2013-05-14T17:19:41-05:00 2012-06-30 861065772 Deloitte Tax LLP 250 East Fifth Street Suite 1900 Cincinnati OH 45202 990 2011-07-01 630909073 St Vincent's Blount STVI 2052743000 150 Gilbreath Drive Oneonta AL 35121 David Cauble 2059397791 2013-05-14 1 Rebecca Lyons P01487105 5137847100 2011 2016-02-24 21:20:13Z St Vincent's Blount John O'Neil 810 St Vincents Dr Birmingham AL 35205 19230044 0 0928 X www.stvhs.com X 1985 AL Provides healthcare activities to the communities which it serves. 15 14 206 39 60171 -86510 340638 289638 16854050 18247227 -6718 0 137909 421942 17325879 18958807 4199 0 0 0 8208631 7824384 0 0 0 12263589 13151231 20476419 20975615 -3150540 -2016808 14445780 13526030 74109292 75206350 -59663512 -61680320 X Rooted in the loving ministry of Jesus as healer, we commit ourselves to serving all persons with special attention to those who are poor and vulnerable. Our Catholic health ministry is dedicated to spiritually centered, holistic care which sustains and improves the health of individuals and communities. We are advocates for a compassionate and just society through our actions and words. 0 0 18878053 18453710 The Hospital is dedicated to spirtually centered, Holistic care that sustains and improves the health of the individuals and communities. It furthers this goal through delivery of patient services, care to the elderly and indigent, patient education and health awareness programs for the community. For detailed information on the Hospital's program service accomplishments and statistical data see Schedule H. 18878053 1 1 0 1 0 0 0 0 0 0 1 0 0 0 1 0 0 1 0 0 0 0 0 0 0 0 1 1 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 1 1 1 0 0 1 X 0 0 206 1 1 1 0 0 0 0 0 0 0 0 0 X 15 14 1 0 0 0 1 1 1 1 1 0 0 1 1 1 1 1 0 1 1 0 X David Cauble 2059397079 810 St Vincents Drive Birmingham AL 35205 X Dan Sansone 5.00 X X 0 0 0 Susan W Matlock end 1011 5.00 X X 0 0 0 Ken Graeve start 1011 5.00 X X 0 0 0 James D Davis 5.00 X X 0 0 0 Douglas B Nunnelley 5.00 X X 0 0 0 Robert Barnett 5.00 X 0 0 0 William K Bibb end 0711 5.00 X 0 0 0 Marc E Bloomston MD 5.00 X 0 0 0 Tina N Corr 5.00 X 0 0 0 Sr Mary E Cullenstart 1011 5.00 X 0 0 0 Norman B Davis Jr 5.00 X 0 0 0 Morton Goldfarb MD 5.00 X 0 0 0 M James Gorrie end 1011 5.00 X 0 0 0 Benny M LaRussa Jr 5.00 X 0 0 0 William H McClanahan JrMD 5.00 X 0 0 0 Willie H Parker 5.00 X 0 0 0 Stan Starnes start 112 5.00 X 0 0 0 John D O'Neil Sch O 40.00 X X 0 1107013 22435 David A Cauble Sch O 40.00 X X 0 337263 17527 Sean C Tinney end 412 40.00 X 122695 122695 13978 Vicki L Briggs start 911 40.00 X 0 110450 3065 Nan M Priest Sch O 40.00 X 0 352803 21440 Carol A Maietta Sch O 40.00 X 0 221660 17124 Gregory L James 40.00 X 0 370601 16418 Kidada Y Hawkins 40.00 X 132156 0 14343 Paula H McCullough 40.00 X 0 135132 15521 Gavin K Gilliland 40.00 X 108613 0 17117 Neeysa C Biddle Sch O 40.00 X 0 426422 16465 363464 3184039 175433 3 1 1 0 Morrison's Management Specialist PO Box 102289 Atlanta GA 30369 Dietary Services 402412 Southern Perioperative Services 405 Riverdale Drive Tuscaloosa AL 35406 Anesthesia Services 298011 Alliance Healthcare PO Box 96485 Chicago IL 60693 MRI Imaging Services 276497 TriMedx PO Box 636129 Cincinnati OH 45263 Clinical Engineering Services 243667 4 280173 9465 2688 289638 Net Patient Revenue 621990 18247227 18212214 35013 18247227 332795 215413 117382 117382 117382 118888 55824 63064 25158 37906 ARRA Revenue 561499 205109 205109 36387 36387 241496 18958807 18453710 60171 155288 691906 622715 69191 5610757 5049681 561076 238265 214438 23827 842609 758348 84261 440847 396762 44085 14957 14957 525250 472725 52525 180574 162517 18057 853656 768290 85366 524968 472471 52497 16552 14897 1655 1463110 1316799 146311 86240 77616 8624 Bad Debt 3220645 2898581 322064 Medical Supplies 1769687 1592718 176969 Purchased Services 1744614 1570153 174461 Corporate Allocation 1607395 1446656 160739 1143583 1027729 115854 20975615 18878053 2097562 0 58570 -1 802536 531176 264047 446516 18151 26878 19609872 7118242 13292275 12491630 10201 29831 14445780 13526030 335278 291384 1476 5168 73772538 74909798 74109292 75206350 X -59663512 -61680320 0 0 -59663512 -61680320 14445780 13526030 -2016808 0 X 0 1 1 X 0 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 0 0 0 0 0 0 0 0 1 14957 14957 0 Part IV, Supplemental Information: Part II-B, Line 1(i), Other Lobbying Activities: Lobbying expenses represent the portion of dues paid to national and state hospital associations that is specifically allocable to lobbying. St. Vincent's Blount does not participate in or intervene in (including the publishing or distributing of statements), any political campaign on behalf of (or in opposition to) any candidate for public office. 16494123 5538638 10955485 336000 168000 168000 2673629 1394164 1279465 106120 17440 88680 12491630 Other Liabilities 23412 Due to Affiliates 74886386 74909798 1 1 X 1 X 1 X 1 1 1 0 1 1 383725 383725 0.02160 2959679 1101406 1858273 0.10470 3343404 1101406 2241998 0.12630 4 1775 7370 90 7280 0.00040 1 120 5520 5520 0.00030 3 52 4204 4204 0.00020 8 1947 17094 90 17004 0.00090 8 1947 3360498 1101496 2259002 0.12720 3 1620 1620 0.00010 1 215 455 455 0.00000 1 200 4414 4414 0.00020 1 50 45 45 0.00000 6 465 6534 6534 0.00030 0 636997 230657 8434100 9076276 -642176 X 1 1 1 1 St Vincent's Blount

150 Gilbreath Drive Oneonta AL 35121

X X X X St Vincent's Blount 1 0 1 1 200.000000000000 1 300.000000000000 1 X X X X 1 1 X X X X 1 0 1 X 0 0 Part I, Line 7: The cost of providing charity care, means tested government programs, and community benefit programs is estimated using internal cost data, and is calculated in compliance with Catholic Health Association ("CHA") guidelines. The organization uses a costing accounting system that addresses all patient segments (for example: inpatient, outpatient, emergency room, private insurance, Medicaid, Medicare, uninsured, or self pay). The best available data was used to calculate the amounts reported in the table. For the information in the table, a cost-to-charge ratio were calculated and applied. Part I, Line 7g: The organization employs its physicians at physician clinics, so the associated costs and charges relating to those physician services are included in all relevant categories in Part I. Part I, L7 Col(f): The amount of bad debt expense reported on Form 990, Part IX, Line 25, column (A), but subtracted for purposes of calculating the percentages in Part I, Line 7, column (f) is $3,220,645. Part II: St. Vincent's Health System provided the following communiity building activities in FY 2012:St. Vincent's Health System has taken the lead in creating a Community Health Care Provider Coalition that meets every other month to collaborate, coordinate and educate each other and the community about important health issues and resources. This group includes hospitals, mental health providers, non-profit clinics, local health department, and other service providers.St. Vincent's Heart Day - A System-wide initiative with its main goal to assist in providing individuals with access to heart tests at an affordable cost if they would otherwise be unable to access such services. Heart assessment tests (valued at $350) are made available for a low fee of $40. Follow up by Dial-A-Nurse is offered to those who need additional testing. Dial-A-Nurse - Registered nurses are available during normal business hours to answer health information inquiries. They are able to triage callers who express symptoms and give basic information about health conditions. St. Vincent's Christmas Store - A Christmas program in partnership with Catholic Center of Concern and King's Home that works to provide families who have experienced an emergency with Christmas items as well as health information. The program provides a toy, winter coat, food box with fresh produce, books for the children and the option for parents to receive a free flu shot. It is a collaborative effort between St. Vincent's Birmingham, St. Vincent's East and St. Vincent's One Nineteen.King's Home - St. Vincent's One Nineteen provides assistance to this local home for women and children experiencing homelessness or domestic violence. One Nineteen hosts a race event benefiting the organization and residents participate in the Christmas Store initiative. Camp Bluebird is a St. Vincent's Birmingham and St. Vincent's East program for adult cancer survivors. The camp provides retreat and supportive services for participants. The model has acquired national recognition and other healthcare providers have adopted the program's model. St. Vincent's Wellness Services provide a wide variety of community outreach and health education. From free or low cost workshops to health fairs and classes, the outreach is designed to emphasize healthy living and healthy habits. Wellness Services perform screenings at local churches free of charge and at events related to the Hispanic Outreach Program and Elder Care. Wellness services provides programming in local assisted living facilities, especially those in underserved areas, free of charge. They have also worked closely with schools and neighborhood organizations to provide programs about nutrition to children and young adults. St. Vincent's Birmingham and St. Vincent's East both maintain a cancer registry, which provides information for the community's benefit. These two facilities also support research that is unsponsored but ultimately benefits the greater community as well.As a Health System, St. Vincent's is committed to disaster preparedness, especially in light of recent events. Our System Safety Officer facilitates trainings and education above and beyond what is required to ensure that the employees are more than prepared for any emergency situations.St. Vincent's St. Clair, Blount and East all participate in local organizations such as Rotary Club, Chamber of Commerce and Kiwanis to educate local leaders about health issues. St. Vincent's Case Management at all facilities frequently go above and beyond the required care by providing assistance in applying for public benefits (MedAssist), providing transportation services for medical appointments (shuttle service), sponsoring sitters/companions for those who are unable to afford, and medication assistance to those who cannot afford prescriptions.St. Vincent's East provides community support in the form of various on-campus support groups. The groups include support for: cancer survivors, individuals living with low vision, gastric bypass, diabetes, grief support and heart health.At every St. Vincent's facility, students and interns shadow and train with associates in a variety of fields: nursing, physical therapy, health information management, business administration, respiratory therapy, patient care assisting, phlebotomy, medical secretary, radiology, surgery, sterile processing, as well as a medical residency program and clinic in collaboration with St. Vincent's East. We provide essential medical services to the community, train and recruit healthcare professionals to serve the needs of the broader community, provide appropriate charity services to those unable to pay for their health care needs, and provide services to other organizations that allow them to provide quality services to their patients or constituents. St. Vincent's Health System currently partners with local chapters of national organizations with intent to assist those with varying health issues. Among the organizations that associates may volunteer with, participate in and raise funds for are: American Cancer Society, American Diabetes Association, American Heart Association, Leukemia and Lymphoma Society, March of Dimes, Susan G. Komen for the Cure, Dispensary of Hope, Red Cross, and United Way. Local health-related organizations that receive support from St. Vincent's Health System include: Birmingham AIDS Outreach, Tot Shots (free vaccination program), Sickle Cell Foundation, Cahaba Valley Health Care (dental and vision), Office of Women's Health, and M-POWER Ministries (free clinic). Other organizations in the community that St. Vincent's sponsors and supports are: -Cristo Rey - an internship program for inner city youth at Holy Family Catholic School -MedMission - a medical supply organization that matches international need with surplus or nearly expired items -Royal Family Kids Camp - which provides a summer camp experience for foster care children-Magic City Harvest - provides food distribution to homeless shelters-Ladies of Charity - raise funds and volunteer in the spirit of St. Vincent dePaul-The Nest - a homeless health outreach-Christian Service Mission - provides emergency donations and need (especially in recent disaster relief efforts)-YWCA and Pathways - a set of services designed to assist homeless women become self-sufficient-Our Lady of Fatima and St. Barnabas Catholic Schools - which provide private school education in underserved communities-The Exceptional Foundation - that supports mentally challenged children to learn skills and socialize-Jones Valley Urban Farm - which supports urban farming and healthy nutrition. Part III, Line 4: From the consolidated audited financial statements of Ascension Health Alliance (which includes the activity of St. Vincent's Blount):The provision for bad debt expense is based upon management's assessment of expected net collections considering economic conditions, historical experience, trends in healthcare coverage, and other collection indicators. Periodically throughout the year, management assesses the adequacy of the allowance for uncollectible accounts based upon historical write-off experience by payor category, including those amounts not covered by insurance. The results of this review are then used to make any modifications to the provision for bad debt expense to establish an appropriate allowance for uncollectible accounts. After satisfaction of amounts due from insurance and reasonable efforts to collect from the patient have been exhausted, the System follows established guidelines for placing certain past-due patient balances with collection agencies, subject to the terms of certain restrictions on collection efforts as determined by the System. Accounts receivable are written off after collection efforts have been followed in accordance with the System's policies.The cost of charge ratio was used to determine the bad debt expense at cost. Bad debt expense at cost attributable to patients eligible under the organization's charity polity was calculated by using the US Census date to determine the percentage of population below 200% of the FPL and applied that percentage to bad debt expense at cost as an estimate of charity in bad debt. Part III, Line 8: Ascension Health and related health ministries follow the Catholic Health Association ("CHA") guidelines for determining community benefit. CHA community benefit reporting guidelines suggest that Medicare shortfall is not treated as community benefit. The cost to charge ratio method is used in determining the shortfall. Part III, Line 9b: St. Vincent's Health System follows the Ascension guidelines for collection practices related to patients qualifying for charity or financial assistance. A patient can apply for charity or financial assistance at any time during the collection cycle. Once qualifying documentation is received the patient's account is adjusted. Patient accounts for the qualifying patient in the previous six months may also be considered for charity or financial assistance. Once a patient qualifies for charity or financial assistance, all collection activity is suspended. Part VI, Line 2: Our most recent community needs assessment was conducted in April 2008 by our parent company, Ascension Health, and was limited geographically to the seven counties served by St. Vincent's Health System. The assessment was completed by interviewing key stakeholders both within St. Vincent's Health Care System and in the external community. The interviews were conducted between December 2007 and April 2008. Interviewees included a range of CEO's and program managers from area health care organizations, and 55 interviews were completed. The needs assessment consists of census data, public health information, and findings from the interviews. These findings include an assessment of the local healthcare infrastructure and the service gaps, especially in regards to those in our community who lack access to basic healthcare services. Part VI, Line 3: St. Vincent's Health System uses visual aids to inform patients of available financial assistance. The statement of Patient Financial Services Financial Assistance is displayed at all registration areas throughout the hospital, including the Emergency Department to make patients aware that assistance is available. Our staff, when discussing collections with patients, also makes patients aware of the available assistance if they are unable to pay. Part VI, Line 4: St. Vincent's Health System primarily services residents of central Alabama in the following seven counties: Blount, Cullman, Jefferson, Shelby, St. Clair, Talladega, and Walker. -Our primary service area consists of both rural and urban communities with a population of 1,231,544; median income of $45,822; and median age of 38. - Age of population: 26.15% age 0-19, 33.12% age 20-44, 27.23% age 45-64, 13.5% age 65+.- Sex: 51.8% Female and 48.1% Male.-Ethnicity: 67.5% White non-Hispanic, 27.4% Black non-Hispanic, 4.2% Hispanic, 1.2% Asian non-Hispanic.- Language: English speaking 96.44%, Non-English age 5+ 3.56%.- There are 102 federally designated Medically Underserved Areas (MUAs) and 17% of the population is eligible for Medicaid inside the seven county service areas. - Insurance coverage breakdown is 57.7% Private, 15.8% Medicare, 15.4% Medicaid, and 11.1% Uninsured. - Poverty: 15.1% on average in poverty. Range in 7 counties (6.9% to 19.3%).- Hospitals in service area: 18 total, 16 Nonprofit, 2 For profit, 1 academic medical center.- Health Statistics- Obesity: 31%.- Leading causes of death: Heart disease, Cancer, Stroke. Part VI, Line 5: This report illustrates the significant degree to which St. Vincent's Health System through its four hospitals and Health & Wellness facility, contributes to the positive health status of the communities we serve. The system's four hospitals include: St. Vincent's Birmingham, St. Vincent's East, St. Vincent's Blount and St. Vincent's St. Clair. Each hospital has a separate Tax ID number. Each makes an important contribution to caring for their community, including those who are underserved. As a member of Ascension Health, St. Vincent's Health System continues to build and strengthen sustainable collaborative efforts that benefit the health of individuals, families and the community as a whole. The Health System's mission is to extend the healing ministry of Christ. The hospitals of the health system further the mission through the delivery of patient services, care to the elderly and indigent, patient education, and health awareness programs for the community. Our concern for all human life and commitment to the dignity of each person leads us to provide medical services to all people in the community without regard to race, creed, national origin, economic status, or ability to pay. Based on our Core Values and in the spirit of principles adopted by Ascension Health, our Health System has taken proactive steps to address those issues that affect accessibility, the financing, and the delivery of health care to all persons, especially the uninsured, underinsured, and the underserved. The following chart demonstrates the significant number of patient days and the estimated unreimbursed cost of services provide by our four hospitals to the uninsured or underserved. FY12 Number of Number of Estimated Licensed Beds Patient Days Unreimbursed costSt. Vincent's Birmingham 409 98,995 9,711,933 St. Vincent's East 328 78,770 9,864,608 St. Vincent's Blount 40 4,869 957,278 St. Vincent's St. Clair 40 5,992 1,586,040 Total 777 188,626 22,119,859 St. Vincent's Heath System has a deep commitment to serving the community. We earmark a certain percentage of our yearly profits for charitable donations. Through this charitable donation program, we are able to support local chapters of national organizations such as: the American Cancer Society, the American Heart Association, March of Dimes, and Susan G. Komen for the Cure. We also fund local programs and initiatives such as the United Way. Many of our executives serve on the boards of these organizations.We also realize that our community can extend beyond geographic boundaries, which is why we are pleased to partner with MedMission International. For many reasons, perfectly usable medical supplies, which could be used to save lives in poor countries, are required to be discarded in the United States. At St. Vincent's Health System, we collect that medical surplus and donate to MedMission International to redistribute it to under-served hospitals and clinics around the world.We provide essential medical services to the community, train and recruit healthcare professionals to serve the needs of the broader community, provide appropriate charity services to those unable to pay for their health care needs, and provide services to other organizations that allow them to provide quality services to their patients or constituents. Some of these services include Liz Moore Low Vision Center located at St. Vincent's East, Jeremiah's Hope Skills Program, Hispanic Outreach Ministry, Adult Medical Clinic and Elder Care Services program which are all located at St. Vincent's Birmingham.The goal of the Liz Moore Low Vision Center at St. Vincent's East is to assist the person with low vision to use functional vision to the utmost capacity. A person with low vision may be legally blind but able to function with visual aids that enhance the remaining vision. With the assistance of magnification and adaptations of the special low vision aids that are useful for certain daily tasks, the visually impaired person can function with less difficulty. The Vision Center provides services for the person with low vision. These services are designed to benefit a person's daily life activities, which may be hindered by the visual loss.St. Vincent's Birmingham Jeremiah's Hope Skills Program focuses on training at-risk individuals, particularly women, for entry level jobs in the healthcare industry. Today, more than 450 people have graduated from Jeremiah's Hope, and most are still working in the healthcare industry. St. Vincent's has also recently partnered with Jeff State Community College to begin identifying "under-employed" individuals from within our own workforce and training them to become nurses. Philanthropy allowed this revolutionary program to blossom and it has now become a model for other healthcare facilities nationwide.In 2003, St. Vincent's Birmingham initiated a Hispanic Outreach program, La Sana Esperanza/The Healthy Hope, recognizing the changing demographics in Birmingham. This program provides health and medical assistance to the burgeoning Latino population, often an isolated sector of our community. By identifying and placing high-risk persons in our Adult Medical Clinic, we are providing critical care for those in need in a fiscally responsible manner. We have provided health fairs, health screenings, health information, case management assistance, and language assistance to a myriad of persons within the Birmingham community in order to break down the barriers that lead to poor heath in the Latino population.The Adult Medical Clinic is a healthcare option for the "working poor" in the Birmingham area, serving individuals who are employed but lack health insurance. The Clinic treats up to 350 patients at any given time, providing for all of their healthcare needs at no cost to the patient. St. Vincent's works with patients to identify ways to acquire insurance and screens patients based on a willingness to make life changes conducive to good health. This charity care is only made possible because of charitable gifts which provide the equipment, space and staffing the Clinic needs. The Clinic is a service for those patients who have no other options and is possible because of the many philanthropists who support this ministry.The St. Vincent's Birmingham Elder Care Services Program was created in response to a need expressed by a donor to St. Vincent's Foundation. That donor is a self-described Elder Orphan. She has few family members and no prospects to assist her with care as she ages. She worries about her future when the time comes when she is no longer able to drive herself to and from physician appointments and to the grocery store. She trusts St. Vincent's to care for her medical needs and wondered if there was a way for St. Vincent's to assist people like her who will need additional assistance as they age. The idea was presented to Susann Montgomery-Clark in the Foundation office, and after more than two years of focus groups and meetings with St. Vincent's associates, the project was officially launched. Initial funding was requested from a group of focus group members who were supportive and excited about the project and a grant was obtained from the Daughters of Charity to begin work on the outline of services that the Elder Care Services Program might provide. Just in its infancy, the Elder Care Program has hopes to become one that assists our original donor and those like her who will need support services in their twilight years. We Are Called To: -Service of the Poor -Generosity of spirit, especially for persons most in need-Reverence-Respect and compassion for the dignity and diversity of life-Integrity-Inspiring trust through personal leadership-Wisdom-Integrating excellence and stewardship-Creativity-Courageous innovation-Dedication-Affirming the hope and joy of our ministry.St. Vincent's Health System is made up of five facilities: St. Vincent's Birmingham, St. Vincent's Blount, St. Vincent's East, St. Vincent's St. Clair, and One Nineteen Health and Wellness. Together, we provide a special brand of high-touch, high-tech quality care to people in more than 40 different zip codes. Our healthcare family has an extensive network of skilled physicians and associates, as well as the most advanced technologies available. We are a part of Ascension Health, the nation's largest Catholic and non-profit health system, with more than 100,000 associates serving in 20 states and the District of Columbia. We are committed to providing healthcare that works, healthcare that is safe, and healthcare that leaves no one behind for life. Part VI, Line 6: St. Vincent's Health System (the Health Ministry) is a member of Ascension Health. Ascension Health Alliance is the sole corporate member and parent organization of Ascension Health, a Catholic national health system consisting primarily of nonprofit corporations that own and operate local healthcare facilities, or Health Ministries, located in 21 of the United States and the District of Columbia.The Health Ministry, located in Birmingham, Alabama, is a nonprofit health system. The Health Ministry is the sole corporate member of four not-for-profit acute care hospitals - St. Vincent's Birmingham, St. Vincent's East, St. Vincent's Blount, and St. Vincent's St. Clair, LLC (collectively referred to as the Hospitals). The Hospitals provide inpatient, outpatient and emergency care services for the residents of Birmingham and surrounding areas. Admitting physicians are primarily practitioners in the local area. The Health Ministry is also the sole corporate member of St. Vincent's Foundation of Alabama, Inc. and St. Vincent's East Foundation, Inc. (collectively referred to as the Foundations). The Foundations provide fund raising efforts to support charitable, religious and educational purposes of charitable works of the Health Ministry in accordance with mission and values of Ascension Health. The consolidated financial statements of the Health Ministry also include the following healthcare entities: Universal Health Services (provides physician, diagnostic and rehabilitative services, as well as temporary lodging to families of patients), Seton Property Corporation of North Alabama (owns and rents professional office buildings and other real property primarily for medical services), Ascension Venture Corporation (provides for-profit wellness, spa and fitness services), and Vincentian Ventures of North Alabama, Inc. (operates a for-profit pharmacy and other occupational health services). The Health Ministry is related to Ascension Health's other sponsored organizations through common control. Substantially all expenses of Ascension Health are related to providing health care services.MissionThe System directs its governance and management activities toward strong, vibrant, Catholic Health Ministries united in service and healing, and dedicates its resources to spiritually centered care which sustains and improves the health of the individuals and communities it serves. In accordance with the System's mission of service to those persons living in poverty and other vulnerable persons, each Health Ministry accepts patients regardless of their ability to pay. The System uses four categories to identify the resources utilized for the care of persons living in poverty and community benefit programs: - Traditional charity care includes the cost of services provided to persons who cannot afford health care because of inadequate resources and/or who are uninsured or underinsured.- Unpaid cost of public programs, excluding Medicare, represents the unpaid cost of services provided to persons covered by public programs for the persons living in poverty and other vulnerable persons.- Cost of other programs for persons living in poverty and other vulnerable persons includes unreimbursed costs of programs intentionally designed to serve the persons living in poverty and other vulnerable persons of the community, including substance abusers, the homeless, victims of child abuse, and persons with acquired immune deficiency syndrome.- Community benefit consists of the unreimbursed costs of community benefit programs and services for the general community, not solely for the poor, including health promotion and education, health clinics and screenings, and medical research.Discounts are provided to all uninsured patients, including those with the means to pay. Discounts provided to those patients who did not qualify for assistance under charity care guidelines are not included in the cost of providing care of persons who are poor and community benefit programs. The cost of providing care of persons who are poor and community benefit programs is estimated using internal cost data. Unreimbursed Services Provided to the Elderly and the PoorSt. Vincent's Health System provides a substantial portion of its services to the elderly and poor. During the fiscal year ending 2012, approximately 46% of the value of services rendered were to elderly patients under the Medicare program, and approximately 6% of the services were provided to patients who were deemed indigent under state, county, or Medical Center Guidelines. In the spirit of principles adopted by Ascension Health, St. Vincent's Health System has taken proactive steps to address those issues that will affect accessibility, the financing, and the delivery of healthcare to all persons, especially the uninsured, underinsured, and the underserved. During the fiscal year ending 2012, the estimated unreimbursed cost of services provided to the elderly, uninsured, and underinsured totaling approximately $22.1 million.Patient ServicesSt. Vincent's Health System mission focused health ministry, provides acute care services and community focused services.During the fiscal year ending 2012, our Health System treated 38,225 adults and children in the community for a total of 188,626 patient days of service. The Health System also provided services to 498,084 outpatients, including 33,647 outpatient surgery patients, 135,307 emergency and minor care visits and 110,379 clinic and office visits.SummarySt. Vincent's Health System furthers its charitable purposes by providing a broad array of services to meet the healthcare needs of patients and organizations in the community. We provide essential medical services to the community, train and recruit healthcare professionals to serve the needs of the broader community, provide appropriate charity services to those patients who are not able to pay for their own healthcare needs, provide services to other organizations that allow them to provide quality services to their patients or constituents, and present education information classes and activities to the community in order to improve its overall health status. X 1 1 0 1 0 0 0 0 0 0 0 John D O'Neil Sch O 0 573221 0 455586 0 78206 0 4900 0 17535 0 1129448 0 17180 David A Cauble Sch O 0 334555 0 0 0 2708 0 948 0 16579 0 354790 0 0 Sean C Tinney end 412 108352 108352 0 0 14343 14343 3277 3277 3712 3712 129684 129684 0 0 Nan M Priest Sch O 0 287681 0 0 0 65122 0 7350 0 14090 0 374243 0 61633 Carol A Maietta Sch O 0 205343 0 0 0 16317 0 6341 0 10783 0 238784 0 0 Gregory L James 0 350406 0 0 0 20195 0 7350 0 9068 0 387019 0 0 Paula H McCullough 0 115911 0 0 0 19221 0 3577 0 11944 0 150653 0 0 Neeysa C Biddle Sch O 0 215431 0 0 0 210991 0 5694 0 10771 0 442887 0 102817 Part I, Line 1a St. Vincent's Health System provides membership to The Summit Club and The Club for the executive team, as well as, Rotary and Kiwanis club memberships for various members of the management team to facilitate networking and community benefit related to St. Vincent's Health System. Supplemental Information Part III Part I, Line 3: The following are used by St. Vincent's Health System to establish the compensation of the organization's CEO: -Compensation Committee -Independent Compensation Consultant -Written Employment Contract -Compensation Survey or Study -Approval by the Board or Compensation Committee Supplemental Information Part III Part I, Line 4b: Eligible executives participate in a program that provides for supplemental retirement benefits. The payment of benefits under the program, if any, is entirely dependent upon the facts and circumstances under which the executive terminates employment with the organization. Benefits under the program are unfunded and non-vested. Due to the substantial risk of forfeiture provision, there is no guarantee that these executives will ever receive any benefit under the program. Any amount ultimately paid under the program to the executive is reported as compensation on Form 990, Schedule J, Part II, Column B in the year paid. A related organization that paid the salaries of the individuals listed in Schedule J, Part II, paid out of the supplemental nonqualified retirement plan in the amounts as noted: Neeysa C. Biddle - $102,817 John D. O'Neil - $17,180 Nan M. Priest - $61,633 A related organization that paid the salaries of the individuals listed in Schedule J, Part II, contributed to the supplemental nonqualified retirement plan in the amounts as noted: Kidada Y. Hawkins - $1,625 Sean C. Tinney - $2,540 Supplemental Information Part III Schedule J, Part II: Description of Compensation: Executive compensation, in keeping with Ascension Health's philosophy, is in line with the national average. Compensation may include short or long term incentive pay, deferred compensation, PTO (vacation/holiday) converted to cash, etc. Explanation of Attached Audited Financial Statements: Form 990, Part IV, Line 20b: The financial statements of St. Vincent's Health System, which include the activity of St. Vincent's Blount, fall under the full scope audit of Ascension Health Alliance. The activity of St. Vincent's Blount and other members of St. Vincent's Health System are reported in the consolidated financial statements of Ascension Health Alliance. No individual audit for St. Vincent's Blount is completed. Therefore, the attached audited financial statements are of Ascension Health Alliance and Affiliates (which include the activity of St. Vincent's Blount). Number of Forms 1099 Filed: Form 990, Part V, Line 1a: St. Vincent's Health System, a related organization of St. Vincent's Blount, uses a common paymaster to compensate all independent contractors used within the Health System. The number attributable to each hospital is not easily distinguished. The total amount of Forms 1099 filed for the entire Health System appears on Part V, Line 1a of St. Vincent's Health System's Form 990. Form 990, Part VI, Section A, line 2 Dan Sansone and Susan Matlock have a business relationship. Form 990, Part VI, Section A, line 6 St. Vincent's Blount has a single corporate member, St. Vincent's Health System. Form 990, Part VI, Section A, line 7a St. Vincent's Blount has a single corporate member, St. Vincent's Health System, who has the ability to elect members to the governing body of St. Vincent's Blount. Form 990, Part VI, Section A, line 7b All decisions that have a material impact to St. Vincent's Blount financial information or corporation as a whole are subject to approval by its sole corporate member, St. Vincent's Health System. Form 990, Part VI, Section B, line 11 Management, including certain Officers, work diligently to complete the Form 990 and attached schedules in a thorough manner. Management presents the Form to a designated committee of St. Vincent's Health System (which has oversight over this entity), to review and answer questions. Prior to filing the return, all Board Members are provided the Form 990 and management team members are available to answer any Board Members' questions. Form 990, Part VI, Section B, line 12c The organization regularly and consistently monitors and enforces compliance with the conflict of interest policy in that any director, principal officer, or member of a committee with governing board delegated powers, who has a direct or indirect financial interest, must disclose the existence of the financial interest and be given the opportunity to disclose all material facts to the directors and members of the committees with governing board delegated powers considering the proposed transaction or arrangement. The remaining individuals on the governing board or committee meeting will decide if conflicts of interest exist. Each director, principal officer, and member of a committee with governing board delegated powers annually signs a statement which affirms such person has received a copy of the conflict of interest policy, has read and understands the policy, has agreed to comply with the policy, and understands that the organization is charitable and in order to maintain its federal tax exemption it must engate primarily in activities which accomplish its tax exempt status. Form 990, Part VI, Section B, line 15 In determining the compensation for the President of St. Vincent's Blount, the process, performed by St. Vincent's Health System (a related entity that paid the President), included a review and approval by independent persons, comparability data, and contemporaneous substantiation of the deliberation and decision. The Health System Compensation Committee reviewed and approved the compensation, with facilitation by the SVP of HR/CLO and the Director of Compensation. In the review of the compensation, the President was compared to individuals at other hospitals in the area who hold the same title. During the review and approval of the compensation, documentation of the decision was recorded in the board minutes. The individual was not present when his compensation was decided. In determining the compensation of other officers of the organization, the process, performed by St. Vincent's Health System (a related entity that paid the officers), included a review and approval by independent persons, comparability data, and contemporaneous substantiation of the deliberation and decision. The Health System Compensation Committee reviewed and approved the compensation. In the review of the compensation, the other officers of the organization were compared to individuals at other hospitals in the area who hold the same title. During the review and approval of the compensation, documentation of the decision was recorded in the board minutes. Form 990, Part VI, Section C, line 19 The organization will provide any documents open to public inspection upon request. Document Retention and Destructions Policy: Form 990, Part VI, Section B, Line 14: St. Vincent's Health System, the parent organization of St. Vincent's Blount has drafted a document retention and destruction policy to be approved by the board of directors or designated committee. The policy was drafted but not approved prior to the close of the current fiscal year; however, St. Vincent's Health System plans to have the policy in place prior to June 30, 2013. Average Hours Devoted to Related Organization(s) when Related Compensation: Form 990, Part VII, Section A: Officers (as noted with a "Sch O" reference) for St. Vincent's Blount provide services to St. Vincent's Health System and its subsidiaries. Hours worked are not tracked on an entity by entity basis. Therefore, officers hours reported on Form 990, Part VII, Compensation of Officers, Directors, Trustees, Key Employees, Highest Compensated Employees, and Independent Contractors represent aggregate hours worked per week for all entities. The St. Vincent's Health System Board of Directors has governance power for St. Vincent's Blount. Therefore, the Health System Board of Directors are listed on Form 990, Part VII, Compensation of Officers, Directors, Trustees, Key Employees, Highest Compensated Employees, and Independent Contractors. Ascension Health PO Box 45998 St Louis MO 63145 311662309 National Health System MO Section 501(c)(3) Schedule A, Line 11a Ascension Health Alliance 0 St Vincent's Health System 810 St Vincents Drive Birmingham AL 35205 630931008 Health System Parent AL Section 501(c)(3) Schedule A, Line 11c Ascension Health 0 St Vincent's Birmingham 810 St Vincents Drive Birmingham AL 35205 630288864 Hospital AL Section 501(c)(3) Schedule A, Line 3 St Vincent's Health System 1 St Vincent's East 50 Medical Park East Drive Birmingham AL 35235 630578923 Hospital AL Section 501(c)(3) Schedule A, Line 3 St Vincent's Health System 1 American Sports Medicine Institute 2660 10th Avenue South No 505 Birmingham AL 35205 630952490 Sports Medicine AL Section 501(c)(3) Schedule A, Line 7 St Vincent's Birmingham 1 Universal Health Services 810 St Vincents Drive Birmingham AL 35205 630932323 Physician Group AL Section 501(c)(3) Schedule A, Line 11b St Vincent's Health System 1 Eastern Health Foundation 50 Medical Park East Drive Birmingham AL 35235 630909071 Fundraising AL Section 501(c)(3) Schedule A, Line 7 St Vincent's Health System 1 St Vincent's Foundation of Alabama Inc 810 St Vincents Drive Birmingham AL 35205 630868068 Fundraising AL Section 501(c)(3) Schedule A, Line 7 St Vincent's Health System 1 Seton Property Corporation of North Alabama 810 St Vincents Drive Birmingham AL 35205 237326976 Real Estate AL Section 501(c)(2) N/A St Vincent's Health System 1 St Vincent's Outpatient Surgery Services LLC 810 St Vincents Drive Birmingham AL 35205 200708162 Outpatient Surgery AL N/A St Vincent's Sleep Disorder Center LLC 810 St Vincents Drive Birmingham AL 35205 631282288 Sleep Disorder Center AL N/A Vincentian Ventures of North Alabama Inc 810 St Vincents Drive Birmingham AL 35205 630965456 Misc Healthcare Services AL N/A C Ascension Ventures Corporation 810 St Vincents Drive Birmingham AL 35205 631217059 Misc Healthcare Services AL N/A C Eastside Ventures Inc 810 St Vincents Drive Birmingham AL 35205 630846221 Misc Healthcare Services AL N/A C 0 0 1 0 0 0 0 0 1 0 0 0 0 1 1 0 0 0 Eastside Ventures Inc I 71100 Journal Entry Transaction St Vincent's Health System O 2461051 Journal Entry Transaction St Vincent's Foundation of Alabama Inc C 280173 Journal Entry Transaction