SCHEDULE H (Form 990)
Department of the Treasury
Internal Revenue Service
Hospitals
MediumBullet Complete if the organization answered "Yes" to Form 990, Part IV, question 20.
MediumBullet Attach to Form 990. MediumBullet See separate instructions.
OMB No. 1545-0047
2012
Open to Public Inspection
Name of the organization
DEACONESS HOSPITAL INC
 
Employer identification number

35-0593390
Part I
Financial Assistance and Certain Other Community Benefits at Cost
Yes
No
1a
Did the organization have a financial assistance policy during the tax year? If "No," skip to question 6a ...
1a
Yes
 
b
If "Yes," was it a written policy? .......................
1b
Yes
 
2
If the organization had multiple hospital facilities, indicate which of the following best describes application of the financial assistance policy to its various hospital facilities during the tax year.
3
Answer the following based on the financial assistance eligibility criteria that applied to the largest number of the organization's patients during the tax year.
a
Did the organization use Federal Poverty Guidelines (FPG) as a factor in determining eligibility for providing free care?
If "Yes," indicate which of the following was the FPG family income limit for eligibility for free care:
3a
Yes
 
b
Did the organization use FPG as a factor in determining eligibility for providing discounted care? If "Yes," indicate
which of the following was the family income limit for eligibility for discounted care: .........
3b
Yes
 
%
c
If the organization used factors other than FPG in determining eligibility, describe in Part VI the income based criteria for determining eligibility for free or discounted care. Include in the description whether the organization used an asset test or other threshold, regardless of income, as a factor in determining eligibility for free or discounted care.
4
Did the organization's financial assistance policy that applied to the largest number of its patients during the tax year provide for free or discounted care to the "medically indigent"? ..............

4

Yes

 
5a
Did the organization budget amounts for free or discounted care provided under its financial assistance policy during the tax year? ............................

5a

Yes

 
b
If "Yes," did the organization's financial assistance expenses exceed the budgeted amount? ......
5b
 
No
c
If "Yes" to line 5b, as a result of budget considerations, was the organization unable to provide free or discountedcare to a patient who was eligibile for free or discounted care? ..............
5c
 
 
6a
Did the organization prepare a community benefit report during the tax year? ..........
6a
Yes
 
b
If "Yes," did the organization make it available to the public? ..............
6b
Yes
 
Complete the following table using the worksheets provided in the Schedule H instructions. Do not submit these worksheets with the Schedule H.
7
Financial Assistance and Certain Other Community Benefits at Cost
Financial Assistance and
Means-Tested
Government Programs
 (a) Number of activities or programs (optional) (b) Persons served (optional) (c) Total community benefit expense (d) Direct offsetting revenue (e) Net community benefit expense (f) Percent of total expense
a Financial Assistance at cost
(from Worksheet 1) .. 		    22,872,446   22,872,446 3.960 %
b Medicaid (from Worksheet 3,
column a) .... 		    73,681,506 53,624,066 20,057,440 3.470 %
c Costs of other means-tested
government programs (from
Worksheet 3, column b) . 		           
d Total Financial Assistance
and Means-Tested
Government Programs . 		    96,553,952 53,624,066 42,929,886 7.430 %
Other Benefits
     732,049 36,211 695,838 0.120 %
e Community health
improvement services and
community benefit operations
(from Worksheet 4) ..
f Health professions education
(from Worksheet 5) .. 		    4,403,251 1,658,288 2,744,963 0.480 %
g Subsidized health services
(from Worksheet 6) .. 		    8,961,794 6,565,848 2,395,946 0.410 %
h Research (from Worksheet 7)            
i Cash and in-kind
contributions for community
benefit (from Worksheet 8) 		    1,146,998 28,933 1,118,065 0.190 %
j Total. Other Benefits ..     15,244,092 8,289,280 6,954,812 1.200 %
k Total. Add lines 7d and 7j .     111,798,044 61,913,346 49,884,698 8.630 %
For Paperwork Reduction Act Notice, see the Instructions for Form 990. Cat. No. 50192T Schedule H (Form 990) 2012
Schedule H (Form 990) 2012
Page
Part II
Community Building Activities Complete this table if the organization conducted any community building activities during the tax year, and describe in Part VI how its community building activities promoted the health of the communities it serves.
(a) Number of activities or programs (optional) (b) Persons served (optional) (c) Total community building expense (d) Direct offsetting
revenue 		(e) Net community building expense (f) Percent of total expense
1 Physical improvements and housing     1,555   1,555 0 %
2 Economic development            
3 Community support     10,946 660 10,286 0 %
4 Environmental improvements     1,801   1,801 0 %
5 Leadership development and training for community members     4,000   4,000 0 %
6 Coalition building     8,207   8,207 0 %
7 Community health improvement advocacy     935   935 0 %
8 Workforce development     64,434 16,350 48,084 0.010 %
9 Other            
10 Total     91,878 17,010 74,868 0.010 %
Part III
Bad Debt, Medicare, & Collection Practices
Section A. Bad Debt Expense
Yes
No
1
Did the organization report bad debt expense in accordance with Heathcare Financial Management Association Statement No. 15? ..........................
1
Yes
 
2
Enter the amount of the organization's bad debt expense. Explain in Part VI the methodology used by the organization to estimate this amount. ......
2
40,019,702
3
Enter the estimated amount of the organization's bad debt expense attributable to patients eligible under the organization's financial assistance policy. Explain in Part VI the methodology used by the organization to estimate this amount and the rationale, if any, for including this portion of bad debt as community benefit. ......
3
 
4
Provide in Part VI the text of the footnote to the organization’s financial statements that describes bad debt expense or the page number on which this footnote is contained in the attached financial statements.
Section B. Medicare
5
Enter total revenue received from Medicare (including DSH and IME).....
5
131,537,693
6
Enter Medicare allowable costs of care relating to payments on line 5.....
6
151,926,989
7
Subtract line 6 from line 5. This is the surplus (or shortfall)........
7
-20,389,296
8
Describe in Part VI the extent to which any shortfall reported in line 7 should be treated as community benefit.Also describe in Part VI the costing methodology or source used to determine the amount reported on line 6.Check the box that describes the method used:
Section C. Collection Practices
9a
Did the organization have a written debt collection policy during the tax year? ..........
9a
Yes
 
b
If "Yes," did the organization’s collection policy that applied to the largest number of its patients during the tax year contain provisions on the collection practices to be followed for patients who are known to qualify for financial assistance? Describe in Part VI.......................

9b

Yes

 
Part IV
Management Companies and Joint Ventures(owned 10% or more by officers, directors, trustees, key employees, and physicians—see instructions)
(a) Name of entity (b) Description of primary
activity of entity 		(c) Organization's
profit % or stock
ownership % 		(d) Officers, directors,
trustees, or key
employees' profit %
or stock ownership % 		(e) Physicians'
profit % or stock
ownership %
1
2
3
4
5
6
7
8
9
10
11
12
13
Schedule H (Form 990) 2012
Schedule H (Form 990) 2012
Page
Part VFacility Information
Section A. Hospital Facilities
(list in order of size from largest to smallest—see instructions)
How many hospital facilities did the organization operate during the tax year?3
Name, address, and primary website address 		Licensed Hospital General-Medical-Surgical Children's Hospital Teaching Hospital Critical Hospital Research Facility ER-24Hours ER-Other Other (Describe) Facility reporting group
1 DEACONESS HOSPITAL INC
600 MARY STREET
EVANSVILLE,IN47747
WWW.DEACONESS.COM 		X X   X     X      
2 DEACONESS GATEWAY HOSPITAL
4011 GATEWAY BLVD
NEWBURGH,IN47630
WWW.DEACONESS.COM 		X X   X     X      
3 DEACONESS CROSS POINTE
7200 E INDIANA STREET
EVANSVILLE,IN47715
WWW.DEACONESS.COM 		X                  
Schedule H (Form 990) 2012
Schedule H (Form 990) 2012
Page
Part VFacility Information (continued)

Section B. Facility Policies and Practices

(Complete a separate Section B for each of the hospital facilities or facility reporting groups listed in Part V, Section A)
DEACONESS HOSPITAL INC
Name of hospital facility or facility reporting group  
For single facility filers only: line Number of Hospital Facility (from Schedule H, Part V, Section A) 1
Yes No
Community Health Needs Assessment (Lines 1 through 8c are optional for tax years begining on or before March 23, 2012)
1 During the tax year or either of the two immediately preceding tax years, did the hospital facility conduct a community health needs assessment (CHNA)? If "No," skip to line 9.................... 1 Yes  
If “Yes,” indicate what the CHNA report describes (check all that apply):
a
b
c
d
e
f
g
h
i
j
2 Indicate the tax year the hospital facility last conducted a CHNA: 20 12
3 In conducting its most recent CHNA, did the hospital facility take into account input from representatives of the community served by the hospital facility, including those with special knowledge of or expertise in public health? If “Yes,” describe in Part VI how the hospital facility took into account input from persons who represent the community, and identify the persons the hospital facility consulted .................... 3 Yes  
4 Was the hospital facility’s CHNA conducted with one or more other hospital facilities? If “Yes,” list the other hospital facilities in Part VI................................ 4 Yes  
5 Did the hospital facility make its CHNA report widely available to the public? ............. 5 Yes  
If “Yes,” indicate how the CHNA report was made widely available (check all that apply):
a
b
c
6 If the hospital facility addressed needs identified in its most recently conducted CHNA, indicate how (check all that apply to date):
a
b
c
d
e
f
g
h
i
7 Did the hospital facility address all of the needs identified in its most recently conducted CHNA? If “No,” explain in Part VI which needs it has not addressed and the reasons why it has not addressed such needs ........ 7 Yes  
8a Did the organization incur an excise tax under section 4959 for the hospital facility's failure to conduct a CHNA as required by section 501(r)(3)? ........................... 8a   No
b If "Yes" to line 8a, did the organization file Form 4720 to report the section 4959 excise tax? ...... 8b    
c If "Yes" to line 8b, what is the total amount of section 4959 excise tax the organization reported on Form 4720 for all of its hospital facilities? $  

Schedule H (Form 990) 2012
Schedule H (Form 990) 2012
Page
Part VFacility Information (continued)

Financial Assistance Policy Yes No
9 Did the hospital facility have in place during the tax year a written financial assistance policy that:
Explained eligibility criteria for financial assistance, and whether such assistance includes free or discounted care? 9 Yes  
10 Used federal poverty guidelines (FPG) to determine eligibility for providing free care?........... 10 Yes  
If "Yes," indicate the FPG family income limit for eligibility for free care: 300.000000000000%
If "No," explain in Part VI the criteria the hospital facility used.
11 Used FPG to determine eligibility for providing discounted care?................. 11 Yes  
If “Yes,” indicate the FPG family income limit for eligibility for discounted care: 300.000000000000%
If "No," explain in Part VI the criteria the hospital facility used.
12 Explained the basis for calculating amounts charged to patients?................. 12 Yes  
If “Yes,” indicate the factors used in determining such amounts (check all that apply):
a
b
c
d
e
f
g
h
13 Explained the method for applying for financial assistance?................... 13 Yes  
14 Included measures to publicize the policy within the community served by the hospital facility?....... 14 Yes  
If “Yes,” indicate how the hospital facility publicized the policy (check all that apply):
a
b
c
d
e
f
g
Billing and Collections
15 Did the hospital facility have in place during the tax year a separate billing and collections policy, or a written financial assistance policy (FAP) that explained actions the hospital facility may take upon non-payment?....... 15 Yes  
16 Check all of the following actions against an individual that were permitted under the hospital facility's policies during the tax year before making reasonable efforts to determine the patient’s eligibility under the facility’s FAP:
a
b
c
d
e
17 Did the hospital facility or an authorized third party perform any of the following actions during the tax year before making reasonable efforts to determine the patient’s eligibility under the facility’s FAP?.......... 17   No
If “Yes,” check all actions in which the hospital facility or a third party engaged:
a
b
c
d
e
Schedule H (Form 990) 2012
Schedule H (Form 990) 2012
Page
Part VFacility Information (continued)

18 Indicate which efforts the hospital facility made before initiating any of the actions listed in line 17 (check all that apply):
a
b
c
d
e
Policy Relating to Emergency Medical Care
Yes No
19 Did the hospital facility have in place during the tax year a written policy relating to emergency medical care that requires the hospital facility to provide, without discrimination, care for emergency medical conditions to individuals regardless of their eligibility under the hospital facility’s financial assistance policy?.......... 19 Yes  
If “No,” indicate why:
a
b
c
d
Charges to Individuals Eligible for Assistance under the FAP (FAP-Eligible Individuals)
20 Indicate how the hospital facility determined, during the tax year, the maximum amounts that can be charged to FAP-eligible individuals for emergency or other medically necessary care.
a
b
c
d
21 During the tax year, did the hospital facility charge any FAP-eligible individuals to whom the hospital facility provided emergency or other medically necessary services, more than the amounts generally billed to individuals who had insurance covering such care? ............................ 21   No
If “Yes,” explain in Part VI.
22 During the tax year, did the hospital facility charge any FAP-eligible individuals an amount equal to the gross charge for any service provided to that individual? ......................... 22   No
If “Yes,” explain in Part VI.
Schedule H (Form 990) 2012
Schedule H (Form 990) 2012
Page
Part VFacility Information (continued)

Section B. Facility Policies and Practices

(Complete a separate Section B for each of the hospital facilities or facility reporting groups listed in Part V, Section A)
DEACONESS GATEWAY HOSPITAL
Name of hospital facility or facility reporting group  
For single facility filers only: line Number of Hospital Facility (from Schedule H, Part V, Section A) 2
Yes No
Community Health Needs Assessment (Lines 1 through 8c are optional for tax years begining on or before March 23, 2012)
1 During the tax year or either of the two immediately preceding tax years, did the hospital facility conduct a community health needs assessment (CHNA)? If "No," skip to line 9.................... 1 Yes  
If “Yes,” indicate what the CHNA report describes (check all that apply):
a
b
c
d
e
f
g
h
i
j
2 Indicate the tax year the hospital facility last conducted a CHNA: 20 12
3 In conducting its most recent CHNA, did the hospital facility take into account input from representatives of the community served by the hospital facility, including those with special knowledge of or expertise in public health? If “Yes,” describe in Part VI how the hospital facility took into account input from persons who represent the community, and identify the persons the hospital facility consulted .................... 3 Yes  
4 Was the hospital facility’s CHNA conducted with one or more other hospital facilities? If “Yes,” list the other hospital facilities in Part VI................................ 4 Yes  
5 Did the hospital facility make its CHNA report widely available to the public? ............. 5 Yes  
If “Yes,” indicate how the CHNA report was made widely available (check all that apply):
a
b
c
6 If the hospital facility addressed needs identified in its most recently conducted CHNA, indicate how (check all that apply to date):
a
b
c
d
e
f
g
h
i
7 Did the hospital facility address all of the needs identified in its most recently conducted CHNA? If “No,” explain in Part VI which needs it has not addressed and the reasons why it has not addressed such needs ........ 7 Yes  
8a Did the organization incur an excise tax under section 4959 for the hospital facility's failure to conduct a CHNA as required by section 501(r)(3)? ........................... 8a   No
b If "Yes" to line 8a, did the organization file Form 4720 to report the section 4959 excise tax? ...... 8b    
c If "Yes" to line 8b, what is the total amount of section 4959 excise tax the organization reported on Form 4720 for all of its hospital facilities? $  

Schedule H (Form 990) 2012
Schedule H (Form 990) 2012
Page
Part VFacility Information (continued)

Financial Assistance Policy Yes No
9 Did the hospital facility have in place during the tax year a written financial assistance policy that:
Explained eligibility criteria for financial assistance, and whether such assistance includes free or discounted care? 9 Yes  
10 Used federal poverty guidelines (FPG) to determine eligibility for providing free care?........... 10 Yes  
If "Yes," indicate the FPG family income limit for eligibility for free care: 300.000000000000%
If "No," explain in Part VI the criteria the hospital facility used.
11 Used FPG to determine eligibility for providing discounted care?................. 11 Yes  
If “Yes,” indicate the FPG family income limit for eligibility for discounted care: 300.000000000000%
If "No," explain in Part VI the criteria the hospital facility used.
12 Explained the basis for calculating amounts charged to patients?................. 12 Yes  
If “Yes,” indicate the factors used in determining such amounts (check all that apply):
a
b
c
d
e
f
g
h
13 Explained the method for applying for financial assistance?................... 13 Yes  
14 Included measures to publicize the policy within the community served by the hospital facility?....... 14 Yes  
If “Yes,” indicate how the hospital facility publicized the policy (check all that apply):
a
b
c
d
e
f
g
Billing and Collections
15 Did the hospital facility have in place during the tax year a separate billing and collections policy, or a written financial assistance policy (FAP) that explained actions the hospital facility may take upon non-payment?....... 15 Yes  
16 Check all of the following actions against an individual that were permitted under the hospital facility's policies during the tax year before making reasonable efforts to determine the patient’s eligibility under the facility’s FAP:
a
b
c
d
e
17 Did the hospital facility or an authorized third party perform any of the following actions during the tax year before making reasonable efforts to determine the patient’s eligibility under the facility’s FAP?.......... 17   No
If “Yes,” check all actions in which the hospital facility or a third party engaged:
a
b
c
d
e
Schedule H (Form 990) 2012
Schedule H (Form 990) 2012
Page
Part VFacility Information (continued)

18 Indicate which efforts the hospital facility made before initiating any of the actions listed in line 17 (check all that apply):
a
b
c
d
e
Policy Relating to Emergency Medical Care
Yes No
19 Did the hospital facility have in place during the tax year a written policy relating to emergency medical care that requires the hospital facility to provide, without discrimination, care for emergency medical conditions to individuals regardless of their eligibility under the hospital facility’s financial assistance policy?.......... 19 Yes  
If “No,” indicate why:
a
b
c
d
Charges to Individuals Eligible for Assistance under the FAP (FAP-Eligible Individuals)
20 Indicate how the hospital facility determined, during the tax year, the maximum amounts that can be charged to FAP-eligible individuals for emergency or other medically necessary care.
a
b
c
d
21 During the tax year, did the hospital facility charge any FAP-eligible individuals to whom the hospital facility provided emergency or other medically necessary services, more than the amounts generally billed to individuals who had insurance covering such care? ............................ 21   No
If “Yes,” explain in Part VI.
22 During the tax year, did the hospital facility charge any FAP-eligible individuals an amount equal to the gross charge for any service provided to that individual? ......................... 22   No
If “Yes,” explain in Part VI.
Schedule H (Form 990) 2012
Schedule H (Form 990) 2012
Page
Part VFacility Information (continued)

Section B. Facility Policies and Practices

(Complete a separate Section B for each of the hospital facilities or facility reporting groups listed in Part V, Section A)
DEACONESS CROSS POINTE
Name of hospital facility or facility reporting group  
For single facility filers only: line Number of Hospital Facility (from Schedule H, Part V, Section A) 3
Yes No
Community Health Needs Assessment (Lines 1 through 8c are optional for tax years begining on or before March 23, 2012)
1 During the tax year or either of the two immediately preceding tax years, did the hospital facility conduct a community health needs assessment (CHNA)? If "No," skip to line 9.................... 1 Yes  
If “Yes,” indicate what the CHNA report describes (check all that apply):
a
b
c
d
e
f
g
h
i
j
2 Indicate the tax year the hospital facility last conducted a CHNA: 20 12
3 In conducting its most recent CHNA, did the hospital facility take into account input from representatives of the community served by the hospital facility, including those with special knowledge of or expertise in public health? If “Yes,” describe in Part VI how the hospital facility took into account input from persons who represent the community, and identify the persons the hospital facility consulted .................... 3 Yes  
4 Was the hospital facility’s CHNA conducted with one or more other hospital facilities? If “Yes,” list the other hospital facilities in Part VI................................ 4 Yes  
5 Did the hospital facility make its CHNA report widely available to the public? ............. 5 Yes  
If “Yes,” indicate how the CHNA report was made widely available (check all that apply):
a
b
c
6 If the hospital facility addressed needs identified in its most recently conducted CHNA, indicate how (check all that apply to date):
a
b
c
d
e
f
g
h
i
7 Did the hospital facility address all of the needs identified in its most recently conducted CHNA? If “No,” explain in Part VI which needs it has not addressed and the reasons why it has not addressed such needs ........ 7 Yes  
8a Did the organization incur an excise tax under section 4959 for the hospital facility's failure to conduct a CHNA as required by section 501(r)(3)? ........................... 8a   No
b If "Yes" to line 8a, did the organization file Form 4720 to report the section 4959 excise tax? ...... 8b    
c If "Yes" to line 8b, what is the total amount of section 4959 excise tax the organization reported on Form 4720 for all of its hospital facilities? $  

Schedule H (Form 990) 2012
Schedule H (Form 990) 2012
Page
Part VFacility Information (continued)

Financial Assistance Policy Yes No
9 Did the hospital facility have in place during the tax year a written financial assistance policy that:
Explained eligibility criteria for financial assistance, and whether such assistance includes free or discounted care? 9 Yes  
10 Used federal poverty guidelines (FPG) to determine eligibility for providing free care?........... 10 Yes  
If "Yes," indicate the FPG family income limit for eligibility for free care: 300.000000000000%
If "No," explain in Part VI the criteria the hospital facility used.
11 Used FPG to determine eligibility for providing discounted care?................. 11 Yes  
If “Yes,” indicate the FPG family income limit for eligibility for discounted care: 300.000000000000%
If "No," explain in Part VI the criteria the hospital facility used.
12 Explained the basis for calculating amounts charged to patients?................. 12 Yes  
If “Yes,” indicate the factors used in determining such amounts (check all that apply):
a
b
c
d
e
f
g
h
13 Explained the method for applying for financial assistance?................... 13 Yes  
14 Included measures to publicize the policy within the community served by the hospital facility?....... 14 Yes  
If “Yes,” indicate how the hospital facility publicized the policy (check all that apply):
a
b
c
d
e
f
g
Billing and Collections
15 Did the hospital facility have in place during the tax year a separate billing and collections policy, or a written financial assistance policy (FAP) that explained actions the hospital facility may take upon non-payment?....... 15 Yes  
16 Check all of the following actions against an individual that were permitted under the hospital facility's policies during the tax year before making reasonable efforts to determine the patient’s eligibility under the facility’s FAP:
a
b
c
d
e
17 Did the hospital facility or an authorized third party perform any of the following actions during the tax year before making reasonable efforts to determine the patient’s eligibility under the facility’s FAP?.......... 17   No
If “Yes,” check all actions in which the hospital facility or a third party engaged:
a
b
c
d
e
Schedule H (Form 990) 2012
Schedule H (Form 990) 2012
Page
Part VFacility Information (continued)

18 Indicate which efforts the hospital facility made before initiating any of the actions listed in line 17 (check all that apply):
a
b
c
d
e
Policy Relating to Emergency Medical Care
Yes No
19 Did the hospital facility have in place during the tax year a written policy relating to emergency medical care that requires the hospital facility to provide, without discrimination, care for emergency medical conditions to individuals regardless of their eligibility under the hospital facility’s financial assistance policy?.......... 19 Yes  
If “No,” indicate why:
a
b
c
d
Charges to Individuals Eligible for Assistance under the FAP (FAP-Eligible Individuals)
20 Indicate how the hospital facility determined, during the tax year, the maximum amounts that can be charged to FAP-eligible individuals for emergency or other medically necessary care.
a
b
c
d
21 During the tax year, did the hospital facility charge any FAP-eligible individuals to whom the hospital facility provided emergency or other medically necessary services, more than the amounts generally billed to individuals who had insurance covering such care? ............................ 21   No
If “Yes,” explain in Part VI.
22 During the tax year, did the hospital facility charge any FAP-eligible individuals an amount equal to the gross charge for any service provided to that individual? ......................... 22   No
If “Yes,” explain in Part VI.
Schedule H (Form 990) 2012
Schedule H (Form 990) 2012
Page
Part VFacility Information (continued)

Section C. Other Health Care Facilities That Are Not Licensed, Registered, or Similarly Recognized as a Hospital Facility
(list in order of size, from largest to smallest)
How many non-hospital health care facilities did the organization operate during the tax year?45
Name and address Type of Facility (describe)
1 DEACONESS PROCEDURE CENTER
421 CHESTNUT STREET
EVANSVILLE,IN47713 		OUTPATIENT SERVICES
2 DEACONESS HOSPITAL PHYSICAL MEDICINE
520 MARY STREET SUITE 280
EVANSVILLE,IN47747 		OUTPATIENT SERVICES
3 DEACONESS COMPREHENSIVE PAIN CTR & PROG
4600 W LLOYD EXPRESSWAY
EVANSVILLE,IN47712 		OUTPATIENT SERVICES
4 DEACONESS CHEMOTHERAPY INFUSION CTR
4055 GATEWAY BLVD SUITE 1200
NEWBURGH,IN47630 		OUTPATIENT SERVICES
5 DEACONESS HOSPITAL INFUSION SVCS
421 CHESTNUT STREET
EVANSVILLE,IN47713 		OUTPATIENT SERVICES
6 DEACONESS HOSPITAL PHYSICAL MEDICINE
10455 ORTHOPAEDIC DRIVE
NEWBURGH,IN47630 		OUTPATIENT SERVICES
7 DEACONESS COMPREHENSIVE PAIN CTR-GATEWAY
4099 GATEWAY BLVD
NEWBURGH,IN47630 		OUTPATIENT SERVICES
8 DEACONESS CRITICAL CARE GROUP
519 HARRIET STREET
EVANSVILLE,IN47747 		OUTPATIENT PHYSICIAN CLINIC
9 DEACONESS HOSPITAL BREAST CENTER
520 MARY STREET SUITE 140
EVANSVILLE,IN47710 		DIAGNOSTIC CENTER
10 DEACONESS REGIONAL LABORATORY
421 CHESTNUT STREET
EVANSVILLE,IN47713 		DIAGNOSTIC CENTER
11 DEACONESS HOME CARE
701 GARFIELD STREET
EVANSVILLE,IN47747 		HOME HEALTH AGENCY
12 CHANCELLOR CENTER FOR ONCOLOGY
4055 GATEWAY BLVD
NEWBURGH,IN47630 		OUTPATIENT SERVICES
13 DEACONESS SLEEP LAB
350 W COLUMBIA STREET SUITE 210
EVANSVILLE,IN47710 		OUTPATIENT SERVICES
14 DEACONESS SLEEP LAB
350 W COLUMBIA STREET SUITE LL-10
EVANSVILLE,IN47710 		DIAGNOSTIC CENTER
15 DEACONESS OHIO VALLEY HOSPICE
701 GARFIELD STREET
EVANSVILLE,IN47747 		HOSPICE
16 DEACONESS REGIONAL LABORATORY
4133 GATEWAY BLVD SUITE 110
NEWBURGH,IN47630 		DIAGNOSTIC CENTER
17 THE FAMILY PRACTICE CENTER
515 READ STREET
EVANSVILLE,IN47710 		OUTPATIENT PHYSICIAN CLINIC
18 DEACONESS WOUND CARE CENTER
611 HARRIET STREET SUITE 501
EVANSVILLE,IN47710 		OUTPATIENT SERVICES
19 DEACONESS HOSPITAL MAMMOGRAPHY & IMAGING
421 CHESTNUT STREET
EVANSVILLE,IN47713 		DIAGNOSTIC CENTER
20 DEACONESS CLINIC GATEWAY REG LAB
4233 GATEWAY BLVD
NEWBURGH,IN47630 		DIAGNOSTIC CENTER
21 DEACONESS ANTICOAGULATION CLINIC
4107 GATEWAY BLVD
NEWBURGH,IN47630 		OUTPATIENT SERVICES
22 DEACONESS CLINIC WEST REG LAB RADIOLOGY
545 S BOEHNE CAMP ROAD
EVANSVILLE,IN47712 		OUTPATIENT PHYSICIAN CLINIC
23 MIDWEST RADIOLOGIC IMAGING
10455 ORTHOPAEDIC DRIVE
NEWBURGH,IN47630 		DIAGNOSTIC CENTER
24 MIDWEST RADIOLOGICAL IMAGING
4087 GATEWAY BLVD
NEWBURGH,IN47630 		DIAGNOSTIC CENTER
25 DEACONESS REGIONAL LABORATORY
611 HARRIET STREET SUITE 102
EVANSVILLE,IN47710 		DIAGNOSTIC CENTER
26 DEACONESS RILEY CHILDREN'S SPECIALTY CTR
4133 GATEWAY BLVD
NEWBURGH,IN47630 		OUTPATIENT PHYSICIAN CLINIC
27 DEACONESS RILEY SPECIALITY CTR OP
4121 GATEWAY BLVD
NEWBURGH,IN47630 		OUTPATIENT PHYSICIAN CLINIC
28 DOCTOR'S PLAZA X-RAY
611 HARRIET STREET
EVANSVILLE,IN47710 		DIAGNOSTIC CENTER
29 DEACONESS PRIMARY CARE FOR SENIORS
4498 FIRST AVENUE
EVANSVILLE,IN47710 		OUTPATIENT PHYSICIAN CLINIC
30 DEACONESS REGIONAL LABORATORY
4494 N FIRST AVENUE
EVANSVILLE,IN47710 		DIAGNOSTIC CENTER
31 DEACONESS CLINIC PRINCETON RADIOLOGY SRV
685 VAIL STREET
PRINCETON,IN47670 		OUTPATIENT PHYSICIAN CLINIC
32 DEACONESS PRIMARY CARE FOR SENIORS
1750 OAK HILL ROAD
EVANSVILLE,IN47710 		OUTPATIENT PHYSICIAN CLINIC
33 DEACONESS PRE-ADMISSION TESTING
520 MARY STREET SUITE 330
EVANSVILLE,IN47747 		DIAGNOSTIC CENTER
34 MT VERNON MEDICAL CENTER LAB & RADIOLOGY
1900 W FOURTH STREET
MT VERNON,IN47620 		DIAGNOSTIC CENTER
35 DEACONESS FAMILY MEDICINE
611 HARRIET STREET SUITE 504
EVANSVILLE,IN47710 		OUTPATIENT PHYSICIAN CLINIC
36 DEACONESS DIABETES CENTER - EDUCATION
421 CHESTNUT STREET
EVANSVILLE,IN47713 		OUTPATIENT SERVICES
37 DEACONESS GATEWAY GASTROENTEROLOGY
4133 GATEWAY BLVD
NEWBURGH,IN47630 		OUTPATIENT PHYSICIAN CLINIC
38 DEACONESS WEIGHT LOSS SOLUTIONS
310 W IOWA STREET
EVANSVILLE,IN47710 		OUTPATIENT PHYSICIAN CLINIC
39 DEACONESS REGIONAL LABORATORY
1204 W WILLIAMS STREET
OAKLAND CITY,IN47660 		DIAGNOSTIC CENTER
40 DEACONESS CROSS POINTE-OWENSBORO
920 FREDERICA STREET SUITE 1003
OWENSBORO,KY42301 		OUTPATIENT PHYSICIAN CLINIC
41 DEACONESS CROSS POINTE-HENDERSON
209 N ELM STREET
HENDERSON,KY42420 		OUTPATIENT PHYSICIAN CLINIC
42 DEACONESS CROSS POINTE OUTPATIENT CLINIC
445 CROSS POINTE BLVD
EVANSVILLE,IN47715 		OUTPATIENT PHYSICIAN CLINIC
43 DEACONESS CROSS POINTE
7200 E INDIANA
EVANSVILLE,IN47715 		OUTPATIENT PHYSICIAN CLINIC
44 DEACONESS RADIOLOGY LABORATORY- MT PLEA
8600 NORTH KENTUCKY AVENUE
EVANSVILLE,IN47725 		DIAGNOSTIC CENTER
45 DEACONESS RADIOLOGY SERVICES- MT PLEASA
8600 NORTH KENTUCKY AVENUE
EVANSVILLE,IN47725 		DIAGNOSTIC CENTER
Schedule H (Form 990) 2012
Schedule H (Form 990) 2012
Page
Part VI
Supplemental Information
Complete this part to provide the following information.
1 Required descriptions. Provide the descriptions required for Part I, lines 3c, 6a, and 7; Part II; Part III, lines 4, 8, and 9b; Part V, Section A; and Part V, Section B, lines 1j, 3, 4, 5c, 6i, 7, 10, 11, 12h, 14g, 16e, 17e, 18e, 19c, 19d, 20d, 21, and 22.
2 Needs assessment. Describe how the organization assesses the health care needs of the communities it serves, in addition to any needs assessments reported in Part V, Section B.
3 Patient education of eligibility for assistance. 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 financial assistance policy.
4 Community information. Describe the community the organization serves, taking into account the geographic area and demographic constituents it serves.
5 Promotion of community health. Provide any other information important to describing how the organization’s hospital facilities or other health care facilities further its exempt purpose by promoting the health of the community (e.g., open medical staff, community board, use of surplus funds, etc.).
6 Affiliated health care system. 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.
7 State filing of community benefit report. If applicable, identify all states with which the organization, or a related organization, files a community benefit report.
8 Facility reporting group(s). If applicable, for each hospital facility in a facility reporting group provide the descriptions required for Part V, Section B, lines 1j, 3, 4, 5c, 6i, 7, 10, 11, 12h, 14g, 16e, 17e, 18e, 19c, 19d, 20d, 21, and 22.
Identifier ReturnReference Explanation
    PART I, LINE 6A: DEACONESS HOSPITAL PREPARES AN ANNUAL COMMUNITY BENEFIT REPORT. THE REPORT IS MADE AVAILABLE IN THE FOLLOWING WAYS:1. MAILED TO ALL THE MAJOR EMPLOYERS IN THE TRI-STATE AREA.2. AN ADVERTISEMENT IS PLACED IN THE SUNDAY PAPER OF THE EVANSVILLE COURIER AND PRESS.3. IS MADE AVAILABLE ON THE DEACONESS WEBSITE AT HTTP://WWW.DEACONESS.COM/CAREERS/FOR-OUR-EMPLOYEES/ OUR-COMMUNITY/COMMUNITY-BENEFIT.ASPX
    PART I, LINE 7: A COST TO CHARGE RATIO WAS USED FOR MOST OF THE CALCULATIONS FOR THE TABLE. IRS INSTRUCTION'S WORKSHEET 2 WAS USED FOR THIS CALCULATION. WE DID NOT USE THE COST TO CHARGE RATIO FOR LINE 7G AS IT WAS NOT RELEVANT TO THESE SERVICES. THE ACTUAL COST FROM OUR COSTING SYSTEM WAS USED WHEN AVAILABLE. THE COST TO CHARGE RATIO FOR EACH SERVICE TYPE WAS USED TO ESTIMATE COST WHEN NOT AVAILABLE FROM OUR INTERNAL COSTING SYSTEM.
    PART I, LINE 7G: SUBSIDIZED HEALTH SERVICES ATTRIBUTED TO PHYSICIAN CLINICS HAVE A COST OF $455,161. THESE CLINICS ARE OPERATED AS A BENEFIT TO THE COMMUNITY.
    PART I, L7 COL(F): THE BAD DEBT EXPENSE IS NOT INCLUDED ON FORM 990, PART IX, LINE 25, COLUMN (A) DUE TO EARLY ADOPTION OF ACCOUNTING STANDARDS UPDATE (ASU) 2011-07, HEALTHCARE ENTITIES (TOPIC 954).
    PART II: COMMUNITY BUILDING ACTIVITIES:DURING FISCAL YEAR 2014, DEACONESS PROVIDED FINANCIAL SUPPORT TO MORE THAN 100 NON-PROFIT ORGANIZATIONS LOCATED IN OUR THREE-STATE SERVICE AREA. THIS INCLUDES SPONSORSHIP OF WALKS AND RUNS TO RAISE AWARENESS FOR DISEASES AND HEALTH CONDITIONS, DONATIONS TO AREA FOOD PANTRIES, SIGNIFICANT PARTNERSHIPS WITH EVENTS THAT FUND RESEARCH FOR BREAST CANCER AND TYPE 1 DIABETES, AND FUNDING FOR SOCIAL WORKERS SO THEY CAN BE IN THE MIDDLE AND HIGH SCHOOLS WHERE THEIR SERVICES ARE DESPERATELY NEEDED. THE HOSPITAL GAVE EACH TEACHER IN THE DESIGNATED "COMMUNITY BENEFIT SCHOOLS" $100 TO BUSY SUPPLIES FOR THEIR CLASSROOM, TOTALING OF $23,236. THE HOSPITAL ALSO SENT $100 TO EVERY "AFTER PROM" EVENT IN THE REGION TO PROVIDE TEENAGERS WITH A SAFE PLACE TO CELEBRATE FREE FROM DRUGS, ALCOHOL, AND RISKY BEHAVIOR, TOTALING $2,100. DEACONESS PROVIDED FREE AND REDUCED CARE WITHIN OUR HOSPITAL BUILDINGS. THROUGH OUR MEDICATION ASSISTANCE PROGRAM, OUR FAMILY PRACTICE RESIDENCY CLINIC, AND COMMUNITY HEALTH SCREENINGS, AREA RESIDENTS CAN ACCESS THE HIGH QUALITY HEALTHCARE THEY NEED IN CONVENIENT LOCATIONS AND AT A PRICE THEY CAN AFFORD. DEACONESS PROMOTES HEALTHY LIVING IN THE COMMUNITY THROUGH SEVERAL INITIATIVES INCLUDING:1. HEALTHIER U WORKS: ORGANIZED, OUTDOOR COMMUNITY WALK EVERY MORNING FROM APRIL TO OCTOBER2. WISE CHOICE: VENDORS AT THE ANNUAL FALL FESTIVAL SUBMIT RECIPES TO OUR DIETICIANS. IF THEY MEET CERTAIN NUTRITIONAL REQUIREMENTS, THE VENDOR'S BOOTH GETS A GREEN SIGN TO HANG THAT INDICATES THE SERVE HEALTHY FOOD OPTIONS AT THEIR BOOTH.3. MEN'S HEALTH SERIES: ONCE A MONTH FROM MARCH THROUGH NOVEMBER, MEN IN THE COMMUNITY ARE INVITED TO COME TO THE HOSPITAL, EAT DINNER, AND HEAR A PRESENTATION SPECIFICALLY GEARED TOWARD IMPROVING MEN'S HEALTH.4. COMMUNITY SCREENINGS: EACH, WEEK, REDUCED COST HEALTH SCREENINGS ARE OFFERED AT A DEACONESS CLINIC LOCATION. THE LOCATION ROTATES BETWEEN MULTIPLE STATES AND COUNTIES. 5. MENTAL HEALTH FIRST-AID COURSES: AN EDUCATION PROGRAM THAT HELPS THE PUBLIC IDENTIFIES, UNDERSTAND, AND RESPOND TO SIGNS OF MENTAL ILLNESSES AND SUBSTANCE ABUSE DISORDERS.6. TRAUMA EDUCATION: DEACONESS TRAUMA SERVICES DEVOTES TIME AND RESOURCES TO EDUCATING EMS PERSONNEL AND OTHER FIRST RESPONDERS IN THE REGION. 7. HEALTH SCIENCE INSTITUTE: A HANDS-ON SUMMER PROGRAM FOR HIGH SCHOOL STUDENTS INTERESTED IN THE MEDICAL PROFESSION. 8. SUICIDE PREVENTION: MEMBERS OF OUR MENTAL HEALTH HOSPITAL TRAVEL AROUND THE REGION TO PROVIDE SUICIDE PREVENTION TRAINING TO SCHOOLS, CHURCHES, NON-PROFIT GROUPS, ETC.
    PART III, LINE 4: SECTION A. FOOTNOTE TO ORGANIZATION'S FINANCIAL STATEMENTS THAT DESCRIBES BAD DEBT EXPENSE: (BELOW IS THE PORTION OF THE AUDITED FINANCIAL STATEMENT FOOTNOTE "PATIENT ACCOUNTS RECEIVABLE, ESTIMATED THIRD-PARTY PAYOR SETTLEMENTS AND NET PATIENT SERVICE REVENUE" RELATED TO BAD DEBTS.)PATIENT ACCOUNTS RECEIVABLE ARE REDUCED BY AN ALLOWANCE FOR UNCOLLECTIBLE ACCOUNTS BASED ON THE SYSTEM'S EVALUATION OF ITS MAJOR PAYOR SOURCES OF REVENUE, THE AGING OF THE ACCOUNTS, HISTORICAL LOSSES, CURRENT ECONOMIC CONDITIONS, AND OTHER FACTORS UNIQUE TO ITS SERVICE AREA AND THE HEALTHCARE INDUSTRY. MANAGEMENT REGULARLY REVIEWS DATA ABOUT THE MAJOR PAYOR SOURCES OF REVENUE IN EVALUATING THE SUFFICIENCY OF THE ALLOWANCE FOR UNCOLLECTIBLE ACCOUNTS. FOR RECEIVABLES ASSOCIATED WITH SERVICES PROVIDED TO PATIENTS WHO HAVE THIRD-PARTY COVERAGE, THE SYSTEM ANALYZES CONTRACTUALLY DUE AMOUNTS AND PROVIDES AN ALLOWANCE FOR UNCOLLECTIBLE ACCOUNTS AND A PROVISION FOR BAD DEBTS, IF NECESSARY. FOR RECEIVABLES ASSOCIATED WITH SELF-PAY PAYMENTS THE SYSTEM RECORDS A SIGNIFICANT PROVISION FOR BAD DEBTS IN THE PERIOD OF SERVICE ON THE BASIS OF ITS PAST EXPERIENCE, WHICH INDICATES THAT MANY PATIENTS ARE UNABLE OR UNWILLING TO PAY THE PORTION OF THEIR BILL FOR WHICH THEY ARE FINANCIALLY RESPONSIBLE. THE DIFFERENCE BETWEEN THE STANDARD RATES (OR THE DISCOUNTED RATES IF NEGOTIATED) AND THE AMOUNTS ACTUALLY COLLECTED AFTER ALL REASONABLE COLLECTION EFFORTS HAVE BEEN EXHAUSTED IS CHARGED OFF AGAINST THE ALLOWANCE FOR UNCOLLECTIBLE ACCOUNTS.
    PART III, LINE 8: THE SOURCE USED TO DETERMINE THE AMOUNT OF MEDICARE REVENUE AND ALLOWABLE COSTS REPORTED FOR PART III, SECTION B, LINE 8: THE MEDICARE TOTAL REVENUE AND ALLOWABLE COSTS WERE ESTIMATED BASED UPON THE 2013 MEDICARE COST REPORT. THE MEDICARE SHORTFALL FOR DEACONESS HOSPITAL IS TREATED AS COMMUNITY BENEFIT DUE TO THE HOSPITAL PROVIDING CARE TO MEDICARE PATIENTS AT LESS THAN THE ALLOWABLE MEDICARE COSTS.
    PART III, LINE 9B: DEACONESS HOSPITAL MAKES A DISTINCTION BETWEEN CHARITY AND BAD DEBT. IN DETERMINING AN INDIVIDUAL OR FAMILY'S ABILITY TO PAY, DEACONESS HOSPITAL EVALUATES WHETHER OR NOT THE RESPONSIBLE PARTY HAS SUFFICIENT RESOURCES FOR PAYMENT. IF AN INDIVIDUAL IS DETERMINED TO NOT HAVE SUFFICIENT RESOURCES TO PAY, THEY WILL BE CONSIDERED ELIGIBLE FOR CHARITY CARE AND WILL NOT BE PROCESSED THROUGH EITHER INTERNAL OR EXTERNAL COLLECTIONS. ACCOUNTS OF CHARITY CARE PATIENTS WHO ARE UNABLE TO PAY DO NOT RESULT IN BAD DEBT AND ARE NOT COLLECTED UPON.
DEACONESS HOSPITAL, INC.   PART V, SECTION B, LINE 3: DESCRIPTION OF COMMUNITY INPUT:IN 2011, DEACONESS HEALTH SYSTEM JOINED FOUR OTHER LOCAL HEALTH-RELATED ORGANIZATIONS, ECHO COMMUNITY HEALTH CARE, ST. MARY'S MEDICAL CENTER, UNITED WAY, AND WELBORN BAPTIST FOUNDATION, TO PLAN FOR AND ADMINISTER A COMMUNITY HEALTH NEEDS ASSESSMENT (CHNA). MEMBERS OF THE DEACONESS COMMUNITY BENEFIT TEAM MET REGULARLY WITH OTHER MEMBERS OF THE COLLABORATIVE TO CREATE A STRATEGY AND TACTICS THAT ADDRESS OUR FOUR IDENTIFIED COMMUNITY HEALTH NEEDS. WE ALSO PARTICIPATED IN FOCUS GROUP SESSIONS WITH 51 BUSINESS, COMMUNITY, AND SOCIAL SERVICE LEADERS AND STRATEGY SESSIONS WITH 42 PROVIDERS AND AGENCIES TO DEVELOP A PLAN THAT WOULD CAUSE POSITIVE CHANGE IN THE OVERALL HEALTH OF OUR POPULATION. ADDITIONALLY, EACH PARTNER CREATED AN ORGANIZATION SPECIFIC PLAN TO ADDRESS THE SAME ISSUES. THE PLANS WERE TRANSCRIBED, PRESENTED AT A PRESS CONFERENCE, AND POSTED ON THE WEBSITE OF EACH PARTNER'S ORGANIZATION.
DEACONESS GATEWAY HOSPITAL   PART V, SECTION B, LINE 3: DESCRIPTION OF COMMUNITY INPUT:IN 2011, DEACONESS HEALTH SYSTEM JOINED FOUR OTHER LOCAL HEALTH-RELATED ORGANIZATIONS, ECHO COMMUNITY HEALTH CARE, ST. MARY'S MEDICAL CENTER, UNITED WAY, AND WELBORN BAPTIST FOUNDATION, TO PLAN FOR AND ADMINISTER A COMMUNITY HEALTH NEEDS ASSESSMENT (CHNA). MEMBERS OF THE DEACONESS COMMUNITY BENEFIT TEAM MET REGULARLY WITH OTHER MEMBERS OF THE COLLABORATIVE TO CREATE A STRATEGY AND TACTICS THAT ADDRESS OUR FOUR IDENTIFIED COMMUNITY HEALTH NEEDS. WE ALSO PARTICIPATED IN FOCUS GROUP SESSIONS WITH 51 BUSINESS, COMMUNITY, AND SOCIAL SERVICE LEADERS AND STRATEGY SESSIONS WITH 42 PROVIDERS AND AGENCIES TO DEVELOP A PLAN THAT WOULD CAUSE POSITIVE CHANGE IN THE OVERALL HEALTH OF OUR POPULATION. ADDITIONALLY, EACH PARTNER CREATED AN ORGANIZATION SPECIFIC PLAN TO ADDRESS THE SAME ISSUES. THE PLANS WERE TRANSCRIBED, PRESENTED AT A PRESS CONFERENCE, AND POSTED ON THE WEBSITE OF EACH PARTNER'S ORGANIZATION.
DEACONESS CROSS POINTE   PART V, SECTION B, LINE 3: DESCRIPTION OF COMMUNITY INPUT:IN 2011, DEACONESS HEALTH SYSTEM JOINED FOUR OTHER LOCAL HEALTH-RELATED ORGANIZATIONS, ECHO COMMUNITY HEALTH CARE, ST. MARY'S MEDICAL CENTER, UNITED WAY, AND WELBORN BAPTIST FOUNDATION, TO PLAN FOR AND ADMINISTER A COMMUNITY HEALTH NEEDS ASSESSMENT (CHNA). MEMBERS OF THE DEACONESS COMMUNITY BENEFIT TEAM MET REGULARLY WITH OTHER MEMBERS OF THE COLLABORATIVE TO CREATE A STRATEGY AND TACTICS THAT ADDRESS OUR FOUR IDENTIFIED COMMUNITY HEALTH NEEDS. WE ALSO PARTICIPATED IN FOCUS GROUP SESSIONS WITH 51 BUSINESS, COMMUNITY, AND SOCIAL SERVICE LEADERS AND STRATEGY SESSIONS WITH 42 PROVIDERS AND AGENCIES TO DEVELOP A PLAN THAT WOULD CAUSE POSITIVE CHANGE IN THE OVERALL HEALTH OF OUR POPULATION. ADDITIONALLY, EACH PARTNER CREATED AN ORGANIZATION SPECIFIC PLAN TO ADDRESS THE SAME ISSUES. THE PLANS WERE TRANSCRIBED, PRESENTED AT A PRESS CONFERENCE, AND POSTED ON THE WEBSITE OF EACH PARTNER'S ORGANIZATION.
DEACONESS HOSPITAL, INC.   PART V, SECTION B, LINE 4: OTHER HOSPITAL FACILITIES CHNA WAS CONDUCTED WITH:DEACONESS GATEWAY HOSPITALDEACONESS CROSS POINTEST. MARY'S MEDICAL CENTER
DEACONESS GATEWAY HOSPITAL   PART V, SECTION B, LINE 4: OTHER HOSPITAL FACILITIES CHNA WAS CONDUCTED WITH:DEACONESS HOSPITAL, INC.DEACONESS CROSS POINTEST. MARY'S MEDICAL CENTER
DEACONESS CROSS POINTE   PART V, SECTION B, LINE 4: OTHER HOSPITAL FACILITIES CHNA WAS CONDUCTED WITH:DEACONESS HOSPITAL, INC.DEACONESS GATEWAY HOSPITALST. MARY'S MEDICAL CENTER
DEACONESS HOSPITAL, INC.   PART V, SECTION B, LINE 5C: CHNA IS MADE WIDELY AVAILABLE ON THE HOSPITAL'S WEBSITE: THE HOSPITAL COMMUNITY HEALTH NEEDS ASSESSMENT IS LOCATED AT HTTP://WWW.DEACONESS.COM/CHNA.
DEACONESS GATEWAY HOSPITAL   PART V, SECTION B, LINE 5C: CHNA IS MADE WIDELY AVAILABLE ON THE HOSPITAL'S WEBSITE: THE HOSPITAL COMMUNITY HEALTH NEEDS ASSESSMENT IS LOCATED AT HTTP://WWW.DEACONESS.COM/CHNA.
DEACONESS CROSS POINTE   PART V, SECTION B, LINE 5C: CHNA IS MADE WIDELY AVAILABLE ON THE HOSPITAL'S WEBSITE: THE HOSPITAL COMMUNITY HEALTH NEEDS ASSESSMENT IS LOCATED AT HTTP://WWW.DEACONESS.COM/CHNA.
DEACONESS HOSPITAL, INC.   PART V, SECTION B, LINE 6I: METHOD FOR ADDRESSING NEEDS IDENTIFIED IN CHNA:6A: IN 2011, DEACONESS HEALTH SYSTEM JOINED FOUR OTHER LOCAL HEALTH-RELATED ORGANIZATIONS, ECHO COMMUNITY HEALTH CARE, ST. MARY'S MEDICAL CENTER, UNITED WAY, AND WELBORN BAPTIST FOUNDATION, TO PLAN FOR AND ADMINISTER A COMMUNITY HEALTH NEEDS ASSESSMENT (CHNA). REVIEW OF THE ASSESSMENT DATA LED THE TEAM TO IDENTIFY FOUR MAIN ISSUES AT THE CORE OF POOR COMMUNITY HEALTH: TOBACCO USE, OBESITY, SUBSTANCE ABUSE, AND MENTAL HEALTH. THE COLLABORATIVE CREATED A GROUP PLAN OF ACTION TO ADDRESS THE FOUR IDENTIFIED COMMUNITY HEALTH ISSUES. MEETING WITH COMMUNITY PARTNERS AND STAKEHOLDERS GUIDED THE PLANNING PROCESS. ADDITIONALLY, EACH PARTNER CREATED AN ORGANIZATION SPECIFIC PLAN TO ADDRESS THE SAME ISSUES. THE PLANS WERE TRANSCRIBED, PRESENTED AT A PRESS CONFERENCE, AND POSTED ON THE WEBSITE OF EACH PARTNER'S ORGANIZATION.6B: STRATEGIES FOR EACH OF THE FOUR TARGET AREAS WERE CREATED FOR THE COLLABORATIVE AND FOR DEACONESS. SINCE THE HOSPITAL SERVES VANDERBURGH AND WARRICK COUNTIES IN INDIANA, THE STRATEGY FOR DEACONESS INCLUDES TACTICS TO ADDRESS THESE ISSUES IN BOTH COMMUNITIES. AN INTERNAL TEAM LEADER WAS ASSIGNED TO EACH OF THE FOUR TOPIC AREAS AND RESPONSIBLE FOR PUTTING TOGETHER A TEAM AND THEN A PLAN TO CREATE POSITIVE CHANGE IN THE SPECIFIC HEALTH AREA. THE PLANNING PHASE IS COMPLETE AND THE EXECUTION PHASE TAKES PLACE IN TAX YEARS 2013, 2014, 2015.6C: MEMBERS OF THE DEACONESS COMMUNITY BENEFIT TEAM MET REGULARLY WITH OTHER MEMBERS OF THE COLLABORATIVE TO CREATE A STRATEGY AND TACTICS THAT ADDRESS OUR FOUR IDENTIFIED COMMUNITY HEALTH NEEDS. THE BENEFIT TEAM PARTICIPATED IN FOCUS GROUP SESSIONS WITH 51 BUSINESS, COMMUNITY, AND SOCIAL SERVICE LEADERS, AND STRATEGY SESSIONS WITH 42 PROVIDERS AND AGENCIES TO DEVELOP A PLAN THAT WOULD CAUSE POSITIVE CHANGE IN THE OVERALL HEALTH OF OUR POPULATION.6D: THE FIRST STEP IN EXECUTING OUR COMMUNITY HEALTH NEEDS ASSESSMENT IMPLEMENTATION PLAN WAS RELEASING INFORMATION TO THE PUBLIC. A PRESS CONFERENCE WAS HELD JUNE 13, 2013, AT A LOCAL BUSINESS. DURING THE PRESS CONFERENCE, REPRESENTATIVES FROM THE COLLABORATIVE EXPLAINED THE CHNA SURVEY PROCESS, RESULTS, CONTRIBUTIONS OF COMMUNITY PARTNERS, AND THE FOUR HEALTH ISSUES SELECTED AS OUR FOCUS FOR THE NEXT THREE YEARS. FOLLOWING THIS ANNOUNCEMENT, THE COLLABORATIVE SET UP MEETINGS FOR EACH OF THE FOUR HEALTH TOPICS AND INVITED ALL RELEVANT COMMUNITY PARTNERS TO ATTEND. DURING THESE MEETINGS, THE GROUP REVIEWS THE ACTION ITEMS IN THE IMPLEMENTATION PLAN, REPORTS ON THE PROGRESS OF THOSE ITEMS, AND ASKS FOR ASSISTANCE OR ADDITIONAL RESOURCES AS APPROPRIATE. 6G: MEMBERS OF OUR THREE KEY INFORMANT GROUPS (COMMUNITY LEADERS, BUSINESS LEADERS, AND SOCIAL SERVICE AGENCIES) SUBMITTED THEIR TOP 5 HEALTH PRIORITIES FOR THE COMMUNITY. THIS INFORMATION WAS COUPLED WITH THE SURVEY DATA RESULTING IN A LIST OF SEVEN KEY COMMUNITY HEALTH ISSUES. FOLLOWING FURTHER ANALYSIS, THE COLLABORATIVE DECIDED THAT TOBACCO USE, OBESITY, SUBSTANCE ABUSE, AND MENTAL HEALTH ISSUES WERE THE ROOT CAUSES OF MULTIPLE HEALTH CONDITIONS AND HIGHER HEALTH CARE COSTS. BY ADDRESSING THESE FOUR AREAS, THE COLLABORATIVE COULD HAVE THE BIGGEST IMPACT ON THE CURRENT HEALTH CONDITIONS IN OUR COMMUNITIES. 6H:AS PART OF OUR AGREEMENT WITH THE CHNA COLLABORATIVE, DEACONESS WILL FOCUS TIME AND RESOURCES FOR THE NEXT THREE YEARS ON CREATING POSITIVE CHANGE IN THE FOUR IDENTIFIED TOPIC AREAS. DEACONESS OPERATES AN ACCOUNTABLE CARE ORGANIZATION (ACO) CALLED DEACONESS CARE INTEGRATION. THE ACO HOUSES MANY OF THE PROGRAMS WE WILL USED TO ADDRESS OBESITY, TOBACCO USE, MENTAL HEALTH AND SUBSTANCE ABUSE. SPECIFIC SERVICES INCLUDE CERTIFICATION FOR ALL DEACONESS CLINIC LOCATIONS AS PATIENT CENTERED MEDICAL HOMES (PCMH), USE OF HEALTH COACHES IN THE PCMH, REFERRALS TO OUR MEDICATION MANAGEMENT PROGRAM, DIABETES MANAGEMENT PROGRAM, SUBSTANCE ABUSE, AND MENTAL HEALTH SERVICES (DEACONESS OPERATES A BEHAVIORAL HEALTH CLINIC AS WELL AS INPATIENT AND OUTPATIENT MENTAL HEALTH SERVICES.) THE DESIGN OF OUR ACO AND PCMH ENABLES STAFF MEMBERS TO EASILY ADDRESS THE FOUR IDENTIFIED COMMUNITY HEALTH NEEDS DURING ROUTINE OFFICE VISITS.
DEACONESS GATEWAY HOSPITAL   PART V, SECTION B, LINE 6I: METHOD FOR ADDRESSING NEEDS IDENTIFIED IN CHNA:6A: IN 2011, DEACONESS HEALTH SYSTEM JOINED FOUR OTHER LOCAL HEALTH-RELATED ORGANIZATIONS, ECHO COMMUNITY HEALTH CARE, ST. MARY'S MEDICAL CENTER, UNITED WAY, AND WELBORN BAPTIST FOUNDATION, TO PLAN FOR AND ADMINISTER A COMMUNITY HEALTH NEEDS ASSESSMENT (CHNA). REVIEW OF THE ASSESSMENT DATA LED THE TEAM TO IDENTIFY FOUR MAIN ISSUES AT THE CORE OF POOR COMMUNITY HEALTH: TOBACCO USE, OBESITY, SUBSTANCE ABUSE, AND MENTAL HEALTH. THE COLLABORATIVE CREATED A GROUP PLAN OF ACTION TO ADDRESS THE FOUR IDENTIFIED COMMUNITY HEALTH ISSUES. MEETING WITH COMMUNITY PARTNERS AND STAKEHOLDERS GUIDED THE PLANNING PROCESS. ADDITIONALLY, EACH PARTNER CREATED AN ORGANIZATION SPECIFIC PLAN TO ADDRESS THE SAME ISSUES. THE PLANS WERE TRANSCRIBED, PRESENTED AT A PRESS CONFERENCE, AND POSTED ON THE WEBSITE OF EACH PARTNER'S ORGANIZATION.6B: STRATEGIES FOR EACH OF THE FOUR TARGET AREAS WERE CREATED FOR THE COLLABORATIVE AND FOR DEACONESS. SINCE THE HOSPITAL SERVES VANDERBURGH AND WARRICK COUNTIES IN INDIANA, THE STRATEGY FOR DEACONESS INCLUDES TACTICS TO ADDRESS THESE ISSUES IN BOTH COMMUNITIES. AN INTERNAL TEAM LEADER WAS ASSIGNED TO EACH OF THE FOUR TOPIC AREAS AND RESPONSIBLE FOR PUTTING TOGETHER A TEAM AND THEN A PLAN TO CREATE POSITIVE CHANGE IN THE SPECIFIC HEALTH AREA. THE PLANNING PHASE IS COMPLETE AND THE EXECUTION PHASE TAKES PLACE IN TAX YEARS 2013, 2014, 2015.6C: MEMBERS OF THE DEACONESS COMMUNITY BENEFIT TEAM MET REGULARLY WITH OTHER MEMBERS OF THE COLLABORATIVE TO CREATE A STRATEGY AND TACTICS THAT ADDRESS OUR FOUR IDENTIFIED COMMUNITY HEALTH NEEDS. THE BENEFIT TEAM PARTICIPATED IN FOCUS GROUP SESSIONS WITH 51 BUSINESS, COMMUNITY, AND SOCIAL SERVICE LEADERS, AND STRATEGY SESSIONS WITH 42 PROVIDERS AND AGENCIES TO DEVELOP A PLAN THAT WOULD CAUSE POSITIVE CHANGE IN THE OVERALL HEALTH OF OUR POPULATION.6D: THE FIRST STEP IN EXECUTING OUR COMMUNITY HEALTH NEEDS ASSESSMENT IMPLEMENTATION PLAN WAS RELEASING INFORMATION TO THE PUBLIC. A PRESS CONFERENCE WAS HELD JUNE 13, 2013, AT A LOCAL BUSINESS. DURING THE PRESS CONFERENCE, REPRESENTATIVES FROM THE COLLABORATIVE EXPLAINED THE CHNA SURVEY PROCESS, RESULTS, CONTRIBUTIONS OF COMMUNITY PARTNERS, AND THE FOUR HEALTH ISSUES SELECTED AS OUR FOCUS FOR THE NEXT THREE YEARS. FOLLOWING THIS ANNOUNCEMENT, THE COLLABORATIVE SET UP MEETINGS FOR EACH OF THE FOUR HEALTH TOPICS AND INVITED ALL RELEVANT COMMUNITY PARTNERS TO ATTEND. DURING THESE MEETINGS, THE GROUP REVIEWS THE ACTION ITEMS IN THE IMPLEMENTATION PLAN, REPORTS ON THE PROGRESS OF THOSE ITEMS, AND ASKS FOR ASSISTANCE OR ADDITIONAL RESOURCES AS APPROPRIATE. 6G: MEMBERS OF OUR THREE KEY INFORMANT GROUPS (COMMUNITY LEADERS, BUSINESS LEADERS, AND SOCIAL SERVICE AGENCIES) SUBMITTED THEIR TOP 5 HEALTH PRIORITIES FOR THE COMMUNITY. THIS INFORMATION WAS COUPLED WITH THE SURVEY DATA RESULTING IN A LIST OF SEVEN KEY COMMUNITY HEALTH ISSUES. FOLLOWING FURTHER ANALYSIS, THE COLLABORATIVE DECIDED THAT TOBACCO USE, OBESITY, SUBSTANCE ABUSE, AND MENTAL HEALTH ISSUES WERE THE ROOT CAUSES OF MULTIPLE HEALTH CONDITIONS AND HIGHER HEALTH CARE COSTS. BY ADDRESSING THESE FOUR AREAS, THE COLLABORATIVE COULD HAVE THE BIGGEST IMPACT ON THE CURRENT HEALTH CONDITIONS IN OUR COMMUNITIES. 6H:AS PART OF OUR AGREEMENT WITH THE CHNA COLLABORATIVE, DEACONESS WILL FOCUS TIME AND RESOURCES FOR THE NEXT THREE YEARS ON CREATING POSITIVE CHANGE IN THE FOUR IDENTIFIED TOPIC AREAS. DEACONESS OPERATES AN ACCOUNTABLE CARE ORGANIZATION (ACO) CALLED DEACONESS CARE INTEGRATION. THE ACO HOUSES MANY OF THE PROGRAMS WE WILL USED TO ADDRESS OBESITY, TOBACCO USE, MENTAL HEALTH AND SUBSTANCE ABUSE. SPECIFIC SERVICES INCLUDE CERTIFICATION FOR ALL DEACONESS CLINIC LOCATIONS AS PATIENT CENTERED MEDICAL HOMES (PCMH), USE OF HEALTH COACHES IN THE PCMH, REFERRALS TO OUR MEDICATION MANAGEMENT PROGRAM, DIABETES MANAGEMENT PROGRAM, SUBSTANCE ABUSE, AND MENTAL HEALTH SERVICES (DEACONESS OPERATES A BEHAVIORAL HEALTH CLINIC AS WELL AS INPATIENT AND OUTPATIENT MENTAL HEALTH SERVICES.) THE DESIGN OF OUR ACO AND PCMH ENABLES STAFF MEMBERS TO EASILY ADDRESS THE FOUR IDENTIFIED COMMUNITY HEALTH NEEDS DURING ROUTINE OFFICE VISITS.
DEACONESS CROSS POINTE   PART V, SECTION B, LINE 6I: METHOD FOR ADDRESSING NEEDS IDENTIFIED IN CHNA:6A: IN 2011, DEACONESS HEALTH SYSTEM JOINED FOUR OTHER LOCAL HEALTH-RELATED ORGANIZATIONS, ECHO COMMUNITY HEALTH CARE, ST. MARY'S MEDICAL CENTER, UNITED WAY, AND WELBORN BAPTIST FOUNDATION, TO PLAN FOR AND ADMINISTER A COMMUNITY HEALTH NEEDS ASSESSMENT (CHNA). REVIEW OF THE ASSESSMENT DATA LED THE TEAM TO IDENTIFY FOUR MAIN ISSUES AT THE CORE OF POOR COMMUNITY HEALTH: TOBACCO USE, OBESITY, SUBSTANCE ABUSE, AND MENTAL HEALTH. THE COLLABORATIVE CREATED A GROUP PLAN OF ACTION TO ADDRESS THE FOUR IDENTIFIED COMMUNITY HEALTH ISSUES. MEETING WITH COMMUNITY PARTNERS AND STAKEHOLDERS GUIDED THE PLANNING PROCESS. ADDITIONALLY, EACH PARTNER CREATED AN ORGANIZATION SPECIFIC PLAN TO ADDRESS THE SAME ISSUES. THE PLANS WERE TRANSCRIBED, PRESENTED AT A PRESS CONFERENCE, AND POSTED ON THE WEBSITE OF EACH PARTNER'S ORGANIZATION.6B: STRATEGIES FOR EACH OF THE FOUR TARGET AREAS WERE CREATED FOR THE COLLABORATIVE AND FOR DEACONESS. SINCE THE HOSPITAL SERVES VANDERBURGH AND WARRICK COUNTIES IN INDIANA, THE STRATEGY FOR DEACONESS INCLUDES TACTICS TO ADDRESS THESE ISSUES IN BOTH COMMUNITIES. AN INTERNAL TEAM LEADER WAS ASSIGNED TO EACH OF THE FOUR TOPIC AREAS AND RESPONSIBLE FOR PUTTING TOGETHER A TEAM AND THEN A PLAN TO CREATE POSITIVE CHANGE IN THE SPECIFIC HEALTH AREA. THE PLANNING PHASE IS COMPLETE AND THE EXECUTION PHASE TAKES PLACE IN TAX YEARS 2013, 2014, 2015.6C: MEMBERS OF THE DEACONESS COMMUNITY BENEFIT TEAM MET REGULARLY WITH OTHER MEMBERS OF THE COLLABORATIVE TO CREATE A STRATEGY AND TACTICS THAT ADDRESS OUR FOUR IDENTIFIED COMMUNITY HEALTH NEEDS. THE BENEFIT TEAM PARTICIPATED IN FOCUS GROUP SESSIONS WITH 51 BUSINESS, COMMUNITY, AND SOCIAL SERVICE LEADERS, AND STRATEGY SESSIONS WITH 42 PROVIDERS AND AGENCIES TO DEVELOP A PLAN THAT WOULD CAUSE POSITIVE CHANGE IN THE OVERALL HEALTH OF OUR POPULATION.6D: THE FIRST STEP IN EXECUTING OUR COMMUNITY HEALTH NEEDS ASSESSMENT IMPLEMENTATION PLAN WAS RELEASING INFORMATION TO THE PUBLIC. A PRESS CONFERENCE WAS HELD JUNE 13, 2013, AT A LOCAL BUSINESS. DURING THE PRESS CONFERENCE, REPRESENTATIVES FROM THE COLLABORATIVE EXPLAINED THE CHNA SURVEY PROCESS, RESULTS, CONTRIBUTIONS OF COMMUNITY PARTNERS, AND THE FOUR HEALTH ISSUES SELECTED AS OUR FOCUS FOR THE NEXT THREE YEARS. FOLLOWING THIS ANNOUNCEMENT, THE COLLABORATIVE SET UP MEETINGS FOR EACH OF THE FOUR HEALTH TOPICS AND INVITED ALL RELEVANT COMMUNITY PARTNERS TO ATTEND. DURING THESE MEETINGS, THE GROUP REVIEWS THE ACTION ITEMS IN THE IMPLEMENTATION PLAN, REPORTS ON THE PROGRESS OF THOSE ITEMS, AND ASKS FOR ASSISTANCE OR ADDITIONAL RESOURCES AS APPROPRIATE. 6G: MEMBERS OF OUR THREE KEY INFORMANT GROUPS (COMMUNITY LEADERS, BUSINESS LEADERS, AND SOCIAL SERVICE AGENCIES) SUBMITTED THEIR TOP 5 HEALTH PRIORITIES FOR THE COMMUNITY. THIS INFORMATION WAS COUPLED WITH THE SURVEY DATA RESULTING IN A LIST OF SEVEN KEY COMMUNITY HEALTH ISSUES. FOLLOWING FURTHER ANALYSIS, THE COLLABORATIVE DECIDED THAT TOBACCO USE, OBESITY, SUBSTANCE ABUSE, AND MENTAL HEALTH ISSUES WERE THE ROOT CAUSES OF MULTIPLE HEALTH CONDITIONS AND HIGHER HEALTH CARE COSTS. BY ADDRESSING THESE FOUR AREAS, THE COLLABORATIVE COULD HAVE THE BIGGEST IMPACT ON THE CURRENT HEALTH CONDITIONS IN OUR COMMUNITIES. 6H:AS PART OF OUR AGREEMENT WITH THE CHNA COLLABORATIVE, DEACONESS WILL FOCUS TIME AND RESOURCES FOR THE NEXT THREE YEARS ON CREATING POSITIVE CHANGE IN THE FOUR IDENTIFIED TOPIC AREAS. DEACONESS OPERATES AN ACCOUNTABLE CARE ORGANIZATION (ACO) CALLED DEACONESS CARE INTEGRATION. THE ACO HOUSES MANY OF THE PROGRAMS WE WILL USED TO ADDRESS OBESITY, TOBACCO USE, MENTAL HEALTH AND SUBSTANCE ABUSE. SPECIFIC SERVICES INCLUDE CERTIFICATION FOR ALL DEACONESS CLINIC LOCATIONS AS PATIENT CENTERED MEDICAL HOMES (PCMH), USE OF HEALTH COACHES IN THE PCMH, REFERRALS TO OUR MEDICATION MANAGEMENT PROGRAM, DIABETES MANAGEMENT PROGRAM, SUBSTANCE ABUSE, AND MENTAL HEALTH SERVICES (DEACONESS OPERATES A BEHAVIORAL HEALTH CLINIC AS WELL AS INPATIENT AND OUTPATIENT MENTAL HEALTH SERVICES.) THE DESIGN OF OUR ACO AND PCMH ENABLES STAFF MEMBERS TO EASILY ADDRESS THE FOUR IDENTIFIED COMMUNITY HEALTH NEEDS DURING ROUTINE OFFICE VISITS.
DEACONESS HOSPITAL, INC.   PART V, SECTION B, LINE 14G: OTHER METHOD USED TO PUBLICIZE THE FINANCIAL ASSISTANCE POLICY: DEACONESS HOSPITAL SEEKS OUT THE PATIENTS THAT ARE SELF-PAY AND INTERVIEWS THESE PATIENTS WHILE THEY ARE IN THE FACILITY. THE FINANCIAL ASSISTANCE POLICY IS PROMOTED TO PATIENTS. DEACONESS HOSPITAL SEEKS OUT THOSE PATIENTS THAT WOULD QUALIFY FOR THE FINANCIAL ASSISTANCE POLICY. COLLECTABILITY SCORING IS ALSO COMPLETED AND ALLOWANCES ARE MADE BASED UPON THESE SCORES.
DEACONESS GATEWAY HOSPITAL   PART V, SECTION B, LINE 14G: OTHER METHOD USED TO PUBLICIZE THE FINANCIAL ASSISTANCE POLICY: DEACONESS HOSPITAL SEEKS OUT THE PATIENTS THAT ARE SELF-PAY AND INTERVIEWS THESE PATIENTS WHILE THEY ARE IN THE FACILITY. THE FINANCIAL ASSISTANCE POLICY IS PROMOTED TO PATIENTS. DEACONESS HOSPITAL SEEKS OUT THOSE PATIENTS THAT WOULD QUALIFY FOR THE FINANCIAL ASSISTANCE POLICY. COLLECTABILITY SCORING IS ALSO COMPLETED AND ALLOWANCES ARE MADE BASED UPON THESE SCORES.
DEACONESS CROSS POINTE   PART V, SECTION B, LINE 14G: OTHER METHOD USED TO PUBLICIZE THE FINANCIAL ASSISTANCE POLICY: DEACONESS HOSPITAL SEEKS OUT THE PATIENTS THAT ARE SELF-PAY AND INTERVIEWS THESE PATIENTS WHILE THEY ARE IN THE FACILITY. THE FINANCIAL ASSISTANCE POLICY IS PROMOTED TO PATIENTS. DEACONESS HOSPITAL SEEKS OUT THOSE PATIENTS THAT WOULD QUALIFY FOR THE FINANCIAL ASSISTANCE POLICY. COLLECTABILITY SCORING IS ALSO COMPLETED AND ALLOWANCES ARE MADE BASED UPON THESE SCORES.
DEACONESS HOSPITAL, INC.   PART V, SECTION B, LINE 20D: DEACONESS USES ITS AVERAGE MANAGED CARE NEGOTIATED DISCOUNT FOR ALL COMMERCIAL PAYERS.
DEACONESS GATEWAY HOSPITAL   PART V, SECTION B, LINE 20D: DEACONESS USES ITS AVERAGE MANAGED CARE NEGOTIATED DISCOUNT FOR ALL COMMERCIAL PAYERS.
DEACONESS CROSS POINTE   PART V, SECTION B, LINE 20D: DEACONESS USES ITS AVERAGE MANAGED CARE NEGOTIATED DISCOUNT FOR ALL COMMERCIAL PAYERS.
    PART VI, LINE 2: NEEDS ASSESSMENT PROCESS: IN ADDITION TO THE CHNA REPORTED IN PART V, SECTION B DEACONESS HOSPITAL UTILIZES A VARIETY OF SOURCES TO GATHER DATA ON LOCAL HEALTH CARE NEEDS. A MAJOR SOURCE IS THE 7-COUNTY HEALTH SURVEY CONDUCTED BY WELBORN BAPTIST FOUNDATION. DEACONESS ALSO USES DATA FROM THE UNITED WAY OF SOUTHWESTERN INDIANA'S COMPREHENSIVE NEEDS ASSESSMENT, COUNTY HEALTH RANKINGS WEBSITE, INDIANA STATE DEPARTMENT OF HEALTH, CENTERS FOR DISEASE CONTROL AND PREVENTION, NATIONAL CENTER FOR HEALTH STATISTICS, AND THE U.S. CENSUS BUREAU. ADDITIONAL INFORMATION COMES THROUGH THE HOSPITAL'S INTERACTION WITH LOCAL SERVICE PROVIDERS AND OTHER NON-PROFIT ORGANIZATIONS. THE COMMITTEE USES A DYNAMIC, ONGOING PROCESS TO INCLUDE A REVIEW OF PREVIOUS OR CURRENT ASSESSMENTS BY OTHER COMMUNITY GROUPS, PRESENTATIONS MADE BY OUTSIDE GROUPS SOLICITING DEACONESS HOSPITAL'S INVOLVEMENT IN COMMUNITY INITIATIVES, REVIEW OF HEALTH AND DEMOGRAPHIC INFORMATION OF INPATIENTS AND OUTPATIENTS, AND ANALYSIS OF INFORMATION FROM OUTSIDE ORGANIZATIONS AND INTERNAL RECORDS TO IDENTIFY TRENDS AND AREAS OF CONCERN REQUIRING ATTENTION.
    PART VI, LINE 3: PATIENT EDUCATION OF ELIGIBILITY FOR ASSISTANCE: DEACONESS HOSPITAL UTILIZES FINANCIAL COUNSELORS TO EDUCATE, INFORM AND ASSIST PATIENTS AND FAMILIES IN UNDERSTANDING THEIR FINANCIAL OBLIGATION, ABILITY TO QUALIFY FOR FINANCIAL ASSISTANCE THROUGH DEACONESS HOSPITAL'S FINANCIAL ASSISTANCE PROGRAM AND PAYMENT OPTIONS. SPECIFICALLY, FINANCIAL COUNSELORS STAFF THE EMERGENCY DEPARTMENT, REGISTRATION AREAS, CASHIER AREA, AS WELL AS, FLOAT AMONG INPATIENT AREAS TO ENSURE EACH AND EVERY PATIENT REQUIRING ASSISTANCE IS REACHED. IN ADDITION TO THE PERSONAL AND INDIVIDUALIZED COUNSELING PROVIDED BY THE FINANCIAL COUNSELORS, VARIOUS FORMS OF MEDIA ARE DISTRIBUTED THROUGHOUT DEACONESS HOSPITAL EXPLAINING THE FINANCIAL ASSISTANCE PROCESS. ADDITIONALLY, POLICIES FOR FINANCIAL ASSISTANCE ARE POSTED WIDELY THROUGHOUT DEACONESS HOSPITAL AND ON THE INTERNET AT WWW.DEACONESS.COM. HTTP://WWW.DEACONESS.COM/DEACONESSHOSPITAL/BUSINESS-OFFICE/FINANCIAL-ASSISTANCE.ASPX
    PART VI, LINE 4: COMMUNITY INFORMATION: DEACONESS HOSPITAL IS A MAJOR REFERRAL CENTER FOR A 25-COUNTY TRI-STATE AREA IN SOUTHWESTERN INDIANA, WESTERN KENTUCKY AND SOUTHEASTERN ILLINOIS. THE HOSPITAL AND ITS FACILITIES ARE LOCATED ON FOUR CAMPUSES WHICH INCLUDE THE MAIN 28-ACRE CAMPUS ON THE NEAR NORTH SIDE OF EVANSVILLE IN VANDERBURGH COUNTY; THE 63-ACRE GATEWAY CAMPUS LOCATED IN WARRICK COUNTY ON THE EASTERN BORDER OF VANDERBURGH COUNTY; AND TWO OTHER EASTSIDE EVANSVILLE LOCATIONS FOR PSYCHIATRIC BEHAVIORAL SERVICES AND REHABILITATION SERVICES. THE HOSPITAL OPERATES A MAIN CAMPUS WITH A TOTAL OF 305 BEDS CONSISTING OF 38 INTENSIVE CARE BEDS, 16 CARDIAC INTENSIVE CARE BEDS, 66 CARDIAC BEDS, 23 ONCOLOGY/ PULMONOLOGY BEDS, 61 ORTHOPAEDIC/ NEUROLOGICAL BEDS, 96 MEDICAL/ SURGICAL BEDS AND 5 HOSPICE BEDS. IN ADDITION, THE HOSPITAL PROVIDES A FULL-ARRAY OF COMPREHENSIVE OUTPATIENT AND AMBULATORY SERVICES ON ITS MAIN CAMPUS AND OTHER SPECIFIC SERVICES AT MULTIPLE SITES WITHIN ITS PRIMARY AND SECONDARY SERVICE AREAS. THE HOSPITAL OPERATES THE 158 BED DEACONESS GATEWAY HOSPITAL WHICH WAS OPENED IN JANUARY 2006, ON THE GATEWAY CAMPUS CONSISTING OF 13 ADULT INTENSIVE CARE BEDS, 17 PEDIATRIC AND PEDIATRIC INTENSIVE CARE BEDS, 16 NEUROSURGICAL BEDS, 32 ORTHOPAEDIC BEDS, 16 NEURO INTENSIVE CARE BEDS, 32 SURGICAL ONCOLOGY BEDS, AND 32 GENERAL MED/ TELEMETRY BEDS. THE HOSPITAL PROVIDES A FULL ARRAY OF COMPREHENSIVE OUTPATIENT AND AMBULATORY SERVICE ON THE GATEWAY CAMPUS. THE HOSPITAL OWNS AND OPERATES DEACONESS CROSS POINTE, A FREE-STANDING, 60-BED INPATIENT PSYCHIATRIC HOSPITAL LOCATED APPROXIMATELY 7 MILES EAST OF THE MAIN CAMPUS IN EVANSVILLE. ALSO, THE HOSPITAL IS AN OWNER IN THREE JOINT VENTURE HOSPITALS:1. DEACONESS WOMEN'S HOSPITAL OF SOUTHERN INDIANA, LLC D/B/A THE WOMEN'S HOSPITAL, A FREE STANDING SPECIALTY 74-BED WOMEN'S AND INFANT'S HOSPITAL, LOCATED ON THE GATEWAY CAMPUS.2. HEALTHSOUTH/DEACONESS, LLC D/B/A TRI-STATE REGIONAL REHABILITATION HOSPITAL, A 80-BED INPATIENT ACUTE REHABILITATION HOSPITAL, LOCATED APPROXIMATELY 8 MILES TO THE SOUTHEAST OF THE MAIN CAMPUS.3. THE HEART HOSPITAL AT DEACONESS GATEWAY, LLC, A 24-BED CARDIOVASCULAR SPECIALTY HOSPITAL, RESIDING ON THE GATEWAY CAMPUS. THE HOSPITAL PLAYS AN ACTIVE ROLE IN MEDICAL EDUCATION, OPERATING A THREE YEAR FAMILY MEDICINE RESIDENCY PROGRAM, A POST-GRADUATE PHARMACY RESIDENT PROGRAM, AND SEVERAL UNDERGRADUATE MEDICAL AFFILIATIONS. THE HOSPITAL ALSO PROVIDES CONTINUING MEDICAL EDUCATION PROGRAMS FOR ATTENDING PHYSICIANS, OTHER HEALTH PROFESSIONALS, OTHER ALLIED HEALTH PROGRAMS, AND THE COMMUNITY AT LARGE. THE HOSPITAL, THROUGH ITS RELATED CORPORATIONS, PROVIDES OUTREACH SERVICES TO NURSING HOMES, PHYSICIANS' OFFICES AND SURROUNDING SMALLER HOSPITALS IN ITS SERVICE AREA.VANDERBURGH COUNTY DEMOGRAPHICS INCLUDE:POPULATION: VANDERBURGH COUNTY INCLUDES A POPULATION OF 183,833 PEOPLE, A NUMBER THAT IS EXPECTED TO REMAIN RELATIVELY FLAT OVER THE NEXT 5 YEARS. WITHIN VANDERBURGH, ONE OF THE MOST SIGNIFICANT GROWTH SEGMENTS IS THE 65+ AGE POPULATION, WHERE AN 8.8% INCREASE IS PROJECTED FOR THE 5-YEAR PERIOD BETWEEN 2012 AND 2017. MARKET DIVERSITY: THE EVANSVILLE AREA CONTINUES TO BE A RELATIVELY NON-DIVERSE POPULATION, WITH 86% OF THE POPULATION CHARACTERIZED AS WHITE OR CAUCASIAN ALONE AND 9% OF THE POPULATION CHARACTERIZED AS BLACK OR AFRICAN AMERICAN ALONE.POOR AND VULNERABLE POPULATIONS: ONE OUT OF SEVEN HOUSEHOLDS IN VANDERBURGH (15.1%) EARNS LESS THAN $15,000 ANNUALLY. IT IS ESTIMATED THAT 15.9% OF RESIDENTS ARE UNINSURED, A NUMBER THAT IS PROJECTED TO DECLINE TO 7.5% BY 2017, ASSUMING THAT THE EXPANSION OF MEDICAID TAKES PLACE AS ORIGINALLY SCHEDULED.HEALTH OUTCOMES: BASED ON THE 2012 COUNTY HEALTH RAKINGS, VANDERBURGH COUNTY RANKS 76TH OUT OF 92 INDIANA COUNTIES BASED ON SPECIFIC HEALTH FACTORS AND HEALTH OUTCOMES. IT RANKS 78TH RELATIVE TO ITS PHYSICAL ENVIRONMENT (E.G. AIR POLLUTION). (SOURCE: ROBERT WOODS JOHNSON FOUNDATION, ACCESSED AT WWW.COUNTYHEALTHRANKINGS.ORG). HOUSEHOLD INCOME: THE MEDIAN HOUSEHOLD INCOME IN VANDERBURGH COUNTY IS ESTIMATED AT $38,851 FOR 2012.MEDIAN AGE: THE MEDIAN AGE IN VANDERBURGH DURING 2012 WAS 38 YEARS.WARRICK COUNTY DEMOGRAPHICS INCLUDE:POPULATION: WARRICK COUNTY INCLUDES A POPULATION OF 61,138 PEOPLE, A NUMBER THAT IS EXPECTED TO GROW BY MORE THAN 5% OVER THE NEXT 5 YEARS. WITHIN WARRICK, ONE OF THE MOST SIGNIFICANT GROWTH SEGMENTS IS THE 65+ AGE POPULATION, WHERE A 27.8% INCREASE IS PROJECTED FOR THE 5-YEAR PERIOD BETWEEN 2012 AND 2017. MARKET DIVERSITY: THE WARRICK AREA CONTINUES TO BE A RELATIVELY NON-DIVERSE POPULATION, WITH 95% OF THE POPULATION CHARACTERIZED AS WHITE OR CAUCASIAN ALONE.POOR AND VULNERABLE POPULATIONS: A RELATIVELY AFFLUENT POPULATION, ONLY 8% OF WARRICK'S HOUSEHOLDS EARNS LESS THAN $15,000 ANNUALLY. IT IS ESTIMATED THAT 7% OF RESIDENTS ARE UNINSURED, A NUMBER THAT IS PROJECTED TO DECLINE TO 3% BY 2017, ASSUMING THAT THE EXPANSION OF MEDICAID TAKES PLACE AS ORIGINALLY SCHEDULED.HEALTH OUTCOMES: BASED ON THE 2012 COUNTY HEALTH RAKINGS, WARRICK COUNTY RANKS 11TH OUT OF 92 INDIANA COUNTIES BASED ON SPECIFIC HEALTH FACTORS AND HEALTH OUTCOMES. IT RANKS 85TH BASED ON ITS PHYSICAL ENVIRONMENT (E.G. AIR POLLUTION). HOUSEHOLD INCOME: THE MEDIAN HOUSEHOLD INCOME IN WARRICK COUNTY IS ESTIMATED AT $47,922 FOR 2012.MEDIAN AGE: THE MEDIAN AGE IN WARRICK DURING 2012 WAS 40 YEARS.
    PART VI, LINE 5: OTHER IMPORTANT COMMUNITY HEALTH PROMOTION:THE ORGANIZATION FURTHERS ITS EXEMPT PURPOSE BY PROMOTING HEALTH OF THE COMMUNITY INCLUDES: A MAJORITY OF ORGANIZATION'S GOVERNING BODY IS INDEPENDENT AND COMPRISED OF PERSONS WHO RESIDED IN THE ORGANIZATION'S PRIMARY SERVICE AREA; EXTENDS MEDICAL STAFF PRIVILEGES TO ALL QUALIFIED PHYSICIANS IN ITS COMMUNITY; AND APPLIES SURPLUS FUNDS TO IMPROVEMENTS IN PATIENT CARE.
    PART VI, LINE 6: AFFILIATED HEALTH CARE SYSTEM:DEACONESS HOSPITAL WORKS IN CONCERT WITH DEACONESS HEALTH SYSTEM AND DEACONESS CLINIC TO PROVIDE HEALTHCARE SERVICES WITH A COMPASSIONATE AND CARING SPIRIT TO PERSONS, FAMILIES AND COMMUNITIES OF THE TRI-STATE. DEACONESS HEALTH SYSTEM WORKS TO INCREASE ACCESS TO HEALTHCARE SERVICES WITHIN OUR COMMUNITY THROUGH DEACONESS HOSPITAL AND DEACONESS CLINIC. DEACONESS HOSPITAL IS A MEDICAL INSTITUTION DEDICATED TO PROVIDING QUALITY PATIENT CARE WITH UNRELENTING ATTENTION TO CLINICAL EXCELLENCE, PATIENT SAFETY AND AN UNPARALLELED PASSION AND COMMITMENT TO ASSURE THE VERY BEST HEALTHCARE FOR THE PATIENTS SERVED. DEACONESS CLINIC PROVIDES EXCELLENT PRIMARY AND MULTI-SPECIALTY HEALTHCARE IN A PERSONALIZED FASHION WITH A DEDICATED FOCUS TO SERVE THE COMMUNITY WITH EXCELLENT, TIMELY AND COMPASSIONATE PATIENT CARE.PART VI, LINE 7, LIST OF STATES RECEIVING COMMUNITY BENEFIT REPORT: INDIANA
Schedule H (Form 990) 2012
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