TY 2012 Form 990 Schedule O

efile Public Visual Render ObjectId: 201441339349305574 - Submission: 2014-05-13 TIN: 91-1939739

SCHEDULE O
(Form 990 or 990-EZ)

Department of the Treasury
Internal Revenue Service

Supplemental Information to Form 990 or 990-EZ

Complete to provide information for responses to specific questions on
Form 990 or to provide any additional information.
MediumBullet

Attach to Form 990 or 990-EZ.

OMB No. 1545-0047

2012

Open to Public
Inspection

Name of the organization

FRANCISCAN MEDICAL GROUP

Employer identification number

91-1939739

Identifier	Return Reference	Explanation
STATEMENT OF PROGRAM SERVICE ACCOMPLISHMENTS	FORM 990, PART III, LINE 4A	I. INTRODUCTION A. MARKET BASED ORGANIZATION MISSION AND VISION FRANCISCAN MEDICAL GROUP WAS FOUNDED IN APRIL 1999 TO PROVIDE COMMUNITY BASED HEALTH CARE SERVICES. SINCE ITS INCEPTION, FRANCISCAN MEDICAL GROUP HAS FOCUSED ON PROVIDING QUALITY HEALTH CARE TO ALL MEMBERS OF THEIR COMMUNITY REGARDLESS OF ABILITY TO PAY FOR SERVICES. COMMUNITY SERVICE HAS ALWAYS BEEN AT THE CORE OF OUR ACTIVITY. B. COMMUNITY BENEFIT APPROACH FRANCISCAN MEDICAL GROUP CLINICS PROVIDE SERVICES ACROSS A LARGE GEOGRAPHY OF SOUTH PUGET SOUND IN WASHINGTON STATE, SERVING A DIVERSE POPULATION IN OUR SERVICE AREA. FRANCISCAN MEDICAL GROUP PROVIDES SERVICES TO PATIENTS REGARDLESS OF RACE, CREED, SEX, NATIONAL ORIGIN, HANDICAP OR ABILITY TO PAY. THE PROGRAMS AND SERVICES DESCRIBED THROUGHOUT THIS DOCUMENT NOT ONLY SERVE THE COMMUNITY BUT ALSO REDUCE THE BURDEN ON GOVERNMENTAL PROGRAMS, I.E. MEDICARE AND MEDICAID. WITHOUT THE CHARITY CARE PROVIDED BY FRANCISCAN MEDICAL GROUP CLINICS, THE COMMUNITY CHARITY CARE CASES WOULD FALL UPON THE MORE EXPENSIVE EMERGENCY ROOMS IN LOCAL HOSPITALS, INCLUDING THOSE OPERATED BY LOCAL GOVERNMENT. FRANCISCAN MEDICAL GROUP HAS OVER 250 PRIMARY CARE AND SPECIALTY PROVIDERS LOCATED IN OVER 100 CLINICS AND HOSPITALS WITH 711,157 PATIENT VISITS IN 2013. II. QUANTITATIVE DESCRIPTION OF COMMUNITY BENEFIT: UNCOMPENSATED CARE AS DESCRIBED BELOW, FRANCISCAN MEDICAL GROUP PROVIDED A SIGNIFICANT LEVEL OF CHARITY CARE SERVICES TO THOSE WITH LIMITED OR AN INABILITY TO PAY. TO THE EXTENT MEDICARE AND MEDICAID REIMBURSEMENT IS BELOW COST, FRANCISCAN MEDICAL GROUP RECOGNIZES THESE AMOUNTS AS THE UNCOMPENSATED COST OF PROVIDING CARE. AS MENTIONED ABOVE, FRANCISCAN MEDICAL GROUP PROVIDES SERVICES TO PATIENTS REGARDLESS OF RACE, CREED, SEX, NATIONAL ORIGIN, HANDICAP, OR ABILITY TO PAY. MOST PHYSICIAN GROUPS IN THE STATE OF WASHINGTON HAVE EITHER PARTIALLY OR FULLY CLOSED THEIR PRACTICES TO NEW MEDICARE AND MEDICAID PATIENTS AS THE REIMBURSEMENT FOR THESE PROGRAMS HAS INCREASINGLY FALLEN SHORT OF THE COST OF PROVIDING THAT CARE. ALTHOUGH REIMBURSEMENT FOR SERVICES RENDERED IS CRITICAL TO THE OPERATION AND STABILITY OF FRANCISCAN MEDICAL GROUP, NOT ALL INDIVIDUALS POSSESS THE ABILITY TO PURCHASE ESSENTIAL MEDICAL SERVICES AND OUR MISSION IS TO SERVE THE COMMUNITY BY PROVIDING HEALTH CARE SERVICES AND HEALTH CARE EDUCATION. THEREFORE, IN KEEPING WITH FRANCISCAN MEDICAL GROUP'S COMMITMENT TO SERVE ALL MEMBERS OF ITS COMMUNITY, WE PROVIDE CARE TO PERSONS COVERED BY GOVERNMENTAL PROGRAMS - ALTHOUGH THE COST OF PROVIDING THAT CARE EXCEEDS GOVERNMENTAL PROGRAM REIMBURSEMENT. FOR THE FISCAL YEAR ENDING JUNE 30, 2013, THE COST OF UNCOMPENSATED MEDICARE CARE AMOUNTED TO $29.6 MILLION; FOR MEDICAID IT AMOUNTED TO $ 14.9 MILLION; CHARITY CARE TOTALED $ 1.8 MILLION FOR THE YEAR. III. QUALITATIVE DESCRIPTION OF COMMUNITY BENEFIT A. COMMUNITY OUTREACH FOR THE POOR AND THE BROADER COMMUNITY ACTIVITIES OFFERED INCLUDE WELLNESS PROGRAMS, COMMUNITY EDUCATION PROGRAMS, SPECIAL PROGRAMS FOR TERMINALLY ILL PATIENTS, AND A BROAD VARIETY OF COMMUNITY SUPPORT ACTIVITIES. FRANCISCAN MEDICAL GROUP PROVIDES CHARITY CARE FOR PEOPLE WHO ARE POOR. CHARITY CARE IS ALSO PROVIDED THROUGH MANY REDUCED PRICE SERVICES AND FREE PROGRAMS OFFERED THROUGHOUT THE YEAR BASED UPON ACTIVITIES AND SERVICES WHICH FRANCISCAN MEDICAL GROUP BELIEVES SERVE A BONA FIDE COMMUNITY HEALTH NEED. THESE INCLUDE COMMUNITY EDUCATION SERVICE COST FOR THE COMMUNITY, CLASSES FOR CHILDREN THAT COVER HEALTH CARE TOPICS, EMERGENCY RESPONSE, FIRE SAFETY, BIKE AND TRAFFIC SAFETY, PHOTO AND FINGERPRINTING, ELECTRICAL SAFETY, SEAT BELTS AND OTHER CARE SAFETY, AND OTHER COMMUNITY HEALTH TOPICS. IT IS SIGNIFICANT TO NOTE THAT ALL OF THE FRANCISCAN MEDICAL GROUP PRIMARY CARE CLINICS OPERATE IN COMMUNITIES DESIGNATED BY THE US DEPARTMENT OF HEALTH AS MEDICALLY UNDERSERVED AREAS FOR ACCESS TO PRIMARY CARE. HEALTH FAIRS, EVENTS AND SCREENINGS FRANCISCAN MEDICAL GROUP PROVIDES CHOLESTEROL SCREENINGS, GLUCOSE SCREENINGS, BLOOD PRESSURE CHECKS, AND HEALTH EDUCATION INFORMATION TO THE COMMUNITY. IN FISCAL YEAR 2013, THESE SCREENINGS AND COMMUNITY HEALTH EDUCATION OPPORTUNITIES REACHED APPROXIMATELY 8,320 PEOPLE IN OUR COMMUNITIES. FMG MANAGERS PROVIDED A MINIMUM OF 865 VOLUNTEER HOURS SERVING OUR COMMUNITIES. FUNDRAISERS SUPPORTED ALZHEIMER'S ASSOCIATION AMERICAN CANCER SOCIETY - RELAY FOR LIFE AMERICAN HEART ASSOCIATION AMERICAN DIABETES ASSOCIATION AMERICAN RED CROSS - MT RAINIER CHAPTER UNITED WAY MUSCULAR DYSTROPHY ASSOCIATION TACOMA RESCUE MISSION LEUKEMIA AND LYMPHOMA SOCIETY SALVATION ARMY FRANCISCAN FOUNDATION - CORNERSTONE CLUB FRANCISCAN FOUNDATION - ST JOSEPH HOSPITAL BALL FRANCISCAN FOUNDATION - ST FRANCIS HOSPITAL GALA FRANCISCAN FOUNDATION - HOSPICE GOLF TOURNAMENT FRANCISCAN FOUNDATION - ST FRANCIS HOSPITAL GOLF TOURNAMENT FRANCISCAN FOUNDATION - ST CLARE HOSPITAL GOLF TOURNAMENT ENUMCLAW COMMUNITY HOSPITAL FOUNDATION CATHOLIC CHARITIES MOST OF THESE FUNDRAISING ACTIVITIES WERE SUPPORTED BY ACTUAL FUNDRAISING ACTIVITIES, BUT MOST WERE ALSO SUPPORTED BY CASH DONATIONS FROM FRANCISCAN MEDICAL GROUP.
EXECUTIVE COMMITTEE	FORM 990, PART VI, LINE 1A	PURSUANT TO SECTION 8.5 OF THE BYLAWS OF THE FRANCISCAN MEDICAL GROUP THE EXECUTIVE COMMITTEE IS COMPOSED OF FOUR (4) MEMBERS, INCLUDING TWO (2) PHYSICIAN DIRECTORS, ONE (1) COMMUNITY REPRESENTATIVE NON-PHYSICIAN DIRECTOR AND THE CHAIRPERSON OF THE BOARD (UNLESS SUCH CHAIRPERSON OF THE BOARD IS ALSO ONE OF THE OTHER QUALIFIED MEMBERS, IN WHICH CASE THE FOURTH MEMBER SHALL BE A DIRECTOR APPOINTED BY THE CHAIRPERSON OF THE BOARD). EACH OF WHOM SHALL SERVE AS AN EX OFFICIO VOTING MEMBER OF THE EXECUTIVE COMMITTEE, AND TWO VOTING MEMBERS APPOINTED BY THE BOARD OF DIRECTORS. THE EXECUTIVE COMMITTEE SHALL CONSIST OF ONLY DIRECTORS OF THE CORPORATION. PURSUANT TO SECTION 8.1 OF THE CORPORATION'S BYLAWS, COMMITTEES, SUCH AS THE EXECUTIVE COMMITTEE, THAT ARE GRANTED THE AUTHORITY TO ACT ON BEHALF OF THE BOARD OF DIRECTORS MAY INCLUDE ONLY DIRECTORS OF THE CORPORATION. FURTHER, PURSUANT TO SECTION 8.5 OF THE CORPORATION'S BYLAWS, THE EXECUTIVE COMMITTEE HAS AND MAY EXERCISE SUCH POWERS AS MAY BE DELEGATED TO IT BY THE BOARD OF DIRECTORS. THE EXECUTIVE COMMITTEE ALSO POSSESSES THE POWER TO TRANSACT ROUTINE BUSINESS OF THE CORPORATION IN THE INTERIM PERIOD BETWEEN REGULARLY SCHEDULED MEETINGS OF THE BOARD OF DIRECTORS.
Classes of members or stockholders	Form 990, Part VI, Section A, Line 6	ACCORDING TO THE BYLAWS OF FRANCISCAN MEDICAL GROUP THE SOLE MEMBER IS FRANCISCAN HEALTH SYSTEM, A WASHINGTON NONPROFIT CORPORATION.
Members or stockholders electing members of governing body	Form 990, Part VI, Section A, Line 7a	THE SOLE MEMBER HAS THE POWER TO APPOINT, REPLACE OR REMOVE THE MEMBERS OF THE BOARD OF DIRECTORS.
Decisions requiring approval by members or stockholders	Form 990, Part VI, Section A, Line 7b	THE ORGANIZATION'S CORPORATE MEMBER IS FRANCISCAN HEALTH SYSTEM ("FHS"). PURSUANT TO SECTION 5.4 OF THE ORGANIZATION'S BYLAWS, BOTH FRANCISCAN HEALTH SYSTEM AND CATHOLIC HEALTH INITIATIVES ("CHI") (FHS'S SOLE CORPORATE MEMBER) HAVE RESERVED POWERS AS OUTLINED IN THE CHI GOVERNANCE MATRIX. PURSUANT TO THE GOVERNANCE MATRIX THE FOLLOWING RIGHTS ARE RESERVED TO THE FRANCISCAN HEALTH SYSTEM (FHS) BOARD: 1. APPROVE MEMBERS OF THE FRANCISCAN MEDICAL GROUP (FMG) BOARD 2. AMENDMENT OF THE CORPORATE DOCUMENTS OF FMG 3. APPROVE REMOVAL OF A MEMBER OF THE GOVERNING BODY OF FMG 4. ADOPTION OF LONG RANGE AND STRATEGIC PLANS FOR FMG THE FOLLOWING RIGHTS ARE RESERVED TO THE CHI BOARD DIRECTLY OR THROUGH POWERS DELEGATED TO THE CHI CHIEF EXECUTIVE OFFICER: 1. SUBSTANTIAL CHANGE IN THE MISSION OR PHILOSOPHY OF FMG 2. REMOVAL OF A MEMBER OF THE GOVERNING BODY OF FMG 3. APPROVAL OF ISSUANCE OF DEBT BY FMG 4. APPROVAL OF PARTICIPATION OF FMG IN A JOINT VENTURE 5. APPROVAL OF FORMATION OF A NEW CORPORATION BY FMG 6. APPROVAL OF A MERGER INVOLVING FMG 7. APPROVAL OF THE SALE OF ALL OR SUBSTANTIALLY ALL OF THE ASSETS OF FMG 8. TO REQUIRE THE TRANSFER OF ASSETS BY FMG TO CHI TO ACCOMPLISH CHI'S GOALS AND OBJECTIVES, AND TO SATISFY CHI DEBTS. IN ADDITION, PURSUANT TO SECTION 5.5.2 OF THE ORGANIZATION'S BYLAWS, FHS OR CHI MAY, IN EXERCISE OF ITS APPROVAL POWERS, GRANT OR WITHHOLD APPROVAL IN WHOLE OR IN PART, OR MAY, IN ITS COMPLETE DISCRETION, AFTER CONSULTATION WITH THE BOARD AND THE PRESIDENT AND CHIEF EXECUTIVE OFFICER OF THE ORGANIZATION, RECOMMEND SUCH OTHER OR DIFFERENT ACTIONS AS IT DEEMS APPROPRIATE.
Review of form 990 by governing body	Form 990, Part VI, Section B, Line 11b	THE CFO REVIEWS THE TAX RETURN AND ANY NECESSARY CHANGES ARE INCLUDED IN THE FINAL VERSION THAT IS APPROVED FOR FILING WITH THE IRS. IN ADDITION, THE RETURN IS PROVIDED TO THE BOARD PRIOR TO FILING. SUBSEQUENT TO REVIEW, THE TAX DEPARTMENT FILES THE RETURN WITH THE APPROPRIATE FEDERAL AGENCIES, MAKING ANY NON-SUBSTANTIVE CHANGES NECESSARY TO EFFECT E-FILING.
Conflict of interest policy	Form 990, Part VI, Section B, Line 12c	EACH EMPLOYEE IS PROVIDED EDUCATION REGARDING CONFLICT OF INTEREST POLICY AT NEW EMPLOYEE ORIENTATION. AS A PART OF THE ANNUAL PERFORMANCE REVIEW PROCESS, THE FOLLOWING STATEMENT IS INITIALED BY ALL EMPLOYEES: CONFLICTS OF INTEREST: "I WILL COMPLY WITH THE STANDARDS AND GUIDELINES CONTAINED IN THE CONFLICT OF INTEREST POLICY. I UNDERSTAND THAT I AM RESPONSIBLE FOR RECOGNIZING ANY SITUATION IN WHICH A CONFLICT OF INTEREST IS PRESENT OR MIGHT ARISE. I WILL IMMEDIATELY REPORT ANY SUCH SITUATION TO MY MANAGER/VICE PRESIDENT AND WILL TAKE APPROPRIATE ACTION TO ELIMINATE OR PREVENT A CONFLICT." THE GOVERNING BODY IS ALSO REQUIRED TO ANNUALLY DECLARE CONFLICTS OF INTERESTS, AS WELL AS THE MEDICAL STAFF LEADERS. WHEN A CONFLICT IS ACKNOWLEDGED, THE INDIVIDUALS ARE PROHIBITED FROM DELIBERATIONS AND DECISIONS IN THE TRANSACTION. THE EXECUTIVE COMMITTEE OF THE BOARD REVIEWS ALL GOVERNANCE CONFLICTS OF INTERESTS, AND AT EACH BOARD MEETING THE CHAIRPERSON ASKS IF THERE ARE ANY CONFLICTS OF INTERESTS RELATED TO CURRENT AGENDA ITEMS. CONFLICTS OF INTERESTS ARE REVIEWED BY THE CFO, CEO, LEGAL OR AT THE APPROPRIATE LEVEL OF MANAGEMENT DEPENDING ON THE NATURE OF THE CONFLICT OF INTEREST.
WRITTEN DOCUMENT RETENTION PLAN	FORM 990, PART VI, LINE 14	WHILE FRANCISCAN MEDICAL GROUP HAS A WRITTEN DOCUMENT RETENTION PLAN, THE GOVERNING BOARD HAS NOT FORMALLY ADOPTED IT.
Process used to establish compensation of top management official	Form 990, Part VI, Section B, Line 15a	AN EXTERNAL COMPENSATION FIRM IS USED WHO UTILIZES ACTUAL MARKET DATA COMPENSATION FROM SIMILAR INSTITUTIONS WITH COMPARABLE POSITIONS AND COMPENSATION LEVELS AND CONSIDERING THE ORGANIZATION'S GEOGRAPHIC LOCATION. THE EXECUTIVE COMMITTEE OF THE BOARD ANNUALLY EVALUATES AND APPROVES THE EXECUTIVE COMPENSATION ARRANGEMENT FOR EACH EXECUTIVE FOR FAIR MARKET VALUE ALONG WITH OTHER APPLICABLE FACTORS RELIED ON BY THE BOARD'S DETERMINATION. THE SUPPORTING DOCUMENTATION BECOMES PART OF THE MINUTES OF THE MEETING. THIS PROCESS IS COMPLETED YEARLY.
Process used to establish compensation of other officers/key employees	Form 990, Part VI, Section B, Line 15b	AN EXTERNAL COMPENSATION FIRM IS USED WHO UTILIZES ACTUAL MARKET DATA COMPENSATION FROM SIMILAR INSTITUTIONS WITH COMPARABLE POSITIONS AND COMPENSATION LEVELS AND CONSIDERING THE ORGANIZATION'S GEOGRAPHIC LOCATION. THE EXECUTIVE COMMITTEE OF THE BOARD ANNUALLY EVALUATES AND APPROVES THE EXECUTIVE COMPENSATION ARRANGEMENT FOR EACH EXECUTIVE FOR FAIR MARKET VALUE ALONG WITH OTHER APPLICABLE FACTORS RELIED ON BY THE BOARD'S DETERMINATION. THE SUPPORTING DOCUMENTATION BECOMES PART OF THE MINUTES OF THE MEETING. THIS PROCESS IS COMPLETED YEARLY.
Governing documents, conflict of interest policy and financial statements available to the public	Form 990, Part VI, Section C, Line 19	THE ORGANIZATION'S FINANCIAL STATEMENTS ARE INCLUDED IN CATHOLIC HEALTH INITIATIVES' CONSOLIDATED AUDITED FINANCIAL STATEMENTS THAT ARE AVAILABLE AT WWW.CATHOLICHEALTHINIT.ORG OR AT WWW.DACBOND.COM. THE ORGANIZATION'S GOVERNING DOCUMENTS ARE AVAILABLE ON THE WASHINGTON SECRETARY OF STATE'S WEBSITE. THE CONFLICT OF INTEREST POLICY IS AVAILABLE TO THE PUBLIC IN THE ORGANIZATION'S ADMINISTRATION OFFICES.

Identifier

Return Reference

Explanation

STATEMENT OF PROGRAM SERVICE ACCOMPLISHMENTS

FORM 990, PART III, LINE 4A

I. INTRODUCTION A. MARKET BASED ORGANIZATION MISSION AND VISION FRANCISCAN MEDICAL GROUP WAS FOUNDED IN APRIL 1999 TO PROVIDE COMMUNITY BASED HEALTH CARE SERVICES. SINCE ITS INCEPTION, FRANCISCAN MEDICAL GROUP HAS FOCUSED ON PROVIDING QUALITY HEALTH CARE TO ALL MEMBERS OF THEIR COMMUNITY REGARDLESS OF ABILITY TO PAY FOR SERVICES. COMMUNITY SERVICE HAS ALWAYS BEEN AT THE CORE OF OUR ACTIVITY. B. COMMUNITY BENEFIT APPROACH FRANCISCAN MEDICAL GROUP CLINICS PROVIDE SERVICES ACROSS A LARGE GEOGRAPHY OF SOUTH PUGET SOUND IN WASHINGTON STATE, SERVING A DIVERSE POPULATION IN OUR SERVICE AREA. FRANCISCAN MEDICAL GROUP PROVIDES SERVICES TO PATIENTS REGARDLESS OF RACE, CREED, SEX, NATIONAL ORIGIN, HANDICAP OR ABILITY TO PAY. THE PROGRAMS AND SERVICES DESCRIBED THROUGHOUT THIS DOCUMENT NOT ONLY SERVE THE COMMUNITY BUT ALSO REDUCE THE BURDEN ON GOVERNMENTAL PROGRAMS, I.E. MEDICARE AND MEDICAID. WITHOUT THE CHARITY CARE PROVIDED BY FRANCISCAN MEDICAL GROUP CLINICS, THE COMMUNITY CHARITY CARE CASES WOULD FALL UPON THE MORE EXPENSIVE EMERGENCY ROOMS IN LOCAL HOSPITALS, INCLUDING THOSE OPERATED BY LOCAL GOVERNMENT. FRANCISCAN MEDICAL GROUP HAS OVER 250 PRIMARY CARE AND SPECIALTY PROVIDERS LOCATED IN OVER 100 CLINICS AND HOSPITALS WITH 711,157 PATIENT VISITS IN 2013. II. QUANTITATIVE DESCRIPTION OF COMMUNITY BENEFIT: UNCOMPENSATED CARE AS DESCRIBED BELOW, FRANCISCAN MEDICAL GROUP PROVIDED A SIGNIFICANT LEVEL OF CHARITY CARE SERVICES TO THOSE WITH LIMITED OR AN INABILITY TO PAY. TO THE EXTENT MEDICARE AND MEDICAID REIMBURSEMENT IS BELOW COST, FRANCISCAN MEDICAL GROUP RECOGNIZES THESE AMOUNTS AS THE UNCOMPENSATED COST OF PROVIDING CARE. AS MENTIONED ABOVE, FRANCISCAN MEDICAL GROUP PROVIDES SERVICES TO PATIENTS REGARDLESS OF RACE, CREED, SEX, NATIONAL ORIGIN, HANDICAP, OR ABILITY TO PAY. MOST PHYSICIAN GROUPS IN THE STATE OF WASHINGTON HAVE EITHER PARTIALLY OR FULLY CLOSED THEIR PRACTICES TO NEW MEDICARE AND MEDICAID PATIENTS AS THE REIMBURSEMENT FOR THESE PROGRAMS HAS INCREASINGLY FALLEN SHORT OF THE COST OF PROVIDING THAT CARE. ALTHOUGH REIMBURSEMENT FOR SERVICES RENDERED IS CRITICAL TO THE OPERATION AND STABILITY OF FRANCISCAN MEDICAL GROUP, NOT ALL INDIVIDUALS POSSESS THE ABILITY TO PURCHASE ESSENTIAL MEDICAL SERVICES AND OUR MISSION IS TO SERVE THE COMMUNITY BY PROVIDING HEALTH CARE SERVICES AND HEALTH CARE EDUCATION. THEREFORE, IN KEEPING WITH FRANCISCAN MEDICAL GROUP'S COMMITMENT TO SERVE ALL MEMBERS OF ITS COMMUNITY, WE PROVIDE CARE TO PERSONS COVERED BY GOVERNMENTAL PROGRAMS - ALTHOUGH THE COST OF PROVIDING THAT CARE EXCEEDS GOVERNMENTAL PROGRAM REIMBURSEMENT. FOR THE FISCAL YEAR ENDING JUNE 30, 2013, THE COST OF UNCOMPENSATED MEDICARE CARE AMOUNTED TO $29.6 MILLION; FOR MEDICAID IT AMOUNTED TO $ 14.9 MILLION; CHARITY CARE TOTALED $ 1.8 MILLION FOR THE YEAR. III. QUALITATIVE DESCRIPTION OF COMMUNITY BENEFIT A. COMMUNITY OUTREACH FOR THE POOR AND THE BROADER COMMUNITY ACTIVITIES OFFERED INCLUDE WELLNESS PROGRAMS, COMMUNITY EDUCATION PROGRAMS, SPECIAL PROGRAMS FOR TERMINALLY ILL PATIENTS, AND A BROAD VARIETY OF COMMUNITY SUPPORT ACTIVITIES. FRANCISCAN MEDICAL GROUP PROVIDES CHARITY CARE FOR PEOPLE WHO ARE POOR. CHARITY CARE IS ALSO PROVIDED THROUGH MANY REDUCED PRICE SERVICES AND FREE PROGRAMS OFFERED THROUGHOUT THE YEAR BASED UPON ACTIVITIES AND SERVICES WHICH FRANCISCAN MEDICAL GROUP BELIEVES SERVE A BONA FIDE COMMUNITY HEALTH NEED. THESE INCLUDE COMMUNITY EDUCATION SERVICE COST FOR THE COMMUNITY, CLASSES FOR CHILDREN THAT COVER HEALTH CARE TOPICS, EMERGENCY RESPONSE, FIRE SAFETY, BIKE AND TRAFFIC SAFETY, PHOTO AND FINGERPRINTING, ELECTRICAL SAFETY, SEAT BELTS AND OTHER CARE SAFETY, AND OTHER COMMUNITY HEALTH TOPICS. IT IS SIGNIFICANT TO NOTE THAT ALL OF THE FRANCISCAN MEDICAL GROUP PRIMARY CARE CLINICS OPERATE IN COMMUNITIES DESIGNATED BY THE US DEPARTMENT OF HEALTH AS MEDICALLY UNDERSERVED AREAS FOR ACCESS TO PRIMARY CARE. HEALTH FAIRS, EVENTS AND SCREENINGS FRANCISCAN MEDICAL GROUP PROVIDES CHOLESTEROL SCREENINGS, GLUCOSE SCREENINGS, BLOOD PRESSURE CHECKS, AND HEALTH EDUCATION INFORMATION TO THE COMMUNITY. IN FISCAL YEAR 2013, THESE SCREENINGS AND COMMUNITY HEALTH EDUCATION OPPORTUNITIES REACHED APPROXIMATELY 8,320 PEOPLE IN OUR COMMUNITIES. FMG MANAGERS PROVIDED A MINIMUM OF 865 VOLUNTEER HOURS SERVING OUR COMMUNITIES. FUNDRAISERS SUPPORTED ALZHEIMER'S ASSOCIATION AMERICAN CANCER SOCIETY - RELAY FOR LIFE AMERICAN HEART ASSOCIATION AMERICAN DIABETES ASSOCIATION AMERICAN RED CROSS - MT RAINIER CHAPTER UNITED WAY MUSCULAR DYSTROPHY ASSOCIATION TACOMA RESCUE MISSION LEUKEMIA AND LYMPHOMA SOCIETY SALVATION ARMY FRANCISCAN FOUNDATION - CORNERSTONE CLUB FRANCISCAN FOUNDATION - ST JOSEPH HOSPITAL BALL FRANCISCAN FOUNDATION - ST FRANCIS HOSPITAL GALA FRANCISCAN FOUNDATION - HOSPICE GOLF TOURNAMENT FRANCISCAN FOUNDATION - ST FRANCIS HOSPITAL GOLF TOURNAMENT FRANCISCAN FOUNDATION - ST CLARE HOSPITAL GOLF TOURNAMENT ENUMCLAW COMMUNITY HOSPITAL FOUNDATION CATHOLIC CHARITIES MOST OF THESE FUNDRAISING ACTIVITIES WERE SUPPORTED BY ACTUAL FUNDRAISING ACTIVITIES, BUT MOST WERE ALSO SUPPORTED BY CASH DONATIONS FROM FRANCISCAN MEDICAL GROUP.

EXECUTIVE COMMITTEE

FORM 990, PART VI, LINE 1A

PURSUANT TO SECTION 8.5 OF THE BYLAWS OF THE FRANCISCAN MEDICAL GROUP THE EXECUTIVE COMMITTEE IS COMPOSED OF FOUR (4) MEMBERS, INCLUDING TWO (2) PHYSICIAN DIRECTORS, ONE (1) COMMUNITY REPRESENTATIVE NON-PHYSICIAN DIRECTOR AND THE CHAIRPERSON OF THE BOARD (UNLESS SUCH CHAIRPERSON OF THE BOARD IS ALSO ONE OF THE OTHER QUALIFIED MEMBERS, IN WHICH CASE THE FOURTH MEMBER SHALL BE A DIRECTOR APPOINTED BY THE CHAIRPERSON OF THE BOARD). EACH OF WHOM SHALL SERVE AS AN EX OFFICIO VOTING MEMBER OF THE EXECUTIVE COMMITTEE, AND TWO VOTING MEMBERS APPOINTED BY THE BOARD OF DIRECTORS. THE EXECUTIVE COMMITTEE SHALL CONSIST OF ONLY DIRECTORS OF THE CORPORATION. PURSUANT TO SECTION 8.1 OF THE CORPORATION'S BYLAWS, COMMITTEES, SUCH AS THE EXECUTIVE COMMITTEE, THAT ARE GRANTED THE AUTHORITY TO ACT ON BEHALF OF THE BOARD OF DIRECTORS MAY INCLUDE ONLY DIRECTORS OF THE CORPORATION. FURTHER, PURSUANT TO SECTION 8.5 OF THE CORPORATION'S BYLAWS, THE EXECUTIVE COMMITTEE HAS AND MAY EXERCISE SUCH POWERS AS MAY BE DELEGATED TO IT BY THE BOARD OF DIRECTORS. THE EXECUTIVE COMMITTEE ALSO POSSESSES THE POWER TO TRANSACT ROUTINE BUSINESS OF THE CORPORATION IN THE INTERIM PERIOD BETWEEN REGULARLY SCHEDULED MEETINGS OF THE BOARD OF DIRECTORS.

Classes of members or stockholders

Form 990, Part VI, Section A, Line 6

ACCORDING TO THE BYLAWS OF FRANCISCAN MEDICAL GROUP THE SOLE MEMBER IS FRANCISCAN HEALTH SYSTEM, A WASHINGTON NONPROFIT CORPORATION.

Members or stockholders electing members of governing body

Form 990, Part VI, Section A, Line 7a

THE SOLE MEMBER HAS THE POWER TO APPOINT, REPLACE OR REMOVE THE MEMBERS OF THE BOARD OF DIRECTORS.

Decisions requiring approval by members or stockholders

Form 990, Part VI, Section A, Line 7b

THE ORGANIZATION'S CORPORATE MEMBER IS FRANCISCAN HEALTH SYSTEM ("FHS"). PURSUANT TO SECTION 5.4 OF THE ORGANIZATION'S BYLAWS, BOTH FRANCISCAN HEALTH SYSTEM AND CATHOLIC HEALTH INITIATIVES ("CHI") (FHS'S SOLE CORPORATE MEMBER) HAVE RESERVED POWERS AS OUTLINED IN THE CHI GOVERNANCE MATRIX. PURSUANT TO THE GOVERNANCE MATRIX THE FOLLOWING RIGHTS ARE RESERVED TO THE FRANCISCAN HEALTH SYSTEM (FHS) BOARD: 1. APPROVE MEMBERS OF THE FRANCISCAN MEDICAL GROUP (FMG) BOARD 2. AMENDMENT OF THE CORPORATE DOCUMENTS OF FMG 3. APPROVE REMOVAL OF A MEMBER OF THE GOVERNING BODY OF FMG 4. ADOPTION OF LONG RANGE AND STRATEGIC PLANS FOR FMG THE FOLLOWING RIGHTS ARE RESERVED TO THE CHI BOARD DIRECTLY OR THROUGH POWERS DELEGATED TO THE CHI CHIEF EXECUTIVE OFFICER: 1. SUBSTANTIAL CHANGE IN THE MISSION OR PHILOSOPHY OF FMG 2. REMOVAL OF A MEMBER OF THE GOVERNING BODY OF FMG 3. APPROVAL OF ISSUANCE OF DEBT BY FMG 4. APPROVAL OF PARTICIPATION OF FMG IN A JOINT VENTURE 5. APPROVAL OF FORMATION OF A NEW CORPORATION BY FMG 6. APPROVAL OF A MERGER INVOLVING FMG 7. APPROVAL OF THE SALE OF ALL OR SUBSTANTIALLY ALL OF THE ASSETS OF FMG 8. TO REQUIRE THE TRANSFER OF ASSETS BY FMG TO CHI TO ACCOMPLISH CHI'S GOALS AND OBJECTIVES, AND TO SATISFY CHI DEBTS. IN ADDITION, PURSUANT TO SECTION 5.5.2 OF THE ORGANIZATION'S BYLAWS, FHS OR CHI MAY, IN EXERCISE OF ITS APPROVAL POWERS, GRANT OR WITHHOLD APPROVAL IN WHOLE OR IN PART, OR MAY, IN ITS COMPLETE DISCRETION, AFTER CONSULTATION WITH THE BOARD AND THE PRESIDENT AND CHIEF EXECUTIVE OFFICER OF THE ORGANIZATION, RECOMMEND SUCH OTHER OR DIFFERENT ACTIONS AS IT DEEMS APPROPRIATE.

Review of form 990 by governing body

Form 990, Part VI, Section B, Line 11b

THE CFO REVIEWS THE TAX RETURN AND ANY NECESSARY CHANGES ARE INCLUDED IN THE FINAL VERSION THAT IS APPROVED FOR FILING WITH THE IRS. IN ADDITION, THE RETURN IS PROVIDED TO THE BOARD PRIOR TO FILING. SUBSEQUENT TO REVIEW, THE TAX DEPARTMENT FILES THE RETURN WITH THE APPROPRIATE FEDERAL AGENCIES, MAKING ANY NON-SUBSTANTIVE CHANGES NECESSARY TO EFFECT E-FILING.

Conflict of interest policy

Form 990, Part VI, Section B, Line 12c

EACH EMPLOYEE IS PROVIDED EDUCATION REGARDING CONFLICT OF INTEREST POLICY AT NEW EMPLOYEE ORIENTATION. AS A PART OF THE ANNUAL PERFORMANCE REVIEW PROCESS, THE FOLLOWING STATEMENT IS INITIALED BY ALL EMPLOYEES: CONFLICTS OF INTEREST: "I WILL COMPLY WITH THE STANDARDS AND GUIDELINES CONTAINED IN THE CONFLICT OF INTEREST POLICY. I UNDERSTAND THAT I AM RESPONSIBLE FOR RECOGNIZING ANY SITUATION IN WHICH A CONFLICT OF INTEREST IS PRESENT OR MIGHT ARISE. I WILL IMMEDIATELY REPORT ANY SUCH SITUATION TO MY MANAGER/VICE PRESIDENT AND WILL TAKE APPROPRIATE ACTION TO ELIMINATE OR PREVENT A CONFLICT." THE GOVERNING BODY IS ALSO REQUIRED TO ANNUALLY DECLARE CONFLICTS OF INTERESTS, AS WELL AS THE MEDICAL STAFF LEADERS. WHEN A CONFLICT IS ACKNOWLEDGED, THE INDIVIDUALS ARE PROHIBITED FROM DELIBERATIONS AND DECISIONS IN THE TRANSACTION. THE EXECUTIVE COMMITTEE OF THE BOARD REVIEWS ALL GOVERNANCE CONFLICTS OF INTERESTS, AND AT EACH BOARD MEETING THE CHAIRPERSON ASKS IF THERE ARE ANY CONFLICTS OF INTERESTS RELATED TO CURRENT AGENDA ITEMS. CONFLICTS OF INTERESTS ARE REVIEWED BY THE CFO, CEO, LEGAL OR AT THE APPROPRIATE LEVEL OF MANAGEMENT DEPENDING ON THE NATURE OF THE CONFLICT OF INTEREST.

WRITTEN DOCUMENT RETENTION PLAN

FORM 990, PART VI, LINE 14

WHILE FRANCISCAN MEDICAL GROUP HAS A WRITTEN DOCUMENT RETENTION PLAN, THE GOVERNING BOARD HAS NOT FORMALLY ADOPTED IT.

Process used to establish compensation of top management official

Form 990, Part VI, Section B, Line 15a

AN EXTERNAL COMPENSATION FIRM IS USED WHO UTILIZES ACTUAL MARKET DATA COMPENSATION FROM SIMILAR INSTITUTIONS WITH COMPARABLE POSITIONS AND COMPENSATION LEVELS AND CONSIDERING THE ORGANIZATION'S GEOGRAPHIC LOCATION. THE EXECUTIVE COMMITTEE OF THE BOARD ANNUALLY EVALUATES AND APPROVES THE EXECUTIVE COMPENSATION ARRANGEMENT FOR EACH EXECUTIVE FOR FAIR MARKET VALUE ALONG WITH OTHER APPLICABLE FACTORS RELIED ON BY THE BOARD'S DETERMINATION. THE SUPPORTING DOCUMENTATION BECOMES PART OF THE MINUTES OF THE MEETING. THIS PROCESS IS COMPLETED YEARLY.

Process used to establish compensation of other officers/key employees

Form 990, Part VI, Section B, Line 15b

Governing documents, conflict of interest policy and financial statements available to the public

Form 990, Part VI, Section C, Line 19

THE ORGANIZATION'S FINANCIAL STATEMENTS ARE INCLUDED IN CATHOLIC HEALTH INITIATIVES' CONSOLIDATED AUDITED FINANCIAL STATEMENTS THAT ARE AVAILABLE AT WWW.CATHOLICHEALTHINIT.ORG OR AT WWW.DACBOND.COM. THE ORGANIZATION'S GOVERNING DOCUMENTS ARE AVAILABLE ON THE WASHINGTON SECRETARY OF STATE'S WEBSITE. THE CONFLICT OF INTEREST POLICY IS AVAILABLE TO THE PUBLIC IN THE ORGANIZATION'S ADMINISTRATION OFFICES.

For Paperwork Reduction Act Notice, see the Instructions for Form 990 or 990-EZ.

Cat. No. 51056K

Schedule O (Form 990 or 990-EZ) 2012

Software ID:	12000266
Software Version:	v2012.1.0