2013-05-14T15:08:10-05:00 2012-06-30 KPMG LLP 191 West Nationwide Blvd Ste 500 Columbus OH 432152568 990 2011-07-01 370663567 ST ELIZABETH'S HOSPITAL of the hospital sisters of THE THIRD ORDER OF ST FRANCIS % LESLIE LOVSHIN STEL 6182342120 211 SOUTH THIRD STREET BELLEVILLE IL 622201998 Leslie Lovshin 6182342120 2013-05-13 true 6142492300 2011 2016-02-24 21:20:13Z MARYANN REESE 211 SOUTH THIRD STREET BELLEVILLE IL 622201998 168280652 false 0928 X WWW.STELIZ.ORG X 1875 IL TO REVEAL AND EMBODY CHRIST'S HEALING LOVE FOR ALL PEOPLE THROUGH OUR HIGH QUALITY FRANCISCAN HEALTH CARE MINISTRY. 9 7 1755 229 17731 1006 366018 317879 173382447 167054450 2249698 -2523354 1057936 2058748 177056099 166907723 0 0 0 0 81215417 73654386 0 0 0 118902735 107971159 200118152 181625545 -23062053 -14717822 127988273 122615352 96905178 127642383 31083095 -5027031 X SEE SCHEDULE O. false false 24587457 23407883 CARDIAC SERVICES - SEE SCHEDULE O 10818507 9879200 ORTHOPEDIC SERVICES - SEE SCHEDULE O 10212563 9334732 REHABILITATION SERVICES - SEE SCHEDULE O 101883526 124432635 147502053 true true false true false false false false false false true false false false true true false true false false false false false false false false true true false false true false false false false false false false false false false false false true true false false false false true 150 0 1755 true true true false false false false false false false false false X 9 7 false false false false true true true true true false false true true true true true true true true false X LESLIE LOVSHIN 6182342120 211 SOUTH THIRD BELLEVILLE IL 622201998 X LINDA A CAMP MD 1.0 X 0 544580 15558 MARYANN L REESE RN 60.0 X X 0 444138 82810 WILLIAM S LYKE 1.0 X X 0 0 0 SISTER JANICE SCHNEIDER OSF 1.0 X 0 0 0 THOMAS M EGAN 1.0 X X 0 0 0 JACQUELYN M CLEMENT PHD 1.0 X 0 0 0 SISTER MARYBETH CULNAN OSF 1.0 X 0 0 0 REV JAMES E DEITERS 1.0 X 0 0 0 ANWAR A KHAN MD 1.0 X 37187 0 0 STEPHANIE STRANO-MAINE 1.0 X 0 0 0 KEVIN PESKO 1.0 X 0 0 0 ANN M CARR 0.25 X 0 225812 215561 MARK REIFSTECK 38.1 X 0 392603 214175 JOHNNY E WATKINS 38.1 X 253946 0 60364 LESLIE LOVSHIN 60.0 X 131234 0 28663 SHELLEY HARRIS 60.0 X 137979 0 120613 TERENCE WADE MD 60.0 X 290737 0 13530 JAMES RUSHFORD 60.0 X 597709 0 59465 DONALD JOHNSTON 60.0 X 654263 0 52357 JAMES BURKE 38.1 X 192773 0 45402 ADAM THACKER 60.0 X 144122 0 9306 JOSEPH B STASIAK 60.0 X 131176 0 167434 ALICE CHATLEY 0.0 X 112267 0 -8285 EDWARD JACQUIN 0.0 X 114339 0 21673 ROBERT S MILLER 0.0 X 251171 0 256414 3048903 1607133 1355040 12 true true false PROFESSIONAL THERAPY SVC INC 2810 Frank Scott Pkwy West Suite 8 BELLEVILLE IL 62223 Physical Therapy 3330665 SODEXO OPERATIONS LLC 4880 Payshere Circle CHICAGO IL 60674 Food service 1304839 SLU CARE 1402 S Grand Blvd ST LOUIS MO 63104 Physician services 1291796 Impact Strategies 340 Office Court FAIRVIEW HEIGHTS IL 62208 Construction 850039 ERLINGER CONSTRUCTION CO 2502 S Belt West BELLEVILLE IL 62226 construction 748855 5 317879 317879 NET PATIENT REVENUE 900000 165837296 165837296 PHARMACY 446110 109868 109868 HEALTH PROGRAMS 900000 7195 7195 ONCOLOGY CENTER INCOME 900000 1100091 1100091 167054450 -2507040 0 -2507040 0 0 1460182 1134060 326122 326122 326122 222555 238869 -16314 -16314 -16314 0 0 0 ADMINISTRATION INCOME 900099 996410 996410 PURCHASE DISCOUNTS 900099 444036 444036 CAFETERIA SALES 722210 53557 53557 238623 17731 220892 1732626 166907723 167054450 17731 -482337 0 0 0 0 1088204 456033 632171 0 54974143 46908392 8065751 3553962 3002574 551388 10048890 7870920 2177970 3989187 3370275 618912 3564918 3564918 938800 0 938800 0 28903 28903 0 0 24879370 21120665 3758705 88730 2372 86358 1099227 886768 212459 7564828 32008 7532820 0 4281682 4281017 665 102457 61675 40782 0 49074 29158 19916 395471 395471 0 9281289 7530467 1750822 3099977 392531 2707446 MEDICAL SUPPLIES 21428840 21428840 PROVISION FOR BAD DEBTS 19388604 19388604 LICENSE AND TAXES 7170295 7158097 12198 0 MAINTENANCE & REPAIRS 4018701 3400253 618448 589993 152501 437492 181625545 147502053 34123492 0 0 0 -2050973 -4023125 935530 7247610 23000542 32423111 0 0 0 0 464693 101817 2400379 2566401 1490338 1016709 205736492 143486367 64051241 62250125 32839677 16615232 0 0 4344685 3944776 0 0 512161 472696 127988273 122615352 14382276 15389849 0 0 2130 9199 48367764 62791810 0 0 0 0 0 0 0 0 34153008 49451525 96905178 127642383 X 24892315 -11327023 6146850 6226005 43930 73987 31083095 -5027031 127988273 122615352 X -14717822 -21392304 X false true true X true true X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED X false false false false false false false false true 28903 28903 false DESCRIPTION OF OTHER LOBBYING ACTIVITIES SCHEDULE C, PART II-B, QUESTION 1I ST. ELIZABETH'S HOSPITAL ("THE HOSPITAL") IS A MEMBER OF THE CATHOLIC HEALTH ASSOCIATION ("CHA"), THE ILLINOIS HEALTH ASSOCIATION ("IHA"), THE NATIONAL ASSOCIATION FOR HOME CARE AND HOSPICE, AND THE AMERICAN HEALTH ASSOCIATION ("AHA"). AS A MEMBER OF THESE ORGANIZATIONS, THE HOSPITAL PAYS DUES, PART OF WHICH ARE ATTRIBUTABLE TO LOBBYING FEES PAID BY THE ORGANIZATIONS. THE AMOUNT LISTED ABOVE IS THE AMOUNT ATTRIBUTABLE TO THE HOSPITAL FROM ITS DUES PAID. false 3630755 3630755 117009758 78546032 38463726 359390 182552 176838 75156706 59345730 15810976 9579883 5412053 4167830 62250125 0 ACCRUED BENEFIT LIABILITY 38566561 RETIREMENT OBLIGATION ASBESTOS 8250172 SELF INSURANCE COST 2634792 49451525 FIN 48 (ASC 740 FOOTNOTE) SCHEDULE D, PART X, LINE 2 ON JULY 1, 2007, HSHS ADOPTED ASC SUBTOPIC 740-10, ACCOUNTING FOR UNCERTAINTY IN INCOME TAXES - AN INTERPRETATION OF FASB STATEMENT NO. 109. ASC SUBTOPIC 740-10 ADDRESSES THE DETERMINATION OF HOW TAX BENEFITS CLAIMED OR EXPECTED TO BE CLAIMED ON A TAX RETURN SHOULD BE RECORDED IN THE CONSOLIDATED FINANCIAL STATEMENTS. UNDER ASC SUBTOPIC 740-10, HSHS MUST RECOGNIZE THE TAX BENEFIT FROM AN UNCERTAIN TAX POSITION ONLY IF IT IS MORE LIKELY THAN NOT THAT THE TAX POSITION WILL BE SUSTAINED ON EXAMINATION BY THE TAXING AUTHORITIES, BASED ON THE TECHNICAL MERITS OF THE POSITION. THE TAX BENEFITS RECOGNIZED IN THE CONSOLIDATED FINANCIAL STATEMENTS FROM SUCH A POSITION ARE MEASURED BASED ON THE LARGEST BENEFIT THAT HAS A GREATER THAN 50% LIKELIHOOD OF BEING REALIZED UPON ULTIMATE SETTLEMENT. ASC SUBTOPIC 740-10 ALSO PROVIDES GUIDANCE ON DERECOGNITION, CLASSIFICATION, INTEREST, AND PENALTIES ON INCOME TAXES, ACCOUNTING IN INTERIM PERIODS AND REQUIRES INCREASED DISCLOSURES. AT THE DATE OF ADOPTION, AND AS OF JUNE 30, 2012 AND 2011, HSHS DOES NOT HAVE A LIABILITY FOR UNRECOGNIZED TAX BENEFITS. true true true X true X 600. true true true false true true 4559607 4559607 0.02810 28849020 18628153 10220867 0.06300 33408627 18628153 14780474 0.09110 39 10472 332690 332690 0.00210 6 1808 2250537 466145 1784392 0.01100 2 2189 190128 190128 0.00120 5 627 78919 78919 0.00050 52 15096 2852274 466145 2386129 0.01480 52 15096 36260901 19094298 17166603 0.10590 6 1043 44757 44757 0.00030 2 724 1564 1564 1 350 237 237 9 2117 46558 46558 0.00030 true 5613001 0 52786538 48196120 4590418 X true true MEM & ST ELIZ'S HEALTHCARE 0.50000 0.00000 0.00000 HEALTHCARE SVS SOUTHERN ILLINOIS FACILITATE CARDIOVASCULAR SVS 0.50000 0.00000 0.00000 CARDIOVASCULAR FAC 1 1 St Elizabeth's Hospital - Belleville

211 South Third Street Belleville IL 622201998

X St Elizabeth's Hospital - Belleville 1 true X X X X X X X X 11 true false true X X X X X X X X false true true 150. true 600. true X X X X X X X true true X X X X true false true X false false PART I, LINE 3C NOT APPLICABLE AS ST. ELIZABETH'S HOSPITAL DOES FOLLOW FPG TO DETERMINE ELIGIBILITY FOR PROVIDING CHARITY AND DISCOUNTED CARE TO LOW-INCOME, UNINSURED AND UNDERINSURED INDIVIDUALS. PART I, LINE 6A THE HOSPITAL'S COMMUNITY BENEFIT REPORT CAN BE ACCESSED AT: HTTP://WWW.STELIZ.ORG/ABOUT/ PART I, LINE 7 THE CALCULATION OF COST IS BASED ON THE CHARGES FOR THESE SERVICES MULTIPLIED BY THE OVERALL COST TO CHARGE RATIO BASED ON THE HOSPITAL'S FINANCIAL STATEMENTS TO DETERMINE THE ACTUAL COST OF THESE SERVICES. PART II UNDER COMMUNITY BUILDING ACTIVITIES, ST. ELIZABETH'S HOSPITAL PROVIDES THE FOLLOWING FOR COMMUNITY SUPPORT: BRIDGES CONNECTIONS DISTRICT 201: THIS PROGRAM IS DESIGNED TO HELP SPECIAL NEEDS STUDENTS LEARN MARKETABLE SKILLS THROUGH ON THE JOB TRAINING. TWO HOURS A DAY AND UP TO THREE STUDENTS RECEIVE SUPERVISED JOB TRAINING. EACH STUDENT PROGRESSES THROUGH A THREE PHASE PROGRAM. AS THEY PROGRESS THROUGH EACH PHASE OF THE PROGRAM, THE HOSPITAL ABSORBS AN INCREASING PERCENTAGE OF THE COST. THIS PROGRAM ENHANCES THIS HIGH RISK POPULATION'S ABILITY TO BE A PRODUCTIVE PART OF OUR COMMUNITY. FOOD, CLOTHING, SCHOOL SUPPLY DRIVES AND ELIZABETH'S GARDEN: THROUGHOUT THE YEAR, THESE PROGRAMS ARE SUPPORTED BY OUR COLLEAGUES TO SUPPORT OUR COMMUNITY NEED. ITEMS ARE DONATED TO LOCAL AGENCIES THAT WORK WITH THE POOR AND/OR TO LOCAL FOOD PANTRIES; THUS, REDUCING THE BURDEN TO GOVERNMENT. MENTORING AT HENRY RAAB ELEMENTARY SCHOOL: THE SCHOOL SELECTS STUDENTS FROM LOW INCOME, AT RISK FAMILIES WHO ARE IN NEED OF AN ADULT ROLE-MODEL. DIRECTORS/MANAGERS SPEND ONE-ON-ONE TIME WITH THEIR ASSIGNED STUDENT TO BOTH ENCOURAGE GROWTH AND OFFER ASSISTANCE WITH SCHOOL WORK AND RELATIONSHIP BUILDING. THIS ENHANCES THE LEARNING EXPERIENCE OF THESE CHILDREN, WHICH WILL INCREASE THEIR CHANCES OF GRADUATING AND IMPROVE THEIR HEALTH OUTCOMES. UNDER COMMUNITY BUILDING ACTIVITIES, ST. ELIZABETH'S HOSPITAL PROVIDES THE FOLLOWING FOR LEADERSHIP DEVELOPMENT/ TRAINING FOR COMMUNITY MEMBERS: BASIC INITIATIVE: BASIC (BELLEVILLE ACHIEVES STRENGTH IN CHARACTER) IS A PARTNERSHIP OF SCHOOLS, THE CITY OF BELLEVILLE, AND THE BUSINESS COMMUNITY TO STRENGTHEN CHARACTER IN OUR YOUTH AND IN THE COMMUNITY. BASIC ENCOURAGES YOUTHS AND ADULTS TO BE PRODUCTIVE CITIZENS IN OUR COMMUNITY. PART III, LINE 4 SINCE THE HOSPITAL IMPLEMENTED THE SEARCH AMERICA PROCESS, A MUCH CLOSER REPRESENTATION OF THE TRUE COMMUNITY BENEFIT IS REFLECTED. SELF-PAY PATIENTS ARE SCREENED FOR VERIFICATION OF NO INSURANCE COVERAGE. ONCE VERIFICATION OF NO COVERAGE HAS BEEN COMPLETED, THE GUARANTORS WILL BE SCREENED FOR CHARITY CARE OR UNINSURED DISCOUNTS BASED ON INCOME LEVELS. THOSE GUARANTORS THAT DO NOT QUALIFY FOR CHARITY CARE THROUGH THE SCREENING PROCESS WILL BE ASKED TO PROVIDE PROOF OF INCOME IN THE FORM OF A RECENT PAY STUB AND/OR RECENT TAX RETURN TO DETERMINE THE LEVEL OF UNINSURED DISCOUNTING. IF NO PROOF OF INCOME IS PROVIDED, AN APPROPRIATE DISCOUNT ACCORDING TO THE ESTABLISHED CRITERIA WILL BE APPLIED. THAT AMOUNT OF MONEY NOT COLLECTED FROM THOSE SELF-PAY PATIENTS WHO ARE NOT ELIGIBLE FOR CHARITY CARE IS CALCULATED AS PART OF BAD DEBT. DURING THE YEAR, THE HOSPITAL'S BAD DEBT EXPENSE (AT COST) WAS $5.6 MILLION. BAD DEBT AT COST IS DERIVED BY MULTIPLYING THE HOSPITAL'S TOTAL BAD DEBT EXPENSE FOR THE FISCAL YEAR BY THE COST TO CHARGE RATIO. THE COST TO CHARGE RATIO USED WAS DERIVED BY DIVIDING THE HOSPITAL'S OPERATING EXPENSES MINUS BAD DEBT BY NET PATIENT SERVICE REVENUE LESS ANY NON PATIENT CARE ACTIVITIES. PART III, LINE 8 The amount reported on Part III, line 6 is pulled from our most recent Medicare Cost Report. The cost reported on our Medicare Cost Report is derived by using a cost to charge ratio. PART III, LINE 9B EVERY EFFORT IS MADE PRIOR TO, DURING AND AFTER PROVISION OF MEDICAL SERVICES TO DETERMINE WHETHER A PATIENT IS ELIGIBLE FOR CHARITY/COMMUNITY CARE AND TO ASSIST THE PATIENT IN COMPLETING THE APPLICATION AND PROVIDING ADEQUATE DOCUMENTATION. IF THE PATIENT QUALIFIED FOR CHARITY/COMMUNITY CARE FOR THE FULL BALANCE OF THEIR ACCOUNT, THE ENTIRE AMOUNT IS WRITTEN OFF TO CHARITY/COMMUNITY CARE AND HENCE NO DEBT COLLECTION IS PURSUED. IF THE PATIENT QUALIFIED FOR CHARITY/COMMUNITY CARE FOR A PORTION OF THEIR ACCOUNT BALANCE, THAT PORTION IS WRITTEN OFF TO CHARITY/COMMUNITY CARE, WITH THE PATIENT BEING RESPONSIBLE FOR THE REMAINDER OF THE BALANCE. ADDITIONALLY, REASONABLE EFFORT WILL BE MADE TO OBTAIN THIRD-PARTY OR GOVERNMENT PAYER REIMBURSEMENT ON BEHALF OF THE PATIENT. IF THOSE EFFORTS ARE NOT FRUITFUL, AN OFFER WILL BE EXTENDED TO THE PATIENT TO MAKE INSTALLMENT PAYMENTS ON THEIR BALANCE. ONLY AT SUCH POINT THAT THE PATIENT DEFAULTS ON INSTALLMENT PAYMENTS OR REFUSES TO COOPERATE WITH THE HOSPITAL'S EFFORTS TO BE REIMBURSED WILL THE ACCOUNT BE SENT TO COLLECTIONS. FOR ADDITIONAL INFORMATION, SEE RESPONSE TO QUESTION VI, 3. PART V, SECTION B, 1 ST. ELIZABETH'S HOSPITAL IS A CATHOLIC-SPONSORED, NOT-FOR-PROFIT, COMMUNITY HOSPITAL LOCATED IN ST. CLAIR COUNTY, ILLINOIS. THE HOSPITAL HAS SERVED THIS COMMUNITY SINCE ITS FOUNDING IN 1875 BY THE HOSPITAL SISTERS OF ST. FRANCIS. ST. ELIZABETH'S HOSPITAL IS PART OF THE HOSPITAL SISTERS HEALTHCARE SYSTEM (HSHS), LOCATED IN SPRINGFIELD, ILLINOIS. THE HOSPITAL HAS A WELL-ESTABLISHED TRADITION OF PARTNERING WITH THE COMMUNITY TO IMPROVE THE HEALTH OF THE COMMUNITY. THE PRIMARY SERVICE AREA FOR ST. ELIZABETH'S HOSPITAL COVERS MOST OF ST. CLAIR COUNTY, POP. 270,046 (2010 CENSUS). THE SECONDARY SERVICE AREA EXTENDS INTO MONROE, CLINTON, RANDOLPH AND MADISON COUNTIES. TOTAL POPULATION OF THE PRIMARY AND SECONDARY SERVICE AREA IS 353,346 (2010 CENSUS). ST. ELIZABETH'S HOSPITAL ALSO SERVES AS A REFERRAL HOSPITAL FOR THE HSHS SOUTHERN ILLINOIS DIVISION WHICH INCLUDES ST. JOSEPH'S HOSPITAL IN HIGHLAND, ST. JOSEPH'S HOSPITAL IN BREESE AND ST. ANTHONY'S MEMORIAL HOSPITAL IN EFFINGHAM. ST. ELIZABETH'S HOSPITAL CURRENTLY STAFFS 260 INPATIENT BEDS. THE HOSPITAL EMPLOYS 1,349 COLLEAGUES. INPATIENT ADMISSIONS FOR FISCAL YEAR 2012 WERE 12,486. THE EMERGENCY DEPARTMENT HAD 28,514 VISITS AND ADMITTED 7,096 TO INPATIENT SERVICES. THE URGI-CENTER IN O'FALLON, AN OFFSITE FACILITY, HAD 18,143 VISITS. TOTAL OUTPATIENT VISITS FOR THE HOSPITAL WERE 176,824. ST. ELIZABETH'S HOSPITAL IS A RECOGNIZED ACCREDITED CHEST PAIN CENTER SINCE 2004. THE CENTER RECEIVED THE AMERICAN HEART ASSOCIATION MISSION LIFE LINE BRONZE AWARD FOR OVERALL CARDIAC CARE. THE INTENSIVE CARE UNIT FOR THE PAST FOUR YEARS HAS BEEN RECOGNIZED TO BE IN THE TOP 10% IN THE NATION. RESPONDING TO THE IDENTIFIED NEEDS IN THE 2012 COMMUNITY HEALTH NEEDS ASSESSMENT (CHNA), ST. ELIZABETH'S HOSPITAL CONTINUES TO FOCUS ON PROVIDING ACCESS TO CARE AND SERVICES TO THE UNDERSERVED AND UNINSURED IN THE SERVICE AREA. FIVE COMMUNITY ENGAGEMENT GROUPS BRAINSTORMED HEALTH NEEDS OF THE COMMUNITY, REVIEWED PERTINENT HEALTH DATA AND PRIORITIZED THE REGION'S TOP NEEDS. THE COMMUNITY BENEFIT STEERING COMMITTEE THEN REVIEWED ALL OF THESE FINDINGS AND RANKED EACH NEED BASED ON THE MISSION OF THE HOSPITAL, THE MAGNITUDE, FEASIBILITY AND SEVERITY OF THE NEED THE 2012 CHNA PROCESS IDENTIFIED AND THE BOARD OF DIRECTORS APPROVED THE FOLLOWING THREE STRATEGIC INITIATIVES: ACCESS TO HEALTHCARE FOR THE UNDERSERVED AND UNINSURED MENTAL HEALTH - DECREASE DEPRESSION AND RATE OF SUICIDE CHRONIC DISEASE - IMPROVE MANAGEMENT OF DIABETES ST. ELIZABETH'S COMMITMENT TO IMPROVING THE HEALTH OF OUR COMMUNITY, REDUCING THE BURDEN OF GOVERNMENT, IMPROVING ACCESS TO HEALTH CARE SERVICES TO THE UNINSURED AND UNDERSERVED AND PROVIDING HEALTH PROFESSION EDUCATION IS EVIDENCED BY THE VALUE OF OUR COMMUNITY BENEFIT. THE FY 2012 COMMUNITY BENEFIT EQUALS $17,213,161. PART V, LINE 3 IN MARCH 2012, ST. ELIZABETH'S HOSPITAL HOSTED FIVE TWO-HOUR COMMUNITY ENGAGEMENT SESSIONS WITH 10 TO 15 PARTICIPANTS PER SESSION. PARTICIPANTS WERE INVITED BASED ON THEIR AWARENESS AND EXPERTISE IN THE HEALTHCARE NEEDS OF OUR COMMUNITY. EMPHASIS WAS PLACED ON REPRESENTATION OF THE UNDERSERVED, LOW-INCOME AND MINORITY POPULATIONS AS WELL AS POPULATIONS WITH CHRONIC DISEASE. NINETY PEOPLE WERE INVITED TO PARTICIPATE. FIFTY-EIGHT PEOPLE ATTENDED ONE OF THE SESSIONS. THE FOLLOWING DESCRIBES THOSE WHO PARTICIPATED AND THE SPECIAL NEED AREAS THEY REPRESENTED ARE SHOWN IN ITALICS: PHYSICIANS (ER, PRIMARY CARE PHYSICIANS, DENTISTS, UROLOGIST) - CHRONIC DISEASE, UNDERSERVED, LOW INCOME, MINORITY PRACTICING NURSES, RETIRED NURSES, HOSPICE NURSES, UNIVERSITY NURSE EDUCATORS, PARISH NURSES - CHRONIC DISEASE BUSINESS LEADERS CIVIC LEADERS (MAYOR'S OFFICE, CHAMBER OF COMMERCE, ALDERMEN) LEGAL COMMUNITY (LAWYER AND JUDGE, ADVISOR FOR THE LEGAL AID SOCIETY) - LOW INCOME, MINORITY HEALTH AGENCIES (AMERICAN CANCER, CALL FOR HELP, FIRST RESPONDERS/EMS) - CHRONIC DISEASE, UNDERSERVED, MINORITY, LOW INCOME COMMUNITY SERVICE AGENCY DIRECTORS - UNDERSERVED, MINORITY, LOW INCOME SCHOOLS REPRESENTATION (PRIMARY AND SECONDARY REPRESENTATION) - UNDERSERVED, MINORITY, LOW INCOME MENTAL HEALTH AGENCY DIRECTORS (INCLUDING ALCOHOL AND DRUG ADDICTION EXPERTS) - UNDERSERVED, MINORITY, LOW INCOME PARENTS OF SPECIAL NEEDS CHILDREN - UNDERSERVED HISPANIC SERVICE AGENCY - UNDERSERVED, MINORITY, LOW INCOME RELIGIOUS LEADERS - INNER CITY AND RURAL - MINORITY, LOW INCOME AGENCY FOR THE AGING - MINORITY MILITARY COMMANDER FOR SCOTT AIR FORCE BASE HEALTH SERVICES COMMUNITY INPUT WAS ALSO OBTAINED THROUGH A HOUSEHOLD SURVEY. PART V, LINE 4 ST. ELIZABETH'S HOSPITAL CONDUCTED THE COMMUNITY HEALTH NEEDS ASSESSMENT IN COLLABORATION WITH THE ST. CLAIR COUNTY HEALTH DEPARTMENT, KARLA SMITH FOUNDATION AND 708 MENTAL HEALTH BOARD. PART V, LINE 5C THE CHNA REPORT IS POSTED ON OUR HOSPITAL WEBSITE AT: HTTP://WWW.STELIZ.ORG/ABOUT/ IN ADDITION, THE REPORT IS POSTED ON OUR HOSPITAL INTRANET MISSION PAGE FOR ALL OF OUR COLLEAGUES AND WAS SHARED WITH THE ST. CLAIR COUNTY HEALTH CARE COMMISSION AT THEIR QUARTERLY MEETING IN JULY, 2012. PART V, LINE 7 PRIORITY NEEDS NOT BEING ADDRESSED AND THE REASONS: THE BOARD OF DIRECTORS APPROVED THE COMMUNITY BENEFIT IMPLEMENTATION STRATEGY BASED ON THE CHNA DURING THE REPORTING YEAR. THE APPROVED IMPLEMENTATION STRATEGY WILL BE EXECUTED IN THE FOLLOWING YEAR (FY2013). BASED ON HOSPITAL CAPABILITIES, RESOURCES, SEVERITY OF THE NEED, AND OTHER FACTORS, ST. ELIZABETH'S WILL BE ADDRESSING THREE AREAS: IMPROVE ACCESS TO HEALTHCARE, ESPECIALLY FOR THOSE WHO ARE UNINSURED OR UNDERINSURED MENTAL HEALTH, REDUCE THE RATE OF DEPRESSION AND SUICIDE IN THE ADULT POPULATION IN THE COUNTY CHRONIC DISEASE, EDUCATE AND EMPOWER DIABETICS TO LIVE A EALTHIER LIFESTYLE THE FOLLOWING ADDITIONAL NEEDS WERE IDENTIFIED AND THE REASONS THEY WILL NOT BE ADDRESSED DIRECTLY BY THE HOSPITAL IN FY2013 FOR THE REASONS INDICATED: MENTAL HEALTH - APPROPRIATE SERVICES FOR UNINSURED: THIS WILL BE PARTLY ADDRESSED AS A COROLLARY OF THE MENTAL HEALTH SUICIDE/ DEPRESSION INITIATIVE. CONSOLIDATION OF COMMUNITY HEALTH/RESOURCE INFORMATION: ST. ELIZABETH'S HOSPITAL LACKS THE EXPERTISE TO DEVELOP AND MAINTAIN THIS DATA BASE. UNITED WAY MAINTAINS A DATA BASE IN THEIR "211" SYSTEM. DEVELOP RESPONSIBILITY FOR ONE'S HEALTHCARE: ST. ELIZABETH'S HOSPITAL ADDRESSES THIS ISSUE THROUGH OUR SOCIAL SERVICE DEPARTMENT ON CASE BY CASE BASIS. GERIATRIC POPULATION (ACCESS MEDICAL/PSYCHIATRIC):ST. ELIZABETH'S HOSPITAL PROVIDES INPATIENT AND OUTPATIENT CARE AS PART OF THE BEHAVIORAL HEALTHCARE SERVICE LINE TO THIS POPULATION. THE HOSPITAL LACKS ADEQUATE SPACE TO ESTABLISH A SEPARATE GERO-PSYCH PROGRAM. ADDRESSING THE LACK OF GERIATRIC TRAINED PHYSICIANS IS BEYOND THE SCOPE OF THIS FACILITY. VIOLENCE PREVENTION AND SAFETY: THIS NEED IS AN IDENTIFIED NEED IN THE IPLAN (ILLINOIS PROJECT FOR LOCAL ASSESSMENT OF NEEDS). THE ST. CLAIR COUNTY HEALTH DEPARTMENT WILL BE THE LEAD AGENCY ADDRESSING THIS NEED. ST. ELIZABETH'S HOSPITAL LACKS THE ABILITY TO ADDRESS THIS ISSUE IN ANY MEANINGFUL WAY. LUNG CANCER AND COPD: THIS NEED IS AN IDENTIFIED NEED IN THE IPLAN. THIS ISSUE IS ALREADY BEING ADDRESSED BY THE HOSPITAL, ST. CLAIR COUNTY HEALTH DEPARTMENT AND OTHER COMMUNITY BASED PROGRAMS. MATERIAL AND CHILD HEALTH AS RELATED TO INFANT MORTALITY, TEEN PREGNANCY AND STD/HIV: THIS NEED IS AN IDENTIFIED NEED IN THE IPLAN. THE HOSPITAL CURRENTLY HAS A LEVEL 2 NICU WITH A NEONATOLOGIST AND PERINATOLOGIST ON THE MEDICAL STAFF. THE HOSPITAL LACKS THE REQUIRED RESOURCES TO FURTHER ENHANCE PROGRAMS FOR MATERNAL AND CHILD HEALTH AT THIS TIME. PART V, LINE 15-17 THE HOSPITAL MAKES REASONABLE EFFORTS TO DETERMINE A PATIENT'S ELIGIBILITY FOR THE CHRISTIAN ASSISTANCE PROGRAM BEFORE UTILIZING ANY EXTRAORDINARY COLLECTION ACTIONS. ON ADMISSION, A PATIENT RECEIVES INFORMATION ABOUT THE CHRISTIAN ASSISTANCE PROGRAM AND HOW TO FILL OUT AN APPLICATION, ALONG WITH A PHONE NUMBER TO CONTACT FOR FURTHER HELP. INPATIENTS, WHO ARE UNINSURED AND NOT ELIGIBLE FOR MEDICAID, ARE GIVEN A CHRISTIAN ASSISTANCE APPLICATION. EACH PATIENT WILL THEN RECEIVE THREE BILLS WITH INFORMATION ON HOW TO APPLY FOR CHRISTIAN ASSISTANCE. PATIENTS WHO HAVE NOT RESPONDED TO ANY OF THESE INQUIRIES WILL BE SENT TO A COLLECTION AGENCY. IF THE COLLECTION AGENCY HAS EVIDENCE THAT THE PATIENT MAY QUALIFY FOR CHRISTIAN ASSISTANCE, THE ACCOUNT WILL BE RETURNED TO THE HOSPITAL AND A CHRISTIAN ASSISTANCE APPLICATION PROCESS WILL BEGIN. EXTRAORDINARY COLLECTION EFFORTS ARE UTILIZED ONLY AFTER REASONABLE EFFORTS HAVE BEEN TAKEN TO DETERMINE A PATIENT IS NOT ELIGIBLE FOR CHRISTIAN ASSISTANCE. PART V, LINE 19D WE ASK EACH PATIENT TO FILL OUT A FORM IN ORDER TO DETERMINE THEIR ELIGIBILITY UNDER THE ILLINOIS UNINSURED ACT. IF THE PATIENT FAILS TO FILL OUT THE FORM, FINANCIAL COUNSELORS WILL SEEK TO DETERMINE PATIENT ELIGIBILITY BY SEEKING APPROPRIATE INFORMATION IN THE SEARCH AMERICA PROGRAM. WE ALSO REVIEW THE PATIENTS' ACCOUNTS TO ENSURE THEY ARE NOT CHARGED MORE THAN 25% OF THEIR ANNUAL GROSS INCOME. ONCE THE CHARGES FOR A SELF-PAY BALANCE EXCEED 25% OF THE PATIENTS' ANNUAL GROSS INCOME, THE REMAINING BALANCE IS ADJUSTED OFF TO CHRISTIAN CARE. PART VI, NEEDS ASSESSMENT TRADITIONALLY, ST. ELIZABETH'S HOSPITAL WORKED CLOSELY WITH THE ST. CLAIR COUNTY HEALTH DEPARTMENT AND PARTICIPATED IN DEVELOPING OF THE COUNTY'S IPLAN. THE IPLAN IS A COMMUNITY HEALTH ASSESSMENT AND PLANNING PROCESS THAT IS CONDUCTED EVERY FIVE YEARS BY THE LOCAL HEALTH JURISDICTIONS IN ILLINOIS. IN THE PAST, THE IPLAN WAS UTILIZED TO HELP DETERMINE THE HOSPITAL'S COMMUNITY BENEFIT IMPROVEMENT STRATEGIES. THIS YEAR (FY2012) A TEAM, CONSISTING OF A HOSPITAL ADMINISTRATIVE CONSULTANT, THE DIRECTOR OF MISSION INTEGRATION AND THE DIRECTOR OF PASTORAL CARE, FACILITATED THE CHNA FOR THE HOSPITAL IN COLLABORATION WITH THE ST. CLAIR COUNTY HEALTH DEPARTMENT. HOSPITAL SISTERS HEALTH SYSTEM (HSHS) ESTABLISHED A GOAL FOR ALL SYSTEM HOSPITALS TO COMPLETE A CHNA BY THE END OF FISCAL YEAR 2012. HSHS SELECTED LEEDE RESEARCH, A MARKETING RESEARCH FIRM SPECIALIZING IN HEALTHCARE INFORMATION, TO COMPLETE AN INDEPENDENT HEALTH NEEDS ASSESSMENT SURVEY OF OUR COMMUNITY. LEEDE RESEARCH UTILIZED A SET OF STANDARD HEALTH ASSESSMENT QUESTIONS AND LOCALLY DEFINED CUSTOM QUESTIONS. DURING DECEMBER, 2011 LEEDE RESEARCH COMPLETED 400 TELEPHONE SURVEYS IN THE HOSPITAL'S PRIMARY SERVICE AREA. OUR CHNA INTEGRATED THE FOLLOWING DATA SOURCES TO DEVELOP OUR IMPLEMENTATION STRATEGY: LEEDE RESEARCH SURVEY ST. CLAIR COUNTY HEALTH DEPARTMENT IPLAN MISSOURI HOSPITAL ASSOCIATION - ASSESSING THE HEALTH OF COMMUNITIES UNIVERSITY OF WISCONSIN COUNTY HEALTH RANKINGS DIGNITY HEALTH COMMUNITY NEED INDEX IN MARCH 2012, THE HOSPITAL HOSTED FIVE TWO-HOUR COMMUNITY ENGAGEMENT SESSIONS WITH 10 TO 15 PARTICIPANTS PER SESSION. PARTICIPANTS WERE INVITED BASED ON THEIR AWARENESS AND EXPERTISE IN THE HEALTHCARE NEEDS OF OUR COMMUNITY, EMPHASIS WAS PLACED ON REPRESENTATION OF UNDERSERVED, LOW-INCOME AND MINORITY POPULATIONS AS WELL AS POPULATIONS WITH CHRONIC DISEASE. NINETY PEOPLE WERE INVITED TO PARTICIPATE. FIFTY-EIGHT PEOPLE ATTENDED AT LEAST ONE OF THE SESSIONS. EACH SESSION IDENTIFIED THE FIVE MOST SIGNIFICANT HEALTH NEEDS IN OUR SERVICE AREA, UTILIZING ALL OF THE HEALTH DATA PROVIDED, THE NEEDS IDENTIFIED IN A BRAINSTORMING SESSION AND THE PARTICIPANTS' PERSONAL EXPERTISE TO FORMULATE THEIR TABLE'S TOP FIVE HEALTH NEEDS. 1. ACCESS TO HEALTH CARE CLINICS FOR UNINSURED LACK OF PRIMARY CARE PROVIDERS INSURANCE COSTS 2. EDUCATION HEALTHY LIVING HEALTHCARE RESOURCES END OF LIFE 3. MENTAL HEALTH/ADDICTIONS 4. CHRONIC ISSUES DIABETES CARDIAC/PULMONARY OBESITY MOTHER /CHILD 5. SERVICES GERIATRIC SPECIAL NEEDS THE 16 MEMBER COMMUNITY BENEFIT STEERING COMMITTEE EVALUATED THE DATA SOURCES AND THE COMMUNITY ENGAGEMENT GROUP'S RESULTS WITH THE HOSPITAL'S MISSION AND RESOURCES. THE GOAL WAS TO DETERMINE THE NEEDS OF OUR COMMUNITY THAT COULD BEST BE ADDRESSED BY ST. ELIZABETH'S HOSPITAL. THIS COMMITTEE REPRESENTED CLINICAL SPECIALTIES FROM THE HOSPITAL AS WELL AS EXPERTS FROM THE COMMUNITY, (DIRECTOR OF COMMUNITY HEALTH, ST. CLAIR COUNTY HEALTH DEPARTMENT; EXECUTIVE DIRECTOR, ST. CLAIR COUNTY 708 MENTAL HEALTH BOARD; PRESIDENT KARLA SMITH FOUNDATION, SUICIDE AND FAMILY SUPPORT GROUP; PASTOR, ST. PAUL'S UNITED CHURCH OF CHRIST IN LEBANON, IL). USING FOUR CRITERIA, THE STEERING COMMITTEE MEMBERS RANK ORDERED THE LIST OF HEALTH NEEDS IDENTIFIED BY THE COMMUNITY ENGAGEMENT GROUPS. THE CRITERIA CONSISTED OF: MEETS THE MISSION OF THE HOSPITAL THE MAGNITUDE OF THE NEED THE FEASIBILITY OR AVAILABLE RESOURCES TO ADDRESS THOSE NEEDS THE SEVERITY OF THE HEALTH NEED IN OUR COMMUNITY THE STEERING COMMITTEE IDENTIFIED THREE PRIMARY NEEDS; ACCESS TO HEALTHCARE, ESPECIALLY FOR THOSE WHO ARE UNINSURED OR UNDERINSURED MENTAL HEALTH, REDUCE THE RATE OF DEPRESSION AND SUICIDE IN THE ADULT POPULATION IN THE COUNTY CHRONIC DISEASE, EDUCATE AND EMPOWER DIABETICS TO LIVE A HEALTHIER LIFESTYLE HOSPITAL COLLEAGUES AND COMMUNITY MEMBERS WERE ASSIGNED TO EACH OF THE TOP THREE HEALTH NEEDS. EACH COMMITTEE THEN FOCUSED ON ONE SPECIFIC PRIORITY TO DEFINE THE IMPLEMENTATION STRATEGY, TAKING INTO ACCOUNT THE ASSETS IN THE COMMUNITY AVAILABLE TO HELP ADDRESS THE HEALTH NEED GOALS, OBJECTIVES, AND INDICATORS WERE THEN DEVELOPED TO MEASURE SUCCESS. ST. ELIZABETH'S HOSPITAL BOARD OF DIRECTORS, WHICH INCLUDES REPRESENTATION FROM RELIGIOUS LEADERS, COMMUNITY SERVICE, EDUCATION, ADVOCACY, PHYSICIANS, EXPERTISE IN GOVERNANCE, BUSINESS, ORGANIZATION AND PLANNING, REVIEWED THE FY2013 COMMUNITY BENEFIT IMPLEMENTATION STRATEGY FOR ADDRESSING PRIORITIES IDENTIFIED IN THE MOST RECENT CHNA. THIS REPORT WAS APPROVED BY THE BOARD OF DIRECTORS EXECUTIVE COMMITTEE ON MAY 25, 2012. THE COMMUNITY HEALTH NEEDS AND ASSOCIATED IMPLEMENTATION STRATEGY WILL BE USED TO GUIDE OUR EFFORTS IN FY2013. THE COMMUNITY HEALTH NEEDS ASSESSMENT CAN BE ACCESSED AT: http://www.steliz.org/about/ PART VI, PATIENT EDUCATION OF ELIGIBILITY FOR ASSISTANCE THE PATIENT ACCESS DEPARTMENT PROVIDES EACH PATIENT WITH INFORMATION ABOUT THE CHRISTIAN ASSISTANCE PROGRAM (CAP) AVAILABLE AT ST. ELIZABETH'S HOSPITAL. PATIENTS RECEIVE A CONTACT PHONE NUMBER FOR FURTHER ASSISTANCE. INFORMATION ABOUT THE CHRISTIAN ASSISTANCE PROGRAM IS ALSO AVAILABLE ON THE HOSPITAL'S WEB SITE ALONG WITH THE APPLICATION FORM AND CONTACT NUMBERS. THE HOSPITAL HAS A REPRESENTATIVE ON SITE TO ASSIST PATIENTS WHO MAY BE ELIGIBLE FOR MEDICAID ASSISTANCE THROUGH THE ILLINOIS DEPARTMENT OF PUBLIC ASSISTANCE. THE HOSPITAL REPRESENTATIVE WORKS WITH PATIENTS AND ASSISTS THEM WITH THE APPLICATION PROCESS. PATIENTS DETERMINED INELIGIBLE FOR MEDICAID ARE GIVEN A CAP APPLICATION FORM AND INSTRUCTION LETTER WITH A PHONE NUMBER TO CONTACT FOR FURTHER HELP IN MAKING APPLICATION FOR ASSISTANCE. ASSISTANCE IS PROVIDED AS NEEDED. EACH BILL A PATIENT RECEIVES HAS INFORMATION ABOUT THE CHRISTIAN ASSISTANCE PROGRAM AND A PHONE NUMBER TO CONTACT FOR HELP IN APPLYING. PATIENTS WHO COME TO THE CASHIER'S OFFICE ARE GIVEN INFORMATION ABOUT PAYMENT OPTIONS, INCLUDING THE CHRISTIAN ASSISTANCE PROGRAM. EVEN AFTER AN ACCOUNT IS SENT TO A COLLECTION AGENCY AND/OR ANYTIME IN THE PROCESS THEY BELIEVE A PATIENT MAY BE ELIGIBLE FOR CHRISTIAN ASSISTANCE, THE ACCOUNT IS RETURNED TO THE HOSPITAL AND EVALUATED FOR CHRISTIAN ASSISTANCE. PART VI, COMMUNITY INFORMATION DURING FISCAL YEAR 2012 (JULY 1, 2011 TO JUNE 30, 2012), A COMMUNITY HEALTH NEEDS ASSESSMENT WAS CONDUCTED BY ST. ELIZABETH'S HOSPITAL, LOCATED IN BELLEVILLE, IL. OUR PRIMARY SERVICE AREA, CONSIDERED PART OF THE GREATER METROPOLITAN ST. LOUIS AREA, INCLUDES BOTH URBAN AND RURAL AREAS. BELLEVILLE, THE COUNTY SEAT FOR ST. CLAIR COUNTY, HAS A POPULATION OF 41,410. ST. CLAIR COUNTY HAS A POPULATION OF 270,086. IN ST. CLAIR COUNTY, 11% OF THE POPULATION LIVES IN RURAL COMMUNITIES. THE MEDIAN HOUSEHOLD INCOME IS $35,979 COMPARED TO THE NATIONAL INCOME OF $41,994. 19.4% OF POPULATION LIVES BELOW THE POVERTY LINE. 27.4% OF FAMILIES EARN LESS THAN $25,000 A YEAR. FAMILIES LIVING BELOW THE POVERTY LEVEL WAS 9.3% COMPARED TO NATIONAL AVERAGE OF 9.2%. IN ST. CLAIR COUNTY 8.2% OF THE POPULATION IS COVERED BY MEDICAID COMPARED TO 7.5% FOR THE STATE. PERCENT OF UNINSURED ADULTS, NON-SENIORS IN THE COUNTY IS 16.6% COMPARED TO 16.8% FOR THE STATE AND 20.4% FOR THE NATION. THE COUNTY HEALTH RANKINGS RATES ST. CLAIR COUNTY FOR HEALTH FACTORS AT 100 OUT OF 102 COUNTIES IN ILLINOIS (1 IS BEST, 102 IS WORST RANKING). PART VI PROMOTION OF COMMUNITY HEALTH ST. ELIZABETH'S HOSPITAL OFFERS HOPE TO OUR COMMUNITY IN THE TRADITION OF THE HOSPITAL SISTERS OF ST. FRANCIS. AS A HEALING MINISTRY OF THE CATHOLIC CHURCH AND AN AFFILIATE OF THE HOSPITAL SISTERS HEALTH SYSTEM (HSHS), ST.ELIZABETH'S IS COMMITTED TO DELIVERING HIGH QUALITY, COMPASSIONATE, AND COST-EFFECTIVE HEALTH CARE SERVICES TO ALL. THE HOSPITAL WAS FOUNDED 136 YEARS AGO TO BRING A HEALING PRESENCE AND IMPROVE THE HEALTH OF OUR COMMUNITY, ESPECIALLY FOR PEOPLE WHO ARE SICK, POOR, AND DISADVANTAGED. BECAUSE OF THE HOSPITAL'S MISSION AND TRADITION, IT IS ORGANIZED TO PROMOTE THE HEALTH OF ST. CLAIR COUNTY AND SURROUNDING AREAS. THE HOSPITAL IS GOVERNED BY A BOARD OF DIRECTORS, THE MAJORITY OF WHICH IS COMPRISED OF PERSONS WHO RESIDE IN THE HOSPITAL'S PRIMARY SERVICE AREA AND WHO ARE NEITHER EMPLOYEES NOR CONTRACTORS OF THE HOSPITAL (NOR FAMILY MEMBERS THEREOF). THE BOARD ENSURES THAT ST. ELIZABETH'S HOSPITAL IS RESPONDING TO COMMUNITY NEED. DURING THE LAST YEAR, FOR EXAMPLE, THE BOARD REVIEWED THE COMMUNITY HEALTH NEEDS ASSESSMENT AND APPROVED AN IMPLEMENTATION STRATEGY FOR ADDRESSING IDENTIFIED NEEDS. OUR ADVISORY BOARD AND FRIENDS BOARD CONSIST OF PERSONS WHO RESIDE IN OUR PRIMARY SERVICE AREA. MEMBERS OF THESE BOARDS PARTICIPATED IN THE COMMUNITY ENGAGEMENT GROUPS THAT WERE INTEGRAL IN DEVELOPMENT OF THE CHNA. ALSO CONSISTENT WITH ITS EXEMPT PURPOSE, ST. ELIZABETH'S HOSPITAL HAS AN OPEN MEDICAL STAFF WITH PRIVILEGES AVAILABLE TO ALL QUALIFIED PHYSICIANS IN THE AREA. IN ADDITION, THE HOSPITAL OPERATES AN EMERGENCY DEPARTMENT THAT IS OPEN 24 HOURS TO ALL PERSONS REGARDLESS OF THEIR ABILITY TO PAY. AS A NOT-FOR-PROFIT HOSPITAL, ST. ELIZABETH'S HOSPITAL REINVESTS SURPLUS FUNDS INTO THE MISSION OF THE ORGANIZATION AND HEALTH OF THE COMMUNITY RATHER THAN DISTRIBUTING THEM AS PROFITS TO SHAREHOLDERS OR INDIVIDUALS. FUNDS NOT COMMITTED TO ONGOING OPERATIONS ARE GENERALLY USED TO UPGRADE FACILITIES, SECURE NEW TECHNOLOGIES, IMPROVE PATIENT CARE, AND SUPPORT INITIATIVES DESIGNED TO PROMOTE HEALTH AND ENSURE ACCESS FOR ALL. FOR EXAMPLE, ST. ELIZABETH'S HOSPITAL IS CURRENTLY WORKING WITH ITS PARENT ORGANIZATION, HOSPITAL SISTERS HEALTH SYSTEM, TO CONTINUOUSLY ENHANCE QUALITY AND IMPROVE COORDINATION OF CARE BOTH INSIDE THE HOSPITAL AND WITH A GROWING NUMBER OF PHYSICIAN PARTNERS. SUPPORTED BY INVESTMENTS IN INFORMATION TECHNOLOGY, THIS "CARE INTEGRATION" STRATEGY IS DESIGNED TO BETTER COORDINATE CARE, IMPROVE HEALTH OUTCOMES, CREATE NEW EFFICIENCIES, AND HELP ENSURE THAT PATIENTS (ESPECIALLY THOSE WITH CHRONIC CONDITIONS) GET WELL AND STAY WELL. STANDARDIZED ORDER SETS, USING EVIDENCED BASED MEDICINE, WERE DEVELOPED IN PREPARATION FOR GO LIVE FOR CPOE (COMPUTERIZED PROVIDER ORDER ENTRY) IN FY13. THE GOAL IS TO: REDUCE VARIATION IN PROCESSES BY LOOKING TO THE EVIDENCE FOR THE STANDARD OF CARE ENHANCE CLINICAL EFFICIENCY FOR OPTIMAL MANAGEMENT OF INDIVIDUAL PATIENT CONDITIONS IMPROVE OUTCOMES OF CARE THROUGH BEST PRACTICE ORDER SETS CPOE WILL REDUCE ORDER ENTRY ERRORS AND INCREASE EFFICIENCY IN THE HEALTHCARE SYSTEM. ST. ELIZABETH'S ALSO DEVOTES SIGNIFICANT RESOURCES TO ACCESS FOR PATIENTS WHO CANNOT AFFORD CARE, ALONG WITH OTHER COMMUNITY BENEFITS. IN FISCAL YEAR 2012, ST. ELIZABETH'S PROVIDED OVER $17.2 MILLION IN COMMUNITY BENEFIT SERVICES, INCLUDING CHARITY CARE AT COST, UNPAID COSTS OF MEDICAID AND OTHER PUBLIC PROGRAMS, AND A RANGE OF DIVERSE PROGRAMS DESIGNED TO ENHANCE ACCESS AND IMPROVE COMMUNITY HEALTH. ADDITIONALLY, DURING THIS PERIOD, ST. ELIZABETH'S PROVIDED $5.6 MILLION (AT COST) IN UNCOMPENSATED CARE TO PATIENTS THAT DID NOT QUALIFY FOR CHARITY CARE FOR PUBLIC ASSISTANCE. THE RANGE OF BENEFITS PROVIDED BY ST. ELIZABETH'S FLOWS FROM OUR MISSION AND LONG-STANDING COMMITMENT TO OUR COMMUNITY. IN MANY CASES, THESE PROGRAMS WOULD NOT EXIST WITHOUT THE LEADERSHIP ROLE PLAYED BY ST. ELIZABETH'S HOSPITAL. THESE PROGRAMS RELIEVE A BURDEN THAT WOULD OTHERWISE BE CARRIED BY GOVERNMENT. IN THE COMING YEAR, MANY OF THESE ACTIVITIES WILL BE MODIFIED OR SUPPLEMENTED TO FOCUS ON THE PRIORITY NEEDS IDENTIFIED BY THE FY 2012 COMMUNITY HEALTH NEEDS ASSESSMENT PROCESS. ENHANCING HEALTH OF OUR COMMUNITY: HEALTHY HEART FAIR AT ECKERT'S COUNTRY STORE HEART DISEASE WAS IDENTIFIED IN THE ST. CLAIR COUNTY HEALTH DEPARTMENT'S IPLAN FOR 2005-2010 AS THE NUMBER ONE CAUSE OF DEATH. ST. ELIZABETH'S HOSPITAL HAS FOR THE PAST FOUR YEARS SPONSORED MANY ACTIVITIES IN FEBRUARY TO PROMOTE HEALTHY HEARTS IN A PROGRAM CALLED, "HEART2HEART". ONE OF THE PROGRAMS WAS A FREE HEALTHY HEART FAIR HELD AT ECKERT'S COUNTRY STORE AND FARMS IN BELLEVILLE. OVER 125 PEOPLE PARTICIPATED. ACTIVITIES INCLUDED EDUCATIONAL AND FITNESS INFORMATION AND PRESENTATIONS, FREE COOKING DEMONSTRATIONS FOR BOTH ADULTS AND CHILDREN, AND COMPLIMENTARY CHAIR MASSAGES PROVIDED BY SWIC'S MASSAGE THERAPY PROGRAM. THE COOKING DEMONSTRATIONS, PRESENTED BY LANA SHEPEK , DIETITIAN FROM ECKERT'S, FOCUSED ON HEART HEALTHY MEALS FOR ADULTS AND TAUGHT CHILDREN THE IMPORTANCE OF EATING HEALTHY WITH A SPECIAL MENU GEARED TOWARD THEM. HSHS MEDICAL GROUP FAMILY PHYSICIAN, DR. GREG CLIMACO, PRESENTED A PROGRAM ENTITLED HEART DISEASE AND HORMONE REPLACEMENT THERAPY. HE ADDRESSED RISK FACTORS AND CURRENT GUIDANCE RELATED TO HEART HEALTH. OTHER DEMONSTRATIONS THROUGHOUT THE DAY HIGHLIGHTED THE IMPORTANCE OF EXERCISE IN THE FIGHT AGAINST HEART DISEASE. HEALTH BOUND, ST. ELIZABETH'S EMPLOYEE HEALTH AND FITNESS SERVICES, PERFORMED EASY AT-HOME EXERCISES WHILE MEMBERS OF ST. LOUIS HOOP CLUB SPOKE OF THE FUN AND BENEFITS OF THE CHILDHOOD FAVORITE, HULA-HOOPING. MANY MEMBERS OF THE PUBLIC JOINED IN FOR THIS INTERACTIVE PROGRAM. ALL OF THE EXERCISE SESSIONS EMPHASIZED THE MESSAGE THAT GETTING REGULAR PHYSICAL ACTIVITY CAN HELP HEART AND LUNGS WORK BETTER, LOWER BLOOD PRESSURE, BLOOD CHOLESTEROL, AND LOWER BLOOD SUGAR, AND HELP PEOPLE CONTROL THEIR APPETITE AND WEIGHT. WHAT'S MORE, IT CAN HELP ONE RELAX AND SLEEP BETTER. ALL ARE IMPORTANT ASPECTS FOR A HEALTHY HEART. MANAGING CARE FOR CHRONIC DISEASE: DIABETIC SUPPORT GROUP THE ST. CLAIR COUNTY IPLAN FOR 2005-2010 AND 2011-2016 IDENTIFIED CHRONIC DISEASE, INCLUDING DIABETES, AS A SERIOUS CONCERN FOR ST. CLAIR COUNTY. THE DEVELOPMENT OF THE HOSPITAL'S DIABETIC SUPPORT GROUP HELPED ADDRESS THIS ISSUE, ESPECIALLY FOR THE UNINSURED AND UNDERINSURED. THE LEEDE RESEARCH SURVEY DISCOVERED THAT 22.9% OF THOSE SURVEYED IN OUR PRIMARY REFERRAL AREA HAD A DIAGNOSIS OF DIABETES. THE COMMUNITY ENGAGEMENT GROUPS AND THE COMMUNITY BENEFIT STEERING COMMITTEE IDENTIFIED DIABETES AS ONE OF THE HOSPITAL'S STRATEGIC INITIATIVES TO IMPROVE THE HEALTH OF THE COMMUNITY OVER THE NEXT THREE YEARS. FOR FOUR YEARS ST. ELIZABETH'S HOSPITAL HAS OFFERED OUTPATIENT NUTRITION COUNSELING TO HELP DIABETICS MANAGE THEIR ILLNESS. THE 1:1 NUTRITION COUNSELING SESSION MET THE INDIVIDUAL NEEDS OF PATIENTS. IN 2010 IT WAS IDENTIFIED THAT THERE WERE MANY PEOPLE IN NEED OF SUPPORT SERVICES WHO COULD NOT AFFORD THE COST OF THE 1:1 COUNSELING SESSIONS. A MONTHLY DIABETIC EDUCATION SUPPORT GROUP WAS STARTED. THIS PROGRAM IS OFFERED AT NO COST TO THOSE ATTENDING. THE GOAL IS TO EDUCATE DIABETICS ON HOW TO MANAGE THEIR ILLNESS. TOPICS INCLUDE: CARBOHYDRATE COUNTING, STRESS MANAGEMENT, CARDIOVASCULAR DISEASE, MEDICATION MANAGEMENT, PAIN MANAGEMENT, AND EXERCISE AND FOOT CARE. IN JANUARY, 2012 THE OUTPATIENT DIETITIAN COLLABORATED WITH THE CARDIAC REHAB DEPARTMENT AND ADDED AN EXERCISE COMPONENT TO THE DIABETIC SUPPORT GROUP. TWICE A WEEK THE DIABETIC SUPPORT GROUP NOW OFFERS A ONE HOUR EXERCISE SESSION IN THE CARDIAC REHAB GYM, FOLLOWED BY A HALF-HOUR OF YOGA. THE COMBINATION OF EDUCATION AND EXERCISE IS DESIGNED TO ENHANCE BETTER OUTCOMES FOR THIS PATIENT POPULATION. TWENTY-ONE PEOPLE FROM THE COMMUNITY HAVE JOINED THE EXERCISE GROUP. ON AN AVERAGE 16 PEOPLE PARTICIPATE EACH WEEK IN THE EXERCISE/YOGA SESSION. SOME COME ONCE A WEEK, OTHERS TWICE A WEEK. THE MARKETING DEPARTMENT PROMOTES THIS SERVICE. PRESS RELEASES ARE ROUTINELY SENT OUT. INFORMATION IS SENT TO COMMUNITY PARTNERS, SUCH AS, CHURCHES, ASKING THEM TO PROMOTE THE DIABETIC SUPPORT GROUP. MENTORING FUTURE HEALTHCARE PROFESSIONALS ST. ELIZABETH'S HOSPITAL IS COMMITTED TO HELPING TO PREPARE FUTURE HEALTHCARE PROFESSIONALS. STUDENTS FROM LOCAL COMMUNITY COLLEGES AND UNIVERSITIES PARTICIPATE IN CLINICAL TRAINING IN THE FOLLOWING AREAS: NURSING, BEHAVIORAL HEALTHCARE, RESPIRATORY, PHYSICAL & OCCUPATIONAL THERAPY, PHARMACY, RADIOLOGY, SURGERY, PASTORAL CARE, PATIENT ACCOUNTS AND DIETARY. THIS PAST YEAR 744 STUDENTS IN UNDERGRADUATE, GRADUATE AND INTERNSHIP PROGRAMS PARTICIPATED IN OVER 93,000 HOURS OF CLINICAL EDUCATION. STAFF PROVIDED 10,732 HOURS OF MENTORING, VALUED AT OVER $485,000. THROUGH THE CLINICAL ROUNDS AND INTERNSHIPS THESE STUDENTS GAINED VALUABLE SKILLS IN THEIR RESPECTIVE HEALTHCARE PROFESSIONS. PRESENTLY, THERE IS A SHORTAGE IN ST. CLAIR COUNTY OF PRIMARY CARE FAMILY PRACTICE DOCTORS. ST. ELIZABETH'S HOSPITAL SUBSIDIZES THE SLU FAMILY MEDICINE R PART VI, AFFILIATED HEALTH CARE SYSTEM. ST. ELIZABETH'S HOSPITAL IS AN AFFILIATE OF HOSPITAL SISTERS HEALTH SYSTEM (HSHS), A HEALTH CARE MINISTRY THAT INCLUDES 13 HOSPITALS, SCORES OF COMMUNITY-BASED HEALTH CENTERS AND CLINICS, AND MORE THAN 2,000 PHYSICIAN PARTNERS ACROSS ILLINOIS AND WISCONSIN. THE MISSION OF HSHS IS TO REVEAL AND EMBODY CHRIST'S HEALING LOVE FOR ALL PEOPLE THROUGH OUR HIGH QUALITY FRANCISCAN HEALTH CARE MINISTRY. WE LIVE OUR MISSION BY HEALING THOSE WHO SEEK OUR CARE, AS WELL AS THROUGH OUR COMMUNITY BENEFIT INITIATIVES. WORKING COLLABORATIVELY WITH OTHERS IN THE 12 COMMUNITIES WE SERVE, OUR COMMUNITY BENEFIT EFFORTS ARE SUCCESSFULLY EXPANDING ACCESS TO CARE, IMPROVING THE HEALTH STATUS OF RESIDENTS, AND FURTHERING MEDICAL EDUCATION AND KNOWLEDGE. ACROSS HSHS, WE COLLECTIVELY PROVIDED $174.2 MILLION IN COMMUNITY BENEFITS (OR 9.7% OF TOTAL HOSPITAL EXPENSES) IN FY2012. INCLUDED IN THIS AMOUNT WAS $43.1 MILLION PROVIDED FOR CHARITY CARE AND $97.9 MILLION FOR UNREIMBURSED CARE PROVIDED UNDER THE MEDICAID PROGRAM. IN ADDITION, HSHS HOSPITALS COMMITTED SIGNIFICANT RESOURCES TO CARE FOR MEDICARE PATIENTS. THE COST OF PROVIDING SERVICES TO PRIMARILY ELDERLY BENEFICIARIES OF THE MEDICARE PROGRAM - IN EXCESS OF GOVERNMENTAL AND MANAGED CARE CONTRACT PAYMENTS - WAS $168.4 MILLION. HSHS HOSPITALS ALSO RECORDED $106.6 MILLION IN UNCOLLECTIBLE ACCOUNTS. BEYOND THE DOLLARS INVESTED IN OUR COMMUNITY BENEFIT PROGRAMS, HSHS ALSO CONTINUES TO REINVEST ANY SURPLUS REVENUE FROM OPERATIONS AND INVESTMENTS INTO NEW MEDICAL TECHNOLOGY, FACILITY INFRASTRUCTURE AND HEALTH CARE SERVICES IN OUR COMMUNITIES. BY DOING DO, WE ENSURE WE ARE ABLE TO MEET THE ONGOING DEMAND FOR HIGH QUALITY, EFFICIENT AND EASILY ACCESSIBLE HEALTH CARE. RECOGNIZING THAT THE HEALTH CARE DELIVERY MODEL IN THE U.S. IS EVOLVING, HSHS REMAINS FOCUSED ON IMPLEMENTING OUR CARE INTEGRATION STRATEGY. CARE INTEGRATION COORDINATES THE DELIVERY OF CARE AROUND THE NEEDS OF EACH PATIENT. DURING FY2012, WE MADE SIGNIFICANT PROGRESS WITH THIS STRATEGY AS WE FURTHER IMPLEMENTED INTEROPERABLE HEALTH INFORMATION TECHNOLOGIES, EXPANDED THE NUMBER OF MEDICAL HOMES, AND STRENGTHENED OUR ALIGNMENT WITH PHYSICIANS. GREATER ACCESS TO CARE AS A FRANCISCAN HEALTH CARE MINISTRY, HSHS IS DEEPLY COMMITTED TO SERVING THOSE WHO ARE MOST IN NEED. WE NOT ONLY PROVIDE CARE TO EVERY PATIENT WHO WALKS THROUGH OUR DOORS, BUT ALSO REACH OUT BEYOND THE WALLS OF OUR HOSPITALS AND CLINICS TO CARE FOR THE INDIVIDUAL. OUR EFFORTS TO ENSURE RESIDENTS IN THE COMMUNITIES WE SERVE RECEIVE THE RIGHT CARE AT THE RIGHT TIME OFTEN INVOLVE PARTNERING WITH OTHERS TO ACHIEVE THIS GOAL. ACROSS OUR TWO-STATE SYSTEM, THERE ARE NUMEROUS EXAMPLES OF HSHS COLLABORATING WITH OTHER ORGANIZATIONS TO ENHANCE ACCESS TO CARE FOR THOSE IN NEED. IN WESTERN WISCONSIN, ST. JOSEPH'S HOSPITAL IN CHIPPEWA FALLS WORKS CLOSELY WITH THE CHIPPEWA HEALTH IMPROVEMENT PARTNERSHIP (CHIP) TO SUPPORT THE OPEN DOOR CLINIC. THE FREE MEDICAL CLINIC PROVIDES HEALTH CARE FOR THOSE WITHOUT INSURANCE COVERAGE. THIS PAST YEAR, THE CLINIC RECEIVED A TOTAL OF 2,216 PATIENT VISITS, A 25% INCREASE FROM THE PRIOR YEAR. WITH MORE THAN 150 INDIVIDUALS VOLUNTEERING, THE CLINIC PROVIDED OVER 6,500 HOURS (INCLUDING 700 PHYSICIAN HOURS AND 1,500 NURSING HOURS) OF SERVICE TO INDIVIDUALS. THE OPEN DOOR CLINIC IS AN EXAMPLE OF HSHS PROVIDING LEADERSHIP AND SUPPORT TO A COMMUNITY-BASED PROGRAM DESIGNED TO MEET THE NEEDS OF THOSE LESS FORTUNATE. IN NORTHEASTERN WISCONSIN, ST. VINCENT HOSPITAL IN GREEN BAY SUPPORTS PATIENT CARE FOR THE UNINSURED AT THE NEW COMMUNITY CLINIC BY PAYING A NURSE'S SALARY AND OFFERING FREE AND DISCOUNTED LABORATORY AND RADIOLOGY SERVICES. MORE THAN 70% OF PATIENTS WHO USE THE CLINIC REPORT THE CARE THEY RECEIVED HELPED KEEP THEM OUT OF THE EMERGENCY DEPARTMENT. ST. NICHOLAS HOSPITAL IN SHEBOYGAN PROACTIVELY REACHES OUT TO LOCAL HMONG AND HISPANIC ORGANIZATIONS TO ENSURE THESE POPULATIONS CAN PARTICIPATE IN FREE SCREENINGS AND HEALTH EDUCATION PROGRAMS. THROUGH THIS ONGOING OUTREACH INITIATIVE, ST. NICHOLAS ENGAGED MORE THAN 350 PEOPLE LAST YEAR, AND IN MANY CASES WAS ABLE TO IDENTIFY CRITICAL HEALTH CONDITIONS EARLY AND PROVIDE APPROPRIATE FOLLOW-UP CARE. A WOMAN'S PLACE AT ST. MARY'S HOSPITAL MEDICAL CENTER IN GREEN BAY REACHES OUT TO HISPANIC NEIGHBORS TO PROVIDE HEALTH AND WELLNESS EDUCATION, HEALTH SCREENINGS, RESOURCES AND REFERRAL SERVICES. LAST YEAR A WOMAN'S PLACE TOUCHED THE LIVES OF MORE THAN 7,000 WOMEN THROUGH HEALTH SCREENINGS, EDUCATIONAL EVENTS, CLASSES AND ITS RESOURCE CENTER. IN SOUTHEAST ILLINOIS, AREA RESIDENTS CAN GET HELP FILLING A PRESCRIPTION THROUGH THE LONG-TERM COLLABORATION BETWEEN ST. ANTHONY'S MEMORIAL HOSPITAL IN EFFINGHAM AND CATHOLIC CHARITIES. LAST YEAR, ST. ANTHONY'S HELPED UNDERWRITE THE COST OF PRESCRIPTION MEDICATIONS FOR MORE THAN 430 RESIDENTS. IN SOUTHWEST ILLINOIS, ST. JOSEPH'S HOSPITAL IN HIGHLAND RECOGNIZED MANY RURAL RESIDENTS DID NOT HAVE A RELIABLE MEANS OF TRANSPORTATION AND PARTNERED WITH GENEROUS INDIVIDUALS IN THE COMMUNITY TO OFFER A FREE TRANSPORTATION SERVICE. THE "FRIENDS' VAN," FULLY SUPPORTED BY THE FRIENDS OF ST. JOSEPH'S HOSPITAL, PROVIDES FREE RIDES TO MEDICAL, DENTAL AND OTHER PERSONAL APPOINTMENTS WITHIN A 20-MILE RADIUS OF HIGHLAND. IN FY2012, THE FRIENDS VAN TRANSPORTED 2,050 INDIVIDUALS FOR A TOTAL OF 12,561 MILES. IN ADDITION TO PROGRAMS SUCH AS THESE, HSHS MAKES SURE THAT THOSE WHO NEED FINANCIAL ASSISTANCE FOR CARE RECEIVE IT. OUR CHARITY CARE PROGRAM COVERS 100% OF HOSPITAL CHARGES FOR INDIVIDUALS AND FAMILIES WHO EARN LESS THAN 200% OF THE FEDERAL POVERTY LEVEL. HSHS CHARITY CARE PROGRAMS HAVE A SLIDING SCALE, IN SOME INSTANCES PROVIDING UP TO A 60% DISCOUNT ON CHARGES FOR THOSE EARNING UP TO 600% OF THE FEDERAL POVERTY LEVEL. COUNSELORS ARE AVAILABLE IN OUR HOSPITALS TO EXPLAIN OUR CHARITY CARE POLICIES TO PATIENTS, PROVIDE THEM WITH ASSISTANCE IN FILLING OUT A SIMPLE APPLICATION FORM, OR HELP THEM ENROLL IN PUBLICLY FUNDED HEALTH CARE PROGRAMS. BETTER COMMUNITY HEALTH AS PART OF OUR MISSION TO EMBODY CHRIST'S HEALING LOVE, WE UNDERSTAND THAT WE HAVE A RESPONSIBILITY TO IMPROVE THE OVERALL QUALITY OF LIFE IN OUR COMMUNITIES BY SUPPORTING INITIATIVES THAT PROMOTE HEALTH AND WELLNESS. WE RECOGNIZE WE ARE MOST SUCCESSFUL WHEN WE WORK TOGETHER WITH A WIDE ARRAY OF PUBLIC AND PRIVATE ORGANIZATIONS THAT SHARE OUR COMMITMENT TO IMPROVING LIVES. BY DOING SO, WE MAXIMIZE OUR EFFORTS AND REDUCE THE DUPLICATION OF SERVICES. HSHS HOSPITALS ALSO UNDERSTAND WE NEED TO LISTEN CLOSELY TO THE RESIDENTS OF THE COMMUNITIES WE SERVE TO ENSURE THE HEALTH CARE NEEDS OF ALL ARE BEING MET. TO THAT END, EACH OF OUR 13 HOSPITALS COMPLETED COMMUNITY HEALTH NEEDS ASSESSMENTS (CHNA) DURING FY2012. THE INFORMATION GATHERED FROM THESE ASSESSMENTS IS BEING USED TO HELP US DEVELOP NEW, AND ENHANCE EXISTING, PROGRAMS AND SERVICES THAT BEST ADDRESS THE NEEDS OF THE COMMUNITY. AMONG THE MANY PRIORITY NEEDS IDENTIFIED FROM THE CHNAS INCLUDE METABOLIC AND CARDIOVASCULAR DISEASE MANAGEMENT, ADEQUATE FOOD AND NUTRITION, AND MENTAL HEALTH. HSHS HOSPITALS ARE ADDRESSING THESE AND OTHER NEEDS BY PROACTIVELY OFFERING EDUCATIONAL OPPORTUNITIES, PREVENTATIVE SCREENINGS, AND NEW OR ENHANCED CLINICAL SERVICES. TO ADDRESS METABOLIC DISEASE MANAGEMENT, ST. FRANCIS HOSPITAL IN LITCHFIELD, ILLINOIS, PARTNERS WITH MONTGOMERY COUNTY HEALTH DEPARTMENT TO PROVIDE SCREENING FOR DIABETES AND RENAL DISEASE. ST. FRANCIS HOSPITAL TEAMS UP WITH MACOUPIN COUNTY HEALTH DEPARTMENT TO PROVIDE DIABETES SELF-MANAGEMENT CLASSES. ST. JOSEPH'S HOSPITAL IN BREESE, ILLINOIS COORDINATES SEVERAL COMMUNITY EDUCATION SEMINARS AND HEALTH FAIRS ON CARDIOVASCULAR DISEASE AND HEALTHY EATING EACH YEAR. OVER 3,000 RESIDENTS PARTICIPATED IN THESE HEALTH EVENTS LAST YEAR. RECOGNIZING THE IMPORTANCE OF PROPER FOOD AND NUTRITION TO OVERALL HEALTH, ST. JOHN'S HOSPITAL IN SPRINGFIELD INITIATED THE DESTINATION DINNER PROGRAM WHICH TEACHES FAMILIES HOW TO COOK HEALTHY, FROM-SCRATCH MEALS, AND EAT TOGETHER AS A FAMILY. FAMILIES MEET QUARTERLY TO LEARN NEW COOKING SKILLS. THEY ALSO LEARN HOW TO PREPARE A MEAL FOR A FAMILY OF FOUR ON A BUDGET OF $8.00. IN ADDITION TO RAISING AWARENESS ABOUT HOW TO EAT HEALTHY ON A LIMITED BUDGET, THE PROGRAM BRINGS FAMILIES TOGETHER AROUND THE DINNER TABLE, WHICH RESEARCH SHOWS PROMOTES HEALTHY RELATIONSHIPS, INCREASED ACADEMIC PERFORMANCE AND DECREASED RISK FOR SUBSTANCE ABUSE AND RISKY SEXUAL BEHAVIOR. SACRED HEART HOSPITAL IN EAU CLAIRE, WISCONSIN ADDRESSED THE NEED FOR ACCESS TO MENTAL HEALTH SERVICES FOR CHILDREN AND ADOLESCENTS BY OPENING AN OUTPATIENT BEHAVIORAL HEALTH CLINIC. SACRED HEART HAS ALSO ADOPTED SCREENING TOOLS FOR BEHAVIORAL AND MENTAL HEALTH RISK FACTORS FOR USE AT AFFILIATED CLINICS. THE GOAL IS TO BETTER IDENTIFY MENTAL HEALTH ISSUES AND PROVIDE EARLIER INTERVENTION. SACRED HEART HOSPITAL IS ALSO WORKING WITH THE CHIPPEWA VALLEY FREE CLINIC (CVFC) TO DEVELOP EXPANDED PROVIDER COVERAGE FOR CVFC PATIENTS WHO REQUIRE MENTAL HEALTH SERVICES. ST. MARY STATE FILING OF COMMUNITY BENEFIT REPORT 990 SCHEDULE H, PART VI IL, true true false false false false false false false LINDA A CAMP MD 0 528044 0 0 0 16536 0 0 0 16378 0 560958 0 0 ANN M CARR 0 180382 0 0 0 45430 0 197622 0 18652 0 442086 0 15440 MARYANN L REESE RN 0 299290 0 100000 0 44848 0 60006 0 23530 0 527674 0 0 MARK REIFSTECK 0 368111 0 0 0 24492 0 186986 0 33979 0 613568 0 41500 ROBERT S MILLER 99716 0 6800 0 144655 0 253897 0 2962 0 508030 0 0 0 JOHNNY E WATKINS 242446 0 11500 0 0 0 51651 0 9602 0 315199 0 0 0 ALICE CHATLEY 21823 0 3750 0 86694 0 -8880 0 1066 0 104453 0 0 0 EDWARD JACQUIN 46574 0 0 0 67765 0 17361 0 4567 0 136267 0 0 0 LESLIE LOVSHIN 120435 0 0 0 10799 0 12955 0 16336 0 160525 0 0 0 SHELLEY HARRIS 137979 0 0 0 0 0 99688 0 21338 0 259005 0 0 0 JAMES RUSHFORD 575710 0 0 0 21999 0 38540 0 21772 0 658021 0 0 0 DONALD JOHNSTON 577487 0 56976 0 19800 0 30983 0 22194 0 707440 0 0 0 JAMES BURKE 192773 0 0 0 0 0 19472 0 26774 0 239019 0 0 0 TERENCE WADE MD 253157 0 0 0 37580 0 0 0 14192 0 304929 0 0 0 ADAM THACKER 127622 0 0 0 16500 0 9306 0 589 0 154017 0 0 0 JOSEPH B STASIAK 82623 0 1041 0 47512 0 149728 0 18191 0 299095 0 0 0 SCHEDULE J, PART I, LINE 3 PLEASE SEE RESPONSE TO FORM 990, PART VI, LINE 15 IN SCHEDULE O. Severance Payment Schedule J, Part I, Line 4a THE FOLLOWING INDIVIDUALS RECEIVED SEVERANCE PAYMENTS: EDWARD JACQUIN $35,188 ROBERT S. MILLER $95,406 ALICE CHATLEY $82,795. ANN M. CARR SCHEDULE J, PART I, LINE 4B ANN M. CARR PARTICIPATED IN A SERP DURING THE YEAR IN THE AMOUNT OF $33,655. MARYANN L. REESE SCHEDULE J, PART I, LINE 4B MARYANN L. REESE PARTICIPATED IN A SERP DURING THE YEAR IN THE AMOUNT OF $30,462. MARK REIFSTECK SCHEDULE J, PART I, LINE 4B MARK REIFSTECK PARTICIPATED IN A SERP DURING THE YEAR IN THE AMOUNT OF $80,860. ORGANIZATION'S MISSION FORM 990, PART III, LINE 1 THE MISSION OF ST. ELIZABETH'S HOSPITAL IS TO REVEAL AND EMBODY CHRIST'S HEALING LOVE FOR ALL PEOPLE THROUGH OUR HIGH QUALITY FRANCISCAN HEALTH CARE MINISTRY. IN THE PERFORMANCE OF ITS MISSION, ST. ELIZABETH'S HOSPITAL WILL FOSTER THE VALUES OF RESPECT, CARE, COMPETENCE AND JOY. RESPECT IS THE FRANCISCAN RESPECT FOR LIFE FROM CONCEPTION TO DEATH AND FOR THE DIGNITY OF EACH INDIVIDUAL PERSON. IT IS A COMMITMENT TO FREEING AND EMPOWERING EACH PERSON TO DEVELOP TO HIS OR FULL POTENTIAL. CARE EMBODIES THE CONCERN, COMPASSION, AND SENSITIVITY WITH WHICH WE CARE FOR PATIENTS, CLIENTS, EMPLOYEES AND CO-WORKERS. MANY TIMES IT IS THOUGHT OF AS BEDSIDE BEHAVIOR, BUT IT BELONGS IN BUSINESS OFFICES, CAFETERIAS AND BOARDROOMS. COMPETENCE MEANS THAT OUR WORK IS PERFORMED AND ST. ELIZABETH'S IS MANAGED WITH THE HIGHEST LEVEL OF SKILL AND ABILITY. WE ARE COMMITTED TO RECRUITING AND DEVELOPING PEOPLE WHO ARE COMPETENT IN THEIR WORK AND WHOSE VALUES REFLECT OUR OWN. OUR VALUES ARE AN INTEGRAL PART OF OUR SYSTEM'S STRATEGIC PLAN, WHICH PROVIDES THE OVERALL FRAMEWORK FOR LOCAL ACTIVITIES. JOY IS THE MANNER IN WHICH OUR EMPLOYEES AND ALL WHO JOIN US IN OUR MINISTRY SEEK TO PERFORM THEIR WORK -- THE PERSONAL FULFILLMENT OF CARING FOR OTHERS. IT IS AN ESSENTIAL INGREDIENT IN BRINGING A SENSE OF HOPE TO THOSE WHO SUFFER. PROGRAM SERVICES FORM 990, PART III, LINE 4A Cardiac Services (Expense $24,587,457 Revenue $23,407,882) St. Elizabeth's provides comprehensive cardiovascular services from diagnosis to surgery to rehabilitation and wellness. St. Elizabeth's is accredited by the Society of Chest Pain Centers, a professional organization focused on improving care for patients with acute coronary syndromes and teaching the public to recognize and react to the early symptoms of a possible heart attack. This accreditation attests that St. Elizabeth's meets strict criteria for recognizing and treating patients who come to the emergency room with heart attack symptoms. We are also a heart attack receiving center. Currently, more than 5 area hospitals send their patients to us for heart attack care. Our patients benefit from our highly credentialed physicians and state-of-the-art technologies, as well as our commitment to superior patient outcomes. Some of the services provided included: Cardiac catheterization, stent placement, stress testing, pacemaker, implantable cardioverter defibrillator (ICD), electrocardiography, coronary artery bypass graft (open heart) surgery and cardiac rehabilitation. During FY 2012, St. Elizabeth's Hospital had 12,147 cardiac cases. PROGRAM SERVICES FORM 990, PART III, LINE 4B Rehabilitation Services (Expense $10,818,507 Revenue $9,879,200) St. Elizabeth's Hospital's comprehensive rehabilitation unit provides the care that maximizes the patient's capabilities. We assist in achieving full recovery potential allowing patients to live as independently as possible. We support patients families by providing them with the education, resources and encouragement needed to achieve positive outcomes. Our comprehensive integrated inpatient rehabilitation program is accredited by the Commission on Accreditation of Rehabilitation Facilities (CARF). We are one of the few accredited rehab facilities in Southern Illinois and the only one available in St. Clair County. The rehabilitation unit is accredited to provide services to those adults who have been affected by stroke, amputation, arthritis, spinal cord injury, joint replacement, hip fracture, neurological disease, and more. When admitted to our program, patients are treated by a multi-disciplinary team of caring professionals. During FY 2012 our Rehabilitation Unit performed 5,363 cases. PROGRAM SERVICES FORM 990, PART III, LINE 4C Orthopedic Services (Expense $10,212,563 Revenue $9,334,732) St. Elizabeth's specializes in the treatment and prevention of orthopedic problems and sports-related musculoskeletal injuries. We perform surgical and non-surgical procedures. Our orthopedic surgical services are provided on an inpatient and outpatient basis. Our physicians are all board certified and provide first class care. Some of the orthopedic services provided include: General orthopedics, fracture care, total joint replacement, carpal tunnel treatment, arthroscopic and reconstructive surgery, and foot and ankle orthopedic care. During FY 2012, St. Elizabeth's Hospital had 7,979 orthopedic cases. PROGRAM SERVICES FORM 990, PART III, LINE 4D Other Program Services (Expense $101,883,526 Revenue $124,432,635) Health Care Services St. Elizabeth's delivers a comprehensive array of healthcare services to both inpatients and outpatients. Our accredited programs have consistently demonstrated quality outcomes that positively impact our patients, their families and the entire community. We provides quality medical healthcare regardless of race, creed, sex, national origin, handicap, age, or ability to pay. Although reimbursement for services rendered is critical to the operation and stability of St. Elizabeth's Hospital, it is recognized that not all individuals possess the ability to purchase essential medical services. It is our mission to serve the sick, especially the poor, with quality healthcare services and healthcare education. We have further defined our mission of identifying those who are at greatest health risk, the elderly, children, those coping with mental illness, and those with less means who are dependent on quality healthcare. St. Elizabeth's Hospital currently staffs 260 inpatient beds. The hospital employs 1,349 colleagues. Inpatient admissions for Fiscal Year 2012 were 12,486. The Emergency Department had 28,514 visits and admitted 7,096 to inpatient services. The Urgi-Center in O'Fallon, an offsite facility, had 18,143 visits. Total Outpatient visits for the hospital were 176,824 Community Benefit Charity and Government Means-Tested Program: During the period, St. Elizabeth's provided in excess of $14,780,474 million to support our commitment to the community. Included in this total was charity care provided to individuals unable to afford their care. The cost of charity care was $4,559,607. St. Elizabeth's Hospital also provided care to persons covered by governmental programs at or below cost. This resulted in providing $10,220,867 to Medicaid patients which was not reimbursed. Also, included in the total was the extensive number of free educational programs, screenings, clinical services and consultations provided at a reduced fee or at no charge to other healthcare agencies and human service agencies in our service area. To the extent that reimbursement was below cost, St. Elizabeth's Hospital recognized these expenses as a cost of fulfilling its mission for the entire community. Other Benefits: St. Elizabeth's Hospital takes a proactive role in educating its communities on wellness programs, sponsoring health screenings, collaborating with the local health district in targeting local health concerns, and organizing support groups. Included in the above Community Benefit figures are the following initiatives aimed at improving access and promoting health for the people of Belleville and surrounding communities. The total other benefits reported value $2,432,687. In addition to the Community Benefit total, St. Elizabeth's provided 5.6 million (at cost) in uncompensated care to patients that did not qualify for charity care or public assistance, and over $4 million (at cost) in excess of Medicare payment for health services. TAX EXEMPT BONDS FORM 990, PART IV, LINE 24 ST. ELIZABETH'S HOSPITAL HOLDS A LIABILITY ON ITS BOOKS FOR TAX-EXEMPT BONDS, WHICH IS AN ALLOCATION FROM ITS SOLE CORPORATE MEMBER, HOSPITAL SISTERS SERVICES, INC. AS A RESULT, THIS QUESTION WAS ANSWERED NO, AND SCHEDULE K WILL BE COMPLETED ON THE HOSPITAL SISTERS SERVICES, INC. FORM 990. RIGHTS OF MEMBERS TO ELECT GOVERNING BODY FORM 990, PART VI, LINEs 6 & 7A THE SENIOR GOVERNING BODY OF ST. ELIZABETH'S HOSPITAL (THE "CORPORATION") IS THE MEMBER OF THE CORPORATION, WHICH IS HOSPITAL SISTERS HEALTH SERVICES, INC. ("HSSI"), AN ILLINOIS NOT FOR PROFIT CORPORATION EXEMPT FROM FEDERAL TAXATION UNDER SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE. PURSUANT TO SECTION 2.3 OF THE CORPORATION'S BYLAWS, HSSI HAS THE RIGHT TO APPOINT AND REMOVE THE CORPORATION'S BOARD OF DIRECTORS, CHAIRPERSON OF THE BOARD AND PRESIDENT. MEMBER RESERVED POWERS FORM 990, PART VI, LINE 7B RESPONSIBILITY FOR THE POLICY AND OPERATIONS OF ST. ELIZABETH'S HOSPITAL (THE "CORPORATION") IS VESTED IN ITS BOARD OF DIRECTORS, EXCEPT WITH RESPECT TO SPECIFIC POWERS RESERVED IN THE CORPORATION'S BYLAWS TO THE CORPORATION'S MEMBER, HOSPITAL SISTERS HEALTH SERVICES, INC. ("HSSI"), AN ILLINOIS NOT FOR PROFIT CORPORATION EXEMPT FROM FEDERAL TAXATION UNDER SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE. THE MEMBER OF HSSI IS HOSPITAL SISTERS HEALTH SYSTEM ("HSHS"), AN ILLINOIS NOT FOR PROFIT CORPORATION EXEMPT FROM FEDERAL TAXATION UNDER SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE. THE MEMBERS OF HSHS ARE THE INDIVIDUAL SISTERS WHO FROM TIME TO TIME ARE THE DULY ELECTED PROVINCIAL SUPERIOR AND PROVINCIAL COUNCILORS, RESPECTIVELY OF THE AMERICAN PROVINCE OF THE HOSPITAL SISTERS OF ST. FRANCIS ("AMERICAN PROVINCE"). THE AMERICAN PROVINCE IS THE UNITED STATES ORGANIZATION OF THE CONGREGATION OF THE HOSPITAL SISTERS OF THE THIRD ORDER REGULAR OF ST. FRANCIS, A RELIGIOUS INSTITUTE OF THE ROMAN CATHOLIC CHURCH. THE GOVERNANCE AND OPERATIONS OF THE CORPORATION ARE SUBJECT TO HSSI'S RIGHT TO EXERCISE THESE RESERVED POWERS WITH RESPECT TO THE CORPORATION AND ORGANIZATIONS OF WHICH THE CORPORATION IS EITHER, DIRECTLY OR INDIRECTLY, A CONTROLLING MEMBER OR A CONTROLLING SHAREHOLDER ("AFFILIATES"). HSSI'S RIGHT TO EXERCISE CERTAIN OF THESE RESERVED POWERS IS, IN TURN, SUBJECT TO THE APPROVAL OF HSHS AND HSHS' MEMBERS. THE RESERVED POWERS INCLUDE ALL RIGHTS GRANTED TO HSSI BY LAW AND THE RIGHT TO: (A) ADOPT, APPROVE AMENDMENTS TO, OR AMEND ANY STATEMENT OF PHILOSOPHY, MISSION, MISSION INTEGRATION OR VALUES OR ANY NAME, LOGO, OR MARK OF THE CORPORATION OR OF ANY AFFILIATE; (B) ADOPT, APPROVE AMENDMENTS TO, OR AMEND THE ARTICLES OF INCORPORATION OF THE CORPORATION OR OF ANY AFFILIATE; (C) ADOPT, APPROVE AMENDMENTS TO, OR AMEND THE BYLAWS OF THE CORPORATION OR OF ANY AFFILIATE; (D) APPOINT AND REMOVE THE BOARD OF DIRECTORS, ANY ONE OR MORE OF THE DIRECTORS OF THE CORPORATION OR OF ANY AFFILIATE, AND THE CHAIRPERSON AND PRESIDENT OF THE CORPORATION OR OF ANY AFFILIATE; (E) APPROVE THE RECOMMENDATION OF THE BOARD OF DIRECTORS TO APPOINT OR REMOVE THE BOARD OF DIRECTORS, ANY ONE OR MORE DIRECTORS OF THE CORPORATION OR OF ANY AFFILIATE, OR THE CHAIRPERSON AND PRESIDENT OF THE CORPORATION OR OF ANY AFFILIATE. (F) WITH RESPECT TO THE CORPORATION OR ANY AFFILIATE, APPROVE THE PURCHASE, SALE, ALIENATION, EXCHANGE, LEASE OR ENCUMBRANCE OF ANY REAL PROPERTY OF THE CORPORATION OR OF ANY AFFILIATE, WHICH PROPERTY HAS A VALUE IN EXCESS OF LIMITS SET FROM TIME TO TIME BY HSSI; (G) APPROVE THE OPERATING AND CAPITAL BUDGETS OF THE CORPORATION OR OF ANY AFFILIATE, AND ANY DEVIATIONS BY THE CORPORATION OR OF ANY AFFILIATE FROM SUCH BUDGETS IN AN AMOUNT OR PERCENTAGE SPECIFIED BY HSSI FROM TIME TO TIME; (H) APPROVE THE STRATEGIC PLAN AND GOALS OF THE CORPORATION OR OF ANY AFFILIATE; (I) APPROVE THE SALE OF SUBSTANTIALLY ALL OF THE ASSETS OF THE (II) CORPORATION OR OF ANY AFFILIATE; (J) APPROVE THE MERGER OR DISSOLUTION OF THE CORPORATION OR OF ANY AFFILIATE; (K) ADOPT OR AMEND THE PLAN FOR MINISTRY EDUCATION AND GOVERNANCE FOR THE CORPORATION AND ITS AFFILIATES; (L) APPROVE THE CORPORATION'S MISSION ACCOUNTABILITY REPORTS AND THOSE OF ANY AFFILIATE; (M) APPROVE THE FINANCIAL POLICIES AND PROCEDURES OF THE CORPORATION OR OF ANY AFFILIATE AND APPROVE ANY DEVIATIONS FROM SUCH POLICIES AND PROCEDURES BY THE CORPORATION OR ANY AFFILIATE; AND (N) ADOPT POLICIES TO IMPLEMENT THE RESERVED POWERS OF HSSI. FORM 990 REVIEW PROCESS FORM 990, PART VI, LINE 11b THE HOSPITAL EMPLOYS KPMG TO ASSIST IN THE OVERALL PREPARATION, REVIEW AND ELECTRONIC SUBMISSION OF ITS FORM 990. KPMG PROVIDES GUIDANCE IN IDENTIFYING CRITICAL ERRORS IN THE RETURN SUBMISSION AND FEEDBACK ON QUANTITATIVE AND QUALITATIVE RESPONSES. ADDITIONALLY, THE HOSPITAL CFO PERFORMS A THOROUGH REVIEW OF THE RETURN AND REVIEWS IT WITH THE HOSPITAL CEO AND/OR SENIOR LEADERS BEFORE PRESENTING IT IN ITS ENTIRETY TO THE HOSPITAL BOARD FOR QUESTIONING AND REVIEW PRIOR TO THE RETURN'S SIGNING AND SUBMISSION TO THE IRS. CONFLICT OF INTEREST POLICY FORM 990, PART VI, LINE 12C A REVISED CORPORATE COMPLIANCE PROGRAM AND CONFLICT OF INTEREST POLICY HAS BEEN USED SINCE JANUARY, 2009 TO ESTABLISH THE PRACTICE OF MANAGING CONFLICTS OF INTEREST USING A SYSTEM-WIDE PROTOCOL FOR DISCLOSURE STATEMENTS. IN ACCORDANCE WITH OUR CONFLICT OF INTEREST POLICY ALL COVERED PERSONS HAVE A DUTY TO COMPLY WITH THE CONFLICT OF INTEREST POLICY FOR ANY CONTRACT, TRANSACTION, RELATIONSHIP OR ACTIVITY CONTEMPLATED, ENTERED INTO OR CONDUCTED AT HSHS. THE POLICY DEFINES COVERED PERSONS AS A.) BOARD MEMBERS, BOARD COMMITTEE MEMBERS, OFFICERS, BOARD DESIGNEES, SENIOR MANAGEMENT, MEMBERS OF ANY COMMITTEE THAT OVERSEES THE APPROVAL OF PHARMACEUTICALS AND MEDICAL DEVICES, ANY OTHER INDIVIDUAL WHO HOLDS A POSITION OF TRUST AND B.) NON-EMPLOYED MEMBERS OF THE MEDICAL STAFF WHO ALSO EITHER: 1) HOLD PAID OR UNPAID MEDICAL ADMINISTRATIVE POSITIONS, SUCH AS CHAIRS OF CLINICAL DEPARTMENTS, SECTION AND DIVISION CHIEFS, DIRECTORS OF SPECIAL CARE UNITS, DIRECTORS OF RESEARCH OR INDIVIDUALS WHO OTHERWISE DIRECT OR MATERIALLY INFLUENCE RESEARCH; OR 2) HAVE PROCUREMENT RESPONSIBILITY, OR THE AUTHORITY EFFECTIVELY TO RECOMMEND SUCH PROCUREMENT. ON AN ANNUAL BASIS HSHS DISCLOSES A COPY OF THE CONFLICT OF INTEREST POLICY (AND ALL CORRESPONDING PROCEDURES, GUIDELINES, FORMS AND TOOLS), TO ALL COVERED PERSONS AND ADVISES ALL COVERED PERSONS IN WRITING OF ANY SUBSTANTIVE CHANGES TO THIS POLICY AND SUCH RELATED MATERIALS. THE COVERED PERSONS ARE REQUIRED TO REVIEW AND COMPLETE THE CORRESPONDING CONFLICT OF INTEREST STATEMENT. THE SYSTEM OFFICE VICE PRESIDENT, SYSTEM RESPONSIBILITY, VICE PRESIDENT, RISK & COMPLIANCE OR MEMBERS OF THE AUDIT AND INTEGRITY COMMITTEE ("COMMITTEE") ARE AVAILABLE TO ANSWERS ANY QUESTIONS A COVERED PERSON MAY HAVE. IN ADDITION, IF, AT ANY TIME AFTER SUBMITTING AN ANNUAL CONFLICT OF INTEREST STATEMENT, A COVERED PERSON BECOMES AWARE OF AN INTEREST THAT HE OR SHE WOULD HAVE HAD TO DISCLOSE AT THE ANNUAL INTERVAL, THE COVERED PERSON SHALL PROMPTLY DISCLOSE THE INTEREST TO THE COMMITTEE USING THE HSHS CONFLICT OF INTEREST DISCLOSURE STATEMENT. COMPLETED CONFLICT OF INTEREST STATEMENTS ARE SUBMITTED TO THE COMMITTEE OF HSHS WHICH IS RESPONSIBLE FOR IDENTIFYING, ASSESSING, AND MANAGING CONFLICTS OF INTEREST THAT ARISE IN THE COURSE OF CONDUCTING THE AFFAIRS OF HSHS. IF THE COMMITTEE DETERMINES THAT A CONFLICT OF INTEREST EXISTS, HSHS SHALL NOT ENGAGE IN OR ENTER INTO A PROPOSED CONTRACT, TRANSACTION, RELATIONSHIP, ARRANGEMENT OR ACTIVITY UNLESS THE COMMITTEE OR, WHERE NECESSARY, THE BOARD OF DIRECTORS (ACTING THROUGH ITS DISINTERESTED MEMBERS), HAS INVESTIGATED ALTERNATIVES TO THE PROPOSED CONTRACT, TRANSACTION, RELATIONSHIP, ARRANGEMENT OR ACTIVITY AND, IN THE ABSENCE OF ALTERNATIVES THAT ARE IN THE BEST INTERESTS OF HSHS, HAS DETERMINED: 1. THAT, REGARDLESS OF WHETHER THE COVERED PERSON PARTICIPATES IN THE IMPLEMENTATION OF THE PROPOSED CONTRACT, TRANSACTION, RELATIONSHIP, ARRANGEMENT, OR ACTIVITY; 2. THE CONTRACT, TRANSACTION, ARRANGEMENT OR ACTIVITY IS IN THE BEST INTERESTS OF HSHS; 3. THE CONTRACT, TRANSACTION, ARRANGEMENT OR ACTIVITY IS FAIR AND REASONABLE FROM THE PERSPECTIVE OF HSHS;AND 4. HSHS CANNOT OBTAIN A MORE ADVANTAGEOUS CONTRACT, TRANSACTION, ARRANGEMENT OR ACTIVITY WITH REASONABLE EFFORTS UNDER THE CIRCUMSTANCES. IN DETERMINING WHETHER A CONTRACT, TRANSACTION OR ARRANGEMENT IS FAIR AND REASONABLE TO HSHS, THE COMMITTEE SHALL CONSIDER, WHERE APPLICABLE: 1. APPRAISALS OR OTHER INDEPENDENT VALUATIONS OF THE FAIR MARKET VALUE OF THE CONTRACT, TRANSACTION OR ARRANGEMENT; 2. INFORMATION REGARDING COMPARABLE CONTRACTS, TRANSACTIONS OR ARRANGEMENTS BETWEEN UNRELATED PARTIES; 3. OFFERS FROM COMPARABLE COMPETING ENTITIES; AND/OR 4. STUDIES OF COMPARABLE COMPENSATION ARRANGEMENTS. IN ANY CASE IN WHICH THE COMMITTEE FINDS, AFTER TAKING THE STEPS DESCRIBED ABOVE, THAT HSHS SHOULD PARTICIPATE IN A PROPOSED TRANSACTION OR ARRANGEMENT DESPITE THE EXISTENCE OF A CONFLICT OF INTEREST, THE COMMITTEE SHALL DEVELOP, IMPLEMENT, MONITOR, AND ENFORCE COMPLIANCE WITH, A CONFLICT MANAGEMENT PLAN FOR MANAGING THE CONFLICT OF INTEREST AS IT CONSIDERS NECESSARY FOR SUCH FINDINGS TO REMAIN VALID THROUGHOUT THE LIFE OF THE CONTRACT, TRANSACTION, RELATIONSHIP, ARRANGEMENT OR ACTIVITY. ALL CONFLICT MANAGEMENT PLANS SHALL: 1. STATE THAT THE COMMITTEE WILL OVERSEE, MONITOR AND ENFORCE COMPLIANCE WITH THE PLAN THROUGHOUT THE COURSE OF THE STUDY AND SPECIFY MEANS FOR DOING SO, INCLUDING, WITHOUT LIMITATION, THAT THE APPROPRIATE INDIVIDUALS MUST PROVIDE THE COMMITTEE WITH WRITTEN REPORTS PERTAINING TO COMPLIANCE WITH THE CONFLICT MANAGEMENT PLAN, THAT THE COMMITTEE SHALL HAVE THE RIGHT TO AUDIT THE STUDY FOR SUCH COMPLIANCE AND THE RIGHT TO IMPOSE SANCTIONS FOR NON-COMPLIANCE; 2. STATE THAT THE PLAN MUST BE SHARED WITH THE COVERED PERSON OR PERSONS WHOSE INTERESTS IT WAS DEVELOPED TO MANAGE; 3. STATE THAT THE PLAN MUST BE SHARED WITH, AND PERIODIC REPORTS ON COMPLIANCE WITH THE PLAN MUST BE PROVIDED TO, THE BOARD, SENIOR MANAGEMENT AND/OR GOVERNMENT AGENCIES; AND 4. PROVIDE FOR SUCH OTHER MANAGEMENT STEPS AND MECHANISMS THE COMMITTEE CONSIDERS NECESSARY AND APPROPRIATE. IN ADDITION TO THE COMMITTEE, THE SYSTEM OFFICE VICE PRESIDENTS OF SYSTEM RESPONSIBILITY AND RISK & COMPLIANCE MAY RETAIN SUCH INDEPENDENT ADVISORS OR EXPERTS AS DEEMED NECESSARY TO ASSIST IN MAKING ITS DETERMINATIONS AND DECISIONS. IF THE COMMITTEE DETERMINES THAT THE CONTEMPLATED TRANSACTION, RELATIONSHIP ARRANGEMENT OR ACTIVITY CANNOT PROCEED DUE TO A CONFLICT OF INTEREST, THE COMMITTEE SHALL INFORM THE APPLICABLE COVERED PERSON OR DECISION-MAKING BODY OF SUCH DETERMINATION WITHIN ONE WEEK OF THE COMMITTEE MEETING AT WHICH THE CONTEMPLATED TRANSACTION WAS DISCUSSED. THE COMMITTEE SHALL DOCUMENT ITS REJECTION OF THE CONTEMPLATED TRANSACTION IN THE COMMITTEE'S MEETING MINUTES. WHISTLEBLOWER POLICY FORM 990, PART VI, LINE 13 PROVISIONS WITHIN THE CORPORATE COMPLIANCE HOTLINE AND CONFLICT OF INTEREST POLICY PROVIDE PROTECTIONS FOR WHISTLEBLOWER TYPE ACTIVITIES. COMPENSATION PROCESS FORM 990, PART VI, LINE 15 THE COMPENSATION COMMITTEE ("COMMITTEE") IS COMPRISED OF INDEPENDENT MEMBERS OF THE BOARD OF DIRECTORS. THE COMMITTEE DEVELOPS A COMPENSATION PHILOSOPHY FOR THE SYSTEM AND ALL AFFILIATES. THE COMMITTEE SELECTS AND HIRES THE INDEPENDENT COMPENSATION CONSULTANT TO DEVELOP COMPARABILITY DATA AND ADVISE THE COMMITTEE DURING ITS DELIBERATIONS REGARDING ALL ELEMENTS OF TOTAL COMPENSATION FOR ALL DISQUALIFIED INDIVIDUALS. INTEGRATED HEALTHCARE STRATEGIES ("IHS"), THE CONSULTANTS UTILIZED BY THE COMMITTEE, USE DATA FROM MULTIPLE TAX-EXEMPT PEER GROUP SOURCES TO DETERMINE SALARY RANGES, INCENTIVE OPPORTUNITY RANGES AND BENEFITS FOR THE DISQUALIFIED INDIVIDUALS. IHS THEN ASSISTS THE COMMITTEE IN PREPARING CONTEMPORANEOUS DOCUMENTATION OF ALL ACTIONS. EACH COMMITTEE MEETING IS CONDUCTED WITH THE INTENT TO CREATE A REBUTTABLE PRESUMPTION OF REASONABLENESS FOR ALL ELEMENTS OF EXECUTIVE TOTAL COMPENSATION FOR THE DISQUALIFIED INDIVIDUALS. THE CHAIRMAN MAKES THIS DECLARATION AND ALSO INQUIRES IF THERE ARE ANY CONFLICTS OF INTEREST BY ANY ATTENDEES. ANY CONFLICTS ARE DISCLOSED AND THE COMMITTEE THEN ACTS IN A MANNER TO AVOID ANY CONFLICTED INDIVIDUAL PARTICIPATING IN ANY MANNER WHERE A CONFLICT MIGHT EXIST. AT THE END OF THE MEETING, THE COMMITTEE PREPARES CONTEMPORANEOUS MINUTES THAT RECORD ALL ACTIONS TAKEN DURING THE MEETING. DISCLOSURE: DOCUMENTS AVAILABLE TO THE PUBLIC FORM 990, PART VI, LINE 19 BOARD-APPROVED FINANCIAL STATEMENTS ARE MADE AVAILABLE TO THE PUBLIC UPON REQUEST. THE GOVERNING DOCUMENTS AND CONFLICT OF INTEREST POLICY ARE NOT MADE AVAILABLE TO THE GENERAL PUBLIC AT THIS TIME. POOLED INVESTMENT ACCOUNT FORM 990, PART X, LINE 11 PARTICIPATION IN THE POOLED FUND IS LIMITED TO THE 501(C)(3) HOSPITALS AND RELATED HEALTH SERVICES ORGANIZATIONS SPONSORED BY HOSPITAL SISTERS HEALTH SYSTEM. THE POOLED ACCOUNT CONSISTS OF CASH, EQUITY AND DEBT SECURITIES THAT ARE PUBLICLY TRADED. IN ACCORDANCE WITH THE PROVISIONS OF SFAS NO. 124 "ACCOUNTING FOR CERTAIN INVESTMENTS HELD BY NOT-FOR-PROFIT ORGANIZATIONS", INVESTMENTS IN EQUITY SECURITIES WITH READILY DETERMINABLE VALUES AND ALL INVESTMENTS IN DEBT SECURITIES ARE REPORTED AT FAIR VALUE ON THE BALANCE SHEET. INCOME, REALIZED AND UNREALIZED GAINS AND LOSSES ARE POOLED AND ALLOCATED TO THE PARTICIPANTS. INDIVIDUAL COMPONENTS OF ASSETS AND REVENUE ARE NOT IDENTIFIED TO THE PARTICIPANTS. OTHER CHANGES IN NET ASSETS OR FUND BALANCES FORM 990, PART XI, LINE 5 UNREALIZED GAIN ON INVESTMENTS (563,282) RECOGNITION OF CHANGES IN PENSION FUNDED STATUS (15,264,000) NET ASSETS RELEASED FROM RESTRICTIONS 19,389 CONTRIBUTIONS FROM RELATED PARTIES (327,879) TEMPORARILY RESTRICTED NET INCOME 198,000 PERMANENTLY RESTRICTED NET INCOME 30,000 TRANSFER TO AFFILIATES (5,495,000) FAMLAND INCOME 10,000 ROUNDING 468 ----------- TOTAL OTHER CHANGES IN NET ASSETS OR FUND BALANCES (21,392,304) =========== TRANSACTIONS WITH RELATED ENTITIES FORM 990 SCHEDULE R, PART V, LINE 2 THE TRANSACTIONS REPORTED IN QUESTION 1 ARE BETWEEN RELATED 501(C)(3) PUBLIC CHARITIES AND ARE NOT REPORTED IN THIS SECTION. HOURS DEVOTED FOR RELATED ORGANIZATION FORM 990 PART VII NAME:SISTER MARYBETH CULNAN, OSF TITLE:BOARD MEMBER HOURS:59 HOURS DEVOTED FOR RELATED ORGANIZATION FORM 990 PART VII NAME:ANN M. CARR TITLE:TREASURER HOURS:60 HOURS DEVOTED FOR RELATED ORGANIZATION FORM 990 PART VII NAME:MARK REIFSTECK TITLE:DIVISION CEO HOURS:22 HOURS DEVOTED FOR RELATED ORGANIZATION FORM 990 PART VII NAME:JOHNNY E. 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