2012-11-13T13:15:52-06:00 2011-12-31 381357951 PLANTE & MORAN PLLC 600 E FRONT ST SUITE 300 TRAVERSE CITY MI 49686 990 2011-01-01 610445850 ST ELIZABETH MEDICAL CENTER INC STEL 8596551642 ONE MEDICAL VILLAGE DRIVE EDGEWOOD KY 41017 NATHAN VANLANINGHAM 8596551642 2012-11-09 1 P00842339 2319477800 2011 2016-02-24 21:20:13Z ST ELIZABETH HEALTHCARE JOHN S DUBIS ONE MEDICAL VILLAGE DRIVE EDGEWOOD KY 41017 920843250 0 0928 X WWW.STELIZABETH.COM X 1861 KY ST. ELIZABETH HEALTHCARE IS ONE OF THE OLDEST, LARGEST AND MOST RESPECTED MEDICAL PROVIDERS IN THE GREATER CINCINNATI REGION. WITHIN OUR THRIVING, MULTI-FACETED ORGANIZATION, SOME OF THE NATION'S TOP MEDICAL PROFESSIONALS ARE WORKING TOGETHER TO DELIVER THE BEST CARE AVAILABLE TO THE GREATER CINCINNATI REGION. ST. ELIZABETH HEALTHCARE HAS INVESTED IN OUR COMMUNITY FOR GENERATIONS. ST. ELIZABETH BELIEVES THAT REACHING OUT TO HELP THE UNDERPRIVILEGED AND IMPROVING THE OVERALL HEALTH OF THE COMMUNITY IS THE FOUNDATION OF ITS MISSION TO PROVIDE COMPREHENSIVE AND COMPASSIONATE CARE TO OUR NEIGHBORHOOD AND OUR FAMILIES. IT IS BECAUSE OF THIS BELIEF THAT THE COMMUNITY BENEFIT PROGRAM HELPS OTHERS HAVE ACCESS TO ST. ELIZABETH'S RESOURCES AND SERVICES. IT IS ST. ELIZABETH'S INTENTION TO ALWAYS BALANCE FINANCIAL VIABILITY WITH COMPASSIONATE CARE, STAYING TRUE TO ITS NON-PROFIT ROOTS. 17 5 6849 1233 2465402 0 4030667 4446340 796602023 898470837 8162714 10499963 26400583 4421990 835195987 917839130 0 0 0 0 392950985 426219642 42000 57325 1095016 367166117 398483436 760159102 824760403 75036885 93078727 875944968 936028962 459266358 509456924 416678610 426572038 AS A CATHOLIC HEALTHCARE MINISTRY, WE PROVIDE COMPREHENSIVE AND COMPASSIONATE CARE THAT IMPROVES THE HEALTH OF THE PEOPLE WE SERVE. ST. ELIZABETH IS THE PREFERRED DESTINATION FOR HEALTHCARE, WHERE INNOVATIVE PROFESSIONALS DELIVER THE HIGHEST QUALITY OF CARE. 0 0 630885086 0 892140703 ST. ELIZABETH HEALTHCARE IS ONE OF THE OLDEST, LARGEST AND MOST RESPECTED MEDICAL PROVIDERS IN THE GREATER CINCINNATI REGION. WITHIN OUR THRIVING, MULTI-FACETED ORGANIZATION, SOME OF THE NATION'S TOP MEDICAL PROFESSIONALS ARE WORKING TOGETHER TO DELIVER THE BEST CARE AVAILABLE TO THE GREATER CINCINNATI REGION. 630885086 1 1 0 1 0 0 0 0 0 1 1 0 0 0 1 1 0 1 0 0 0 0 0 1 1 0 1 1 0 0 1 1 0 0 0 0 0 0 0 0 0 1 1 0 0 0 1 1 1 1 0 0 1 194 0 1 6849 1 1 1 0 0 0 0 1 1 0 0 0 0 X 17 5 0 0 0 0 0 1 1 1 1 0 0 1 1 1 1 1 1 1 1 1 0 KY OH X NATHAN VANLANINGHAM CFO 8596551642 401 EAST 20TH STREET COVINGTON KY 41014 X JOHN DUBIS 60.00 X X 744566 0 189567 GEORGE S HALL MD 4.00 X 269962 0 21540 HEIDI C MURLEY MD 4.00 X 0 299753 21210 THOMAS C COLVIN 4.00 X 0 0 0 MICHAEL A CONNER 4.00 X 0 0 0 BARRY L DICK 4.00 X 0 0 0 CHRISTOPHER FISTER 4.00 X 0 0 0 MICHAEL J GIBBONS 4.00 X X 0 0 0 RALPH F HULLER 4.00 X 0 0 0 BARI JOSLYN 4.00 X 0 0 0 FRED A MACKE JR 4.00 X X 0 0 0 GARY W MOORE 4.00 X 0 0 0 TED ROBINSON 4.00 X 0 0 0 JAMES ROEBKER 4.00 X 0 0 0 PAUL A SARTORI 4.00 X 0 0 0 JO ANN SIMPSON 4.00 X 0 0 0 JOAN WURTENBERGER 4.00 X 0 0 0 GARREN COLVIN 60.00 X 542796 0 114928 NATHAN VANLANINGHAM 60.00 X 332698 0 47283 BARBARA KROHMAN 60.00 X 116566 0 19894 THOMAS SAALFELD 40.00 X 1287534 0 36967 TREVA JANE SWAIM 40.00 X 1002971 0 36807 GLENN LOOMIS 40.00 X 431706 0 68801 SARAH GIOLANDO 40.00 X 343284 0 37209 MARTIN OSCADAL 40.00 X 313067 0 69349 CHISTOPHER CARLE 40.00 X 308587 0 69801 GARY BLANK 40.00 X 256374 0 53215 MARK REIDINGER 40.00 X 242924 0 55667 RAYMOND WILL 40.00 X 599700 0 20010 VICTOR SCHMELZER 40.00 X 591124 0 40927 MICHAEL GIBSON 40.00 X 586932 0 39196 KARL ULICNY 40.00 X 587844 0 40696 JACKSON PEMBERTON 40.00 X 441731 0 43920 JOSEPH GROSS 40.00 X 535480 0 12807 9535846 299753 1039794 268 1 1 0 MILLS SHERMAN GILLIAM & GOODWIN PSC 9600 COLERAIN AVE SUITE 204 CINCINNATI OH 45251 PHYSICIAN FEES 13374337 FRANK MESSER & SONS CONSTRUCTION COMPANY 7384 TURFWAY RD FLORENCE KY 41042 CONSTRUCTION SERVICES 11231872 EPIC SYSTEMS CORPORATION 1979 MILKY WAY VERONA WI 53593 CONSULTING SERVICES 6747961 CAREFUSION 3698 COLLECTION CENTER DR CHICAGO IL 60693 MEDICAL SUPPLIES & EQUIPMENT 4860664 DRESSMAN BENZINGER & LAVELLE PSC 207 THOMAS MORE PKWY CRESTVIEW HILLS KY 41017 LEGAL FEES 3199094 113 281749 1140937 3023654 127050 4446340 NET PATIENT REVENUE 621400 870421418 870421418 OTHER RELATED REVENUE 900099 18683067 18683067 PATIENT/EMPLOYEE DRUGS 446110 4184071 316900 3867171 ELEC HEALTHCARE RECORD 900099 3036218 3036218 LABORATORY 621500 2146063 2146063 898470837 9458797 9458797 1600509 1913057 -312548 -312548 -312548 1741732 161151 0 861717 1741732 -700566 1041166 1041166 229346 281749 229346 0 CAFETERIA/VENDING 722210 3463727 3463727 GIFT SHOP 453220 1268372 1268372 OTHER UBI 900099 2439 2439 4734538 917839130 892140703 2465402 18786685 7014065 1629871 5384194 319994619 248534397 71166779 293443 24968566 19401162 5546219 21185 51307543 37742071 13526985 38487 22934849 17339481 5576427 18941 2880948 2879904 1044 586844 586844 39525 39525 57325 57325 1070668 1070668 103759788 66231517 37379783 148488 1955720 143537 1797981 14202 3855601 1309638 2477319 68644 8468208 1672116 6743721 52371 10161987 5122760 5031593 7634 345600 263087 80682 1831 2363034 524396 1593604 245034 6706840 3984534 2712916 9390 50762060 34512473 16217691 31896 5841835 2347548 3494287 MEDICAL SUPPLIES 108261911 107755228 506683 BAD DEBT 52068634 52068634 GENERAL SUPPLIES 23381950 16404747 6926639 50564 PROVIDER TAX 12545828 12545828 3426455 1352061 2039857 34537 824760403 630885086 192780301 1095016 3874543 56714359 58883223 2876033 3346784 84669893 97938354 4272264 4810666 10099259 11780429 7192105 5485720 900207249 563174078 333514299 337033171 338878736 370097928 26363343 33583705 3664935 3125503 3756681 2458760 3943061 3610176 875944968 936028962 74365730 82201628 5898925 6787371 136975000 133850000 900000 683333 241126703 285934592 459266358 509456924 X 414033462 422801928 2645148 3770110 416678610 426572038 875944968 936028962 X 93078727 -83185299 X X 0 1 1 X 0 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 0 1 0 0 0 1 37300 1 2225 0 0 39525 0 PART IV, SUPPLEMENTAL INFORMATION: PART II-B, LINE 1F: THE PORTION OF THE KENTUCKY HOSPITAL ASSOCIATION DUES ATTRIBUTABLE TO LOBBYING ACTIVITIES IS $37,300. PART II-B, LINE 1B AND 1G: THE PORTION OF TWO ST. ELIZABETH HEALTHCARE EMPLOYEES SALARIES RELATED TO DIRECT CONTACT WITH LEGISLATORS REGARDING LEGISLATION. ST. ELIZABETH HEALTHCARE 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. 3347274 -82691 4831 3259752 2945631 406302 4659 3347274 2332334 618143 4846 2945631 3600819 -1261366 6119 2332334 1.00000 0.00000 0.00000 0 0 15148443 15148443 440933943 255453592 185480351 5772300 1897396 3874904 406449647 288404492 118045155 31902916 17418598 14484318 337033171 ACCRUED PENSION LIABILITY 201862145 ACCRUED THIRD-PARTY 19403253 INTEREST RATE SWAP 5565074 SELF-INSURANCE 43126200 OTHER LONG-TERM LIABILITIES 2112943 OTHER CURRENT LIABILITIES HOSPITAL 13864977 285934592 DESCRIPTION OF INTENDED USE OF ENDOWMENT FUNDS: PART V, LINE 4: THE ENDOWMENT FUNDS INCLUDE TWO FUNDS THAT WERE PART OF THE ST. ELIZABETH HEALTHCARE'S VISION CAMPAIGN: 1) TO SUPPORT TECHNOLOGY FOR THE HEART OF EXCELLENCE PROGRAM, AND 2) TO ESTABLISH PRENATAL CARE FOR WOMEN WITHOUT HEALTHCARE COVERAGE. DESCRIPTION OF UNCERTAIN TAX POSITIONS UNDER FIN 48: PART X: ST. ELIZABETH HEALTHCARE IS EXEMPT FROM FEDERAL INCOME TAXES PURSUANT TO SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE (IRC) AND ITS RELATED INCOME IS EXEMPT FROM FEDERAL INCOME TAX UNDER IRC SECTION 501(A). AS REQUIRED BY ASC 740, INCOME TAX, ST. ELIZABETH HEALTHCARE COMPLETED AN ANALYSIS OF ITS TAX POSITIONS AT DECEMBER 31, 2011 AND 2010, AND DETERMINED THAT NO MATERIAL AMOUNTS WERE REQUIRED TO BE RECOGNIZED UNDER ASC 740 IN THE CONSOLIDATED FINANCIAL STATEMENTS AT DECEMBER 31, 2011 OR 2010. X X X X X X X 1 HILLARY LYONS ASSOCIATES PO BOX 99 DIAMONDALE MI 488210099 CONSULTANT FEE 0 0 38500 0 JOHNSON GROSSNICKLE AND ASSOCIATES 29 SOUTH PARK BLVD GREENWOOD IN 46143 CONSULTANT FEE 0 0 18825 0 57325 KY 150 YEAR GALA 234355 100403 133952 23126 63994 5965 40867 GOLF PAR TEE 216070 147248 68822 35618 13445 15161 4598 4 60670 34098 26572 2359 15719 128 291 8075 511095 281749 229346 37977 52290 79283 6256 53540 229346 0 1 1 X 1 X 0 1 1 1 0 1 1 47191692 13276310 33915382 0.04390 78506146 63728340 14777806 0.01910 125697838 77004650 48693188 0.06300 44 147890 3327615 4940 3322675 0.00430 21 1199 9081857 4175616 4906241 0.00630 23 25194 4646452 4646452 0.00600 3 0 162676 162676 0.00020 32 1242 653172 653172 0.00080 123 175525 17871772 4180556 13691216 0.01760 123 175525 143569610 81185206 62384404 0.08060 6 58 8649 8649 0.00000 2 1716 1716 0.00000 2 182 1564 1564 0.00000 1 22 749 749 0.00000 11 262 12678 12678 0 52068634 6716854 210428068 224826613 -14398545 X 1 1 1 BLUEGRASS DIALYSIS LLC RENAL DIALYSIS 0.32000 0.00000 0.17000 5 1 ST ELIZABETH EDGEWOOD

1 MEDICAL VILLAGE DRIVE EDGEWOOD KY 41017

X X X 2 ST ELIZABETH FLORENCE

4900 HOUSTON ROAD FLORENCE KY 41042

X X X 3 ST ELIZABETH FORT THOMAS

85 NORTH GRAND AVENUE FORT THOMAS KY 41075

X X X 4 ST ELIZABETH GRANT

238 BARNES ROAD WILLIAMSTOWN KY 41097

X X X X 5 ST ELIZABETH FALMOUTH

512 SOUTH MAPLE AVENUE FALMOUTH KY 41040

X X SUBSTANCE ABUSE SERVICES ST ELIZABETH EDGEWOOD 1 1 1 200.000000000000 0 1 X 1 1 X 1 0 1 X 0 0 ST ELIZABETH FLORENCE 2 1 1 200.000000000000 0 1 X 1 1 X 1 0 1 X 0 0 ST ELIZABETH FORT THOMAS 3 1 1 200.000000000000 0 1 X 1 1 X 1 0 1 X 0 0 ST ELIZABETH GRANT 4 1 1 200.000000000000 0 1 X 1 1 X 1 0 1 X 0 0 ST ELIZABETH FALMOUTH 5 1 1 200.000000000000 0 1 X 1 1 X 1 0 1 X 0 0 26 ST ELIZABETH - COVINGTON

1500 JAMES SIMPSON JR WAY COVINGTON KY 41011

AMBULATORY CARE CENTER ST ELIZABETH HEALTHCARE SURGERY CENTER

580 SOUTH LOOP ROAD EDGEWOOD KY 41017

AMBULATORY SURGERY CENTER ST ELIZABETH HEALTHCARE SURGERY CENTER

2845 CHANCELLOR DRIVE CRESTVIEW HILLS KY 41017

AMBULATORY SURGERY CENTER ST ELIZABETH HEALTHCARE CARDIAC DIAGNOS

350 THOMAS MORE PARKWAY SUITE 280 CRESTVIEW HILLS KY 41017

CARDIOLOGY OUTPATIENT CLINIC ST ELIZABETH HEALTHCARE CARDIAC DIAGNOS

7370 TURFWAY ROAD SUITE 109 FLORENCE KY 41042

CARDIOLOGY OUTPATIENT CLINIC ST ELIZABETH HEALTHCARE CARDIAC DIAGNOS

8257 PINE ROAD CINCINNATI OH 45236

CARDIOLOGY OUTPATIENT CLINIC ST ELIZABETH IMAGING CENTER - EDGEWOOD

2904 FOLTZ ROAD EDGEWOOD KY 41017

IMAGING CENTER ST ELIZABETH HEALTHCARE CARDIAC DIAGNOS

900 MEDICAL VILLAGE DRIVE EDGEWOOD KY 41017

CARDIOLOGY OUTPATIENT CLINIC ST ELIZABETH HEALTHCARE CARDIAC DIAGNOS

380 CENTRE VIEW BLVD EDGEWOOD KY 41017

CARDIOLOGY OUTPATIENT CLINIC ST ELIZABETH MATERNAL FETAL CENTER

20 MEDICAL VILLAGE DRIVE SUITE 212 EDGEWOOD KY 41017

MATERNAL FETAL CLINIC ST ELIZABETH IMAGING CENTER - HEBRON

2200 CONNER ROAD HEBRON KY 41048

IMAGING CENTER ST ELIZABETH HOSPICE CENTER

483 SOUTH LOOP DRIVE EDGEWOOD KY 41017

INPATIENT HOSPICE ST ELIZABETH IMAGING CENTER - ALEXANDRI

7200 ALEXANDRIA PIKE ALEXANDRIA KY 41001

IMAGING CENTER ST ELIZABETH HEALTH CARE HAND THERAPY

560 SOUTH LOOP DRIVE EDGEWOOD KY 41017

HAND THERAPY ST ELIZABETH FAMILY PRACTICE CENTER

413 SOUTH LOOP ROAD EDGEWOOD KY 41017

FAMILY MEDICINE ST ELIZABETH HEALTHCARE SPORTS MEDICINE

830 THOMAS MORE PARKWAY EDGEWOOD KY 41017

SPORTS MEDICINE ST ELIZABETH SPORTS MEDICINE - FLORENCE

10095 INVESTMENT WAY FLORENCE KY 41042

SPORTS MEDICINE ST ELIZABETH HEALTHCARE CARDIOVASCULAR

20 MEDICAL VILLAGE DRIVE SUITE 204 EDGEWOOD KY 41017

CARDIOLOGY OUTPATIENT CLINIC ST ELIZABETH SPORTS MEDICINE - SOUTHGAT

525 ALEXANDRIA PIKE SUITE 100 SOUTHGATE KY 41071

SPORTS MEDICINE ST ELIZABETH PHYSICAL THERAPY CENTER- H

2200 CONNER ROAD HEBRON KY 41048

PHYSICAL THERAPY ST ELIZABETH PHYSICAL THERAPY CENTER -

5522 TAYLOR MILL ROAD TAYLOR MILL KY 41015

PHYSICAL THERAPY ST ELIZABETH BUSINESS HEALTH - MOUNT ZI

10095 INVESTMENT WAY FLORANCE KY 41042

BUSINESS HEALTH ST ELIZABETH PHYSICAL THERAPY CENTER -

6159 FIRST FINANCIAL DRIVE BURLINGTON KY 41005

PHYSICAL THERAPY WALTON - NICHOLSON DIAGNOSTIC CENTER

1974 WALTON NICHOLSON PIKE INDEPENCENCE KY 41051

IMAGING CENTER ST ELIZABETH UNION DIAGNOSTIC CENTER

10134 OLD UNION ROAD UNION KY 41091

DIAGNOSTIC TESTS AND THERAPY ST ELIZABETH HOLISTIC HEALTH

210 THOMAS MORE PARKWAY EDGEWOOD KY 41017

HOLISTIC HEALTH PART I, LINE 3C: ST. ELIZABETH HEALTHCARE USES FEDERAL POVERTY GUDELINES AS THE CRITERIA TO DETERMINE ELIGIBILITY FOR FREE CARE. ST. ELIZABETH HEALTHCARE DISCOUNTS ALL PRIVATE PAY PATIENTS WHOSE INCOME IS ABOVE 200% OF FEDERAL POVERTY GUIDELINES AT 47% OF THEIR CHARGES. PART I, LINE 6A: N/A PART I, LINE 7: ST. ELIZABETH HEALTHCARE USED COST TO CHARGE RATIOS FOR DETERMINING COSTS RELATED TO FINANCIAL ASSISTANCE. COSTS RELATED TO UNREIMBURSED MEDICAID WERE DETERMINED BY USING ST. ELIZABETH HEALTHCARE'S COST ACCOUNTING SYSTEM. OTHER COSTS IN SECTIONS 7(G-I) WERE TAKEN USING THE ACTUAL COSTS OR DIRECT AND INDIRECT COSTS. PART I, LINE 7G: ST. ELIZABETH HEALTHCARE COSTS REFLECTED AS SUBSIDIED HEALTH SERVICES ARE BASED ON ACTUAL COSTS OR DIRECT AND INDIRECT COSTS. THE REVENUES AND THEIR RELATED EXPENSES HAVE BEEN NETTED TOGETHER IN THE COMMUNITY BENEFIT EXPENSE COLUMN ON LINE 7 OF THE SCHEDULE H. THE ORGANIZATION REPORTED THE FOLLOWING AS SUBSIDIZED HEALTH SERVICES: PARISH NURSING HEALTH MINISTRIES, ATHLETIC TRAINERS AT THE AREA HIGH SCHOOL, WOMEN'S AND CHILDREN'S SERVICES, AND BEHAVIOR HEALTH SERVICES. PART I, L7 COL(F): THE BAD DEBT EXPENSE INCLUDED ON FORM 990, PART IX, LINE 25, COLUMN (A), THAT IS SUBTRACTED FOR PURPOSES OF CALCULATING PERCENTAGES IN THIS COLUMN IS $52,068,634. PART II: ST. ELIZABETH HEALTHCARE PROVIDES A BROAD RANGE OF PROGRAMS AND SERVICES TO ADDRESS THE NEEDS IDENTIFIED BY OUR PATIENTS AND THE COMMUNITY THAT CONTRIBUTES TO THE IMPROVED HEALTH OF NORTHERN KENTUCKY. ST. ELIZABETH HEALTHCARE PROVIDES PROGRAMS AND SERVICES THAT ENABLE PEOPLE TO MAKE CHANGES IN THEIR HEALTH, BUT MAKING THOSE DECISIONS TO CHANGE RELIES ON THE INDIVIDUAL. IN ADDITION, CHANGING THE HEALTH STATUS OF A COMMUNITY REQUIRES MULTIPLE SYSTEMIC CHANGES THAT ARE BEYOND THE CONTROL OF ONE ORGANIZATION. THEREFORE, THE HOSPITAL TOOK A THREE PRONGED APPROACH WHERE IT COULD MAKE A DIFFERENCE ON FOCUSING ON OUTCOMES THAT ARE WITHIN ITS CONTROL. EACH OF THESE PRONGS HAS ESTABLISHED MEASURES TO MONITOR PROGRESS AND SUCCESS. THE PRONGED APPROACH INCLUDES: 1) PROVIDING FREE OR DISCOUNTED CARE TO OUR COMMUNITY, AS APPROPRIATE; 2) PROVIDING EDUCATIONAL PROGRAMS AND RESOURCES FOR BOTH HEALTH PROFESSIONALS AND COMMUNITY MEMBERS; AND 3) FOCUSING ON ONE CLINICAL PROGRAM THAT RELATES TO A SPECIFIC NEED IDENTIFIED AS IMPORTANT TO OUR COMMUNITY, WHICH IN THIS PLAN, IS A DIABETES CENTER OF EXCELLENCE. PART III, LINE 4: ACCOUNTS RECEIVABLE FINANCIAL STATEMENT FOOTNOTE:NET PATIENT ACCOUNTS ARE REDUCED BY AN ALLOWANCE FOR DOUBTFUL RECEIVABLES BASED UPON THE HISTORICAL COLLECTION EXPERIENCE OF ST. ELIZABETH HEALTHCARE ADJUSTED FOR CURRENT ENVIRONMENTAL RISKS AND TRENDS FOR EACH MAJOR PAYOR SOURCE. AMOUNTS RECOGNIZED ARE SUBJECT TO ADJUSTMENT UPON REVIEW BY THIRD-PARTY PAYORS. SIGNIFICANT PROVISION IS MADE FOR SELF-PAY PATIENT ACCOUNTS IN THE PERIOD OF SERVICE BASED ON PAST COLLECTION EXPERIENCE. NET PATIENT SERVICE REVENUE IS REPORTED AT THE ESTIMATED NET REALIZABLE AMOUNTS FROM PATIENTS, THIRD-PARTY PAYORS, AND OTHERS FOR SERVICES RENDERED, INCLUDING ESTIMATED RETROACTIVE ADJUSTMENTS UNDER REIMBURSEMENT AGREEMENTS WITH THIRD-PARTY PAYORS. SETTLEMENTS ARE ACCRUED ON AN ESTIMATED BASIS IN THE PERIOD THE RELATED SERVICES ARE RENDERED AND ADJUSTED IN FUTURE PERIODS BASED UPON ADDITIONAL INFORMATION, INTERIM SETTLEMENTS, AND FINAL SETTLEMENTS. MANAGEMENT RECOGNIZES BAD DEBT EXPENSE AND THE ALLOWANCE FOR DOUBTFUL ACCOUNTS BASED UPON HISTORICAL EXPOSURE ADJUSTED FOR CURRENT ECONOMIC TRENDS.THE BAD DEBT EXPENSE REPORTED ON PART III, LINE 2 IS GREATER THAN THE AMOUNT REPORTED IN THE 2010 RETURN BECAUSE OF A CHANGE IN THE REPORTING REQUIREMENT PER THE SCHEDULE H INSTRUCTIONS. IN PRIOR YEARS, THIS AMOUNT WAS REQUIRED TO BE REPORTED AT COST AND A COST-TO-CHARGE RATIO WAS APPLIED TO THE BAD DEBT EXPENSE. IN 2011, BAD DEBT IS REQUIRED TO BE REPORTED AT THE EXPENSE AMOUNT AND NOT AT COST. IF THE 2011 BAD DEBT EXPENSE WAS REPORTED AT COST, THE AMOUNT WOULD BE LESS THAN THE AMOUNT REPORTED ON THE 2010 RETURN.THE ESTIMATED AMOUNT OF THE ORGANIZATION'S BAD DEBT EXPENSE ATTRIBUTABLE TO PATIENTS ELIGIBLE UNDER THE ORGANIZATIONS FINANCIAL ASSISTANCE POLICY, $6,716,854. THE PERCENTAGE OF BAD DEBTS THAT COULD LIKELY BE CHARITY CARE IF ENOUGH INFORMATION WAS OBTAINED UP FRONT WAS DEVELOPED WITH THE HELP OF OUR LARGEST COLLECTION AGENCY WHO DETERMINED BASED ON THE ACCOUNTS REVIEWED WHO MAY NOT HAVE HAD THE FINANCIAL ABILITY TO PAY. ST. ELIZABETH HEALTHCARE ALSO BELIEVES THAT MANY PATIENTS FALL INTO THE CATEGORY WHERE THEY DO NOT MEET THE POVERTY GUIDELINES BUT YET HAVE NO INSURANCE AND CANNOT AFFORD THE COST OF THE SERVICES PROVIDED. ST. ELIZABETH HEALTHCARE THEREFORE BELIEVES THOSE NON REIMBURSED COSTS SHOULD ALSO BE COUNTED AS A BENEFIT TO THE COMMUNITY WE SERVE. THE AMERICAN HOSPITAL ASSOCIATION'S POSITION IS ALSO THAT BAD DEBTS SHOULD BE COUNTED AS COMMUNITY BENEFIT. PART III, LINE 8: ST. ELIZABETH HEALTHCARE USES THE STEP DOWN METHODOLOGY TO DETERMINE COSTS FOR MEDICARE. THE REPORTS WERE THEN COMPLETED BY FOLLOWING THE GUIDANCE PROVIDED IN THE INSTRUCTIONS FOR PART III. ST. ELIZABETH HEALTHCARE BELIEVES MEDICARE LOSSES SHOULD BE AN ALLOWABLE COMMUNITY BENEFIT. ST. ELIZABETH HEALTHCARE PROVIDES NEEDED SERVICES TO THE ELDERLY AND DISABLED MEDICARE POPULATION AT A FINANCIAL LOSS TO THE ORGANIZATION TO HELP THOSE INDIVIDUALS GET THE CARE THEY NEED IN THE COMMUNITY WE SERVE. THE AMERICAN HOSPITAL ASSOCIATION'S POSITION IS ALSO THAT MEDICARE LOSSES SHOULD BE COUNTED AS COMMUNITY BENEFIT. PART III, LINE 9B: ST. ELIZABETH HEALTHCARE HAS A WRITTEN DEBT COLLECTION POLICY THAT ALSO INCLUDES A PROVISION ON THE COLLECTION PRACTICES TO BE FOLLOWED FOR PATIENTS WHO ARE KNOWN TO QUALIFY FOR CHARITY CARE OR FINANCIAL ASSISTANCE. IF A PATIENT QUALIFIES FOR CHARITY OR FINANCIAL ASSISTANCE CERTAIN COLLECTION PRACTICES DO NOT APPLY. ST. ELIZABETH EDGEWOOD PART V, SECTION B, LINE 19D: THE HOSPITAL FACILITY USES THE AVERAGE RATE COMPUTED FROM ITS THREE LARGEST NEGOTIATED COMMERCIAL INSURANCE CARRIERS WHEN CALCULATING THE MAXIMUM AMOUNT THAT CAN BE CHARGED. ST. ELIZABETH FLORENCE PART V, SECTION B, LINE 19D: THE HOSPITAL FACILITY USES THE AVERAGE RATE COMPUTED FROM ITS THREE LARGEST NEGOTIATED COMMERCIAL INSURANCE CARRIERS WHEN CALCULATING THE MAXIMUM AMOUNT THAT CAN BE CHARGED. ST. ELIZABETH FORT THOMAS PART V, SECTION B, LINE 19D: THE HOSPITAL FACILITY USES THE AVERAGE RATE COMPUTED FROM ITS THREE LARGEST NEGOTIATED COMMERCIAL INSURANCE CARRIERS WHEN CALCULATING THE MAXIMUM AMOUNT THAT CAN BE CHARGED. ST. ELIZABETH GRANT PART V, SECTION B, LINE 19D: THE HOSPITAL FACILITY USES THE AVERAGE RATE COMPUTED FROM ITS THREE LARGEST NEGOTIATED COMMERCIAL INSURANCE CARRIERS WHEN CALCULATING THE MAXIMUM AMOUNT THAT CAN BE CHARGED. ST. ELIZABETH FALMOUTH PART V, SECTION B, LINE 19D: THE HOSPITAL FACILITY USES THE AVERAGE RATE COMPUTED FROM ITS THREE LARGEST NEGOTIATED COMMERCIAL INSURANCE CARRIERS WHEN CALCULATING THE MAXIMUM AMOUNT THAT CAN BE CHARGED. PART VI, LINE 7: STATE FILING OF COMMUNITY BENEFIT REPORT: ST. ELIZABETH HEALTHCARE IS NOT REQUIRED TO FILE A COMMUNITY BENEFIT REPORT WITH ANY OF THE STATES IN WHICH IT OPERATES. ST. ELIZABETH HEALTHCARE DOES PRODUCE AN ANNUAL COMMUNITY BENEFIT REPORT WHICH IS POSTED ON THE WEBSITE, DISTRIBUTED TO STAKEHOLDERS, AND AVAILABLE UPON REQUEST TO THE PUBLIC IN GENERAL. PART VI, LINE 2: IN 2009, ST. ELIZABETH HEALTHCARE PARTICIPATED IN A COMMUNITY-WIDE EFFORT TO COMPLETE A COMMUNITY HEALTH ASSESSMENT. THE PROCESS WAS COORDINATED THROUGH THE NORTHERN KENTUCKY INDEPENDENT HEALTH DISTRICT AND VISION 2015 USING A NATIONAL PLANNING PROCESS CALLED MOBILIZING FOR ACTION THROUGH PLANNING AND PARTNERSHIPS (MAPP). USING THIS FRAMEWORK, THE ASSESSMENT PROCESS INVOLVED MORE THAN 200 PARTICIPANTS WITH 10 REPRESENTATIVES SERVING ON FOUR DIFFERENT COMMITTEES TO ASSESS THE HEALTH STATUS OF THE COMMUNITY. ST. ELIZABETH HEALTHCARE ALSO REVIEWED THE STATISTICS ON INCIDENCE OF DISEASE IN ITS COMMUNITY. THESE DATA SOURCES WERE USED TO DEVELOP ST. ELIZABETH HEALTHCARES 2010 THROUGH 2012 COMMUNITY BENEFITS PLAN. IN 2011 ST. ELIZABETH HEALTHCARE BEGAN RESEARCHING AVAILABLE INCIDENCE OF DISEASE RESOURCES IN PREPARATION TO CONDUCT ITS COMMUNITY HEALTH NEEDS ASSESSMENT IN 2012. THE RESULTS OF THIS ASSESSMENT WILL BE USED TO DEVELOP THE COMMUNITY BENEFITS PLAN 2013 THROUGH 2015, FOR EACH OF THE SYSTEMS HOSPITALS. PART VI, LINE 3: THE FINANCIAL ASSISTANCE POLICY IS PUBLISHED ON ST. ELIZABETH HEALTHCARE'S WEB SITE. A WRITTEN COPY IS ALSO INCLUDED IN THE PATIENT HANDBOOK PROVIDED TO INPATIENT ADMISSIONS. A NOTICE THAT FINANCIAL ASSISTANCE IS AVAILABLE FOR QUALIFYING INDIVIDUALS ON THE PATIENT BILLS. FINANCIAL COUNSELORS ARE AVAILABLE TO ASSIST PATIENTS TO DETERMINE QUALFICATION AND A COPY OF THE POLICY IS AVAILABLE TO PATIENTS UPON REQUEST. PART VI, LINE 4: ST. ELIZABETH HEALTHCARE SERVES THE NORTHERN KENTUCKY REGION, CONSISTING OF 12 COUNTIES (BOONE, CAMPBELL, GRANT, KENTON, OWEN, PENDLETON, BRACKEN, CARROLL, GALLATIN, HARRISON, MASON, AND ROBERTSON COUNTIES). THE SERVICE AREA INCLUDES URBAN, SUBURBAN, AND RURAL AREAS. THE TOTAL POPULATION OF THE AREA IS OVER 500,000. ST. ELIZABETH HEALTHCARE HAS BEEN EXPANDING SERVICES IN DEARBORN COUNTY, INDIANA.THE AREA IS PREDOMINANTLY WHITE WITH AN INCREASING NUMBER OF PERSONS WITH HISPANIC BACKGROUNDS MOVING INTO THE AREA, ESTIMATED TO BE 13,000 IN 2011. MINORITY POPULATIONS REPRESENT APPROXIMATELY 8.9% OF THE POPULATION. APPROXIMATELY 11.4% OF THE POPULATION IS 65+ YEARS OLD. THE PERCENT OF PERSONS LIVING IN POVERTY VARIES BY COUNTY WITH THE LOWEST AT 9.2% IN BOONE COUNTY AND THE HIGHEST AT 22.6% IN ROBERTSON COUNTY. OVERALL, THE PERCENTAGE OF PERSONS LIVING BELOW POVERTY IS 13.4%. APPROXIMATELY 17.17% OF THE NORTHERN KENTUCKY POPULATION IS UNINSURED. PART VI, LINE 5: ST. ELIZABETH HEALTHCARE FURTHERS ITS EXEMPT PURPOSES IN IMPROVING COMMUNITY HEALTH BY: 1) ENCOURAGING AND SUPPORTING STAFF TO PARTICIPATE ON VARIOUS COMMUNITY BOARDS/ACTIVITIES THAT SUPPORT AND/OR DEVELOP PROGRAMS THAT ADDRESS COMMUNITY HEALTH NEEDS AND WORKFORCE DEVELOPMENT. 2) THE HOSPITAL'S BOARD OF TRUSTEES IS MADE UP OF COMMUNITY REPRESENTATIVES TO ENSURE THE ORGANIZATION ADHERES TO ITS MISSION TO IMPROVE THE HEALTH OF THE PEOPLE WE SERVE. 3) THROUGH ITS PRIMEWISE SENIOR SERVICES FOR AGE 50+ PERSONS, THE INSTITUTION SUBSIDIZES COURSE OFFERINGS TO SENIOR CITIZENS INCLUDING DRIVER'S SAFETY, LOW IMPACT EXERCISE, COMPUTER SKILLS, MEDICATION REVIEW AND HEALTH SCREENINGS, ALONG WITH PROVIDING LITERATURE PERTINENT TO THIS AGE GROUP. 4) ON A QUARTERLY BASIS, THE HOSPITAL PRODUCES AND DISTRIBUTES TO MORE THAN 60,000 HOUSEHOLDS THROUGHOUT NORTHERN KENTUCKY, LITERATURE ON VARIOUS HEALTHCARE ISSUES AND SCHEDULES PERTAINING TO AREA HEALTH EVENTS AND PROGRAMS. 5) PERIODICALLY, ST. ELIZABETH HEALTHCARE WILL PARTNER WITH COMMUNITY ORGANIZATIONS AND BUSINESS AGENCIES TO PRESENT HEALTH RELATED PROGRAMS AND HEALTH SCREENINGS. PART VI, LINE 6: ST ELIZABETH HEALTHCARE IS A SYSTEM THAT FEATURES FIVE FACILITIES THROUGHOUT NORTHERN KENTUCKY - ST. ELIZABETH EDGEWOOD, ST. ELIZABETH FLORENCE, ST ELIZABETH FORT THOMAS, ST. ELIZABETH GRANT, AND ST. ELIZABETH FALMOUTH. EACH OF THESE FACILITIES ADDRESSES THE SPECIFIC NEEDS OF ITS LOCALE AS IDENTIFIED BY THE PATIENTS IN THE COMMUNITY. THE SERVICE AREAS VARY FROM RURAL AREAS TO SUBURBAN COMMUNITIES TO URBAN AREAS IN GREATER CINCINNATI AND NORTHERN KENTUCKY. ST. ELIZABETH HEALTHCARE OFFERS 1,187 LICENSED BEDS, MORE THAN 6,800 EMPLOYEES, MORE THAN 800 PHYSICIANS WITH ADMITTING PRIVILEGES AND A WHOLLY OWNED PHYSICIAN ORGANIZATION WHICH INCLUDES 62 PRIMARY CARE AND SPECIALTY OFFICE LOCATIONS. ST. ELIZABETH HEALTHCARE IS SPONSORED BY THE DIOCESE OF COVINGTON. X X X 1 1 X X X X X X 1 1 0 0 0 0 0 0 0 JOHN DUBIS 650000 0 83125 0 11441 0 141841 0 47726 0 934133 0 0 0 GEORGE S HALL MD 246154 0 16085 0 7723 0 0 0 21540 0 291502 0 0 0 HEIDI C MURLEY MD 0 296342 0 0 0 3411 0 0 0 21210 0 320963 0 0 GARREN COLVIN 451000 0 71750 0 20046 0 88290 0 26638 0 657724 0 0 0 NATHAN VANLANINGHAM 289423 0 35000 0 8275 0 45163 0 2120 0 379981 0 0 0 THOMAS SAALFELD 273000 0 37564 0 976970 0 16500 0 20467 0 1324501 0 0 0 TREVA JANE SWAIM 273000 0 46025 0 683946 0 16500 0 20307 0 1039778 0 0 0 GLENN LOOMIS 430000 0 0 0 1706 0 44978 0 23823 0 500507 0 0 0 SARAH GIOLANDO 300000 0 42446 0 838 0 34472 0 2737 0 380493 0 0 0 MARTIN OSCADAL 273000 0 37498 0 2569 0 47138 0 22211 0 382416 0 0 0 CHISTOPHER CARLE 272300 0 35400 0 887 0 46886 0 22915 0 378388 0 0 0 GARY BLANK 229000 0 26246 0 1128 0 35017 0 18198 0 309589 0 0 0 MARK REIDINGER 14884 0 26875 0 201165 0 38903 0 16764 0 298591 0 0 0 RAYMOND WILL 522460 0 62762 0 14478 0 0 0 20010 0 619710 0 0 0 VICTOR SCHMELZER 523460 0 62762 0 4902 0 16500 0 24427 0 632051 0 0 0 MICHAEL GIBSON 522460 0 62762 0 1710 0 16500 0 22696 0 626128 0 0 0 KARL ULICNY 522460 0 62762 0 2622 0 16500 0 24196 0 628540 0 0 0 JACKSON PEMBERTON 437464 0 0 0 4267 0 16500 0 27420 0 485651 0 0 0 JOSEPH GROSS 200000 0 326140 0 9340 0 0 0 12807 0 548287 0 0 0 PART I, LINE 1A TRAVEL FOR COMPANIONS: THIS IS PROVIDED TO JOHN DUBIS, GARREN COLVIN, BARBARA KROHMAN, GEORGE HALL, SARAH GIOLANDO, AND GLENN LOOMIS. BOARD RETREAT COMPANION TRAVEL IS TREATED AS TAXABLE COMPENSATION. TAX INDEMNIFICATION AND GROSS-UP PAYMENTS: SEE ABOVE LIST OF INDIVIDUALS. TAXABLE BOARD RETREAT COMPENSATION WAS GROSSED UP FOR FICA AND LOCAL TAXES. HOUSING ALLOWANCE OR RESIDENCE FOR PERSONAL USE: THIS IS PROVIDED TO NATHAN VANLANINGHAM FOR PART OF MOVING EXPENSES WHICH IS TREATED AS TAXABLE COMPENSATION. PART I, LINES 4A-B SEVERANCE PAYMENT: THE SEVERANCE RECEIVED BY MARK REIDINGER WAS THE COMPENSATION REQUIRED UNDER THE REMAINING TERM OF HIS CONTRACT, THE PERIOD OF FEBRUARY 1, 2011 THROUGH JANUARY 31, 2012. SEVERANCE PAYMENTS FOR 2011: MARK REIDINGER $198,462 SUPPLEMENTAL NONQUALIFIED RETIREMENT PLAN: 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. NONQUALIFIED RETIREMENT PLAN PAYMENTS FOR 2011: JANE SWAIM $680,018 TOM SAALFELD $965,211 KENTUCKY ECONOMIC DEVELOPMENT FINANCE AUTHORITY 521643102 49126KGH8 2009-12-09 101960448 CONSTRUCTION OF HOSPITAL FACILITIES/PARTIAL REFUNDING OF BOND ISSUED 6/11/03 0 0 0 KENTUCKY ECONOMIC DEVELOPMENT FINANCE AUTHORITY 521643102 NONEAVAIL 2009-12-09 38150000 PARTIAL REFUNDING OF BONDS ISSUED 6/11/03 0 0 0 4000000 101960448 1430179 29195269 71335000 2009 1 0 1 1 2150000 38150000 360000 37790000 1 0 1 1 0 1 1 1 0 0.03000 0.03000 1 0 0 1 1 0 1 0 0 0 0 0 1 0 1 0 0 0 1 SCHEDULE K, PART III, LINE 7: ST. ELIZABETH MEDICAL CENTER, INC. HAS WRITTEN PROCEDURES TO ENSURE THAT VIOLATIONS OF FEDERAL TAX REQUIREMENTS ARE TIMELY IDENTIFIED. IF SELF-REMEDIATION IS NOT AVAILABLE UNDER APPLICABLE REGULATIONS, THE ORGANIZATION WOULD CONTACT ITS BOND COUNCEL REGARDING THE IRS' VOLUNTARY CLOSING AGREEMENT PROGRAM. NORTHERN KENTUCKY WATER DISTRICT SEH BOARD MEMBER FRED MACKE IS A BOARD MEMBER OF NKWD 373746 UTILITIES 0 CHAMPLIN HAUPT ARCHITECTS SEH BOARD MEMBER JOAN WURTENBERGER IS A PARTNER OF CHA. 349065 ARCHITECT FEES 0 HBC II LLC SEH BOARD MEMBER JOAN WURTENBERGER'S HUSBAND IS A 30% OWNER OF HBC II. 120530 MANAGEMENT FEES 0 SCHIFF KRIEDLER SHELL SEH BOARD MEMBER TOM COLVIN IS AN OFFICER OF SKS 843236 INSURANCE 0 FIFTH THIRD BANK SEH BOARD MEMBER CHRIS FISTER IS A BOARD MEMBER OF FIFTH THIRD BANK. 1286434 INTEREST EXP, TRUSTEE FEES AND BANK FEES 0 PERFECT SERVE INC SEH BOARD MEMBER TED ROBINSON IS A 1% OWNER OF PERFECT SERVE, INC. 302995 TELEPHONE MESSAGING SERVICES 0 CRANLEY SURGICAL ASSOCIATES SEH BOARD MEMBER BARRY DICK IS A PHYSICIAN WITH CSA. 623383 WOUND CARE / VASCULAR FEES 0 INTERNAL MEDICINE ASSOCIATES SEH BOARD MEMBER RALPH HULLER IS A PHYSICIAN WITH IMA. 587629 EKG FEES 0 RADIOLOGY ASSOCIATES SEH BOARD MEMBER JAMES ROEBKER IS A PHYSICIAN WITH RADIOLOGY ASSOCIATES. 741404 RADIOLOGY FEES 0 CINCINNATI REDS SEH BOARD MEMBER CHRIS FISTER IS AN OWNER/OFFICER OF THE CINCINNATI REDS. 195115 ADVERTISING AND GAME TICKETS 0 X 11 70388 COST/SELLING PRICE X MEDICAL SUPPLES 7 29959 COST/SELLING PRICE X FOOD/PRIZES 123 26703 COST/SELLING PRICE 0 0 0 0 FORM 990, PART VI, SECTION A, LINE 7A MOST REVEREND CATHOLIC BISHOP OF COVINGTON KENTUCKY HAS CERTAIN RESERVED POWERS IN REGARD TO MAJOR TRANSACTIONS. THE BOARD OF TRUSTEES OF THE CORPORATION WILL BE APPOINTED ACCORDING TO THE FOLLOWING SUMMARIZED PROCEDURE: (I) THE BOARD SHALL SUBMIT TO THE BISHOP UP TO THREE NAMES OF CANDIDATES FOR EACH VACANCY; (II) ORDINARILY THE BISHOP WILL CHOOSE TRUSTEES TO FILL THE VACANCIES OR OPENINGS FROM THE RECOMMENDED CANDIDATES AFTER PERSONAL CONSULTATION WITH THE PRESIDENT. IF THE BISHOP DOES NOT CHOOSE ANYONE FROM THE LIST, THE BOARD WILL SUBMIT NEW NAMES AS SOON AS PRACTICAL; (III) THE BISHOP RESERVES THE RIGHT TO SUBMIT OTHER NAMES TO THE BOARD FOR REVIEW AND COMMENT; (IV) IN CONSULTATION WITH THE PRESIDENT OF THE MEDICAL CENTER OR THE BOARD CHAIR, THE BISHOP MAY REMOVE ANY MEMBER OF THE BOARD IF CERTAIN ACTIONS ARE COMMITTED; (V) IF THE BISHOP DECLINES A CANDIDATE OR THE CANDIDATE DECLINES, THE LIST OF CANDIDATES WILL BE REVISITED ACCORDING TO PROCEDURES (I) THROUGH (III) ABOVE. FORM 990, PART VI, SECTION A, LINE 7B MOST REVEREND CATHOLIC BISHOP OF COVINGTON KENTUCKY HAS CERTAIN RESERVED POWERS IN REGARD TO MAJOR TRANSACTIONS. THE FOLLOWING ACTIONS REQUIRE PRIOR APPROVAL OF THE BISHOP: (I) THE AMENDMENT OR REPEAL OF SECTIONS 2(B) OR 2(C) OF THE BYLAWS OR ANY PROVISIONS OF THE GOVERNING DOCUMENTS RELATING TO THE AUTHORITY OF THE BISHOP OR BOARD OF TRUSTEES OF THE CORPORATION; (II) ANY ACTION THAT RESULTS IN A SUBSTANTIAL CHANGE, AS DETERMINED BY THE BISHOP OR THE BOARD, IN THE PHILOSOPHY OR MISSION OF THE CORPORATION, OR IN THE USE OF A CORPORATION HOSPITAL FACILITY; (III) THE DISSOLUTION, CONSOLIDATION, MERGER, OR TERMINATION OF EXISTENCE OF THE CORPORATION; AND (IV) A BORROWING, LEASE, TRANSFER, OR ENCUMBRANCE OF ANY REAL ESTATE OF THE CORPORATION EXCEEDING $5,000,000. FORM 990, PART VI, SECTION B, LINE 11 ST. ELIZABETH HEALTHCARE'S PROCESS TO REVIEW THE FORM 990 CONSISTS OF REVIEW AND APPROVAL BY CERTAIN MEMBERS OF MANAGEMENT. THE FORM 990 IS REVIEWED WITH THE FINANCE COMMITTEE AND APPROVED BY THE FINANCE COMMITTEE. SUBSEQUENT TO THE FINANCE COMMITTEE'S APPROVAL, BUT PRIOR TO FILING WITH THE IRS, THE FORM 990 IS PROVIDED TO THE BOARD OF TRUSTEES FOR THEIR REVIEW AND MANAGEMENT IS AVAILABLE FOR ANY QUESTIONS OR COMMENTS. FORM 990, PART VI, SECTION B, LINE 12C THE ORGANIZATION REGULARLY AND CONSISTENTLY MONITORS AND ENFORCES COMPLIANCE WITH ITS CONFLICT OF INTEREST POLICY. EACH DIRECTOR, PRINCIPAL OFFICER AND MEMBER OF A BOARD 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 ENGAGE PRIMARILY IN ACTIVITIES WHICH ACCOMPLISH ITS TAX EXEMPT PURPOSE. IN ADDITION, ANY OF THESE PERSONS WHO HAVE A DIRECT OR INDIRECT FINANCIAL INTEREST MUST DISCLOSE THE EXISTENCE OF THE FINANCIAL INTEREST AND DISCLOSE ALL MATERIAL FACTS TO THE DIRECTORS AND MEMBERS OF THE COMMITTEES WITH GOVERNING BOARD DELEGATED POWERS CONSIDERING THE PROPOSED TRANSACTION OR ARRANGEMENT. WHEN BUSINESS COMES BEFORE THE BOARD IN WHICH A MEMBER IS INVOLVED AND A POTENTIAL CONFLICT OF INTEREST MAY EXIST, THE MEMBER SHOULD AGAIN MAKE A VERBAL DISCLOSURE TO THE MEMBERSHIP PRESENT. IN ADDITION: (A) THE BOARD SHALL ASK THE INTERESTED MEMBER TO LEAVE THE MEETING DURING DISCUSSION OF THE MATTER THAT GIVES RISE TO THE POTENTIAL CONFLICT; (B) THE INTERESTED MEMBER SHALL NOT VOTE ON NOR USE HIS OR HER PERSONAL INFLUENCE ON THE MATTER THAT GIVES RISE TO THE POTENTIAL CONFLICT; (C) THE INTERESTED MEMBER SHALL NOT BE COUNTED IN DETERMINING THE EXISTENCE OF A QUORUM AT SUCH MEETING; AND (D) THE MINUTES OF THE MEETING SHALL REFLECT THE DISCLOSURE MADE, THE VOTE TAKEN, AND WHICH MEMBERS WERE PRESENT AND VOTING. FORM 990, PART VI, SECTION B, LINE 15 IN DETERMINING COMPENSATION OF THE ORGANIZATION'S CEO, AN EVALUATION IS DONE BY THE COMPENSATION COMMITTEE AND EXECUTIVE COMMITTEE USING APPROPRIATE COMPARABLE DATA, AND THEN A COMPENSATION RECOMMENDATION IS PRESENTED TO THE BOARD FOR APPROVAL. OTHER KEY EXECUTIVES ARE REVIEWED AND THE CEO MAKES RECOMMENDATIONS FOR THEIR COMPENSATION TO THE COMPENSATION COMMITTEE. THIS COMMITTEE THEN EVALUATES AND APPROVES THE COMPENSATION FOR THE OTHER KEY EXECUTIVES. FOR BOTH THE CEO AND OTHER KEY EXECUTIVES, THE PROCESS INCLUDED A REVIEW AND APPROVAL BY INDEPENDENT PERSONS, REVIEW OF COMPARABILITY DATA, AND CONTEMPORANEOUS SUBSTANTIATION OF THE DELIBERATION AND DECISION. THE EXTERNAL REVIEW OF EXECUTIVE COMPENSATION IS PERFORMED ANNUALLY AND APPROVED BY THE BOARD - THIS WAS LAST PERFORMED IN 2011. FORM 990, PART VI, SECTION C, LINE 19 THE ORGANIZATION WILL PROVIDE THE FORM 990 SCHEDULES, OF WHICH ARE OPEN TO PUBLIC INSPECTION, UPON REQUEST. THE ORGANIZATION DOES NOT MAKE ITS GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, OR FINANCIAL STATEMENTS AVAILABLE TO THE PUBLIC UPON REQUEST. FORM 990, PART VII, SECTION A: THESE INDIVIDUALS DEVOTE THE FOLLOWING HOURS PER WEEK TO, RELATED ORGANIZATION, ST. ELIZABETH PHYSICIAN SERVICES, FOR WHICH COMPENSATION IS REPORTED IN COLUMNS E & F: HEIDI C. MURLEY 40 HOURS THESE INDIVIDUALS DEVOTE THE FOLLOWING HOURS PER WEEK TO, RELATED ORGANIZATION, SUMMIT MEDICAL GROUP, INC.: JOHN DUBIS 1.00 HOUR GARREN COLVIN 1.00 HOUR NATHAN VANLANINGHAM 1.00 HOUR GLENN LOOMIS 40.00 HOURS CHANGES IN NET ASSETS OR FUND BALANCES: FORM 990, PART XI, LINE 5: NET UNREALIZED LOSSES ON INVESTMENTS: -16,730,504. CHANGE IN FMV OF INTEREST RATE SWAP -3,059,736. AMORTIZATION OF PREVIOUSLY HEDGED INTEREST RATE SWAP -69,650. CHANGE IN VALUE OF SPLIT INTEREST AGREEMENT -9,759. CHANGE IN PENSION PLAN ASSETS AND BENEFIT OBLIGATION -58,469,705. CONTRIBUTED CAPITAL TO SUMMIT MEDICAL GROUP, INC. -4,845,945. TOTAL TO FORM 990, PART XI, LINE 5: -83,185,299. FORM 990, PART XII, LINE 2C: THE PROCESS HAS NOT CHANGED FROM THE PRIOR YEAR. ST ELIABETH PHYSICIAN SERVICES 334 THOMAS MORE PARKWAY STE 200 CRESTVIEW HILLS KY 41017 611339639 PHYSICIAN MANAGEMENT SERVICES KY 1090380 6475557 ST ELIZABETH MEDICAL CENTER INC SUMMIT MEDICAL GROUP INC 334 THOMAS MORE PARKWAY STE 200 CRESTVIEW HILLS KY 41017 611300608 PHYSICIAN PRACTICE KY 501(C)(3) LINE 3 ST ELIZABETH MEDICAL CENTER INC 1 NORTHERN KY CHILDREN'S MEDICAL SERVICES LLC C/O CHMC 3333 BURNET AVE CINCINNATI OH 45229 260084305 MEDICAL SERVICES OH CHILDREN'S HOSPITAL MEDICAL CENTER RELATED 465335 114444 0 0 0.50000 ST ELIZABETH HOME CARE SERVICES LLC 1700 EDISON DRIVE MILFORD OH 45150 261236191 HOME HEALTH OH AMERICAN NURSING CARE RELATED 661000 677000 0 0 0.50000 VESCENT AESTHETIC SKIN AND LASER CENTER 210 THOMAS MORE PARKWAY CRESTVIEW HILLS KY 41017 273137980 COSMETIC SERVICES (DISSOLVED 10/1/11) KY ST ELIZABETH MEDICAL CENTER INC RELATED -95335 0 0 0.50000 AMSURG NORTHERN KENTUCKY GI LLC 20 BURTON HILLS BLVD 5TH FLOOR NASHVILLE TN 37215 621719097 AMBULATORY SURGERY CENTER TN N/A RELATED 323878 0 0 0.49000 JLD MANAGEMENT LLC 207 THOMAS MORE PARKWAY CRESTVIEW HILLS KY 41017 205361603 REAL ESTATE KY ST ELIZABETH MEDICAL CENTER INC C -35326 1.00000 0 1 0 0 0 0 0 0 1 1 0 0 0 0 1 1 1 1 JLD MANAGEMENT LLC R 32285 CASH JLD MANAGEMENT LLC Q 67611 CASH SUMMIT MEDICAL GROUP INC J 436838 CASH SUMMIT MEDICAL GROUP INC I 262145 CASH SUMMIT MEDICAL GROUP INC B 4845945 CASH SUMMIT MEDICAL GROUP INC P 1074217 CASH SUMMIT MEDICAL GROUP INC O 31599259 CASH VESCENT AESTHETIC SKIN AND LASER CENTER O 100957 CASH