2025-05-12T15:56:06-05:00 2024-06-30 470617373 COMMONSPIRIT HEALTH 198 INVERNESS DRIVE WEST ENGLEWOOD CO 80112 990 2023-07-01 910564491 FRANCISCAN HEALTH SYSTEM FRAN 2536804005 1717 S J STREET TACOMA WA 98405 DAVID NOSACKA CFO 2536804005 2025-05-12 1 0 MARK STOCKI P00642127 3032989100 2023 2025-03-06 01:10:19Z KETUL PATEL 1717 S J STREET TACOMA WA 98405 1821452038 0 0928 X WWW.VMFH.ORG X 1891 WA FHS WAS FOUNDED ON THE PRINCIPLE TO PROVIDE COMPASSIONATE CARE TO EVERYONE REGARDLESS OF ABILITY TO PAY OR SOCIAL STATUS. FHS INCLUDES MULTIPLE FACILITIES AND HOSPICE, AND AN EXPANDING NETWORK OF CLINICS. 16 15 8864 225 12319099 527365 30296794 25679893 1505568321 1719329495 1367395 30299183 48600195 46143467 1585832705 1821452038 434864 1198351 0 0 775242748 791565865 0 0 0 957211507 1089533644 1732889119 1882297860 -147056414 -60845822 958034404 1170404055 419213825 757366370 538820579 413037685 AS AN AFFILIATE OF COMMONSPIRIT HEALTH, WE MAKE THE HEALING PRESENCE OF GOD KNOWN IN OUR WORLD BY IMPROVING THE HEALTH OF THE PEOPLE WE SERVE, ESPECIALLY THOSE WHO ARE VULNERABLE, WHILE WE ADVANCE SOCIAL JUSTICE FOR ALL. 0 0 1597353647 1198351 1719329495 SEE SCHEDULE H 1597353647 1 1 0 1 0 0 0 0 0 0 1 0 0 1 1 1 0 1 0 0 1 1 0 0 0 0 1 1 1 0 1 0 0 0 0 0 0 1 0 0 0 0 0 1 1 1 0 0 0 1 X 0 0 8864 1 1 1 0 0 0 0 0 0 0 0 0 1 0 X 16 15 0 0 0 0 1 1 1 1 1 0 0 1 1 1 1 1 0 0 1 1 0 X DAVID NOSACKA 2536804000 1717 SOUTH J STREET TACOMA WA 98405 KETUL PATEL CEO VMFH & PRESIDENT NORTHWEST REGION 2.00 48.00 X 0 2613387 32903 KERRY SHANNON SVP/CHIEF INTEGRATION OFFICER (THRU 10/13/23) 40.00 0.00 X 1747441 0 37676 JAMES TERWILLIGER PRESIDENT, PUGET SOUND MARKET 60.00 0.00 X 996476 0 20951 THOMAS KRUSE SVP/CHIEF STRATEGY OFFICER, NORTHWEST REGION 60.00 0.00 X 780008 0 42890 JENNIFER SCHOMBURG PRESIDENT ST JOSEPH MEDICAL CENTER 60.00 0.00 X 750367 0 40126 CHARLEEN TACHIBANA RN SVP/CHIEF QUALITY, SAFETY AND PATIENT EXPERIENCE O 40.00 0.00 X 668330 0 40888 DAVID NOSACKA TREASURER/SVP&CFO NORTHWEST REGION 48.00 2.00 X 645696 0 57994 RYAN PONG DIV VP-ACADEMIC OFFICER 40.00 0.00 X 524459 0 55690 KIMBERLY MOORE VP/INTERIM CHIEF MEDICAL OFFICER (THRU 5/6/2024) 60.00 0.00 X 495696 0 35165 DIANNE AROH SVP/CHIEF NURSING OFFICER 60.00 0.00 X 508305 0 22333 NARINE FRANGULYAN RN 40.00 0.00 X 496702 0 27295 DAVID WEISS MKT VP MEDICAL OPERATIONS 40.00 0.00 X 420643 0 39293 MIRIAM CHAMBLISS CORPORATE SECRETARY/VP GENERAL COUNSEL NORTHWEST R 2.00 40.00 X 0 412275 47607 RUSSELL WOOLLEY FORMER COO ST FRANCIS & ST ANNE HOSPITALS 40.00 0.00 X 220449 155903 58527 SHARON ROYNE FORMER KE/VP ADMINISTRATIVE SERVICES 40.00 0.00 X 390024 0 39392 DAVID BUTCHERITE FORMER TREASURER/DIV VP FINANCE 40.00 0.00 X 319432 0 41528 DINO JOHNSON PRES. ST ANTHONY HOSPITAL & INTERIM PRES. ST FRANC 40.00 0.00 X 283827 0 54557 MICHAEL COX FORMER KEY EMPLOYEE/CHIEF MISSION OFFICER 50.00 0.00 X 284793 0 40371 DEEPAK DEVASTHALI PRES. ST ANNE HOSPITAL & INTERIM PRES. ST ELIZABET 40.00 0.00 X 279491 0 38761 LOIS ERICKSON PRESIDENT ST CLARE HOSPITAL 40.00 0.00 X 260000 0 39677 CHUCK ARNOLD DIRECTOR 2.00 6.00 X 0 0 0 LARRY BJORK DIRECTOR 2.00 6.00 X 0 0 0 BOB CARLILE DIRECTOR 2.00 6.00 X 0 0 0 ULI CHI PHD CHAIR 2.00 6.00 X X 0 0 0 JAMES CIVILLA DIRECTOR 2.00 6.00 X 0 0 0 SR JUDE CONNELLY OSF DIRECTOR (THROUGH 3/28/24) 2.00 6.00 X 0 0 0 CAROLYN CORVI DIRECTOR 2.00 6.00 X 0 0 0 SR RUTH GOODWIN OSF DIRECTOR 2.00 6.00 X 0 0 0 TOD HAMACHEK DIRECTOR 2.00 6.00 X 0 0 0 DENNIS HUNTHAUSEN DIRECTOR 2.00 6.00 X 0 0 0 KAREN LEE DIRECTOR 2.00 6.00 X 0 0 0 ROBERT LEMON VICE CHAIR 2.00 6.00 X X 0 0 0 SR ANNE MCNAMARA OSF DIRECTOR 2.00 6.00 X 0 0 0 GREGG MEYER MD MSC DIRECTOR 2.00 6.00 X 0 0 0 JOHN OPPENHEIMER DIRECTOR 2.00 6.00 X 0 0 0 DIANN PULS DIRECTOR 2.00 6.00 X 0 0 0 JAMES SMALLEY DIRECTOR 2.00 6.00 X 0 0 0 10072139 3181565 813624 2419 1 1 0 MEDICAL SOLUTIONS LLC 1010 N 102ND ST SUITE 300 OMAHA NE 68114 TRAVEL NURSE SERVICES 125164123 ALDRICH & ASSOCIATES INC 810 240TH ST SE BOTHELL WA 98021 CONSTRUCTION SERVICES 13789651 SELLEN CONSTRUCTION COMPANY IN 227 WESTLAKE AVE SEATTLE WA 98109 CONSTRUCTION SERVICES 12621154 BLOODWORKS NORTHWEST 921 TERRY AVENUE SEATTLE WA 98104 MEDICAL SERVICES 7809179 DAVITA INC 2000 16TH ST MALL DENVER CO 80202 MEDICAL SERVICES 7137776 244 2096950 23231756 351187 25679893 NET PATIENT SERVICES 900099 1713525362 1713525362 0 0 INTERCOMPANY TRANSACTI 900099 3051196 3051196 0 0 RENTAL INCOME 900099 2752937 2752937 0 0 1719329495 2094134 214903 1879231 1591701 0 1591701 1591701 1591701 94267 28110782 0 0 94267 28110782 28205049 28205049 PHARMACY SERVICES 446110 24095978 0 11185206 12910772 INSURANCE RECOVERIES 900099 10159987 0 0 10159987 CAFETERIA 722100 4988809 0 0 4988809 5306992 918990 4388002 44551766 1821452038 1719329495 12319099 64123551 X 1176314 1176314 22037 22037 4762168 4762168 623053748 541465334 81588414 31650383 27229498 4420885 80278644 68575356 11703288 51820922 44047783 7773139 1879032 1785080 93952 180798 180798 407334970 329925294 77409676 7455166 7082408 372758 33385965 31716667 1669298 71863557 68270379 3593178 27466251 26092938 1373313 1909667 1145801 763866 539001 134750 404251 3120145 3120145 79564886 79564886 70857804 67314914 3542890 12422320 12422320 MEDICAL SUPPLIES 250515977 250515977 0 0 STATE PROVIDER TAX 56437272 53615408 2821864 0 OTHER TAXES 20787996 19748596 1039400 0 REPAIRS AND MAINTENANCE 19927673 18931289 996384 0 23885164 23015359 869805 1882297860 1597353647 284944213 0 1313 1396 0 0 0 0 217357628 403216179 0 0 0 0 0 0 44428410 45256062 6714814 4345555 1579039609 1101025894 475328416 478013715 0 0 15611784 720927 0 0 16146928 16128395 182445111 222721826 958034404 1170404055 158074132 416389008 0 0 954604 584222 0 0 0 0 0 0 0 0 0 0 260185089 340393140 419213825 757366370 X 538572079 412745185 248500 292500 538820579 413037685 958034404 1170404055 X -60845822 -67530 -64869542 X 0 1 X 1 1 1 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 0 0 0 0 0 1 180799 0 0 0 180799 0 PART II-B, LINE 1: THE PORTION OF ORGANIZATION DUES THAT ARE RELATED TO LOBBYING ARE AS FOLLOWS: AMERICAN HOSPITAL ASSOCIATION - $17632 CATHOLIC HEALTH ASSOCIATION - $7,607 ALLOCATED 340B LOBBYING-$936 WASHINGTON STATE HOSPITAL ASSOCIATION - $154,624 31803055 31803055 581606798 317672289 263934509 81987965 53191738 28796227 800630886 720256443 80374443 83010905 9905424 73105481 478013715 INVESTMENTS IN UNCONSOLIDATED ORGS - CONTROLLING INTEREST 31381685 INVESTMENTS IN UNCONSOLIDATED ORGS - NONCONTROLLING INTEREST 2850430 OTHER ASSETS 505427 LEASE RIGHT OF USE ASSETS 31928533 INTERCOMPANY RECEIVABLE 134944283 DEFERRED COMPENSATION 18987968 ESCROW ASSETS 2123500 222721826 INTERCOMPANY PAYABLES 185747935 ENVIRONMENTAL REMEDIATION LIABILITY 1531753 UNCLAIMED PROPERTY 630119 OTHER LIABILITIES 1968177 LEASE RIGHT OF USE LIABILITIES 33272411 CHI DEBT PROGRAM 80454098 PHYSICIAN RECRUIT AND GUARANTEE PAYABLE 36761394 ONPLAN SERVICE FEE LIABILITY 27253 340393140 X PART X, LINE 2: FRANCISCAN HEALTH SYSTEM'S FINANCIAL INFORMATION IS INCLUDED IN COMMONSPIRIT HEALTH'S CONSOLIDATED AUDITED FINANCIAL STATEMENTS, WHICH INCLUDES THE FOLLOWING DISCLOSURE: COMMONSPIRIT REVIEWS ITS TAX POSITIONS QUARTERLY AND HAS DETERMINED THAT THERE ARE NO MATERIAL UNCERTAIN TAX POSITIONS THAT REQUIRE RECOGNITION IN THE ACCOMPANYING CONSOLIDATED FINANCIAL STATEMENTS. 1 EAST ASIA AND THE PACIFIC - AUSTRALIA, BRUNEI, BURMA, CAMBODIA, PROGRAM SERVICES DONATION OF MEDICAL SUPPLIES 14454 SUB-SAHARAN AFRICA PROGRAM SERVICES DONATION OF MEDICAL SUPPLIES 7481 EUROPE (INCLUDING ICELAND & GREENLAND) PROGRAM SERVICES DONATION OF MEDICAL SUPPLIES 102 0 0 0 0 0 0 22037 0 22037 EAST ASIA AND THE PACIFIC MEDICAL 0 14454 MED SUPPLIES AND EQUIPMENT COST SUB-SAHARAN AFRICA MEDICAL 0 7481 MED SUPPLIES AND EQUIPMENT COST EUROPE (INCLUDING ICELAND & GREENLAND) MEDICAL 0 102 MED SUPPLIES AND EQUIPMENT COST 1 0 0 0 0 0 0 PART I, LINE 2: FHS ONLY GRANTS TO 501(C)(3) AND 501(C)(6) ORGANIZATIONS TO ENSURE THE FUNDS WILL BE USED PROPERLY. PART I, LINE 3: THE DONATED MEDICAL SUPPLIES ARE ACCOUNTED FOR AT COST. 1 1 X 1 X 300.000000000000 1 X 1 1 1 0 0 26935210 26935210 0.01430 397912308 278311516 119600792 0.06350 424847518 278311516 146536002 0.07780 52 17775 9282302 391164 8891138 0.00470 13 1276 12431372 1516099 10915273 0.00580 5 53172 50022154 39834893 10187261 0.00540 15 4186 1315114 1315114 0.00070 85 76409 73050942 41742156 31308786 0.01660 85 76409 497898460 320053672 177844788 0.09440 1 150 355 355 0.00000 1 150 355 355 0.00000 1 56864546 233440234 382752499 -149312265 X 0 1 MILITARY ROAD PROPERTIES REAL ESTATE RENTAL 0.50000 0.00000 0.50000 2 PERFORMANCE MODALITIES INC DURABLE EQUIPMENT RENTAL 0.50000 0.00000 0.50000 6 1 ST JOSEPH MEDICAL CENTER 1717 SOUTH J STREET TACOMA WA 98405 VMFH.ORG/OUR-HOSPITALS/ST-JOSEPH-MEDIC HAC.FS.00000032 X X X X A 2 ST ANTHONY HOSPITAL 11567 CANTERWOOD BLVD NW GIG HARBOR WA 98332 VMFH.ORG/OUR-HOSPITALS/ST-ANTHONY-HOSP HAC.FS.60075769 X X X A 3 ST CLARE HOSPITAL 11315 BRIDGEPORT WAY SW LAKEWOOD WA 98499 VMFH.ORG/OUR-HOSPITALS/ST-CLARE-HOSPIT HAC.FS.00000132 X X X A 4 ST FRANCIS HOSPITAL 34515 9TH AVE S FEDERAL WAY WA 98003 VMFH.ORG/OUR-HOSPITALS/ST-FRANCIS-HOSP HAC.FS.00000201 X X X X A 5 CHI FRANCISCAN REHABILITATION HOSPITAL 815 S VASSAULT ST TACOMA WA 984652008 VMFH.ORG/OUR-HOSPITALS/REHABILITATION- HAC.FS.60833232 X REHAB HOSPITAL A 6 ST ANNE HOSPITAL 16251 SYLVESTER ROAD SW BURIEN WA 98166 VMFH.ORG/OUR-HOSPITALS/ST-ANNE-HOSPITA HAC.FS.00000126 X X X A FACILITY REPORTING GROUP - A 0 0 1 X X X X X X X X X 21 1 1 1 1 X SEE PART V, PAGE 8 X X 1 22 1 SEE PART V, PAGE 8 0 1 X 300.000000000000 400.000000000000 X X X X X X 1 1 X X X 1 X HTTPS://WWW.VMFH.ORG/BILLING-INSURANCE/FINANCIAL-ASSISTANCE-DISCOUNTS X HTTPS://WWW.VMFH.ORG/BILLING-INSURANCE/FINANCIAL-ASSISTANCE-DISCOUNTS X HTTPS://WWW.VMFH.ORG/BILLING-INSURANCE/FINANCIAL-ASSISTANCE-DISCOUNTS X X X X X X 1 X 0 X X X X 1 X 0 0 PART V, SECTION B, LINE 6A: ST. JOSEPH MEDICAL CENTER, ST. ANTHONY HOSPITAL, ST. CLARE HOSPITAL, CHI FRANCISCAN REHABILITATION HOSPITAL OTHER HOSPITALS WHO PARTICIPATED IN THE CHNA INCLUDE ALLENMORE HOSPITAL, GOOD SAMARITAN HOSPITAL, TACOMA GENERAL HOSPITAL, AND WELLFOUND BEHAVIORAL HEALTH HOSPITAL. ST. FRANCIS HOSPITAL, ST. ANNE HOSPITALTHE HOSPITAL SYSTEMS IN KING COUNTY COLLABORATE ON THE CHNA. THE HOSPITAL SYSTEMS WHICH PARTICIPATED IN THE CHNA INCLUDE, EVERGREEN HEALTH, KAISER PERMANENTE, MULTICARE HEALTH SYSTEM, OVERLAKE MEDICAL CENTER AND CLINICS, SEATTLE CANCER CARE ALLIANCE, SEATTLE CHILDREN'S, SWEDISH HEALTH SERVICES, AND UW MEDICINE. PART V, SECTION B, LINE 6B ST. JOSEPH MEDICAL CENTER, ST. ANTHONY HOSPITAL, ST. CLARE HOSPITAL, CHI FRANCISCAN REHABILITATION HOSPITAL VIRGINIA MASON FRANCISCAN HEALTH PARTNERS WITH THE TACOMA PIERCE COUNTY HEALTH DEPARTMENT TO COMPLETE AND COMPILE THE CHNA. ST. FRANCIS HOSPITAL, ST. ANNE HOSPITALPUBLIC HEALTH SEATTLE & KING COUNTY, NAVOS, WASHINGTON STATE HOSPITAL ASSOCIATION, KING COUNTY DEPARTMENT OF COMMUNITY AND HUMAN SERVICES, KING COUNTY PROSECUTING ATTORNEY'S OFFICE, AND URBAN INDIAN HEALTH INSTITUTE. PART V, LINE 3E THE SIGNIFICANT HEALTH NEEDS ARE A PRIORITIZED DESCRIPTION OF THE SIGNIFICANT HEALTH NEEDS OF THE COMMUNITY AS IDENTIFIED THROUGH THE CHNA. PART V, SECTION B FACILITY REPORTING GROUP A FACILITY REPORTING GROUP A CONSISTS OF: - FACILITY 1: ST. JOSEPH MEDICAL CENTER, - FACILITY 5: CHI FRANCISCAN REHABILITATION HOSPITAL, - FACILITY 2: ST. ANTHONY HOSPITAL, - FACILITY 3: ST. CLARE HOSPITAL, - FACILITY 4: ST. FRANCIS HOSPITAL, - FACILITY 6: ST. ANNE HOSPITAL FACILITY REPORTING GROUP - A PART V, SECTION B, LINE 5: ST. JOSEPH MEDICAL CENTER, ST. ANTHONY HOSPITAL, ST. CLARE HOSPITAL, CHI FRANCISCAN REHABILITATION HOSPITALVIRGINIA MASON FRANCISCAN HEALTH CONTRACTS WITH THE TACOMA PIERCE COUNTY HEALTH DEPARTMENT TO CONDUCT AND CREATE THE COMMUNITY HEALTH NEEDS ASSESSMENT. TO ENSURE MEANINGFUL COMMUNITY ENGAGEMENT, TWO METHODS WERE EMPLOYED TO GATHER AND RECEIVE INPUT - COMMUNITY FEEDBACK SESSIONS AND KEY INFORMANT INTERVIEWS. ASSESSMENT OUTREACH AND ENGAGEMENT WAS SPECIFICALLY DESIGNED TO ENSURE THAT THE VOICES OF OUR BLACK, INDIGENOUS, PERSONS OF COLOR, AND LGBTQ COMMUNITIES WERE REPRESENTED AND RECOGNIZED. THREE COMMUNITY WORKSHOPS WERE CONDUCTED TO HEAR DIRECTLY FROM RESIDENTS IN SMALL GROUP SETTINGS. POPULATIONS OF INTEREST WERE IDENTIFIED BASED ON GAPS IN PREVIOUS ASSESSMENTS AND RECOGNIZED HEALTH DISPARITIES, AND INCLUDED LGBTQ ADULTS, YOUTH AGES 14 - 17, AND PEOPLE EXPERIENCING HOMELESSNESS. ALL THREE GROUPS INCLUDED INDIVIDUALS REPRESENTING DIVERSITY IN RACE, ETHNICITY, GENDER, AND SEXUAL ORIENTATION. TEN KEY INFORMANT INTERVIEWS WERE CONDUCTED WITH COMMUNITY LEADERS ACROSS SEVEN SECTORS. THE FOLLOWING COMMUNITY ORGANIZATIONS WERE REPRESENTED IN THE KEY INFORMANT INTERVIEWS OR SUPPORTED THE FACILITATION OF THE FOCUS GROUPS: CENTRAL LATINO, CLOVER PARK SCHOOL DISTRICT, DEGREES OF CHANGE, EMERGENCY FOOD NETWORK, FIRST 5 FUNDAMENTALS, FRANKLIN PIERCE SCHOOL DISTRICT, GRADUATE TACOMA, TACOMA COMMUNITY FOUNDATION, MARY BRIDGE CHILDREN'S HOSPITAL, OASIS YOUTH CENTER, PIERCE COLLEGE, PIERCE TRANSIT, TACID, TACOMA COMMUNITY COLLEGE, TACOMA HOUSING AUTHORITY, TACOMA PIERCE COUNTY COALITION TO END HOMELESSNESS, TACOMA PUBLIC SCHOOLS, AND THE RAINBOW CENTER. ST. FRANCIS HOSPITAL, ST. ANNE HOSPITALTO ENSURE REPRESENTATION FROM THE COMMUNITY, NUMEROUS COMMUNITY-BASED ORGANIZATIONS, CLINICS, STATE AND LOCAL AGENCIES, COALITIONS, SCHOOLS AND HOSPITALS HAVE BEEN ENGAGED TO ELEVATE BOTH THE STRENGTHS AND CONCERNS OF THE COMMUNITIES SERVED. ADDITIONALLY, 48 LOCAL COMMUNITY NEEDS ASSESSMENTS, STRATEGIC PLANS, AND REPORTS (FROM 2018 TO 2020) THAT INCLUDED ASPECTS OF COMMUNITY ENGAGEMENT WERE REVIEWED TO IDENTIFY NEEDS, PROVIDE CONTEXT TO THE QUANTITATIVE DATA PRESENTED, AND ENHANCE OUR UNDERSTANDING OF KING COUNTY RESIDENTS' PRIORITIES AND STRENGTHS. THROUGH THE COMPREHENSIVE REVIEW OF THE REPORTS AND ASSESSMENTS INCLUDED IN THE CHNA, EACH REGION WITHIN KING COUNTY WAS REPRESENTED, AS WELL AS THE DIVERSE COMMUNITIES THAT MAKE UP THE SERVICE AREA. OF THE 48 ASSESSMENTS AND PLANS REVIEWED, APPROXIMATELY HALF WERE COMPLETED BY CITIES, COUNTIES, THE STATE, UNIVERSITIES, HOSPITALS AND HEALTH PLANS, WITH THE OTHER HALF COMPLETED BY COALITIONS, EDUCATIONAL DISTRICTS AND ORGANIZATIONS SERVING AND REPRESENTING DIVERSE COMMUNITY NEEDS AND PRIORITIES. FACILITY REPORTING GROUP - A PART V, SECTION B, LINE 7D: THE CHNA IS SHARED PUBLICLY WITH COMMUNITY PARTNERS AND MEMBERS OF THE COMMUNITY WHO PARTICIPATE IN HEALTH RELATED COALITIONS, PROGRAMS, AND EVENTS. FACILITY REPORTING GROUP - A PART V, SECTION B, LINE 11: ST. JOSEPH MEDICAL CENTER, ST. ANTHONY HOSPITAL. ST. CLARE HOSPITALSIGNIFICANT NEEDS IDENTIFIED IN THE CHNA INCLUDE ACCESS TO CARE, INCLUDING MATERNAL CHILD HEALTH, CHRONIC DISEASE, BEHAVIORAL HEALTH, AND VIOLENCE PREVENTION. THE HOSPITALS ARE TAKING ACTION AND DEDICATING RESOURCES TO ADDRESS EACH OF THESE PRIORITIES. ACCESS TO CARE: TOWARD IMPROVING ACCESS TO CARE FOR THOSE WHO ARE UNHOUSED, UNINSURED, UNDER-INSURED, OR EXPERIENCING DISPARITIES, THE HOSPITALS SUPPORTED NUMEROUS PROGRAMS TO INCREASE ACCESS TO CARE FOR THOSE IN NEED, INCLUDING COMMUNITY HEALTH EDUCATION, MATERNAL CHILD HEALTH PROGRAMS, FINANCIAL SUPPORT, AND DONATED CARE. THROUGH PROJECT ACCESS, INSURANCE PREMIUM SUPPORT, DONATED CARE, AND CARE COORDINATION FOR VULNERABLE COMMUNITY MEMBERS WAS PROVIDED. THE MEDICAL CENTERS ADDITIONALLY PROVIDED DEDICATED SUPPORT FOR MEDICAL RESPITE FOR UNHOUSED PATIENTS TO RECUPERATE FOLLOWING A HOSPITAL STAY. CARE MANAGEMENT STAFF PROVIDED PATIENT SUPPORT TO ASSIST WITH TRANSPORTATION, HOUSING, MEDICAL EQUIPMENT, CLOTHING, COUNSELING AND OTHER NEEDS. THROUGH THE WIC CLINICS, THE HOSPITALS PROVIDED SUPPLEMENTAL NUTRITION SUPPORT FOR LOW-INCOME, PREGNANT WOMEN AND FAMILIES. UNCONSUMED FOOD FROM HOSPITAL FOOD & NUTRITION SERVICES WAS DONATED TO HOT MEAL PROGRAMS. THROUGH A PARTNERSHIP WITH COMMUNITY PARTNERS, THE HOSPITALS PROVIDED MEDICALLY TAILORED MEALS TO PATIENTS WITH TRANSPORTATION BARRIERS. A COMMUNITIES OF FOCUS PROGRAM, IN PARTNERSHIP WITH THE TACOMA PIERCE COUNTY HEALTH DEPARTMENT ENGAGED RESIDENTS AND STAKEHOLDERS WITH HIGH RATES OF DISPARITIES AND HEALTH INEQUITY. GRANT FUNDING WAS PROVIDED TO COMMUNITY BASED ORGANIZATIONS TO ADDRESS ACCESS TO CARE. CHRONIC DISEASE: THE HOSPITALS CONTINUED ACTIVATION OF A CONGREGATIONAL MINISTRIES PROGRAM TO SUPPORT FAITH COMMUNITIES WITH THE CREATION OF HEALTH MINISTRIES TO FOSTER CHRONIC DISEASE PREVENTION AND EDUCATION. THROUGH PARTNERSHIP WITH THE TACOMA PIERCE COUNTY HEALTH DEPARTMENT, THE HOSPITALS PROVIDED STAFF AND PROGRAM SUPPORT TO REDUCE HEART FAILURE RATES, AS WELL AS DIABETES PROGRAMMING FOR NEWLY DIAGNOSED PATIENTS. BREAST CANCER EDUCATION AND SCREENING PROGRAMS WERE IMPLEMENTED, AS WELL AS BLOOD PRESSURE SCREENINGS. SUPPORT GROUPS FOR CANCER PATIENTS AND SURVIVORS WERE IMPLEMENTED MONTHLY. A MEDICALLY TAILORED FOOD BOX PROGRAM WAS IMPLEMENTED TO REDUCE FOOD INSECURITY AND TRANSPORTATION BARRIERS FOR CARDIOLOGY AND DIABETES PATIENTS. FOOD BANKS WERE PROVIDED WITH EDUCATIONAL MATERIALS AND PROGRAM SUPPORT TO IMPROVE HEALTHY EATING AMONG FOOD BANK RECIPIENTS. EDIBLE FOOD RECOVERY WAS ACTIVATED AT THE MEDICAL CENTER TO PROVIDE MEALS TO FOOD BANKS/HOT MEAL PROGRAMS. EDUCATIONAL PROGRAMS WERE HELD TO IMPROVE MATERNAL HEALTH. GRANT FUNDING WAS PROVIDED TO COMMUNITY BASED ORGANIZATIONS TO ADDRESS CHRONIC DISEASE. BEHAVIORAL HEALTH: THE HOSPITALS PARTNERED WITH CONCERT HEALTH TO PROVIDE VIRTUAL CONSULTATIONS AND CARE TO VULNERABLE PATIENTS. THROUGH A PARTNERSHIP WITH QUARTET HEALTH, THE SYSTEM PROVIDED VIRTUAL PSYCHIATRY TO MEDICAID PATIENTS WHO DO NOT HAVE A PRIMARY CARE PROVIDER OR ACCESS TO OTHER BEHAVIORAL HEALTH SERVICES. GRANT FUNDING WAS PROVIDED TO COMMUNITY BASED ORGANIZATIONS TO ADDRESS BEHAVIORAL HEALTH. VIOLENCE PREVENTION: IN PARTNERSHIP WITH REBUILDING HOPE, THE MEDICAL CENTERS CONTINUED SUPPORT OF MEDICAL ADVOCACY PROGRAMS FOR VICTIMS OF SEXUAL ASSAULT AND HUMAN TRAFFICKING. THE HOSPITALS PARTNERED WITH NUMEROUS COMMUNITY BASED ORGANIZATIONS FOCUSED ON YOUTH VIOLENCE PREVENTION TO PROVIDE FINANCIAL AND PROGRAM SUPPORT. CHI FRANCISCAN REHABILITATION HOSPITALSIGNIFICANT NEEDS IDENTIFIED IN THE CHNA INCLUDE ACCESS TO CARE INCLUDING MATERNAL CHILD HEALTH, CHRONIC DISEASE, BEHAVIORAL HEALTH, AND VIOLENCE PREVENTION. DUE TO THE SPECIALIZED NATURE OF THE FACILITY AND LIMITED RESOURCES, CHI FRANCISCAN REHABILITATION HOSPITAL IS TAKING ACTION AND DEDICATING RESOURCES TO ADDRESS ONLY ACCESS TO CARE AND CHRONIC DISEASE. ACCESS TO CARE: CHI FRANCISCAN REHABILITATION HOSPITAL CONTINUED TO BUILD CAPACITY AND OPEN MORE BEDS FOR PATIENTS NEEDING ACUTE REHABILITATION CARE. THE HOSPITAL MAKES ACCESS TO FINANCIAL ASSISTANCE EASY AND ACCESSIBLE FOR ALL WHO QUALIFY. CHI FRANCISCAN REHABILITATION HOSPITAL PROVIDED HOME VISITS TO PATIENTS TO ENSURE THE HOME IS READY FOR A PATIENT'S CONTINUED RECOVERY AND CONNECTED PATIENTS TO POST-ACUTE SERVICES. CHRONIC DISEASE: CHI FRANCISCAN REHABILITATION HOSPITAL SUPPORTS PATIENTS WITH CHRONIC CONDITIONS AND COORDINATES POST DISCHARGE FOLLOW UP FOR CONTINUING CARE. THE HOSPITAL PROVIDES PATIENT EDUCATION FROM AN INTERDISCIPLINARY TEAM TO ENSURE SUCCESSFUL CHRONIC DISEASE MANAGEMENT. CONTINUED FACILITY REPORTING GROUP - A PART V, SECTION B, LINE 13H: NO MINIMUM ACCOUNT BALANCE SHALL BE REQUIRED FOR A PATIENT TO QUALIFY FOR FINANCIAL ASSISTANCE.THE PATIENT MUST SUBMIT A COMPLETED FINANCIAL ASSISTANCE APPLICATION.PATIENT COOPERATION STANDARDS - A PATIENT MUST EXHAUST ALL OTHER PAYMENT OPTIONS, INCLUDING PRIVATE COVERAGE, FEDERAL, STATE AND LOCAL MEDICAL ASSISTANCE PROGRAMS, AND OTHER FORMS OF ASSISTANCE PROVIDED BY THIRD-PARTIES PRIOR TO BEING APPROVED. AN APPLICANT FOR FINANCIAL ASSISTANCE IS RESPONSIBLE FOR APPLYING TO PUBLIC PROGRAMS FOR AVAILABLE COVERAGE. HE OR SHE IS ALSO EXPECTED TO PURSUE PUBLIC OR PRIVATE HEALTH INSURANCE PAYMENT OPTIONS FOR CARE PROVIDED BY A COMMONSPIRIT HOSPITAL ORGANIZATION WITHIN A HOSPITAL FACILITY. A PATIENT'S AND, IF APPLICABLE, ANY GUARANTOR'S COOPERATION IN APPLYING FOR APPLICABLE PROGRAMS AND IDENTIFIABLE FUNDING SOURCES, INCLUDING COBRA COVERAGE (A FEDERAL LAW ALLOWING FOR A TIME-LIMITED EXTENSION OF EMPLOYEE HEALTHCARE BENEFITS), SHALL BE REQUIRED. IF A HOSPITAL FACILITY DETERMINES THAT COBRA COVERAGE IS POTENTIALLY AVAILABLE, AND THAT A PATIENT IS NOT A MEDICARE OR MEDICAID BENEFICIARY, THE PATIENT OR GUARANTOR SHALL PROVIDE THE HOSPITAL FACILITY WITH INFORMATION NECESSARY TO DETERMINE THE MONTHLY COBRA PREMIUM FOR SUCH PATIENT, AND SHALL COOPERATE WITH HOSPITAL FACILITY STAFF TO DETERMINE WHETHER HE OR SHE QUALIFIES FOR HOSPITAL FACILITY COBRA PREMIUM ASSISTANCE, WHICH MAY BE OFFERED FOR A LIMITED TIME TO ASSIST IN SECURING INSURANCE COVERAGE. A HOSPITAL FACILITY SHALL MAKE AFFIRMATIVE EFFORTS TO HELP A PATIENT OR PATIENT'S GUARANTOR APPLY FOR PUBLIC AND PRIVATE PROGRAMS."PATIENT COOPERATION STANDARDS," AS DEFINED IN THE FINANCIAL ASSISTANCE POLICY, SHALL ONLY APPLY TO THE EXTENT THEY:1) ALLOW THE HOSPITAL FACILITY TO PURSUE REIMBURSEMENT FROM ANY THIRD-PARTY COVERAGE THAT MAY BE IDENTIFIED TO THE HOSPITAL FACILITY, IN ACCORDANCE WITH WAC 246-453-020(1);2) ALLOW THE HOSPITAL FACILITY TO MAKE EVERY REASONABLE EFFORT TO DETERMINE THE EXISTENCE OR NONEXISTENCE OF THIRD-PARTY SPONSORSHIP THAT MIGHT COVER IN FULL OR IN PART THE CHARGES FOR SERVICES PROVIDED TO EACH PATIENT, IN ACCORDANCE WITH WAC246-453-020(4); AND3) DO NOT IMPOSE APPLICATION PROCEDURES FOR CHARITY CARE SPONSORSHIP WHICH PLACE AN UNREASONABLE BURDEN UPON THE RESPONSIBLE PARTY, TAKING INTO ACCOUNT ANY PHYSICAL, MENTAL, INTELLECTUAL, OR SENSORY DEFICIENCIES OR LANGUAGE BARRIERS WHICH MAY HINDER THE RESPONSIBLE PARTY'S CAPABILITY OF COMPLYING WITH THE APPLICATION PROCEDURES, IN ACCORDANCE WITH WAC 246-453-020(5).ELIGIBILITY FOR FINANCIAL ASSISTANCE SHALL NOT BE BASED ON A PERSON'S RESIDENCY. PART V, LINE 7A, CHNA ON HOSPITAL WEBSITE: HTTPS://WWW.VMFH.ORG/ABOUT-VMFH/WHY-CHOOSE-VMFH/REPORTS-TO-THE-COMMUNITY/COMMUNITY-HEALTH-NEEDS-ASSESSMENT PART V, LINE 10A, IMPLEMENTATION STRATEGY ON HOSPITAL WEBSITE: HTTPS://VMFH.ORG/ABOUT-VMFH/WHY-CHOOSE-VMFH/REPORTS-TO-THE-COMMUNITY/COMMUNITY-HEALTH-NEEDS-ASSESSMENT PART V, LINE 11, HOW ADDRESSING SIGNIFICANT NEEDS CONTINUED ST. FRANCIS HOSPITAL, ST. ANNE HOSPITAL SIGNIFICANT NEEDS IDENTIFIED IN THE CHNA INCLUDE ACCESS TO CARE, BEHAVIORAL HEALTH, CHRONIC DISEASE INCLUDING FOOD INSECURITY, AND VIOLENCE PREVENTION. THE HOSPITALS ARE TAKING ACTION AND DEDICATING RESOURCES TO ADDRESS EACH OF THESE PRIORITIES. ACCESS TO CARE: THE HOSPITALS PROVIDED FINANCIAL SUPPORT AND DONATED CARE TO PROJECT ACCESS PROGRAMS ACROSS THE SERVICE AREA, INCLUDING INSURANCE PREMIUM SUPPORT, DONATED CARE, AND CARE COORDINATION TO VULNERABLE COMMUNITY MEMBERS. THROUGH A COLLABORATION WITH LOCAL NON-PROFIT ORGANIZATIONS, THE HOSPITALS PROVIDED DEDICATED SPACE FOR UNHOUSED PATIENTS TO RECUPERATE AFTER A HOSPITAL STAY. CARE MANAGEMENT STAFF PROVIDED PATIENT SUPPORT TO ASSIST PATIENTS WITH TRANSPORTATION, HOUSING, MEDICAL EQUIPMENT, CLOTHING AND OTHER NEEDS. GRANT FUNDING WAS PROVIDED TO COMMUNITY BASED ORGANIZATIONS TO ADDRESS ACCESS TO CARE. BEHAVIORAL HEALTH: THROUGH A COLLABORATION WITH CONCERT HEALTH AND QUARTET HEALTH, THE HOSPITALS PROVIDED VIRTUAL CONSULTATIONS AND CARE TO VULNERABLE PATIENTS AND VIRTUAL PSYCHIATRY TO MEDICAID PATIENTS WHO DO NOT HAVE A PRIMARY CARE PROVIDER OR ACCESS TO OTHER BEHAVIORAL HEALTH SERVICES. GRANT FUNDING WAS PROVIDED TO COMMUNITY BASED ORGANIZATIONS TO ADDRESS BEHAVIORAL HEALTH.CHRONIC DISEASE: THE HOSPITALS CONTINUED ACTIVATION OF A CONGREGATIONAL MINISTRIES PROGRAM TO SUPPORT FAITH COMMUNITIES WITH THE CREATION OF HEALTH MINISTRIES TO FOSTER CHRONIC DISEASE PREVENTION AND EDUCATION. THE HOSPITALS CONDUCTED REGULAR BLOOD PRESSURE SCREENINGS AT EVENTS THROUGHOUT THE REGION, AND PROVIDED RESOURCES TO SUPPORT GROUPS FOR CANCER SURVIVORS FOCUSED ON KNITTING. IN COLLABORATION WITH COMMUNITY PARTNERS, THE HOSPITALS PROVIDED EDUCATION, SUPPORT AND RESOURCES TO COMMUNITY MEMBERS MANAGING DIABETES. GRANT FUNDING WAS PROVIDED TO COMMUNITY BASED ORGANIZATIONS TO ADDRESS CHRONIC DISEASE. VIOLENCE PREVENTION: THE HOSPITALS CONTINUED ACTIVATION OF A HUMAN TRAFFICKING TASK FORCE AND PARTICIPATED IN THE SOUTH KING COUNTY YOUTH VIOLENCE PREVENTION INITIATIVE TO WORK TOWARD PREVENTING VIOLENCE ACROSS KING COUNTY COMMUNITIES. ADDITIONAL SUPPORT WAS PROVIDED TO BUILD THE BRIDGE COALITION, WHICH BRINGS STAKEHOLDERS TOGETHER TO PLAN AND IMPLEMENT VIOLENCE PREVENTION PROGRAMS AND THE REACH OUT DES MOINES COALITION, DESIGNED TO CONNECT LOCAL ORGANIZATIONS, SCHOOLS, AND GOVERNMENTS TOWARD REDUCING YOUTH VIOLENCE. GRANT FUNDING WAS PROVIDED TO NUMEROUS COMMUNITY BASED ORGANIZATIONS FOR VIOLENCE PREVENTION. PART I, LINE 3C: UNLESS ELIGIBLE FOR PRESUMPTIVE FINANCIAL ASSISTANCE, THE FOLLOWING ELIGIBILITY CRITERIA MUST BE MET IN ORDER FOR A PATIENT TO QUALIFY FOR FINANCIAL ASSISTANCE: * NO MINIMUM ACCOUNT BALANCE SHALL BE REQUIRED FOR A PATIENT TO QUALIFY FOR FINANCIAL ASSISTANCE* PURSUANT TO THE TERMS OF THE FINANCIAL ASSISTANCE POLICY, UNLESS ELIGIBLE FOR PRESUMPTIVE FINANCIAL ASSISTANCE, CERTAIN ELIGIBILITY CRITERIA MUST BE MET IN ORDER FOR A PATIENT TO QUALIFY FOR FINANCIAL ASSISTANCE. THIS ADDENDUM UPDATES SUCH ELIGIBILITY CRITERIA WITH THE FOLLOWING:1. ANY PATIENT WHOSE FAMILY INCOME IS AT OR BELOW 300% PERCENT OF THE FPL SHALL RECEIVE A FULL DISCOUNT FROM THEIR ACCOUNT BALANCE FOR APPROPRIATE HOSPITAL BASED MEDICAL SERVICES AND EMERGENCY CARE OR EMERGENCY SERVICES PROVIDED TO THE PATIENT AFTER PAYMENT, IF ANY, BY THIRD-PARTY PAYERS OR SPONSORS. 2. ANY PATIENT WHOSE FAMILY INCOME IS BETWEEN 301% TO 350% OF THE FPL SHALL RECEIVE DISCOUNTED CARE UP TO 75%, WHICH MAY BE REDUCED FROM THEIR ACCOUNT BALANCE FOR APPROPRIATE HOSPITAL BASED MEDICAL SERVICES AND EMERGENCY CARE OR EMERGENCY SERVICES PROVIDED TO THE PATIENT AFTER PAYMENT, IF ANY, BY THIRD-PARTY PAYERS OR SPONSORS, AND ANY AMOUNTS REASONABLY RELATED TO ASSETS CONSIDERED AS SET FORTH IN THE HOSPITAL FACILITY'S POLICY ON ASSET TESTING. 3. ANY PATIENT WHOSE FAMILY INCOME IS BETWEEN 351% TO 400% OF THE FPL SHALL RECEIVE DISCOUNTED CARE UP TO 50% FROM THEIR ACCOUNT BALANCE FOR APPROPRIATE HOSPITAL BASED MEDICAL SERVICES AND EMERGENCY CARE OR EMERGENCY SERVICES PROVIDED TO THE PATIENT AFTER PAYMENT, IF ANY, BY ANY THIRD-PARTY PAYERS OR SPONSORS, AND ANY AMOUNTS REASONABLY RELATED TO ASSETS CONSIDERED AS SET FORTH IN THE HOSPITAL FACILITY'S POLICY ON ASSET TESTING. 4. IN THE EVENT A HOSPITAL FACILITY PROVIDES DISCOUNTED CARE GREATER THAN WHAT IS REQUIRED ABOVE (EITHER THROUGH AMOUNTS GENERALLY BILLED ("AGB"), SELF-PAY, OR OTHER DISCOUNTS) THE PATIENT SHALL RECEIVE THAT GREATER DISCOUNTED CARE AMOUNT.* WITH RESPECT TO THOSE ASSETS THAT MAY BE TAKEN INTO CONSIDERATION, HOSPITAL FACILITY WILL SEEK ONLY SUCH INFORMATION REGARDING ASSETS AS IS REASONABLY NECESSARY AND READILY AVAILABLE TO DETERMINE THE EXISTENCE, AVAILABILITY, AND VALUE OF SUCH ASSETS.1. HOSPITAL FACILITY WILL CONSIDER ASSETS AND COLLECT INFORMATION RELATED TO SUCH ASSETS AS REQUIRED BY THE CENTERS FOR MEDICARE AND MEDICAID ("CMS") FOR MEDICARE COST REPORTING. SUCH INFORMATION MAY INCLUDE REPORTING OF ASSETS CONVERTIBLE TO CASH AND UNNECESSARY FOR THE PATIENT'S DAILY LIVING.2. DUPLICATE FORMS OF VERIFICATION WILL NOT BE REQUESTED AND ONLY ONE CURRENT ACCOUNT STATEMENT IS REQUIRED TO VERIFY MONETARY ASSETS.3. IF NO DOCUMENTATION FOR AN ASSET IS AVAILABLE, A WRITTEN AND SIGNED STATEMENT FROM THE PATIENT OR GUARANTOR IS SUFFICIENT.4. ASSET INFORMATION WILL NOT BE USED FOR COLLECTION ACTIVITIES.THE FOLLOWING TYPES OF ASSETS SHALL BE EXCLUDED FROM CONSIDERATION:-THE FIRST $5,000 OF MONETARY ASSETS FOR AN INDIVIDUAL OR $8,000 OF MONETARY ASSETS FOR A FAMILY OF TWO, PLUS AN ADDITIONAL $1,500 OF MONETARY ASSETS FOR EACH ADDITIONAL FAMILY MEMBER. THE VALUE OF ANY ASSET THAT HAS A PENALTY FOR EARLY WITHDRAWAL SHALL BE THE VALUE OF THE ASSET AFTER THE PENALTY HAS BEEN PAID;-ANY EQUITY IN A PRIMARY RESIDENCE;RETIREMENT PLANS OTHER THAN 401(K) PLANS;-ONE MOTOR VEHICLE AND A SECOND MOTOR VEHICLE IF IT IS NECESSARY FOR EMPLOYMENT OR MEDICAL PURPOSES;-ANY PREPAID BURIAL CONTRACT OR BURIAL PLOT; AND-ANY LIFE INSURANCE POLICY WITH A FACE VALUE OF $10,000 OR LESS ASSISTANCE IS OFFERED TO THOSE WHOSE ANNUAL FAMILY INCOME FALLS WITHIN THE CATEGORIES ABOVE AND HAVE:-COOPERATED WITH EFFORTS TO EXHAUST ALL OTHER PAYMENT OPTIONS; AND-COMPLETED A FINANCIAL ASSISTANCE APPLICATION AND PROVIDED SUFFICIENT SUPPORT TO VERIFY INCOME. IN SOME CASES, PATIENTS MAY BE AWARDED FINANCIAL ASSISTANCE WITHOUT A FORMAL APPLICATION. DETAILS ARE OUTLINED IN THE FINANCIAL ASSISTANCE POLICYTHE PATIENT COOPERATION STANDARDS AS DEFINED IN THE FINANCIAL ASSISTANCE POLICY, SHALL ONLY APPLY TO THE EXTENT THEY:1) ALLOW THE HOSPITAL FACILITY TO PURSUE REIMBURSEMENT FROM ANY THIRD-PARTY COVERAGE THAT MAY BE IDENTIFIED TO THE HOSPITAL FACILITY, IN ACCORDANCE WITH WAC 246-453-020(1);2) ALLOW THE HOSPITAL FACILITY TO MAKE EVERY REASONABLE EFFORT TO DETERMINE THE EXISTENCE OR NONEXISTENCE OF THIRD-PARTY SPONSORSHIP THAT MIGHT COVER IN FULL OR IN PART THE CHARGES FOR SERVICES PROVIDED TO EACH PATIENT, IN ACCORDANCE WITH WAC 246-453-020(4); AND3) DO NOT IMPOSE APPLICATION PROCEDURES FOR CHARITY CARE SPONSORSHIP WHICH PLACE AN UNREASONABLE BURDEN UPON THE RESPONSIBLE PARTY, TAKING INTO ACCOUNT ANY PHYSICAL, MENTAL, INTELLECTUAL, OR SENSORY DEFICIENCIES OR LANGUAGE BARRIERS WHICH MAY HINDER THE RESPONSIBLE PARTY'S CAPABILITY OF COMPLYING WITH THE APPLICATION PROCEDURES, IN ACCORDANCE WITH WAC 246-453-020(5).ELIGIBILITY FOR FINANCIAL ASSISTANCE SHALL NOT BE BASED ON A PERSON'S RESIDENCY.COMMONSPIRIT HOSPITAL ORGANIZATIONS RECOGNIZE THAT NOT ALL PATIENTS AND GUARANTORS ARE ABLE TO COMPLETE THE FINANCIAL ASSISTANCE APPLICATION OR PROVIDE REQUISITE DOCUMENTATION. FINANCIAL COUNSELORS ARE AVAILABLE AT EACH HOSPITAL FACILITY LOCATION TO ASSIST ANY INDIVIDUAL SEEKING APPLICATION ASSISTANCE. FOR PATIENTS AND GUARANTORS WHO ARE UNABLE TO PROVIDE REQUIRED DOCUMENTATION, A HOSPITAL FACILITY MAY GRANT PRESUMPTIVE FINANCIAL ASSISTANCE BASED ON INFORMATION OBTAINED FROM OTHER RESOURCES. IN PARTICULAR, PRESUMPTIVE ELIGIBILITY MAY BE DETERMINED ON THE BASIS OF INDIVIDUAL LIFE CIRCUMSTANCES THAT MAY INCLUDE:-RECIPIENT OF STATE-FUNDED PRESCRIPTION PROGRAMS;-HOMELESS OR ONE WHO RECEIVED CARE FROM A HOMELESS OR FREE CARE CLINIC;-PARTICIPATION IN WOMEN, INFANTS AND CHILDREN PROGRAMS (WIC);-FOOD STAMP ELIGIBILITY;-ELIGIBILITY OR REFERRALS FOR OTHER STATE OR LOCAL ASSISTANCE PROGRAMS (E.G., MEDICAID);-LOW INCOME/SUBSIDIZED HOUSING IS PROVIDED AS A VALID ADDRESS; OR-PATIENT IS DECEASED WITH NO KNOWN SPOUSE OR KNOWN ESTATE.IN THE EVENT THE RESPONSIBLE PARTY'S IDENTIFICATION AS AN INDIGENT PERSON IS OBVIOUS TO HOSPITAL FACILITY PERSONNEL, AND THE HOSPITAL FACILITY PERSONNEL ARE ABLE TO ESTABLISH THE POSITION OF THE INCOME LEVEL WITHIN THE BROAD CRITERIA DESCRIBED IN WAC 246-453-040, BASED ON THE INDIVIDUAL LIFE CIRCUMSTANCES CONTAINED WITHIN THE FINANCIAL ASSISTANCE POLICY OR OTHERWISE, THE HOSPITAL FACILITY IS NOT OBLIGATED TO ESTABLISH THE EXACT INCOME LEVEL OR TO REQUEST DOCUMENTATION FROM THE RESPONSIBLE PARTY, UNLESS THE RESPONSIBLE PARTY REQUESTS FURTHER REVIEW.HOSPITAL FACILITIES SHALL MAKE EVERY REASONABLE EFFORT TO REACH INITIAL AND FINAL DETERMINATIONS OF ELIGIBILITY FOR FINANCIAL ASSISTANCE IN A TIMELY MANNER. NEVERTHELESS, HOSPITAL FACILITIES SHALL MAKE THOSE DETERMINATIONS AT ANY TIME, EVEN AFTER THE APPLICATION PERIOD, UPON LEARNING OF FACTS OR RECEIVING THE DOCUMENTATION DESCRIBED HEREIN, INDICATING THAT THE RESPONSIBLE PARTY'S INCOME IS EQUAL TO OR BELOW THREE HUNDRED PERCENT (300%) OF THE FEDERAL POVERTY GUIDELINES AS ADJUSTED FOR FAMILY SIZE. THE TIMING OF REACHING A FINAL DETERMINATION OF ELIGIBILITY FOR FINANCIAL ASSISTANCE SHALL HAVE NO BEARING ON THE HOSPITAL FACILITY'S IDENTIFICATION OF CHARITY CARE DEDUCTIONS FROM REVENUE AS DISTINCT FROM BAD DEBTS. WAC 246-453-020(10). PART I, LINE 7: THE HOSPITALS USE AN ADJUSTED COST TO CHARGE RATIO (CCR) CALCULATED IN A MANNER CONSISTENT WITH WORKSHEET 2 FOR EACH REPORTING FACILITY, TO DERIVE THE REPORTED COSTS OF FINANCIAL ASSISTANCE, MEDICAID AND OTHER MEANS-TESTED PROGRAMS. WORKSHEET 3 IS USED IN THE COMMUNITY BENEFIT INVENTORY FOR SOCIAL ACCOUNTABILITY (CBISA) SOFTWARE TO CALCULATE MEDICAID AND OTHER MEANS-TESTED PROGRAMS EXPENSE AND REVENUE, INCLUDING WHERE APPLICABLE MEDICAID PROVIDER FEES AND PAYMENTS FROM UNCOMPENSATED CARE PROGRAMS. ACTUAL OR ESTIMATED COST AND ANY DIRECT OFFSETTING REVENUE IS REPORTED, AND SCHEDULE H WORKSHEETS OR THEIR EQUIVALENTS ARE USED, FOR OTHER COMMUNITY BENEFIT ACTIVITIES INCLUDING COMMUNITY HEALTH IMPROVEMENT SERVICES, COMMUNITY BENEFIT OPERATIONS, HEALTH PROFESSIONS EDUCATION, SUBSIDIZED HEALTH SERVICES, RESEARCH, AND CASH AND IN-KIND DONATIONS. PART II, COMMUNITY BUILDING ACTIVITIES: FRANCISCAN HEALTH SYSTEM PROVIDES JOB SHADOW OPPORTUNITIES TO RESIDENTS EXPLORING HEALTH CARE CAREERS OR SEEKING ENTRY INTO JOB TRAINING PROGRAMS. PART III, LINE 2: THE AMOUNT OF THE ORGANIZATION'S BAD DEBT AT COST IS DETERMINED BY APPLYING THE COST TO CHARGE RATIO TO PATIENT CHARGES THAT ARE DEEMED TO BE UNCOLLECTIBLE. THIS AMOUNT REPRESENTS THE COST OF SERVICES PROVIDED TO PATIENTS WHO ARE UNABLE OR REFUSE TO PAY THEIR BILLS AND DO NOT QUALIFY FOR FREE OR ADDITIONAL DISCOUNTED CARE, GOVERNMENT SPONSORED PROGRAMS OR OTHER PAYMENT ASSISTANCE, AND ARE OTHERWISE UNINSURED.THE FILING ORGANIZATION PROVIDES FREE CARE TO ANY PATIENT WHOSE FAMILY INCOME IS AT OR BELOW 300% OF THE FEDERAL POVERTY LEVEL, OR DISCOUNTED CARE TO UNINSURED OR UNDER-INSURED INDIVIDUALS WHOSE FAMILY INCOME IS ABOVE 301% BUT LOWER THAN 400% OF THE FEDERAL POVERTY LEVEL. THE FILING ORGANIZATION ALSO PROVIDES OPTIONS FOR INTEREST-FREE EXTENDED PAYMENT PLANS FOR PATIENTS WHO HAVE DEMONSTRATED GOOD FAITH AND ARE COOPERATING IN RESOLVING THEIR HOSPITAL BILLS. ALL ACCOUNTS FOR ELIGIBLE UNINSURED PATIENTS AT ALL FACILITIES RECEIVE AN AUTOMATIC UNINSURED DISCOUNT. THE EXPECTED PATIENT PAYMENT AMOUNT ON THE PATIENT'S BILL REFLECTS THIS DISCOUNT. DISCOUNTS ARE ACCOUNTED FOR AS DEDUCTIONS FROM REVENUE, NOT AS BAD DEBT EXPENSE PART III, LINE 3: FRANCISCAN HEALTH SYSTEM MAKES EVERY EFFORT TO DETERMINE IF A PATIENT QUALIFIES FOR FINANCIAL ASSISTANCE UPON ADMISSION. FRANCISCAN HEALTH SYSTEM'S FINANCIAL ASSISTANCE POLICY IS COMMUNICATED TO PATIENTS UPON ADMISSION AND IS AVAILABLE IN THE LANGUAGES PRIMARILY SPOKEN IN THE COMMUNITY. IT IS ALSO POSTED IN VARIOUS COMMON AREAS OF THE HOSPITAL, SUCH AS EMERGENCY ROOMS, URGENT CARE CENTERS, ADMITTING AND REGISTRATION DEPARTMENTS, HOSPITAL BUSINESS OFFICES LOCATED ON FACILITY CAMPUSES, AND OTHER PUBLIC PLACES, AND IS PROVIDED UPON BILLING IF ELIGIBILITY IS NOT PREVIOUSLY DETERMINED. ELIGIBILITY IS REEVALUATED AS NEEDED AND AMOUNTS ARE CLASSIFIED AS CHARITY AS SOON AS ELIGIBILITY IS KNOWN. FRANCISCAN HEALTH SYSTEM ALSO UTILIZES A WAYSTAR SCORING SYSTEM TO ASSIST IN DETERMINING IF A PATIENT MAY QUALIFY FOR PAYMENT ASSISTANCE EVEN THOUGH THEY HAVE NOT APPLIED FOR IT. WAYSTAR USES A METHODOLOGY THAT APPLIES CONSISTENT SCREENING AND APPLICATION STANDARDS TO ALL PATIENTS UTILIZING HISTORICAL DATA TO DEVELOP A PREDICTIVE MODEL FOR HEALTHCARE PAYMENT ASSISTANCE. IN ITS DEVELOPMENT, SPECIAL ATTENTION WAS PAID TO THOSE SOCIOECONOMIC FACTORS THAT MIGHT ADVERSELY AFFECT THOSE PATIENTS DESERVING THE MOST ATTENTION. OTHER CRITERIA ARE ALSO UTILIZED TO ENSURE THAT SERVICES THAT HAVE QUALIFIED AS FINANCIAL ASSISTANCE ARE NOT REPORTED AS BAD DEBT. AS SUCH, FRANCISCAN HEALTH SYSTEM DOES NOT BELIEVE THAT ANY AMOUNTS INCLUDED IN PART III, LINE 2, ARE ATTRIBUTABLE TO PATIENTS ELIGIBLE UNDER THE ORGANIZATION'S PAYMENT ASSISTANCE POLICY, AND THEREFORE, NO PORTION OF BAD DEBT EXPENSE IS INCLUDED AS COMMUNITY BENEFIT EXPENSE. PART III, LINE 4: FRANCISCAN HEALTH SYSTEM DOES NOT ISSUE SEPARATE COMPANY AUDITED FINANCIAL STATEMENTS. HOWEVER, THE ORGANIZATION IS INCLUDED IN THE CONSOLIDATED FINANCIAL STATEMENTS OF COMMONSPIRIT HEALTH. THE FOLLOWING IS AN EXCERPT FROM COMMONSPIRIT'S CONSOLIDATED ANNUAL AUDITED FINANCIAL STATEMENTS FOR THE YEAR ENDED JUNE 30, 2024, RELATED TO PATIENT ACCOUNTS RECEIVABLE AND NET PATIENT REVENUE. THE ENTIRE FOOTNOTE CAN BE VIEWED IN THE ATTACHED COMMONSPIRIT CONSOLIDATED FINANCIAL STATEMENTS ON PAGES 11-12."PATIENT SERVICE REVENUE IS REPORTED AT THE AMOUNTS THAT REFLECT THE CONSIDERATION COMMONSPIRIT EXPECTS TO BE PAID IN EXCHANGE FOR PROVIDING PATIENT CARE. THESE AMOUNTS ARE DUE FROM PATIENTS, THIRD-PARTY PAYORS (INCLUDING HEALTH INSURERS AND GOVERNMENT PROGRAMS), AND OTHERS, AND INCLUDE CONSIDERATION FOR RETROACTIVE REVENUE ADJUSTMENTS DUE TO SETTLEMENT OF AUDITS AND REVIEWS. GENERALLY, PERFORMANCE OBLIGATIONS FOR PATIENTS RECEIVING INPATIENT ACUTE CARE SERVICES AND OUTPATIENT SERVICES ARE RECOGNIZED OVER TIME AS SERVICES ARE PROVIDED. NET PATIENT REVENUE IS PRIMARILY COMPRISED OF HOSPITAL AND PHYSICIAN SERVICES." PART III, LINE 8: COMMONSPIRIT HEALTH HOSPITALS PREPARE MEDICARE COST REPORTS IN A MANNER THAT COMPORTS WITH PROVIDER REIMBURSEMENT MANUAL (PRM) 15-1 AND PRM 15-2 CHAPTER 40 (TRANSMITTAL 13). AS SUCH, THE FOLLOWING LANGUAGE PER PRM 15-1 DESCRIBES THE COMPUTATION OF COSTS PER THE MEDICARE COST REPORT: TOTAL ALLOWABLE COSTS OF A PROVIDER ARE APPORTIONED BETWEEN PROGRAM BENEFICIARIES AND OTHER PATIENTS SO THAT THE SHARE BORNE BY THE PROGRAM IS BASED UPON ACTUAL SERVICES RECEIVED BY PROGRAM BENEFICIARIES. THE RATIO OF COVERED BENEFICIARY CHARGES TO TOTAL PATIENT CHARGES FOR THE SERVICES OF EACH ANCILLARY DEPARTMENT IS APPLIED TO THE COST OF THE DEPARTMENT. ADDED TO THIS AMOUNT IS THE COST OF ROUTINE SERVICES FOR PROGRAM BENEFICIARIES, DETERMINED ON THE BASIS OF A SEPARATE AVERAGE COST PER DIEM FOR ALL PATIENTS FOR GENERAL ROUTINE PATIENT CARE AREAS. ANOTHER FACTOR CONSIDERED IS A SEPARATE AVERAGE COST PER DIEM FOR EACH INTENSIVE CARE UNIT, CORONARY CARE UNIT, AND OTHER SPECIAL CARE INPATIENT HOSPITAL UNITS. COMMONSPIRIT HEALTH AND ITS SUBORDINATE CORPORATIONS BELIEVE THAT THE ENTIRE MEDICARE SHORTFALL FOR THE CONSOLIDATED ENTITIES CONSTITUTES COMMUNITY BENEFIT. THE IRS COMMUNITY BENEFIT STANDARD INCLUDES THE PROVISION OF CARE TO THE ELDERLY AND MEDICARE PATIENTS. MEDICARE SHORTFALLS MUST BE ABSORBED BY COMMONSPIRIT HEALTH HOSPITALS IN ORDER TO CONTINUE TREATING THE ELDERLY IN OUR COMMUNITIES. THE HOSPITALS PROVIDE CARE REGARDLESS OF THIS SHORTFALL AND THEREBY RELIEVE THE FEDERAL GOVERNMENT OF THE BURDEN OF PAYING THE FULL COST FOR MEDICARE BENEFICIARIES. FRANCISCAN HEALTH SERVICES'S SHORTFALL, AS REPORTED ON PART III, SECTION B, LINE 7, OF $(149,312,265)REPRESENTS THE FILING ORGANIZATION'S MEDICARE COST REPORTS. PART III, LINE 9B: COMMONSPIRIT HEALTH ENSURES THAT PATIENT ACCOUNTS ARE PROCESSED FAIRLY AND CONSISTENTLY. COMMONSPIRIT HEALTH'S BILLING AND COLLECTION POLICY CONTAINS PROVISIONS THAT PROHIBIT THE COLLECTION OF AMOUNTS DUE FROM PATIENTS WHO THE ORGANIZATION KNOWS QUALIFY FOR FINANCIAL ASSISTANCE. ACCOUNTS WITH INCORRECT OR INCOMPLETE DEMOGRAPHIC INFORMATION ARE ASSIGNED TO A COLLECTION AGENCY IF THE COMMONSPIRIT HEALTH FACILITY, OR BILLING COMPANY RETAINED BY COMMONSPIRIT HEALTH, IS UNABLE TO OBTAIN AN UPDATED ADDRESS THROUGH SKIP TRACING OR OTHER MEANS. FOR PATIENTS WHO HAVE AN APPLICATION PENDING FOR EITHER GOVERNMENT-SPONSORED ASSISTANCE OR FOR ASSISTANCE UNDER COMMONSPIRIT HEALTH'S FINANCIAL ASSISTANCE POLICY, OR WHERE THE PATIENT IS ATTEMPTING IN GOOD FAITH TO SETTLE AN OUTSTANDING BILL WITH THE FACILITY VIA PAYMENT PLANS, COMMONSPIRIT HEALTH WILL NOT KNOWINGLY SEND THAT PATIENT'S BILL TO AN OUTSIDE COLLECTION AGENCY. ON SELF-PAY ACCOUNTS THAT DO NOT MEET THE CRITERIA NOTED ABOVE, THE INITIAL DETERMINATION OF ASSIGNMENT TO A COLLECTION AGENCY WILL VARY DEPENDING ON THE NATURE OF THE ACCOUNT WITH THE FINAL DECISION BEING AT THE DISCRETION OF THE BILLING COMPANY RETAINED BY COMMONSPIRIT HEALTH. UPON ASSIGNMENT OF SUCH A PATIENT ACCOUNT TO A COLLECTION AGENCY, COMMONSPIRIT HEALTH REQUIRES THE AGENCY TO COMPLY WITH THE FAIR DEBT COLLECTION PRACTICES ACT. PART VI, LINE 2: VIRGINIA MASON FRANCISCAN HEALTH STAFF ARE ACTIVE MEMBERS OF NUMEROUS COMMUNITY COALITIONS AND COMMITTEES THROUGHOUT THE SERVICE AREA TO ASCERTAIN THE HEALTH CARE NEEDS OF THE COMMUNITIES WE SERVE. PART VI, LINE 3: INFORMATION ABOUT COMMONSPIRIT HEALTH'S FINANCIAL ASSISTANCE PROGRAM AND A CONTACT NUMBER ARE MADE AVAILABLE TO PATIENTS AND THE PUBLIC. PATIENTS ARE INFORMED OF COMMONSPIRIT HEALTH'S FINANCIAL ASSISTANCE PROGRAM VIA SIGNAGE IN ALL ADMITTING AREAS AND IN VARIOUS COMMON AREAS OF THE HOSPITAL. FINANCIAL ASSISTANCE PROGRAM INFORMATION NOTICES ARE POSTED IN THE EMERGENCY AND ADMITTING DEPARTMENTS AND AT OTHER PUBLIC PLACES AS EACH FACILITY MAY ELECT. SUCH INFORMATION IS PROVIDED IN THE PRIMARY LANGUAGES SPOKEN IN THE COMMUNITIES COMMONSPIRIT HEALTH SERVES. THE SIGNAGE INCLUDES NOTIFICATION THAT FURTHER DISCOUNTS MAY BE PROVIDED UPON THE COMPLETION AND SUBMISSION OF A FINANCIAL ASSISTANCE APPLICATION AND HOW TO REACH STAFF THAT CAN ASSIST WITH ANSWERING QUESTIONS AND GUIDE PATIENTS THROUGH THE APPLICATION PROCESS. INFORMATION CAN ALSO BE FOUND ON THE FACILITY WEBSITES. IF FINANCIAL ASSISTANCE ELIGIBILITY IS NOT DETERMINED PRIOR TO BILLING, INITIAL BILLING STATEMENTS TO PATIENTS INCLUDE A REQUEST TO THE PATIENT TO PROVIDE ANY INSURANCE INFORMATION THAT WAS VALID FOR THE DATES OF SERVICE BILLED AND A STATEMENT INFORMING PATIENTS HOW TO CONTACT US REGARDING FINANCIAL ASSISTANCE. ADDITIONALLY, CONTRACT TERMS WITH COLLECTION VENDORS WORKING ON BEHALF OF COMMONSPIRIT HEALTH REQUIRE THEY FOLLOW COMMONSPIRIT HEALTH FINANCIAL ASSISTANCE POLICY. ALSO, REFERRAL OF PATIENTS FOR FINANCIAL ASSISTANCE MAY BE MADE BY ANY MEMBER OF THE COMMONSPIRIT HOSPITAL ORGANIZATION NON-MEDICAL OR MEDICAL STAFF, INCLUDING PHYSICIANS, NURSES, FINANCIAL COUNSELORS, SOCIAL WORKERS, CASE MANAGERS, CHAPLAINS, AND RELIGIOUS SPONSORS. A REQUEST FOR ASSISTANCE MAY BE MADE BY THE PATIENT OR A FAMILY MEMBER, CLOSE FRIEND OR ASSOCIATE OF THE PATIENT, SUBJECT TO APPLICABLE PRIVACY LAWS. PART VI, LINE 4: ST. JOSEPH MEDICAL CENTER, ST. ANTHONY HOSPITAL, ST. CLARE HOSPITAL, CHI FRANCISCAN REHABILITATION HOSPITAL THE PRIMARY SERVICE AREA IS PIERCE COUNTY, WASHINGTON, WHICH HAS A POPULATION OF MORE THAN 900,000 RESIDENTS. THE COMPOSITION OF THE COUNTY IS PRIMARILY NON-HISPANIC, WHITE RESIDENTS, WITH THE HISPANIC POPULATION REPRESENTING 11% OF THE POPULATION. THE PROPORTION OF ADULTS 55 YEARS AND OLDER CONTINUES TO INCREASE. FOR THE PERIOD 2015 - 2017, THE SERVICE AREA REFLECTS 404,000 MEDICAID BENEFICIARIES. NEARLY HALF OF PIERCE COUNTY STUDENTS ARE ELIGIBLE FOR FREE OR REDUCED PRICE LUNCH. THE FOUR-YEAR AVERAGE PERCENTAGE OF ADULTS AGED 25 YEARS AND OLDER WHO EARNED A BACHELOR'S DEGREE IS LOWER IN PIERCE COUNTY COMPARED TO THE STATE AVERAGE. OVERALL, LIFE EXPECTANCY WITHIN THE SERVICE AREA IS SIGNIFICANTLY LOWER AS COMPARED TO THE STATEWIDE AVERAGE. INDIVIDUALS IDENTIFYING WITH MORE THAN ONE RACE HAVE THE LONGEST LIFE EXPECTANCY, WHILE NATIVE HAWAIIAN/OTHER PACIFIC ISLANDERS EXPERIENCE THE SHORTEST LIFE EXPECTANCY. ST. FRANCIS HOSPITAL, ST ANNE HOSPITALTHE PRIMARY SERVICE AREA FOR ST. FRANCIS HOSPITAL AND ST. ANNE HOSPITAL IS KING COUNTY, WA. KING COUNTY HAS OVER 2.1 MILLION RESIDENTS AND COVERS OVER 2,300 SQUARE MILES. THE COMMUNITY IS INCREASING ITS RACIAL AND ETHNIC DIVERSITY. THE POPULATION OF CHILDREN UNDER 18 IS NOW 53% PEOPLE OF COLOR. ONE IN FOUR KING COUNTY RESIDENTS LIVE IN A HOUSEHOLD WHERE A LANGUAGE OTHER THAN ENGLISH IS SPOKEN. ONE IN FIVE RESIDENTS LIVE IN POVERTY OR NEAR POVERTY. RACIAL AND ETHNIC GAPS IN HEALTH AND WEALTH HAVE BEEN DOCUMENTED AND INCLUDE GAPS IN HOUSEHOLD NET WORTH, EDUCATIONAL ATTAINMENT, HOUSEHOLD INCOME, UNEMPLOYMENT, FOOD SECURITY, HOUSING, AND TRANSPORTATION. FOR THE PURPOSES OF THE CHNA, THE COUNTY HAS BEEN DIVIDED INTO FOUR REGIONS: THE NORTH REGION, SEATTLE, THE EAST REGION, AND THE SOUTH REGION. THE SOUTH REGION OF THE COUNTY IS DISPROPORTIONATELY IMPACTED WITH SIGNIFICANT GAPS IN BOTH HEALTH AND WEALTH. PART VI, LINE 5: FINANCIAL ASSISTANCE: IT IS THE POLICY OF COMMONSPIRIT HEALTH TO PROVIDE, WITHOUT DISCRIMINATION, EMERGENCY MEDICAL CARE AND MEDICALLY NECESSARY CARE IN COMMONSPIRIT HOSPITAL FACILITIES TO ALL PATIENTS, WITHOUT REGARD TO A PATIENT'S FINANCIAL ABILITY TO PAY. THIS HOSPITAL HAS A FINANCIAL ASSISTANCE POLICY THAT DESCRIBES THE ASSISTANCE PROVIDED TO PATIENTS FOR WHOM IT WOULD BE A FINANCIAL HARDSHIP TO FULLY PAY THE EXPECTED OUT-OF-POCKET EXPENSES FOR SUCH CARE, AND WHO MEET THE ELIGIBILITY CRITERIA FOR SUCH ASSISTANCE. THE FINANCIAL ASSISTANCE POLICY, A PLAIN LANGUAGE SUMMARY AND RELATED MATERIALS ARE AVAILABLE IN MULTIPLE LANGUAGES ON THE HOSPITAL'S WEBSITE.USE OF SURPLUS FUNDS: AS A NOT-FOR-PROFIT HOSPITAL ORGANIZATION DEDICATED TO IMPROVING THE QUALITY OF LIFE, THE HOSPITAL REINVESTS ALL OF ITS SURPLUS FUNDS FROM OPERATING AND INVESTMENT ACTIVITIES TO IMPROVE THE QUALITY OF PATIENT CARE, EXPAND AND REPLACE EXISTING FACILITIES AND EQUIPMENT, INVEST IN TECHNOLOGICAL ADVANCEMENTS, SUPPORT COMMUNITY HEALTH PROGRAMS, AND ADVANCE MEDICAL TRAINING, EDUCATION, AND RESEARCH. THIS ACTIVE REINVESTMENT OF FUNDS MAKES IT POSSIBLE FOR THE HOSPITAL TO DELIVER ON ITS MISSION, INCLUDING HELPING TO ENSURE THAT EVERYONE IN THE COMMUNITIES SERVED HAS ACCESS TO HEALTH CARE.OPEN MEDICAL STAFF: MEDICAL STAFF PRIVILEGES ARE OPEN TO PHYSICIANS WHOSE EXPERIENCE AND TRAINING ARE VERIFIED THROUGH A CREDENTIALING PROCESS. THE PROCESS INCLUDES GATHERING AND VERIFYING CREDENTIALS, ALLOWING THE MEDICAL STAFF TO EVALUATE AN APPLICANT'S QUALIFICATIONS, PREVIOUS EXPERIENCE, AND COMPETENCE, AND ULTIMATELY MAKING A DECISION TO GRANT OR DENY MEDICAL STAFF MEMBERSHIP AND CLINICAL PRIVILEGES ON THE BASIS OF AUTHENTIC AND VALID CREDENTIALS.ROLE OF THE BOARD: THE COMMONSPIRIT HEALTH BOARD AND SPECIFIC COMMITTEES HAVE ORGANIZATIONAL, POLICY-BASED ROLES TO OVERSEE COMMUNITY BENEFIT AND COMMUNITY HEALTH PROGRAMS, AND THEY RECEIVE REPORTS ON ACTIVITIES AND PERFORMANCE. HOSPITAL COMMUNITY BOARDS (OR THEIR DESIGNATED COMMITTEES) ARE RESPONSIBLE FOR ENSURING THAT THE HOSPITALS CONDUCT AND ADOPT COMMUNITY HEALTH NEEDS ASSESSMENTS AND IMPLEMENTATION STRATEGIES, TAKE ACTIONS TO HELP ADDRESS IDENTIFIED SIGNIFICANT HEALTH NEEDS WITH AN EMPHASIS ON POOR AND VULNERABLE POPULATIONS AND HEALTH EQUITY, AND MONITORING ACTIONS AND PROGRESS TOWARD IDENTIFIED GOALS. PART VI, LINE 6: THE ORGANIZATION IS AFFILIATED WITH COMMONSPIRIT HEALTH. COMMONSPIRIT HEALTH WAS CREATED BY THE ALIGNMENT OF CATHOLIC HEALTH INITIATIVES AND DIGNITY HEALTH IN EARLY 2019. COMMONSPIRIT HEALTH, A NONPROFIT, FAITH-BASED HEALTH SYSTEM IS COMMITTED TO BUILDING HEALTHIER COMMUNITIES, ADVOCATING FOR THOSE WHO ARE POOR AND VULNERABLE, AND INNOVATING HOW AND WHERE HEALING CAN HAPPEN BOTH INSIDE ITS HOSPITALS AND OUT IN THE COMMUNITY. COMMONSPIRIT HEALTH OWNS AND OPERATES HEALTH CARE FACILITIES IN 24 STATES AND IS THE SOLE CORPORATE MEMBER (PARENT CORPORATION) OF OTHER PRIMARILY NONPROFIT CORPORATIONS. COMMONSPIRIT HEALTH AND SUBSTANTIALLY ALL OF ITS DIRECT AFFILIATES AND SUBSIDIARIES HAVE BEEN GRANTED EXEMPTIONS FROM FEDERAL INCOME TAX AS CHARITABLE ORGANIZATIONS UNDER SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE. AS OF SEPTEMBER 25, 2024, COMMONSPIRIT HEALTH IS COMPRISED OF APPROXIMATELY 2,300 CARE SITES, CONSISTING OF 137 HOSPITALS, INCLUDING ACADEMIC HEALTH CENTERS, MAJOR TEACHING HOSPITALS, AND CRITICAL ACCESS FACILITIES, COMMUNITY HEALTH SERVICES ORGANIZATIONS, ACCREDITED NURSING COLLEGES, HOME HEALTH AGENCIES, LIVING COMMUNITIES, A MEDICAL FOUNDATION AND OTHER AFFILIATED MEDICAL GROUPS, AND OTHER FACILITIES AND SERVICES THAT SPAN THE INPATIENT AND OUTPATIENT CONTINUUM OF CARE. AN ADDITIONAL 21 HOSPITALS ARE OPERATED THROUGH UNCONSOLIDATED JOINT VENTURES. IN FISCAL YEAR 2024, COMMONSPIRIT HEALTH PROVIDED MORE THAN $2.574 BILLION IN FINANCIAL ASSISTANCE AND COMMUNITY BENEFIT FOR PROGRAMS AND SERVICES FOR THE POOR, FREE CLINICS, EDUCATION AND RESEARCH. FINANCIAL ASSISTANCE AND COMMUNITY BENEFIT TOTALED MORE THAN $4.22 BILLION WITH THE INCLUSION OF THE UNPAID COSTS OF MEDICARE. THE HEALTH SYSTEM, WHICH GENERATED OPERATING REVENUES OF $37.5 BILLION IN FISCAL YEAR 2024, HAS TOTAL ASSETS OF APPROXIMATELY $54.73 BILLION.COMMONSPIRIT HEALTH PROVIDES STRATEGIC PLANNING AND MANAGEMENT SERVICES AS WELL AS CENTRALIZED SERVICES FOR ITS DIVISIONS. 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 DIVISIONS. THE COST SAVINGS ACHIEVED THROUGH COMMONSPIRIT HEALTH'S CENTRALIZATION ENABLE DIVISIONS TO DEDICATE ADDITIONAL RESOURCES TO HIGH-QUALITY HEALTH CARE AND COMMUNITY OUTREACH SERVICES TO THE MOST VULNERABLE MEMBERS OF OUR SOCIETY. 1 PIERCE COUNTY PROJECT ACCESS 4301 S PINE ST TACOMA WA 98409 271185895 501(C)(3) 353618 0 PROGRAM SUPPORT YMCA OF PIERCE & KITSAP CTY 4717 S 19TH STREET TACOMA WA 98405 910565562 501(C)(3) 18308 0 PROGRAM SUPPORT TACOMA URBAN LEAGUE 2550 S YAKIMA AVE TACOMA WA 98405 910826302 501(C)(3) 25000 0 PROGRAM SUPPORT PEACE EVENGELICAL LUTHERAN 8316 39TH AVE SW SEATTLE WA 98136 916052141 501(C)(3) 36500 0 PROGRAM SUPPORT KNIGHTS COMMUNITY HOSPITAL PO BOX 1951 POULSBO WA 98370 854232541 501(C)(3) 35000 0 PROGRAM SUPPORT MULTICULTURAL CHILD & FAMILY 2021 S 19TH ST TACOMA WA 98405 352266626 501(C)(3) 96000 0 PROGRAM SUPPORT VINE MAPLE PLACE PO BOX 1092 MAPLE VALLEY WA 98038 912082308 501(C)(3) 95000 0 PROGRAM SUPPORT TACOMA SEED 6824 19TH ST W UNIVERSITY PL WA 98466 825099194 501(C)(3) 67013 0 PROGRAM SUPPORT PACIFIC LUTHERAN UNIVERSITY 12780 PACIFIC AVE S TACOMA WA 98447 910565571 501(C)(3) 42170 0 PROGRAM SUPPORT COMMUNITIES IN SCHOOLS OF LAKEWOOD 10828 GRAVELLY LAKE DR SW STE 104 TACOMA WA 98499 911732922 501(C)(3) 95000 0 PROGRAM SUPPORT RAINIER FOOTHILLS WELLNESS FOUNDATION 1304 GRIFFIN AVE ENUMCLAW WA 98022 911192604 501(C)(3) 24248 0 PROGRAM SUPPORT HOPESPARKS 6424 N 9TH ST TACOMA WA 98406 910598103 501(C)(3) 53560 0 PROGRAM SUPPORT PIKE MARKET SENIOR CENTER 85 PIKE ST STE 200 SEATTLE WA 98101 911034838 501(C)(3) 98200 0 PROGRAM SUPPORT NORTH KITSAP FISHLINE PO BOX 1517 POULSBO WA 98370 911244431 501(C)(3) 50000 0 PROGRAM SUPPORT KEY PENINSULA COMMUNITY SERVICES 15610 89TH ST CT LAKEBAY WA 98349 911188981 501(C)(3) 63859 0 PROGRAM SUPPORT GOOD SHEPHERD YOUTH OUTREACH 720 S 333RD ST STE 100 FEDERAL WAY WA 98003 263713948 501(C)(3) 10000 0 PROGRAM SUPPORT 16 0 PART I, LINE 2: FHS ONLY GRANTS TO 501(C)(3) AND 501(C)(6) ORGANIZATIONS TO ENSURE THE FUNDS WILL BE USED PROPERLY. 1 1 0 0 0 0 0 0 0 KETUL PATEL CEO VMFH & PRESIDENT NORTHWEST REGIO 0 1393552 0 959840 0 259995 0 19350 0 13553 0 2646290 0 0 KERRY SHANNON SVP/CHIEF INTEGRATION OFFICER (THRU 563896 0 100800 0 1082745 0 19175 0 18501 0 1785117 0 0 0 JAMES TERWILLIGER PRESIDENT, PUGET SOUND MARKET 704308 0 176177 0 115991 0 19175 0 1776 0 1017427 0 0 0 THOMAS KRUSE SVP/CHIEF STRATEGY OFFICER, NORTHWES 677573 0 100800 0 1635 0 18156 0 24734 0 822898 0 0 0 JENNIFER SCHOMBURG PRESIDENT ST JOSEPH MEDICAL CENTER 543331 0 205921 0 1115 0 15269 0 24857 0 790493 0 0 0 CHARLEEN TACHIBANA RN SVP/CHIEF QUALITY, SAFETY AND PATIEN 591593 0 67300 0 9437 0 17527 0 23361 0 709218 0 0 0 DAVID NOSACKA TREASURER/SVP&CFO NORTHWEST REGION 568187 0 75800 0 1709 0 19175 0 38819 0 703690 0 0 0 RYAN PONG DIV VP-ACADEMIC OFFICER 522094 0 800 0 1565 0 19683 0 36007 0 580149 0 0 0 KIMBERLY MOORE VP/INTERIM CHIEF MEDICAL OFFICER (TH 493187 0 800 0 1709 0 20185 0 14980 0 530861 0 0 0 DIANNE AROH SVP/CHIEF NURSING OFFICER 502601 0 800 0 4904 0 19243 0 3090 0 530638 0 0 0 NARINE FRANGULYAN RN 495663 0 800 0 239 0 7625 0 19670 0 523997 0 0 0 DAVID WEISS MKT VP MEDICAL OPERATIONS 416648 0 800 0 3195 0 19350 0 19943 0 459936 0 0 0 MIRIAM CHAMBLISS CORPORATE SECRETARY/VP GENERAL COUNS 0 280293 0 131031 0 951 0 15119 0 32488 0 459882 0 0 RUSSELL WOOLLEY FORMER COO ST FRANCIS & ST ANNE HOSP 219956 96151 0 800 493 58952 0 18664 8312 31551 228761 206118 0 0 SHARON ROYNE FORMER KE/VP ADMINISTRATIVE SERVICES 383891 0 800 0 5333 0 17017 0 22375 0 429416 0 0 0 DAVID BUTCHERITE FORMER TREASURER/DIV VP FINANCE 314518 0 800 0 4114 0 19350 0 22178 0 360960 0 0 0 DINO JOHNSON PRES. ST ANTHONY HOSPITAL & INTERIM 282526 0 800 0 501 0 19000 0 35557 0 338384 0 0 0 MICHAEL COX FORMER KEY EMPLOYEE/CHIEF MISSION OF 262000 0 21930 0 863 0 5101 0 35270 0 325164 0 0 0 DEEPAK DEVASTHALI PRES. ST ANNE HOSPITAL & INTERIM PRE 252334 0 0 0 27157 0 6027 0 32734 0 318252 0 0 0 LOIS ERICKSON PRESIDENT ST CLARE HOSPITAL 255437 0 800 0 3763 0 16535 0 23142 0 299677 0 0 0 PART I, LINE 3 DURING THE CALENDAR YEAR 2023, COMPENSATION FOR THE TOP MANAGEMENT OFFICIAL WAS ESTABLISHED AND PAID BY COMMONSPIRIT HEALTH, A RELATED ORGANIZATION. COMMONSPIRIT HEALTH USED ONE OR MORE OF THE METHODS DESCRIBED IN SCHEDULE J, PART I, LINE 3 TO ESTABLISH THE TOP MANAGEMENT OFFICIAL'S COMPENSATION: (1) COMPENSATION COMMITTEE; (2) INDEPENDENT COMPENSATION CONSULTANT; (3) COMPENSATION SURVEY OR STUDY; (4) APPROVAL BY THE BOARD OR COMPENSATION COMMITTEE. PART I, LINES 4A-B CERTAIN REPORTABLE INDIVIDUALS ARE COVERED BY AN EXECUTIVE SEVERANCE POLICY THAT PROVIDES MARKET-STANDARD COMPENSATION, RANGING FROM PAYMENTS OF 9 MONTHS TO 2 YEARS OF BASE COMPENSATION, DEPENDING ON THE EXECUTIVE'S POSITION, IN THE EVENT OF A POSITION ELIMINATION OR OTHER INVOLUNTARY TERMINATION, IN ACCORDANCE WITH THE GUIDELINES OF THE POLICY. CERTAIN REPORTABLE INDIVIDUALS ARE COVERED BY A NON-EXECUTIVE SEVERANCE POLICY THAT PROVIDES MARKET-STANDARD COMPENSATION, RANGING FROM PAYMENTS OF 2 WEEKS TO 52 WEEKS OF BASE COMPENSATION, DEPENDING ON THE EMPLOYEE'S POSITION AND TENURE, IN THE EVENT OF A POSITION ELIMINATION OR OTHER INVOLUNTARY TERMINATION, IN ACCORDANCE WITH THE GUIDELINES OF THE POLICY. THE FOLLOWING REPORTABLE INDIVIDUALS RECEIVED SEVERANCE PAYMENTS DURING THE 2023 CALENDAR YEAR, AND THESE SEVERANCE PAYMENTS WERE INCLUDED IN THE INDIVIDUALS' W-2 INCOME AND REPORTABLE COMPENSATION ON PART VII AND SCHEDULE J, PART II, COLUMN (B)(III): KERRY SHANNON, $1,078,267. SCH J, PART I, LINE 4B DURING THE 2023 CALENDAR YEAR, COMMONSPIRIT HEALTH ("COMMONSPIRIT") MAINTAINED A SUPPLEMENTAL NON-QUALIFIED DEFERRED COMPENSATION PLAN FOR DIVISION CEOS/PRESIDENTS AND OTHER DESIGNATED COMMONSPIRIT EXECUTIVES AT THE LEVEL OF SENIOR VICE PRESIDENT AND ABOVE. DUE TO THE "SUPER" VESTING RULES UNDER COMMONSPIRIT'S DEFERRED COMPENSATION PLAN, PARTICIPANTS WHO HAVE MET CERTAIN REQUIREMENTS SUCH AS INVOLUNTARY TERMINATION WITHOUT CAUSE, AGE, AGE AND YEARS OF SERVICE, OR MORE THAN 5 YEARS OF PLAN PARTICIPATION ARE ELIGIBLE TO RECEIVE THEIR 2023 CONTRIBUTIONS IN CASH. THESE CASH PAYOUTS ARE INCLUDED IN THE PARTICIPANT'S REPORTABLE COMPENSATION IN COLUMN (III) OTHER REPORTABLE COMPENSATION ON SCHEDULE J PART II. DURING 2023, THE FOLLOWING PAYMENTS WERE MADE PURSUANT TO THE SUPER VESTING RULES: KETUL J. PATEL, $246,662. VIRGINIA MASON MEDICAL CENTER MAINTAINED A SUPPLEMENTAL EXECUTIVE RETIREMENT PLAN (SERP) FOR ELIGIBLE SENIOR EXECUTIVES. THE SERP IS A 457(F) NONQUALIFIED DEFERRED COMPENSATION PLAN PURSUANT TO WHICH PLAN BENEFITS ARE SUBJECT TO A SUBSTANTIAL RISK OF FORFEITURE. THE PLAN WAS APPROVED BY THE BOARD'S COMPENSATION AND BENEFITS COMMITTEE, A COMMITTEE COMPOSED OF INDEPENDENT BOARD MEMBERS TO WHOM THE BOARD DELEGATES THE AUTHORITY TO APPROVE COMPENSATION AND BENEFITS FOR THE MEDICAL CENTER'S MOST SENIOR EXECUTIVES. THE COMMITTEE RECEIVES ADVICE FROM AN INDEPENDENT COMPENSATION CONSULTANT TO ENSURE THAT COMPENSATION AND BENEFITS, INCLUDING THE SERP, ARE MARKET COMPETITIVE AND REASONABLE. SCHEDULE J, PART II FRANCISCAN HEALTH SYSTEM FOLLOWS COMMONSPIRIT'S EXECUTIVE COMPENSATION PHILOSOPHY. COMMONSPIRIT'S EXECUTIVE COMPENSATION PHILOSOPHY IS DESIGNED TO ASSIST COMMONSPIRIT IN ATTRACTING AND RETAINING THE CALIBER OF EXECUTIVES REQUIRED TO ENABLE COMMONSPIRIT TO FULFILL ITS MISSION OF PROVIDING HIGH QUALITY HEALTHCARE FOR ALL PERSONS REGARDLESS OF THEIR ABILITY TO PAY FOR SERVICES, IMPROVING THE QUALITY OF LIFE IN THE COMMUNITIES COMMONSPIRIT SERVES, PROMOTING PATIENT AND EMPLOYEE SATISFACTION, AND ENSURING FINANCIAL STABILITY. A SUBSTANTIAL PORTION OF EXECUTIVE COMPENSATION IS PERFORMANCE BASED AND IS LINKED TO ORGANIZATIONAL GOALS APPROVED IN ADVANCE BY THE HUMAN RESOURCES AND COMPENSATION COMMITTEE. THESE GOALS INCLUDE ATTAINMENT OF ANNUAL AND LONG-TERM FINANCIAL PERFORMANCE, CERTAIN HEALTHCARE QUALITY STANDARDS AND COMMONSPIRIT'S COMMITMENT TO SERVING THE POOR AND DISENFRANCHISED IN THE COMMUNITIES IT SERVES. TOTAL COMPENSATION, WHICH INCLUDES BASE SALARY, ANNUAL, AND LONG-TERM INCENTIVE COMPENSATION, IS ESTABLISHED TO APPROXIMATE THE PREVAILING MARKET CONDITIONS FOR EXECUTIVES OF COMPANIES OF SIMILAR SIZE, REVENUES AND COMPLEXITY. PAYMENTS PURSUANT TO A LONG-TERM FINANCIAL PERFORMANCE GOAL WERE PAID IN CALENDAR YEAR 2023. GILES NOSACKA FAMILY MEMBER OF AN OFFICER 110780 EMPLOYEE PAYROLL WAGES 0 HANNAH HUNTHAUSEN FAMILY MEMBER OF A DIRECTOR 18745 EMPLOYEE PAYROLL WAGES 0 FORM 990, PART V, LINE 1C: PAYMENTS TO VENDORS FOR ENTITIES THAT ARE PART OF COMMONSPIRIT HEALTH ARE MADE BY COMMONSPIRIT HEALTH. THEREFORE, NO FORMS 1099 ARE ISSUED BY FRANCISCAN HEALTH SYSTEM. COMMONSPIRIT HEALTH FILES THE FORMS 1099 AND COMPLIES WITH THE BACKUP WITHHOLDING RULES FOR REPORTABLE PAYMENTS TO VENDORS AND GAME WINNINGS. THE FORMS 1099 ISSUED ON BEHALF OF FRANCISCAN HEALTH SYSTEM ARE REPORTED TO THE IRS. FORM 990, PART VI, SECTION A, LINE 6 THE SOLE MEMBER OF THE ORGANIZATION IS COMMONSPIRIT HEALTH, A COLORADO NON PROFIT CORPORATION. FORM 990, PART VI, SECTION A, LINE 7A THE SOLE MEMBER HAS THE POWER TO APPOINT, REPLACE OR REMOVE THE MEMBERS OF THE BOARD OF DIRECTORS. (CHCF RESERVED RIGHTS) EXCEPT AS OTHERWISE PROVIDED IN THE CORPORATION'S ARTICLES OF INCORPORATION OR THE LAWS OF THE STATE OF ORGANIZATION, CATHOLIC HEALTH CARE FEDERATION ("CHCF") SHALL HAVE SUCH RIGHTS AS ARE RESERVED TO THE CORPORATE MEMBER, ACTING IN ITS CAPACITY AS THE MEMBERSHIP BODY OF CHCF, UNDER THE GOVERNANCE MATRIX. FORM 990, PART VI, SECTION A, LINE 7B THE ORGANIZATION'S CORPORATE MEMBER IS COMMONSPIRIT HEALTH (CSH). PURSUANT TO SECTION 5.4 OF THE ORGANIZATION'S BYLAWS, THE CORPORATE MEMBER SHALL HAVE THE SPECIFIC RIGHTS SET FORTH IN THE GOVERNANCE MATRIX. PURSUANT TO THE GOVERNANCE MATRIX THE FOLLOWING RIGHTS ARE RESERVED TO THE CSH BOARD DIRECTLY OR THROUGH POWERS DELEGATED TO THE CSH CHIEF EXECUTIVE OFFICER: - SUBSTANTIAL CHANGE IN THE MISSION OR PHILOSOPHY OF FHS - AMENDMENT OF THE CORPORATE DOCUMENTS OF FHS - APPROVE MEMBERS OF THE FHS BOARD - REMOVAL OF A MEMBER OF THE GOVERNING BODY OF FHS - APPROVAL OF ISSUANCE OF DEBT BY FHS - APPROVAL OF PARTICIPATION OF FHS IN A JOINT VENTURE - APPROVAL OF FORMATION OF A NEW CORPORATION BY FHS - APPROVAL OF A MERGER INVOLVING THE FHS - APPROVAL OF THE SALE OF ALL OR SUBSTANTIALLY ALL OF THE ASSETS OF THE FHS - TO REQUIRE THE TRANSFER OF ASSETS BY FHS TO CSH TO ACCOMPLISH CSH'S GOALS AND OBJECTIVES, AND TO SATISFY CSH DEBTS. - ADOPTION OF LONG RANGE AND STRATEGIC PLANS FOR FHS PURSUANT TO SECTION 5.5.2 OF THE ORGANIZATION'S BYLAWS, CSH 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. (CHCF RESERVED RIGHTS) EXCEPT AS OTHERWISE PROVIDED IN THE CORPORATION'S ARTICLES OF INCORPORATION OR THE LAWS OF THE STATE OF ORGANIZATION, CATHOLIC HEALTH CARE FEDERATION ("CHCF") SHALL HAVE SUCH RIGHTS AS ARE RESERVED TO THE CORPORATE MEMBER, ACTING IN ITS CAPACITY AS THE MEMBERSHIP BODY OF CHCF, UNDER THE GOVERNANCE MATRIX. FORM 990, PART VI, SECTION B, LINE 11B THE CFO REVIEWS THE FORM AND ANY NECESSARY CHANGES ARE INCLUDED IN THE FINAL VERSION THAT IS APPROVED FOR FILING WITH THE IRS. THE CFO ALSO PROVIDES THE RETURN TO THE BOARD, AND ALL BOARD MEMBERS HAVE THE OPPORTUNITY TO REVIEW THE 990 PRIOR TO FILING WITH THE IRS. SUBSEQUENT TO REVIEW, THE 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 RESUBMITTED TO THE BOARD. FORM 990, PART VI, SECTION B, LINE 12C THE ORGANIZATION HAS A CONFLICTS OF INTEREST ("COI") POLICY (THE "POLICY") IN PLACE TO PROTECT THE INTERESTS OF COMMONSPIRIT HEALTH ("COMMONSPIRIT") IN CIRCUMSTANCES THAT MAY RESULT IN A CONFLICT BETWEEN PERSONAL INTERESTS OF A PERSON AND THE INTERESTS OF THE ORGANIZATION AND THOSE IT SERVES. COMMONSPIRIT'S COI POLICY APPLIES TO COMMONSPIRIT, ITS DIRECT AFFILIATES AND SUBSIDIARIES AND ANY RELATED ENTITY THE GOVERNING DOCUMENTS OF WHICH REQUIRE THE ENTITY TO COMPLY WITH COMMONSPIRIT POLICY (COLLECTIVELY THE "SYSTEM ENTITIES"). THE FOLLOWING PERSONS ARE REQUIRED TO DISCLOSE ACTUAL OR POTENTIAL CONFLICTS OF INTEREST AT LEAST ANNUALLY (VIA A FORMAL SYSTEM-ADMINISTERED SURVEY) IF THE PERSON'S AFFILIATION WITH COMMONSPIRIT CONTINUES: - MEMBERS OF CORPORATE AND COMMUNITY BOARDS OF SYSTEM ENTITIES - MEMBERS OF COMMITTEES OF CORPORATE AND COMMUNITY BOARDS OF SYSTEM ENTITIES - MEMBERS OF THE EXECUTIVE LEADERSHIP TEAM ("ELT") OF COMMONSPIRIT - CORPORATE OFFICERS OF SYSTEM ENTITIES - EMPLOYED PHYSICIANS AND ADVANCED PRACTICE PROVIDERS - KEY EMPLOYEES AND HIGHEST COMPENSATED EMPLOYEES AS SPECIFIED BY THE INTERNAL REVENUE SERVICE FOR FORM 990 PURPOSES WHO ARE NOT OTHERWISE INCLUDED IN THE CATEGORIES ABOVE - EMPLOYEES OF SYSTEM ENTITIES AT THE VICE PRESIDENT LEVEL AND ABOVE - ALL INDIVIDUALS ENGAGED IN RESEARCH AT INSTITUTIONS OWNED OR OPERATED BY A SYSTEM ENTITY - SELECT EMPLOYEES AS DETERMINED FROM TIME TO TIME BY LEADERSHIP DISCLOSURE, REVIEW, AND MANAGEMENT OF PERCEIVED, POTENTIAL, OR ACTUAL CONFLICTS OF INTEREST ARE ACCOMPLISHED THROUGH A DEFINED COI DISCLOSURE REVIEW PROCESS. EACH PERSON IS REQUIRED TO PROMPTLY AND FULLY DISCLOSE ANY SITUATION OR CIRCUMSTANCE THAT MAY CREATE A CONFLICT OF INTEREST AS SOON AS SHE/HE BECOMES AWARE OF IT. IN ADDITION, AT THE INCEPTION OF AN INDIVIDUAL'S RELATIONSHIP WITH COMMONSPIRIT (E.G. HIRING, BOARD APPOINTMENT), AND FOR CERTAIN POSITIONS, ANNUALLY THEREAFTER, WRITTEN CONFLICT OF INTEREST DISCLOSURE FORMS MUST BE COMPLETED. A FAILURE TO DISCLOSE MAY RESULT IN DISCIPLINARY OR CORRECTIVE ACTIONS. REPORTED POTENTIAL OR ACTUAL CONFLICTS OF INTEREST ARE INITIALLY REVIEWED BY LEGAL, CORPORATE RESPONSIBILITY OR RESEARCH INTEGRITY STAFF. IF NECESSARY, A CONFLICT OF INTEREST MANAGEMENT PLAN IS DEVELOPED, WHICH PLAN SHALL BE SUBJECT TO ACCEPTANCE BY THE APPROPRIATE DIRECT MANAGER, SUPERVISOR, MEDICAL STAFF OFFICE, BOARD OR BOARD COMMITTEE (FOR BOARD, BOARD COMMITTEE, ELT OR CORPORATE OFFICER CONFLICTS), OR OTHER APPROPRIATE INDIVIDUAL OR BODY. ONCE ACCEPTED, THE CONFLICT OF INTEREST MANAGEMENT PLAN IS COMMUNICATED TO THE PERSON WITH THE ACTUAL OR POTENTIAL CONFLICT AND THE INDIVIDUAL MUST CONDUCT THEMSELVES IN CONFORMITY WITH THE PLAN. IN THE EVENT THAT A TRANSACTIONAL CONFLICT INTEREST ARISES IN CONNECTION WITH A SYSTEM ENTITY BOARD MEETING, THE CONFLICTED INDIVIDUAL MUST DISCLOSE THAT CONFLICT PRIOR TO OR AT THE BEGINNING OF THE MEETING IN WHICH THE MATTER IS TO BE CONSIDERED. THE CONFLICTED INDIVIDUAL IS EXCLUDED FROM VOTING ON THE TRANSACTION AND IS PROHIBITED FROM USING PERSONAL INFLUENCE WITH RESPECT TO THE MATTER, BUT IS NOT PROHIBITED FROM PROVIDING INPUT IF REQUESTED TO DO SO. FORM 990, PART VI, SECTION B, LINE 15B FOR LEADERSHIP POSITIONS WITH SUBSTANTIAL INFLUENCE (NOT INCLUDING THE PRESIDENT/CEO, WHO IS PAID BY A RELATED ORGANIZATION), COMPENSATION IS PRESENTED TO THE ORGANIZATION'S EXECUTIVE COMMITTEE FOR APPROVAL OF BASE PAY INCREASES AND INCENTIVE ACHIEVEMENT. COMPENSATION FOR OTHER OFFICERS (INCLUDING THE PRESIDENT/CEO) AND KEY EMPLOYEES OF THE ORGANIZATION IS ESTABLISHED BY COMMONSPIRIT HEALTH COMPENSATION USING EXTERNAL COMPENSATION SURVEYS OR STUDIES CONTAINING COMPARABLE DATA FOR SIMILARLY SITUATED ORGANIZATIONS, BOTH TAXABLE AND TAX EXEMPT FOR SIMILAR JOB RESPONSIBILITIES. COMMONSPIRIT'S BOARD OF STEWARDSHIP TRUSTEES APPOINTS A HUMAN RESOURCES AND COMPENSATION COMMITTEE, COMPRISED EXCLUSIVELY OF INDEPENDENT DIRECTORS, WHO ARE ACCOUNTABLE FOR SETTING REASONABLE COMPENSATION PRACTICES FOR CERTAIN EXECUTIVES WITHIN THE ORGANIZATION. THE HUMAN RESOURCES AND COMPENSATION COMMITTEE APPROVES, CONSISTENT WITH THE ORGANIZATION'S PHILOSOPHY AND PRINCIPLES, THE ANNUAL PERFORMANCE GOALS AND CRITERIA TO BE USED IN DETERMINING VARIABLE COMPENSATION. THE HUMAN RESOURCES AND COMPENSATION COMMITTEE ALSO ENGAGES AN INDEPENDENT CONSULTANT AND FINANCIAL LEGAL COUNSEL TO VALIDATE THE ORGANIZATION'S BENCHMARKING APPROACH AND REASONABLENESS OF THE TOTAL COMPENSATION AND BENEFITS PACKAGES FOR CERTAIN EXECUTIVES. APPROPRIATE COMPARABLE DATA IS OBTAINED BY THE COMMONSPIRIT HEALTH COMPENSATION DEPARTMENT FROM INDEPENDENT THIRD-PARTY SALARY SURVEYS, (E.G., TOTAL ECONOMIC BENEFITS PAID BY SIMILARLY SITUATED ORGANIZATIONS, BOTH TAXABLE AND TAX-EXEMPT, FOR SIMILAR JOB RESPONSIBILITIES) FOR ALL OTHER STAFF AND LEADERSHIP ROLES. THE DOCUMENTATION OF COMPENSATION DECISIONS INCLUDES (A) THE DECISION MADE AND THE DATE APPROVED; AND (B) THE COMPARABILITY DATA OBTAINED AND RELIED UPON BY THE COMPENSATION DEPARTMENT AND THE SOURCES FROM WHICH THE DATA WAS OBTAINED. FORM 990, PART VI, SECTION C, LINE 19 THE ORGANIZATION'S FINANCIAL STATEMENTS, CONFLICT OF INTEREST POLICY AND GOVERNING DOCUMENTS ARE AVAILABLE TO THE PUBLIC UPON REQUEST. THE ORGANIZATION'S FINANCIAL STATEMENTS ARE INCLUDED IN COMMONSPIRIT HEALTH'S CONSOLIDATED AUDITED FINANCIAL STATEMENTS THAT ARE AVAILABLE AT WWW.COMMONSPIRIT.ORG OR WWW.CATHOLICHEALTHINITIATIVES.ORG. FORM 990, PART VI, SECTION B, LINE 16B: FRANCISCAN HEALTH SYSTEM HAS NOT FORMALLY ADOPTED A WRITTEN POLICY OR WRITTEN PROCEDURE REGARDING JOINT VENTURES. HOWEVER COMMONSPIRIT HEALTH'S SYSTEM-WIDE JOINT VENTURE MODEL OPERATING AGREEMENT INCORPORATES CONTROLS OVER THE VENTURE SUFFICIENT TO ENSURE THAT (1) THE EXEMPT ORGANIZATION AT ALL TIMES RETAINS CONTROL OVER THE VENTURE SUFFICIENT TO ENSURE THAT THE PARTNERSHIP FURTHERS THE EXEMPT PURPOSE OF THE ORGANIZATION; (2) IN ANY PARTNERSHIP IN WHICH THE EXEMPT ORGANIZATION IS A PARTNER, ACHIEVEMENT OF EXEMPT PURPOSES IS PRIORITIZED OVER MAXIMIZATION OF PROFITS FOR THE PARTNERS; (3) THE PARTNERSHIP DOES NOT ENGAGE IN ANY ACTIVITIES THAT WOULD JEOPARDIZE THE EXEMPT ORGANIZATION'S EXEMPTION; AND (4) RETURNS OF CAPITAL, ALLOCATIONS, AND DISTRIBUTIONS MUST BE MADE IN PROPORTION TO THE PARTNERS' RESPECTIVE OWNERSHIP INTERESTS. ANY JOINT VENTURE AGREEMENTS THAT DO NOT CONFORM TO THE MODEL AGREEMENT ARE GENERALLY REVIEWED BY COUNSEL. FORM 990, PART IX, LINE 11G CONTRACT LABOR: PROGRAM SERVICE EXPENSES 109,427,075. MANAGEMENT AND GENERAL EXPENSES 12,158,564. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 121,585,639. CONSULTING: PROGRAM SERVICE EXPENSES 2,281,121. MANAGEMENT AND GENERAL EXPENSES 3,421,681. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 5,702,802. CONTRACT SERVICES: PROGRAM SERVICE EXPENSES 40,162,115. MANAGEMENT AND GENERAL EXPENSES 26,774,743. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 66,936,858. PURCHASED SERVICES: PROGRAM SERVICE EXPENSES 68,105,218. MANAGEMENT AND GENERAL EXPENSES 7,567,246. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 75,672,464. OTHER FEES: PROGRAM SERVICE EXPENSES 109,949,765. MANAGEMENT AND GENERAL EXPENSES 27,487,442. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 137,437,207. FORM 990, PART XI, LINE 9: AFFILIATE TRANSFERS -60,405,755. CHANGES IN EQUITY OF UNCONSOLIDATED ORGS -4,336,571. SUBSIDIARY/NON-CONTROLLING OWNERSHIP CHANGES -151,137. SERP LIABILITY ADJUSTMENT 23,921. 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