SCHEDULE H
(Form 990)
Department of the Treasury
Internal Revenue Service
Hospitals
Medium right arrow Complete if the organization answered "Yes" on Form 990, Part IV, question 20a.
Medium right arrow Attach to Form 990.
Medium right arrow Go to www.irs.gov/Form990EZ for instructions and the latest information.
OMB No. 1545-0047
2022
Open to Public Inspection
Name of the organization
St Charles Health System Inc
 
Employer identification number

93-0602940
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
 
No
c
If "Yes" to line 5b, as a result of budget considerations, was the organization unable to provide free or discountedcare to a patient who was eligibile for free or discounted care? . . . . . . . . . . . . .
5c
 
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) . . . 		  33,267 13,205,238   13,205,238 1.230 %
b Medicaid (from Worksheet 3, column a) . . . . .   208,836 254,343,008 176,134,780 78,208,228 7.290 %
c Costs of other means-tested government programs (from Worksheet 3, column b) . .            
d Total Financial Assistance and Means-Tested Government Programs . . . . .   242,103 267,548,246 176,134,780 91,413,466 8.520 %
Other Benefits
e Community health improvement services and community benefit operations (from Worksheet 4).   6,037 756,887   756,887 0.070 %
f Health professions education (from Worksheet 5) . . .   2,282 1,705,711 395,337 1,310,374 0.120 %
g Subsidized health services (from Worksheet 6) . . . .            
h Research (from Worksheet 7) .   499 27,457   27,457  
i Cash and in-kind contributions for community benefit (from Worksheet 8) . . . .   2,000 1,223,696   1,223,696 0.110 %
j Total. Other Benefits . .   10,818 3,713,751 395,337 3,318,414 0.300 %
k Total. Add lines 7d and 7j .   252,921 271,261,997 176,530,117 94,731,880 8.820 %
For Paperwork Reduction Act Notice, see the Instructions for Form 990. Cat. No. 50192T Schedule H (Form 990) 2022
Schedule H (Form 990) 2022
Page
Part II
Community Building Activities Complete this table if the organization conducted any community building activities during the tax year, and describe in Part VI how its community building activities promoted the health of the communities it serves.
(a) Number of activities or programs (optional) (b) Persons served (optional) (c) Total community building expense (d) Direct offsetting
revenue 		(e) Net community building expense (f) Percent of total expense
1 Physical improvements and housing            
2 Economic development            
3 Community support            
4 Environmental improvements            
5 Leadership development and
training for community members		            
6 Coalition building            
7 Community health improvement advocacy            
8 Workforce development   205,634 317,159   317,159 0.030 %
9 Other            
10 Total   205,634 317,159   317,159 0.030 %
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 Healthcare Financial Management Association Statement No. 15? ..........................
1
Yes
 
2
Enter the amount of the organization's bad debt expense. Explain in Part VI the methodology used by the organization to estimate this amount. ......
2
 
3
Enter the estimated amount of the organization's bad debt expense attributable to patients eligible under the organization's financial assistance policy. Explain in Part VI the methodology used by the organization to estimate this amount and the rationale, if any, for including this portion of bad debt as community benefit. ......
3
 
4
Provide in Part VI the text of the footnote to the organization’s financial statements that describes bad debt expense or the page number on which this footnote is contained in the attached financial statements.
Section B. Medicare
5
Enter total revenue received from Medicare (including DSH and IME).....
5
203,798,739
6
Enter Medicare allowable costs of care relating to payments on line 5.....
6
253,718,025
7
Subtract line 6 from line 5. This is the surplus (or shortfall)........
7
-49,919,286
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 %
1Cascade Medical Imaging LLC
  		CT, Mammography and Other 70.000 %   30.000 %
2Central Oregon Magnetic Res
  		Magnetic Resonance Imaging 33.300 %   66.700 %
3Heart Center of the Cascade
  		Owns & manages a medical bu 50.000 %   50.000 %
4Cascade SurgiCenter LLC
  		Outpatient surgery 50.000 %   50.000 %
5
6
7
8
9
10
11
12
13
Schedule H (Form 990) 2022
Schedule H (Form 990) 2022
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?4Name, 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 and Surgical Children's Hospital Teaching Hospital Critical Access Hospital Research Facility ER-24Hours ER-Other Other (describe) Facility reporting group
1 St Charles Bend
2500 NE NEFF RD
BEND,OR97701 		X X         X     A
2 St Charles Prineville
384 SE COMBS FLAT RD
PRINEVILLE,OR97754 		X X     X   X     B
3 St Charles Madras
470 NE A St
Madras,OR97741 		X X     X   X     B
4 St Charles Redmond
1253 NW Canal Boulevard
Redmond,OR97756 		X X         X     A
Schedule H (Form 990) 2022
Page 4
Schedule H (Form 990) 2022
Page 4
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)
A
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): 		14
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 22
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   No
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 22
10 Is the hospital facility's most recently adopted implementation strategy posted on a website?......... 10 Yes  
a If "Yes" (list url): SEE PART V SECTION C SUPPLEMENTAL INFO
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) 2022
Page 5
Schedule H (Form 990) 2022
Page 5
Part VFacility Information (continued)

Financial Assistance Policy (FAP)
A
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 Was widely publicized 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
SEE PART V SECTION C SUPPLEMENTAL INFO
b
SEE PART V SECTION C SUPPLEMENTAL INFO
c
d
e
f
g
h
i
j
Schedule H (Form 990) 2022
Page 6
Schedule H (Form 990) 2022
Page 6
Part VFacility Information (continued)

Billing and Collections
A
Name of hospital facility or letter of facility reporting group  
Yes No
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 nonpayment?.................................. 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
f
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
e
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
Schedule H (Form 990) 2022
Page 7
Schedule H (Form 990) 2022
Page 7
Part VFacility Information (continued)

Charges to Individuals Eligible for Assistance Under the FAP (FAP-Eligible Individuals)
A
Name of hospital facility or letter of facility reporting group  
Yes No
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) 2022
Page 4
Schedule H (Form 990) 2022
Page 4
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)
B
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): 		23
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 22
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   No
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   No
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 22
10 Is the hospital facility's most recently adopted implementation strategy posted on a website?......... 10 Yes  
a If "Yes" (list url): SEE PART V SECTION C SUPPLEMENTAL INFO
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) 2022
Page 5
Schedule H (Form 990) 2022
Page 5
Part VFacility Information (continued)

Financial Assistance Policy (FAP)
B
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 Was widely publicized 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
SEE PART V SECTION C SUPPLEMENTAL INFO
b
SEE PART V SECTION C SUPPLEMENTAL INFO
c
d
e
f
g
h
i
j
Schedule H (Form 990) 2022
Page 6
Schedule H (Form 990) 2022
Page 6
Part VFacility Information (continued)

Billing and Collections
B
Name of hospital facility or letter of facility reporting group  
Yes No
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 nonpayment?.................................. 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
f
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
e
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
Schedule H (Form 990) 2022
Page 7
Schedule H (Form 990) 2022
Page 7
Part VFacility Information (continued)

Charges to Individuals Eligible for Assistance Under the FAP (FAP-Eligible Individuals)
B
Name of hospital facility or letter of facility reporting group  
Yes No
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) 2022
Page 8
Schedule H (Form 990) 2022
Page 8
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, 16j, 18e, 19e, 20a, 20b, 20c, 20d, 20e, 21c, 21d, 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
Facility: A 1, 4 - Part V, Section B, Line 5 The CHNA was conducted using many forms of data collection and analysis including the following primary research: Surveys: DHM Research conducted telephone interviews of 700 residents throughout the communities (Crook, Deschutes and Jefferson Counties), served by a St. Charles facility to determine the health-related priorities of the population residing in Central Oregon. The survey was designed to establish a baseline of importance, priorities and needs around health and wellness, including access, quality and cost. Respondents were contacted from a list of registered voters, which included cell phones. In gathering responses, a variety of quality control measures were employed, including questionnaire pre-testing and validation. A link to the full DHM Research questionnaire and results can be found in the References page. Community Input: Community input was gathered via a collaboration between the St. Charles Health System Community Benefit department and Central Oregon Health Council. The CHNA was developed with data, input, and information from a wide variety of health and community based organizations, stakeholders and community members. The input was gathered from the Central Oregon Health Councils Community Advisory Council, a number of health-related advisory boards and groups, and via numerous community focus groups throughout the region. Individuals (such as traditional health workers/peer support specialists/community health workers) and organizations were asked to share their expertise through a health equity and social determinants of health lens. You can see a list of contributors by accessing the 2019 Central Oregon Regional Health Assessment, link is provided in the Reference page section of this CHNA. Methodologysecondary research The process began by compiling, reviewing and analyzing secondary information available including information at the local, state and national level of the populations health. All information used in this report was taken from the most recent information available from the listed resources.
Facility: B 2, 3 - Part V, Section B, Line 5 The CHNA was conducted using many forms of data collection and analysis including the following primary research: Surveys: DHM Research conducted telephone interviews of 700 residents throughout the communities (Crook, Deschutes and Jefferson Counties), served by a St. Charles facility to determine the health-related priorities of the population residing in Central Oregon. The survey was designed to establish a baseline of importance, priorities and needs around health and wellness, including access, quality and cost. Respondents were contacted from a list of registered voters, which included cell phones. In gathering responses, a variety of quality control measures were employed, including questionnaire pre-testing and validation. A link to the full DHM Research questionnaire and results can be found in the References page. Community Input: Community input was gathered via a collaboration between the St. Charles Health System Community Benefit department and Central Oregon Health Council. The CHNA was developed with data, input, and information from a wide variety of health and community based organizations, stakeholders and community members. The input was gathered from the Central Oregon Health Councils Community Advisory Council, a number of health-related advisory boards and groups, and via numerous community focus groups throughout the region. Individuals (such as traditional health workers/peer support specialists/community health workers) and organizations were asked to share their expertise through a health equity and social determinants of health lens. You can see a list of contributors by accessing the 2019 Central Oregon Regional Health Assessment, link is provided in the Reference page section of this CHNA. Methodologysecondary research The process began by compiling, reviewing and analyzing secondary information available including information at the local, state and national level of the populations health. All information used in this report was taken from the most recent information available from the listed resources.
Facility: A 1, 4 - Part V, Section B, Line 6a St. Charles Bend & St. Charles Redmond
Facility: A 1, 4 - Part V, Section B, Line 11 To prioritize the varied health needs of Deschutes County - the defined community served by St. Charles Flagship hospital (Bend and Redmond), Jefferson County - the defined community served by St. Charles Madras and Crook County - the defined community served by St. Charles Prineville, an extensive review of existing data, community partner information and a professionally facilitated phone survey were conducted and completed as part of the CHNA research. Once the initial analysis of available secondary data was collated, the phone survey completed and input collected from key stakeholders, the Community Benefit department prioritized significant health needs as follows: St. Charles (Flagship Hospital):1. Behavioral Health: Increase Access and Coordination 2. Stable Housing and Supports 3. Substance and Alcohol Misuse Prevention and Treatment 4. Address Poverty and Enhance Self Sufficiency 5. Upstream Prevention: Promotion of Individual Well-Being 6. Promote Enhanced Physical Health Across CommunitiesSt. Charles Prineville & St. Charles Madras Hospitals:1. Stable Housing and Support2. Address Poverty and Enhance Self Sufficiency3. Upstream Prevention: Promotion of Individual Well-Being4. Substance and Alcohol Misuse Prevention and Treatment5. Behavioral Health: Increase Access and Coordination6. Promote Enhanced Physical Health Across CommunitiesCriteria determining needs to be addressed:When determining which of the above significant health needs would be selected as the health priorities to be addressed, St. Charles considered the following criteria: Severity of issue Ability to impact Community Resources St. Charles Bend and Redmond campuses available resources and expertise St. Charles Prineville campus available resources and expertise St. Charles Madras campus available resources and expertise St. Charles Health System strategic plan St. Charles Hospitals' Prioritized Need(s):The Community Health Needs Assessment (CHNA) identified that access to affordable housing, living wage jobs and mental health services would most improve the health of our community. After careful consideration, St. Charles Hospitals will focus on efforts that reduce feelings of loneliness and social isolation while fostering a sense of belonging for the 2023-2025 regional health implementation strategy (RHIS) to start addressing mental health concerns and promoting individual well-being. The CDC defines loneliness as the feeling of being alone, regardless of the amount of social contact. Social isolation is a lack of social connections. Social isolation can lead to loneliness in some people, while others can feel lonely without being socially isolated.About one in five Americans suffer from chronic loneliness, with a survey in 2020 revealing that young adults suffer the most. Older adults are also at higher risk for social isolation and loneliness due to changes in health and social connections that can come with growing older, hearing, vision, and memory loss, disability, trouble getting around and/or the loss of family and friends. Loneliness has broader implications for our mental and physical health too. Its not difficult to understand how loneliness leads to depression, a growing problem in the United States. Among older adults, loneliness increases the risk of developing dementia, slows down their walking speeds, interferes with their ability to take care of themselves, and increases their risk of heart disease and stroke. Loneliness is even associated with dying earlier. Among adolescents and young adults, loneliness increases the likelihood of headaches, stomach aches, sleep disturbances, and compulsive internet use. Chronic loneliness is said to have similar impacts on health as smoking a pack of cigarettes a day. Furthermore, according to Thomas Joiner, a leading expert on suicide, when people hold two specific psychological states in their minds simultaneously, and when they do so for long enough, they develop the desire for death. The two psychological states are perceived burdensomeness and a sense of low belongingness or social alienation. In 2017, Angus Deaton and Anne Case discovered that 158,000 Americans died through the process of addiction to alcohol, painkillers, or other drugs or by suicide and this number has grown year over year. They also attribute these statistics to social isolation or feeling disconnected. Acknowledging that mental health issues are complex and intertwined, creating opportunities for engagement and socialization outside of medical interventions is the first step to begin addressing the loneliness epidemic that was amplified by the COVID-19 pandemic. During our Regional Health Implementation Strategy (RHIS) key informant interviews, a majority of participants felt that loneliness was a major contributor to the mental and behavioral health issues in our communities. When informants were asked if they had ideas to combat loneliness and social isolation, the ideas unanimously centered on the concept of creating opportunities for individuals and families to come together and rediscover what it means to belong within their own community. Belonging is often defined as the feeling of security and support when there is a sense of acceptance, inclusion, and identity for a member of a certain group and it has been identified as a pillar in Maslows Hierarchy of Needs. Maslows Hierarchy of Needs is the idea that our needs range from the very basic, such as the things required for our survival, through to higher goals such as altruism and spirituality. Maslow included social belonging because we need friendships, family connections and emotional intimacy with others. People in different societies meet this need in different ways: for some people, their need for social belonging might be met entirely within their extended family; for others, it might be organized activities such as a church community; for others, it might be a network of friendships and romantic relationships that meet this need. Its worth noting that meeting this need can enable us to overcome a lack of our basic needs through the strength of our relationships with others. We truly are stronger together than we are alone. To that end, St. Charles Health System aims to come alongside community members, partners, and caregivers to help older adults, youth and those who are feeling lonely establish a sense of belonging.The following are the significant health needs identified in the St. Charles CHNAs that will not be addressed in this implementation strategy: Behavioral Health Stable Housing and Supports Substance and Alcohol Misuse Prevention and Treatment Address Poverty and Enhance Self Sufficiency Promote Enhanced Physical Health Across Communities To achieve real improvement, this plan will focus on issues the organization has the most ability to impact alongside our community partners. By selecting one priority, a more focused effort can be made by the caregivers at all St. Charles campuses, in collaboration with local partners, to improve the health of those the health system serves. While all of the needs listed above are important, St. Charles leaders have decided to focus Community Benefit resources and efforts on the issue of reducing loneliness and increasing belonging. Having a laser focus on this issue will ensure real progress is made. Work will also continue on each of the other identified needs listed above through internal St. Charles departments and through external community partners. In addition, focusing on belonging could ultimately positively impact these other identified needs.
Facility: B 2, 3 - Part V, Section B, Line 11 To prioritize the varied health needs of Deschutes County - the defined community served by St. Charles Flagship hospital (Bend and Redmond), Jefferson County - the defined community served by St. Charles Madras and Crook County - the defined community served by St. Charles Prineville, an extensive review of existing data, community partner information and a professionally facilitated phone survey were conducted and completed as part of the CHNA research. Once the initial analysis of available secondary data was collated, the phone survey completed and input collected from key stakeholders, the Community Benefit department prioritized significant health needs as follows: St. Charles (Flagship Hospital):1. Behavioral Health: Increase Access and Coordination 2. Stable Housing and Supports 3. Substance and Alcohol Misuse Prevention and Treatment 4. Address Poverty and Enhance Self Sufficiency 5. Upstream Prevention: Promotion of Individual Well-Being 6. Promote Enhanced Physical Health Across CommunitiesSt. Charles Prineville & St. Charles Madras Hospitals:1. Stable Housing and Support2. Address Poverty and Enhance Self Sufficiency3. Upstream Prevention: Promotion of Individual Well-Being4. Substance and Alcohol Misuse Prevention and Treatment5. Behavioral Health: Increase Access and Coordination6. Promote Enhanced Physical Health Across CommunitiesCriteria determining needs to be addressed:When determining which of the above significant health needs would be selected as the health priorities to be addressed, St. Charles considered the following criteria: Severity of issue Ability to impact Community Resources St. Charles Bend and Redmond campuses available resources and expertise St. Charles Prineville campus available resources and expertise St. Charles Madras campus available resources and expertise St. Charles Health System strategic plan St. Charles Hospitals' Prioritized Need(s):The Community Health Needs Assessment (CHNA) identified that access to affordable housing, living wage jobs and mental health services would most improve the health of our community. After careful consideration, St. Charles Hospitals will focus on efforts that reduce feelings of loneliness and social isolation while fostering a sense of belonging for the 2023-2025 regional health implementation strategy (RHIS) to start addressing mental health concerns and promoting individual well-being. The CDC defines loneliness as the feeling of being alone, regardless of the amount of social contact. Social isolation is a lack of social connections. Social isolation can lead to loneliness in some people, while others can feel lonely without being socially isolated.About one in five Americans suffer from chronic loneliness, with a survey in 2020 revealing that young adults suffer the most. Older adults are also at higher risk for social isolation and loneliness due to changes in health and social connections that can come with growing older, hearing, vision, and memory loss, disability, trouble getting around and/or the loss of family and friends. Loneliness has broader implications for our mental and physical health too. Its not difficult to understand how loneliness leads to depression, a growing problem in the United States. Among older adults, loneliness increases the risk of developing dementia, slows down their walking speeds, interferes with their ability to take care of themselves, and increases their risk of heart disease and stroke. Loneliness is even associated with dying earlier. Among adolescents and young adults, loneliness increases the likelihood of headaches, stomach aches, sleep disturbances, and compulsive internet use. Chronic loneliness is said to have similar impacts on health as smoking a pack of cigarettes a day. Furthermore, according to Thomas Joiner, a leading expert on suicide, when people hold two specific psychological states in their minds simultaneously, and when they do so for long enough, they develop the desire for death. The two psychological states are perceived burdensomeness and a sense of low belongingness or social alienation. In 2017, Angus Deaton and Anne Case discovered that 158,000 Americans died through the process of addiction to alcohol, painkillers, or other drugs or by suicide and this number has grown year over year. They also attribute these statistics to social isolation or feeling disconnected. Acknowledging that mental health issues are complex and intertwined, creating opportunities for engagement and socialization outside of medical interventions is the first step to begin addressing the loneliness epidemic that was amplified by the COVID-19 pandemic. During our Regional Health Implementation Strategy (RHIS) key informant interviews, a majority of participants felt that loneliness was a major contributor to the mental and behavioral health issues in our communities. When informants were asked if they had ideas to combat loneliness and social isolation, the ideas unanimously centered on the concept of creating opportunities for individuals and families to come together and rediscover what it means to belong within their own community. Belonging is often defined as the feeling of security and support when there is a sense of acceptance, inclusion, and identity for a member of a certain group and it has been identified as a pillar in Maslows Hierarchy of Needs. Maslows Hierarchy of Needs is the idea that our needs range from the very basic, such as the things required for our survival, through to higher goals such as altruism and spirituality. Maslow included social belonging because we need friendships, family connections and emotional intimacy with others. People in different societies meet this need in different ways: for some people, their need for social belonging might be met entirely within their extended family; for others, it might be organized activities such as a church community; for others, it might be a network of friendships and romantic relationships that meet this need. Its worth noting that meeting this need can enable us to overcome a lack of our basic needs through the strength of our relationships with others. We truly are stronger together than we are alone. To that end, St. Charles Health System aims to come alongside community members, partners, and caregivers to help older adults, youth and those who are feeling lonely establish a sense of belonging.The following are the significant health needs identified in the St. Charles CHNAs that will not be addressed in this implementation strategy: Behavioral Health Stable Housing and Supports Substance and Alcohol Misuse Prevention and Treatment Address Poverty and Enhance Self Sufficiency Promote Enhanced Physical Health Across Communities To achieve real improvement, this plan will focus on issues the organization has the most ability to impact alongside our community partners. By selecting one priority, a more focused effort can be made by the caregivers at all St. Charles campuses, in collaboration with local partners, to improve the health of those the health system serves. While all of the needs listed above are important, St. Charles leaders have decided to focus Community Benefit resources and efforts on the issue of reducing loneliness and increasing belonging. Having a laser focus on this issue will ensure real progress is made. Work will also continue on each of the other identified needs listed above through internal St. Charles departments and through external community partners. In addition, focusing on belonging could ultimately positively impact these other identified needs.
Facility: A 1, 4 - Part V, Section B, Line 16j A REFERENCE TO THE FINANCIAL ASSISTANCE PROGRAM WAS INCLUDED ON BILLING STATEMENTS AS WELL AS VOICE MESSAGING ON CUSTOMER SERVICE PHONE LINES & PROMPTS.
Facility: B 2, 3 - Part V, Section B, Line 16j A REFERENCE TO THE FINANCIAL ASSISTANCE PROGRAM WAS INCLUDED ON BILLING STATEMENTS AS WELL AS VOICE MESSAGING ON CUSTOMER SERVICE PHONE LINES & PROMPTS.
Facility: A 1, 4 - Part V, Section B, Line 20e BEFORE INITIATING EAC'S, PATIENTS ARE SCREENED FOR FPL under 200%. IF FPL IS 200% OR BELOW, A FINANCIAL ASSISTANCE POLICY & FINANCIAL ASSISTANCE APPLICATION ARE MAILED TO THE GUARANTOR. IF THE GUARANTOR FAILS TO COMPLETE AND RETURN THE APPLICATION, OR FAILS TO PAY THE ACCOUNT IN FULL, OR FAILS TO SET UP A PAYMENT PLAN WITHIN 45-DAYS OF MAILING THE POLICY APPLICATION, THE ACCOUNTS ARE ASSIGNED TO A BAD DEBT AGENCY.
Facility: B 2, 3 - Part V, Section B, Line 20e BEFORE INITIATING EAC'S, PATIENTS ARE SCREENED FOR FPL under 200%. IF FPL IS 200% OR BELOW, A FINANCIAL ASSISTANCE POLICY & FINANCIAL ASSISTANCE APPLICATION ARE MAILED TO THE GUARANTOR. IF THE GUARANTOR FAILS TO COMPLETE AND RETURN THE APPLICATION, OR FAILS TO PAY THE ACCOUNT IN FULL, OR FAILS TO SET UP A PAYMENT PLAN WITHIN 45-DAYS OF MAILING THE POLICY APPLICATION, THE ACCOUNTS ARE ASSIGNED TO A BAD DEBT AGENCY.
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
Schedule H (Form 990) 2022
Page 9
Schedule H (Form 990) 2022
Page 9
Part VFacility Information (continued)

Section D. Other Health Care Facilities That Are Not Licensed, Registered, or Similarly Recognized as a Hospital Facility
(list in order of size, from largest to smallest)
How many non-hospital health care facilities did the organization operate during the tax year?  
Name and address Type of Facility (describe)
1 St Charles Heart & Lung Specialists
2500 NE Neff Rd
Bend,OR97701 		Heart and Lung Services
2 Cascade Medical Imaging
1460 NE Medical Center Dr
Bend,OR97701 		Diagnostic imaging clinic
3 St Charles Surgical Specialists Redmond
1245 NW 4th Street STE 101
Remdond,OR97756 		Surgical Specialists
4 St Charles Center for Womens Health Redmond
340 NW 5th Street Ste 101
Redmond,OR97756 		OB/GYN Clinic
5 St Charles Family Care Redmond
211 NW Larch Ave
Redmond,OR97756 		Primary Care Clinic
6 St Charles Cancer Center
2500 NE Neff Rd
Bend,OR97701 		Outpatient Cancer center
7 Sage View
1885 NE Purcell Blvd
Bend,OR97701 		Mental Health Services
8 St Charles Family Care Bend East
2600 NE Neff Rd
Bend,OR97701 		Primary Care Clinic
9 St Charles Family Care Prineville
384 SE Combs Flat Road
Prineville,OR97754 		Rural Health Clinic
10 Wound Care & Ostomy Clinic Bend
2275 NE Doctors Dr Suite 9
Bend,OR97701 		Wound & Ostomy Care
11 St Charles Trauma & Acute Care
2275 NE Doctors Dr Suite 6
Bend,OR97701 		Trauma and & Surgical Services
12 St Charles Urgent Care South Bend
61250 SE Coombs Place
Bend,OR97702 		Urgent Care Clinic
13 St Charles Hospice
2275 NE Doctors Dr Suite 5
Bend,OR97701 		Hospice Care
14 St Charles Sleep Center Bend
2042 NE Williamson Ct
Bend,OR97701 		Sleep Lab
15 St Charles Family Care Bend South
61250 SE Coombs Place
Bend,OR97702 		Primary Care Clinic
16 Behavioral Health
360 NW Bond St Suite 330
Bend,OR97701 		Behavioral Health clinic
17 St Charles Urgent Care La Pine
51781 Huntington Rd
La Pine,OR97739 		Urgent Care Clinic
18 St Charles Urgent Care Prineville
384 SE Combs Flat Road
Prineville,OR97754 		Urgent Care Clinic
19 St Charles Family Care Madras
480 NE A St
Madras,OR97741 		Primary Care Clinic
20 Cascade Surgicenter
2200 NE Neff Rd 100
Bend,OR97701 		Surgery Center
21 St Charles Family Care La Pine
51781 Huntington Rd
La Pine,OR97739 		Primary Care Clinic
22 St Charles Rheumatology
2600 NE Neff Rd
Bend,OR97701 		Rheumatology Clinic
23 St Charles Neonatology
2500 NE Neff Rd
Bend,OR97701 		Neonatology Intensive Care Unit
24 St Charles Family Care Sisters
630 N Arrowleaf Trail
Sisters,OR97759 		Primary Care Clinic
25 St Charles Pulmonary Clinic Bend
2500 NE Neff Rd
Bend,OR97701 		Lung clinic
26 St Charles Anticoagulation Clinic Bend
2275 NE Doctors Dr Suite 7
Bend,OR97701 		Anticoag Clinic
27 St Charles PEDAL Clinic
2036 NW Williamson Court
Bend,OR97701 		Pediatric Behavioral Health
28 St Charles Sleep Center Redmond
655 NW Jackpine Ave
Redmond,OR97756 		Sleep Lab
29 Central Oregon Magnetic Resonance Imaging
1460 NE Medical Center Dr
Bend,OR97701 		MRI Center
30 St Charles Palliative Care
2275 NE Doctors Dr Suite 5
Bend,OR97701 		Palliative Care
31 St Charles East Infusion
2600 NE Neff Rd
Bend,OR97701 		Infusion Therapy Clinic
32 St Charles Preoperative Medicine
2275 NE Doctors Dr Suite 6
Bend,OR97701 		Care for Surgery Patients
33 SCMG Imaging Redmond
211 NW Larch Ave
Redmond,OR97756 		Imaging Services
34 St Charles Pulmonary Clinic Redmond
655 NW Jackpine Ave
Redmond,OR97756 		Lung clinic
35 St Charles Infectious Disease
2965 NE Conners Ave Suite 127
Bend,OR97701 		Infectious Disease Clinic
36 Sisters School Based Health Clinic
640 N Arrowleaf Trail
Sisters,OR97759 		School Based Clinic
37 St Charles Dietitians & Community Outreach
2036 NE Williamson Court
Bend,OR97701 		nutrition education and counseling
38 Sister Diagnostic Radiology
630 N Arrowleaf Trail
Sister,OR97759 		Radiology Services
39 St Charles Imaging Bend East
2600 NE Neff Rd
Bend,OR97701 		Imaging Services
40 St Charles Imaging La Pine
51781 Huntington Rd
La Pine,OR97739 		Imaging Services
41 St Charles Diabetes Clinic
2036 NE Williamson Court
Bend,OR97701 		Diabetes Clinic
42 St Charles Urgent Care East Bend
2600 NE Neff Rd
Bend,OR97701 		Urgent Care Clinic
43 St Charles Anticoagulation Clinic Redmond
655 NW Jackpine Ave
Redmond,OR97756 		Anticoag Clinic
44 St Charles Laboratory Services La Pine
51781 Huntington Rd
La Pine,OR97739 		Outpatient Lab
45 St Charles Preoperative Medicine LaPine
51781 Huntington Rd
La Pine,OR97739 		Periop Services
46 Wound Care & Ostomy Clinic Madras
470 NE A Street
Madras,OR97741 		Wound & Ostomy Care
47 St Charles Cancer Center Redmond
1541 NW Canal Blvd
Redmond,OR97756 		Outpatient Cancer Center
48 St Charles Laboratory Services Redmond
1245 NW 4th Street
Redmond,OR97756 		Outpatient Lab
49 Behavioral Health Redmond
916 SW 17th St Suite 202
Redmond,OR97756 		Behavioral Health clinic
50 St Charles Surgical Specialists Prineville
384 SE Combs Flat Rd Suite 1200
Prineville,OR97754 		Surgical Specialists
51 St Charles Surgical Specialists Madras
470 NE A St
Madras,OR97741 		Surgical Specialists
52 St Charles Laboratory Services Madras
470 NE A Street
Madras,OR97741 		Outpatient Lab
53 St Charles Preoperative Medicine Redmond
916 SW 17th St
Redmond,OR97756 		Periop Services
54 St Charles Heart & Lung Specialists Redmond
655 NW Jackpine Ave
Redmond,OR97756 		Heart and Lung Services
Schedule H (Form 990) 2022
Page 10
Schedule H (Form 990) 2022
Page 10
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
Part I, Line 7 - Explanation of Costing Methodology The costing methodology used was derived from SCHS's financial systems, which address all hospital-based patient segments and other services provided. A cost-to-charge ratio from the financial systems was used to calculate the cost of Financial Assistance in line 7a. Numbers reported in column (b) in lines 7a and 7b refer to the number of patient encounters.
Part III, Line 2 - Methodology Used To Estimate Bad Debt Expense When SCHS provides care to patients, it does not require collateral; however, itmaintains an estimated allowance for doubtful accounts. The primary collection risksrelate to uninsured patient accounts and patient accounts for which the primaryinsurance payor has paid, but patient responsibility amounts (generally deductiblesand copayments) remain outstanding. The reserves against accounts receivable is estimated based primarily upon SCHS historical collection experience, the age of the patient's account, management's estimate of the patient's economic ability to pay, and the effectiveness of collection efforts. Patient accounts receivable balances are routinely reviewed in conjunction with historical collection rates and other economic conditions that might ultimately affect the collectability of patientaccounts when considering the adequacy of the amounts recorded as net patient revenues. Actual write offs have historically been within management'sexpectations.
Part III, Line 3 - Methodology of Estimated Amount & Rationale for Including in Community Benefit SCHS currently has no reasonable way to track or estimate the amount of bad debt expense attributable to charity care, and accordingly this line has been left blank.
Part III, Line 4 - Bad Debt Expense See page 14, footnote 4 "Net Patient Service Revenue", in the attached Audited Financial Statements.
Part III, Line 8 - Explanation Of Shortfall As Community Benefit As a response to efforts to improve the health and quality of life of people living in the community, SCHS provided approximately $50 million in unreimbursed services to patients enrolled in traditional Medicare programs. SCHS believes that the Medicare shortfall should be treated as a community benefit since it has a clear mission to serving and improving the health status of the elderly. If SCHS should cease to exist, this shortfall would have to be absorbed by another health care provider. Costs are from the Medicare Cost Report, but none of these costs are being claimed as a community benefit in Part I, line 7.SCHS had a total medicare shortfall of approximately $139M which differs from the shortfall of $50M reported in Part III Section B because Part III Section B includes only those costs allowed in the Medicare Cost Report which excludes the Medicare Advantage shortfall.
Part III, Line 9b - Provisions On Collection Practices For Qualified Patients Collection policies are the same for all patients. Every effort is made to identify patients who may need financial assistance at the earliest point during the patients experience with St. Charles. Patients may be identified as a candidate for financial assistance at any time before, during or after services are delivered. If at any point during the collection process documentation or information is received that indicates the patient may be eligible for our financial assistance program, the account is reviewed by our financial assistance team for eligibility. Prior to sending an account to collections, patient accounts are reviewed for Federal Poverty Level(FPL). If FPL is 200% or below, a Financial Assistance policy & Financial Assistance application are mailed to the guarantor. If the guarantor fails to complete and return the application, or fails to pay the account in full, or fails to set up a payment plan within 45-days of mailing the policy application, the accounts are assigned to a bad debt agency.
Part VI, Line 2 - Needs Assessment St. Charles Health System (SCHS) assesses the needs of each of our communities in many different ways other than the facility community health needs assessments. SCHS partners with many organizations from around the community. We collaborated with the Central Oregon Health Council (COHC) to establish a local community data website. The data is provide by Healthy Communities Institute (HCI) and COHC staff manages the website. The website will have dashboards of each community and population risk profiling data that is continuously updated and accessible to the community. This information helps SCHS to keep a finger on the pulse of each population's many health indicators, helping us to continually assess each community's needs, positive changes and/or opportunities for improvement. This information can be found at http://www.centraloregonhealthdata.org. Each year St. Charles also produces the St. Charles Health System Annual Report. This report is comprised of a summary of each of the following: Community BenefitTotalsFinancial OverviewDays cash on handOperating marginExcess marginOperating ExpensesFull time employee countEach health system facility (St. Charles Bend, St. Charles Redmond, St. Charles Prineville and St. Charles Madras) BirthsDischargesIn-patient casesOut-patient casesEmergency visitsSt. Charles Medical GroupPatient visits for each clinicsThe 2021 Annual Report is posted online on the St. Charles Health System website at https://www.stcharleshealthcare.org/about-us/st-charles-annual-report. This report and the primary data collected for its creation let us know what the trends are for different hospital stays, conditions and out-patient visits, helping to decide what services we offer and where the needs are. St. Charles also plays a significant role in local, regional and State groups in order to stay abreast of the newest information, trends, health data and best practices. SCHS has representation on the Central Oregon Health Council (COHC), the governance entity over the region's Coordinated Care Organization, PacificSource Community Solutions, County Commissions, patients, community members & local medical clinics. BY PARTICIPATING ON THIS COUNCIL, ST. CHARLES IS ABLE TO WORK WITH THE EXPERTS IN EACH OF THE THREE COUNTIES TO HEAR FIRSTHAND HOW EACH COMMUNITY IS DOING AND WHAT THEIR HEALTH NEEDS ARE. ST. CHARLES ALSO SITS ON DIFFERENT COMMITTEES FOR THE OREGON ASSOCIATION FOR HOSPITALS AND HEALTH SYSTEMS (OAHHS) AND LOCAL NON-PROFITS. BEING PART OF THESE GROUPS HELPS ST. CHARLES TO BETTER UNDERSTAND THE NEEDS OF OUR COMMUNITIES WHILE ALSO LEARNING HOW TO BETTER COLLECT, TRACK, REPORT AND IMPROVE UPON COLLECTED INFORMATION.
Part VI, Line 3 - Patient Education of Eligibility for Assistance The Financial assistance program policy is posted on the SCHS website.Financial Counselors and registration staff in our facilities & primary care clinics offer financial assistance to patients, both upon request and when patients are uninsured.SCHS works to identify patients who may qualify for coverage through the following government programs (uninsured patients seen in our Emergency departments & those admitted to all of our facilities are automatically referred to a Financial Counseling Patient Advocate): CobraCrime Victims AssistanceEmergency Medicaid for Aliens Medicaid for pregnant women and children Medicaid, Medicare Supplemental Security Income (SSI)Temporary Aid for Needy Families (TANF) VeteransOur Financial Counseling Patient Advocate will work with these individuals through the process of qualifying for coverage or denial of coverage from all applicable government programs.Patients working with the Financial Counseling Patient Advocate have their accounts put on hold from collections. Patients will be referred to the SCHS Financial Assistance Department for follow-up.
Part VI, Line 4 - Community Information DESCHUTES COUNTY: (ST. CHARLES BEND AND ST. CHARLES REDMOND) INFORMATION TAKEN FROM UNITED STATES CENSUS BUREAU(HTTPS://WWW.CENSUS.GOV/QUICKFACTS/FACT/TABLE/DESCHUTESCOUNTYOREGON) UNLESS OTHERWISE NOTED:URBANLAND AREA IN SQUARE MILES (2020): 3,018POPULATION (2022): 206,549UNDER 5 YEARS: 4.7%UNDER 18 YEARS: 19.4%65 YEARS AND OVER: 20.6%FEMALE: 50.1%HOUSEHOLDS (2017-2021): 79,329PERSONS PER HOUSEHOLD (2017-2021): 2.44MEDIAN HOUSEHOLD INCOME (2017-2021): $74,082PERCENTAGE OF PERSONS BELOW POVERTY LEVEL (2017-2021): 8.7%HIGH SCHOOL GRADUATE OR HIGHER, PERCENT OF PERSONS AGE 25+ (2017-2021): 94.3%POPULATION BY RACE (2021):WHITE ALONE, NOT HISPANIC: 93.7% HISPANIC OR LATINO: 8.6%TWO OR MORE RACES: 3%AMERICAN INDIAN AND ALASKA NATIVE ALONE: 1.1% ASIAN ALONE: 1.4%BLACK OR AFRICAN AMERICAN ALONE: .6%NATIVE HAWAIIAN OR OTHER PACIFIC ISLANDER: 0.2%HEALTH CARE PROVIDER ASSETS IN DESCHUTES COUNTY (OUTSIDE OF ST. CHARLES BEND AND REDMOND): MOSAIC MEDICAL CLINIC, (BEND AND REDMOND) (FQHC) LYNCH COMMUNITY CLINIC (SCHOOL-BASED HEALTH CENTER PARTNERSHIP BETWEEN MOSAIC MEDICAL, REDMOND SCHOOL DISTRICT AND DESCHUTES COUNTY) ENSWORTH COMMUNITY SCHOOL-BASED HEALTH CENTER (PARTNERSHIP BETWEEN MOSAIC MEDICAL, BEND-LAPINE SCHOOL DISTRICT AND DESCHUTES COUNTY) BEND MEMORIAL CLINIC, (BEND, REDMOND AND SISTERS) HIGH LAKES HEALTH CARE (BEND, REDMOND AND SISTERS).CROOK COUNTY: (ST. CHARLES PRINEVILLE) INFORMATION TAKEN FROM UNITED STATES CENSUS BUREAU (HTTPS://WWW.CENSUS.GOV/QUICKFACTS/FACT/TABLE/CROOKCOUNTYOREGON) UNLESS OTHERWISE NOTED: RURALMEDICALLY UNDERSERVED AREA (MUA)LAND AREA IN SQUARE MILES (2020): 2.979POPULATION (2022 ESTIMATE): 26,375UNDER 5 YEARS: 5.3%UNDER 18 YEARS: 19.9%65 YEARS AND OVER: 25.2%FEMALE: 49.9%HOUSEHOLDS (2017-2021): 9,951PERSONS PER HOUSEHOLD (2017-2021): 2.43 MEDIAN HOUSEHOLD INCOME (2017-2021): $64,820PERCENTAGE OF PERSONS BELOW POVERTY LEVEL (2017-2021): 12.0%HIGH SCHOOL GRADUATE OR HIGHER, PERCENT OF PERSONS AGE 25+ (2017-2021): 90.8%POPULATION BY RACE (2021):WHITE ALONE, NOT HISPANIC: 94.4% HISPANIC OR LATINO: 8%TWO OR MORE RACES: 2.6%AMERICAN INDIAN AND ALASKA NATIVE ALONE: 1.8% ASIAN ALONE: 0.7%BLACK OR AFRICAN AMERICAN ALONE: 0.5%NATIVE HAWAIIAN OR OTHER PACIFIC ISLANDER: 0.1%HEALTH CARE PROVIDER ASSETS IN CROOK COUNTY (OUTSIDE OF ST. CHARLES PRINEVILLE): MOSAIC MEDICAL (FQHC)CROOK KIDS CLINIC (SCHOOL-BASED HEALTH CENTER PARTNERSHIP BETWEEN MOSAIC MEDICAL AND CROOK COUNTY SCHOOL DISTRICT).JEFFERSON COUNTY: (ST. CHARLES MADRAS) INFORMATION TAKEN FROM UNITED STATES CENSUS BUREAU (HTTPS://WWW.CENSUS.GOV/QUICKFACTS/FACT/TABLE/JEFFERSONCOUNTYOREGON)UNLESS OTHERWISE NOTED: RURALMEDICALLY UNDERSERVED AREA (MUA)LAND AREA IN SQUARE MILES (2020): 1,782POPULATION (2022 ESTIMATE): 25,330UNDER 5 YEARS: 5.9%UNDER 18 YEARS: 23.3%65 YEARS AND OVER: 19.7%FEMALE: 48.0%HOUSEHOLDS (2017-2021): 8,244PERSONS PER HOUSEHOLD (2017-2021): 2.79MEDIAN HOUSEHOLD INCOME (2017-2021): $59,748PERCENTAGE OF PERSONS BELOW POVERTY LEVEL (2017-2021): 15.9%HIGH SCHOOL GRADUATE OR HIGHER, PERCENT OF PERSONS AGE 25+ (2015-2019): 87.8%POPULATION BY RACE (2022):WHITE ALONE, NOT HISPANIC: 75.7% HISPANIC OR LATINO: 20.8%TWO OR MORE RACES: 3.7%AMERICAN INDIAN AND ALASKA NATIVE ALONE: 18.3%
Part VI, Line 4 - Community Building Activities Our community building activities focused on workforce development activities which support the community by offering the expertise and resources of our hospital systems caregivers for the betterment of the community. Specifically these programs address community-wide workforce issues, potentially providing health care workers to promote the health of the community.
Part VI, Line 5 - Promotion of Community Health SCHS provides services without charge, or at amounts less than its established rates, to patients who meet the criteria of its charity care policy. SCHS criteria for the determination of charity care include the patientsor other responsible partys annual household income, number of people in the home and amount claimed on taxes, credit history, existing medical debt obligations and other indicators of the patient's ability to pay. Generally, those individuals with an annual household income at or less than 300% of the Federal Poverty Guidelines (the Guidelines) qualify for charity care under SCHS policy. In addition, SCHS provides discounts on a sliding scale to those individuals with an annual household income of between 300% and 400% of the Guidelines. Since SCHS does not pursue collection of amounts determined to qualify as charity care, those amounts are not reported as net patient service revenue.BECAUSE MADRAS PRINEVILLE AND LA PINE ARE LOCATED IN MEDICALLY UNDERSERVED AREAS(MUAS), THE RESOURCES USED FOR PROVIDER RECRUITMENT IN THOSE COMMUNITIES ARE COUNTED AS COMMUNITY BENEFIT. ST. CHARLES ALSO ALLOWS NURSING STUDENTS, HIGH SCHOOL STUDENTS AND OTHER PROVIDERS TO PARTAKE IN JOB-SHADOWING WITH OUR PAID CAREGIVERS TO HELP THEM COMPLETE THEIR COURSE WORK AND/OR EARN CREDITS, WITHOUT RESTRICTIONS RELATED TO FUTURE EMPLOYMENT. THE ST. CHARLES HEALTH SYSTEM BOARD OF DIRECTORS IS COMPRISED OF MEMBERS FROM MULTIPLE COMMUNITIES SERVED BY THE SYSTEMBEND, PRINEVILLE, SISTERS,ETC.ALLOWING FOR DIVERSE VIEWS AND LEADERSHIP RELATED TO PROMOTING THE HEALTH OF THE COMMUNITY. VARIOUS COMMUNITY CLASSES ARE OFFERED VIRTUALLY OR IN PERSON FOR EACH CAMPUS, INCLUDING CHILDBIRTH EDUCATION, HEALTH HEART EDUCATION, ETC. IN ORDER TO CONTINUE TO PROMOTE HEALTH IN THE COMMUNITY AND ELIMINATE BARRIERS, SCHOLARSHIPS ARE AVAILABLE FOR THOSE WHO ARE UNABLE TO PAY BUT WOULD STILL LIKE TO PARTICIPATE IN ANY OF THESE CLASSES. DUE TO COVID-19, WE SHIFTED RESOURCES AND ASSETS TO COLLABORATING WITH OUR LOCAL PARTNERS TO HELP TACKLE THE ISSUES THAT HAVE ARISED BECAUSE OF THE PANDEMIC. BEING THE ONLY HEALTH CARE SYSTEM IN CENTRAL OREGON, MANY NON-PROFIT COMMUNITYORGANIZATIONS COME TO ST. CHARLES NEEDING FUNDS AND OTHER DONATIONS, SUCH AS IN-KIND SUPPORT. DURING 2021 ST. CHARLES FACILITY CAREGIVERS PROVIDED HUNDREDS OF HOURS OF IN-KIND SUPPORT TO THESE ORGANIZATIONS WHO SHARE IN ST. CHARLES VISION OF CREATING AMERICAS HEALTHIEST COMMUNITY, TOGETHER. IN-KIND SUPPORT ACTIVITIES INCLUDE BUT ARE NOT LIMITED TO MEMBERSHIP ON NON-PROFIT COMMUNITY ORGANIZATION BOARDS, BELOW FAIRMARKET VALUE RENT FEES, FREE CLEANING AND LANDSCAPING SERVICES AND HOURS SPENT COORDINATING EVENTS PROMOTING HEALTH IMPROVEMENT FOR VULNERABLE AND LOW-INCOME COMMUNITY MEMBERS.
Part VI, Line 7 - States Filing of Community Benefit Report OR
Part VI - Additional Information URL of CHNA and Implementation Strategy:https://www.stcharleshealthcare.org/community-health/community-health-needs-assessmentWebsite where FAP, FAP application, and plain language summary was widely available:https://www.stcharleshealthcare.org/patients/billing-and-insurance/patient-financial-assistance
Schedule H (Form 990) 2022
Additional Data


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