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 Go to www.irs.gov/Form990 for instructions and the latest information.
OMB No. 1545-0047
2018
Open to Public Inspection
A For the 2019 calendar year, or tax year beginning 07-01-2018 , and ending 06-30-2019
BCheck if applicable:
CName of organization
St Elizabeth's Hospital of the Hospital Sisters of the Third Order of St Fr
ancis
 
Doing business as
 
 
Number and street (or P.O. box if mail is not delivered to street address)
One St Elizabeths Blvd
 
Room/suite
City or town, state or province, country, and ZIP or foreign postal code
OFallon, IL62269
D Employer identification number

37-0663567
E Telephone number

G Gross receipts $ 213,703,540
F Name and address of principal officer:
Patricia Fischer CEO
One St Elizabeths Blvd
OFallon,IL62269
I
Tax-exempt status: (   ) LeftBullet (insert no.) or
J
Website:MediumBullet
WWW.STELIZ.ORG
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 MediumBullet0928
K Form of organization:  
L Year of formation: 1875
M State of legal domicile: IL
Part I
Summary
Activities & Governance 1 Briefly describe the organization’s mission or most significant activities: TO REVEAL AND EMBODY CHRIST'S HEALING LOVE FOR ALL PEOPLE THROUGH OUR HIGH QUALITY FRANCISCAN HEALTH CARE MINISTRY.
2 Check this box MediumBullet
3 Number of voting members of the governing body (Part VI, line 1a) ........ 3 14
4 Number of independent voting members of the governing body (Part VI, line 1b) ..... 4 11
5 Total number of individuals employed in calendar year 2018 (Part V, line 2a) ...... 5 1,621
6 Total number of volunteers (estimate if necessary) ............. 6 207
7a Total unrelated business revenue from Part VIII, column (C), line 12 ........ 7a 19,209
b Net unrelated business taxable income from Form 990-T, line 34 ......... 7b 3,222
Revenues Prior Year Current Year
8 Contributions and grants (Part VIII, line 1h) ......... 5,210,380 1,515,031
9 Program service revenue (Part VIII, line 2g) ......... 180,118,370 210,698,748
10 Investment income (Part VIII, column (A), lines 3, 4, and 7d ) .... 870,469 -1,204,992
11 Other revenue (Part VIII, column (A), lines 5, 6d, 8c, 9c, 10c, and 11e) 360,747 513,167
12 Total revenue—add lines 8 through 11 (must equal Part VIII, column (A), line 12) 186,559,966 211,521,954
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) 69,658,294 80,392,634
16a Professional fundraising fees (Part IX, column (A), line 11e) .....   0
b Total fundraising expenses (Part IX, column (D), line 25) MediumBullet0    
17 Other expenses (Part IX, column (A), lines 11a–11d, 11f–24e).... 154,449,261 154,350,047
18 Total expenses. Add lines 13–17 (must equal Part IX, column (A), line 25) 224,107,555 234,742,681
19 Revenue less expenses. Subtract line 18 from line 12....... -37,547,589 -23,220,727
Net Assets or Fund Balances; Beginning of Current Year End of Year
20 Total assets (Part X, line 16)............. 314,049,704 309,787,819
21 Total liabilities (Part X, line 26)............. 511,126,166 567,376,527
22 Net assets or fund balances. Subtract line 21 from line 20..... -197,076,462 -257,588,708
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 (2018)
Form 990 (2018)
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: SEE SCHEDULE O
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 $ 58,620,177 including grants of $ 0 ) (Revenue $ 53,504,423 )
Cardiac Services: HSHS St. Elizabeth's Hospital provides comprehensive cardiovascular services from diagnosis to surgery to rehabilitation and wellness. HSHS St. Elizabeth's is accredited by the Society of Chest Pain Centers, a professional organization focused on improving care for patients with acute coronary syndromes and teaching the public to recognize and react to the early symptoms of a possible heart attack. HSHS St. Elizabeth's, in partnership with Prairie Heart and Vascular Institute, continues to add envelope-pushing technologies and new procedures to lead the region in heart care, including TAVR (trans aortic valve replacement). TAVR makes it possible to replace an aortic valve without opening the patient's chest. In this minimally invasive procedure, a tube is simply inserted in the groin and routed to the aorta for the valve replacement. Prairie also brought the world's smallest pacemaker, the Micra TPS, and the CardioMEMS monitoring system for heart failure patients to the region over the past year. The Electrophysiology Lab is outfitted with a low radiation dose Bi-Plane angio suite where complicated procedures can be performed to treat a full spectrum of heart arrhythmias and implant cardiac devices to serve patients with irregular heartbeats. Other services provided include cardiac catheterization, stent placement, stress testing, pacemaker, implantable cardioverter defibrillator (ICD), electrocardiography, coronary artery bypass graft (open heart) surgery and cardiac rehabilitation. During FY 2019, HSHS St. Elizabeth's Hospital had 9,393 cardiac cases.
4b (Code:   ) (Expenses $ 51,266,676 including grants of $ 0 ) (Revenue $ 40,416,996 )
Surgical Services: HSHS St. Elizabeth's Hospital's state-of-the-art hospital provides the newest and most advanced equipment and integrated technologies. The new building also allows for future medical innovations and easy upgrades in technology. With highly-trained and experienced surgeons on staff, numerous surgical and non-surgical procedures are offered in a wide range of specialties, including: cardiothoracic, orthopedic, plastic surgery, neurosurgery, podiatry and more. The hospital has nine Operating Rooms plus an advanced Hybrid OR. Another feature is Computerized Integrated Surgery, which is a sophisticated platform that allows physicians to remotely connect through tele-surgical technology to specialized physicians during surgery for consults, assistance and education. The in-house surgical team can tele-communicate in real time through the in-light camera to a specialist to address the issue at that moment, saving time and eliminating the need for additional surgeries. The Hybrid Operating Room is a surgical theater equipped with technologically advanced imaging equipment used in high-intensity procedures, such as neurosurgeries, vascular procedures and everything in between. These imaging devices also enable minimally-invasive procedures which require imaging techniques that can visualize smaller body parts such as thin vessels in the heart muscle. Utilizing our Hybrid OR directly impacts patient safety, because everything can occur in one room - emergencies or complications can be handled in one spot without putting a patient's safety at risk to move to another operating room. During FY 2019, HSHS St. Elizabeth's Hospital had 4,632 cases.
4c (Code:   ) (Expenses $ 26,461,272 including grants of $ 0 ) (Revenue $ 27,884,814 )
Emergency Services: HSHS St. Elizabeth's Hospital Emergency Department is open around the clock to treat serious injuries or dangerous symptoms. In an emergency, seconds matter. HSHS St. Elizabeth's relationship with local EMS teams in the field allows special alert processes for heart attack and stroke to be activated so patients can be seen quickly at our facility. Our emergency department staff includes doctors, nurses and technicians who are specially trained in caring for patients facing life-threatening and other emergency situations. Vituity provides physician management and expertise in providing high-quality care. With leading edge technology at our fingertips, we can process x-rays, CT scans and other diagnostic tests accurately and quickly, allowing faster diagnosis and treatment in a wide range of other areas, including: stroke, heart attack, shortness of breath, motor vehicle and other accidents, broken bones, abdominal pain, lacerations, and mental health problems. In FY19, HSHS St. Elizabeth's Hospital Emergency Department had 37,270 visits and admitted 4,957 to inpatient services. The Urgicare Center in O'Fallon, an offsite facility, had 23,846 visits.
(Code:   ) (Expenses $ 48,620,599 including grants of $ 0 ) (Revenue $ 88,892,515 )
Other Health Care Services: HSHS St. Elizabeth's Hospital delivers a comprehensive array of healthcare services to both inpatients and outpatients. It is our mission to serve the sick, especially the poor, with quality healthcare services and healthcare education. Our accredited programs have consistently demonstrated quality outcomes that positively impact our patients, their families and the entire community. We provide quality medical healthcare regardless of race, creed, sex, national origin, handicap, age, or ability to pay. The recently opened HSHS St. Elizabeth's Hospital fulfills our health care Mission through advanced technologies, professional, skilled and compassionate caregivers, and the highest level of quality service. Our new hospital and physicians' office building opened in November 2017 to offer our patients the highest quality care in a new, comfortable and healing setting. The healing environment combines the newest technology and efficiencies to provide region leading, high-quality care. We offer state-of-the-art technologies that provide advanced services in surgery, medical imaging, laboratory, physical therapy and the emergency department, just to name a few. With 144 all private patient rooms, efficiently designed clinical areas, which allow nurses to spend more time with their patients at the bedside, and the deluxe amenities offered in our Women and Infants Center, our staff continues to deliver the difference in quality, safe care. We also proudly partner with top providers such as HSHS Medical Group, Prairie Heart & Vascular Institute, SSM Health Cardinal Glennon, Vituity and SLU Family Medicine Residency Program. Our main service lines continue to grow to provide high-quality procedures close to home. In addition to the hospital itself, HSHS St. Elizabeth's also continues to serve the Belleville community through HSHS St. Elizabeth's Belleville Health Center, located in downtown Belleville at 180 S. Third Street, Belleville. The convenient, outpatient services available at this location include: physical and occupational therapy, laboratory, x-ray and 3D mammography services, a walk-in clinic and physician offices. HSHS St. Elizabeth's Hospital currently staffs 144 inpatient beds. The hospital employs 1,621 colleagues. Inpatient admissions for Fiscal Year 2019 were 9,484. Total Outpatient visits for the hospital were 175,138.
4d Other program services (Describe in Schedule O.)
(Expenses $ 48,620,599 including grants of $   ) (Revenue $ 88,892,515 )
4e Total program service expensesMediumBullet184,968,724
Form 990 (2018)
Form 990 (2018)
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
 
 
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 IIIClick to see attachment.............
8
Yes
 
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 VII.......
11b
 
No
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.........
14b
 
No
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) ....
17
 
No
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............
18
 
No
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...................
19
 
No
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
 
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
Form 990 (2018)
Form 990 (2018)
Page 4
Part IV
Checklist of Required Schedules (continued)
Yes
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...............
24a
 
No
b
Did the organization invest any proceeds of tax-exempt bonds beyond a temporary period exception?...
24b
 
 
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
 
 
d
Did the organization act as an "on behalf of" issuer for bonds outstanding at any time during the year?...
24d
 
 
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
 
No
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 ...
35b
 
 
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
 
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
862
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
 
Form 990 (2018)
Form 990 (2018)
Page 5
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
1,621
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
 
No
b
If "Yes," did the organization notify the donor of the value of the goods or services provided? .....
7b
 
 
c
Did the organization sell, exchange, or otherwise dispose of tangible personal property for which it was required to file Form 8282? .........................
7c
Yes
 
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
 
 
15
Is the organization subject to the section 4960 tax on payment(s) of more than $1,000,000 in remuneration or excess parachute payment(s) during the year? If "Yes," see instructions and file Form 4720, Schedule N .....
15
 
No
16
Is the organization an educational institution subject to the section 4968 excise tax on net investment income?
If "Yes," complete Form 4720, Schedule O ................
16
 
No
Form 990 (2018)
Form 990 (2018)
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
14
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
11
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
 
No
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
Yes
 
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
Yes
 
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
18
Section 6104 requires an organization to make its Form 1023 (or 1024-A 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:
MediumBulletDavid NosackaOne St Elizabeths Blvd   OFallon,IL62269 (618) 234-2120
Form 990 (2018)
Form 990 (2018)
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) PATRICIA FISCHER
 
PRESIDENT & CEO
 40.0
.................
0.0 		X   X       0 463,140 63,132
(2) JAMES DOVER
 
Interim Pres/ CEO SOUTHERN IL DIV - Thru June 2019
 26.0
.................
34.0 		X   X       0 627,463 125,470
(3) STEPHANIE STRANO-MAINE
 
2018 Secretary & 2019 Chair
 1.0
.................
0 		X   X       0 0 0
(4) REV JAMES DEITERS
 
2018 Chair
 1.0
.................
1.0 		X   X       0 0 0
(5) RICHARD J THOMAN
 
2018 & 2019 VICE CHAIR
 1.0
.................
0 		X   X       0 0 0
(6) THOMAS DINGES
 
2019 Secretary
 1.0
.................
0 		X   X       0 0 0
(7) DAVID BEACH
 
BOARD MEMBER
 1.0
.................
59.0 		X           0 424,615 85,521
(8) LORRAINE CAVATAIO
 
BOARD MEMBER
 1.0
.................
0 		X           0 0 0
(9) JIM CLANAHAN MD
 
BOARD MEMBER
 1.0
.................
0 		X           0 0 0
(10) JACQUELYN M CLEMENT PHD
 
BOARD MEMBER
 1.0
.................
0 		X           0 0 0
(11) SR Margurite Cook OSF
 
Board Member
 1.0
.................
0 		X           0 0 0
(12) Georgia Costello
 
Board Member
 1.0
.................
0 		X           0 0 0
(13) Michael Hall
 
BOARD MEMBER
 1.0
.................
0 		X           0 0 0
(14) SR Helen Marie Plummer OSF
 
BOARD MEMBER
 1.0
.................
2.0 		X           0 0 0
(15) DAVID NOSACKA
 
CFO Southern IL Division
 23.0
.................
37.0 		    X       358,453 0 52,011
(16) ANN M CARR
 
TREASURER
 0.3
.................
59.7 		    X       0 329,829 110,463
(17) ELIZABETH GOVERO
 
CHIEF NURSING OFFICER
 60.0
.................
30.0 		    X       161,924 0 58,480
Form 990 (2018)
Form 990 (2018)
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) MATTHEW BRANDT
 
Director of Finance
 40.0
.......................0 		    X       148,393 0 11,854
(19) Vinay Bhooma
 
CHIEF MEDICAL OFFICER (begin 4/2019)
 60.0
.......................0 		    X       0 0 0
(20) MARGARET A LUNA
 
CHIEF PEOPLE OFFICER SOUTHERN IL DIVISION
 29.0
.......................4.2 		      X     261,775 0 79,409
(21) AMY M BALLANCE
 
VP BUSINESS DEVELOPMENT SOUTHERN IL DIVISION
 29.0
.......................7.8 		      X     235,605 0 62,543
(22) SUSAN M HOLLOWAY
 
PROJECT MANAGER, NEW CONSTRUCTION
 60.0
.......................0 		      X     192,222 0 67,647
(23) JACQUELYNNE N HOLST
 
VP LEGAL AFFAIRS SOUTHERN IL DIVISION / HSHS ASSOCIATE GENERAL COUNSEL
 29.0
.......................7.8 		        X   198,903 0 44,598
(24) LINDA SUTTERER
 
RN - FIRST ASSIST
 40.0
.......................0 		        X   174,554 0 60,517
(25) JULIA K SCHIMMELPFENNIG
 
DIRECTOR OF PHARMACY
 60.0
.......................0 		        X   164,435 0 24,732
(26) COREY J HASTINGS
 
DIRECTOR OF FINANCE SOUTHERN IL DIVISION
 29.0
.......................0 		        X   161,140 0 34,099
(27) Scott A Berry
 
DIVISION DIRECTOR OF ONCOLOGY
 40.0
.......................0 		        X   158,791 0 24,569
(28) GARY A HAGENS
 
FORMER CHIEF MEDICAL OFFICER
 60.0
.......................0 		          X 365,430 0 9,071
(29) Peggy Sebastian
 
FORMER PRESIDENT & CEO
 0.0
.......................0.0 		          X 0 455,700 9,261


1b Sub-Total................MediumBullet
c Total from continuation sheets to Part VII, Section A....MediumBullet
d Total (add lines 1b and 1c)...........MediumBullet 2,581,625 2,300,747 923,377
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 MediumBullet93
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
 
No
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
AHRENS CONTRACTING INC

140 LAFAYETTE AVE
ST LOUIS,MO63104 		CONSTRUCTION SERVICES 9,826,436
MCCARTHY BUILDING COMPANIES INC

1341 NORTH ROCK NILL ROAD
ST LOUIS,MO63124 		CONSTRUCTION SERVICES 5,489,929
CEP AMERICA

2100 POWELL ST
SUITE 900
EMERYVILLE,CA94608 		HOSPITALIST-INTENSIVIST-ER SERVICES 3,785,261
PROFESSIONAL THERAPY SERVICES

2810 FRANK SCOTT PARK WAY W
BELLEVILLE,IL622238506 		THERAPY SERVICES 3,288,296
FOCUSONE SOLUTIONS

13609 CALIFORNIA ST
OMAHA,NE681545260 		CONTRACT CLINICAL STAFFING 2,182,323
2
Total number of independent contractors (including but not limited to those listed above) who received more than $100,000 of compensation from the organization MediumBullet59
Form 990 (2018)
Form 990 (2018)
Page 9
Part VIII
Statement of Revenue
Check if Schedule O contains a response or note to any line in this Part VIII.............
(A)
Total revenue 		(B)
Related or
exempt
function
revenue 		(C)
Unrelated
business
revenue 		(D)
Revenue
excluded from
tax under sections
512 - 514
Contributions, Gifts, GrantAmt and OtherAmt Similar Amounts 1a Federated campaigns..1a  
b Membership dues..1b  
c Fundraising events..1c  
d Related organizations1d 1,515,031
e Government grants (contributions)1e  
f All other contributions, gifts, grants, and similar amounts not included above1f  
g Noncash contributions included in lines 1a - 1f:$ 1,462,000
h Total. Add lines 1a-1f.......MediumBullet 1,515,031
Program Service RevenueAmt Business Code
2a Net Patient Revenue 621990 209,923,704 209,923,704    
b Oncology Center 621999 410,000 410,000    
c Health Programs 621999 3,184 3,184    
d Rental Income-Affiliates 531120 361,860 361,860    
e
f All other program service revenue. 0 0 0 0
g Total. Add lines 2a–2f ....MediumBullet 210,698,748
OtherAmtRevenueAmt 3 Investment income (including dividends, interest, and othersimilar amounts) ......MediumBullet -41,946     -41,946
4 Income from investment of tax-exempt bond proceedsMediumBullet        
5 Royalties...........MediumBullet        
(ii) Personal (i) Real
6a Gross rents   974,327
b Less: rental expenses   929,116
c Rental income or (loss) 0 45,211
d Net rental income or (loss)......MediumBullet 45,211     45,211
(ii) Other (i) Securities
7a Gross amount from sales of assets other than inventory   89,424
b Less: cost or other basis and sales expenses   1,252,470
c Gain or (loss) 0 -1,163,046
d Net gain or (loss).....MediumBullet -1,163,046     -1,163,046
8a Gross income from fundraising events (not including $   of contributions reported on line 1c). See Part IV, line 18 ....
a  
b Less: direct expenses ...b  
c Net income or (loss) from fundraising events..MediumBullet      
9a Gross income from gaming activities.
See Part IV, line 19 ...
a  
b Less: direct expenses ...b  
c Net income or (loss) from gaming activities..MediumBullet        
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 Outside Services 900099 435,710     435,710
b Insurance Captive Distrib. 900099 12,993     12,993
c Laundry Services 812300 19,209   19,209  
d All other revenue .... 44 0 0 44
e Total. Add lines 11a–11d ...... MediumBullet 467,956
12 Total revenue. See Instructions......MediumBullet 211,521,954 210,698,748 19,209 -711,034
Form 990 (2018)
Form 990 (2018)
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 domestic individuals. See Part IV, line 22    
3 Grants and other assistance to foreign organizations, foreign governments, and foreign individuals. See Part IV, line 15 and 16.    
4 Benefits paid to or for members    
5 Compensation of current officers, directors, trustees, and key employees .... 1,858,870 568,411 1,290,459  
6 Compensation not included above, to disqualified persons (as defined under section 4958(f)(1)) and persons described in section 4958(c)(3)(B) .... 257,244 257,244    
7 Other salaries and wages 61,977,670 53,200,261 8,777,409  
8 Pension plan accruals and contributions (include section 401(k) and 403(b) employer contributions) .... -353,322 -303,284 -50,038  
9 Other employee benefits ....... 11,403,892 9,788,849 1,615,043  
10 Payroll taxes ........... 5,248,280 4,505,007 743,273  
11 Fees for services (non-employees):        
a Management ......        
b Legal ......... -1,257,046   -1,257,046  
c Accounting ...........        
d Lobbying ...........        
e Professional fundraising services. See Part IV, line 17    
f Investment management fees ......        
g Other (If line 11g amount exceeds 10% of line 25, column (A) amount, list line 11g expenses on Schedule O) 57,896,681 39,967,082 17,929,599 0
12 Advertising and promotion .... 1,167,460   1,167,460  
13 Office expenses ....... 629,184 400,049 229,135  
14 Information technology ...... 12,575,940   12,575,940  
15 Royalties ..        
16 Occupancy ........... 5,594,137 5,594,137    
17 Travel ............ 456,921 165,382 291,539  
18 Payments of travel or entertainment expenses for any federal, state, or local public officials .        
19 Conferences, conventions, and meetings .... 49,287 28,944 20,343  
20 Interest ........... 4,208,731 4,199,029 9,702  
21 Payments to affiliates .......        
22 Depreciation, depletion, and amortization .. 15,652,494 10,615,335 5,037,159  
23 Insurance ... 3,545,880 3,545,880    
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 36,170,467 36,150,226 20,241  
b Provision for uncollectible accounts 3,559,678 3,559,678    
c License & Taxes 8,922,307 8,768,979 153,328  
d Maintenance & Repairs 3,327,253 3,155,587 171,666  
e All other expenses 1,850,673 801,928 1,048,745 0
25 Total functional expenses. Add lines 1 through 24e 234,742,681 184,968,724 49,773,957 0
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 (2018)
Form 990 (2018)
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 ........   1  
2 Savings and temporary cash investments ......... 7,984,036 2 1,200,037
3 Pledges and grants receivable, net ...... 3,315,886 3 4,023,400
4 Accounts receivable, net ............. 31,729,958 4 41,453,637
5 Loans and other receivables from current and former officers, directors, trustees, key employees, and highest compensated employees. Complete Part II of Schedule L .............
0 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 ..............
0 6 0
7 Notes and loans receivable, net ....   7  
8 Inventories for sale or use ........ 3,154,907 8 4,824,226
9 Prepaid expenses and deferred charges ...... 886,028 9 1,488,952
10a Land, buildings, and equipment: cost or other basis. Complete Part VI of Schedule D 10a 324,692,999
b Less: accumulated depreciation 10b 75,601,691 261,078,495 10c 249,091,308
11 Investments—publicly traded securities . 3,433,171 11 4,239,036
12 Investments—other securities. See Part IV, line 11 ..... 0 12  
13 Investments—program-related. See Part IV, line 11 .. 2,467,223 13 2,467,223
14 Intangible assets ............... 0 14 1,000,000
15 Other assets. See Part IV, line 11 ........... 0 15 0
16 Total assets. Add lines 1 through 15 (must equal line 34)... 314,049,704 16 309,787,819
Liabilities 17 Accounts payable and accrued expenses ..... 36,807,973 17 32,565,133
18 Grants payable ...   18  
19 Deferred revenue .........   19  
20 Tax-exempt bond liabilities ......... 451,491,416 20 499,738,814
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.. 0 22 0
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 22,826,777 25 35,072,580
26 Total liabilities. Add lines 17 through 25.. 511,126,166 26 567,376,527
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 -203,492,283 27 -264,058,508
28 Temporarily restricted net assets ........... 5,991,609 28 6,041,879
29 Permanently restricted net assets 424,212 29 427,921
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 ........... -197,076,462 33 -257,588,708
34 Total liabilities and net assets/fund balances ........ 314,049,704 34 309,787,819
Form 990 (2018)
Form 990 (2018)
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
211,521,954
2
Total expenses (must equal Part IX, column (A), line 25) ............
2
234,742,681
3
Revenue less expenses. Subtract line 2 from line 1 ..............
3
-23,220,727
4
Net assets or fund balances at beginning of year (must equal Part X, line 33, column (A)) ..
4
-197,076,462
5
Net unrealized gains (losses) on investments ...............
5
55,748
6
Donated services and use of facilities .................
6
 
7
Investment expenses .....................
7
 
8
Prior period adjustments .....................
8
1
9
Other changes in net assets or fund balances (explain in Schedule O) ........
9
-37,347,268
10
Net assets or fund balances at end of year. Combine lines 3 through 9 (must equal Part X, line 33, column (B))
10
-257,588,708
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
Yes
 
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
Yes
 
Form 990 (2018)
Form 990 (2018)
Additional Data


Software ID: 18007697
Software Version: 2018v3.1
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 Go to www.irs.gov/Form990 for the latest information.
OMB No. 1545-0047
2018
Open to Public
Inspection
Name of the organization
St Elizabeth's Hospital of the Hospital Sisters of the Third Order of St Fr
ancis
Employer identification number

37-0663567
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 12, check only one box.)
1
2
3
4
5
6
7
8
9

10
11
12
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- 10 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) 2018

Schedule A (Form 990 or 990-EZ) 2018
Page 2
Part II
Support Schedule for Organizations Described in Sections 170(b)(1)(A)(iv), 170(b)(1)(A)(vi), and 170(b)(1)(A)(ix)
(Complete only if you checked the box on line 5, 7, 8, or 9 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) 2014 (b) 2015 (c) 2016 (d) 2017 (e) 2018 (f) Total
1 Gifts, grants, contributions, and membership fees received. (Do not include any "unusual grant.") ..            
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) 2014 (b) 2015 (c) 2016 (d) 2017 (e) 2018 (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) 2018

Schedule A (Form 990 or 990-EZ) 2018
Page 3
Part III
Support Schedule for Organizations Described in Section 509(a)(2)
(Complete only if you checked the box on line 10 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) 2014 (b) 2015 (c) 2016 (d) 2017 (e) 2018 (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) 2014 (b) 2015 (c) 2016 (d) 2017 (e) 2018 (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) 2018

Schedule A (Form 990 or 990-EZ) 2018
Page 4
Part IV
Supporting Organizations
(Complete only if you checked a box on line 12 of Part I. If you checked 12a of Part I, complete Sections A and B. If you checked 12b of Part I, complete Sections A and C. If you checked 12c of Part I, complete Sections A, D, and E. If you checked 12d 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 12a or 12b 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) 2018

Schedule A (Form 990 or 990-EZ) 2018
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) 2018

Schedule A (Form 990 or 990-EZ) 2018
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) 2018

Schedule A (Form 990 or 990-EZ) 2018
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 2018 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-2018 		(iii)
Distributable
Amount for 2018
1 Distributable amount for 2018 from Section C, line
6 		 
2 Underdistributions, if any, for years prior to 2018 (reasonable cause required-- explain in Part VI).
See instructions.		  
3 Excess distributions carryover, if any, to 2018:
a From 2013.......  
b From 2014.......  
c From 2015.......  
d From 2016.......  
e From 2017.......  
fTotal of lines 3a through e  
g Applied to underdistributions of prior years  
h Applied to 2018 distributable amount  
i Carryover from 2013 not applied (see
instructions) 		 
j Remainder. Subtract lines 3g, 3h, and 3i from 3f.  
4Distributions for 2018 from Section D, line 7:
$  
a Applied to underdistributions of prior years  
b Applied to 2018 distributable amount  
c Remainder. Subtract lines 4a and 4b from 4.  
5 Remaining underdistributions for years prior to
2018, if any. Subtract lines 3g and 4a from line 2.
If the amount is greater than zero, explain in Part VI.
See instructions.		  
6 Remaining underdistributions for 2018. Subtract
lines 3h and 4b from line 1. If the amount is greater
than zero, explain in Part VI. See instructions.		  
7 Excess distributions carryover to 2019. Add lines
3j and 4c.		  
8 Breakdown of line 7:
a Excess from 2014......  
b Excess from 2015.....  
c Excess from 2016.....  
d Excess from 2017.....  
e Excess from 2018.....  
Schedule A (Form 990 or 990-EZ) (2018)

Schedule A (Form 990 or 990-EZ) 2018
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) 2018


Additional Data


Software ID: 18007697
Software Version: 2018v3.1
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 Go to www.irs.gov/Form990 for the latest information.
OMB No. 1545-0047
2018
Name of the organization
St Elizabeth's Hospital of the Hospital Sisters of the Third Order of St Fr
ancis
Employer identification number

37-0663567
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 isn't covered by the General Rule and/or the Special Rules doesn't 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 doesn't 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) (2018)
Schedule B (Form 990, 990-EZ, or 990-PF) (2018) Page 2
Name of organization
St Elizabeth's Hospital of the Hospital Sisters of the Third Order of St Fr
ancis 		Employer identification number
37-0663567
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) (2018)
Schedule B (Form 990, 990-EZ, or 990-PF) (2018)
Page 3
Name of organization
St Elizabeth's Hospital of the Hospital Sisters of the Third Order of St Fr
ancis 		Employer identification number

37-0663567
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) (2018)
Schedule B (Form 990, 990-EZ, or 990-PF) (2018)
Page 4
Name of organization
St Elizabeth's Hospital of the Hospital Sisters of the Third Order of St Fr
ancis 		Employer identification number

37-0663567
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) (2018)

Additional Data


Software ID: 18007697
Software Version: 2018v3.1
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 BulletGo to www.irs.gov/Form990 for instructions and the latest information.
OMB No. 1545-0047
2018
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's Hospital of the Hospital Sisters of the Third Order of St Fr
ancis
Employer identification number

37-0663567
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 (see instructions for definition of “political campaign activities")

2
Political campaign activity expenditures (see instructions) ....................................................................SchCMd Bullet
$  
3
Volunteer hours for political campaign activities (see instructions) ..................................................................
 

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) 2018

Schedule C (Form 990 or 990-EZ) 2018
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) 2015 (b) 2016 (c) 2017 (d) 2018 (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) 2018


Schedule C (Form 990 or 990-EZ) 2018
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)? ........
 
No
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? .......................
 
No
 
h
Rallies, demonstrations, seminars, conventions, speeches, lectures, or any similar means? ..................
 
No
 
i
Other activities? ...................................................................................................................
Yes
 
43,644
j
Total. Add lines 1c through 1i ....................................................................................................
43,644
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 1 DETAILED DESCRIPTION OF THE LOBBYING ACTIVITY ST. ELIZABETH'S HOSPITAL (THE HOSPITAL) IS A MEMBER OF THE CATHOLIC HEALTH ASSOCIATION ("CHA"), THE ILLINOIS HOSPITAL ASSOCIATION ("IHA"), THE NATIONAL ASSOCIATION FOR HOME CARE AND HOSPICE, AND THE AMERICAN HOSPITAL ASSOCIATION ("AHA"). AS A MEMBER OF THESE ORGANIZATIONS, THE HOSPITAL PAYS DUES, WITH PART OF THESE DUES BEING ATTRIBUTABLE TO LOBBYING FEES PAID BY THE ORGANIZATIONS. THE AMOUNT LISTED IS THE AMOUNT ATTRIBUTABLE TO THE HOSPITAL FROM ITS DUES PAID. THE ASSOCIATIONS THE HOSPITAL PAYS ARE AS FOLLOWS: - AMERICAN HOSPITAL ASSOCIATION ("AHA") AT 22.73% LOBBYING EXPENSE - CATHOLIC HEALTH ASSOCIATION ("CHA") AT 3.52% LOBBYING EXPENSE - ILLINOIS HOSPITAL ASSOCIATION ("IHA") AT 35.00% LOBBYING EXPENSE - NATIONAL ASSOCIATION FOR HOME CARE & HOSPICE AT 15.00% LOBBYING EXPENSE. LOBBYING EXPENSE THE TOTAL AMOUNT OF ANNUAL DUES PAID TO EACH ASSOCIATION IS MULTIPLIED BY THE PERCENTAGE OF DUES ALLOCATED TO LOBBYING EXPENSE TO CALCULATE THE TOTAL LOBBYING EXPENDITURES PAID.
Schedule C (Form 990 or 990EZ) 2018


Additional Data


Software ID: 18007697
Software Version: 2018v3.1

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.
SchDMd Bullet Go to www.irs.gov/Form990 for the latest information.
OMB No. 1545-0047
2018
Open to Public Inspection
Name of the organization
St Elizabeth's Hospital of the Hospital Sisters of the Third Order of St Fr
ancis
Employer identification number

37-0663567
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 7/25/06, 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 $ 0
(ii)
Assets included in Form 990, Part X ...............................SchDMd Bullet $ 325,061
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) 2018

Schedule D (Form 990) 2018
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
SEE PART III, LINE 4
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 .....   22,847,634 22,847,634
b Buildings ....   173,139,257 20,573,966 152,565,291
c Leasehold improvements   1,756,987 170,166 1,586,821
d Equipment ....   82,682,529 49,793,433 32,889,096
e Other .....   44,266,592 5,064,126 39,202,466
Total. Add lines 1a through 1e. (Column (d) must equal Form 990, Part X, column (B), line 10(c).)..SchDMdBullet 249,091,308
Schedule D (Form 990) 2018

Schedule D (Form 990) 2018
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)
(B)
(C)
(D)
(E)
(F)
(G)
(H)
Total. (Column (b) must equal Form 990, Part X, col. (B) line 12.)Small Bullet  
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  
Retire Obligation Asbestos 8,743,601
Accrued Pension Benefit 26,319,288
Derivative Instruments 9,691
(4)
(5)
(6)
(7)
(8)
(9)
Total. (Column (b) must equal Form 990, Part X, col.(B) line 25.)Small Bullet 35,072,580
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) 2018

Schedule D (Form 990) 2018
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  
2 Amounts included on line 1 but not on Form 990, Part VIII, line 12:
a Net unrealized gains (losses) on investments .... 2a  
b Donated services and use of facilities ......... 2b  
c Recoveries of prior year grants ........... 2c  
d Other (Describe in Part XIII.) ............ 2d  
e Add lines 2a through 2d ..................... 2e  
3 Subtract line 2e from line 1.................. 3  
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  
b Other (Describe in Part XIII.) ........... 4b  
c Add lines 4a and 4b.................... 4c  
5 Total revenue. Add lines 3 and 4c. (This must equal Form 990, Part I, line 12.) ...... 5  
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  
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  
e Add lines 2a through 2d.................... 2e  
3 Subtract line 2e from line 1................... 3  
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  
b Other (Describe in Part XIII.) ............ 4b  
c Add lines 4a and 4b..................... 4c  
5 Total expenses. Add lines 3 and 4c. (This must equal Form 990, Part I, line 18.) ...... 5  
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 III, Line 4 Collections of art - description of collections The hospital has received various donations of artwork, which are held and displayed throughout the facility to beautify the hospital and promote healing.
Schedule D, Part X, Line 2 FIN 48 (ASC 740) footnote HSHS and the Foundation are Illinois not-for-profit organizations as described in Section 501(c) (3) of the Internal Revenue Code (the Code) and are exempt from federal income taxes on related income pursuant to Section 501(a) of the Code. Kiara, Inc. is an Illinois for-profit corporation that recognizes income taxes under the asset-and-liability method. Deferred tax assets and liabilities are recognized for the future tax consequences attributable to differences between the consolidated financial statement carrying amounts of existing assets and liabilities and their respective tax basis and operating loss and tax credit carryforwards. Deferred tax assets and liabilities are measured using the enacted tax rates expected to apply to taxable income in the years in which those temporary differences are expected to be recovered or settled. The effect on deferred tax assets and liabilities of a change in tax rates is recognized in income in the period that includes the enactment date. The net operating loss carryforwards result in a deferred tax asset of $70,000 and $60,575 at June 30, 2019 and 2018, respectively. In assessing the realizability of deferred tax assets, management considers whether it is more likely than not that some portion or all of the deferred tax assets will not be realized. The ultimate realization of deferred tax assets is dependent upon the generation of future taxable income during the periods in which those temporary differences become deductible. Management considers projected future taxable income and tax planning strategies in making this assessment. Based upon the level of historical taxable losses and projections for future taxable losses over the periods for which the deferred tax assets are deductible, management believes it is more likely Kiara, Inc. will not realize the majority of the benefits of these deductible differences. Full valuation allowances have been applied against the deferred tax assets attributable to the net operating loss carryforwards not realized as of June 30, 2019 and 2018 in the accompanying consolidated financial statements due to the uncertainty of realization. HSHS recognizes the tax benefit from an uncertain tax position only if it is more likely than not the tax position will be sustained on examination by the taxing authorities, based on the technical merits of the position. As of June 30, 2019 and 2018, HSHS does not have any liabilities for unrecognized tax benefits.
Schedule D (Form 990) 2018


Additional Data


Software ID: 18007697
Software Version: 2018v3.1




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 Go to www.irs.gov/Form990EZ for instructions and the latest information.
OMB No. 1545-0047
2018
Open to Public Inspection
Name of the organization
St Elizabeth's Hospital of the Hospital Sisters of the Third Order of St Fr
ancis
Employer identification number

37-0663567
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
Yes
 
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
 
No
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
 
 
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) . . . 		    4,957,179 0 4,957,179 2.14 %
b Medicaid (from Worksheet 3, column a) . . . . .     39,417,133 29,905,446 9,511,687 4.11 %
c Costs of other means-tested government programs (from Worksheet 3, column b) . .         0 0 %
d Total Financial Assistance and Means-Tested Government Programs . . . . . 0 0 44,374,312 29,905,446 14,468,866 6.26 %
Other Benefits
e Community health improvement services and community benefit operations (from Worksheet 4).     623,225 270 622,955 0.27 %
f Health professions education (from Worksheet 5) . . .     2,809,920 1,125,840 1,684,080 0.73 %
g Subsidized health services (from Worksheet 6) . . . .         0 0 %
h Research (from Worksheet 7) .         0 0 %
i Cash and in-kind contributions for community benefit (from Worksheet 8) . . . .     161,734 0 161,734 0.07 %
j Total. Other Benefits . . 0 0 3,594,879 1,126,110 2,468,769 1.07 %
k Total. Add lines 7d and 7j . 0 0 47,969,191 31,031,556 16,937,635 7.33 %
For Paperwork Reduction Act Notice, see the Instructions for Form 990. Cat. No. 50192T Schedule H (Form 990) 2018
Schedule H (Form 990) 2018
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         0 0 %
3 Community support     4,933 0 4,933 0 %
4 Environmental improvements         0 0 %
5 Leadership development and
training for community members		         0 0 %
6 Coalition building         0 0 %
7 Community health improvement advocacy     1,655 0 1,655 0 %
8 Workforce development         0 0 %
9 Other         0 0 %
10 Total 0 0 6,588 0 6,588 0 %
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
Yes
 
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
3,559,678
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
0
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
61,966,973
6
Enter Medicare allowable costs of care relating to payments on line 5.....
6
70,447,918
7
Subtract line 6 from line 5. This is the surplus (or shortfall)........
7
-8,480,945
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 %
1
2
3
4
5
6
7
8
9
10
11
12
13
Schedule H (Form 990) 2018
Schedule H (Form 990) 2018
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?1Name, 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'S HOSPITAL
One St Elizabeths Blvd
OFallon,IL62269
http://www.steliz.org/
00002345 		X X   X     X      
Schedule H (Form 990) 2018
Schedule H (Form 990) 2018
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)
ST ELIZABETH'S HOSPITAL
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): 		1
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 17
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 Yes  
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 17
10 Is the hospital facility's most recently adopted implementation strategy posted on a website?......... 10 Yes  
a If "Yes" (list url): https://www.steliz.org/www-seb/media/SEB-PDF-Documents/2018-Community-Health-Implementation-Plan.pdf
b If "No," is the hospital facility’s most recently adopted implementation strategy attached to this return? ...... 10b    
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) 2018
Schedule H (Form 990) 2018
Page 5
Part VFacility Information (continued)

Financial Assistance Policy (FAP)
ST ELIZABETH'S HOSPITAL
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 Was widely publicized 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
http://www.hshs.org/FAP
b
http://www.hshs.org/FAP
c
d
e
f
g
h
i
j
Schedule H (Form 990) 2018
Schedule H (Form 990) 2018
Page 6
Part VFacility Information (continued)

Billing and Collections
ST ELIZABETH'S HOSPITAL
Name of hospital facility or letter of facility reporting group  
Yes No
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 nonpayment?.................................. 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
f
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
e
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
Schedule H (Form 990) 2018
Schedule H (Form 990) 2018
Page 7
Part VFacility Information (continued)

Charges to Individuals Eligible for Assistance Under the FAP (FAP-Eligible Individuals)
ST ELIZABETH'S HOSPITAL
Name of hospital facility or letter of facility reporting group  
Yes No
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) 2018
Schedule H (Form 990) 2018
Page 8
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, 16j, 18e, 19e, 20e, 21c, 21d, 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 3E Yes, the significant health needs are a prioritized description of the significant health needs of the community and identified through the CHNA process.
Schedule H, Part V, Section B, Line 5 Facility , 1 Facility , 1 - HSHS St. Elizabeth's Hospital. HSHS St. Elizabeth's Hospital completed a 10-month planning and implementation effort to develop the CHNA, identify and prioritize community health needs for its service area and formulate an implementation plan to guide ongoing population health initiatives with like-missioned partners and collaborators. The process and methods used to conduct the assessment required leveraging both internal and external individuals and groups. These planning and development activities included the following internal and external steps: HSHS St. Elizabeth's senior leadership engaged University of Illinois Survey Research Office, Springfield, Illinois, to provide quantitative and secondary data and community health data on the HSHS St. Elizabeth's service area. In addition, the team, along with members of the community benefits committee identified additional data sets to review and discuss. Additional data included the top 10 emergency department discharge diagnosis, the top 10 inpatient diagnosis and a review of two of the surveys that were conducted as part of the St. Clair County MAPP process (Mobilizing Action through Process and Partnerships). In addition, they took into consideration the information provided by the stakeholder community leader focus group. The team also reviewed the FY2015 CHNA. A core group of HSHS St. Elizabeth's colleagues provided valuable input for the FY2018 CHNA. This focus group discussed the data, shared insights from their perspective vantage points and identified their top three healthcare areas of focus. HSHS St. Elizabeth's Hospital also leveraged existing relationships that provided diverse input for a comprehensive review and analysis of community health needs in the hospital's service area. External components and steps included working in concert with the St. Clair County Health Department IPLAN process. In anticipation of the HSHS St. Elizabeth's CHNA, the hospital worked collaboratively with the St. Clair County Health Department as a partner to lead one aspect of the MAPP process. In addition, the hospital fully supported all aspects of the IPLAN development. St. Clair County hosted their annual Healthcare Policy Summit with keynote speaker Tyler Norris and a panel of regional health care leaders. The summit generated collective energy regarding the county health rankings and an unprecedented commitment by community leaders to get involved. This increased awareness by a broad section of the community offers great potential for further collaboration throughout the county. For the first time, two other local hospitals partnered with HSHS St. Elizabeth's to conduct a focus group on the perceptions of the health needs of St. Clair County residents from the perspective of community leaders. Community leaders were invited based on their awareness and expertise in the needs of our community. There was particular attention, roughly 30%, afforded to those who work with the underserved, low income, and minority populations. THE HOSPITAL'S FY2018 CHNA WAS CONDUCTED WITH THE FOLLOWING ORGANIZATIONS: ST. CLAIR COUNTY PUBLIC HEALTH DEPARTMENT, CATHOLIC URBAN PROGRAMS*, ST VINCENT DEPAUL-EAST ST LOUIS*, 275TH AIR MOBILITY WING, SCOTT AIR FORCE BASE, EAST SIDE ALIGNED*, PROGRAMS AND SERVICES FOR OLDER PERSONS*, YMCA, CITY OF O'FALLON, CITY OF BELLEVILLE, O'FALLON CHAMBER OF COMMERCE, ST. CLAIR COUNTY 708 MENTAL HEALTH BOARD*, 932ND RESERVE UNIT, SCOTT AIR FORCE BASE, SOUTHERN ILLINOIS HEALTH FOUNDATION (FQHC), MCKENDREE UNIVERSITY, TOUCHETTE REGIONAL HOSPITAL, AGE SMART, ST. CLAIR REGIONAL OFFICE OF EDUCATION, KARLA SMITH BEHAVIORAL HEALTH*, BEACON MINISTRIES*, HSHS SOUTHERN ILLINOIS DIVISION, BJC HEALTH CARE, AND THE UNIVERSITY OF ILLINOIS AT SPRINGFIELD SURVEY RESEARCH OFFICE. *Denotes groups representing medically underserved, low-income and minority populations. Input from Members of Medically Underserved, Low Income and Minority Populations Hospital Sisters Health System and HSHS St. Elizabeth's Hospital are committed to promoting and defending human dignity, caring for persons living in poverty and other vulnerable persons, promoting the common good, and stewarding resources. We believe that the CHNA process must be informed by input from the poor and vulnerable populations we seek to serve. To ensure that the needs of these groups were adequately represented, we included representatives from Catholic Urban programs, St. Vincent DePaul East St. Louis, BEACON ministries, Karla Smith Foundation, St. Clair County 708 Mental Health Board, East Side Aligned, Programs and Services for Older Persons, and Age Smart. These organizations serve the under-resourced in our community, including low-income seniors, adults and children living in poverty, and persons with mental illness and substance abuse. Representatives of these organizations, who work 20 directly with their constituents, have extensive knowledge and quantifiable data regarding the needs of their service populations. Actively including these organizations in the CHNA process was critical to ensure that the needs of the most vulnerable persons in our communities were being shared and addressed in the CHNA process and development of related implementation strategies.
Schedule H, Part V, Section B, Line 6a Facility , 1 Facility , 1 - HSHS St. Elizabeth's Hospital. Yes, BJC Memorial Belleville and BJC Memorial East.
Schedule H, Part V, Section B, Line 6b Facility , 1 Facility , 1 - HSHS St. Elizabeth's Hospital. Yes, the hospital conducted the FY2018 CHNA with the following organizations: St. Clair County Public Health Department, Catholic Urban Programs, St Vincent DePaul-East St Louis, 275th Air Mobility Wing, Scott Air Force Base, East Side Aligned, Programs and Services for Older Persons, YMCA, City of O'Fallon, City of Belleville, O'Fallon Chamber of Commerce, St. Clair County 708 mental Health Board, 932nd Reserve Unit, Scott Air Force Base, Southern Illinois Health foundation (FQHC), McKendree University, Touchette Regional Hospital, Age Smart, St. Clair Regional Office of Education, Karla Smith Behavioral Health, BEACON Ministries, HSHS southern Illinois Division, BJC Health Care, University of Illinois at Springfield Survey Research Office.
Schedule H, Part V, Section B, Line 7 Facility , 1 Facility , 1 - HSHS St. Elizabeth's Hospital. After the approval by the HSHS St. Elizabeth's board the CHNA was shared at a community event for social agencies to inform them of our findings and our implementation plan. The CHNA aligns with the St. Clair county wide initiative and it shared with the work groups that align with our priority health needs and it is also shared with the St. Clair County Health Commission.
Schedule H, Part V, Section B, Line 11 Facility , 1 Facility , 1 - HSHS St. Elizabeth's Hospital. In FY2018, HSHS St. Elizabeth's Hospital conducted a CHNA. The hospital partnered with other agencies and hospitals and reviewed primary and secondary data. Then the internal work group gathered and based on the data and the prioritization process, the following priority community health needs were selected: 1. Mental Health and Substance Abuse 2. Nutrition 3. Infant Mortality The FY2018 Implementation Plan outlined the strategies that the hospital would undertake to address the priority community health needs identified through the CHNA process. Evaluation of the impact of the actions that were taken in response to the hospital's FY2018 CHNA is as follows. At this point it is important to note that HSHS St. Elizabeth's is a partner in the Healthier Together movement. As a long-standing member of the St Clair County Health Commission, the hospital is aware of the poor county health rankings and the associated difficulty to gain support and traction regarding both the severity of the situation and the capacity to develop sustainable solutions for incremental improvement. In 2017, key community leaders inspired by the collective impact principles resolved to adopt an "All In" approach to address the county health issues and work with members of the Commission, such as HSHS St. Elizabeth's Hospital, to prepare the Community Health Improvement Plan (CHIP) for St Clair County. This approach led to the formation of a grassroots movement known as Healthier Together. The Healthier Together movement is 100% volunteer driven and governed by an independent Council of Partners whose members include leaders in healthcare, business, faith, education, and local government and social agencies. The movement seeks to support the efforts of six work groups comprised of over 85 volunteers representing 45 service organization, dedicated to working together to improve the health and quality of life in the following areas: - Chronic Disease - Community Safety - Education - Maternal and Infant Death - Mental Health - Substance Abuse HSHS St. Elizabeth's priority health needs align with the Healthier Together movement and the hospital is actively engaged in several workgroups as we align our implementation plan with the county and work collectively with other organizations to meet our goals and the county goals. Poverty is one issue that can affect our patients' health. It is an insidious, self-perpetuating problem that affects generations of families. Beginning in utero and continuing throughout an individual's life, poverty affects health via complex mechanisms. Life expectancy, learning abilities, health behaviors, and risks for developing disease are affected by poverty, as are education, employment, and lifestyle opportunities. The degree to which an individual's health outcome is affected is filtered by his or her level of "host resistance" to poverty. Poverty does not automatically determine an individual's health status, although it can significantly influence it. This distinction opens a door of opportunity at both the individual and population levels. Society can intervene to increase host resistance and mitigate poverty's negative effects on individual and population health by expanding access to health care, providing infrastructure that supports healthy habits, and promoting strategies to reduce poverty (AAFP, 2015). The poverty level of St. Clair County is 4% higher than the state, i.e. 18% of the population falls below 100% of the Federal poverty line while 35% fall below the 200% federal poverty line, thus creating barriers that influence health services, nutritional food, and other necessities that contribute to poor health status. Mental Health and Substance Abuse Mental health and Substance abuse is not only a county health issue but a national epidemic. The following data supports the impact of mental health and substance abuse on St. Clair County. The internal work group who selected our top priorities believed that poverty plays a factor in substance abuse. Of the four counties comprising the St. Elizabeth service area, only St. Clair County, at 18.23%, has a poverty rate higher than the state rate. This indicator is revealed because poverty creates barriers to access including health services, nutritional food, and other necessities that contribute to poor health status. In addition, suicide rates in St. Clair Counties were all higher than the state rate and the percent of Medicare Beneficiaries diagnosed with depression in the St. Elizabeth service area was higher than the state rate. When considering substance abuse, compared to the statewide density, there is a higher ratio of bars and drinking establishments per 100,000 people in the St. Elizabeth service area than the state as a whole - 11% higher. However, the data suggests that there are fewer beer, wine, or liquor stores in St. Elizabeth's service area. When assessing the data as it relates to students, cigarettes, alcohol, and marijuana usage are higher in the 12th grade when compared to the state. FY2019 Outcomes HSHS St. Elizabeth's is actively involved in the both the mental health and the substance abuse work groups in Healthier Together. A colleague attends the meeting for Drug Free Alliance and the Suicide Preventions Partnership. In FY2019, HSHS St. Elizabeth's sponsored two trauma informed care classes for more than 30 colleagues and held a community event hosted by the Alton Police Department Drug Task Force. The community learned about what drugs and drug paraphernalia look like and how to address this their community. More than 20 people who attended requested more information related to this topic. Through a grant, HSHS St. Elizabeth's partnered with Gateway Foundation to assist patients with drug and alcohol addiction. The goal of this partnership is to assist individuals who are substance abusers with the opportunity for rehabilitation. Patients who present to the Emergency Department with a drug or alcohol diagnosis are offered the opportunity to meet with a counselor and arrange for rehabilitation services. Recognizing that patients are frequent utilizers of health care resources, the counselor will work to develop a relationship with the patient and follow-up with them. This partnership was initiated at the end of FY2019. HSHS St. Elizabeth's worked diligently to coordinate and onboard the community health worker (CHW). As the regional EMS Resource Hospital, HSHS St. Elizabeth's is committed to provide Narcan training to our EMS community. Since becoming the EMS Resource hospital, the number of organizations that are part of our network significantly increased and there are more than 400 EMS personnel in our system to include many rural EMS teams. Narcan education was one of our first commitments to the network. This required hiring and training two community outreach educators, completion and certification of Narcan training, purchase of equipment, and the development policies and protocols that are compliant with the Illinois Department of Public Health (IDPH). This was completed toward the end of FY2019 and approximately 20 people persons received Narcan Training. HSHS St. Elizabeth's is viewed as a safe haven for support groups. Naranon meets weekly in our facility with new members joining every few weeks. This group grew over the past year with new members joining monthly. Alanon will begin a support group at the hospital in FY2020. Nutrition Nutrition impacts multiple areas of health including diabetes, obesity, food insecurity, food accessibility, and impact of diet on other chronic diseases such as heart and cardiovascular disease. Food insecurity is an indicator that reports the estimated percentage of the total population and the population under age 18 that experienced food insecurity at some point during the year but are ineligible for State or Federal nutrition assistance. The rate of food insecurity in children in HSHS St. Elizabeth's service area was higher than the local counties. Other factors that indicate nutrition is a health priority, include a 3% higher population that receive supplement nutritional assistance program (SNAP), a higher obesity rate than the state average, a decrease in consumption of fresh fruits and vegetables, and 31% of the residents live in a census tract identified as food deserts. Secondary effects of poor nutrition are also evident. Residents of St. Clair County have statistically higher cholesterol, blood pressure, and diabetes. FY2019 Outcomes To address this issue, the Chronic Disease Work Group and the Education Work Group (two of the six work groups that are part of the collective impact, Healthier Together) collaborated to provide nutrition and healthy lifestyles curricula to the summer camp program serving 365 K-6th grade students.
Schedule H, Part V, Section B, Line 11 Facility , 2 Facility , 2 - HSHS St. Elizabeth's Hospital. This collaboration included 200 hours of program planning, 96 hours of youth health literacy programming, 15 different agency partners, and 29 Southern Illinois University - Edwardsville (SIUE) School of Nursing student volunteers. The follow-up survey is pending. Working with the Belleville Old Town Market, HSHS St. Elizabeth's updated its strategy to address access to healthy food. As a member of the Chronic Disease Work Group, St. Elizabeth's assisted the Belleville Old Town Market to be able to accept EBT/LINK. The EBT Debit/Credit machine was secured through a special state grant. HSHS St. Elizabeth's provided funding for EBT promotion in the community and the purchase of EBT tokens and $5.00 vouchers for low income families and seniors on fixed incomes. The vouchers enabled participants to purchase an additional $5.00 of produce if they used the voucher on healthy foods such as fruits and vegetables. Data is not back on the totals since the market remains open. However, as the summer progressed the vendors noted an increased use of tokens and coupons as the marketing of the Old Town market spread. In May and June no tokens were used. However, vendors started seeing coupons and tokens in late July 2019. Infant Mortality Recognizing that poverty and other social determinants of health factors impact the delivery of a healthy baby, the local statistics identified smoking, little or no prenatal care, and sexually transmitted disease negatively affect infant mortality. The rate of infant mortality for St. Clair County was 8.2 per 100,000; during this same period the state rate was 7 per 1,000 live births while the Healthy People 2020 objective for infant mortality rate is 6.0 per 1,000 live births. In the St. Elizabeth service area, a significantly higher rate of infants are born to mothers who smoke than compared to the state rate. However, the data offered by the Illinois Department of Public Health had not been updated since 2008. In St. Clair County, 6.18% of mothers had late or no prenatal care; this is higher than the state rate of 5.4% of pregnant women who received late or no prenatal care. The teen birth rate per 1,000 females aged 15-19 for St. Clair County was 50 per 1,000 while the statewide rate was 30 per 1,000. The sexually transmitted disease prevalence rates in St. Clair County for chlamydia, gonorrhea, and syphilis were much higher than the state rate; 12.9/100,000 compared to 8.4/100.00 which also impacts infant mortality. FY2019 Outcomes A short-term goal related to infant mortality is to provide healthy and affordable food for woman and children. As a member of the Chronic Disease Work Group, HSHS St. Elizabeth's assisted the Belleville Old Town Market to be able to accept EBT/LINK. The EBT Debit/Credit machine was secured through a special state grant program. HSHS St. Elizabeth's provided funding for EBT promotion in the community and the purchase of EBT tokens and $5.00 vouchers for low income families and seniors on fixed incomes. The vouchers enabled qualified customers to purchase an additional $5.00 of produce if they used the voucher on healthy foods. Data is not back yet on the totals since the market remains open. However, as the summer progressed the vendors noted an increase use of tokens and coupons as EBT promotion at the Old Town Market spread. In May and June 2019, no tokens were used. However, vendors started seeing coupons and tokens in late July 2019. Another strategy related to infant mortality is safe sleep practices. In FY2019, St. Elizabeth's offered prenatal classes to mothers who will deliver at the hospital. Prenatal classes are also advertised at the Pregnancy Care Center (PCC), a resource for the underserved who are pregnant. The PCC is located on the St. Elizabeth's campus in Belleville, and St. Elizabeth's has supported the center for more than 25 years, providing resources to mothers and infants. Annually an event is held to educate the community about services at the hospital including prenatal classes, infant care and other community resources that support mothers and babies. The community is also encouraged to provide items to support the PCC during this very successful annual event. In addition, St. Elizabeth's Hospital was recently recognized by the National Safe Sleep Hospital Certification Program as a "Bronze Safe Sleep Hospital" for their commitment to best practices and education on infant safe sleep. St. Elizabeth's is the first and only hospital in the Metro East region to receive this recognition. While St. Elizabeth's Women and Infants Center always educates new mothers about the risk factors associated with infant mortality, we are working diligently within the hospital and with community partners to increase this important education and resources for mothers and families to improve these outcomes. HSHS St. Elizabeth's also partnered with SSM Health to educate pregnant mothers on safe sleep practices. The classes were held in the same building as the Pregnancy Care Center and at the end of the class the mothers receive a new Pack n' Play. Mothers who are in need are referred to the SSM educator and either scheduled for the HSHS St. Elizabeth's class or referred to a class that meets their needs. In addition to the three health needs selected as top priorities, an internal work group along with community members identified one other significant health need in St. Clair County. The internal work group spent quality time assessing the chart located on page 18 of the CHNA. This chart, a result of the feedback provided by the stakeholders, addressed the many needs of the community and ranked the needs according to the community's assessment of the ability to collaborate on a shared problem and the perceived impact this need has on the population. While mental health and substance abuse were selected, the group felt that violent crime and poverty were very much intertwined with substance abuse and mental health. In addition, the priority need of nutrition provided an overarching focus that encompasses obesity, food availability, diabetes, and cardiovascular disease. Infant mortality was selected as a priority because it is considered a result of the other two health needs. HSHS St. Elizabeth's will collaborate with multiple organizations to address these issues. The one priority health need that HSHS St. Elizabeth's will not address and measure will be resources needed for the elderly. Several other organizations that participated in the CHNA process do address elder care needs. While this issue will not be addressed by the hospital as a priority health need, we provide support for this community effort whenever possible. Organizations that support the elderly in the community include AgeSmart, Health Visions East, Programs and Services for Older Persons (PSOP), and the St. Clair Office on Aging. HSHS St. Elizabeth's provides monthly health education to seniors who are on a fixed income through the St. Clair office on Aging. Along with these efforts the hospital participates in health care events, some of which focus on the senior population.
Schedule H, Part V, Section B, Line 13 Facility , 1 Facility , 1 - St. Elizabeth's Hospital. Presumptive eligibility provides individuals participating in one of the following categories with a 100% write off. These programs are granted by outside organizations based on screening criteria of less than 200% of the FPG. 1. Homelessness 2. Deceased with no estate 3. Mental incapacitation with no one to act on patient's behalf 4. Medicaid eligibility, but not on date of service or for non-covered services 5. Incarceration in a penal institution 6. Enrollment in the following assistance programs for low-income individuals: 6a. Temporary Assistance for Needy Families (TANF) 6b. Illinois Housing Development Authority's Rental Housing Support Program 7. Wisconsin Department of Health Services Housing Assistance Program 8. Participation in Women, Infants and Children programs (WIC); 9. Supplemental Nutrition Assistance Program (SNAP) eligibility; 10. Illinois Free Lunch and Breakfast Program; 11. Wisconsin Free Lunch Program; 12. Low Income Home Energy Assistance Program (LIHEAP); 13. Wisconsin Home Energy Assistance Program (WHEAP); 14. Enrollment in an organized community-based program providing access to medical care that assesses and documents limited low-income financial status as criteria; 15. Receipt of grant assistance for medical services
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
Schedule H (Form 990) 2018
Schedule H (Form 990) 2018
Page 9
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?0
Name and address Type of Facility (describe)
1
2
3
4
5
6
7
8
9
10
Schedule H (Form 990) 2018
Schedule H (Form 990) 2018
Page 10
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 7 Bad Debt Expense excluded from financial assistance calculation 3559678
Schedule H, Part I, Line 7 Costing Methodology used to calculate financial assistance TO DETERMINE THE ACTUAL COST OF THESE SERVICES, THE HOSPITAL USES A COST-TO-CHARGE RATIO (DERIVED FROM THE IRS SCHEDULE H - WORKSHEET 2) BASED ON OUR AUDITED FINANCIAL STATEMENTS TO CALCULATE THE AMOUNTS REPORTED ON LINES 7A THROUGH 7I. THE BAD DEBT EXPENSE INCLUDED ON FORM 990, PART IX, LINE 25, COLUMN (A) WAS SUBTRACTED PRIOR TO AND FOR THE PURPOSE OF CALCULATING THE PERCENTAGE IN PART I, LINE 7, COLUMN (F) IS $3,559,678.
Schedule H, Part II Community Building Activities Community Building activities are programs that address underlying causes of health problems and thus improve health status and quality of life. They focus on root causes of health problems such as poverty, homelessness, and environmental hazards. These activities enhance community assets by offering the expertise and resources of the health care organization. Workforce (non-hospital) development: Bridges Connections District 201 Bridges Connections District 201 is designed to help special needs students learn marketable skills through on the job training. Up to three students receive two hours of supervised job training for each day during the school year. Each student progresses through a three-phase program. Bridges enhances this high-risk population's ability to be productive members of our community. The Bridges program has successfully transitioned two students into part-time colleagues at St. Elizabeth's. Providing opportunities to special needs young adults builds one's confidence and encourages them to seek employment. Leadership Development: Leadership Belleville Partnerships with community business leaders is an important part of furthering positive perceptions of St. Elizabeth's as a healing and caring organization. One HSHS St. Elizabeth's leader participated in many community functions to further convey our message of commitment to Southwestern Illinois. Leadership Belleville is a 9-month commitment and unique training program for individuals who have demonstrated high leadership qualities. HSHS St. Elizabeth's is committed to this program on an annual basis by hosting an event at the hospital and ensuring one leader is actively involved each year. Coalition Building: BASIC Initiative (Belleville Achieves Strength in Character) BASIC is a partnership of schools, the City of Belleville, and the business community to strengthen character in our youth and in the community. BASIC encourages youth and adults to be productive citizens in our community. The BASIC initiative is very active in the schools and builds a child's spirit of self-worth and value. HSHS St. Elizabeth's is an active board member of this organization. Annually, students and adults are recognized for service to the community, emphasizing the value of each awardee from all walks of life. Coalition Building: St. Clair County Health Commission St. Elizabeth's Hospital initiated practices that later became part of the health department when they formed in 1985. A member of St. Elizabeth's participates in the Health Care Commission. The Health Care Commission, founded in 1991, is a 20 plus member organization that serves as a public health system to establish priority health issues, mobilize resources to meet identified needs, and promote the health and well-being of the all-county residents. As a result of the policy summit in spring of 2017, a collective impact movement is now underway to address specific health issues in the county. Community Support: Emergency Management and Disaster Preparedness- St. Elizabeth's is a community leader for emergency management. Our EMS coordinator is on the advisory council for two counties and is certified by the National Incident Management System (NIMS) and Incident Command Structure (ICS). In conjunction with our sister hospital, St. Anthony Memorial Hospital in Effingham, he taught 84 students NIMS and ICS. However, it is his involvement in the Local Emergency Planning Committees (LEPC) that integrates and prepares St. Elizabeth's to respond effectively in a disaster. Three HSHS St. Elizabeth's colleagues trained in emergency management served as instructors and evaluators at a local full scale railroad derailment mass casualty exercise and a full scale active shooter exercise. In addition, St. Elizabeth's is now the St. Clair County EMS resource hospital. The EMS team provides local support for world events such as the 2017 eclipse, as well as Songs for Soldiers and the Belleville Marathon. Community Support: Pregnancy Care Center The hospital provides space for the Pregnancy Care Center (PCC) on the hospital campus. The PCC provides free services including pregnancy tests, referrals for medical care, WIC and other resource information; the hospital supports these efforts. In addition, the PCC provides clothing and supplies to those with financial needs. Due to the recent move of the hospital, the PCC moved into a renovated space that creates a warm and welcoming environment for their clients. The Mother Child Department collects items for the PCC and annually a community baby shower is held to obtain donations for the center; often colleagues give generously to this organization. Community Support: Social Agency Donations Food, hygiene products, and school supply drives were conducted in collaboration with local social agencies such as St Vincent DePaul, Catholic Urban Programs, the Violence Prevention Center. Seventy-six school back packs stuffed with school supplies were donated to colleagues' students in need and an additional 75 pounds were donated to the Violence Prevention Center, a women's shelter. HSHS St. Elizabeth's partners with the local blood services and provides a location for blood donation and contributes to incentives to encourage colleagues and the public to participate. A colleague also serves on the board for the Center of Autism. St. Elizabeth's has a positive long standing relationship with St. Vincent DePaul (SVDP) in East St. Louis. The building that houses Cosgrove's Soup Kitchen and a thrift store underwent a complete remodel, and needed many items. Through careful planning and inventorying of resources at the old facility and after the move, HSHS St. Elizabeth's facilitated the donation of numerous items needed for the renovation, thus reducing St. Vincent DePaul's overhead costs. The hospital also donated canned and frozen food, metal rolling racks, kitchen supplies, and paper products. With the hospital move from Belleville to O'Fallon, some equipment was either obsolete or incompatible with the new technology at the new hospital. This surplus allowed for generous donations to the community and HSHS Mission Outreach, our regional medical surplus partner. Mission Outreach received their largest donation ever from St. Elizabeth's Hospital. In addition, many local agencies benefited and obtained items that would either improve their work or make life more comfortable. Such agencies included the local health department, a high school, a priest retirement home and a low-income school. Community Health improvement and advocacy: Behavioral Health Care HSHS St. Elizabeth's is a member of the Metro-East Behavioral Health Network Council. This is a group of agencies within our community that share resources and implement new treatment strategies for our patients with psychiatric needs. Even though St. Elizabeth's does not have mental health services, it is aligned with area facilities and specialists that accommodate our patient population. To facilitate the care of mental health patients a mental health nurse practitioner is on staff to assess the needs of this patient population. Athletes Advantage Sports Medicine HSHS Athletes Advantage Sports Medicine provides certified athletic trainers to local schools. Although the program has been in effect for 15 years, HSHS St. Elizabeth's joined forces in 2017 by providing resources to two area high schools. The commitment to provide on-site, quality medical care to local athletes was and continues to be our goal. With the addition of the ImPACT Concussion program in 2015, Athletics Advantage provides baselines free of charge to partner schools. The Athletes Advantage team consists of certified athletic trainers, board-certified sports medicine physicians with over 30 years of combined experience and credentialed ImPACT consultants, board-certified orthopedic surgeons with specialties in sports medicine and fracture care, and licensed physical therapists with emphasis on rehabilitating sports injuries. they work in conjunction with the certified athletic trainers to ensure a comprehensive rehabilitation and timely return to activity. Community Building activities also included attending the Illinois Hospital Association Advocacy Day where staff and other local health care organizations met our legislators to discuss health care legislation.
Schedule H, Part III, Line 2 Bad debt expense - methodology used to estimate amount Self-pay patients are screened for verification of no insurance coverage. Once verification of no coverage has been completed, the guarantors will be screened for charity or uninsured discounts based on income levels. Those guarantors who do not qualify for charity through the screening process will be asked to provide proof of income in the form of a recent pay stub and/or recent tax return to determine the level of uninsured discounting. If no proof of income is provided or a guarantor's income is greater than 201% of the federal poverty level, the appropriate discount according to the established criteria up to 600% of the federal poverty level will be applied. The amount of money not collected from those self-pay patients who are not eligible for charity care is reported as bad debt. Allowances for Doubtful Accounts have been recorded based on an historical matrix, using collectability percentages by payor and aging category in accordance with HSHS Executive Policy #F-23, Valuation of Net Accounts Receivable. Percentages are based on historical experience at the hospital and adjusted for known limitations. The Hospital reports bad debt in accordance with Generally Accepted Accounting Principles (GAAP).
Schedule H, Part III, Line 3 Bad Debt Expense Methodology The hospital strongly believes that its charity care, and the related community benefit obtained from such care, is understated because of those patients who potentially qualify for charity care but do not wish to apply for it. In addition, some care is not classified as charity because of missing documentation on patient resources. Thus, the hospital's bad debt includes a portion that could be classified as charity care if application for such care was sought and/or completed. While the hospital feels their bad debt expense includes amounts attributable to patients who would qualify for financial assistance under the hospital's financial assistance policy, the hospital is unable to estimate this amount.
Schedule H, Part III, Line 4 Bad debt expense - financial statement footnote The text of the footnote to the organization's financial statements that describes bad debt expense can be found on page 19 of the HSHS Consolidated Audit Report. Please also reference Footnote 2Q on page 14 for an explanation of how the financials account for bad debt.
Schedule H, Part III, Line 8 Community benefit & methodology for determining medicare costs HSHS St. Elizabeth's Hospital continually strives to provide excellent patient care in the most cost effective fashion. Nonetheless, the Medicare program, in many cases, does not provide payment that covers the full cost of the care provided. Since it is the mission of the hospital to respond to community need, hospital management continually advocates for improved Medicare payment so that the cost of quality care to those patients who are not able to afford it is not compromised and is fairly subsidized by all payers. While this shortfall in Medicare payments is not classified as community benefit by the IRS, we nonetheless believe it is an important contribution made by the hospital to the health and well-being of the community. If the Medicare program did not exist, many Medicare patients would be eligible for charity care or other means-tested government programs. Further, by absorbing this payment shortfall and providing care below cost to these individuals, HSHS St. Elizabeth's is relieving the burdens of the government. Accordingly, this shortfall restricts HSHS St. Elizabeth's ability to make funds available to provide for charity care and other community benefits. The hospital Medicare shortfall at cost for fiscal year 2019 was $8,480,945.
Schedule H, Part III, Line 9b Collection practices for patients eligible for financial assistance Every effort is made prior to, during and after provision of medical services to determine whether a patient is eligible for charity/community care and to assist the patient in completing the application and provide adequate documentation. If the patient qualified for charity/community care for the full balance of their account, the entire amount is written off to charity/community care and hence no debt collection is pursued. If the patient qualified for charity/community care for a portion of their account balance, that portion is written off to charity/community care, with the patient being responsible for the remainder of the balance. Additionally, reasonable effort will be made to obtain third-party or government payer reimbursement on behalf of the patient. If those efforts are not fruitful, an offer will be extended to the patient to make installment payments on their balance. Only at such point that the patient defaults on installment payments or refuses to cooperate with the hospital's efforts to be reimbursed will the account be sent to collections. The hospital will make reasonable efforts to determine whether a patient is eligible under the financial assistance policy before it engages in an ECA. To the extent a patient is determined to be eligible for financial assistance under the FAP, the hospital will take all reasonably available measures to reverse any ECA taken against the patient to obtain payment for the care.
Schedule H, Part V, Section B, Line 16a FAP website - ST. ELIZABETH'S HOSPITAL: Line 16a URL: http://www.hshs.org/FAP;
Schedule H, Part V, Section B, Line 16b FAP Application website - ST. ELIZABETH'S HOSPITAL: Line 16b URL: http://www.hshs.org/FAP;
Schedule H, Part V, Section B, Line 16c FAP plain language summary website - ST. ELIZABETH'S HOSPITAL: Line 16c URL: http://www.hshs.org/FAP;
Schedule H, Part VI, Line 2 Needs assessment HSHS St. Elizabeth's is heavily involved in the community, especially in our underserved, low income areas. Having this presence in the underserved community and having leaders committed to a variety of different community groups, the leaders hear about opportunities that allow the hospital to connect more effectively. Due to this participation one leader serves on the steering committee of a nonprofit that serves low income areas. Because of our presence in the community, HSHS St. Elizabeth's is approached and asked to provide care, education or resources to underserved areas. The hospital also continually assesses the needs of the community through pre- and post-evaluations, patient surveys, the Hospital Advisory Council, and Patient Family Advisory Council. In addition, colleagues who participate in community events complete a survey about their experience. The survey includes a place to add community connections and suggestions from other agencies who may ask us to participate in other events. The community can also visit the hospital's website and submit a request for hospital participation. The Community Benefit/Hospital Advisory Council meets quarterly and discusses opportunities to community involvement. HSHS St. Elizabeth's is often approached to assist and provide medical assistance for events. For example, the hospital provides the medical care for the annual Belleville Marathon and financially supports EMS for services during public community festivities. Whenever the hospital hosts community education events, evaluations include suggestions for additional education or services.
Schedule H, Part VI, Line 3 Patient education of eligibility for assistance HSHS St. Elizabeth's Hospital collaborates with our physician partners and financial assistance information is available in the Medical Group offices. Financial Assistance posters are displayed in the registration and the Emergency Department waiting areas. During the registration process, a patient may request a financial assistance program brochure and application which are readily available. This packet contains a letter identifying financial assistance opportunities offered to our patients as well as a financial assistance application. Information about the hospital's financial assistance policy is easily accessible on our website. The hospital has onsite advocates to assist patients with enrollment in several federal, state and local government programs. These advocates visit patients while in the hospital or contact them by phone once discharged. The advocates will also make home visits as needed in order to assist patient with enrollment as well as gathering necessary documents for application. If the patient is not eligible, the advocates refer them to our financial assistance program and they follow-up with the patients. HSHS St. Elizabeth's Hospital makes its financial assistance program brochure, application and standard response letters available in Spanish, as well as English. Financial Assistance Program information is also available in English and Spanish on the hospital's website. Each billing statement that a patient receives contains information about our financial assistance program and a phone number and email for assistance with applying. Any patient visiting the onsite financial counselor, as well as contacting the hospital via phone, is given information about payment options including our financial assistance program options. Even after an account is sent to a collection agency, but no later than 12 months from placement, and/or anytime in the process they believe a patient may be eligible for Financial Assistance, the account is returned to the hospital for evaluation. Patients are also provided a Fair Billing Act notification at the point of registration regarding separate physician billing they can expect to receive, plus information about the patient's financial responsibility if their insurance plan is out of network. A system called PayNav through Passport is used on self-pay patients after failed attempts made by the hospital, but before sending to a collection agency. That system accesses credit and other information and allows us to see the probability of a patient being able to pay their bill. After assessing that information, the hospital determines whether to grant financial assistance or continue collection efforts.
Schedule H, Part VI, Line 4 Community information HSHS St. Elizabeth's provides services for patients in four counties (St. Clair, Clinton, Madison, and Monroe counties), a total population of more than 600,000 residents. The FY2018 CHNA, however, focused on St. Clair County which has an approximate population of 262,000 which is slightly smaller than Madison County by 3,000 residents. It is the eighth most populous county in the state, however, both counties saw a decrease in population. St. Clair County lost approximately 3% of their residents. Clinton and Monroe counties have a population of 37,00 and 33,000 respectively and are considered rural counties. Belleville, the county seat for St. Clair County, has roughly 44,000 residents. St. Clair County is the oldest county in Illinois and its western border is formed by the Mississippi River and comprises 674 square miles and includes urban, suburban and rural areas. As an organization, HSHS St. Elizabeth's does not exclude Medically Underserved Areas (MUAs), low income or minority populations from its service area. Although the population is aging, the average age is 37.8 years old. The greatest shift in population occurred in the 65 years and older with an increase of 16.8% from the 2010 census. The younger population ages 18-64 and under 5 years of age showed a decline in population of 6% and 7% respectfully. The population consists mostly of white (62.1%) and African American (30.4%). All races and ethnicities increased except white (non-Hispanics). The Hispanic and Latino population showed a significant growth in six years with 29% increase in population. Native American group grew by 50%, however, overall the makeup is only 0.3% of the population. Along with the aging population comes increased health care costs. Chronic disease studies show that the health of the aging population can be maintained, and chronic disease reduced by promoting healthy behaviors and expanding preventive health services. The average income is $50,006 in St. Clair county. Although it went up it remains the lowest of the four counties in the service area. St. Clair county also suffers from a high rate of poverty with 18.23% living at 100% below the federal poverty line and 35% living at 200% below the federal poverty line. This is a 1% increase from the last CHNA. This indicator is relevant because poverty creates barriers to access health services, nutritional food and other necessities that contribute to poor health status. Of the four counties included in the St. Elizabeth's service area, all have a lower uninsured rate than the state. However, St. Clair County has a higher rate of uninsured children, a lower percentage of privately insured residents and a higher rate of publicly insured residents when compared to the state rate. In St. Clair county 9.2% of the population is uninsured. Of those who are insured 36.8% are publicly insured which is higher than the state average of 31%. Violent crime is defined as offenses involving face to-face confrontation (e.g. assault, rape, robbery) The crime rate in the St. Elizabeth's service area is significantly higher and almost doubling the state rate:749 to 397 per 100,000. Crime impacts health because it limits interaction with others, prevents children from playing outdoors, lacks community organization and creates chronic stress, thus having a negative impact on health and health outcomes. Four hospitals serve the local community; one hospital in Belleville, the county seat for St. Clair County, has a satellite hospital in the community where St. Elizabeth's resides. In 2017 St. Elizabeth's built and moved into its replacement hospital in O'Fallon to meet and address the needs of the larger community and provide a higher level of care with the support of advanced technology. The aging facility in Belleville could no longer meet the needs of the area. A Federally Qualified Health Care Facility also serves Southern Illinois and has a hospital with mental health services in the East St. Louis area.
Schedule H, Part VI, Line 5 Promotion of community health As a healing ministry of the Catholic Church and an affiliate of Hospital Sisters Health System (HSHS), HSHS St. Elizabeth's Hospital is committed to delivering high quality, compassionate, and cost-effective health care services to all. Founded in 1875 the hospital brings a healing presence and improves the health of our community, especially those persons who are sick, poor, and disadvantaged. Because of the hospital's mission and heritage, the hospital is dedicated to promoting the health of St. Clair County and surrounding areas. The hospital is governed by a Board of Directors, most of whom reside in the hospital's primary service area and who are neither employees nor independent contractors of the hospital (nor family members thereof). The Board ensures that HSHS St. Elizabeth's is responding to community need. In FY2019, for example, the board reviewed and approved the many Community Benefits activities that transpire in the community. Monthly they are updated on the events that happen in the community and are kept abreast of the collective impact process happening throughout the county called Healthier Together. In addition, the Hospital Advisory/Community Benefit Committee expanded membership to complement the CHNA priority needs. Along with this committee, the Foundation and our volunteer auxiliary group advocate on behalf of the hospital in the community. Consistent with its exempt purpose, HSHS St. Elizabeth's has an open medical staff with privileges available to all qualified physicians in the area. The hospital also operates an emergency department that is open 24 hours to all persons regardless of their ability to pay. As a not-for-profit hospital, HSHS St. Elizabeth's reinvests surplus funds to support the mission of the organization and promote the health of the community rather than distributing surplus funds as profits to shareholders or individuals. Funds not committed to ongoing operations are generally used to upgrade facilities, secure new technologies, improve patient care, and support initiatives designed to promote health and ensure access for all. HSHS St. Elizabeth's is a strong supporter of education and provides mentoring to individuals in the clinical disciplines as well those outside of the clinical setting. In conjunction with St. Louis University, Southern Illinois Health Foundation (FQHC), and Scott Air Force Base, the hospital supports a three-year Family Practice Residency. Other disciplines that receive on site education and mentoring include nursing, pharmacy, pharmacy informatics, respiratory, radiology, occupational, physical, and speech therapies, and phlebotomy. Nonclinical education includes administrative secretary, medical records, and Master of Health Administration. HSHS St. Elizabeth's, HSHS Medical Group, Prairie Cardiovascular Consultants, and both the St. Clair and Madison County Medical Societies offer a "Call M.E. Doctor" Medical Explorers program for high school seniors who are interested in the medical profession. The overall goal of the program is to address the doctor crisis in the United States. The program consisted of three Saturday sessions for the students and featured hands-on activities and presentations from physicians in different clinical areas such as emergency medicine, cardiology, and orthopedic surgery. This event occurs twice a year with a variety of local high school students. HSHS St. Elizabeth's is a community leader for emergency management. The EMS coordinator is on the Advisory Council for two counties and is a certified National Incident Management System (NIMS) and Incident Command Structure (ICS) instructor. He trains St. Elizabeth's colleagues and provides NIMS training to the community. It is his involvement in the Local Emergency Planning Committees (LEPC) that integrates and prepares St. Elizabeth's to respond effectively in a disaster. For example, St. Elizabeth's participated in an active shooter exercise with many community partners in an industrial area. St. Elizabeth's colleagues served as evaluator and as a controller. The exercise focused on pre-hospital care of victims, and the responders were evaluated against FEMA standards and care. HSHS St. Elizabeth's gained knowledge and expertise with these exercises and developed relationships with other agencies. To ensure the community receives cardiac standard of care, HSHS St. Elizabeth's educates community physicians, Scott Air Force Base medical personnel, and community members on a variety of American Heart association classes such as Hands-Only CPR, Advanced Cardiac Life Support (ACLS), Pediatric Advanced Life Support (PALS), and Neonatal resuscitation (NRP) courses. Annually, HSHS St. Elizabeth's Hospital works to enhance community awareness and connect with the community to educate and raise awareness of the importance of breast and cardiac health. In FY2019 the hospital partnered with local businesses and invited the community to participate in two breast health awareness events. In February the community attended a heart health screening and educational program where citizens learned Hands-only CPR, completed glucose and cholesterol screens and learned about cardiac health and innovative heart care procedures. HSHS St. Elizabeth's continues to provide a meal and a health care topic for seniors on fixed incomes every month. Seniors value the meal and the information. It creates social interaction among the group and reduces isolation. HSHS St. Elizabeth's routinely makes cash and in-kind donations to various social and educational agencies. For example, conference room space is donated to a variety of organizations that are aligned with our mission and principles. An example of such space includes providing meeting space for support groups such as Naranon, blood drives, and housing the county morgue. HSHS St. Elizabeth's donates printing services and office supplies for two small local non-profit organizations. HSHS St. Elizabeth's continues to provide space for the Pregnancy Care Center that offers free services to mothers and babies. The hospital provides flu vaccines to members in the community who are homeless or who are served by the soup kitchen. Hearing screens are offered to children in underserved areas. HSHS St. Elizabeth's provides the medical oversight for local emergency services. Recently receiving our EMS Resource Hospital designation through the Illinois Department of Public Health, we incurred the personnel and fiscal responsibility of EMS oversight for O'Fallon EMS's protection district, Washington County ambulance service, and several other rural services that benefit the care and transport of the sick and injured. Included in this responsibility is outreach education related to general health care, emergent decision-making, and accident prevention such as Stop the Bleed and Narcan training education. HSHS St. Elizabeth's also devotes significant resources to access for patients who cannot afford care, along with other Community Benefits. In FY 2019, HSHS St. Elizabeth's provided more than $16.9 million in Community Benefits, including financial assistance at cost, unpaid cost of Medicaid and other public programs, and a range of diverse programs designed to enhance access and improve community health. Additionally, in FY 2019 HSHS St Elizabeth's provided $917,329 (at cost) in uncompensated care to patients who did not quality for charity care or public assistance and more than $8.4 million (at cost) in excess of Medicare payment for health care services. HSHS St. Elizabeth's Hospital provides a range of Community Benefit initiatives and programs that further our mission and long-standing commitment to our community. In many cases, these Community Benefits would not exist without the leadership role played by HSHS St. Elizabeth's and they often relieve a burden that would otherwise be carried by government.
Schedule H, Part VI, Line 6 Affiliated health care system Headquartered in Springfield, Illinois, Hospital Sisters Health System (HSHS) is a highly integrated, multi-institutional health care system comprised of 15 hospitals and more than 200 physician practice sites in Illinois and Wisconsin. HSHS is sponsored by Hospital Sisters Ministries (HSM), which is a public juridic person of the Roman Catholic Church. HSHS continues the health care ministries begun by its founders, the Hospital Sisters of St. Francis, more than 140 years ago, in rural and midsized communities throughout Illinois and Wisconsin. HSHS provides compassionate, holistic, high quality, and cost-effective health care through its acute care hospitals, physician practices, home health programs, palliative and hospice programs, and community outreach services. In addition, HSHS affiliated hospitals include critical access facilities that offer essential health services that otherwise would not be available in many communities. Our mission calls us to reveal and embody Christ's healing love for all people, and we extend our high quality Franciscan health care ministry beyond the walls of our hospitals by providing community health improvement services with special emphasis on the poor and vulnerable. In addition to providing community health improvement services to the broader community, HSHS cares for everyone who comes to its facilities, regardless of their ability to pay. In tandem with a variety of cross sector community partners, HSHS's Community Benefit initiatives are strategically planned and professionally implemented to improve access to health care services; enhance the health of the community; advance medical or general health care knowledge; and relieve or reduce the burden of government to improve health. In FY2019, HSHS collectively provided $211.7 million in Community Benefit (9.2% of total hospital expenses). This amount included $27.7 million provided for Financial Assistance (a.k.a. Charity Care) and $142.3 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 $279.9 million. HSHS hospitals also recorded $41.1 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.
Schedule H, Part VI, Line 7 State filing of community benefit report IL
Schedule H (Form 990) 2018
Additional Data


Software ID: 18007697
Software Version: 2018v3.1
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 Go to www.irs.gov/Form990 for instructions and the latest information.
OMB No. 1545-0047
2018
Open to Public Inspection
Name of the organization
St Elizabeth's Hospital of the Hospital Sisters of the Third Order of St Fr
ancis
Employer identification number

37-0663567
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
Yes
 
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 nonfixed
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) 2018

Schedule J (Form 990) 2018
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
1Peggy Sebastian
 
FORMER PRESIDENT & CEO 		(i)

(ii)		 0
-------------
50,204 		0
-------------
0 		0
-------------
405,496 		0
-------------
0 		0
-------------
9,261 		0
-------------
464,961 		0
-------------
63,747
2PATRICIA FISCHER
 
PRESIDENT & CEO 		(i)

(ii)		 0
-------------
357,145 		0
-------------
4,132 		0
-------------
101,863 		0
-------------
30,768 		0
-------------
32,364 		0
-------------
526,272 		0
-------------
0
3JAMES DOVER
 
Interim Pres/ CEO SOUTHERN IL DIV - Thru June 2019 		(i)

(ii)		 0
-------------
590,693 		0
-------------
19,406 		0
-------------
17,364 		0
-------------
87,150 		0
-------------
38,320 		0
-------------
752,933 		0
-------------
0
4DAVID BEACH
 
BOARD MEMBER 		(i)

(ii)		 0
-------------
381,102 		0
-------------
9,042 		0
-------------
34,471 		0
-------------
56,956 		0
-------------
28,565 		0
-------------
510,136 		0
-------------
0
5GARY A HAGENS
 
FORMER CHIEF MEDICAL OFFICER 		(i)

(ii)		 148,662
-------------
0 		0
-------------
0 		216,768
-------------
0 		0
-------------
0 		9,071
-------------
0 		374,501
-------------
0 		0
-------------
0
6DAVID NOSACKA
 
CFO Southern IL Division 		(i)

(ii)		 347,932
-------------
0 		0
-------------
0 		10,521
-------------
0 		28,146
-------------
0 		23,865
-------------
0 		410,464
-------------
0 		0
-------------
0
7ANN M CARR
 
TREASURER 		(i)

(ii)		 0
-------------
268,272 		0
-------------
4,360 		0
-------------
57,197 		0
-------------
89,873 		0
-------------
20,590 		0
-------------
440,292 		0
-------------
28,431
8ELIZABETH GOVERO
 
CHIEF NURSING OFFICER 		(i)

(ii)		 160,461
-------------
0 		0
-------------
0 		1,463
-------------
0 		14,844
-------------
14,844 		28,792
-------------
0 		205,560
-------------
14,844 		0
-------------
0
9MATTHEW BRANDT
 
Director of Finance 		(i)

(ii)		 147,484
-------------
0 		909
-------------
0 		0
-------------
0 		4,624
-------------
0 		7,230
-------------
0 		160,247
-------------
0 		0
-------------
0
10MARGARET A LUNA
 
CHIEF PEOPLE OFFICER SOUTHERN IL DIVISION 		(i)

(ii)		 258,410
-------------
0 		0
-------------
0 		3,365
-------------
0 		62,379
-------------
0 		17,030
-------------
0 		341,184
-------------
0 		0
-------------
0
11AMY M BALLANCE
 
VP BUSINESS DEVELOPMENT SOUTHERN IL DIVISION 		(i)

(ii)		 232,394
-------------
0 		0
-------------
0 		3,211
-------------
0 		40,467
-------------
0 		22,076
-------------
0 		298,148
-------------
0 		0
-------------
0
12SUSAN M HOLLOWAY
 
PROJECT MANAGER, NEW CONSTRUCTION 		(i)

(ii)		 188,473
-------------
0 		3,749
-------------
0 		0
-------------
0 		66,091
-------------
0 		1,556
-------------
0 		259,869
-------------
0 		0
-------------
0
13JACQUELYNNE N HOLST
 
VP LEGAL AFFAIRS SOUTHERN IL DIVISION / HSHS ASSOCIATE GENERAL COUNSEL 		(i)

(ii)		 196,187
-------------
0 		0
-------------
0 		2,716
-------------
0 		17,813
-------------
0 		26,785
-------------
0 		243,501
-------------
0 		0
-------------
0
14LINDA SUTTERER
 
RN - FIRST ASSIST 		(i)

(ii)		 158,319
-------------
0 		13,602
-------------
0 		2,633
-------------
0 		59,870
-------------
0 		647
-------------
0 		235,071
-------------
0 		0
-------------
0
15JULIA K SCHIMMELPFENNIG
 
DIRECTOR OF PHARMACY 		(i)

(ii)		 164,435
-------------
0 		0
-------------
0 		0
-------------
0 		23,733
-------------
0 		999
-------------
0 		189,167
-------------
0 		0
-------------
0
16COREY J HASTINGS
 
DIRECTOR OF FINANCE SOUTHERN IL DIVISION 		(i)

(ii)		 160,360
-------------
0 		0
-------------
0 		780
-------------
0 		12,938
-------------
0 		21,161
-------------
0 		195,239
-------------
0 		0
-------------
0
17Scott A Berry
 
DIVISION DIRECTOR OF ONCOLOGY 		(i)

(ii)		 149,416
-------------
0 		9,375
-------------
0 		0
-------------
0 		4,977
-------------
0 		19,592
-------------
0 		183,360
-------------
0 		0
-------------
0
Schedule J (Form 990) 2018

Schedule J (Form 990) 2018
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 JACQUELYNNE HOLST, AMY BALLANCE, DAVID NOSACKA AND MARGARET LUNA EACH RECEIVED $117 FOR SPOUSAL TRAVEL. PATRICIA FISCHER RECEIVED $880 FOR SPOUSAL TRAVEL. THE FAIR VALUE OF THESE BENEFITS WAS INCLUDED IN THE INDIVIDUAL'S ANNUAL REPORTED INCOME.
Schedule J, Part I, Line 1a Tax indemnification and gross-up payments TAX GROSS-UPS WERE PAID TO THE FOLLOWING: LINDA SUTTERER $132 PATRICIA FISCHER $32,902. THE FAIR VALUE OF THESE BENEFITS WAS INCLUDED IN THE INDIVIDUALS' ANNUAL REPORTED INCOME.
Schedule J, Part I, Line 1a Housing allowance or residence for personal use PATRICIA FISCHER RECEIVED A HOUSING ALLOWANCE OF $7,222. THE FAIR VALUE OF THESE BENEFITS WAS INCLUDED IN THE INDIVIDUAL'S ANNUAL REPORTED INCOME.
Schedule J, Part I, Line 3 Arrangement used to establish the top management official's compensation PLEASE SEE RESPONSE TO FORM 990, PART VI, LINE 15A IN SCHEDULE O.
Schedule J, Part I, Line 4a Severance or change-of-control payment Interested Person: Gary Hagens Organization: St. Elizabeth's Hospital of the Hospital Sisters of the Third Order of St. Francis EIN: 37-0663567 Amount: $191,284 Terms: Compensation paid as a result of a severance from the position of Chief Medical Officer.
Schedule J, Part I, Line 4b Supplemental nonqualified retirement plan HSHS EXECUTIVES ELIGIBLE TO PARTICIPATE IN SUPPLEMENTAL EXECUTIVE RETIREMENT PLAN (SERP) ARE DEFINED IN THE SERP PLAN DOCUMENTS. THE SERP WAS ESTABLISHED TO PROVIDE ADDITIONAL RETIREMENT BENEFITS TO ENSURE REASONABLE MARKET COMPETITIVE BENEFITS IN ACCORDANCE WITH THE HSHS EXECUTIVE COMPENSATION PHILOSOPHY ESTABLISHED BY THE HSHS COMPENSATION COMMITTEE. THE PLAN PROVIDES A DEFINED RETIREMENT CONTRIBUTION TO PARTICIPANTS COMMENCING ON JANUARY 1, 2008, EQUAL TO A PERCENTAGE OF COMPENSATION AS DEFINED IN THE SERP PLAN DOCUENTS FOR THE PLAN YEAR. PARTICIPANTS CONSTRUCTIVELY RECEIVE A DISTRIBUTION FROM THE PLAN NO LATER THAN MARCH 15TH OF THE CALENDAR YEAR FOLLOWING THE CALENDAR YEAR IN WHICH AN AMOUNT IS VESTED AND TAXABLE PURSUANT TO A VESTING SCHEDULE AS SPECIFIED IN THE PLAN DOCUMENT. THE ACTUAL DISTRIBUTION OF THE VESTED BENEFIT UNDER THE PLAN IS PAID IN A SINGLE LUMP SUM TO THE PARTICIPANT OR THE PARTICIPANT'S BENEFICIARY UPON THE EARLIER OF THE PARTICIPANT'S TERMINATION OF EMPLOYMENT, DEATH, OR TOTAL AND PERMANENT DISABILITY. THE FOLLOWING INTERESTED PERSONS CONSTRUCTIVELY RECEIVED DEFERRALS TO THE SUPPLEMENTAL EXECUTIVE RETIREMENT PLAN (SERP) IN 2018 THESE DEFERRALS ARE INCLUDED IN SCHEDULE J, PART II, COLUMN (C). Ann Carr -- $ 29,653 DAVID BEACH -- $50,003 James Dover --$ 80,581 PATRICIA FISCHER -- $23,829 THE FOLLOWING INTERESTED PERSONS RECEIVED DISTRIBUTIONS FROM THE SUPPLEMENTAL EXECUTIVE RETIREMENT PLAN (SERP) IN 2018 THESE PAYMENTS ARE INCLUDED IN SCHEDULE J, PART II, COLUMN (B)(III) AND SCHEDULE J, PART II, COLUMN (F), AS APPLICABLE. Ann Carr -- $28,431 Peggy Sebastian -- $63,747
Schedule J (Form 990) 2018
Additional Data


Software ID: 18007697
Software Version: 2018v3.1
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 imageGo to www.irs.gov/Form990 for the latest information.
OMB No. 1545-0047
2018
Open to Public Inspection
Name of the organization
St Elizabeth's Hospital of the Hospital Sisters of the Third Order of St Fr
ancis
Employer identification number

37-0663567
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 .        
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 ... X 1 1,462,000 Market value
18 Collectibles .....        
19 Food inventory ...        
20 Drugs and medical supplies .        
21 Taxidermy ......        
22 Historical artifacts ....        
23 Scientific specimens ..        
24 Archeological artifacts ...        
25 Other Right pointing arrow large image ( )
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 nonstandard contributions?
31
Yes
 
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) (2018)
Schedule M (Form 990) (2018)
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 Real estate - Other - Land Number of Contributions
Schedule M (Form 990) (2018)

Additional Data


Software ID: 18007697
Software Version: 2018v3.1
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 Go to www.irs.gov/Form990 for the latest information.
OMB No. 1545-0047
2018
Open to Public
Inspection
Name of the organization
St Elizabeth's Hospital of the Hospital Sisters of the Third Order of St Fr
ancis
Employer identification number

37-0663567
Return Reference Explanation
Form 990, Part III, Line 1 ORGANIZATION'S MISSION THE MISSION OF HSHS ST. ELIZABETH'S HOSPITAL IS TO REVEAL AND EMBODY CHRIST'S HEALING LOVE FOR ALL PEOPLE THROUGH OUR HIGH QUALITY FRANCISCAN HEALTH CARE MINISTRY. IN THE PERFORMANCE OF ITS MISSION, HSHS ST. ELIZABETH'S HOSPITAL WILL FOSTER THE VALUES OF RESPECT, CARE, COMPETENCE AND JOY. RESPECT IS THE FRANCISCAN RESPECT FOR LIFE FROM CONCEPTION TO DEATH AND FOR THE DIGNITY OF EACH INDIVIDUAL PERSON. IT IS A COMMITMENT TO FREEING AND EMPOWERING EACH PERSON TO DEVELOP TO HIS OR FULL POTENTIAL. CARE EMBODIES THE CONCERN, COMPASSION, AND SENSITIVITY WITH WHICH WE CARE FOR PATIENTS, CLIENTS, EMPLOYEES AND CO-WORKERS. MANY TIMES IT IS THOUGHT OF AS BEDSIDE BEHAVIOR, BUT IT BELONGS IN BUSINESS OFFICES, CAFETERIAS AND BOARDROOMS. COMPETENCE MEANS THAT OUR WORK IS PERFORMED AND ST. ELIZABETH'S IS MANAGED WITH THE HIGHEST LEVEL OF SKILL AND ABILITY. WE ARE COMMITTED TO RECRUITING AND DEVELOPING PEOPLE WHO ARE COMPETENT IN THEIR WORK AND WHOSE VALUES REFLECT OUR OWN. OUR VALUES ARE AN INTEGRAL PART OF OUR SYSTEM'S STRATEGIC PLAN, WHICH PROVIDES THE OVERALL FRAMEWORK FOR LOCAL ACTIVITIES. JOY IS THE MANNER IN WHICH OUR EMPLOYEES AND ALL WHO JOIN US IN OUR MINISTRY SEEK TO PERFORM THEIR WORK -- THE PERSONAL FULFILLMENT OF CARING FOR OTHERS. IT IS AN ESSENTIAL INGREDIENT IN BRINGING A SENSE OF HOPE TO THOSE WHO SUFFER.
Form 990, Part III, Line 4d Description of other program services (Expenses $ 48,620,599 including grants of $ 0)(Revenue $ 88,892,515) Other Health Care Services: HSHS St. Elizabeth's Hospital delivers a comprehensive array of healthcare services to both inpatients and outpatients. It is our mission to serve the sick, especially the poor, with quality healthcare services and healthcare education. Our accredited programs have consistently demonstrated quality outcomes that positively impact our patients, their families and the entire community. We provide quality medical healthcare regardless of race, creed, sex, national origin, handicap, age, or ability to pay. The recently opened HSHS St. Elizabeth's Hospital fulfills our health care Mission through advanced technologies, professional, skilled and compassionate caregivers, and the highest level of quality service. Our new hospital and physicians' office building opened in November 2017 to offer our patients the highest quality care in a new, comfortable and healing setting. The healing environment combines the newest technology and efficiencies to provide region leading, high-quality care. We offer state-of-the-art technologies that provide advanced services in surgery, medical imaging, laboratory, physical therapy and the emergency department, just to name a few. With 144 all private patient rooms, efficiently designed clinical areas, which allow nurses to spend more time with their patients at the bedside, and the deluxe amenities offered in our Women and Infants Center, our staff continues to deliver the difference in quality, safe care. We also proudly partner with top providers such as HSHS Medical Group, Prairie Heart & Vascular Institute, SSM Health Cardinal Glennon, Vituity and SLU Family Medicine Residency Program. Our main service lines continue to grow to provide high-quality procedures close to home. In addition to the hospital itself, HSHS St. Elizabeth's also continues to serve the Belleville community through HSHS St. Elizabeth's Belleville Health Center, located in downtown Belleville at 180 S. Third Street, Belleville. The convenient, outpatient services available at this location include: physical and occupational therapy, laboratory, x-ray and 3D mammography services, a walk-in clinic and physician offices. HSHS St. Elizabeth's Hospital currently staffs 144 inpatient beds. The hospital employs 1,621 colleagues. Inpatient admissions for Fiscal Year 2019 were 9,484. Total Outpatient visits for the hospital were 175,138.
Form 990, Part IV, Line 24a TAX EXEMPT BONDS ST. ELIZABETH'S HOSPITAL HOLDS A LIABILITY ON ITS BOOKS FOR TAX-EXEMPT BONDS, WHICH IS AN ALLOCATION FROM ITS SOLE CORPORATE MEMBER, HOSPITAL SISTERS SERVICES, INC. AS A RESULT, THIS QUESTION WAS ANSWERED NO, AND SCHEDULE K WILL BE COMPLETED ON THE HOSPITAL SISTERS SERVICES, INC. FORM 990.
Form 990, Part IV, Line 10 Endowment Funds The organization maintains temporarily and permanently restricted net assets on its balance sheet. Such funds are held by Hospital Sisters of St. Francis Foundation, Inc., a related tax-exempt organization. While these funds are held to further one or more exempt purposes of the filing organization, they are not maintained exclusively for the filing organization. The board of directors of Hospital Sisters of St. Francis Foundation, Inc. maintains ownership and ultimately authority and discretion over the use of these funds. Based on the above, the related amounts have not been reported as endowment funds on Part V of Schedule D.
Form 990, Part V, Line 1a NUMBER REPORTED IN BOX 3 OF FORM 1096 THE FORM 1096, ANNUAL SUMMARY AND TRANSMITTAL OF U.S. INFORMATION RETURN IS FILED BY THE ORGANIZATION'S PARENT, HOSPITAL SISTERS HEALTH SYSTEM (HSHS) ON THE ORGANIZATION'S BEHALF TO TRANSMIT TO THE IRS FORMS 1099, 1098, 5498, AND W-2G. THE ORGANIZATION IS UNABLE TO DETERMINE THE NUMBER OF FORMS 1099, 1098, 5498 AND W-2G FILED BY HSHS, ON THEIR BEHALF. HOWEVER, AS THE PARENT ORGANIZATION, HSHS ENSURES THAT THE FILING ORGANIZATION COMPLIES WITH ALL INFORMATION RETURN REPORTING REQUIREMENTS AND BACKUP WITHHOLDING RULES FOR REPORTABLE PAYMENTS TO VENDORS AND REPORTABLE GAMING WINNINGS TO PRIZE WINNERS, AS APPLICABLE.
Form 990, Part VI, Line 13 WHISTLEBLOWER POLICY PROVISIONS WITHIN THE CORPORATE COMPLIANCE HOTLINE AND CONFLICT OF INTEREST POLICY PROVIDE PROTECTIONS FOR WHISTLEBLOWER TYPE ACTIVITIES.
Form 990, Part VI, Line 16b JOINT VENTURES HOSPITAL SISTERS HEALTH SYSTEM ADOPTED A JOINT VENTURE COMPLIANCE PROGRAM POLICY EFFECTIVE ON JANUARY 1, 2012 FOR ALL SYSTEM HOSPITALS, INCLUDING ST. ELIZABETH'S HOSPITAL. THE OVERALL PURPOSE OF THE POLICY IS TO PROVIDE PRACTICAL GUIDELINES FOR ETHICAL BUSINESS CONDUCT, TO ACHIEVE COMPLIANCE, AND TO DETECT AND PREVENT VIOLATIONS OF APPLICABLE LAWS. THE POLICY REQUIRES ST. ELIZABETH'S HOSPITAL, AND ALL HSHS HOSPITALS, TO EVALUATE THEIR PARTICIPATION IN JOINT VENTURE ARRANGEMENTS, INCLUDING UNDER APPLICABLE FEDERAL TAX LAWS, AND TO SAFEGUARD ST. ELIZABETH'S HOSPITAL'S TAX EXEMPT STATUS WITH RESPECT TO ANY JOINT VENTURE ARRANGEMENTS.
Form 990, Part VI, Line 1a Delegate broad authority to a committee PER ARTICLE 5.5 OF THE ORGANIZATION'S BY-LAWS, THE GOVERNING BODY DELEGATES BROAD AUTHORITY TO AN EXECUTIVE COMMITTEE. THE EXECUTIVE COMMITTEE SHALL BE VESTED WITH AND MAY IN ITS DISCRETION EXERCISE THE FULL POWERS, DUTIES, RESPONSIBILITIES, AND AUTHORITY OF THE BOARD EXCEPT WHERE PROHIBITED BY LAW AND SUBJECT TO ANY LIMITATIONS IMPOSED BY THE BYLAWS OR THE BOARD OF DIRECTORS. AS PROVIDED IN THE BY-LAWS, THE EXECUTIVE COMMITTEE SHALL CONSIST OF THREE TO SIX MEMBERS, INCLUDING THE CHAIRPERSON OF THE BOARD, THE VICE CHAIRPERSON, THE PRESIDENT AND OTHER MEMBERS SELECTED FROM AMONG THE DIRECTORS BY THE BOARD.
Form 990, Part VI, Line 6 Classes of members or stockholders THE SOLE CORPORATE MEMBER OF HSHS ST. ELIZABETH'S HOSPITAL (THE CORPORATION) IS HOSPITAL SISTERS SERVICES, INC. ("HSSI"), AN ILLINOIS NOT FOR PROFIT CORPORATION EXEMPT FROM FEDERAL TAXATION UNDER SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE.
Form 990, Part VI, Line 7a Members or stockholders electing members of governing body PURSUANT TO SECTION 2.3 OF THE CORPORATION'S BYLAWS, THE ORGANIZATION'S MEMBER, HOSPITAL SISTERS SERVICES, INC. ("HSSI"), AN ILLINOIS NOT FOR PROFIT CORPORATION EXEMPT FROM FEDERAL TAXATION UNDER SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE, HAS THE RIGHT TO APPOINT AND REMOVE THE CORPORATION'S BOARD OF DIRECTORS.
Form 990, Part VI, Line 7b Decisions requiring approval by members or stockholders RESPONSIBILITY FOR THE POLICY AND OPERATIONS OF HSHS ST. ELIZABETH'S HOSPITAL (THE "CORPORATION") IS VESTED IN ITS BOARD OF DIRECTORS, EXCEPT WITH RESPECT TO SPECIFIC POWERS RESERVED IN THE CORPORATION'S BYLAWS TO THE CORPORATION'S MEMBER, HOSPITAL SISTERS SERVICES, INC. ("HSSI"), AN ILLINOIS NOT FOR PROFIT CORPORATION EXEMPT FROM FEDERAL TAXATION UNDER SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE. THE MEMBER OF HSSI 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 GOVE RNANCE AND OPERATIONS OF THE CORPORATION ARE SUBJECT TO HSSI'S RIGHT TO EXERCISE THESE RESERVED POWERS WITH RESPECT TO THE CORPORATION AND ORGANIZATIONS OF WHICH THE CORPORATION IS EITHER, DIRECTLY OR INDIRECTLY, A CONTROLLING MEMBER OR A CONTROLLING SHAREHOLDER ("AFFILIATES"). HSSI'S RIGHT TO EXERCISE CERTAIN OF THESE RESERVED POWERS IS, IN TURN, SUBJECT TO THE APPROVAL OF HSHS AND HSHS' MEMBERS. THE RESERVED POWERS INCLUDE ALL RIGHTS GRANTED TO HSSI BY LAW AND THE RIGHT TO: (A) ADOPT, APPROVE AMENDMENTS TO, OR AMEND ANY STATEMENT OF PHILOSOPHY, MISSION, MISSION INTEGRATION OR VALUES, OR ANY NAME, LOGO, OR MARK OF THE CORPORATION OR OF ANY AFFILIATE; (B) ADOPT, APPROVE AMENDMENTS TO, OR AMEND THE ARTICLES OF INCORPORATION OF THE CORPORATION OR OF ANY AFFILIATE; (C) ADOPT, APPROVE AMENDMENTS TO, OR AMEND THE BYLAWS OF THE CORPORATION OR OF ANY AFFILIATE; (D) APPOINT AND REMOVE THE BOARD OF DIRECTORS, ANY ONE OR MORE OF THE DIRECTORS OF THE CORPORATION OR OF ANY AFFILIATE, AND THE PRESIDENT OF THE CORPORATION OR OF ANY AFFILIATE; (E) APPROVE THE RECOMMENDATION OF THE BOARD OF DIRECTORS TO APPOINT OR REMOVE THE BOARD OF DIRECTORS, ANY ONE OR MORE DIRECTORS OF THE CORPORATION OR OF ANY AFFILIATE, AND THE PRESIDENT OF THE CORPORATION OR OF ANY AFFILIATE; (F) WITH RESPECT TO THE CORPORATION OR ANY AFFILIATE, APPROVE THE PURCHASE, SALE, ALIENATION, EXCHANGE, LEASE, OR ENCUMBRANCE OF ANY REAL TANGIBLE PROPERTY OF THE CORPORATION OR OF ANY AFFILIATE, WHICH PROPERTY HAS A VALUE IN EXCESS OF LIMITS SET FROM TIME TO TIME BY THE MEMBER; (G) APPROVE DEBT INCURRED BY THE CORPORATION OR ANY AFFILIATE IN AN AMOUNT IN EXCESS OF LIMITS SET FROM TIME TO TIME BY THE MEMBER. (H) APPROVE THE OPERATING AND CAPITAL BUDGETS OF THE CORPORATION OR OF ANY AFFILIATE, AND ANY DEVIATIONS BY THE CORPORATION OR OF ANY AFFILIATE FROM SUCH BUDGETS IN AN AMOUNT OR PERCENTAGE SPECIFIED BY THE MEMBER FROM TIME TO TIME; (I) APPROVE THE STRATEGIC PLAN AND ANNUAL GOALS OF THE CORPORATION OR OF ANY AFFILIATE; (J) APPROVE THE SALE OF SUBSTANTIALLY ALL OF THE ASSETS OF THE CORPORATION OR OF ANY AFFILIATE; (K) APPROVE THE MERGER OR DISSOLUTION OF THE CORPORATION OR OF ANY AFFILIATE; (L) ADOPT OR AMEND THE PLAN FOR MINISTRY EDUCATION AND GOVERNANCE FOR THE CORPORATION AND ITS AFFILIATES; (M) APPROVE THE CORPORATION'S MISSION ACCOUNTABILITY REPORTS AND THOSE OF ANY AFFILIATE; (N) APPROVE THE FINANCIAL POLICIES AND PROCEDURES OF THE CORPORATION OR OF ANY AFFILIATE AND APPROVE ANY DEVIATIONS FROM SUCH POLICIES AND PROCEDURES BY THE CORPORATION OR ANY AFFILIATE; AND (O) ADOPT POLICIES TO IMPLEMENT THE RESERVED POWERS OF THE MEMBER.
Form 990, Part VI, Line 11b Review of form 990 by governing body THE HOSPITAL EMPLOYS CROWE LLP TO ASSIST IN THE OVERALL REVIEW AND ELECTRONIC SUBMISSION OF ITS FORM 990. CROWE LLP PROVIDES GUIDANCE IN IDENTIFYING CRITICAL ERRORS IN THE RETURN SUBMISSION AND FEEDBACK ON QUANTITATIVE AND QUALITATIVE RESPONSES. ADDITIONALLY, THE HOSPITAL CFO PERFORMS A THOROUGH REVIEW OF THE RETURN AND REVIEWS IT WITH THE HOSPITAL CEO AND/OR SENIOR LEADERS BEFORE PRESENTING IT IN ITS ENTIRETY TO THE HOSPITAL BOARD FOR QUESTIONING AND REVIEW PRIOR TO THE RETURN'S SIGNING AND SUBMISSION TO THE IRS.
Form 990, Part VI, Line 12c Conflict of interest policy THE ORGANIZATION IS SUBJECT TO THE CORPORATE COMPLIANCE PROGRAM AND CONFLICT OF INTEREST POLICY ("POLICY") OF HOSPITAL SISTERS HEALTH SYSTEM, AN ILLINOIS NOT FOR PROFIT CORPORATION EXEMPT FROM FEDERAL TAXATION UNDER SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE. A REVISED CORPORATE COMPLIANCE PROGRAM AND CONFLICT OF INTEREST POLICY HAVE BEEN IMPLEMENTED SINCE JANUARY, 2009 TO MANAGE CONFLICTS OF INTEREST USING A SYSTEM-WIDE PROTOCOL FOR DISCLOSURE STATEMENTS. IN ACCORDANCE WITH THE ORGANIZATON'S CONFLICT OF INTEREST POLICY, ALL COVERED PERSONS HAVE A DUTY TO COMPLY WITH THE CONFLICT OF INTEREST POLICY FOR ANY CONTRACT, TRANSACTION, RELATIONSHIP, OR ACTIVITY CONTEMPLATED, ENTERED INTO, OR CONDUCTED AT HSHS OR ITS AFFILIATES. THE POLICY DEFINES COVERED PERSONS AS BOARD MEMBERS, BOARD COMMITTEE MEMBERS, OFFICERS, BOARD DESIGNEES, SENIOR MANAGEMENT, MEMBERS OF ANY COMMITTEE THAT OVERSEES THE APPROVAL OF PHARMACEUTICALS AND MEDICAL DEVICES, AND ANY OTHER INDIVIDUAL WHO HOLDS A POSITION OF TRUST. ON AN ANNUAL BASIS, HSHS DISCLOSES A COPY OF THE CONFLICT OF INTEREST POLICY (AND ALL CORRESPONDING PROCEDURES, GUIDELINES, FORMS, AND TOOLS) TO ALL COVERED PERSONS AND ADVISES ALL COVERED PERSONS IN WRITING OF ANY SUBSTANTIVE CHANGES TO THIS POLICY AND SUCH RELATED MATERIALS. COVERED PERSONS ARE REQUIRED TO REVIEW AND COMPLETE THE CORRESPONDING CONFLICT OF INTEREST STATEMENT. THE SYSTEM OFFICE VICE PRESIDENT - SYSTEM RESPONSIBILITY, VICE PRESIDENT - RISK & COMPLIANCE, OR MEMBERS OF THE AUDIT AND INTEGRITY COMMITTEE ("COMMITTEE") ARE AVAILABLE TO ANSWER ANY QUESTIONS A COVERED PERSON MAY HAVE. IN ADDITION, IF, AT ANY TIME AFTER SUBMITTING AN ANNUAL CONFLICT OF INTEREST STATEMENT, A COVERED PERSON BECOMES AWARE OF AN INTEREST THAT HE OR SHE WOULD HAVE HAD TO DISCLOSE AT THE ANNUAL INTERVAL, THE COVERED PERSON IS REQUIRED PROMPTLY TO DISCLOSE THE INTEREST TO THE COMMITTEE USING THE HSHS CONFLICT OF INTEREST DISCLOSURE STATEMENT. COMPLETED CONFLICT OF INTEREST STATEMENTS ARE SUBMITTED TO THE COMMITTEE, WHICH IS RESPONSIBLE FOR IDENTIFYING, ASSESSING, AND MANAGING CONFLICTS OF INTEREST THAT ARISE IN THE COURSE OF CONDUCTING THE AFFAIRS OF HSHS AND ITS AFFILIATES. IF THE COMMITTEE DETERMINES THAT A CONFLICT OF INTEREST EXISTS, THE CONFLICT OF INTEREST POLICY REQUIRES HSHS NOT TO ENGAGE IN, OR ENTER INTO A PROPOSED CONTRACT, TRANSACTION, RELATIONSHIP, ARRANGEMENT, OR ACTIVITY UNLESS THE COMMITTEE OR, WHERE NECESSARY, THE BOARD OF DIRECTORS (ACTING THROUGH ITS DISINTERESTED MEMBERS), HAS INVESTIGATED ALTERNATIVES TO THE PROPOSED CONTRACT, TRANSACTION, RELATIONSHIP, ARRANGEMENT, OR ACTIVITY AND, IN THE ABSENCE OF ALTERNATIVES THAT ARE IN THE BEST INTERESTS OF HSHS, HAS DETERMINED: 1. THAT, REGARDLESS OF WHETHER THE COVERED PERSON PARTICIPATES IN THE IMPLEMENTATION OF THE PROPOSED CONTRACT, TRANSACTION, RELATIONSHIP, ARRANGEMENT, OR ACTIVITY; 2. THE CONTRACT, TRANSACTION, ARRANGEMENT, OR ACTIVITY IS IN THE BEST INTERESTS OF HSHS; 3. THE CONTRACT, TRANSACTION, ARRANGEMENT, OR ACTIVITY IS FAIR AND REASONABLE FROM THE PERSPECTIVE OF HSHS; AND 4. HSHS CANNOT OBTAIN A MORE ADVANTAGEOUS CONTRACT, TRANSACTION, ARRANGEMENT, OR ACTIVITY WITH REASONABLE EFFORTS UNDER THE CIRCUMSTANCES. IN DETERMINING WHETHER A CONTRACT, TRANSACTION OR ARRANGEMENT IS FAIR AND REASONABLE TO HSHS, THE COMMITTEE SHALL CONSIDER, WHERE APPLICABLE: 1. APPRAISALS OR OTHER INDEPENDENT VALUATIONS OF THE FAIR MARKET VALUE OF THE CONTRACT, TRANSACTION, OR ARRANGEMENT; 2. INFORMATION REGARDING COMPARABLE CONTRACTS, TRANSACTIONS, OR ARRANGEMENTS BETWEEN UNRELATED PARTIES; 3. OFFERS FROM COMPARABLE COMPETING ENTITIES; AND/OR 4. STUDIES OF COMPARABLE COMPENSATION ARRANGEMENTS. IN ANY CASE IN WHICH THE COMMITTEE FINDS, AFTER TAKING THE STEPS DESCRIBED ABOVE, THAT HSHS SHOULD PARTICIPATE IN A PROPOSED TRANSACTION OR ARRANGEMENT DESPITE THE EXISTENCE OF A CONFLICT OF INTEREST, THE COMMITTEE SHALL DEVELOP, IMPLEMENT, MONITOR, AND ENFORCE COMPLIANCE WITH A CONFLICT MANAGEMENT PLAN FOR MANAGING THE CONFLICT OF INTEREST AS IT CONSIDERS NECESSARY FOR SUCH FINDINGS TO REMAIN VALID THROUGHOUT THE LIFE OF THE CONTRACT, TRANSACTION, RELATIONSHIP, ARRANGEMENT, OR ACTIVITY. ALL CONFLICT MANAGEMENT PLANS SHALL: 1. STATE THAT THE COMMITTEE WILL OVERSEE, MONITOR, AND ENFORCE COMPLIANCE WITH THE PLAN THROUGHOUT THE COURSE OF THE STUDY AND SPECIFY MEANS FOR DOING SO, INCLUDING, WITHOUT LIMITATION, THAT THE APPROPRIATE INDIVIDUALS MUST PROVIDE THE COMMITTEE WITH WRITTEN REPORTS PERTAINING TO COMPLIANCE WITH THE CONFLICT MANAGEMENT PLAN, THAT THE COMMITTEE SHALL HAVE THE RIGHT TO AUDIT THE STUDY FOR SUCH COMPLIANCE AND THE RIGHT TO IMPOSE SANCTIONS FOR NON-COMPLIANCE; 2. STATE THAT THE PLAN MUST BE SHARED WITH COVERED PERSON WHOSE INTERESTS IT WAS DEVELOPED TO MANAGE; 3. STATE THAT THE PLAN MUST BE SHARED WITH, AND PERIODIC REPORTS ON COMPLIANCE WITH THE PLAN MUST BE PROVIDED TO, THE BOARD, SENIOR MANAGEMENT, AND/OR GOVERNMENT AGENCIES; AND 4. PROVIDE FOR SUCH OTHER MANAGEMENT STEPS AND MECHANISMS THE COMMITTEE CONSIDERS NECESSARY AND APPROPRIATE. IN ADDITION TO THE COMMITTEE, THE SYSTEM OFFICE VICE PRESIDENTS OF SYSTEM RESPONSIBILITY AND RISK & COMPLIANCE MAY RETAIN SUCH INDEPENDENT ADVISORS OR EXPERTS AS DEEMED NECESSARY TO ASSIST IN MAKING ITS DETERMINATIONS AND DECISIONS. IF THE COMMITTEE DETERMINES THAT THE CONTEMPLATED TRANSACTION, RELATIONSHIP, ARRANGEMENT, OR ACTIVITY CANNOT PROCEED DUE TO A CONFLICT OF INTEREST, THE COMMITTEE SHALL INFORM THE APPLICABLE COVERED PERSON OR DECISION-MAKING BODY OF SUCH DETERMINATION WITHIN ONE WEEK OF THE COMMITTEE MEETING AT WHICH THE CONTEMPLATED TRANSACTION WAS DISCUSSED. THE COMMITTEE SHALL DOCUMENT ITS REJECTION OF THE CONTEMPLATED TRANSACTION IN THE COMMITTEE'S MEETING MINUTES.
Form 990, Part VI, Line 15a Process to establish compensation of top management official THE COMPENSATION COMMITTEE (COMMITTEE) IS COMPRISED OF INDEPENDENT MEMBERS OF THE BOARD OF DIRECTORS. THE COMMITTEE DEVELOPS A COMPENSATION PHILOSOPHY FOR THE SYSTEM AND ALL AFFILIATES. THE COMMITTEE SELECTS AND HIRES THE INDEPENDENT COMPENSATION CONSULTANT TO DEVELOP COMPARABILITY DATA AND ADVISE THE COMMITTEE DURING ITS DELIBERATIONS REGARDING ALL ELEMENTS OF TOTAL COMPENSATION FOR ALL HSHS EXECUTIVES, (the top management official, other officers and key employees). INTEGRATED HEALTHCARE STRATEGIES ("IHS"), THE CONSULTANTS UTILIZED BY THE COMMITTEE, USE DATA FROM MULTIPLE TAX-EXEMPT PEER GROUP SOURCES TO DETERMINE SALARY RANGES, INCENTIVE OPPORTUNITY RANGES AND BENEFITS FOR THE HSHS executives. IHS THEN ASSISTS THE COMMITTEE IN PREPARING CONTEMPORANEOUS DOCUMENTATION OF ALL ACTIONS. EACH COMMITTEE MEETING IS CONDUCTED WITH THE INTENT TO CREATE A REBUTTABLE PRESUMPTION OF REASONABLENESS FOR ALL ELEMENTS OF EXECUTIVE TOTAL COMPENSATION. THE CHAIRMAN MAKES THIS DECLARATION AND ALSO INQUIRES IF THERE ARE ANY CONFLICTS OF INTEREST BY ANY ATTENDEES. ANY CONFLICTS ARE DISCLOSED AND THE COMMITTEE THEN ACTS IN A MANNER TO AVOID ANY CONFLICTED INDIVIDUAL PARTICIPATING IN ANY MANNER WHERE A CONFLICT MIGHT EXIST. AT THE END OF THE MEETING, THE COMMITTEE PREPARES CONTEMPORANEOUS MINUTES THAT RECORD ALL ACTIONS TAKEN DURING THE MEETING.
Form 990, Part VI, Line 15b Process to establish compensation of other employees PLEASE SEE RESPONSE TO FORM 990, PART VI, LINE 15a.
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 GOVERNING DOCUMENTS AND CONFLICT OF INTEREST POLICY ARE NOT MADE AVAILABLE TO THE GENERAL PUBLIC AT THIS TIME.
Form 990, Part VIII, Line 11d Other Miscellaneous Revenue Cafeteria Sales - Total Revenue: 44, Related or Exempt Function Revenue: , Unrelated Business Revenue: , Revenue Excluded from Tax Under Sections 512, 513, or 514: 44;
Form 990, Part IX, Line 11g Other Fees Purchased Services - Total Expense: 33802341, Program Service Expense: 31577970, Management and General Expenses: 2224371, Fundraising Expenses: ; Professional Fees - Total Expense: 12878650, Program Service Expense: 3416516, Management and General Expenses: 9462134, Fundraising Expenses: ; Contract Labor - Total Expense: 5015333, Program Service Expense: 4972596, Management and General Expenses: 42737, Fundraising Expenses: ; HSHS Shared Services Fee - Total Expense: 6200357, Program Service Expense: , Management and General Expenses: 6200357, Fundraising Expenses: ;
Form 990, Part X, Line 11 POOLED INVESTMENT ACCOUNT THE ORGANIZATION'S CASH RESERVES ARE INVESTED IN A POOLED INVESTMENT ACCOUNT MAINTAINED BY HOSPITAL SISTERS HEALTH SYSTEM ("HSHS"). PARTICIPATION IN THE POOLED INVESTMENT FUND IS LIMITED TO THE 501(C)(3) HOSPITALS AND RELATED HEALTH SERVICES ORGANIZATIONS SPONSORED BY THE HOSPITAL SISTERS HEALTH SYSTEM. THE POOLED ACCOUNT CONSISTS OF CASH, EQUITY AND DEBT SECURITIES THAT ARE PUBLICLY TRADED. IN ACCORDANCE WITH THE PROVISIONS OF STATEMENT OF FINANCIAL ACCOUNTING STANDARDS ("SFAS") NO. 124, "ACCOUNTING FOR CERTAIN INVESTMENTS HELD BY NOT-FOR-PROFIT ORGANIZATIONS", INVESTMENTS IN EQUITY SECURITIES WITH READILY DETERMINABLE FAIR VALUES AND ALL INVESTMENTS IN DEBT SECURITIES ARE REPORTED AT FAIR VALUE ON THE BALANCE SHEET. INCOME, REALIZED AND UNREALIZED GAINS AND LOSSES ARE POOLED AND ALLOCATED TO THE PARTICIPANTS. INDIVIDUAL COMPONENTS OF ASSETS AND REVENUE ARE NOT IDENTIFIED TO THE INDIVIDUAL HOSPITAL PARTICIPANTS.
Form 990, Part XI, Line 9 Other changes in net assets or fund balances Mark to Market Pension Adjustment - -20595584; Affiliate Transfer - -16801536; Change in Fair Value Interest Rate Swaps - -3469; Change in Temporarily Restricted Net Assets - 50269; Swap Payment - -658; Change in Permanently Restricted Net Assets - 3710;
For Paperwork Reduction Act Notice, see the Instructions for Form 990 or 990-EZ.
Cat. No. 51056K
Schedule O (Form 990 or 990-EZ) 2018


Additional Data


Software ID: 18007697
Software Version: 2018v3.1
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 Go to www.irs.gov/Form990 for instructions and the latest information.

OMB No. 1545-0047
2018
Open to Public Inspection
Name of the organization
St Elizabeth's Hospital of the Hospital Sisters of the Third Order of St Fr
ancis
Employer identification number

37-0663567
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) KIARA CLINICAL INTEGRATION NETWORK LLC
4936 LAVERNA ROAD
SPRINGFIELD,IL62707
26-1417684 		HEALTHCARE IL -1,945,270 3,230,896 HSSI
 
(2) PHYSICIAN CLINICAL INTEGRATION NETWORK LLC
4936 LAVERNA ROAD
SPRINGFIELD,IL62707
37-1668647 		HEALTHCARE IL 563,783 11,970,191 KCIN
 
(3) HSHS ACO LLC
4936 LAVERNA ROAD
SPRINGFIELD,IL62707
32-0465666 		HEALTHCARE & SOCIAL ASSISTANCE IL -381,285 458,242 KCIN
 






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)HOSPITAL SISTERS HEALTH SYSTEM
4936 LAVERNA ROAD

SPRINGFIELD,IL62707
37-1058692 		HEALTHCARE IL 501(c)(3) Type III-FI NA
 
 
No
(2)HOSPITAL SISTERS OF ST FRANCIS FOUNDATION
4936 LAVERNA ROAD

SPRINGFIELD,IL62707
37-1186514 		HEALTHCARE IL 501(c)(3) 7 HSHS
 
Yes
 
(3)HOSPITAL SISTERS HEALTHCARE WEST INC
2661 COUNTY HIGHWAY 1

CHIPPEWA FALLS,WI54729
51-0157933 		HEALTHCARE WI 501(c)(3) Type I HSSI
 
Yes
 
(4)SACRED HEART HOSPITAL
990 WEST CLAIREMONT AVENUE

EAU CLAIRE,WI54701
39-0807060 		HEALTHCARE WI 501(c)(3) 3 HSSI
 
Yes
 
(5)ST ANTHONY'S HOSPITAL
503 N MAPLE STREET

EFFINGHAM,IL62401
37-0661233 		HEALTHCARE IL 501(c)(3) 3 HSSI
 
Yes
 
(6)ST NICHOLAS HOSPITAL
3100 SUPERIOR AVENUE

SHEBOYGAN,WI53081
39-0808480 		HEALTHCARE WI 501(c)(3) 3 HSSI
 
Yes
 
(7)ST JOHN'S HOSPITAL
800 EAST CARPENTER STREET

SPRINGFIELD,IL62769
37-0661238 		HEALTHCARE IL 501(c)(3) 3 HSSI
 
Yes
 
(8)ST JOSEPH'S HOSPITAL
9515 HOLY CROSS LANE

BREESE,IL62230
37-1208459 		HEALTHCARE IL 501(c)(3) 3 HSSI
 
Yes
 
(9)ST JOSEPH'S HOSPITAL
2661 COUNTY HIGHWAY 1

CHIPPEWA FALLS,WI54729
39-0810545 		HEALTHCARE WI 501(c)(3) 3 HSSI
 
Yes
 
(10)ST MARY'S HOSPITAL
1800 E LAKE SHORE DRIVE

DECATUR,IL62521
37-0661244 		HEALTHCARE IL 501(c)(3) 3 HSSI
 
Yes
 
(11)ST MARY'S HOSPITAL
111 SPRING STREET

STREATOR,IL61364
36-2169181 		HEALTHCARE IL 501(c)(3) 3 HSSI
 
Yes
 
(12)ST MARY'S MEDICAL CENTER
1762 SHAWANO AVENUE

GREEN BAY,WI54303
39-0818682 		HEALTHCARE WI 501(c)(3) 3 HSSI
 
Yes
 
(13)ST VINCENT HOSPITAL
835 S VAN BUREN

GREEN BAY,WI51301
39-0817529 		HEALTHCARE WI 501(c)(3) 3 HSSI
 
Yes
 
(14)ST JOSEPH'S HOSPITAL
12866 TROXLER AVENUE

HIGHLAND,IL62249
37-0663568 		HEALTHCARE IL 501(c)(3) 3 HSSI
 
Yes
 
(15)ST FRANCIS HOSPITAL
1215 FRANCISCAN DRIVE

LITCHFIELD,IL62056
37-0661236 		HEALTHCARE IL 501(c)(3) 3 HSSI
 
Yes
 
(16)HOSPITAL SISTERS SERVICES INC
4936 LAVERNA ROAD

SPRINGFIELD,IL62707
37-1163402 		HEALTHCARE IL 501(c)(3) Type III-FI HSHS
 
Yes
 
(17)HSHS MEDICAL GROUP INC
3215 EXECUTIVE PARK DRIVE

SPRINGFIELD,IL62703
26-3956318 		HEALTHCARE IL 501(c)(3) Type III-FI HSSI
 
Yes
 
(18)HSHS WISCONSIN MEDICAL GROUP INC
3215 EXECUTIVE PARK DRIVE

SPRINGFIELD,IL62703
26-4515959 		HEALTHCARE WI 501(c)(3) Type III-FI HSSI
 
Yes
 
(19)ORANGE CROSS AMBULANCE INC
919 ASHLAND AVENUE

SHEBOYGAN,WI53081
39-1860942 		HEALTHCARE WI 501(c)(3) 10 ST NICHOLAS
 
Yes
 
(20)UNITY LIMITED PARTNERSHIP
2366 OAK RIDGE CIRCLE

DE PERE,WI54115
39-1750729 		HEALTHCARE WI 501(c)(3) 10 HSSI
 
Yes
 
(21)PRAIRIE EDUCATION & RESEARCH COOPERATIVE
317 NORTH 5TH STREET

SPRINGFIELD,IL62701
37-1157915 		HEALTHCARE IL 501(c)(3) 4 HSSI
 
Yes
 
(22)ST CLARE MEMORIAL HOSPITAL
855 S MAIN STREET

OCONTO FALLS,WI54154
39-0848401 		HEALTHCARE WI 501(c)(3) 3 HSSI
 
Yes
 
(23)HSHS HOLY FAMILY HOSPITAL
200 HEALTHCARE DRIVE

GREENVILLE,IL62246
37-0792770 		HEALTHCARE IL 501(c)(3) 3 HSSI
 
Yes
 
(24)UTLAUT MEMORIAL FOUNDATION
200 HEALTHCARE DRIVE

GREENVILLE,IL62246
37-1140166 		FUNDRAISING IL 501(c)(3) Type II HSSI
 
Yes
 
(25)HSHS GOOD SHEPHERD HOSPITAL INC
200 SOUTH CEDAR STREET

SHELBYVILLE,IL62565
37-0512290 		HEALTHCARE IL 501(c)(3) 3 HSSI
 
Yes
 
(26)SHELBY MEMORIAL HOSPITAL EMPLOYEE BENEFIT TRUST
200 SOUTH CEDAR STREET

SHELBYVILLE,IL62565
37-1778753 		TRUST IL 501(a)   GSS
 
Yes
 
For Paperwork Reduction Act Notice, see the Instructions for Form 990.
Cat. No. 50135Y
Schedule R (Form 990) 2018
Schedule R (Form 990) 2018
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) PAIN CENTER OF WISCONSIN

4131 W LOOMIS ROAD
SUITE 300
GREENFIELD,WI53221
26-3155343 		HEALTHCARE WI ST VINCENT
  		Related 742,948 556,009   No     No 50 %
(2) PAIN CENTER OF WISCONSIN - OCONTO FALLS LLC

4131 W LOOMIS ROAD
SUITE 300
GREENFIELD,WI53221
36-4717036 		HEALTHCARE WI ST CLARE
  		Related 26,375 142,266   No     No 50 %
(3) CARPENTER STREET HOTEL LLC

525 NORTH SIXTH STREET
SPRINGFIELD,IL62702
36-4128127 		HOTEL IL LASANTE INC
  		N/A               0 %
(4) SPRINGFIELD URGENT CARE REAL ESTATE LLC

PO BOX 19456
SPRINGFIELD,IL627949456
03-0413258 		RENTAL REAL ESTATE IL LASANTE INC
  		N/A               0 %
(5) PRAIRIE HEART INSTITUTE MANAGEMENT COMPANY LLC

4936 LAVERNA ROAD
SPRINGFIELD,IL62707
26-1479945 		MEDICAL IL HSHS
  		Related -6,697 9,753   No   Yes   100 %
(6) SOUTHWEST ILLINOIS HEALTH SERVICES REAL ESTATE LLP

4000 NORTH ILLINOIS STREET
SWANSEA,IL62226
82-3633320 		REAL ESTATE IL ST ELIZABETH'S
  		Related 337,078 1,174,120   No     No 50 %
(7) PRAIRIE HEART INSTITUTE ST JOHN'S

800 EAST CARPENTER STREET
SPRINGFIELD,IL62769
37-1321197 		HEALTHCARE IL HSHS
  		Related 0 0   No     No 100 %
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) KIARA INC

4936 LAVERNA ROAD
SPRINGFIELD,IL62707
37-1163401 		HEALTHCARE IL HSHS
  		C Corporation     100 % Yes  
(2) LASANTE WISCONSIN INC

4936 LAVERNA ROAD
SPRINGFIELD,IL62707
39-1572196 		HEALTHCARE IL KIARA INC
  		C Corporation       Yes  
(3) LASANTE INC

4936 LAVERNA ROAD
SPRINGFIELD,IL62707
37-1163400 		HEALTHCARE IL KIARA INC
  		C Corporation       Yes  
(4) PRAIRIE CARDIOVASCULAR

619 EAST MASON SUITE 4P57
SPRINGFIELD,IL62701
37-1071858 		HEALTHCARE IL KIARA INC
  		C Corporation       Yes  
(5) PREVEA HEALTH SERVICES INC

2710 EXECUTIVE DRIVE
GREEN BAY,WI54304
39-1839351 		HEALTHCARE WI HSSI
  		C Corporation     50 % Yes  
(6) PREVEA CLINIC INC

2710 EXECUTVE DRIVE
GREEN BAY,WI54304
39-1839349 		HEALTHCARE WI PHSI
  		C Corporation       Yes  
(7) RENAISSANCE QUALITY INSURANCE LTD

PO BOX 1159
  GRAND CAYMANKY11102
CJ
98-0669953 		SELF-INSURANCE CJ HSSI
  		C Corporation     100 % Yes  
(8) OJV INC

4936 LAVERNA ROAD
SPRINGFIELD,IL62707
46-0873384 		HEALTHCARE IL LASANTE INC
  		C Corporation       Yes  
Schedule R (Form 990) 2018
Schedule R (Form 990) 2018
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
Yes
 
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
 
No
l Performance of services or membership or fundraising solicitations for related organization(s) .....................
1l
 
No
m Performance of services or membership or fundraising solicitations by related organization(s) .................
1m
 
No
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
 
No
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





Schedule R (Form 990) 2018
Schedule R (Form 990) 2018
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) 2018
Schedule R (Form 990) 2018
Page 5
Part VII
Supplemental Information
Provide additional information for responses to questions on Schedule R (see instructions).
Return Reference Explanation
Schedule R, Part VII RELATED ORGANIZATIONS Due to the increasingly complex organization structure of Hospital Sisters Health System and Affiliates, the filing organization has elected to report all organizations within Hospital Sisters Health System as related, regardless of ownership interest or "control" as defined by the instructions to Schedule R. The intent of this reporting is to promote transparency and increase consistency across the numerous Form 990 submissions by Hospital Sisters Health System and Affiliates.
Schedule R (Form 990) 2018

Additional Data


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Software Version: 2018v3.1