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 Vincent Seton Specialty Hospital Inc
 
Employer identification number

35-1712001
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

 

No
b
If "Yes," did the organization's financial assistance expenses exceed the budgeted amount? . . . . . .
5b
 
 
c
If "Yes" to line 5b, as a result of budget considerations, was the organization unable to provide free or discountedcare to a patient who was eligibile for free or discounted care? . . . . . . . . . . . . .
5c
 
 
6a
Did the organization prepare a community benefit report during the tax year? . . . . . . . . .
6a
Yes
 
b
If "Yes," did the organization make it available to the public? . . . . . . . . . . . . .
6b
Yes
 
Complete the following table using the worksheets provided in the Schedule H instructions. Do not submit these worksheets with the Schedule H.
7
Financial Assistance and Certain Other Community Benefits at Cost
Financial Assistance and
Means-Tested
Government Programs
(a) Number of activities or programs (optional) (b) Persons served (optional) (c) Total community benefit expense (d) Direct offsetting revenue (e) Net community benefit expense (f) Percent of total expense
a Financial Assistance at cost
(from Worksheet 1) . . .
    152,164   152,164 0.83 %
b Medicaid (from Worksheet 3, column a) . . . . .     1,158,663   1,158,663 6.29 %
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 1,310,827 0 1,310,827 7.12 %
Other Benefits
e Community health improvement services and community benefit operations (from Worksheet 4). 2 2 73,764 898 72,866 0.40 %
f Health professions education (from Worksheet 5) . . . 2 172 86,376 0 86,376 0.47 %
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) . . . .         0 0 %
j Total. Other Benefits . . 4 174 160,140 898 159,242 0.87 %
k Total. Add lines 7d and 7j . 4 174 1,470,967 898 1,470,069 7.99 %
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         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 Healthcare 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
33,675
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
7,413,390
6
Enter Medicare allowable costs of care relating to payments on line 5.....
6
11,354,887
7
Subtract line 6 from line 5. This is the surplus (or shortfall)........
7
-3,941,497
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) 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?1Name, 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 ASCENSION ST VINCENT SETON SPECIALTY HOSPITAL
8050 TOWNSHIP LINE ROAD
INDIANAPOLIS,IN46260
https://healthcare.ascension.org/locations/indiana/ineva/indianapolis-ascension-st-vincent-seton
22-003350-1
X                  
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)
ASCENSION ST VINCENT SETON SPECIALTY HOSPITAL
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 21
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 21
10 Is the hospital facility's most recently adopted implementation strategy posted on a website?......... 10 Yes  
a If "Yes" (list url): https://healthcare.ascension.org/CHNA
b If "No," is the hospital facility’s most recently adopted implementation strategy attached to this return? ...... 10b    
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)
ASCENSION ST VINCENT SETON SPECIALTY HOSPITAL
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
http://healthcare.ascension.org/financial-assistance/Indiana
b
http://healthcare.ascension.org/financial-assistance/Indiana
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
ASCENSION ST VINCENT SETON SPECIALTY HOSPITAL
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)
ASCENSION ST VINCENT SETON SPECIALTY HOSPITAL
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
Schedule H, Part V, Section B, Line 3E In Ascension St. Vincent Seton Specialty Hospital's most recent CHNA, significant health needs of the community were identified after analyzing secondary data and primary data from community, public health, and associate input. The process for identifying significant health needs as well as the prioritization process is as follows. Existing Health Indicator Data (also known as secondary data) - In collaboration with healthcare consultants, the hospital reviewed a variety of community health indicators for the county, which were benchmarked against state-wide, peer county, and national averages. The CHNA identifies certain health issues as significant if indicators benchmark unfavorably. Following the review of this data, key insights were incorporated into CHNA activities and considered during the selection of health priorities. Community, Public Health, and Associate Input (also known as primary data) - Multiple methods were used to gather input, including community input meetings, a hospital input meeting, and key informant interviews. The community input meetings and key stakeholder interviews were conducted in collaboration with other Indiana health systems, when possible, which included IU Health, Community Health Network, Riverview Health, and the Rehabilitation Hospital of Indiana. Additionally, Ascension St. Vincent Seton Specialty Hospital collected primary data through a hospital input meeting with associates who had grassroots knowledge of the needs of the community. A concerted effort was made to ensure that the individuals and organizations represented the needs and perspectives of 1) public health practice and research; 2) individuals who are medically underserved, are low-income, or considered among the minority populations served by the hospital; and 3) the broader community at large and those who represent the broad interests and needs of the community served. Health Needs Prioritization Session - Ascension St. Vincent Seton Specialty Hospital used a phased prioritization approach to identify the needs within Marion County. The first step was to determine the broader set of identified needs. Through the CHNA, identified needs were then narrowed to a set of significant needs which were determined most crucial for community stakeholders to address. Following the completion of the CHNA, significant needs were further narrowed down to a set of prioritized needs that the hospital will address within the Implementation Strategy. To arrive at the prioritized needs, Ascension St. Vincent Seton Specialty Hospital used the following process and criteria: hospital leaders reviewed the 2021 CHNA significant health needs and the data used to define each as significant, then voted on the top 3-5 needs they determined the hospital could address in the next three years. The criteria used to prioritize the significant needs were: Alignment with the organization's mission, values, and strategic priorities. Alignment with existing service and area of expertise. Concern for low-income or vulnerable persons. Ability for organization to have an impact. Ability to leverage organizational assets. Consequently, after all hospitals had prioritized their top three to five needs, the two most commonly prioritized needs across the system were determined to be the system-wide health improvement priorities, and the most commonly prioritized need across a region was determined to be a region-wide health improvement priority. Most hospital's implementation strategy addresses three needs: two system-wide and one region-wide. See Schedule H, Part V, Line 7 for the link to the CHNA and Schedule H, Part V, Line 11 for how those needs are being addressed.
Schedule H, Part V, Section B, Line 5 Facility , 1 Facility , 1 - Ascension St. Vincent Seton Specialty. Recognizing its vital importance to understanding the health needs and assets of the community, Ascension St. Vincent Seton Specialty Hospital consulted with a range of public health and social service providers that represent the broad interests of residents of Marion County. Multiple methods were used to gather community input, including community input meetings, a hospital input meeting with hospital staff, and key informant interviews. A summary of the process and results is outlined below. Four community input meetings were conducted by Verite Healthcare Consulting in May and June 2021 to gather feedback on the health needs and assets of Marion County. Fifty-three (53) individuals participated in the Marion County community meetings. These individuals represented organizations including local health departments, non-profit organizations, faith-based organizations, health care providers, and local policymakers. The organizations that participated in the community input meetings are the following: Allen Chapel A.M.E. Church, Indianapolis City Council, Anthem Medicaid, Indianapolis City-County Council, Broadway United Methodist Church, Indianapolis Neighborhood Housing Partnership, City of Indianapolis (Division of Community Nutrition and Food Policy), Indianapolis Public Transportation Corporation (IndyGo), Coalition for Our Immigrant Neighbors, Indianapolis Urban League, Concerned Clergy of Indianapolis, Indy Hunger Network, Connections IN Health, Jump IN for Healthy Kids, Connections IN Health - IU School of Medicine, Managed Health Services (MHS), Covering Kids & Families of Indiana, Marian University, Crossroads A.M.E. Church, Marian University - College of Osteopathic Medicine, First Baptist Church North Indianapolis, Marion County Public Health Department, Gennesaret Free Clinic, Neighborhood Christian Legal Clinic, Gleaners Food Bank of Indiana, Nine13sports, Habitat for Humanity of Greater Indianapolis, Nurse Family Partnership - Goodwill of Central and Southern Indiana, Health by Design, Office of Representative Andre Carson, Horizon House, Pathway to Recovery, Immigrant Welcome Center, Playworks Indiana, Indiana Civil Rights Commission (American Indian and Asian), Raphael Health Center, Indiana Clinical and Translational Sciences Institute (CTSI), Richard M. Fairbanks Foundation, Indiana Legal Services, The Julian Center, Indiana Public Health Association, Top 10 Coalition, Indiana State Department of Health, University of Indianapolis, Indiana University Richard M. Fairbanks School of Public Health, and YMCA of Greater Indianapolis. A hospital input meeting was conducted by Verite Healthcare Consulting in November 2021 to gather feedback from hospital staff on the health needs and assets of Marion County. Three individuals participated and completed a post-meeting survey to identify significant community needs. These staff included nursing leadership, clinicians, and others. Finally, an interview was conducted with a local public health department representative to obtain subject-matter expertise regarding health needs in Marion County. Questions focused, first, on identifying and discussing health issues in the community before the COVID-19 pandemic began. Questions then focused on the pandemic's impacts and on what has been learned about the community's health given those impacts. The individuals and organizations that participated represented a variety of vulnerable populations, which included individuals who are medically underserved (census tracts in Indianapolis and central Marion County are designed as MUA and the lower income population of the Northwest Side have been designed as MUPs), living in poverty, struggling to meet basic needs (including housing and food insecurity), experiencing addiction, seeking government assistance, victims of domestic violence and/or neglect, senior citizens, and/or experiencing racial/ethnic health disparities. Additionally, the Marion County Public Health Department represented the needs of these vulnerable populations via their public health expertise.
Schedule H, Part V, Section B, Line 6a Facility , 1 Facility , 1 - Ascension St. Vincent Seton Specialty. Ascension St. Vincent Seton Specialty Hospital also collaborated with other Indiana health systems to collect primary data through online community input meetings and key stakeholder interviews. These health systems include IU Health, Community Health Network, Riverview Health, and the Rehabilitation Hospital of Indiana. Ascension St. Vincent Seton Specialty Hospital also collaborated with other hospitals that are members of Ascension St. Vincent.
Schedule H, Part V, Section B, Line 11 Facility , 1 Facility , 1 - Ascension St. Vincent Seton Specialty. In Ascension St. Vincent Seton Specialty Hospital's most recent CHNA, the following were identified as significant needs in the community: Access to Care; COVID-19 Pandemic; Food Security; Mental Health Status and Access to Mental Health Services; Obesity, PHYSICAL INACTIVITY, AND ASSOCIATED CHRONIC DISEASE; Social Determinants of Health, including Poverty, Affordable Housing, Food Insecurity, and Transportation; Smoking and Tobacco Use; and Violence and Crime. The FY2023-2025 Implementation Strategy specifically addresses Access to Care and Mental Health in the following ways: Access to Care - The goal of the initiative is to increase access to comprehensive, high-quality health care services (Healthy People 2030). The hospital will do this through various strategies, which include the evidence-based approach called Pathways, utilized by the hospital's health advocates, to assist individuals with accessing various health, human, and social services. Specifically, the hospital will focus on increasing the proportion of people with a usual primary care provider by increasing the number of patients established with a medical home by 2.0% each year, amongst individuals who complete a Medical Home Pathway, from baseline established in FY2023. Also, the hospital will focus on increasing the proportion of people with health insurance by 5.0% each year, amongst individuals who complete an enrollment pathway, from baseline established in FY2023. Finally, in an effort to work collaboratively with community groups and organizations, the hospital will strengthen community engagement by supporting coalitions and implementing partners to improve access to care. During FY23, the hospital established the following baselines: 5 individuals were connected to a medical home and 17 individuals obtained health insurance. Mental Health - The goal of the initiative is to improve mental health (Healthy People 2030). The strategy is based on the HP2030 Mental Health and Mental Disorders objective: Reduce the suicide rate (MHMD-01). The hospital will collaborate with the Ascension St. Vincent Stress Center, to offer at least one QPR (Question, Persuade, Refer) training to the community at no charge by the end of the implementation strategy cycle. The target population will include community members, first responders, educators, students, and faith-based organizations. Additionally, this initiative includes a community engagement objective. The hospital will strengthen community engagement to expand the reach of evidence-based programs, advocacy, and/or services through financial support, facilitation, and/or promotion to improve mental health. During FY23, the hospital completed the following planning steps: identified a lead, determined individual roles and expectations and updated resource lists from the previous I.S. cycle to reflect possible collaborating organizations. Community Engagement - The goal of the community engagement initiative is to strengthen the hospital's strategies that respond to the market-wide and regional-wide prioritized health needs. A market-wide workstream, composed of multidisciplinary hospital representatives, will assess the status, identify opportunities, make recommendations and develop a strategic plan to enhance community engagement. The hospital, with guidance from the workstream, will implement the strategic plan at a market and regional level. During FY23, the workstream was developed with regional leads, individual roles and expectations were determined and an existing assessment tool was identified. Ascension St. Vincent Seton Specialty Hospital is committed to improving community health by directly, and indirectly, addressing community needs. However, certain factors impact the hospital's ability to fully address all of the identified needs. The needs listed below are not included in Ascension St. Vincent Seton Specialty Hospital's implementation strategy for the following reasons: COVID-19 Pandemic - The hospital, together with Ascension Medical Group (AMG), a physician-led provider organization, continues to provide treatment for community members diagnosed with COVID-19, as it has done since the beginning of the pandemic. As federal, state, and local authorities are providing leadership for prevention and surveillance activities, the hospital will not directly address the COVID-19 pandemic in the current Implementation Strategy. Food Security - The hospital works to improve food security of community members through a variety of means, such as continuation of partnerships with schools to support weekend feeding programs or school nutrition programs, financial donations to charitable organizations, and/or food drives. Moreover, the hospital, together with AMG, screens patients for food insecurity and provides referrals to community resources and/or hospital-based local resources. Additionally, the hospital remains committed to partnering with community groups to address this identified health need and will continue to seek opportunities to do so. As federal, state, and local authorities, as well as community-based organizations, are working to improve food security, the hospital will not directly address this need in the current Implementation Strategy. Obesity, Physical Inactivity, and Associated Chronic Disease - The hospital, together with AMG, provides education on various health topics related to obesity, physical inactivity, and associated chronic disease through health fairs and screenings, health education, wellness programs, lectures, school health education programs, and/or community support groups. Additionally, the hospital remains committed to partnering with community groups to address these identified health needs and will continue to seek opportunities to do so. As federal, state, and local authorities, as well as community-based organizations, are working to reduce this need, the hospital will not directly address this need in their current Implementation Strategy. Smoking and Tobacco Use - The hospital, together with AMG, screens patients for tobacco use and promotes the use of the evidence-based state tobacco cessation quitline (1-800-Quit-Now). Additionally, the hospital remains committed to partnering with community groups to address this identified health issue and will continue to seek opportunities to do so. As federal, state, and local authorities, as well as community-based organizations, are working to reduce smoking and tobacco use, the hospital will not directly address this need in the current Implementation Strategy. Violence and Crime - The hospital, together with AMG, screens patients to identify safety concerns as well as for social determinants of health factors related to violence and crime. Moreover, supporting services and referrals are provided by Community Health Workers in the Ascension St. Vincent Health Access Department, to respond to violence and crime encountered by patients. Additionally, the hospital remains committed to partnering with community groups to address these identified health needs and will continue to seek opportunities to do so. As federal, state, and local authorities, as well as community-based organizations, are working to reduce violence and crime, the hospital will not directly address this need in the current Implementation Strategy. Social Determinants of Health, including poverty, affordable housing, food insecurity, and transportation - The hospital, together with AMG, screens patients for needs related to social determinants of health. Moreover, supporting services and referrals are provided by Community Health Workers in the Ascension St. Vincent Health Access Department, to meet needs, such as transportation and housing. Additionally, the hospital remains committed to partnering with community groups to address needs related to social determinants of health and will continue to seek opportunities to do so. As federal, state, and local authorities, as well as community-based organizations, are working to reduce this need, the hospital will not directly address this need in the current Implementation Strategy. While these needs are not the focus of this Implementation Strategy, Ascension St. Vincent Seton Specialty Hospital may consider investing resources in these areas as appropriate, depending on opportunities to leverage organizational assets in partnership with local communities and organizations. Also, this report does not encompass a complete inventory of everything Ascension St. Vincent Seton Specialty Hospital does to support health within the community.
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
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?0
Name and address Type of Facility (describe)
1
2
3
4
5
6
7
8
9
10
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
Schedule H, Part I, Line 3c FACTORS OTHER THAN FPG IN ADDITION TO FPG, THE ORGANIZATION USES MEDICAL INDIGENCY, ASSET TEST, INSURANCE STATUS AND RESIDENCY AS OTHER FACTORS IN DETERMINING ELIGIBILITY FOR FREE OR DISCOUNTED CARE. A PATIENT MAY NOT BE ELIGIBLE FOR THE FINANCIAL ASSISTANCE IF SUCH PATIENT IS DEEMED TO HAVE SUFFICIENT ASSETS TO PAY PURSUANT TO AN "ASSET TEST." THE ASSET TEST INVOLVES A SUBSTANTIVE ASSESSMENT OF A PATIENT'S ABILITY TO PAY BASED ON THE CATEGORIES OF ASSETS MEASURED IN THE FAP APPLICATION. A PATIENT WITH SUCH ASSETS THAT EXCEED 250% OF SUCH PATIENT'S FPL AMOUNT MAY NOT BE ELIGIBLE FOR FINANCIAL ASSISTANCE. AN ASSET TEST APPLIES IF A PATIENT HAS ELIGIBLE LIQUID ASSETS THAT EXCEED 250% OF THE PATIENT'S FPG LEVEL FOR CONSIDERATION OF FINANCIAL ASSISTANCE ELIGIBILITY. LIQUID ASSETS INCLUDE ASSETS THAT CAN BE CONVERTED TO CASH WITHIN 1 YEAR. THESE INCLUDE ITEMS SUCH AS CHECKING ACCOUNTS, SAVINGS ACCOUNTS, TRUST FUNDS AND LUXURY ITEMS SUCH AS RECREATIONAL VEHICLES, BOATS, A SECOND HOME, ETC.
Schedule H, Part I, Line 5a BUDGET AMOUNTS FOR FREE OR DISCOUNTED CARE THE ORGANIZATION ADMINISTERS ITS FINANCIAL ASSISTANCE POLICY IN ACCORDANCE WITH THE TERMS OF THE POLICY.
Schedule H, Part I, Line 7 Costing Methodology used to calculate financial assistance THE COST OF PROVIDING CHARITY CARE, MEANS-TESTED GOVERNMENT PROGRAMS, AND OTHER COMMUNITY BENEFIT PROGRAMS IS ESTIMATED USING INTERNAL COST DATA, AND IS CALCULATED IN COMPLIANCE WITH CATHOLIC HEALTH ASSOCIATION ("CHA") GUIDELINES. THE ORGANIZATION USES A COST ACCOUNTING SYSTEM THAT ADDRESSES ALL PATIENT SEGMENTS (FOR EXAMPLE, INPATIENT, OUTPATIENT, EMERGENCY ROOM, PRIVATE INSURANCE, MEDICAID, MEDICARE, UNINSURED, OR SELF PAY). THE BEST AVAILABLE DATA WAS USED TO CALCULATE THE AMOUNTS REPORTED IN THE TABLE. FOR THE INFORMATION IN THE TABLE, A COST-TO-CHARGE RATIO WAS CALCULATED AND APPLIED.
Schedule H, Part II Community Building Activities Research shows that social determinants and quality of life play a major role in the health status of individuals and communities. Community building activities, which focus on the root causes of health problems, ultimately influence and improve health status. Examples of community building activities include physical improvement and housing, economic development, community support, environmental improvements, leadership development and leadership training for community members, coalition building, advocacy for community health improvements and safety, and workforce development. During FY23, there were no community building activities to report. All reported activities qualify as community benefit and are described in the narrative under Schedule H Part I Line 7.
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 IN FISCAL YEAR 2023 WAS $105,234 AT CHARGES, ($33,675 AT COST).
Schedule H, Part III, Line 3 Bad Debt Expense Methodology BASED ON THE ORGANIZATION'S ADMINISTRATION OF ITS FINANCIAL ASSISTANCE PROGRAM, NO ESTIMATE FOR BAD DEBT ATTRIBUTABLE TO FINANCIAL ASSISTANCE ELIGIBLE PATIENTS IS DEEMED APPLICABLE TO HOSPITAL OPERATIONS.
Schedule H, Part III, Line 4 Bad debt expense - financial statement footnote THE ORGANIZATION IS PART OFASCENSION HEALTH ALLIANCE'S CONSOLIDATED AUDIT IN WHICH THE FOOTNOTE THAT DISCUSSESBAD DEBT (IMPLICIT PRICE CONCESSIONS) EXPENSE IS LOCATED IN FOOTNOTE #2, PAGES 17-19, OF THE AUDITED FINANCIAL STATEMENTS.
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 GROSS CHARGES TO CALCULATE MEDICARE COSTS, WHICH ARE THEN COMPARED TO MEDICARE PAYMENTS RECEIVED, TO DETERMINE A MEDICARE GAIN OR LOSS. 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 A MEDICARE SHORTFALL (LOSS) IS NOT TREATED AS COMMUNITY BENEFIT, EVEN THOUGH THE HOSPITAL HAS INCURRED LOSSES IN PROVIDING CARE TO MEDICARE PATIENTS. THEREFORE, NONE OF THE AMOUNT ON LINE 7 IS TREATED AS COMMUNITY BENEFIT.
Schedule H, Part III, Line 9b Collection practices for patients eligible for financial assistance ST. VINCENT SETON SPECIALTY HOSPITAL, INC. FOLLOWS THE ASCENSION GUIDELINES FOR COLLECTION PRACTICES RELATED TO PATIENTS QUALIFYING FOR CHARITY OR FINANCIAL ASSISTANCE. A PATIENT CAN APPLY FOR CHARITY OR FINANCIAL ASSISTANCE AT ANY TIME DURING THE COLLECTION CYCLE. ONCE QUALIFYING DOCUMENTATION IS RECEIVED THE PATIENT'S ACCOUNT IS ADJUSTED IF ELIGIBLE UNDER THE FINANCIAL ASSISTANCE POLICY. PATIENT ACCOUNTS FOR THE QUALIFYING PATIENT IN THE PREVIOUS SIX MONTHS MAY ALSO BE CONSIDERED FOR CHARITY OR FINANCIAL ASSISTANCE. ONCE A PATIENT QUALIFIES FOR CHARITY OR FINANCIAL ASSISTANCE, ALL COLLECTION ACTIVITY IS SUSPENDED FOR THE AMOUNTS FOR WHICH THE PATIENT QUALIFIES.
Schedule H, Part V, Section B, Line 16a FAP website - ASCENSION ST. VINCENT SETON SPECIALTY HOSPITAL: Line 16a URL: http://healthcare.ascension.org/financial-assistance/Indiana;
Schedule H, Part V, Section B, Line 16b FAP Application website - ASCENSION ST. VINCENT SETON SPECIALTY HOSPITAL: Line 16b URL: http://healthcare.ascension.org/financial-assistance/Indiana;
Schedule H, Part V, Section B, Line 16c FAP plain language summary website - ASCENSION ST. VINCENT SETON SPECIALTY HOSPITAL: Line 16c URL: http://healthcare.ascension.org/financial-assistance/Indiana;
Schedule H, Part VI, Line 2 Needs assessment ST. VINCENT SETON SPECIALTY HOSPITAL, INC. USES INTERNAL AND EXTERNAL DATA AND REPORTS FROM THIRD PARTIES, INCLUDING GOVERNMENT SOURCES, TO ASSESS THE HEALTHCARE NEEDS OF THE COMMUNITIES WE SERVE. THESE REPORTS PROVIDE KEY INFORMATION ABOUT HEALTH, SOCIOECONOMIC, AND DEMOGRAPHIC FACTORS THAT IDENTIFY AREAS OF NEED AND INFORM OUR STRATEGIES THAT HELP TO MEET THOSE NEEDS OF OUR COMMUNITY. THESE REPORTS INCLUDE, BUT ARE NOT LIMITED TO: SG2 HEALTHCARE INTELLIGENCE, CLARIFY FOR HEALTHCARE CLAIMS DATASETS, 3D HEALTH, INDIANA HOSPITAL ASSOCIATION, AND INTERNAL DATA. ST. VINCENT SETON SPECIALTY HOSPITAL, INC. UTILIZES INFORMATION FROM THESE SECONDARY SOURCES TO DEVELOP PROGRAMS AND PROVIDE APPROPRIATE SERVICES NEEDED THROUGHOUT THE REGION. IN ADDITION, ST. VINCENT SETON SPECIALTY HOSPITAL, INC. CONSIDERS THE HEALTH CARE NEEDS OF THE OVERALL COMMUNITY WHEN EVALUATING INTERNAL FINANCIAL AND OPERATIONAL DECISIONS.
Schedule H, Part VI, Line 3 Patient education of eligibility for assistance St. Vincent Seton Specialty Hospital, Inc. IS COMMITTED TO DELIVERING EFFECTIVE, SAFE, PERSON-CENTRIC, HEALTH CARE TO ALL PATIENTS REGARDLESS OF THEIR ABILITY TO PAY. AS A NONPROFIT HOSPITAL, IT IS OUR MISSION AND PRIVILEGE TO PLAY THIS IMPORTANT ROLE IN OUR COMMUNITY. STAFF SCREEN UNINSURED PATIENTS AND IF FOUND POTENTIALLY ELIGIBLE FOR A GOVERNMENT FUNDING SOURCE, PROVIDE ASSISTANCE AND/OR RESOURCES TO THE PATIENT AND THEIR FAMILY. IF A PATIENT IS NOT ELIGIBLE FOR A PAYMENT SOURCE, THE HOSPITAL'S FINANCIAL ASSISTANCE POLICY COVERS PATIENTS WHO LACK THE FINANCIAL RESOURCES TO PAY FOR ALL OR PART OF THEIR BILLS. ELIGIBILITY FOR FINANCIAL ASSISTANCE IS BASED UPON THE ANNUAL FEDERAL POVERTY GUIDELINES. St. Vincent Seton Specialty Hospital, Inc. PROVIDES FULL FINANCIAL ASSISTANCE FOR THOSE WHO EARN UP TO 250% OF THE FEDERAL POVERTY LEVEL AND SLIDING SCALE ASSISTANCE UP TO 400% OF THE FEDERAL POVERTY LEVEL. St. Vincent Seton Specialty Hospital, Inc. WIDELY PUBLICIZES ITS: - FINANCIAL ASSISTANCE POLICY - FINANCIAL ASSISTANCE APPLICATION - FINANCIAL ASSISTANCE POLICY SUMMARY - LIST OF PROVIDERS COVERED BY THE FINANCIAL ASSISTANCE POLICY VIA THE HOSPITAL FACILITY'S WEBSITE - https://healthcare.ascension.org/financial-assistance/indiana St. Vincent Seton Specialty Hospital, Inc. MAKES PAPER COPIES OF THE: - FINANCIAL ASSISTANCE POLICY - FINANCIAL ASSISTANCE APPLICATION - FINANCIAL ASSISTANCE POLICY SUMMARY - LIST OF PROVIDERS COVERED BY THE FINANCIAL ASSISTANCE POLICY - AMOUNT GENERALLY BILLED CALCULATION. THE PAPER COPIES ARE MADE READILY AVAILABLE AS PART OF THE INTAKE, DISCHARGE AND CUSTOMER SERVICE PROCESSES. UPON REQUEST, PAPER COPIES CAN ALSO BE OBTAINED BY MAIL. St. Vincent Seton Specialty Hospital, Inc. INFORMS ITS PATIENTS OF THE FINANCIAL ASSISTANCE POLICY VIA A NOTICE ON PATIENT BILLING STATEMENTS, INCLUDING THE PHONE NUMBER AND WEB ADDRESS WHERE MORE INFORMATION MAY BE FOUND. St. Vincent Seton Specialty Hospital, Inc. INFORMS ITS PATIENTS OF THE FINANCIAL ASSISTANCE POLICY VIA SIGNAGE DISPLAYED IN THE EMERGENCY ROOM AND ADMISSIONS AREAS.
Schedule H, Part VI, Line 4 Community information ST. VINCENT SETON SPECIALTY HOSPITAL, INC. SERVICES CENTRAL INDIANA WITH A 12-COUNTY PRIMARY SERVICE AREA. THE TOTAL POPULATION OF THE 12-COUNTY PRIMARY SERVICE AREA IS ESTIMATED TO BE 2,067,065 RESIDENTS IN CALENDAR 2022 AND IS EXPECTED TO INCREASE BY APPROXIMATELY 3.4% TO 2,136,639 RESIDENTS IN FIVE YEARS. THE MEDIAN HOUSEHOLD INCOME OF THE PRIMARY SERVICE AREA IS $68,925. APPROXIMATELY 11.3% OF THE SERVICE AREA RESIDENTS LIVE BELOW THE POVERTY LINE. WITHIN THE PRIMARY SERVICE AREA, THERE ARE 13 FEDERALLY DESIGNATED MEDICALLY UNDERSERVED AREAS. There are 28 acute care hospitals located within the primary service area.
Schedule H, Part VI, Line 5 Promotion of community health ST. VINCENT SETON SPECIALTY HOSPITAL, INC.'S GOVERNING BODY IS COMPRISED OF PERSONS REPRESENTING DIVERSE ASPECTS AND INTERESTS OF THE COMMUNITY. MANY MEMBERS OF ST. VINCENT SETON SPECIALTY HOSPITAL, INC.'S GOVERNING BODY RESIDE IN THE ORGANIZATION'S PRIMARY SERVICE AREA AND WHO ARE NEITHER EMPLOYEES NOR INDEPENDENT CONTRACTORS OF THE ORGANIZATION, NOR FAMILY MEMBERS THEREOF. ST. VINCENT SETON SPECIALTY HOSPITAL, INC. EXTENDS MEDICAL STAFF PRIVILEGES TO ALL QUALIFIED PHYSICIANS IN ITS COMMUNITY FOR SOME OR ALL OF ITS DEPARTMENTS OR SPECIALTIES. ST. VINCENT SETON SPECIALTY HOSPITAL, INC. APPLIES SURPLUS FUNDS TO FUND IMPROVEMENTS IN PATIENT CARE.
Schedule H, Part VI, Line 6 Affiliated health care system ST. VINCENT SETON SPECIALTY HOSPITAL, INC. IS A MEMBER OF ASCENSION. 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. ASCENSION IS SPONSORED BY ASCENSION SPONSOR, A PUBLIC JURIDIC PERSON. THE PARTICIPATING ENTITIES OF ASCENSION SPONSORS ARE THE DAUGHTERS OF CHARITY OF ST. VINCENT DE PAUL IN THE UNITED STATES, ST. LOUISE PROVINCE, THE CONGREGATION OF THE SISTERS OF ST. JOSEPH, INC., 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. ST. VINCENT SETON SPECIALTY HOSPITAL, INC. OPERATES A HOSPITAL FACILITY IN MARION COUNTY, INDIANA AND IS PART OF ASCENSION ST. VINCENT WHICH ALSO OWNS AND OPERATES OTHER HEALTHCARE RELATED ENTITIES, INCLUDING ASCENSION ST. VINCENT INDIANAPOLIS HOSPITAL. THE HEALTH SYSTEM PROVIDES INPATIENT, OUTPATIENT, AND EMERGENCY CARE SERVICES FOR RESIDENTS OF INDIANA.
Schedule H (Form 990) 2022
Additional Data


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