Form990
Department of the TreasuryInternal Revenue Service
Return of Organization Exempt From Income Tax
Under section 501(c), 527, or 4947(a)(1) of the Internal Revenue Code (except private
foundations)
MediumBullet Do not enter social security numbers on this form as it may be made public.
MediumBullet Information about Form 990 and its instructions is at www.IRS.gov/form990.
OMB No. 1545-0047
2015
Open to Public Inspection
A For the 2015 calendar year, or tax year beginning 01-01-2015 , and ending 12-31-2015
BCheck if applicable:
CName of organization
St Elizabeth Medical Center Inc
 
 
Doing business as
 
 
Number and street (or P.O. box if mail is not delivered to street address)
One Medical Village Drive
 
Room/suite
City or town, state or province, country, and ZIP or foreign postal code
Edgewood, KY41017
D Employer identification number

61-0445850
E Telephone number

G Gross receipts $ 1,421,048,588
F Name and address of principal officer:
Garren Colvin
One Medical Village Drive
Edgewood,KY41017
I
Tax-exempt status: (   ) LeftBullet (insert no.) or
J
Website:MediumBullet
www.stelizabeth.com
H(a)
Is this a group return for
subordinates?
H(b)
Are all subordinates
included?
If "No," attach a list. (see instructions)
H(c)
Group exemption number MediumBullet  
K Form of organization:  
L Year of formation: 1861
M State of legal domicile: KY
Part I
Summary
Activities & Governance 1 Briefly describe the organization’s mission or most significant activities: AS A CATHOLIC HEALTHCARE MINISTRY, WE PROVIDE COMPREHENSIVE AND COMPASSIONATE CARE THAT IMPROVES THE HEALTH OF THE PEOPLE WE SERVE.
2 Check this box MediumBullet
3 Number of voting members of the governing body (Part VI, line 1a) ........ 3 19
4 Number of independent voting members of the governing body (Part VI, line 1b) ..... 4 18
5 Total number of individuals employed in calendar year 2015 (Part V, line 2a) ...... 5 7,009
6 Total number of volunteers (estimate if necessary) ............. 6 1,253
7a Total unrelated business revenue from Part VIII, column (C), line 12 ........ 7a 3,271,128
b Net unrelated business taxable income from Form 990-T, line 34 ......... 7b 0
Revenues Prior Year Current Year
8 Contributions and grants (Part VIII, line 1h) ......... 5,299,606 3,222,670
9 Program service revenue (Part VIII, line 2g) ......... 952,732,025 974,634,063
10 Investment income (Part VIII, column (A), lines 3, 4, and 7d ) .... 21,176,056 27,109,382
11 Other revenue (Part VIII, column (A), lines 5, 6d, 8c, 9c, 10c, and 11e) 4,977,738 5,849,442
12 Total revenue—add lines 8 through 11 (must equal Part VIII, column (A), line 12) 984,185,425 1,010,815,557
Expenses; 13 Grants and similar amounts paid (Part IX, column (A), lines 1–3 )...   0
14 Benefits paid to or for members (Part IX, column (A), line 4).....   0
15 Salaries, other compensation, employee benefits (Part IX, column (A), lines 5–10) 410,296,134 460,743,700
16a Professional fundraising fees (Part IX, column (A), line 11e) ..... 28,200 27,620
b Total fundraising expenses (Part IX, column (D), line 25) MediumBullet1,378,332    
17 Other expenses (Part IX, column (A), lines 11a–11d, 11f–24e).... 468,803,927 463,279,469
18 Total expenses. Add lines 13–17 (must equal Part IX, column (A), line 25) 879,128,261 924,050,789
19 Revenue less expenses. Subtract line 18 from line 12....... 105,057,164 86,764,768
Net Assets or Fund Balances; Beginning of Current Year End of Year
20 Total assets (Part X, line 16)............. 1,354,790,705 1,469,096,050
21 Total liabilities (Part X, line 26)............. 507,554,608 566,139,592
22 Net assets or fund balances. Subtract line 21 from line 20..... 847,236,097 902,956,458
Part II
Signature Block
Under penalties of perjury, I declare that I have examined this return, including accompanying schedules and statements, and to the best of my knowledge and belief, it is true, correct, and complete. Declaration of preparer (other than officer) is based on all information of which preparer has any knowledge.
Sign Here
JumboBullet
Signature of officer Date
JumboBullet
Type or print name and title
Paid Preparer Use Only
Print/Type preparer's name
Preparer's signature
Date
PTIN
Firm's name MediumBullet
Firm's EIN MediumBullet
Firm's address MediumBullet



Phone no.
May the IRS discuss this return with the preparer shown above? (see instructions) ..........
For Paperwork Reduction Act Notice, see the separate instructions.
Cat. No. 11282Y Form 990 (2015)
Form 990 (2015)
Page 2
Part III
Statement of Program Service Accomplishments
Check if Schedule O contains a response or note to any line in this Part III ..............
1
Briefly describe the organization’s mission: AS A CATHOLIC HEALTHCARE MINISTRY, WE PROVIDE COMPREHENSIVE AND COMPASSIONATE CARE THAT IMPROVES THE HEALTH OF THE PEOPLE WE SERVE.
2
Did the organization undertake any significant program services during the year which were not listed on
the prior Form 990 or 990-EZ? .....................
If "Yes," describe these new services on Schedule O.
3
Did the organization cease conducting, or make significant changes in how it conducts, any program
services? ...........................
If "Yes," describe these changes on Schedule O.
4
Describe the organization’s program service accomplishments for each of its three largest program services, as measured by expenses. Section 501(c)(3) and 501(c)(4) organizations are required to report the amount of grants and allocations to others, the total expenses, and revenue, if any, for each program service reported.
4a (Code:   ) (Expenses $ 604,254,716 including grants of $   ) (Revenue $ 969,447,038 )
ST. ELIZABETH HEALTHCARE IS ONE OF THE OLDEST, LARGEST AND MOST RESPECTED MEDICAL PROVIDERS IN THE NORTHERN KENTUCKY, SOUTHERN OHIO, AND SOUTHERN INDIANA AREAS. WITHIN OUR THRIVING, MULTI-FACETED ORGANIZATION, SOME OF THE NATION'S TOP MEDICAL PROFESSIONALS ARE WORKING TOGETHER TO DELIVER THE BEST CARE AVAILABLE TO THESE AREAS. ST. ELIZABETH HEALTHCARE HAS INVESTED IN OUR COMMUNITY FOR GENERATIONS. ST. ELIZABETH HEALTHCARE BELIEVES THAT REACHING OUT TO HELP THE UNDERPRIVILEGED AND IMPROVING THE OVERALL HEALTH OF THE COMMUNITY IS THE FOUNDATION OF ITS MISSION TO PROVIDE COMPREHENSIVE AND COMPASSIONATE CARE TO OUR NEIGHBORHOOD AND OUR FAMILIES. IT IS BECAUSE OF THIS BELIEF THAT THE ST. ELIZABETH HEALTHCARE COMMUNITY BENEFIT PROGRAM HELPS OTHERS HAVE ACCESS TO ST. ELIZABETH HEALTHCARE RESOURCES AND SERVICES. IT IS ST. ELIZABETH HEALTHCARE'S INTENTION TO ALWAYS BALANCE FINANCIAL VIABILITY WITH COMPASSIONATE CARE, AND TO STAY TRUE TO ITS NON- PROFIT ROOTS. TOTAL ADMISSIONS: 90,871 TOTAL PATIENT DAYS: 204,970 TOTAL EMERGENCY ROOM VISITS: 204,171
4b (Code:   ) (Expenses $   including grants of $   ) (Revenue $   )
4c (Code:   ) (Expenses $   including grants of $   ) (Revenue $   )
4d Other program services (Describe in Schedule O.)
(Expenses $   including grants of $   ) (Revenue $   )
4e Total program service expensesMediumBullet604,254,716
Form 990 (2015)
Form 990 (2015)
Page 3
Part IV
Checklist of Required Schedules
Yes
No
1
Is the organization described in section 501(c)(3) or 4947(a)(1) (other than a private foundation)? If "Yes," complete Schedule AClick to see attachment.....................
1
Yes
 
2
Is the organization required to complete Schedule B, Schedule of Contributors (see instructions)? Click to see attachment...
2
Yes
 
3
Did the organization engage in direct or indirect political campaign activities on behalf of or in opposition to candidates for public office? If "Yes," complete Schedule C, Part I.............
3
 
No
4
Section 501(c)(3) organizations. Did the organization engage in lobbying activities, or have a section 501(h) election in effect during the tax year? If "Yes," complete Schedule C, Part IIClick to see attachment..............
4
Yes
 
5
Is the organization a section 501(c)(4), 501(c)(5), or 501(c)(6) organization that receives membership dues, assessments, or similar amounts as defined in Revenue Procedure 98-19? If "Yes," complete Schedule C, Part III.................
5
 
No
6
Did the organization maintain any donor advised funds or any similar funds or accounts for which donors have the right to provide advice on the distribution or investment of amounts in such funds or accounts? If "Yes," complete Schedule D, Part I..................
6
 
No
7
Did the organization receive or hold a conservation easement, including easements to preserve open space,
the environment, historic land areas, or historic structures? If "Yes," complete Schedule D, Part II...
7
 
No
8
Did the organization maintain collections of works of art, historical treasures, or other similar assets? If "Yes," complete Schedule D, Part III .............
8
 
No
9
Did the organization report an amount in Part X, line 21 for escrow or custodial account liability; serve as a custodian for amounts not listed in Part X; or provide credit counseling, debt management, credit repair, or debt negotiation services? If "Yes," complete Schedule D, Part IV..............
9
 
No
10
Did the organization, directly or through a related organization, hold assets in temporarily restricted endowments, permanent endowments, or quasi-endowments? If "Yes," complete Schedule D, Part V......
10
 
No
11
If the organization’s answer to any of the following questions is "Yes," then complete Schedule D, Parts VI, VII, VIII, IX, or X as applicable.
a
Did the organization report an amount for land, buildings, and equipment in Part X, line 10?
If "Yes," complete Schedule D, Part VI.Click to see attachment...................
11a
Yes
 
b
Did the organization report an amount for investments—other securities in Part X, line 12 that is 5% or more of its total assets reported in Part X, line 16? If "Yes," complete Schedule D, Part VIIClick to see attachment.......
11b
Yes
 
c
Did the organization report an amount for investments—program related in Part X, line 13 that is 5% or more of its total assets reported in Part X, line 16? If "Yes," complete Schedule D, Part VIII.......
11c
 
No
d
Did the organization report an amount for other assets in Part X, line 15 that is 5% or more of its total assets reported in Part X, line 16? If "Yes," complete Schedule D, Part IX............
11d
 
No
e
Did the organization report an amount for other liabilities in Part X, line 25? If "Yes," complete Schedule D, Part XClick to see attachment
11e
Yes
 
f
Did the organization’s separate or consolidated financial statements for the tax year include a footnote that addresses the organization’s liability for uncertain tax positions under FIN 48 (ASC 740)? If "Yes," complete Schedule D, Part XClick to see attachment
11f
Yes
 
12a
Did the organization obtain separate, independent audited financial statements for the tax year?
If "Yes," complete Schedule D, Parts XI and XII .................
12a
 
No
b
Was the organization included in consolidated, independent audited financial statements for the tax year? If "Yes," and if the organization answered "No" to line 12a, then completing Schedule D, Parts XI and XII is optional Click to see attachment
12b
Yes
 
13
Is the organization a school described in section 170(b)(1)(A)(ii)? If "Yes," complete Schedule E
13
 
No
14a
Did the organization maintain an office, employees, or agents outside of the United States? .....
14a
 
No
b
Did the organization have aggregate revenues or expenses of more than $10,000 from grantmaking, fundraising, business, investment, and program service activities outside the United States, or aggregate foreign investments valued at $100,000 or more? If "Yes," complete Schedule F, Parts I and IV.........Click to see attachment
14b
Yes
 
15
Did the organization report on Part IX, column (A), line 3, more than $5,000 of grants or other assistance to or for any foreign organization? If “Yes,” complete Schedule F, Parts II and IV.....
15
 
No
16
Did the organization report on Part IX, column (A), line 3, more than $5,000 of aggregate grants or other assistance to or for foreign individuals? If “Yes,” complete Schedule F, Parts III and IV...
16
 
No
17
Did the organization report a total of more than $15,000 of expenses for professional fundraising services on Part IX, column (A), lines 6 and 11e? If "Yes," complete Schedule G, Part I (see instructions) ....Click to see attachment
17
Yes
 
18
Did the organization report more than $15,000 total of fundraising event gross income and contributions on Part VIII, lines 1c and 8a? If "Yes," complete Schedule G, Part II............ Click to see attachment
18
Yes
 
19
Did the organization report more than $15,000 of gross income from gaming activities on Part VIII, line 9a? If "Yes," complete Schedule G, Part III...................Click to see attachment
19
Yes
 
20a
Did the organization operate one or more hospital facilities? If "Yes," complete Schedule H....Click to see attachment
20a
Yes
 
b
If "Yes" to line 20a, did the organization attach a copy of its audited financial statements to this return? Click to see attachment
20b
Yes
 
Form 990 (2015)
Form 990 (2015)
Page 4
Part IV
Checklist of Required Schedules (continued)
21
Did the organization report more than $5,000 of grants or other assistance to any domestic organization or domestic government on Part IX, column (A), line 1? If “Yes,” complete Schedule I, Parts I and II.....
21
 
No
22
Did the organization report more than $5,000 of grants or other assistance to or for domestic individuals on Part IX, column (A), line 2? If “Yes,” complete Schedule I, Parts I and III........
22
 
No
23
Did the organization answer "Yes" to Part VII, Section A, line 3, 4, or 5 about compensation of the organization’s current and former officers, directors, trustees, key employees, and highest compensated employees? If "Yes," complete Schedule J....................... Click to see attachment
23
Yes
 
24a
Did the organization have a tax-exempt bond issue with an outstanding principal amount of more than $100,000 as of the last day of the year, that was issued after December 31, 2002? If “Yes,” answer lines 24b through 24d and complete Schedule K. If “No,” go to line 25a...............Click to see attachment
24a
Yes
 
b
Did the organization invest any proceeds of tax-exempt bonds beyond a temporary period exception?...
24b
 
No
c
Did the organization maintain an escrow account other than a refunding escrow at any time during the year
to defease any tax-exempt bonds? ...............
24c
 
No
d
Did the organization act as an "on behalf of" issuer for bonds outstanding at any time during the year?...
24d
 
No
25a
Section 501(c)(3), 501(c)(4), and 501(c)(29) organizations. Did the organization engage in an excess benefit transaction with a disqualified person during the year? If "Yes," complete Schedule L, Part I............
25a
 
No
b
Is the organization aware that it engaged in an excess benefit transaction with a disqualified person in a prior year, and that the transaction has not been reported on any of the organization’s prior Forms 990 or 990-EZ? If "Yes," complete Schedule L, Part I ...................
25b
 
No
26
Did the organization report any amount on Part X, line 5, 6, or 22 for receivables from or payables to any current or former officers, directors, trustees, key employees, highest compensated employees, or disqualified persons? If "Yes," complete Schedule L, Part II ................
26
 
No
27
Did the organization provide a grant or other assistance to an officer, director, trustee, key employee, substantial contributor or employee thereof, a grant selection committee member, or to a 35% controlled entity or family member of any of these persons? If "Yes," complete Schedule L, Part III.........
27
 
No
28
Was the organization a party to a business transaction with one of the following parties (see Schedule L, Part IV instructions for applicable filing thresholds, conditions, and exceptions):
a
A current or former officer, director, trustee, or key employee? If "Yes," complete Schedule L,
Part IV ........................
28a
 
No
b
A family member of a current or former officer, director, trustee, or key employee? If "Yes," complete Schedule L, Part IV.....................
28b
 
No
c
An entity of which a current or former officer, director, trustee, or key employee (or a family member thereof) was an officer, director, trustee, or direct or indirect owner? If "Yes," complete Schedule L, Part IV...
28c
 
No
29
Did the organization receive more than $25,000 in non-cash contributions? If "Yes," complete Schedule M..Click to see attachment
29
Yes
 
30
Did the organization receive contributions of art, historical treasures, or other similar assets, or qualified conservation contributions? If "Yes," complete Schedule M .............
30
 
No
31
Did the organization liquidate, terminate, or dissolve and cease operations? If "Yes," complete Schedule N, Part I.
31
 
No
32
Did the organization sell, exchange, dispose of, or transfer more than 25% of its net assets? If "Yes," complete Schedule N, Part II ...........
32
 
No
33
Did the organization own 100% of an entity disregarded as separate from the organization under Regulations sections 301.7701-2 and 301.7701-3? If "Yes," complete Schedule R, Part I ........Click to see attachment
33
Yes
 
34
Was the organization related to any tax-exempt or taxable entity? If "Yes," complete Schedule R, Part II, III, or IV, and Part V, line 1.........................Click to see attachment
34
Yes
 
35a
Did the organization have a controlled entity within the meaning of section 512(b)(13)?
35a
Yes
 
b
If ‘Yes’ to line 35a, did the organization receive any payment from or engage in any transaction with a controlled entity within the meaning of section 512(b)(13)? If "Yes," complete Schedule R, Part V, line 2 ...Click to see attachment
35b
Yes
 
36
Section 501(c)(3) organizations. Did the organization make any transfers to an exempt non-charitable related organization? If "Yes," complete Schedule R, Part V, line 2.............
36
 
No
37
Did the organization conduct more than 5% of its activities through an entity that is not a related organization and that is treated as a partnership for federal income tax purposes? If "Yes," complete Schedule R, Part VI
37
 
No
38
Did the organization complete Schedule O and provide explanations in Schedule O for Part VI, lines 11b and 19? Note. All Form 990 filers are required to complete Schedule O. ............
38
Yes
 
Form 990 (2015)
Form 990 (2015)
Page 5
Part V
Statements Regarding Other IRS Filings and Tax Compliance
Check if Schedule O contains a response or note to any line in this Part V...........
Yes
No
1a
Enter the number reported in Box 3 of Form 1096 Enter -0- if not applicable ..
1a
503
b
Enter the number of Forms W-2G included in line 1a. Enter -0- if not applicable .
1b
0
c
Did the organization comply with backup withholding rules for reportable payments to vendors and reportable gaming (gambling) winnings to prize winners? ..................
1c
Yes
 
2a
Enter the number of employees reported on Form W-3, Transmittal of Wage and
Tax Statements, filed for the calendar year ending with or within the year covered by this return ..................
2a
7,009
b
If at least one is reported on line 2a, did the organization file all required federal employment tax returns?
Note. If the sum of lines 1a and 2a is greater than 250, you may be required to e-file (see instructions)
2b
Yes
 
3a
Did the organization have unrelated business gross income of $1,000 or more during the year?...
3a
Yes
 
b
If “Yes,” has it filed a Form 990-T for this year? If “No” to line 3b, provide an explanation in Schedule O...
3b
Yes
 
4a
At any time during the calendar year, did the organization have an interest in, or a signature or other authority over, a financial account in a foreign country (such as a bank account, securities account, or other financial account)? ..
4a
 
No
b
If "Yes," enter the name of the foreign country: MediumBullet
See instructions for filing requirements for FinCEN Form 114, Report of Foreign Bank and Financial Accounts (FBAR).
5a
Was the organization a party to a prohibited tax shelter transaction at any time during the tax year? ..
5a
 
No
b
Did any taxable party notify the organization that it was or is a party to a prohibited tax shelter transaction?
5b
 
No
c
If "Yes," to line 5a or 5b, did the organization file Form 8886-T? ............
5c
 
 
6a
Does the organization have annual gross receipts that are normally greater than $100,000, and did the organization solicit any contributions that were not tax deductible as charitable contributions? ...
6a
 
No
b
If "Yes," did the organization include with every solicitation an express statement that such contributions or gifts were not tax deductible? ......................
6b
 
 
7
Organizations that may receive deductible contributions under section 170(c).
a
Did the organization receive a payment in excess of $75 made partly as a contribution and partly for goods and services provided to the payor? ....................
7a
Yes
 
b
If "Yes," did the organization notify the donor of the value of the goods or services provided? .....
7b
Yes
 
c
Did the organization sell, exchange, or otherwise dispose of tangible personal property for which it was required to file Form 8282? .........................
7c
 
No
d
If "Yes," indicate the number of Forms 8282 filed during the year ....
7d
 
e
Did the organization receive any funds, directly or indirectly, to pay premiums on a personal benefit contract?
7e
 
No
f
Did the organization, during the year, pay premiums, directly or indirectly, on a personal benefit contract? ..
7f
 
No
g
If the organization received a contribution of qualified intellectual property, did the organization file Form 8899 as required? ......................
7g
 
 
h
If the organization received a contribution of cars, boats, airplanes, or other vehicles, did the organization file a Form 1098-C? ..........................
7h
 
 
8
Sponsoring organizations maintaining donor advised funds.
Did a donor advised fund maintained by the sponsoring organization have excess business holdings at any time during the year? .........................
8
 
 
9a
Did the sponsoring organization make any taxable distributions under section 4966?...
9a
 
 
b
Did the sponsoring organization make a distribution to a donor, donor advisor, or related person?...
9b
 
 
10
Section 501(c)(7) organizations. Enter:
a
Initiation fees and capital contributions included on Part VIII, line 12 ...
10a
 
b
Gross receipts, included on Form 990, Part VIII, line 12, for public use of club facilities
10b
 
11
Section 501(c)(12) organizations. Enter:
a
Gross income from members or shareholders .........
11a
 
b
Gross income from other sources (Do not net amounts due or paid to other sources against amounts due or received from them.) ..........
11b
 
12a
Section 4947(a)(1) non-exempt charitable trusts. Is the organization filing Form 990 in lieu of Form 1041?
12a
 
 
b
If "Yes," enter the amount of tax-exempt interest received or accrued during the year.
12b
 
13
Section 501(c)(29) qualified nonprofit health insurance issuers.
a
Is the organization licensed to issue qualified health plans in more than one state?
Note. See the instructions for additional information the organization must report on Schedule O.
13a
 
 
b
Enter the amount of reserves the organization is required to maintain by the states in which the organization is licensed to issue qualified health plans ....
13b
 
c
Enter the amount of reserves on hand ............
13c
 
14a
Did the organization receive any payments for indoor tanning services during the tax year?.....
14a
 
No
b
If "Yes," has it filed a Form 720 to report these payments? If "No," provide an explanation in Schedule O..
14b
 
 
Form 990 (2015)
Form 990 (2015)
Page 6
Part VI
Governance, Management, and Disclosure For each "Yes" response to lines 2 through 7b below, and for a "No" response to lines 8a, 8b, or 10b below, describe the circumstances, processes, or changes in Schedule O. See instructions.
Check if Schedule O contains a response or note to any line in this Part VI ..............
Section A. Governing Body and Management
Yes
No
1a
Enter the number of voting members of the governing body at the end of the tax year
1a
19
If there are material differences in voting rights among members of the governing body, or if the governing body delegated broad authority to an executive committee or similar committee, explain in Schedule O.
b
Enter the number of voting members included in line 1a, above, who are independent
1b
18
2
Did any officer, director, trustee, or key employee have a family relationship or a business relationship with any other officer, director, trustee, or key employee? .................
2
Yes
 
3
Did the organization delegate control over management duties customarily performed by or under the direct supervision of officers, directors or trustees, or key employees to a management company or other person? .
3
 
No
4
Did the organization make any significant changes to its governing documents since the prior Form 990 was filed? ...........................
4
 
No
5
Did the organization become aware during the year of a significant diversion of the organization’s assets? .
5
 
No
6
Did the organization have members or stockholders? ................
6
 
No
7a
Did the organization have members, stockholders, or other persons who had the power to elect or appoint one or more members of the governing body? ....................
7a
Yes
 
b
Are any governance decisions of the organization reserved to (or subject to approval by) members, stockholders, or persons other than the governing body? ...................
7b
Yes
 
8
Did the organization contemporaneously document the meetings held or written actions undertaken during the year by the following:
a
The governing body? .......................
8a
Yes
 
b
Each committee with authority to act on behalf of the governing body? ............
8b
 
No
9
Is there any officer, director, trustee, or key employee listed in Part VII, Section A, who cannot be reached at the organization’s mailing address? If "Yes," provide the names and addresses in Schedule O.......
9
 
No
Section B. Policies (This Section B requests information about policies not required by the Internal Revenue Code.)
Yes
No
10a
Did the organization have local chapters, branches, or affiliates? ............
10a
 
No
b
If "Yes," did the organization have written policies and procedures governing the activities of such chapters, affiliates, and branches to ensure their operations are consistent with the organization's exempt purposes?
10b
 
 
11a
Has the organization provided a complete copy of this Form 990 to all members of its governing body before filing the form? ............................
11a
Yes
 
b
Describe in Schedule O the process, if any, used by the organization to review this Form 990. .....
12a
Did the organization have a written conflict of interest policy? If "No," go to line 13.......
12a
Yes
 
b
Were officers, directors, or trustees, and key employees required to disclose annually interests that could give rise to conflicts? ..........................
12b
Yes
 
c
Did the organization regularly and consistently monitor and enforce compliance with the policy? If "Yes," describe in Schedule O how this was done...................
12c
Yes
 
13
Did the organization have a written whistleblower policy? ...............
13
Yes
 
14
Did the organization have a written document retention and destruction policy? .........
14
Yes
 
15
Did the process for determining compensation of the following persons include a review and approval by independent persons, comparability data, and contemporaneous substantiation of the deliberation and decision?
a
The organization’s CEO, Executive Director, or top management official ...........
15a
Yes
 
b
Other officers or key employees of the organization ................
15b
Yes
 
If "Yes" to line 15a or 15b, describe the process in Schedule O (see instructions).
16a
Did the organization invest in, contribute assets to, or participate in a joint venture or similar arrangement with a taxable entity during the year? ......................
16a
Yes
 
b
If "Yes," did the organization follow a written policy or procedure requiring the organization to evaluate its participation in joint venture arrangements under applicable federal tax law, and take steps to safeguard the organization’s exempt status with respect to such arrangements? ............
16b
Yes
 
Section C. Disclosure
17
List the States with which a copy of this Form 990 is required to be filedMediumBullet
IN , KY
18
Section 6104 requires an organization to make its Form 1023 (or 1024 if applicable), 990, and 990-T (501(c)(3)s only) available for public inspection. Indicate how you made these available. Check all that apply.
19
Describe in Schedule O whether (and if so, how) the organization made its governing documents, conflict of interest policy, and financial statements available to the public during the tax year.
20
State the name, address, and telephone number of the person who possesses the organization's books and records:
MediumBulletLORI RITCHEY-BALDWINONE MEDICAL VILLAGE DRIVE   EDGEWOOD,KY41017 (859) 655-1642
Form 990 (2015)
Form 990 (2015)
Page 7
Part VII
Compensation of Officers, Directors,Trustees, Key Employees, Highest Compensated Employees, and Independent Contractors
Check if Schedule O contains a response or note to any line in this Part VII ..............
Section A. Officers, Directors, Trustees, Key Employees, and Highest Compensated Employees
1a Complete this table for all persons required to be listed. Report compensation for the calendar year ending with or within the organization’s tax year.
RoundBullet List all of the organization’s current officers, directors, trustees (whether individuals or organizations), regardless of amount
of compensation. Enter -0- in columns (D), (E), and (F) if no compensation was paid.

RoundBullet List all of the organization’s current key employees, if any. See instructions for definition of "key employee."
RoundBullet List the organization’s five current highest compensated employees (other than an officer, director, trustee or key employee)
who received reportable compensation (Box 5 of Form W-2 and/or Box 7 of Form 1099-MISC) of more than $100,000 from the
organization and any related organizations.

RoundBullet List all of the organization’s former officers, key employees, or highest compensated employees who received more than $100,000
of reportable compensation from the organization and any related organizations.

RoundBullet List all of the organization’s former directors or trustees that received, in the capacity as a former director or trustee of the
organization, more than $10,000 of reportable compensation from the organization and any related organizations.

List persons in the following order: individual trustees or directors; institutional trustees; officers; key employees; highest
compensated employees; and former such persons.
Check this box if neither the organization nor any related organization compensated any current officer, director, or trustee.
(A)
Name and Title 		(B)
Average hours per week (list any hours for related organizations below dotted line) 		(C)
Position (do not check more than one box, unless person is both an officer and a director/trustee) 		(D)
Reportable compensation from the organization (W- 2/1099-MISC) 		(E)
Reportable compensation from related organizations (W- 2/1099-MISC) 		(F)
Estimated amount of other compensation from the organization and related organizations
Individual Trustee or Director; Institutional Trustee; OfficerInd; Key Employee; Highest compensated employee; FormerOfcrDirectorTrusteeInd;
(1) GARREN COLVIN
 
PRESIDENT/CEO (partial year)
 40.0
.................
1.0 		X   X       980,152 0 230,356
(2) JOHN DUBIS
 
PRESIDENT/CEO (PARTIAL YEAR)
 40.0
.................
1.0 		X   X       2,487,256 0 49,428
(3) JAMES VOTRUBA
 
Chairman
 4.0
.................
0 		X   X       785 0 0
(4) FRED A MACKE JR
 
VICE CHAIRMAN
 4.0
.................
0 		X   X       26,137 0 0
(5) GARY W MOORE
 
TRUSTEE
 4.0
.................
0 		X           1,663 0 0
(6) THOMAS R DIETZ
 
TRUSTEE
 4.0
.................
0 		X           20,176 0 0
(7) JAMES ROEBKER
 
TRUSTEE
 4.0
.................
0 		X           1,120 0 0
(8) MICHAEL E JONES
 
TRUSTEE
 4.0
.................
0 		X           1,057 0 0
(9) RICHARD H TAPKE JR
 
TRUSTEE
 4.0
.................
0 		X           687 0 0
(10) MICHAEL A CONNER
 
TRUSTEE
 4.0
.................
0 		X           1,271 0 0
(11) CHRISTOPHER FISTER
 
TRUSTEE
 4.0
.................
0 		X           1,073 0 0
(12) MARSHA CROXTON
 
TRUSTEE
 4.0
.................
0 		X           21,038 0 0
(13) ROGER PETERMAN
 
TRUSTEE
 4.0
.................
0 		X           11,172 0 0
(14) Heidi MURLEY MD
 
TRUSTEE
 1.0
.................
40.0 		X           0 634,394 37,224
(15) George Hall
 
Trustee
 4.0
.................
0 		X           0 0 0
(16) LaRoy Kendall
 
Trustee
 4.0
.................
0 		X           0 0 0
(17) Debbie Simpson
 
Trustee
 4.0
.................
0 		X           1,078 0 0
Form 990 (2015)
Form 990 (2015)
Page 8
Part VII
Section A. Officers, Directors, Trustees, Key Employees, and Highest Compensated Employees (continued)
(A)
Name and Title 		(B)
Average hours per week (list any hours for related organizations below dotted line) 		(C)
Position (do not check more than one box, unless person is both an officer and a director/trustee) 		(D)
Reportable compensation from the organization (W- 2/1099-MISC) 		(E)
Reportable compensation from related organizations (W- 2/1099-MISC) 		(F)
Estimated amount of other compensation from the organization and related organizations
Individual Trustee or Director; Institutional Trustee; OfficerInd; Key Employee; Highest compensated employee; FormerOfcrDirectorTrusteeInd;
(18) Robert Zapp
 
Trustee
 4.0
.......................0 		X           368 0 0
(19) Tillie Hidalgo Lima
 
Trustee
 4.0
.......................0 		X           1,688 0 0
(20) Ross McHenry
 
Trustee
 4.0
.......................0 		X           516 0 0
(21) BARBARA KROHMAN
 
CORPORATE SECRETARY
 40.0
.......................0 		    X       115,106 0 45,026
(22) LORI RITCHEY-BALDWIN
 
Senior Vice President/CFO/Treasurer
 40.0
.......................1.0 		    X       599,854 0 124,392
(23) GARY BLANK
 
EXECUTIVE VP & COO, CNE
 40.0
.......................0 		    X       518,201 0 104,909
(24) GLENN LOOMIS MD
 
President/CEO OF SEP (partial year)
 20.0
.......................20.0 		      X     761,843 0 144,108
(25) ROBERT PRICHARD MD
 
Chief Clinical Integration Officer, SEP President & CEO
 20.0
.......................20.0 		      X     662,944 0 130,192
(26) SARAH GIOLANDO
 
SVP/CHIEF STRATEGY OFFICER
 40.0
.......................0 		      X     467,365 0 83,163
(27) MARTIN OSCADAL
 
SVP HUMAN RESOURCES
 40.0
.......................0 		      X     444,114 0 105,464
(28) ALEXANDER RODRIGUEZ
 
VP CIO
 40.0
.......................0 		      X     440,374 0 94,253
(29) CHRISTOPHER CARLE
 
PRESIDENT & CEO SEPN
 40.0
.......................0 		      X     427,645 0 93,229
(30) WILLIAM BANKS
 
VP REVENUE CYCLE MANAGED CARE
 40.0
.......................0 		      X     401,597 0 80,411
(31) SUSAN MCDONALD
 
VP Nursing - Edgewood
 40.0
.......................0 		      X     310,818 0 72,917
(32) LARRY WARKOCZESKI
 
VP - ST. ELIZABETH FOUNDATION
 40.0
.......................0 		      X     303,467 0 60,584
(33) BRUNO GIACOMUZZI
 
COO Flo FT Cov & SVP Prof Svcs
 40.0
.......................0 		      X     287,953 0 54,353
(34) BENITA UTZ
 
VP Nursing - Florence/Ft. Thomas
 40.0
.......................0 		      X     283,983 0 81,736
(35) ANTHONY HELTON
 
VP Revenue Cycle
 40.0
.......................0 		      X     257,564 0 63,182
(36) LISA FREY
 
VP LEGAL SERVICES/GENERAL COUNSEL
 40.0
.......................0 		      X     238,379 0 41,675
(37) HARRY WATSON
 
Sr. VP Facilities
 40.0
.......................0 		      X     231,206 0 39,795
(38) LAROY KENDALL
 
VP Medical Services
 40.0
.......................0 		      X     188,771 0 37,952
(39) VERA HALL
 
SVP System CNE
 40.0
.......................0 		      X     182,522 0 41,107
(40) JOSEPH BOZELLI
 
VP MISSION SVCS & PASTORAL CARE
 40.0
.......................0 		      X     142,357 0 34,911
(41) KARL ULICNY
 
PHYSICIAN
 40.0
.......................0 		        X   941,349 0 63,076
(42) VICTOR SCHMELZER
 
PHYSICIAN
 40.0
.......................0 		        X   793,220 0 62,201
(43) MICHAEL GIBSON
 
PHYSICIAN
 40.0
.......................0 		        X   459,417 0 28,260
(44) JACKSON PEMBERTON
 
PHYSICIAN DIRECTOR - LABORATORY
 40.0
.......................0 		        X   440,729 0 55,908
(45) DONN BURNS
 
pathologist
 40.0
.......................0 		        X   404,356 0 44,680
(46) GEORGE S HALL MD
 
Former VP Medical Affairs
 40.0
.......................0 		          X 119,679 0 14,997
(47) THOMAS SAALFELD
 
Former SVP/COO FT. THOMAS/FALMOUT
 40.0
.......................0 		          X 108,178 0 0
1b Sub-Total................MediumBullet
c Total from continuation sheets to Part VII, Section A....MediumBullet
d Total (add lines 1b and 1c)...........MediumBullet 14,090,228 634,394 2,119,489
2
Total number of individuals (including but not limited to those listed above) who received more than $100,000 of reportable compensation from the organization MediumBullet323
Yes
No
3
Did the organization list any former officer, director or trustee, key employee, or highest compensated employee on line 1a? If "Yes," complete Schedule J for such individual ..............
3
Yes
 
4
For any individual listed on line 1a, is the sum of reportable compensation and other compensation from the organization and related organizations greater than $150,000? If "Yes," complete Schedule J for such
individual...........................
4
Yes
 
5
Did any person listed on line 1a receive or accrue compensation from any unrelated organization or individual for services rendered to the organization? If "Yes," complete Schedule J for such person ........
5
Yes
 
Section B. Independent Contractors
1
Complete this table for your five highest compensated independent contractors that received more than $100,000 of compensation from the organization. Report compensation for the calendar year ending with or within the organization’s tax year.
(A)
Name and business address 		(B)
Description of services 		(C)
Compensation
MILLS SHERMAN GILLIAM & GOODWIN PSC

1 MEDICAL VILLAGE DRIVE
EDGEWOOD,KY41017 		PHYSICIAN SERVICES 5,638,598
ADVANCED ICU CARE INC

One City Place Dr Ste 570
St Louis,MO63141 		MEDICAL SERVICES 2,811,815
EPIC SYSTEMS CORPORATION

1979 Milky Way
Verona,WI53593 		COMPUTER MAINTENANCE / UPGRADES 2,622,405
DELOITTE CONSULTING LLP

4022 Sells Dr
Hermitage,TN37076 		CONSULTING 2,452,248
TRI STATE HEALTHCARE LAUNDRY INC

551 South Loop Rd
Edgewood,KY41017 		LAUNDRY SERVICES AND SUPPLIES 2,121,726
2
Total number of independent contractors (including but not limited to those listed above) who received more than $100,000 of compensation from the organization MediumBullet132
Form 990 (2015)
Form 990 (2015)
Page 9
Part VIII
Statement of Revenue
Check if Schedule O contains a response or note to any line in this Part VIII .............
(A)
Total revenue 		(B)
Related or
exempt
function
revenue 		(C)
Unrelated
business
revenue 		(D)
Revenue
excluded from
tax under sections
512-514
Contributions, Gifts, GrantAmt and OtherAmt Similar Amounts 1a Federated campaigns..1a  
b Membership dues..1b  
c Fundraising events..1c 84,573
d Related organizations1d  
e Government grants (contributions)1e 1,058,823
f All other contributions, gifts, grants, and similar amounts not included above1f 2,079,274
g Noncash contributions included in lines 1a-1f:$ 170,331
h Total.Add lines 1a-1f.......MediumBullet 3,222,670
Program Service RevenueAmt Business Code
2a NET PATIENT REVENUE 621400 751,387,712 751,387,712    
b OTHER RELATED REVENUE 900099 17,757,803 17,738,380 19,423  
c ELEC HEALTHCARE RECORDS 900099 1,721,477 1,721,477    
d PATIENT/EMPLOYEE DRUGS 446110 2,920,889   1,004,992 1,915,897
e LABORATORY 621500 190,086,183 188,730,758 1,355,425  
f All other program service revenue. 10,759,999 9,868,711 891,288 0
g Total.Add lines 2a–2f.....MediumBullet 974,634,063
OtherAmt RevenueAmt 3 Investment income (including dividends, interest, and othersimilar amounts) ..........MediumBullet 17,777,748     17,777,748
4 Income from investment of tax-exempt bond proceedsMediumBullet        
5 Royalties...........MediumBullet        
(ii) Personal (i) Real
6a Gross rents   2,066,044
b Less: rental expenses   1,805,228
c Rental income or (loss) 0 260,816
d Net rental income or (loss)......MediumBullet 260,816     260,816
(ii) Other (i) Securities
7a Gross amount from sales of assets other than inventory 735,323 416,878,431
b Less: cost or other basis and sales expenses 1,595,095 406,687,025
c Gain or (loss) -859,772 10,191,406
d Net gain or (loss).....MediumBullet 9,331,634     9,331,634
8a Gross income from fundraising events (not including $ 84,573of contributions reported on line 1c). See Part IV, line 18 ....
a 274,573
b Less: direct expenses ...b 138,098
c Net income or (loss) from fundraising events..MediumBullet 136,475   136,475
9a Gross income from gaming activities.
See Part IV, line 19 ...
a 23,349
b Less: direct expenses ...b 7,585
c Net income or (loss) from gaming activities..MediumBullet 15,764     15,764
10a Gross sales of inventory, less
returns and allowances ..
a  
b Less: cost of goods sold ..b  
c Net income or (loss) from sales of inventory..MediumBullet        
Business Code Miscellaneous Revenue
11a CAFETERIA 722210 3,788,106     3,788,106
b GIFT SHOP 900099 1,521,034     1,521,034
c VENDING 453220 127,247     127,247
d All other revenue .... 0 0 0 0
e Total. Add lines 11a–11d ...... MediumBullet 5,436,387
12 Total revenue. See Instructions......MediumBullet 1,010,815,557 969,447,038 3,271,128 34,874,721
Form 990 (2015)
Form 990 (2015)
Page 10
Part IX
Statement of Functional Expenses
Section 501(c)(3) and 501(c)(4) organizations must complete all columns. All other organizations must complete column (A).Check if Schedule O contains a response or note to any line in this Part IX ..............
Do not include amounts reported on lines 6b,
7b, 8b, 9b, and 10b of Part VIII. 		(A)
Total expenses 		(B)
Program service expenses 		(C)
Management and general expenses 		(D)
Fundraising expenses
1 Grants and other assistance to domestic organizations and domestic governments. See Part IV, line 21    
2 Grants and other assistance to individuals in the United States. See Part IV, line 22    
3 Grants and other assistance to governments, organizations, and individuals outside the United States. See Part IV, lines 15 and 16    
4 Benefits paid to or for members    
5 Compensation of current officers, directors, trustees, and key employees .... 12,789,472 2,159,275 10,630,197  
6 Compensation not included above, to disqualified persons (as defined under section 4958(f)(1)) and persons described in section 4958(c)(3)(B) ....        
7 Other salaries and wages 321,307,632 226,014,519 94,990,998 302,115
8 Pension plan accruals and contributions (include section 401(k) and 403(b) employer contributions) .... 56,697,695 39,536,615 17,108,240 52,840
9 Other employee benefits ....... 46,971,699 32,837,327 14,098,109 36,263
10 Payroll taxes ........... 22,977,202 16,288,599 6,665,749 22,854
11 Fees for services (non-employees):        
a Management ......        
b Legal ......... 2,781,703   2,781,536 167
c Accounting ........... 659,053   659,053  
d Lobbying ........... 106,229     106,229
e Professional fundraising services. See Part IV, line 17 27,620 27,620
f Investment management fees ...... 1,098,953   1,098,703 250
g Other (If line 11g amount exceeds 10% of line 25, column (A) amount, list line 11g expenses on Schedule O) 146,023,447 50,496,277 95,281,447 245,723
12 Advertising and promotion .... 10,716,442 328,922 10,246,501 141,019
13 Office expenses ....... 3,328,139 1,032,181 2,191,532 104,426
14 Information technology ...... 11,308,466 644,259 10,659,947 4,260
15 Royalties ..        
16 Occupancy ........... 7,533,306 4,400,204 3,133,102  
17 Travel ............ 678,879 403,407 270,678 4,794
18 Payments of travel or entertainment expenses for any federal, state, or local public officials .        
19 Conferences, conventions, and meetings .... 2,243,944 321,316 1,785,417 137,211
20 Interest ........... 5,891,813 3,441,408 2,450,405  
21 Payments to affiliates .......        
22 Depreciation, depletion, and amortization .. 59,693,573 34,810,251 24,877,766 5,556
23 Insurance ... 9,026,999 5,532,698 3,494,301  
24 Other expenses. Itemize expenses not covered above (List miscellaneous expenses in line 24e. If line 24e amount exceeds 10% of line 25, column (A) amount, list line 24e expenses on Schedule O.)
a MEDICAL SUPPLIES 131,726,759 129,660,086 2,066,673  
b BAD DEBT 31,505,631 31,505,631    
c GENERAL SUPPLIES 21,190,544 11,536,016 9,575,511 79,017
d PROVIDER TAX 12,550,615 12,550,615    
e All other expenses 5,214,974 755,110 4,351,876 107,988
25 Total functional expenses. Add lines 1 through 24e 924,050,789 604,254,716 318,417,741 1,378,332
26 Joint costs. Complete this line only if the organization reported in column (B) joint costs from a combined educational campaign and fundraising solicitation. Check here MediumBullet if following SOP 98-2 (ASC 958-720).        
Form 990 (2015)
Form 990 (2015)
Page 11
Part X
Balance Sheet
Check if Schedule O contains a response or note to any line in this Part IX ..............
(A)
Beginning of year 		(B)
End of year
Assets 1 Cash–non-interest-bearing ........ 3,558,922 1 3,558,922
2 Savings and temporary cash investments ......... 24,620,555 2 73,911,731
3 Pledges and grants receivable, net ...... 4,378,751 3 3,777,551
4 Accounts receivable, net ............. 103,503,711 4 103,490,315
5 Loans and other receivables from current and former officers, directors, trustees, key employees, and highest compensated employees. Complete Part II of Schedule L
  5 0
6 Loans and other receivables from other disqualified persons (as defined under section 4958(f)(1)), persons described in section 4958(c)(3)(B), and contributing employers and sponsoring organizations of section 501(c)(9) voluntary employees' beneficiary organizations (see instructions) Complete Part II of Schedule L
  6 0
7 Notes and loans receivable, net .... 5,916,169 7 8,400,829
8 Inventories for sale or use ........ 21,187,747 8 22,516,555
9 Prepaid expenses and deferred charges ...... 6,679,975 9 8,755,165
10a Land, buildings, and equipment: cost or other basis. Complete Part VI of Schedule D 10a 971,369,535
b Less: accumulated depreciation 10b 566,111,612 384,047,966 10c 405,257,923
11 Investments—publicly traded securities . 620,176,880 11 531,823,965
12 Investments—other securities. See Part IV, line 11 ..... 163,915,725 12 286,784,889
13 Investments—program-related. See Part IV, line 11 .. 3,995,385 13 3,734,127
14 Intangible assets ............... 227,718 14 4,481,618
15 Other assets. See Part IV, line 11 ........... 12,581,201 15 12,602,460
16 Total assets. Add lines 1 through 15 (must equal line 34)... 1,354,790,705 16 1,469,096,050
Liabilities 17 Accounts payable and accrued expenses ..... 106,621,138 17 110,525,693
18 Grants payable ...   18  
19 Deferred revenue ......... 6,897,922 19 6,563,171
20 Tax-exempt bond liabilities ......... 123,825,000 20 177,641,124
21 Escrow or custodial account liability. Complete Part IV of Schedule D   21  
22 Loans and other payables to current and former officers, directors, trustees, key employees, highest compensated employees, and disqualified
persons. Complete Part II of Schedule L..   22  
23 Secured mortgages and notes payable to unrelated third parties ..   23  
24 Unsecured notes and loans payable to unrelated third parties ..   24  
25 Other liabilities (including federal income tax, payables to related third parties, and other liabilities not included on lines 17-24). Complete Part X of Schedule D 270,210,548 25 271,409,604
26 Total liabilities. Add lines 17 through 25.. 507,554,608 26 566,139,592
Net Assets or Fund Balance Organizations that follow SFAS 117 (ASC 958), check here MediumBullet and complete lines 27 through 29, and lines 33 and 34.
27 Unrestricted net assets 843,463,859 27 897,679,274
28 Temporarily restricted net assets ........... 3,772,238 28 5,277,184
29 Permanently restricted net assets   29  
Organizations that do not follow SFAS 117 (ASC 958), check here MediumBullet and complete lines 30 through 34.
30 Capital stock or trust principal, or current funds .....   30  
31 Paid-in or capital surplus, or land, building or equipment fund ...   31  
32 Retained earnings, endowment, accumulated income, or other funds   32  
33 Total net assets or fund balances ........... 847,236,097 33 902,956,458
34 Total liabilities and net assets/fund balances ........ 1,354,790,705 34 1,469,096,050
Form 990 (2015)
Form 990 (2015)
Page 12
Part XI
Reconcilliation of Net Assets
Check if Schedule O contains a response or note to any line in this Part XI ..............
1
Total revenue (must equal Part VIII, column (A), line 12) ............
1
1,010,815,557
2
Total expenses (must equal Part IX, column (A), line 25) ............
2
924,050,789
3
Revenue less expenses. Subtract line 2 from line 1 ..............
3
86,764,768
4
Net assets or fund balances at beginning of year (must equal Part X, line 33, column (A)) ..
4
847,236,097
5
Net unrealized gains (losses) on investments ...............
5
-37,084,240
6
Donated services and use of facilities .................
6
 
7
Investment expenses .....................
7
 
8
Prior period adjustments .....................
8
 
9
Other changes in net assets or fund balances (explain in Schedule O) ........
9
6,039,833
10
Net assets or fund balances at end of year. Combine lines 3 through 9 (must equal Part X, line 33, column (B))
10
902,956,458
Part XII
Financial Statements and Reporting
Check if Schedule O contains a response or note to any line in this Part XII .............
Yes
No
1
Accounting method used to prepare the Form 990:  
If the organization changed its method of accounting from a prior year or checked "Other," explain in
Schedule O.
2a
Were the organization’s financial statements compiled or reviewed by an independent accountant?
2a
 
No
If ‘Yes,’ check a box below to indicate whether the financial statements for the year were compiled or reviewed on a separate basis, consolidated basis, or both:
b
Were the organization’s financial statements audited by an independent accountant?
2b
Yes
 
If ‘Yes,’ check a box below to indicate whether the financial statements for the year were audited on a separate basis, consolidated basis, or both:
c
If "Yes," to line 2a or 2b, does the organization have a committee that assumes responsibility for oversight of the audit, review, or compilation of its financial statements and selection of an independent accountant?
2c
Yes
 
If the organization changed either its oversight process or selection process during the tax year, explain in Schedule O.
3a
As a result of a federal award, was the organization required to undergo an audit or audits as set forth in the Single Audit Act and OMB Circular A-133?
3a
 
No
b
If "Yes," did the organization undergo the required audit or audits? If the organization did not undergo the required audit or audits, explain why in Schedule O and describe any steps taken to undergo such audits.
3b
 
 
Form 990 (2015)
Form 990 (2015)
Additional Data


Software ID: 15000238
Software Version: 2015v2.1
Form 990, Special Condition Description:
Special Condition Description
SCHEDULE A
(Form 990 or 990EZ)

Department of the Treasury
Internal Revenue Service
Public Charity Status and Public Support
Complete if the organization is a section 501(c)(3) organization or a section 4947(a)(1) nonexempt charitable trust.
right arrow Attach to Form 990 or Form 990-EZ.
right arrow Information about Schedule A (Form 990 or 990-EZ) and its instructions is at www.irs.gov/form990.
OMB No. 1545-0047
2015
Open to Public
Inspection
Name of the organization
St Elizabeth Medical Center Inc
 
Employer identification number

61-0445850
Part I
Reason for Public Charity Status (All organizations must complete this part.) See instructions.
The organization is not a private foundation because it is: (For lines 1 through 11, check only one box.)
1
2
3
4


5
6
7
8
9
10
11
a
b
c
d
e
f
Enter the number of supported organizations ..............  

g
Provide the following information about the supported organization(s).
(i)Name of supported organization (ii) EIN (iii) Type of organization (described on lines 1- 9 above (see instructions)) (iv) Is the organization listed in your governing document? (v) Amount of monetary support (see instructions) (vi) Amount of other support (see instructions)
Yes No
Total      

For Paperwork Reduction Act Notice, see the Instructions for
Form 990 or 990-EZ.
Cat. No. 11285F
Schedule A (Form 990 or 990-EZ) 2015

Schedule A (Form 990 or 990-EZ) 2015
Page 2
Part II
Support Schedule for Organizations Described in Sections 170(b)(1)(A)(iv) and 170(b)(1)(A)(vi)
(Complete only if you checked the box on line 5, 7, or 8 of Part I or if the organization failed to qualify under Part III. If the organization fails to qualify under the tests listed below, please complete Part III.)
Section A. Public Support
Calendar year (or fiscal year beginning in) right arrow (a) 2011 (b) 2012 (c) 2013 (d) 2014 (e) 2015 (f) Total
1 Gifts, grants, contributions, and membership fees received. (Do not include any unusual grants.) ....            
2 Tax revenues levied for the organization's benefit and either paid to or expended on its behalf.......            
3 The value of services or facilities furnished by a governmental unit to the organization without charge..            
4 Total. Add lines 1 through 3            
5 The portion of total contributions by each person (other than a governmental unit or publicly supported organization) included on line 1 that exceeds 2% of the amount shown on line 11, column (f)..  
6 Public support. Subtract line 5 from line 4.  
Section B. Total Support
Calendar year (or fiscal year beginning in) right arrow (a) 2011 (b) 2012 (c) 2013 (d) 2014 (e) 2015 (f) Total
7 Amounts from line 4..            
8 Gross income from interest, dividends, payments received on securities loans, rents, royalties and income from similar sources...            
9 Net income from unrelated business activities, whether or not the business is regularly carried on..            
10 Other income. Do not include gain or loss from the sale of capital assets (Explain in Part VI.)..            
11 Total support. Add lines 7 through 10.  
12
12
 
13
First five years. If the Form 990 is for the organization's first, second, third, fourth, or fifth tax year as a section 501(c)(3) organization, check this box and stop here........................................right arrow
Section C. Computation of Public Support Percentage
14
14
 
15
15
 
16a
b
17a
b
18
Private foundation. If the organization did not check a box on line 13, 16a, 16b, 17a, or 17b, check this box and see
instructions ..................................................... right arrow
Schedule A (Form 990 or 990-EZ) 2015

Schedule A (Form 990 or 990-EZ) 2015
Page 3
Part III
Support Schedule for Organizations Described in Section 509(a)(2)
(Complete only if you checked the box on line 9 of Part I or if the organization failed to qualify under Part II. If the organization fails to qualify under the tests listed below, please complete Part II.)
Section A. Public Support
Calendar year (or fiscal year beginning in) right arrow (a) 2011 (b) 2012 (c) 2013 (d) 2014 (e) 2015 (f) Total
1 Gifts, grants, contributions, and membership fees received. (Do not include any "unusual grants.") .            
2 Gross receipts from admissions, merchandise sold or services performed, or facilities furnished in any activity that is related to the organization's tax-exempt purpose......            
3 Gross receipts from activities that are not an unrelated trade or business under section 513...            
4 Tax revenues levied for the organization's benefit and either paid to or expended on its behalf...            
5 The value of services or facilities furnished by a governmental unit to the organization without charge..            
6 Total. Add lines 1 through 5.            
7a Amounts included on lines 1, 2, and 3 received from disqualified persons...            
b Amounts included on lines 2 and 3 received from other than disqualified persons that exceed the greater of $5,000 or 1% of the amount on line 13 for the year.            
c Add lines 7a and 7b..            
8 Public support. (Subtract line 7c from line 6.)  
Section B. Total Support
Calendar year (or fiscal year beginning in) right arrow (a) 2011 (b) 2012 (c) 2013 (d) 2014 (e) 2015 (f) Total
9 Amounts from line 6...            
10a Gross income from interest, dividends, payments received on securities loans, rents, royalties and income from similar sources..            
b Unrelated business taxable income (less section 511 taxes) from businesses acquired after June 30, 1975.            
c Add lines 10a and 10b.            
11 Net income from unrelated business activities not included in line 10b, whether or not the business is regularly carried on.            
12 Other income. Do not include gain or loss from the sale of capital assets (Explain in Part VI.) ..            
13 Total support. (Add lines 9, 10c, 11, and 12.)..            
14
Section C. Computation of Public Support Percentage
15
15
 
16
16
 
Section D. Computation of Investment Income Percentage
17
17
 
18
18
 
19a
b
20
Schedule A (Form 990 or 990-EZ) 2015

Schedule A (Form 990 or 990-EZ) 2015
Page 4
Part IV
Supporting Organizations
(Complete only if you checked a box on line 11 of Part I. If you checked 11a of Part I, complete Sections A and B. If you checked 11b of Part I, complete Sections A and C. If you checked 11c of Part I, complete Sections A, D, and E. If you checked 11d of Part I, complete Sections A and D, and complete Part V.)
Section A. All Supporting Organizations
Yes
No
1
Are all of the organization’s supported organizations listed by name in the organization’s governing documents?
If "No," describe in Part VI how the supported organizations are designated. If designated by class or purpose,
describe the designation. If historic and continuing relationship, explain.
1
 
 
2
Did the organization have any supported organization that does not have an IRS determination of status under section 509(a)(1) or (2)? If "Yes," explain in Part VI how the organization determined that the supported organization was described in section 509(a)(1) or (2).
2
 
 
3a
Did the organization have a supported organization described in section 501(c)(4), (5), or (6)? If "Yes," answer (b) and (c) below.
3a
 
 
b
Did the organization confirm that each supported organization qualified under section 501(c)(4), (5), or (6) and satisfied the public support tests under section 509(a)(2)? If "Yes," describe in Part VI when and how the organization made the determination.
3b
 
 
c
Did the organization ensure that all support to such organizations was used exclusively for section 170(c)(2)(B) purposes? If "Yes," explain in Part VI what controls the organization put in place to ensure such use.
3c
 
 
4a
Was any supported organization not organized in the United States ("foreign supported organization")? If “Yes” and if you checked 11a or 11b in Part I, answer (b) and (c) below.
4a
 
 
b
Did the organization have ultimate control and discretion in deciding whether to make grants to the foreign supported organization? If “Yes,” describe in Part VI how the organization had such control and discretion despite being controlled or supervised by or in connection with its supported organizations.
4b
 
 
c
Did the organization support any foreign supported organization that does not have an IRS determination under sections 501(c)(3) and 509(a)(1) or (2)? If “Yes,” explain in Part VI what controls the organization used to ensure that all support to the foreign supported organization was used exclusively for section 170(c)(2)(B) purposes.
4c
 
 
5a
Did the organization add, substitute, or remove any supported organizations during the tax year? If “Yes,” answer (b) and (c) below (if applicable). Also, provide detail in Part VI, including (i) the names and EIN numbers of the supported organizations added, substituted, or removed; (ii) the reasons for each such action; (iii) the authority under the organization's organizing document authorizing such action; and (iv) how the action was accomplished (such as by amendment to the organizing document).
5a
 
 
b
Type I or Type II only. Was any added or substituted supported organization part of a class already designated in the organization's organizing document?
5b
 
 
c
Substitutions only. Was the substitution the result of an event beyond the organization's control?
5c
 
 
6
Did the organization provide support (whether in the form of grants or the provision of services or facilities) to anyone other than (i) its supported organizations, (ii) individuals that are part of the charitable class benefited by one or more of its supported organizations, or (iii) other supporting organizations that also support or benefit one or more of the filing organization’s supported organizations? If “Yes,” provide detail in Part VI.
6
 
 
7
Did the organization provide a grant, loan, compensation, or other similar payment to a substantial contributor (defined in section 4958(c)(3)(C)), a family member of a substantial contributor, or a 35% controlled entity with regard to a substantial contributor? If “Yes,” complete Part I of Schedule L (Form 990 or 990-EZ) .
7
 
 
8
Did the organization make a loan to a disqualified person (as defined in section 4958) not described in line 7? If “Yes,” complete Part I of Schedule L (Form 990 or 990-EZ).
8
 
 
9a
Was the organization controlled directly or indirectly at any time during the tax year by one or more disqualified persons as defined in section 4946 (other than foundation managers and organizations described in section 509(a)(1) or (2))? If “Yes,” provide detail in Part VI.
9a
 
 
b
Did one or more disqualified persons (as defined in line 9a) hold a controlling interest in any entity in which the supporting organization had an interest? If “Yes,” provide detail in Part VI.
9b
 
 
c
Did a disqualified person (as defined in line 9a) have an ownership interest in, or derive any personal benefit from, assets in which the supporting organization also had an interest? If “Yes,” provide detail in Part VI.
9c
 
 
10a
Was the organization subject to the excess business holdings rules of section 4943 because of section 4943(f) (regarding certain Type II supporting organizations, and all Type III non-functionally integrated supporting organizations)? If “Yes,” answer line 10b below.
10a
 
 
b
Did the organization have any excess business holdings in the tax year? (Use Schedule C, Form 4720, to determine whether the organization had excess business holdings).
10b
 
 
Schedule A (Form 990 or 990-EZ) 2015

Schedule A (Form 990 or 990-EZ) 2015
Page 5
Part IV
Supporting Organizations (continued)
Yes
No
11
Has the organization accepted a gift or contribution from any of the following persons?
a
A person who directly or indirectly controls, either alone or together with persons described in (b) and (c) below, the governing body of a supported organization?
11a
 
 
b
A family member of a person described in (a) above?
11b
 
 
c
A 35% controlled entity of a person described in (a) or (b) above? If “Yes” to a, b, or c, provide detail in Part VI.
11c
 
 
Section B. Type I Supporting Organizations
Yes
No
1
Did the directors, trustees, or membership of one or more supported organizations have the power to regularly appoint or elect at least a majority of the organization’s directors or trustees at all times during the tax year? If “No,” describe in Part VI how the supported organization(s) effectively operated, supervised, or controlled the organization’s activities. If the organization had more than one supported organization, describe how the powers to appoint and/or remove directors or trustees were allocated among the supported organizations and what conditions or restrictions, if any, applied to such powers during the tax year.
1
 
 
2
Did the organization operate for the benefit of any supported organization other than the supported organization(s) that operated, supervised, or controlled the supporting organization? If “Yes,” explain in Part VI how providing such benefit carried out the purposes of the supported organization(s) that operated, supervised or controlled the supporting organization.
2
 
 
Section C. Type II Supporting Organizations
Yes
No
1
Were a majority of the organization’s directors or trustees during the tax year also a majority of the directors or trustees of each of the organization’s supported organization(s)? If “No,” describe in Part VI how control or management of the supporting organization was vested in the same persons that controlled or managed the supported organization(s).
1
 
 
Section D. All Type III Supporting Organizations
Yes
No
1
Did the organization provide to each of its supported organizations, by the last day of the fifth month of the organization’s tax year, (i) a written notice describing the type and amount of support provided during the prior tax year, (ii) a copy of the Form 990 that was most recently filed as of the date of notification, and (iii) copies of the organization’s governing documents in effect on the date of notification, to the extent not previously provided?
1
 
 
2
Were any of the organization’s officers, directors, or trustees either (i) appointed or elected by the supported organization(s) or (ii) serving on the governing body of a supported organization? If "No," explain in Part VI how the organization maintained a close and continuous working relationship with the supported organization(s).
2
 
 
3
By reason of the relationship described in (2), did the organization’s supported organizations have a significant voice in the organization’s investment policies and in directing the use of the organization’s income or assets at all times during the tax year? If "Yes," describe in Part VI the role the organization’s supported organizations played in this regard.
3
 
 
Section E. Type III Functionally-Integrated Supporting Organizations
1
Check the box next to the method that the organization used to satisfy the Integral Part Test during the year (see instructions):
a
b
c
2
Activities Test. Answer (a) and (b) below.
Yes
No
a
Did substantially all of the organization’s activities during the tax year directly further the exempt purposes of the supported organization(s) to which the organization was responsive? If "Yes," then in Part VI identify those supported organizations and explain how these activities directly furthered their exempt purposes, how the organization was responsive to those supported organizations, and how the organization determined that these activities constituted substantially all of its activities.
2a
 
 
b
Did the activities described in (a) constitute activities that, but for the organization’s involvement, one or more of the organization’s supported organization(s) would have been engaged in? If "Yes," explain in Part VI the reasons for the organization’s position that its supported organization(s) would have engaged in these activities but for the organization’s involvement.
2b
 
 
3
Parent of Supported Organizations. Answer (a) and (b) below.
a
Did the organization have the power to regularly appoint or elect a majority of the officers, directors, or trustees of each of the supported organizations? Provide details in Part VI.
3a
 
 
b
Did the organization exercise a substantial degree of direction over the policies, programs and activities of each of its supported organizations? If "Yes," describe in Part VI. the role played by the organization in this regard.
3b
 
 
Schedule A (Form 990 or 990-EZ) 2015

Schedule A (Form 990 or 990-EZ) 2015
Page 6
Part V
Type III Non-Functionally Integrated 509(a)(3) Supporting Organizations
1
Section A - Adjusted Net Income (A) Prior Year (B) Current Year
(optional)
1 Net short-term capital gain 1    
2 Recoveries of prior-year distributions 2    
3 Other gross income (see instructions) 3    
4 Add lines 1 through 3 4    
5 Depreciation and depletion 5    
6 Portion of operating expenses paid or incurred for production or collection of gross income or for management, conservation, or maintenance of property held for production of income (see instructions) 6    
7 Other expenses (see instructions) 7    
8 Adjusted Net Income (subtract lines 5, 6 and 7 from line 4) 8    

Section B - Minimum Asset Amount (A) Prior Year (B) Current Year
(optional)
1 Aggregate fair market value of all non-exempt-use assets (see instructions for short tax year or assets held for part of year): 1
a Average monthly value of securities 1a    
b Average monthly cash balances 1b    
c Fair market value of other non-exempt-use assets 1c    
d Total (add lines 1a, 1b, and 1c) 1d    
e Discount claimed for blockage or other factors
(explain in detail in Part VI):  
2 Acquisition indebtedness applicable to non-exempt use assets 2    
3 Subtract line 2 from line 1d 3    
4 Cash deemed held for exempt use. Enter 1-1/2% of line 3 (for greater amount, see instructions). 4    
5 Net value of non-exempt-use assets (subtract line 4 from line 3) 5    
6 Multiply line 5 by .035 6    
7 Recoveries of prior-year distributions 7    
8 Minimum Asset Amount (add line 7 to line 6) 8    

Section C - Distributable Amount Current Year
1 Adjusted net income for prior year (from Section A, line 8, Column A) 1  
2 Enter 85% of line 1 2  
3 Minimum asset amount for prior year (from Section B, line 8, Column A) 3  
4 Enter greater of line 2 or line 3 4  
5 Income tax imposed in prior year 5  
6 Distributable Amount. Subtract line 5 from line 4, unless subject to emergency temporary reduction (see instructions) 6  
7
Schedule A (Form 990 or 990-EZ) 2015

Schedule A (Form 990 or 990-EZ) 2015
Page 7
Part V
Type III Non-Functionally Integrated 509(a)(3) Supporting Organizations (continued)
Section D - Distributions Current Year
1 Amounts paid to supported organizations to accomplish exempt purposes  
2 Amounts paid to perform activity that directly furthers exempt purposes of supported organizations, in
excess of income from activity		  
3 Administrative expenses paid to accomplish exempt purposes of supported organizations  
4 Amounts paid to acquire exempt-use assets  
5 Qualified set-aside amounts (prior IRS approval required)  
6 Other distributions (describe in Part VI). See instructions  
7Total annual distributions. Add lines 1 through 6.  
8 Distributions to attentive supported organizations to which the organization is responsive (provide
details in Part VI). See instructions		  
9 Distributable amount for 2015 from Section C, line 6  
10 Line 8 amount divided by Line 9 amount  

Section E - Distribution Allocations (see instructions) (i)
Excess Distributions 		(ii)
Underdistributions
Pre-2015 		(iii)
Distributable
Amount for 2015
1 Distributable amount for 2015 from Section C, line
6 		 
2 Underdistributions, if any, for years prior to 2015
(reasonable cause required--see instructions)		  
3 Excess distributions carryover, if any, to 2015:
a
b
c
d From 2013.......  
e From 2014.......  
fTotal of lines 3a through e  
g Applied to underdistributions of prior years  
h Applied to 2015 distributable amount  
i Carryover from 2010 not applied (see
instructions)
j Remainder. Subtract lines 3g, 3h, and 3i from 3f.  
4Distributions for 2015 from Section D, line 7:
$  
a Applied to underdistributions of prior years  
b Applied to 2015 distributable amount  
c Remainder. Subtract lines 4a and 4b from 4.  
5 Remaining underdistributions for years prior to
2015, if any. Subtract lines 3g and 4a from line 2
(if amount greater than zero, see instructions)		  
6 Remaining underdistributions for 2015. Subtract
lines 3h and 4b from line 1 (if amount greater than
zero, see instructions)		  
7 Excess distributions carryover to 2016. Add lines
3j and 4c.		  
8 Breakdown of line 7:
a
b
c Excess from 2013.......  
d From 2014.......  
e From 2015.......  
Schedule A (Form 990 or 990-EZ) (2015)

Schedule A (Form 990 or 990-EZ) 2015
Page 8
Part VI
Supplemental Information. Provide the explanations required by Part II, line 10; Part II, line 17a or 17b; Part III, line 12; Part IV, Section A, lines 1, 2, 3b, 3c, 4b, 4c, 5a, 6, 9a, 9b, 9c, 11a, 11b, and 11c; Part IV, Section B, lines 1 and 2; Part IV, Section C, line 1; Part IV, Section D, lines 2 and 3; Part IV, Section E, lines 1c, 2a, 2b, 3a and 3b; Part V, line 1; Part V, Section B, line 1e; Part V Section D, lines 5, 6, and 8; and Part V, Section E, lines 2, 5, and 6. Also complete this part for any additional information. (See instructions).
Facts And Circumstances Test
 
Return Reference Explanation
Schedule A (Form 990 or 990-EZ) 2015


Additional Data


Software ID: 15000238
Software Version: 2015v2.1
Schedule B
(Form 990, 990-EZ,
or 990-PF)
Department of the Treasury
Internal Revenue Service
Schedule of Contributors
Arrow Bullet Attach to Form 990, 990-EZ, or 990-PF.
Arrow Bullet Information about Schedule B (Form 990, 990-EZ, or 990-PF) and its instructions is at www.irs.gov/form990.
OMB No. 1545-0047
2015
Name of the organization
St Elizabeth Medical Center Inc
 
Employer identification number

61-0445850
Organization type (check one):
Filers of:
Section:
Form 990 or 990-EZ





Form 990-PF




Check if your organization is covered by the General Rule or a Special Rule.  
Note. Only a section 501(c)(7), (8), or (10) organization can check boxes for both the General Rule and a Special Rule. See instructions.
General Rule
Special Rules
......... Arrow Bullet $  
Caution. An organization that is not covered by the General Rule and/or the Special Rules does not file Schedule B (Form 990,
990-EZ, or 990-PF), but it must answer “No” on Part IV, line 2, of its Form 990; or check the box on line H of its
Form 990-EZ or on its Form 990PF, Part I, line 2, to certify that it does not meet the filing requirements of Schedule B (Form 990,
990-EZ, or 990-PF).
For Paperwork Reduction Act Notice, see the Instructions
for Form 990, 990-EZ, or 990-PF.
Cat. No. 30613XSchedule B (Form 990, 990-EZ, or 990-PF) (2015)
Schedule B (Form 990, 990-EZ, or 990-PF) (2015) Page 2
Name of organization
St Elizabeth Medical Center Inc
  		Employer identification number
61-0445850
Part I
Contributors (see instructions). Use duplicate copies of Part I if additional space is needed.
(a)
No.		 (b)
Name, address, and ZIP + 4		 (c)
Total contributions		 (d)
Type of contribution
RESTRICTED
 
 

   
 
 
  ,    

$ RESTRICTED


(Complete Part II for noncash contributions.)
(a)
No.		 (b)
Name, address, and ZIP + 4		 (c)
Total contributions		 (d)
Type of contribution
 
 
 

   
 
 

$  


(Complete Part II for noncash contributions.)
(a)
No.		 (b)
Name, address, and ZIP + 4		 (c)
Total contributions		 (d)
Type of contribution
 
 
 

   
 
 

$  


(Complete Part II for noncash contributions.)
(a)
No.		 (b)
Name, address, and ZIP + 4		 (c)
Total contributions		 (d)
Type of contribution
 
 
 

   
 
 

$  


(Complete Part II for noncash contributions.)
(a)
No.		 (b)
Name, address, and ZIP + 4		 (c)
Total contributions		 (d)
Type of contribution
 
 
 

   
 
 

$  


(Complete Part II for noncash contributions.)
(a)
No.		 (b)
Name, address, and ZIP + 4		 (c)
Total contributions		 (d)
Type of contribution
 
 
 

   
 
 

$  


(Complete Part II for noncash contributions.)
Schedule B (Form 990, 990-EZ, or 990-PF) (2015)
Schedule B (Form 990, 990-EZ, or 990-PF) (2015)
Page 3
Name of organization
St Elizabeth Medical Center Inc
  		Employer identification number

61-0445850
Part II
Noncash Property (see instructions). Use duplicate copies of Part II if additional space is needed.
(a)
No.from Part I		 (b)
Description of noncash property given		 (c)
FMV (or estimate)
(see instructions) 		(d)
Date received
 
$    
(a)
No.from Part I		 (b)
Description of noncash property given		 (c)
FMV (or estimate)
(see instructions) 		(d)
Date received
 
$    
(a)
No.from Part I		 (b)
Description of noncash property given		 (c)
FMV (or estimate)
(see instructions) 		(d)
Date received
 
$    
(a)
No.from Part I		 (b)
Description of noncash property given		 (c)
FMV (or estimate)
(see instructions) 		(d)
Date received
 
$    
(a)
No.from Part I		 (b)
Description of noncash property given		 (c)
FMV (or estimate)
(see instructions) 		(d)
Date received
 
$    
(a)
No.from Part I		 (b)
Description of noncash property given		 (c)
FMV (or estimate)
(see instructions) 		(d)
Date received
 
$    
Schedule B (Form 990, 990-EZ, or 990-PF) (2015)
Schedule B (Form 990, 990-EZ, or 990-PF) (2015)
Page 4
Name of organization
St Elizabeth Medical Center Inc
  		Employer identification number

61-0445850
Part III
Exclusively religious, charitable, etc., contributions to organizations described in section 501(c)(7), (8), or (10) that total more than $1,000 for the year from any one contributor. Complete columns (a) through (e) and the following line entry. For organizations completing Part III, enter the total of exclusively religious, charitable, etc., contributions of $1,000 or less for the year. (Enter this information once. See instructions.) Arrow Bullet$  
Use duplicate copies of Part III if additional space is needed.
(a)
No.from Part I		 (b) Purpose of gift (c) Use of gift (d) Description of how gift is held
 
(e) Transfer of gift
Transferee's name, address, and ZIP 4 Relationship of transferor to transferee
 
 
     
 
(a)
No.from Part I		 (b) Purpose of gift (c) Use of gift (d) Description of how gift is held
 
(e) Transfer of gift
Transferee's name, address, and ZIP 4 Relationship of transferor to transferee
 
 
     
 
(a)
No.from Part I		 (b) Purpose of gift (c) Use of gift (d) Description of how gift is held
 
(e) Transfer of gift
Transferee's name, address, and ZIP 4 Relationship of transferor to transferee
 
 
     
 
(a)
No.from Part I		 (b) Purpose of gift (c) Use of gift (d) Description of how gift is held
 
(e) Transfer of gift
Transferee's name, address, and ZIP 4 Relationship of transferor to transferee
 
 
     
 
Schedule B (Form 990, 990-EZ, or 990-PF) (2015)

Additional Data


Software ID: 15000238
Software Version: 2015v2.1
SCHEDULE C
(Form 990 or 990-EZ)

Department of the Treasury
Internal Revenue Service
Political Campaign and Lobbying Activities

For Organizations Exempt From Income Tax Under section 501(c) and section 527
SchCMd Bullet Complete if the organization is described below. SchCMd Bullet Attach to Form 990 or Form 990-EZ.
SchCMd BulletInformation about Schedule C (Form 990 or 990-EZ) and its instructions is at www.irs.gov/form990.
OMB No. 1545-0047
2015
Open to Public
Inspection
If the organization answered "Yes" on Form 990, Part IV, Line 3, or Form 990-EZ, Part V, line 46 (Political Campaign Activities), then
Round Bullet Section 501(c)(3) organizations: Complete Parts I-A and B. Do not complete Part I-C.
Round Bullet Section 501(c) (other than section 501(c)(3)) organizations: Complete Parts I-A and C below. Do not complete Part I-B.
Round Bullet Section 527 organizations: Complete Part I-A only.
If the organization answered "Yes" on Form 990, Part IV, Line 4, or Form 990-EZ, Part VI, line 47 (Lobbying Activities), then
Round Bullet Section 501(c)(3) organizations that have filed Form 5768 (election under section 501(h)): Complete Part II-A. Do not complete Part II-B.
Round Bullet Section 501(c)(3) organizations that have NOT filed Form 5768 (election under section 501(h)): Complete Part II-B. Do not complete Part II-A.
If the organization answered "Yes" on Form 990, Part IV, Line 5 (Proxy Tax) (see separate instructions) or Form 990-EZ, Part V, line 35c (Proxy Tax) (see separate instructions), then
Round Bullet Section 501(c)(4), (5), or (6) organizations: Complete Part III.
Name of the organization
St Elizabeth Medical Center Inc
 
Employer identification number

61-0445850
Part I-A
Complete if the organization is exempt under section 501(c) or is a section 527 organization.

1
Provide a description of the organization’s direct and indirect political campaign activities in Part IV.
2
Political expenditures ......................................................................................................................SchCMd Bullet
$  
3
Volunteer hours .............................................................................................................................
 

Part I-B
Complete if the organization is exempt under section 501(c)(3).
1
Enter the amount of any excise tax incurred by the organization under section 4955 ................................SchCMd Bullet
$  
2
Enter the amount of any excise tax incurred by organization managers under section 4955 .......................SchCMd Bullet
$  
3
If the organization incurred a section 4955 tax, did it file Form 4720 for this year? .........................................
4a
Was a correction made? ......................................................................................................................
b
If "Yes," describe in Part IV.
Part I-C
Complete if the organization is exempt under section 501(c), except section 501(c)(3).
1
Enter the amount directly expended by the filing organization for section 527 exempt function activities ..... SchCMd Bullet
$  
2
Enter the amount of the filing organization's funds contributed to other organizations for section 527 exempt function activities ............................................................................................................................SchCMd Bullet

$  
3
Total exempt function expenditures. Add lines 1 and 2. Enter here and on Form 1120-POL, line 17b...........SchCMd Bullet

$  
4
Did the filing organization file Form 1120-POL for this year? ...................................................................
5
Enter the names, addresses and employer identification number (EIN) of all section 527 political organizations to which the filing
organization made payments. For each organization listed, enter the amount paid from the filing organization’s funds. Also enter the amount of political contributions received that were promptly and directly delivered to a separate political organization, such as a separate segregated fund or a political action committee (PAC). If additional space is needed, provide information in Part IV.
(a) Name (b) Address (c) EIN (d) Amount paid from filing organization's funds. If none, enter -0-. (e) Amount of political contributions received and promptly and directly delivered to a separate political organization. If none, enter -0-.
1
2
3
4
5
6
For Paperwork Reduction Act Notice, see the instructions for Form 990 or 990-EZ.
Cat. No. 50084S
Schedule C (Form 990 or 990-EZ) 2015

Schedule C (Form 990 or 990-EZ) 2015
Page 2
Part II-A
Complete if the organization is exempt under section 501(c)(3) and filed Form 5768 (election under section 501(h)).
A Check SchCMd Bulletexpenses, and share of excess lobbying expenditures).
B Check SchCMd Bullet
Limits on Lobbying Expenditures
(The term "expenditures" means amounts paid or incurred.) 		(a) Filing
organization's
totals 		(b) Affiliated group totals
1a Total lobbying expenditures to influence public opinion (grass roots lobbying) ...............................................    
b Total lobbying expenditures to influence a legislative body (direct lobbying) ...........................................    
c Total lobbying expenditures (add lines 1a and 1b) .......................................................................    
d Other exempt purpose expenditures .........................................................................................    
e Total exempt purpose expenditures (add lines 1c and 1d) ....................................................................    
f Lobbying nontaxable amount. Enter the amount from the following table in both
columns.		    
If the amount on line 1e, column (a) or (b) is:The lobbying nontaxable amount is:
Not over $500,00020% of the amount on line 1e.
Over $500,000 but not over $1,000,000$100,000 plus 15% of the excess over $500,000.
Over $1,000,000 but not over $1,500,000$175,000 plus 10% of the excess over $1,000,000.
Over $1,500,000 but not over $17,000,000$225,000 plus 5% of the excess over $1,500,000.
Over $17,000,000$1,000,000.
g Grassroots nontaxable amount (enter 25% of line 1f) ..........................................................................    
h Subtract line 1g from line 1a. If zero or less, enter -0-. ..........................................................................    
i Subtract line 1f from line 1c. If zero or less, enter -0-. ...........................................................................    
j If there is an amount other than zero on either line 1h or line 1i, did the organization file Form 4720 reporting
section 4911 tax for this year? ..............................................................................................................

4-Year Averaging Period Under section 501(h)
(Some organizations that made a section 501(h) election do not have to complete all of the five
columns below. See the separate instructions for lines 2a through 2f.)
Lobbying Expenditures During 4-Year Averaging Period
Calendar year (or fiscal year
beginning in) 		(a) 2012 (b) 2013 (c) 2014 (d) 2015 (e) Total
2a Lobbying nontaxable amount          
b Lobbying ceiling amount
(150% of line 2a, column(e)) 		 
c Total lobbying expenditures          
d Grassroots nontaxable amount          
e Grassroots ceiling amount
(150% of line 2d, column (e))		  
f Grassroots lobbying expenditures          
Schedule C (Form 990 or 990-EZ) 2015


Schedule C (Form 990 or 990-EZ) 2015
Page 3
Part II-B
Complete if the organization is exempt under section 501(c)(3) and has NOT filed Form 5768 (election under section 501(h)).
For each "Yes" response on lines 1a through 1i below, provide in Part IV a detailed description of the lobbying activity.
(a)
No
Yes
(b)
Amount
1
During the year, did the filing organization attempt to influence foreign, national, state or local legislation, including any attempt to influence public opinion on a legislative matter or referendum, through the use of:
a
Volunteers? ...........................................................................................................
 
No
b
Paid staff or management (include compensation in expenses reported on lines 1c through 1i)? ........
Yes
 
c
Media advertisements? ...................................................................................................
 
No
 
d
Mailings to members, legislators, or the public? .............................................................................
 
No
 
e
Publications, or published or broadcast statements? ...........................................................
 
No
 
f
Grants to other organizations for lobbying purposes? ..........................................................
 
No
 
g
Direct contact with legislators, their staffs, government officials, or a legislative body? .......................
Yes
 
71,998
h
Rallies, demonstrations, seminars, conventions, speeches, lectures, or any similar means? ..................
 
No
 
i
Other activities? ...................................................................................................................
Yes
 
34,231
j
Total. Add lines 1c through 1i ....................................................................................................
106,229
2a
Did the activities in line 1 cause the organization to be not described in section 501(c)(3)? .....
 
No
b
If "Yes," enter the amount of any tax incurred under section 4912 ...........................................
 
c
If "Yes," enter the amount of any tax incurred by organization managers under section 4912 ...................
 
d
If the filing organization incurred a section 4912 tax, did it file Form 4720 for this year? ........................
 
 
Part III-A
Complete if the organization is exempt under section 501(c)(4), section 501(c)(5), or section 501(c)(6).
Yes
No
1
Were substantially all (90% or more) dues received nondeductible by members? ...............................................
1
 
 
2
Did the organization make only in-house lobbying expenditures of $2,000 or less? ............................................
2
 
 
3
Did the organization agree to carry over lobbying and political expenditures from the prior year? .................................
3
 
 
Part III-B
Complete if the organization is exempt under section 501(c)(4), section 501(c)(5), or section 501(c)(6) and if either (a) BOTH Part III-A, lines 1 and 2, are answered "No" OR (b) Part III-A, line 3, is answered “Yes."
1
Dues, assessments and similar amounts from members ......................................................................
1
 
2
Section 162(e) nondeductible lobbying and political expenditures (do not include amounts of political expenses for which the section 527(f) tax was paid).
a
Current year .............................................................................................................................
2a
 
b
Carryover from last year ............................................................................................................
2b
 
c
Total ...........................................................................................................................................
2c
 
3
Aggregate amount reported in section 6033(e)(1)(A) notices of nondeductible section 162(e) dues .
3
 
4
If notices were sent and the amount on line 2c exceeds the amount on line 3, what portion of the excess does the organization agree to carryover to the reasonable estimate of nondeductible lobbying and political expenditure next year? ......................................................................................................................
4
 
5
Taxable amount of lobbying and political expenditures (see instructions) .........................................
5
 
Part IV
Supplemental Information
Provide the descriptions required for Part l-A, line 1; Part l-B, line 4; Part l-C, line 5; Part II-A (affiliated group list); Part II-A, lines 1 and 2 (see instructions), and Part ll-B, line 1. Also, complete this part for any additional information.
Return Reference Explanation
Schedule C, Part II-B, Line 1j OTHER ACTIVIITIES THE PORTION OF THE KENTUCKY HOSPITAL ASSOCIATION DUES THAT ARE ATTRIBUTABLE TO LOBBYING ACTIVITIES IS $34,231.
Schedule C, Part II-B, Line 1g Direct contact with legislators A PORTION OF TWO ST. ELIZABETH HEALTHCARE EMPLOYEES' SALARIES IS RELATED TO DIRECT CONTACT WITH LEGISLATORS AS IT RELATES TO LEGISLATION FOR THE TAX YEAR 2015. THE AMOUNT IS $6,498. ST. ELIZABETH HEALTHCARE ALSO ENLISTED THE ASSISTANCE OF LOBBYING CONSULTANTS IN 2015. THE AMOUNT PAID TO THESE CONSULTANTS IS $65,500.
Schedule C, Part II-B, Line 1 DETAILED DESCRIPTION OF THE LOBBYING ACTIVITY ST. ELIZABETH HEALTHCARE hired two lobbying consultants to provide lobbying support at the state and local levels on legislative issues being considered by the Kentucky General Assembly or by cities and counties in our community. Primarily, the consulting work includes monitoring bills, notifying St. Elizabeth if there are issues of concern or bills introduced that are of concern, assistance in talking with legislators or other government officials about these concerns, sharing positions on bills or issues with our legislators, and summarizing actions that have taken place on a weekly basis during the session. We have hired the consulting firm because they are based in Frankfort, Kentucky and can be at the meetings and hearings every day during the session so that we can be more timely in responding if issues arise.
Schedule C, Part II-B, Line 1 DETAILED DESCRIPTION OF THE LOBBYING ACTIVITY ST. ELIZABETH HEALTHCARE hired two lobbying consultants to provide lobbying support at the state and local levels on legislative issues being considered by the Kentucky General Assembly or by cities and counties in our community. Primarily, the consulting work includes monitoring bills, notifying St. Elizabeth if there are issues of concern or bills introduced that are of concern, assistance in talking with legislators or other government officials about these concerns, sharing positions on bills or issues with our legislators, and summarizing actions that have taken place on a weekly basis during the session. We have hired the consulting firm because they are based in Frankfort, Kentucky and can be at the meetings and hearings every day during the session so that we can be more timely in responding if issues arise.
Schedule C (Form 990 or 990EZ) 2015


Additional Data


Software ID: 15000238
Software Version: 2015v2.1

SCHEDULE D
(Form 990)
Department of the Treasury
Internal Revenue Service
Supplemental Financial Statements
SchDMd Bullet Complete if the organization answered "Yes," on Form 990,
Part IV, line 6, 7, 8, 9, 10, 11a, 11b, 11c, 11d, 11e, 11f, 12a, or 12b.
SchDMd Bullet Attach to Form 990.
Information about Schedule D (Form 990) and its instructions is at www.irs.gov/form990.
OMB No. 1545-0047
2015
Open to Public Inspection
Name of the organization
St Elizabeth Medical Center Inc
 
Employer identification number

61-0445850
Part I
Organizations Maintaining Donor Advised Funds or Other Similar Funds or Accounts. Complete if the organization answered "Yes" on Form 990, Part IV, line 6.
(a) Donor advised funds (b) Funds and other accounts
1 Total number at end of year ....    
2 Aggregate value of contributions to (during year)    
3 Aggregate value of grants from (during year)    
4 Aggregate value at end of year ....    
5
Did the organization inform all donors and donor advisors in writing that the assets held in donor advised
funds are the organization's property, subject to the organization's exclusive legal control? ...........
6
Did the organization inform all grantees, donors, and donor advisors in writing that grant funds can be
used only for charitable purposes and not for the benefit of the donor or donor advisor, or for any other purpose conferring impermissible private benefit? ............................
Part II
Conservation Easements. Complete if the organization answered "Yes" on Form 990, Part IV, line 7.
1
Purpose(s) of conservation easements held by the organization (check all that apply).
2
Complete lines 2a through 2d if the organization held a qualified conservation contribution in the form of a conservation easement on the last day of the tax year.
Held at the End of the Year
a Total number of conservation easements ...................... 2a  
b Total acreage restricted by conservation easements .................... 2b  
c Number of conservation easements on a certified historic structure included in (a) ..... 2c  
d Number of conservation easements included in (c) acquired after 8/17/06, and not on a historic structure listed in the National Register ... 2d  
3
Number of conservation easements modified, transferred, released, extinguished, or terminated by the organization during the
tax year SchDMd Bullet  
4
Number of states where property subject to conservation easement is located SchDMd Bullet  
5
Does the organization have a written policy regarding the periodic monitoring, inspection, handling of violations, and enforcement of the conservation easements it holds? ............
6
Staff and volunteer hours devoted to monitoring, inspecting, handling of violations, and enforcing conservation easements during the year
SchDMd Bullet  
7
Amount of expenses incurred in monitoring, inspecting, handling of violations, and enforcing conservation easements during the year
SchDMd Bullet $  
8
Does each conservation easement reported on line 2(d) above satisfy the requirements of section 170(h)(4)(B)(i) and section 170(h)(4)(B)(ii)? .............................
9
In Part XIII, describe how the organization reports conservation easements in its revenue and expense statement, and
balance sheet, and include, if applicable, the text of the footnote to the organization’s financial statements that describes
the organization’s accounting for conservation easements.
Part III
Organizations Maintaining Collections of Art, Historical Treasures, or Other Similar Assets.
Complete if the organization answered "Yes" on Form 990, Part IV, line 8.
1a
If the organization elected, as permitted under SFAS 116 (ASC 958), not to report in its revenue statement and balance sheet works of art, historical treasures, or other similar assets held for public exhibition, education, or research in furtherance of public service, provide, in Part XIII, the text of the footnote to its financial statements that describes these items.
b
If the organization elected, as permitted under SFAS 116 (ASC 958), to report in its revenue statement and balance sheet works of art, historical treasures, or other similar assets held for public exhibition, education, or research in furtherance of public service, provide the following amounts relating to these items:
(i)
Revenue included on Form 990, Part VIII, line 1 .........................SchDMd Bullet $  
(ii)
Assets included in Form 990, Part X ...............................SchDMd Bullet $  
2
If the organization received or held works of art, historical treasures, or other similar assets for financial gain, provide the
following amounts required to be reported under SFAS 116 (ASC 958) relating to these items:
a
Revenue included on Form 990, Part VIII, line 1 ..........................SchDMd Bullet $  
b
Assets included in Form 990, Part X ...............................SchDMd Bullet $  
For Paperwork Reduction Act Notice, see the Instructions for Form 990.
Cat. No. 52283D
Schedule D (Form 990) 2015

Schedule D (Form 990) 2015
Page 2
Part III
Organizations Maintaining Collections of Art, Historical Treasures, or Other Similar Assets (continued)
3
Using the organization’s acquisition, accession, and other records, check any of the following that are a significant use of its collection items (check all that apply):
a
d
b
e
 
c
4
Provide a description of the organization’s collections and explain how they further the organization’s exempt purpose in
Part XIII.
5
During the year, did the organization solicit or receive donations of art, historical treasures or other similar
assets to be sold to raise funds rather than to be maintained as part of the organization’s collection?...
Part IV
Escrow and Custodial Arrangements. Complete if the organization answered "Yes" on Form 990, Part IV, line 9, or reported an amount on Form 990, Part X, line 21.
1a
Is the organization an agent, trustee, custodian or other intermediary for contributions or other assets not
included on Form 990, Part X? ....................................
b If "Yes," explain the arrangement in Part XIII and complete the following table: Amount
c Beginning balance ............................. 1c  
d Additions during the year ............................ 1d  
e Distributions during the year .......................... 1e  
f Ending balance ................................ 1f  
2a
Did the organization include an amount on Form 990, Part X, line 21, for escrow or custodial account liability?
b
If "Yes," explain the arrangement in Part XIII. Check here if the explanation has been provided in Part XIII ........
Part V
Endowment Funds. Complete if the organization answered "Yes" on Form 990, Part IV, line 10.
(a)Current year (b)Prior year (c)Two years back (d)Three years back (e)Four years back
1a Beginning of year balance ....          
b Contributions ...          
c Net investment earnings, gains, and losses          
d Grants or scholarships ...          
e Other expenditures for facilities
and programs ... 		         
f Administrative expenses ....          
g End of year balance ......          
2
Provide the estimated percentage of the current year end balance (line 1g, column (a)) held as:
a
Board designated or quasi-endowment SchDMd Bullet  
b
Permanent endowment SchDMd Bullet  
c
Temporarily restricted endowment SchDMd Bullet  
The percentages on lines 2a, 2b, and 2c should equal 100%.
3a
Are there endowment funds not in the possession of the organization that are held and administered for the
organization by:

Yes
No
(i) unrelated organizations .................
3a(i)
 
 
(ii) related organizations .................
3a(ii)
 
 
b
If "Yes" on 3a(ii), are the related organizations listed as required on Schedule R? .........
3b
 
 
4
Describe in Part XIII the intended uses of the organization's endowment funds.
Part VI
Land, Buildings, and Equipment.
Complete if the organization answered 'Yes' on Form 990, Part IV, line 11a. See Form 990, Part X, line 10.
Description of property (a) Cost or other basis
(investment) 		(b)Cost or other basis (other) (c) Accumulated depreciation (d) Book value
1a Land ...   17,860,930 17,860,930
b Buildings   518,807,207 298,091,431 220,715,776
c Leasehold improvements   29,971,002 19,900,178 10,070,824
d Equipment ...   369,650,568 248,120,003 121,530,565
e Other ...   35,079,828   35,079,828
Total. Add lines 1a through 1e. (Column (d) must equal Form 990, Part X, column (B), line 10(c).)..SchDMdBullet 405,257,923
Schedule D (Form 990) 2015

Schedule D (Form 990) 2015
Page 3
Part VII
Investments—Other Securities. Complete if the organization answered 'Yes' on Form 990, Part IV, line 11b. See Form 990, Part X, line 12.
(a) Description of security or category
(including name of security)		 (b)Book value (c)Method of valuation:
Cost or end-of-year market value
(1)Financial derivatives    
(2)Closely-held equity interests    
(3)Other
(A) ENSURE A GOOD BEGINNING 		   

(B) HEART OF EXCELLENCE 		   

(C) FOUNDATION - UNRESTRICTED 		286,784,889 F
(C)
(D)
(E)
(F)
(G)
(H)
Total. (Column (b) must equal Form 990, Part X, col. (B) line 12.)Small Bullet 286,784,889
Part VIII
Investments—Program Related. Complete if the organization answered 'Yes' on Form 990, Part IV, line 11c. See Form 990, Part X, line 13.
(a) Description of investment (b) Book value (c) Method of valuation:
Cost or end-of-year market value
(1)
(2)
(3)
(4)
(5)
(6)
(7)
(8)
(9)
Total. (Column (b) must equal Form 990, Part X, col.(B) line 13.)Small Bullet  
Part IX
Other Assets. Complete if the organization answered 'Yes' on Form 990, Part IV, line 11d. See Form 990, Part X, line 15.
(a) Description (b) Book value
(1)
(2)
(3)
(4)
(5)
(6)
(7)
(8)
(9)
Total. (Column (b) must equal Form 990, Part X, col.(B) line 15.)...........Small Bullet  
Part X
Other Liabilities. Complete if the organization answered 'Yes' on Form 990, Part IV, line 11e or 11f. See Form 990, Part X, line 25.
1.(a) Description of liability (b) Book value
(1) Federal income taxes  
ANNUITY PAYMENT LIABILITY 118,841
ACCRUED PENSION LIABILITY 190,814,851
OTHER LONG TERM LIABILITIES 10,650,446
SELF-INSURANCE 56,969,905
OTHER CURRENT LIABILITIES HOSPITAL 7,739,000
INTEREST RATE SWAP 4,753,153
ASSET RETIREMENT OBLIGATION 363,408
(8)
(9)
Total. (Column (b) must equal Form 990, Part X, col.(B) line 25.)Small Bullet 271,409,604
2. Liability for uncertain tax positions. In Part XIII, provide the text of the footnote to the organization's financial statements that reports the organization's liability for uncertain tax positions under FIN 48 (ASC 740). Check here if the text of the footnote has been provided in Part XIII
Schedule D (Form 990) 2015

Schedule D (Form 990) 2015
Page 4
Part XI Reconciliation of Revenue per Audited Financial Statements With Revenue per Return Complete if the organization answered 'Yes' on Form 990, Part IV, line 12a.
1 Total revenue, gains, and other support per audited financial statements ....... 1 943,607,918
2 Amounts included on line 1 but not on Form 990, Part VIII, line 12:
a Net unrealized gains (losses) on investments .... 2a -37,084,240
b Donated services and use of facilities ......... 2b  
c Recoveries of prior year grants ........... 2c  
d Other (Describe in Part XIII.) ............ 2d 2,810,902
e Add lines 2a through 2d ..................... 2e -34,273,338
3 Subtract line 2e from line 1.................. 3 977,881,256
4 Amounts included on Form 990, Part VIII, line 12, but not on line 1:
a Investment expenses not included on Form 990, Part VIII, line 7b . 4a 1,098,953
b Other (Describe in Part XIII.) ........... 4b 31,835,348
c Add lines 4a and 4b.................... 4c 32,934,301
5 Total revenue. Add lines 3 and 4c. (This must equal Form 990, Part I, line 12.) ...... 5 1,010,815,557
Part XII Reconciliation of Expenses per Audited Financial Statements With Expenses per Return. Complete if the organization answered 'Yes' on Form 990, Part IV, line 12a.
1 Total expenses and losses per audited financial statements ........... 1 894,635,740
2 Amounts included on line 1 but not on Form 990, Part IX, line 25:
a Donated services and use of facilities ......... 2a  
b Prior year adjustments ............ 2b  
c Other losses ................ 2c  
d Other (Describe in Part XIII.) ............ 2d 3,289,776
e Add lines 2a through 2d.................... 2e 3,289,776
3 Subtract line 2e from line 1................... 3 891,345,964
4 Amounts included on Form 990, Part IX, line 25, but not on line 1:
a Investment expenses not included on Form 990, Part VIII, line 7b .. 4a 1,098,953
b Other (Describe in Part XIII.) ............ 4b 31,605,872
c Add lines 4a and 4b..................... 4c 32,704,825
5 Total expenses. Add lines 3 and 4c. (This must equal Form 990, Part I, line 18.) ...... 5 924,050,789

Part XIII
Supplemental Information
Provide the descriptions required for Part II, lines 3, 5, and 9; Part III, lines 1a and 4; Part lV, lines 1b and 2b;
Part V, line 4; Part X, line 2; Part XI, lines 2d and 4b; and Part XII, lines 2d and 4b. Also complete this part to provide any additional information.
Return Reference Explanation
Schedule D, Part X, Line 2 FIN 48 (ASC 740) footnote NO PROVISION HAS BEEN MADE FOR INCOME TAXES SINCE ST. ELIZABETH HEALTHCARE IS EXEMPT FROM FEDERAL INCOME TAXES UNDER INTERNAL REVENUE CODE SECTION 501(C)(3) AND IS CLASSIFIED AS OTHER THAN A PRIVATE FOUNDATION BY THE INTERNAL REVENUE SERVICE. MANAGEMENT HAS ANALYZED THE TAX POSITIONS TAKEN BY ST. ELIZABETH AND HAS CONCLUDED THAT AS OF DECEMBER 31, 2015, THERE ARE NO UNCERTAIN POSITIONS TAKEN OR EXPECTED TO BE TAKEN THAT WOULD REQUIRE RECOGNITION OF A LIABILITY OR DISCLOSURE IN THE FINANCIAL STATEMENTS. ST. ELIZABETH HEALTHCARE IS NOT CURRENTLY UNDER EXAMINATION BY THE INTERNAL REVENUE SERVICE OR ANY STATE OR LOCAL TAX AUTHORITIES. ST. ELIZABETH HEALTHCARE'S FEDERAL TAX RETURNS FOR THE YEARS ENDED PRIOR TO DECEMBER 31, 2012 ARE NO LONGER SUBJECT TO EXAMINATION.
Schedule D, Part XI, Line 2(d) Other revenues in audited financial statements not in form 990 Rental Expenses - 1805228 Fundraising direct expenses - 138098 Gaming direct expenses - 7585 LOSS ON DISPOSITION OF ASSETS - 859991
Schedule D, Part XI, Line 4(b) Other revenues in form 990 not in audited financial statements CHANGE IN FMV OF INTEREST RATE SWAP - 179717 PROVISION FOR BAD DEBT - 31505631 Write off of uncollectible pledges - 150000
Schedule D, Part XII, Line 2(d) Other expenses in audited financial statements not in form 990 RENTAL EXPENSES - 1805228 FUNDRAISING DIRECT EXPENSES - 138098 GAMING DIRECT EXPENSES - 7585 LOSS ON DISPOSITION OF ASSETS - 859991 Expenses Related to St. Elizabeth Provider Network, Inc. - 478874
Schedule D, Part XII, Line 4(b) Other expenses in form 990 not in audited financial statements Provision for Bad Debt - 31505631 St. Elizabeth Physician Services - 100241
Schedule D (Form 990) 2015


Additional Data


Software ID: 15000238
Software Version: 2015v2.1




SCHEDULE F(Form 990)
Department of the Treasury
Internal Revenue Service
Statement of Activities Outside the United States
Right pointing arrow large image Complete if the organization answered "Yes" to Form 990,Part IV, line 14b, 15, or 16.Right pointing arrow large image Attach to Form 990. Right pointing arrow large image See separate instructions.Right pointing arrow large image Information about Schedule F (Form 990) and its instructions is at www.irs.gov/form990.
OMB No. 1545-0047
2015
Open to Public Inspection
Name of the organization
St Elizabeth Medical Center Inc
 
Employer identification number

61-0445850
Part I
General Information on Activities Outside the United States. Complete if the organization answered "Yes" to Form 990, Part IV, line 14b.
1
For grantmakers.Does the organization maintain records to substantiate the amount of its grants and
other assistance, the grantees’ eligibility for the grants or assistance, and the selection criteria used
to award the grants or assistance? . . . . . . . . . . . . . . . . . . . . . . . . .
2
For grantmakers. Describe in Part V the organization’s procedures for monitoring the use of its grants and other assistance outside the United States.
3
Activites per Region. (The following Part I, line 3 table can be duplicated if additional space is needed.)
(a) Region (b) Number of offices in the region (c) Number of employees, agents, and independent contractors in region (d) Activities conducted in region (by type) (e.g., fundraising, program services, investments, grants to recipients located in the region) (e) If activity listed in (d) is a program service, describe specific type of
service(s) in region		 (f) Total expenditures
for and investments
in region
Central America and the Caribbean 0 0 Investments N/A 129,812,000
           
           
           
           
           
           
           
           
           
           
           
           
           
           
           
           
3a Sub-total ..... 0 0 129,812,000
b Total from continuation sheets to Part I ... 0 0 0
c Totals (add lines 3a and 3b) 0 0 129,812,000
For Paperwork Reduction Act Notice, see the Instructions for Form 990.Cat. No. 50082W Schedule F (Form 990) 2015
Schedule F (Form 990) 2015
Page 2
Part II
Grants and Other Assistance to Organizations or Entities Outside the United States. Complete if the organization answered "Yes" to Form 990, Part IV, line 15, for any recipient who received more than $5,000. Part II can be duplicated if additional space is needed.
1 (a) Name of organization (b) IRS code section
and EIN (if applicable)		 (a)(c) Region (b)(d) Purpose of
grant 		(e) Amount of
cash grant 		(f) Manner of
cash
disbursement 		(g) Amount
of non-cash
assistance 		(h) Description
of non-cash
assistance 		(i) Method of
valuation
(book, FMV,
appraisal, other)
             
             
             
             
             
             
             
             
             
             
             
             
             
             
             
             
2 Enter total number of recipient organizations listed above that are recognized as charities by the foreign country, recognized as tax-exempt by the IRS, or for which the grantee or counsel has provided a section 501(c)(3) equivalency letter .......MediumBullet
 
3 Enter total number of other organizations or entities .......................MediumBullet
 
Schedule F (Form 990) 2015
Schedule F (Form 990) 2015Page 3
Part III
Grants and Other Assistance to Individuals Outside the United States. Complete if the organization answered "Yes" to Form 990, Part IV, line 16.
Part III can be duplicated if additional space is needed.
(a) Type of grant or assistance (b) Region (c) Number of recipients (d) Amount of
cash grant 		(e) Manner of cash
disbursement 		(f) Amount of
non-cash
assistance 		(g) Description
of non-cash
assistance 		(h) Method of
valuation
(book, FMV,
appraisal, other)
               
               
               
               
               
               
               
               
               
               
               
               
               
               
               
               
               
               
Schedule F (Form 990) 2015
Schedule F (Form 990) 2015
Page 4
Part IV
Foreign Forms
1 Was the organization a U.S. transferor of property to a foreign corporation during the tax year? If "Yes,"the organization may be required to file Form 926, Return by a U.S. Transferor of Property to a Foreign Corporation (see Instructions for Form 926). . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
2 Did the organization have an interest in a foreign trust during the tax year? If "Yes," the organization may be required to separately file Form 3520, Annual Return to Report Transactions with Foreign Trusts and Receipt of Certain Foreign Gifts, and/or Form 3520-A, Annual Information Return of Foreign Trust With a U.S. Owner (see Instructions for Forms 3520 and 3520-A). . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
3 Did the organization have an ownership interest in a foreign corporation during the tax year? If "Yes," the organization may be required to file Form 5471, Information Return of U.S. Persons with Respect to Certain Foreign Corporations. (see Instructions for Form 5471). . . . . . . . . . . . . . . . . . . . . . . . . . . .
4 Was the organization a direct or indirect shareholder of a passive foreign investment company or a qualified electing fund during the tax year? If “Yes,” the organization may be required to file Form 8621, Information Return by a Shareholder of a Passive Foreign Investment Company or Qualified Electing Fund. (see Instructions for Form 8621) .
5 Did the organization have an ownership interest in a foreign partnership during the tax year? If "Yes," the organization may be required to file Form 8865, Return of U.S. Persons with Respect to Certain Foreign Partnerships. (see Instructions for Form 8865). . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
6 Did the organization have any operations in or related to any boycotting countries during the tax year? If "Yes," the organization may be required to separately file Form 5713, International Boycott Report (see Instructions for Form 5713).. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Schedule F (Form 990) 2015
Schedule F (Form 990) 2015
Page 5
Part V
Supplemental Information
Provide the information required by Part I, line 2 (monitoring of funds); Part I, line 3, column (f) (accounting method; amounts of investments vs. expenditures per region); Part II, line 1 (accounting method); Part III (accounting method); and Part III, column (c) (estimated number of recipients), as applicable. Also complete this part to provide any additional information (see instructions).
ReturnReference Explanation
Schedule F, Part I, Line 2 Procedures for monitoring use of grant funds St. Elizabeth Healthcare maintains records to substantiate amounts and eligibility to be used for the criteria for selecting program related investments. St. Elizabeth Healthcare's program related investments are considered to be low risk and have low volatility to the marketplace. St. Elizabeth Healthcare monitors their program related investments by having an independent investment consultant receive, on a quarterly basis, separate financial reports for each investment and on an annual basis, audited financial statements performed by third party independent auditors for each investment. These reports and financial statements are reviewed by the independent investment consultant and performance is calculated based on actual and projected cash flows for each investment. This performance is compared to benchmarked industry standards. In addition, rates of return are compared to what is actually reported and what the industry standards provide. Any significant disparities are discussed with St. Elizabeth Healthcare's investment committee. Further, If necessary, an investment research team will review the strategy, performance, and goals of the program related investment(s) to ensure that the funds are being used for their proper purpose and are not otherwise diverted from their intended use.
Schedule F, Part I, Line 2 PROCEDURES FOR MONITORING USE OF GRANT FUNDS St. Elizabeth Healthcare maintains records to substantiate amounts and eligibility to be used for the criteria for selecting program related investments. St. Elizabeth Healthcare's program related investments are considered to be low risk and have low volatility to the marketplace. St. Elizabeth Healthcare monitors their program related investments by having an independent investment consultant receive, on a quarterly basis, separate financial reports for each investment and on an annual basis, audited financial statements performed by third party independent auditors for each investment. These reports and financial statements are reviewed by the independent investment consultant and performance is calculated based on actual and projected cash flows for each investment. This performance is compared to benchmarked industry standards. In addition, rates of return are compared to what is actually reported and what the industry standards provide. Any significant disparities are discussed with St. Elizabeth Healthcare's investment committee. Further, If necessary, an investment research team will review the strategy, performance, and goals of the program related investment(s) to ensure that the funds are being used for their proper purpose and are not otherwise diverted from their intended use.
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
Schedule F (Form 990) 2015
Additional Data


Software ID: 15000238
Software Version: 2015v2.1



SCHEDULE G (Form 990 or 990-EZ)
Department of the Treasury
Internal Revenue Service
Supplemental Information Regarding
Fundraising or Gaming Activities
Complete if the organization answered "Yes" on Form 990, Part IV, lines 17, 18, or 19, or if the organization entered more than $15,000 on Form 990-EZ, line 6a. right arrowAttach to Form 990 or Form 990-EZ.
right arrowInformation about Schedule G (Form 990 or 990-EZ) and its instructions is at www.irs.gov/form990.
OMB No. 1545-0047
2015
Open to Public Inspection
Name of the organization
St Elizabeth Medical Center Inc
 
Employer identification number

61-0445850
Part I
Fundraising Activities. Complete if the organization answered "Yes" on Form 990, Part IV, line 17.
Form 990-EZ filers are not required to complete this part.
1
Indicate whether the organization raised funds through any of the following activities. Check all that apply.
a e
b f
c g
d
2a
Did the organization have a written or oral agreement with any individual (including officers, directors, trustees
or key employees listed in Form 990, Part VII) or entity in connection with professional fundraising services?
b
If "Yes," list the ten highest paid individuals or entities (fundraisers) pursuant to agreements under which the fundraiser is
to be compensated at least $5,000 by the organization.


(i) Name and address of individual
or entity (fundraiser) 		(ii) Activity (iii) Did fundraiser have custody or control of contributions? (iv) Gross receipts
from activity 		(v) Amount paid to
(or retained by)
fundraiser listed in
col. (i) 		(vi) Amount paid to
(or retained by)
organization
Yes No
 
PRIDE PHILANTHROPY
885 WOODSTOCK ROAD SUITE 430
 
ROSWELL, GA300752374 		CONSULTANT FEE   No 149,408 16,500 132,908
 
THE KAISER INSTITUTE
PO BOX 339
 
BRIGHTON, CO80601 		CONSULTANT FEE   No 0 11,120 -11,120
             
             
             
             
             
             
             
             
Total . . . . . . . . . . . . . . . . . . . . right arrow 149,408 27,620 121,788
3
List all states in which the organization is registered or licensed to solicit contributions or has been notified it is exempt from registration or licensing.
KY, OH
For Paperwork Reduction Act Notice, see the Instructions for Form 990 or 990-EZ.
Cat. No. 50083H
Schedule G (Form 990 or 990-EZ) 2015
Schedule G (Form 990 or 990-EZ) 2015
Page 2
Part II
Fundraising Events. Complete if the organization answered "Yes" on Form 990, Part IV, line 18, or reported more than $15,000 of fundraising event contributions and gross income on Form 990-EZ, lines 1 and 6b. List events with gross receipts greater than $5,000.




VerticalRevenue
(a) Event #1

Golf Partee
(event type) 		(b) Event #2

Style Show
(event type) 		(c) Other events

2
(total number) 		(d) Total events
(add col. (a) through col. (c))

1
Gross receipts . . . . .
261,263
62,985
34,898
359,146

2
Less: Contributions . . . .
47,998
17,650
18,925
84,573
3 Gross income (line 1 minus
line 2) . . . . . .
213,265
45,335
15,973
274,573



VerticalDirectExpenses
4 Cash prizes . . . . .        
5 Noncash prizes . . . . 43,167   5,621 48,788
6 Rent/facility costs . . . . 19,952 9,948 6,883 36,783
7 Food and beverages . . . 19,724 654 3,273 23,651
8 Entertainment . . . .   138   138
9 Other direct expenses . . . 7,665 16,985 4,088 28,738
10 Direct expense summary. Add lines 4 through 9 in column (d) . . . . . . . . . . right arrow 138,098
11 Net income summary. Subtract line 10 from line 3, column (d). . . . . . . . . . right arrow 136,475
Part III
Gaming. Complete if the organization answered "Yes" on Form 990, Part IV, line 19, or reported more than $15,000 on Form 990-EZ, line 6a.
VerticalRevenue
(a) Bingo (b) Pull tabs/Instant
bingo/progressive bingo 		(c) Other gaming (d) Total gaming (add col.(a) through col.(c))

1
Gross revenue . . . . .
 
 
23,349
23,349
VerticalDirectExpenses

2
Cash prizes . . . . .
 
 
7,585
7,585

3
Noncash prizes . . . .
 
 
 
 

4
Rent/facility costs . . . .
 
 
 
 

5
Other direct expenses . . .
7,665
16,985
4,088
28,738


6

Volunteer labor . . . .
%
%
%


7
Direct expense summary. Add lines 2 through 5 in column (d) . . . . . . . . . . right arrow
 

8
Net gaming income summary. Subtract line 7 from line 1, column (d). . . . . . . . . right arrow
 

9
Enter the state(s) in which the organization conducts gaming activities: KY
a
Is the organization licensed to conduct gaming activities in each of these states? . . . . . . . .
b
If "No," explain:
 
10a
Were any of the organization's gaming licenses revoked, suspended or terminated during the tax year? . . .
b
If "Yes," explain:
 
Schedule G (Form 990 or 990-EZ) 2015
Schedule G (Form 990 or 990-EZ) 2015
Page 3
11
Does the organization conduct gaming activities with nonmembers? . . . . . . . . . . .
12
Is the organization a grantor, beneficiary or trustee of a trust or a member of a partnership or other entity
formed to administer charitable gaming? . . . . . . . . . . . . . . . . .
13
Indicate the percentage of gaming activity conducted in:
a
The organization's facility . . . . . . . . . . . . . . . . . .
13a
31 %
b
An outside facility . . . . . . . . . . . . . . . . . . . .
13b
69 %
14
Enter the name and address of the person who prepares the organization's gaming/special events books and records:
Name right arrow
Lisa Speier
Address right arrow
1 Medical Village Dr
Edgewood,KY41017
15a
Does the organization have a contract with a third party from whom the organization receives gaming
revenue? . . . . . . . . . . . . . . . . . . . . . . . .
b
If "Yes," enter the amount of gaming revenue received by the organization right arrow $   and the
amount of gaming revenue retained by the third party right arrow $   .
c
If "Yes," enter name and address of the third party:
Name right arrow
Address right arrow
 
 
16
Gaming manager information:
Name right arrow
Gaming manager compensation right arrow $ 0
Description of services provided right arrow
Lisa has overall supervision and management of the gaming operation. Generally, her responsibilities include recordkeeping, money counting, hiring and firing of workers, and making the bank deposits for the gaming operation.
17
Mandatory distributions:
a
Is the organization required under state law to make charitable distributions from the gaming proceeds to
retain the state gaming license? . . . . . . . . . . . . . . . . . . .
b
Enter the amount of distributions required under state law distributed to other exempt organizations or spent
in the organization's own exempt activities during the tax year right arrow$ 15,764
Part IV
Supplemental Information. Provide the explanations required by Part I, line 2b, columns (iii) and (v); and Part III, lines 9, 9b, 10b, 15b, 15c, 16, and 17b, as applicable. Also complete this part to provide any additional information (see instructions).
Return Reference Explanation
Schedule G, Part I, Line 2b PRIDE PHILANTHROPY PRIDE PHILANTHROPY provides professional philanthropy and campaign counsel services TO ST. ELIZABETH HEALTHCARE WHICH INCLUDES FEASIBILITY STUDIES TO SUPPORT THE GROWTH OF ST. ELIZABETH HEALTHCARE'S FUNDRAISING ACTIVITIES. PRIDE PHILANTHROPY DOES NOT PARTICIPATE IN THE SOLICITATION OF CONTRIBUTIONS.
Schedule G, Part I, Line 2b KAISER INSTITUTE THE KAISER INSTITUTE PROVIDES CONSULTING SERVICES ON LEADERSHIP, STRATEGY AND PLANNING, HOSPITAL/PHYSICIAN ARRANGEMENTS, CHANGE & INNOVATION, AND MEDICAL SCIENCE & TECHNOLOGY TO ST. ELIZABETH HEALTHCARE. THE KAISER INSTITUTE DOES NOT PARTICIPATE IN THE SOLICITATION OF CONTRIBUTIONS.
Schedule G, Part III, Line 17b MANDATORY DISTRIBUTIONS MANDATORY DISTRIBUTIONS FROM THE CHARITABLE GAMING ACTIVITIES ARE AS FOLLOWS: DESCRIPTIONS and AMOUNT: 1. St. Elizabeth Grant: $1,220 2. Clinical Research Institute: $8,585 3. St. Elizabeth Physicians Scholarship Program: $102 4. Walkers for Skilled Nursing Unit St. Elizabeth Ft. Thomas: $3,087 5. Renovate Locker Rooms St. Elizabeth Florence: $2,770 TOTAL $ 15,764
Schedule G, Part III, Line 17 Distributions required under state law STATE=KENTUCKY,MANDATORY DISTRIBUTION AMOUNT=15764;
Schedule G (Form 990 or 990-EZ) 2015
Additional Data


Software ID: 15000238
Software Version: 2015v2.1
SCHEDULE H
(Form 990)
Department of the Treasury
Internal Revenue Service
Hospitals
MediumBullet Complete if the organization answered "Yes" on Form 990, Part IV, question 20.
MediumBullet Attach to Form 990.
MediumBullet Information about Schedule H (Form 990) and its instructions is at www.irs.gov/form990.
OMB No. 1545-0047
2015
Open to Public Inspection
Name of the organization
St Elizabeth Medical Center Inc
 
Employer identification number

61-0445850
Part I
Financial Assistance and Certain Other Community Benefits at Cost
Yes
No
1a
Did the organization have a financial assistance policy during the tax year? If "No," skip to question 6a . . . .
1a
Yes
 
b
If "Yes," was it a written policy? ......................
1b
Yes
 
2
If the organization had multiple hospital facilities, indicate which of the following best describes application of the financial assistance policy to its various hospital facilities during the tax year.
3
Answer the following based on the financial assistance eligibility criteria that applied to the largest number of the organization's patients during the tax year.
a
Did the organization use Federal Poverty Guidelines (FPG) as a factor in determining eligibility for providing free care?
If "Yes," indicate which of the following was the FPG family income limit for eligibility for free care:
3a
Yes
 
%
b
Did the organization use FPG as a factor in determining eligibility for providing discounted care? If "Yes," indicate
which of the following was the family income limit for eligibility for discounted care: . . . . . . . .
3b
 
No
%
c
If the organization used factors other than FPG in determining eligibility, describe in Part VI the criteria used for determining eligibility for free or discounted care. Include in the description whether the organization used an asset test or other threshold, regardless of income, as a factor in determining eligibility for free or discounted care.
4
Did the organization's financial assistance policy that applied to the largest number of its patients during the tax year provide for free or discounted care to the "medically indigent"? . . . . . . . . . . . . .

4

Yes

 
5a
Did the organization budget amounts for free or discounted care provided under its financial assistance policy during
the tax year? . . . . . . . . . . . . . . . . . . . . . . .

5a

Yes

 
b
If "Yes," did the organization's financial assistance expenses exceed the budgeted amount? . . . . . .
5b
Yes
 
c
If "Yes" to line 5b, as a result of budget considerations, was the organization unable to provide free or discountedcare to a patient who was eligibile for free or discounted care? . . . . . . . . . . . . .
5c
 
No
6a
Did the organization prepare a community benefit report during the tax year? . . . . . . . . .
6a
Yes
 
b
If "Yes," did the organization make it available to the public? . . . . . . . . . . . . .
6b
Yes
 
Complete the following table using the worksheets provided in the Schedule H instructions. Do not submit these worksheets with the Schedule H.
7
Financial Assistance and Certain Other Community Benefits at Cost
Financial Assistance and
Means-Tested
Government Programs
 (a) Number of activities or programs (optional) (b) Persons served (optional) (c) Total community benefit expense (d) Direct offsetting revenue (e) Net community benefit expense (f) Percent of total expense
a Financial Assistance at cost
(from Worksheet 1) . . . 		    20,324,674 12,550,523 7,774,151 0.87 %
b Medicaid (from Worksheet 3, column a) . . . . .     172,366,341 126,239,199 46,127,142 5.17 %
c Costs of other means-tested government programs (from Worksheet 3, column b) . .     0 0 0 0 %
d Total Financial Assistance and Means-Tested Government Programs . . . . . 0 0 192,691,015 138,789,722 53,901,293 6.04 %
Other Benefits
e Community health improvement services and community benefit operations (from Worksheet 4).     2,122,664 51,800 2,070,864 0.23 %
f Health professions education (from Worksheet 5) . . .     7,458,273 3,927,885 3,530,388 0.40 %
g Subsidized health services (from Worksheet 6) . . . .     2,943,590 1,246,190 1,697,400 0.19 %
h Research (from Worksheet 7) .     761,233 390,164 371,069 0.04 %
i Cash and in-kind contributions for community benefit (from Worksheet 8) . . . .     5,277,486 0 5,277,486 0.59 %
j Total. Other Benefits . . 0 0 18,563,246 5,616,039 12,947,207 1.45 %
k Total. Add lines 7d and 7j . 0 0 211,254,261 144,405,761 66,848,500 7.49 %
For Paperwork Reduction Act Notice, see the Instructions for Form 990. Cat. No. 50192T Schedule H (Form 990) 2015
Schedule H (Form 990) 2015
Page
Part II
Community Building Activities Complete this table if the organization conducted any community building activities during the tax year, and describe in Part VI how its community building activities promoted the health of the communities it serves.
(a) Number of activities or programs (optional) (b) Persons served (optional) (c) Total community building expense (d) Direct offsetting
revenue 		(e) Net community building expense (f) Percent of total expense
1 Physical improvements and housing         0 0 %
2 Economic development 5   500,556   500,556 0.06 %
3 Community support 25   387,608   387,608 0.04 %
4 Environmental improvements         0 0 %
5 Leadership development and
training for community members		         0 0 %
6 Coalition building 2   4,051   4,051 0 %
7 Community health improvement advocacy 3   5,814   5,814 0 %
8 Workforce development 7 415 9,742   9,742 0 %
9 Other 2 67 4,328   4,328 0 %
10 Total 44 482 912,099 0 912,099 0.10 %
Part III
Bad Debt, Medicare, & Collection Practices
Section A. Bad Debt Expense
Yes
No
1
Did the organization report bad debt expense in accordance with Heathcare Financial Management Association Statement No. 15? ..........................
1
 
No
2
Enter the amount of the organization's bad debt expense. Explain in Part VI the methodology used by the organization to estimate this amount. ......
2
31,505,631
3
Enter the estimated amount of the organization's bad debt expense attributable to patients eligible under the organization's financial assistance policy. Explain in Part VI the methodology used by the organization to estimate this amount and the rationale, if any, for including this portion of bad debt as community benefit. ......
3
3,150,563
4
Provide in Part VI the text of the footnote to the organization’s financial statements that describes bad debt expense or the page number on which this footnote is contained in the attached financial statements.
Section B. Medicare
5
Enter total revenue received from Medicare (including DSH and IME).....
5
201,351,207
6
Enter Medicare allowable costs of care relating to payments on line 5.....
6
218,523,065
7
Subtract line 6 from line 5. This is the surplus (or shortfall)........
7
-17,171,858
8
Describe in Part VI the extent to which any shortfall reported in line 7 should be treated as community benefit.Also describe in Part VI the costing methodology or source used to determine the amount reported on line 6.Check the box that describes the method used:
Section C. Collection Practices
9a
Did the organization have a written debt collection policy during the tax year? ..........
9a
Yes
 
b
If "Yes," did the organization’s collection policy that applied to the largest number of its patients during the tax year
contain provisions on the collection practices to be followed for patients who are known to qualify for financial assistance? Describe in Part VI .........................

9b

Yes

 
Part IV
Management Companies and Joint Ventures(owned 10% or more by officers, directors, trustees, key employees, and physicians—see instructions)
(a) Name of entity (b) Description of primary
activity of entity 		(c) Organization's
profit % or stock
ownership % 		(d) Officers, directors,
trustees, or key
employees' profit %
or stock ownership % 		(e) Physicians'
profit % or stock
ownership %
1BLUEGRASS DIALYSIS LLC
  		RENAL DIALYSIS 32 % 0 % 17 %
2
3
4
5
6
7
8
9
10
11
12
13
Schedule H (Form 990) 2015
Schedule H (Form 990) 2015
Page
Part VFacility Information
Section A. Hospital Facilities
(list in order of size from largest to smallest—see instructions)
How many hospital facilities did the organization operate during the tax year?4
Name, address, primary website address, and state license number (and if a group return, the name and EIN of the subordinate hospital organization that operates the hospital facility) 		Licensed Hospital General-Medical-Surgical Children's Hospital Teaching Hospital Critical Hospital ResearchGrp Facility ER-24Hours ER-Other Other (Describe) Facility reporting group
1 ST ELIZABETH HEALTHCARE
4900 HOUSTON ROAD
FLORENCE,KY41042
www.stelizabeth.com
100273 		X X         X     A
2 ST ELIZABETH EDGEWOOD
1 MEDICAL VILLAGE DRIVE
EDGEWOOD,KY41017
www.stelizabeth.com
100500 		X X         X     A
3 ST ELIZABETH GRANT
238 BARNES ROAD
WILLIAMSTOWN,KY41097
www.stelizabeth.com
600062 		X X     X   X     A
4 ST ELIZABETH FORT THOMAS
85 NORTH GRAND AVENUE
FORT THOMAS,KY41075
www.stelizabeth.com
100059 		X X         X     A
Schedule H (Form 990) 2015
Schedule H (Form 990) 2015
Page 4
Part VFacility Information (continued)

Section B. Facility Policies and Practices

(Complete a separate Section B for each of the hospital facilities or facility reporting groups listed in Part V, Section A)
A
Name of hospital facility or letter of facility reporting group  
Line number of hospital facility, or line numbers of hospital facilities in a facility
reporting group (from Part V, Section A): 		 
Yes No
Community Health Needs Assessment
1 Was the hospital facility first licensed, registered, or similarly recognized by a state as a hospital facility in the current tax year or the immediately preceding tax year?........................ 1   No
2 Was the hospital facility acquired or placed into service as a tax-exempt hospital in the current tax year or the immediately preceding tax year? If “Yes,” provide details of the acquisition in Section C............... 2   No
3 During the tax year or either of the two immediately preceding tax years, did the hospital facility conduct a community health needs assessment (CHNA)? If "No," skip to line 12...................... 3 Yes  
If "Yes," indicate what the CHNA report describes (check all that apply):
a
b
c
d
e
f
g
h
i
j
4 Indicate the tax year the hospital facility last conducted a CHNA: 20 15
5 In conducting its most recent CHNA, did the hospital facility take into account input from persons who represent the broad interests of the community served by the hospital facility, including those with special knowledge of or expertise in public health? If "Yes," describe in Section C how the hospital facility took into account input from persons who represent the community, and identify the persons the hospital facility consulted ................. 5 Yes  
6 a Was the hospital facility’s CHNA conducted with one or more other hospital facilities? If "Yes," list the other hospital facilities in Section C.................................. 6a Yes  
b Was the hospital facility’s CHNA conducted with one or more organizations other than hospital facilities?” If “Yes,” list the other organizations in Section C. ............................ 6b   No
7 Did the hospital facility make its CHNA report widely available to the public?.............. 7 Yes  
If "Yes," indicate how the CHNA report was made widely available (check all that apply):
a
b
c
d
8 Did the hospital facility adopt an implementation strategy to meet the significant community health needs
identified through its most recently conducted CHNA? If "No," skip to line 11. .............. 		8 Yes  
9 Indicate the tax year the hospital facility last adopted an implementation strategy: 20 15
10 Is the hospital facility's most recently adopted implementation strategy posted on a website?......... 10 Yes  
a If "Yes" (list url): http://www.stelizabeth.com/COMMUNITYBENEFITS.ASPX
b If "No," is the hospital facility’s most recently adopted implementation strategy attached to this return? ...... 10b   No
11 Describe in Section C how the hospital facility is addressing the significant needs identified in its most recently conducted CHNA and any such needs that are not being addressed together with the reasons why such needs are not being addressed.
12a Did the organization incur an excise tax under section 4959 for the hospital facility's failure to conduct a CHNA as required by section 501(r)(3)?............................... 12a   No
b If "Yes" on line 12a, did the organization file Form 4720 to report the section 4959 excise tax?........ 12b    
c If "Yes" on line 12b, what is the total amount of section 4959 excise tax the organization reported on Form 4720 for all of its hospital facilities? $  

Schedule H (Form 990) 2015
Schedule H (Form 990) 2015
Page 5
Part VFacility Information (continued)

Financial Assistance Policy (FAP)
A
Name of hospital facility or letter of facility reporting group  
Yes No
Did the hospital facility have in place during the tax year a written financial assistance policy that:
13 Explained eligibility criteria for financial assistance, and whether such assistance included free or discounted care? 13 Yes  
If “Yes,” indicate the eligibility criteria explained in the FAP:
a
b
c
d
e
f
g
h
14 Explained the basis for calculating amounts charged to patients?................. 14 Yes  
15 Explained the method for applying for financial assistance?................... 15 Yes  
If “Yes,” indicate how the hospital facility’s FAP or FAP application form (including accompanying instructions) explained the method for applying for financial assistance (check all that apply):
a
b
c
d
e
16 Included measures to publicize the policy within the community served by the hospital facility?........ 16 Yes  
If "Yes," indicate how the hospital facility publicized the policy (check all that apply):
a
WWW.STELIZABETH.COM
b
WWW.STELIZABETH.COM
c
d
e
f
g
h
i
Billing and Collections
17 Did the hospital facility have in place during the tax year a separate billing and collections policy, or a written financial assistance policy (FAP) that explained all of the actions the hospital facility or other authorized party may take upon non-payment?.................................. 17 Yes  
18 Check all of the following actions against an individual that were permitted under the hospital facility's policies during the tax year before making reasonable efforts to determine the individual’s eligibility under the facility’s FAP:
a
b
c
d
e
Schedule H (Form 990) 2015
Schedule H (Form 990) 2015
Page 6
Part VFacility Information (continued)

A
Name of hospital facility or letter of facility reporting group  
Yes No
19 Did the hospital facility or other authorized party perform any of the following actions during the tax year before making reasonable efforts to determine the individual’s eligibility under the facility’s FAP?............ 19   No
If "Yes," check all actions in which the hospital facility or a third party engaged:
a
b
c
d
20 Indicate which efforts the hospital facility or other authorized party made before initiating any of the actions listed (whether or not checked) in line 19. (check all that apply):
a
b
c
d
e
f
Policy Relating to Emergency Medical Care
21 Did the hospital facility have in place during the tax year a written policy relating to emergency medical care that required the hospital facility to provide, without discrimination, care for emergency medical conditions to individuals regardless of their eligibility under the hospital facility’s financial assistance policy?.................. 21 Yes  
If "No," indicate why:
a
b
c
d
Charges to Individuals Eligible for Assistance Under the FAP (FAP-Eligible Individuals)
22 Indicate how the hospital facility determined, during the tax year, the maximum amounts that can be charged to FAP-eligible individuals for emergency or other medically necessary care.
a
b
c
d
23 During the tax year, did the hospital facility charge any FAP-eligible individual to whom the hospital facility provided emergency or other medically necessary services more than the amounts generally billed to individuals who had insurance covering such care? ............................... 23   No
If "Yes," explain in Section C.
24 During the tax year, did the hospital facility charge any FAP-eligible individual an amount equal to the gross charge for any service provided to that individual? ........................... 24   No
If "Yes," explain in Section C.
Schedule H (Form 990) 2015
Schedule H (Form 990) 2015
Page 7
Part V
Facility Information (continued)
Section C. Supplemental Information for Part V, Section B. Provide descriptions required for Part V, Section B, lines 2, 3j, 5, 6a, 6b, 7d, 11, 13b, 13h, 15e, 16i, 18d, 19d, 20e, 21c, 21d, 22d, 23, and 24. If applicable, provide separate descriptions for each hospital facility in a facility reporting group, designated by facility reporting group letter and hospital facility line number from Part V, Section A (“A, 1,” “A, 4,” “B, 2,” “B, 3,” etc.) and name of hospital facility.
Form and Line Reference Explanation
Schedule H, Part V, Section B, Line 5 Facility A, 1 Facility A, 1 - St. Elizabeth Healthcare - Florence, Edgewood, Grant & Ft. Thomas. For the 2012 - 2015 CHNA, ST. ELIZABETH HEALTHCARE INVITED 349 COMMUNITY LEADERS, BUSINESS PERSONS, AND RESIDENTS TO PARTICIPATE IN EITHER A FOCUS GROUP OR SURVEY. PARTICIPANTS IN THE ASSESSMENT INCLUDED REPRESENTATION FROM ST. ELIZABETH HEALTHCARE, STATE LEGISLATURE, FISCAL COURTS, LAW ENFORCEMENT, HEALTH DEPARTMENTS, CITY OFFICIALS, AREA SCHOOL SYSTEMS, AND OTHER HEALTHCARE & SOCIAL SERVICE PROVIDERS. ORGANIZATIONS AND OTHER GROUPS CONSULTED INCLUDE: -TRACY MANN, EXECUTIVE DIRECTOR OF ACADEMIC & STUDENT SUPPORT SERVICES KENTON COUNTY SCHOOLS -JOHN SCHICKEL, SENATOR OF THE STATE OF KENTUCKY -SHAWN CARROLL, EXECUTIVE DIRECTOR OF NEW PERCEPTIONS -DR. KATHY BURKHARDT, SUPERINTENDENT OF ERLANGER ELSMERE SCHOOLS -MARY BURCH, RN, HEALTH COORDINATOR OF ERLANGER ELSMERE SCHOOLS -CRAIG RICE, PRESIDENT OF BOYS & GIRLS CLUBS OF GREATER CINCINNATI -RICK SKINNER, MAYOR OF THE CITY OF WILLIAMSTOWN -NANCY ATKINSON, COUNCIL MEMBER OF THE CITY OF EDGEWOOD -SR. JEAN HOFFMAN, DIOCESAN CATHOLIC CHILDREN'S HOME -MARK KREIMBORG, KENTON COUNTY FISCAL COURT -ED HUGHES, PRESIDENT OF GATEWAY COMMUNITY COLLEGE -ROSANA AYDT, EXECUTIVE DIRECTOR/DIRECTOR OF PHARMACY OF FAITH COMMUNITY PHARMACY -KEN RECHTIN, SENIOR SERVICES OF NORTHERN KENTUCKY -CHARLES KORZENBORN, SHERIFF OF KENTON COUNTY -STEVE STEVENS, PRESIDENT AND CEO OF NORTHERN KENTUCKY CHAMBER OF COMMERCE -TOM SZURLNSKI, CHIEF OF POLICE OF FLORENCE KENTUCKY -CATHY VOETER, CITY OF DAYTON -LINDA YOUNG, EXECUTIVE DIRECTOR OF WELCOME HOUSE OF NORTHERN KENTUCKY -DENISE BINGHAM, DIRECTOR OF NURSING OF THREE RIVERS DISTRICT HEALTH -DEBBIE JONES, THREE RIVERS DISTRICT HEALTH -TONY KRAMER, CHIEF OF POLICE OF EDGEWOOD KENTUCKY -DR. LYNNE SADDLER, NORTHERN KENTUCKY HEALTH DEPARTMENT -Transitions, Inc. DURING 2015, ST. ELIZABETH HEALTHCARE CONDUCTED ITS NEXT REQUIRED CHNA FOR YEARS 2016 -2018. -PRIMARY DATA WAS COLLECTED FROM PERSONS WHO REPRESENT THE BROAD INTERESTS OF THE COMMUNITY, INCLUDING THOSE WITH EXPERTISE IN PUBLIC HEALTH. REPRESENTATION INCLUDED AREA HEALTH DEPARTMENTS, LOCAL GOVERNMENTAL/CIVIC AGENCIES, HEALTHCARE PROVIDERS, COMMUNITY BASED SOCIAL SERVICE AGENCIES AND AREA SCHOOL DISTRICTS. - THE METHODOLOGY USED TO COLLECT THE DATA INCLUDED ONE-ON-ONE MEETINGS, PRESENTATIONS TO GROUPS, PHONE CALLS, AND AN ON-LINE SURVEY. THE PROCESS INCLUDED AN EXPLANATION OF THE CHNA REQUIREMENTS AND HOW THE DATA GARNERED WILL BE USED TO DEVELOP THE CHNA PLAN. PARTICIPANTS WERE THEN ASKED TO LIST IN ORDER FROM MOST IMPORTANT TO LEAST IMPORTANT WHAT THEY BELIEVE ARE THE TOP FIVE COMMUNITY HEALTH NEEDS THAT NEED TO BE ADDRESSED AND/OR CONSIDERED IN THIS ASSESSMENT. THIS PRIMARY DATA WAS SUMMARIZED AND TABULATED. -CONCENTRATING ON SOCIAL SERVICE AGENCIES, SCHOOL DISTRICTS AND CIVIC SERVICES ENSURED THAT THE CHNA IDENTIFIED AND RECEIVED DATA ON THE MOST PRESSING HEALTH NEEDS WITHIN THE COMMUNITY SERVED. TWO LOCAL COMMUNITY ORGANIZATIONS THAT WORK IN COLLABORATION WITH LIKE COMMUNITY PROVIDERS ARE THE SAFETY NET ALLIANCE AND THE NORTHERN KENTUCKY EDUCATION COUNCIL. THEY PERMITTED ST. ELIZABETH TO USE THEIR MEMBERSHIP EMAIL LISTING TO SEND INFORMATION ABOUT THE CHNA AND THE REQUEST FOR INPUT. THE FOLLOWING IS A LISTING OF THE COMMUNITY PARTICIPANTS: SOCIAL SERVICE AGENCIES: -AHEC HISPANIC HEALTH EDU SURVEY -APPRISEN -BE CONCERNED -BRIGHTON CENTER, INC. -CAMPBELL CTY FISCAL COURT - ASSISTANCE PROGRAM -CATHOLIC CHARITIES -CHILDREN HOME OF NKY -CHILDREN INC. -CHILDREN'S LAW CENTER -CINCINNATI VA -CITY HEIGHTS HEALTH CENTER -FAITH COMMUNITY PHARMACY -HOSEA HOUS -INTERACT FOR HEALTH -ITN GREATER CINCINNATI -JACC, INC. -KY Office for the Blind -Life Learning Center -Life Point Solutions -NKU NACU Ctr City Heights -Rosedale Green -The Butler Foundation -Transitions, Inc. -Welcomed House of NKY Inc. BUSINESSES: -ANTHEM MEDICAID -CARESOURCE & HUMANA -NKY CHAMBER OF COMMERCE -BUSINESS BENEFITS SCHOOLS: -BELLEVUE INDEPENDENT SCHOOLS -BOONE CTY SCHOOLS- NORTH POINTE -CAMPBELL COUNTY SCHOOLS -CAMPBELL COUNTY SCHOOLS -CAYWOOD ELEMENTARY -COLLINS ELEMENTARY SCHOOL -COVINGTON INDEPENDENT PUBLIC SCHOOLS -COVINGTON INDEPENDENT SCHOOLS -DAYTON HIGH SCHOOL -ERLANGER-ELSMERE INDEPENDENT SCHOOLS -GRANT COUNTY MIDDLE SCHOOL -GRANT COUNTY SCHOOLS -KENTON COUNTY SCHOOL DISTRICT -LARRY A. RYLE HIGH SCHOOL -LAWRENCEBURG COMMUNITY SCHOOL -LLOYD MEMORIAL HIGH SCHOOL -NORTHERN KENTUCKY UNIVERSITY -OCKERMAN MIDDLE SCHOOL -PENDLETON COUNTY HIGH SCHOOL -PINER ELEMENTARY -REILEY ELEMENTARY HEALTH DEPARTMENTS: -NKY INDEPENDENT HEALTH DEPARTMENT -THREE RIVERS DISTRICT HEALTH DEPT. -DEARBORN COUNTY HEALTH DEPARTMENT CIVIC SERVICES: -KENTON COUNTY DETENTION CENTER -BOONE COUNTY DETENTION CENTER -CAMPBELL COUNTY DETENTION CENTER -NKY AREA DEVELOPMENT DISTRICT -KENTON COUNTY FISCAL COURT -CAMPBELL COUNTY FISCAL COURT CITIES: -EDGEWOOD -FORT WRIGHT -INDEPENDENCE HEALTHCARE: -HEALTHPOINT FAMILY CARE (FQHC) -ST. ELIZABETH HEALTHCARE (SEH) -SEH CARE COORDINATION -SEH COVINGTON EMERGENCY DEPARTMENT -SEH EDGEWOOD EMERGENCY DEPARTMENT -SEH FAMILY MEDICAL RESIDENCY PROGRAM -SEH GRANT EMERGENCY DEPARTMENT -SEH HEALTH MINISTRIES PROGRAM -ST. ELIZABETH PHYSICIANS (73 RESPONDENTS MULTIPLE OFFICE LOCATIONS)
Schedule H, Part V, Section B, Line 6a Facility A, 1 Facility A, 1 - ST. ELIZABETH HEALTHCARE. ST. ELIZABETH - EDGEWOOD ST. ELIZABETH - FLORENCE ST. ELIZABETH - FT. THOMAS ST. ELIZABETH - GRANT COUNTY
Schedule H, Part V, Section B, Line 11 Facility A, 1 Facility A, 1 - ST. ELIZABETH HEALTHCARE - FLORENCE, EDGEWOOD, GRANT, & FT. THOMAS. ST. ELIZABETH HEALTHCARE HAS CONTINUED TO ADDRESS THE THREE (3) PRIORITIZED NEEDS LISTED IN ITS 2012 - 2015 CHNA . (I) OBESITY, (II) HEART DISEASE, & (III) DIABETES. OBESITY: ST. ELIZABETH HEALTHCARE IS ADDRESSING THIS SIGNIFICANT NEED BY DEVELOPING HEALTH EDUCATION PROGRAMS / SERVICES TO EDUCATE, PREVENT, AND ASSIST RESIDENTS OF NORTHERN KENTUCKY, ESPECIALLY CHILDREN, REGARDING OBESITY. PARTNERSHIPS WERE ESTABLISHED WITH AREA SCHOOLS TO PROVIDE WELLNESS EDUCATION AND OTHER INITIATIVES, FOCUSING ON GRADE SCHOOLS: PROGRAMS WERE PROVIDED IN CAYWOOD ELEMENTARY, FT. WRIGHT ELEMENTARY, FLORENCE ELEMENTARY, GOODRIDGE ELEMENTARY, TAYLOR MILL ELEMENTARY, ST. PHILLIPS ELEMENTARY, SUMMIT VIEW MIDDLE SCHOOL, HINSDALE ELEMENTARY, STEPHENS ELEMENTARY, KELLY ELEMENTARY, SUMMIT VIEW ACADEMY, THORNWILDE ELEMENTARY, KENTON ELEMENTARY, BEECHGROVE ELEMENTARY, WHITES TOWER ELEMENTARY. THESE PROGRAMS WERE ALSO PRESENTED AT COUNTY LIBRARIES, COMMUNITY CENTERS, SENIOR CENTERS, AND COMMUNITY HEALTH FAIRS. THESE HEALTH EDUCATION PROGRAMS INCLUDE (I) HEALTHY EATING, (II) PORTION CONTROL, (III) FOOD GROUPS, & (IV) NUTRITION. ST. ELIZABETH HEALTHCARE ENHANCED SERVICES THROUGH THE ST. ELIZABETH PHYSICIANS PRIMARY CARE DIVISIONS THAT PROVIDED THE TOOLS, EDUCATION RESOURCES, PATIENT ACCOUNTABILITIES TO THOSE IN OUR COMMUNITY WHO STRUGGLE WITH OBESITY AND ENSUING CO-MORBIDITIES. ALSO, CONTINUED TO STRATEGICALLY DEVELOP AND PROMOTE CORPORATE BASED WELLNESS SERVICES. ST. ELIZABETH HEALTHCARE LEVERAGED AND EXPLORED NEW PARTNERSHIPS WITH COMMUNITY ORGANIZATIONS TO SUPPORT EFFORTS TO REDUCE OBESITY E.G. UNITED WAY SUCCESS BY SIX, NKU COLLEGE OF INFORMATICS, REMKES, NKIHD, PARISH NURSING, WEIGHT OF THE NATION, SIT TO FIT (CHILDREN'S HOSPITAL), ETC. ST. ELIZABETH CONTINUED TO SUPPORT/ENHANCE EFFORTS FOR ST. ELIZABETH HEALTHCARE EMPLOYEES SUCH AS TARGET HEALTH, INSURANCE INCENTIVES, FITNESS CENTERS, ETC. DIABETES: IN 2015, ST. ELIZABETH HEALTHCARE DIABETES CENTER ESTABLISHED 1. OUTREACH LOCATIONS IN THE RURAL COMMUNITIES OF GRANT COUNTY, KENTUCKY AND AURORA INDIANA. 2. PARTICIPATED IN COMMUNITY HEALTHFAIRS PERFORMING DIABETES RISK ASSESSMENT SCREENINGS 3. HOSTED A WORLD DIABETES DAY EVENT 4. PROVIDED MONTHLY DIABETES SUPPORT GROUPS 5. PROVIDED MONTHLY DIABETES SELF-MANAGEMENT GROUPS 6. MAINTAINED NURSE PRACTITIONER OUTREACH PROGRAM IN FORT MITCHELL, TAYLOR MILL & FLORENCE. CONTINUED TO PROVIDE AND ENHANCE THE REGIONAL DIABETES CENTER FOR THE COMMUNITY INCLUDING EDUCATION, SUPPORT, SCREENINGS, AND TREATMENT. INCLUDING PROVIDING NEW EDUCATION ON THE PREVENTION OF DIABETES TO THE COMMUNITIES, SCHOOLS AND CHURCHES. HEART DISEASE: ST. ELIZABETH HEALTHCARE IS ADDRESSING THIS SIGNIFICANT NEED BY SPONSORING HEART & VASCULAR SCREENINGS, UTILIZING THE CARDIOVASCULAR MOBILE HEALTH UNIT, SPONSORING EDUCATION SEMINARS AND EVENTS, WHICH ARE HOSTED BY ST. ELIZABETH HEALTHCARE PHYSICIANS, IMPLEMENTED RESEARCH STUDIES THROUGH THE ST. ELIZABETH HEALTHCARE HEART & VASCULAR INSTITUTE. ALSO, IN 2015, SEVERAL ST. ELIZABETH HEALTHCARE DEPARTMENTS SPONSORED OTHER HEALTH EDUCATION AND SCREENING ACTIVITIES INCLUDING (I) EXERCISE & FITNESS CLASSES, (II) FITNESS CHALLENGES, (IV) BLOOD PRESSURE CHECKS, (V) BODY MASS INDEX CHECKS, (VI) SCREENING FOR CATARACTS, GLAUCOMA, ARTHRITIS. CONTINUED OPERATING AND UPDATING FACEBOOK & TWITTER ACCOUNTS TO SHARE WEEKLY HEALTHY EATING TIPS, PROMOTING HEALTH EVENTS, & SCHEDULE OF VARIOUS PROGRAMS. IN ST. ELIZABETH HEALTHCARE'S CURRENT CHNA (2012 - 2015), THERE WERE TEN (10) NEEDS THAT WERE NOT RECOGNIZED AS ONE OF THE THREE SIGNIFICANT NEEDS. THESE INCLUDE, ACCESS TO PRIMARY CARE, AVOIDABLE EMERGENCY ROOM VISITS, CANCER, INFANT MORTALITY, LACK OF HEALTH INSURANCE, MEDICATION COSTS, MENTAL HEALTH, SMOKING CESSATIONS, SUBSTANCE ABUSE, & WELLNESS. IN 2015, NONE OF THESE NEEDS WENT COMPLETELY WITHOUT BEING ADDRESSED. HOWEVER, THESE NEEDS WERE ASSIGNED A LOWER PRIORITY MAINLY (AND IN PART) DUE TO THESE NEEDS ARE BEING ADDRESSED BY OTHER ORGANIZATIONS IN THE COMMUNITY, COUPLED WITH ST. ELIZABETH HEALTHCARE'S LIMITED FINANCIAL OR OTHER RESOURCE CONSTRAINTS, LACK OF EFFECTIVE INTERVENTIONS IDENTIFIED, AND/OR LACK OF EXPERTISE/COMPETENCY TO EFFICIENTLY & EFFECTIVELY ADDRESS THE NEEDS.
Schedule H, Part V, Section B, Line 22 Facility A, 1 Facility A, 1 - St. Elizabeth Healthcare - Florence, Edgewood, Grant & Ft. Thomas. A patient who is eligible to receive financial assistance under the Financial Assistance Policy will be charged less than "gross charges" for all services. For emergency or other medical necessary care provided to patients who are eligible to receive financial assistance under this policy, St. Elizabeth Healthcare will not charge amounts in excess of Amounts Generally Billed (AGB) to individuals who have insurance covering such care for each hospital based on the Look Back Method as defined by Treasury Regulations under section 501(r) of the Internal Revenue Code of 1986, as amended.
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
Schedule H (Form 990) 2015
Schedule H (Form 990) 2015
Page 8
Part VFacility Information (continued)

Section D. Other Health Care Facilities That Are Not Licensed, Registered, or Similarly Recognized as a Hospital Facility
(list in order of size, from largest to smallest)
How many non-hospital health care facilities did the organization operate during the tax year?31
Name and address Type of Facility (describe)
1 ST ELIZABETH HEALTHCARE - SURGERY CENTER - EDGEWOOD
580 SOUTH LOOP ROAD
EDGEWOOD,KY41017 		AMBULATORY SURGERY CENTER
2 ST ELIZABETH HEALTHCARE - HEART & VASCULAR - CRESTVIEW HILLS
380 CENTRE VIEW BLVD
CRESTVIEW HILLS,KY41017 		CARDIOLOGY DIAGNOSTIC TESTS
3 ST ELIZABETH HEALTHCARE - IMAGING - ALEXANDRIA
7200 ALEXANDRIA PIKE
ALEXANDRIA,KY41001 		IMAGING CENTER
4 ST ELIZABETH HEALTHCARE - SPORTS MEDICINE - FLORENCE
10095 INVESTMENT WAY
FLORENCE,KY41042 		SPORTS MEDICINE
5 ST ELIZABETH HEALTHCARE - HEART & VASCULAR - KENWOOD
8251 PINE ROAD
CINCINNATI,OH45236 		CARDIOLOGY DIAGNOSTIC TESTS
6 ST ELIZABETH HEALTHCARE - SURGERY CENTER - CRESTVIEW HILLS
2845 CHANCELLOR DRIVE
CRESTVIEW HILLS,KY41017 		AMBULATORY SURGERY CENTER
7 ST ELIZABETH HEALTHCARE - HEART & VASCULAR - CRESTVIEW HILLS
350 THOMAS MORE PARKWAY SUITE 280
CRESTVIEW HILLS,KY41017 		CARDIOLOGY DIAGNOSTIC TESTS
8 ST ELIZABETH HEALTHCARE - BUSINESS HEALTH - HEBRON
2200 CONNER ROAD
HEBRON,KY41048 		BUSINESS HEALTH SERVICES
9 ST ELIZABETH HEALTHCARE - PHYSICAL THERAPY - GRANT COUNTY
300 BARNES ROAD
WILLIAMSTOWN,KY41097 		PHYSICAL THERAPY
10 ST ELIZABETH HEALTHCARE - HEART & VASCULAR - FLORENCE
7370 TURFWAY ROAD SUITE 109
FLORENCE,KY41042 		CARDIOLOGY DIAGNOSTIC TESTS
11 ST ELIZABETH HEALTHCARE - HOSPICE CENTER - EDGEWOOD
483 SOUTH LOOP DRIVE
EDGEWOOD,KY41017 		INPATIENT HOSPICE
12 ST ELIZABETH HEALTHCARE - PHYSICAL THERAPY - HEBRON
2200 CONNER ROAD
HEBRON,KY41048 		PHYSICAL THERAPY
13 ST ELIZABETH HEALTHCARE - FAMILY PRACTICE CENTER - EDGEWOOD
413 SOUTH LOOP ROAD
EDGEWOOD,KY41017 		FAMILY MEDICINE
14 ST ELIZABETH HEALTHCARE - BUSINESS HEALTH - MOUNT ZION
10095 INVESTMENT WAY
FLORANCE,KY41042 		BUSINESS HEALTH SERVICES
15 ST ELIZABETH HEALTHCARE - IMAGING - HEBRON
2200 CONNER ROAD
HEBRON,KY41048 		IMAGING CENTER
16 ST ELIZABETH HEALTHCARE - SPORTS MEDICINE - WILDER
1018 TOWN DRIVE
WILDER,KY41076 		SPORTS MEDICINE
17 ST ELIZABETH HEALTHCARE - HAND THERAPY - EDGEWOOD
560 SOUTH LOOP DRIVE 2ND FLOOR
EDGEWOOD,KY41017 		HAND THERAPY
18 ST ELIZABETH HEALTHCARE - SPORTS MEDICINE - EDGEWOOD
830 THOMAS MORE PARKWAY SUITE 101
EDGEWOOD,KY41017 		SPORTS MEDICINE
19 ST ELIZABETH HEALTHCARE - COVINGTON
1500 JAMES SIMPSON JR WAY
COVINGTON,KY41011 		AMBULATORY CARE CENTER
20 ST ELIZABETH HEALTHCARE - IMAGING - EDGEWOOD
2904 FOLTZ ROAD
EDGEWOOD,KY41017 		IMAGING CENTER
21 ST ELIZABETH HEALTHCARE - HEART & VASCULAR - EDGEWOOD
900 MEDICAL VILLAGE DRIVE
EDGEWOOD,KY41017 		CARDIOLOGY DIAGNOSTIC TESTS
22 ST ELIZABETH HEALTHCARE - HEART & VASCULAR - AURORA
204 BRIDGEWAY STREET
AURORA,IN47001 		CARDIOLOGY DIAGNOSTIC TESTS
23 BLUEGRASS DIALYSIS LLC
1500 JAMES SIMPSON JR WAY
COVINGTON,KY41011 		RENAL DIALYSIS
24 ST ELIZABETH HEALTHCARE - PHYSICAL THERAPY - WILDER
1018 TOWN DRIVE
WILDER,KY41076 		PHYSICAL THERAPY
25 ST ELIZABETH HEALTHCARE - CARDIAC REHAB - EDGEWOOD
830 THOMAS MORE PARKWAY SUITE 102
EDGEWOOD,KY41017 		CARDIAC REHAB CENTER
26 ST ELIZABETH HEALTHCARE - CARDIAC & THORACIC SURGERY - EDGEWOOD
20 MEDICAL VILLAGE DRIVE SUITE 105
EDGEWOOD,KY41017 		CARDIAC DIAGNOSTICS AND CATHETERIZATION
27 ST ELIZABETH HEALTHCARE - PHYSICAL THERAPY - WALTON
13260 SERVICE ROAD
WALTON,KY41094 		PHYSICAL THERAPY
28 ST ELIZABETH HEALTHCARE - HEART & VASCULAR - MEDICAL PAVILION
1400 GRAND AVENUE
NEWPORT,KY41071 		CARDIOLOGY DIAGNOSTIC TESTS
29 ST ELIZABETH HEALTHCARE - LABORATORY - FLORENCE
8726 US 42
FLORENCE,KY41042 		LABORATORY SERVICES
30 ST ELIZABETH HEALTHCARE - PHYSICAL THERAPY - ALEXANDRIA
7200 ALEXANDRIA PIKE
ALEXANDRIA,KY41001 		PHYSICAL THERAPY
Schedule H (Form 990) 2015
Schedule H (Form 990) 2015
Page 9
Part VI
Supplemental Information
Provide the following information.
1 Required descriptions. Provide the descriptions required for Part I, lines 3c, 6a, and 7; Part II and Part III, lines 2, 3, 4, 8 and 9b.
2 Needs assessment. Describe how the organization assesses the health care needs of the communities it serves, in addition to any CHNAs reported in Part V, Section B.
3 Patient education of eligibility for assistance. Describe how the organization informs and educates patients and persons who may be billed for patient care about their eligibility for assistance under federal, state, or local government programs or under the organization’s financial assistance policy.
4 Community information. Describe the community the organization serves, taking into account the geographic area and demographic constituents it serves.
5 Promotion of community health. Provide any other information important to describing how the organization’s hospital facilities or other health care facilities further its exempt purpose by promoting the health of the community (e.g., open medical staff, community board, use of surplus funds, etc.).
6 Affiliated health care system. If the organization is part of an affiliated health care system, describe the respective roles of the organization and its affiliates in promoting the health of the communities served.
7 State filing of community benefit report. If applicable, identify all states with which the organization, or a related organization, files a community benefit report.
Form and Line Reference Explanation
Schedule H, Part I, Line 7g Subsidized Health Services ST. ELIZABETH HEALTHCARE'S COSTS, REFLECTED AS SUBSIDIZED HEALTH SERVICES, ARE BASED ON ACTUAL COSTS OR DIRECT AND INDIRECT COSTS. ST. ELIZABETH HEALTHCARE REPORTED THE FOLLOWING AS SUBSIDIZED HEALTH SERVICES: (I) EBOLA PREPAREDNESS; (II) PARISH NURSING-HEALTH MINISTRIES; (III) ATHLETIC TRAINERS AT THE AREA HIGH SCHOOLS; (IV) WOMEN'S AND CHILDREN'S SERVICES; AND (V) BEHAVIOR HEALTH SERVICES. NO PHYSICIAN OFFICES HAVE BEEN REPORTED ON LINE 7G.
Schedule H, Part I, Line 7 Bad Debt Expense excluded from financial assistance calculation 31505631
Schedule H, Part I, Line 7 Costing Methodology used to calculate financial assistance ST. ELIZABETH HEALTHCARE USED COST TO CHARGE RATIOS FOR DETERMINING COSTS RELATED TO FINANCIAL ASSISTANCE. ST. ELIZABETH HEALTHCARE USED THEIR COST ACCOUNTING SYSTEM TO DETERMINE COSTS RELATED TO UNREIMBURSED MEDICAID. ST. ELIZABETH USED THE ACTUAL COST, OR DIRECT AND INDIRECT COSTS, TO DETERMINE OTHER COSTS IN SECTION 7(G-I).
Schedule H, Part II Community Building Activities COMMUNITY BUILDING ACTIVITIES IMPROVE THE COMMUNITY'S HEALTH AND SAFETY BY ADDRESSING THE ROOT CAUSES OF HEALTH PROBLEMS, SUCH AS POVERTY, HOMELESSNESS, AND ENVIRONMENTAL HAZARDS. CHANGING THE HEALTH STATUS OF A COMMUNITY REQUIRES MULTIPLE SYSTEMIC CHANGES THAT ARE BEYOND THE CONTROL OF ST. ELIZABETH HEALTHCARE. ST. ELIZABETH HEALTHCARE PROVIDES A BROAD RANGE OF PROGRAMS AND SERVICES THAT ENABLE COMMUNITIES AND THEIR RESIDENTS TO MAKE CHANGES TO IMPROVE THEIR HEALTH AND ENVIRONMENTS. THESE SERVICES AND PROGRAMS ARE IDENTIFIED IN COLLABORATION WITH OUR COMMUNITY PARTNERS. EXAMPLES INCLUDE: * SUPPORTING STAFF TO PARTICIPATE ON ACADEMIC INSTITUTIONS AND COMMUNITY BUSINESS WORKFORCE BOARDS SUCH AS: NKY WORKFORCE INVESTMENT BOARD, THE NKY CHAMBER OF COMMERCE, AND HEALTH & BUSINESS CAREER MENTORING * PROJECTS SUCH AS JOB SHADOWING VIA THE NORTH CENTRAL AREA HEALTH EDUCATION CENTER AND VARIOUS EDUCATIONAL INSITTUTIONS * MONETARY SUPPORT FOR ORGANIZATIONS THAT INVEST IN IMPROVING THE COMMUNITIES SERVED, SUCH AS: - SKYWARD NKY WHOSE PURPOSE IS TO CONNECT NKY EDUCATION, WELLNESS, BUSINESS AND CULTURE IN INNOVATIVE, INCLUSIVE, PRODUCTIVE WAYS - LOCAL COMMUNITY FOUNDATIONS (SUCH AS HABITAT FOR HUMANITIES) THAT MEET THE DEFINITION OF COMMUNITY BUILDING ACTIVITIES
Schedule H, Part III, Line 2 Bad debt expense - methodology used to estimate amount ST. ELIZABETH HEALTHCARE RECOGNIZES PATIENT SERVICE REVENUE AT THE TIME SERVICES ARE RENDERED FOR, EVEN THOUGH ST. ELIZABETH HEALTHCARE DOES NOT ASSESS THE PATIENT'S ABILITY TO PAY. AS A RESULT, THE PROVISION FOR BAD DEBTS AND CHARITY CARE ARE PRESENTED AS A DEDUCTION FROM PATIENT SERVICE REVENUE (NET OF CONTRACTUAL PROVISIONS AND DISCOUNTS). ST. ELIZABETH HEALTHCARE RECOGNIZES REVENUE WHEN SERVICES ARE RENDERED FOR UNINSURED AND UNDERINSURED PATIENTS THAT DO NOT QUALIFY FOR CHARITY CARE. BASED ON HISTORICAL EXPERIENCE, A SIGNIFICANT PORTION OF ST. ELIZABETH HEALTHCARE'S UNINSURED AND UNDERINSURED PATIENTS WILL BE UNABLE OR UNWILLING TO PAY FOR THE SERVICES RENDERED. AS A RESULT, ST. ELIZABETH HEALTHCARE RECORDS A SIGNIFICANT PROVISION FOR BAD DEBTS RELATED TO UNINSURED AND UNDERINSURED PATIENTS IN THE PERIOD THE SERVICES ARE RENDERED. THE BAD DEBT EXPENSE REPORTED ON PART III, LINE 2, IS THE BAD DEBT EXPENSE REPORTED ON FORM 990, PART IX, LINE 24B.
Schedule H, Part III, Line 3 Bad Debt Expense Methodology THE ESTIMATED AMOUNT OF ST. ELIZABETH HEALTHCARE'S BAD DEBT EXPENSE ATTRIBUTABLE TO PATIENTS ELIGIBLE UNDER ST. ELIZABETH HEALTHCARE'S FINANCIAL ASSISTANCE POLICY IS $3,150,563. THE PERCENTAGE OF BAD DEBTS THAT LIKELY COULD BE CHARITY CARE, IF ENOUGH INFORMATION WAS OBTAINED UP FRONT, WAS DEVELOPED WITH THE HELP OF OUR LARGEST COLLECTION AGENCY WHO HAS DETERMINED, BASED ON ACCOUNTS REVIEWED, WHO MAY NOT HAVE HAD THE FINANCIAL ABILITY TO PAY. ST. ELIZABETH HEALTHCARE ALSO BELIEVES THAT MANY PATIENTS FALL INTO THE CATEGORY WHERE THEY DO NOT MEET THE FEDERAL POVERTY GUIDELINES BUT YET CANNOT AFFORD THE COST OF THE SERVICES RENDERED, OR HAVE INSURANCE THAT MAY NOT COVER THE COST OF SERVICES. THEREFORE, ST. ELIZABETH HEALTHCARE BELIEVES THESE NON REIMBURSED COSTS SHOULD BE COUNTED AS A BENEFIT TO THE COMMUNITY WE SERVE. THE AMERICAN HOSPITAL ASSOCIATION'S POSITION IS THAT BAD DEBTS SHOULD BE COUNTED AS A COMMUNITY BENEFIT.
Schedule H, Part III, Line 4 Bad debt expense - financial statement footnote NET PATIENT ACCOUNTS ARE REDUCED BY AN ALLOWANCE FOR DOUBTFUL RECEIVABLES BASED UPON THE HISTORICAL COLLECTION EXPERIENCE OF ST. ELIZABETH HEALTHCARE, ADJUSTED FOR CURRENT ENVIRONMENTAL RISKS AND TRENDS FOR EACH MAJOR PAYOR SOURCE. AMOUNTS RECOGNIZED ARE SUBJECT TO ADJUSTMENT UPON REVIEW BY THIRD-PARTY PAYORS. SIGNIFICANT PROVISION IS MADE FOR SELF-PAY PATIENT ACCOUNTS IN THE PERIOD OF SERVICE BASED ON PAST COLLECTION EXPERIENCE. NET PATIENT SERVICE REVENUE IS REPORTED AT THE ESTIMATED NET REALIZABLE AMOUNTS FROM PATIENTS, THIRD-PARTY PAYORS, AND OTHERS FOR SERVICES RENDERED, INCLUDING ESTIMATED RETROACTIVE ADJUSTMENTS UNDER REIMBURSEMENT AGREEMENTS WITH THIRD-PARTY PAYORS. SETTLEMENTS ARE ACCRUED ON AN ESTIMATED BASIS IN THE PERIOD THE RELATED SERVICES ARE RENDERED AND ADJUSTED IN FUTURE PERIODS BASED UPON ADDITIONAL INFORMATION, INTERIM SETTLEMENTS, AND FINAL SETTLEMENTS.
Schedule H, Part III, Line 8 Community benefit & methodology for determining medicare costs ST. ELIZABETH HEALTHCARE USES THE STEP DOWN METHODOLOGY TO DETERMINE COSTS FOR MEDICARE. THE REPORTS WERE THEN COMPLETED BY FOLLOWING THE GUIDANCE PROVIDED IN THE INSTRUCTIONS FOR PART III. ST. ELIZABETH HEALTHCARE BELIEVES MEDICARE LOSSES SHOULD BE AN ALLOWABLE COMMUNITY BENEFIT. ST. ELIZABETH HEALTHCARE PROVIDES NEEDED SERVICES TO THE ELDERLY AND DISABLED MEDICARE POPULATION AT A FINANCIAL LOSS TO ST. ELIZABETH HEALTHCARE TO HELP THOSE INDIVIDUALS GET THE CARE THEY NEED IN THE COMMUNITY WE SERVE. THE AMERICAN HOSPITAL ASSOCIATION'S POSITION IS ALSO THAT MEDICARE LOSSES SHOULD BE COUNTED AS COMMUNITY BENEFIT.
Schedule H, Part III, Line 9b Collection practices for patients eligible for financial assistance ST. ELIZABETH HEALTHCARE HAS A WRITTEN DEBT COLLECTION POLICY THAT ALSO INCLUDES A PROVISION ON THE COLLECTION PRACTICES TO BE FOLLOWED FOR PATIENTS WHO ARE KNOWN TO QUALIFY FOR CHARITY CARE OR FINANCIAL ASSISTANCE. IF A PATIENT QUALIFIES FOR CHARITY OR FINANCIAL ASSISTANCE, CERTAIN COLLECTION PRACTICES DO NOT APPLY.
Schedule H, Part V, Section B, Line 16a FAP website A - ST. ELIZABETH HEALTHCARE: Line 16a URL: WWW.STELIZABETH.COM;
Schedule H, Part V, Section B, Line 16b FAP Application website A - ST. ELIZABETH HEALTHCARE: Line 16b URL: WWW.STELIZABETH.COM;
Schedule H, Part V, Section B, Line 16c FAP plain language summary website A - ST. ELIZABETH HEALTHCARE: Line 16c URL: WWW.STELIZABETH.COM;
Schedule H, Part VI, Line 2 Needs assessment IN 2015, ST. ELIZABETH HEALTHCARE CONTINUED TO WORK WITH THE NORTHERN KENTUCKY HEROIN IMPACT TASK FORCE TO ADDRESS THE HEROIN EPIDEMIC. THIS INCLUDED PROVIDING DATA AND SUPPORT TO THE STATE OF KENTUCKY LEGISLATURE TO ENACT NEW LEGISLATION DIRECTED TOWARDS EXPANDING TREATMENT. IN ADDITION, ST. ELIZABETH HEALTHCARE DEVELOPED AN INTERNAL WORKGROUP FOCUSED ON ENHANCING PREVENTION AND PROVIDING TREATMENT FOR THE COMMUNITIES IT SERVES. FURTHER, ST. ELIZABETH HEALTHCARE ACQUIRED THE HAZELDEN BETTY FORD FOUNDATION COMMUNITY TOOLKIT TO PROVIDE EDUCATION AND TRAINING ON ADDICTION TO THE COMMUNITIES IT SERVES. IN 2015, ST. ELIZABETH HEALTHCARE COLLABORATED WITH PHYSICIANS AND THE NORTHERN KENTUCKY HEALTH DEPARTMENT TO ENSURE EMERGENCY PREPAREDNESS MEASURES WERE IN PLACE SHOULD ANY MEMBER OF THE COMMUNITY (PATIENT, RESIDENT, AND/OR VISITOR) EXHIBIT SYMPTOMS OF EBOLA. PREPAREDNESS MEASURES INCLUDED (I) FOLLOWING PROTOCOLS FOR REVIEWING ST. ELIZABETH HEALTHCARE'S INFECTION CONTROL POLICIES AND PROCEDURES, (II) PROVIDING PERSONAL PROTECTIVE EQUIPMENT, AND (III) PROVIDING TRAINING AND EDUCATION TO STAFF MEMBERS, WHICH INCLUDED CONSTRUCTING A SIMULATION ROOM FOR TRAINING EXERCISES AND A SPECIALIZED EBOLA RESPONSE TEAM WAS ORGANIZED. IN 2015, ST. ELIZABETH HEALTHCARE CONTINUED TO SUPPORT A PERTUSSIS COCOONING PROJECT TO HELP PREVENT THE DEADLY EFFECTS OF INFANT PERTUSSIS BY SURROUNDING INFANTS WITH A PROTECTIVE "COCOON" AND IMMUNIZED MOTHERS, FAMILY MEMBERS, AND CAREGIVERS. PERTUSSIS, ALSO KNOWN AS WHOOPING COUGH, IS A HIGHLY CONTAGIOUS RESPIRATORY DISEASE CAUSED BY THE BORDETELLA PERTUSSIS BACTERIUM. WHOOPING COUGH IS KNOWN FOR CONTROLLABLE, VIOLENT COUGHING WHICH OFTEN MAKES IT HARD FOR INFANTS TO BREATHE. IN 2015, ST. ELIZABETH HEALTHCARE CONTINUED TO PROVIDE THE PATIENT AND FAMILY ADVISORY COUNCIL (PAFAC), WHICH MEETS EVERY TWO (2) MONTHS TO IDENTIFY NEEDS OF THE COMMUNITY BASED ON THE FEEDBACK OBTAINED FROM OUR PATIENTS AND FAMILY MEMBERS. CONTINUOUSLY, ST. ELIZABETH EVALUATES DATA FROM SOURCES SUCH AS OUR PATIENT SATISFACTION AND COMMUNITY HEALTH SURVEYS TO IDENTIFY THE NEEDS OF OUR COMMUNITY FOR THE PEOPLE WE SERVE.
Schedule H, Part VI, Line 3 Patient education of eligibility for assistance THE FINANCIAL ASSISTANCE POLICY IS PUBLISHED ON ST. ELIZABETH HEALTHCARE'S WEB SITE. A WRITTEN COPY IS ALSO INCLUDED IN THE PATIENT HANDBOOK PROVIDED TO INPATIENT ADMISSIONS. A NOTICE THAT FINANCIAL ASSISTANCE IS AVAILABLE FOR QUALIFYING INDIVIDUALS ON THE PATIENT BILLS. FINANCIAL COUNSELORS ARE AVAILABLE TO ASSIST PATIENTS TO DETERMINE QUALIFICATION AND A COPY OF THE POLICY IS AVAILABLE TO PATIENTS UPON REQUEST. PATIENT FINANCIAL ASSISTANCE PROGRAM INFORMATION IS POSTED AT EACH SITE (THERE IS A FRAMED SIGN POSTED IN SPANISH AND ENGLISH) -IN ADDITION, THERE IS A 1-PAGE DESCRIPTION OF OUR FINANCIAL ASSISTANCE PROGRAM THAT IS ATTACHED TO THE "PATIENT RIGHTS AND RESPONSIBILITIES" DOCUMENT, AND ALL PATIENTS ARE GIVEN THESE DOCUMENTS UPON REGISTRATION. -IF A PATIENT DOES NOT HAVE INSURANCE, THEY ARE ALSO OFFERED AN APPLICATION PACKET FOR FINANCIAL ASSISTANCE. PATIENTS ARE NOTIFIED OF THEIR FINANCIAL RESPONSIBILITY -THE PATIENT RIGHTS AND RESPONSIBILITIES DOCUMENT GIVEN TO ALL PATIENTS STATES THEY HAVE A RESPONSIBILITY TO "PROVIDE NECESSARY FINANCIAL INFORMATION TO ASSURE ACCURATE BILLING AND MEET FINANCIAL COMMITMENTS" -THE FINANCIAL ASSISTANCE PLAN DOCUMENT THEY ARE GIVEN PROVIDES DETAILED INFORMATION ON ELIGIBLE FINANCIAL AID SERVICES, AND ALSO STATES THAT "FINANCIAL ASSISTANCE IS NOT CONSIDERED AN ALTERNATIVE OPTION TO PAYMENT, AND PATIENTS MAY BE ASSISTED IN FINDING OTHER MEANS OF PAYMENT FOR FINANCIAL ASSISTANCE BEFORE APPROVAL FOR ST. ELIZABETH FINANCIAL ASSISTANCE PROGRAM."
Schedule H, Part VI, Line 4 Community information ST. ELIZABETH HEALTHCARE SERVES THE NORTHERN KENTUCKY COUNTIES, WHICH INCLUDE: BOONE, BRACKEN, CAMPBELL, CARROLL, GALLATIN, GRANT, HARRISON, KENTON, MASON, OWEN, PENDLETON, AND ROBERTSON, ALSO HAMILTON COUNTY IN SOUTHERN OHIO; AND DEARBORN COUNTY IN SOUTHERN INDIANA. THESE SERVICE AREAS INCLUDE URBAN, SUBURBAN, AND RURAL AREAS. THE TOTAL POPULATION OF THE SERVICE AREAS IS OVER 500,000. ST. ELIZABETH HEALTHCARE'S PRIMARY SERVICE AREAS DURING 2015 WAS DETERMINED BY IDENTIFYING WHERE 90% OF ITS PATIENT POPULATION ORIGINATES. THIS APPROACH ENSURES THAT THE ASSESSMENT WAS NOT LIMITED TO CERTAIN GEOGRAPHIC AREAS BUT INCLUDED THE MAJORITY OF THE POPULATION SERVED. THE DATA REVEALED THAT 93.19% OF THE PATIENT POPULATION RESIDES IN THE COUNTIES THAT MAKE UP THE NORTHERN KENTUCKY AREA DEVELOPMENT DISTRICT (NKADD). THE NKADD ENCOMPASSES THE COUNTIES OF BOONE, CAMPBELL, CARROLL, GALLATIN, GRANT, KENTON, OWEN AND PENDLETON, AND REPRESENTS OVER 454,020 RESIDENTS. ALL HOSPITALS IN THE ST. ELIZABETH HEALTHCARE SYSTEM ARE LOCATED IN THIS REGION. THE PRIMARY SERVICE AREAS ARE PREDOMINANTLY WHITE WITH AN INCREASE IN AFRICAN-AMERICAN AND HISPANIC ORIGINS MOVING INTO THE AREA. POPULATION BY ORIGIN: 90.07% WHITE, 3.43% BLACK, 3.17% HISPANIC, 1.44% ASIAN, 1.89% OTHER. POPULATION BY AGE: 0-19; 27.05%; 20 - 64; 59.87%; 65+; 13.08% (SOURCE: ANNUAL COUNTY RESIDENT POPULATION ESTIMATES BY AGE, SEX, RACE, AND HISPANIC ORIGIN: APRIL 1, 2010 TO JULY 1, 2015. POPULATION DIVISION, U.S. CENSUS BUREAU. UPDATED: JUNE 23. 2016). PERSONS BELOW POVERTY LEVEL IN NKY, PERCENT 2009-2013 ALL AGES: 17.01% DUE TO THE ENACTMENT OF THE AFFORDABLE CARE ACT, IT IS ESTIMATED THAT APPROXIMATELY 8.0% OF THE NORTHERN KENTUCKY POPULATION REMAINS UNINSURED (KENTUCKY HEALTH FACTS 2014). THERE ARE SIX (6) OTHER HOSPITALS THAT SERVE THE NORTHERN KENTUCKY COMMUNITY. 1. GATEWAY REHABILITATION HOSPITAL IN BOONE COUNTY, 2. CARROLL COUNTY MEMORIAL HOSPITAL IN CARROLL COUNTY, 3. HARRISON MEMORIAL HOSPITAL IN HARRISON COUNTY, 4. HEALTHSOUTH REHABILITATION HOSPITAL IN KENTON COUNTY, 5. MEADOWVIEW REGIONAL MEDICAL CENTER IN MASON COUNTY, AND 6. NEW HORIZONS MEDICAL CENTER IN OWEN COUNTY. THERE IS ONE (1) HOSPITAL THAT SERVES THE SOUTHERN INDIANA COMMUNITY - DEARBORN COUNTY HOSPITAL IN DEARBORN COUNTY. THERE ARE A NUMBER OF HOSPITALS THAT SERVE THE SOUTHERN OHIO COMMUNITY, INCLUDING; THE CHRIST HOSPITAL, TRIHEALTH, MERCY HEALTH, AND THE UNIVERSITY OF CINCINNATI MEDICAL CENTER. THERE ARE IS A FEW FEDERALLY DESIGNATED - MEDICALLY UNDERSERVED AREAS OR POPULATIONS IN THE COMMUNITIES.
Schedule H, Part VI, Line 5 Promotion of community health ST. ELIZABETH HEALTHCARE FURTHERS ITS EXEMPT PURPOSES IN IMPROVING COMMUNITY HEALTH STATUS BY: 1) ENCOURAGING AND SUPPORTING STAFF TO PARTICIPATE ON VARIOUS COMMUNITY BOARDS/ACTIVITIES THAT SUPPORT AND/OR DEVELOP PROGRAMS THAT ADDRESS COMMUNITY HEALTH NEEDS AND WORKFORCE DEVELOPMENT. 2) ST. ELIZABETH HEALTHCARE'S BOARD OF TRUSTEES IS MADE UP OF COMMUNITY REPRESENTATIVES TO ENSURE THAT ST. ELIZABETH HEALTHCARE ADHERES TO ITS MISSION TO IMPROVE THE HEALTH OF THE PEOPLE WE SERVE. THE MAJORITY OF THE GOVERNING BODY IS COMPRISED OF PERSONS WHO RESIDE WITHIN ST. ELIZABETH'S PRIMARY SERVICE AREA. ST. ELIZABETH EXTENDS MEDICAL STAFF PRIVILEGES TO ALL QUALIFIED PHYSICIANS IN ITS COMMUNITY FOR SOME OR ALL OF ITS DEPARTMENTS OR SPECIALTIES. 3) THROUGH ITS PRIMEWISE SENIOR SERVICES FOR AGE 50+ PERSONS, ST. ELIZABETH HEALTHCARE SUBSIDIZES COURSE OFFERINGS TO SENIOR CITIZENS INCLUDING DRIVER'S SAFETY, LOW IMPACT EXERCISE, COMPUTER SKILLS, MEDICATION REVIEW AND HEALTH SCREENINGS, ALONG WITH PROVIDING LITERATURE PERTINENT TO THIS AGE GROUP. 4) ON A QUARTERLY BASIS, ST ELIZABETH HEALTHCARE PRODUCES AND DISTRIBUTES TO MORE THAN 60,000 HOUSEHOLDS THROUGHOUT NORTHERN KENTUCKY, LITERATURE ON VARIOUS HEALTHCARE ISSUES AND SCHEDULES PERTAINING TO AREA HEALTH EVENTS AND PROGRAMS. 5) PERIODICALLY, ST. ELIZABETH HEALTHCARE WILL PARTNER WITH COMMUNITY ORGANIZATIONS AND BUSINESS AGENCIES TO PRESENT HEALTH RELATED PROGRAMS AND HEALTH SCREENINGS. 6) ST. ELIZABETH APPLIES SURPLUS FUNDS TO IMPROVE PATIENT CARE BY IMPROVING FACILITIES, ACCESS TO CARE, TECHNOLOGY, RECRUITING AND RETAINING TOP TALENT, AND CONTINUING EDUCATION OF OUR STAFF THROUGH EITHER RESIDENCY OR COLLEGE EDUCATIONAL PROGRAMS. EXAMPLES OF HOW SURPLUS FUNDS WERE APPLIED IN 2015 ARE AS FOLLOWS: A) ST. ELIZABETH HEALTHCARE CONTINUES TO PARTNER WITH THE MAYO CLINIC CARE NETWORK TO ENHANCE THE QUALITY OF CARE AND IMPROVE THE ACCESS FOR THE PEOPLE WE SERVE TO THE MAYO CLINIC'S SPECIALISTS AND PROTOCOLS. B) ST. ELIZABETH HEALTHCARE PROVIDED OUTREACH TO THE COMMUNITIES THROUGH THE MOBILE MAMMOGRAPHY AND MOBILE HEART PROGRAMS. C) ST. ELIZABETH HEALTHCARE PROVIDED COHORT EDUCATIONAL PROGRAMS WITH THE NORTHERN KENTUCKY UNIVERSITY (NKU), THOMAS MORE COLLEGE (TMC), AND MT. SAINT JOSEPH UNIVERSITY (MSJU) TO PROVIDE FOR CONTINUING AND/OR ADDITIONAL EDUCATION FOR OUR STAFF. D) THE CONTINUED FINANCIAL ASSISTANCE AND SUPPORT FOR THE FAMILY PRACTICE RESIDENCY PROGRAM WHICH IS COMPRISED OF TWENTY-FOUR (24) FAMILY PRACTICE RESIDENTS WHO LIVE AND STAY IN THE COMMUNITY TO IMPROVE AND ENHANCE THE ACCESS TO PRIMARY CARE FOR THE PEOPLE WE SERVE. E) ST. ELIZABETH HEALTHCARE CONTINUES FINANCIAL SUPPORT FOR OUR PARISH NURSING PROGRAM WHICH PROVIDES OUTREACH, EDUCATION, AND PREVENTION INFORMATION TO OVER FORTY (40) CHURCHES IN OUR COMMUNITY. F) ST. ELIZABETH HEALTHCARE CONTINUES FINANCIAL SUPPORT FOR PREVENTION AND INJURY TREATMENT FOR ATHLETES ATTENDING SCHOOLS IN OUR COMMUNITIES. G) ST. ELIZABETH HEALTHCARE SPONSORS COMMUNITY BENEFITS TO ADDRESS THE HEALTHCARE NEEDS FOR DISEASES SUCH AS OBESITY, DIABETES, AND HEART DISEASE FOR THE PEOPLE WE SERVE. H) ST. ELIZABETH PHYSICIANS PRIMARY CARE PROVIDED ENHANCED SERVICES FOR EDUCATION AND RESOURCES TO THOSE IN THE COMMUNITY WE SERVE WHO STRUGGLE WITH OBESITY AND ENSUING CO-MORBIDITIES.
Schedule H, Part VI, Line 6 Affiliated health care system ST. ELIZABETH HEALTHCARE IS A SYSTEM THAT FEATURES FOUR (4) FACILITIES THROUGHOUT NORTHERN KENTUCKY WHICH ARE: (I) ST. ELIZABETH - EDGEWOOD; (II) ST. ELIZABETH - FLORENCE; (III) ST. ELIZABETH - FORT THOMAS; AND; (IV) ST. ELIZABETH - GRANT EACH OF THESE FACILITIES ADDRESSES THE SPECIFIC NEEDS OF ITS LOCALE AS IDENTIFIED BY THE PATIENTS IN THE COMMUNITY. THE SERVICE AREAS VARY FROM RURAL AREAS TO SUBURBAN AREAS TO URBAN AREAS. ST. ELIZABETH HEALTHCARE OFFERS ALMOST 1,200 LICENSED BEDS, APPROXIMATELY 8,400 EMPLOYEES, 1,200 PHYSICIANS WITH ADMITTING PRIVILEGES AND A WHOLLY OWNED PHYSICIAN ORGANIZATION WHICH INCLUDES OVER 117 PRIMARY CARE AND SPECIALTY OFFICE LOCATIONS. ST. ELIZABETH HEALTHCARE IS SPONSORED BY THE DIOCESE OF COVINGTON.
Schedule H (Form 990) 2015
Additional Data


Software ID: 15000238
Software Version: 2015v2.1
Schedule J
(Form 990)
Department of the Treasury
Internal Revenue Service
Compensation Information
For certain Officers, Directors, Trustees, Key Employees, and Highest
Compensated Employees
SchJMediumBullet Complete if the organization answered "Yes" on Form 990, Part IV, line 23.
SchJMediumBullet Attach to Form 990.
SchJMediumBullet Information about Schedule J (Form 990) and its instructions is at www.irs.gov/form990.
OMB No. 1545-0047
2015
Open to Public Inspection
Name of the organization
St Elizabeth Medical Center Inc
 
Employer identification number

61-0445850
Part I
Questions Regarding Compensation
Yes
No
1a
Check the appropiate box(es) if the organization provided any of the following to or for a person listed on Form
990, Part VII, Section A, line 1a. Complete Part III to provide any relevant information regarding these items.
b
If any of the boxes in line 1a are checked, did the organization follow a written policy regarding payment or reimbursement or provision of all of the expenses described above? If "No," complete Part III to explain .........
1b
Yes
 
2
Did the organization require substantiation prior to reimbursing or allowing expenses incurred by all
directors, trustees, officers, including the CEO/Executive Director, regarding the items checked in line 1a? ..
2
Yes
 
3
Indicate which, if any, of the following the filing organization used to establish the compensation of the
organization's CEO/Executive Director. Check all that apply. Do not check any boxes for methods
used by a related organization to establish compensation of the CEO/Executive Director, but explain in Part III.
4
During the year, did any person listed on Form 990, Part VII, Section A, line 1a with respect to the filing organization or a related organization:
a
Receive a severance payment or change-of-control payment? ................
4a
 
No
b
Participate in, or receive payment from, a supplemental nonqualified retirement plan? .........
4b
Yes
 
c
Participate in, or receive payment from, an equity-based compensation arrangement? .........
4c
 
No
If "Yes" to any of lines 4a-c, list the persons and provide the applicable amounts for each item in Part III.
Only 501(c)(3), 501(c)(4), and 501(c)(29) organizations must complete lines 5-9.
5
For persons listed on Form 990, Part VII, Section A, line 1a, did the organization pay or accrue any
compensation contingent on the revenues of:
a
The organization? ...........................
5a
 
No
b
Any related organization?
5b
 
No
If "Yes," on line 5a or 5b, describe in Part III.
6
For persons listed on Form 990, Part VII, Section A, line 1a, did the organization pay or accrue any
compensation contingent on the net earnings of:
a
The organization?
6a
 
No
b
Any related organization? .........................
6b
 
No
If "Yes," on line 6a or 6b, describe in Part III.
7
For persons listed on Form 990, Part VII, Section A, line 1a, did the organization provide any non-fixed
payments not described in lines 5 and 6? If "Yes," describe in Part III ............
7
 
No
8
Were any amounts reported on Form 990, Part VII, paid or accured pursuant to a contract that was
subject to the initial contract exception described in Regulations section 53.4958-4(a)(3)? If "Yes," describe
in Part III .............................
8
 
No
9
If "Yes" on line 8, did the organization also follow the rebuttable presumption procedure described in Regulations section 53.4958-6(c)? .........................
9
 
 
For Paperwork Reduction Act Notice, see the Instructions for Form 990.
Cat. No. 50053T
Schedule J (Form 990) 2015

Schedule J (Form 990) 2015
Page 2
Part II
Officers, Directors, Trustees, Key Employees, and Highest Compensated Employees. Use duplicate copies if additional space is needed.
For each individual whose compensation must be reported on Schedule J, report compensation from the organization on row (i) and from related organizations, described in the
instructions, on row (ii). Do not list any individuals that are not listed on Form 990, Part VII.
Note. The sum of columns (B)(i)-(iii) for each listed individual must equal the total amount of Form 990, Part VII, Section A, line 1a, applicable column (D) and (E) amounts for that individual.
(A) Name and Title (B) Breakdown of W-2 and/or 1099-MISC compensation (C) Retirement and other deferred compensation (D) Nontaxable
benefits		 (E) Total of columns
(B)(i)-(D) 		(F) Compensation in column(B) reported as deferred on prior Form 990
(i) Base compensation (ii) Bonus & incentive compensation (iii) Other reportable compensation
1GARREN COLVIN
  PRESIDENT/CEO (partial year) 		(i)

(ii)		 752,076
-------------
0 		220,864
-------------
0 		7,212
-------------
0 		209,871
-------------
0 		20,485
-------------
0 		1,210,508
-------------
0 		0
-------------
0
2JOHN DUBIS
  PRESIDENT/CEO (PARTIAL YEAR) 		(i)

(ii)		 155,685
-------------
0 		517,703
-------------
0 		1,813,868
-------------
0 		33,105
-------------
0 		16,323
-------------
0 		2,536,684
-------------
0 		1,515,149
-------------
0
3Heidi MURLEY MD
  TRUSTEE 		(i)

(ii)		 0
-------------
631,069 		0
-------------
0 		0
-------------
3,325 		0
-------------
13,150 		0
-------------
24,074 		0
-------------
671,618 		0
-------------
0
4BARBARA KROHMAN
  CORPORATE SECRETARY 		(i)

(ii)		 113,373
-------------
0 		0
-------------
0 		1,733
-------------
0 		24,723
-------------
0 		20,303
-------------
0 		160,132
-------------
0 		0
-------------
0
5LORI RITCHEY-BALDWIN
  Senior Vice President/CFO/Treasurer 		(i)

(ii)		 471,226
-------------
0 		124,057
-------------
0 		4,571
-------------
0 		103,757
-------------
0 		20,635
-------------
0 		724,246
-------------
0 		0
-------------
0
6GARY BLANK
  EXECUTIVE VP & COO, CNE 		(i)

(ii)		 395,006
-------------
0 		116,854
-------------
0 		6,341
-------------
0 		95,266
-------------
0 		9,643
-------------
0 		623,110
-------------
0 		0
-------------
0
7GEORGE S HALL MD
  Former VP Medical Affairs 		(i)

(ii)		 6,767
-------------
0 		78,225
-------------
0 		34,687
-------------
0 		0
-------------
0 		14,997
-------------
0 		134,676
-------------
0 		34,687
-------------
0
8THOMAS SAALFELD
  Former SVP/COO FT. THOMAS/FALMOUT 		(i)

(ii)		 108,178
-------------
0 		0
-------------
0 		0
-------------
0 		0
-------------
0 		0
-------------
0 		108,178
-------------
0 		0
-------------
0
9GLENN LOOMIS MD
  President/CEO OF SEP (partial year) 		(i)

(ii)		 586,295
-------------
0 		174,355
-------------
0 		1,193
-------------
0 		123,473
-------------
0 		20,635
-------------
0 		905,951
-------------
0 		0
-------------
0
10ROBERT PRICHARD MD
  Chief Clinical Integration Officer, SEP President & CEO 		(i)

(ii)		 516,857
-------------
0 		139,364
-------------
0 		6,723
-------------
0 		112,924
-------------
0 		17,268
-------------
0 		793,136
-------------
0 		0
-------------
0
11SARAH GIOLANDO
  SVP/CHIEF STRATEGY OFFICER 		(i)

(ii)		 352,825
-------------
0 		111,709
-------------
0 		2,831
-------------
0 		68,026
-------------
0 		15,137
-------------
0 		550,528
-------------
0 		0
-------------
0
12MARTIN OSCADAL
  SVP HUMAN RESOURCES 		(i)

(ii)		 331,486
-------------
0 		107,254
-------------
0 		5,374
-------------
0 		86,896
-------------
0 		18,568
-------------
0 		549,578
-------------
0 		0
-------------
0
13ALEXANDER RODRIGUEZ
  VP CIO 		(i)

(ii)		 351,169
-------------
0 		87,392
-------------
0 		1,813
-------------
0 		68,312
-------------
0 		25,941
-------------
0 		534,627
-------------
0 		0
-------------
0
14CHRISTOPHER CARLE
  PRESIDENT & CEO SEPN 		(i)

(ii)		 323,216
-------------
0 		102,620
-------------
0 		1,809
-------------
0 		84,586
-------------
0 		8,643
-------------
0 		520,874
-------------
0 		0
-------------
0
15WILLIAM BANKS
  VP REVENUE CYCLE MANAGED CARE 		(i)

(ii)		 294,208
-------------
0 		77,594
-------------
0 		29,795
-------------
0 		60,656
-------------
0 		19,755
-------------
0 		482,008
-------------
0 		0
-------------
0
16SUSAN MCDONALD
  VP Nursing - Edgewood 		(i)

(ii)		 256,837
-------------
0 		50,251
-------------
0 		3,730
-------------
0 		63,300
-------------
0 		9,617
-------------
0 		383,735
-------------
0 		0
-------------
0
17LARRY WARKOCZESKI
  VP - ST. ELIZABETH FOUNDATION 		(i)

(ii)		 248,914
-------------
0 		50,958
-------------
0 		3,595
-------------
0 		49,505
-------------
0 		11,079
-------------
0 		364,051
-------------
0 		0
-------------
0
18BRUNO GIACOMUZZI
  COO Flo FT Cov & SVP Prof Svcs 		(i)

(ii)		 257,974
-------------
0 		15,000
-------------
0 		14,979
-------------
0 		39,782
-------------
0 		14,571
-------------
0 		342,306
-------------
0 		0
-------------
0
19BENITA UTZ
  VP Nursing - Florence/Ft. Thomas 		(i)

(ii)		 240,592
-------------
0 		39,551
-------------
0 		3,840
-------------
0 		67,371
-------------
0 		14,365
-------------
0 		365,719
-------------
0 		0
-------------
0
20ANTHONY HELTON
  VP Revenue Cycle 		(i)

(ii)		 204,447
-------------
0 		50,747
-------------
0 		2,370
-------------
0 		39,562
-------------
0 		23,620
-------------
0 		320,746
-------------
0 		0
-------------
0
21LISA FREY
  VP LEGAL SERVICES/GENERAL COUNSEL 		(i)

(ii)		 218,555
-------------
0 		18,725
-------------
0 		1,099
-------------
0 		31,642
-------------
0 		10,033
-------------
0 		280,054
-------------
0 		0
-------------
0
22HARRY WATSON
  Sr. VP Facilities 		(i)

(ii)		 222,041
-------------
0 		0
-------------
0 		9,165
-------------
0 		38,076
-------------
0 		1,719
-------------
0 		271,001
-------------
0 		0
-------------
0
23LAROY KENDALL
  VP Medical Services 		(i)

(ii)		 187,943
-------------
0 		0
-------------
0 		828
-------------
0 		29,223
-------------
0 		8,729
-------------
0 		226,723
-------------
0 		0
-------------
0
24VERA HALL
  SVP System CNE 		(i)

(ii)		 167,295
-------------
0 		14,122
-------------
0 		1,105
-------------
0 		10,882
-------------
0 		30,225
-------------
0 		223,629
-------------
0 		0
-------------
0
25JOSEPH BOZELLI
  VP MISSION SVCS & PASTORAL CARE 		(i)

(ii)		 132,036
-------------
0 		7,133
-------------
0 		3,188
-------------
0 		25,485
-------------
0 		9,426
-------------
0 		177,268
-------------
0 		0
-------------
0
26KARL ULICNY
  PHYSICIAN 		(i)

(ii)		 577,466
-------------
0 		357,324
-------------
0 		6,559
-------------
0 		33,105
-------------
0 		29,971
-------------
0 		1,004,425
-------------
0 		0
-------------
0
27VICTOR SCHMELZER
  PHYSICIAN 		(i)

(ii)		 680,444
-------------
0 		107,324
-------------
0 		5,452
-------------
0 		33,105
-------------
0 		29,096
-------------
0 		855,421
-------------
0 		0
-------------
0
28MICHAEL GIBSON
  PHYSICIAN 		(i)

(ii)		 380,962
-------------
0 		77,337
-------------
0 		1,118
-------------
0 		15,105
-------------
0 		13,155
-------------
0 		487,677
-------------
0 		0
-------------
0
29JACKSON PEMBERTON
  PHYSICIAN DIRECTOR - LABORATORY 		(i)

(ii)		 406,711
-------------
0 		28,500
-------------
0 		5,518
-------------
0 		33,105
-------------
0 		22,803
-------------
0 		496,637
-------------
0 		0
-------------
0
30DONN BURNS
  pathologist 		(i)

(ii)		 371,157
-------------
0 		28,500
-------------
0 		4,699
-------------
0 		15,105
-------------
0 		29,575
-------------
0 		449,036
-------------
0 		0
-------------
0
Schedule J (Form 990) 2015

Schedule J (Form 990) 2015
Page 3
Part III
Supplemental Information
Provide the information, explanation, or descriptions required for Part I, lines 1a, 1b, 3, 4a, 4b, 4c, 5a, 5b, 6a, 6b, 7, and 8, and for Part II. Also complete this part for any additional information.
Return Reference Explanation
Schedule J, Part I, Line 1a Travel for companions THIS IS PROVIDED TO GARREN COLVIN. BOARD RETREAT COMPANION TRAVEL IS TREATED AS TAXABLE COMPENSATION.
Schedule J, Part I, Line 1a Tax indemnification and gross-up payments TAXABLE BOARD RETREAT COMPENSATION WAS GROSSED UP FOR FICA AND LOCAL TAXES FOR GARREN COLVIN.
Schedule J, Part I, Line 1a Housing allowance or residence for personal use WILLIAM BANKS IS PROVIDED A HOUSING ALLOWANCE THAT IS TREATED AS TAXABLE COMPENSATION.
Schedule J, Part I, Line 4b Supplemental nonqualified retirement plan EXECUTIVES PARTICIPATE IN A PROGRAM THAT PROVIDES FOR SUPPLEMENTAL RETIREMENT BENEFITS. THE PAYMENT OF BENEFITS UNDER THE PROGRAM, IF ANY, IS ENTIRELY DEPENDENT UPON THE FACTS AND CIRCUMSTANCES UNDER WHICH THE EXECUTIVE TERMINATES EMPLOYMENT WITH ST. ELIZABETH HEALTHCARE. BENEFITS UNDER THE PROGRAM ARE UNFUNDED AND NON-VESTED. DUE TO THE SUBSTANTIAL RISK OF FORFEITURE PROVISION, THERE IS NO GUARANTEE THAT THESE EXECUTIVES WILL EVER RECEIVE ANY BENEFIT UNDER THE PROGRAM. ANY AMOUNT ULTIMATELY PAID UNDER THE PROGRAM TO THE EXECUTIVE IS REPORTED AS COMPENSATION ON FORM 990, SCHEDULE J, PART II, COLUMN B(I) IN THE YEAR PAID. DURING 2015, THE FOLLOWING EXECUTIVES RECEIVED A PAYMENT: JOHN DUBIS - $1,515,149, AND GEORGE HALL - $34,687. 2015 EMPLOYER CONTRIBUTIONS ON BEHALF OF COVERED EMPLOYEES INCLUDES: GLENN LOOMIS - $92,323, GARREN COLVIN - $176,766, ROBERT PRICHARD -$79,819, SARAH GIOLANDO - $56,725, ALEXANDER RODRIGUEZ - $53,207, CHRISTOPHER CARLE - $51,481, MARTIN OSCADAL - $53,791, GARY BLANK - $62,161, WILLIAM BANKS - $45,551, SUSAN MCDONALD - $37,350, LORI RITCHEY-BALDWIN - $72,607, BENITA UTZ - $34,266, LARRY WARKOCZESKI - $36,355, JOSEPH BOZELLI - $17,235, BRUNO GIACOMUZZI - $31,832, ANTHONY HELTON - $31,650, LAROY KENDALL - $22,050, AND HARRY WATSON - $26,999.
Schedule J (Form 990) 2015
Additional Data


Software ID: 15000238
Software Version: 2015v2.1
Schedule K
(Form 990)
Department of the Treasury
Internal Revenue Service
Supplemental Information on Tax Exempt Bonds
SchKMediumBullet Complete if the organization answered "Yes" to Form 990, Part IV, line 24a. Provide descriptions,
explanations, and any additional information in Part VI.
SchKMediumBullet Attach to Form 990.
SchKMediumBulletInformation about Schedule K (Form 990) and its instructions is at www.irs.gov/form990.
OMB No. 1545-0047
2015
Open to Public
Inspection
Name of the organization
St Elizabeth Medical Center Inc
 
Employer identification number
61-0445850
Part I
Bond Issues
(a) Issuer name (b) Issuer EIN (c) CUSIP # (d) Date issued (e) Issue price (f) Description of purpose (g) Defeased (h) On
behalf of
issuer		 (i) Pool
financing
Yes No Yes No Yes No
A KENTUCKY ECONOMIC DEVELOPMENT FINANCE AUTHORITY - SERIES 2009A
  		52-1643102 49126KGH8 12-09-2009 101,960,448 CONSTRUCTION OF HOSPITAL FACILITY / PARTIAL REFUNDING OF BOND ISSUED 6/11/03   X   X   X
B KENTUCKY ECONOMIC DEVELOPMENT FINANCE AUTHORITY - SERIES 2009B
  		52-1643102   12-09-2009 38,150,000 PARTIAL REFUNDING OF BONDS ISSUED 6/11/03   X   X   X
C KENTUCKY BOND DEVELOPMENT CORPORATION - 2015A
  		47-2650498   12-30-2015 50,000,000 RENOVATIONS TO HOSPITAL   X   X   X
D KENTUCKY BOND DEVELOPMENT CORPORATION - 2015B
  		47-2650498   12-30-2015 50,000,000 RENOVATIONS TO HOSPITAL   X   X   X
Part II
Proceeds
A B C D
1 Amount of bonds retired .................. 12,850,000 6,900,000 0 0
2 Amount of bonds legally defeased .............. 0 0 0 0
3 Total proceeds of issue .................. 101,960,448 38,150,000 50,000,000 50,000,000
4 Gross proceeds in reserve funds ............. 0 0 0 0
5 Capitalized interest from proceeds ............. 0 0 0 0
6 Proceeds in refunding escrows ............... 0 0 0 0
7 Issuance costs from proceeds ............... 1,430,179 360,000 245,000 222,000
8 Credit enhancement from proceeds ............. 0 0 0 0
9 Working capital expenditures from proceeds ............. 0 0 0 0
10 Capital expenditures from proceeds ............. 29,195,269 0 5,885,382 9,777,995
11 Other spent proceeds ............. 71,335,000 37,790,000 0 0
12 Other unspent proceeds ............. 0 0 43,869,618 40,000,005
13 Year of substantial completion ............. 2009 2003
Yes No Yes No Yes No Yes No
14 Were the bonds issued as part of a current refunding issue? .... X   X     X   X
15 Were the bonds issued as part of an advance refunding issue? .....   X   X   X   X
16 Has the final allocation of proceeds been made? .......... X   X     X   X
17 Does the organization maintain adequate books and records to support the final allocation of proceeds? .................. X   X   X   X  
Part III
Private Business Use
A B C D
Yes No Yes No Yes No Yes No
1 Was the organization a partner in a partnership, or a member of an LLC, which owned property financed by tax-exempt bonds? .............   X   X   X   X
2 Are there any lease arrangements that may result in private business use of bond-financed property? ............... X     X   X   X
For Paperwork Reduction Act Notice, see the Instructions for Form 990.
Cat. No. 50193E
Schedule K (Form 990) 2015

Schedule K (Form 990) 2015
Page 2
Part III
Private Business Use (Continued)
A B C D
Yes No Yes No Yes No Yes No
3a Are there any management or service contracts that may result in private business use of bond-financed property? ............. X   X     X   X
b If "Yes" to line 3a, does the organization routinely engage bond counsel or other outside counsel to review any management or service contracts relating to the financed property? X   X          
c Are there any research agreements that may result in private business use of bond-financed property? .............   X   X   X X  
d If "Yes" to line 3c, does the organization routinely engage bond counsel or other outside counsel to review any research agreements relating to the financed property?         X   X  
4 Enter the percentage of financed property used in a private business use by entities other than a section 501(c)(3) organization or a state or local government ....SchKMediumBullet 3 %     0.01 %
5 Enter the percentage of financed property used in a private business use as a result of unrelated trade or business activity carried on by your organization, another section 501(c)(3) organization, or a state or local government ......... SchKMediumBullet        
6 Total of lines 4 and 5 ............. 3 % 0 % 0 % 0.01 %
7 Does the bond issue meet the private security or payment test? ...   X   X   X   X
8a Has there been a sale or disposition of any of the bond-financed property to a nongovernmental person other than a 501(c)(3) organization since the bonds were issued?.............   X   X   X   X
b If "Yes" to line 8a, enter the percentage of bond-financed property sold or disposed of. ..        
c If "Yes" to line 8a, was any remedial action taken pursuant to Regulations sections 1.141-12 and 1.145-2? .............                
9 Has the organization established written procedures to ensure that all nonqualified bonds of the issue are remediated in accordance with the requirements under
Regulations sections 1.141-12 and 1.145-2? ........ 		X   X   X   X  
Part IV
Arbitrage
A B C D
Yes No Yes No Yes No Yes No
1 Has the issuer filed Form 8038-T, Arbitrage Rebate, Yield Reduction and Penalty in Lieu of Arbitrage Rebate? ...   X   X   X   X
2 If "No" to line 1, did the following apply? ....
a Rebate not due yet? .......   X   X X   X  
b Exception to rebate? ........   X   X   X   X
c No rebate due? ......... X   X     X   X
If "Yes" to line 2c, provide in Part VI the date the rebate
computation was performed ......
3 Is the bond issue a variable rate issue? .....   X X   X   X  
4a Has the organization or the governmental issuer entered into a qualified hedge with respect to the bond issue?   X   X   X X  
b Name of provider ..........  
  		 
  		 
  		PNC BANK NATIONAL ASSOCIATION
 
c Term of hedge .........       3000 %
d Was the hedge superintegrated? ......               X
e Was the hedge terminated? ........               X
Schedule K (Form 990) 2015

Schedule K (Form 990) 2015
Page 3
Part IV
Arbitrage (Continued)
A B C D
Yes No Yes No Yes No Yes No
5a Were gross proceeds invested in a guaranteed investment contract (GIC)?   X   X   X   X
b Name of provider ..........  
  		 
  		 
  		 
 
c Term of GIC .........        
d Was the regulatory safe harbor for establishing the fair market value of the GIC satisfied? ........                
6 Were any gross proceeds invested beyond an available temporary period?   X   X   X   X
7 Has the organization established written procedures to monitor the requirements of section 148? ... X   X   X   X  
Part V
Procedures To Undertake Corrective Action
A B C D
Yes No Yes No Yes No Yes No
Has the organization established written procedures to ensure that violations of federal tax requirements are timely identified and corrected through the voluntary closing agreement program if self-remediation is not available under applicable regulations? X   X   X   X  
Part VI
Supplemental Information. Provide additional information for responses to questions on Schedule K (see instructions).
Return Reference Explanation
Schedule K, Part V Procedures to Undertake Corrective Action St. Elizabeth Medical Center, Inc. d/b/a St. Elizabeth Healthcare has written procedures to ensure that violations of federal tax requirements are timely identified. If self-remediation is not available under applicable regulations, St. Elizabeth Healthcare would contact its bond counsel regarding the IRS' voluntary closing agreement program.
Schedule K, Part II, Line 11 Other Spent Proceeds Amount of bond proceeds used for current refunding of series 2003 bonds.
Schedule K, Part III, Line 4 Research Agreement Revenue The amount of revenue from the Research Agreements is de minimis representing less than 0.0057% of the Total Operating Revenue.
Schedule K, Part IV, Line 2c COLUMN A Issuer name: KENTUCKY ECONOMIC DEVELOPMENT FINANCE AUTHORITY - SERIES 2009A The calculation for computing no rebate due was performed on 06/04/2014
Schedule K, Part IV, Line 2c COLUMN B Issuer name: KENTUCKY ECONOMIC DEVELOPMENT FINANCE AUTHORITY - SERIES 2009B The calculation for computing no rebate due was performed on 06/04/2014
Schedule K (Form 990) 2015

Additional Data


Software ID: 15000238
Software Version: 2015v2.1

SCHEDULE M
(Form 990)

Department of the Treasury
Internal Revenue Service
Noncash Contributions
Right pointing arrow large imageComplete if the organizations answered "Yes" on Form 990, Part IV, lines 29 or 30.
Right pointing arrow large image Attach to Form 990.
Right pointing arrow large imageInformation about Schedule M (Form 990) and its instructions is at www.irs.gov/form990
OMB No. 1545-0047
2015
Open to Public Inspection
Name of the organization
St Elizabeth Medical Center Inc
 
Employer identification number

61-0445850
Part I
Types of Property
(a)
Check if applicable 		(b)
Number of contributions or items contributed 		(c)
Noncash contribution amounts reported on
Form 990, Part VIII, line 1g 		(d)
Method of determining
noncash contribution amounts
1 Art—Works of art ....        
2 Art—Historical treasures .        
3 Art—Fractional interests ..        
4 Books and publications ..      
5 Clothing and household
goods ....... 		     
6 Cars and other vehicles ..        
7 Boats and planes ....        
8 Intellectual property ...        
9 Securities—Publicly traded . X 12 129,188 Market value
10 Securities—Closely held stock .        
11 Securities—Partnership, LLC,
or trust interests .... 		       
12 Securities—Miscellaneous ..        
13 Qualified conservation
contribution—Historic
structures ..... 		       
14 Qualified conservation
contribution—Other ... 		       
15 Real estate—Residential .        
16 Real estate—Commercial ..        
17 Real estate—Other ...        
18 Collectibles .....        
19 Food inventory ...        
20 Drugs and medical supplies . X 6 6,681 Cost
21 Taxidermy ......        
22 Historical artifacts ....        
23 Scientific specimens ..        
24 Archeological artifacts ...        
25 Other Right pointing arrow large image ( FOOD/PRIZES ) X 96 34,462 Cost
26 Other Right pointing arrow large image ( )
27 Other Right pointing arrow large image ( )
28 Other Right pointing arrow large image ( )
29
Number of Forms 8283 received by the organization during the tax year for contributions
for which the organization completed Form 8283, Part IV, Donee Acknowledgement
29
0
Yes
No
30a
During the year, did the organization receive by contribution any property reported in Part I, lines 1 through 28, that
it must hold for at least three years from the date of the initial contribution, and which is not required to be used
for exempt purposes for the entire holding period? ..................
30a
 
No
b
If "Yes," describe the arrangement in Part II.
31
Does the organization have a gift acceptance policy that requires the review of any non-standard contributions?
31
 
No
32a
Does the organization hire or use third parties or related organizations to solicit, process, or sell noncash
contributions? ..........................
32a
 
No
b
If "Yes," describe in Part II.
33
If the organization did not report an amount in column (c) for a type of property for which column (a) is checked,
describe in Part II.
For Paperwork Reduction Act Notice, see the Instructions for Form 990.
Cat. No. 51227J
Schedule M (Form 990) (2015)
Schedule M (Form 990) (2015)
Page 2
Part II
Supplemental Information. Provide the information required by Part I, lines 30b, 32b, and 33, and whether the organization is reporting in Part I, column (b), the number of contributions, the number of items received, or a combination of both. Also complete this part for any additional information.
Return Reference Explanation
Schedule M, Part I Explanations of reporting method for number of contributions Securities - Publicly traded: ST. ELIZABETH HEALTHCARE IS REPORTING THE 12 NUMBER OF CONTRIBUTIONS RECEIVED BASED ON USING A COMBINATION OF BOTH METHODS. Drugs and medical supplies: ST. ELIZABETH HEALTHCARE IS REPORTING THE 6 NUMBER OF ITEMS RECEIVED BASED ON USING A COMBINATION OF BOTH METHODS. Other: ST. ELIZABETH HEALTHCARE IS REPORTING THE 96 ITEMS RECEIVED BASED ON USING A COMBINATION OF BOTH METHODS.
Schedule M (Form 990) (2015)

Additional Data


Software ID: 15000238
Software Version: 2015v2.1
SCHEDULE O
(Form 990 or 990-EZ)

Department of the Treasury
Internal Revenue Service
Supplemental Information to Form 990 or 990-EZ

Complete to provide information for responses to specific questions on
Form 990 or 990-EZ or to provide any additional information.
MediumBullet Attach to Form 990 or 990-EZ.
MediumBullet Information about Schedule O (Form 990 or 990-EZ) and its instructions is at
www.irs.gov/form990.
OMB No. 1545-0047
2015
Open to Public
Inspection
Name of the organization
St Elizabeth Medical Center Inc
 
Employer identification number

61-0445850
Return Reference Explanation
Form 990, Part VI, Line 13 WHISTLEBLOWER POLICY ST. ELIZABETH MEDICAL CENTER, INC. DBA ST. ELIZABETH HEALTHCARE DOES NOT HAVE A SPECIFIC WHISTLEBLOWER POLICY. HOWEVER, THERE IS A SECTION OF ST. ELIZABETH HEALTHCARE'S CORPORATE RESPONSIBILITY PROGRAM THAT ADDRESSES COMPLIANCE WITH THE FEDERAL FALSE CLAIMS ACT AND WITHIN THAT SECTION, PROTECTION FOR WHISTLEBLOWERS IS SPECIFICALLY ADDRESSED.
Form 990, Part VI, Line 2 Family/business relationships amongst interested persons Robert Zapp and Richard H. Tapke, Jr. - Business relationship
Form 990, Part VI, Line 7a Members or stockholders electing members of governing body MOST REVEREND CATHOLIC BISHOP OF COVINGTON KENTUCKY HAS CERTAIN RESERVED POWERS IN REGARD TO MAJOR TRANSACTIONS. THE BOARD OF TRUSTEES OF ST. ELIZABETH HEALTHCARE WILL BE APPOINTED ACCORDING TO THE FOLLOWING SUMMARIZED PROCEDURE: (I) THE BOARD SHALL SUBMIT TO THE BISHOP UP TO THREE NAMES OF CANDIDATES FOR EACH VACANCY; (II) ORDINARILY THE BISHOP WILL CHOOSE TRUSTEES TO FILL THE VACANCIES OR OPENINGS FROM THE RECOMMENDED CANDIDATES AFTER PERSONAL CONSULTATION WITH THE PRESIDENT. IF THE BISHOP DOES NOT CHOOSE ANYONE FROM THE LIST, THE BOARD WILL SUBMIT NEW NAMES AS SOON AS PRACTICAL; (III) THE BISHOP RESERVES THE RIGHT TO SUBMIT OTHER NAMES TO THE BOARD FOR REVIEW AND COMMENT; (IV) IN CONSULTATION WITH THE PRESIDENT OF THE MEDICAL CENTER OR THE BOARD CHAIR, THE BISHOP MAY REMOVE ANY MEMBER OF THE BOARD IF CERTAIN ACTIONS ARE COMMITTED; (V) IF THE BISHOP DECLINES A CANDIDATE OR THE CANDIDATE DECLINES, THE LIST OF CANDIDATES WILL BE REVISITED ACCORDING TO PROCEDURES (I) THROUGH (III) ABOVE.
Form 990, Part VI, Line 7b Decisions requiring approval by members or stockholders MOST REVEREND CATHOLIC BISHOP OF COVINGTON KENTUCKY HAS CERTAIN RESERVED POWERS IN REGARD TO MAJOR TRANSACTIONS. THE FOLLOWING ACTIONS REQUIRE PRIOR APPROVAL OF THE BISHOP: (I) THE AMENDMENT OR REPEAL OF SECTIONS 2(B) OR 2(C) OF THE BYLAWS OR ANY PROVISIONS OF THE GOVERNING DOCUMENTS RELATING TO THE AUTHORITY OF THE BISHOP OR BOARD OF TRUSTEES OF ST. ELIZABETH HEALTHCARE; (II) ANY ACTION THAT RESULTS IN A SUBSTANTIAL CHANGE, AS DETERMINED BY THE BISHOP OR THE BOARD, IN THE PHILOSOPHY OR MISSION OF ST. ELIZABETH HEALTHCARE, OR IN THE USE OF A ST. ELIZABETH HEALTHCARE HOSPITAL FACILITY; (III) THE DISSOLUTION, CONSOLIDATION, MERGER, OR TERMINATION OF EXISTENCE OF ST. ELIZABETH HEALTHCARE; AND (IV) A BORROWING, LEASE, TRANSFER, OR ENCUMBRANCE OF ANY REAL ESTATE OF ST. ELIZABETH HEALTHCARE EXCEEDING $5,000,000.
Form 990, Part VI, Line 8b Documentation of meetings held by committees of governing body The organization did not have any committees with authority to act on behalf of the governing body.
Form 990, Part VI, Line 11b Review of form 990 by governing body ST. ELIZABETH HEALTHCARE'S PROCESS TO REVIEW THE FORM 990 CONSISTS OF REVIEW AND APPROVAL BY CERTAIN MEMBERS OF MANAGEMENT AND THE ST. ELIZABETH HEALTHCARE'S BOARD OF TRUSTEES. THE FORM 990 IS REVIEWED WITH AND APPROVED BY THE FINANCE COMMITTEE. SUBSEQUENT TO THE FINANCE COMMITTEE'S APPROVAL, BUT PRIOR TO FILING WITH THE IRS, THE FORM 990 IS PROVIDED TO THE BOARD OF TRUSTEES FOR THEIR REVIEW AND MANAGEMENT IS AVAILABLE FOR ANY QUESTIONS OR COMMENTS.
Form 990, Part VI, Line 12c Conflict of interest policy ST. ELIZABETH HEALTHCARE REGULARLY AND CONSISTENTLY MONITORS AND ENFORCES COMPLIANCE WITH ITS CONFLICT OF INTEREST POLICY IN THAT ANY DIRECTOR, PRINCIPAL OFFICER, OR A MEMBER OF A COMMITTEE WITH GOVERNING BOARD DELEGATED POWERS, WHO HAS A DIRECT OR INDIRECT FINANCIAL INTEREST, MUST DISCLOSE THE EXISTENCE OF THE FINANCIAL INTEREST AND BE GIVEN THE OPPORTUNITY TO DISCLOSE ALL MATERIAL FACTS TO THE DIRECTORS AND MEMBERS OF THE COMMITTEE WITH THE GOVERNING BOARD DELEGATED POWERS CONSIDERING THE PROPOSED TRANSACTION OR ARRANGEMENT. THE REMAINING INDIVIDUALS ON THE GOVERNING BOARD OR COMMITTEE MEETING WILL DECIDE IF CONFLICTS OF INTEREST EXISTS. EACH DIRECTOR, PRINCIPAL OFFICER, AND MEMBER OF A COMMITTEE WITH GOVERNING BOARD DELEGATED POWERS ANNUALLY SIGNS A STATEMENT WHICH AFFIRMS THAT SUCH PERSON: (I) HAS RECEIVED A COPY OF THE CONFLICT OF INTEREST POLICY, (II) HAS READ AND UNDERSTANDS THE POLICY, (III) HAS AGREED TO COMPLY WITH THE POLICY, AND (IV) UNDERSTANDS THAT ST. ELIZABETH HEALTHCARE IS CHARITABLE AND IN ORDER TO MAINTAIN ITS FEDERAL TAX EXEMPTION, IT MUST ENGAGE PRIMARILY IN ACTIVITIES WHICH ACCOMPLISH ITS TAX EXEMPT PURPOSE. WHEN BUSINESS MATTERS COME BEFORE THE BOARD IN WHICH A MEMBER IS INVOLVED AND A POTENTIAL CONFLICT OF INTEREST MAY EXIST: (I) THE MEMBER SHOULD AGAIN MAKE A VERBAL DISCLOSURE TO THE MEMBERSHIP PRESENT. (II) THE BOARD SHALL ASK THE INTERESTED MEMBER TO LEAVE THE MEETING DURING DISCUSSION OF THE MATTER THAT GIVES RISE TO THE POTENTIAL CONFLICT; (III) THE INTERESTED MEMBER SHALL NOT VOTE ON NOR USE HIS OR HER PERSONAL INFLUENCE ON THE MATTER THAT GIVES RISE TO THE POTENTIAL CONFLICT; (IV) THE INTERESTED MEMBER SHALL NOT BE COUNTED IN DETERMINING THE EXISTENCE OF A QUORUM AT SUCH MEETING; AND (V) THE MINUTES OF THE MEETING SHALL REFLECT THE DISCLOSURE MADE, THE VOTE TAKEN, AND WHICH MEMBERS WERE PRESENT AND VOTING.
Form 990, Part VI, Line 15a Process to establish compensation of top management official IN DETERMINING THE COMPENSATION OF ST. ELIZABETH HEALTHCARE'S CHIEF EXECUTIVE OFFICER, AN EVALUATION IS DONE BY THE COMPENSATION COMMITTEE AND EXECUTIVE COMMITTEE USING APPROPRIATE COMPARABLE DATA, AND THEN A COMPENSATION RECOMMENDATION IS PRESENTED TO THE BOARD FOR APPROVAL.
Form 990, Part VI, Line 15b Process to establish compensation of other employees OTHER KEY EXECUTIVES ARE REVIEWED, AND THE CHIEF EXECUTIVE OFFICER MAKES RECOMMENDATIONS FOR THEIR COMPENSATION TO THE COMPENSATION COMMITTEE. THE COMPENSATION COMMITTEE THEN EVALUATES AND APPROVES THE COMPENSATION FOR THE OTHER KEY EXECUTIVES. FOR BOTH THE CHIEF EXECUTIVE OFFICER AND OTHER KEY EXECUTIVES, THE PROCESS INCLUDED A REVIEW AND APPROVAL BY INDEPENDENT PERSONS, REVIEW OF COMPARABILITY DATA, AND CONTEMPORANEOUS SUBSTANTIATION OF THE DELIBERATION AND DECISION. THE EXTERNAL REVIEW OF EXECUTIVE COMPENSATION IS PERFORMED ANNUALLY AND APPROVED BY THE BOARD. THIS WAS LAST PERFORMED IN 2015.
Form 990, Part VI, Line 19 Required documents available to the public UPON REQUEST, ST. ELIZABETH HEALTHCARE WILL MAKE AVAILABLE THE FORM 990 AND THE RELATED APPLICABLE SCHEDULES, OF WHICH ARE SUBJECT TO AND OPEN TO PUBLIC INSPECTION.
Form 990, Part VIII, Line 2f Other Program Service Revenue MEDICAID SETTLEMENT - Total Revenue: 10759999, Related or Exempt Function Revenue: 9868711, Unrelated Business Revenue: 891288, Revenue Excluded from Tax Under Sections 512, 513, or 514: ;
Form 990, Part IX, Line 11g Other Fees CONTRACT LABOR - Total Expense: 2870865, Program Service Expense: , Management and General Expenses: 2870865, Fundraising Expenses: ; AMBULANCE SERVICE - Total Expense: 187871, Program Service Expense: 187871, Management and General Expenses: , Fundraising Expenses: ; ANESTHESIOLOGY SERVICE - Total Expense: 2311743, Program Service Expense: 2311743, Management and General Expenses: , Fundraising Expenses: ; LABORATORY SERVICES - Total Expense: 5923131, Program Service Expense: 5923131, Management and General Expenses: , Fundraising Expenses: ; LAUNDRY EXPENSE - Total Expense: 2970229, Program Service Expense: 461043, Management and General Expenses: 2509186, Fundraising Expenses: ; PERFUSION SERVICE - Total Expense: 832583, Program Service Expense: 832583, Management and General Expenses: , Fundraising Expenses: ; RADIOLOGY SERVICE - Total Expense: 402896, Program Service Expense: 402896, Management and General Expenses: , Fundraising Expenses: ; PHYSICIAN FEES - Total Expense: 13352922, Program Service Expense: 11398039, Management and General Expenses: 1954883, Fundraising Expenses: ; CONSULTING SERVICE - Total Expense: 11832573, Program Service Expense: 826759, Management and General Expenses: 11005814, Fundraising Expenses: ; COLLECTION SERVICE - Total Expense: 1327099, Program Service Expense: 90230, Management and General Expenses: 1236869, Fundraising Expenses: ; OTHER FEES - Total Expense: 70298808, Program Service Expense: 15414666, Management and General Expenses: 54884107, Fundraising Expenses: 35; PURCHASED SERVICE - Total Expense: 22856259, Program Service Expense: 10850973, Management and General Expenses: 11780878, Fundraising Expenses: 224408; MAINTENANCE & REPAIR - Total Expense: 10856468, Program Service Expense: 1796343, Management and General Expenses: 9038845, Fundraising Expenses: 21280;
Form 990, Part XI, Line 9 Other changes in net assets or fund balances CHANGE IN FMV OF 2003C SERIES INTEREST RATE SWAP - -249367; MINIMUM PENSION LIABILITY ADJUSTMENT - 6828417; CHANGE IN FMV OF SPLIT LIFE INSURANCE INTEREST - -9759; CHANGE IN INVESTMENT OF ST. ELIZABETH PHYSICIANS - -116342; CHANGE IN INVESTMENT IN AMSURG - -59994; NET ASSETS RELEASED FROM RESTRICTIONS - 275752; Write off of Uncollectible Pledges - -150000; Expenses Related to St. Elizabeth Provider Network, Inc. - -478874;
Sch. H, Part V, Section B, Line 7 ST. ELIZABETH FLORENCE (Continued:) NEXT, THE LIST WAS ADVANCED TO THE STRATEGIC PLANNING COMMITTEE OF THE BOARD OF TRUSTEES TO REVIEW, IN WHICH THEY NARROWED THE LIST DOWN TO THE TOP THREE ISSUES TO FOCUS ON THAT WILL HAVE THE GREATEST POSSIBLE IMPACT ON COMMUNITY HEALTH STATUS. THE TOP THREE PRIORITIES ARE OBESITY, HEART DISEASE, AND DIABETES. THE FOLLOWING IS A LIST OF HEALTH NEEDS INDENTIFIED BY THE ASSESSMENT, BUT NOT INCLUDED AS ONE OF THE TOP THREE: - ACCESS TO PRIMARY CARE - AVOIDABLE ED VISITS - CANCER - INFANT MORTALITY - LACK OF HEALTH INSURANCE - MEDICATION COSTS - MENTAL HEALTH - SMOKING - SUBSTANCE ABUSE - WELLNESS ST. ELIZABETH HEALTHCARE WILL CONTINUE PROVIDING SERVICES TO SUPPORT THESE IMPORTANT COMMUNITY HEALTH NEEDS. THE FOLLOWING IS A SUMMARY OF MANY OF THE PROGRAMS THAT ARE ALREADY PROVIDED FOR EACH OF THE ISSUES IDENTIFIED: AVOIDABLE ED VISITS/ACCESS TO PRIMARY CARE - ESTABLISHING 100% OF ST. ELIZABETH PHYSICIAN PRACTICES AS CERTIFIED MEDICAL HOMES - DEVELOPING WALK-IN CLINICS AND URGENT CARE OPTIONS THROUGH ST. ELIZABETH PHYSICIANS - PROVIDING TRAINING AND CARE THROUGH THE FAMILY PRACTICE RESIDENCY PROGRAM - CONTINUING TO OFFER THE PARISH NURSING/HEALTH MINISTRY PROGRAM - RECRUITING ST. ELIZABETH HEALTHCARE MEDICAL SPECIALISTS AS IDENTIFIED - TREATING DENTAL PATIENTS NEEDING EMERGENT CARE IN THE EMERGENCY DEPARTMENT - PROVIDING CAB AND BUS VOUCHERS FOR PATIENTS CANCER - PROVIDING CANCER SCREENINGS, SUPPORT GROUPS AND BREAST CANCER NAVIGATORS - PROVIDING DRUG REPLACEMENT SERVICES CHEMOTHERAPY PROVIDED TO THOSE WHO ARE UNINSURED - PROVIDING MOBILE MAMMOGRAPHY VAN NO COST MAMMOGRAMS - OFFERING THE COOPER CLAYTON SMOKING CESSATION PROGRAM - DONATING FINANCIAL / OPERATIONAL SUPPORT TO SEVERAL COMMUNITY HEALTH IMPROVEMENT ORGANIZATIONS INFANT MORTALITY - OFFERING MATERNAL CHILD PROGRAMS: FIRST STEPS POINT OF ENTRY AND NURSE-FAMILY PARTNERSHIPS - PROVIDING OBSTETRICIANS TO HEALTHPOINT FOR PRENATAL CARE - ADMINISTERING IMMUNIZATIONS COCOONING PROJECT - OFFERING PRE-ADMISSION EDUCATION LACK OF HEALTH INSURANCE - SPONSORING A FINANCIAL ASSISTANCE PROGRAM - ASSISTING PATIENTS ELIGIBLE FOR GOVERNMENT PROGRAMS TO REGISTER FOR THOSE PROGRAMS, PLUS PROVIDES CHARITY CARE WHEN APPROPRIATE MEDICATION COSTS/ACCESS - PROVIDING MEDICATIONS UPON DISCHARGE FROM THE EMERGENCY DEPARTMENT OR INPATIENT AND REFERRAL TO ST. VINCENT DEPAUL PHARMACY MENTAL HEALTH - PROVIDING INPATIENT TREATMENT TO UNINSURED - PROVIDING MULTIPLE SUPPORT GROUPS FOR PATIENTS AND FAMILIES - WORKING WITH MENTAL HEALTH COURTS AND JAILS TO COORDINATE CARE - IMPLEMENTING TELEPSYCHIATRY IN THE EMERGENCY DEPARTMENT TO ASSESS MENTAL HEALTH PATIENTS WELLNESS - PROVIDING TO THE COMMUNITY NUMEROUS PROGRAMS ON VARIOUS HEALTH TOPICS AND SCREENINGS SUBSTANCE ABUSE - PROVIDING INPATIENT AND OUTPATIENT TREATMENT PROGRAMS FOR ADULTS - OFFERING 12-STEP PROGRAMS ON SITE BY COMMUNITY ORGANIZATIONS SMOKING CESSATIONS - ASSURING ALL OF ST. ELIZABETH HEALTHCARE CAMPUSES ARE SMOKE FREE - OFFERING COOPER CLAYTON SMOKING CESSATION CLASSES
For Paperwork Reduction Act Notice, see the Instructions for Form 990 or 990-EZ.
Cat. No. 51056K
Schedule O (Form 990 or 990-EZ) 2015


Additional Data


Software ID: 15000238
Software Version: 2015v2.1
SCHEDULE R
(Form 990)
Department of the Treasury
Internal Revenue Service
Related Organizations and Unrelated Partnerships
MediumBulletComplete if the organization answered "Yes" on Form 990, Part IV, line 33, 34, 35b, 36, or 37.
MediumBulletAttach to Form 990.
MediumBullet Information about Schedule R (Form 990) and its instructions is at www.irs.gov/form990.

OMB No. 1545-0047
2015
Open to Public Inspection
Name of the organization
St Elizabeth Medical Center Inc
 
Employer identification number

61-0445850
Part I
Identification of Disregarded Entities Complete if the organization answered "Yes" on Form 990, Part IV, line 33.
(a)
Name, address, and EIN (if applicable) of disregarded entity


(b)
Primary activity


 		(c)
Legal domicile (state
or foreign country)

 		(d)
Total income


 		(e)
End-of-year assets


 		(f)
Direct controlling
entity
(1) ST ELIZABETH PHYSICIAN SERVICES
334 THOMAS MORE PARKWAY STE 200
CRESTVIEW HILLS,KY41017
61-1339639 		PHYSICIAN MANAGEMENT SERVICES KY -100,241 4,045,433 ST ELIZABETH MEDICAL CENTER INC
 










Part II
Identification of Related Tax-Exempt Organizations Complete if the organization answered "Yes" on Form 990, Part IV, line 34 because it had one or more related tax-exempt organizations during the tax year.
(a)
Name, address, and EIN of related organization


(b)
Primary activity


 		(c)
Legal domicile (state
or foreign country)

 		(d)
Exempt Code section


 		(e)
Public charity status
(if section 501(c)(3))

 		(f)
Direct controlling
entity

 		(g)
Section 512(b)(13) controlled entity?
Yes No
(1)SUMMIT MEDICAL GROUP INC
334 THOMAS MORE PARKWAY STE 200

CRESTVIEW HILLS,KY41017
61-1300608 		PHYSICIAN PRACTICE KY 501(c)(3 3 ST ELIZABETH MEDICAL CENTER INC
 
Yes
 












For Paperwork Reduction Act Notice, see the Instructions for Form 990.
Cat. No. 50135Y
Schedule R (Form 990) 2015
Schedule R (Form 990) 2015
Page 2
Part III
Identification of Related Organizations Taxable as a Partnership Complete if the organization answered "Yes" on Form 990, Part IV, line 34 because it had one or more related organizations treated as a partnership during the tax year.
(a)
Name, address, and EIN of
related organization



 		(b)
Primary activity




 		(c)
Legal
domicile
(state or foreign
country)


 		(d)
Direct controlling
entity



 		(e)
Predominant income(related, unrelated, excluded from tax under sections 512-514)

(f)
Share of total income




 		(g)
Share of end-of-year
assets



 		(h)
Disproprtionate allocations?




 		(i)
Code V-UBI
amount in box 20 of
Schedule K-1
(Form 1065)
 		(j)
General or
managing
partner?



 		(k)
Percentage
ownership
Yes No Yes No
(1) Health Care Solutions Network LLC

619 Oak Street
Cincinnati,OH45206
47-2103334 		PHO OH HSN
  		Related -221,282 0   No   Yes   50 %












Part IV
Identification of Related Organizations Taxable as a Corporation or Trust Complete if the organization answered "Yes" on Form 990, Part IV, line 34 because it had one or more related organizations treated as a corporation or trust during the tax year.
(a)
Name, address, and EIN of
related organization
 		(b)
Primary activity
 		(c)
Legal
domicile
(state or foreign
country)
 		(d)
Direct controlling
entity
 		(e)
Type of entity
(C corp, S corp,
or trust) 		(f)
Share of total income
 		(g)
Share of end-of-year
assets
 		(h)
Percentage
ownership
 		(i)
Section 512(b)(13) controlled entity?
Yes No
(1) St Elizabeth Provider Network Inc

One Medical Village Dr
Edgewood,KY41017
47-2862438 		Physician-Hospital Org. KY St Elizabeth Medical Center Inc
  		C Corporation 0 475,942 100 % Yes  












Schedule R (Form 990) 2015
Schedule R (Form 990) 2015
Page 3
Part V
Transactions With Related Organizations Complete if the organization answered "Yes" on Form 990, Part IV, line 34, 35b, or 36.
Note. Complete line 1 if any entity is listed in Parts II, III, or IV of this schedule.
Yes
No
1 During the tax year, did the orgranization engage in any of the following transactions with one or more related organizations listed in Parts II-IV?
a Receipt of (i) interest, (ii) annuities, (iii) royalties, or (iv) rent from a controlled entity .....................
1a
 
No
b Gift, grant, or capital contribution to related organization(s) ............................
1b
 
No
c Gift, grant, or capital contribution from related organization(s) ............................
1c
 
No
d Loans or loan guarantees to or for related organization(s) ............................
1d
 
No
e Loans or loan guarantees by related organization(s) ............................
1e
 
No
f Dividends from related organization(s) ............................
1f
 
No
g Sale of assets to related organization(s) ............................
1g
 
No
h Purchase of assets from related organization(s) ............................
1h
 
No
i Exchange of assets with related organization(s) ............................
1i
 
No
j Lease of facilities, equipment, or other assets to related organization(s) .......................
1j
Yes
 
k Lease of facilities, equipment, or other assets from related organization(s) ......................
1k
Yes
 
l Performance of services or membership or fundraising solicitations for related organization(s) .....................
1l
Yes
 
m Performance of services or membership or fundraising solicitations by related organization(s) .................
1m
Yes
 
n Sharing of facilities, equipment, mailing lists, or other assets with related organization(s) ...................
1n
 
No
o Sharing of paid employees with related organization(s) ............................
1o
Yes
 
p Reimbursement paid to related organization(s) for expenses ............................
1p
Yes
 
q Reimbursement paid by related organization(s) for expenses ............................
1q
Yes
 
r Other transfer of cash or property to related organization(s) ............................
1r
Yes
 
s Other transfer of cash or property from related organization(s) ............................
1s
Yes
 
2
If the answer to any of the above is "Yes," see the instructions for information on who must complete this line, including covered relationships and transaction thresholds.
(a)
Name of related organization 		(b)
Transaction
type (a-s) 		(c)
Amount involved 		(d)
Method of determining amount involved
(1) St Elizabeth Provider Network

 L 478,874 Cash
(2) Summit Medical Group

 R 68,501,608 Cash
(3) Summit Medical Group

 M 705,451 Cash
(4) Summit Medical Group

 J 1,392,482 Cash
(5) Summit Medical Group

 O 5,931,897 Cash
(6) Summit Medical Group

 Q 190,157 Cash
Schedule R (Form 990) 2015
Schedule R (Form 990) 2015
Page 4
Part VI
Unrelated Organizations Taxable as a Partnership Complete if the organization answered "Yes" on Form 990, Part IV, line 37.
Provide the following information for each entity taxed as a partnership through which the organization conducted more than five percent of its activities (measured by total assets or gross revenue) that was not a related organization. See instructions regarding exclusion for certain investment partnerships.
(a)
Name, address, and EIN of entity 		(b)
Primary activity 		(c)
Legal domicile
(state or foreign
country) 		(d)
Predominant income (related, unrelated, excluded from tax under sections 512-514)

(e)
Are all partners
section
501(c)(3)
organizations? 		(f)
Share of total income




 		(g)
Share of
end-of-year
assets 		(h)
Disproprtionate allocations? 		(i)
Code V-UBI
amount in box 20
of Schedule K-1
(Form 1065) 		(j)
General or
managing
partner? 		(k)
Percentage
ownership
Yes No Yes No Yes No






























Schedule R (Form 990) 2015
Schedule R (Form 990) 2015
Page 5
Part VII
Supplemental Information
Provide additional information for responses to questions on Schedule R (see instructions).
Return Reference Explanation
Schedule R (Form 990) 2015

Additional Data


Software ID: 15000238
Software Version: 2015v2.1