4A (Expenses $ 2049216830 including grants of $ 0) (Revenue $ 2573458557)
"For over 140 years, Franciscan Alliance, Inc. (""Franciscan"") has endeavored to stay true to our founding mission of caring for patients who come through our doors and we continue to look for opportunities to serve our communities through the very best in medical care and service to the less fortunate among us. Franciscan's purpose is to continue the healing ministry of Christ in accordance with the teachings of the Roman Catholic Church and in partnership with others to provide a full continuum of health care services; to carry on educational activities related to the promotion of health; to promote and carry on scientific research related to health care; and to participate in activities designed and conducted to promote the general health of those served by Franciscan. Franciscan operates thirteen hospital campuses (two in Illinois and eleven in Indiana) along with numerous physician clinics and ancillary services centers and offers numerous community health improvement programs that are further described below. In 2014, Franciscan admitted approximately 77,000 inpatients and recorded over 350,000 inpatient days, 382,000 emergency room visits, and provided over $496 million in charity care and other community benefits which includes Medicaid and Medicare shortfalls at cost. Franciscan provides significant benefits that reflect the organization's commitment to healthcare and the communities it is privileged to serve. We break community benefits down into two primary categories: a) benefits for the poor and underserved which includes the cost of providing programs and services to persons who are economically poor or are medically indigent and cannot afford to pay for health care services because they have inadequate resources and/or are uninsured or underinsured and b) benefits for the broader community which includes the cost of providing programs and services aimed at persons and groups for reasons other than poverty (however it may include needy populations that may not qualify as poor but need special services and support) or broader populations who benefit from healthy community initiatives with the provision of these programs and services not intended to be financially self-supporting. In 2014, Franciscan provided over $496 million in quantifiable community benefits which included: Benefits for the Poor: Charity Care $91,268,235 Unpaid Costs of Medicaid $89,253,753 Other Public Programs $6,106,350 _______________ Subtotal $186,628,338 Benefits for the Community: Unpaid Costs of Medicare $237,326,064 Other Community Benefits $46,888,818 Bad Debt $25,733,323 _____________ Subtotal $309,948,205 Total $496,576,543 ""Our Giving Journal"" at www.FranciscanAlliance.org/CommunityBenefit reflects Franciscan's mission of ""Continuing Christ's Ministry in Our Franciscan Tradition"" along with a report of our community benefit activities. Although it is not all inclusive of the many benefits provided by Franciscan it does portray the significant benefits that reflect our commitment to healthcare and the communities we are privileged to serve. The following is a subset of the many clinical services as well as population health improvement and community outreach activities offered by one or more of Franciscan's healthcare facilities: - Inpatient Hospital Services including: Medical Services, Surgical Services, Intensive Care Services, Telemetry Services, Obstetrics Services, Pediatrics Services, Neonatal Intensive Care Services, Acute Rehabilitation Services, Oncology Services, Bone Marrow Transplant Services, General Surgery Services, Cardiac Surgery Services, Vascular Services, Pulmonary Services, Interventional Radiology, Orthopedics, Joint and Spine Care, Gastrointestinal Care, Neurosciences Services, Colon and Rectal Services, Anesthesia Services, Hospice Services, Inpatient Psychiatric Care, Residential Treatment Program for Adolescents, etc. - Emergency Services including: 24 hour Emergency Room Services, Ambulance Services, Immediate Care Services, Advanced Life Support Services, Basic Life Support Services, Behavioral Health Emergency Consultation Services, 24-Hour Crisis and Referral Hotline, etc. - Outpatient Services including: Laboratory Services, Physical Therapy Services, Occupational Therapy Services, Speech Therapy Services, General Radiology Services, Computed Tomography Services, Magnetic Resonance Imaging (MRI), Nuclear Medicine Services, Mammography Services, Angiography Services, Neurodiagnostics Services, Gastro/Intestinal Services, Sleep Laboratory, Pulmonary Services, Outpatient Surgery, Cardiac Testing, Electrocardiogram (EKG) Services, Medical Oncology Services, Radiation Oncology Services, Pharmacy, Occupational Medicine Services, Cardiac/Pulmonary Rehabilitation Services, Congestive Heart Failure Clinic, Wound Healing and Prevention, Nutritional Counseling, Diabetes Management, Bariatric Services, Pain Management, Social Services, Palliative Care, Sports Medicine, Behavioral Health, Stroke Services, Home Health Services, Skilled Nursing Services, Social Services, Durable Medical Equipment. - Primary Care and Specialty Care Physician Clinics. - Subsidized Healthcare Services offered by Franciscan: - Franciscan has neighborhood health clinics that offer family practice services designed for families without access to affordable health care. The focus is on providing primary and preventive care as well as health education. These clinics offer free immunizations. - Franciscan's Sexual Assault Clinics that provide medical and forensic assistance that is sensitive to the special needs of the victim as well as a victim advocate program and crisis intervention counselors. - Franciscan's Blood and Marrow Transplant program is only one of two programs in Indiana offering full service transplant care and specializes in the treatment of patients with leukemia, Hodgkin's or non-Hodgkin's lymphoma, multiple myeloma, and many other malignancies and blood disorders. - Franciscan's Diabetes Education Centers offer a number of diabetes classes and individualized sessions to help patients take control of their health with a focus on nutrition, exercise, medications, chronic conditions, preconception and pregnancy, blood glucose monitoring, goal setting, problem solving, psychosocial adjustment, detection/treatment of high and low blood sugar, and insulin administration. - Franciscan's Women's and Children's Services include preventive medical care and health screenings to gynecological care, maternity, lactation consultation services, and beyond, Franciscan's facilities focus on keeping women healthy. - Franciscan's Hospice Care Services provide a sense of dignity and compassion to both the patient and their family in caring for patients with a life expectancy of six months or less. Our programs affirm and celebrate life and regard dying as a natural process, recognizing that every person has the right to die with dignity, peace, and comfort regardless of their ethnicity, faith background, or ability to pay. - Level III NICU - Ambulance Service - Physician Services - Residential Treatment Program for Adolescents - St. Monica Home for pregnant teens - Emergency Services - Inpatient Psychiatric Units - Palliative Care Services - Indigent Health Care Clinics. - Health and Wellness Centers and Healthy Living Education Centers. - Clinical care coordinators to support Franciscan's various Accountable Care Organizations which are designed to improve quality and reduce cost. - Community Outreach and Education Programs including: Health Fairs, Free Health Screenings, Free Immunizations, Free Breast Health Screening Services, Free Prostate Screenings, Free Skin Cancer Screenings, Free Cervical Cancer Screenings, Free Glucose Screenings, Free Cholesterol Screenings, Free Bone Density Screenings, Free Lung Screenings, Free Spa Services for Cancer Patients, Online Health Condition Assessment Tools, Cancer Prevention Activities, Cancer Survivor Programs and Retreats, Cancer and Heart Care Clinical Symposiums, Health Care Decision-Making Sessions, Senior Health Education, Diabetes Management Education and Activities, Pain Management Seminars and Activities, Cardiac Risk Factors Educational Sessions and Online Tools, Hospice and Palliative Care Counseling and Education Services, Alzheimer Support Services, Behavioral Health Community Education, Smoking Cessation Programs, Mobile Dental Clinics, Basic Life-Saving Skills Programs, Children's Health Needs Activities, Childhood Obesity Activities, Weight Loss Education, Organ and Tissue Donation Fairs, Volunteer Advocates for Seniors, Parenting Programs, Residential Support Program for Pregnant Girls, Prenatal 'Baby Showers', Athletic Training (Schools and Various Marathons), Orthopedic Road Shows, Flu Vaccinations, Child Seat Safety Programs, Bereavement Support Groups, Community Education Lectures, Indigent Prescription Programs, Sex Can Wait Programs, Caregivers Education Symposiums, Health Career"

SCHEDULE H, PART V, SECTION C - SUPPLEMENTAL INFORMATION
In this section, the following abbreviations are used to reference the hospital facilities operated by Franciscan Alliance, Inc.: Franciscan St. Francis Health - Indianapolis: FSFH-Indianapolis Franciscan St. Anthony Health - Crown Point: FSAH-Crown Point Franciscan St. Margaret Health - Hammond: FSMH-Hammond Franciscan St. Margaret Health - Dyer: FSMH-Dyer Franciscan St. James Health - Chicago Heights: FSJH-Chicago Heights Franciscan St. Elizabeth Health - Lafayette: FSEH-Lafayette East Franciscan St. Anthony Health - Michigan City: FSAH-Michigan City Franciscan St. James Health - Olympia Fields: FSJH-Olympia Fields Franciscan St. Francis Health - Mooresville: FSFH-Mooresville Franciscan St. Elizabeth Health - Lafayette Central: FSEH-Lafayette Central Franciscan St. Elizabeth Health - Crawfordsville: FSEH-Crawfordsville Franciscan Healthcare - Munster: FH-Munster Franciscan St. Francis Health - Carmel: FSFH-Carmel LINE 5: FSMH-DYER, FSMH-HAMMOND, FSAH-CROWN POINT, FH-MUNSTER INPUT FROM INDIVIDUALS IN THE COMMUNITY: An independent, third party was retained to conduct the community assessment and a part of that work was the facilitation of several Focus Groups designed to have in-person exchange and information gathering about community health needs, including needs of low income, minorities and the uninsured. The following individuals attended and contributed to that information gathering opportunity: Dr. Janet Seabrook - Executive Director, Gary Community Health Center Dr. Janice Zunich, Indiana University School of Medicine Dr. Mark Feldner, Community Care Network Dr. Lisa Green - CEO, Family Christian Health Centers Janice Wilson - CEO, North Shore Health Centers Olga Gonzales - Manager, Women's Care Center of NWI Tracy Tucker - School Nurse, Eggers Middle School Duane Dedalow - Executive Director, Catholic Charities Diocese of Gary Gordon Johnson - CEO, American Red Cross of NWI Gary Olund - President, Northwest Indiana Community Action Grace Talbot - Director, Hammond Rescue Mission Jane Bisbee - Regional Manager, Child Protective Services Lou Martinez - President, Lake Area United Way Gilda Orange - Trustee, North Township Tom DeGuilio - Town Manager, Munster LINE 5: FSAH-MICHIGAN CITY INPUT FROM INDIVIDUALS IN THE COMMUNITY: A survey of community opinion leaders was conducted soliciting input regarding community health needs. Individuals contributing to this information resource included: Ed Merrion - Housing Program Manager, Catholic Charities Kathy Dennis - Commission on Women George Kucka - President, Fair Meadows Home Health Center Terese Fabbri - Friend of the Open Door Health Center Fred McNulty - EVP, HR Dimensions Deborah Chugg - Executive Director, Imagination Station (behavioral medicine) Patricia Pease - Administrator, LaPorte County Emergency Medical Services Cathy Ellis - Life Care Center of Valparaiso W. Faye Moore - VP, Michigan City Women's Commission/NAACP Deborah Briggs - Program Director, Open Door Adolescent Health Center Tyra Walker - Samaritan Center and LaPorte County Jail Cee Taylor - Executive Director, Samaritan Counseling Center Terri Phillips - Executive Director, Life Care of Michigan City (Skilled Nursing Facility) Gerry Jones - Executive Director, Stepping Stone Shelter for Women Steve Birnth - Executive Director, Youth Service Bureau LINE 5: FSJH-CHICAGO HEIGHTS, FSJH-OLYMPIA FIELDS INPUT FROM INDIVIDUALS IN THE COMMUNITY: A community wide survey was conducted by a third party in collaboration with many hospitals coordinated by the Chicago Metropolitan Hospital Council. Subsequent to that community survey the same third party conducted a series of Focus Groups, specific to each participating hospital, comprised of individuals representing various sectors of the service area population including: public health; low income; minorities; medically underserved; chronic disease services; and more. Individuals providing input via the focus groups included: Apostle Carl White, Jr. - Victory International Christian Ministries Deborah Harper - Community and Economic Development Association, Chicago Heights Marianne Bithos - National Alliance on Mental Illness, South Suburbs of Chicago Mary Pat Ambrosino - Southwest Community Services, Tinley Park (services for the disabled) Yvonne Orr - South/Southwest Suburban United Way LINE 5: FSEH-LAFAYETTE EAST, FSEH-LAFAYETTE CENTRAL INPUT FROM INDIVIDUALS IN THE COMMUNITY: A community survey was conducted, followed by a review of results by a cross section of community representatives. That review resulted in conducting an Opinion Leader survey of approximately 200 individuals to add more information regarding priorities. Finally, individual interviews were conducted with the following individuals to further solicit direct input from their respective experiences and knowledge: John Dennis - Mayor, West Lafayette Tom Murtaugh - President of the County Council Sheila Klinker - Indiana State Representative Ronnie Alting - Indiana State Senator Randy Truitt - Indiana State Representative Brandt Hershman - Indiana State Senator Gary Henriott - Chairman and CEO, Henriott Group Trish Hauber - HR Manager, Caterpillar, Inc. Julia Cole - HR Manager, Subaru Veronique LeBlanc - President, Riggs Community Health Center Pam Biggs-Reed - CEO, Bauer Center (Head Start and Counseling Center) Marilyn Redmon - CEO, Right Steps Child Development Centers Ron Cripe - Tippecanoe County Health Department Barry Richards - Boys and Girls Club James Taylor - Executive Director, United Way of Greater Lafayette and Tippecanoe County Joe Seaman - President, Greater Lafayette Chamber of Commerce Cheryl Ubelhor - Program Manager, Community Foundation of Greater Lafayette Scott Hanback - Superintendent, Tippecanoe Schools Eric Davis - President, Lafayette Catholic School Corp. Rocky Killian - Superintendent, West Lafayette Schools Jane Kirkpatrick - Dean, Purdue School of Nursing Anita Reed - St. Elizabeth School of Nursing LINE 5: FSEH-CRAWFORDSVILLE INPUT FROM INDIVIDUALS IN THE COMMUNITY: A community wide survey was conducted, followed by an opinion leader survey. The opinion leaders were then interviewed for focused input. The individuals from whom input was gained are: Robert Cook - Abilities services Todd Barton - Mayor, City of Crawfordsville Fawn Johnson - Crawfordsville Community Center Joanie Crum - Division of Family and Children Phil Wray - FISH Clothes Closet/Food Pantry Brenda Deckard - Friendship Kitchen/HUB Ministries Denise Maxwell - Montgomery County American Red Cross Kelly Taylor - Montgomery County Community Foundation Cheryl Kiem - Montgomery County Community Foundation Jan Sears - St. Bernard Catholic Church Dave Peach - WCVL/WIMC/WCDQ (broadcasting) Joy Dugan - Purdue University Extension Service Deanna Durett - Montgomery County Commissioner Tina McGrady - Editor, Crawfordsville Journal Review Rich Holtz - The Paper of Montgomery County Amber Reed - Montgomery County Health Department Bill Doemel - Mary Ludwig Free Clinic LINE 5: FSFH-INDIANAPOLIS, FSFH-MOORESVILLE, FSFH-CARMEL INPUT FROM INDIVIDUALS IN THE COMMUNITY: A community survey was conducted followed by a survey of opinion leaders. Additionally, interviews were conducted with a variety of community leaders and people knowledgeable in the areas of public health and the needs of target populations. The individuals interviewed include the following: Robert Lyons - Church Odyssey Thomas Zoss - Executive Director, Community Foundation of Morgan County Betty Pedigo - Site Manager, Eskenazi Medical Group (a provider to low income and minorities) Marjorie Porter - Executive Director, Good Shepherd Clinic Mary Kay Mitchell - Horizon House Norman Connell - Board Member, Kendrick Foundation Michael Crosley - Executive Director, Life Bridge Community Julia Brillhart - VP, Magellan Health Joni Collins - Executive Director, Martin Luther King Community Center Dennis Payton - Pastor, Mooresville First United Methodist Church Debra Page - Mooresville Schools M. Cloud - Supervisor, Noble of Indiana Joseph Donahue - Sycamore Services Lydia Rychtarczyk - Director, Tomorrow's Promise Pre-school Pamela Taylor - EMS, Westfield Fire Department Additional Individuals providing information through means other than an interview: Mark Lindenlaub - Executive Director, Aging and Community Services of So. Central Indiana Carla Marchbanks - Director, Beech Grove Senior Citizens Center Rick Whitten - Executive Director, Boys and Girls Clubs of Indianapolis Elaisa Vahnie - Executive Director, Burmese American Community Julie Heger - Case Manager, Children's Bureau Frank Mascari - City-County Council Member Stephen Rink - Trustee, Decatur Township Nancy Beals - Drug Free Marion County Bud Swisher - Executive Director, Healthier Morgan County Initiative Beth Ann Leach - Executive Director, Hendricks County Senior Services Doug Bush - Executive Director, Indiana Dental Association Ann Alley - Director, Primary Care, Indiana State Department of

LINE 6a: FSJH-CHICAGO HEIGHTS, FSJH-OLYMPIA FIELDS
CHNA CONDUCTED WITH ONE OR MORE OTHER FACILITIES: Franciscan St. James Health-Chicago Heights and Franciscan St. James Health-Olympia Fields are part of Franciscan Alliance, Inc. who collaborated in using the same third party resource (Professional Research Consultants). Franciscan St. James Health-Chicago Heights and Franciscan St. James Health-Olympia Fields coordinated with a number of other hospitals as part of a coordinated program sponsored by the Metropolitan Chicago Hospital Council using the services of a third party, Professional Research Consultants. LINE 6a: FSEH-LAFAYETTE EAST, FSEH-LAFAYETTE CENTRAL CHNA CONDUCTED WITH ONE OR MORE OTHER FACILITIES: A community survey was conducted jointly with Franciscan St. Elizabeth Health-Lafayette East, Franciscan St. Elizabeth Health-Lafayette Central, and Indiana University Arnett Hospital, as well as with some assistance from the staff of the county health department. LINE 6a: FSFH-INDIANAPOLIS, FSFH-MOORESVILLE, FSFH-CARMEL CHNA CONDUCTED WITH ONE OR MORE OTHER FACILITIES: All CHNA related activities were a joint effort between Franciscan St. Francis Health-Indianapolis, Franciscan St. Francis Health-Mooresville, and Franciscan St. Francis Health-Carmel. LINE 7a: ALL FACILITIES All 13 hospital's CHNAs are available on Franciscan Alliance's website at: HTTP://WWW.FRANCISCANALLIANCE.ORG/COMMUNITY/COMMUNITY-NEEDS-ASSESSMENT/ ANNUAL-REPORT/PAGES/DEFAULT.ASPX LINE 10: ALL FACILITIES All 13 hospital's Implementation Strategies are available on Franciscan Alliance's website at: HTTP://WWW.FRANCISCANALLIANCE.ORG/COMMUNITY/COMMUNITY-NEEDS-ASSESSMENT/ ANNUAL-REPORT/PAGES/DEFAULT.ASPX LINE 11: FSMH-DYER, FSMH-HAMMOND NEEDS BEING ADDRESSED VIA SPECIFIC CHNA STRATEGIES A. Cardiovascular Health - Identify at risk patients among African American population and improve health thru reducing risk by screening, education and monitoring of scores of key indicators. B. Adolescent Substance Abuse - Identify at-risk children and provide interventions to stop and/or prevent abuse of alcohol and substances. C. Lung Cancer - Reduce the incidence of untreatable lung cancer among low-income, at-risk population thru early screening, education and treatment. D. Diabetes - Improve self-management to avoid complications among low income, at-risk Hispanic population thru screening, education, individual counseling and early identification of complications. NEEDS IDENTIFIED BUT NOT SELECTED AMONG CHNA STRATEGIES A. Access to health care services - The hospitals already operate a community clinic (Mother McAuley Clinic) to serve under and uninsured; operate physician practices that accept all patients; expect provisions of the Affordable care Act will improve access via Medicaid and employer insurance expansion. B. Cancer of the breast, cervix, colon and prostate - identified as being of higher incidence and being addressed through other, established programs and through gradually improving underlying social issues. C. Chlamydia Incidence Rate - As a Catholic organization we are limited by the Ethical and Religious Directives as to what we can do regarding the use of contraceptives. D. Chronic Kidney Disease - developing a program to improve diabetes management, which is an underlying cause of kidney disease. E. High Use of ER - Various new programs initiated as part of Franciscan's ACO, also we operate several Urgent Care centers and have expanded to include new sites. F. Injury and Violence Prevention - We regard this as primarily a task of the public sector as we do not have expertise or resources to develop and sustain programs. G. Maternal, Infant and Child Health - A robust program needs neo-natal resources we do not have. We do already offer some services through our community clinic and through our St. Monica Home for unwed mothers. H. Oral Health - we do not have dental services, staff, resources or expertise to meet this need. I. Social and Economic Factors - there are a variety of conditions including education, transportation, employment, crime, etc., which are obligations of government to address as we do not have needed expertise, funding, resources or experience to address. LINE 11: FSAH-MICHIGAN CITY NEEDS BEING ADDRESSED VIA SPECIFIC CHNA STRATEGIES A. Access to Medications - Prevent adverse impact of not complying with medication treatment by increasing the access to needed medications. B. Diabetes - Increase the number of people in at-risk population receiving education and referrals to treatment. C. Congestive Heart Failure - Improve overall management of care and avoidance of acute episodes thru better continuity of care among providers, education and treatment compliance. NEEDS IDENTIFIED BUT NOT SELECTED AMONG CHNA STRATEGIES A. Access to Health Services - The hospital already works closely with established Federally Qualified Health Centers in the community; operates physician practices that accept all patients; expect the provisions of the Affordable Care Act to improve access via Medicaid and employer expansion of insurance coverage. B. Maternal Infant and Child Health - some needs are served through Women's Care Center; limited capability in neo-natal care; shortage of physician staff with whom to partner. C. Homelessness - hospital does not have expertise in this area. D. Mental Health - limited resources (no psychiatric services) plus the existence of several other mental health resources in the community. E. Nutrition, Fitness/Life Style - existing programs address some of these needs plus the programs selected for development (diabetes and cardiovascular) will include emphasis on these factors for improved health. F. Tobacco Use - existing programs address this need plus, other community programs emphasize this problem; plus, the heart failure program that is a CHNA selection will include smoking cessation. LINE 11: FH-Munster NEEDS BEING ADDRESSED VIA SPECIFIC CHNA STRATEGIES A. Diabetes - Improve self-management of disease among at-risk Hispanic population thru screening and education. B. Colorectal Cancer - Reduce the incidence of the disease and improve the treatment among at-risk African-American population thru early screening, education and referrals for treatment. NEEDS IDENTIFIED BUT NOT SELECTED AMONG CHNA STRATEGIES A. Access to Care - Franciscan Alliance already operates a clinic for the under and uninsured population in the geographic area. The hospital does not operate an ER and expect that the provisions of the Affordable Care Act will improve access via Medicaid and employer expansion of insurance coverage. B. Preventable hospitalizations - Franciscan's ACO is working toward addressing this problem and there are other targeted programs addressing re-admissions. C. Maternal and Child Health - the hospital does not offer any obstetric or pediatric services and thus, does not have the resources or expertise typical for such programs. D. Adult Immunizations - other community resources and physician offices address this need. E. Asthma - due to our limited services we do not have the resources or expertise typical for such programs. F. Health Education - it was decided that broad-based health education is available from many sources. However, targeted health education in the areas of Diabetes and colon disease will be part of the selected CHNA programs provided. G. Substance Abuse - other programs are currently available in the community to address the need. H. Oral Health - the hospital does not have the expertise or resources required for this service. I. Nutrition, Physical Activity/Life-style - targeted effort will be a part of the diabetes program being developed; plus, other community programs are very active regarding this need. J. Mental Health - other community services are available and another Franciscan hospital that is part of this Form 990 already provides a variety of inpatient and outpatient mental health programs. K. Heart Disease and Stroke - existing services in our hospital address some of these needs and another Franciscan hospital that is part of this Form 990 already offers services specific to these needs and they are developing more targeted programs in their CHNA efforts. LINE 11: FSAH-CROWN POINT NEEDS BEING ADDRESSED VIA SPECIFIC CHNA STRATEGIES A. Diabetes - Improve self-management of disease among low income population to gain better compliance with disease management thru screening, education and monitoring of key indicators. B. Cardiovascular Disease - Reduce risk and incidence of disease among low-income population thru screening, smoking cessation, improved health behaviors and monitoring of key indicators. NEEDS IDENTIFIED BUT NOT SELECTED AMONG CHNA STRATEGIES A. Access to Health Services - the hospital already operates a clinic (St. Clare Health Clinic) to serve the under and uninsured population. People can also access a Federally Qualified Health Clinic in the area; the hospital also operates physician practices that accept all

LINE 11: FSEH-LAFAYETTE CENTRAL
"NEEDS BEING ADDRESSED VIA SPECIFIC CHNA STRATEGIES Same as FSEH-East except for Maternal and /Child Health since this facility does not provide obstetrical services. NEEDS IDENTIFIED BUT NOT SELECTED AMONG CHNA STRATEGIES A. Obesity - existing programs address aspects of this need, plus, the programs we are developing in diabetes and congestive heart failure include a focus on this need. B. Substance and tobacco use - existing community programs address these needs plus, the CHNA programs in diabetes and congestive heart failure will include smoking cessation efforts. C. Preventive health screenings - a variety of health screenings are conducted by many organizations, including our hospital. D. Chlamydia - as a Catholic organization we are constrained by our Ethical and Religious Directives from developing a comprehensive program. E. Medication Access - other community resources address this need and while not selected at this time, it will be examined more fully in the future. F. Pre-natal care in the first trimester - it was felt that other areas of need were of higher priority, partially due to the number of people that could benefit. G. Cancer and respiratory disease - existing programs in our hospital and in the community already address these needs. H. General social and economic needs such as: transportation; education; air quality; crime, etc., are felt to be responsibilities of the public sector plus, we do not have expertise, funding or resources adequate to address these needs. LINE 11: FSEH-CRAWFORDSVILLE NEEDS BEING ADDRESSED VIA SPECIFIC CHNA STRATEGIES A. Access to Care - Improve utilization/access to established low-income clinics by more effective ER identification and referrals and by expanding provider capacity. B. Diabetes - Improve referral of identified patients to appropriate care to reduce incidence of complications and improve self-management thru education and coaching. NEEDS IDENTIFIED BUT NOT SELECTED AMONG CHNA STRATEGIES A. Prenatal Care - our hospital does not operate an obstetrics service and thus, we have few of the resources and expertise necessary to support such a program. B. Asthma - due to our small size and limited staff, we do not have the resources necessary to develop an adequate program. C. Smoking cessation - the opportunity to develop a collaborative program collapsed due to a change in the resources available from that non-owned/non-affiliated entity. D. Lung cancer - as with smoking cessation, a program under consideration could not be developed due to the inability of the planned collaborator to provide necessary resources. E. Pediatric asthma - due to our small size and limited staff, we do not have the resources necessary to develop an adequate program. F. General social and economic needs such as: transportation; education; air quality; crime, etc., are felt to be responsibilities of the public sector plus, we do not have expertise, funding or resources adequate to address these needs. LINE 11: FSFH-INDIANAPOLIS NEEDS BEING ADDRESSED VIA SPECIFIC CHNA STRATEGIES A. Cardiovascular Health - Implement programs targeting 34 - 45 age men and women to educate and monitor key biometric indicators to improve health among those with identified risks. B. Breast Cancer - Implement program to increase awareness generally and to enhance self-exam capability to promote early detection and treatment. C. Lung Cancer - Address early education and healthy behaviors among children by providing programs with schools. D. Access to Care - Promote and improve access to appropriate care among a Burmese population by improving cultural awareness among providers, appropriate use of ER's and better access to available primary care sites. E. Diabetes - Promote improved awareness and self-management among employees of participating employers and identified at-risk family units. NEEDS IDENTIFIES BUT NOT SELECTED AMONG CHNA STRATEGIES A. Substance Abuse - other community organizations have the resources and established programs to address this need. B. Inpatient Mental Health - we have limited resources relative to other providers and community resources. C. Immunization and Infectious Disease - strong programs in existence among a variety of community organizations plus, a strong program is already in place in our Visiting Nurse Service/home health division. D. Injury and Violence Prevention - It is felt that these needs are more the responsibility of the public sector plus, we lack the expertise, resources and funding to be effective in these needs. LINE 11: FSFH-MOORESVILLE NEEDS BEING ADDRESSED VIA SPECIFIC CHNA STRATEGIES A. Cardiovascular Health - same as FSFH-Indianapolis but different geographic coverage B. Breast Cancer - same as FSFH-Indianapolis but different geographic coverage C. Lung Cancer - same as FSFH-Indianapolis but different geographic coverage D. Access to Care - Increase capacity of established clinic to respond to needs among low-income population. E. Joint and Arthritis Care - Improve care of population (especially seniors) thru education offerings, osteoporosis screening, aquatic offerings and appropriate referrals. NEEDS IDENTIFIED BUT NOT SELECTED AMONG CHNA STRATEGIES Same as FSFH-Indianapolis LINE 11: FSFH-CARMEL NEEDS BEING ADDRESSED VIA SPECIFIC CHNA STRATEGIES A. Joint and Arthritis Care - same as FSFH-Mooresville but different geographic coverage B. Breast Cancer - same as FSFH-Indianapolis but different geographic coverage C. Access to Care - same as FSFH-Mooresville but different clinic and geographic coverage NEEDS IDENTIFIED BUT NOT SELECTED AMONG CHNA STRATEGIES Same as FSFH-Indianapolis and FSFH-Mooresville LINES 15 AND 16: ALL FACILITIES Through Franciscan Alliance, Inc. (""Franciscan""), we continue the healing ministry of Christ in a Catholic health care system that upholds the moral values and teachings of the Catholic Church. Central concerns of this corporate ministry include compassion for those in need, respect for life and the dignity of persons. Franciscan believes in the dignity, uniqueness, and worth of each individual and, within the limits of our resources, Franciscan offers a comprehensive range of health care services to all regardless of race, creed, color, sex, national origin, handicap or an individual's financial capability. In light of this belief, we consider our health care services to be reaching out and responding, in a Christ-like manner, to those who are physically, materially, or spiritually in need. Franciscan is committed to providing financial assistance, in the form of charity care or uninsured discounts, to persons who are uninsured or underinsured, who are ineligible for governmental or social service programs, and who otherwise are unable to pay for emergency services or medically necessary care based on their individual financial situation. Consistent with our mission to deliver compassionate, high quality, affordable health care and to advocate for those who are poor and disenfranchised, Franciscan strives to ensure the financial capacity of people who need medically necessary health care services does not prevent them from seeking or receiving that care. Franciscan's financial assistance policy is designed to allow relief from all or part of the charges related to emergency or medically necessary health care services that exceed a patient's reasonable ability to pay. In order to ensure transparency, consistency and fairness, we ask patients to cooperate by providing necessary information to determine their eligibility for financial assistance. For patients not initially identified as qualifying for financial assistance, Franciscan communicates the availability of charity care and financial assistance in the applicable languages of the hospital community through the following means: 1. Franciscan communicates the availability of financial assistance in appropriate care settings such as emergency departments, admitting/registration areas, billing offices, outpatient service settings, and on our hospitals' websites. Signs/postings inform patients that free or reduced cost care may be available to qualifying patients who complete a financial assistance application. 2. Brochures summarizing our financial assistance programs are available throughout each Franciscan hospital. 3. Financial counselors and business office personnel are available to help patients understand and apply for local, state, federal health care, and health insurance exchange programs and Franciscan's financial assistance programs. 4. All bills and statements for services inform uninsured patients that financial assistance is available. 5. Patients/guarantors may request a copy of the financial assistance application by calling the Franciscan billing office or downloading a copy at no cost from Franciscan hospital's websites. 6. Patients/guarantors can request financial assistance information by calling Franciscan's billing office phone line on a 24-hour basis. 7. Indiv"

SUPPLEMENTAL INFORMATION
"SCHEDULE H, PART VI, ITEM 2 NEEDS ASSESSMENT Franciscan Alliance, Inc. (""Franciscan"") hospitals assess the health care needs of the communities we serve by collaborating with public and private agencies to determine community health needs and how best to address them. Franciscan's Corporate Community Benefit Committee, as well as committees in the local facilities, committed to an ongoing assessment of community health needs and priorities based upon health initiatives of the municipal, county, and state health departments, community-based assessments by other public sector partners, professional research consultant reports, and faith-based partners within the communities served. In addition, our hospitals address public agency and community group requests to provide community benefit activities and programs that meet certain specialty or hybrid needs or populations. The detailed CHNA activities for each of Franciscan's hospitals can be found in Part V of this Schedule H. ------------------------------------------------------------------- SCHEDULE H, PART VI, ITEM 3 FINANCIAL ASSISTANCE POLICY Franciscan's hospitals inform and educate patients and persons who may be billed for patient care about their eligibility for assistance under federal, state, or local government programs or under Franciscan's financial assistance and charity care policy. For patients not initially identified as qualifying for financial assistance, Franciscan communicates the availability of charity care and financial assistance in the applicable languages of the hospital community through the following means: 1. Franciscan communicates the availability of financial assistance in appropriate care settings such as emergency departments, admitting/registration areas, billing offices, outpatient service settings, and on our hospitals' websites. Signs/postings inform patients that free or reduced cost care may be available to qualifying patients who complete a financial assistance application. 2. Brochures summarizing our financial assistance programs are available throughout each Franciscan hospital. 3. Financial counselors and business office personnel are available to help patients understand and apply for local, state, federal health care programs; health insurance exchanges; and Franciscan's financial assistance programs. 4. All bills and statements for services inform uninsured patients that financial assistance is available. 5. Patients/guarantors may request a copy of the financial assistance application by calling the Franciscan billing office or downloading a copy at no cost from Franciscan hospital's websites. 6. Individuals other than the patient, such as the patient's physician, family members, community or religious groups, social services, or hospital personnel may make requests for financial assistance on the patient's behalf, subject to applicable privacy laws. 7. Franciscan sends 4 statements and makes 6 phone call attempts to contact the patient/guarantor at the address and phone number provided by the patient/guarantor. Statements and communications inform the patient of the amount due and if they cannot pay their balance the availability of financial assistance. ------------------------------------------------ SCHEDULE H, PART VI, ITEM 4 COMMUNITY INFORMATION The Franciscan Alliance serves a large geographic area which includes 18 counties in Indiana (Benton, Carroll, Fountain, Hamilton, Jasper, Johnson, Lake, LaPorte, Marion, Montgomery, Morgan, Newton, Porter, Shelby, Starke, Tippecanoe, Warren, and White) and 3 counties in Illinois (Cook, Kankakee, and Will). The population of the communities that we serve was estimated at over 3.9 million people with an average household income close to $55,000 in 2014. For these communities, the percentage of residents below the federal poverty level was estimated at 16.4%. The percentage of inpatients from these communities who were served by Medicaid was 21.8%. And the percentage of inpatients from these communities who were uninsured was approximately 4.7%. In comparison, the percentages of Medicaid and uninsured inpatients treated by the hospitals of the Franciscan Alliance were 17.6% and 4.6% respectively in 2014. There are 56 other hospitals that serve within these communities as well. ----------------------------------------- SCHEDULE H, PART VI, ITEM 5 & PART I, LINE 6A OTHER INFORMATION ""Our Giving Journal"" at www.FranciscanAlliance.org/CommunityBenefit reflects Franciscan's mission of ""Continuing Christ's Ministry in Our Franciscan Tradition"" along with a report of our community benefit activities. Although it is not all inclusive of the many benefits provided by Franciscan it does portray the significant benefits that reflect our commitment to healthcare and the communities we are privileged to serve. The following is a subset of the many clinical services as well as population health improvement and community outreach activities offered by one or more of Franciscan's healthcare facilities: - Inpatient Hospital Services including: Medical Services, Surgical Services, Intensive Care Services, Telemetry Services, Obstetrics Services, Pediatrics Services, Neonatal Intensive Care Services, Acute Rehabilitation Services, Oncology Services, Bone Marrow Transplant Services, General Surgery Services, Cardiac Surgery Services, Vascular Services, Pulmonary Services, Interventional Radiology, Orthopedics, Joint and Spine Care, Gastrointestinal Care, Neurosciences Services, Colon and Rectal Services, Anesthesia Services, Hospice Services, Inpatient Psychiatric Care, Residential Treatment Program for Adolescents, etc. - Emergency Services including: 24 hour Emergency Room Services, Ambulance Services, Immediate Care Services, Advanced Life Support Services, Basic Life Support Services, Behavioral Health Emergency Consultation Services, 24-Hour Crisis and Referral Hotline, etc. - Outpatient Services including: Laboratory Services, Physical Therapy Services, Occupational Therapy Services, Speech Therapy Services, General Radiology Services, Computed Tomography Services, Magnetic Resonance Imaging (MRI), Nuclear Medicine Services, Mammography Services, Angiography Services, Neurodiagnostics Services, Gastro/Intestinal Services, Sleep Laboratory, Pulmonary Services, Outpatient Surgery, Cardiac Testing, Electrocardiogram (EKG) Services, Medical Oncology Services, Radiation Oncology Services, Pharmacy, Occupational Medicine Services, Cardiac/Pulmonary Rehabilitation Services, Congestive Health Failure Clinic, Wound Healing and Prevention, Nutritional Counseling, Diabetes Management, Bariatric Services, Pain Management, Social Services, Palliative Care, Sports Medicine, Behavioral Health, Stroke Services, Home Health Services, Skilled Nursing Services, Social Services, Durable Medical Equipment. - Primary Care and Specialty Care Physician Clinics. - Subsidized Healthcare Services offered by Franciscan: - Franciscan has neighborhood health clinics that offer family practice services designed for families without access to affordable health care. The focus is on providing primary and preventive care as well as health education. These clinics offer free immunizations. - Franciscan's Sexual Assault Clinics that provide medical and forensic assistance that is sensitive to the special needs of the victim as well as a victim advocate program and crisis intervention counselors. - Franciscan's Blood and Marrow Transplant program is only one of two programs in Indiana offering full service transplant care and specializes in the treatment of patients with leukemia, Hodgkin's or non-Hodgkin's lymphoma, multiple myeloma, and many other malignancies and blood disorders. - Franciscan's Diabetes Education Centers offer a number of diabetes classes and individualized sessions to help patients take control of their health with a focus on nutritional, exercise, medications, chronic conditions, preconception and pregnancy, blood glucose monitoring, goal setting, problem solving, psychosocial adjustment, detection/treatment of high and low blood sugar, and insulin administration. - Franciscan's Women's and Children's Services include preventive medical care and health screenings to gynecological care, maternity, lactation consultation services, and beyond, Franciscan's facilities focus on keeping women healthy. - Franciscan's Hospice Care Services provide a sense of dignity and compassion to both the patient and their family in caring for patients with a life expectancy of six months or less. Our programs affirm and celebrate life and regard dying as a natural process, recognizing that every person has the right to die with dignity, peace, and comfort regardless of their ethnic, faith background, or ability to pay. - St. Monica Home for pregnant teens offers a medically sound and emotionally healthy environment for a pregnant teen to reside in while waiting for the birth of her baby. Opened in July of 1994 on the Franciscan St. Ma"

SCHEDULE H, PART II
"COMMUNITY BUILDING ACTIVITIES Franciscan is involved in and actively participates in numerous community building activities. We work to provide quality care and community building activities by partnering with other health care providers, government agencies, and not-for-profit social service agencies to serve our communities' diverse health care needs. The community building activities offered by FRANCISCAN are provided without reimbursement, serve at-risk populations, and provide health education to key community groups. We monitor these activities for outcomes by identifying changes in health behaviors and knowledge. Some examples of community health programs Franciscan provides include: health education, health fairs, free or low cost health screening, access to healthcare services, immunization services, prescription medication assistance programs, nutritional counseling, enrollment assistance in Medicaid, free spa services for cancer patients, food assistance, transportation assistance, referral assistance, breast cancer and childhood obesity initiatives, healthy choices initiatives, childhood alcoholism prevention, and other various community outreach programs as further described in ""Our Giving Journal"" at www.franciscanalliance.org/communitybenefit. Additionally, several of our hospitals have been identified by the federal government as designated regional medication distribution sites in the event of a national disaster or epidemic/pandemic. Responding to federal, state and local needs in the event of national or local disasters or epidemic/pandemics, we collaborate and coordinate our efforts with many civic and other agencies to ensure that those needs will be met should disaster strike. Franciscan Alliance provides medical and other supplies, health care and other services, screenings, support groups, educational opportunities and presentations, and other sponsorships. Members from all of our organization contribute their time and skills and, in meaningful ways, touch many lives in our communities. Members from our facilities participate on boards, coalitions, task forces and work with colleges, universities and other groups to address the healthcare needs of our communities. ----------------------------------------- SCHEDULE H, PART III, LINE 2 Throughout the year, the Corporation estimates this allowance based on the aging of its patient accounts receivable, historical collection experience, and other relevant factors. These factors include changes in the economy and unemployment rates, which has an impact on the number of uninsured and underinsured patients, as well as trends in health care coverage, such as the increased burden of deductibles, copayments, and coinsurance payments to be made by patients with insurance. After satisfaction of amounts due from insurance and reasonable efforts to collect from the patient have been exhausted, the Corporation follows established procedures for placing certain past due patient balances with collection agencies, subject to the terms and certain restrictions on collection efforts as determined by the Corporation. Uncollectible patient accounts receivable are written off against the allowance for doubtful accounts with any subsequent recoveries being recorded against the provision for doubtful accounts. ----------------------------------------- SCHEDULE H, PART III, LINE 3 The corporation has a system-wide charity care and uninsured discount policy; has detailed administrative procedures established for qualifying and enrolling patients for charity care or uninsured/underinsured discounts; uses various analytical programs including soft credit inquiries that do not affect credit scores to help assess a patient's ability to pay; and utilizes numerous mechanisms to inform and educate patients about their eligibility for assistance which are detailed under Schedule H, Part VI, item 3. Despite these rigorous efforts, patients who need subsidized care may not seek this assistance or choose to enroll in the state's Medicaid program. Also, as further described in HFMA statement No. 15, the appropriate classification of charity care and bad debt is often difficult. The urgency of some treatments, as well as certain federal regulations, often requires the provision of service without consideration of the patient's ability to pay. Some patients have complex medical conditions with unpredictable treatment needs. For these and other reasons, Franciscan believes, a portion of its bad debt expense as reported on Line 3 of Part III represents charity care delivered to individuals in the communities it serves consistent with its charitable healthcare mission. -------------------------------------- SCHEDULE H, PART III, LINE 4 The Corporation's allowance for doubtful accounts footnote from its audited financial statements is as follows: ""The collection of outstanding patient accounts receivable from governmental payors, managed care and other third party payors, and patients is the Corporation's primary source of cash. The Corporation's main collection risk relates to uninsured patient accounts and patient accounts for which the third party payor has paid amounts in accordance with the applicable agreement, however the patient's responsibility, usually in the form of deductibles, copayments, and coinsurance payments, remain outstanding (""self pay accounts""). The Corporation's patient accounts receivable is reduced by an allowance for amounts, primarily self pay accounts, which could become uncollectible in the future. Throughout the year, the Corporation estimated this allowance based on the aging of its patient accounts receivable, historical collection experience, and other relevant factors. These factors include changes in the economy and unemployment rates, which has an impact on the number of uninsured and underinsured patients, as well as trends in health care coverage, such as the increased burden of deductibles, copayments, and coinsurance payments to be made by patients with insurance. After satisfaction of amounts due from insurance and reasonable efforts to collect from the patient have been exhausted, the Corporation follows established procedures for placing certain past due patient balances with collection agencies, subject to the terms and certain restrictions on collection efforts determined by the Corporation. Uncollectible patient accounts receivable are written off against the allowance for doubtful accounts with any subsequent recoveries being recorded against the provision for doubtful accounts."" ------------------------------------------------ SCHEDULE H, PART III, LINE 8 Consistent with the charitable healthcare mission of Franciscan and the community benefit standard set forth in IRS Revenue Ruling 69-545, Franciscan provides care for all patients covered by Medicare seeking medical care at Franciscan. Such care is provided regardless of whether the reimbursement provided for such services meets or exceeds the costs incurred by Franciscan to provide such services. Like Medicaid, payment rates for Medicare are set by law rather than through a negotiation process as with private insurers. These payment rates are currently set below the costs of providing care resulting in underpayments. Medicare rates are determined within the context of all the budgetary needs of the federal government and Medicare payments have historically been set below the costs of providing care to Medicare patients though how far below varies over time and by service. Each year Medicare is supposed to provide hospitals an increase in both inpatient and outpatient payments to account for inflation in the prices for goods and services hospitals must purchase in order to provide patient care. However inpatient updates have been set below the rate of inflation and actually negative in recent years resulting in a shortfall that has grown over time. The compounding issue that occurs is that this shortfall jeopardizes hospitals' ability to serve their communities because they are not reimbursed their incurred costs. Providers make the decision to eliminate or significantly reduce necessary clinical services within the marketplace placing the Medicare shortfall burden on others that do, such as Franciscan. Given that Franciscan provides such services to Medicare patients knowing that they will result in a loss, and given that Franciscan believes that it provides these services in an efficient and cost effective manner, the shortfall reported on line 7 of Part III should be viewed as community benefit provided by Franciscan. ------------------------------------------------ SCHEDULE H, PART III, LINE 9B Franciscan Alliance, Inc.'s written Charity Care and Uninsured Patient Discount Policy and Patient Collection Procedure include various provisions on the collection practices to be followed for patients who are known to qualify for charity or financial assistance. If a patient qualifies for charity or fina"