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URGENT CARE FACILITY COST METHODOLOGY PART I, LINE 7 THE COSTS REPORTED IN THE TABLE IN PART I, LINE 7 USED THE COST ACCOUNTING METHODOLOGY. THIS METHODOLOGY WAS USED FOR ALL PATIENT SEGMENTS, WITH THE EXCEPTION OF PART I, LINES 7(A) AND 7(B), WHICH USED A RATIO OF PATIENT CARE COSTS TO CHARGES AS COMPUTED IN WORKSHEET 2 OF THE FORM INSTRUCTIONS. BAD DEBT EXPENSE PART I, LINE 7, COLUMN F THE ORGANIZATION HAD BAD DEBT EXPENSE IN THE AMOUNT OF $26,897,777 REPORTED ON PART IX, LINE 24. HOWEVER, IT HAS BEEN SUBTRACTED FOR PURPOSES OF CALCULATING THE PERCENTAGE IN THIS COLUMN. METHODOLOGY USED TO DETERMINE BAD DEBT EXPENSE PART III, LINE 2 THE AMOUNT ENTERED REPRESENTS THE BAD DEBT EXPENSE RECORDED IN THE AUDITED FINANCIAL STATEMENTS. FOOTNOTE TO AUDITED FINANCIAL STATEMENTS - BAD DEBT EXPENSE PART III, LINE 4 NOTES TO CONSOLIDATED THE FINANCIAL STATEMENTS, PAGE 9 SEE NOTE 1: PATIENT ACCOUNTS RECEIVABLE MEDICARE SHORTFALL TREATED AS COMMUNITY BENEFIT PART III, LINE 8 THE SHORTFALL IS UNCOMPENSATED MEDICARE COST WHICH SHOULD BE INCLUDED IN COMMUNITY BENEFITS SINCE MEDICALLY NECESSARY SERVICES WERE PROVIDED AND NOT REIMBURSED. COSTING METHODOLOGY USED FOR MEDICARE PART III, LINE 8 THE COSTING METHODOLOGY SOURCE USED WAS THE FY 2013 MEDICARE COST REPORT. DEBT COLLECTION POLICY PART III, LINE 9(B) PROCEDURES ARE IN PLACE TO PROCESS ACCOUNTS FOR PATIENTS THAT QUALIFY FOR CHARITY CARE. NO COLLECTION PRACTICES TAKE PLACE FOR THOSE PATIENTS. CHNA C0MMUNITY INPUT PART V, SECTION B, LINE 3 ST. ANTHONY'S MEDICAL CENTER SOUGHT TO CONDUCT ITS NEEDS ASSESSMENT IN PART BY COLLECTING PRIMARY DATA FROM KEY COMMUNITY MEMBERS. DATA WAS COLLECTED IN THREE WAYS - A COLLABORATION OF KEY STAKEHOLDERS IN A FOCUS GROUP SETTING; A TELEPHONE SURVEY OF 500 ADULT COMMUNITY MEMBERS; AND PHYSICIAN SURVEYS. IN THE KEY STAKEHOLDER ANALYSIS, ST. ANTHONY'S MEDICAL CENTER PARTNERED WITH BARNES JEWISH WEST COUNTY HOSPITAL (BJWCH), MISSOURI BAPTIST MEDICAL CENTER (MBMC), AND ST. LUKE'S HOSPITAL (SLH). EACH HOSPITAL REPRESENTATIVE INVITED UP TO FOUR KEY LEADERS FROM THEIR RESPECTIVE COMMUNITIES TO ATTEND A TWO-PART FOCUS GROUP AND REPRESENT THEIR COMMUNITIES. AN INITIAL FOCUS GROUP WAS CONDUCTED IN JUNE 2012 TO SOLICIT FEEDBACK FROM THE KEY LEADERS ON THE HEALTH NEEDS OF THE ST. LOUIS COUNTY POPULATION. A SECOND MEETING WAS HELD IN JULY 2012 TO SHARE THE RESULTS OF THE FIRST FOCUS GROUP AND FINDINGS FROM OTHER SECONDARY DATA ANALYSIS. EIGHTEEN INDIVIDUALS WERE IN ATTENDANCE, REPRESENTING VARIOUS ST. LOUIS COUNTY ORGANIZATIONS. EACH INDIVIDUAL RECEIVED A WORKSHEET TO COMPLETE PRIOR TO THE FOCUS GROUP, TO IDENTIFY PERCEPTIONS OF THE GREATEST HEALTH-CARE NEEDS IN ST. LOUIS COUNTY. THE SUBSEQUENT FOCUS GROUP SESSION WAS TARGETED AT IDENTIFYING PRIORITY HEALTH-CARE NEEDS IN THE COMMUNITY, AND THE COMMUNITY'S ABILITY TO COLLABORATE ON THEM. ST. ANTHONY'S MEDICAL CENTER PARTNERED WITH THE PRELL ORGANIZATION TO ASSESS THE HEALTH-CARE NEEDS OF THE COMMUNITY BY CONDUCTING A TELEPHONE SURVEY WITH A RANDOM SAMPLE OF 500 ADULTS AGE 21 YEARS OR OLDER IN THE COMMUNITY. THESE INTERVIEWS WERE CONDUCTED IN NOVEMBER 2012 AT COMMUNICATIONS FOR RESEARCH IN STEELVILLE, MO, USING A COMPUTER ASSISTED TELEPHONE INTERVIEW INTERVIEWING SYSTEM. PRELL EMPLOYED A STRATIFIED RANDOM SAMPLE THAT SET QUOTAS FOR EACH ZIP CODE TO MATCH THE OVERALL ADULT POPULATION IN THE PSA. THIS HAD THE EFFECT OF REDUCING THE SAMPLING ERROR FOR THIS SURVEY. BECAUSE PHYSICIANS PLAY THIS ROLE IN RECOGNIZING THE HEALTH NEEDS OF THE POPULATION, ST. ANTHONY'S MEDICAL CENTER CHOSE TO SURVEY PRIMARY CARE PHYSICIANS AND OBSTETRICIAN/GYNECOLOGISTS AFFILIATED WITH ST. ANTHONY'S MEDICAL CENTER. TWENTY-SEVEN PHYSICIANS TOOK PART IN A SEVEN-QUESTION SURVEY USING AN ONLINE SURVEY TOOL. THE PHYSICIANS WERE ASKED THREE OPEN-ENDED QUESTIONS AND FOUR CLOSED QUESTIONS FOCUSED ON THE HEALTH NEEDS OF OUR POPULATION. OTHER HOSPITALS CHNA CONDUCTED WITH PART V, SECTION B, LINE 4 ST. ANTHONY'S MEDICAL CENTER PARTNERED WITH BARNES JEWISH WEST COUNTY HOSPITAL (BJWCH), MISSOURI BAPTIST MEDICAL CENTER (MBMC), AND ST. LUKE'S HOSPITAL (SLH) TO CONDUCT A KEY STAKEHOLDER ANALYSIS IN OUR COMMUNITY. IN THE ANALYSIS, EACH HOSPITAL REPRESENTATIVE INVITED UP TO FOUR KEY LEADERS FROM THEIR RESPECTIVE COMMUNITIES TO ATTEND A TWO-PART FOCUS GROUP AND REPRESENT THEIR COMMUNITIES. AN INITIAL FOCUS GROUP WAS CONDUCTED IN JUNE 2012 TO SOLICIT FEEDBACK FROM THE KEY LEADERS ON THE HEALTH NEEDS OF THE ST. LOUIS COUNTY POPULATION. A SECOND MEETING WAS HELD IN JULY 2012 TO SHARE THE RESULTS OF THE FIRST FOCUS GROUP AND FINDINGS FROM OTHER SECONDARY DATA ANALYSIS. EIGHTEEN INDIVIDUALS WERE IN ATTENDANCE, REPRESENTING VARIOUS ST. LOUIS COUNTY ORGANIZATIONS. EACH INDIVIDUAL RECEIVED A WORKSHEET TO COMPLETE PRIOR TO THE FOCUS GROUP, TO IDENTIFY PERCEPTIONS OF THE GREATEST HEALTH-CARE NEEDS IN ST. LOUIS COUNTY. HOW CHNA WAS MADE WIDELY AVALIABLE PART V, SECTION B, LINES 5A & 5C THE CHNA CAN BE ACCESSED ON THE HOSPITAL WEBSITE AT THE FOLLOWING ADDRESS: HTTP://WWW.STANTHONYSMEDCENTER.COM/COMMUNITY/CHNA.PDF. THE IMPLEMENTATION PLAN HAS ALSO BEEN POSTED TO THE WEBSITE AND CAN BE ACCESSED AT THE FOLLOWING ADDRESS: HTTP://WWW.STANTHONYSMEDCENTER.COM/COMMUNITY/CHNA_IMPLEMENTATION_PLAN.PDF OTHER WAYS IN WHICH THE NEEDS ASSESSMENT WAS MADE WIDELY AVALIABLE: - THE ST. ANTHONY'S MEDICAL CENTER CHNA DOCUMENT DISPLAYED CONSPICUOUSLY ON WEB SITE WITH DIRECTIONS TO DOWNLOAD - SHARED FINAL DOCUMENT & NEXT STEPS WITH THE ST. ANTHONY'S MEDICAL CENTER COMMUNITY BENEFIT COUNCIL - SHARED HIGHLIGHTS AND OVERVIEW OF THE CHNA AND PROCESS WITH EMPLOYEES IN THIS WEEK (AN EMPLOYEE PUBLICATION) - SHARED HIGHLIGHTS AND OVERVIEW OF THE CHNA WITH A LINK TO THE WEBSITE IN A PRESS RELEASE TO THE COMMUNITY - SHARED THE CHNA ON SOCIAL MEDIA - SHARED THE CHNA WITH THE COMMUNITY BY PROVIDING FLIERS IN LOCAL LIBRARIES WITH A LINK TO THE DOCUMENT/WEBSITE - SHARED THE CHNA/IMPLEMENTATION STRATEGY AND BACKGROUND IN YOUR HEALTH TODAY (A QUARTERLY PUBLICATION THAT REACHES 100,000 LOCAL MEMBERS OF THE ST. ANTHONY'S MEDICAL CENTER COMMUNITY) NEEDS ADDRESSED IN CHNA PART V, SECTION B, LINE 7 THERE WAS A NEED IDENTIFIED IN OUR ASSESSMENT THAT ST. ANTHONY'S MEDICAL CENTER DID NOT CHOOSE TO ADDRESS. ALTHOUGH ALL IDENTIFIED COMMUNITY HEALTH NEEDS ARE IMPORTANT TO ST. ANTHONY'S, WE HAD TO CHOOSE NEEDS IN WHICH WE COULD MAKE THE MOST IMPACT ON OUR COMMUNITY AND IN WHICH WE COULD BEST ALIGN OUR RESOURCES. THE NEED THAT WE CHOSE NOT TO ADDRESS WAS TOBACCO USE. TOBACCO USE, AND SMOKING ATTRIBUTABLE DEATHS, ARE HIGHER IN MISSOURI THAN THE NATIONAL AVERAGE AND POSE A PROBLEM FOR OUR COMMUNITY. WE CHOSE NOT TO ADDRESS THIS NEED BECAUSE OF THE AVAILABILITY OF RESOURCES IN OUR AREA, SPECIFICALLY THE EFFORTS THAT ARE ALREADY BEING PUT FORTH BY THE JEFFERSON COUNTY HEALTH DEPARTMENT TO ADDRESS SMOKING. JEFFERSON COUNTY WAS THE PART OF OUR COMMUNITY THAT WAS IDENTIFIED IN OUR ASSESSMENT AS BEING THE HIGHEST IN TOBACCO USE. CHARGES FOR MEDICAL CARE PART V, SECTION B, LINE 20 FINANCIAL ASSISTANCE DETERMINATION LEVELS ARE UPDATED ANNUALLY BASED ON FEDERAL POVERTY GUIDELINES USUALLY PUBLISHED IN JANUARY. THE MEDICARE COST-TO-CHARGE RATIO IS UPDATED ANNUALLY AFTER PREPARATION OF THE MEDICARE COST REPORT. THE UNINSURED DISCOUNT FOR PATIENTS WHO DO NOT QUALIFY FOR FINANCIAL ASSISTANCE IS REVIEWED ANNUALLY AND IS BASED ON LOW VOLUMES MANAGED CARE CONTRACT DISCOUNTS. POLICIES WILL BE UPDATED ANNUALLY AFTER RECEIPT OF THE FEDERAL POVERTY GUIDELINES AND THE CMS TENTATIVE REVIEW OF THE COST REPORT SETTLEMENT. NEEDS ASSESSMENT PART VI, LINE 2 ST. ANTHONY'S MEDICAL CENTER (SAMC) CONDUCTED A COMMUNITY HEALTH NEEDS ASSESSMENT (CHNA) AND DEVELOPED AN IMPLEMENTATION PLAN WITH STRATEGIES TO ADDRESS IDENTIFIED NEEDS. THIS PROCESS WAS UNDERTAKEN BY THE COMMUNITY OUTREACH TEAM AT SAMC, LED BY COMMUNITY OUTREACH COORDINATOR LAURA BUB, MPH. ST. ANTHONY'S SOUGHT GUIDANCE AND PARTNERSHIP FROM THE ST. LOUIS DEPARTMENT OF HEALTH AND IN COLLABORATION WITH BARNES-JEWISH WEST COUNTY HOSPITAL (BJWCH), MISSOURI BAPTIST MEDICAL CENTER (MBMC), AND ST. LUKE'S HOSPITAL (SLH). SAMC USED SURVEY DATA FROM COMMUNITY MEMBERS AND LOCAL PHYSICIANS, A KEY STAKEHOLDER ANALYSIS, AND SECONDARY DATA FROM EXISTING RESOURCES TO IDENTIFY AND PRIORITIZE HEALTH PROBLEMS AND RISK FACTORS IN THE ST. ANTHONY'S MEDICAL CENTER SERVICE AREA. PATIENT EDUCATION OF ELIGIBILITY FOR ASSISTANCE PART VI, LINE 3 THE MEDICAL ELIGIBILITY PROGRAM IS A HOSPITAL SERVICE PROVIDED TO PATIENTS AT NO COST. PATIENTS MAY QUALIFY FOR GOVERNMENT PROGRAMS WHICH PAY FOR ALL OR PART OF THEIR HOSPITAL AND MEDICAL EXPENSES. IF PATIENT IS UNDER 21 OR OVER 65 YEARS OLD, HAVE CHILDREN IN THE HOUSEHOLD, ARE PREGNANT, POTENTIALLY DISABLED, OR HAVE BEEN A VICTIM OF CRIME THEY MAY QUALIFY. SAMC HOSPITAL FINANCIAL COUNSELORS WILL ASSIST PATIENT WITH THE APPLICATION PROCESS. PATIENTS ARE INFORMED ABOUT OUR FINANCIAL ASSISTANCE PROCESS IN A NUMBER OF WAYS: - FINANCIAL COUNSELORS ARE AVAILABLE TO PATIENTS DURING THEIR STAY. - DISCUSSIONS ABOUT FINANCIAL ASSISTANCE OCCUR WHEN SPEAKING TO PATIENTS ON THE PHONE ABOUT THEIR ACCOUNT BALANCES. - INFORMATION REGARDING OUR FINANCIAL ASSISTANCE POLICY IS LOCATED AT SAMC AND ON THE BILLING STATEMENTS. - ADDITIONAL INFORMATION IN REGARD TO FINANCIAL ASSISTANCE IS LISTED ON BILLING STATEMENTS OR CAN BE FOUND ON SAMC'S WEBSITE. COMMUNITY INFORMATION PART VI, LINE 4 THE PRIMARY COMMUNITY THAT ST. ANTHONY'S SERVES INCLUDES A GEOGRAPHIC AREA OF SOUTH ST. LOUIS COUNTY, SOUTH ST. LOUIS CITY AND JEFFERSON COUNTY IN MISSOURI AND MONROE COUNTY IN ILLINOIS. THE SERVICE AREA COULD BEST BE DESCRIBED AS A COMBINATION SUBURBAN COMMUNITY. ST. ANTHONY'S SERVES A COMBINED POPULATION OF MORE THAN 564,000 RESIDENTS WHO RESIDE WITHIN A 25-30 MINUTE DRIVE TO ST. ANTHONY'S. THE PRIMARY SERVICE AREA ACCOUNTS FOR ABOUT 80% OF THE PATIENTS SERVED. THE DEMOGRAPHIC DATA* FOR THE PRIMARY SERVICE AREA INCLUDES A POPULATION OF MORE THAN 564,000 WITH TOTAL HOUSEHOLDS OF MORE THAN 228,000. MOST OF THE RESIDENTS ARE WHITE (94%), WITH 4% BLACK RESIDENTS, AND 2% BEING OF OTHER RACE. WE ALSO SERVE A LARGE BOSNIAN POPULATION. THE APPROXIMATE OCCUPATION BREAKOUT OF THE PRIMARY SERVICE AREA IS: 62% WHITE COLLAR, 22% BLUE COLLAR AND ABOUT 16% SERVICE WORKERS. THE AVERAGE HOUSEHOLD INCOME IS ABOUT $70,000/YR. THE ELDERLY POPULATION OF AGES 65 AND OLDER IS 23%. THE HOUSEHOLDS OF OWNER OCCUPIED ARE 77% VERSUS 23% RENTER OCCUPIED. SINGLE PARENT HOUSEHOLDS ARE ABOUT 34%. THE PERCENTAGE OF RESIDENTS WITH INCOME LEVELS OF LESS THAN $25,000 IS 18%. *SOURCE : 2010 ESTIMATES AND 2015 PROJECTIONS: NIELSEN CLARITAS THE PRIMARY SERVICE AREA PAYOR MIX OF SELF-PAY AND MEDICAID PATIENTS AT ST. ANTHONY'S FROM FISCAL YEAR 2010, WAS 18%. DATA SHOWS THIS PERCENTAGE HAS RISEN MORE THAN 4% OVER THE LAST FIVE FISCAL YEARS. PROMOTION OF COMMUNITY HEALTH PART VI, LINE 5 -ST. ANTHONY'S OPERATES AN EMERGENCY ROOM THAT ACCEPTS ALL PERSONS WHO ARE IN NEED OF MEDICAL ATTENTION REGARDLESS OF THEIR ABILITY TO PAY. -ST. ANTHONY'S HAS AN OPEN MEDICAL STAFF WITH PRIVILEGES AVAILABLE TO ALL QUALIFIED PHYSICIANS IN THE AREA. -ST. ANTHONY'S HAS A GOVERNING BOARD OF DIRECTORS IN WHICH INDEPENDENT PERSONS REPRESENTATIVE OF THE COMMUNITY COMPRISE A MAJORITY. -ST. ANTHONY'S WORKS IN COOPERATION WITH LOCAL UNIVERSITIES AND HEALTH CARE ORGANIZATIONS TO ADVANCE THE SCIENCE OF MEDICINE BY PROVIDING A CLINICAL SETTING WHERE INNOVATIVE TREATMENTS AND NEW THERAPEUTIC PROTOCOLS CAN BE DEVELOPED AND STUDIED. -ST. ANTHONY'S ENGAGES IN THE TRAINING AND EDUCATION OF HEALTH CARE PROFESSIONALS BY TEAMING UP WITH LOCAL COMMUNITY COLLEGES AND UNIVERSITIES TO PROVIDE A CLINICAL SETTING FOR HEALTH CARE STUDENTS. -ST. ANTHONY'S PARTICIPATES IN MEDICAID, MEDICARE, CHAMPUS, TRICARE, AND/OR OTHER GOVERNMENT-SPONSORED HEALTH CARE PROGRAMS. -ST. ANTHONY'S MEDICAL CENTER FOUNDATION CONTRIBUTED $56,691 IN CASH DONATIONS TO NON-PROFIT ORGANIZATIONS AND SET UP $502,500 IN SCHOLARSHIP FUNDING FOR EMPLOYEE'S SONS AND DAUGHTERS WHICH IS NOT INCLUDED IN THIS TAX RETURN. STATE FILING OF COMMUNITY BENEFIT REPORT PART VI, LINE 7 MO true PROCEDURE FOR MONITORING GRANTS PART I, LINE 2 THE ORGANIZATION MONITORS THE GRANT MONEY BY HAVING EACH RECIPIENT COMPLETE A MID-YEAR AND FINAL REPORT. THE FINAL REPORT INCLUDES ITEMIZED EXPENDITURES AND HOW THE PROGRAMMING FITS THE GOALS OF THE GRANT. NO ONE RECIPIENT RECEIVED GRANT MONEY IN EXCESS OF $5,000 IN THE CURRENT YEAR. X X true true X X X X true true false false false false false false false THOMAS ROCKERS 501470 0 0 0 57317 0 8140 0 0 0 566927 0 0 0 JOHN SKEANS 285527 0 0 0 65214 0 22399 0 10625 0 383765 0 0 0 ROBERT P THAMES 170398 0 0 0 3605 0 8553 0 0 0 182556 0 0 0 ROBERT GRIESBAUM 227645 0 0 0 22568 0 16047 0 0 0 266260 0 0 0 ANN BOLLONE 212007 0 0 0 43478 0 8015 0 0 0 263500 0 0 0 SHERRY NELSON 198967 0 0 0 18661 0 22495 0 0 0 240123 0 0 0 EMILY NIEHAUS 131025 0 0 0 20792 0 20059 0 0 0 171876 0 0 0 PATRICK GARRETT 297620 0 12644 0 15270 0 29685 0 10625 0 365844 0 0 0 GREGORY W BOTTERON 789842 0 127006 0 22098 0 16520 0 7500 0 962966 0 0 0 DAVID DOBMEYER 786274 0 127006 0 25783 0 30354 0 10625 0 980042 0 0 0 DENNIS DISCH 788367 0 127006 0 22070 0 33521 0 10625 0 981589 0 0 0 CHARLES CAREY 789042 0 127006 0 21359 0 25957 0 10625 0 973989 0 0 0 JAMES PERSCHBACHER 783953 0 127006 0 20836 0 33521 0 10625 0 975941 0 0 0 JAMES E GARDNER 445022 0 70000 0 27421 0 8385 0 10625 0 561453 0 0 0 DAVID MORTON 750360 0 23710 0 347166 0 33573 0 10625 0 1165434 0 0 0 JAMES WELDON 137598 0 0 0 23391 0 731 0 4777 0 166497 0 0 0 CATHI BLISE 137282 0 0 0 14212 0 6060 0 4627 0 162181 0 0 0 RICHARD WILMOTH 200906 0 0 0 26013 0 8312 0 7732 0 242963 0 0 0 DISCRETIONARY SPENDING ACCOUNT & HOUSING ALLOWANCE PART I, LINE 1(A) JAMES GARDNER, THE CEO, RECEIVED AN EXECUTIVE ALLOWANCE THAT HE USED AS AN AUTO ALLOWANCE. HE WAS ALSO PROVIDED WITH A HOUSING ALLOWANCE FOR 6 MONTHS WHEN HE FIRST RELOCATED TO ST. LOUIS. ALL ALLOWANCES WERE INCLUDED IN TAXABLE INCOME. SEVERANCE & NONQUALIFIED RETIREMENT PLAN PART I, LINES 4(A)&(B) THE FOLLOWING INDIVIDUALS RECEIVED A SEVERANCE PAYMENT: THOMAS ROCKERS $373,199 ANN M. BOLLONE $110,914 ROBERT GRIESBAUM $227,820 SHERRY R. NELSON $124,045 EMILY T. NIEHAUS $4,039 ROBERT THAMES $172,771 RICHARD WILMOTH $33,078 THE FOLLOWING INDIVIDUAL RECEIVED CONTRIBUTIONS FROM A RELATED ORGANIZATION TO A NONQUALIFIED RETIREMENT PLAN UNDER SECTION 457(F): THOMAS ROCKERS $33,000 A HEALTH & EDUCATIONAL FACILITIES AUTHORITY OF MO 431178966 2007-05-09 3100000 ACQUIRE MEDICAL EQUIPMENT false false false B HEALTH & EDUCATIONAL FACILITIES AUTHORITY OF MO 431178966 2013-04-25 172740000 CURRENT REFUND OF SERIES 2005&2006 false false false A 2638381 0 3100000 0 0 0 0 0 0 31000000 0 0 2007 false false true true B 0 0 172740000 0 0 0 1094097 0 0 0 171628501 17402 2010 true false false true A false false true true true true 0.00000 0.00000 0.00000 false false 0.00000 false true B false false true true true true 0.00000 0.00000 0.00000 false false 0.00000 false true A false false true false false false 0 false 0 false true B false true true false true true SEE SUPPLEMENT INFO 29.8 false false false 0 false true A true B true OTHER SPENT PROCEEDS PART II, LINE 11, COLUMN B THE SERIES 2013 BONDS REFUNDED THE SERIES 2005 BONDS AND THE SERIES 2006 BONDS. SWAP AGREEMENTS WERE ENTERED INTO AND INTEGRATED WITH BOTH THE SERIES 2005 BONDS AND SERIES 2006 BONDS. THESE SWAP AGREEMENTS WERE TERMINATED ON APRIL 23, 2013 IN CONJUNCTION WITH THE ISSUANCE OF THE SERIES 2013 BONDS. $34,242,000 OF SERIES 2013 BOND PROCEEDS WERE USED TO PAY THE ASSOCIATED TERMINATION PAYMENTS. THE REMAINING AMOUNT OF $137,386,500.89 WAS USED TO REDEEM THE SERIES 2005 BONDS AND SERIES 2006 BONDS. OTHER UNSPENT PROCEEDS PART II, LINE 12, COLUMN B AS OF THE END OF ST. ANTHONY'S FISCAL YEAR, $17,402.11 OF SERIES 2013 BOND PROCEEDS ORIGINALLY INTENDED TO BE USED TO PAY COSTS OF ISSUING THE BONDS REMAINED UNSPENT. THIS AMOUNT WILL BE TRANSFERRED TO THE DEBT SERVICE ACCOUNT AND WILL BE USED TO PAY DEBT SERVICE ON THE BONDS ON THE FIRST AVAILABLE DEBT SERVICE PAYMENT DATE. PRIVATE BUSINESS USE PART III, COLUMN B THE SERIES 2013 BONDS REFUNDED THE SERIES 2005 BONDS AND THE SERIES 2006 BONDS. THE SERIES 2005 BONDS REFUNDED PROJECTS THAT WERE ORIGINALLY FINANCED PRIOR TO 1/1/2003. ACCORDINGLY, IN PART III, COLUMN B, ST. ANTHONY'S IS REPORTING SOLELY ON THE PROJECTS FINANCED BY THE SERIES 2006 BONDS. NAME OF PROVIDER PART IV, LINE 4B, COLUMN B TWO SEPARATE QUALIFIED HEDGES WERE ENTERED INTO WITH RESPECT TO THE SERIES 2013 BONDS. THE TWO HEDGE PROVIDERS WERE PNC BANK, NATIONAL ASSOCIATION AND UNION BANK, NATIONAL ASSOCIATION. LEWIS RICE AND FINGERISH W REED III, BOARD MEMBER, 625361 LEGAL SERVICES false LEWIS RICE AND FINGERISH CON'T IS A MEMBER OF LRF SC ANESTHESIA J WILKINSON,BOARD MEMBER, 1079254 ANESTHESIA SERVICES false SC ANESTHESIA CON'T IS A CO-OWNER OF SCA INTEGRITY HOSPITAL COMPANY M RINDLER, CEO & MEMBER, 1773942 CONSULTING SERVICES false INTEGRITY HOSPITAL CO CON'T IS A PRINCIPAL OF IHC INTEGRITY HOSPITAL COMPANY PART IV, LINE 5 PAYMENTS DURING THE FISCAL YEAR TO INTEGRITY HOSPITAL COMPANY REPRESENT PAYMENTS FOR CONSULTING SERVICES PRIOR TO MR. RINDLER ASSUMING THE POSITION OF CEO. PAYMENTS TO INTEGRITY HOSPITAL COMPANY FOR MR. RINDLER'S SERVICES AS CEO WERE PAID IN THE SUBSEQUENT YEAR. STATEMENT OF PROGRAM SERVICE ACCOMPLISHMENT FORM 990, SUPPLEMENT TO PART III, LINE 1 THE COMMUNITY BENEFIT CONTRIBUTION OF ST. ANTHONY'S MEDICAL CENTER INCLUDES PROGRAMS AND ACTIVITIES THAT IMPROVE ACCESS TO HEALTH CARE AND IMPROVE HEALTH IN OUR COMMUNITIES. IN ORDER TO PORTRAY THE FULL BREADTH OF OUR CONTRIBUTION, OUR COMMUNITY BENEFIT INFORMATION IS DESCRIBED BELOW: SECTION 1 - QUALITATIVE DESCRIPTION OF COMMUNITY BENEFIT 1. ORGANIZATIONAL COMMITMENT TO PROVIDING COMMUNITY BENEFIT A. MISSION STATEMENT: ST. ANTHONY'S, A CATHOLIC MEDICAL CENTER, HAS THE DUTY AND PRIVILEGE TO PROVIDE THE BEST CARE TO EVERY PATIENT, EVERY DAY. PRIMARY EXEMPT PURPOSE: ST. ANTHONY'S PROVIDES CARE IN A NONDISCRIMINATORY MANNER, OPERATES AN EMERGENCY DEPARTMENT OPEN TO ALL, OFFERS MEDICAL STAFF PRIVILEGES TO ALL QUALIFIED PHYSICIANS, AND MAINTAINS A GOVERNING BOARD OF DIRECTORS COMPRISED PRIMARILY OF COMMUNITY MEMBERS. WE PROMOTE AND ADDRESS THE SPECIFIC HEALTH NEEDS OF THE COMMUNITY AND PROVIDE SUPPORT THROUGH EDUCATIONAL, RELIGIOUS, AND CHARITABLE ACTIVITIES. EXCESS REVENUE IS USED FOR THE FURTHER DEVELOPMENT OF SUCH ACTIVITIES. B. ST. ANTHONY'S MEDICAL CENTER'S APPROACH TO PROVIDING COMMUNITY BENEFIT IS ILLUSTRATED AS FOLLOWS: - OUR GEOGRAPHIC AREA AND TARGET POPULATION ARE SOUTH ST. LOUIS COUNTY, JEFFERSON COUNTY, OUTSTATE MISSOURI AND SOUTHERN ILLINOIS. - ST. ANTHONY'S MEDICAL CENTER COMPLETED ITS FIRST COMMUNITY HEALTH NEEDS ASSESSMENT AND IMPLEMENTATION PLAN IN 2013 TO GUIDE THE EFFORTS IN OUR COMMUNITY. LINKS CAN BE FOUND BELOW: 1. COMMUNITY HEALTH NEEDS ASSESSMENT: HTTP://WWW.STANTHONYSMEDCENTER.COM/COMMUNITY/CHNA.PDF 2.IMPLEMENTATION PLAN: HTTP://WWW.STANTHONYSMEDCENTER.COM/COMMUNITY/CHNA_IMPLEMENTATION_PLAN .PDF - MAJOR TRENDS, NEEDS, AND PROBLEMS IN THE COMMUNITY ARE ADDRESSED BY ST. ANTHONY'S MEDICAL CENTER IN A VARIETY OF WAYS. ALONG WITH TREATING ILLNESS AND DISEASE, ST. ANTHONY'S SUPPORTS PROGRAMS THAT FOCUS ON DISEASE PREVENTION. CARE IS TAKEN TO PLAN PROGRAMS AND EVENTS THAT ARE TARGETED TO THE NEEDS OF OUR COMMUNITY. PROGRAMS ARE PLANNED BASED ON THE EVIDENCE THAT THE PROGRAM OR EVENT IS ADDRESSING A COMMUNITY HEALTH NEED. COMMUNITY HEALTH NEEDS ARE ESTABLISHED BY EXAMINING DATA AND STATISTICS THAT ARE TARGETED TO RELECTTHE SERVICE AREA OF ST. ANTHONY'S AND BY PRIMARY DATA FROM COMMUNITY EVALUATIONS THROUGH THE ST. ANTHONY'S MEDICAL CENTER COMMUNITY HEALTH NEEDS ASSESSMENT. - ST. ANTHONY'S MEDICAL CENTER SUPPORTS NEEDS AND PROBLEMS UNIQUE TO ITS COMMUNITY. WHILE NOT DIRECTLY RELATED TO HEALTH CARE, OUR SUPPORT FOR ACTIVITIES SUCH AS NEIGHBORHOOD REVITALIZATION; LOCAL ECONOMIC DEVELOPMENT, EDUCATION, COMMUNITY HEALTH ADVOCACY, AND SIMILAR EFFORTS ALL CONTRIBUTE TO IMPROVEMENT FOR THE PEOPLE WE SERVE THROUGHOUT THE REGION. ST. ANTHONY'S OFFERS NUMEROUS EDUCATIONAL EVENTS, COMMUNITY CLINICS, SUPPORT GROUPS, SELF-HELP PROGRAMS (E.G., WEIGHT MANAGEMENT, SMOKING CESSATION); AND PASTORAL OUTREACH AND SOCIAL SERVICE PROGRAMS. THESE PROGRAMS ARE WIDELY AVAILABLE TO ALL, CONVENIENTLY LOCATED ON OUR CAMPUS AND OFFERED CONTINUOUSLY THROUGHOUT THE YEAR. - VARIOUS COMMUNITY ORGANIZATIONS COLLABORATE WITH ST. ANTHONY'S MEDICAL CENTER TO IMPROVE COMMUNITY HEALTH, EXPAND ACCESS TO HEALTH CARE OR IN OTHER WAYS BENEFIT THE COMMUNITY. ST. ANTHONY'S WORKS IN COLLABORATION WITH THE FOLLOWING GROUPS: ST. LOUIS COUNTY DEPARTMENT OF HEALTH, LOCAL SCHOOL DISTRICTS, BARNES-JEWISH WEST COUNTY HOSPITAL, MISSOURI BAPTIST MEDICAL CENTER, ST. LUKES HOSPITAL (THROUGH THE CHNA), HOSPICE AGENCIES, ST. LOUIS ASSOCIATION OF DIABETES EDUCATORS, LOCAL COLLEGES & UNIVERSITIES, AMERICAN HEART ASSOCIATION, AMERICAN CANCER SOCIETY, CARDINAL GLENNON HOSPITAL, SOUTH COUNTY YMCA, BEHAVIORAL HEALTH SUPPORT GROUPS, ST. LOUIS UNIVERSITY, ,AMERICAN LUNG ASSOCIATION AND THE AMERICAN RED CROSS. - SEVERAL HOSPITAL DEPARTMENTS DEDICATE STAFF TO ASSIST IN COMMUNITY BENEFITS EFFORTS. ST. ANTHONY'S HAS A COMMUNITY BENEFIT COUNCIL THAT IS DESIGNED SPECIFICALLY TO OVERSEE AND ALIGN COMMUNITY RESOURCES AND GUIDE THE COMMUNITY HEALTH NEEDS ASSESSMENT AND IMPLEMENTATION PLAN. HOSPITAL STAFF FOR THIS INITIATIVE COME FROM THE AREAS OF COMMUNITY OUTREACH, NUTRITION SERVICES, SENIOR SERVICES, PHYSICIAN RELATIONS, BEHAVIORAL HEALTH, PASTORAL CARE, HEALTH & WELLNESS AND DIABETES EDUCATION, COMMUNITY BENEFIT REPORTS AND ACTIVITIES COME FROM ALL PARTS OF THE HOSPITAL. C. ST. ANTHONY'S MEDICAL CENTER HAS FINANCIAL ASSISTANCE AND UNINSURED POLICIES AND PROGRAMS AS DESCRIBED BELOW. FINANCIAL ASSISTANCE POLICY - ST. ANTHONY'S MEDICAL CENTER HAS ESTABLISHED A PROGRAM TO REDUCE OR COMPLETELY ADJUST DEBTS FOR CERTAIN PATIENTS REQUIRING HEALTH CARE BUT LACKING THE MEANS TO PAY FOR SERVICES RENDERED. UNINSURED PATIENTS POLICY - ST. ANTHONY'S MEDICAL CENTER WORKS WITH ALL PATIENTS THAT HAVE SELF-PAY BALANCES TO ESTABLISH PAYMENT PLANS THAT ARE REASONABLE FOR THE PATIENT AND STILL MAINTAIN THE CASH FLOW NEEDS OF THE HOSPITAL. PAYMENT PLANS ARE TYPICALLY ESTABLISHED AFTER SERVICE HAS BEEN RENDERED AND BY COMMUNICATION BETWEEN THE PATIENT/RESPONSIBLE PARTY AND PATIENT ACCOUNTS CUSTOMER SERVICE OR FINANCIAL COUNSELING STAFF. PATIENTS THAT ARE UNINSURED MAY CONTACT OR BE CONTACTED BY CUSTOMER SERVICE OR FINANCIAL COUNSELING STAFF IN ORDER TO DETERMINE WHETHER OTHER MEANS OF PAYMENT OF THE BILL ARE AVAILABLE (E.G., MEDICAID ELIGIBILITY, VICTIMS OF CRIME, THIRD PARTY LIABILITY INSURANCE, ETC.). IF NO ADDITIONAL OUTSIDE FUNDS ARE AVAILABLE, THEN THE PATIENT MAY QUALIFY FOR FINANCIAL ASSISTANCE FROM ST. ANTHONY'S MEDICAL CENTER. ANY PATIENT THAT IS UNINSURED AND DOES NOT QUALIFY FOR FINANCIAL ASSISTANCE OR DOES NOT WANT TO ACCESS HOSPITAL FINANCIAL ASSISTANCE WILL RECEIVE AN AUTOMATIC DISCOUNT OF 40% FROM BILLED CHARGES. COLLECTION POLICY - IT IS THE POLICY OF ST. ANTHONY'S MEDICAL CENTER TO TREAT ALL PATIENTS REQUIRING EMERGENCY TREATMENT REGARDLESS OF THEIR ABILITY TO PAY. IN ADDITION, STAFF WILL ASSIST PATIENTS WHO CANNOT PAY FOR PART OF ALL OF THE CARE THEY RECEIVE BY WORKING WITH THE PATIENT TO FIND ALTERNATIVE SOURCES OF PAYMENT OR TO DEVELOP A PAYMENT SCHEDULE THAT IS SATISFACTORY FOR ALL PARTIES. WE MUST ALSO BALANCE THE NEED FOR FINANCIAL ASSISTANCE FOR SOME PATIENTS WITH BROADER FISCAL RESPONSIBILITIES IN ORDER TO KEEP OUR HOSPITAL DOORS OPEN FOR ALL THAT MAY NEED CARE IN THE COMMUNITY. FINANCIAL COUNSELING AND PATIENT ACCOUNT STAFFS ARE AVAILABLE BY TELEPHONE AND IN-PERSON TO DISCUSS HOSPITAL BILLS, BILLING POLICIES, METHODS OF PAYMENT, AND ALTERNATIVE SOURCES OF PAYMENT. QUESTIONS REGARDING HOSPITAL BILLS AND FINANCIAL ASSISTANCE ARE ACKNOWLEDGED PROMPTLY. PRICE QUOTES, ESTIMATES OF CHARGES, AND FULLY ITEMIZED BILLS ARE PROVIDED UPON REQUEST. CHARITY CARE INFORMATION IS PROVIDED TO UNINSURED AND UNDERINSURED PATIENTS UPON REQUEST. THE INFORMATION IS AVAILABLE IN SEVERAL LANGUAGES. ST. ANTHONY'S MEDICAL CENTER PARISH NURSES CAN ALSO PROVIDE THE SAME INFORMATION TO POTENTIAL PATIENTS NEEDING HEALTHCARE SERVICES. THE HOSPITAL PROVIDES ASSISTANCE TO PATIENTS APPLYING FOR MEDICAID OR VICTIM OF CRIMES FUNDS. ST. ANTHONY'S MEDICAL CENTER IS A HOST SITE FOR THE CLAIM PROGRAM IN THE STATE OF MISSOURI. THIS FREE SERVICE PROVIDES ASSISTANCE FOR MEDICARE ELIGIBLE PATIENTS WHO NEED HELP UNDERSTANDING MEDICARE INSURANCE OR THEIR HEALTHCARE BILLS. DISCOUNTS ARE PROVIDED TO UNINSURED PATIENTS WHO DO NOT QUALIFY FOR CHARITY CARE. AFTER ALL INSURANCE HAS PAID OR BEEN FINALIZED BY THE INSURANCE PLAN, OUR PATIENTS OR GUARANTORS RECEIVE TWO BILLING STATEMENTS AND TWO PRE-COLLECTION NOTICES PRIOR TO BEING FORWARDED TO AN OUTSIDE AGENCY FOR COLLECTION IF NO PAYMENTS ARE RECEIVED. LARGER ACCOUNTS MAY ALSO RECEIVE FOLLOW UP PHONE CALLS FROM THE HOSPITAL IN ADDITION TO THE BILLING STATEMENTS. PAYMENT OPTIONS INCLUDE A PAYMENT PLAN WITH NO INTEREST OR A LOW-INTEREST BANK LOAN PROGRAM FOR LONGER PAYMENT PLAN PERIODS. IN SOME CASES, ACCOUNTS MAY BE SENT TO A COLLECTION ATTORNEY AND SUIT BY THE HOSPITAL AUTHORIZED WHEN ALL PREVIOUS ATTEMPTS AT COLLECTING PAYMENT OR ESTABLISHING A PAYMENT PLAN FAIL. SUCCESSFUL SUITS ARE COLLECTED BY GARNISHING WAGES, BUT NO ASSETS SUCH AS HOUSES, CARS, OR BANK ACCOUNTS ARE ATTACHED. CUSTOMER COMPLAINTS REGARDING AN AGENCY ARE INVESTIGATED PROMPTLY AND THE RESULTS OF THE INVESTIGATION ARE REPORTED BACK TO THE CUSTOMER. COLLECTION AGENCIES ARE AUTHORIZED BY ST. ANTHONY'S MEDICAL CENTER TO LIST ACCOUNTS WITH CREDIT BUREAUS NINETY DAYS FROM DATE OF PLACEMENT WHEN NO ACCOUNT RESOLUTION OR PAYMENT SCHEDULE AGREEMENT HAS OCCURRED. PAYMENT SCHEDULE AGREEMENT HAS OCCURRED. STATEMENT OF PROGRAM SERVICE ACCOMPLISHMENT FORM 990, SUPPLEMENT TO PART III, LINE 1 (CONT') 2. ORGANIZATIONAL DESCRIPTION FOR TAX EXEMPTION ST. ANTHONY'S MEDICAL CENTER QUALIFIES FOR TAX EXEMPTION THROUGH VARIOUS ACTIVITIES AND PARTICIPATION AS DESCRIBED BELOW: - ST. ANTHONY'S OPERATES AN EMERGENCY ROOM THAT ACCEPTS ALL PERSONS WHO ARE IN NEED OF MEDICAL ATTENTION REGARDLESS OF THEIR ABILITY TO PAY. - ST. ANTHONY'S HAS AN OPEN MEDICAL STAFF WITH PRIVILEGES AVAILABLE TO ALL QUALIFIED PHYSICIANS IN THE AREA. - ST. ANTHONY'S HAS A GOVERNING BOARD OF DIRECTORS IN WHICH INDEPENDENT PERSONS REPRESENTATIVE OF THE COMMUNITY COMPRISE A MAJORITY; - ST. ANTHONY'S WORKS IN COOPERATION WITH LOCAL UNIVERSITIES AND HEALTH CARE ORGANIZATIONS TO ADVANCE THE SCIENCE OF MEDICINE BY PROVIDING A CLINICAL SETTING WHERE INNOVATIVE TREATMENTS AND NEW THERAPEUTIC PROTOCOLS CAN BE DEVELOPED AND STUDIED. - ST. ANTHONY'S ENGAGES IN THE TRAINING AND EDUCATION OF HEALTH CARE PROFESSIONALS BY TEAMING UP WITH LOCAL COMMUNITY COLLEGES AND UNIVERSITIES TO PROVIDE A CLINICAL SETTING FOR HEALTH CARE STUDENTS. - ST. ANTHONY'S PARTICIPATES IN MEDICAID, MEDICARE, CHAMPUS, TRICARE, AND/OR OTHER GOVERNMENT-SPONSORED HEALTH CARE PROGRAMS. 3. DESCRIPTION OF COMMUNITY BENEFIT PROGRAMS A. THE PROGRAMS BELOW DESCRIBE AND HIGHLIGHT SEVERAL PROGRAMS THAT CLEARLY MEET IDENTIFIED COMMUNITY HEALTH NEEDS. HEALTH SCREENINGS, LECTURES AND EVENTS - EACH YEAR, ST. ANTHONY'S OFFERS HEALTH SCREENINGS THAT ARE FREE AND OPEN TO THE COMMUNITY. THESE SCREENINGS ARE DESIGNED TO RAISE AWARENESS OF THE IMPORTANCE OF PREVENTIVE HEALTH CARE AND EARLY DETECTION OF DISEASE. OFTEN, THE SCREENINGS ARE IN CONJUNCTION WITH LARGER HEALTH FAIRS OFFERING FREE INFORMATION AND CONSULTATION WITH NUMEROUS MEDICAL PROFESSIONALS FROM PHYSICIANS, NURSE PRACTITIONERS AND OTHER CLINICIANS TO NUTRITIONISTS, EXERCISE PHYSIOLOGISTS AND THERAPISTS. ADDITIONALLY, THE MEDICAL CENTER SPONSORS ONGOING FREE LECTURES, HOSTED BY PHYSICIANS AND CLINICIANS, TO ADDRESS KEY CONCERNS, SUCH AS HEART DISEASE, CANCER, DIABETES, AND SAFETY AND INJURY PREVENTION. COMMUNITY OUTREACH HEALTH EDUCATION AND SPEAKERS BUREAU - ST. ANTHONY'S MEDICAL CENTER OFFERS EXTENSIVE PREVENTATIVE HEALTH EDUCATION BY SKILLED STAFF TO COMMUNITY GROUPS SUCH AS SCHOOLS, CHURCH GROUPS, BUSINESSES AND OTHER ORGANIZATIONS FREE OF CHARGE. BASED ON THE NEEDS OF THE GROUPS, ST. ANTHONY'S MEDICAL CENTER PRESENTS TOPICS AND HEALTH INFORMATION THAT WILL HELP THE COMMUNITY TO MAKE HEALTHY, EDUCATED AND WISE CHOICES WHEN IT COMES TO THEIR HEALTH. THERAPY INTERNSHIPS AND ROTATIONS - ST. ANTHONY'S MEDICAL CENTER IS NOTED AS A LEADER IN HELPING COLLEGE STUDENTS COMPLETE THEIR CLINICAL ROTATIONS OR INTERNSHIPS IN FIELDS SUCH AS PHYSICAL THERAPY, OCCUPATIONAL THERAPY, AND SPEECH THERAPY. ST. ANTHONY'S HAS ACTIVE THERAPY PROGRAMS INTERNSHIP PROGRAMS WITH WELL OVER A DOZEN UNIVERSITIES, COLLEGES AND COMMUNITY COLLEGES IN THE REGION. BEREAVEMENT AND GRIEF SUPPORT - ADDRESSES THE NEED OF BEREAVEMENT AND GRIEF SUPPORT THROUGH A BROAD RANGE OF PROGRAMS AND SERVICES. THESE TOOLS AND SUPPORT HELP THE PARTICIPANTS TO MOVE THROUGH THE STAGES OF GRIEF TO A PLACE OF UNDERSTANDING AND ACCEPTANCE OF THEIR LOSS. PROGRAMS BEYOND ST. ANTHONY'S MEDICAL CENTER AND EXTEND INTO THE COMMUNITY WITH A PRESENCE AT NURSING HOMES, HELPING THEIR STAFF DEVELOP SKILLS FOR PROVIDING COMPASSIONATE, END OF LIFE CARE. FREE HELMET FITTINGS - TRAINED STAFF MEMBERS FROM THE ST. ANTHONY'S EMERGENCY DEPARTMENT OFFER FREE HELMET FITTINGS FOR BOTH CHILDREN AND ADULTS. BICYCLE SAFETY EDUCATION IS ALSO PROVIDED TO THE CHILDREN. PARTICIPANTS ARE MADE AWARE OF THE SERIOUSNESS OF HEAD INJURIES AND HOW THEY CAN BE PREVENTED, RESULTING IN FEWER HEAD INJURIES IN CHILDREN. 4. LINKS TO ADDITIONAL COMMUNITY BENEFIT INFORMATION A. COMMUNITY HEALTH NEEDS ASSESSMENT: HTTP://WWW.STANTHONYSMEDCENTER.COM/COMMUNITY/CHNA.PDF B. IMPLEMENTATION PLAN: HTTP://WWW.STANTHONYSMEDCENTER.COM/COMMUNITY/CHNA_IMPLEMENTATION_PLAN .PDF C. COMMUNITY EVENTS & PROGRAMS: HTTP://WWW.STANTHONYSMEDCENTER.COM/CLASSES/INDEX.ASP BUSINESS RELATIONSHIP FORM 990, PART VI, SECTION A, LINE 2 JOHN H BERRA JR HAS A BUSINESS RELATIONSHIP WITH HOWARD CHILCUTT AND STACIE HASTIE; PAUL A NOVELLY HAS A BUSINESS RELATIONSHIP WITH PAUL G LORENZINI. REVIEW PROCESS FORM 990, PART VI, SECTION B, LINE 11B RETURNS ARE PREPARED AND INITIALLY REVIEWED BY ST ANTHONY'S FINANCE STAFF AND PREPARER BKD. AFTER THESE REVIEWS ARE COMPLETED, THE RETURNS ARE THEN REVIEWED WITH THE CHIEF FINANCIAL OFFICER (CFO) BY FINANCE STAFF. ONCE THIS REVIEW OCCURS, RETURNS ARE MAILED TO BOARD / FINANCE COMMITTEE MEMBERS ALONG WITH THE BOARD / FINANCE COMMITTEE PACKET. REVIEW OF THE 990 IS AN AGENDA ITEM AT THE FINANCE COMMITTEE MEETING WHERE EACH OF THE RETURNS ARE REVIEWED AND DISCUSSED WITH MEMBERS, TO INCLUDE THE CEO. ONCE THIS REVIEW OCCURS, RETURNS ARE DISTRIBUTED TO THE FULL BOARD FOR REVIEW AND DISCUSSION AS PART OF THE FINANCE COMMITTEE REPORT. ONCE ALL REVIEWS HAVE TAKEN PLACE, THE RETURNS ARE FILED WITH THE INTERNAL REVENUE SERVICE. IN THE EVENT THAT THE FORM 990 CANNOT BE REVIEWED IN A FINANCE COMMITTEE OR BOARD MEETING, THE FORM 990 WILL BE DISTRIBUTED TO THE GOVERNING BODY VIA OTHER MEANS PRIOR TO FILING WITH THE IRS. COMPLIANCE WITH CONFLICT OF INTEREST POLICY FORM 990, PART VI, SECTION B, LINE 12C TO ENSURE THAT ST. ANTHONY'S OPERATES IN A MANNER CONSISTENT WITH ITS CHARITABLE PURPOSES AND THAT IT DOES NOT ENGAGE IN ACTIVITIES THAT COULD JEOPARDIZE ITS STATUS AS AN ORGANIZATION EXEMPT FROM FEDERAL INCOME TAX, PERIODIC REVIEWS SHALL BE CONDUCTED. THE PERIODIC REVIEWS SHALL, AT A MINIMUM, INCLUDE THE FOLLOWING SUBJECTS: -WHETHER COMPENSATION ARRANGEMENTS AND BENEFITS ARE REASONABLE AND ARE THE RESULT OF ARM'S-LENGTH BARGAINING. -WHETHER ACQUISITIONS OF PHYSICIAN PRACTICES AND OTHER PROVIDER SERVICES RESULT IN INUREMENT OR IMPERMISSIBLE PRIVATE BENEFIT. -WHETHER PARTNERSHIP AND JOINT VENTURE ARRANGEMENTS AND ARRANGEMENTS WITH MANAGEMENT SERVICE ORGANIZATIONS AND PHYSICIAN HOSPITAL ORGANIZATIONS CONFORM TO WRITTEN POLICIES, ARE PROPERLY RECORDED, REFLECT REASONABLE PAYMENTS FOR GOODS AND SERVICES, FURTHER ST. ANTHONY'S CHARITABLE PURPOSES AND DO NOT RESULT IN INUREMENT OR IMPERMISSIBLE PRIVATE BENEFIT. -WHETHER AGREEMENTS TO PROVIDE HEALTH CARE AND AGREEMENTS WITH OTHER HEALTH CARE PROVIDERS, EMPLOYEES, AND THIRD PARTY PAYORS FURTHER ST. ANTHONY'S CHARITABLE PURPOSES AND DO NOT RESULT IN INUREMENT OR IMPERMISSIBLE PRIVATE BENEFIT. IF THE BOARD OR COMMITTEE OR ADMINISTRATOR HAS REASONABLE CAUSE TO BELIEVE THAT AN INDIVIDUAL HAS FAILED TO DISCLOSE ACTUAL OR POSSIBLE CONFLICTS OF INTEREST, IT SHALL INFORM THE INDIVIDUAL OF THE BASIS FOR SUCH BELIEF AND AFFORD THE INDIVIDUAL AN OPPORTUNITY TO EXPLAIN THE ALLEGED FAILURE TO DISCLOSE. IF, AFTER HEARING THE RESPONSE OF THE INDIVIDUAL AND MAKING SUCH FURTHER INVESTIGATION AS MAY BE WARRANTED IN THE CIRCUMSTANCES, THE BOARD OR COMMITTEE OR ADMINISTRATOR DETERMINES THAT THE INDIVIDUAL HAS IN FACT FAILED TO DISCLOSE AN ACTUAL OR POSSIBLE CONFLICT OF INTEREST, IT SHALL TAKE APPROPRIATE DISCIPLINARY AND CORRECTIVE ACTION. PROCESS FOR DETERMINING COMPENSATION FORM 990, PART VI, SECTION B, LINE 15(A & B) COMPENSATION FOR THE CEO AND ALL SENIOR MANAGEMENT STAFF MEMBERS IS BASED UPON COMPARABLE MARKET RATES FOR SIMILAR POSITIONS WITHIN THE NATION. PERIODICALLY, AN OUTSIDE COMPENSATION CONSULTANT IS HIRED TO REVIEW COMPENSATION AND COMPARE IT TO APPROPRIATE PEER GROUPS. THESE EXTERNAL REPORTS ARE PRESENTED TO THE BOARD OF DIRECTORS' COMPENSATION COMMITTEE FOR REVIEW AND APPROVAL ALONG WITH THE ANNUAL EVALUATIONS OF THE SENIOR STAFF MEMBERS. THE MOST RECENT COMPENSATION REVIEW WAS CONDUCTED IN APRIL OF 2013. JOINT VENTURES FORM 990, PART VI, SECTION B, LINE 16(B) THE ORGANIZATION DOES NOT HAVE A FORMAL POLICY FOR EVALUATING JOINT VENTURES. HOWEVER, THE ORGANIZATION IS THE MAJORITY OWNER OF THE TWO JOINT VENTURES IN WHICH IT PARTICIPATES, WHICH PLACES IT IN A POSITION TO SAFEGUARD ITS EXEMPT STATUS WITH RESPECT TO THE ARRANGEMENTS. THE OPERATING AGREEMENTS FOR BOTH OF THE JOINT VENTURES CONTAIN PROVISIONS THAT RESTRICT THE JOINT VENTURES FROM OPERATING IN A MANNER THAT COULD CAUSE THE JOINT VENTURE OR SAMC TO ACT OTHER THAN IN FURTHERANCE OF AND CONSISTENT WITH THE TAX-EXEMPT PURPOSES OF SAMC OR ADVERSELY AFFECT SAMC'S TAX-EXEMPT STATUS. PROCESS FOR MAKING DOCUMENTS AVAILABLE TO PUBLIC PART VI, SECTION C, LINE 19 THE ORGANIZATION CONSIDERS ITS GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY AND FINANCIAL STATEMENTS TO BE PROPRIETARY. ACCORDINGLY THEY ARE NOT MADE AVAILABLE TO THE GENERAL PUBLIC. OTHER CHANGES IN NET ASSETS OR FUND BALANCES PART XI, LINE 9 DEFINED BENEFIT PENSION PLANS 4,770,387 RECLASS NONCONTROLLING INTEREST 89,330 CURTAILMENT LOSS (468,796) CHANGE IN FAIR VALUE OF SWAP 7,680,798 INTEREST RATE SWAP 8,873,428 LOSS ON REFINANCING (3,891,241) OTHER CHANGES IN FUND BALANCE 250,000 ----------- TOTAL OTHER CHANGES IN NET ASSETS 17,303,906 DELEGATION OF CONTROL OVER MANAGEMENT DUTIES PART VI, SECTION A, LINE 3 DURING JUNE OF 2013, THE ORGANIZATION CONTRACTED WITH INTEGRITY HOSPITAL COMPANY TO PROVIDE A CEO TO OVERSEE THE DAY TO DAY OPERATIONS OF THE ORGANIZATION. 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