4A (Expenses $ 184964390 including grants of $ 194717) (Revenue $ 180934155)
ST. FRANCIS HEALTH HAS SERVED THE HEALTHCARE NEEDS OF TOPEKA, KAN., AND SURROUNDING COMMUNITIES SINCE 1909. AS PART OF SCL HEALTH, A FAITH-BASED, NONPROFIT HEALTH SYSTEM, ST. FRANCIS WORKS TO IMPROVE NOT ONLY THE HEALTH OF THOSE WE SERVE, BUT PEOPLE'S LIVES. WE BRING COMPASSIONATE CARE AND THE MOST ADVANCED TECHNOLOGY TO OUR PATIENTS BY WAY OF OUR ACUTE-CARE HOSPITAL AND MORE THAN 30 PHYSICIAN CLINICS THROUGHOUT THE REGION.ST. FRANCIS HEALTH EMBODIES A DIVERSE AND CARING COMMUNITY DEDICATED TO IMPROVING THE HEALTH AND WELFARE OF OTHERS. ST. FRANCIS EMPLOYEES HAVE PROVIDED INNOVATIVE, INSPIRED SERVICE FOR MORE THAN A CENTURY. WE CARE FOR THOUSANDS OF PATIENTS AND THEIR FAMILIES WITH THE SAME SPIRIT AND RESOLVE DEMONSTRATED BY THE RESOURCEFUL SISTERS WHO OPENED THE FACILITY. ST. FRANCIS HEALTH CENTER OPENED ON OCT. 17, 1909, WITH 40 BEDS. ASSEMBLING SCRAPS OF FABRIC AND FASHIONING THEM INTO COLORFUL QUILTS FOR PATIENTS WAS ONE OF THE FIRST ASPECTS OF BUSINESS THE SISTERS OF CHARITY OF LEAVENWORTH PURSUED. EVER MINDFUL OF THE COST OF THINGS, THEY WERE PRUDENT IN THEIR APPROACHES TO ENSURE THAT WHATEVER RESOURCES THEY HAD AVAILABLE COULD BE STRETCHED TO ACCOMMODATE THE NEEDS OF EVERYONE WHO SOUGHT ASSISTANCE FOR THEIR AILMENTS. TODAY, THE HOSPITAL HAS A MEDICAL STAFF REPRESENTING NEARLY ALL SPECIALTIES, ADULT AND YOUTH VOLUNTEERS AND A THRIVING AUXILIARY. SKILLFULLY INTEGRATING TECHNOLOGY WITH TENDERNESS, ST. FRANCIS AND ITS EMPLOYEES HAVE FOSTERED A PREMIER REGIONAL HOSPITAL FEATURING THE NEWEST MEDICAL INNOVATIONS AND STATE-OF-THE-ART EQUIPMENT. ST. FRANCIS WAS THE FIRST IN THE AREA TO PURCHASE AN X-RAY MACHINE, ESTABLISH AN INTENSIVE CARE UNIT, INSTALL DIAGNOSTIC ULTRASOUND EQUIPMENT, CONDUCT A HEART TRANSPLANT, USE BEDSIDE COMPUTERS TO PROVIDE POINT OF SERVICE DOCUMENTATION AND PURCHASE A POSITRON EMISSION TOMOGRAPHY (PET) SCANNER. THE HOSPITAL IS ALSO ONE OF ONLY TWO NON-VETERANS ADMINISTRATION HOSPITALS IN KANSAS TO BAR CODE PHARMACEUTICALS TO PREVENT MEDICATION ERRORS FOR PATIENT SAFETY AND PEACE OF MIND. THE HEALING TOUCH OF ST. FRANCIS EXTENDS BEYOND THE WALLS OF THE HOSPITAL TO INCLUDE PROGRAMS FOCUSED ON PREVENTIVE MEDICINE, SUCH AS THE BREAST CENTER AND ITS SPIRIT OF WOMEN HEALTH IMPROVEMENT EVENTS AND PROGRAMS. THROUGH THE MARIAN DENTAL CLINIC, ST. FRANCIS HELPS THE WORKING POOR AND THE UNINSURED SECURE THE TREATMENT THEY NEED, FROM ROUTINE TEETH CLEANING TO CROWN AND DENTURE WORK.MISSIONWE REVEAL AND FOSTER GOD'S HEALING LOVE BY IMPROVING THE HEALTH OF THE PEOPLE AND COMMUNITIES WE SERVE, ESPECIALLY THOSE WHO ARE POOR AND VULNERABLE. VISIONINSPIRED BY OUR FAITH:WE WILL BE DISTINGUISHED AS THE TRUSTED PERSON-CENTERED PARTNER TO THOSE WHO ENGAGE WITH US IN THEIR PHYSICAL, MENTAL AND SPIRITUAL HEALTH DECISIONS.WE WILL SHARE ACCOUNTABILITY WITH OUR CLINICIANS, ASSOCIATES AND AFFILIATED STAKEHOLDERS TO DELIVER EXCEPTIONAL CARE THAT IS WELL-COORDINATED, ACCESSIBLE, AFFORDABLE, SAFE, AND RESULTS IN OPTIMAL OUTCOMES FOR INDIVIDUALS AND POPULATIONS.WE WILL GROW AS COMMUNITY-BASED HEALTH NETWORKS IN PARTNERSHIP WITH OTHERS WHO SHARE OUR VISION AND VALUES AND ALIGN WITH US TO BE AN ESSENTIAL PROVIDER TO THOSE WE SERVE.VALUES CARING SPIRIT WE HONOR THE SACRED DIGNITY OF EACH PERSON. EXCELLENCE WE SET AND SURPASS HIGH STANDARDS. GOOD HUMOR WE CREATE JOYFUL AND WELCOMING ENVIRONMENTS. INTEGRITY WE DO THE RIGHT THING WITH OPENNESS AND PRIDE. SAFETY WE DELIVER CARE THAT SEEKS TO ELIMINATE ALL HARM FOR PATIENTS AND ASSOCIATES. STEWARDSHIP WE ARE ACCOUNTABLE FOR THE RESOURCES ENTRUSTED TO US.ST. FRANCIS HEALTH CENTER IS A FULL-SERVICE HOSPITAL WITH A VARIETY OF HEALTHCARE SERVICES TO CARE FOR AND KEEP OUR COMMUNITY HEALTHY:ANTICOAGULATION CLINIC, BARIATRIC SERVICE, CARDIOLOGY SERVICES, CENTER FOR INFANT AND CHILD HEALTH, COMPREHENSIVE CANCER CENTER, COUMADIN CLINIC, DA VINCI SURGICAL ROBOT SERVICES, DIABETES CENTER, DIAGNOSTIC SERVICES, EMERGENCY SERVICES, FAMILY MEDICINE, HOME CARE, IMAGING CENTER, JOINT REPLACEMENT CENTER, LABORATORY SERVICES, NEUROLOGY SERVICES, NEW LIFE CENTER, OCCUPATIONAL MEDICINE, PAIN MANAGEMENT, PRIMARY CARE, PEDIATRICS, PULMONOLOGY REHABILITATION SERVICES, SPINE CENTER, SPORTS MEDICINE, VEIN CLINIC, WOMEN'S SERVICES, WOUND CENTER.FORM 990, PART VI, SECTION A, LINE 1A:VOTING MEMBERS OF THE GOVERNING BODY AT THE END OF THE YEAR THE BOARD OF DIRECTORS DISBANDED WITH THE SALE OF THE ASSETS AND OPERATIONS OF ST. FRANCIS HEALTH CENTER. THEREFORE THERE WERE NO VOTING BOARD MEMBERS AS OF THE END OF 2017. ST. FRANCIS HEALTH CENTER IS CURRENTLY WINDING DOWN OPERATIONS AND DISBURSING REMAINING FUNDS IN ACCORDANCE WITH THE ORGANIZING DOCUMENTS.

ST. FRANCIS HEALTH CENTER, INC.
PART V, SECTION B, LINE 5: THE 2016 SHAWNEE COUNTY COMMUNITY HEALTH NEEDS ASSESSMENT WHICH IS A COLLABORATIVE CHNA PROCESS BETWEEN ST. FRANCIS HEALTH, STORMONT VAIL HEALTH, AND SHAWNEE COUNTY HEALTH AGENCY - SOLICITED AND RECEIVED INPUT FROM A VARIETY OF SOURCES REPRESENTING THE BROAD SPECTRUM OF THE COMMUNITY. THE FIRST AND MOST IMPORTANT SOURCE WAS THE LEADERSHIP OF SHAWNEE COUNTY HEALTH AGENCY ON THE TEAM. THE PUBLIC HEALTH PERSPECTIVE IS VERY DIFFERENT FROM THE ACUTE CARE APPROACH OF THE TWO HOSPITALS, SO THEY PROVIDE AN IMPORTANT CONNECTION TO THE LARGER COMMUNITY HEALTH ISSUES.THE SECOND SOURCE OF COMMUNITY INPUT WAS GATHERED FROM THE HEARTLAND HEALTHY NEIGHBORHOODS FOCUS GROUPS. MANY OF THE 62 PARTICIPANTS WORK FOR ORGANIZATIONS REPRESENTING MEDICALLY UNDERSERVED, LOW-INCOME, AND MINORITY POPULATIONS. THESE INCLUDED BIKEWAYS/CITY OF TOPEKA, BLUE CROSS AND BLUE SHIELD OF KANSAS, CAPITAL CARE TRASITIONS COALITION, CITY OF TOPEKA, HEALTH ACCESS, FAMILY SERVICE AND GUIDANCE CENTER, KANSAS BREASTFEEDING COALITION INC., KANSAS DEPARTMENT OF HEALTH AND ENVIRONMENT, MARIAN CLINIC, SAFE STREETS COALITION, TOPEKA METROPOLITAN TRANSIT AUTHORITY, UNITED WAY AND TOPEKA PUBLIC SCHOOLS. A COMPLETE LIST IS AVAILABLE IN APPENDIX 1 OF THE CHNA WHICH LISTS THE 42 ORGANIZATIONS/AGENCIES THAT PARTICIPATED IN THESE FOCUS GROUPS. THE THIRD SOURCE OF COMMUNITY INPUT WAS GATHERED THROUGH AN EMAIL SURVEY. THIS SURVEY WAS SENT TO HEARTLAND HEALTHY NEIGHBORHOOD RESIDENTS WITH INSTRUCTIONS TO FORWARD IT ON TO OTHER CONTACTS. THE SURVEY WAS ALSO AVAILABLE THROUGH THE COMMUNITY RESOURCE COUNCIL'S ELECTRONIC NEWSLETTER. EMPLOYEES OF THE HEALTHY SHAWNEE COUNTY TASK FORCE MEMBERS ALSO RECEIVED THE SURVEY. A TOTAL OF 1362 COMPLETED SURVEYS WERE RECEIVED. THE FOURTH SOURCE OF COMMUNITY INPUT WAS GATHERED FROM INTERVIEWS OF PERSONS WITH PUBLIC HEALTH EXPERTISE AND INSIGHT. 12 KEY COMMUNITY PROVIDERS WERE INTERVIEWED. AMONG THOSE INTERVIEWED INCLUDED THE EMERGENCY DEPARTMENT DIRECTORS OF BOTH HOSPITALS, THE MEDICAL DIRECTORS OF BOTH HOSPITALS, AND THE DIRECTORS OF BOTH COMMUNITY SAFETY NET CLINICS, PRIMARY CARE PHYSICIANS AND COMMUNITY HEALTH LEADERS.

ST. FRANCIS HEALTH CENTER, INC.
PART V, SECTION B, LINE 6A: AS PART OF THE HEALTHY SHAWNEE COUNTY TASK FORCE, THE ST. FRANCIS HEALTH CENTER CHNA WAS CONDUCTED IN A PARTNERSHIP WITH STORMONT-VAIL HEALTHCARE HOSPITAL FACILITY.

ST. FRANCIS HEALTH CENTER, INC.
PART V, SECTION B, LINE 6B: SHAWNEE COUNTY HEALTH AGENCY WAS THE OTHER PRIMARY PARTNER IN THE CHNA PROCESS. HOWEVER THERE WERE NUMEROUS COMMUNITY BASED ORGANIZATIONS THAT WERE INCLUDED AS A PART OF GATHERING INSIGHTS ON COMMUNITY ISSUES. THESE ARE INCLUDED IN APPENDIX 1 OF THE CHNA REPORT AND ARE REFLECTED IN THE PARTIAL LISTING OF ORGANIZATIONS DESCRIBED IN PART 5, SECTION C, QUESTION 5.ST. FRANCIS HEALTH CENTER:PART V, SECTION B, LINE 7A: WWW.STFRANCISTOPEKA.ORG/ABOUT-US/COMMUNITY-HEALTH-NEEDS-ASSESSMENT/THIS WEB ADDRESS WAS ACTIVE PRIOR TO THE SALE OF THE ST. FRANCIS HEALTH CENTER FACILITY AND OPERATIONS ON NOVEMBER 1, 2017.ST. FRANCIS HEALTH CENTER:PART V, SECTION B, LINE 10A: WWW.STFRANCISTOPEKA.ORG/ABOUT-US/COMMUNITY-HEALTH-NEEDS-ASSESSMENT/THIS WEB ADDRESS WAS ACTIVE PRIOR TO THE SALE OF THE ST. FRANCIS HEALTH CENTER FACILITY AND OPERATIONS ON NOVEMBER 1, 2017.

ST. FRANCIS HEALTH CENTER, INC.
"PART V, SECTION B, LINE 11: EIGHT COMMUNITY HEALTH NEEDS WERE IDENTIFIED IN THE 2016 CHNA PROCESS. THE NEEDS CATEGORIES WERE: HEALTHY EATING, ACTIVE LIVING, MENTAL HEALTH, SUBSTANCE ABUSE, BABIES/YOUTH HEALTH, ACCESS TO CARE, CHRONIC ILLNESS, AND SOCIAL DETERMINANTS OF HEALTH. EACH NEED AREA WAS EVALUATED BASED ON THE ORGANIZATION'S EXPERTISE, ABILITY TO CREATE MEANINGFUL IMPACT AND AVAILABILITY OF RESOURCES. THREE TOP PRIORITIES WERE SELECTED FOR FOCUS, INCLUDING:1. HEALTHY EATING2. SUBSTANCE ABUSE, WITH A POINTED FOCUS ON TOBACCO3. ACCESS TO CAREWITH THE CONTINUATION OF WORK FROM THE PREVIOUS IMPLEMENTATION PLAN YEAR (2016) AND THE IDENTIFICATION OF PRIORITIES FROM THE 2016 CHNA, ST. FRANCIS HEALTH IS ADDRESSING THE SIGNIFICANT COMMUNITY HEALTH NEEDS THROUGH THE FOLLOWING ACTIONS: - PROVIDE REGULARLY SCHEDULED PUBLIC FORUMS, FREE OF CHARGE - INCLUDING BABY FAIR WITH EDUCATIONAL SESSIONS ON PRENATAL CARE AND HEALTHY PARENTING; EDUCATIONAL SESSIONS WITH CARDIOLOGISTS AND ONCOLOGISTS ON HEALTH RISKS AND PREVENTION /MANAGEMENT OF MAJOR DISEASES (DIABETES, HIGH BLOOD PRESSURE, HIGH CHOLESTEROL AND ARTHRITIS. - CONTINUED COLLABORATION WITH COMMUNITY PARTNERS TO IDENTIFY AND SUPPORT CENTRALIZED ACCESS RESOURCES THROUGH INVOLVEMENT IN HEARTLAND HEALTHY NEIGHBORHOOD COMMUNITY WIDE IMPROVEMENT PROCESS WITH PARTICIPATION OF KEY ST. FRANCIS LEADERS PARTICIPATING IN WORKGROUP ACTIVITIES. - MAINTAINED COLLABORATIONS WHICH PROVIDE SERVICES TO IDENTIFIED VULNERABLE POPULATIONS - INCLUDING PARTNERSHIP WITH VALEO BEHAVIORAL HEALTH AND WASHBURN UNIVERSITY FOR INCREASED ACCESS TO PRIMARY CARE FOR MENTAL HEALTH PATIENTS; CONTINUED FINANCIAL AND OPERATIONAL SUPPORT TO MARIAN DENTAL CLINIC; AND PARTICIPATION AND SUPPORT OF THE SAFETY NET SUMMIT GROUP WITH PLANNED IMPLEMENTATION WITH SHAWNEE COUNTY HEALTH DEPARTMENT. - PARTICIPATE IN ACTIVITIES AND SERVICES WHICH INCREASE ACCESS AND AFFORDABILITY OF HEALTHCARE SERVICES, INCLUDING - PROVIDING EDUCATION TO PUBLIC ON INSURANCE COVERAGE AND FINANCIAL PLANNING FOR HEALTH CARE; PROVIDING COUNSELING TO INPATIENTS WHO LACK HEALTH INSURANCE COVERAGE BY CERTIFIED COUNSELORS; PROVIDING COUNSEL TO PUBLIC REGARDING QUESTIONS WITH INSURANCE COVERAGE THROUGH ACA; MAINTAINING EDUCATIONAL INFORMATION REGARDING INSURANCE COVERAGE AVAILABLE TO PUBLIC ONLINE. - PARTICIPATES IN AND CREATE OPPORTUNITY FOR ACTIVITIES AND SERVICES WHICH INCREASE AWARENESS OF HEALTHY EATING AND ACTIVE LIVING BY DELIVERING COMMUNITY WELLNESS EVENTS, SUCH AS THE WILD WELLNESS EVENT, FOCUSED ON TEACHING FAMILIES THE IMPORTANCE OF HEALTHY/BALANCED DIETS, DAILY PHYSICAL FITNESS, AND ROUTINE PREVENTIVE CARE; CREATED STRATEGIC PLAN FOR DELIVERY OF ""MASTER GOOD HEALTH"" FITNESS AND HEALTHY EATING PROGRAMS THROUGH SOCIAL MEDIA PLATFORMS AVAILABLE TO THE BROAD COMMUNITY THROUGH 2017. - IMPLEMENTED PARTNERSHIP WITH MULTIPLE COMMUNITY ORGANIZATIONS TO INCREASE ACCESS TO HEALTHY FOODS FOR PATIENTS AND SURROUNDING NEIGHBORHOOD - FOOD BANKS, UNITED WAY, AND SENIOR RESOURCES. - PROVIDE EXPERTISE AND AWARENESS OF SUBSTANCE ABUSE ISSUES IN COMMUNITY THROUGH EDUCATION AND PLANNING FOR PATIENTS WHO USE TOBACCO PRODUCTS TO RAISE AWARENESS OF HEALTH EFFECTS OF TOBACCO USE AND THE BENEFITS OF QUITTING FOR HEALTH AND WELLNESS. - PROVIDE EMPLOYEES WITH OPPORTUNITIES FOR HEALTHY EATING AND PHYSICAL ACTIVITY AT WORK THROUGH HEALTHY MEAL REWARDS PROGRAM; OFFERING HEALTHY EATING DEMONSTRATIONS AND FOOD SAMPLING; INCREASED THE NUMBER OF HEALTHY MEAL AND SNACK OPTIONS FOR EMPLOYEES AND VISITORS; INCREASED WELLNESS AWARENESS AND INCENTIVE OPTIONS THROUGH BIOMETRIC SCREENING FAIR AND ONLINE EDUCATIONAL OPPORTUNITIES. - ST FRANCIS HEALTH HAS INITIATED AND CONTINUED FOCUS ON PRENATAL CARE EDUCATION, HEALTHY NUTRITION, AND SAFE PARENTIG PRACTICES BY: PROVIDING REGULARLY SCHEDULED AND FREE CHILDBIRTH PREPARATION, INFANT WELLNESS AND SAFETY CLASSES TO NEW PARENTS; COLLABORATED WITH OUTPATIENT CLINICS TO INCREASE EARLY AWARENESS OF PRENATAL HEALTH CONCERNS (SUCH AS SMOKING) AND EDUCATION FOR SOLUTIONS AND EARLY INFORMATION ABOUT THE HEALTH BENEFITS OF BREASTFEEDING; MAINTAINED THE HIGH 5 FOR MOM AND BABY INITIATIVE WITH CONTINUED ADOPTION OF QUALITY PRACTICES; EDUCATED COMMUNITY ON SAFE SLEEP PRACTICES AND PROVIDED FREE SLEEP SACKS FOR BABIES TO REDUCE SIDS AT HOME.HEALTH NEEDS NOT ADDRESSEDTHE OTHER COMMUNITY HEALTH NEEDS IDENTIFIED IN THE 2016 CHNA ARE VERY IMPORTANT. HOWEVER, DUE TO LIMITED AVAILABLE RESOURCES IN THE ORGANIZATION AND THE AVAILABILITY OF OTHER COMMUNITY ORGANIZATIONS WHO ARE BETTER EQUIPPED TO ADDRESS THESE NEEDS, ST. FRANCIS HEALTH WILL FOCUS ON THE SELECTED PRIORITY AREAS. A REPRESENTATIVE LIST OF OTHER COMMUNITY ORGANIZATIONS THAT ARE ADDRESSING COMMUNITY NEEDS INCLUDE STORMONT VAIL HEALTH, SHAWNEE COUNTY PUBLIC HEALTH, UNITED WAY, SHAWNEE COUNTY HEALTH AGENCY, VALEO BEHAVIORAL HEALTH CARE, BREWSTER PLACE, COMMUNITY ACTION, INC., AND JAYHAWK AREA AGENCY ON AGING. ST. FRANCIS HEALTH WILL CONTINUE TO PARTNER WITH THESE AND OTHER COMMUNITY ORGANIZATIONS TO ENSURE ALL NEEDS ARE BEING ADDRESSED.ST. FRANCIS HEALTH CENTER:PART V, SECTION, B, LINE 16A, 16B, 16C: WWW.STFRANCISTOPEKA.ORG/FOR-PATIENTS-AND-VISITORS/FINANCIAL-ASSISTANCE-AND-CHARITY/THIS WEB ADDRESS WAS ACTIVE PRIOR TO THE SALE OF THE ST. FRANCIS HEALTH CENTER FACILITY AND OPERATIONS ON NOVEMBER 1, 2017."

PART I, LINE 6A:
THIS ORGANIZATION IS PART OF SCL HEALTH SYSTEM WHICH PREPARES AN ANNUAL COMMUNITY BENEFIT REPORT ON A CONSOLIDATED BASIS. THE REPORT IS PREPARED BY THE PARENT COMPANY, SISTERS OF CHARITY OF LEAVENWORTH HEALTH SYSTEM, INC.

PART I, LINE 7:
THE AMOUNTS REPORTED ON FORM 990, SCHEDULE H, PART I, LINE 7A, 7B AND 7C WERE DETERMINED USING THE COST TO CHARGE RATIO DERIVED FROM WORKSHEET 2, IN THE SCHEDULE H, FORM 990 INSTRUCTIONS. FORM 990, SCHEDULE H, PART I, LINES 7E, 7F, 7G, 7H AND 7I ARE REPORTED AT COST AS REPORTED IN THE ORGANIZATION'S FINANCIAL STATEMENTS.

PART I, LINE 7, COLUMN (F):
THE BAD DEBT EXPENSE INCLUDED ON FORM 990, PART IX, LINE 25, COLUMN (A), BUT SUBTRACTED FOR PURPOSES OF CALCULATING THE PERCENTAGE IN THIS COLUMN IS $ 4,373,424.

PART II, COMMUNITY BUILDING ACTIVITIES:
ST. FRANCIS HEALTH BELIEVES THAT PARTNERSHIPS WITH COMMUNITY ORGANIZATIONS ARE KEY TO KEEPING THE LOCAL COMMUNITY HEALTHY. IN 2017, ST. FRANCIS HEALTH CONTINUED TO SPONSOR LOCAL ORGANIZATIONS WHO ARE COMMITTED TO CHANGE IN THE COMMUNITY IN THE AREAS OF HUNGER, HOMELESSNESS, EDUCATION, ARTS AND MUSIC, MENTAL HEALTH, PHYSICAL FITNESS AND WELLNESS. THROUGH SPONSORSHIPS AND VOLUNTEERISM, ST. FRANCIS HEALTH ENABLED PARTNER ORGANIZATIONS TO FURTHER THEIR WORK IN THE COMMUNITY.ST. FRANCIS HEALTH ALSO PARTNERS WITH MANY ORGANIZATIONS THROUGH COMMUNITY AND BOARD LEADERSHIP. LEADERSHIP FURTHERS THE REACH AND NETWORK OF THE ORGANIZATIONS IN THE FOLLOWING AREAS: PAIN/OPIOID CRISIS MANAGEMENT, SAFETY NET CLINICS AND DENTAL CLINICS, HEALTH ASSOCIATIONS, AND ECONOMIC DEVELOPMENT ORGANIZATIONS. LEADERSHIP'S PARTICIPATION IN THESE KEY COMMUNITY BOARDS/COMMITTEES WILL ENSURE THE SOCIAL DETERMINANTS OF HEALTH ARE BEING ADDRESSED ACROSS THE COMMUNITY IN MULTIPLE AREAS OF FOCUS - TRANSPORTATION, JOB TRAINIG, HOUSING, SAFETY AND EDUCATION.PART III, LINE 1THE ORGANIZATION REPORTS BAD DEBT IN ACCORDANCE WITH HEALTHCARE FINANCIAL MANAGEMENT ASSOCIATION (HFMA) STATEMENT NO. 15 TO THE EXTENT THAT HFMA STATEMENT NO. 15 FOLLOWS GENERALLY ACCEPTED ACCOUNTING PRINCIPLES (GAAP) FOR REPORTING BAD DEBT.

PART III, LINE 2:
THE BAD DEBT EXPENSE REPORTED ON PART III, LINE 2 IS AT CHARGES AS RECORDED IN THE ORGANIZATION'S FINANCIAL STATEMENTS. THE ALLOWANCE FOR BAD DEBT IS BASED UPON MANAGEMENT'S ASSESSMENT OF HISTORICAL AND EXPECTED NET COLLECTIONS CONSIDERING THE BUSINESS AND GENERAL ECONOMIC CONDITIONS IN ITS SERVICE AREA, TRENDS IN HEALTH CARE COVERAGE, AND OTHER COLLECTION INDICATORS.THE BAD DEBT ALLOWANCE IS CALCULATED AS A PERCENTAGE OF PATIENT RECEIVABLES AFTER DEDUCTIONS FOR ESTIMATED PROVISIONS FOR CONTRACTUAL ADJUSTMENTS (DISCOUNTS) ON SERVICES PROVIDED TO ENROLLEES OF MEDICARE, MEDICAID, THIRD-PARTY PAYOR PROGRAMS, CHARITY CARE, UNINSURED DISCOUNTS, AND OTHER ADMINISTRATIVE ADJUSTMENTS.

PART III, LINE 4:
THE ALLOWANCE FOR BAD DEBT IS BASED UPON MANAGEMENT'S ASSESSMENT OF HISTORICAL AND EXPECTED NET COLLECTIONS CONSIDERING THE BUSINESS AND GENERAL ECONOMIC CONDITIONS IN ITS SERVICE AREA, TRENDS IN HEALTH CARE COVERAGE, AND OTHER COLLECTION INDICATORS.THE BAD DEBT ALLOWANCE IS CALCULATED AS A PERCENTAGE OF PATIENT RECEIVABLES AFTER DEDUCTIONS FOR ESTIMATED PROVISIONS FOR CONTRACTUAL ADJUSTMENTS (DISCOUNTS) ON SERVICES PROVIDED TO ENROLLEES OF MEDICARE, MEDICAID, THIRD-PARTY PAYOR PROGRAMS, CHARITY CARE, UNINSURED DISCOUNTS, AND OTHER ADMINISTRATIVE ADJUSTMENTS.THE ORGANIZATION HAS A FINANCIAL ASSISTANCE PROGRAM THAT PROVIDES PATIENTS OPPORTUNITIES TO APPLY FOR FREE OR DISCOUNTED CARE OR TO BE ENROLLED IN A GOVERNMENT SPONSORED MEDICAL CARE PROGRAM. THE PROCESS INCLUDES IDENTIFYING PATIENTS WITH A FINANCIAL CONCERN AND PROVIDING FINANCIAL COUNSELING AND ASSISTANCE IN APPLYING FOR THE ORGANIZATION'S CHARITY CARE AND OTHER FINANCIAL ASSISTANCE PROGRAMS.CERTAIN PATIENT ACCOUNTS ARE WRITTEN OFF TO BAD DEBT BECAUSE THE ORGANIZATION DOES NOT HAVE SUFFICIENT INFORMATION TO DETERMINE IF THE PATIENT WOULD QUALIFY FOR FREE CARE OR FINANCIAL AID. THEREFORE, IT IS POSSIBLE THAT SOME BAD DEBT IS ACTUALLY CHARITY CARE. HOWEVER, IF A PATIENT ACCOUNT IS WRITTEN OFF TO BAD DEBT AND THE COLLECTION AGENCY LATER DETERMINES THAT THE PATIENT WOULD HAVE QUALIFIED FOR FREE CARE OR FINANCIAL AID, THEN THE BAD DEBT EXPENSE IS RECLASSIFIED TO CHARITY CARE. THE FOLLOWING IS THE TEXT OF THE FOOTNOTE IN THE ORGANIZATION'S FINANCIAL STATEMENTS THAT DESCRIBE THE BAD DEBT ALLOWANCE AND BAD DEBT EXPENSE: THE ALLOWANCE FOR UNCOLLECTIBLE ACCOUNTS IS BASED UPON MANAGEMENT'S ASSESSMENT OF HISTORICAL AND EXPECTED NET COLLECTIONS CONSIDERING THE BUSINESS AND GENERAL ECONOMIC CONDITION IN ITS SERVICE AREA, TRENDS IN HEALTH CARE COVERAGE, AND OTHER COLLECTION INDICATORS. THROUGHOUT THE YEAR, MANAGEMENT ASSESSES THE ADEQUACY OF THE ALLOWANCE FOR UNCOLLECTIBLE ACCOUNTS BASED UPON HISTORICAL COLLECTION EXPERIENCE BY PAYOR CATEGORY AND OTHER FACTORS. THE RESULTS OF THESE REVIEWS ARE THEN USED TO MAKE MODIFICATIONS TO THE ALLOWANCE FOR UNCOLLECTIBLE ACCOUNTS. THE ALLOWANCE FOR UNCOLLECTIBLE ACCOUNTS INCLUDES A RESERVE FOR BOTH UNINSURED PATIENTS AND BALANCES DUE FROM PATIENTS AFTER INSURANCE.

PART III, LINE 8:
"THE ORGANIZATION BELIEVES THAT AT LEAST SOME PORTION OF THE COSTS WE INCUR IN EXCESS OF PAYMENTS RECEIVED FROM THE FEDERAL GOVERNMENT FOR PROVIDING MEDICAL SERVICES TO MEDICARE ENROLLEES AND BENEFICIARIES UNDER THE FEDERAL MEDICARE PROGRAM (SHORTFALL OR MEDICARE SHORTFALL) CONSTITUTES A COMMUNITY BENEFIT. PROVIDING THESE SERVICES CLEARLY LESSENS THE BURDENS OF THE GOVERNMENT BY ALLEVIATING THE FEDERAL GOVERNMENT FROM HAVING TO DIRECTLY PROVIDE THESE MEDICAL SERVICES. AS DEMONSTRATED AND CALCULATED ON FORM 990, SCHEDULE H, PART III, LINES 5, 6 AND 7, OUR MEDICARE ""ALLOWABLE COSTS"" CLEARLY EXCEED THE PAYMENTS WE RECEIVE FOR PROVIDING THESE MEDICAL SERVICES UNDER THE MEDICARE PROGRAM. BY ABSORBING THE MEDICARE SHORTFALL COSTS WE ARE PROVIDING A COMMUNITY BENEFIT AS WELL AS EASING THE BURDEN OF THE FEDERAL GOVERNMENT HAVING TO COVER THESE COSTS.TO ARRIVE AT THE FORM 990, SCHEDULE H, PART III, LINE 6 AMOUNT, WE USED ACTUAL MEDICARE CHARGES FROM INTERNAL RECORDS AND APPLIED AN ESTIMATED COST TO CHARGE RATIO TO DETERMINE THE MEDICARE ALLOWABLE COSTS. THE ESTIMATED MEDICARE COST TO CHARGE RATIO IS THE PRIOR PERIOD MEDICARE COST REPORT COST TO CHARGE RATIO."

PART III, LINE 9B:
AN INTEGRAL COMPONENT OF OUR MISSION IS TO BE GOOD FINANCIAL STEWARDS. THIS REQUIRES US TO DETERMINE WHICH PATIENTS ARE IN NEED OF CHARITY CARE AND WHICH ARE ABLE TO CONTRIBUTE SOME PAYMENT FOR CARE RECEIVED. WEMAINTAIN A BALANCE THAT ENABLES US TO CONTINUE TO PROVIDE CHARITY CARE TOTHOSE WHO NEED IT MOST AND ENSURE THAT WE MANAGE OUR RESOURCES SOWE CAN CONTINUE TO BE HERE WHEN PEOPLE NEED US MOST. THE ORGANIZATION NOTIFIES PATIENTS OF FINANCIAL ASSISTANCE POLICY UPON ADMISSION AND DISCHARGE. IN ADDITION, THE PATIENTS RECEIVE INFORMATION ABOUT THE FINANCIAL ASSISTANCE POLICY WITH THEIR PATIENT BILLS. PATIENTS ARE CONTACTED MULTIPLE TIMES ABOUT UNPAID BALANCES PRIOR TO INITIATING ANY COLLECTION ACTION. IF A PATIENT IS DETERMINED TO BE ELIGIBLE FOR FINANCIAL ASSISTANCE AT ANY TIME DURING THE COLLECTION PROCESS, THE ACCOUNT IS RECLASSIFIED AS FINANCIAL ASSISTANCE AND DEBT COLLECTION EFFORTS ARE CEASED.

PART VI, LINE 2:
ST. FRANCIS HEALTH IS REGULARLY ASSESSING COMMUNITY NEEDS THROUGH RELATIONSHIPS AND PARTNERSHIPS WITH ORGANIZATIONS IN THE COMMUNITY. WHILE THE CHNA GIVES AN ACTIVE PICTURE OF THE COMMUNITY AT A POINT IN TIME, THERE ARE URGENT NEEDS IN THE COMMUNITY THAT ARISE BEYOND THE CHNA TIMEFRAME. OUR PARTICIPATION WITH THE HEARTLAND HEALTHY NEIGHBORHOOD GROUP, UNITED WAY AND HEALTHY KANSANS 2020 ENABLE A REALTIME VIEW OF COMMUNITY HEALTH NEEDS. EACH OF THESE ORGANIZATIONS DEVELOP ASSESSMENTS AT DIFFERENT INTERVALS FROM ST. FRANCIS AND MANY REVIEW PROGRAM EFFECTIVENESS ON A MONTHLY BASIS. THIS ADDITIONAL DATA PROVIDES ANOTHER WAY FOR OUR HOSPITAL TO SUPPORT CHANGING NEEDS WITHIN THE COMMUNITY. THROUGH PARTNERSHIPS WITH OTHER ORGANIZATIONS, ST. FRANCIS HEALTH CAN READILY RESPOND TO NEEDS AS THEY ARISE.

PART VI, LINE 3:
THE ORGANIZATION NOTIFIES PATIENTS ABOUT THE FINANCIAL ASSISTANCE POLICY UPON ADMISSION AND PRIOR TO DISCHARGE. NOTICES ABOUT THE FINANCIAL ASSISTANCE POLICY ARE DISPLAYED THROUGHOUT THE HOSPITAL. IN ADDITION, PATIENTS RECEIVE INFORMATION ABOUT THE FINANCIAL ASSISTANCE POLICY WITH THEIR PATIENT BILLS. THE FINANCIAL ASSISTANCE POLICY AND APPLICATION ARE POSTED ON THE HOSPITAL'S WEBSITE. THE POLICY AND APPLICATION ARE ALSO AVAILABLE UPON REQUEST. THE ORGANIZATION HAS A FINANCIAL ASSISTANCE PROGRAM THAT PROVIDES PATIENTS OPPORTUNITIES TO APPLY FOR FREE OR DISCOUNTED CARE OR TO BE ENROLLED IN A GOVERNMENT SPONSORED MEDICAL CARE PROGRAM. THE PROCESS INCLUDES IDENTIFYING PATIENTS WITH A FINANCIAL CONCERN, PROVIDING FINANCIAL COUNSELING AND ASSISTANCE IN APPLYING FOR THE ORGANIZATION'S CHARITY CARE AND OTHER FINANCIAL ASSISTANCE PROGRAMS.

PART VI, LINE 4:
ST. FRANCIS HEALTH IS LOCATED IN THE CITY OF TOPEKA, KANSAS IN SHAWNEE COUNTY. THE HOSPITAL'S PRIMARY AND SECONDARY SERVICES AREA INCLUDES SHAWNEE COUNTY AND THE SURROUNDING COUNTIES, PARTICULARLY TO THE WEST TOWARD MANHATTAN, KANSAS AND TO THE SOUTH TOWARD EMPORIA, KANSAS. THE 2016 CHNA COVERED THE PRIMARY SERVICE AREA OF SHAWNEE COUNTY. THE DEMOGRAPHICS OF THE COMMUNITY ARE AS FOLLOWS: - SHAWNEE COUNTY RESIDENTS ACCOUNT FOR 74% OF ST. FRANCIS HEALTH INPATIENTS - 82% OF ST. FRANCIS HEALTH'S OUTPATIENTS ARE FROM SHAWNEE COUNTY - AFTER SHAWNEE COUNTY, THE SERVICE AREA OF BOTH HOSPITALS IS VERY RURAL WITH 12 COUNTIES CONTRIBUTING ANYWHERE FROM 1% TO 5% OF THEIR INPATIENT AND OUTPATIENT VOLUMESTOPEKA IS THE MAJOR URBAN CENTER IN SHAWNEE COUNTY. WITH A POPULATION 178,406, SHAWNEE COUNTY IS THE THIRD LARGEST COUNTY IN THE STATE. IT IS ONE OF THE FEW URBAN COUNTIES IN KANSAS. THEREFORE IT IS MORE RACIALLY DIVERSE AND HAS A HIGHER RATE OF POVERTY THAN MOST OF THE STATE: - AFRICAN AMERICAN POPULATION IS 8.8%, STATE 6.3% - TWO OR MORE RACES IS 3.9%, STATE 2.8% - HISPANIC OR LATINO IS 11.6%, STATE 11.4% - PERSONS IN POVERTY IS 15.0%, STATE 13.6% - PERSONS WITHOUT HEALTH INSURANCE 13.9%, STATE 11.8%GENDER - 50.3% FEMALE AND 49.7% MALEAGE - ADULTS OVER 65 YEARS OF AGE REPRESENT 15.5% OF TOTAL POPULATION WITH THOSE UNDER 18 YEARS REPRESENTING 24.5%; 60% OF THE POPULATION REPRESENTED BETWEEN 18-34 YEARS AND 35-60 YEARS.EDUCATION - HIGH SCHOOL GRADUATION RATE IS 81.7% COMPARED TO 85.8% FOR THE STATE; 28.6% OF RESIDENTS HAVE A BACHELOR'S DEGREELANGUAGE - ENGLISH IS THE DOMINANT LANGUAGE WITH ONLY 11.2% OF HOUSEHOLDS SPEAKING A LANGUAGE OTHER THAN ENGLISH (1 IN 10); SPANISH LANGUAGE IS SECOND MOST COMMONLY SPOKENINCOME - MEDIAN HOUSEHOLD INCOME OF $48,451 WITH 15% LIVING BELOW THE POVERTY LEVEL

PART VI, LINE 5:
COMMUNITY ACTIVITIES INCLUDE A VARIETY OF CLASSES OFFERED AT NO- OR VERY LOW COSTS ON SUCH TOPICS AS WEIGHT MANAGEMENT, MENTAL HEALTH AWARENESS, SAFETY AND FIRST AID/CPR CERTIFICATION. THERE ARE SUPPORT GROUPS FOR CANCER PATIENTS, CAREGIVERS, HEALTHY LIFESTYLE, SMOKING CESSATION, BREAST CANCER SURVIVORSHIP PROGRAMS, AS WELL AS CLASSES FOR PROSPECTIVE PARENTS AND DIABETES MANAGEMENT CLASSES.FREE HEALTH SCREENINGS ARE PROVIDED IN THE COMMUNITY INCLUDING CHOLESTEROL TESTING AND BLOOD PRESSURE SCREENINGS SEVERAL TIMES THROUGHOUT THE YEAR. WE PROVIDE PRESENTATIONS TO COMMUNITY GROUPS ON SUBJECTS SUCH AS BALANCE, EXERCISE AND STRETCHING. WE HAVE PARTNERED WITH SENIOR GROUPS, AND PUBLIC SCHOOLS AS PARTICIPANTS IN HEALTH FAIRS AND HEALTH EDUCATION EVENTS.WE ARE AN IMPORTANT PART OF OUR COMMUNITY AND SERVE IN MANY WAYS, IN RESPONSE TO DIRECT REQUESTS FROM COMMUNITY ORGANIZATIONS AND RESIDENTS. FROM DELIVERING CORE HEALTH CARE TO PREVENTIVE CARE TO SUPPORT OF OTHER CIVIC GROUPS, OUR COMMUNITY INVOLVEMENT TAKES MANY FORMS. OUR BOARD OF DIRECTORS REPRESENTS MEDICAL AND BUSINESS PROFESSIONALS, AND ALL PROVIDE HOURS OF SERVICE IN SUPPORT OF OUR HOSPITAL. WHEN ST. FRANCIS HAS EXCESS REVENUE, WE USE THOSE FUNDS TO OBTAIN CURRENT HEALTH CARE TECHNOLOGIES AND EQUIPMENT, IMPROVE PATIENT CARE, PROVIDE MEDICAL TRAINING EDUCATION, AND TO EXPAND ACCESS TO CARE FOR UNMET NEED AREAS.

PART VI, LINE 6:
"THE ORGANIZATION IS A CONTROLLED ENTITY OF THE SISTERS OF CHARITY OF LEAVENWORTH HEALTH SYSTEM, INC. (SCLHS). SCLHS AND ITS AFFILIATED ENTITIES HAVE A COMMON CALLING AND MISSION: ""WE REVEAL AND FOSTER GOD'S HEALING LOVE BY IMPROVING THE HEALTH OF THE PEOPLE AND COMMUNITIES WE SERVE, ESPECIALLY THOSE WHO ARE POOR AND VULNERABLE."" WE STRIVE TO PROVIDE HIGH-QUALITY, COMPASSIONATE AND AFFORDABLE HEALTHCARE IN EACH OF OUR HOSPITAL SITES AND THEIR RESPECTIVE COMMUNITY, AS WELL AS IN A VARIETY OF OUTPATIENT SETTINGS AND IN THE HOME. SCLHS IS A FAITH-BASED, NONPROFIT HEALTHCARE ORGANIZATION THAT OPERATES NINE HOSPITALS, TWO SAFETY NET CLINICS, ONE CHILDREN'S MENTAL HEALTH CENTER AND MORE THAN 210 AMBULATORY SERVICE CENTERS IN THREE STATES - COLORADO, KANSAS AND MONTANA. THE HEALTH SYSTEM INCLUDES MORE THAN 16,000 FULL-TIME ASSOCIATES AND MORE THAN 600 EMPLOYED PROVIDERS.AS OUR HEALTH SYSTEM GROWS, WE'RE LEVERAGING THAT GROWTH TO ACHIEVE BENEFITS OF SCALE - IDENTIFYING COST AND OTHER ADVANTAGES THAT WE GAIN DUE TO OUR SIZE. WE'RE ALSO WORKING TO STREAMLINE AND UNIFY OUR SYSTEM-WIDE PROCESSES TO ELIMINATE COSTLY DUPLICATION OF EFFORT. WE ACTIVELY ENCOURAGE OUR PEOPLE TO PURSUE CREATIVE IDEAS THAT IMPROVE EFFICIENCY, SERVICE AND THE OVERALL CARE EXPERIENCE. WHEN OUR ASSOCIATES OR LEADERSHIP TEAMS IDENTIFY BEST PRACTICES IN ANY AREA OF CARE, WE RAPIDLY REPLICATE THOSE ACROSS ALL CARE SITES.THE ORGANIZATION PROMOTES THE HEALTH OF THE COMMUNITY BY DELIVERING DIRECT HIGH QUALITY HEALTHCARE SERVICES THAT ARE RESPONSIVE TO THE NEEDS OF ITS PATIENTS AND THEIR FAMILIES. THIS INCLUDES COORDINATING COMMUNITY BENEFIT PROCESSES, PROVIDING GUIDANCE WITH COMMUNITY NEEDS ASSESSMENTS, AND ESTABLISHING CONSISTENT FINANCIAL ASSISTANCE AND CHARITY CARE POLICIES AND PROCEDURES. ADDITIONALLY, SCLHS BENEFITS AFFILIATES THROUGH QUALITY IMPROVEMENT AND PERFORMANCE EXCELLENCE INITIATIVES; SYSTEM-WIDE INFORMATION TECHNOLOGY IMPLEMENTATION AND INFRASTRUCTURE; STRATEGIC AND OPERATIONS DIRECTION AND OVERSIGHT; SUPPLY CHAIN MANAGEMENT AND PURCHASING; FINANCE ADMINISTRATION, REVENUE CYCLE SUPPORT, BENEFITS ADMINISTRATION, RISK MANAGEMENT; DISASTER PLANNING AND CRISIS ASSISTANCE, CENTRAL CASH MANAGEMENT AND INVESTMENT, INTERNAL AUDIT, LEGAL SERVICES, TAX SERVICES AND MISSION INTEGRATION."