4A (Expenses $ 2174914947 including grants of $ 1643789) (Revenue $ 2522660037)
"For over 135 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 is further described below. In 2012, Franciscan admitted approximately 90,000 inpatients and recorded over 413,000 inpatient days, 420,000 emergency room visits, and provided over $524 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 2012, Franciscan provided over $524 million in quantifiable community benefits which included: Benefits for the Poor: Charity Care $83,775,331 Unpaid Costs of Medicaid $92,536,775 Community Services $4,252,504 Other Public Programs $4,134,629 _______________ Subtotal $184,699,239 Benefits for the Community: Unpaid Costs of Medicare $250,738,928 Other Community Benefits $54,206,499 Bad Debt $34,552,073 _____________ Subtotal $339,497,500 Total $524,196,739 ""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. - Indigent Health Care Clinics. - Health and Wellness Centers and Healthy Living Education Centers. - Community Outreach and Education Programs including: Health Fairs, Free Health Screenings, Free Breast Health Screening Services, Free Prostrate Screenings, Free Skin Cancer Screenings, Free Cervical Cancer Screenings, Free Glucose Screenings, Free Cholesterol Screenings, Free Bone Density Screenings, Free Spa Services for Cancer Patients, Online Health Condition Assessment Tools, Cancer Prevention Activities, Cancer Survivor Programs and Retreats, 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, Smoking Cessation Programs, 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 Days, Arthritis Exercise Group, Babysitting Course, Prepared Childbirth Programs, Food Share Programs, Nutritional Counseling for Grade Schools and Seniors, etc. - Social Services including: Pastoral Care, Eucharistic Ministry Program, No One Dies Alone Programs, Language Interpreter Services, Deaf Interpreter Services, Transportation for the Indigent, enrollment assistance in Medicaid, etc. - Medical Education including: Physician Residency Programs, Family Medicine Residency Program, Emergency Room Physician Residency Program, Pharmacy Residency Program, Medical Student Training Program, St. Elizabeth School of Nursing Program, Advance Nursing Continuing Education, Nursing Clinical Rotations, Phlebotomy Training Program, Medical Assistance Training, Medical Technology Training Programs, OR Technology Training, etc. - Research Programs including - Cancer Genome Project, Cardiac Research, HLA-Vascular Biology Research, Clinical Trails, Plaque Formation Studies, Use of Drug Eluting Stents Studies, etc. Again, please visit ""Our Giving Journal"" at www.FranciscanAlliance.org/CommunityBenefit for further details."

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. ------------------------------------------------ SCHEDULE H, PART VI, ITEM 3 PATIENT EDUCATION OF ELIGIBILITY FOR ASSISTANCE 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, and federal health care 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. 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. 8. Franciscan sends a minimum of 4 statements and makes 7 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 FRANCISCAN ALLIANCE SERVICES A LARGE GEOGRAPHIC AREA WHICH INCLUDES 17 COUNTIES IN INDIANA (BENTON, CARROLL, FOUNTAIN, 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 3.8 MILLION PEOPLE WITH AN AVERAGE HOUSEHOLD INCOME OF APPROXIMATELY $58,119 IN 2012. FOR THESE COMMUNITIES, THE PERCENTAGE OF RESIDENTS BELOW THE FEDERAL POVERTY LEVEL WAS ESTIMATED AT 17.1% IN 2012. THE PERCENTAGE OF INPATIENTS FROM THESE COMMUNITIES WHO WERE SERVED BY MEDICAID WAS 17.9%. AND THE PERCENTAGE OF INPATIENTS FROM THESE COMMUNITIES WHO WERE UNINSURED WAS APPROXIMATELY 3.1%. IN COMPARISON, THE PERCENTAGES OF MEDICAID AND UNINSURED TREATED BY FRANCISCAN ALLIANCE WERE 15.7% AND 5.9% RESPECTIVELY IN 2012. THERE WERE 54 OTHER HOSPITALS IN 2012 THAT SERVE WITHIN THESE COMMUNITIES AS WELL. ----------------------------------------- SCHEDULE H, PART VI, ITEM 5 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. - Indigent Health Care Clinics. - Health and Wellness Centers and Healthy Living Education Centers. - Community Outreach and Education Programs including: Health Fairs, Free Health Screenings, Free Breast Health Screening Services, Free Prostrate Screenings, Free Skin Cancer Screenings, Free Cervical Cancer Screenings, Free Glucose Screenings, Free Cholesterol Screenings, Free Bone Density Screenings, Free Spa Services for Cancer Patients, Online Health Condition Assessment Tools, Cancer Prevention Activities, Cancer Survivor Programs and Retreats, 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, Smoking Cessation Programs, 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 Days, Arthritis Exercise Group, Babysitting Course, Prepared Childbirth Programs, Food Share Programs, Nutritional Counseling for Grade Schools and Seniors, etc. - Social Services including: Pastoral Care, Eucharistic Ministry Program, No One Dies Alone Programs, Language Interpreter Services, Deaf Interpreter Services, Transportation for the Indigent, enrollment assistance in Medicaid, etc. - Medical Education including: Physician Residency Programs, Family Medicine Residency Program, Emergency Room Physician Residency Program, Pharmacy Residency Program, Medical Student Training Program, St. Elizabeth School of Nursing Program, Advance Nursing Continuing Education, N"

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 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 assitance 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 financial assistance certain collection practices do not apply. ------------------------------------------------ SCHEDULE H, PART IV NAME OF ENTITY: FRANCISCAN IMAGING EQUIPMENT LEASING LLC DESCRIPTION OF PRIMARY ACTIVITY OF ENTITY: IMAGING EQUIPMENT LEASING ORGANIZATION'S PROFIT % OR STOCK OWNERSHIP %: 59.67000 OFFICERS, DIRECTORS, TRUSTEES. ETC. PROFIT % OR STOCK OWNERSHIP %: 0 PHYSICIANS' PROFIT % OR STOCK OWNERSHIP %: 40.33000 NAME OF ENTITY: MOORESVILLE ENDOSCOPY CENTER LLC DESCRIPTION OF PRIMARY ACTIVITY OF ENTITY: ENDOSCOPY SERVICES ORGANIZATION'S PROFIT % OR STOCK OWNERSHIP %: 50.00000 OFFICERS, DIRECTORS, TRUSTEES. ETC. PROFIT % OR STOCK OWNERSHIP %: 0 PHYSICIANS' PROFIT % OR STOCK OWNERSHIP %: 50.00000 NAME OF ENTITY: LAPORTE COUNTY OPEN MRI LLC DESCRIPTION OF PRIMARY ACTIVITY OF ENTITY: MRI SERVICES ORGANIZATION'S PROFIT % OR STOCK OWNERSHIP %: 33.33333 OFFICERS, DIRECTORS, TRUSTEES. ETC. PROFIT % OR STOCK OWNERSHIP %: 0 PHYSICIANS' PROFIT % OR STOCK OWNERSHIP %: 66.66667 NAME OF ENTITY: INDIANA SLEEP CENTER LLC DESCRIPTION OF PRIMARY ACTIVITY OF ENTITY: SLEEP CENTER ORGANIZATION'S PROFIT % OR STOCK"

STATE FILING OF COMMUNITY BENEFIT REPORT 990 SCHEDULE H, PART VI
IL,IN,