY HEALTH ASSESSMENT TOOLKIT WAS UTILIZED AS THE FRAMEWORK TO COMPLETE THE CHNA. THIS APPROACH TO THE CHNA REQUIRES SIGNIFICANT INPUT FROM THE COMMUNITY AND DELIBERATE EFFORTS AT COMMUNITY BUILDING; THE APPROACH FOCUSES ON THECHNA AS AN OPPORTUNITY TO DEMONSTRATE TO THE COMMUNITY OUR SHARED, CONSISTENT COMMITMENT TO THE HEALTH OF OUR RESIDENTS. THE LEAD ENTITY IN THIS COMMUNITY HEALTH NEEDS ASSESSMENT WAS THE HEALTHY SHAWNEE COUNTY TASK FORCE. THE TASK FORCE HAD AN ASSESSMENT ADVISORY COMMITTEE TO PROVIDE DIRECTION AND FEEDBACK DURING THIS PROCESS INCLUDING SHAWNEE COUNTY HEALTH AGENCY, ST. FRANCIS HEALTH CENTER, AND STORMONT-VAIL HEALTHCARE. HEALTHY SHAWNEE COUNTY ASSESSMENT ADVISORY COMMITTEE INCLUDED COMMUNITY REPRESENTATIVES FROM TOPEKA PUBLIC SCHOOLS FOUNDATION, KANSAS CHILDREN'S SERVICE LEAGUE, COMMUNITY RESOURCES COUNCIL, UNITED WAY OF GREATER TOPEKA AS WELL AS A COMMUNITY VOLUNTEER.TO OBTAIN COMMUNITY INPUT, A HEALTHY SHAWNEE COUNTY COMMUNITY PERCEPTION SURVEY WAS MADE AVAILABLE ON-LINE TO RESIDENTS OF SHAWNEE COUNTY. A TOTAL OF 548 COMMUNITY INDIVIDUALS AND 229 ORGANIZATION MEMBERS COMPLETED THE SURVEY. INSIGHT INTO SHAWNEE COUNTY'S HEALTH-RELATED NEEDS WAS ALSO PROVIDED BY THREE FOCUS GROUPS. EACH GROUP HAD A DIFFERENT SET OF PARTICIPANTS - HEALTH CARE PROFESSIONALS, SOCIAL SERVICE PROFESSIONALS AND NEIGHBORHOOD LEADERS. FOCUS GROUPS WERE CONDUCTED AUGUST 15 AND 16, 2012 AT THE TOPEKA-SHAWNEE COUNTY PUBLIC LIBRARY. ADDITIONALLY, THIRTY-FIVE TARGETED COMMUNITY STAKEHOLDERS WITH PUBLIC HEALTH EXPERTISE WERE SENT AN E-MAIL SURVEY. RESPONDING TO THE SURVEY WERE REPRESENTATIVES FROM: BREWSTER PLACE RETIREMENT COMMUNITY, KANSAS CHILDREN'S SERVICE LEAGUE, POSITIVE CONNECTIONS, INC., KANSAS ASSOCIATION FOR THE MEDICALLYUNDERSERVED, COMMUNITY ACTION, INC., UNITED WAY OF GREATER TOPEKA, SHAWNEE COUNTY HEALTH AGENCY - COMMUNITY HEALTH CENTER, AND A RETIRED NON-PROFIT EXECUTIVE DIRECTOR.THE HEALTHY SHAWNEE COUNTY TASK FORCE COMPILED THE COLLECTIVE DATA AND 14 COMMUNITY ISSUES EMERGED: 1) ADULTS WHO ARE OVERWEIGHT OR OBESE; 2)ADULTS CONSUMING FRUITS AND VEGETABLES FIVE OR MORE TIMES PER DAY; 3)ADULTS PARTICIPATING IN RECOMMENDED LEVEL OF PHYSICAL ACTIVITY; 4) ADULT CIGARETTE SMOKING; 5) ADULTS WHO REPORTED THEIR MENTAL HEALTH WAS NOTGOOD ON 14 OR MORE DAYS, PAST 30 DAYS; 6) BIRTHS OCCURRING TO TEENS (15-19); 7) ADULTS WITH DIAGNOSED DIABETES; 8) ADULTS WITH AND AT RISK FOR HEART DISEASE AND STROKE; 9) INFANT MORTALITY; 10) INFANTS FULLY IMMUNIZED AT 24 MONTHS; 11) CHILDREN WITHOUT ADEQUATE ORAL HEALTH; 12) ACCESS TO HEALTH SERVICES; 13) KNOWLEDGE OF AVAILABLE HEALTH/SOCIAL SERVICES AND 14) TRANSPORTATION CONNECTING PERSONS TO SERVICES AND RECREATION. BASED ON THIS LIST, ST. FRANCIS IDENTIFIED THREE FOCUS AREAS FOR IMPACTING THE HEALTH OF ITS COMMUNITY: HEALTHY EATING AND ACTIVE LIVING IMPROVING ACCESS TO HEALTHCARE SERVICES HEALTHY BABIESA HOSPITAL IMPLEMENTATION PLAN HAS BEEN APPROVED BY ST. FRANCIS, SETTING IN MOTION HYOSPITAL-LED COMMUNITY ACTIVITIES THAT ARE ADDRESSING THE TOP THREE AREAS OF NEED. PART VI, LINE 3: THE ORGANIZATION NOTIFIES PATIENTS ABOUT THE FINANCIAL ASSISTANCE POLICY UPON ADMISSION AND PRIOR TO DISCHARGE. NOTICES ABOUT THE FINANCIAL ASSISTANCE POLICY ARE DISPLAYED THROUGHOUT THE HOSPITAL. IN ADDITION, PATIENTS RECEIVE INFORMATION ABOUT THE FINANCIAL ASSISTANCE POLICY WITH THEIR PATIENT BILLS. THE FINANCIAL ASSITANCE POLICY AND APPLICATION ARE POSTED ON THE HOSPITAL'S WEBSITE. THE POLICY AND APPLICATION ARE ALSO AVAILBLE UPON REQUEST. THE ORGANIZATION HAS A FINANCIAL ASSISTANCE PROGRAM THAT PROVIDES PATIENTS OPPORTUNITIES TO APPLY FOR FREE OR DISCOUNTED CARE OR TO BE ENROLLED IN A GOVERNMENT SPONSORED MEDICAL CARE PROGRAM. THE PROCESS INCLUDES IDENTIFYING PATIENTS WITH A FINANCIAL CONCERN, PROVIDING FINANCIAL COUNSELING AND ASSISTANCE IN APPLYING FOR THE ORGANIZATION'S CHARITY CARE AND OTHER FINANCIAL ASSISTANCE PROGRAMS. PART VI, LINE 4: ST. FRANCIS HEALTH CENTER ("ST. FRANCIS") IS LOCATED IN TOPEKA, KANSAS. ST. FRANCIS PROVIDES CARE TO MANY COMMUNITIES IN EASTERN AND NORTHERN KANSAS. ST. FRANCIS' MAIN CONCENTRATION OF CARE IS PROVIDED TO PATIENTS LIVING WITHIN THE CITY OF TOPEKA, REPRESENTING ABOUT 65% OF ITS TOTAL INPATIENT CARE. THE CARE SITE ALSO TREATS MANY PATIENTS ORIGINATING FROM COMMUNITIES SUCH AS HOLTON, MANHATTAN, TECUMSEH, MERIDEN, AUBURN, MAYETTA AND JUNCTION CITY.ST. FRANCIS' PRIMARY SERVICE AREA CONSISTS OF 34 ZIP CODES EXTENDING ACROSS SIX COUNTIES, INCLUDING SHAWNEE COUNTY (22 ZIP CODES), OSAGE COUNTY (4 ZIP CODES), JACKSON COUNTY (3 ZIP CODES), JEFFERSON COUNTY (2 ZIP CODES), WABAUNSEE COUNTY (2 ZIP CODES) AND POTTAWATOMIE COUNTY (1 ZIP CODE). THE SECONDARY SERVICE AREA CONTAINS ANOTHER 57 ZIP CODES AND INCLUDES ZIP CODES WITHIN THE COUNTIES OF POTTAWATOMIE, DOUGLAS, JEFFERSON, JACKSON, LYON, OSAGE, WABAUNSEE, RILEY, COFFEY, ATCHISON,FRANKLIN AND GEARY. THE PRIMARY SERVICE AREA IS DEFINED AS THEGEOGRAPHIC AREA OF CONTIGUOUS ZIP CODES FROM WHICH THE HOSPITAL DRAWS APPROXIMATELY 75% OF ITS INPATIENT DISCHARGES AND THE COMBINED PRIMARY AND SECONDARY SERVICE AREA IS BASED ON APPROXIMATELY 90% OF DISCHARGES.ST. FRANCIS PROVIDES CARE TO A LITTLE LESS THAN ONE THIRD OF THEINPATIENTS WITHIN ITS PRIMARY SERVICE AREA AND STORMONT VAIL HEALTHCARE, THE OTHER ACUTE CARE FACILITY IN TOPEKA, PROVIDES THE VAST MAJORITY OF THE BALANCE. ADDITIONALLY, GIVEN TOPEKA'S CLOSE PROXIMITY TO THE MAJOR METROPOLITAN AREA OF KANSAS CITY, ABOUT 75 MILES AWAY, SOME PATIENTS WILL TRAVEL TO HOSPITALS IN KANSAS CITY FOR CARE.THERE ARE ONLY TWO HOSPITALS LOCATED IN ST. FRANCIS' PRIMARY SERVICE AREA, ST. FRANCIS AND STORMONT VAIL HEALTHCARE. STORMONT VAIL IS BASED IN TOPEKA AND IS AN INDEPENDENT, NOT-FOR-PROFIT HOSPITAL. WITHIN THE CARE SITE'S SECONDARY SERVICE AREA, THERE ARE 11 HOSPITALS. THIS INCLUDES SEVEN ACUTE CARE FACILITIES IN THE CITIES OF OTTAWA, EMPORIA, TWO IN MANHATTAN, LAWRENCE, JUNCTION CITY AND BURLINGTON REPRESENTING FIVE GOVERNMENT OWNED HOSPITALS, ONE PHYSICIAN OWNED HOSPITAL AND ONE NOT-FOR-PROFIT. ALSO LOCATED IN THE SECONDARY SERVICE AREA ARE FOUR CRITICAL ACCESS HOSPITALS IN THE COMMUNITIES OF WAMEGO, WINCHESTER,HOLTON AND ONAGA, ALL OF WHICH ARE NOT-FOR-PROFITS. THE CRITICAL ACCESS HOSPITAL IN HOLTON IS MANAGED BY SCL HEALTH SYSTEM.FROM THE CHNA:TOPEKA DEMOGRAPHIC PROFILE (SOURCE: U.S. CENSUS BUREAU, 2012): POPULATION 127,939; 24.4% AGE LESS THAN 18; 14.3% AGE 65 AND OVER; 76.2% WHITE, NOT HISPANIC; 13.4% HISPANIC; 11.3% AFRICAN-AMERICAN; 1.8% ALL OTHERS.FROM COUNTY HEALTH RANKINGS 2014 FOR SHAWNEE COUNTY:THE PERCENT OF UNINSURED BELOW THE AGE OF 65 IS 14%, EQUAL TO THE STATE AVERAGE.77% OF 9TH GRADERS GRADUATE FROM HIGH SCHOOL, WORSE THAN THE STATE AVERAGE OF 83%.OF RESIDENTS AGE 16+ WHO ARE UNEMPLOYED BUT SEEKING WORK, 6.2% REMAIN UNEMPLOYED VERSUS 5.7% STATEWIDE.24% OF CHILDREN LIVE IN POVERTY, MUCH WORSE THAN THE STATE AVERAGE OF 19%.39% OF CHILDREN LIVE IN SINGLE-PARENT HOUSEHOLDS, WELL ABOVE THE STATE AVERAGE OF 29%.TEEN BIRTH RATE FOR WOMEN AGE 13-19 YEARS WAS 50 PER 1,000 BIRTHS, RANKING THEM IN THE 80TH PERCENTILE NATIONWIDE.FROM THE 2012 USDA ECONOMIC RESEARCH SERVICE, SHAWNEE COUNTY: 16.4% OF ALL PERSONS AND 24.3% OF CHILDREN AGE 0 TO 17 WERE LIVING AT OR BELOW THE FEDERAL POVERTY LEVEL. THESE RATES ARE HIGHER THAN THE STATE AVERAGES OF 14.0% AND 19.0% RESPECTIVELY. PART VI, LINE 5: ST. FRANCIS PROVIDES FOCUSED SUPPORT FOR MARIAN CLINIC, THE LOCAL HEALTH CLINIC FOR THE UNINSURED WHICH PROVIDES QUALITY PRIMARY HEALTH CARE SERVICES FOR UNINSURED, LOW-INCOME PATIENTS, REGARDLESS OF A PATIENT'S ABILITY TO PAY. OUR CLOSE WORKING RELATIONSHIP WITH MARIAN CLINIC PROVIDERS AND STAFF SUPPORTS INTEGRATED CARE FOR THIS VULNERABLE POPULATION. SERVICES THE CLINIC PROVIDES INCLUDE PRIMARY CARE, ONGOING MANAGEMENT OF CHRONIC DISEASES, MEDICATION ASSISTANCE, AND DENTAL CARE. IN ADDITION TO OUTRIGHT FINANCIAL SUPPORT, ST. FRANCIS HEALTH CENTER PROVIDES EXTENSIVE INPATIENT AND OUTPATIENT SERVICES TO MARIAN CLINIC PATIENTS AND SUPPORTS THE CLINIC IN OTHER WAYS SUCH AS STRATEGY AND OPERATIONS GUIDANCE, DONATING SUPPLIES, AND PROVIDING INFORMATION TECHNOLOGY AND FINANCIAL SYSTEMS MANAGEMENT.ADDITIONALLY, WE HAVE A SOLID PARTNERSHIP WITH OUR LOCAL WASHBURN UNIVERSITY SCHOOL OF NURSING. COLLABORATIVE EFFORTS INCLUDE THE INTEGRATION OF PRIMARY CARE AND BEHAVIORAL HEALTH CARE PROJECT WHICH PARTNERS SFHC, THE SCHOOL OF NURSING, AND VALEO BEHAVIORAL HEALTH. THIS PROJECT IMBEDS AN APRN IN THE EXISTING LOCAL BEHAVIORAL HEALTH SERVICES OUTPATIENT CLINIC TO PROVIDE PRIMARY CARE SERVICES AND POPULATION HEALTH MANAGEMENT FOR A HISTORICALLY UNDERSERVED PEOPLE. WE HAVE ALSO JOINEDFORCES TO DEVELOP A MOBILE CLINIC PROGRAM TO PROVIDE HEALTH CARE TO PEOPLE LIVING IN AREAS OF THE COMMUNITY WHERE IDENTIFIED BARRIERS TO HEALTH CARE SERVICES EXIST. SISTERS OF CHARITY OF LEAVENWORTH HEALTH SYSTEM (SCLHS) SUPPORT ITS HOSPITALS BY PROVIDING GUIDANCE, OVERSIGHT, AND RESOURCES TO HELP THEM ACCOMPLISH INITIATIVES THAT IMPROVE HEALTH IN ALL OUR COMMUNITIES. THIS INCLUDES COORDINATING COMMUNITY BENEFIT PROCESSES, PROVIDING GUIDANCE WITH COMMUNITY NEEDS ASSESSMENTS, AND ESTABLISHING CONSISTENT FINANCIAL ASSISTANCE AND CHARITY CARE POLICIES AND PROCEDURES. ADDITIONALLY, SCLHS BENEFITS AFFILIATES THROUGH QUALITY IMPROVEMENT AND PERFORMANCE EXCELLENCE INITIATIVES; SYSTEM-WIDE INFORMATION TECHNOLOGY IMPLEMENTATION AND INFRASTRUCTURE; STRATEGIC AND OPERATIONS DIRECTION AND OVERSIGHT; SUPPLY CHAIN MANAGEMENT AND URCHASING; BENEFITS ADMINISTRATION (INCLUDING A WELLNESS PROGRAM FREE TO EMPLOYEES), RISK MANAGEMENT; DISASTER PLANNING AND CRISIS ASSISTANCE. BEING PART OF SCLHS AFFORDS SFHC INSTITUTIONALKNOWLEDGE FROM THE SYSTEM LEVEL AND THE ABILITY TO SHARE AND LEVERAGE RESOURCES ACROSS T HE SYSTEM TO PROMOTE BEST PRACTICE. PART VI, LINE 6: ST. FRANCIS HEALTH CENTER IS A CONTROLLED ENTITY OF THE SISTERS OF CHARITY OF LEAVENWORTH HEALTH SYSTEM, INC. (SCLHS). SCLHS AND ITS AFFILIATED ENTITIES HAVE A COMMON CALLING AND MISSION: "WE REVEAL AND FOSTER GOD'S HEALING LOVE BY IMPROVING THE HEALTH OF THE PEOPLE AND COMMUNITIES WE SERVE, ESPECIALLY THOSE WHO ARE POOR AND VULNERABLE." WE STRIVE TO PROVIDE HIGH-QUALITY, COMPASSIONATE AND AFFORDABLE HEALTHCARE IN EACH OF OUR HOSPITAL SITES AND THEIR RESPECTIVE COMMUNITIES, AS WELL AS IN A VARIETY OF OUTPATIENT SETTINGS AND IN THE HOME. SCLHS IS A FAITH-BASED, NONPROFIT HEALTHCARE ORGANIZATION THAT OPERATES EIGHT HOSPITALS, FOUR SAFETY NET CLINICS, ONE CHILDREN'S MENTAL HEALTH CENTER AND MORE THAN 190 AMBULATORY SERVICE CENTERS IN THREE STATES - COLORADO, KANSAS AND MONTANA. THE HEALTH SYSTEM INCLUDES 15,000 FULL-TIME ASSOCIATES AND MORE THAN 500 EMPLOYED PROVIDERS.AS OUR HEALTH SYSTEM GROWS, WE'RE LEVERAGING THAT GROWTH TO ACHIEVE BENEFITS OF SCALE - IDENTIFYING COST AND OTHER ADVANTAGES THAT WE GAIN DUE TO OUR SIZE. WE'RE ALSO WORKING TO STREAMLINE AND UNIFY OUR SYSTEMWIDE PROCESSES TO ELIMINATE COSTLY DUPLICATION OF EFFORT. WE ACTIVELY ENCOURAGE OUR PEOPLE TO PURSUE CREATIVE IDEAS THAT IMPROVE EFFICIENCY, SERVICE AND THE OVERALL CARE EXPERIENCE. WHEN OUR ASSOCIATES OR LEADERSHIP TEAMS IDENTIFY BEST PRACTICES IN ANY AREA OF CARE, WE RAPIDLY REPLICATE THOSE ACROSS ALL CARE SITES.ST. FRANCIS HEALTH CENTER PROMOTES THE HEALTH OF THE COMMUNITY BY DELIVERING DIRECT HIGH QUALITY HEALTHCARE SERVICES THAT ARE RESPONSIVE TO THE NEEDS OF ITS PATIENTS AND THEIR FAMILIES. THIS INCLUDES COORDINATING COMMUNITY BENEFIT PROCESSES, PROVIDING GUIDANCE WITH COMMUNITY NEEDS ASSESSMENTS, AND ESTABLISHING CONSISTENT FINANCIAL ASSISTANCE AND CHARITY CARE POLICIES AND PROCEDURES. ADDITIONALLY, SCLHS BENEFITS AFFILIATES THROUGH QUALITY IMPROVEMENT AND PERFORMANCE EXCELLENCE INITIATIVES; SYSTEM-WIDE INFORMATION TECHNOLOGY IMPLEMENTATION AND INFRASTRUCTURE; STRATEGIC AND OPERATIONS DIRECTION AND OVERSIGHT; SUPPLY CHAIN MANAGEMENT AND PURCHASING; FINANCE ADMINISTRATION AND REVENUE CYCLE SUPPORT, BENEFITS ADMINISTRATION, RISK MANAGEMENT; DISASTER PLANNING AND CRISIS ASSISTANCE, CENTRAL CASH MANAGEMENT AND INVESTMENT, INTERNAL AUDIT, LEGAL SERVICES, AND MISSION INTEGRATION. 1 MARIAN CLINIC 1001 SW GARFIELD AVE TOPEKA KS 66604 480543749 501(C)(3) 6839 FMV SUPPLIES SUPPORT MISSION ST FRANCIS HEALTH CENTER FOUNDATION INC 1700 SW 7TH STREET TOPEKA KS 66606 481092520 501(C)(3) 660787 SUPPORT MISSION 2 PART I, LINE 2: GRANTS RECEIVED FROM ST. FRANCIS HEALTH CENTER MUST ADDRESS ONE OF THE IDENTIFIED COMMUNITY HEALTH NEEDS IN THE ASSESSMENT REPORT FOR TOPEKA/SHAWNEE COUNTY SPONSORED BY THE UNITED WAY OF GREATER TOPEKA. ONLY ONE GRANT APPLICATION PER ORGANIZATION WILL BE ACCEPTED EACH YEAR. GRANTS CAN BE RENEWED AND FUNDED FOR A MAXIMUM OF THREE YEARS BASED ON THE PREVIOUS YEAR'S OUTCOMES AS DETERMINED BY COMMITTEE. THE GRANT CANNOT BE THE SOLE FUNDING SOURCE FOR ANY PROJECT REQUEST THAT EXCEEDS $1,000. THE ORGANIZATION RECEIVING THE GRANT IS REQUIRED TO SUBMIT AN INTERIM REPORT SIX MONTHS INTO THE GRANT YEAR. AT THE END OF THE GRANT YEAR A FINAL ACCOUNTING AND EVALUATION MUST BE SUBMITTED. BOTH REPORTS INCLUDE FINANCIAL INFORMATION AND A NARRATIVE REPORT DISCUSSING GOALS, OUTCOMES, FINANCIAL VARIANCES, AND PLANS TO OVERCOME VARIANCES. X 0 1 1 1 0 0 0 0 0 1 0 KATHLEEN TULIPANA BOARD MEMBER 0 191966 0 34874 0 3090 0 32953 0 9270 0 272153 0 0 ROBERT ERICKSON CEO 0 367472 0 122772 0 13006 0 104873 0 20426 0 628549 0 0 DEBRA CARTWRIGHT VP & CFO 1/14 - 10/14 0 195792 0 47278 0 72900 0 10299 0 16529 0 342798 0 0 THOMAS HAMILTON CHIEF MEDICAL OFFICER 0 323781 0 41999 0 8791 0 55319 0 24221 0 454111 0 0 DAVID SETCHEL COO 0 247643 0 62276 0 1728 0 39722 0 22597 0 373966 0 0 SCOTT WELLS VP PATIENT CARE SERVICES 0 215364 0 55842 0 4797 0 37810 0 20719 0 334532 0 0 ERIC BARNABY VP STRAT & BUS DVPMT 1/14 - 10/14 0 175874 0 46920 0 66204 0 12675 0 23451 0 325124 0 0 FLORIN NICOLAE PAIN MGMT PHYSICIAN CLINIC 1008073 0 247156 0 4306 0 18720 0 25660 0 1303915 0 0 0 JOHN JOLIFF PHYSICIAN CCT 658034 0 316555 0 6939 0 18720 0 20564 0 1020812 0 0 0 SUMER DHIR PHYSICIAN CCT 572568 0 338171 0 4114 0 16120 0 24360 0 955333 0 0 0 BERNITA BERNTSEN PHYSICIAN CLINIC TALLGRASS 686256 0 225964 0 6960 0 16120 0 28100 0 963400 0 0 0 DAVID FRITZ PHYSICIAN - NEURO 816029 0 0 0 5160 0 18720 0 27640 0 867549 0 0 0 GWEN HELLER FORMER KEY EMPLOYEE 1/14 0 195185 0 7882 0 5531 0 26329 0 16916 0 251843 0 0 PART I, LINE 1A THE ORGANIZATION AND RELATED ORGANIZATIONS ALLOW FOR CERTAIN TAX INDEMNIFICATION AND GROSS-UP PAYMENTS IN THE INSTANCES OF RELOCATION AND TEMPORARY HOUSING. THESE AMOUNTS ARE TREATED AS TAXABLE COMPENSATION. THE INDIVIDUALS LISTED THAT WERE TAXED FOR 2014 WERE: GWEN HELLER. PART I, LINE 1B THE ORGANIZATION AND RELATED ORGANIZATIONS DO NOT HAVE A FORMAL WRITTEN POLICY FOR TAX INDEMNIFICATION AND GROSS-UP PAYMENTS. HOWEVER, BEFORE ANY TAX INDEMNIFICATION AND GROSS-UP PAYMENTS ARE MADE; PROPER APPROVAL FROM THE EMPLOYEE'S MANAGER IS REQUIRED. IN ADDITION, APPROVAL IS ALSO REQUIRED FROM HUMAN RESOURCES. PART I, LINES 4A-B SCHEDULE J, PART I, LINE 4A THE ORGANIZATION AND RELATED ORGANIZATIONS PERIODICALLY INCUR SEVERANCE PAYMENTS TO FORMER EMPLOYEES. THE AMOUNTS PAID TO LISTED INDIVIDUALS FOR SEVERANCE IN 2014 WERE: DEBRA CARTWRIGHT - $47,970, ERIC BARNABY - $43,033. SCHEDULE J, PART I, LINE 4B PAYMENTS FROM SUPPLEMENTAL NONQUALIFIED RETIREMENT PLAN A RELATED ORGANIZATION PROVIDES NONQUALIFIED DEFERRED COMPENSATION PLANS (NQDC) FOR EXECUTIVES TO COMPENSATE FOR REGULATORY IMPOSED LIMITATIONS IN QUALIFIED RETIREMENT PLANS AND TO PROVIDE A BENEFIT CONSISTENT WITH OTHER NOT FOR PROFIT HEALTH SYSTEMS. THESE PLANS ENABLE THE EXECUTIVE TO EARN BENEFITS DURING EACH YEAR THAT THEY PARTICIPATE. PRIOR TO 2014, THE RELATED ORGANIZATION'S NQDC PLAN PROVIDED A BENEFIT TO ELIGIBLE PARTICIPANTS BASED ON A PERCENTAGE OF THEIR BASE COMPENSATION. THE VESTING PERIOD IS 5 YEARS OR WHEN THE PARTICIPANT IS AGE 65 OR OLDER. THERE WERE NO CONTRIBUTIONS TO THIS PLAN AFTER DECEMBER 31, 2013. ANY DISTRIBUTIONS FROM THIS PLAN ARE REPORTED BELOW. IN 2014, THE RELATED ORGANIZATION'S NQDC PLAN PROVIDED A BENEFIT TO ELIGIBLE PARTICIPANTS BASED ON A PERCENTAGE OF THEIR BASE COMPENSATION. THE VESTING PERIOD IS 3 YEARS OR WHEN THE PARTICIPANT IS AGE 65 OR OLDER. THERE WERE NO CONTRIBUTIONS TO THIS PLAN BEFORE JANUARY 1, 2014. ANY DISTRIBUTIONS FROM THIS PLAN ARE REPORTED BELOW. THE RELATED ORGANIZATION HAS DETERMINED THAT THESE BENEFITS SHOULD BE SUBJECT TO TAXATION AS THEY ARE EARNED AND VESTED RATHER THAN WHEN THEY ARE RECEIVED. AS A RESULT, THE TOTAL NONQUALIFIED RETIREMENT PLAN BENEFITS, WHICH WERE ACCRUED AND VESTED IN THE CURRENT YEAR, ARE NOW CONSIDERED TAXABLE AND THUS WERE TAXED TO THE PARTICIPANTS. FOR SOME OF THE PARTICIPANTS, AN AMOUNT EQUAL TO THE PARTICIPANT'S EXPECTED INCOME TAX LIABILITY WAS WITHDRAWN FROM THE PARTICIPANT'S ACCOUNT AND REMITTED TO THE FEDERAL AND STATE GOVERNMENTS AS WITHHOLDING ON THE TAXABLE BENEFIT. THE AMOUNTS WITHDRAWN FROM THE PLAN FOR TAXES IN 2014 WERE: NONE. FOR CONTRIBUTIONS MADE IN 2014, CERTAIN PARTICIPANTS ARE VESTED OR BECAME VESTED IN THE PLAN DURING 2014. VESTED AMOUNTS ARE PAYABLE TO THE RECIPIENT. THE VESTED AMOUNTS ARE TAXABLE TO THE RECIPIENT IN THE CURRENT YEAR. THE TAXABLE AMOUNTS ARE INCLUDED ON THE RECIPIENT'S W-2. IN ADDITION, FOR AMOUNTS CONTRIBUTED PRIOR TO 2014, VESTED AMOUNTS ARE PAYABLE UPON THE END OF EMPLOYMENT. THE VESTED AMOUNTS WITHDRAWN INCLUDE AMOUNTS PREVIOUSLY TAXED TO THE RECIPIENT AND AMOUNTS TAXABLE TO THE RECIPIENT IN THE CURRENT YEAR. THE TAXABLE AMOUNTS ARE INCLUDED ON THE RECIPIENT'S W-2. THE AMOUNTS WITHDRAWN FROM THE PLAN IN 2014 WERE: DEBRA CARTWRIGHT - $22,187, ERIC BARNABY - $19,491. PART I, LINE 7 THE AT RISK COMPENSATION PLAN WAS ESTABLISHED TO ENABLE THE HEALTH CARE SYSTEM AND ITS CARE SITES TO ATTRACT AND ENGAGE QUALIFIED LEADERS AND TO PROVIDE SUCH LEADERS WITH AN ADDITIONAL PERFORMANCE COMPENSATION OPPORTUNITY TO PROMOTE AND FURTHER ITS CHARITABLE MISSION, VISION, STRATEGIC PRIORITIES AND KEY INITIATIVES. THE PLAN OPERATES ON A CALENDAR-YEAR BASIS AND IS FUNDED EACH YEAR BY MEETING THRESHOLD LEVELS OF OPERATING INCOME. TARGET AWARD AMOUNTS ARE A PERCENTAGE OF LEADERS' BASE PAY AS DETERMINED BY THEIR SPECIFIC ROLE AT THE HEALTH CARE SYSTEM. ACTUAL AWARDS ARE PAID OUT BASED ON ATTAINMENT OF OPERATING INCOME AND OTHER PLAN PERFORMANCE STANDARDS. AWARDS ARE BASED ON HOW WELL THE HEALTH CARE SYSTEM OR THE CARE SITE PERFORMS RELATIVE TO THE PLAN'S STATED PERFORMANCE STANDARDS AND THE WEIGHT GIVEN TO EACH OF THE PERFORMANCE MEASURES AS DEFINED BY THE CARE SITE CEO OR THE HEALTH CARE SYSTEM SERVICES SENIOR EXECUTIVE LEADERSHIP TEAM FOR THAT PLAN YEAR. THE AT RISK COMPENSATION PLANS ARE BASED ON A COMBINATION OF PERFORMANCE MEASURES. PERFORMANCE MEASURES INCLUDE PATIENT EXPERIENCE, PATIENT SAFETY, EMPLOYEE SAFETY, COMMUNITY BENEFIT AND OPERATING INCOME. THE AT RISK COMPENSATION PLAN SHALL BE INTERPRETED, APPLIED AND ADMINISTERED AT ALL TIMES IN ACCORDANCE WITH CODE SECTION 409A AND GUIDANCE ISSUED THEREUNDER. THE HEALTH CARE SYSTEM RESERVES THE RIGHT TO AMEND OR TERMINATE THIS PLAN AT ANY TIME FOR ANY REASON. ADDITIONAL OFFICER AND BOARD DISCLOSURES THE SISTERS OF CHARITY OF LEAVENWORTH HEALTH SYSTEM, INC. (SCLHS) AND RELATED TAX EXEMPT ORGANIZATIONS CONSISTS OF NINE HOSPITALS, TEN FOUNDATIONS AND FOUR CLINICS IN FOUR STATES. SCLHS AND RELATED TAX EXEMPT ORGANIZATIONS ADHERE TO GOVERNANCE EXCELLENCE STANDARDS INCLUDING TRANSPARENCY AND ACCOUNTABILITY. IN KEEPING WITH SCLHS' CORE VALUE OF STEWARDSHIP, NO BOARD MEMBER SERVING ON THE BOARD OF DIRECTORS (BOARD) IS COMPENSATED FOR THAT SERVICE. SCLHS' BOARD COMPENSATION COMMITTEE (COMMITTEE) HAS RETAINED THE SERVICES OF AN INDEPENDENT COMPENSATION ADVISOR. THE COMPENSATION ADVISOR IS RESPONSIBLE FOR ADVISING THE COMMITTEE ON ALL MATTERS RELATING TO EXECUTIVE COMPENSATION INCLUDING SUPPORTING THE COMMITTEE'S EFFORTS TO ENSURE THAT THE LEVEL OF COMPENSATION PROVIDED OFFICERS IS CONSISTENT WITH MARKET VALUE AND THE PAY PHILOSOPHY SET BY THE BOARD. THE PAY PHILOSOPHY SET BY THE BOARD IS TO PAY AT THE MIDDLE OF THE MARKET FOR EXECUTIVES OF SIMILAR SIZED ORGANIZATIONS OVERALL. SCLHS EXECUTIVE COMPENSATION IS COMPARABLE TO THAT PROVIDED BY SIMILAR, NOT-FOR-PROFIT HEALTHCARE SYSTEMS AND HOSPITALS. THE SISTERS WHO SERVE AS OFFICERS AND/OR BOARD MEMBERS ARE MEMBERS OF THE SISTERS OF CHARITY OF LEAVENWORTH (A RELIGIOUS ORDER OF WOMEN). THE SISTERS HAVE TAKEN VOWS OF POVERTY AND RECEIVE NO COMPENSATION, EXPENSE ACCOUNT ALLOWANCE, OR CONTRIBUTIONS TO BENEFIT PLANS FOR THEIR SERVICES TO THE HEALTH SYSTEM. HOWEVER, PAYMENT IS MADE DIRECTLY TO THE SISTERS OF CHARITY OF LEAVENWORTH FOR THE SERVICES OF THOSE WHO PERFORM PROFESSIONAL, ADMINISTRATIVE, AND OTHER SUCH SERVICES. SCHWERDT DESIGN GROUP INC BOARD MEMBER, GREG SCHWERDT IS THE OWNER OF SCHWERDT DESIGN GROUP, INC. 146206 ARCHITECTURAL SERVICES 0 SCHWERDT CONTRACT INTERIORS INC BD MMBR GREG SCHWERDT'S SPOUSE - OWNER OF SCHWERDT DESIGN INTERIORS, INC. 261288 INTERIOR DESIGN 0 FORM 990, PART VI, SECTION A, LINE 6 MEMBERS OR STOCKHOLDERS SISTERS OF CHARITY OF LEAVENWORTH HEALTH SYSTEM, INC. (SCLHS) IS THE SOLE MEMBER OF ST. FRANCIS HEALTH CENTER, INC. FORM 990, PART VI, SECTION A, LINE 7A POWER TO ELECT OR APPOINT MEMBERS SISTERS OF CHARITY OF LEAVENWORTH HEALTH SYSTEM, INC., THE SOLE MEMBER OF ST. FRANCIS HEALTH CENTER, INC., APPOINTS MEMBERS OF ST. FRANCIS HEALTH CENTER, INC. BOARD OF DIRECTORS. FORM 990, PART VI, SECTION A, LINE 7B DECISIONS RESERVED TO MEMBERS OR STOCKHOLDERS SISTERS OF CHARITY OF LEAVENWORTH HEALTH SYSTEM, INC. (SCLHS) HAS CERTAIN RESERVE POWERS TO APPROVE CHANGES TO THE BYLAWS REGARDING APPOINTMENT OF BOARD MEMBERS. SCLHS ALSO HAS EXTENSIVE RESERVE POWERS OVER ANY CHANGE IN MISSION, CHANGES TO THE ARTICLES OF INCORPORATION OR BYLAWS, ACQUISITION OF ASSETS, INCURRENCE OF DEBT, MERGER OR DISSOLUTION, APPROVAL OF STRATEGIC PLANS AND BUDGETS, AND APPOINTMENT OF AUDITORS. FORM 990, PART VI, SECTION B, LINE 11 THE FORM 990 IS PREPARED BY THE TAX DEPARTMENT OF THE PARENT ORGANIZATION, SISTERS OF CHARITY OF LEAVENWORTH HEALTH SYSTEM, INC. (SCLHS). THE FORM 990 IS REVIEWED BY CERTAIN MEMBERS OF SENIOR MANAGEMENT. A COPY OF THE FORM 990 IS PROVIDED TO THE BOARD OF DIRECTORS PRIOR TO THE FILING OF THE FORM 990 WITH THE INTERNAL REVENUE SERVICE. ANY QUESTIONS ARE ADDRESSED TO THE TAX DIRECTOR OF SCLHS PRIOR TO FILING THE FORM 990 WITH THE INTERNAL REVENUE SERVICE. FORM 990, PART VI, SECTION B, LINE 12C MONITORING AND ENFORCEMENT OF COMPLIANCE WITH CONFLICT OF INTEREST POLICY THE ORGANIZATION'S EXECUTIVES, DIRECTORS, MANAGERS, BOARD MEMBERS, BOARD COMMITTEE MEMBERS, MEDICAL EXECUTIVE COMMITTEE (MEC) MEMBERS AND OTHER PHYSICIANS IN DECISION MAKING ROLES OR SERVING ON COMMITTEES, COMPLETE A NEW CONFLICT OF INTEREST (COI) DISCLOSURE FORM EACH YEAR. A COPY OF THE POLICY IS DISTRIBUTED ALONG WITH THE COI FORMS. IN THE EVENT OF A CHANGE OF CIRCUMSTANCE, EACH INDIVIDUAL WHO HAS ALREADY SIGNED A COI IS EXPECTED TO NOTIFY THE ORGANIZATION OF THE CHANGE AND UPDATE THE CONFLICT OF INTEREST INFORMATION. THE STATEMENTS ARE REVIEWED AND COI ISSUES ARE ADDRESSED BY THE ORGANIZATION'S RESPONSIBILITY OFFICE (ORO) AND LEADERSHIP AT THE APPROPRIATE LEVEL: BOARD MEMBERS - BY BOARD CHAIR PHYSICIANS - BY THE MEC PRESIDENT EXECUTIVES - BY THE PARENT ORGANIZATION, SISTERS OF CHARITY OF LEAVENWORTH HEALTH SYSTEM, INC. DIRECTORS AND MANAGERS - BY ADMINISTRATION THE SIGNED COI FORMS ARE MAINTAINED IN ADMINISTRATION AND IN COMPLIANCE. THE CONFLICT OF INTEREST DISCLOSURE STATEMENTS FOR THE EXECUTIVES ARE MAINTAINED AT SISTERS OF CHARITY OF LEAVENWORTH HEALTH SYSTEM, INC. AT THE BEGINNING OF BOARD AND BOARD COMMITTEE MEETINGS, THE QUESTION OF COI IS ASKED OF THOSE IN ATTENDANCE. WHEN AN ACTUAL CONFLICT IS IDENTIFIED, THE INDIVIDUAL IS EXCUSED FROM PARTICIPATING IN THE DISCUSSIONS AND DECISION-MAKING. FORM 990, PART VI, SECTION B, LINE 15 THE ORGANIZATION'S OFFICERS ARE PAID BY A RELATED ORGANIZATION, THE SISTERS OF CHARITY OF LEAVENWORTH HEALTH SYSTEM, INC. (SCLHS) SCLHS' PROCESS FOR DETERMINING COMPENSATION FOR THE TOP MANAGEMENT AND SENIOR LEADERSHIP IS THE RESPONSIBILITY OF THE COMPENSATION COMMITTEE. THIS COMMITTEE IS COMPOSED OF THREE OR MORE MEMBERS WHO ARE NOT CURRENT EMPLOYEES OF SCLHS, OR FORMER EMPLOYEES WITH NO ACTIVE INTEREST IN THE SCLHS' COMPENSATION PROGRAM, INCLUDING AT LEAST TWO MEMBERS OF THE SCLHS BOARD. SCLHS BELIEVES THAT THE INDEPENDENCE OF THESE MEMBERS IS VITAL TO THE INTEGRITY OF THE PROCESS. THE WORK OF THIS COMMITTEE INCLUDES BEING CONSTANTLY AWARE OF THE CURRENT COMPETITIVE MARKET FOR MANAGEMENT AND SENIOR LEADERS, AS WELL AS COMPILING AND MAINTAINING RECORDS OF COMPARABLE COMPENSATION AND BENEFITS DATA, INCLUDING SURVEYS AND OTHER ANALYSES, TO SUPPORT SCLHS' TOTAL COMPENSATION TO EACH INDIVIDUAL. AS PART OF THE REVIEW PROCESS, SCLHS USES THE FOLLOWING IN ESTABLISHING THE COMPENSATION OF TOP MANAGEMENT AND SENIOR LEADERSHIP. 1) COMPENSATION COMMITTEE 2) INDEPENDENT COMPENSATION CONSULTANT 3) FORM 990 OF OTHER ORGANIZATIONS 4) WRITTEN EMPLOYMENT CONTRACTS 5) COMPENSATION SURVEYS AND STUDIES 6) APPROVAL BY THE BOARD OR COMPENSATION COMMITTEE THE ITEMS LISTED ABOVE SUPPORT THE COMPENSATION COMMITTEE'S EFFORTS TO ENSURE THAT THE LEVEL OF COMPENSATION PROVIDED TO ITS EXECUTIVES (OFFICERS, KEY EMPLOYEES, ETC.) IS CONSISTENT WITH THE MARKET VALUE AND THE PAY PHILOSOPHY SET BY THE BOARD. MINUTES ARE KEPT CONTEMPORANEOUSLY FOR EACH MEETING OF THE COMMITTEE. LIKEWISE, THE COMMITTEE IS RESPONSIBLE FOR ENSURING THAT NO "EXCESS BENEFIT" IS CONFERRED ON AN INDIVIDUAL, OR THAT SUCH COMPENSATION DOES NOT CONSTITUTE PROHIBITED INUREMENT. THIS PROCESS IS COMPLETED FOR ALL SENIOR LEADERSHIP, AT THE AFFILIATE AND SYSTEM LEVEL, AND THE COMMITTEE'S RECOMMENDATION IS THEN SUBMITTED TO THE SCLHS BOARD FOR APPROVAL. THE CHARGE OF THIS COMMITTEE ADHERES TO SCLHS' CORE VALUE OF STEWARDSHIP, ENSURING THAT THE MINISTRY'S RESOURCES HELD IN TRUST ARE NOT WASTED OR MISUSED, AND ARE DEPLOYED TO EFFECTIVELY AND EFFICIENTLY ADVANCE THE MISSION. FORM 990, PART VI, SECTION C, LINE 19 AVAILABILITY OF GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS AVAILABLE TO THE PUBLIC THE ORGANIZATION MAKES ITS CONFLICT OF INTEREST POLICY, FINANCIAL STATEMENTS, AND GOVERNING DOCUMENTS AVAILABLE UPON REQUEST. 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