2011-11-11T15:00:25-06:00 2010-12-31 BKD LLP 312 WALNUT STREET SUITE 300 CINCINNATI OH 45202 990 2010-01-01 340864230 ALLEN MEDICAL CENTER ALLE 4407751211 200 W Lorain Street Oberlin OH 440741077 DAVID RICHARDS 2011-11-03 true 5136218300 2010 2016-03-07 17:11:31Z MERCY ALLEN HOSPITAL SUSAN BOWERS PRESIDENT 200 W LORAIN ST OBERLIN OH 44074 26436479 false X N/A X 1959 OH ALLEN MEDICAL CENTER EXTENDS THE HEALING MINISTRY OF JESUS BY IMPROVING THE HEALTH OF OUR COMMUNITIES WITH EMPHASIS ON PEOPLE WHO ARE POOR AND UNDER-SERVED. 12 9 269 70 0 0 634000 78221 25960763 26308851 2171 -4380 56110 49400 26653044 26432092 0 0 0 0 10426432 9992634 0 0 0 12170200 12769036 22596632 22761670 4056412 3670422 15877207 18262278 1891115 605450 13986092 17656828 THE PRIMARY EXEMPT PURPOSE OF ALLEN MEDICAL CENTER IS TO EXTEND THE HEALING MINISTRY OF JESUS BY IMPROVING THE HEALTH OF OUR COMMUNITIES WITH EMPHASIS ON PEOPLE WHO ARE POOR AND UNDER-SERVED. ALLEN MEDICAL CENTER ACCOMPLISHES THIS PURPOSE BY DEMONSTRATING BEHAVIORS REFLECTING OUR CORE VALUES OF COMPASSION, EXCELLENCE, HUMAN DIGNITY, JUSTICE, SACREDNESS OF LIFE AND SERVICE. false 18777427 26358251 THE PRIMARY EXEMPT PURPOSE OF ALLEN MEDICAL CENTER IS TO EXTEND THE HEALING MINISTRY OF JESUS BY IMPROVING THE HEALTH OF OUR COMMUNITIES WITH EMPHASIS ON PEOPLE WHO ARE POOR AND UNDER-SERVED. ALLEN MEDICAL CENTER ACCOMPLISHES THIS PURPOSE BY DEMONSTRATING BEHAVIORS REFLECTING OUR CORE VALUES OF COMPASSION, EXCELLENCE, HUMAN DIGNITY, JUSTICE, SACREDNESS OF LIFE AND SERVICE. $971,918 OF CHARITY CARE WAS PROVIDED SERVING 1,995 INDIVIDUALS IN 2010. 18777427 true true false true false false false false false true false false true true true false true false false false false false false false false true false false false true false false false false false false false false false false false false false true true true false false true 0 0 269 true false false false false false false false false false false X 12 9 false false false false true true true true true false false true true true true true true true true false X JAMES HEIKKINEN 4409604000 3700 KOLBE ROAD LORAIN OH 44053 X RONALD RYBARCZYK 2 X 0 0 0 VAMSEE K AMIRNENI 40 X 188029 0 20268 EDWIN M OLEY 10 X 0 470096 234801 SUSAN BOWERS 50 X X 228215 0 31086 REV BRIAN D BURKE 1 X 0 0 0 SR DOROTHY M THUM RSM 2 X 0 0 0 KIM E STRAUSS 1 X 0 0 0 MAUD W DE LA PORTE 1 X 0 0 0 DOUGLAS B WILBER 1 X 0 0 0 GEORGIA L NEWMAN MD 2 X 0 0 0 SR JANE PANK HM 1 X X 0 0 0 MARCIA E MILLER 3 X X 0 0 0 SANDRA L HODGE 3 X X 0 0 0 416244 470096 286155 2 false true false 0 23774 54447 78221 NET PATIENT SERVICE REVENUE 621990 25954775 25954775 VENDOR/PURCHASE DISCOUNTS 900099 2039 2039 AMBULANCE SERVICE 621910 352037 352037 0 0 0 0 26308851 7 7 0 0 0 0 0 4387 0 -4387 -4387 -4387 0 0 0 ANSWERING SERVICE 561499 2298 2298 MEDICAL RECORDS 900099 1656 1656 MEDICAL STAFF DUES 900099 10840 10840 34606 0 0 34606 49400 26432092 26308851 0 45020 0 0 0 0 259301 207441 51860 0 8189999 6551998 1638001 320333 256266 64067 635438 508350 127088 587563 470050 117513 1037074 829659 207415 311 311 21025 21025 0 0 0 2239143 1791314 447829 0 671020 536816 134204 673138 538510 134628 0 465858 372686 93172 10355 8284 2071 0 0 0 0 1003471 802777 200694 341594 341594 BAD DEBT EXPENSE 2369409 2369409 SUPPLIES 3516205 2812964 703241 STATE MEDICAID ASSESSMENT PAYMENTS 265053 265053 MEMBERSHIP DUES 60663 48530 12133 BANK FEES 12560 12560 82157 65726 16431 0 22761670 18777427 3984243 0 0 4901111 5392115 2953650 3052432 167564 150880 35230 32658 18485750 9989109 7819652 8496641 0 0 1137552 15877207 18262278 1751536 530450 139579 75000 1891115 605450 X 13986092 17656828 13986092 17656828 15877207 18262278 X 3670422 314 X false true true X true true X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 0 false false false false false true 2390 false false false 2390 false 0 LOBBYING ACTIVITIES PART II, LINE 1 LOBBYING ACTIVITIES PERFORMED INCLUDE BOTH THE USE OF VOLUNTEERS ENCOURAGED TO WRITE LETTERS TO PUBLIC OFFICIALS ON ISSUES THAT IMPACT THE ORGANIZATION'S ABILITY TO CONTINUE TO PROVIDE HEALTH SERVICES TO THE COMMUNITIES SERVED, AND THE USE OF PAID STAFF MEMBERS AND MANAGEMENT PERSONNEL. PAID MANAGEMENT PERSONNEL REGULARLY ISSUE MAILINGS TO LEGISLATORS ATTEMPTING TO INFLUENCE LEGISLATIVE MATTERS AND REFERENDUM, AND ORGANIZE AND HOST MEETINGS AMONG HOSPITAL EXECUTIVES AND THEIR LEGISLATORS REGARDING ISSUES THAT IMPACT THE ORGANIZATION'S ABILITY TO CONTINUE PROVIDING HEALTHCARE SERVICES TO ITS PATIENTS AND TO CONTINUE IMPROVING THE HEALTH OF THE COMMUNITIES WE SERVE. PAID STAFF MEMBERS HAVE, ON LIMITED OCCASIONS, WRITTEN TO LEGISLATORS ON SUCH ISSUES. THE PRIMARY PURPOSE FOR LOBBYING ACTIVITIES IS TO ENHANCE THE ORGANIZATION'S PUBLIC POSITION ON LEGISLATIVE AND REGULATORY ISSUES THAT IMPACT PATIENT CARE THROUGHOUT OUR SYSTEM. THE ORGANIZATION FOCUSES ON PUBLIC POLICY ISSUES THAT EXTEND OUR HEALING MINISTRY TO THOSE WHO ARE POOR AND UNDERSERVED IN THE COMMUNITIES WE SERVE. TO CARRYOUT THESE EFFORTS, THE ORGANIZATION PARTNERS WITH EXPERT CONSULTANTS AND PROFESSIONAL TRADE ASSOCIATIONS TO BUILD AWARENESS AND EXECUTE SPECIFIC STRATEGIES THAT WILL YIELD A FAVORABLE OUTCOME FOR PATIENT CARE IN THE ORGANIZATION'S FACILITIES WHERE THEY ARE TREATED. 0 8264236 2081480 6182756 306922 94947 211975 9906157 7812682 2093475 8435 8435 8496641 RECEIVABLES FROM RELATED ORGANIZATIONS 1137552 1137552 0 ACCRUED PENSION LIABILITY 75000 75000 26432092 22761670 3670422 0 0 3670422 0 0 0 0 0 0 0 0 0 0 0 0 FIN 48 (ASC 740) footnote Schedule D, Part X, Line 2 THE COMPANY [CATHOLIC HEALTH PARTNERS AND AFFILIATED ENTITIES] COMPLETED AN ANALYSIS OF ITS TAX POSITIONS IN ACCORDANCE WITH APPLICABLE ACCOUNTING GUIDANCE AT DECEMBER 31, 2010 AND 2009, AND DETERMINED THAT NO AMOUNTS WERE REQUIRED TO BE RECOGNIZED IN THE CONSOLIDATED FINANCIAL STATEMENTS AT DECEMBER 31, 2010 OR 2009. true true X true X true X true true false true true 1995 971918 971918 0.04770 4876 974504 974504 0.04780 0 0.00000 0 6871 1946422 0 1946422 0.09550 0 0.00000 0 0.00000 0 0.00000 0 0.00000 0 0.00000 0 0 0 0 0 0.00000 0 6871 1946422 0 1946422 0.09550 0 0.00000 0 0.00000 0 0.00000 0 0.00000 0 0.00000 0 0.00000 0 0.00000 0 0.00000 0 0.00000 0 0 0 0 0 0.00000 false 619288 463786 6177101 5935080 X true true 1 1 ALLEN MEDICAL CENTER

200 W LORAIN ST OBERLIN OH 44074

X X X ALLEN MEDICAL CENTER 1 1 THE BINDER BUILDING

105 OPPORTUNITY WAY LAGRANGE OH 44050

MEDICAL OFFICE BUILDING LEASED TO CHP PHYSICIANS, INC. Community benefit report prepared by related organization Schedule H, Part I, Line 6a CATHOLIC HEALTH PARTNERS Bad Debt Expense excluded from financial assistance calculation Schedule H, Part I, Line 7, column(f) 2,369,409 Costing Methodology used to calculate financial assistance Schedule H, Part I, Line 7 COST OF FINANCIAL ASSISTANCE WAS CALCULATED WITH A COST TO CHARGE RATIO USING WORKSHEET 2. THE COST RELATED TO MEDICAID PATIENTS WAS DETERMINED USING THE HOSPITAL COST ACCOUNTING SYSTEM AND INCLUDED BOTH INPATIENTS AND OUTPATIENTS FOR TRADITIONAL MEDICAID AND MEDICAID MANAGED CARE PLANS. FOR SUBSIDIZED SERVICES THE HOSPITAL'S COST ACCOUNTING SYSTEM IS USED TO DETERMINE COST RELATED TO THE SPECIFIC SERVICE EXCLUDING TRADITIONAL MEDICAID AND MEDICAID MANAGED CARE PATIENTS. COSTS FOR FINANCIAL ASSISTANCE AND BAD DEBT ACCOUNTS ARE DEDUCTED USING A RATIO OF COST TO CHARGE SPECIFIC TO THAT SUBSIDIZED SERVICE. COSTS FOR OTHER PROGRAMS REFLECT THE DIRECT AND INDIRECT COSTS OF PROVIDING THOSE PROGRAMS. Bad debt expense - financial statement footnote Schedule H, Part III, Line 4 THE ORGANIZATION'S AUDITED FINANCIAL STATEMENTS DO NOT CONTAIN A FOOTNOTE THAT DESCRIBES BAD DEBT EXPENSE. BAD DEBT IS CLASSIFIED AS AN OPERATING EXPENSE. THIS TREATMENT IS CONSISTENT WITH THE HFMA PRINCIPLES AND PRACTICES BOARD STATEMENT NO. 15 AND WITH THE AICPA AUDIT AND ACCOUNTING GUIDE FOR HEALTH CARE ORGANIZATIONS. AN AGGREGATE COST TO CHARGE RATIO WAS USED TO PROVIDE BAD DEBT AT COST FOR PART III, LINE 2. REMAINING BALANCES FOR PATIENTS THAT WE KNOW ARE ELIGIBLE FOR CHARITY CARE POLICIES ARE WRITTEN OFF TO CHARITY CARE. PATIENTS WHO MIGHT BE ELIGIBLE FOR CHARITY CARE BUT ARE UNKNOWN TO US ARE WRITTEN OFF TO BAD DEBT AND THEREFORE NOT INCLUDED IN CHARITY CARE. THE ESTIMATED AMOUNT OF THE HOSPITAL'S BAD DEBT EXPENSE (AT COST) ATTRIBUTABLE TO PATIENTS ELIGIBLE UNDER THE HOSPITAL'S CHARITY CARE POLICY REPORTED ON PART III, LINE 3 WAS DETERMINED AS FOLLOWS: REVIEWED DOLLAR AMOUNTS FOR TOTAL REFERRED FOR ASSISTANCE, APPROVED FOR ASSISTANCE AND APPLICATIONS DENIED BECAUSE OF INCOMPLETE INFORMATION; DEVELOPED THE PERCENTAGE OF APPROVED APPLICATIONS TO COMPLETED APPLICATIONS AND THEN APPLIED PERCENTAGE TO THOSE APPLICATIONS THAT WERE INCOMPLETE. THIS PROVIDED AN ESTIMATED AMOUNT OF THOSE APPLICATIONS THAT WERE INCOMPLETE THAT WOULD HAVE QUALIFIED FOR ASSISTANCE IF THE APPLICATION HAS BEEN COMPLETED. THE DOLLAR AMOUNT OF CHARITY CARE ACTUALLY WRITTEN-OFF REPRESENTS THOSE THAT WERE APPROVED. TO CALCULATE THE FULL ESTIMATED AMOUNT OF CHARITY CARE, A CALCULATION WAS DONE TO DETERMINE WHAT 100% OF CHARITY WOULD BE FOR THE TOTAL OF THE APPROVED APPLICATIONS AND THE ESTIMATED AMOUNT FOR THOSE APPLICATIONS THAT WERE INCOMPLETE BUT WOULD HAVE BEEN APPROVED IF COMPLETED. THE DIFFERENCE BETWEEN THIS ESTIMATED TOTAL AMOUNT AND THE ACTUAL WRITE-OFF AMOUNT FOR CHARITY CARE WAS THEN APPLIED TO THE RATIO COST-OF-CHARGES USED FOR CHARITY CARE AT COST. Community benefit & methodology for determining medicare costs Schedule H, Part III, Line 8 MEDICARE SHORTFALL IS NOT TREATED AS A COMMUNITY BENEFIT. THE AMOUNTS ON PART III, LINE 6 WERE GENERATED BY THE MEDICARE COST REPORT WHICH UTILIZES A DEPARTMENT COST TO CHARGE METHODOLOGY. Collection practices for patients eligible for financial assistance Schedule H, Part III, Line 9b PATIENTS KNOWN TO QUALIFY FOR CHARITY CARE OR FINANCIAL ASSISTANCE ARE NOT SENT TO A COLLECTION AGENCY. THE ORGANIZATION REPEATEDLY OFFERS PATIENTS ACCESS TO FINANCIAL HELP DURING THEIR HOSPITAL STAY AND AFTER, AS WELL AS WITH EACH BILLING NOTICE. BILLS ARE SENT TO A COLLECTION AGENCY AS A LAST RESORT AND ONLY: WHEN PATIENTS HAVE THE ABILITY TO PAY SOME PORTION OF THEIR HEALTHCARE EXPENSES BUT REFUSE TO DO SO; WHEN PATIENTS REFUSE TO WORK WITH THE ORGANIZATION TO DETERMINE IF THEY QUALIFY FOR FREE OR DISCOUNTED CARE VIA FEDERAL, STATE, LOCAL OR HOSPITAL ASSISTANCE PROGRAMS; WHEN THE ORGANIZATION IS UNABLE TO LOCATE THE PATIENT OR PERSON RESPONSIBLE FOR THE BILL. Needs assessment. Schedule H, Part VI, Line 2 ALLEN MEDICAL CENTER CONDUCTS AN ASSESSMENT WITH THE ASSISTANCE OF OUTSIDE EXPERTS SUCH AS FACULTY FROM SCHOOLS OR PUBLIC HEALTH. THE HOSPITAL CONTRACTS WITH AN OUTSIDE ORGANIZATION TO CONDUCT THIS ASSESSMENT (JOINT CENTER FOR POLICY RESEARCH PUBLIC SERVICES INSTITUTE LORAIN COUNTY COMMUNITY COLLEGE). Patient education of eligibility for assistance. Schedule H, Part VI, Line 3 ALLEN MEDICAL CENTER POSTS ITS CHARITY CARE POLICY, OR A SUMMARY THEREOF, AND FINANCIAL ASSISTANCE CONTACT INFORMATION IN ADMISSIONS AREAS, EMERGENCY DEPARTMENTS AND OTHER AREAS OF THE ORGANIZATION'S FACILITIES IN WHICH ELIGIBLE PATIENTS ARE LIKELY TO BE PRESENT. THE HOSPITAL PROVIDES A COPY OF THE POLICY, OR A SUMMARY THEREOF, AND FINANCIAL ASSISTANCE CONTACT INFORMATION TO PATIENTS AS PART OF THE INTAKE PROCESS AND WITH DISCHARGE MATERIALS. ADDITIONALLY, A COPY OF THE POLICY OR A SUMMARY ALONG WITH FINANCIAL ASSISTANCE CONTACT INFORMATION IS INCLUDED IN PATIENT BILLS. THE HOSPITAL DISCUSSES WITH THE PATIENT THE AVAILABILITY OF VARIOUS GOVERNMENT BENEFITS, SUCH AS MEDICAID OR STATE PROGRAMS, AND ASSISTS THE PATIENT WITH QUALIFICATION FOR SUCH PROGRAMS, WHERE APPLICABLE. THE HOSPITAL ELIGIBILITY LINK PROGRAM (HELP) IS A FREE REFERRAL SERVICE PROVIDED BY ALLEN MEDICAL CENTER. THE PURPOSE OF HELP IS TO ASSIST PATIENTS IN OBTAINING MEDICAL BENEFITS THROUGH FEDERAL, STATE, AND HOSPITAL PROGRAMS. HELP REPRESENTATIVES WILL PROVIDE THE FOLLOWING SERVICES AT NO COST TO THE PATIENT: * EXPLORE ELIGIBILITY UNDER PUBLIC ASSISTANCE PROGRAMS * FILE APPLICATIONS ON PATIENT'S BEHALF * SCHEDULE AND ATTEND APPOINTMENTS * PROVIDE TRANSPORTATION WHEN NECESSARY * PROVIDE MEDICAL DOCUMENTATION TO SOCIAL SECURITY ADMINISTRATION FOR DISABILITY CLAIMS. THROUGH HELP, PATIENTS AND THEIR COUNSELORS LOOK AT WHAT OPTIONS ARE AVAILABLE. THE HOSPITAL UNDERSTANDS THAT NOT EVERYONE CAN PAY FOR HEALTHCARE SERVICES. HELP IS HERE TO OFFER OPTIONS AND ASSISTANCE FOR THOSE WHO ARE UNINSURED OR UNDERINSURED. HELP IS AN EXTENSION OF THE HOSPITAL'S MISSION TO IMPROVE THE HEALTH OF OUR COMMUNITY WITH EMPHASIS ON THE POOR AND UNDERSERVED. MEETING THE NEEDS OF THOSE WITH LIMITED RESOURCES HAS BEEN THE HEART OF OUR MISSION. Community information. Schedule H, Part VI, Line 4 COMMUNITY HEALTH PARTNERS REGIONAL MEDICAL CENTER AND ALLEN MEDICAL CENTER (CHP) PRIMARILY SERVE LORAIN COUNTY AND ALSO SOME PORTIONS OF ERIE AND HURON COUNTIES. THE POPULATION OF CHP'S PRIMARY SERVICE AREA IS APPROXIMATELY 214,000, AND IS OLDER, POORER AND HAS WORSE HEALTH STATISTICS THAN THE REMAINING PORTION OF THE COUNTY. OUR COMMUNITY IS CHANGING AND WE ALSO SERVE A GROWING UNINSURED AND UNDERINSURED POPULATION. THERE ARE FOUR ACUTE HOSPITALS AND ONE LONG-TERM ACUTE CARE HOSPITAL IN LORAIN COUNTY, AND ALL ARE NON-PROFIT HOSPITALS. THERE ARE THREE PORTIONS OF LORAIN COUNTY WHICH HAVE BEEN FEDERALLY DESIGNATED AS A MEDICALLY UNDERSERVED AREA OR POPULATION. THE LARGEST SECTION IS A CLUSTER OF CENSUS TRACTS IN LORAIN / SOUTH LORAIN WHICH IS WITHIN 3 - 5 MILES OF THE REGIONAL MEDICAL CENTER. THERE ARE ALSO TWO ISOLATED CENSUS TRACTS IN LORAIN COUNTY - ONE OF THEM BEING IN ELYRIA - THAT ALSO HAVE MUA DESIGNATION. THE SOUTHERN PORTION OF LORAIN COUNTY, WHICH IS SERVED BY ALLEN MEDICAL CENTER, CONTAINS WELLINGTON, WHICH HAS A HEALTH PROFESSIONALS SHORTAGE AREA (HPSA) DESIGNATION. PART OF THE LORAIN AREA DESIGNATED AS MUA THAT IS MENTIONED ABOVE ALSO HAS HPSA DESIGNATION THE DEMOGRAPHIC AREA SERVED BY CHP INCLUDES MULTIPLE ETHNIC AND CULTURAL GROUPS. BASED ON 2006-2008 COMMUNITY ESTIMATES PROVIDED BY THE US CENSUS BUREAU, APPROXIMATELY 7.7% OF THE HOUSEHOLDS IN LORAIN COUNTY SPEAK A PRIMARY LANGUAGE OTHER THAN ENGLISH. THIS IS HIGHER THAN THE STATE RATE. ALSO, WE EXPECT THE PERCENTAGE TO BE HIGHER IN OUR PSA, AS THERE IS A LARGE CONCENTRATION OF SPANISH-SPEAKING RESIDENTS LIVING IN THE CITY OF LORAIN. ALMOST 10% OF RESIDENTS ARE IN HOUSEHOLDS BELOW THE FEDERAL POVERTY GUIDELINES, WHICH IS HIGHER THAN THE NATIONAL AVERAGE. THE RATE IN THE PSA IS EXPECTED TO BE MUCH HIGHER, AS THE OVERALL COUNTY NUMBER IS OFFSET BY THE MORE AFFLUENT GROWING POPULATIONS IN THE EASTERN PORTION OF THE COUNTY. ACCORDING TO A 2008 COUNTY PROFILE BY THE OHIO DEPARTMENT OF JOB AND FAMILY SERVICES, 14.1% OF RESIDENTS ARE ON MEDICAID. THIS FIGURE IS A LITTLE LOWER THAN THE STATE AVERAGE, BUT THE OVERALL MEDICAID RATE IN OUR PSA WOULD BE EXPECTED TO BE SIGNIFICANTLY HIGHER THAN THE COUNTY RATE IN LORAIN COUNTY, CARDIOVASCULAR DISEASE, CANCER, AND CORONARY HEART DISEASE ARE THE LEADING CAUSES OF DEATH BASED ON A 2007 COMMUNITY NEEDS ASSESSMENT COMMISSIONED BY CHP. EACH OF THESE ARE PREVENTABLE THROUGH PROPER CARE AND MAINTAINING CONTROL OF THE ILLNESS/DISEASE AS WELL AS LEADING HEALTHIER LIVES. BASED ON OUR NEEDS ASSESSMENT, THE SMOKING RATE IS 28% OF THE ADULT POPULATION. CHP WORKS CLOSELY WITH LOCAL COMMUNITY AGENCIES AND HEALTH DEPARTMENTS TO ADDRESS THESE PROBLEMS AND MINIMIZE THE EFFECTS ON THOSE WHO SUFFER. IN 2010, CHP HAD 16,631 ADMISSIONS (INCLUDING NEWBORNS AND SNF), OF WHICH, 15,618 WERE AT THE REGIONAL MEDICAL CENTER AND 1,013 WERE AT ALLEN MEDICAL CENTER. CHP ALSO HAD 67,280 EMERGENCY ROOM VISITS - 47,868 AT THE REGIONAL MEDICAL CENTER AND 19,412 AT ALLEN MEDICAL CENTER. Promotion of community health Schedule H, Part VI, Line 5 ALLEN MEDICAL CENTER (AMC) OPERATES AN EMERGENCY ROOM OPEN TO ALL PERSONS REGARDLESS OF ABILITY TO PAY. IN ADDITION TO PROVIDING EMERGENCY SERVICES, AMC ALSO PROVIDES MINOR EMERGENCY AND URGENT CARE SERVICES TO ALL REGARDLESS OF ABILITY TO PAY. AMC HAS AN OPEN MEDICAL STAFF WITH PRIVILEGES AVAILABLE TO ALL QUALIFIED PHYSICIANS IN THE AREA. THE MAJORITY OF THE GOVERNING BODY CONSISTS OF INDEPENDENT PERSONS REPRESENTATIVE OF THE COMMUNITY SERVED. AMC ENGAGES IN THE TRAINING AND EDUCATION OF HEALTH CARE PROFESSIONALS, AND SERVES AS A CLINICAL EXPERIENCE SITE FOR OTHER HEALTH PROFESSIONALS. EXAMPLES OF DEPARTMENTS OFFERING CLINICAL EXPERIENCE ARE: NURSING, PHARMACY, RESPIRATORY, PHYSICAL, OCCUPATIONAL AND SPEECH THERAPIES. AMC PARTICIPATES IN MEDICAID, MEDICARE, CHAMPUS, AND/OR OTHER GOVERNMENT -SPONSORED HEALTH CARE PROGRAMS. AMC FURTHERS ITS EXEMPT PURPOSE BY PROVIDING COMMUNITY BENEFIT PROGRAMS IN THE COMMUNITIES IN WHICH IT SERVES. SOME EXAMPLES INCLUDE OUTPATIENT DIABETIC EDUCATION, OUTPATIENT PALLIATIVE CARE, HEALTH MINISTRY AND FAMILY OUTREACH. IT IS OUR GOAL TO HELP PREVENT AND MANAGE MAJOR DISEASES AFFECTING OUR COMMUNITY. IN ADDITION OUR HEALTH MINISTRY AND FAMILY OUTREACH PROGRAMS HAVE SUCCESSFULLY IDENTIFIED, THROUGH HEALTH SCREENINGS AND INTENSE MENTORING, MAJOR HEALTH CONCERNS OF OUR COMMUNITY: CANCER, CARDIO VASCULAR, HEART, OBESITY AND HEALTHY PRENATAL CARE FOR THE DELIVERY OF HEALTHY BABIES AMONG AT-RISK MOTHERS. THESE PROGRAMS HAVE BEEN SUCCESSFUL IN MANAGING AND PREVENTING CHRONIC DISEASES. AMC'S EMERGENCY DEPARTMENT TREATS AN INCREASING NUMBER OF PATIENTS WHO USE THE FACILITY FOR PRIMARY CARE NEEDS. PATIENT DEMOGRAPHICS REFLECT THE CHANGING COMMUNITY. AS IN OTHER COMMUNITIES, SOME AREA PHYSICIANS PLACE LIMITS ON THEIR ACCEPTANCE OF MEDICAID PATIENTS. IN ADDITION, SOME PRIMARY CARE PHYSICIANS REFER PATIENTS WITH AFTER-HOURS NEEDS DIRECTLY TO AREA EMERGENCY ROOMS. COMMUNITY GROUPS AND INDIVIDUALS ARE VERY SUPPORTIVE OF THE HOSPITAL. THE FREE CLINIC, COMMUNITY FOUNDATION, NORD FOUNDATION AND THE UNINSURED COALITION AND NUMEROUS VOLUNTEERS ARE SUPPORTIVE OF AMC. AMC RECEIVES GUIDANCE AND INPUT FROM ITS COMMUNITY ADVISORY COUNCIL. Affiliated health care system Schedule H, Part VI, Line 6 ALLEN MEDICAL CENTER IS A MEMBER OF CATHOLIC HEALTH PARTNERS AND IS AFFILIATED WITH COMMUNITY HEALTH PARTNERS (CHP) (AKA MERCY REGIONAL MEDICAL CENTER). ALL ARE OHIO NON-PROFIT CORPORATIONS. CHP IS SPONSORED BY THE SISTERS OF THE HUMILITY OF MARY AND HAS BEEN AN INTEGRAL PART OF THE COMMUNITY SINCE 1860. CHP IS AN ACUTE CARE HOSPITAL WITH APPROXIMATELY 328 LICENSED BEDS. COMMUNITY HEALTH PARTNERS COMMUNITY BENEFIT FOR 2010 PER THE AUDIT FOOTNOTE (INCLUDING CHP AND ALLEN) IS AS FOLLOWS: TOTAL 2010 COMMUNITY BENEFIT: $21.8 MILLION BENEFITS TO THE BROADER COMMUNITY $ 1.5 MILLION UNREIMBURSED CARE FOR THOSE WHO ARE POOR AND QUALIFY FOR MEDICAID $10.4 MILLION COST OF CARE FOR THOSE WHO COULD NOT AFFORD TO PAY $ 7.8 MILLION SUPPORT FOR OTHER PROGRAMS FOR THOSE WHO ARE POOR $ 2.1 MILLION COMMUNITY BENEFIT AS PERCENT OF TOTAL EXPENSE: 8.4 PERCENT CHP IS A MEMBER OF CATHOLIC HEALTH PARTNERS. CATHOLIC HEALTH PARTNERS IS THE CONTINUATION OF THE HEALTH MINISTRY STARTED MORE THAN 150 YEARS AGO BY OUR CO-SPONSORING CONGREGATIONS: THE SISTERS OF MERCY, REGIONAL COMMUNITY OF CINCINNATI (OH); THE MID-ATLANTIC COMMUNITY, MERION STATION, PA; THE SISTERS OF HUMILITY OF MARY; THE FRANCISCAN SISTERS OF THE POOR; AND COVENANT HEALTH SYSTEMS. OUR SYSTEM OF REGIONAL HEALTH CARE PROVIDERS SERVES LOCAL HEALTH NEEDS IN COMMUNITIES IN OHIO, KENTUCKY, PENNSYLVANIA AND TENNESSEE. CATHOLIC HEALTH PARTNERS IS FOCUSED ON IMPROVING THE HEALTH OF COMMUNITIES WE SERVE BY PROVIDING INTEGRATED HEALTH SERVICES THROUGH FACILITIES THAT INCLUDE ACUTE CARE HOSPITALS, LONG-TERM CARE RESIDENCES, HOUSING SITES FOR THE ELDERLY, HOME HEALTH AGENCIES, HOSPICE PROGRAMS, OUTREACH SERVICES AND WELLNESS CENTERS. OUR HOSPITALS INCLUDE FOUR CRITICAL ACCESS FACILITIES OFFERING ESSENTIAL HEALTH SERVICES THAT WOULD OTHERWISE NOT EXIST IN THOSE COMMUNITIES. WE CARE FOR EVERYONE WHO COMES TO US, REGARDLESS OF THEIR ABILITY TO PAY. AS WE HAVE DONE FOR DECADES, WE PROVIDE EXTENSIVE SERVICES TO THE BROADER COMMUNITY, WITH EMPHASIS ON SERVICES FOR PERSONS WHO ARE POOR AND UNDER-SERVED. CATHOLIC HEALTH PARTNERS' HOME OFFICE PROVIDES SERVICES AND SUPPORT TO THE ENTIRE SYSTEM, INCLUDING BUT NOT LIMITED TO: PROVIDING GOVERNANCE, MANAGEMENT OVERSIGHT, STRATEGIC LEADERSHIP, FOCUSING RESOURCES TO ASSURE THE HEALING MISSION, PROVIDING ACCESS TO LOWER COST DEBT FINANCING TO SUPPORT OPERATIONS, IMPROVING CLINICAL OUTCOMES AND REDUCING OPERATING COSTS. SYSTEM-WIDE COMMUNITY BENEFIT FOR 2010 PER THE AUDIT FOOTNOTE IS AS FOLLOWS: TOTAL 2010 COMMUNITY BENEFIT: $365.1 MILLION BENEFITS TO THE BROADER COMMUNITY $77.1 MILLION UNREIMBURSED CARE FOR THOSE WHO ARE POOR AND QUALIFY FOR MEDICAID $131.7 MILLION COST OF CARE FOR THOSE WHO COULD NOT AFFORD TO PAY $123.2 MILLION SUPPORT FOR OTHER PROGRAMS FOR THOSE WHO ARE POOR $33.1 MILLION COMMUNITY BENEFIT AS PERCENT OF TOTAL EXPENSE: 8.5 PERCENT X X false true false false false false false true false VAMSEE K AMIRNENI 160503 0 27211 0 315 0 13536 0 6732 0 208297 0 0 0 EDWIN M OLEY 0 346655 0 106170 0 17271 0 220327 0 14474 0 704897 0 0 SUSAN BOWERS 184818 0 33660 0 9737 0 24025 0 7061 0 259301 0 0 0 Supplemental nonqualified retirement plan Schedule J, Part I, Line 4b THE COMMUNITY HEALTH PARTNERS REGIONAL HEALTH SYSTEM NONQUALIFIED SUPPLEMENTAL EMPLOYEE RETIREMENT PLAN IS AN EXECUTIVE RETENTION PLAN FOR CERTAIN HIGHLY COMPENSATED INDIVIDUALS, AS DETERMINED BY THE BOARD OF TRUSTEES' EXECUTIVE EVALUATION AND COMPENSATION COMMITTEE. THE PLAN PURPOSE IS TO PROVIDE A BENEFIT TO REPLACE THE BENEFIT THESE PARTICIPANTS WOULD HAVE RECEIVED UNDER THE APPLICABLE QUALIFIED PLAN PRIOR TO ITS AMENDMENT TO COMPLY WITH THE OMNIBUS BUDGET RECONCILIATION ACT OF 1993. IT PROVIDES A DEFERRED COMPENSATION BENEFIT OF 3% TO 5% OF ANNUAL BASE SALARY. PARTICIPANTS VEST AND RECEIVE PLAN BENEFITS ONCE TWO CONDITIONS ARE SATISFIED: (1) MEET THE VESTING REQUIREMENTS OF THE APPLICABLE QUALIFIED PLAN, AND (2) COMPLETE A 24-MONTH POST-EMPLOYMENT NON-COMPETE REQUIREMENT. AMOUNTS INCLUDIBLE AS TAXABLE COMPENSATION FOR LISTED PARTICIPATING INDIVIDUALS IN THE REPORTING YEAR ARE AS FOLLOWS: EDWIN M. OLEY $0; SUSAN BOWERS $0 Non-fixed payments Schedule J, Part I, Line 7 THE ORGANIZATION PROVIDES ANNUAL INCENTIVE COMPENSATION FOR LISTED INDIVIDUALS. THE ORGANIZATION'S BOARD OF TRUSTEES ESTABLISHES OBJECTIVE THRESHOLDS FOR QUALITY, COMMUNITY BENEFIT, AND FINANCIAL PERFORMANCE WHICH MUST BE ACHIEVED FOR INCENTIVES TO BE AWARDED. THE BOARD ALSO ESTABLISHES THRESHOLD, TARGET AND MAXIMUM LEVELS FOR INCENTIVE AWARDS. WITHIN THESE ESTABLISHED PARAMETERS, THE BOARD DETERMINES THE CEO'S INCENTIVE AWARD AND INCENTIVE AWARDS FOR OTHER LISTED INDIVIDUALS ARE DETERMINED BY THE LISTED INDIVIDUAL'S SUPERVISOR AND DISCLOSED TO THE BOARD. THE BOARD MAY AUTHORIZE MODIFIED INCENTIVE AWARDS WHEN APPROPRIATE IN ITS JUDGMENT. Classes of members or stockholders Form 990, Part VI, Section A, Line 6 COMMUNITY HEALTH PARTNERS REGIONAL HEALTH SYSTEM (HOLDING COMPANY) IS THE SOLE MEMBER OF ALLEN MEDICAL CENTER. Members or stockholders electing members of governing body Form 990, Part VI, Section A, Line 7a COMMUNITY HEALTH PARTNERS REGIONAL HEALTH SYSTEM (HOLDING COMPANY) HAS THE RIGHT TO APPOINT AND REMOVE MEMBERS OF THE GOVERNING BODY. Decisions requiring approval by members or stockholders Form 990, Part VI, Section A, Line 7b THE FOLLOWING ACTIONS REQUIRE APPROVAL BY THE CORPORATE MEMBER: TO APPROVE ANY AMENDMENTS TO GOVERNING DOCUMENTS; TO APPROVE THE SALE, TRANSFER, OR ENCUMBRANCE OR DESTRUCTION OF LAND AND/OR BUILDINGS; TO REMOVE AT WILL, WITH OR WITHOUT CAUSE, ANY MEMBER OF THE GOVERNING BOARD; TO ADOPT, CHANGE AND INTERPRET THE VISION AND VALUES THAT REGULATE AND DETERMINE ACTIVITIES; TO APPROVE A MATERIAL CHANGE IN THE USE OF A FACILITY. Review of form 990 by governing body Form 990, Part VI, Section B, Line 11b THE FORM 990 IS PREPARED BY CATHOLIC HEALTH PARTNER'S TAX DEPARTMENT AND REVIEWED BY AN INDEPENDENT ACCOUNTING FIRM. A COPY OF THE FORM 990 IS THEN REVIEWED BY MANAGEMENT. UPON REVIEW, THE FORM 990 IS THEN FORWARDED TO THE AUDIT & CORPORATE RESPONSIBILITY COMMITTEE FOR APPROVAL. ADDITIONALLY, THE COMPENSATION COMMITTEE REVIEWS ALL COMPENSATION RELATED SCHEDULES AND DISCLOSURES. BOTH THE AUDIT & CORPORATE RESPONSIBILITY COMMITTEE AND THE COMPENSATION COMMITTEE ARE INDEPENDENT OF THE FILING. Conflict of interest policy Form 990, Part VI, Section B, Line 12c ALL BOARD MEMBERS ARE COVERED BY THE CATHOLIC HEALTH PARTNERS CONFLICT OF INTEREST POLICY WHICH REQUIRES DISCLOSURE ON AN ANNUAL BASIS. ALL POTENTIAL CONFLICTS OF INTEREST ARE REVIEWED BY THE CATHOLIC HEALTH PARTNERS CORPORATE COMPLIANCE OFFICER. AT THE BEGINNING OF EACH BOARD MEETING ALL BOARD MEMBERS ARE REQUIRED TO DISCLOSE ANY CONFLICTS OF INTEREST. BOARD MEMBERS DETERMINED TO HAVE A CONFLICT OF INTEREST ARE PROHIBITED FROM PARTICIPATING IN DELIBERATIONS AND DECISION-MAKING FOR THE TRANSACTION IN WHICH THE CONFLICT EXISTS. Process used to establish compensation of top management official Form 990, Part VI, Section B, Line 15a THE ORGANIZATION'S FORMAL PROCESS FOR DETERMINING TOTAL COMPENSATION FOR THE CEO AND OTHER OFFICERS AND KEY EMPLOYEES IS INTENDED TO PROVIDE REASONABLE COMPENSATION FOR ACCOMPLISHING THE ORGANIZATION'S MISSION, TO RECOGNIZE PERFORMANCE, AND TO OPERATE IN KEEPING WITH THE ORGANIZATION'S OBLIGATIONS AS A TAX-EXEMPT CHARITABLE ORGANIZATION. THE COMPENSATION COMMITTEE OF THE REGIONAL BOARD OF TRUSTEES CONDUCTS AN ANNUAL REVIEW OF THE COMPENSATION AND PERFORMANCE OF THE CEO AND OTHER OFFICERS AND KEY EMPLOYEES. IN DOING SO, THE COMMITTEE RETAINS A QUALIFIED INDEPENDENT COMPENSATION CONSULTANT (SULLIVAN, COTTER, & ASSOCIATES, INC.) TO CONDUCT COMPETITIVE MARKET ANALYSIS ANNUALLY OF THE MARKET RANGES OF BASE, INCENTIVE, AND TOTAL CASH COMPENSATION. THE COMMITTEE UTILIZES THAT ANALYSIS AND OTHER APPROPRIATE INFORMATION IN CONNECTION WITH ITS ANNUAL REVIEW AND ADJUSTMENT OF COMPENSATION RANGES. IT ALSO REVIEWS AND RECOMMENDS TO THE FULL BOARD THE THRESHOLD AND MAXIMUM INCENTIVE AWARDS FOR WHICH THE LISTED INDIVIDUALS MAY BE ELIGIBLE, BASED UPON THE ORGANIZATION'S PERFORMANCE RESULTS FOR COMMUNITY BENEFIT, QUALITY, AND FINANCIAL PERFORMANCE. THE DIVISIONAL CEO RECOMMENDS THE REGIONAL CEO'S COMPENSATION, AND THE REGIONAL CEO RECOMMENDS COMPENSATION FOR OFFICERS AND KEY EMPLOYEES. THE COMMITTEE REVIEWS AND APPROVES OR ADJUSTS THE RECOMMENDED ADJUSTMENTS TO THE CEO, OFFICERS, AND KEY EMPLOYEES' BASE COMPENSATION AND INCENTIVE AWARD, WITHIN SUCH ESTABLISHED PARAMETERS. A FORMAL PERFORMANCE APPRAISAL PROCESS IS INCORPORATED IN THE COMPENSATION ADJUSTMENT AND AWARD PROCESS. IT UTILIZES A MULTI-PERSPECTIVE APPROACH AND PERFORMANCE MEASURE WHICH ARE LINKED TO THE ORGANIZATION'S ACHIEVEMENT OF TEAM AND INDIVIDUAL PERFORMANCE. COMPENSATION-RELATED DETERMINATIONS ARE CONDUCTED IN ACCORDANCE WITH APPLICABLE REQUIREMENTS OF THE INTERNAL REVENUE CODE. AND REGULATIONS TO QUALIFY FOR THE PRESUMPTION THAT THE COMPENSATION IS REASONABLE, INCLUDING BUT NOT LIMITED TO APPROVAL BY AN AUTHORIZED BODY COMPOSED OF INDIVIDUALS WHO DO NOT HAVE A CONFLICT OF INTEREST, OBTAINING AND RELYING ON APPROPRIATE DATA AS TO COMPARABILITY, AND CONCURRENT DOCUMENTATION OF THE BASIS FOR THE COMPENSATION DETERMINATIONS. Process used to establish compensation of other officers/key employees Form 990, Part VI, Section B, Line 15b PLEASE REFER TO THE LINE 15A RESPONSE DIRECTLY ABOVE WHICH DESCRIBES THE PROCESS USED FOR BOTH THE TOP MANAGEMENT OFFICIAL AND FOR OTHER KEY EMPLOYEES. Public Disclosure Form 990, Part VI, Section C, Line 19 THE SYSTEM-WIDE CONFLICT OF INTEREST POLICY AND FINANCIAL STATEMENTS ARE POSTED ON THE CATHOLIC HEALTH PARTNERS WEBSITE. AVERAGE HOURS PER WEEK DEVOTED TO RELATED ORGANIZATIONS BY LISTED PERSONS FORM 990 PART VII SECTION A COLUMN (B) SUSAN BOWERS 3 EDWIN M. OLEY 40 MAUD W. DE LA PORTE 5 DOUGLAS B. WILBER 7 SR. JANE PANK HM 1 MARCIA E MILLER 1 SANDRA L. HODGE 1 REV BRIAN D. BURKE 1 SR. DOROTHY M. THUM RSM 1 KIM E. STRAUSS 1 GEORGIA L. NEWMAN MD 1 RONALD RYBARCZYK 1 Other changes in net assets or fund balances Form 990, Part XI, Line 5 MISCELLANEOUS CORRECTIONS - 314; CATHOLIC HEALTH PARTNERS 615 ELSINORE PLACE CINCINNATI OH 45202 311161086 HEALTHCARE SYSTEM PARENT OH 501(C)(3) 11 - Type III - FI NA CATHOLIC HEALTHCARE PARTNERS FOUNDATION 615 ELSINORE PLACE CINCINNATI OH 45202 201072726 FUNDRAISING OH 501(C)(3) 7 CATHOLIC HEALTH PARTNERS CATHOLIC HEALTHCARE PARTNERS HOUSING DEVELOPMENT 615 ELSINORE PLACE CINCINNATI OH 45202 208943658 HUD PARENT OH 501(C)(3) 9 CATHOLIC HEALTH PARTNERS CATHOLIC HEALTHCARE PARTNERS RETIREMENT TRUST 615 ELSINORE PLACE CINCINNATI OH 45202 316046304 RETIREMENT TRUST OH 501(C)(3) 8 CATHOLIC HEALTH PARTNERS SISTERS OF MERCY WORKERS COMPENSATION SELF-INSURANCE TRUST 615 ELSINORE PLACE CINCINNATI OH 45202 310990309 TRUST ADMINISTRATION OH 501(C)(3) 11 - Type I CATHOLIC HEALTH PARTNERS COMMUNITY HEALTH PARTNERS REGIONAL HEALTH SYSTEM 3700 KOLBE ROAD LORAIN OH 44053 270071694 REGIONAL PARENT OH 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