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.
MediumBullet Information about Schedule H (Form 990) and its instructions is at www.irs.gov/form990.
OMB No. 1545-0047
2013
Open to Public Inspection
Name of the organization
SAINT JOSEPH HOSPITAL
 
Employer identification number

84-0417134
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) . . . 		    17,211,402   17,211,402 4.020 %
b Medicaid (from Worksheet 3, column a) . . . . .     53,079,116 47,099,162 5,979,954 1.400 %
c Costs of other means-tested government programs (from Worksheet 3, column b) . .     423,582 516,243 -92,661  
d Total Financial Assistance and Means-Tested Government Programs . . . . .     70,714,100 47,615,405 23,098,695 5.420 %
Other Benefits
e Community health improvement services and community benefit operations (from Worksheet 4).     1,110,383   1,110,383 0.260 %
f Health professions education (from Worksheet 5) . . .     20,680,948 6,793,470 13,887,478 3.240 %
g Subsidized health services (from Worksheet 6) . . . .     12,276,141 4,255,680 8,020,461 1.870 %
h Research (from Worksheet 7) .     414,096   414,096 0.100 %
i Cash and in-kind contributions for community benefit (from Worksheet 8) . . . .     409,344   409,344 0.100 %
j Total. Other Benefits . .     34,890,912 11,049,150 23,841,762 5.570 %
k Total. Add lines 7d and 7j .     105,605,012 58,664,555 46,940,457 10.990 %
For Paperwork Reduction Act Notice, see the Instructions for Form 990. Cat. No. 50192T Schedule H (Form 990) 2013
Schedule H (Form 990) 2013
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            
2 Economic development     4,080   4,080 0 %
3 Community support     42,251   42,251 0 %
4 Environmental improvements     53,948   53,948 0 %
5 Leadership development and
training for community members		            
6 Coalition building     10,570   10,570 0 %
7 Community health improvement advocacy            
8 Workforce development            
9 Other            
10 Total     110,849   110,849 0 %
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
2,027,276
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
0
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
131,792,349
6
Enter Medicare allowable costs of care relating to payments on line 5.....
6
134,507,330
7
Subtract line 6 from line 5. This is the surplus (or shortfall)........
7
-2,714,981
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) 2013
Schedule H (Form 990) 2013
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?1
Name, address, primary website address, and state license number 		Licensed Hospital General-Medical-Surgical Children's Hospital Teaching Hospital Critical Hospital ResearchGrp Facility ER-24Hours ER-Other Other (Describe) Facility reporting group
1 ST JOSEPH HOSPITAL
1835 FRANKLIN STREET
DENVER,CO80218
WWW.EXEMPLA.ORG
010430 		X X   X     X      
Schedule H (Form 990) 2013
Schedule H (Form 990) 2013
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)
ST JOSEPH HOSPITAL
Name of hospital facility or facility reporting group  
If reporting on Part V, Section B for a single hospital facility 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 persons who represent the broad interests 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
d
6 If the hospital facility addressed needs identified in its most recently conducted CHNA, indicate how (check all that apply
as of the end of the tax year):
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   No
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) 2013
Schedule H (Form 990) 2013
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: 200.%
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: 400.%
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
i
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 individual’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 individual’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) 2013
Schedule H (Form 990) 2013
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 individual 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 individual an amount equal to the gross charge for any service provided to that individual?.......................... 22   No
If "Yes," explain in Section C.
Schedule H (Form 990) 2013
Schedule H (Form 990) 2013
Page
Part V
Facility Information (continued)
Section C. Supplemental Information for Part V, Section B.Provide descriptions required for Part V, Section B, lines 1j, 3, 4, 5d, 6i, 7, 10, 11, 12i, 14g, 16e, 17e, 18e, 19c, 19d, 20d, 21, and 22. If applicable, provide separate descriptions for each facility in a facility reporting group, designated by "Facility A," "Facility B," etc.
Form and Line Reference Explanation
FORM 990, SCHEDULE H, PART V, LINE 3 Facility Policies and Procedures THE CENTER FOR HEALTH ADMINISTRATION ("CHA") AT THE UNIVERSITY OF COLORADO DENVER WAS RETAINED TO CONDUCT DATA COLLECTION FOR THE 2012 COMMUNITY HEALTH NEEDS ASSESSMENTS ("CHNA") FOR THE EXEMPLA HEALTHCARE SYSTEM AND ITS MEMBER HOSPITAL FACILITIES PER INTERNAL REVENUE CODE REQUIREMENTS. CHA MET WITH REPRESENTATIVES OF THE COLORADO DEPARTMENT OF PUBLIC HEALTH AND ENVIRONMENT ("CDPHE") TO GAIN AN UNDERSTANDING OF AVAILABLE VITAL EVENT AND HEALTH SURVEY DATA IN COLORADO. CDPHE PUBLISHES DATA ON SELECTED HEALTH INDICATORS THAT INCLUDES COUNTY, REGIONAL AND STATE LEVEL DATA ON A VARIETY OF HEALTH, ENVIRONMENTAL AND SOCIAL TOPICS. THESE DATA ARE USED IN COLORADO'S HEALTH ASSESSMENT AND PLANNING SYSTEM ("CHAPS"). CHAPS IS A STANDARD PROCESS CREATED TO HELP LOCAL PUBLIC HEALTH AGENCIES MEET ASSESSMENT AND PLANNING REQUIREMENTS. ACCORDING TO CDPHE, THESE INDICATORS ARE USEFUL FOR ANYONE WHO NEEDS COLORADO HEALTH DATA FOR A COMMUNITY HEALTH ASSESSMENT OR FOR OTHER RESEARCH PURPOSES. CHAPS FOCUSES ON THE INDICATORS SELECTED SPECIFICALLY TO FACILITATE STANDARDIZED HEALTH ASSESSMENT ACROSS ALL JURISDICTIONS IN COLORADO. THE INDICATORS ARE ORGANIZED ACCORDING TO A HEALTH EQUITY MODEL WHICH TAKES INTO ACCOUNT A WIDE RANGE OF FACTORS THAT INFLUENCE HEALTH. BASED ON THE DATA, REPORTS WERE CREATED FOR EACH INDIVIDUAL EXEMPLA HEALTHCARE HOSPITAL FACILITY. HOSPITAL FACILITIES INCLUDED: EXEMPLA GOOD SAMARITAN MEDICAL CENTER, LAFAYETTE, CO, EXEMPLA LUTHERAN MEDICAL CENTER, WHEATRIDGE, CO, AND EXEMPLA SAINT JOSEPH HOSPITAL, DENVER, CO. FORM 990, SCHEDULE H, PART V, LINE 4 THE THREE HOSPITALS THAT WORKED TOGETHER IN COMPLETION OF THE COMMUNITY HEALTH NEEDS ASSESSMENT WERE EXEMPLA ST. JOSEPH HOSPITAL, DENVER, CO, EXEMPLA GOOD SAMARITAN MEDICAL CENTER, LAFAYETTE, CO AND EXEMPLA LUTHERAN MEDICAL CENTER, WHEATRIDGE, CO. FORM 990, SCHEDULE H, PART V, LINE 7 EXEMPLA SAINT JOSEPH HOSPITAL ("ESJH")VETTED THE RESULTS OF THE COMMUNITY HEALTH NEEDS ASSESSMENT ("CHNA") AND TOP HEALTH INDICATORS BY DETERMINING WHICH INDICATORS WERE BELOW THE COLORADO STATE AVERAGE FOR ITS SERVICE AREA. THE FOLLOWING INDICATORS WERE SELECTED: 1. ACCESS 2. OBESITY, NUTRITION AND PHYSICAL ACTIVITY 3. TOBACCO COMMUNITY PARTNERS BROUGHT TO THE TABLE FOR PLANNING INTERVENTIONS WERE DENVER HEALTH, KAISER PERMANENTE, HOSPITAL LEADERSHIP AND THE COMMUNITY RESOURCES FORUM. THE FORUM IS HOSTED BY ESJH AND MEETS QUARTERLY AND MEMBERS INCLUDE THOSE FROM ORGANIZATIONS REPRESENTING COMMUNITY AGENCIES, GOVERNMENTAL SERVICE PROGRAMS BUSINESS AND HEALTH CARE PARTNERS. THE REMAINDER OF THE NEEDS IDENTIFIED IN THE CHNA ARE IMPORTANT TO ESJH BUT DUE TO LIMITED EXPERTISE AT THE HOSPITAL AND THE AVAILABILITY OF COMMUNITY ORGANIZATIONS WHO ARE ALREADY ADDRESSING NEEDS, ESJH WILL COLLABORATE WITH COMMUNITY ORGANIZATIONS TO ENSURE ALL NEEDS AND HEALTH INDICATORS ARE BEING ADDRESSED.
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
Schedule H (Form 990) 2013
Schedule H (Form 990) 2013
Page
Part VFacility Information (continued)

Section D. 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?  
Name and address Type of Facility (describe)
1
2
3
4
5
6
7
8
9
10
Schedule H (Form 990) 2013
Schedule H (Form 990) 2013
Page
Part VI
Supplemental Information
Provide the following information.
1 Required descriptions. Provide the descriptions required for Part I, lines 3c, 6a, and 7; Part II and Part III, lines 2, 3, 4, 8 and 9b.
2 Needs assessment. Describe how the organization assesses the health care needs of the communities it serves, in addition to any CHNAs 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.
Form and Line Reference Explanation
FORM 990, SCHEDULE H, PART I, LINE 7G COSTS ATTRIBUTABLE TO PHYSICIAN CLINICS THE ORGANIZATION DID NOT INCLUDE AS SUBSIDIZED HEALTH SERVICES ANY COSTS ATTRIBUTABLE TO PHYSICIAN CLINICS. PART I, LINE 7G, COLUMN (F) BAD DEBT EXPENSE THE BAD DEBT EXPENSE INCLUDED ON FORM 990,PART IX, LINE 25, COLUMN (A), BUT SUBTRACTED FOR PURPOSES OF CALCULATING THE PERCENTAGE ON SCHEDULE H, PART I, LINE 7 COLUMN (F) IS $10,418,084. FORM 990, SCHEDULE H, PART I, LINE 7 COSTING METHODOLOGY THE COST TO CHARGE RATIO USED TO REPORT AMOUNTS IN FORM 990, SCHEDULE H, PART I, LINE 7 WERE DERIVED FROM WORKSHEET 2, IN THE SCHEDULE H, FORM 990 INSTRUCTIONS. FORM 990, SCHEDULE H, PART II COMMUNITY BUILDING ACTIVITIES, THOSE THAT ENHANCE EXISTING EFFORTS OR FILL GAPS OF COMMUNITY NEED, INCLUDE PROGRAMS THAT SUPPORT THOSE IN THE COMMUNITY WHO ARE LIVING AT OR BELOW POVERTY. SAINT JOSEPH HOSPITAL ADMINISTRATIVE LEADERSHIP AND ITS EMPLOYEES PERFORMED CIVIC ACTIVITIES IN WHICH THE HEALTH OF THE COMMUNITY WAS ADVOCATED AS A PRIORITY BY THE HOSPITAL. IN 2013, ST. JOSEPH'S CEO PARTICIPATED IN THE DENVER CHAMBER OF COMMERCE TO INFLUENCE ISSUES IMPACTING THE COMMUNITY'S HEALTH AND SAFETY. COMMUNITY SUPPORT PROGRAMS INCLUDE AN ELEMENTARY SCHOOL READING PROGRAM, SUPPORT OF AN INNER-CITY HIGH SCHOOL, AND A DRIVE FOR LOCAL SCHOOLS TO PROVIDE CLOTHING, SCHOOL SUPPLIES AND FAMILY NECESSITIES. TO ASSURE COMMUNITY ACCESS TO FOOD, ST. JOSEPH'S PARTICIPATED IN A NORTHEAST DENVER FOOD ASSESSMENT AND HOSTED A FARMERS MARKET. ST. JOSEPH ALSO HOSTS AN ONGOING COMMUNITY RESOURCES FORUM FOR LOCAL COMMUNITY ORGANIZATIONS TO NETWORK AND LEVERAGE RESOURCES. FORM 990, SCHEUDLE H, PART III, LINE 1 THE ORGANIZATION REPORTS BAD DEBT IN ACCORDANCE TO HEALTHCARE FINANCIAL MANAGEMENT ASSOCIATION (HFMA) STATEMENT NO. 15 TO THE EXTENT THAT HFMA STATEMENT NO. 15 FOLLOWS THE GENERALLY ACCEPTED ACCOUNTING PRINCIPLES (GAAP) FOR THE REPORTING OF BAD DEBT. FORM 990, SCHEDULE H, PART III, LINE 2 THE ALLOWANCE FOR BAD DEBT IS BASED UPON THE ASSESSMENT OF HISTORICAL AND EXPECTED NET COLLECTIONS CONSIDERING BUSINESS AND ECONOMIC CONDITIONS, TRENDS IN HEALTH CARE COVERAGE, AND OTHER COLLECTION INDICATORS. THE BAD DEBT ALLOWANCE IS CALCULATED AS A PERCENTAGE OF PATIENT RECEIVABLES AFTER DEDUCTIONS FOR ESTIMATED PROVISIONS FOR CONTRACTUAL ADJUSTMENTS (DISCOUNTS) ON SERVICES PROVIDED TO ENROLLEES OF MEDICARE, MEDICAID, THIRD-PARTY PAYOR PROGRAMS, CHARITY CARE, UNINSURED DISCOUNTS, AND OTHER ADMINISTRATIVE ADJUSTMENTS. THE BAD DEBT EXPENSE REPORTED ON PART III, LINE 2 IS AT COST. THE COST TO CHARGE RATIO USED TO CALCULATE BAD DEBT AT COST WAS DERIVED FROM WORKSHEET 2, IN THE SCHEDULE H, FORM 990 INSTRUCTIONS. FORM 990, SHCEDULE H, PART III, LINE 4 THE ALLOWANCE FOR BAD DEBT IS BASED UPON THE ASSESSMENT OF HISTORICAL AND EXPECTED NET COLLECTIONS CONSIDERING BUSINESS AND ECONOMIC CONDITIONS, TRENDS IN HEALTH CARE COVERAGE, AND OTHER COLLECTION INDICATORS. THE BAD DEBT ALLOWANCE IS CALCULATED AS A PERCENTAGE OF PATIENT RECEIVABLES AFTER DEDUCTIONS FOR ESTIMATED PROVISIONS FOR CONTRACTUAL ADJUSTMENTS (DISCOUNTS) ON SERVICES PROVIDED TO ENROLLEES OF MEDICARE, MEDICAID, THIRD-PARTY PAYOR PROGRAMS, CHARITY CARE, UNINSURED DISCOUNTS, AND OTHER ADMINISTRATIVE ADJUSTMENTS. THE FOLLOWING IS THE TEXT OF THE FOOTNOTE TO THE ORGANIZATIONS FINANCIAL STATEMENTS THAT DESCRIBE THE BAD DEBT ALLOWANCE AND BAD DEBT EXPENSE: THE ALLOWANCE FOR UNCOLLECTIBLE ACCOUNTS IS BASED UPON MANAGEMENT'S ASSESSMENT OF HISTORICAL AND EXPECTED NET COLLECTIONS CONSIDERING THE BUSINESS AND GENERAL ECONOMIC CONDITION IN ITS SERVICE AREA, TRENDS IN HEALTH CARE COVERAGE, AND OTHER COLLECTION INDICATORS. THROUGHOUT THE YEAR, MANAGEMENT ASSESSES THE ADEQUACY OF THE ALLOWANCE FOR UNCOLLECTIBLE ACCOUNTS BASED UPON HISTORICAL COLLECTION EXPERIENCE BY PAYOR CATEGORY AND OTHER FACTORS. THE RESULTS OF THESE REVIEWS ARE THEN USED TO MAKE ANY MODIFICATIONS TO THE PROVISION FOR UNCOLLECTIBLE ACCOUNTS TO ESTABLISH AN APPROPRIATE ALLOWANCE FOR UNCOLLECTIBLE ACCOUNTS. THE ALLOWANCE FOR UNCOLLECTIBLE ACCOUNTS INCLUDES A RESERVE FOR BOTH UNINSURED PATIENTS AND BALANCE AFTER INSURANCE ACCOUNTS RECEIVABLE. THE ORGANIZATION HAS A FINANCIAL ASSISTANCE PROGRAM THAT PROVIDES PATIENTS OPPORTUNITIES TO APPLY FOR FREE OR DISCOUNTED CARE OR TO BE ENROLLED IN A GOVERNMENT SPONSORED MEDICAL CARE PROGRAM. THE PROCESS INCLUDES IDENTIFYING PATIENTS WITH A FINANCIAL CONCERN AND PROVIDING FINANCIAL COUNSELING AND ASSISTANCE IN APPLYING FOR THE ORGANIZATION'S CHARITY CARE AND OTHER FINANCIAL ASSISTANCE PROGRAMS. CERTAIN PATIENT ACCOUNTS ARE WRITTEN OFF TO BAD DEBT BECAUSE THE ORGANIZATION DOES NOT HAVE SUFFICIENT INFORMATION TO DETERMINE IF THE PATIENT WOULD QUALIFY FOR FREE CARE OR FINANCIAL AID. THEREFORE, IT IS POSSIBLE THAT SOME BAD DEBT IS ACTUALLY CHARITY CARE. HOWEVER, IF A PATIENT ACCOUNT IS WRITTEN OFF TO BAD DEBT AND THE COLLECTION AGENCY LATER DETERMINES THAT THE PATIENT WOULD HAVE QUALIFIED FOR FREE CARE OR FINANCIAL AID, THEN THE BAD DEBT EXPENSE IS RECLASSIFIED TO CHARITY CARE. FORM 990, SCHEDULE H, PART III, LINE 8 THE ORGANIZATION BELIEVES THAT AT LEAST SOME PORTION OF THE COSTS WE INCUR IN EXCESS OF PAYMENTS RECEIVED FROM THE FEDERAL GOVERNMENT FOR PROVIDING MEDICAL SERVICES TO MEDICARE ENROLLEES AND BENEFICIARIES UNDER THE FEDERAL MEDICARE PROGRAM (SHORTFALL OR MEDICARE SHORTFALL) CONSTITUTES A COMMUNITY BENEFIT. PROVIDING THESE SERVICES CLEARLY LESSENS THE BURDENS OF THE GOVERNMENT BY ALLEVIATING THE FEDERAL GOVERNMENT FROM HAVING TO DIRECTLY PROVIDE THESE MEDICAL SERVICES. AS DEMONSTRATED AND CALCULATED ON FORM 990, SCHEDULE H, PART III, LINES 5, 6 AND 7, OUR MEDICARE "ALLOWABLE COSTS" CLEARLY EXCEED THE PAYMENTS WE RECEIVE FOR PROVIDING THESE MEDICAL SERVICES UNDER THE MEDICARE PROGRAM. BY ABSORBING THE MEDICARE SHORTFALL COSTS WE ARE PROVIDING A COMMUNITY BENEFIT AS WELL AS EASING THE BURDEN OF THE FEDERAL GOVERNMENT HAVING TO COVER THESE COSTS. TO ARRIVE AT THE FORM 990, SCHEDULE H, PART III, LINE 6 AMOUNT WE USED ACTUAL MEDICARE CHARGES FROM INTERNAL RECORDS AND APPLIED AN ESTIMATED COST TO CHARGE RATIO TO DETERMINE THE MEDICARE ALLOWABLE COSTS. THE ESTIMATED MEDICARE COST TO CHARGE RATIO IS THE PRIOR PERIOD MEDICARE COST REPORT COST TO CHARGE RATIO. FORM 990, SCHEDULE H, PART III, LINE 9B AN INTEGRAL COMPONENT OF OUR MISSION IS TO BE GOOD FINANCIAL STEWARDS. THIS REQUIRES US TO DETERMINE WHICH PATIENTS ARE IN NEED OF CHARITY CARE AND WHICH ARE ABLE TO CONTRIBUTE SOME PAYMENT FOR CARE RECEIVED. WE MAINTAIN A BALANCE THAT ENABLES US TO CONTINUE TO PROVIDE CHARITY CARE TO THOSE WHO NEED IT MOST, AND TO ENSURE THAT WE MANAGE OUR RESOURCES SO THAT WE CAN CONTINUE TO BE HERE WHEN PEOPLE NEED US MOST. THE ORGANIZATION NOTIFIES PATIENTS OF FINANCIAL ASSISTANCE POLICY UPON ADMISSION, DISCHARGE AND IN COMMUNICATION REGARDING PATIENT BILLS. PATIENTS ARE CONTACTED MULTIPLE TIMES ABOUT UNPAID BALANCES PRIOR TO INITIATING ANY COLLECTION ACTION. IF A PATIENT IS DETERMINED TO BE ELIGIBLE FOR FINANCIAL ASSISTANCE AT ANY TIME DURING THE COLLECTION PROCESS, THE ACCOUNT IS RECLASSIFIED AS FINANCIAL ASSISTANCE AND DEBT COLLECTION EFFORTS ARE CEASED. FORM 990, SCHEDULE H, PART VI, LINE 2 NEEDS ASSESSMENT AS PART OF OUR CORE VALUE OF RESPONSE TO NEED, SAINT JOSEPH HOSPITAL ("SJH") TAKES STEPS TO DETERMINE WHERE THERE IS THE MOST NEED IN ORDER TO PROVIDE THE GREATEST GOOD. SJH HAS REGULARLY PARTICIPATED IN NEEDS ASSESSMENTS TO IDENTIFY THE ONGOING AND CHANGING NEEDS OF THE COMMUNITY. FOR 2012, THE PROCESS INCLUDED TWO OTHER SISTERS OF CHARITY OF LEAVENWORTH HEALTH SYSTEM (SCLHS) as HOSPITALS: EXEMPLA GOOD SAMARITAN MEDICAL CENTER, LAFAYETTE, CO AND EXEMPLA LUTHERAN MEDIAL CENTER, WHEATRIDGE. IN 2013, EACH HOSPITAL DEVELOPED A HOSPITAL IMPLEMENTATION PLAN TO ADDRESS TOP NEEDS, IDENTIFY PARTNERS, AND SET IN PLACE A PLAN OF ACTION TO IMPROVE THE HEALTH OF THEIR COMMUNITIES. THE MOST RECENT SURVEY WAS CONDUCTED IN 2012, AND OTHER SURVEYS WILL BE CONDUCTED ON A REGULAR BASIS. THE FINAL COMMUNITY HEALTH NEEDS ASSESSMENT ("CHNA") FOR SJH WAS APPROVED BY THE SCL Health-FRONT RANGE, Inc. BOARD IN JUNE 2012. THE CHNA WAS MADE WIDELY AVAILABLE TO THE PUBLIC IN 2013 AFTER ALL COMMUNITY INPUT WAS OBTAINED. IT IS AVAILABLE ON THE SCLHS WEBSITE, MADE AVAILABLE TO THE PUBLIC UPON REQUEST, AND IS PROVIDED TO COMMUNITY ORGANIZATIONS WHO REQUEST FUNDING OR DONATIONS FROM THE HOSPITAL. THE SJH CHNA MIRRORS APPLICABLE PARTS OF THE COLORADO DEPARTMENT OF PUBLIC HEALTH AND ENVIRONMENT'S 2012 COLORADO'S 10 WINNABLE BATTLES WHICH IDENTIFIES KEY HEALTH ISSUES WHERE PROGRESS CAN BE MADE IN THE NEXT FIVE YEARS. THE HEALTH INDICATORS ARE AS FOLLOWS: OVERALL HEALTH STATUS; ACCESS; CANCER; DIABETES; HEART DISEASE AND CEREBROVASCULAR DISEASE; HIV/AIDS; COMMUNICABLE DISEASE; INJURY; MENTAL HEALTH; OBESITY, NUTRITION AND PHYSICAL ACTIVITY; ORAL HEALTH; SEXUAL HEALTH; SUBSTANCE ABUSE; AND TOBACCO. BY ALIGNING WITH THE CDPHE, THE SCL- HEALTH FRONT RANGE, INC. HOSPITALS JOIN FORCES WITH AN ALLY IN EFFORTS TO MAKE AN IMPACT ON IMPROVING THE HEALTH OF ITS HOSP
Schedule H (Form 990) 2013
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