2011-05-12T12:49:18-05:00 2010-06-30 CATHOLIC HEALTH INITIATIVES 198 INVERNESS DRIVE WEST ENGLEWOOD CO 80112 990 2009-07-01 910715805 Enumclaw Regional Hospital Association ENUM 3608252505 1455 BATTERSBY AVENUE ENUMCLAW WA 98022 Michael Fitzgerald 2011-05-05 MARK STOCKI 7208741500 2009 2016-02-24 21:20:13Z X St Elizabeth Hospital Joe Wilczek 1455 BATTERSBY AVENUE ENUMCLAW WA 98022 50509934 false X www.fhshealth.org X 1949 WA St. Elizabeth Hospital (formally Enumclaw Regional Hospital) is part of FHS and is founded on the principle to provide compassionate care to everyone regardless of the ability to pay or social status. 11 10 331 43 19424 104945 4422649 44792555 46316228 -426746 -609808 308864 380865 44779618 50509934 19313 13612 0 0 16214079 19631557 0 0 0 17219447 20321241 33452839 39966410 11326779 10543524 50619421 61030619 14227440 11972503 36391981 49058116 The organization's mission is to nurture the healing ministry of the Church by bringing it new life, energy and viability in the 21st century. Fidelity to the Gospel urges us to emphasize human dignity and social justice as we move toward the creation of healthier communities. false false 29025088 13612 46316228 See Schedule H 29025088 true true false true false false false false false true false true false false false false false false false false true true false true false false false false false false false false false false false false false true true false false true 48 0 true 331 true true true false false false false false false false false 11 10 false false false false true true true true true false false true true true true true true true false false WA X Dennis Popp 3608023210 1455 Battersby Ave Enumclaw WA 98022 Jim Anderson 1.0 X Stephen Atkinson 1.0 X 81000 Roy Brooks 1.0 X X Paul Gunderson 1.0 X X Steve Harlow 1.0 X Ted Lewis 1.0 X X Greg Pratt 1.0 X Sue Reiter 1.0 X David Rice MD 1.0 X Mario Sorci 1.0 X Bette Zech 1.0 X Dennis Popp 40.0 X 278329 0 30709 Terry Tyrrell 40.0 X 161488 30842 Shelly Pricco 40.0 X 135650 16240 Kathleen Gibson 36.0 X 125258 6837 Mark Ignacio 36.0 X 121829 17388 Deborah Sutphin 32.0 X 116530 17379 1020084 0 119395 17 false true false TOSHIBA AMERICA MEDICAL SYSTEMS PO BOX 91605 Chicago IL 60693 Maintenance contract 785364 INFORMATION RESOURCE MANAGEMENT PO BOX 469 Spokane WA 99210 System support 317007 HEALTHCARE RESOURCE GROUP 476394 HWY 95 STE 201 Ponderay ID 83852 Professional staff 234489 ON ASSIGNMENT STAFFING SERVICES INC FILE 50730 Los Angeles CA 90074 Professional staff 210045 MEDICAL STAFFING NETWORK PO BOX 840416 DALLAS TX 75284 Professional Staff 760448 13 4392479 30170 9242 4422649 Patient Services 900099 46314705 46314705 Rental Income 900099 323 323 INTERCOMPANY TRANSACTIONS 900099 1200 1200 46316228 273088 -40 273128 0 0 -882896 -882896 -882896 -882896 0 0 0 Cafeteria 722100 182186 19464 162722 Gift Shop 453220 17532 17532 MEDICAL TRANSCRIPTION 900099 76916 76916 104231 104231 380865 50509934 46316228 19424 -248367 13612 13612 0 0 0 315756 315756 0 15674429 11590202 4084227 625805 453604 172201 1865845 1002891 862954 1149722 702152 447570 0 12596 12596 0 0 0 0 3688195 2134899 1553296 271762 271762 4141986 3649210 492776 0 0 804501 580207 224294 93947 36159 57788 0 2226 2226 0 1028750 1028750 2037752 1752467 285285 540415 540415 Bad debts 5945705 5945705 Income/sales/property taxes 423498 423498 Repairs and maintenance 859159 360778 498381 Dues & subscriptions 58065 9111 48954 Workplace Improvement Fund 42091 42091 370593 370593 39966410 29025088 10941322 0 -123161 180 7721840 2729521 600000 0 5671332 5407810 0 0 607609 603876 36494 17454 65712943 18636267 20511768 47076676 15280843 4867368 312696 327734 50619421 61030619 3834856 5028263 10392584 6944240 14227440 11972503 X 36391981 49058116 36391981 49058116 50619421 61030619 X false true true X false X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED false false false false false true 3495 false false 3495 990 Sch C Supplemental Lobbying Activities Explanation Line 1(f) The portion of organization dues that are related to lobbying are as follows: American Hospital Association - $635, Catholic Healthcare Association - $456, and Washington State Hospital Association - $2,404. 2264403 2264403 2601483 2601483 0 104025 104025 18524813 15930759 2594054 42218218 42218218 47076675 CHI OIP - Fixed Income 2541769 F CHI OIP - Equity Securities 2325598 F 4867367 0 Deferred Compensation 327734 Severance 373000 Unclaimed Property 10992 THIRD PARTY SETTLEMENTS PAYABLE 2232514 INTERCOMPANY PAYABLE 4000000 6944240 50509934 39966410 10543524 2212625 -90014 2122611 12666135 REPORTING OF LIABILITY FOR UNCERTAIN TAX POSITIONS UNDER FIN 48 Enumclaw Regional Hospital Association's financial information is included in the consolidated audited financial statements of Catholic Health Initiatives (CHI), a related organization. CHI's FIN 48 footnote for the year ended June 30, 2010 reads as follows: "CHI is a tax-exempt Colorado corporation and has been granted an exemption from federal income tax under Section 501(c)(3) of the Internal Revenue Code. CHI owns certain taxable subsidiaries and engages in certain activities that are unrelated to its exempt purpose and therefore subject to income tax. Management annually reviews its tax positions and has determined that there are no material uncertain tax positions that require recognition in the consolidated financial statements." true true false false true false true true 823788 823788 0.02420 2946300 2946300 0.08660 3770088 3770088 0.11080 4 835 47222 4273 42949 0.00130 4 150 3147 3147 0.00010 8 985 50369 4273 46096 0.00140 8 985 3820457 4273 3816184 0.11220 true 1752199 0 9488225 9394282 93943 true true ENUMCLAW REGIONAL HOSPITAL

1455 Battersby Avenue Enumclaw WA 98022

X X X X If applicable, describe the income-based criteria for determining eligibility for free or discounted care under the organization's charity care policy. Also describe whether the organization uses the asset test or other threshold regardless of income to determine eligibility for free or discounted care. When Catholic Health Initiatives (the ultimate parent organization to Enumclaw Regional Hospital Association) established its charity care policy it was determined that establishing a household income scale based on the HUD very low income guidelines more accurately reflects the socioeconomic dispersions among the 69 urban and rural communities in 19 states served by CHI hospitals and health care facilities. In comparing HUD guidelines to the Federal Poverty Guidelines ("FPG"), we find that on average HUD guidelines compute to approximately 200% to 250% (and sometimes 300%) of FPG. Enumclaw Regional Hospital Association bases its charity care eligibility on HUD's 130% of Very Low Income Guidelines based on geography, and affords the uninsured and underinsured the ability to obtain charity care write-offs, based on a sliding scale, ranging from 25%-100% of charges. An individual's income under the HUD guidelines is a significant factor in determining eligibility for charity care. However, in determining whether to extend discounted or free care to a patient, the patient's assets may also be taken into consideration. For example, a patient suffering a catastrophic illness may have a reasonable level of income, but a low level of liquid assets such that the payment of medical bills would be seriously detrimental to the patient's basic financial (and ultimately physical) well-being and survival. Such a patient may be extended discounted or free care based upon the facts and circumstances. If the organization's community benefit report is contained in a report prepared by a related organization, rather than a separate report prepared by the organization, identify the related organization. Enumclaw Regional Hospital Association prepares its own annual written community benefit report. Its community benefit report is not contained in that of a related organization. Provide an explanation of the costing methodology used to calculate the amounts reported in the table. If a cost accounting system was used, indicate whether the cost accounting system addresses all patient segments (for example, inpatient, outpatient, emergency room, private insurance, Medicaid, Medicare, uninsured or self pay). Also indicate whether a cost-to-charge ratio was used for any of the figures reported in the table. Describe whether this cost-to-charge ratio was derived from Worksheet 2, and, if not, what kind of cost-to-charge ratio was used and how it was derived. If some other costing methodology was used besides a cost accounting system, cost-to-charge ratio, or a combination of the two, describe the method used. Worksheet 2 was utilized to compute the cost-to-charge ratio for the year ended 6/30/10 using the following formula: Operating Expense (less non-patient care activities, Medicare provider taxes, community benefit expense and community building expense) divided by gross patient revenue (less gross charges for community benefit programs). Based on that formula, $33,974,609/$115,287,892 results in a 29.47% cost-to-charge ratio. If applicable, state the bad debt expense included on Form 990 Part IX, line 25, column (A) but subtracted for purposes of calculating the percentage in this column. Total bad debt expense reported on Form 990 Part IX, line 25, Column A was $ 5,945,705. (A) Provide the rationale and the costing methodology used to determine the amount reported in Part III lines 2 and 3. Describe how the organization accounts for discounts and payments on patient accounts in determining bad debt expense. (B) Also describe the method the organization uses to determine the amount that reasonably could be attributable to patients who likely would qualify for financial assistance under the hospital's charity care policy, if sufficient information has been available to make a determination as to their eligibility. Also, provide if applicable, the text of the footnote to the organization's financial statements that describes bad debt expense. If the organization's financial statements include a footnote on these issues that also includes other information, report only the relevant portions of the footnote. If the organization's financial statements do not contain such a footnote, state that the organization's financial statements do not include such a footnote and explain how the financial statements account for bad debt, if at all. (A) Costing methodology for amounts reported on line 2 is determined using the organization's cost/charge ratio of 29.47%. When discounts are extended to self-pay patients, these patient account discounts are recorded as a reduction in revenue, not as bad debt expense. (B) Enumclaw Regional Hospital Association does not believe that any portion of bad debt expense could reasonably be attributed to patients who qualify for financial assistance since amounts due from those individuals' accounts will be reclassified from bad debt expense to charity care within 30 days following the date that the patient is determined to qualify for charity care. Enumclaw Regional Hospital Association does not issue separate company audited financial statements. However, the organization is included in the consolidated financial statements of Catholic Health Initiatives. The consolidated footnote reads as follows: "The provision for bad debts is based upon management's assessment of historical and expected net collections considering historical business and economic conditions, trends in health care coverage, and other collection indicators. Management periodically assesses the adequacy of the allowances for uncollectible accounts based upon historical write-off experience by payor category. The results of these reviews are used to modify, as necessary, the provision for bad debts and to establish appropriate allowances for uncollectible net patient accounts receivable. After satisfaction of amounts due from insurance, CHI follows established guidelines for placing certain patient balances with collection agencies, subject to the terms of certain restrictions on collection efforts as determined by each facility." Describe the costing methodology used to determine the Medicare allowable costs reported in the organization's Medicare Cost Report, as reflected in the amount reported in Part III, line 6. Describe, if applicable, the extent to which any shortfall reported in Part III, line 7 should be treated as a community benefit, and the rationale for the organization's position. Enumclaw Regional Hospital Association is designated as a Critical Access Hospital ("CAH"). CAHs are rural community hospitals that are certified to receive cost-based reimbursement from Medicare. The reimbursement that CAHs receive is intended to improve their financial performance and thereby reduce hospital closures. CAHs are certified under a different set of Medicare Conditions of Participation (CoP). Shortfalls are created when a facility receives payments that are less than the costs of caring for program beneficiaries. Enumclaw Regional Hospital Association will not experience Medicare related shortfalls due to their CAH designation, which receives cost-based reimbursement for Medicare purposes. If the organization has a written debt collection policy and answered "yes" to Part III, line 9b, describe the collection practices set forth in the policy that apply to patients who it knows qualify for charity care or financial assistance, whether or not such practices apply specifically to such patients or more broadly to also cover other types of patients. Enumclaw Regional Hospital Association's ("ERHA") debt collection policy provides that ERHA will perform a reasonable review of each inpatient account prior to turning an account for to a third-party collection agent and prior to instituting any legal action for non-payment, to assure that the patient and patient guarantor are not eligible for any assistance program (e.g. Medicaid) and do not qualify for coverage through ERHA's community assistance policy. After having been turned over to a third-party collection agent, any patient account that is subsequently determined to meet the ERHA community assistance policy is required to be returned immediately by the third-party collection agent to ERHA for appropriate follow-up. ERHA requires its third-party collection agents to include a message on all statements indicating that if a patient or patient guarantor meets certain stipulated income requirements, the patient or patient guarantor may be eligible for financial assistance. All of Catholic Health Initiatives' hospitals' contracts with third party collection agencies include the following standards: - Neither CHI hospitals nor their collection agencies will request bench or arrest warrants as a result of non-payment; - Neither CHI hospitals nor their collection agencies will seek liens that would require the sale or foreclosure of a primary residence; and - No Catholic Health Initiatives' collection agency may seek court action without hospital approval. Finally, collection agencies are trained on the Catholic Health Initiatives Mission, Core Values and Standard of Conduct to make sure all patients are treated with dignity and respect. Line 2: Describe how the organization assesses the health care needs of the communities it serves. Line 4: Describe the community the organization serves, taking into account the geographic area and demographic constituents it serves. Line 5: Describe how the organization's community building activities, as reported in Part II, promote the health of the communities the organization serves. Line 6: Provide any other information important to describing how the organization's hospitals or other health care facilities further its exempt purpose by promoting health of the community (e.g. open medical staff, community board, use of surplus funds, etc). Enumclaw Regional Hospital (ERH) provides quality medical healthcare regardless of race, creed, sex, national origin, handicap, age, or ability to pay. Enumclaw Regional Hospital is an acute-care facility that serves communities in Southeast King and Northeast Pierce counties, including Enumclaw, Buckley, Bonney Lake, Black Diamond, Carbonado, Orting, South Prairie and Wilkeson. Although reimbursement for services rendered is critical to the operation and stability of ERH, it is recognized that not all individuals possess the ability to purchase essential medical services, and further, that our mission is to serve the community with respect to providing healthcare education. Therefore, in keeping with this hospital's commitment to serve all members of its community these services will be considered where the need and/or an individual's inability to pay coexists: -Free care and/or subsidized care. -Care provided to persons covered by governmental programs at less than cost. -Health activities and programs to support the community. Community Benefit Approach Located in King County, the City of Enumclaw is about 45 miles southeast of Seattle and 30 miles east of Tacoma; very near the foothills of the Cascade Mountain Range. With a current population of 11,470, Enumclaw remains a small town in size and character, despite significant growth in the surrounding area. It is a rural community with strong self-identity, solidarity among its residents, and a tradition of pulling together for the common good. The "Foothills" is the larger community of which Enumclaw is a part. Coalition work involves the Foothills community, but also benefits residents of the entire area defined by Enumclaw Regional Hospital Association's service area. The service area has a population of 134,990 residents and includes the neighboring cities of Black Diamond, Buckley, Sumner, Bonney Lake and Auburn. Process Enumclaw Regional Hospital Foundation (ERHF), initiated a professional Community Health Assessment in 2007, utilizing feedback from interviews with community leaders, focus groups with major stakeholder groups and a survey of the general community. ERHF shared the Community Health Assessment with the community in Fall 2007 at their first Annual Health Summit, and via their website. The Health Summit convened approximately forty community members, who participated in small group discussions about major health and safety issues: 1) Limited medical, preventive and health-related services, including geographic and cost factors 2) Alcohol and drug abuse, including underage use, drunk driving and methamphetamine production 3) Lack of easily accessible health resource information 4) Poor access to mental health treatment and related support services 5) Few dental care providers, especially for people with low or no income Uncompensated Care Enumclaw Regional Hospital provides a significant amount of uncompensated care each year. In fiscal year 2010, the cost of traditional charity care provided was $823,787. ERH also incurred $2.94 million in unreimbursed costs for services provided to Medicaid patients. Frequently, the costs of providing services to participants of Medicaid are greater than the payments received from the program. Community Outreach for Persons who are Poor Smile-Mobile The Smile-Mobile dental clinic was offered at reduced rates on a sliding scale and for DSHS reimbursement. The hospital provided space, refreshments, and volunteers to handle appointment-setting and logistics. Medicaid Outreach Assistance in completing Medicaid application forms was provided to hospital patients, free of charge. Immunizations Immunization clinics and interpreter services were offered free of charge. Community Outreach for the Broader Community -Transportation via a wheelchair equipped van to medical appointments in our service area with weekly trips to medical specialists in the metropolitan area for those patients unable to secure their own transportation. Nearly 2,500 residents were assisted with transportation by the Care Van in FY10. -Free blood pressure screening was offered through the Emergency Department. -First aid classes were offered to the community on a monthly basis. -ERH supported other community events by providing refreshments and other assistance as necessary. -Enumclaw CNA Program - a partnership with Puget Sound Skills Center and ERH to bring a Certified Nurse program to Enumclaw. -Various support groups were sponsored at no charge, dealing with such issues as grief, fibromyalgia, caregivers, diabetes, new moms, and widowhood. -Other classes were also offered. These classes included Health Care Provider CPR, and Safe Sitter. Self-study materials about HIV/AIDS were made available. -Such services as TB Testing, Paternity Testing, Flu Shots, Hepatitis B Vaccines, and Tender Tots (child care for ill children of ERH and other local employees, physicians and clinic staff) were provided for a fee. We Sponsor American Cancer Society Relay for Life Chamber Of Commerce Employee/Community Health Fairs Volunteers Volunteers are at the heart of Enumclaw Regional Hospital. In fiscal year 2010, FHS Volunteer Services were recognized for 3456 hours of service. These hours of service saved the organization $62,208 in labor costs. -Student /Nurse Program- Enumclaw High School Student receive semester credit for volunteering at the hospital. -Emergency Department Mentors- established to oversee the volunteers Describe how the organization informs and educates patients and persons who may be billed for patient care about their eligibility for assistance under federal, state, or local government programs or under the organization's charity care policy. Enumclaw Regional Hospital Association ("ERHA") includes information concerning its financial assistance policy on its website. In addition, ERHA prominently displays its charity care policy in both English and Spanish in obvious locations throughout the hospitals, including the emergency rooms and other patient intake areas, as well as in ERHA outpatient facilities. In addition, ERHA registration clerks are trained to provide consultation to those who have no insurance or potentially inadequate insurance concerning their financial options including application for Medicaid and for financial assistance under ERHA's charity care policy. Upon registration (and once all EMTALA requirements are met), patients who are identified as uninsured (and not covered by Medicare or Medicaid) are provided with a packet of information that addresses the financial assistance policy and procedures including an application for assistance. ERHA registration clerks read the organization's medical assistance policy to those who appear to be incapable of reading, and provide translators for non English-speaking individuals. ERHA's staff will also assist the patient / guarantor with applying for other available coverage (such as Medicaid), if necessary. Counselors assist Medicare eligible patients in enrollment by providing referrals to the appropriate government agencies. Describe the community the organization serves, taking into account the geographic area and demographic constituents it serves. Please refer to the Needs Assessment Narrative, Part VI, Item 2. above. Describe how the organization's community building activities, as reported in Part II, promote the health of the communities the organization serves. Please refer to the Needs Assessment Narrative, Part VI, Item 2. above. Provide any other information important to describing how the organization's hospitals or other health care facilities further its exempt purpose by promoting health of the community (e.g. open medical staff, community board, use of surplus funds, etc). Please refer to the Needs Assessment Narrative, Part VI, Item 2. above. If the organization is part of an affiliated health care system, describe the respective roles of the organization and its affiliates in promoting the health of the communities served. Enumclaw Regional Hospital Association, along with its affiliated outpatient facilities are part of Catholic Health Initiatives. Catholic Health Initiatives (CHI) is a national faith-based nonprofit health care organization with headquarters in Englewood, Colorado. CHI's exempt purpose is to serve as an integral part of its national system of hospitals and other charitable entities, which are described as market-based organizations, or MBOs. An MBO is a direct provider of care or services within a defined market area that may be an integrated health system and/or a stand-alone hospital or other facility or service provider. CHI serves as the parent corporation of its MBOs which are comprised of 73 hospitals; 40 long-term care, assisted- and residential-living facilities; and two community health-services organizations. Together, these facilities provided $590 million in charity care and community benefit in the 2010 fiscal year, including services for the poor, free clinics, education and research. CHI provides strategic planning and management services as well as centralized "shared services" for the MBOs. The provision of centralized management and shared services - including areas such as accounting, human resources, payroll and supply chain -- provides economies of scale and purchasing power to the MBOs. Cost savings associated with centralized services for the fiscal year ended June 30, 2010 include more than $105 million in supply chain expense, approximately $30 million for insurance costs and more than $3.9 million as the result of a system-wide effort to coordinate and negotiate technology and equipment purchases. The cost savings achieved through CHI's centralization enable MBOs to dedicate additional resources to high-quality health care and community outreach services to the most vulnerable members of our society. Enumclaw Regional Hospital Association operates with its wholly owned affiliates and community partners, along with its fundraising arm, the Franciscan Health Foundation, to serve the health care needs of the Tacoma, Washington communities. true Metropolitan Development Center 721 Fawcett St Suuite 201 Tacoma WA 98402 910780533 501(c)3 5326 1 Schedule I Part I Q2 Procedures for monitoring the use of grants Grants included in Part II are to companies and community organizations engaged in activities that benefit the community at large. No consideration is received in exchange for these contributions, as they are considered to be a gift to be used by the recipient in accordance with their charitable purpose and as such use of the funds given to the grantee are not monitored beyond their distribution. X X false true false false false false false false false Dennis Popp 243896 0 17034 17398 30709 309038 0 Terry Tyrrell 158517 2676 296 30842 192330 Shelly Pricco 129831 5350 469 16240 151890 Supplemental Nonqualified Compensation Sch J Part I Q 4b DURING THE 2009 CALENDAR YEAR, CHI MAINTAINED A SUPPLEMENTAL NON-QUALIFIED DEFERRED COMPENSATION PLAN FOR SENIOR VICE PRESIDENTS AND ABOVE, INCLUDING MBO CEOs. THE FOLLOWING REPORTABLE INDIVIDUAL WAS ELIGIBLE TO PARTICIPATE AND THE FOLLOWING CONTRIBUTIONS WERE INCLUDED IN THE INDIVIDUAL'S REPORTABLE COMPENSATION REPORTED ON THE W-2 FOR THE 2009 CALENDAR YEAR: DENNIS POPP - $9,534.07 EXECUTIVE COMMITTEE FORM 990, PART VI, Q. 1 The Executive Committee CONSISTS only OF directors of the Corporation and IS composed of the Chairperson of the Board, the Vice Chairperson of the Board, the immediate past chairperson of the board, the President and Executive Director, and the President and Executive Director of the Corporate Member, each of whom serve as ex officio voting members of the Executive Committee, and at least one voting member appointed by the Board of Directors. The Executive Committee HAS THE POWER TO TRANSACT THE ROUTINE BUSINESS OF THE CORPORATION IN THE INTERIM PERIODS BETWEEN REGULARLY SCHEDULED MEETINGS OF THE BOARD OF DIRECTORS, PROVIDED THAT THEIR ACTIONS ARE CONSISTENT WITH ANY ACTIONS OR POLICIES OF THE BOARD, THE CORPORATE MEMBER or the parent corporation. ALL ACTIONS TAKEN ARE CONTEMPORANEOUSLY DOCUMENTED AND REPORTED TO THE BOARD AT THE EARLIEST MEETING. MEMBERS OR SHAREHOLDERS FORM 990, PART VI, Q. 6 THE SOLE MEMBER OF THE ORGANIZATION IS FRANCISCAN HEALTH SYSTEM, A WASHINGTON NONPROFIT CORPORATION. MEMBER ELECT ONE OR MORE MEMBERS OF GOVERNING BOARD FORM 990, PART VI, Q. 7A The organization has the power to appoint, remove or replace the members of the board of directors. GOVERNING POWERS Form 990, Part VI, Q. 7b Enumclaw Community Hospital Association's (ECHA) corporate member is Franciscan Health System.(FHS). Pursuant to Section 5.4 of the organization's bylaws, both FHS and Catholic Health Initiatives ("CHI") (FHS's Sole Corporate Member) have specific rights set forth and reserved in the CHI governance matrix. Pursuant to the governance matrix the following rights are reserved to the FHS Board: 1. Approve members of the ECHA board 2. Amendment of the corporate documents of ECHA 3. Approve Removal of a member of the governing body of ECHA 4. Adoption of long range and strategic plans for ECHA The following rights are reserved to the CHI board directly or through powers delegated to the CHI Chief Executive Officer: 1. Substantial change in the mission or philosophy of ECHA 2. Removal of a member of the governing body of ECHA 3. Approval of issuance of debt by ECHA 4. Approval of participation of ECHA in a joint venture 5. Approval of formation of a new corporation by ECHA 6. Approval of a merger involving ECHA 7. Approval of the sale of all or substantially all of the assets of ECHA 8. To require the transfer of assets by ECHA to CHI to accomplish CHI's goals and objectives, and to satisfy CHI debts. In addition, pursuant to Section 5.4 of the organization's bylaws, FHS or CHI may, in exercise of its approval powers, grant or withhold approval in whole or in part, or may, in its complete discretion, after consultation with the Board and the President and Chief Executive Officer of the organization, recommend such other or different actions as it deems appropriate. of the organization, recommend such other or different actions as it deems appropriate. PROCESS USED TO REVIEW FORM 990 Form 990, Part VI, Q. 11 The CFO of the Franciscan Health System facilitates the return's review with the management team and their revisions are included in the final version of the form. All board members will have the opportunity to review the Form 990 tax return in advance of filing with IRS. Subsequent to the board review, the CHI tax department files the return with the appropriate federal agencies, making any non-substantive changes necessary to effect e-filing. Any such changes are not re-submitted to the board. Procedures for monitoring and enforcing the COI policy FORM 990, PART VI, Q. 12 Enumclaw Community Hospital Association has a board policy that references the duality of interest and conflict of interest policies provided by chi national. At the annual board and board committee meetings all members are requested to sign conflict of interest statements. The signed statements are retained in the administrative files. All members are requested to declare potential conflicts of interest at each board and /or committee meeting of the board (finance/audit and compliance committee and the performance improvement committee). If the board finds that a conflict does exist regarding the agenda items to be presented for action, members are requested to abstain from voting. In addition, a questionnaire is sent annually to all board members, top paid vendors, and top paid employees asking them to disclose any business or family relationships. PROCESS FOR DETERMINING EXECUTIVE COMPENSATION FORM 990, PART VI, Q. 15A THE COMPENSATION FOR THE TOP MANAGEMENT OFFICIAL OF THE ORGANIZATION IS REVIEWED BY THE CFO AND COO OF THE FRANCISCAN HEALTH SYSTEM. THE COMPENSATION IS REVIEWED FOR REASONABLEMENSS AND COMPLIANCE WITH THE ORGANIZATION'S COMPENSATION PHILOSOPHY. Process for Determining Compensation Form 990, Part VI, Q. 15B WITH THE EXCEPTION OF THE PRESIDENT, NO officers, directors, or trustees received compensation from the organization. Any executive compensation paid to officers, directors or trustees by related organizations was set by a compensation committee utilizing an independent consultant and comparability studies and the appropriate board oversight to determine compensation. GOVERNING DOCUMENTS, COI POLICY, AND FINANCIAL STATEMENTS AVAILABLE FORM 990, PART VI, Q. 19 THE Organization'S FINANCIAL STATEMENTS ARE INCLUDED IN CATHOLIC HEALTH INITIATIVES' CONSOLIDATED AUDITED FINANCIAL STATEMENTS THAT ARE AVAILABLE AT WWW.CATHOLICHEALTHINIT.ORG OR AT WWW.DACBOND.COM. The organization's governing documents are available on teh Washington Secreetary of State's website. The conflict of interest policy is available to the public upon request. St Joseph Community Health Services 300 Central SW Suite 300 Albuquerque NM 87102 710897107 Community NM 501(c)(3) 11a CHI St Joseph Community Health Foundation 300 Central SW Suite 300 Albuquerque NM 87102 850253087 Foundation NM 501(c)(3) 7 SJCHS St Francis of Baker City 3325 Pocahontas Road Baker City OR 97814 930412495 Hospital OR 501(c)(3) 3 CHI St Elizabeth Health Care Foundation 3325 Pocahontas Road Baker City OR 97814 943164869 Foundation OR 501(c)(3) 7 SEHS Flaget Memorial Hospital Foundation Inc 4305 New Shepherdsville Road Bardstown KY 40004 562351341 Fundraising KY 501(c)(3) 11a FH Flaget Healthcare DBA Flaget Memorial 4305 New Shepherdsville Road Bardstown KY 40004 611345363 Hospital KY 501(c)(3) 3 CHI Lakewood Health Center 600 Main Avenue South Baudette MN 56623 410758434 LTerm Care MN 501(c)(3) 3 CHI Appletree Court 601 Oak Street Breckenridge MN 56520 411850500 Senior Homes MN 501(c)(3) 9 SFH Healthcare and Wellness Foundation 2400 St Francis Drive Breckenridge MN 56520 760761782 Foundation MN 501(c)(3) 11a SFMC St Francis Home 2400 St Francis Drive Breckenridge MN 56520 410729978 LTerm Care MN 501(c)(3) 9 CHI St Francis Medical Center 2400 St Francis Drive Breckenridge MN 56520 410695598 Healthcare MN 501(c)(3) 3 CHI Carrington Health Center 800 North 4th Street Carrington ND 58421 450227311 Healthcare ND 501(c)(3) 3 CHI Saint Clare's Community Care 66 Ford Road Denville NJ 07834 222876836 Healthcare NJ 501(c)(3) 11b SCHS Saint Clare's Foundation Inc 66 Ford Road Denville NJ 07834 222502997 Fundraising NJ 501(c)(3) 7 SCHS Good Samaritan College of Nursing & Heal 375 Dixmyth Ave Cincinnati OH 45220 311778403 Education KY 501(c)(3) 2 GHS Total Healthcare PO Box 7021 Colorado Springs CO 80933 840927232 Healthcare CO 501(c)(3) 3 CHI Colorado Memorial Health Care System Inc 2525 De Sales Avenue Chattanooga TN 37404 620532345 Hospital TN 501(c)(3) 3 CHI Memorial Health Care System Foundation 2525 De Sales Avenue Chattanooga TN 37404 621839548 Foundation TN 501(c)(3) 7 MHCS Memorial Health Partners Foundation Inc 6028 Shallowford Road Chattanooga TN 37421 030417049 Healthcare TN 501(c)(3) 9 MHCS The Community Limited Care Dialysis Cent 619 Oak Street Accounting-3 West Cincinnati OH 45206 237419853 Dialysis OH 501(c)(2) none GSH Good Samaritan Foundation of Cincinnati 619 Oak Street Accounting-3 West Cincinnati OH 45206 311206047 Foundation OH 501(c)(3) 11a GSH The Good Samaritan Hospital of Cincinnat 619 Oak Street Accounting-3 West Cincinnati OH 45206 310537486 Hospital OH 501(c)(3) 3 TRI-HEALTH Saint Clare's Hospital 66 Ford Road Denville NJ 07834 223319886 Hospital NJ 501(c)(3) 3 CHI St Francis Life Care Corporation 19 Pocono Road Denville NJ 07834 222536017 Elderly Care NJ 501(c)(3) 9 SCHS TriHealth Physician Institute 619 Oak Street Accounting-3 West Cincinnati OH 45206 311074519 Physicians OH 501(c)(3) 11a GSH Catholic Health Initiatives Colorado Fou 961 East Colorado Avenue Colorado Springs CO 80903 840902211 Foundation CO 501(c)(3) 7 CHI Colorado SET of Colorado Springs Inc 825 E Pikes Peak Avenue Bldg 29 Colorado Springs CO 80903 841183335 LTerm Care CO 501(c)(3) 7 CHI Colorado Catholic Health Initiatives 1999 Broadway Suite 4000 Denver CO 80202 470617373 Healthcare CO 501(c)(3) 9 CHI Catholic Health Care Federation 1999 Broadway Suite 4000 Denver CO 80202 208473567 Jurdic Person CO 501(c)(3) 11a CHI Global Health Initiatives 1999 Broadway Suite 4000 Denver CO 80202 201536108 Ministries CO 501(c)(3) 11a CHI Health SET 4200 West Conejos Place 436 Denver CO 80204 841102943 Low Inc.Care CO 501(c)(3) 7 CHI Colorado Bishop Drumm Retirement Center 1111 6th Avenue Des Moines IA 50314 420725196 LTerm Care IA 501(c)(3) 9 CHI-IA Corp Mercy Medical Center - Des Moines AKA 1111 6th Avenue Des Moines IA 50314 420680448 Hospital IA 501(c)(3) 3 CHI-IA Corp House of Mercy 1111 6th Avenue Des Moines IA 50314 421323808 Shelter IA 501(c)(3) 7 CHI-IA Corp Mercy Auxiliary of Central Iowa 1111 6th Avenue Des Moines IA 50314 426076069 Auxiliary IA 501(c)(3) 11a CHI-IA Corp Mercy Clinics Inc 1111 6th Avenue Des Moines IA 50314 421193699 Physician IA 501(c)(3) 9 CHI-IA Corp Mercy College of Health Sciences 1111 6th Avenue Des Moines IA 50314 421511682 Education IA 501(c)(3) 2 CHI-IA Corp Mercy Foundation of Des Moines IA 1111 6th Avenue Des Moines IA 50314 237358794 Foundation IA 501(c)(3) 7 CHI-IA Corp Mercy Medical Center - Centerville FKA 1 St Josephs Drive Centerville IA 52544 420680308 Hospital IA 501(c)(3) 3 CHI-IA Corp Mercy Professional Practice Associates 1111 6th Avenue Des Moines IA 50314 421470935 Physician IA 501(c)(3) 9 CHI-IA Corp Mercy Hospital of Devils Lake 1031 East Seventh Street Devils Lake ND 58301 450227012 Healthcare ND 501(c)(3) 3 CHI Saint Joseph's Hospital Foundation 30 West 7th Street Dickinson ND 58601 363418207 Foundation ND 501(c)(3) 11a SJHHC St Joseph's Hospital and Health Center 30 West 7th Street Dickinson ND 58601 450226429 Healthcare ND 501(c)(3) 3 CHI Mercy Regional Medical Center of Durango 1010 Three Springs Blvd Durango CO 81301 840405515 Hospital CO 501(c)(3) 3 CHI CHI Kentucky Inc 3900 Olympic Blvd Suite 400 Erlanger KY 41018 202741651 Healthcare KY 501(c)(3) 11a CHI Villa Nazareth Inc 801 Page Drive Fargo ND 58103 450226714 LT Care ND 501(c)(3) 9 CHI St Catherine Hospital 401 East Spruce Street Garden City KS 67846 480543721 Hospital KS 501(c)(3) 3 CHI St Catherine Hospital Development Found 401 East Spruce Street Garden City KS 67846 200598702 Foundation KS 501(c)(3) 11a SCH Saint Francis Medical Center Foundation PO Box 9804 Grand Island NE 68802 470630267 Foundation NE 501(c)(3) 7 SFMC Saint Francis Medical Center PO Box 9804 Grand Island NE 68802 470376601 HealthCare NE 501(c)(3) 3 CHI Nebraska Central Kansas Medical Center 3515 Broadway Great Bend KS 67530 480543724 Hospital KS 501(c)(3) 3 CHI St Joseph Memorial Hospital 923 Carroll Ave Larned KS 67550 481253246 Hospital KS 501(c)(3) 3 CKMC MNMCH Inc 220 North Pennsylvania Columbus KS 66725 481216238 Hospital KS 501(c)(3) 3 SJRMC Mercy Lifecare Systems 2727 McClelland Blvd Joplin MO 64804 431305163 Property Mgmt MO 501(c)(3) 11a SJRMC St John's Medical Group 2727 McClelland Blvd Joplin MO 64804 431882377 Phys Practice MO 501(c)(3) 9 SJRMC St John's Mercy Regional Foundation 2727 McClelland Blvd Joplin MO 64804 431308084 Foundation MO 501(c)(3) 7 SJRMC St John's Regional Medical Center 2727 McClelland Blvd Joplin MO 64804 440545809 Hospital MO 501(c)(3) 3 CHI Good Samaritan Hospital PO Box 1990 Kearney NE 68848 470379755 HealthCare NE 501(c)(3) 3 CHI Nebraska Good Samaritan Hospital Foundation PO Box 1810 Kearney NE 68848 470659443 Foundation NE 501(c)(3) 7 GSH St Joseph Health Ministries 1929 Lincoln Hwy E Ste 150 Lancaster PA 17602 232342997 Health PA 501(c)(3) 11a SJHM St Joseph Health Ministries Foundation 1929 Lincoln Hwy E Ste 150 Lancaster PA 17602 232605579 Fundraising PA 501(c)(3) 11a SJHM St Joseph Health Services Inc 1929 Lincoln Hwy E Ste 150 Lancaster PA 17602 201425375 Dental care PA 501(c)(3) 11a SJHM Continuing Care Hospital 150 North Eagle Creek Drive Lexington KY 40509 611400619 LTACH KY 501(c)(3) 3 SJHS Saint Joseph Berea Hospital Foundation 305 Estill Street Berea KY 40403 260152877 Foundation KY 501(c)(3) 7 SJHS Saint Joseph Health System Inc 150 N Eagle Creek Dr Lexington KY 40509 611334601 Hospital KY 501(c)(3) 3 CHI St Joseph Hospital Foundation Inc One St Joseph Drive Lexington KY 40504 611159649 Foundation KY 501(c)(3) 11a SJHS Saint Joseph Medical Foundation Inc One St Joseph Drive Lexington KY 40504 311539059 Phy Practices KY 501(c)(3) 3 SJHS Visiting Nurse Association of Saint Clar 191 Woodport Road Sparta NJ 07871 221768334 Home Health NJ 501(c)(3) 9 SCHS Saint Elizabeth Foundation 555 South 70th Street Lincoln NE 68510 470625523 Foundation NE 501(c)(3) 7 SERMC Saint Elizabeth Health Services 555 South 70th Street Lincoln NE 68510 363233120 Healthcare NE 501(c)(3) 3 SERMC CHI Nebraska 555 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