SCHEDULE H
(Form 990)
Department of the Treasury
Internal Revenue Service
Hospitals
MediumBullet Complete if the organization answered "Yes" on Form 990, Part IV, question 20.
MediumBullet Attach to Form 990.
MediumBullet Information about Schedule H (Form 990) and its instructions is at www.irs.gov/form990.
OMB No. 1545-0047
2015
Open to Public Inspection
Name of the organization
Jane Phillips Memorial Medical Center
 
Employer identification number

73-0606129
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 criteria used 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
Yes
 
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
 
No
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) . . .
    6,618,355 61,908 6,556,447 6.45 %
b Medicaid (from Worksheet 3, column a) . . . . .     12,881,359 10,704,957 2,176,402 2.14 %
c Costs of other means-tested government programs (from Worksheet 3, column b) . .         0 0 %
d Total Financial Assistance and Means-Tested Government Programs . . . . . 0 0 19,499,714 10,766,865 8,732,849 8.59 %
Other Benefits
e Community health improvement services and community benefit operations (from Worksheet 4).         0 0 %
f Health professions education (from Worksheet 5) . . .     254,381 196,956 57,425 0.06 %
g Subsidized health services (from Worksheet 6) . . . .         0 0 %
h Research (from Worksheet 7) .         0 0 %
i Cash and in-kind contributions for community benefit (from Worksheet 8) . . . .     257,501 0 257,501 0.25 %
j Total. Other Benefits . . 0 0 511,882 196,956 314,926 0.31 %
k Total. Add lines 7d and 7j . 0 0 20,011,596 10,963,821 9,047,775 8.90 %
For Paperwork Reduction Act Notice, see the Instructions for Form 990. Cat. No. 50192T Schedule H (Form 990) 2015
Schedule H (Form 990) 2015
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         0 0 %
2 Economic development         0 0 %
3 Community support         0 0 %
4 Environmental improvements         0 0 %
5 Leadership development and
training for community members
        0 0 %
6 Coalition building         0 0 %
7 Community health improvement advocacy         0 0 %
8 Workforce development         0 0 %
9 Other         0 0 %
10 Total 0 0 0 0 0 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
 
No
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
2,334,249
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
44,196,544
6
Enter Medicare allowable costs of care relating to payments on line 5.....
6
47,121,168
7
Subtract line 6 from line 5. This is the surplus (or shortfall)........
7
-2,924,624
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) 2015
Schedule H (Form 990) 2015
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 (and if a group return, the name and EIN of the subordinate hospital organization that operates the hospital facility)
Licensed Hospital General-Medical-Surgical Children's Hospital Teaching Hospital Critical Hospital ResearchGrp Facility ER-24Hours ER-Other Other (Describe) Facility reporting group
1 Jane Phillips Memorial Medical Center
3500 E Frank Phillips Blvd
Bartlesville,OK74006
www.stjohnhealthsystem.com
2190
X X   X     X      
Schedule H (Form 990) 2015
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Schedule H (Form 990) 2015
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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)
Jane Phillips Memorial Medical Center
Name of hospital facility or letter of facility reporting group  
Line number of hospital facility, or line numbers of hospital facilities in a facility
reporting group (from Part V, Section A):
1
Yes No
Community Health Needs Assessment
1 Was the hospital facility first licensed, registered, or similarly recognized by a state as a hospital facility in the current tax year or the immediately preceding tax year?........................ 1   No
2 Was the hospital facility acquired or placed into service as a tax-exempt hospital in the current tax year or the immediately preceding tax year? If “Yes,” provide details of the acquisition in Section C............... 2   No
3 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 12...................... 3 Yes  
If "Yes," indicate what the CHNA report describes (check all that apply):
a
b
c
d
e
f
g
h
i
j
4 Indicate the tax year the hospital facility last conducted a CHNA: 20 15
5 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 Section C how the hospital facility took into account input from persons who represent the community, and identify the persons the hospital facility consulted ................. 5 Yes  
6 a Was the hospital facility’s CHNA conducted with one or more other hospital facilities? If "Yes," list the other hospital facilities in Section C.................................. 6a Yes  
b Was the hospital facility’s CHNA conducted with one or more organizations other than hospital facilities?” If “Yes,” list the other organizations in Section C. ............................ 6b Yes  
7 Did the hospital facility make its CHNA report widely available to the public?.............. 7 Yes  
If "Yes," indicate how the CHNA report was made widely available (check all that apply):
a
b
c
d
8 Did the hospital facility adopt an implementation strategy to meet the significant community health needs
identified through its most recently conducted CHNA? If "No," skip to line 11. ..............
8 Yes  
9 Indicate the tax year the hospital facility last adopted an implementation strategy: 20 15
10 Is the hospital facility's most recently adopted implementation strategy posted on a website?......... 10 Yes  
a If "Yes" (list url): http://www.stjohnhealthsystem.com/about/community-health-needs-assessment
b If "No," is the hospital facility’s most recently adopted implementation strategy attached to this return? ...... 10b   No
11 Describe in Section C how the hospital facility is addressing the significant needs identified in its most recently conducted CHNA and any such needs that are not being addressed together with the reasons why such needs are not being addressed.
12a 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)?............................... 12a   No
b If "Yes" on line 12a, did the organization file Form 4720 to report the section 4959 excise tax?........ 12b    
c If "Yes" on line 12b, 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) 2015
Page 5
Schedule H (Form 990) 2015
Page 5
Part VFacility Information (continued)

Financial Assistance Policy (FAP)
Jane Phillips Memorial Medical Center
Name of hospital facility or letter of facility reporting group  
Yes No
Did the hospital facility have in place during the tax year a written financial assistance policy that:
13 Explained eligibility criteria for financial assistance, and whether such assistance included free or discounted care? 13 Yes  
If “Yes,” indicate the eligibility criteria explained in the FAP:
a
b
c
d
e
f
g
h
14 Explained the basis for calculating amounts charged to patients?................. 14 Yes  
15 Explained the method for applying for financial assistance?................... 15 Yes  
If “Yes,” indicate how the hospital facility’s FAP or FAP application form (including accompanying instructions) explained the method for applying for financial assistance (check all that apply):
a
b
c
d
e
16 Included measures to publicize the policy within the community served by the hospital facility?........ 16 Yes  
If "Yes," indicate how the hospital facility publicized the policy (check all that apply):
a
http://www.stjohnhealthsystem.com/about/payment-for-services
b
http://www.stjohnhealthsystem.com/about/payment-for-services
c
d
e
f
g
h
i
Billing and Collections
17 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 all of the actions the hospital facility or other authorized party may take upon non-payment?.................................. 17 Yes  
18 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
Schedule H (Form 990) 2015
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Schedule H (Form 990) 2015
Page 6
Part VFacility Information (continued)

Jane Phillips Memorial Medical Center
Name of hospital facility or letter of facility reporting group  
Yes No
19 Did the hospital facility or other authorized 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?............ 19   No
If "Yes," check all actions in which the hospital facility or a third party engaged:
a
b
c
d
20 Indicate which efforts the hospital facility or other authorized party made before initiating any of the actions listed (whether or not checked) in line 19. (check all that apply):
a
b
c
d
e
f
Policy Relating to Emergency Medical Care
21 Did the hospital facility have in place during the tax year a written policy relating to emergency medical care that required 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?.................. 21 Yes  
If "No," indicate why:
a
b
c
d
Charges to Individuals Eligible for Assistance Under the FAP (FAP-Eligible Individuals)
22 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
23 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? ............................... 23   No
If "Yes," explain in Section C.
24 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? ........................... 24   No
If "Yes," explain in Section C.
Schedule H (Form 990) 2015
Page 7
Schedule H (Form 990) 2015
Page 7
Part V
Facility Information (continued)
Section C. Supplemental Information for Part V, Section B. Provide descriptions required for Part V, Section B, lines 2, 3j, 5, 6a, 6b, 7d, 11, 13b, 13h, 15e, 16i, 18d, 19d, 20e, 21c, 21d, 22d, 23, and 24. If applicable, provide separate descriptions for each hospital facility in a facility reporting group, designated by facility reporting group letter and hospital facility line number from Part V, Section A (“A, 1,” “A, 4,” “B, 2,” “B, 3,” etc.) and name of hospital facility.
Form and Line Reference Explanation
Schedule H, Part V, Section B, Line 5 Facility , 1 Facility , 1 - Jane Phillips Memorial Medical Center. COMMUNITY INPUT IS A PRIMARY FOCUS OF THE MOST RECENT CHNA THAT WAS ADOPTED AND APPROVED BEFORE 6/30/2016 FOR THE FISCAL YEAR 2017-2019. ACCORDINGLY, INPUT FROM COMMUNITY MEMBERS, COMMUNITY LEADERS AND REPRESENTATIVES, AS WELL AS THE HEALTH'S SYSTEM'S COMMUNITY HEALTH NEEDS ASSESSMENT (CHNA) ADVISORY GROUP AND LEADERSHIP WAS OBTAINED TO EXPAND UPON INFORMATION GLEANED FROM THE SECONDARY DATA REVIEW. A CONCERTED EFFORT WAS MADE TO OBTAIN COMMUNITY INPUT FROM PERSONS WHO REPRESENT THE BROAD INTERESTS OF THE COMMUNITY SERVED BY THE HOSPITAL, INCLUDING THOSE WITH SPECIAL KNOWLEDGE AND EXPERTISE OF PUBLIC HEALTH ISSUES AND POPULATIONS DEEMED VULNERABLE. THIS ASSESSMENT ALSO TOOK IN TO ACCOUNT THE IMPORTANCE OF ENGAGING COMMUNITIES ON AN ONGOING BASIS AND THE PROMOTION OF A CONTINUAL DIALOGUE. THIS INCLUDES DISSEMINATING THE RESULTS OF THE ASSESSMENT WITHIN THE COMMUNITY AND ENGAGING THE COMMUNITY IN MUTUALLY REINFORCING AND COMMUNITY-DRIVEN ACTIVITIES TO IMPROVE THE COMMUNITY HEALTH AND WELL-BEING. THIS ASSESSMENT EMPLOYED SEVERAL METHODS OF COMMUNITY INPUT TO YIELD THE DESIRED RESULTS. FOR THE PURPOSES OF THIS ASSESSMENT, COMMUNITY INPUT WAS OBTAINED THROUGH THE FOLLOWING METHODS: 1)SURVEY OF 1,009 WASHINGTON COUNTY RESIDENTS, 2) A HOSPITAL COMMUNITY INPUT MEETING WITH 16 COMMUNITY MEMBERS, LEADERS, AND REPRESENTATIVES, 3) A SURVEY OF 30 WASHINGTON COUNTY WELLNESS INITIATIVE WORKGROUP MEMBERS, 4) INPUT FROM THE PUBLIC HEALTH WORKFORCE AND LOCAL COALITIONS/PARTNERSHIPS, AND 5) INPUT FROM THE HEALTH'S SYSTEM'S COMMUNITY HEALTH NEEDS ASSESSMENT (CHNA) ADVISORY GROUP AND LEADERSHIP. A SUBSTANTIAL AMOUNT OF COMMUNITY INPUT WAS OBTAINED THROUGH THE 2014-2015 WASHINGTON COUNTY WELLNESS INITIATIVE (WCWI) COMMUNITY ASSESSMENT SURVEY. CONDUCTED BY A LOCAL COMMUNITY COALITION KNOWN AS THE WASHINGTON COUNTY WELLNESS INITIATIVE. AS PART OF THE HEALTH RESOURCES AND SERVICES ADMINISTRATION (HRSA) OF THE U.S. DEPARTMENT OF HEALTH AND HUMAN SERVICES (HHS) UNDER GRANT P10RH26875, RURAL HEALTH NETWORK DEVELOPMENT PLANNING GRANT, THE WASHINGTON COUNTY WELLNESS INITIATIVE (WCWI) DEVELOPED AND CONDUCTED A COUNTY-WIDE COMMUNITY ASSESSMENT. THE ASSESSMENT SURVEY WAS AVAILABLE TO ALL WASHINGTON COUNTY RESIDENTS TO COMPLETE ONLINE OR ON A PAPER FORM BEGINNING NOVEMBER 2014. AFTER 1000 ASSESSMENTS WERE COMPLETED, THE DATA GATHERING PERIOD CONCLUDED IN MAY 2015. ON APRIL 19, 2016, A TOTAL OF 16 COMMUNITY LEADERS AND REPRESENTATIVES PARTICIPATED IN A COMMUNITY INPUT MEETING CONDUCTED AT JANE PHILLIPS MEDICAL CENTER. THE PURPOSE OF THIS MEETING WAS TO SOLICIT COMMUNITY INPUT FROM PERSONS REPRESENTING THE BROAD INTERESTS OF THE COMMUNITY, ESPECIALLY THOSE MOST IN NEED. THE MEETING WAS INTENDED TO OBTAIN COMMUNITY INPUT SPECIFIC TO THE HOSPITAL AND SURROUNDING COMMUNITY OF WASHINGTON COUNTY. THE MEETING TOOK PLACE OVER A TWO-HOUR PERIOD AND CONSISTED OF FOUR MAIN EXERCISES: 1) HOSPITAL ASSESSMENT EXERCISES, 2) NOMINAL GROUP EXERCISE TO VALIDATE AND PRIORITIZE HEALTH NEEDS BASED ON TOP HEALTH NEEDS IDENTIFIED, 3) COMMUNITY PERCEPTION GROUP EXERCISE, AND 4) COMMUNITY CAPACITY ASSESSMENT EXERCISE. THE FOLLOWING COMMUNITY AGENCIES AND ORGANIZATIONS PARTICIPATED IN THE MEETING: CITY OF BARTLESVILLE, STAGES2CHANGE, LLC., BARTLESVILLE REGIONAL UNITED WAY, PHILLIPS 66, BARTLESVILLE CITY COUNCIL, TRI COUNTY TECH, DELAWARE TRIBE OF INDIANS, HOPESTONE CANCER SUPPORT CENTER, WASHINGTON COUNTY WELLNESS INITIATIVE, CONOCOPHILLIPS, BARTLESVILLE PUBLIC SCHOOLS, GREEN COUNTRY FREE CLINIC, WASHINGTON COUNTY HEALTH DEPARTMENT, BARTLESVILLE RADIO, AND THE BARTLESVILLE REGIONAL CHAMBER OF COMMERCE. A COMMUNITY INPUT SURVEY OF WASHINGTON COUNTY WELLNESS INITIATIVE WORKGROUP MEMBERS WAS ALSO CONDUCTED VIA SURVEYMONKEY AND EMAIL. THE SURVEY WAS DESIGNED TO BE SUPPLEMENTAL TO THE HOSPITAL'S COMMUNITY INPUT MEETING AND UTILIZED THE SAME QUESTIONS AND METHODOLOGY TO OBTAIN INPUT AS THE MEETING. APPROXIMATELY 30 WORKGROUP MEMBERS PARTICIPATED IN THE SURVEY. A COMMUNITY HEALTH NEEDS ASSESSMENT (CHNA) ADVISORY GROUP WAS FORMED IN THE BEGINNING OF THIS ASSESSMENT PROCESS TO PROVIDE DIRECTION, INPUT, AND GUIDANCE. THIS GROUP MET SEVERAL TIMES DURING THE PROCESS BETWEEN FEBRUARY AND MAY 2016. GROUP MEMBERSHIP CONSISTED OF THIRTEEN KEY REPRESENTATIVES FROM HOSPITAL FACILITIES, ST. JOHN CLINIC, AND DEPARTMENTS THROUGHOUT THE HEALTH SYSTEM. THESE MEMBERS ASSISTED WITH THE DESIGN AND COORDINATION OF THE HOSPITAL COMMUNITY HEALTH INPUT MEETINGS AND ALSO HELPED TO COMPILE INFORMATION AND DATA RELATED TO OUR EVALUATION OF IMPACT FROM OUR 2013 COMMUNITY HEALTH NEEDS ASSESSMENT PROCESS. ADDITIONAL MEMBERS OF HOSPITAL AND HEALTH SYSTEM LEADERSHIP WERE ALSO ENGAGED TO PROVIDE INPUT AND GUIDANCE THROUGHOUT THE PROCESS. A SHORT COMMUNITY HEALTH NEEDS PRIORITIZATION SURVEY WAS EMAILED TO CHNA ADVISORY GROUP MEMBERS AND HOSPITAL/HEALTH SYSTEM LEADERSHIP VIA SURVEYMONKEY IN APRIL 2016. A TOTAL OF FIFTEEN MEMBERS AND LEADERSHIP RESPONDED TO THE SURVEY. COMMUNITY INPUT WAS SOLICITED FROM A DIVERSE SET OF COMMUNITY STAKEHOLDERS SUCH AS COMMUNITY MEMBERS, COMMUNITY ORGANIZATIONS, AND THE PUBLIC HEALTH WORKFORCE. A VARIETY OF SOURCES ENSURED THAT AS MANY DIFFERENT PERSPECTIVES AS POSSIBLE WERE REPRESENTED WHILE SATISFYING THE BROAD INTERESTS OF THE COMMUNITY. SOURCES OF COMMUNITY INPUT FOR THIS ASSESSMENT WERE AS FOLLOWS: 1) WASHINGTON COUNTY RESIDENTS WHO PARTICIPATED IN THE WASHINGTON COUNTY WELLNESS INITIATIVE 2015 WASHINGTON COUNTY COMMUNITY ASSESSMENT SURVEY, 2) COMMUNITY LEADERS AND REPRESENTATIVES, 3) LOCAL PUBLIC HEALTH WORKFORCE AND COALITIONS/PARTNERSHIPS, 4) MEMBERS AND REPRESENTATIVES OF MEDICALLY UNDERSERVED, LOW-INCOME, MINORITY, AT-RISK, AND OTHERWISE VULNERABLE POPULATIONS, 5) WASHINGTON COUNTY WELLNESS INITIATIVE WORKGROUP MEMBERS, AND 6) HEALTH SYSTEM CHNA ADVISORY GROUP AND LEADERSHIP. COMMUNITY STAKEHOLDERS WHO PROVIDED COMMUNITY INPUT REPRESENTED A VARIETY OF COMMUNITY SECTORS INCLUDING: COMMUNITY MEMBERS, HEALTHCARE PROVIDERS AND SERVICES, NON-PROFIT AGENCIES, COMMUNITY-BASED ORGANIZATIONS, PRIVATE BUSINESSES, EDUCATION AND ACADEMIA, COMMUNITY DEVELOPERS, FAITH COMMUNITIES AND FAITH-BASED ORGANIZATIONS, GOVERNMENT REPRESENTATIVES, SAFETY NET SERVICE PROVIDERS, ECONOMIC AND WORKFORCE DEVELOPMENT, THE PUBLIC HEALTH WORKFORCE, AND OTHER INTEREST GROUPS WORKING WITH AT-RISK AND VULNERABLE POPULATIONS. THIS ASSESSMENT ESPECIALLY FOCUSED ON COMMUNITY INPUT FROM THOSE WITH SPECIAL KNOWLEDGE OR EXPERTISE IN PUBLIC HEALTH AS WELL AS MEMBERS AND REPRESENTATIVES OF MEDICALLY UNDERSERVED, LOW INCOME, MINORITY, OR OTHERWISE VULNERABLE POPULATIONS. EACH OFFERED CRITICAL STRENGTHS AND INSIGHTS ON THE HEALTH NEEDS AND ASSETS OF THE COMMUNITY.
Schedule H, Part V, Section B, Line 6a Facility , 1 Facility , 1 - JANE PHILLIPS MEMORIAL MEDICAL CENTER. THE OTHER HOSPITAL FACILITIES WITH WHICH THE REPORTING HOSPITAL FACILITY CONDUCTED ITS CHNA, INCLUDE: - ST. JOHN MEDICAL CENTER, INC. (TULSA) - ST. JOHN BROKEN ARROW, INC. - ST. JOHN SAPULPA, INC. - OWASSO MEDICAL FACILITY, INC. - JANE PHILLIPS NOWATA HOSPITAL, INC.
Schedule H, Part V, Section B, Line 6b Facility , 1 Facility , 1 - JANE PHILLIPS MEMORIAL MEDICAL CENTER. THE OTHER ORGANIZATIONS OTHER THAN HOSPITAL FACILITIES WITH WHICH THE REPORTING HOSPITAL FACILITY CONDUCTED ITS CHNA, INCLUDE: - THE WASHINGTON COUNTY WELLNESS INITIATIVE - THE WASHINGTON COUNTY HEALTH DEPARTMENT
Schedule H, Part V, Section B, Line 11 Facility , 1 Facility , 1 - JANE PHILLIPS MEMORIAL MEDICAL CENTER. PART I: HOW THE CHNA NEEDS WERE MET IN FY 2016 FOR THE OLD/PREVIOUS CHNA THAT COVERED FISCAL YEAR 2014-2016: USING THE CHNA COMPLETED IN 2013, THE ST. JOHN SYSTEM DEVELOPED, ADOPTED, AND WORKED ON EXECUTING A 2014-2016 IMPLEMENTATION STRATEGY TO ADDRESS THE COMMUNITY HEALTH NEEDS IDENTIFIED IN THE COMMUNITY-WIDE COMMUNITY HEALTH NEEDS ASSESSMENT. MANY OF THESE ARE DONE IN COLLABORATION WITH INDIVIDUALS REPRESENTING INTERESTS OF THE COMMUNITY AND/OR IN SUPPORT OF COMMUNITY BASED PROGRAMS. JANE PHILLIPS MEMORIAL MEDICAL CENTER ADDITIONALLY COLLABORATED WITH THE WASHINGTON COUNTY HEALTH DEPARTMENT, WASHINGTON COUNTY WELLNESS INITIATIVE, AND STAKEHOLDERS IN WASHINGTON COUNTY FOR IDENTIFICATION AND PRIORITIZATION OF NEEDS. UPON COMPLETION OF THE ASSESSMENT WITH INPUT FROM LOCAL PUBLIC HEALTH OFFICIALS AND OTHER LEADERS, JANE PHILLIPS MEMORIAL MEDICAL CENTER IDENTIFIED AND COLLABORATIVELY WORKED TOWARD ADDRESSING THE FOLLOWING PRIORITY NEEDS: 1) ACCESS TO CARE: LACK OF PRIMARY CARE PHYSICIANS; UNINSURED, 2) CHRONIC CONDITIONS AND WELLNESS PROMOTION: HEART DISEASE, DIABETES, RESPIRATORY, OBESITY, PHYSICAL INACTIVITY, DIET, AND SMOKING, AND 3) TRANSPORTATION. AS A HOSPITAL WITHIN A LARGER HEALTH SYSTEM AND THROUGH SUPPORTING THE NEEDS IDENTIFIED FOR A COMMUNITY-WIDE PLAN THE FOLLOWING INITIATIVES WERE UNDERTAKEN: 1. DIET, INACTIVITY, AND OBESITY -THE HOSPITAL HAS SUPPORTED A WASHINGTON COUNTY ORGANIZATION NAMED FLOWCO - FITNESS LOVERS OF WASHINGTON COUNTY, WHICH ENCOURAGES RESIDENTS TO GET HEALTHIER TOGETHER WITH A FREE FITNESS PROGRAM. THE FLOWCO TRAINING PROGRAM IS A FREE WALK/RUN GROUP FITNESS PROGRAM OPEN TO ANYONE 12 YEARS AND OLDER. FLOWCO IS PART OF THE PREVENTATIVE HEALTH PARTNERSHIP, A SUB-COMMITTEE OF THE WASHINGTON COUNTY WELLNESS INITIATIVE. THE PARTNERSHIP WORKS TOWARDS OFFERING FREE OPPORTUNITIES FOR PHYSICAL ACTIVITY AND PROMOTING BETTER NUTRITION IN ORDER TO IMPROVE THE POOR RANKING IN HEALTH BEHAVIOR AND OUTCOME STATISTICS FOR WASHINGTON COUNTY. - THE ST. JOHN SYSTEM PARTICIPATED IN 269 COMMUNITY EVENTS, MANY FOCUSED-ON HEALTH PROMOTION AND WELLNESS. JANE PHILLIPS MEMORIAL MEDICAL CENTER INDIVIDUALLY SPONSORED OR PARTICIPATED IN 30 EVENTS. EACH YEAR A BUDGET IS ESTABLISHED FOR THIS PURPOSE AND IS EXCEEDED THROUGH IDENTIFICATION OF ADDITIONAL COMMUNITY REQUESTS. IN PARTICULAR, THE HEALTH SYSTEM SPONSORED AND PARTICIPATED IN A NUMBER OF LOCAL HEALTH PROMOTION WALKS AND RUNS DURING THIS TIME PERIOD INCLUDING, BUT NOT LIMITED TO THE: AMERICAN CANCER SOCIETY'S RELAY FOR LIFE EVENTS, AMERICAN HEART AND AMERICAN STROKE ASSOCIATIONS' HEART WALK, SUSAN G. KOMEN'S RACE FOR THE CURE, PARKINSON FOUNDATION OF OKLAHOMA'S TULSA PARKINSON'S WALK & 5K, AND OKLAHOMA CHAPTER OF THE ALZHEIMER'S ASSOCIATION'S WALK TO END ALZHEIMER'S. THE HOSPITAL AND BLUESTEM CARDIOLOGY ALSO SPONSOR AND PARTICIPATE IN AN ANNUAL COMMUNITY HEART WALK AND RUN. THE EVENT PROMOTES HEALTH AND WELLNESS AS WELL AS RAISES AWARENESS ABOUT CARDIOVASCULAR HEALTH. THE HEALTH SYSTEM AND HOSPITAL OFFERED ASSOCIATES FREE OR DISCOUNTED REGISTRATION FEES FOR MANY THESE LOCAL RUNS AND WALKS. -JANE PHILLIPS MEDICAL CENTER AND SEVERAL ASSOCIATES ACTIVELY PARTICIPATED IN THE COMMUNITY-WIDE ORGANIZATION, WASHINGTON COUNTY WELLNESS INITIATIVE (WCWI). WCWI IS A 501(C) (3) NON-PROFIT CORPORATION INCORPORATED IN THE STATE OF OKLAHOMA. IT IS CERTIFIED THROUGH THE PUBLIC HEALTH IMPROVEMENT ORGANIZATION (PHIO) AS A COUNTY HEALTH IMPROVEMENT ORGANIZATION (CHIO). THE ORGANIZATION IS DEDICATED TO SUPPORTING THE NUMEROUS ORGANIZATIONS, COALITIONS, INITIATIVES, AND PROJECTS PROVIDING SERVICES TO THE RESIDENTS OF WASHINGTON COUNTY WITH THE GOAL OF IMPROVING THE HEALTH OF THE COMMUNITY. JANE PHILLIPS MEDICAL CENTER COLLABORATED WITH WCWI ON A NUMBER OF HEALTH AND WELLNESS INITIATIVES, ACTIVITIES, AND EVENTS INCLUDING THE FLOWCO PROGRAM AS MENTIONED ABOVE. -THE HOSPITAL AND ASSOCIATES ARE ALSO COMMUNITY PARTNERS WITH THE COMMUNITY CARE TRANSITIONS TEAM. THIS IS A NON-PROFIT TEAM OF HEALTHCARE PROVIDERS WHO WORK TOGETHER TO IMPROVE THE PATIENT'S TRANSITION BETWEEN THE HOSPITAL AND THE NEXT LEVEL OF CARE. JANE PHILLIPS MEDICAL CENTER AND SEVERAL ASSOCIATES PARTICIPATED IN THE ANNUAL TRANSITIONS OF CARE HEALTH FAIR HOSTED BY THE COMMUNITY CARE TRANSITIONS TEAM. -JANE PHILLIPS MEDICAL CENTER SPONSORED THE INSTALLATION OF PROJECT FIT AMERICA EQUIPMENT AT WAYSIDE ELEMENTARY SCHOOL. PROJECT FIT AMERICA IS A NATIONAL NONPROFIT ORGANIZATION THAT CREATES AND ADMINISTERS FITNESS EDUCATION PROGRAMMING IN ELEMENTARY AND MIDDLE SCHOOLS. THE CHARITY WORKS WITH SPONSORS TO BRING IN DONATIONS TO BUILD FITNESS EQUIPMENT AT SCHOOLS. - ST. JOHN HEALTH SYSTEM AND ITS HOSPITALS BEGAN PARTICIPATED IN ASCENSION HEALTH'S SMART HEALTH WELLNESS PROGRAM INITIATIVES - FIRST FOCUSING ON OUR OWN ASSOCIATES AND SUBSEQUENTLY TAKING LESSONS LEARNED TO THE BROADER COMMUNITY. A TOTAL OF 1,538 ASSOCIATES COMPLETED THE 2015 WELLNESS PROGRAM. -JANE PHILLIPS MEDICAL CENTER ALSO CREATED AN EMPLOYEE WELLNESS COMMITTEE. MEMBERSHIP CONSISTS OF 12 PEOPLE FROM ALL AREAS OF THE HOSPITAL. THE COMMITTEE NOW MEETS MONTHLY AND HAS DEVELOPED NUMEROUS PROGRAMS AND INITIATIVES INCLUDING, BUT NOT LIMITED TO: THE RECRUITMENT OF 27 WELLNESS CHAMPIONS SPREAD OUT OVER MOST DEPARTMENTS WITHIN JANE PHILLIPS; THE DEVELOPMENT OF AN EMPLOYEE BREAK PROGRAM WHICH ENCOURAGES EMPLOYEES TO TAKE BREAKS THAT FIT THEIR DEPARTMENT'S NEEDS; A DESIGNATED LACTATION ROOM, WORK TO DEVELOP A MUSIC THERAPY PROGRAM; PARTICIPATION IN THE WORK@HEALTH WELLNESS TRAINING PROGRAM, THE CREATION OF A CO-ED SOFTBALL TEAM, FITNESS WORKSHOPS AND HEALTHY EATING SEMINARS, EMPLOYEE HEALTH SCREENINGS; AND NUMEROUS EMPLOYEE WELLNESS SURVEYS. -THE HOSPITAL MEAL OPTIONS IN THE HOSPITAL MET HEALTHY NUTRITIONAL STANDARDS DURING FY 16 FOR BOTH ASSOCIATES AND PATIENTS ALIKE. THE HOSPITAL ALSO RECENTLY ADDED A STOP LIGHT PROGRAM TO FOOD SERVING UTENSILS AND DRINKS AND IS WORKING TO UPDATE FOOD LABELS TO MEET THE 2017 FEDERAL REGULATIONS.
Schedule H, Part V, Section B, Line 11 Facility , 2 Facility , 2 - JANE PHILLIPS MEMORIAL MEDICAL CENTER. 2. MENTAL HEALTH, SUBSTANCE ABUSE, TOBACCO USE - AS A HEALTHCARE PROVIDER OF EMERGENCY AND ACUTE HOSPITAL AND RELATED SERVICES, THE HOSPITAL SEES THE DIRECT AND OFTEN DEVASTATING EFFECTS OF ALCOHOL AND DRUG ABUSE, AS WELL AS TOBACCO USE, ON A DAILY BASIS. MANY, IF NOT MOST, OF THE PATIENTS WHO PRESENT TO THE SYSTEM IN ACUTE CRISIS FROM ALCOHOL AND ABUSE - WHETHER FROM INJURY OR OVERDOSE (OR BOTH) - ALSO HAVE UNDERLYING ACUTE OR CHRONIC MENTAL HEALTH CONDITIONS AND NEEDS. THE HEALTH SYSTEM IS EXPLORING HOW VIRTUAL TECHNOLOGY MIGHT BE USED TO SUPPORT HOSPITALS IN PROVIDING BETTER ACCESS TO PATIENTS FOR MENTAL HEALTH SERVICES. - PROCESS OUTCOMES ARE MEASURED FOR MENTAL HEALTH AND TOBACCO USE SCREENING THROUGH BOTH THE COMPREHENSIVE PRIMARY CARE PROGRAM AND THE MEDICARE SHARED SAVINGS PROGRAM IN WHICH ST. JOHN HOSPITALS AND EMPLOYED ST. JOHN PHYSICIANS PARTICIPATE. THROUGH THESE PROGRAMS, WE ARE NOW ABLE TO TRACK THE VOLUME OF PATIENTS WHO RECEIVE COUNSELING AND REFERRALS. - EACH HOSPITAL MAINTAINS ONGOING PATIENT EDUCATION RELATED TO SMOKING; MATERIALS ARE PROVIDED TO PATIENTS AND REFERRALS ARE MADE TO THE OKLAHOMA TOBACCO HELPLINE AT 1-800-QUITNOW AND OKHELPLINE.COM FOR TOBACCO CESSATION. - PATIENTS IDENTIFIED AT JANE PHILLIPS MEMORIAL MEDICAL CENTER ARE REFERRED TO THE HOSPITAL OUTPATIENT DEPARTMENT WHERE DRUG AND ALCOHOL COUNSELING IS PROVIDED. REFERRALS ARE ALSO MADE TO AREA AGENCIES. 3. CHRONIC DISEASE MANAGEMENT -JANE PHILLIPS MEDICAL CENTER DEVELOPED A 12-WEEK DIABETES PREVENTION PROGRAM DURING THIS PERIOD. PARTICIPANTS LEARN HOW TO EAT HEALTHY, ADD PHYSICAL ACTIVITY TO THEIR ROUTINE, MANAGER STRESS, STAY MOTIVATED, AND SOLVE PROBLEMS THAT CAN GET IN THE WAY OF HEALTHY CHANGES. THE PROGRAM FOLLOWS THE NATIONAL DIABETES PREVENTION PROGRAM LED BY THE CENTERS FOR DISEASE CONTROL AND PREVENTION (CDC). -JANE PHILLIPS MEMORIAL MEDICAL CENTER PARTICIPATES AS AN ACCOUNTABLE CARE ORGANIZATION (ACO) PARTICIPANT IN THE MEDICARE SHARED SAVINGS PROGRAM, WHICH ESTABLISHES SEVERAL QUALITY AND PROCESS OUTCOME MEASURES THAT PERTAIN TO CHRONIC DISEASE MANAGEMENT SUCH AS DIABETES, HYPERTENSION, CORONARY ARTERY DISEASE, AND COPD. -EMPLOYED PHYSICIANS OF THE HEALTH SYSTEM ALSO PARTICIPATE IN COMPREHENSIVE PRIMARY CARE WHICH FOCUSES ON A MEDICAL HOME MODEL IN CARE FOR HIGH RISK PATIENTS WITH CHRONIC CONDITIONS. 4. ACCESS TO SERVICES -ACCESS TO CARE IN OKLAHOMA IS A SIGNIFICANT CHALLENGE DUE TO THE LIMITED AVAILABILITY OF PRIMARY CARE PHYSICIANS. TO ADDRESS THIS NEED, THE HOSPITAL AND HEALTH SYSTEM HIRED A COUPLE OF ADDITIONAL PHYSICIANS AND ARE ACTIVELY WORKING TO RECRUIT TWO ADDITIONAL FULL TIME PRIMARY CARE PHYSICIANS AND FOUR ADVANCED PRACTICE PROFESSIONALS. TO FURTHER PROMOTE PRIMARY CARE ACCESS, ST. JOHN CLINIC HAS EXPANDED TO INCLUDE REGIONAL AREAS SUCH AS INDEPENDENCE, KANSAS, AS WELL AS ESTABLISHED CLINICS IN PAWHUSKA, OK AND CLINICS IN RURAL AREAS. THE HEALTH SYSTEM HAS THREE RURAL HEALTH CLINICS. SEE SUPP. INFO (SCHEDULE H; PART VI)
Schedule H, Part V, Section B, Line 16 Facility , 1 Facility , 1 - JANE PHILLIPS MEMORIAL MEDICAL CENTER. SIGNS ARE POSTED IN WAITING ROOMS AND AT THE ADMISSIONS OFFICES TO NOTIFY PATIENTS THAT THE HOSPITAL HAS A FINANCIAL ASSISTANCE POLICY. IN ADDITION, EVERY BILLING STATEMENT, THE HOSPITAL'S WEBSITE, AND SIGNS ARE POSTED IN WAITING ROOMS AND AT THE ADMISSIONS OFFICES TO NOTIFY PATIENTS THAT THE HOSPITAL HAS A FINANCIAL ASSISTANCE POLICY. IN ADDITION, EVERY BILLING STATEMENT, THE HOSPITAL'S WEBSITE, AND ADMISSION PACKETS INCLUDE INFORMATION REGARDING THE FINANCIAL ASSISTANCE POLICY. THE POLICY IS PROVIDED AT THE REQUEST OF THE PATIENT.
Schedule H, Part V, Section B, Line 22 Facility , 1 Facility , 1 - JANE PHILLIPS MEMORIAL MEDICAL CENTER. Patients eligible for Financial Assistance will not be charged individually more than THE AMOUNT GENERALLY BILLED (AGB) for emergency and other medically necessary care and not more than gross charges for all other medical care. The Organization calculates one or more AGB percentages using the "look-back" method and including Medicare fee-for-service and all private health insurers that pay claims to the Organization, all in accordance with 501(r). THE HOSPITAL PROVIDES A 40% DISCOUNT ON GROSS CHARGES AND 15% PROMPT PAY DISCOUNT TO ALL UNINSURED PATIENTS. PATIENTS WHO ARE DETERMINED TO BE ELIGIBLE FOR FINANCIAL ASSISTANCE RECEIVE AN ADDITIONAL CHARITY CARE DISCOUNT EQUAL TO 100% OF THE REMAINING AMOUNT DUE.
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
Schedule H (Form 990) 2015
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Schedule H (Form 990) 2015
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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?0
Name and address Type of Facility (describe)
1
2
3
4
5
6
7
8
9
10
Schedule H (Form 990) 2015
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Schedule H (Form 990) 2015
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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
Schedule H, Part I, Line 6a NAME OF THE RELATED ORG THAT PREPARED COMMUNITY BENEFIT REPORT THE HOSPITAL IS A WHOLLY-OWNED (WHOLLY-SPONSORED) SUBSIDIARY OF ST. JOHN HEALTH SYSTEM, INC. - EIN 73-1215174 ("SJHS"). SJHS PREPARED A CONSOLIDATED COMMUNITY BENEFIT REPORT FOR THE CONSOLIDATED ORGANIZATION FOR THIS TAX YEAR. THE REPORT IS MADE AVAILABLE ON DEMAND AND IS REFERENCED BY THE ORGANIZATION IN A NUMBER OF PUBLIC MEETINGS AND COMMUNITY OUTREACH ACTIVITIES.
Schedule H, Part II DESCRIBE HOW BUILDING ACTIVITIES PROMOTE THE HEALTH OF THE COMMUNITY - PART 2 Health Care that is Safe: St. John is striving to become a "high reliability" organization. High reliability means that we will be exceptionally consistent in accomplishing goals and avoiding catastrophic errors in everything we do in providing health care services. This means reducing medical errors by providing our clinicians and our patients with decision support tools to ensure the care provided is consistently based on sound scientific evidence of effectiveness. Physicians and nurses are leading our quality efforts. Among our clinical areas of focus for improvement are goals to reduce hospital acquired conditions and hospital readmissions. Some specific areas of clinical focus include reducing: - Adverse Drug Events (ADE), - Catheter Urinary Tract Infections (CAUTI), - Central Line Blood Stream Infections (CLABSI), - Surgical Site Infections (SSI), - Ventilator Associated Pneumonia (VAP), - Injuries from Falls and Immobility, - Obstetrical Adverse Events, - Pressure Ulcers, and - Venous Thromboembolism (VTE). Healthcare that Leaves No One Behind: We will continue to advocate for state and federal public policy that recognizes the inherent value of all members of society and provides support systems and adequate funding sources to ensure all of those among us have access to the health care they need. This includes providing affordable access to health care for everyone in the United States in a financially sustainable way. Our Enabling Strengths: We will use our enabling strengths to achieve our mission and vision. Those strengths include: a model community of inspired people working to provide our services and achieve our mission; empowering knowledge - clinical and business information systems that provide our associates actionable, timely data and information upon which they can make informed decisions; the creation of trusted partnerships with external partners to expand our capabilities, complement our service offerings and fulfill our mission; and achieve vital presence in the communities we serve. This vital presence contemplates creation and continuation of important safety net services, world-class centers of clinical excellence and creation of medical homes that promote each individual's participation in their own health and well-being and which create and sustain the infrastructure for promoting healthy communities. Our Point of View: Health care delivery and financing in the United States must change. The cost of the current system relative to the value that communities and individuals are receiving is not sustainable. In order to meet the health care needs and contribute to economic vitality of communities, with special attention to the poor and vulnerable, health care providers must fundamentally reconfigure delivery systems, care processes and cost structures. Delivering safe, high-quality care that is low cost with an exceptional patient experience will increasingly require providers to have a strong regional presence, integrated physician relationships and capabilities across the care continuum. Sustaining the St. John mission into the future will require a more continuous, dynamic relationship with those we serve and the ability to share risk with healthcare purchasers, as opportunities for inpatient growth or commercial rate increases will be limited. The movement to manage health of defined populations demands massive transformational change. This requires rapid assessment, assembly and deployment of the necessary capabilities. We believe the St. John System is well positioned to lead this transformation.
Schedule H, Part II DESCRIBE HOW BUILDING ACTIVITIES PROMOTE THE HEALTH OF THE COMMUNITY - PART 3 Community Needs Assessment: The St. John System and each Hospital have completed a Community Health Needs Assessment (CHNA) in 2016 to help us identify the priorities for the limited resources we have to address community need. We partnered with the local health departments and other public and private health care, and educational and community service organizations throughout the service area to complete the assessments, and we are now working to enhance our response to the identified needs. A previous CHNA for each hospital and community served and Implementation Strategy to address identified community health needs were also completed in 2013. Community Benefit: The community benefit provided by the St. John System includes: uncompensated care for the poor, support for the education of medical professionals, provision of subsidized health services, support for other community organizations, initiatives to improve community health, and medical research to be some of the key areas of focus for providing community benefit. The St. John System does not include amounts recorded as bad debt; shortfalls in the difference between payment for and cost of service to Medicare beneficiaries; payment of property, sales, use, income, payroll, and other taxes; OR considerable economic value provided to the local communities in which we operate as components of community benefit. Care for the Poor: "Care for the Poor" (which includes the estimated cost of services provided to patients who qualify for financial assistance (charity) and the uncompensated cost of care provided to Medicaid beneficiaries) is the largest financial category of community benefit. Support for graduate and allied health medical education is the second largest. St. John provides discounts of at least 40% to all uninsured patients and additional discounts of at least 15% to uninsured patients who make the agreed upon timely payments for services they receive. All uninsured individuals living in households with incomes at or below 300% of the federal poverty limit qualify for free care for medically necessary services. Insured patients and others who are faced with financially catastrophic medical bills are also eligible for and encouraged to seek financial assistance. Consistent with our mission and values, St. John has created programs to seek out better ways to serve the uninsured and the vulnerable members of our society. With generous financial support from donors, including the Chapman trusts, and with guidance and counsel from many partners in our community, St. John has created the Medical Access Program ("MAP") to try to increase and improve access to medical care for segments of the uninsured population. Beginning more than five years ago, MAP continues to grow and expand each year. MAP has brought together a network of primary care providers that provides free clinics and other services to uninsured and low income individuals throughout Tulsa. Key elements of MAP include: - Expansion of free primary care by providing direct financial support to other organizations in the community providing access to free primary care, - Operation of Rockford Medical Clinic. The Rockford Clinic is a free primary care medical home for a segment of the uninsured population that meet certain criteria for participation, - Provision of free diagnostic imaging, including CT, MRI, ultrasound, mammography and basic x-ray for patients who meet criteria, - Access to free specialty services through a network of participating clinics and physician partners and through the facilities and physicians of the St. John System, and - Access to free or reduced cost prescription medications. MAP has limited resources but continues to expand the scope of its services each year, routinely spending at least $5 million per year in donated and St. John funds.
Schedule H, Part II DESCRIBE HOW BUILDING ACTIVITIES PROMOTE THE HEALTH OF THE COMMUNITY - PART 4 Support for Medical Education: St. John Medical Center, Inc. is a primary teaching hospital for The University of Oklahoma's Tulsa College of Community Medicine residency programs for internal medicine and general surgery and is the primary teaching hospital for the "In His Image" ("IHI") family medicine residency program. St. John works as a founding member of the Tulsa Medical Education Foundation providing financial support for The University of Oklahoma ("OU") residency programs. St. John also provides additional direct support to both OU and IHI residency programs and also provides direct support for a number of nursing education and allied health professional education programs. Other Community Benefit: St. John provides subsidized health services focused on certain emergency services and on post-acute senior services. Each St. John Hospital provides vital emergency medical services in its community. St. John Medical Center, Inc. services as one of only three trauma centers in Oklahoma, Oklahoma's first and only certified comprehensive stroke center, and a tertiary referral center for the entire state of Oklahoma and portions of Missouri, Arkansas, Kansas and Texas. The associates, physicians and facilities of the St. John System provide services to thousands of patients every day. Among the services provided annually are: -More than 60,000 annual hospital admissions, including 19,000 "observation" patients. -More than 35,000 annual surgeries performed in St. John hospitals. St. John also is a minority owner in two ambulatory surgery centers that perform more than 28,000 annual outpatient surgeries. -More than 3,600 annual births at St. John hospitals. -More than 160,000 annual patient visits to St. John hospital emergency departments. -More than 60,000 annual urgent care visits. -Nearly 500,000 annual patient visits to physician office visits. -More than 9 million annual laboratory tests. Summary: The thousands of associates, physicians and volunteers that make up St. John Health System, Inc. touch the lives of thousands of patients every day and millions of patients every year. As we seek to transform health care in Oklahoma and the United States, St. John is challenged by many factors including: lack of public resources in Oklahoma that are devoted to care for the poor, health care infrastructure and medical education; competition from investor-owned health care facilities that do not share St. John's mission of service and emphasis on service to the poor and powerless but which seek to gain market share in commercially insured patients; poor economic and health care demographic factors contributing to generally poor health status and high rates of poverty and uninsured in Oklahoma; and payment for values.
Schedule H, Part V, Section B, Line 11 CHNA FY 16 for previous CHNA covered FY 14-16: Part 1 FROM SEPTEMBER 2015 AND JANUARY 2016, ST. JOHN HEALTH SYSTEM ENGAGED A TOTAL OF 345 INDIVIDUALS IN DISCUSSION ABOUT THE HEALTH INSURANCE MARKETPLACE AND REFERRED THEM TO ENROLLMENT ASSISTANCE AVAILABLE THROUGH OUR HEALTH SYSTEM. OF THOSE 772 INDIVIDUALS, 145 WERE ENGAGED IN DISCUSSION ABOUT THE ENROLLMENT PROCESS DURING ONE OF OUR 9 COMMUNITY OUTREACH EVENTS HELD BETWEEN SEPTEMBER 2015 AND DECEMBER 2015. THE REMAINING 200 CONSUMERS WHO WERE SEEKING INFORMATION ABOUT THE MARKETPLACE SPOKE TO OUR CONTRACTED CERTIFIED APPLICATION COUNSELORS (CACS) WITH THE MIDLAND GROUP OVER THE PHONE ABOUT THE ENROLLMENT PROCESS. IF THE CALLER DID NOT SCHEDULE AN ENROLLMENT ASSISTANCE APPOINTMENT, THEY WERE EITHER INQUIRING ABOUT WHAT PLANS ST. JOHN HEALTH SYSTEM TAKES, WHETHER THEY QUALIFIED FOR A TAX CREDIT, OR ASKED GENERAL INFORMATION, BUT DID NOT WANT TO SET UP AN APPOINTMENT AT THAT TIME (145 INDIVIDUALS OUT OF 200 TOTAL CONSUMERS). ST. JOHN HEALTH SYSTEM'S CONTRACTED CACS WITH THE MIDLAND GROUP ASSISTED 71 CONSUMERS WITH NAVIGATION ACTIVITIES DURING THE ENROLLMENT PERIOD. TRANSPORTATION INITIATIVES: THE HOSPITAL PARTICIPATES IN THE WASHINGTON COUNTY WELLNESS WORKGROUP, THE WASHINGTON COUNTY TRANSPORTATION COALITION. THE MISSION OF THE WASHINGTON COUNTY TRANSPORTATION COALITION IS TO ADDRESS THE UNMET TRANSPORTATION NEEDS OF WASHINGTON COUNTY IN ORDER TO IMPROVE ECONOMIC DEVELOPMENT AND ENHANCE QUALITY OF LIFE. ITS PRIMARY GOAL IS TO SECURE FUNDING IN ORDER TO SUSTAIN THE PILOT PROJECT AND EXPAND THE ROUTES FOR THE FLEXIBLE, FIXED ROUTE BUS SERVICE.
Schedule H, Part V, Section B, Line 11 NEW CHNA THAT WON'T BE ADDRESSED IN FY 2017-2019 - Part 2 THE FOLLOWING COMMUNITY HEALTH NEEDS WERE SELECTED AS THE TOP FOUR PRIORITIES IN THE MOST RECENT CHNA FOR THE HOSPITAL FACILITY TO ADDRESS: 1) ACCESS TO CARE, 2) BEHAVIORAL HEALTH, 3) WELLNESS AND CHRONIC DISEASE PREVENTION, AND 4) HEALTH LITERACY. THE HOSPITAL AND HEALTH SYSTEM ARE ADDRESSING ACCESS TO CARE THROUGH THE FOLLOWING GOALS AS OUTLINED: GOAL 1) WORK TO IMPROVE ACCESS AS NEEDED FOR HEALTHCARE SERVICES IN SOLIDARITY WITH THOSE LIVING IN POVERTY AND/OR DEEMED OTHERWISE VULNERABLE, AND GOAL 2) IMPROVE ACCESS AS NEEDED TO HEALTHCARE PROVIDERS AND AN ONGOING SOURCE CARE IN NORTHEASTERN OKLAHOMA AND SOUTHERN KANSAS, AND GOAL 3) IMPROVE ACCESS AS NEEDED FOR HEALTHCARE SERVICES IN SOLIDARITY WITH THOSE LIVING IN POVERTY AND/OR DEEMED OTHERWISE VULNERABLE THROUGH THE MEDIAL ACCESS PROGRAM (MAP). THE FOLLOWING ARE STRATEGIES BEING UNDERTAKEN BY THE HOSPITAL AND HEALTH SYSTEM IN FISCAL YEAR 2017-2019 TO MEET THE ACCESS TO CARE GOAL 1: -INCREASE THE NUMBER OF UNINSURED, LOW-INCOME, AND UNDERSERVED PERSONS WHO HAVE ACCESS TO PRIMARY CARE THROUGH EFFORTS TO IMPROVE ACCESS TO PRIMARY CARE SERVICES THROUGH THE TULSA DAY CENTER FOR THE HOMELESS CLINIC. -INCREASE ACCESS TO AN ONGOING SOURCE OF PRIMARY CARE AND PREVENTIVE SERVICES FOR PERSONS WHO ARE UNINSURED, UNDERINSURED, AND/OR LIVING IN POVERTY THROUGH SERVICES OFFERED AT THE ST. JOHN MEDICAL ACCESS CLINIC (MAC). -IMPROVE FOLLOW-UP CARE AND ENSURE A SAFE TRANSITION HOME FOR PATIENTS DISCHARGING FROM ST. JOHN MEDICAL CENTER AND JANE PHILLIPS MEDICAL CENTER WHO DO NOT HAVE A PRIMARY CARE PROVIDER OR WHO CANNOT GET AN APPOINTMENT WITH THEIR PROVIDER THROUGH SERVICES PROVIDED BY THE FACILITIES' TRANSITIONAL CARE CLINICS. -PROMOTE ACCESS TO AFFORDABLE HEALTH INSURANCE COVERAGE THROUGH STATE LEGISLATIVE ADVOCACY. -INCREASE THE PROPORTION OF PERSONS WHO CAN OBTAIN OR NOT DELAY IN OBTAINING NECESSARY PRESCRIPTION MEDICINES THROUGH THE DISPENSARY OF HOPE PROGRAM. -IMPROVE ACCESS TO HEALTHCARE SERVICES BY PROVIDING TRANSPORTATION ASSISTANCE TO COMMUNITY-DWELLING PERSONS SERVED BY ST. JOHN HEALTH SYSTEM WHO ARE LIVING IN POVERTY AND/OR ARE OTHERWISE DEEMED VULNERABLE. THROUGH AN AGREEMENT WITH MORTON COMPREHENSIVE COMMUNITY HEALTH CENTER (FQHC) FOR THEIR BUS SERVICES, ST. JOHN CAN PROVIDE TRANSPORTATION TO THOSE IN NEED IN THE COMMUNITY WHO MEET SPECIFIC CRITERIA (ESTIMATED OVER $120,000 IN 12 MONTHS). SERVICES WILL ALSO BE PROVIDED THROUGH THE ASCENSION/LYFT AGREEMENT ONCE A LOCAL CONTRACT IS IN PLACE. THE FOLLOWING ARE STRATEGIES BEING UNDERTAKEN BY THE HOSPITAL AND HEALTH SYSTEM IN FISCAL YEAR 2017-2019 TO MEET THE ACCESS TO CARE GOAL 2: -INCREASE RECRUITMENT AND HIRING OF PROVIDERS TO IMPROVE ACCESS TO PRIMARY CARE AND SPECIALTY SERVICES IN THE COMMUNITIES SERVED BY ST. JOHN HEALTH SYSTEM. THIS STRATEGY INCLUDES THE EXPLORATION OF METHODS TO EXTEND HOURS AMONG ST. JOHN CLINIC PRIMARY CARE PROVIDERS AND ADOPT PLANS TO UTILIZE VARIOUS METHODS (E.G. OPENING EARLY, STATING OPEN LATE, ON DEMAND E-VISITS, ETC.) TO EXTEND HOURS IN PRIMARY CARE CLINICS. MANY COMMUNITIES SERVED BY ST. JOHN HEALTH SYSTEM INCLUDE PARTIAL OR TOTAL IDENTIFIED HEALTHCARE SHORTAGE AREAS. IMPROVING ACCESS TO CARE THROUGH PROVIDER RECRUITMENT ADDRESSES THESE SHORTAGE AREAS, REDUCES HEALTH DISPARITIES, AND PROMOTES HEALTH EQUITY AMONG PERSONS DEEMED VULNERABLE. THE FOLLOWING ARE STRATEGIES BEING UNDERTAKEN BY THE HOSPITAL AND HEALTH SYSTEM IN FISCAL YEAR 2017-2019 TO MEET THE ACCESS TO CARE GOAL 3: -IMPROVE ACCESS AS NEEDED FOR HEALTHCARE SERVICES IN SOLIDARITY WITH THOSE LIVING IN POVERTY AND/OR DEEMED OTHERWISE VULNERABLE THROUGH THE MEDIAL ACCESS PROGRAM (MAP). THE MAP PROGRAM PROACTIVELY SEEKS AND SERVES UNINSURED PATIENTS. IT CONSISTS OF THE OPERATION OF A ST. JOHN-OWNED PRIMARY CARE CLINIC THAT OPERATES AS A MEDICAL HOME FOR ABOUT 1,000 UNINSURED PATIENTS WITH CHRONIC HEALTH PROBLEMS, DONATIONS TO OTHER ORGANIZATIONS THAT OPERATE FREE CLINICS, AND A VOUCHER PROGRAM IN WHICH THE FREE CLINIC PARTNERS CAN REFER PATIENTS FOR SPECIALTY AND DIAGNOSTIC CARE. FOR EXTENDED OUTREACH IN THE COMMUNITY, ST. JOHN PARTNERS WITH SEVERAL LOCAL HEALTH AND COMMUNITY SERVICE AGENCIES TO IDENTIFY PATIENTS WHO QUALIFY FOR THE PROGRAM. THE HOSPITAL AND HEALTH SYSTEM ARE ADDRESSING BEHAVIORAL HEALTH THROUGH THE FOLLOWING GOALS AS OUTLINED: GOAL 1) IMPROVE ACCESS TO BEHAVIORAL HEALTH SERVICES, AND GOAL 2) IMPROVE ACCESS TO BEHAVIORAL HEALTH SERVICES AND HAVE AN IMPACT ON THE REDUCTION OF SUICIDE RATES IN TULSA COUNTY AND SURROUNDING AREAS. THE FOLLOWING ARE STRATEGIES BEING UNDERTAKEN BY THE HOSPITAL AND HEALTH SYSTEM IN FISCAL YEAR 2017-2019 TO MEET THE BEHAVIORAL HEALTH GOAL 1: - INCREASE ACCESS TO BEHAVIORAL HEALTH SERVICES FOR AT-RISK POPULATIONS THROUGH EARLY IDENTIFICATION AND INTERVENTION VIA AN INTEGRATED MODEL OF BEHAVIORAL HEALTH IN PRIMARY CARE. THIS STRATEGY EMPHASIZES THE USE OF PHQ9 SCREENINGS, FULL SUICIDE RISK ASSESSMENTS FOR HIGH /POSITIVE SCORE ON PHQ9, AND EMBEDDED BEHAVIORAL HEALTH THERAPISTS IN CLINICS. - PROMOTE ACCESS TO BEHAVIORAL HEALTH SERVICES THROUGH STATE LEGISLATIVE ADVOCACY. - INCREASE ACCESS TO BEHAVIORAL HEALTH SERVICES FOR COMMUNITY-DWELLING PERSONS IN NEED OF OUTPATIENT PSYCHIATRY SERVICES IN WASHINGTON COUNTY. THE FOLLOWING ARE STRATEGIES BEING UNDERTAKEN BY THE HOSPITAL AND HEALTH SYSTEM IN FISCAL YEAR 2017-2019 TO MEET THE BEHAVIORAL HEALTH GOAL 2: - IMPROVE CAPACITY FOR HUMANIZED BEHAVIORAL HEALTH CRISIS AND ACUTE CARE THROUGH INCREASED ACCESS TO BEHAVIORAL HEALTH PROFESSIONALS AND SERVICES AS WELL AS INCREASED ASSESSMENT AND RECOGNITION OF SUICIDE RISKS AT THE COMMUNITY LEVEL. THIS STRATEGY EMPHASIZES COLLABORATION ON A COMMUNITY LEVEL RESPONSE PROGRAM PILOT BASED ON A MODEL FROM COLORADO SPRINGS, CO WITH THE MENTAL HEALTH ASSOCIATION OF OKLAHOMA, THE TULSA FIRE DEPARTMENT, AND SEVERAL OTHER COMMUNITY PARTNERS. THERE IS ADDITIONAL EMPHASIS ON VOLUNTARY QPR SUICIDE ASSESSMENT TRAINING FOR ASSOCIATES AND COMMUNITY MEMBERS AS WELL AS THE IMPLEMENTATION OF A SYSTEMATIC APPROACH IN HEALTH SYSTEM TO SUPPORT EFFORTS TO HUMANIZE CRISIS AND ACUTE CARE AT A COMMUNITY LEVEL AS WELL AS TO INCREASE ASSESSMENT AND RECOGNITION FOR POTENTIAL OF SUICIDE. THE HOSPITAL AND HEALTH SYSTEM ARE ADDRESSING THROUGH THE FOLLOWING WELLNESS AND CHRONIC DISEASE PREVENTION GOALS AS OUTLINED: GOAL 1) IMPROVE HEALTH OUTCOMES AND REDUCE PREVENTABLE CONGESTIVE HEART FAILURE (CHF) READMISSIONS AMONG DIVERSE POPULATIONS DIAGNOSED WITH CHF, GOAL 2) PROMOTE EQUITABLE AND PATIENT-CENTERED PRE-DIABETIC AND DIABETIC CARE IN SOLIDARITY WITH THOSE LIVING IN POVERTY AND/OR WHO MAY BE OTHERWISE DEEMED VULNERABLE, AND GOAL 3) IMPROVE HEALTH OUTCOMES FOR INDIVIDUALS WHO ARE IN A PRE-CONDITION STATE OR WHO HAVE BEEN DIAGNOSED WITH A CHRONIC DISEASE. THE FOLLOWING ARE STRATEGIES BEING UNDERTAKEN BY THE HOSPITAL AND HEALTH SYSTEM IN FISCAL YEAR 2017-2019 TO MEET THE WELLNESS AND CHRONIC DISEASE PREVENTION GOAL 1: - MANAGE ALL PATIENTS DIAGNOSED WITH CONGESTIVE HEART FAILURE (CHF) ACROSS THE CONTINUUM OF CARE THROUGH STRUCTURED TRANSITION AND AN EXPANDED FOLLOW-UP APPROACH AS FACILITATED BY THE ST. JOHN MEDICAL CENTER HEART FAILURE INITIATIVE. THE FOLLOWING ARE STRATEGIES BEING UNDERTAKEN BY THE HOSPITAL AND HEALTH SYSTEM IN FISCAL YEAR 2017-2019 TO MEET THE WELLNESS AND CHRONIC DISEASE PREVENTION GOAL 2: -IMPLEMENT AN INITIATIVE TO SUPPORT DIABETIC AND PRE-DIABETIC PATIENTS DISCHARGING FROM THE HOSPITAL WHO LACK PRIMARY CARE FOLLOW-UP THROUGH PATIENT CENTERED TRANSITION OF CARE, EDUCATION, AND DISEASE MANAGEMENT SUPPORT SERVICES. THE FOLLOWING ARE STRATEGIES BEING UNDERTAKEN BY THE HOSPITAL AND HEALTH SYSTEM IN FISCAL YEAR 2017-2019 TO MEET THE WELLNESS AND CHRONIC DISEASE PREVENTION GOAL 3: -PROMOTE HEALTHY DIET, PHYSICAL ACTIVITY, AND PREVENTION ORIENTED WELLNESS THROUGH HEALTH SYSTEM SUPPORT OF COMMUNITY-BASED INITIATIVES IN PARTNERSHIP WITH LOCAL HEALTH DEPARTMENTS, COALITIONS, COMMUNITY-BASED ORGANIZATIONS, AND SCHOOLS; PARTICIPATION IN LOCAL ACTIVITIES, EDUCATION CLASSES, EVENTS, AND HEALTH FAIRS; AND CHRONIC DISEASE MANAGEMENT SUPPORT. THE HOSPITAL AND HEALTH SYSTEM ARE ADDRESSING HEALTH LITERACY THROUGH THE FOLLOWING GOAL AS OUTLINED: GOAL 1) HELP PERSONS OF DIVERSE BACKGROUNDS NAVIGATE HEALTH SERVICES AND GAIN EMPOWERMENT IN TAKING CHARGE OF THEIR OWN HEALTH IMPROVEMENT. THE FOLLOWING ARE STRATEGIES BEING UNDERTAKEN BY THE HOSPITAL AND HEALTH SYSTEM IN FISCAL YEAR 2017-2019 TO MEET THE HEALTH LITERACY GOAL 1: -ASSESS HEALTH LITERACY NEEDS AMONG PATIENTS OF DIVERSE BACKGROUNDS TO WORK TOWARDS ASSISTING PATIENTS IN UNDERSTANDING HOW TO NAVIGATE HEALTH SERVICES AND GAIN EMPOWERMENT IN TAKING CHARGE OF THEIR OWN HEALTH IMPROVEMENT WITH THE ST. JOHN MEDICAL CENTER TRANSITIONAL CARE CLINIC AS THE PILOT SITE FOR THIS EFFORT.
Schedule H, Part V, Section B, Line 11 NEW CHNA THAT WON'T BE ADDRESSED IN FY 2017-2019 PART 3 THE COMMUNITY HEALTH NEEDS ASSESSMENT INEVITABLY IDENTIFIED MORE SIGNIFICANT HEALTH NEEDS THAN THE HOSPITALS, HEALTH SYSTEM, AND COMMUNITY PARTNERS CAN OR SHOULD ADDRESS AS PRIORITY HEALTH NEEDS. IT WOULD NOT BE PRUDENT TO SPREAD HOSPITAL AND COMMUNITY RESOURCES ACROSS TOO MANY INITIATIVES. ACCORDINGLY, THE HOSPITALS, HEALTH SYSTEM, AND COMMUNITY PARTNERS INSTEAD DECIDED TO FOCUS ATTENTION ON PRIORITY AREAS TO HELP ENSURE SUFFICIENT RESOURCES ARE AVAILABLE. SOME REASONS FOR NOT ADDRESSING CERTAIN NEEDS INCLUDE: NEED BEING ADDRESSED BY OTHERS; INSUFFICIENT RESOURCES (FINANCIAL AND PERSONNEL) TO ADDRESS THE NEED; ISSUE IS NOT A PRIORITY FOR COMMUNITY MEMBERS AND THEREFORE APPROACH IS UNLIKELY TO SUCCEED; LACK OF EVIDENCE-BASED APPROACH FOR ADDRESSING THE PROBLEM;NEED IS NOT AS PRESSING AS OTHER PROBLEMS; NEED IS NOT AS LIKELY TO BE RESOLVED AS OTHER PROBLEMS; AND THE HOSPITAL AND/OR HEALTH SYSTEM DOES NOT HAVE EXPERTISE TO EFFECTIVELY ADDRESS THE NEED. THE FOLLOWING SIGNIFICANT HEALTH NEED WAS IDENTIFIED, BUT WILL NOT BE ADDRESSED DIRECTLY BY THE HEALTH SYSTEM AS A PRIORITY HEALTH NEED: TOBACCO USE AND CESSATION. THE COMMUNITY IDENTIFIED THIS NEED AS ONE THAT WAS ALREADY BEING SUFFICIENTLY ADDRESSED AT THE TIME AND DID NOT FEEL ISSUE WAS AS PRESSING OTHER NEEDS IDENTIFIED (THIS WAS A CHANGE IN PERSPECTIVE FROM OUR PREVIOUS COMMUNITY HEALTH NEEDS ASSESSMENT PROCESS IN 2013 WHEN THE NEED WAS IDENTIFIED AS A PRIORITY NEED). IT IS IMPORTANT THAT NOTE THAT, ALTHOUGH NOT A PRIORITY HEALTH NEED FOR THE PURPOSES OF THIS PROCESS, THE HOSPITALS AND HEALTH SYSTEM WILL CONTINUE EXISTING ACTIVITIES REGARDING TOBACCO USE AND CESSATION.WHILE NOT NECESSARILY NOTED AS ONE OF OUR FOUR PRIORITY HEALTH NEEDS, THE REMAINDER OF SIGNIFICANT COMMUNITY HEALTH NEEDS WERE CLOSELY INTER-RELATED WITH THE PRIORITY NEEDS. SO, WHILE, THEY MAY NOT BE EXPLICITLY LISTED AS A PRIORITY HEALTH NEED, THE HOSPITALS AND HEALTH SYSTEM DO FEEL CONFIDENT THAT THE NEEDS ARE BEING ADDRESSED BY ADDRESSING THE FOUR SELECTED PRIORITY HEALTH NEEDS.
Schedule H, Part I, Line 7 Costing Methodology used to calculate financial assistance Costs were determined using a cost to charge ratio derived from Worksheet 2, Patient Care Cost to Charges.
Schedule H, Part II Community Building Activities COMMUNITY BENEFIT REPORT: ST. JOHN HEALTH SYSTEM, INC.'S (THE "ST. JOHN SYSTEM" OR "ST. JOHN") MISSION IS TO IMPROVE THE HEALTH STATUS OF THE INDIVIDUALS WHO LIVE IN THE COMMUNITIES WE SERVE WITH A SPECIAL EMPHASIS ON THE POOR AND VULNERABLE AMONG US; FAITHFUL TO THE TEACHING OF JESUS CHRIST AND THE VALUES OF OUR SPONSORS AND THE CATHOLIC CHURCH. OUR PROMISE TO OUR PATIENTS AND TO OUR COMMUNITIES IS TO PROVIDE MEDICAL EXCELLENCE AND COMPASSIONATE CARE. WE STRIVE TO PROVIDE HEALTHCARE THAT WORKS, HEALTHCARE THAT IS SAFE AND HEALTHCARE THAT LEAVES NO ONE BEHIND. TO MEET THIS MISSION, THE ST. JOHN SYSTEM HAS OPERATED SINCE THE 1920'S; GROWING FROM A FLEDGLING COMMUNITY HOSPITAL, IN WHAT WAS THEN THE SOUTHERN EDGE OF TULSA, OKLAHOMA, TO AN INTEGRATED HEALTH CARE DELIVERY SYSTEM SERVING NORTHEASTERN OKLAHOMA AND SURROUNDING STATES. THE ST. JOHN SYSTEM INCLUDES: THOUSANDS OF ASSOCIATES, EMPLOYED PHYSICIANS AND ADVANCED PRACTICE PROVIDERS, HUNDREDS MORE INDEPENDENT PHYSICIANS AND DOZENS OF VOLUNTEERS. THEY SERVE PATIENTS IN SIX OWNED HOSPITALS OPERATING NEARLY 800 BEDS; SEVERAL SENIOR NURSING AND HOUSING FACILITIES; DOZENS OF PHYSICIAN OFFICES, CLINICS AND URGENT CARE CENTERS; A REFERENCE LABORATORY, AND PARTNERSHIPS AND VENTURES THAT INCLUDE A HEALTH INSURANCE COMPANY, SEVERAL AMBULATORY SURGERY CENTERS AND OTHER HEALTH CARE ACTIVITIES. TOGETHER, OUR ASSOCIATES, PHYSICIANS AND VOLUNTEERS TOUCH THE LIVES OF THOUSANDS OF PATIENTS EVERY DAY, INCLUDING THE POOR AND THE VULNERABLE. THE ST. JOHN SYSTEM IS COMMITTED TO CONTINUE THE LEGACY OF HEALTH CARE EXCELLENCE AND SERVICE STARTED BY OUR ORIGINAL FOUNDERS AND SPONSORS, THE SISTERS OF THE SORROWFUL MOTHER, BY CONTINUING TO PROVIDE VITAL SERVICES TO THE COMMUNITIES WITH CONTINUED EMPHASIS ON SERVICE TO THE POOR AND POWERLESS. OUR MISSION AND VALUES: OUR MISSION OF SERVICE AND OUR CATHOLIC VALUES COMPEL US TO FULFILL OUR PROMISE OF MEDICAL EXCELLENCE AND COMPASSIONATE CARE TO ALL WHO NEED OUR SERVICES, WITH A SPECIAL EMPHASIS ON SERVICE TO THE POOR AND THE POWERLESS. WE WILL DO THIS BY PROVIDING: HEALTH CARE THAT WORKS; HEALTH CARE THAT IS SAFE; AND HEALTH CARE THAT LEAVES NO ONE BEHIND. WE WILL ENDEAVOR TO ESTABLISH TRUSTED RELATIONSHIPS WITH OUR PATIENTS OVER THEIR ENTIRE LIVES: SEEKING TO IMPROVE THEIR HEALTH AND WORKING TO HEAL THEIR MINDS AND BODIES WHEN AFFLICTED BY INJURY OR ILLNESS. SEE SUPPLEMENTAL INFORMATION (SCHEDULE H, PART VI).
Schedule H, Part III, Line 2 Bad debt expense - methodology used to estimate amount After satisfaction of amounts due from insurance and reasonable efforts to collect from the patient have been exhausted, the Corporation follows established guidelines for placing certain past-due patient balances within collection agencies, subject to the terms of certain restrictions on collection efforts as determined by Ascension Health. Accounts receivable are written off after collection efforts have been followed in accordance with the Corporation's policies. After applying the cost-to-charge ratio, the share of the bad debt expense is reported at cost.
Schedule H, Part III, Line 3 Bad Debt Expense Methodology Jane Phillips Memorial Medical Center has a very robust financial assistance program; therefore, no estimate is made for bad debt attributed to financial assistance eligible patients.
Schedule H, Part III, Line 4 Bad debt expense - financial statement footnote From the consolidated audited financial statements of Ascension Health Alliance, which include the activity of Jane Phillips Memorial Medical Center: The provision for doubtful accounts is based upon management's assessment of expected net collections considering historical experience, economic conditions, trends in healthcare coverage, and other collection indicators. Periodically throughout the year, management assesses the adequacy of the allowance for doubtful accounts based upon historical write-off experience by payor category, including those amounts not covered by insurance. The results of this review are then used to make any modifications to the provision for doubtful accounts to establish an appropriate allowance for doubtful accounts. After satisfaction of amounts due from insurance and reasonable efforts to collect from the patient have been exhausted, the System follows established guidelines for placing certain past-due patient balances with collection agencies, subject to the terms of certain restrictions on collection efforts as determined by the System. Accounts receivable are written off after collection efforts have been followed in accordance with the System's policies. The methodology for determining the allowance for doubtful accounts and related write-offs on uninsured patient accounts has remained consistent with the prior year.
Schedule H, Part III, Line 8 Community benefit & methodology for determining medicare costs A cost to charge ratio is applied to the organization's Medicare Expense to determine the Medicare allowable costs reported in the organization's Medicare Cost Report. Ascension Health and its related health ministries follow the Catholic Health Association (CHA) guidelines for determining community benefit. CHA community benefit reporting guidelines suggest that Medicare shortfall is not treated as community benefit.
Schedule H, Part III, Line 9b Collection practices for patients eligible for financial assistance The organization has a written debt collection policy that also includes a provision on the collection practices to be followed for patients who are known to qualify for charity care or financial assistance. If a patient qualifies for charity or financial assistance certain collection practices do not apply and the financial assistance program is followed.
Schedule H, Part V, Section B, Line 16a FAP website - Jane Phillips Memorial Medical Center: Line 16a URL: http://www.stjohnhealthsystem.com/about/payment-for-services;
Schedule H, Part V, Section B, Line 16b FAP Application website - Jane Phillips Memorial Medical Center: Line 16b URL: http://www.stjohnhealthsystem.com/about/payment-for-services;
Schedule H, Part VI, Line 2 Needs assessment The Hospital conducted a Community Health Needs Assessment jointly with its parent entity - St. John Health System, Inc. ("SJHS"). SJHS participates in ongoing community-based needs assessments. Some of the most significant recent activity includes conducting a Community Health Needs Assessment (CHNA) for hospital and the communities we serve as well as developing an Implementation Strategy Plan for addressing priority community health needs identified in each assessment. The most recent CHNAs and Implementation Strategy for each hospital were completed in 2016. Both the most recent CHNA in 2016 and the previous CHNA from 2013 as well as Implementation Strategy Plans are posted to the Hospital and Health System websites: http://www.stjohnhealthsystem.com/about/community-health-needs-assessment. Many local health departments, public health entities, and community organizations participated in the CHNAs and Implementation Strategy. In addition to the above, SJHS through its subsidiary, St. John Medical Center, Inc., has established a Medical Access Program ("MAP") that is attempting to improve and expand access to health care services to the most vulnerable members of the Tulsa community. All SJHS Tulsa Hospitals including St. John Medical Center, Inc. (Tulsa), Owasso Medical Facility, Inc., St. John Sapulpa, Inc., and St. John Broken Arrow, Inc. participate in this initiative. This program is overseen by representatives of St. John, the George Kaiser Family Foundation, trustees of the Chapman trusts and The University of Oklahoma Tulsa School of Community Medicine. The MAP program includes participation of other health care providers including Good Samaritan clinics, Day Center for the Homeless, Community Health Connections FQHC, Morton Health FQHC, and a network of volunteer physician providers and other organizations. The MAP program regularly receives input from all of these organizations on needed services in the community which helps to prioritize the limited resources available to address community needs.
Schedule H, Part VI, Line 3 Patient education of eligibility for assistance The Hospital has a team of financial counselors who, prior to discharge, attempt to visit in person with all uninsured inpatients and all inpatients likely to qualify for medical indigency to explain our financial assistance policies and help guide them through the process of applying for financial assistance. We also attempt to meet with the families of all Medicaid beneficiaries or individuals who we believe could potentially qualify for Medicaid to help them apply for coverage. The Hospital mentions the existence of the Financial Assistance Policy and provides a phone number to call: on its website, in admitting materials, on all invoices for services sent to patients, and in other ways.
Schedule H, Part VI, Line 4 Community information As described above, the Hospital is part of St. John Health System, Inc. ("SJHS"). Although SJHS provides a full spectrum of health related services throughout Northeastern Oklahoma, its tertiary operations and a large part of its other services are concentrated in the Tulsa Metropolitan Statistical Area (the "Tulsa MSA"). According to the 2010 Census, the State of Oklahoma had a resident population of 3,751,351 persons compared to 3,450,654 persons in 2000. This is an 8.7% increase. The U.S. Census Bureau estimated that in 2009, 13.5% of the Oklahoma resident population was eligible for Medicare, compared to 14.7% in 2000. Tulsa County, Oklahoma and the counties that make up the Tulsa MSA, according to the 2010 Census, had populations of 603,403 and 1,008,460, respectively. This compares to populations of 563,299 and 803,235 persons, respectively in 2000, and represents population growth of 7.1% and 25.5%, respectively. The data shows that the counties in the Tulsa MSA that surround Tulsa County grew much faster from 2000 to 2010. At the same time, the population within Tulsa County shifted away from the city of Tulsa and to suburbs such as Owasso and Broken Arrow. The cities of Broken Arrow and Owasso were two of the fastest growing communities in Oklahoma between 2000 and 2010. The population of the city of Owasso grew 56% to 28,915 from 2000 to 2010 and the population of the city of Broken Arrow grew 32% to 98,850 from 2000 to 2010. Wagoner County (southeast of Tulsa) and Rogers County (northeast of Tulsa) showed the two highest population growth rates from 2000 to 2010. Every county in the 8 county Tulsa MSA except Pawnee County grew in population from 2000 to 2010. Washington County, directly north of Tulsa County, which includes the City of Bartlesville (and Jane Phillips Memorial Medical Center), also grew in population from 2000 to 2010. When the population of Washington County is added to the population of the Tulsa County, the 2010 combined population was 1,059,436. There is significant disparity in the general health of populations within the service area depending upon where an individual lives and to what socioeconomic and ethnic group they belong. Citizens who reside in "North" Tulsa and in some areas of "East" and "West" Tulsa generally have poorer health and shorter life spans than individuals who live in "South" Tulsa. Members of minority groups (many of whom reside in the geographic areas described above) share these same health characteristics. It has been demonstrated that these individuals have less access to regular health care services, including specialty care, and many seek even their primary care in hospital emergency rooms, including all of the SJHS Hospitals. Some significant minority groups in the Hospital's and SJHS's principal service area include Native Americans, Hispanics and African Americans. Each of these groups shares common socioeconomic challenges making them more likely to be poor and be uninsured for health care. Each of these groups has unique ethnic health risk factors that contribute to health status that is generally poorer than their White counterparts. However, even among the White population in the Hospital's service area, there is significant adverse health care status. In general, Oklahoma (including the Hospital's service area) ranks near the bottom in many, if not most, measures of health status in the United States. There are high rates of smoking, diabetes, obesity, upper respiratory illness, chronic heart conditions and many other factors. There are high rates of uninsured and underinsured individuals and families in the communities and geographies served by the Hospital, which create many challenges in meeting the demand for basic services and in improving the health status of the population.
Schedule H, Part VI, Line 5 Promotion of community health St. John is a growing integrated delivery system that serves Northeastern Oklahoma and the surrounding area. It has grown significantly in recent years, with increasing revenues from outpatient and physician professional services, as well as other post-acute services. Acute care services are provided on six hospital campuses that are owned by St. John. The owned hospitals are St. John Medical Center, Inc. (the tertiary center in Tulsa, Oklahoma), Jane Phillips Memorial Medical Center in Bartlesville, St. John Owasso in Owasso, Oklahoma, St. John Broken Arrow, Inc., Jane Phillips Nowata Hospital, Inc., a critical access hospital in Nowata, Oklahoma, and St. John Sapulpa, Inc., a critical access hospital in Sapulpa, Oklahoma. Acute care services are also provided at two additional rural critical access hospitals which are managed by Jane Phillips. Diagnostic services and certain acute care services are also provided in a variety of free standing (including hospital-based) settings. The St. John System now includes hundreds of employed physicians and "mid-level providers", and several urgent care clinics, as well as retirement and skilled nursing facilities, including some targeted specifically to serve low-income and physically disabled individuals and other health care providers. St. John is attempting to promote community health in several ways. Most of the affiliated primary care physicians have or are establishing "medical home" models of care that are attempting to improve health status of their patients by better emphasizing preventive care and health screening and by better management of chronic disease. This includes participation in the Medicare Comprehensive Primary Care Initiative. The affiliated primary care physicians utilize a sophisticated electronic medical record that helps provide real time information to make it easier to manage patients' care. The Hospital and the other hospitals in the System have invested heavily in clinical information systems and electronic medical records to better manage patient care during each episode of acute care. St. John is investing in new systems of care to provide better coordination of care between all the different providers responsible for portions of each patient's care, with an emphasis on prevention, screening and coordination of chronic care. The Hospital and St. John Health System, Inc. have invested in tertiary services that are needed by the community. Examples of which include development of Oklahoma's only ACS Level II Trauma Center (the highest accredited center in Tulsa), Northeastern Oklahoma's only JCAHO-accredited stroke center, neonatal intensive care, sophisticated medical technology including all-digital diagnostic radiology, cyberknife and other forms of radiation therapy, DaVinci robotic surgery, an endovascular operating suite, orthopedic and neurosurgical centers of excellence, sophisticated cardiovascular care that emphasizes rapid and effective intervention for heart attack victims and preventive care for those with chronic heart conditions. The Hospital has an open medical staff and has community, religious and physician representatives serving on its board. St. John Health System, Inc. has created and is continuing to create systems and policies to promote better coordination of care and allocation of resources throughout the System. The Hospital participates in many community-wide health screening and health education events, as well as hosting many such events that are open to the public. The Hospital and St. John Health System, Inc. continue to invest in medical education to support the expansion of physicians, nurses and allied health professionals that will serve the current and future generations of patients in the service area. The Hospital participates in St. John Health System, Inc.'s coordinated effort to assess community need collaboratively with other interested parties in the community and to allocate capital and human resources to address the needs of the entire service area. Finally as one of only two major tax-exempt health systems in our service area, St. John reinvests 100% of any profits generated into new or expanded services for the community.
Schedule H, Part VI, Line 6 Affiliated health care system ST. JOHN HEALTH SYSTEM, INC., HEADQUARTERED IN TULSA, OKLAHOMA, AND WITH FACILITIES LOCATED THROUGHOUT NORTHEASTERN OKLAHOMA, IS AN OKLAHOMA NONPROFIT HEALTH SYSTEM. IT OWNS AND OPERATES AN INTEGRATED TERTIARY HEALTH CARE DELIVERY SYSTEM THAT PROVIDES SERVICES PRIMARILY IN NORTHEASTERN OKLAHOMA. ST. JOHN HEALTH SYSTEM, INC. AND ITS SUBSIDIARIES, AFFILIATES, AND EMPLOYED AND AFFILIATED PHYSICIANS, PROVIDE HEALTH CARE SERVICES FOR PATIENTS OF ALL AGES ACROSS A BROAD CONTINUUM OF CARE, FROM PHYSICIAN PRIMARY CARE AND SPECIALTY SERVICES TO AMBULATORY AND INPATIENT ACUTE AND POST-ACUTE SERVICES, AND INCLUDING SENIOR NURSING AND SENIOR LIVING SERVICES. THE HEALTH MINISTRY IS RELATED TO ASCENSION HEALTH'S OTHER SPONSORED ORGANIZATIONS THROUGH COMMON CONTROL. SUBSTANTIALLY ALL EXPENSES OF THE HEALTH MINISTRY ARE RELATED TO PROVIDING HEALTH CARE SERVICES. ASCENSION HEALTH ALLIANCE, D/B/A ASCENSION (ASCENSION), IS A MISSOURI NONPROFIT CORPORATION FORMED ON SEPTEMBER 13, 2011. ASCENSION IS THE SOLE CORPORATE MEMBER AND PARENT ORGANIZATION OF ASCENSION HEALTH, A CATHOLIC NATIONAL HEALTH SYSTEM CONSISTING PRIMARILY OF NONPROFIT CORPORATIONS THAT OWN AND OPERATE LOCAL HEALTHCARE FACILITIES, OR HEALTH MINISTRIES, LOCATED IN 23 STATES AND THE DISTRICT OF COLUMBIA. ASCENSION IS SPONSORED BY ASCENSION SPONSOR, A PUBLIC JURIDIC PERSON. THE PARTICIPATING ENTITIES OF ASCENSION SPONSOR ARE THE DAUGHTERS OF CHARITY OF ST. VINCENT DE PAUL, ST. LOUISE PROVINCE; THE CONGREGATION OF ST. JOSEPH; THE CONGREGATION OF THE SISTERS OF ST. JOSEPH OF CARONDELET; THE CONGREGATION OF ALEXIAN BROTHERS OF THE IMMACULATE CONCEPTION PROVINCE, INC. - AMERICAN PROVINCE; AND THE SISTERS OF THE SORROWFUL MOTHER OF THE THIRD ORDER OF ST. FRANCIS OF ASSISI - US/CARIBBEAN PROVINCE. MISSION: THE SYSTEM DIRECTS ITS GOVERNANCE AND MANAGEMENT ACTIVITIES TOWARD STRONG, VIBRANT, CATHOLIC HEALTH MINISTRIES UNITED IN SERVICE AND HEALING, AND DEDICATES ITS RESOURCES TO SPIRITUALLY CENTERED CARE WHICH SUSTAINS AND IMPROVES THE HEALTH OF THE INDIVIDUALS AND COMMUNITIES IT SERVES. IN ACCORDANCE WITH THE SYSTEM'S MISSION OF SERVICE TO THOSE PERSONS LIVING IN POVERTY AND OTHER VULNERABLE PERSONS, EACH HEALTH MINISTRY ACCEPTS PATIENTS REGARDLESS OF THEIR ABILITY TO PAY. THE SYSTEM USES FOUR CATEGORIES TO IDENTIFY THE RESOURCES UTILIZED FOR THE CARE OF PERSONS LIVING IN POVERTY AND COMMUNITY BENEFIT PROGRAMS: - TRADITIONAL CHARITY CARE INCLUDES THE COST OF SERVICES PROVIDED TO PERSONS WHO CANNOT AFFORD HEALTHCARE BECAUSE OF INADEQUATE RESOURCES AND/OR WHO ARE UNINSURED OR UNDERINSURED. - UNPAID COST OF PUBLIC PROGRAMS, EXCLUDING MEDICARE, REPRESENTS THE UNPAID COST OF SERVICES PROVIDED TO PERSONS COVERED BY PUBLIC PROGRAMS FOR PERSONS LIVING IN POVERTY AND OTHER VULNERABLE PERSONS. - COST OF OTHER PROGRAMS FOR PERSONS LIVING IN POVERTY AND OTHER VULNERABLE PERSONS INCLUDES UNREIMBURSED COSTS OF PROGRAMS INTENTIONALLY DESIGNED TO SERVE THE PERSONS LIVING IN POVERTY AND OTHER VULNERABLE PERSONS OF THE COMMUNITY, INCLUDING SUBSTANCE ABUSERS, THE HOMELESS, VICTIMS OF CHILD ABUSE, AND PERSONS WITH ACQUIRED IMMUNE DEFICIENCY SYNDROME. - COMMUNITY BENEFIT CONSISTS OF THE UNREIMBURSED COSTS OF COMMUNITY BENEFIT PROGRAMS AND SERVICES FOR THE GENERAL COMMUNITY, NOT SOLELY FOR THE PERSONS LIVING IN POVERTY, INCLUDING HEALTH PROMOTION AND EDUCATION, HEALTH CLINICS AND SCREENINGS, AND MEDICAL RESEARCH. DISCOUNTS ARE PROVIDED TO ALL UNINSURED PATIENTS, INCLUDING THOSE WITH THE MEANS TO PAY. DISCOUNTS PROVIDED TO THOSE PATIENTS WHO DID NOT QUALIFY FOR ASSISTANCE UNDER CHARITY CARE GUIDELINES ARE NOT INCLUDED IN THE COST OF PROVIDING CARE OF PERSONS LIVING IN POVERTY AND OTHER COMMUNITY BENEFIT PROGRAMS. THE COST OF PROVIDING CARE TO PERSONS LIVING IN POVERTY AND OTHER COMMUNITY BENEFIT PROGRAMS IS ESTIMATED BY REDUCING CHARGES FORGONE BY A FACTOR DERIVED FROM THE RATIO OF EACH ENTITY'S TOTAL OPERATING EXPENSES TO THE ENTITY'S BILLED CHARGES FOR PATIENT CARE. CERTAIN COSTS SUCH AS GRADUATE MEDICAL EDUCATION AND CERTAIN OTHER ACTIVITIES ARE EXCLUDED FROM TOTAL OPERATING EXPENSES FOR PURPOSES OF THIS COMPUTATION.
Schedule H (Form 990) 2015
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