Attach to Form 990 or 990-EZ.
Information about Schedule O (Form 990 or 990-EZ) and its instructions is at| Return Reference | Explanation |
|---|---|
| Form 990, Part III, Line 3 Significant changes in program services | In accordance with the procedures outlined in Trust Agreement, effective June 30, 2016, the officers of Hospital Sisters Health System authorized the termination of Hospital Sisters Health Care Plan Trust. |
| Form 990, Part VI, Line 15 PROCESS USED TO ESTABLISH COMPENSATION | THE TRUST DOES NOT HAVE COMPENSATED EMPLOYEES; THEREFORE, LINES 15A AND 15B HAVE BEEN ANSWERED "NO" IN ACCORDANCE WITH THE FORM 990 INSTRUCTIONS |
| Form 990, Part VI, Line 13 WHISTLEBLOWER POLICY | PROVISIONS WITHIN THE CORPORATE COMPLIANCE PROGRAM AND CONFLICT OF INTEREST POLICY PROVIDE PROTECTIONS FOR WHISTLEBLOWER TYPE ACTIVITIES. |
| Form 990, Part VI, Line 6 Classes of members or stockholders | See the narrative response for Form 990, Part VI, Line 7a |
| Form 990, Part VI, Line 7a Members or stockholders electing members of governing body | THE SENIOR GOVERNING BODY OF HSHS HEALTH CARE PLAN TRUST FUND (THE "TRUST") IS HOSPITAL SISTERS HEALTH SYSTEM ("HSHS"), AN ILLINOIS NOT FOR PROFIT CORPORATION EXEMPT FROM FEDERAL TAXATION UNDER SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE. THE TRUST DOES NOT HAVE A BOARD OF DIRECTORS. |
| Form 990, Part VI, Line 7b Decisions requiring approval by members or stockholders | MEMBER RESERVED POWERS RESPONSIBILITY FOR THE POLICY AND OPERATIONS OF HSHS HEALTH CARE PLAN TRUST FUND (THE "TRUST") IS VESTED IN HOSPITAL SISTERS HEALTH SYSTEM ("HSHS"), AN ILLINOIS NOT FOR PROFIT CORPORATION EXEMPT FROM FEDERAL TAXATION UNDER SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE. THE TRUST OPERATES IN ACCORDANCE WITH THE HOSPITAL SISTERS HEALTH SYSTEM HEALTH CARE TRUST AGREEMENT, DATED DECEMBER 8, 2008 ("AGREEMENT"). PURSUANT TO THE AGREEMENT, HOSPITAL SISTERS HEALTH SYSTEM, AN ILLINOIS NOT FOR PROFIT CORPORATION EXEMPT FROM FEDERAL TAXATION UNDER SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE ("HSHS") APPOINTS THE TRUSTEE, A BANK WHICH HOLDS, INVESTS, AND DISBURSES FUNDS FROM THE TRUST FUND; AND THE PLAN ADMINSISTRATOR, WHO IS A FIDUCIARY WHO CONTROLS AND MANAGES THE OPERATION AND ADMINISTRATION OF THE HEALTH CARE PLAN, AND APPOINTS THE INVESTMENT ADVISOR, WHO DIRECTS THE INVESTMENT OF THE TRUST FUND. HSHS AND THE TRUSTEE, PLAN ADMINISTRATOR, AND INVESTMENT ADVISOR ARE OBLIGATED TO PERFORM IN ACCORDANCE WITH THE AGREEMENT. |
| Form 990, Part VI, Line 8a Documentation of meetings held by governing body | THE SENIOR GOVERNING BODY OF HSHS HEALTH CARE PLAN TRUST FUND (THE "TRUST") IS HOSPITAL SISTERS HEALTH SYSTEM ("HSHS"), AN ILLINOIS NOT FOR PROFIT CORPORATION EXEMPT FROM FEDERAL TAXATION UNDER SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE. THE TRUST DOES NOT HAVE A BOARD OF DIRECTORS, OR COMMITTEE THEREOF, BY WHICH MEETINGS ARE HELD. |
| Form 990, Part VI, Line 8b Documentation of meetings held by committees of governing body | PLEASE SEE NARRATIVE FOR FORM 990, PART VI, SECTION B, LINE 8A. |
| Form 990, Part VI, Line 11b Review of form 990 by governing body | RESPONSIBILITY FOR THE POLICY AND OPERATIONS OF HSHS HEALTH CARE PLAN TRUST FUND (THE "TRUST") IS VESTED IN HOSPITAL SISTERS HEALTH SYSTEM ("HSHS"), AN ILLINOIS NOT FOR PROFIT CORPORATION EXEMPT FROM FEDERAL TAXATION UNDER SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE. HSHS EMPLOYS CROWE HORWATH TO ASSIST IN THE OVERALL PREPARATION, REVIEW AND ELECTRONIC SUBMISSION OF THE FORM 990. CROWE HORWATH PROVIDES GUIDANCE IN IDENTIFYING CRITICAL ERRORS IN THE RETURN SUBMISSION, AND FEEDBACK ON QUANTITATIVE AND QUALITATIVE RESPONSES. ADDITIONALLY, HSHS' CFO PERFORMS A THOROUGH REVIEW OF THE RETURN, AND REVIEWS IT WITH THE CEO, AND/OR SENIOR LEADERS, BEFORE PRESENTING IT IN ITS ENTIRETY TO HSHS' BOARD FOR QUESTIONING AND REVIEW PRIOR TO THE RETURN'S SIGNING AND SUBMISSION TO THE IRS. |
| Form 990, Part VI, Line 19 Required documents available to the public | BOARD-APPROVED FINANCIAL STATEMENTS ARE MADE AVAILABLE TO THE PUBLIC UPON REQUEST. THE TRUST FOLLOWS THE DOCUMENTS AND POLICIES OF HOSPITAL SISTERS HEALTH SYSTEM ("HSHS"), AN ILLINOIS NOT FOR PROFIT CORPORATION EXEMPT FROM FEDERAL TAXATION UNDER SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE. THESE POLICIES AND THE TRUST'S GOVERNING PLAN DOCUMENTS ARE NOT MADE AVAILABLE TO THE GENERAL PUBLIC AT THIS TIME. |
| Form 990, Part XI, Line 9 Other changes in net assets or fund balances | TRANSFER OF ASSETS TO HOSPITAL SISTERS SERVICES, INC. - -29302601; |
| Schedule O AFFILIATED HEALTH SYSTEM DISCLOSURE | HSHS HEALTH CARE PLAN TRUST FUND IS AN AFFILIATE OF HOSPITAL SISTERS HEALTH SYSTEM (HSHS), A HEALTH CARE MINISTRY THAT INCLUDES 15 HOSPITALS, NUMEROUS COMMUNITY-BASED HEALTH CENTERS AND CLINICS, AND HUNDREDS OF PHYSICIAN PARTNERS ACROSS ILLINOIS AND WISCONSIN. The mission of HSHS is "to reveal and embody Christ's healing love for all people through our high quality Franciscan health care ministry." We live our mission by providing holistic healing to all who seek our care, as well as through Community Benefit. In tandem with others in the communities we serve, our Community Benefit initiatives are strategically increasing access to care, improving the health status of residents, and increasing medical education and knowledge. In FY2016, our hospitals responded to the top needs identified in each of their most recent Community Health Needs Assessments (CHNAs). The information gathered from these assessments was used to develop or enhance Community Benefit programs and services to best address community health needs. Among the priority needs identified in the most recent CHNA process were access to care; alcohol, tobacco, and other drug abuse; chronic disease prevention and management; nutrition/wellness; mental health; and oral health. HSHS hospitals are proactively addressing these and other needs through patient, provider and community education, preventative screenings, self-management classes, and new or enhanced clinical services. In FY2016, HSHS collectively provided $203.8 million in Community Benefit (10.0% of total hospital expenses). This amount included $28.1 million provided for Financial Assistance (i.e. Charity Care) and $134.3 million for unreimbursed care provided as part of the Medicaid program. In addition, HSHS hospitals committed significant resources to treat Medicare patients. The cost of providing services to primarily elderly beneficiaries of the Medicare program - in excess of governmental and managed care contract payments - was $221.3 million. HSHS hospitals also recorded $31.4 million in uncollectible accounts. While HSHS does not count the latter two amounts as Community Benefit, they nonetheless reflect our commitment to serving all persons in need of care. In addition to the dollars invested in our Community Benefit programs, HSHS continues to reinvest any surplus revenue from operations and investments into new medical technology, facility infrastructure and health care services in our communities. By doing so, we ensure our ability to meet the ongoing demand for high quality, efficient and easily accessible health care. Improve access to health services As a Franciscan health care ministry, HSHS is deeply committed to serving those who are most in need with a special focus on the poor and vulnerable. We not only provide care to every patient who walks through our doors, but also reach out beyond the walls of our hospitals and clinics to care for those in our communities. Our efforts to ensure residents in the communities we serve receive the right care, at the right time, and in the right setting involve collaborating with others to achieve this goal. Across our two-state System, there are numerous examples of partnerships with departments of public health, other health care facilities and community and social service organizations to enhance access to care for those in need. In FY2016, HSHS and our 15 hospitals invested Community Benefit resources to educate the uninsured about new enrollment opportunities in affordable health care coverage and to facilitate the process. Studies have shown that people without insurance are more likely to postpone care and develop more severe and expensive conditions than their insured counterparts. It is for this reason that the Catholic Church, Catholic health care and HSHS have long promoted "coverage and access for all." HSHS and our 15 hospitals in partnership with local health departments, social service agencies and other health care providers played a vital role in educating eligible people in their local communities, by referring people to Certified Application Counselors and/or in enrolling them in the health insurance exchanges, or in securing coverage through Medicaid expansion. In southern Illinois, HSHS St. Elizabeth's Hospital in Belleville identified an education gap among newly insured patients. Although these patients now had health insurance, they did not know how to use insurance nor did they understand the many benefits that come with different plans. To bridge the gap, St. Elizabeth's Hospital hosted quarterly resource fairs in collaboration with other social service agencies in the community to not only educate the public about their health insurance benefits but also about other resources in the community that can improve their overall health and quality of life. More than 100 persons participated in the resource fairs and each received a healthy snack or hygiene kit. In response to its FY2015 CHNA, HSHS St. John's Hospital in Springfield, Illinois established a community health worker program to increase access to health care and coordination of care for residents of the Enos Park Neighborhood. The hospital also helped establish an Enos Park Neighborhood Advisory Council and Providers Alliance as part of the access collaborative to drive behavior changes and improve health outcomes. In the first year of the program, 103 clients were 100% engaged. Services provided included basic needs (70%) and health care access (30%). The access collaborative also placed 12 homeless individuals or families in affordable, safe housing in Enos Park. Of the 27 parolees we worked with, we realized an 18% recidivism rate compared to the national rate of 60% due to lack of housing or employment. One hundred percent of our clients visited a primary care provider and 84% connected to a medical home. Due to the program's initial success, it is being replicated in Sangamon County's eastside where our most poor and vulnerable populations live. HSHS St. Mary's Hospital Medical Center in Green Bay led the activities of the community Oral Health Task Force, which focuses on prevention, intervention and policy modification strategies to improve oral health in Brown County. In FY2016, St. Mary's Hospital helped to expand the services at NEW Community Clinic dental clinic by supporting their efforts to secure a HRSA grant for expansion by subsidizing the rent guarantee necessary and by assisting with the design cost for the center. The hospital also subsidized the cost of a staff person to obtain the necessary medical clearances and consent forms for patients, many of whom are elderly and/or disabled and need consent from guardians - thus supporting the oral surgeons who are providing their services free of charge. St. Mary's Hospital expanded oral health services for children by covering the costs of a dental hygienist employed by the Brown County Oral Health Partnership to offer oral health services in the Ashwaubenon school district. Through this new alliance, 79 students received oral health care that otherwise would have been difficult to obtain, including care for dental caries and abscesses. HSHS St. Francis Hospital in Litchfield, Illinois collaborated with Lewis & Clark Community College and local dental providers to bring the College's mobile dental health unit to the Litchfield area; the unit provides free or low cost dental exams and screenings, x-rays and hygiene services. In addition, three local dental providers also participated by opening their offices and donating time, staff and supplies to provide either a free filling, extraction or hygiene services. Beginning in 2015, the hospital collaborated with Catholic Charities to launch a dental voucher program. Five dentists in Macoupin and Montgomery counties participate in the program, which covers an initial exam and x-rays, one tooth extraction and up to three fillings per year per individual. The percentage of total emergency department visits related to dental issues decreased from 2.2 percent in 2011 to 1.27 percent in 2014 because of this collaboration. In southeast Illinois, area residents can get help filling a prescription through the long-term collaboration between HSHS St. Anthony's Memorial Hospital in Effingham and Catholic Charities. In FY2016, St. Anthony's Memorial Hospital helped to underwrite the cost of prescription medications for 518 residents. St. Anthony's Memorial Hospital and Catholic Charities believe no one should be without prescriptions because of the inability to pay. |
| Schedule O AFFILIATED HEALTH SYSTEM DISCLOSURE (CONTINUED A) | In southwest Illinois, HSHS St. Joseph's Hospital in Highland enhanced their offerings to their senior population based on their CHNA. "Senior Renewal" is an outpatient counseling program for senior adults who may be facing emotional and physical problems unique to the aging process such as feelings of loneliness, isolation and anxiety. Clients receive a comprehensive level of treatment without inpatient hospitalization through counseling strategies and education. In addition, St. Joseph's Hospital in collaboration with the Illinois Department of Insurance participates in the Senior Health Insurance Program (SHIP), a free health insurance counseling service for Medicare beneficiaries and their caregivers. In addition to programs designed to increase access to care, HSHS makes sure that those who need financial assistance receive it. HSHS's Financial Assistance (Charity Care) policy was modified effective January 1, 2014 to offer a 25 percent self-pay discount to all patients who register without insurance. HSHS Financial Assistance programs have a sliding scale, in some instances providing up to a 55 percent reduction off billed charges if an uninsured patient's family income level is determined to be above 500 percent but equal to our less than 600 percent of the current Federal Poverty Guidelines. HSHS hospitals waive all charges for patients below 200 percent of the Federal Poverty Levels. Counselors are available in our hospitals to explain our financial assistance policy to patients, provide them with assistance in filling out a simple application form, or help them enroll in publicly funded health care programs. Enhance community health As part of our mission to embody Christ's healing love for all people, we understand that we have a responsibility to improve the overall quality of life in our communities by supporting initiatives that promote health and wellness. We recognize we are most successful when we work together with a wide array of public and private organizations that share our commitment to improving lives. By doing so, we maximize our efforts and reduce the duplication of services. To ensure the health care needs of all are being met, HSHS hospitals also understand we need to listen closely to the residents of the communities we serve. In turn, 13 of our 15 hospitals completed Community Health Needs Assessments (CHNAs) in FY2015. HSHS St. Clare Memorial Hospital in Oconto Falls, Wisconsin, who affiliated with HSHS in September 2015, and HSHS Holy Family Hospital in Greenville, Illinois, who affiliated with HSHS in May 2016, both completed their CHNAs in FY2014. HSHS hospitals are using the information gathered from their most recent CHNAs to develop new, and enhance existing, programs and services that best address the needs of the community. Several priority areas were identified in the FY2015 CHNAs including access to health care services; alcohol, tobacco, and other drug abuse; chronic disease prevention and management; nutrition/wellness; mental health; and oral health. HSHS hospitals are addressing these and other needs by proactively offering educational opportunities, preventative screenings, and new or enhanced clinical services. In many cases, the hospitals collaborate with other hospital facilities, local departments of public health and community organizations to address identified needs. In western Wisconsin, HSHS Sacred Heart Hospital in Eau Claire and HSHS St. Joseph's Hospital in Chippewa Falls are taking the lead on programming to educate the public about mental health issues and treatment, the stigma associated with mental health, and the recognition of mental health issues. To combat the rising rate of suicides in the area, both hospitals under the umbrella of 3D Community Health are providing community education on QPR (Question, Persuade and Refer), an evidence-based suicide prevention program. In FY2016, 3D Community Health provided 37 adult QPR programs for 1,046 persons and 44 youth QPR programs for 1,161 high school students. In addition, 3D Community Health hosted a community forum to discuss the CHNA results and introduce QPR to 192 community members. HSHS St. Vincent Hospital in Green Bay collaborated with Prevea Health to implement the TIPS program, a program for non-violent opioid abusers that provides treatment and deferred/dismissed prosecution upon successful completion of the treatment program. St. Vincent Hospital also subsidized scholarships for a residential treatment program and arranged to have the first dose of Vivitrol donated; Vivitrol prevents relapse to opioid dependence after opioid detox by attaching to opioid receptors and blocking feelings of pain relief and wellbeing. HSHS St. Mary's Hospital in Decatur, Illinois joined the Macon County Mental Health Board to collaborate on existing programs and to provide resources to meet identified gaps. While other communities are cutting back on mental health services, St. Mary's Hospital remains committed to providing a full spectrum of behavioral health services for adolescents, adults and senior. For example, the hospital collaborates with the Decatur Public School District to provide school teachers for two hours per day for children in the adolescent behavioral health unit. The partnership limits the amount of schoolwork missed during hospitalization. The hospital also has substance abuse counselors who provide educational programs on alcohol and other drug abuse in county schools for students and faculty. HSHS St. Nicholas Hospital in Sheboygan identified nutrition and physical activity as a priority health need in its FY2015 CHNA. In response, St. Nicholas Hospital coordinated and supported the development of the "Double Your Bucks" program at the Sheboygan Farmers Market in FY2016 to enable EBT recipients to double the amount of fresh fruits and vegetables they can purchase. The hospital is also a sponsor of the Sheboygan Farmers Market to promote healthy eating in the community. Additionally, St. Nicholas subsidized the cost of additional bike helmets at the Early Learning Center to increase the physical activity levels of Head Start students and purchased culinary equipment for South High School nutrition and fitness classes to increase opportunities for students to learn how to prepare healthy food. HSHS St. Mary's Hospital in Streator, Illinois collaborated with two local schools to establish community gardens on each of their campuses to address childhood obesity in addition to the community garden on the hospital campus. Students, their families, and hospital colleagues planted, tended and harvested the gardens. Math and science teachers incorporated the gardens into their curricula. Neither school offered Home Economics classes, so St. Mary's Hospital provided the produce and colleagues to offer cooking demonstrations in the classrooms to encourage students to prepare fresh fruit and vegetables snacks. The three gardens produced more than 1,713 pounds of produce in three years, which was donated to the local food pantry, Salvation Army, students and local churches providing healthy food to the poor and vulnerable. Advance medical knowledge HSHS works to advance medical knowledge by supporting research initiatives and educational opportunities. In FY2016, HSHS hospitals and affiliated physician groups contributed more than $19.1 million toward research and education. Highlights of this commitment include subsidizing medical school residency programs, offering ongoing medical education to physicians and clinicians, and providing job shadowing programs for high school students. In southern Illinois, HSHS St. Joseph's Hospital in Breese, hosted members of the Health Occupations Students of America onsite to learn about job opportunities in health care from health care professionals. St. Joseph's also provided clinical experience for Kaskaskia College students enrolled in nursing, physical therapy and radiology programs. Pharmacy students have also completed their clinical training at St. Joseph's Hospital. In FY2016, the program served more than 100 students. In FY2016, HSHS St. Mary's Hospital Medical Center and HSHS St. Vincent Hospital in Green Bay invested more than $311,000 to provide onsite training and education of nurses and allied health professionals. In addition, the hospitals have been collaborating with the Medical College of Wisconsin to establish a community medical education program in Green Bay and to provide financial support to offset operating costs in FY2016. Also in eastern Wisconsin, HSHS St. Clare Memorial Hospital in Oconto Falls provided training for local paramedics and emergency response personnel through the hospital's EMS liaison program. |
| Schedule O Affiliated Health System Disclosure (Continued B) | Mission-driven and strategically implemented Community Benefit is an integral part of Hospital Sisters Health System's Mission. Our commitment to Community Benefit arises from our Catholic identity, Mission and Core Values shared by 14,000 colleagues across Illinois and Wisconsin. Through our work to improve access to health care services, enhance community health, advance medical knowledge, and relieve or reduce the burden of government, we believe we have made a positive difference in the quality of lives of tens of thousands of people in Illinois and Wisconsin in FY2016. As a Catholic health care ministry, HSHS is concerned with the dignity of all persons, the common good, and the stewardship of resources. We advocate for health care for all and work to improve social conditions that lead to improved health and well-being. We engage partners in our communities to improve health and quality of life and to reduce duplication. Working side by side with many faith communities, HSHS remains dedicated to our common purpose of compassionate care for all people. |
| Software ID: | 15000238 |
| Software Version: | 2015v3.0 |