2015-05-14T20:00:40-05:00 2014-06-30 470617373 CATHOLIC HEALTH INITIATIVES 198 INVERNESS DRIVE WEST ENGLEWOOD CO 80112 990 2013-07-01 450226429 ST JOSEPH'S HOSPITAL AND HEALTH CENTER STJO 7014564000 2500 Fairway Street DICKINSON ND 58601 STEPHANIE FRANKEN CFO 2015-04-09 true PAMELA KROHN P01210500 3032989100 2013 2016-02-25 16:41:14Z X REED REYMAN 2500 Fairway Street DICKINSON ND 58601 59558981 false 0928 X WWW.CHISTJOSEPHSHEALTH.ORG X 1921 ND THE PRIMARY PURPOSE OF ST JOSEPH'S HOSPITAL AND HEALTH CENTER IS TO PROVIDE IN-PATIENT AND OUT-PATIENT MEDICAL SERVICE TO RESIDENTS IN THE SURROUNDING AREA REGARDLESS OF THEIR ABILITY TO PAY. 11 8 503 196 1532505 325537 171058 1890374 50576960 55458365 11567 60422 1850834 2149670 52610419 59558831 31139 6596 0 0 24479564 24262305 0 0 0 32634718 36261843 57145421 60530744 -4535002 -971913 45382324 104869899 59975316 120434804 -14592992 -15564905 X THE MISSION OF THE CORPORATION IS TO NURTURE THE HEALING MINISTRY OF THE CHURCH, SUPPORTED BY EDUCATION AND RESEARCH. FIDELITY TO THE GOSPEL URGES THE CORPORATION TO EMPHASIZE HUMAN DIGNITY AND SOCIAL JUSTICE AS IT CREATES HEALTHIER COMMUNITIES. THE CORPORATION, SPONSORED BY A LAY-RELIGIOUS PARTNERSHIP, CALLS OTHER CATHOLIC SPONSORS AND SYSTEMS TO UNITE TO ENSURE THE FUTURE OF CATHOLIC HEALTH CARE. TO FULFILL THIS MISSION, THE CORPORATION, AS A VALUES-BASED ORGANIZATION, WILL ASSURE THE INTEGRITY OF THE MINISTRY IN BOTH CURRENT AND DEVELOPING ORGANIZATIONS AND ACTIVITIES; RESEARCH AND DEVELOP NEW MINISTRIES THAT INTEGRATE HEALTH, EDUCATION, PASTORAL, AND SOCIAL SERVICES; PROMOTE LEADERSHIP DEVELOPMENT AND FORMATION FOR MINISTRY THROUGHOUT THE ENTIRE ORGANIZATION; ADVOCATE FOR SYSTEMIC CHANGES WITH SPECIFIC CONCERN FOR PERSONS WHO ARE POOR, ALIENATED, AND UNDERSERVED; AND STEWARD RESOURCES BY GENERAL OVERSIGHT OF THE ENTIRE ORGANIZATION. false false 49541432 6596 55458365 SEE SCHEDULE H 49541432 true true false true false false false false false true false false true true true false true false false false false false false false false true true false false true false false false true false false false false false false false false false true true true false false true 0 0 503 true true true false false false false false false false false false X 11 8 false false false false true true true true true false false true true true true true true true true false ND X Stephanie Franken 7014564277 2500 Fairway Street DICKINSON ND 58601 MIKE LEFOR CHAIR 2.00 1.00 X X 0 0 0 REED REYMAN PRESIDENT/CEO 59.00 1.00 X X 0 248241 47996 VAUNE CRIPE VICE CHAIR 1.00 0 X X 0 0 0 EUGENE JACKSON DIRECTOR 1.00 0 X 0 0 0 JEFFREY DROP Board Member/CHI SVP Division Officer 1.00 60.00 X 0 827539 118272 JON FRANTSVOG DIRECTOR 1.00 0 X 0 0 0 MARK HINRICHS DIRECTOR 1.00 0 X 5305 0 0 PAUL STEFFES DIRECTOR 1.00 0 X 0 0 0 RHONDA DUKART Director 1.00 0 X 0 0 0 SCOTT MESCHKE DIRECTOR 1.00 2.00 X 0 0 0 SR MARIE DAMIAN GLATT DIRECTOR 1.00 0 X 0 0 0 BEVERLY FERDERER SECRETARY 60.00 0 X 49194 0 27707 STEPHANIE E FRANKEN CFO 58.00 2.00 X 94852 48120 41089 COLLEEN LENNARD-LOVE Physician 40.00 0 X 355698 0 40957 DAVID KUYLEN PHYSICIAN 60.00 0 X 379479 0 43957 MICHAEL L CASSIDY PHYSICIAN 60.00 0 X 385155 0 34990 ROBERT S RIDDICK PHYSICIAN 60.00 0 X 429119 0 38054 SHELDON L SWENSON PHYSICIAN 60.00 0 X 425474 0 43910 2124276 1123900 436932 28 false true false JE DUNN CONSTRUCTION COMPANY 2000 S COLORADO BLVD DENVER CO 80222 CONSTRUCTION MGMT 15620451 DAVIS PARTNERSHIP ARCHITECTS 2301 BLAKE STREET SUITE 100 DENVER CO 80205 ARCHITECT SERVICES 2662088 MEDEFIS INC 10826 OLD MILL ROAD SUITE 101 OMAHA NE 68154 TEMPORARY STAFFING AGENCY 1798808 ALLIANCE RECRUITING RESOURCES PO BOX 670416 DALLAS TX 75267 RECRUITING AGENCY 1310794 RURAL RADIOLOGY CONS LTD 817 2ND AVE WEST DICKINSON ND 58601 RADIOLOGIST SERVICES 1008631 20 83726 1806648 19977 1890374 PATIENT SERVICES 900099 55276779 55276779 RENTAL INCOME 900099 181586 181586 0 0 0 0 0 0 0 55458365 56422 56422 0 0 3900 150 3750 0 3750 3750 4000 0 4000 4000 4000 0 0 41960 41960 41960 DURABLE MEDICAL EQUIPMENT 446199 1516416 1516416 CAFETERIA 722100 177642 177642 SERVICES SOLD 900099 61032 5603 55429 348870 0 10486 338384 2103960 59558831 55458365 1532505 677587 X 6596 6596 0 0 0 93042 93042 0 19917910 18931823 986087 930319 880150 50169 1982428 1875408 107020 1338606 1271676 66930 0 64578 64578 0 0 0 0 13198860 10750137 2448723 0 50074 50074 2115595 1722411 393184 4491010 73582 4417428 0 1229242 800791 428451 489379 400049 89330 0 197082 3220 193862 1711687 1711687 1161792 1161792 1182376 1012682 169694 374200 248156 126044 UNRELATED BUSINESS TAXES 75000 75000 MEDICAL SUPPLIES 3923594 3904670 18924 BAD DEBT 5302066 5302066 EDUCATION/RELOCATION/DUES/BOOKS 203910 83124 120786 491398 488204 3194 0 60530744 49541432 10989312 0 0 48749 47790 9846757 11316023 7521349 11822379 37729 20795 0 0 170673 95116 1519446 1456219 119466 171518 76830673 4449090 23745422 72381583 0 0 0 0 153894 152190 2218839 7406286 45382324 104869899 9483411 14779978 12260 229628 0 0 0 0 50479645 105425198 59975316 120434804 X -14649894 -15564554 56902 -351 -14592992 -15564905 45382324 104869899 -971913 0 X false true X true true true X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED false false false false false true 2755 false false false 2755 false Schedule C, Part II-B, Line 1, Description of the activities reported on Lines 1a through 1i THE PORTION OF ORGANIZATION DUES INCLUDED ON LINE 1F THAT ARE RELATED TO LOBBYING ARE AS FOLLOWS: AMERICAN HOSPITAL ASSOCIATION $738 CATHOLIC HOSPITAL ASSOCIATION $255 NORTH DAKOTA HOSPITAL ASSOCIATION $1,762 2581020 2581020 602880 349290 253590 0 8001948 4048394 3953554 65644825 51406 65593419 72381583 INTERCOMPANY RECEIVABLES 7388965 DEPOSITS 17321 7406286 64500 CHI DEBT PROGRAM 96146645 INTERCOMPANY PAYABLES 8553241 ENVIRONMENTAL REMEDIATION LIABILITY 660812 105425198 X Schedule D, Part X, Line 2, FIN 48 (ASC 740) footnote ST. JOSEPH'S HOSPITAL AND HEALTH CENTER'S FINANCIAL INFORMATION IS INCLUDED IN THE CONSOLIDATED AUDITED FINANCIAL STATEMENTS OF CATHOLIC HEALTH INITIATIVES (CHI), A RELATED ORGANIZATION. CHI'S FIN 48 (ASC 740) FOOTNOTE FOR THE YEAR ENDED JUNE 30, 2014 READS AS FOLLOWS: "CHI IS A TAX-EXEMPT COLORADO CORPORATION AND HAS BEEN GRANTED AN EXEMPTION FROM FEDERAL INCOME TAX UNDER SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE. CHI OWNS CERTAIN TAXABLE SUBSIDIARIES AND ENGAGES IN CERTAIN ACTIVITIES THAT ARE UNRELATED TO ITS EXEMPT PURPOSE AND THEREFORE SUBJECT TO INCOME TAX. MANAGEMENT REVIEWS ITS TAX POSITIONS ANNUALLY AND HAS DETERMINED THAT THERE ARE NO MATERIAL UNCERTAIN TAX POSITIONS THAT REQUIRE RECOGNITION IN THE ACCOMPANYING CONSOLIDATED FINANCIAL STATEMENTS." true true X false false true true false true false 1078 510225 510225 0.00930 3457331 3457331 0 0.00000 0 0.00000 0 1078 3967556 3457331 510225 0.00930 17 2789 87562 87562 0.00160 1 18 29772 29772 0.00050 0 0.00000 0 0.00000 2 800 2720 2720 0.00000 20 3607 120054 0 120054 0.00210 20 4685 4087610 3457331 630279 0.01140 0 0.00000 0 0.00000 1 1600 2708 2708 0.00000 0 0.00000 1 206 206 0.00000 1 107 65 65 0.00000 0 0.00000 0 0.00000 0 0.00000 3 1707 2979 0 2979 0.00000 true 5302066 0 14072065 14157094 -85029 X true true 1 1 ST JOSEPH'S HOSPITAL AND HEALTH CENTER 2500 Fairway Street DICKINSON ND 58601 WWW.CHISTJOSEPHSHEALTH.ORG X X X X ST JOSEPH'S HOSPITAL AND HEALTH CENTER 1 true X X X X X X X X X 12 true false true X www.StJoesHospital.org X X X X X X X X false false true false false true X X X X X X true true X X true false true X false false Schedule H, Part V Sec B, Line 3, Community Served by Needs Assessment (1) - ST. JOSEPH'S HOSPITAL AND HEALTH CENTER: THE HOSPITAL FACILITY TOOK INTO ACCOUNT INPUT FROM PERSONS WHO REPRESENT THE BROAD INTERESTS OF THE COMMUNITY BY CONDUCTING TOWN HALL MEETINGS AND SURVEYS WERE DISTRIBUTED TO HOSPITAL STAFF AND TO THE COMMUNITY. INDIVIDUAL, ONE-ON-ONE INTERVIEWS WERE ALSO CONDUCTED WITH REPRESENTATIVES FROM A VARIETY OF ORGANIZATIONS, INCLUDING THE SOUTHWEST DISTRICT HEALTH DEPARTMENT, THE LOCAL PUBLIC SCHOOLS, THE MAYOR, THE CHIEF OF POLICE, LOCAL CHURCHES, AND THE COUNTY COMMISSIONER.; Schedule H, Part V Sec B, Line 7, Needs not addressed in Needs Assessment (1) - ST. JOSEPH'S HOSPITAL AND HEALTH CENTER: IN THE COMMUNITY NEEDS ASSESSMENT COMMUNITY MEETING, THOSE IN ATTENDANCE VOTED ON THE TOP FIVE CONCERNS FROM A LIST OF POTENTIAL NEEDS THAT WERE IDENTIFIED FROM ALL OF ASSESSMENTS RETURNED. THE COMMUNITY VOTED ON THE 5 ITEMS TO FOCUS ON FOR THE CURRENT YEAR, WHICH INCLUDED THE FOLLOWING: 1) LIMITED NUMBER OF PRIMARY CARE PHYSICIANS: ST. JOSEPH'S HOSPITAL AND HEALTH CENTER HAS SET A RECRUITMENT PLAN INTO PLACE IN ORDER TO RECRUIT 4 PRIMARY CARE PHYSICIANS AND 4 PRIMARY CARE MIDLEVEL PROVIDERS. 2) LACK OF AFFORDABLE HOUSING: ST. JOSEPH'S HOSPITAL AND HEALTH CENTER IS COMMITTED TO HELPING ITS STAFF TO BE ABLE TO AFFORD TO LIVE IN DICKINSON, ND. 3) INSUFFICIENT HEALTHCARE STAFF: IN GENERAL, THERE IS NOT ENOUGH HEALTHCARE STAFF IN THE AREA. THEREFORE, RECRUITMENT FOR OPEN STAFF POSITIONS IS ONGOING AND VERY AGGRESSIVE. IN FISCAL YEAR 2013, ST. JOSEPH'S HOSPITAL AND HEALTH CENTER HIRED 166 NEW HIRES. 4) ADDICTION/SUBSTANCE ABUSE 5) MENTAL HEALTH NEEDS: ST. JOSEPH'S HOSPITAL AND HEALTH CENTER HAS SET UP TELEPSYCHIATRY PROGRAM, WHICH IS THE APPLICATION OF TELEMEDICINE TO THE PSYCHIATRY FIELD, AND IS WORKING WITH TWO VENDORS TO PROVIDE THE NECESSARY COVERAGE. THE ORGANIZATION IS ALSO COLLABORATING WITH THE CHI MISSION AND MINISTRY GRANT IN ORDER TO RUN A COMMUNITY WIDE VIOLENCE PREVENTION PROGRAM, WHICH INVOLVES MANY DIFFERENT AGENCIES. THE COMMUNITY NEEDS ASSESSMENT GOALS AND NEEDS ARE DISCUSSED MONTHLY AND ARE AN ONGOING FOCUS FROM YEAR-TO-YEAR.; Schedule H, Part V Sec B, Line 10, Used federal poverty guidelines (FPG) to determine eligibility (1) - ST. JOSEPH'S HOSPITAL AND HEALTH CENTER: HUD LOW INCOME GUIDELINES USED.; Schedule H, Part V Sec B, Line 11, Eligibility for Discounted Care (1) - ST. JOSEPH'S HOSPITAL AND HEALTH CENTER: HUD LOW INCOME GUIDELINES USED.; Schedule H, Part V Sec B, Line 20d, How amounts charged to FAP-eligible patients were determined (1) - ST. JOSEPH'S HOSPITAL AND HEALTH CENTER: ST. JOSEPH'S HOSPITAL AND HEALTH CENTER USES THE AVERAGE MANAGED CARE CONTRACTUAL ALLOWANCE RATE TO DETERMINE THE MAXIMUN AMOUNTS THAT CAN BE CHARGED TO FAP-ELIGIBLE INDIVIDUALS FOR EMERGENCY OR OTHER MEDICALLY NECESSARY CARE. ; KILLDEER MEDICAL CLINIC 150 CENTRAL AVENUE N KILLDEER ND 58640 RURAL HEALTH CLINIC BADLANDS ENT CLINIC 30 W 7TH ST DICKINSON ND 58601 EAR, NOSE, & THROAT CLINIC DAKOTA BONE & JOINT CLINIC 109 7TH ST W DICKINSON ND 58601 ORTHOPEDIC CLINIC ST JOSEPH'S WOMEN'S CLINIC 30 West Seventh Street DICKINSON ND 58601 CLINIC ST JOSEPH'S HOSPITAL WALK-IN CLINIC 227 16th street west DICKINSON ND 58601 WALK-IN CLINIC ST JOSEPH'S SURGICAL CARE CLINIC 30 W 7TH ST DICKINSON ND 58601 SURGERY CLINIC PEDIATRICS CLINIC 227 16th street west DICKINSON ND 58601 CLINIC MEDQUEST 584 12TH ST W DICKINSON ND 58601 DURABLE MEDICAL EQUIPMENT FAMILY PRACTICE CLINIC 227 16th street west DICKINSON ND 58601 CLINIC BEACH MEDICAL CLINIC 95 2ND ST NW BEACH ND 58621 RURAL HEALTH CLINIC Schedule H, Part I, Line 3c, Eligibility criteria for free or discounted care WHEN CATHOLIC HEALTH INITIATIVES (THE ULTIMATE PARENT ORGANIZATION TO ST. JOSEPH'S HOSPITAL AND HEALTH CENTER) ESTABLISHED ITS FINANCIAL ASSISTANCE POLICY IT WAS DETERMINED THAT ESTABLISHING A HOUSEHOLD INCOME SCALE BASED ON THE HUD VERY LOW INCOME GUIDELINES MORE ACCURATELY REFLECTS THE SOCIOECONOMIC DISPERSIONS AMONG URBAN AND RURAL COMMUNITIES IN 17 STATES SERVED BY CHI HOSPITALS AND HEALTH CARE FACILITIES. IN COMPARING HUD GUIDELINES TO THE FEDERAL POVERTY GUIDELINES ("FPG"), WE FIND THAT ON AVERAGE HUD GUIDELINES COMPUTE TO APPROXIMATELY 200% TO 250% (AND SOMETIMES 300%) OF FPG. ST. JOSEPH'S HOSPITAL AND HEALTH CENTER BASES ITS FINANCIAL ASSISTANCE ELIGIBILITY ON HUD'S 130% OF VERY LOW INCOME GUIDELINES BASED ON GEOGRAPHY, AND AFFORDS THE UNINSURED AND UNDERINSURED THE ABILITY TO OBTAIN FINANCIAL ASSISTANCE WRITE-OFFS, BASED ON A SLIDING SCALE, RANGING FROM 25%-100% OF CHARGES. AN INDIVIDUAL'S INCOME UNDER THE HUD GUIDELINES IS A SIGNIFICANT FACTOR IN DETERMINING ELIGIBILITY FOR FINANCIAL ASSISTANCE. HOWEVER, IN DETERMINING WHETHER TO EXTEND DISCOUNTED OR FREE CARE TO A PATIENT, THE PATIENT'S ASSETS MAY ALSO BE TAKEN INTO CONSIDERATION. FOR EXAMPLE, A PATIENT SUFFERING A CATASTROPHIC ILLNESS MAY HAVE A REASONABLE LEVEL OF INCOME, BUT A LOW LEVEL OF LIQUID ASSETS SUCH THAT THE PAYMENT OF MEDICAL BILLS WOULD BE SERIOUSLY DETRIMENTAL TO THE PATIENT'S BASIC FINANCIAL (AND ULTIMATELY PHYSICAL) WELL-BEING AND SURVIVAL. SUCH A PATIENT MAY BE EXTENDED DISCOUNTED OR FREE CARE BASED UPON THE FACTS AND CIRCUMSTANCES. Schedule H, Part I, Line 7, Costing Methodology used to calculate financial assistance A COST ACCOUNTING SYSTEM WAS NOT USED TO COMPUTE AMOUNTS IN THE TABLE; RATHER COSTS IN THE TABLE WERE COMPUTED USING WORKSHEET 2 TO COMPUTE THE COST-TO-CHARGE RATIO. THE COST-TO-CHARGE RATIO COVERS ALL PATIENT SEGMENTS. WORKSHEET 2 WAS UTILIZED TO COMPUTE THE COST-TO-CHARGE RATIO FOR THE YEAR ENDED 6/30/14 USING THE FOLLOWING FORMULA: OPERATING EXPENSE (LESS NON-PATIENT CARE ACTIVITIES, MEDICARE PROVIDER TAXES, COMMUNITY BENEFIT EXPENSE AND COMMUNITY BUILDING EXPENSE) DIVIDED BY GROSS PATIENT REVENUE (LESS GROSS CHARGES FOR COMMUNITY BENEFIT PROGRAMS). BASED ON THAT FORMULA, $44,885,014/$73.265.872 RESULTS IN A 61.26% COST-TO-CHARGE RATIO. Schedule H, Part I, Line 7, col(f), Bad Debt Expense excluded from financial assistance calculation 5,603,254 Schedule H, Part I, Line 7g, Subsidized Health Services THERE ARE NO PHYSICIAN CLINICS INCLUDED IN SUBSIDIZED HEALTH SERVICES. Schedule H, Part III, Line 2, Bad debt expense - methodology used to estimate amount COSTING METHODOLOGY FOR AMOUNTS REPORTED ON LINE 2 IS DETERMINED USING THE ORGANIZATION'S COST/CHARGE RATIO OF 61.26%. WHEN DISCOUNTS ARE EXTENDED TO SELF-PAY PATIENTS, THESE PATIENT ACCOUNT DISCOUNTS ARE RECORDED AS A REDUCTION IN REVENUE, NOT AS BAD DEBT EXPENSE. Schedule H, Part III, Line 3, Bad Debt Expense Methodology ST. JOSEPH'S HOSPITAL AND HEALTH CENTER DOES NOT BELIEVE THAT ANY PORTION OF BAD DEBT EXPENSE COULD REASONABLY BE ATTRIBUTED TO PATIENTS WHO QUALIFY FOR FINANCIAL ASSISTANCE SINCE AMOUNTS DUE FROM THOSE INDIVIDUALS' ACCOUNTS WILL BE RECLASSIFIED FROM BAD DEBT EXPENSE TO CHARITY CARE WITHIN 30 DAYS FOLLOWING THE DATE THAT THE PATIENT IS DETERMINED TO QUALIFY FOR CHARITY CARE. Schedule H, Part III, Line 4, Bad debt expense - financial statement footnote ST. JOSEPH'S HOSPITAL AND HEALTH CENTER DOES NOT ISSUE SEPARATE COMPANY AUDITED FINANCIAL STATEMENTS. HOWEVER, THE ORGANIZATION IS INCLUDED IN THE CONSOLIDATED FINANCIAL STATEMENTS OF CATHOLIC HEALTH INITIATIVES. THE CONSOLIDATED FOOTNOTE READS AS FOLLOWS: "THE PROVISION FOR BAD DEBTS IS BASED UPON MANAGEMENT'S ASSESSMENT OF HISTORICAL AND EXPECTED NET COLLECTIONS, TAKING INTO CONSIDERATION HISTORICAL BUSINESS AND ECONOMIC CONDITIONS, TRENDS IN HEALTH CARE COVERAGE AND OTHER COLLECTION INDICATORS. MANAGEMENT ROUTINELY ASSESSES THE ADEQUACY OF THE ALLOWANCES FOR UNCOLLECTIBLE ACCOUNTS BASED UPON HISTORICAL WRITE-OFF EXPERIENCE BY PAYOR CATEGORY. THE RESULTS OF THESE REVIEWS ARE USED TO MODIFY, AS NECESSARY, THE PROVISION FOR BAD DEBTS AND TO ESTABLISH APPROPRIATE ALLOWANCES FOR UNCOLLECTIBLE NET PATIENT ACCOUNTS RECEIVABLE. AFTER SATISFACTION OF AMOUNTS DUE FROM INSURANCE, CHI FOLLOWS ESTABLISHED GUIDELINES FOR PLACING CERTAIN PATIENT BALANCES WITH COLLECTION AGENCIES, SUBJECT TO THE TERMS OF CERTAIN RESTRICTIONS ON COLLECTION EFFORTS AS DETERMINED BY EACH FACILITY. IN ACCORDANCE WITH ACCOUNTING STANDARDS UPDATE (ASU) NO. 2011-07, PRESENTATION AND DISCLOSURE OF PATIENT SERVICES REVENUE, PROVISION FOR BAD DEBTS, AND ALLOWANCES FOR DOUBTFUL ACCOUNTS FOR CERTAIN HEALTH ENTITIES, THE PROVISION FOR BAD DEBTS IS PRESENTED ON THE CONSOLIDATED STATEMENT OF OPERATIONS AS A DEDUCTION FROM PATIENT SERVICES REVENUES (NET OF CONTRACTUAL ALLOWANCES AND DISCOUNTS) SINCE CHI ACCEPTS AND TREATS ALL PATIENTS WITHOUT REGARD TO THE ABILITY TO PAY." Schedule H, Part III, Line 8, Community benefit & methodology for determining medicare costs ST. JOSEPH'S HOSPITAL AND HEALTH CENTER IS DESIGNATED AS A CRITICAL ACCESS HOSPITAL ("CAH"). CAHS ARE RURAL COMMUNITY HOSPITALS THAT ARE CERTIFIED TO RECEIVE COST-BASED REIMBURSEMENT FROM MEDICARE. THE REIMBURSEMENT THAT CAHS RECEIVE IS INTENDED TO IMPROVE THEIR FINANCIAL PERFORMANCE AND THEREBY REDUCE HOSPITAL CLOSURES. CAHS ARE CERTIFIED UNDER A DIFFERENT SET OF MEDICARE CONDITIONS OF PARTICIPATION (COP). SHORTFALLS ARE CREATED WHEN A FACILITY RECEIVED PAYMENTS THAT ARE LESS THAN THE COSTS OF CARING FOR PROGRAM BENEFICIARIES. BECAUSE SHORTFALLS ARE BASED ON COSTS, NOT CHARGES, ST. JOSEPH'S HOSPITAL AND HEALTH CENTER, DUE TO THEIR DESIGNATION AS A CAH, RECEIVED COST-BASED REIMBURSEMENT FOR INPATIENT AND OUTPATIENT SERVICES. FOR THESE SERVICES, THERE WERE NO MEDICARE SHORTFALLS. FOR SWING BED SERVICES, ST. JOSEPH'S DOES NOT RECEIVE COST BASED REIMBURSEMENT. THERE WERE SHORTFALLS UNDER THESE PROGRAMS. ALTHOUGH NOT PRESENTED ON THE MEDICARE COST REPORT, IN ORDER TO FACILITATE A MORE ACCURATE UNDERSTANDING OF THE "TRUE" COST OF SERVICES (FOR "SHORTFALL" PURPOSES) THE CHI WORKBOOK ALLOWS A HEALTH CARE FACILITY NOT TO OFFSET COSTS THAT MEDICARE CONSIDERS TO BE NON-ALLOWABLE, BUT FOR WHICH THE FACILITY CAN LEGITIMATELY ARGUE ARE RELATED TO THE CARE OF THE FACILITY'S PATIENTS. IN ADDITION, ALTHOUGH NOT REPORTABLE ON THE MEDICARE COST REPORT, THE CHI WORKBOOK INCLUDES THE COST OF SERVICES THAT ARE PAID VIA A SET FEE-SCHEDULE RATHER THAN BEING REIMBURSED BASED ON COSTS (E.G. OUTPATIENT CLINICAL LABORATORY). FINALLY, THE CHI WORKBOOK ALLOWS A FACILITY TO INCLUDE OTHER HEALTH CARE SERVICES PERFORMED BY A SEPARATE FACILITY (SUCH AS A PHYSICIAN PRACTICE) THAT ARE MAINTAINED ON SEPARATE BOOKS AND RECORDS (AS OPPOSED TO THE MAIN FACILITY'S BOOKS AND RECORDS WHICH HAS ITS COSTS OF SERVICE INCLUDED WITHIN A COST REPORT). TRUE COSTS OF MEDICARE COMPUTED USING THIS METHODOLOGY: TOTAL MEDICARE REVENUE: $14,072,065 TOTAL MEDICARE COSTS: $14,157,094 SURPLUS OR SHORTFALL ($85,029) ST. JOSEPH'S HOSPITAL AND HEALTH CENTER BELIEVES THAT EXCLUDING MEDICARE LOSSES FROM COMMUNITY BENEFIT MAKES THE OVERALL COMMUNITY BENEFIT REPORT MORE CREDIBLE FOR THESE REASONS: UNLIKE SUBSIDIZED AREAS SUCH AS BURN UNITS OR BEHAVIORAL-HEALTH SERVICES, MEDICARE IS NOT A DIFFERENTIATING FEATURE OF TAX-EXEMPT HEALTH CARE ORGANIZATIONS. IN FACT, FOR-PROFIT HOSPITALS FOCUS ON ATTRACTING PATIENTS WITH MEDICARE COVERAGE, ESPECIALLY IN THE CASE OF WELL-PAID SERVICES THAT INCLUDE CARDIAC AND ORTHOPEDICS. SIGNIFICANT EFFORT AND RESOURCES ARE DEVOTED TO ENSURING THAT HOSPITALS ARE REIMBURSED APPROPRIATELY BY THE MEDICARE PROGRAM. THE MEDICARE PAYMENT ADVISORY COMMISSION (MEDPAC), AN INDEPENDENT CONGRESSIONAL AGENCY, CAREFULLY STUDIES MEDICARE PAYMENT AND THE ACCESS TO CARE THAT MEDICARE BENEFICIARIES RECEIVE. THE COMMISSION RECOMMENDS PAYMENT ADJUSTMENTS TO CONGRESS ACCORDINGLY. THOUGH MEDICARE LOSSES ARE NOT INCLUDED BY CATHOLIC HOSPITALS AS COMMUNITY BENEFIT, THE CATHOLIC HEALTH ASSOCIATION GUIDELINES ALLOW HOSPITALS TO COUNT AS COMMUNITY BENEFIT SOME PROGRAMS THAT SPECIFICALLY SERVE THE MEDICARE POPULATION. FOR INSTANCE, IF HOSPITALS OPERATE PROGRAMS FOR PATIENTS WITH MEDICARE BENEFITS THAT RESPOND TO IDENTIFIED COMMUNITY NEEDS, GENERATE LOSSES FOR THE HOSPITAL, AND MEET OTHER CRITERIA, THESE PROGRAMS CAN BE INCLUDED IN THE CHA FRAMEWORK IN CATEGORY C AS "SUBSIDIZED HEALTH SERVICES." MEDICARE LOSSES ARE DIFFERENT FROM MEDICAID LOSSES, WHICH ARE COUNTED IN THE CHA COMMUNITY BENEFIT FRAMEWORK, BECAUSE MEDICAID REIMBURSEMENTS GENERALLY DO NOT RECEIVE THE LEVEL OF ATTENTION PAID TO MEDICARE REIMBURSEMENT. MEDICAID PAYMENT IS LARGELY DRIVEN BY WHAT STATES CAN AFFORD TO PAY, AND IS TYPICALLY SUBSTANTIALLY LESS THAN WHAT MEDICARE PAYS. Schedule H, Part III, Line 9b, Collection practices for patients eligible for financial assistance ST. JOSEPH'S HOSPITAL AND HEALTH CENTER'S DEBT COLLECTION POLICY PROVIDES THAT ST. JOSEPH'S HOSPITAL AND HEALTH CENTER WILL PERFORM A REASONABLE REVIEW OF EACH INPATIENT ACCOUNT PRIOR TO TURNING AN ACCOUNT OVER TO A THIRD-PARTY COLLECTION AGENT AND PRIOR TO INSTITUTING ANY LEGAL ACTION FOR NON-PAYMENT, TO ASSURE THAT THE PATIENT AND PATIENT GUARANTOR ARE NOT ELIGIBLE FOR ANY ASSISTANCE PROGRAM (E.G. MEDICAID) AND DO NOT QUALIFY FOR COVERAGE THROUGH ST. JOSEPH'S HOSPITAL AND HEALTH CENTER COMMUNITY ASSISTANCE POLICY. AFTER HAVING BEEN TURNED OVER TO A THIRD-PARTY COLLECTION AGENT, ANY PATIENT ACCOUNT THAT IS SUBSEQUENTLY DETERMINED TO MEET THE ST. JOSEPH'S HOSPITAL AND HEALTH CENTER COMMUNITY ASSISTANCE POLICY IS REQUIRED TO BE RETURNED IMMEDIATELY BY THE THIRD-PARTY COLLECTION AGENT TO ST. JOSEPH'S HOSPITAL AND HEALTH CENTER FOR APPROPRIATE FOLLOW-UP. ST. JOSEPH'S HOSPITAL AND HEALTH CENTER REQUIRES ITS THIRD-PARTY COLLECTION AGENTS TO INCLUDE A MESSAGE ON ALL STATEMENTS INDICATING THAT IF A PATIENT OR PATIENT GUARANTOR MEETS CERTAIN STIPULATED INCOME REQUIREMENTS, THE PATIENT OR PATIENT GUARANTOR MAY BE ELIGIBLE FOR FINANCIAL ASSISTANCE. ALL OF CATHOLIC HEALTH INITIATIVES' HOSPITALS' CONTRACTS WITH THIRD PARTY COLLECTION AGENCIES INCLUDE THE FOLLOWING STANDARDS: * NEITHER CHI HOSPITALS NOR THEIR COLLECTION AGENCIES WILL REQUEST BENCH OR ARREST WARRANTS AS A RESULT OF NON-PAYMENT; * NEITHER CHI HOSPITALS NOR THEIR COLLECTION AGENCIES WILL SEEK LIENS THAT WOULD REQUIRE THE SALE OR FORECLOSURE OF A PRIMARY RESIDENCE; AND * NO CATHOLIC HEALTH INITIATIVES' COLLECTION AGENCY MAY SEEK COURT ACTION WITHOUT HOSPITAL APPROVAL. FINALLY, COLLECTION AGENCIES ARE TRAINED ON THE CATHOLIC HEALTH INITIATIVES MISSION, CORE VALUES AND STANDARD OF CONDUCT TO MAKE SURE ALL PATIENTS ARE TREATED WITH DIGNITY AND RESPECT. SCHEDULE H, PART VI, COMMUNITY BENEFITS, NEEDS ASSESSMENTS, AND OTHER INFORMATION ORGANIZATION'S MISSION, VISION, AND TAX-EXEMPT PURPOSE AS THE FIRST CATHOLIC HOSPITAL TO SERVE THE COMMUNITY, ST. JOSEPH'S HOSPITAL AND HEALTH CENTER ("SJHHC") EMBRACED THE MISSION OF THE FOUNDING RELIGIOUS CONGREGATION, WHICH HAS SINCE JOINED WITH OTHER RELIGIOUS CONGREGATIONS TO FORM CATHOLIC HEALTH INITIATIVES. THE MISSION OF ST. JOSEPH'S IS TO DEVELOP A HEALTHY COMMUNITY AND PROVIDE CARE TO ALL IN NEED. IT ALSO HAS A BOARD OF DIRECTORS THAT IS COMPRISED OF INDEPENDENT COMMUNITY REPRESENTATIVES. CATHOLIC HEALTHCARE HAS HAD A LONG-STANDING TRADITION OF SERVICE TO THE POOR. ST. JOSEPH'S HOSPITAL AND HEALTH CENTER DEFINES THE POOR IN MANY WAYS, NOT JUST ECONOMIC. THEY ARE ALSO THOSE INDIVIDUALS WHO EXPERIENCE DEFICITS IN THEIR LIVES PHYSIOLOGICALLY, SPIRITUALLY, AND/OR EMOTIONALLY. WE GIVE ASSISTANCE AND SUPPORT TO THOSE WHO ARE THE DISADVANTAGED OF OUR SOCIETY, WHICH HELPS THEIR ABILITY TO REALIZE THEIR POTENTIAL IN THEIR ENVIRONMENT. FROM A MISSION PERSPECTIVE, WE STRIVE TO BRING THE HEALING PRESENCE OF GOD TO OUR COMMUNITY AND ASSIST OUR COMMUNITY IN BECOMING A HEALTHIER PLACE TO LIVE AND WORK. THE ACTIVITIES THAT WE ENGAGE IN AIDS THE COMMUNITY DIRECTLY AND FLOWS FROM OUR MISSION STATEMENT. THE DEFINITION OF CHARITY IS "BENEVOLENT GOODWILL TOWARD OR LOVE OF HUMANITY; AN INSTITUTION ENGAGED IN THE NEEDS OF THE POOR; HELPFULNESS TOWARDS THE NEEDY OR SUFFERING." THE WORK WE DO REFLECTS THIS DEFINITION OF CHARITY, WHETHER IT IS THROUGH FINANCIAL ASSISTANCE, SCREENING PROGRAMS, OR OUR PROGRAMS OF OUTREACH THROUGH RURAL HEALTH CLINICS AND COLLABORATION WITH OTHER HEALTHCARE PROVIDERS. OUR EFFORT AT ST. JOSEPH'S IS DIRECTED TOWARDS ENHANCING THE ENTIRE WELLBEING OF OUR COMMUNITY, ESPECIALLY THOSE WHO STRUGGLE WITHIN THE ENVIRONMENT. ST. JOSEPH'S SERVES ALL PERSONS IN THE COMMUNITY ON A NON-DISCRIMINATORY BASIS. WE OPERATE A 24-HOUR EMERGENCY ROOM 365 DAYS PER YEAR THAT IS OPEN TO ALL INDIVIDUALS REGARDLESS OF ABILITY TO PAY. ST. JOSEPH'S HAS AN OPEN MEDICAL STAFF, PARTICIPATES IN MEDICARE AND MEDICAID, AND HAS AN ACTIVE CHARITY CARE PROGRAM. COMMUNITY SERVICE HAS ALWAYS BEEN AT THE CORE OF ST. JOSEPH'S ACTIVITIES. THE PROGRAMS AND SERVICES DESCRIBED THROUGHOUT THIS REPORT NOT ONLY SERVE THE COMMUNITY, BUT ALSO REDUCE THE BURDENS ON THE GOVERNMENT. ST. JOSEPH'S HOSPITAL AND HEALTH CENTER IS INCLUDED IN THE OFFICIAL CATHOLIC DIRECTORY AS A TAX-EXEMPT HOSPITAL. COMMUNITY BENEFIT APPROACH LOCATED IN DICKINSON, ND, ST. JOSEPH'S SERVES STARK COUNTY AND THE SURROUNDING AREA, ENCOMPASSING NUMEROUS COUNTIES IN SOUTHWEST NORTH DAKOTA AND COVERS A POPULATION OF APPROXIMATELY 40,000 PEOPLE. STARK COUNTY: JULY 1, 2013 ESTIMATE - POPULATION: 28,212 PERCENT CHANGE FROM APRIL 1, 2010 TO JULY 1, 2013 - 16.6% PERCENT OF PERSONS UNDER 18: 22.8% 7/1/13 PERCENT OF PERSONS 65 AND OLDER: 13.6% 7/1/13 LARGEST POPULATION: WHITE - 94.3% 7/1/13 MEDIAN HOUSEHOLD INCOME: $62,559 7/1/13 PERCENTAGE OF PERSONS LIVING BELOW THE POVERTY LEVEL, 2008-2013 7.8% SOURCE: SMALL AREA INCOME AND POVERTY ESTIMATES; ESTIMATES ARE NOT COMPARABLE TO OTHER GEOGRAPHIC LEVELS OF POVERTY ESTIMATES. SOURCE: AMERICAN COMMUNITY SURVEY - 5 YEAR ESTIMATES. ESTIMATES ARE NOT COMPARABLE TO OTHER GEOGRAPHIC LEVELS OF POVERTY ESTIMATES. CITY OF DICKINSON: 7/1/13 ESTIMATE POPULATION: 20,826 PERCENT CHANGE FROM APRIL 1, 2010 TO JULY 1, 2013 - 16.6% 2010 PERCENT OF PERSONS UNDER 18: 21.0% 2010 PERCENT OF PERSONS 65 AND OLDER: 16.1% 2010 LARGEST POPULATION: WHITE 94.2% MEDIAN HOUSEHOLD INCOME: $62,828 (2008-2013) PERCENTAGE OF PERSONS LIVING BELOW THE POVERTY LEVEL: 7.8% (2008-2013) SOURCE: QUICKFACTS.CENSUS.GOV MUCH OF THE SURROUNDING AREA, INCLUDING MOST OF THE SURROUNDING COUNTIES, ARE DESIGNATED AS PRIMARY CARE HEALTH PROFESSIONAL SHORTAGE AREAS AND MEDICALLY UNDERSERVED AREAS/POPULATIONS BY HRSA. QUALITATIVE DESCRIPTION OF COMMUNITY BENEFIT COMMUNITY EDUCATION AND OUTREACH ST. JOSEPH'S OFFERS COMMUNITY EDUCATION AND SCREENINGS FOR A VARIETY OF DIFFERENT TOPICS SUCH AS ADVANCED DIRECTIVES, PARENT DEPRESSION AWARENESS, LAB SCREENINGS, DRUG EDUCATION, MEDICAL EXPLORERS (MEDICAL CAREERS), INFECTION CONTROL, SPEAKING ENGAGEMENTS ON HEATH TOPICS, AND INFORMATIONAL HEALTH FAIRS. THESE WERE HELD IN PUBLIC SCHOOLS, DICKINSON AND SURROUNDING COMMUNITIES, BUSINESSES, TELEVISION SPOTS, AND RADIO ADS. THESE SERVICES ARE PROVIDED BY ST. JOSEPH'S TO DICKINSON AND THE SURROUNDING AREAS. ST. JOSEPH'S OFFERS A FOUR-WEEK GRIEF-LOSS RECOVERY SERIES SEMINAR. THIS SEMINAR INCLUDES AN OVERVIEW OF THE NATURAL RESPONSES TO GRIEF AND AN INTRODUCTION TO AID IN THE ADJUSTMENT TO GRIEF AND LOSS. AN OPPORTUNITY TO DISCOVER AND STRENGTHEN COPING SKILLS PROVIDES PARTICIPANTS WITH THE ABILITY TO MOVE POSITIVELY TOWARD RECOVERY. ST. JOSEPH'S OFFERS EDUCATION TO EXPECTANT MOTHERS INCLUDING LAMAZE CHILDBIRTH CLASSES, BREAST FEEDING CLASSES, FREE HEARING TESTS ON INFANTS AND TOURS OF BABYKIND, THE LABOR AND DELIVERY AND NURSERY PROGRAM AT ST. JOSEPH'S. COMMUNITY OUTREACH FOR THE BROADER COMMUNITY ST. JOSEPH'S PROVIDES WELLNESS INFORMATION TO THE PUBLIC THROUGH DISPLAYS, WELLNESS SEMINARS AND A WALKING PROGRAM. WELLNESS SEMINARS ARE OFFERED EVERY THIRD TUESDAY OF THE MONTH STARTING AT 2:00 P.M. THOSE ATTENDING CAN GET THEIR BLOOD PRESSURE CHECKED BEFORE THEY SIT BACK TO ENJOY ONE OF THE INFORMATIVE AND HELPFUL SEMINARS. AMONG THE COMMUNITY HEALTH EDUCATION OFFERED AT NO CHARGE ARE DIABETIC EDUCATION, SELF-MONITORING OF BLOOD-GLUCOSE, AND PREPARATION OF ADVANCED DIRECTIVES. ST. JOSEPH'S ALSO COLLABORATES WITH THE SOUTHWEST DISTRICT HEALTH UNIT ON AN ANNUAL COMMUNITY FAIR FOR THE SOUTHWEST PART OF THE STATE, AS WELL AS WITH NUMEROUS PROGRAMS SUCH AS THE GO RED CAMPAIGN FOR WOMEN'S HEART HEALTH IN FEBRUARY AND BREAST CANCER AWARENESS IN OCTOBER. WE ALSO PARTNER WITH OTHER RURAL COMMUNITIES FOR THEIR ANNUAL HEALTH FAIRS, SUCH AS WIBAUX AND KILLDEER. ST. JOSEPH'S AND THE EAGLES CLUB ARE CO-SPONSORS FOR THE COMMUNITY RUN/WALK FOR DIABETES FUNDRAISER AND EDUCATION. WE ARE MAJOR SPONSORS AND SUPPLY A TEAM FOR RELAY FOR LIFE IN JULY, AND HAVE MEMBERSHIP IN HEALTHY 8, AN EIGHT COUNTY HEALTH COALITION, COCO (COALITION FOR LOCAL NON-PROFITS), SASA (SOUTHWEST AREA SAFETY ASSOCIATION), THE HOMELESS COALITION, AND ROTARY CLUB. ST. JOSEPH'S HOSPITAL PARTNERS WITH BOTH HIGH SCHOOLS AND THE UNIVERSITY IN OUR AREA IN ACADEMICS, ATHLETICS AND FINE ARTS. WE HOST COMMUNITY APPRECIATION EVENTS SUCH AS PICNIC IN THE PARK IN AUGUST AND A HOMETOWN BBQS IN KILLDEER AND IN BEACH DURING THE SUMMER MONTHS. WITHIN THE HOSPITAL WE OFFER JUNIOR VOLUNTEERING OPPORTUNITIES TO LOCAL YOUTH, AS WELL AS A JOB SHADOWING PROGRAM AND MEDICAL EXPLORERS FOR STUDENTS WHO ARE CONSIDERING CAREERS IN THE HEALTH FIELD. ST. JOSEPH'S SUPPORTS UNITED WAY, THE BEST FRIEND'S MENTORING PROGRAM AND NUMEROUS NOT-FOR-PROFIT ORGANIZATIONS THROUGH FUNDRAISING, EVENT ATTENDANCE AND SPONSORSHIP. ST. JOSEPH'S CONTINUES TO EXPLORE OPPORTUNITIES FOR COMMUNITY EDUCATION. THESE WELLNESS PROGRAMS FIT IN VERY WELL WITH OUR MISSION TO COLLABORATE WITH OTHER ORGANIZATIONS IN CREATING HEALTHIER COMMUNITIES. Schedule H, Part VI, Line 3, Patient education of eligibility for assistance. ST. JOSEPH'S HOSPITAL AND HEALTH CENTER INCLUDES INFORMATION CONCERNING ITS FINANCIAL ASSISTANCE POLICY ON ITS WEBSITE AND IT IS AVAILABLE UPON REQUEST. IN ADDITION, ST. JOSEPH'S HOSPITAL AND HEALTH CENTER REGISTRATION CLERKS ARE TRAINED TO PROVIDE CONSULTATION TO THOSE WHO HAVE NO INSURANCE OR POTENTIALLY INADEQUATE INSURANCE CONCERNING THEIR FINANCIAL OPTIONS INCLUDING APPLICATION FOR MEDICAID AND FOR FINANCIAL ASSISTANCE UNDER ST. JOSEPH'S HOSPITAL AND HEALTH CENTER'S FINANCIAL ASSISTANCE POLICY. UPON REGISTRATION (AND ONCE ALL EMTALA REQUIREMENTS ARE MET), PATIENTS WHO ARE IDENTIFIED AS UNINSURED (AND NOT COVERED BY MEDICARE OR MEDICAID) ARE PROVIDED WITH A PACKET OF INFORMATION THAT ADDRESSES THE FINANCIAL ASSISTANCE POLICY AND PROCEDURES INCLUDING AN APPLICATION FOR ASSISTANCE. ST. JOSEPH'S HOSPITAL AND HEALTH CENTER REGISTRATION CLERKS READ THE ORGANIZATION'S MEDICAL ASSISTANCE POLICY TO THOSE WHO APPEAR TO BE INCAPABLE OF READING, AND PROVIDE TRANSLATORS FOR NON ENGLISH-SPEAKING INDIVIDUALS. ST. JOSEPH'S HOSPITAL AND HEALTH CENTER'S STAFF WILL ALSO ASSIST THE PATIENT/GUARANTOR WITH APPLYING FOR OTHER AVAILABLE COVERAGE (SUCH AS MEDICAID), IF NECESSARY. COUNSELORS ASSIST MEDICARE ELIGIBLE PATIENTS IN ENROLLMENT BY PROVIDING REFERRALS TO THE APPROPRIATE GOVERNMENT AGENCIES. Schedule H, Part VI, Line 6, Affiliated health care system ST. JOSEPH'S HOSPITAL AND HEALTH CENTER, ALONG WITH ITS AFFILIATED OUTPATIENT FACILITIES, ARE PART OF CATHOLIC HEALTH INITIATIVES. CATHOLIC HEALTH INITIATIVES (CHI) IS A NATIONAL FAITH-BASED NONPROFIT HEALTH CARE ORGANIZATION WITH HEADQUARTERS IN ENGLEWOOD, COLORADO. CHI'S EXEMPT PURPOSE IS TO SERVE AS AN INTEGRAL PART OF ITS NATIONAL SYSTEM OF HOSPITALS AND OTHER CHARITABLE ENTITIES, WHICH ARE DESCRIBED AS MARKET-BASED ORGANIZATIONS, OR MBOS. AN MBO IS A DIRECT PROVIDER OF CARE OR SERVICES WITHIN A DEFINED MARKET AREA THAT MAY BE AN INTEGRATED HEALTH SYSTEM AND/OR A STAND-ALONE HOSPITAL OR OTHER FACILITY OR SERVICE PROVIDER. CHI SERVES AS THE PARENT CORPORATION OF ITS MBOS WHICH ARE COMPRISED OF 92 HOSPITALS, INCLUDING FOUR ACADEMIC MEDICAL CENTERS, AND 24 CRITICAL ACCESS FACILITIES; COMMUNITY HEALTH SERVICE ORGANIZATIONS; ACCREDITED NURSING COLLEGES; HOME HEALTH AGENCIES; AND OTHER FACILITIES THAT SPAN THE INPATIENT AND OUTPATIENT CONTINUUM OF CARE. TOGETHER, THESE FACILITIES PROVIDED $910 MILLION IN CHARITY CARE AND COMMUNITY BENEFIT IN THE 2014 FISCAL YEAR, INCLUDING SERVICES FOR THE POOR, FREE CLINICS, EDUCATION AND RESEARCH. CHI PROVIDES STRATEGIC PLANNING AND MANAGEMENT SERVICES AS WELL AS CENTRALIZED "SHARED SERVICES" FOR THE MBOS. THE PROVISION OF CENTRALIZED MANAGEMENT AND SHARED SERVICES - INCLUDING AREAS SUCH AS ACCOUNTING, HUMAN RESOURCES, PAYROLL AND SUPPLY CHAIN -- PROVIDES ECONOMIES OF SCALE AND PURCHASING POWER TO THE MBOS. THE COST SAVINGS ACHIEVED THROUGH CHI'S CENTRALIZATION ENABLE MBOS TO DEDICATE ADDITIONAL RESOURCES TO HIGH-QUALITY HEALTH CARE AND COMMUNITY OUTREACH SERVICES TO THE MOST VULNERABLE MEMBERS OF OUR SOCIETY. ST. JOSEPH'S HOSPITAL AND HEALTH CENTER OPERATES WITH ITS WHOLLY OWNED AFFILIATES AND COMMUNITY PARTNERS, ALONG WITH ITS FUNDRAISING ARM, THE ST. JOSEPH'S HOSPITAL FOUNDATION, TO SERVE THE HEALTH CARE NEEDS OF THE DICKINSON, ND COMMUNITIES. Schedule H, Part VI, Line 7, State filing of community benefit report ND false true false false false false false false false REED REYMAN PRESIDENT/CEO 0 180086 0 31496 0 36659 0 33799 0 14197 0 296237 0 14427 JEFFREY DROP BOARD MEMBER/CHI SVP DIVISION OFFICER 0 425696 0 343145 0 58698 0 96266 0 22006 0 945811 0 33686 STEPHANIE E FRANKEN CFO 80423 48108 12000 0 2429 12 0 12578 9510 19001 104362 79699 0 0 ROBERT S RIDDICK PHYSICIAN 411234 0 0 0 17885 0 20952 0 17102 0 467173 0 0 0 SHELDON L SWENSON PHYSICIAN 418384 0 0 0 7090 0 20952 0 22958 0 469384 0 0 0 MICHAEL L CASSIDY PHYSICIAN 379639 0 0 0 5516 0 20952 0 14038 0 420145 0 0 0 DAVID KUYLEN PHYSICIAN 374694 0 0 0 4785 0 20952 0 23005 0 423436 0 0 0 COLLEEN LENNARD-LOVE PHYSICIAN 333164 0 0 0 22534 0 20952 0 20005 0 396655 0 0 0 Schedule J, Part I, Line 3, Arrangement used to establish the top management official's compensation COMPENSATION FOR THE TOP MANAGEMENT OFFICIAL WAS ESTABLISHED AND PAID BY CATHOLIC HEALTH INITIATIVES (CHI), A RELATED ORGANIZATION. CHI USED THE FOLLOWING TO ESTABLISH THE TOP MANAGEMENT OFFICIAL'S COMPENSATION: (1) COMPENSATION COMMITTEE; (2) INDEPENDENT COMPENSATION CONSULTANT; (3) WRITTEN EMPLOYMENT CONTRACTS; (4) COMPENSATION SURVEY OR STUDY; (5) APPROVAL BY THE BOARD OR COMPENSATION COMMITTEE. SCHEDULE J, PART I, LINE 4, POST-TERMINATION PAYMENTS POST-TERMINATION PAYMENTS ARE ADDRESSED IN EXECUTIVE EMPLOYMENT AGREEMENTS FOR CATHOLIC HEALTH INITIATIVES ("CHI") AND RELATED ORGANIZATIONS' EMPLOYEES AT THE LEVEL OF VICE PRESIDENT AND ABOVE, INCLUDING THE MBO CEOS. THESE EMPLOYMENT AGREEMENTS REQUIRE THAT IN ORDER FOR THE EXECUTIVE TO RECEIVE POST-TERMINATION PAYMENTS, THESE INDIVIDUALS MUST EXECUTE A GENERAL RELEASE AND SETTLEMENT AGREEMENT. POST-TERMINATION PAYMENT ARRANGEMENTS ARE PERIODICALLY REVIEWED FOR OVERALL REASONABLENESS IN LIGHT OF THE EXECUTIVE'S OVERALL COMPENSATION PACKAGE. NO REPORTABLE INDIVIDUALS RECEIVED A POST-TERMINATION PAYMENT IN CALENDAR YEAR 2013. Schedule J, Part I, Line 4b, Supplemental nonqualified retirement plan DURING THE 2013 CALENDAR YEAR CATHOLIC HEALTH INITIATIVES (CHI), A RELATED ORGANIZATION, MAINTAINED A SUPPLEMENTAL NON-QUALIFIED DEFERRED COMPENSATION PLAN FOR MBO CEOS AND OTHER CHI EMPLOYEES AT THE LEVEL OF SENIOR VICE PRESIDENT AND ABOVE. THE FOLLOWING REPORTABLE INDIVIDUALS WERE ELIGIBLE TO PARTICIPATE IN THAT PLAN: REED REYMAN, JEFFREY DROP INCLUDE IF APPLICABLE: DURING 2013 THE FOLLOWING CONTRIBUTIONS WERE MADE BY CHI TO THE DEFERRED COMPENSATION PLAN: REED REYMAN - $15,748 JEFFREY DROP - $67,664 INCLUDE IF APPLICABLE: DURING 2013 THE FOLLOWING DISTRIBUTIONS WERE MADE BY CHI FROM THE DEFERRED COMPENSATION PLAN: REED REYMAN - $14,427 JEFFREY DROP - $33,686 COLLEEN LENNARD-LOVE EMPLOYEE SIGNING ADVANCE X 40000 18064 false true true ROBERT RIDDICK EMPLOYEE SIGNING ADVANCE X 40000 2731 false true true 20795 FORM 990, PART III, LINE 1, ORGANIZATION'S MISSION THE MISSION OF THE CORPORATION IS TO NURTURE THE HEALING MINISTRY OF THE CHURCH, SUPPORTED BY EDUCATION AND RESEARCH. FIDELITY TO THE GOSPEL URGES THE CORPORATION TO EMPHASIZE HUMAN DIGNITY AND SOCIAL JUSTICE AS IT CREATES HEALTHIER COMMUNITIES. THE CORPORATION, SPONSORED BY A LAY-RELIGIOUS PARTNERSHIP, CALLS OTHER CATHOLIC SPONSORS AND SYSTEMS TO UNITE TO ENSURE THE FUTURE OF CATHOLIC HEALTH CARE. TO FULFILL THIS MISSION, THE CORPORATION, AS A VALUES-BASED ORGANIZATION, WILL ASSURE THE INTEGRITY OF THE MINISTRY IN BOTH CURRENT AND DEVELOPING ORGANIZATIONS AND ACTIVITIES; RESEARCH AND DEVELOP NEW MINISTRIES THAT INTEGRATE HEALTH, EDUCATION, PASTORAL, AND SOCIAL SERVICES; PROMOTE LEADERSHIP DEVELOPMENT AND FORMATION FOR MINISTRY THROUGHOUT THE ENTIRE ORGANIZATION; ADVOCATE FOR SYSTEMIC CHANGES WITH SPECIFIC CONCERN FOR PERSONS WHO ARE POOR, ALIENATED, AND UNDERSERVED; AND STEWARD RESOURCES BY GENERAL OVERSIGHT OF THE ENTIRE ORGANIZATION. Form 990, Part VI, Sec A, Line 1a, Delegate broad authority to a committee PURSUANT TO THE CORPORATION'S BYLAWS, THE EXECUTIVE COMMITTEE IS COMPOSED OF THE BOARD CHAIR, THE BOARD VICE CHAIR AND THE PRESIDENT, EACH OF WHOM SHALL SERVE AS AN EX OFFICIO VOTING MEMBER OF THE EXECUTIVE COMMITTEE, AND TWO VOTING MEMBERS APPOINTED BY THE BOARD OF DIRECTORS. EACH INDIVIDUAL APPOINTED TO THE EXECUTIVE COMMITTEE SHALL SERVE FOR A TERM OF ONE YEAR OR UNTIL HIS OR HER SUCCESSOR IS DULY APPOINTED BY THE BOARD OF DIRECTORS. THE EXECUTIVE COMMITTEE SHALL CONSIST OF ONLY DIRECTORS OF THE CORPORATION. PURSUANT TO THE CORPORATION'S BYLAWS, COMMITTEES, SUCH AS THE EXECUTIVE COMMITTEE, THAT ARE GRANTED THE AUTHORITY TO ACT ON BEHALF OF THE BOARD OF DIRECTORS MAY INCLUDE ONLY DIRECTORS OF THE CORPORATION. FURTHER, PURSUANT TO THE CORPORATION'S BYLAWS, THE EXECUTIVE COMMITTEE HAS AND MAY EXERCISE SUCH POWERS AS MAY BE DELEGATED TO IT BY THE BOARD OF DIRECTORS. THE EXECUTIVE COMMITTEE ALSO POSSESSES THE POWER TO TRANSACT ROUTINE BUSINESS OF THE CORPORATION IN THE INTERIM PERIOD BETWEEN REGULARLY SCHEDULED MEETINGS OF THE BOARD OF DIRECTORS. Form 990, Part VI, Sec A, Line 6, Classes of members or stockholders ACCORDING TO THE BYLAWS OF ST. JOSEPH'S HOSPITAL AND HEALTH CENTER, THE ENTITY'S SOLE MEMBER IS CATHOLIC HEALTH INITIATIVES, A COLORADO NONPROFIT CORPORATION. Form 990, Part VI, Sec A, Line 7a, Members or stockholders electing members of governing body ACCORDING TO THE ORGANIZATION'S BYLAWS, DIRECTORS SHALL BE APPOINTED OR REFUSED BY THE CORPORATE MEMBER. THE CORPORATE MEMBER MAY APPOINT ONE OR MORE INDIVIDUALS TO THE BOARD OF DIRECTORS, AND MAY AT ANY TIME REMOVE, WITH OR WITHOUT CAUSE, ANY MEMBER OF THE BOARD OF DIRECTORS. ACCORDING TO THE ORGANIZATION'S BYLAWS, DIRECTORS OF THE CORPORATION SHALL BE APPOINTED BY THE CORPORATE MEMBER NO LATER THAN JUNE 30 OF EACH YEAR. THE NAMES AND QUALIFICATIONS OF EACH INDIVIDUAL ACCEPTED BY THE BOARD OF DIRECTORS SHALL BE SUBMITTED TO THE CORPORATE MEMBER, WHO SHALL APPOINT OR REFUSE EACH NOMINEE IN ACCORDANCE WITH THE CORPORATE MEMBER'S BYLAWS AND WITH ENDORSEMENT OF THE SENIOR VICE PRESIDENT OF OPERATIONS. THE CORPORATE MEMBER MAY UNILATERALLY APPOINT ONE OR MORE INDIVIDUALS TO THE BOARD OF DIRECTORS SHOULD THE BOARD FAIL TO FURNISH THE CORPORATE MEMBER WITH A LIST OF INDIVIDUALS QUALIFIED TO SERVE ON THE BOARD OF DIRECTORS OF THE CORPORATION. Form 990, Part VI, Sec A, Line 7b, Decisions requiring approval by members or stockholders THE ORGANIZATION'S CORPORATE MEMBER IS CATHOLIC HEALTH INITIATIVES ("CHI"). PURSUANT TO SECTION 5.4 OF THE ORGANIZATION'S BYLAWS, THE CORPORATE MEMBER SHALL HAVE THE SPECIFIC RIGHTS SET FORTH IN THE GOVERNANCE MATRIX. PURSUANT TO THE GOVERNANCE MATRIX THE FOLLOWING RIGHTS ARE RESERVED TO THE CHI BOARD DIRECTLY OR THROUGH POWERS DELEGATED TO THE CHI CHIEF EXECUTIVE OFFICER: - SUBSTANTIAL CHANGE IN THE MISSION OR PHILOSOPHY OF SJHHC. - AMENDMENT OF THE CORPORATE DOCUMENTS OF SJHHC. - APPROVE MEMBERS OF THE SJHHC BOARD. - REMOVAL OF A MEMBER OF THE GOVERNING BODY OF SJHHC. - APPROVAL OF ISSUANCE OF DEBT BY SJHHC. - APPROVAL OF PARTICIPATION OF SJHHC IN A JOINT VENTURE. - APPROVAL OF FORMATION OF A NEW CORPORATION BY SJHHC. - APPROVAL OF A MERGER INVOLVING SJHHC. - APPROVAL OF THE SALE OF ALL OR SUBSTANTIALLY ALL OF THE ASSETS OF SJHHC. - TO REQUIRE THE TRANSFER OF ASSETS BY SJHHC TO CHI TO ACCOMPLISH CHI'S GOALS AND OBJECTIVES, AND TO SATISFY CHI DEBTS. - ADOPTION OF LONG RANGE AND STRATEGIC PLANS FOR SJHHC. PURSUANT TO SECTION 5.5 OF THE ORGANIZATION'S BYLAWS, CHI MAY, IN EXERCISE OF ITS APPROVAL POWERS, GRANT OR WITHHOLD APPROVAL IN WHOLE OR IN PART, OR MAY, IN ITS COMPLETE DISCRETION, AFTER CONSULTATION WITH THE BOARD AND THE PRESIDENT AND CHIEF EXECUTIVE OFFICER OF THE ORGANIZATION, RECOMMEND SUCH OTHER OR DIFFERENT ACTIONS AS IT DEEMS APPROPRIATE. Form 990, Part VI, Sec B, Line 11b, Review of form 990 by governing body THE ORGANIZATION'S ACCOUNTING PERSONNEL WORK WITH THE CHI TAX DEPARTMENT TO PREPARE THE FORM 990. THE PRESIDENT, VP OF OPERATIONAL FINANCE, AND ACCOUNTING STAFF WILL REVIEW THE COMPLETED FORM 990 WHEN IT IS AVAILABLE. THE FORM 990 IS THEN PROVIDED TO THE BOARD OF DIRECTORS AND ANY NECESSARY REVISIONS WILL BE INCLUDED IN THE FINAL VERSION THAT IS APPROVED FOR FILING. SUBSEQUENT TO THE RETURN BEING PROVIDED TO THE BOARD, THE TAX DEPARTMENT FILES THE RETURN WITH THE APPROPRIATE FEDERAL AND STATE AGENCIES, MAKING ANY NON-SUBSTANTIVE CHANGES NECESSARY TO EFFECT E-FILING. ANY SUCH CHANGES ARE NOT RE-SUBMITTED TO THE BOARD. Form 990, Part VI, Sec B, Line 12c, Conflict of interest policy ST. JOSEPH'S HOSPITAL AND HEALTH CENTER ("SJHHC") HAD IN EFFECT FOR FISCAL YEAR 2014 A CONFLICT OF INTEREST POLICY COVERING ALL DIRECTORS AND OFFICERS HOLDING THE TITLE OF VICE-PRESIDENT OR ABOVE. THE POLICY PLACES ON EACH DIRECTOR A GENERAL OBLIGATION TO DISCLOSE TO THE CHAIR OF THE BOARD OF DIRECTORS ANY SITUATION THAT MAY CREATE A CONFLICT OF INTEREST AS SOON AS HE OR SHE BECOMES AWARE OF SUCH SITUATION. IN THE CASE OF AN OFFICER, DISCLOSURE MUST BE MADE TO THE PRESIDENT OF SJHHC WHO HAS A DUTY TO REPORT SUCH DISCLOSURE TO THE BOARD CHAIR. IN ANY SITUATION WHERE THE DIRECTOR OR OFFICER IS IN DOUBT ABOUT WHETHER A CONFLICT OF INTEREST EXISTS, FULL DISCLOSURE SHOULD BE MADE SO AS TO PERMIT AN IMPARTIAL AND OBJECTIVE DETERMINATION. THE POLICY REQUIRES A WRITTEN RECORD OF THE DISCLOSURE TO BE MADE. IN ADDITION TO THE ONGOING DISCLOSURE OBLIGATION, ALL DIRECTORS AND OFFICERS ARE REQUIRED TO AT LEAST ANNUALLY COMPLETE, SIGN, AND RETURN A CONFLICT OF INTEREST DISCLOSURE STATEMENT. THE COMPLETED STATEMENTS WILL BE REVIEWED BY THE PRESIDENT AND THE BOARD CHAIR. THE BOARD CHAIR OR DESIGNEE SHALL MAKE FURTHER INVESTIGATION OF CONFLICT OF INTEREST DISCLOSURES AS HE OR SHE MAY DEEM APPROPRIATE. BASED ON REVIEW AND EVALUATION OF THE RELEVANT FACTS AND CIRCUMSTANCES, THE BOARD CHAIR WILL MAKE AN INITIAL DETERMINATION AS TO WHETHER A CONFLICT OF INTEREST EXISTS AND WHETHER REVIEW AND APPROVAL OR OTHER ACTION BY THE BOARD OF DIRECTORS IS REQUIRED. A WRITTEN RECORD OF THE BOARD CHAIR'S DETERMINATION, INCLUDING RELEVANT FACTS AND CIRCUMSTANCES, WILL BE MADE. THE BOARD CHAIR SHALL THEN MAKE AN APPROPRIATE REPORT TO THE EXECUTIVE COMMITTEE OF THE BOARD CONCERNING SUCH REVIEW, EVALUATION, AND DETERMINATION. DIFFERENCES OF OPINION BETWEEN THE BOARD CHAIR AND ANOTHER DIRECTOR OR OFFICER AS TO WHETHER THE FACTS AND CIRCUMSTANCES OF A GIVEN SITUATION CONSTITUTE A CONFLICT OF INTEREST OR WHETHER THE BOARD'S REVIEW AND APPROVAL OR OTHER ACTION IS REQUIRED, THE MATTER SHALL BE SUBMITTED TO THE BOARD'S EXECUTIVE COMMITTEE WHICH SHALL MAKE A FINAL DETERMINATION AS TO THE MATTER PRESENTED. SUCH DETERMINATION, INCLUDING RELEVANT FACTS AND CIRCUMSTANCES, WILL BE REFLECTED IN THE COMMITTEE MINUTES AND WILL BE REPORTED TO THE BOARD OF DIRECTORS. THE BOARD OF DIRECTORS WILL CAREFULLY REVIEW AND SCRUTINIZE THE CONFLICT OF INTEREST AND MUST, IN GOOD FAITH, TAKE WHATEVER ACTION IS DEEMED APPROPRIATE UNDER THE CIRCUMSTANCES WITH RESPECT TO THE DIRECTOR OR OFFICER IN ORDER TO PROTECT THE INTERESTS OF THE CORPORATION. SUCH ACTION IS DETERMINED BY A MAJORITY VOTE OF THE BOARD, WITHOUT COUNTING THE VOTE OF THE DIRECTOR OR OFFICER (IF A VOTING MEMBER OF THE BOARD) INVOLVED IN THE CONFLICT OF INTEREST. WHEN CONFLICTS OF INTEREST ARE CONSIDERED BY THE BOARD, THE DIRECTOR OR OFFICER MUST DISCLOSE ALL OF THE MATERIAL FACTS TO THE BOARD. THE DIRECTOR OR OFFICER SHALL NOT VOTE OR USE HIS OR HER PERSONAL INFLUENCE ON THE MATTER. THE DIRECTOR OR OFFICER SHALL BE EXCUSED FROM THE MEETING DURING DISCUSSION AND VOTE ON THE CONFLICT OF INTEREST. MINUTES OF THE BOARD OF DIRECTORS SHALL REFLECT THE FOLLOWING: THE INDIVIDUAL MAKING THE DISCLOSURE, THE NATURE OF THE DISCLOSURE, DISCUSSION REGARDING ANY PROPOSED TRANSACTION, THE DECISION MADE BY THE BOARD, AND THAT THE INTERESTED DIRECTOR OR OFFICER (IF A VOTING MEMBER OF THE BOARD) ABSTAINED FROM VOTING. FORM 990, PART VI, LINE 14, WRITTEN DOCUMENT RETENTION AND DESCRUCTION POLICY ST. JOSEPH'S HOSPITAL AND HEALTH CENTER HAS A DOCUMENT RETENTION AND DESTRUCTION POLICY THAT IT FOLLOWS; HOWEVER, THE POLICY HAS NOT BEEN FORMALLY ADOPTED BY THE BOARD OF DIRECTORS. Form 990, Part VI, Sec B, Line 15a, Process to establish compensation of top management official THE ORGANIZATION'S CEO'S COMPENSATION IS PAID BY CHI. CHI HAS A DEFINED COMPENSATION PHILOSOPHY. BOTH THE EXECUTIVE AND NON-EXECUTIVE COMPENSATION STRUCTURES AND RANGES ARE REVIEWED ANNUALLY IN COMPARISON TO MARKET DATA. CHI USES THE HAY GROUP AS THE INDEPENDENT THIRD PARTY TO ASSESS EXECUTIVE COMPENSATION PROGRAMS AND TO ENSURE THE REASONABLENESS OF ACTUAL SALARIES AND TOTAL COMPENSATION PACKAGES. COMPENSATION OF THE SENIOR MOST EXECUTIVES IS REVIEWED ANNUALLY. THE HAY GROUP REVIEWS BOTH CASH AND TOTAL COMPENSATION FOR OVERALL REASONABLENESS, FOR ADHERENCE TO CHI'S COMPENSATION PHILOSOPHY, AND FOR COMPARABILITY TO THE NOT-FOR-PROFIT HEALTHCARE MARKET. THIS INDEPENDENT REVIEW IS DELIVERED BY HAY GROUP TO THE HR COMMITTEE OF THE CHI BOARD OF STEWARDSHIP TRUSTEES ANNUALLY AT THEIR SEPTEMBER MEETING AND MINUTES ARE SHARED WITH THE FULL BOARD AT THE DECEMBER MEETING. THE LAST REVIEW WAS SEPTEMBER 18, 2014. IN ADDITION, IN DECEMBER 2009, HAY GROUP COMPLETED A COMPREHENSIVE REVIEW OF ALL POSITIONS AT THE LEVEL OF VICE PRESIDENT AND ABOVE TO DETERMINE AND VALIDATE APPROPRIATE COMPENSATION LEVELS. THESE LEVELS HAVE BEEN REVIEWED ANNUALLY SINCE AND REVISED BASED ON MARKET DATA, WHERE APPLICABLE. Form 990, Part VI, Sec B, Line 15b, Process to establish compensation of other employees THE ORGANIZATION'S OTHER OFFICERS' COMPENSATION ARE PAID BY EITHER ST. JOSEPH'S HOSPITAL AND HEALTH CENTER ("ST. JOSEPH'S HOSPITAL") OR THE NATIONAL OFFICE. COMPENSATION OF ST. JOSEPH'S HOSPITAL'S SENIOR MOST EXECUTIVES IS DETERMINED BY THE CHI FARGO DIVISION HUMAN RESOURCES DEPARTMENT IN CONJUNCTION WITH THE ST. JOSEPH'S HOSPITAL HUMAN RESOURCES DEPARTMENT AND ARE ANNUALLY REVIEWED ON AN INDIVIDUAL BASIS. BOTH CASH AND TOTAL COMPENSATION ARE REVIEWED FOR OVERALL REASONABLENESS, FOR ADHERENCE TO THE FARGO DIVISION'S AND ST. JOSEPH'S HOSPITAL'S COMPENSATION PHILOSOPHIES, FOR COMPARABILITY WITH SIMILAR POSITIONS INCLUDED IN THE SALARY SURVEYS LISTED BELOW, AND FOR COMPARABILITY WITH OTHER AFFILIATED FACILITIES IN THE FARGO DIVISION. SALARY SURVEY INFORMATION FROM THE HHRAM SALARY SURVEY, THE SULLIVAN COTTER & ASSOCIATES SALARY SURVEY, AND THE MANAGER AND EXECUTIVE HOSPITAL AND HEALTH SYSTEM SURVEY ARE USED TO PROVIDE A LEVEL OF INDEPENDENT THIRD-PARTY ASSESSMENT OF EXECUTIVE COMPENSATION PROGRAMS AND TO ENSURE REASONABLENESS OF ACTUAL SALARIES AND TOTAL COMPENSATION PACKAGES. FINAL APPROVAL OF COMPENSATION FOR ST. JOSEPH'S HOSPITAL'S SENIOR MANAGEMENT TEAM POSITIONS IS GIVEN BY THE FARGO DIVISION HUMAN RESOURCES DEPARTMENT, THE FARGO DIVISION SVP, AND THE ST. JOSEPH'S HOSPITAL CEO AND IS DOCUMENTED ON THE APPROPRIATE COMPENSATION APPROVAL FORMS AND ANNUAL EMPLOYEE PERFORMANCE EVALUATIONS. IN SEPTEMBER 2012, THE FARGO DIVISION HUMAN RESOURCES DEPARTMENT AND THE ST. JOSEPH'S HOSPITAL HUMAN RESOURCES DEPARTMENT COMPLETED A REVIEW OF ALL ST. JOSEPH'S HOSPITAL'S SENIOR MANAGEMENT TEAM POSITIONS TO DETERMINE AND VALIDATE APPROPRIATE COMPENSATION LEVELS. Form 990, Part VI, Sec C, Line 19, Required documents available to the public THE ORGANIZATION'S ORGANIZING DOCUMENTS AND CONFLICT OF INTEREST POLICY ARE NOT PUBLICLY AVAILABLE. THE ORGANIZATION'S FINANCIAL STATEMENTS ARE INCLUDED IN THE CATHOLIC HEALTH INITIATIVES' CONSOLIDATED AUDITED FINANCIAL STATEMENTS AVAILABLE AT WWW.CATHOLICHEALTHINIT.ORG OR AT HTTP://WWW.DACBOND.COM. Form 990, Part IX, Line 11g, Other Expenses OTHER FEES FOR SERVICES - TOTAL EXPENSE: 2694896, PROGRAM SERVICE EXPENSE: 2194925, MANAGEMENT AND GENERAL EXPENSES: 499971, FUNDRAISING EXPENSES: ; CONTRACT LABOR - TOTAL EXPENSE: 4565803, PROGRAM SERVICE EXPENSE: 3718732, MANAGEMENT AND GENERAL EXPENSES: 847071, FUNDRAISING EXPENSES: ; CONTRACT SERVICES - TOTAL EXPENSE: 5938161, PROGRAM SERVICE EXPENSE: 4836480, MANAGEMENT AND GENERAL EXPENSES: 1101681, FUNDRAISING EXPENSES: ; ALEGENT CREIGHTON CLINIC 12809 W DODGE RD OMAHA NE 68154 470765154 HEALTHCARE NE 501(C)(3) 3 ACH true ALEGENT CREIGHTON HEALTH 12809 W DODGE RD OMAHA NE 68154 470757164 HEALTHCARE NE 501(C)(3) 3 CHI NEBRASKA true ALEGENT CREIGHTON HEALTH FOUNDATION 12809 W DODGE RD OMAHA NE 68154 470648586 FUNDRAISING NE 501(C)(3) 7 ACH true ALEGENT HEALTH - BERGAN MERCY HEALTH SYSTEM 7500 MERCY RD OMAHA NE 68124 470484764 HEALTHCARE NE 501(C)(3) 3 CHI NEBRASKA true ALEGENT HEALTH - COMMUNITY MEMORIAL HOSPITAL OF MISSOURI VALLEY IA 631 N 8TH ST MISSOURI VALLEY IA 51555 420776568 HEALTHCARE IA 501(C)(3) 3 CHI NEBRASKA true ALEGENT HEALTH - IMMANUEL MEDICAL CENTER 6901 N 72ND ST OMAHA NE 68122 470376615 HEALTHCARE NE 501(C)(3) 3 CHI NEBRASKA true ALEGENT HEALTH - MEMORIAL HOSPITAL SCHUYLER 104 W 17TH ST SCHUYLER NE 68661 470399853 HEALTHCARE NE 501(C)(3) 3 CHI NEBRASKA true ALEGENT HEALTH - MERCY HOSPITAL CORNING IOWA PO BOX 368 CORNING IA 50841 420782518 HEALTHCARE IA 501(C)(3) 3 CHI NEBRASKA true ALVERNA APARTMENTS 300 SE 8TH AVE LITTLE FALLS MN 56345 411351177 LTERM CARE MN 501(C)(3) 9 CHI true APPLETREE COURT 601 OAK ST BRECKENRIDGE MN 56520 411850500 SENIOR LIVING MN 501(C)(3) 9 SFH true BISHOP DRUMM RETIREMENT CENTER 1111 6TH AVE DES MOINES IA 50314 420725196 LTERM CARE IA 501(C)(3) 9 CHI-IA CORP true BORNEMANN HEALTHCARE CORPORATION 2500 BERNVILLE RD PO BOX 316 READING PA 19603 232187242 HEALTHCARE PA 501(C)(3) 11 - Type I CHI true CARRINGTON HEALTH CENTER 800 N 4TH ST CARRINGTON ND 58421 450227311 HEALTHCARE ND 501(C)(3) 3 CHI true CATHOLIC HEALTH INITIATIVES 198 INVERNESS DRIVE WEST ENGLEWOOD CO 80112 470617373 HEALTHCARE CO 501(C)(3) 9 NA true CATHOLIC HEALTH INITIATIVES - COLORADO 188 INVERNESS DRIVE WEST STE 500 ENGLEWOOD CO 80112 840405257 HEALTHCARE CO 501(C)(3) 3 CHI true CATHOLIC HEALTH INITIATIVES - IOWA CORP 1111 6TH AVE DES MOINES IA 50314 420680448 HEALTHCARE IA 501(C)(3) 3 CHI true CATHOLIC HEALTH INITIATIVES COLORADO FOUNDATION 6385 CORPORATE DR STE 301 COLORADO SPRINGS CO 80919 840902211 FUNDRAISING CO 501(C)(3) 7 CHIC true CATHOLIC HEALTH INITIATIVES NATIONAL FOUNDATION 6385 CORPORATE DR COLORADO SPRINGS CO 80919 270930004 FUNDRAISING CO 501(C)(3) 11 - Type I CHI true CATHOLIC HEALTH INITIATIVES VIRTUAL HEALTH SERVICES 198 INVERNESS DRIVE WEST ENGLEWOOD CO 80112 460992796 HEALTHCARE CO 501(C)(3) 11 - Type I CHINS true CENTENNIAL MEDICAL GROUP INC 2700 STEWART PKWY ROSEBURG OR 97471 263946191 PHYSICIANS OR 501(C)(3) 9 MMC true CENTRAL KANSAS MEDICAL CENTER 3515 BROADWAY GREAT BEND KS 67530 480543724 SURGERY CENTER KS 501(C)(3) 3 CHI true CHI HEALTH CONNECT AT HOME - FARGO 4816 AMBER VALLEY PKWY S FARGO ND 58104 271966847 HEALTHCARE MN 501(C)(3) 9 CHI true CHI INSTITUTE FOR RESEARCH AND INNOVATION 198 INVERNESS DRIVE WEST ENGLEWOOD CO 80112 271050565 HEALTHCARE CO 501(C)(3) 11 - Type I CHI true CHI KENTUCKY INC 3900 OLYMPIC BLVD STE 400 ERLANGER KY 41018 202741651 HEALTHCARE KY 501(C)(3) 11 - Type I CHI true CHI NATIONAL HOME CARE 198 INVERNESS DRIVE WEST ENGLEWOOD CO 80112 451261716 HEALTHCARE CO 501(C)(3) 9 CHI NS true CHI NATIONAL SERVICES 198 INVERNESS DRIVE WEST ENGLEWOOD CO 80112 452532084 HEALTHCARE CO 501(C)(3) 11 - Type I CHI true CHI NEBRASKA 6940 O ST STE 200 LINCOLN NE 68510 363233121 HEALTHCARE NE 501(C)(3) 11 - Type III - FI CHI true CHI ST LUKE'S HEALTH BAYLOR COLLEGE OF MEDICINE MEDICAL CENTER 6624 FANNIN ST HOUSTON TX 77030 741161938 HEALTHCARE TX 501(C)(3) 3 SLHS true CHI ST VINCENT HOSPITAL HOT SPRINGS 300 WERNER ST HOT SPRINGS AR 71913 710236913 HEALTHCARE AR 501(C)(3) 3 CHISVHS true CHI ST VINCENT HOT SPRINGS 300 WERNER ST HOT SPRINGS AR 71913 261125064 HOLDING CO AR 501(C)(3) 11 - Type II SVIMC true CHI ST VINCENT MEDICAL GROUP HOT SPRINGS 1 MERCY LANE STE 201 HOT SPRINGS AR 71913 261125131 HEALTHCARE AR 501(C)(3) 3 CHISVHS true COMMUNITY LIMITED CARE DIALYSIS CENTER 619 OAK ST ACCOUNTING-3 W CINCINNATI OH 45206 237419853 HOLDING CO OH 501(C)(2) N/A GSH true COMMUNITY MEMORIAL HOSPITAL MEDICAL SERVICE FOUNDATION 631 N 8TH ST MISSOURI VALLEY IA 51555 421294399 FUNDRAISING IA 501(C)(3) 11 - Type I AH-CMHMV true CONTINUING CARE HOSPITAL 150 NORTH EAGLE CREEK DR LEXINGTON KY 40509 611400619 LT ACH KY 501(C)(3) 3 SJHS true COVENANT HOME CARE 198 INVERNESS DRIVE WEST ENGLEWOOD CO 80112 232028429 HOME HEALTH PA 501(C)(3) 11 - Type II CHI NHC true ENUMCLAW REGIONAL HOSPITAL ASSOCIATION 1450 BATTERSBY AVE ENUMCLAW WA 98022 910715805 HEALTHCARE WA 501(C)(3) 3 FHS true FLAGET HEALTHCARE INC 4305 NEW SHEPHERDSVILLE RD BARDSTOWN KY 40004 611345363 HEALTHCARE KY 501(C)(3) 3 KOH true FLAGET MEMORIAL HOSPITAL FOUNDATION INC 4305 NEW SHEPHERDSVILLE RD BARDSTOWN KY 40004 562351341 FUNDRAISING KY 501(C)(3) 11 - Type I FH true FRANCISCAN FOUNDATION 1717 SOUTH J ST TACOMA WA 98405 911145592 FUNDRAISING WA 501(C)(3) 9 FHS true FRANCISCAN HEALTH SYSTEM 1717 SOUTH J ST TACOMA WA 98405 910564491 HEALTHCARE WA 501(C)(3) 3 CHI true FRANCISCAN HEALTH VENTURES FKA SJMGROUP TACOMA FNC CTR BLDG 1145 BROADWAY TACOMA WA 98402 431882377 PHYSICIANS MO 501(C)(3) 9 CHI true FRANCISCAN MEDICAL GROUP 1313 BROADWAY STE 200 TACOMA WA 98402 911939739 HEALTHCARE WA 501(C)(3) 9 FHS true FRANCISCAN VILLA OF SOUTH MILWAUKEE INC 3601 S CHICAGO AVE SOUTH MILWAUKEE WI 53172 391093829 HEALTHCARE WI 501(C)(3) 9 CHI true GLOBAL HEALTH INITIATIVES 198 INVERNESS DRIVE WEST ENGLEWOOD CO 80112 201536108 MINISTRIES CO 501(C)(3) 11 - Type I CHI true GOOD SAMARITAN COLLEGE OF NURSING & HEALTH SCIENCE 619 OAK ST ACCOUNTING-3 W CINCINNATI OH 45206 311778403 EDUCATION OH 501(C)(3) 2 GSH true GOOD SAMARITAN FOUNDATION OF CINCINNATI INC 619 OAK ST ACCOUNTING-3 W CINCINNATI OH 45206 311206047 FUNDRAISING OH 501(C)(3) 11 - Type I GSH true GOOD SAMARITAN HOSPITAL PO BOX 1990 KEARNEY NE 68848 470379755 HEALTHCARE NE 501(C)(3) 3 CHI NEBRASKA true GOOD SAMARITAN HOSPITAL FOUNDATION 111 W 31ST ST KEARNEY NE 68847 470659443 FUNDRAISING NE 501(C)(3) 7 GSH true GOOD SAMARITAN HOSPITAL FOUNDATION - DAYTON 110 N MAIN ST STE 500 DAYTON OH 45402 237296923 FUNDRAISING OH 501(C)(3) 7 SHP true HARRISON MEDICAL CENTER 2520 CHERRY AVE BREMERTON WA 98310 910565546 HEALTHCARE WA 501(C)(3) 3 FHS true HARRISON MEDICAL CENTER FOUNDATION 2520 CHERRY AVE BREMERTON WA 98310 911197626 FUNDRAISING WA 501(C)(3) 7 HMC true HEALTH SET 2420 W 26TH AVE STE 460D DENVER CO 80211 841102943 LOW INC CARE CO 501(C)(3) 7 CHIC true HEALTHCARE AND WELLNESS FOUNDATION 2400 ST FRANCIS DR BRECKENRIDGE MN 56520 760761782 FUNDRAISING MN 501(C)(3) 11 - Type I SFMC true HIGHLINE MEDICAL CENTER 16251 SYLVESTER RD SW BURIEN WA 98166 910712166 HEALTHCARE WA 501(C)(3) 3 FHS true HOUSE OF MERCY 1111 6TH AVE DES MOINES IA 50314 421323808 SHELTER IA 501(C)(3) 7 CHI-IA CORP true JEWISH HOSPITAL AND ST MARY''S HEALTHCARE INC 539 S 4TH ST LOUISVILLE KY 40202 611029768 HEALTHCARE KY 501(C)(3) 3 KOH true KENTUCKYONE HEALTH MEDICAL GROUP INC 539 S 4TH ST LOUISVILLE KY 40202 611352729 HEALTHCARE KY 501(C)(3) 9 JHSMH true KENTUCKYONE HEALTH INC 200 ABRAHAM FLEXNER WAY LOUISVILLE KY 40202 611029769 HEALTHCARE KY 501(C)(3) 9 CHI true LAKEWOOD HEALTH CENTER 600 MAIN AVE S BAUDETTE MN 56623 410758434 HEALTHCARE MN 501(C)(3) 3 CHI true LINUS OAKES INC 2700 STEWART PKWY ROSEBURG OR 97471 930821381 SENIOR LIVING OR 501(C)(3) 9 MMC true LISBON AREA HEALTH SERVICES 905 MAIN ST LISBON ND 58054 820558836 HEALTHCARE ND 501(C)(3) 3 CHI true LUFKIN VISION ACQUISITIONS PO BOX 1447 LUFKIN TX 75901 820563768 PROPERTY MGMT TX 501(C)(3) 11 - Type III - FI MHSET true MEMORIAL HEALTH CARE SYSTEM FOUNDATION INC 2525 DE SALES AVE CHATTANOOGA TN 37404 621839548 FUNDRAISING TN 501(C)(3) 7 MHCS true MEMORIAL HEALTH CARE SYSTEM INC 2525 DE SALES AVE CHATTANOOGA TN 37404 620532345 HEALTHCARE TN 501(C)(3) 3 CHI true MEMORIAL HEALTH PARTNERS FOUNDATION INC 5600 BRAINERD RD STE 500 CHATTANOOGA TN 37411 030417049 HEALTHCARE TN 501(C)(3) 9 MHCS true MEMORIAL HEALTH SYSTEM OF EAST TEXAS PO BOX 1447 LUFKIN TX 75902 750755367 HEALTHCARE TX 501(C)(3) 3 CHI true MEMORIAL MEDICAL CENTER - LIVINGSTON PO BOX 1447 LUFKIN TX 75902 760436439 HEALTHCARE TX 501(C)(3) 3 MHSET true MEMORIAL MEDICAL CENTER - SAN AUGUSTINE PO BOX 1447 LUFKIN TX 75902 752663904 HEALTHCARE TX 501(C)(3) 3 MHSET true MEMORIAL MULTISPECIALTY ASSOCIATES 1201 FRANK AVE LUFKIN TX 95904 752721155 PHYSICIANS TX 501(C)(3) 11 - Type III - FI MHSET true MEMORIAL SPECIALTY HOSPITAL PO BOX 1447 LUFKIN TX 95902 752492741 HEALTHCARE TX 501(C)(3) 3 MHSET true MERCY AUXILIARY OF CENTRAL IOWA 1111 6TH AVE DES MOINES IA 50314 426076069 AUXILIARY IA 501(C)(3) 11 - Type I MF-DM IA true MERCY CLINICS INC 1111 6TH AVE DES MOINES IA 50314 421193699 PHYSICIANS IA 501(C)(3) 9 CHI-IA CORP true MERCY COLLEGE OF HEALTH SCIENCES 1111 6TH AVE DES MOINES IA 50314 421511682 EDUCATION IA 501(C)(3) 2 CHI-IA CORP true MERCY FOUNDATION OF DES MOINES IA 1111 6TH AVE DES MOINES IA 50314 237358794 FUNDRAISING IA 501(C)(3) 7 CHI-IA CORP true MERCY FOUNDATION INC 2700 STEWART PKWY ROSEBURG OR 97471 936088946 FUNDRAISING OR 501(C)(3) 7 MMC true MERCY HEALTH CARE FOUNDATION PO BOX 368 CORNING IA 50841 421461064 FUNDRAISING IA 501(C)(3) 11 - Type I AHMH-CORNING true MERCY HEALTHCARE FOUNDATION 570 CHAUTAUQUA BLVD VALLEY CITY ND 58072 450435338 FUNDRAISING ND 501(C)(3) 11 - Type III - FI MHVC true MERCY HOSPITAL FOUNDATION COUNCIL BLUFFS 800 MERCY DR COUNCIL BLUFFS IA 51503 421178204 FUNDRAISING IA 501(C)(3) 11 - Type I AHBMHS true MERCY HOSPITAL OF DEVILS LAKE 1031 7TH ST NE DEVILS LAKE ND 58301 450227012 HEALTHCARE ND 501(C)(3) 3 CHI true MERCY HOSPITAL OF DEVILS LAKE FOUNDATION 1031 7TH ST NE DEVILS LAKE ND 58301 352367360 FUNDRAISING ND 501(C)(3) 7 MHDL true MERCY HOSPITAL OF VALLEY CITY 570 CHAUTAUQUA BLVD VALLEY CITY ND 58072 450226553 HEALTHCARE ND 501(C)(3) 3 CHI true MERCY MEDICAL CENTER 1301 15TH AVE WEST WILLISTON ND 58801 450231183 HEALTHCARE ND 501(C)(3) 3 CHI true MERCY MEDICAL CENTER - CENTERVILLE ONE ST JOSEPHS DRIVE CENTERVILLE IA 52544 420680308 HEALTHCARE IA 501(C)(3) 3 CHI-IA CORP true MERCY MEDICAL CENTER INC 2700 STEWART PKWY ROSEBURG OR 97471 930386868 HEALTHCARE OR 501(C)(3) 3 CHI true MERCY MEDICAL FOUNDATION 1301 15TH AVE WEST WILLISTON ND 58801 450381803 FUNDRAISING ND 501(C)(3) 11 - Type I MMC true MERCY PROFESSIONAL PRACTICE ASSOCIATES INC 1111 6TH AVE DES MOINES IA 50314 421470935 PHYSICIANS IA 501(C)(3) 9 CHI-IA CORP true NEBRASKA HEART HOSPITAL 7500 S 91ST ST LINCOLN NE 68526 392031968 HEALTHCARE NE 501(C)(3) 3 CHI NEBRASKA true OAKES COMMUNITY HOSPITAL 1200 N 7TH ST OAKES ND 58474 450231675 HEALTHCARE ND 501(C)(3) 3 CHI true OAKES COMMUNITY HOSPITAL FOUNDATION 1200 N 7TH ST OAKES ND 58474 710966606 FUNDRAISING ND 501(C)(3) 11 - Type I OCH true PINEYWOODS MEDICAL DEVELOPMENT CORP PO BOX 1447 LUFKIN TX 75902 752493116 PROPERTY MGMT TX 501(C)(3) 11 - Type III - FI MHSET true PUEBLO STEPUP 1925 E ORMAN AVE STE G52 PUEBLO CO 81004 841234295 COMMUNITY CO 501(C)(3) 7 CHIC true REGIONAL HOSPITAL FOR RESPIRATORY AND COMPLEX CARE 12844 MILITARY RD S TUKWILA WA 98168 911170040 HEALTHCARE WA 501(C)(3) 3 FHS true SET OF COLORADO SPRINGS INC 2864 S CIRCLE DR STE 450 COLORADO SPRINGS CO 80906 841183335 LTERM CARE CO 501(C)(3) 7 CHIC true SAINT CLARE''S COMMUNITY CARE INC 25 POCONO RD DENVILLE NJ 07834 222876836 HEALTHCARE NJ 501(C)(3) 11 - Type II SCHS true SAINT CLARE''S FOUNDATION INC 25 POCONO RD DENVILLE NJ 07834 222502997 FUNDRAISING NJ 501(C)(3) 7 SCHS true SAINT CLARE''S HEALTH SERVICES INC 25 POCONO RD DENVILLE NJ 07834 223639733 MANAGEMENT NJ 501(C)(3) 11 - Type II CHI true SAINT CLARE''S HOSPITAL INC 25 POCONO RD DENVILLE NJ 07834 223319886 HEALTHCARE NJ 501(C)(3) 3 SCHS true SAINT ELIZABETH FOUNDATION 555 S 70TH ST LINCOLN NE 68510 470625523 FUNDRAISING NE 501(C)(3) 7 SERMC true SAINT ELIZABETH HEALTH SERVICES 555 S 70TH ST LINCOLN NE 68510 363233120 HEALTHCARE NE 501(C)(3) 3 SERMC true SAINT ELIZABETH REGIONAL MEDICAL CENTER 555 S 70TH ST LINCOLN NE 68510 470379836 HEALTHCARE NE 501(C)(3) 3 CHI NEBRASKA true SAINT FRANCIS MEDICAL CENTER 2620 W FAIDLEY GRAND ISLAND NE 68803 470376601 HEALTHCARE NE 501(C)(3) 3 CHI NEBRASKA true SAINT FRANCIS MEDICAL CENTER FOUNDATION PO BOX 9804 GRAND ISLAND NE 68802 470630267 FUNDRAISING NE 501(C)(3) 7 SFMC true SAINT JOSEPH BEREA HOSPITAL FOUNDATION INC 305 ESTILL ST BEREA KY 40403 260152877 FUNDRAISING KY 501(C)(3) 7 SJHS true SAINT JOSEPH HEALTH SYSTEM INC 424 LEWIS HARGETT CIRCLE STE 160 LEXINGTON KY 40503 611334601 HEALTHCARE KY 501(C)(3) 3 KOH true SAINT JOSEPH HOSPITAL FOUNDATION INC ONE SAINT JOSEPH DRIVE LEXINGTON KY 40504 611159649 FUNDRAISING KY 501(C)(3) 11 - Type I SJHS true SAINT JOSEPH LONDON FOUNDATION INC 1001 SAINT JOSEPH LANE LONDON KY 40741 260438748 FUNDRAISING KY 501(C)(3) 7 SJHS true SAINT JOSEPH MEDICAL FOUNDATION INC 200 ABRAHAM FLEXNER WAY LOUISVILLE KY 40202 311539059 PHYSICIANS KY 501(C)(3) 3 SJHS true SAINT JOSEPH MOUNT STERLING FOUNDATION INC 225 FALCON DR MOUNT STERLING KY 40353 272884584 FUNDRAISING KY 501(C)(3) 7 SJHS true SAINT JOSEPH'S HOSPITAL FOUNDATION 2500 FAIRWAY STREET DICKINSON ND 58601 363418207 FUNDRAISING ND 501(C)(3) 11 - Type I SJHHC true SAMARITAN BEHAVIORAL HEALTH INC 601 S EDWIN C MOSES BLVD DAYTON OH 45417 020633634 HEALTHCARE OH 501(C)(3) 7 SHP true SAMARITAN HEALTH PARTNERS 110 N MAIN ST STE 500 DAYTON OH 45402 311107411 HEALTHCARE OH 501(C)(3) 11 - Type I CHI true SCHUYLER MEMORIAL HOSPITAL FOUNDATION INC 104 W 17TH ST SCHUYLER NE 68661 363630014 FUNDRAISING NE 501(C)(3) 11 - Type I AHMHS true SJRMC JOPLIN MISSOURI 198 INVERNESS DRIVE WEST ENGLEWOOD CO 80112 440545809 HEALTHCARE MO 501(C)(3) 3 CHI true SL AUGUSTA CORP PO BOX 20269 HOUSTON TX 77225 760226623 TITLE HOLDING TX 501(C)(2) N/A SLPC true ST ANTHONY HOSPITAL 1601 SE COURT AVE PENDLETON OR 97801 930391614 HEALTHCARE OR 501(C)(3) 3 CHI true ST ANTHONY HOSPITAL FOUNDATION 1601 SE COURT AVE PENDLETON OR 97801 930992727 FUNDRAISING OR 501(C)(3) 11 - 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