Form990
Click to see attachment
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
2019
Open to Public Inspection
A For the 2019 calendar year, or tax year beginning 01-01-2019 , and ending 12-31-2019
BCheck if applicable:
CName of organization
ST FRANCIS REGIONAL MEDICAL CENTER
 
 
Doing business as
 
 
Number and street (or P.O. box if mail is not delivered to street address)
PO BOX 43 MAIL ROUTE 10890
 
Room/suite
City or town, state or province, country, and ZIP or foreign postal code
MINNEAPOLIS, MN554400043
D Employer identification number

41-0907986
E Telephone number

G Gross receipts $ 201,380,092
F Name and address of principal officer:
AMY JERDEE
PO BOX 43 MAIL ROUTE 10890
MINNEAPOLIS,MN554400043
I
Tax-exempt status: (   ) LeftBullet (insert no.) or
J
Website:MediumBullet
WWW.STFRANCIS-SHAKOPEE.COM
H(a)
Is this a group return for
subordinates?
H(b)
Are all subordinates
included?
If "No," attach a list. (see instructions)
H(c)
Group exemption number MediumBullet0928
K Form of organization:  
L Year of formation: 1966
M State of legal domicile: MN
Part I
Summary
Activities  & Governance 1 Briefly describe the organization’s mission or most significant activities: PROVIDE QUALITY HEALTH CARE FOR THE PEOPLE IN SCOTT, CARVER AND WESTERN DAKOTA COUNTIES, MINNESOTA.
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 13
5 Total number of individuals employed in calendar year 2019 (Part V, line 2a) ...... 5 0
6 Total number of volunteers (estimate if necessary) ............. 6 223
7a Total unrelated business revenue from Part VIII, column (C), line 12 ........ 7a 0
b Net unrelated business taxable income from Form 990-T, line 39 ......... 7b 0
Revenues Prior Year Current Year
8 Contributions and grants (Part VIII, line 1h) ......... 350,402 293,281
9 Program service revenue (Part VIII, line 2g) ......... 168,594,632 171,374,833
10 Investment income (Part VIII, column (A), lines 3, 4, and 7d ) .... 2,136,696 2,484,011
11 Other revenue (Part VIII, column (A), lines 5, 6d, 8c, 9c, 10c, and 11e) 1,619,803 560,874
12 Total revenue—add lines 8 through 11 (must equal Part VIII, column (A), line 12) 172,701,533 174,712,999
Expenses; 13 Grants and similar amounts paid (Part IX, column (A), lines 1–3 )... 242,331 294,952
14 Benefits paid to or for members (Part IX, column (A), line 4)..... 0 0
15 Salaries, other compensation, employee benefits (Part IX, column (A), lines 5–10) 80,312,972 82,678,452
16a Professional fundraising fees (Part IX, column (A), line 11e) ..... 0 0
b Total fundraising expenses (Part IX, column (D), line 25) MediumBullet364,558    
17 Other expenses (Part IX, column (A), lines 11a–11d, 11f–24e).... 73,345,728 78,995,845
18 Total expenses. Add lines 13–17 (must equal Part IX, column (A), line 25) 153,901,031 161,969,249
19 Revenue less expenses. Subtract line 18 from line 12....... 18,800,502 12,743,750
Net Assets or Fund Balances; Beginning of Current Year End of Year
20 Total assets (Part X, line 16)............. 189,377,451 196,443,242
21 Total liabilities (Part X, line 26)............. 63,572,653 58,179,247
22 Net assets or fund balances. Subtract line 21 from line 20..... 125,804,798 138,263,995
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
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Signature of officer Date
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Type or print name and title
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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 (2019)
Form 990 (2019)
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: ST. FRANCIS REGIONAL MEDICAL CENTER (ST. FRANCIS) HAS A RICH TRADITION OF PROVIDING QUALITY HEALTH CARE FOR THE PEOPLE LIVING IN SCOTT, CARVER AND WESTERN DAKOTA COUNTIES OF MINNESOTA. FOUNDED BY A SMALL GROUP OF FRANCISCAN SISTERS IN 1938, ST. FRANCIS HAS GROWN FROM A SMALL COMMUNITY HOSPITAL TO A COMPREHENSIVE, HIGH-QUALITY REGIONAL MEDICAL CENTER RAPIDLY EXPANDING TO MEET THE NEEDS OF THIS FAST-GROWING AREA. LOCAL ACCESS TO HIGH-QUALITY HEALTH CARE MAKES ST. FRANCIS A VALUABLE COMMUNITY ASSET, BOTH TO THE INDIVIDUALS AND BUSINESSES IT SERVES. ST. FRANCIS CONTINUES TO PROVIDE EXCELLENT, COMPASSIONATE HEALTH CARE SERVICES WITH AN EMPHASIS ON INDIVIDUAL DIGNITY IN THE HEALING OF BODY, MIND, AND SPIRIT. THIS COMMITTMENT IS REFLECTED IN OUR MISSION STATEMENT "AT ST. FRANCIS,WE WORK TOGETHER TO PROVIDE ALL PEOPLE THE HEALING EXPERIENCE WE WOULD EXPECT FOR OURSELVES AND OUR FAMILIES."
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 $ 126,234,700 including grants of $   ) (Revenue $ 179,479,907 )
HOSPITAL, MEDICAL AND OTHER HEALTH CARE SERVICESST.FRANCIS, LOCATED IN THE TWIN CITIES SOUTHWEST METRO IN THE CITY OF SHAKOPEE, MINNESOTA, DELIVERS HIGH QUALITY, RESPECTFUL HOSPITAL,MEDICAL AND OTHER HEALTH CARE SERVICES TO PATIENTS. AS A CATHOLIC, MISSION-DRIVEN ORGANIZATION, ST.FRANCIS IS COMMITTED TO IMPROVING THE LIFELONG HEALTH OF THE COMMUNITIES IT SERVES. ST. FRANCIS SHARES ITS CAMPUS WITH ST.GERTRUDE'S HEALTH AND REHABITLITION CENTER, ALLINA HEALTH CLINIC, PARK NICOLLET CLINIC, CANCER CENTER, DIALYSIS CENTER, EMERGENCY AND URGENT CARE, MEDICAL AND DENTISTRY, AND MANY OTHER SERVICES AND SPECIALTY CLINICS HOUSED IN ADJOINING MEDICAL OFFICE BUILDINGS. ST. FRANCIS IS JOINTLY OWNED BY ALLINA HEALTH SYSTEM, HPI-RAMSEY, CONTROLLED BY HEALTH PARTNERS,INC. AND CRITICAL ACCESS GROUP, CONTROLLED BY ESSENTIA HEALTH.IN 2019 ST. FRANCIS EXPENDED $ 126.2 MILLION TO PROVIDE MEDICAL SERVICES TO PATIENTS THAT INCLUDED OVER 6,100 INPATIENT ADMISSIONS, NEARLY 131,000 OUTPATIENT VISITS AND OVER 1,000 BIRTHS.
4b (Code:   ) (Expenses $ 13,667,019 including grants of $   ) (Revenue $   )
COSTS OF PARTICIPATING IN GOVERNMENT PROGRAMSTO PROMOTE ACCESS TO CARE FOR ALL INDIVIDUALS, ST. FRANCIS PARTICIPATES IN THE FOLLOWING PUBLIC HEALTH CARE PROGRAMS: MEDICARE, MEDICAID, MINNESOTACARE, AND GENERAL ASSISTANCE. PAYMENTS FROM THESE PROGRAMS FREQUENTLY DO NOT COVER THE COSTS ST. FRANCIS INCURS TO SERVE PROGRAM BENEFICIARIES. THE FOLLOWING IS A BREAKDOWN ON COSTS RELATED TO THESE PROGRAMS, SERVICES AND ADDITIONAL TAXES AND FEES.COSTS IN EXCESS OF MEDICARE AND MEDICAID PAYMENTSST. FRANCIS PROVIDES SERVICES TO PUBLIC PROGRAM ENROLLEES. SUCH PUBLIC PROGRAMS HAVE HISTORICALLY BEEN REIMBURSED AT AMOUNTS LESS THAN COST. IN 2019, ST. FRANCIS EXPENDED $8.1 MILLION BEYOND REIMBURSEMENTS TO PROVIDE CARE FOR MEDICARE PATIENTS AND AN ADDITIONAL $1.5 MILLION BEYOND REIMBURSEMENTS FOR MEDICAID PATIENTS.MEDICAID SURCHARGEST. FRANCIS IS A PARTICIPANT IN THE MEDICAID SURCHARGE PROGRAM. THE CURRENT PROGRAM INCLUDES A 1.56% SURCHARGE ON A HOSPITAL'S NET PATIENT REVENUE (EXCLUDING MEDICARE REVENUE). REPORTED AMOUNTS ARE NET OF ANY DISPROPORTIONATE SHARE ADJUSTMENTS. IN 2019, ST. FRANCIS PAID $1.7 MILLION FOR THE MEDICAID SURCHARGE.MINNESOTACARE TAXST. FRANCIS ALSO PARTICIPATES IN THE FUNDING OF MEDICAL CARE FOR PEOPLE WHO ARE UNINSURED THROUGH A MINNESOTACARE TAX OF 2% ON CERTAIN NET REVENUE. PATIENTS WHO ARE UNABLE TO GET INSURANCE THROUGH THEIR EMPLOYER ARE ELIGIBLE TO PARTICIPATE IN MINNESOTACARE. ST. FRANCIS PAID $2.4 MILLION FOR MINNESOTACARE TAX IN 2019.
4c (Code:   ) (Expenses $ 4,238,874 including grants of $   ) (Revenue $ -8,105,074 )
UNCOMPENSATED CARECHARITY CAREST. FRANCIS PROVIDES MEDICAL CARE WITHOUT CHARGE OR AT REDUCED COST TO RESIDENTS OF THE COMMUNITIES THAT IT SERVES THROUGH THE PROVISION OF CHARITY CARE. OUR CHARITY CARE PROGRAM KNOWN AS ALLINA HEALTH PARTNERS CARE PROGRAM WAS ESTABLISHED TO ASSIST PATIENTS WHO DO NOT QUALIFY FOR MEDICAL ASSISTANCE SUCH AS MEDICAID AND WHOSE ANNUAL INCOMES ARE AT OR BELOW 275% OF THE FEDERAL POVERTY LEVEL. CHARITY CARE DOES NOT INCLUDE BAD DEBT (CHARGES WRITTEN OFF FOR PROVIDING SERVICES TO PERSONS ABLE, BUT UNWILLING, TO PAY FOR THESE SERVICES). THROUGH THIS PROGRAM, ST. FRANCIS STRIVES TO ENSURE THAT ALL MEMBERS OF THE COMMUNITY RECEIVE QUALITY MEDICAL CARE; REGARDLESS OF ABILITY TO PAY. IN 2019, ST. FRANCIS PROVIDED $1.2 MILLION IN CHARITY CARE.UNINSURED DISCOUNT PROGRAMFOR UNINSURED PATIENTS WHO DO NOT QUALIFY FOR MEDICAID OR MEET THE FINANCIAL THRESHOLD FOR CHARITY CARE, BUT REQUIRE SOME FINANCIAL ASSISTANCE, ST. FRANCIS PROVIDES A SLIDING SCALE DISCOUNT. ALL UNINSURED PATIENTS ARE ELIGIBLE FOR A MINIMUM OF A 25 PERCENT DISCOUNT ON BILLED CHARGES AND MAY QUALIFY FOR DISCOUNTS UP TO 44 PERCENT BASED ON ELIGIBILITY CRITERIA. IN 2019, ST. FRANCIS PROVIDED $3.0 MILLION IN SUCH DISCOUNTS TO LOW-INCOME, UNINSURED INDIVIDUALS. BAD DEBTST. FRANCIS PROVIDES MEDICAL CARE TO ALL IN NEED. THERE ARE TIMES WHEN PATIENT ACCOUNT BALANCES GO UNPAID, KNOWN AS BAD DEBT. THESE BAD DEBT CHARGES IN 2019 TOTALED $8.1 MILLION. BAD DEBT EXPENSE HAS NOT BEEN INCLUDED IN FORM 990, PART IX, LINE 25 BUT HAS BEEN REPORTED AS A REDUCTION TO PATIENT SERVICE REVENUE ON FORM 990, PART VIII LINE 2B.
(Code:   ) (Expenses $ 2,358,313 including grants of $ 294,952 ) (Revenue $   )
COMMUNITY SERVICESST. FRANCIS IS COMMITTED TO SUPPORTING PROGRAMS AND SERVICES THAT ADDRESS COMMUNITY NEEDS. IN 2019, ST. FRANCIS CONTRIBUTED $1.7 MILLION TO COMMUNITY PROGRAMS AND SERVICES TO ADVANCE THE HEALTH OF THE BROADER COMMUNITY. BELOW ARE EXAMPLES OF PROGRAMS AND SERVICES ST. FRANCIS SUPPORTS WITHIN THE COMMUNITIES WE SERVE UNDER THE CATEGORIES PROVIDED BY THE CATHOLIC HEALTHCARE ASSOCIATION (CHA) AND VHA, INC. THE ACTIVITIES IMPROVE COMMUNITY HEALTH AND DO NOT GENERATE INPATIENT OR OUTPATIENT BILLS. ST. FRANCIS SUPPORTS MANY PROGRAMS THAT FALL UNDER THIS CATEGORY. A FEW EXAMPLES INCLUDE:RIVER VALLEY COMMUNITY PARTNERSHIP (DBA: RIVER VALLEY NURSING CENTER):ST. FRANCIS PROVIDES FINANCIAL SUPPORT TO THE RIVER VALLEY HEALTH SERVICES (RIVER VALLEY). RIVER VALLEY PROVIDES SAFE, HIGH-QUALITY PUBLIC HEALTH NURSING AND BI-LINGUAL COMMUNITY RESOURCE REFERRALS AND CASE MANAGEMENT AT SITES IN SCOTT AND CARVER COUNTIES TO PEOPLE WHO ARE UNINSURED AND UNDERINSURED. IN 2019 THE RVNC SERVED OVER 399 CLIENTS DURING 8 HOUR WEEKLY CLINICS AND PERFORMED 257 HEALTH SCREENINGS IN THE COMMUNITY. THIS PREVENTATIVE MODEL HAS PROVEN EFFECTIVE IN PROVIDING ACCESS TO CARE AS 100% OF THE CLIENTS ARE UNINSURED OR UNDERINSURED. RIVER VALLEY HELPS PEOPLE WITH COMPLEX PROBLEMS NAVIGATE THROUGH THE COMMUNITY AGENCIES AND PROGRAMS AVAILABLE TO THEM. ESPERANZA: WITH DONATIONS TO THE RIVER VALLEY YMCA, AS WELL AS ESPERANZA AT NEW CREATION LUTHERAN, ST. FRANCIS IS A MAJOR FINANCIAL SUPPORTER OF THE ESPERANZA PROGRAM WHICH IS A COLLABORATIVE EFFORT IN OUR COMMUNITY. PARTNERS INCLUDE THE SHAKOPEE PUBLIC SCHOOLS, RIVER VALLEY YMCA, SHAKOPEE SOCCER ASSOCIATION, NEW CREATION LUTHERAN CHURCH, SHEPHERD OF THE LAKE LUTHERAN CHURCH, SCOTT COUNTY TRANSIT, AND SHAKOPEE PARKS AND RECREATION. ESPERANZA IS A HOME-GROWN EFFORT OF SCOTT COUNTY RESIDENTS AND COMMUNITY PARTNERS. DEDICATED COMMUNITY MEMBERS PARTNERED FIRST WITH A LOCAL FAITH COMMUNITY TO PROVIDE MEALS AND SOME PROGRAMMING FOR CHILDREN DURING THE SUMMER. THE GOAL WAS TO GIVE CHILDREN ACCESS TO NUTRITIOUS MEALS AS WELL AS A SAFE ENVIRONMENT. OVER THE YEARS, THE PROGRAM HAS GROWN TO ENCOMPASS THE ENTIRE FAMILY, THROUGH FOOD DISTRIBUTIONS AND THE SUMMER CAMPS NOW INCLUDE MIDDLE SCHOOL AS WELL AS PRE-K THROUGH GRADE SCHOOL SOCCER LEAGUES, STEM PROGRAMMING, WATER SAFETY, GARDENING PROJECTS AND MANY OTHER EXPERIENCES WHICH WOULD HAVE OTHERWISE BEEN OUT OF REACH. OVER 170 PARTICIPANTS ARE IMPACTED BY THE SUMMER CAMP PROGRAM; IN ADDITION AT LEAST 10 YOUNG PEOPLE ARE EMPLOYED IN THE PROGRAM AND RECEIVE WORKFORCE DEVELOPMENT PROGRAMMING. ALL CAMPERS ARE OFFERED 5+ FRUITS/VEGETABLE SERVINGS PER DAY AND HAVE 60+ MINUTES OF PHYSICAL ACTIVITY 4 DAYS/WEEK. ST. MARY'S HEALTH CLINICST. MARY'S HEALTH CLINIC PROVIDES QUALITY, FREE HEALTH SERVICES TO PEOPLE WHO ARE UNINSURED AND UNDERINSURED. FOR MANY YEARS, ST. FRANCIS HAS PROVIDED FINANCIAL SUPPORT,CLINIC SPACE AND SUPPLIES TO ALLOW ST. MARY'S HEALTH CLINIC TO OPERATE IN SHAKOPEE. ST. MARY'S HEALTH CLINICS PROVIDES LABORATORY TESTING, RADIOLOGY, OUTPATIENT CARE AND MEDICAL SUPPLIES. THE ST. MARY'S CLINIC IN SHAKOPEE PROVIDES A CONTINUUM OF FREE HEALTH CARE SERVICES TO LOW-INCOME, UNINSURED PEOPLE IN SCOTT, CARVER AND WESTERN DAKOTA COUNTIES. VOLUNTEER DOCTORS AND NURSES PROVIDE CARE INCLUDING PRIMARY CARE VISITS, LAB TESTS, DIAGNOSTIC SERVICES, HEALTH SCREENING, RADIOLOGY SERVICES, PRESCRIPTION MEDICATIONS AND ANY OTHER MEDICALLY NECESSARY OUTPATIENT MEDICAL SERVICES. INTERPRETING SERVICES ARE PROVIDE, AND THE DIABETES EDUCATION ENHANCEMENT PROGRAM (DEEP) PROVIDES ONE-TO-ONE DIABETES SCREENING AND CARE MANAGEMENT TO PATIENTS. OVER 99% OF THE PATIENTS SEEN AT SMHC IN SHAKOPEE ARE HISPANIC/LATINO AND 100% OF THE PATIENTS ARE AT OR BELOW THE 275% OF FEDERAL POVERTY GUIDELINES. FROM JANUARY 2019-DECEMBER 2019; AT THE SHAKOPEE CLINIC, ST. MARY'S PROVIDED 1,357 PATIENT VISITS FOR 391 INDIVIDUALS. ALL SERVICES ARE PROVIDED FREE OF CHARGE TO THE PATIENTS. ADDITIONAL PROGRAMS AND SERVICES PROVIDED BY ST. FRANCIS INCLUDE: CANCER AND DIABETES SUPPORT GROUPS PROVIDING EDUCATIONAL AND EMOTIONAL SUPPORT TO INDIVIDUALS AND THEIR FAMILIES. WHILE EACH SUPPORT GROUP SERVES A DIFFERENT POPULATION, THE PRIMARY PURPOSE IS TO CREATE A COMMUNITY FOR PEOPLE DEALING WITH EXTREMELY STRESSFUL PERIODS IN THEIR LIVES AND PROVIDE THEM COPING SKILLS AND A SAFE SETTING TO DISCUSS THEIR SITUATION;ST. FRANCIS PARTICIPATES IN THE ALLINA HEALTH HEART SAFE COMMUNITIES PROGRAM, INCREASING SURVIVIAL FROM SUDDEN CARDIAC ARREST, A LEADING CAUSE OF DEATH, BY TRAINING INDIVIDUALS IN THE COMMUNITY ON CPR AND AED USE. IN 2019, ST. FRANCIS ASSISTED IN TRAINING OVER 953 PEOPLE IN CPR.ST. FRANCIS PROVIDES FREE HEALTH SCREENING SERVICES TO PROMOTE EARLY DIAGNOSIS OF HEALTH PROBLEMS, INCLUDING SKIN CANCER, BONE DENSITY, CERVICAL CANCER AND DIABETES.HEALTH PROFESSIONS EDUCATION ST. FRANCIS ACTIVELY SUPPORTS NUMEROUS MEDICAL EDUCATION ACTIVITIES FOR PROVIDERS, HEALTH CARE STUDENTS AND OTHER HEALTH PROFESSIONALS. IN 2019, ST. FRANCIS INVESTED OVER $545 THOUSAND IN INTERNSHIP OPPORTUNITIES, MENTORING PARTNERSHIPS, AND GRADUATE MEDICAL EDUCATION PROGRAMMING. ST. FRANCIS IS COMMITTED TO THE EDUCATION, TRAINING AND DEVELOPMENT OF FUTURE HEALTH CARE PROFESSIONALS AND ENSURES THE AVAILABILITY OF A HIGHLY TRAINED WORKFORCE TO MEET THE COMMUNITY'S HEALTH CARE NEEDS. FINANCIAL AND IN-KIND CONTRIBUTIONSST. FRANCIS PROVIDES NUMEROUS IN-KIND AND MONETARY CONTRIBUTIONS TO NOT-FOR-PROFIT ORGANIZATIONS TO SUPPORT COMMUNITY NEEDS. IN 2019, ST. FRANCIS FUNDED $353 THOUSAND FOR DONATIONS TO COMMUNITY PROGRAMS, EQUIPMENT, SUPPLIES, AND STAFF TIME, ST. FRANCIS PARTNERS WITH LOCAL ORGANIZATIONS POSSESSING EXPERTISE AND STAFF NEEDED TO IMPROVE THE HEALTH OF PEOPLE IN NEED. COMMUNITY-BUILDING ACTIVITIESST. FRANCIS AND ITS EMPLOYEES ARE ACTIVE PARTICIPANTS IN VARIOUS COMMUNITY ACTIVITIES THAT TARGET THE ROOT CAUSES OF HEALTH PROBLEMS, SUCH AS POVERTY, HOMELESSNESS AND HUNGER. EXAMPLES INCLUDE COMMUNITY HEALTH IMPROVEMENT ADVOCACY, WORKFORCE DEVELOPMENT, PARTICIPATING IN VARIOUS COMMUNITY COALITIONS AND DISASTER PREPAREDNESS PLANNING. IN 2019, THE VALUE ST. FRANCIS PROVIDED IS VALUED AT $3,056.RELATED ORGANIZATIONS - ST. FRANCIS ALSO INDIRECTLY SUPPORTS THE NUMEROUS CHARITABLE PURPOSES SUPPORTED BY ITS RESPECTIVE JOINT MEMBER ORGANIZATIONS OF CRITICAL ACCESS GROUP, ALLINA HEALTH SYSTEM AND HPI-RAMSEY.
4d Other program services (Describe in Schedule O.)
(Expenses $ 2,358,313 including grants of $ 294,952 ) (Revenue $   )
4e Total program service expensesMediumBullet146,498,906
Form 990 (2019)
Form 990 (2019)
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 II.........
4
 
No
5
Is the organization a section 501(c)(4), 501(c)(5), or 501(c)(6) organization that receives membership dues, assessments, or similar amounts as defined in Revenue Procedure 98-19? If "Yes," complete Schedule C, Part III..
5
 
No
6
Did the organization maintain any donor advised funds or any similar funds or accounts for which donors have the right to provide advice on the distribution or investment of amounts in such funds or accounts? If "Yes," complete Schedule D, Part IClick to see attachment.........................
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 IIClick to see attachment....
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
 
No
9
Did the organization report an amount in Part X, line 21 for escrow or custodial account liability; serve as a custodian for amounts not listed in Part X; or provide credit counseling, debt management, credit repair, or debt negotiation services? If "Yes," complete Schedule D, Part IVClick to see attachment..............
9
 
No
10
Did the organization, directly or through a related organization, hold assets in temporarily restricted endowments, permanent endowments, or quasi endowments? If "Yes," complete Schedule D, Part V......
10
 
No
11
If the organization’s answer to any of the following questions is "Yes," then complete Schedule D, Parts VI, VII, VIII, IX, or X as applicable.
a
Did the organization report an amount for land, buildings, and equipment in Part X, line 10? If "Yes," complete
Schedule D,
Part VI. Click to see attachment...................
11a
Yes
 
b
Did the organization report an amount for investments—other securities in Part X, line 12 that is 5% or more of its total assets reported in Part X, line 16? If "Yes," complete Schedule D, Part VIIClick to see attachment.......
11b
Yes
 
c
Did the organization report an amount for investments—program related in Part X, line 13 that is 5% or more of its total assets reported in Part X, line 16? If "Yes," complete Schedule D, Part VIIIClick to see attachment.......
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 IXClick to see attachment............
11d
Yes
 
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
Click to see attachment......................
12a
 
No
b
Was the organization included in consolidated, independent audited financial statements for the tax year? If "Yes," and if the organization answered "No" to line 12a, then completing Schedule D, Parts XI and XII is optional Click to see attachment
12b
Yes
 
13
Is the organization a school described in section 170(b)(1)(A)(ii)? If "Yes," complete Schedule E
13
 
No
14a
Did the organization maintain an office, employees, or agents outside of the United States? .....
14a
 
No
b
Did the organization have aggregate revenues or expenses of more than $10,000 from grantmaking, fundraising, business, investment, and program service activities outside the United States, or aggregate foreign investments valued at $100,000 or more? If "Yes," complete Schedule F, Parts I and IV.........Click to see attachment
14b
Yes
 
15
Did the organization report on Part IX, column (A), line 3, more than $5,000 of grants or other assistance to or for any foreign organization? If “Yes,” complete Schedule F, Parts II and IV.....Click to see attachment
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...Click to see attachment
16
 
No
17
Did the organization report a total of more than $15,000 of expenses for professional fundraising services on Part IX, column (A), lines 6 and 11e? If "Yes," complete Schedule G, Part I(see instructions) ....Click to see attachment
17
 
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............ Click to see attachment
18
Yes
 
19
Did the organization report more than $15,000 of gross income from gaming activities on Part VIII, line 9a? If "Yes," complete Schedule G, Part III...................Click to see attachment
19
 
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.....Click to see attachment
21
Yes
 
Form 990 (2019)
Form 990 (2019)
Page 4
Part IV
Checklist of Required Schedules (continued)
Yes
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........Click to see attachment
22
Yes
 
23
Did the organization answer "Yes" to Part VII, Section A, line 3, 4, or 5 about compensation of the organization’s current and former officers, directors, trustees, key employees, and highest compensated employees? If "Yes," complete Schedule J....................... Click to see attachment
23
Yes
 
24a
Did the organization have a tax-exempt bond issue with an outstanding principal amount of more than $100,000 as of the last day of the year, that was issued after December 31, 2002? If “Yes,” answer lines 24b through 24d and complete Schedule K. If “No,” go to line 25a...............Click to see attachment
24a
Yes
 
b
Did the organization invest any proceeds of tax-exempt bonds beyond a temporary period exception?...
24b
 
No
c
Did the organization maintain an escrow account other than a refunding escrow at any time during the year
to defease any tax-exempt bonds? ...............
24c
 
No
d
Did the organization act as an "on behalf of" issuer for bonds outstanding at any time during the year?...
24d
 
No
25a
Section 501(c)(3), 501(c)(4), and 501(c)(29) organizations. Did the organization engage in an excess benefit transaction with a disqualified person during the year? If "Yes," complete Schedule L, Part I ....
25a
 
No
b
Is the organization aware that it engaged in an excess benefit transaction with a disqualified person in a prior year, and that the transaction has not been reported on any of the organization’s prior Forms 990 or 990-EZ? If "Yes," complete Schedule L, Part I.......................
25b
 
No
26
Did the organization report any amount on Part X, line 5 or 22 for receivables from or payables to any current or former officer, director, trustee, key employee, creator or founder, substantial contributor, or 35% controlled entity or family member of any of these persons? If "Yes," complete Schedule L, Part II...........
26
 
No
27
Did the organization provide a grant or other assistance to any current or former officer, director, trustee, key employee, creator or founder, substantial contributor, or employee thereof, a grant selection committee member, or to a 35% controlled entity (including an employee thereof) 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, key employee, creator or founder, or substantial contributor? If "Yes," complete Schedule L, Part IV......................
28a
 
No
b
A family member of any individual described in line 28a? If "Yes," complete Schedule L, Part IV.....
28b
 
No
c
A 35% controlled entity of one or more individuals and/or organizations described in lines 28a or 28b? 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..
29
 
No
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............. Click to see attachment
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 VIClick to see attachment
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
89
b
Enter the number of Forms W-2G included in line 1a. Enter -0- if not applicable .
1b
1
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 (2019)
Form 990 (2019)
Page 5
Part V
Statements Regarding Other IRS Filings and Tax Compliance (continued)
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
0
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
 
 
3a
Did the organization have unrelated business gross income of $1,000 or more during the year?...
3a
 
No
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
 
 
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
Yes
 
b
If "Yes," did the organization include with every solicitation an express statement that such contributions or gifts were not tax deductible? ......................
6b
Yes
 
7
Organizations that may receive deductible contributions under section 170(c).
a
Did the organization receive a payment in excess of $75 made partly as a contribution and partly for goods and services provided to the payor? ....................
7a
Yes
 
b
If "Yes," did the organization notify the donor of the value of the goods or services provided? .....
7b
Yes
 
c
Did the organization sell, exchange, or otherwise dispose of tangible personal property for which it was required to file Form 8282? .........................
7c
 
No
d
If "Yes," indicate the number of Forms 8282 filed during the year ....
7d
 
e
Did the organization receive any funds, directly or indirectly, to pay premiums on a personal benefit contract?
7e
 
No
f
Did the organization, during the year, pay premiums, directly or indirectly, on a personal benefit contract? ..
7f
 
No
g
If the organization received a contribution of qualified intellectual property, did the organization file Form 8899 as required? ......................
7g
 
 
h
If the organization received a contribution of cars, boats, airplanes, or other vehicles, did the organization file a Form 1098-C? ..........................
7h
 
 
8
Sponsoring organizations maintaining donor advised funds. Did a donor advised fund maintained by the sponsoring organization have excess business holdings at any time during the year? ........
8
 
 
9
Sponsoring organizations maintaining donor advised funds.
a
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 (2019)
Form 990 (2019)
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
13
2
Did any officer, director, trustee, or key employee have a family relationship or a business relationship with any other officer, director, trustee, or key employee? .................
2
Yes
 
3
Did the organization delegate control over management duties customarily performed by or under the direct supervision of officers, directors or trustees, or key employees to a management company or other person? .
3
Yes
 
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
MN
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:
MediumBulletTAX SERVICES MAIL ROUTE 108902925 CHICAGO AVENUE   MINNEAPOLIS,MN554071321 (612) 262-0660
Form 990 (2019)
Form 990 (2019)
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.

See instructions for the order in which to list the persons above.
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) ROBERT BERNIER......................................................................
DIRECTOR/TREASURE
2.00
.................
0.00
X           267 0 0
(2) JOANNA BRYANT......................................................................
DIRECTOR
2.00
.................
0.00
X           0 0 0
(3) SR KATHLEEN DEL MONTE......................................................................
DIRECTOR
2.00
.................
0.00
X           0 0 0
(4) JENNIFER DESCHAINE......................................................................
DIRECTOR/SECRETARY
2.00
.................
0.00
X           538 0 0
(5) AMY DEWANE......................................................................
DIRECTOR
2.00
.................
0.00
X           0 0 0
(6) AYESHA DOWNS DDS......................................................................
DIRECTOR/VICE CHAIR
2.00
.................
0.00
X           292 0 0
(7) DAVID DRUCKMAN MD......................................................................
DIRECTOR
2.00
.................
0.00
X           0 0 0
(8) SR ELIZABETH FARIAS......................................................................
DIRECTOR
2.00
.................
0.00
X           0 0 0
(9) SR KATHLEEN HOFER......................................................................
DIRECTOR
2.00
.................
0.00
X           0 0 0
(10) AARON HOLM......................................................................
DIRECTOR
2.00
.................
0.00
X           48 0 0
(11) JENNIFER HUNT MD......................................................................
DIRECTOR
2.00
.................
0.00
X           0 0 0
(12) AMY JERDEE......................................................................
DIRECTOR/PRESIDENT
40.00
.................
0.00
X   X       221,575 0 14,969
(13) MONTE JOHNSON MD......................................................................
DIRECTOR/INTERIM PRES.
24.00
.................
16.00
X   X       279,301 186,201 44,251
(14) MICHAEL MCMAHAN......................................................................
DIR/PRES/CHIEF INTEGRATION
2.00
.................
40.00
X   X       0 511,013 48,280
(15) KEITH OLSON DO......................................................................
DIRECTOR
2.00
.................
40.00
X           0 416,915 36,101
(16) DEBORAH PAULY......................................................................
DIRECTOR/VICE CHAIR/CHAIRM
2.00
.................
0.00
X           338 0 0
(17) REV DANIEL POFFENBERGER......................................................................
DIRECTOR
2.00
.................
0.00
X           315 0 0
Form 990 (2019)
Form 990 (2019)
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) MARK SANNES MD........................................................................
DIRECTOR
2.00
.......................0.00
X           0 0 0
(19) LOU VAN HOUT........................................................................
DIRECTOR
2.00
.......................0.00
X           242 0 0
(20) MICHAEL WEBB........................................................................
DIRECTOR
2.00
.......................0.00
X           224 0 0
(21) CYNTHIA VINCENT........................................................................
VP FINANCE/OPERATIONS
40.00
.......................0.00
    X       293,631 0 55,027
(22) SUE MILLER........................................................................
VP PATIENT CARE SERVICES
40.00
.......................0.00
      X     266,038 0 35,957
(23) KARYN BARRY........................................................................
CRNA
40.00
.......................0.00
        X   182,963 0 29,881
(24) JAMES GRUENWALD........................................................................
CRNA
40.00
.......................0.00
        X   185,382 0 29,581
(25) FARAH PIEPER........................................................................
CRNA
40.00
.......................0.00
        X   192,538 0 1,084
(26) GREGORY SPINDLER........................................................................
CRNA
40.00
.......................0.00
        X   183,825 0 19,485
(27) DEAN TEBRAKE........................................................................
CRNA
40.00
.......................0.00
        X   189,634 0 18,692
(28) BRIAN PROKOSCH MD........................................................................
FORMER VP MEDICAL AFFAIRS
0.00
.......................40.00
          X 0 384,226 16,360




1b Sub-Total................MediumBullet
c Total from continuation sheets to Part VII, Section A....MediumBullet
d Total (add lines 1b and 1c)...........MediumBullet 1,997,151 1,498,355 349,668
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 MediumBullet110
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
PREMIER STAFFING INC

243 WINKLER TRAIL
COLOGNE,MN55322
PROFESSIONAL SERVICES - PHYSICIAN 1,530,110
CHILDREN'S HEALTH CARE INC

2525 CHICAGO AVENUE SOUTH
MINNEAPOLIS,MN55404
PROFESSIONAL SERVICES - MEDICAL 1,115,058
PARK NICOLLET METHODIST HOSPITAL

6500 EXCELSIOR BLVD
ST LOUIS PARK,MN55440
PROFESSIONAL SERVICES - PHYSICIAN 1,066,772
JE DUNN CONSTRUCTION

9855 W 78TH STREET SUITE 270
EDEN PRAIRIE,MN55344
CONSTRUCTION 637,711
HEALTH SYSTEMS COOPERATIVE LAUNDRIES

55 5TH STREET EAST 960
ST PAUL,MN55101
OTHER SERVICES - DRY CLEANING/LAUNDRY 468,629
2
Total number of independent contractors (including but not limited to those listed above) who received more than $100,000 of compensation from the organization MediumBullet12
Form 990 (2019)
Form 990 (2019)
Page 9
Part VIII
Statement of Revenue
Check if Schedule O contains a response or note to any line in this Part VIII.............
(A)
Total revenue
(B)
Related or
exempt
function
revenue
(C)
Unrelated
business
revenue
(D)
Revenue
excluded from
tax under sections
512 - 514
Contributions, Gifts, GrantAmt and OtherAmt Similar Amounts 1a Federated campaigns..1a  
b Membership dues..1b  
c Fundraising events..1c 175,858
d Related organizations1d  
e Government grants (contributions)1e  
f All other contributions, gifts, grants, and similar amounts not included above1f 117,423
g Noncash contributions included in lines 1a - 1f:$ 1g 5,784
h Total. Add lines 1a-1f.......MediumBullet 293,281
 Program Service RevenueAmt Business Code
2a NET PATIENT REVENUE 621110 179,479,907 179,479,907    
b BAD DEBT 621110 -8,105,074 -8,105,074    
c
d
e
f All other program service revenue.        
g Total. Add lines 2a–2f .....MediumBullet 171,374,833
 OtherAmtRevenueAmt 3 Investment income (including dividends, interest, and othersimilar amounts) ......MediumBullet 1,643,470     1,643,470
4 Income from investment of tax-exempt bond proceedsMediumBullet 1,254     1,254
5 Royalties...........MediumBullet        
(ii) Personal (i) Real
6a Gross rents   609,309 6a
b Less: rental expenses   0 6b
c Rental income or (loss)   609,309 6c
d Net rental income or (loss).......MediumBullet 609,309     609,309
(ii) Other (i) Securities
7a Gross amount from sales of assets other than inventory 84,787 27,192,575 7a
b Less: cost or other basis and sales expenses 155,861 26,282,214 7b
c Gain or (loss) -71,074 910,361 7c
d Net gain or (loss).........MediumBullet 839,287     839,287
8a Gross income from fundraising events (not including $ 175,858of contributions reported on line 1c). See Part IV, line 18 ....
8a 166,983
b Less: direct expenses ... 8b 196,627
c Net income or (loss) from fundraising events..MediumBullet -29,644   -29,644
9a Gross income from gaming activities.
See Part IV, line 19 ...
9a 13,600
b Less: direct expenses ... 9b 32,391
c Net income or (loss) from gaming activities..MediumBullet -18,791     -18,791
10a Gross sales of inventory, less
returns and allowances ..
10a  
b Less: cost of goods sold .. 10b  
c Net income or (loss) from sales of inventory..MediumBullet        
Business Code Miscellaneous Revenue
11a            
b            
c            
d All other revenue ....        
e Total. Add lines 11a–11d ...... MediumBullet  
12 Total revenue. See instructions.....MediumBullet 174,712,999 171,374,833 0 3,044,885
Form 990 (2019)
Form 990 (2019)
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 .... 276,507 276,507
2 Grants and other assistance to domestic individuals. See Part IV, line 22 ........... 18,445 18,445
3 Grants and other assistance to foreign organizations, foreign governments, and foreign individuals. See Part IV, lines 15 and 16. .............    
4 Benefits paid to or for members .......    
5 Compensation of current officers, directors, trustees, and key employees ........... 1,195,313 607,847 587,466  
6 Compensation not included above, to disqualified persons (as defined under section 4958(f)(1)) and persons described in section 4958(c)(3)(B) .........        
7 Other salaries and wages........ 61,785,068 57,561,119 4,033,266 190,683
8 Pension plan accruals and contributions (include section 401(k) and 403(b) employer contributions) .... 4,088,514 3,776,170 299,965 12,379
9 Other employee benefits ....... 11,256,381 10,396,445 825,856 34,080
10 Payroll taxes ........... 4,353,176 4,020,613 319,383 13,180
11 Fees for services (non-employees):        
a Management ......        
b Legal .........        
c Accounting ........... 100,000   100,000  
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) 13,502,222 12,212,393 1,250,678 39,151
12 Advertising and promotion .... 338,344   338,344  
13 Office expenses ....... 22,287,255 22,224,130 50,760 12,365
14 Information technology ...... 96,930 22,438 75,357 -865
15 Royalties ..        
16 Occupancy ........... 5,872,647 2,999,665 2,872,982  
17 Travel ............ 33,612 25,414 7,882 316
18 Payments of travel or entertainment expenses for any federal, state, or local public officials .        
19 Conferences, conventions, and meetings .... 86,588 78,025 8,063 500
20 Interest ........... 1,786,599 1,786,599    
21 Payments to affiliates .......        
22 Depreciation, depletion, and amortization .. 8,459,056 6,343,020 2,114,340 1,696
23 Insurance ... 1,689,400 1,182,580 506,820  
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 PURCHASED SERVICES 20,382,360 18,759,110 1,598,570 24,680
b MINNESOTACARE TAX 2,374,891 2,374,891    
c MEDICAID SURCHARGE 1,726,696 1,726,696    
d
e All other expenses 259,245 106,799 116,053 36,393
25 Total functional expenses. Add lines 1 through 24e 161,969,249 146,498,906 15,105,785 364,558
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 (2019)
Form 990 (2019)
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 ........ 148,690 1 450,413
2 Savings and temporary cash investments .........   2  
3 Pledges and grants receivable, net ...... 116,449 3 92,528
4 Accounts receivable, net ............. 22,623,890 4 26,867,280
5 Loans and other payables to any current or former officer, director, trustee, key employee, creator or founder, substantial contributor, or 35% controlled entity or family member of any of these persons .......
  5  
6 Loans and other receivables from other disqualified persons (as defined under section 4958(f)(1)), and persons described in section 4958(c)(3)(B) ...
  6  
7 Notes and loans receivable, net ........... 143,437 7 66,331
8 Inventories for sale or use ............ 1,930,793 8 2,141,857
9 Prepaid expenses and deferred charges ...... 83,157 9 49,003
10a Land, buildings, and equipment: cost or other basis. Complete Part VI of Schedule D 10a 163,222,827
b Less: accumulated depreciation 10b 98,359,647 78,112,402 10c 64,863,180
11 Investments—publicly traded securities .   11  
12 Investments—other securities. See Part IV, line 11 ..... 76,996,077 12 89,524,349
13 Investments—program-related. See Part IV, line 11 .. 5,697,051 13 0
14 Intangible assets ...............   14  
15 Other assets. See Part IV, line 11 ........... 3,525,505 15 12,388,301
16 Total assets. Add lines 1 through 15 (must equal line 33)... 189,377,451 16 196,443,242
Liabilities 17 Accounts payable and accrued expenses ..... 9,721,232 17 9,679,595
18 Grants payable ...   18  
19 Deferred revenue ......... 191,402 19 123,789
20 Tax-exempt bond liabilities ......... 37,927,716 20 36,111,372
21 Escrow or custodial account liability. Complete Part IV of Schedule D   21  
22 Loans and other payables to any current or former officer, director, trustee, key employee, creator or founder, substantial contributor, or 35% controlled entity or family member of any of these persons .........
  22  
23 Secured mortgages and notes payable to unrelated third parties ..   23  
24 Unsecured notes and loans payable to unrelated third parties ..   24  
25 Other liabilities (including federal income tax, payables to related third parties, and other liabilities not included on lines 17 - 24). Complete Part X of Schedule D 15,732,303 25 12,264,491
26 Total liabilities. Add lines 17 through 25.. 63,572,653 26 58,179,247
Net Assets or Fund Balance Organizations that follow FASB ASC 958, check here MediumBullet and complete lines 27, 28, 32, and 33.
27 Net assets without donor restrictions .......... 124,248,291 27 136,719,559
28 Net assets with donor restrictions ........... 1,556,507 28 1,544,436
Organizations that do not follow FASB ASC 958, check here MediumBullet and complete lines 29 through 33.
29 Capital stock or trust principal, or current funds .....   29  
30 Paid-in or capital surplus, or land, building or equipment fund ...   30  
31 Retained earnings, endowment, accumulated income, or other funds   31  
32 Total net assets or fund balances ........... 125,804,798 32 138,263,995
33 Total liabilities and net assets/fund balances ........ 189,377,451 33 196,443,242
Form 990 (2019)
Form 990 (2019)
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
174,712,999
2
Total expenses (must equal Part IX, column (A), line 25) ............
2
161,969,249
3
Revenue less expenses. Subtract line 2 from line 1 ..............
3
12,743,750
4
Net assets or fund balances at beginning of year (must equal Part X, line 32, column (A)) ..
4
125,804,798
5
Net unrealized gains (losses) on investments ...............
5
6,023,236
6
Donated services and use of facilities .................
6
 
7
Investment expenses .....................
7
 
8
Prior period adjustments .....................
8
 
9
Other changes in net assets or fund balances (explain in Schedule O) ........
9
-6,307,789
10
Net assets or fund balances at end of year. Combine lines 3 through 9 (must equal Part X, line 32, column (B))
10
138,263,995
Part XII
Financial Statements and Reporting
Check if Schedule O contains a response or note to any line in this Part XII.............
Yes
No
1
Accounting method used to prepare the Form 990:  
If the organization changed its method of accounting from a prior year or checked "Other," explain in
Schedule O.
2a
Were the organization’s financial statements compiled or reviewed by an independent accountant?
2a
 
No
If ‘Yes,’ check a box below to indicate whether the financial statements for the year were compiled or reviewed on a separate basis, consolidated basis, or both:
b
Were the organization’s financial statements audited by an independent accountant?
2b
Yes
 
If ‘Yes,’ check a box below to indicate whether the financial statements for the year were audited on a separate basis, consolidated basis, or both:
c
If "Yes," to line 2a or 2b, does the organization have a committee that assumes responsibility for oversight of the audit, review, or compilation of its financial statements and selection of an independent accountant?
2c
Yes
 
If the organization changed either its oversight process or selection process during the tax year, explain in Schedule O.
3a
As a result of a federal award, was the organization required to undergo an audit or audits as set forth in the Single Audit Act and OMB Circular A-133?
3a
 
No
b
If "Yes," did the organization undergo the required audit or audits? If the organization did not undergo the required audit or audits, explain why in Schedule O and describe any steps taken to undergo such audits.
3b
 
 
Form 990 (2019)
Form 990 (2019)
Additional Data


Software ID:  
Software Version:  
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 instructions and the latest information.
OMB No. 1545-0047
2019
Open to Public
Inspection
Name of the organization
ST FRANCIS REGIONAL MEDICAL CENTER
 
Employer identification number

41-0907986
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) 2019

Schedule A (Form 990 or 990-EZ) 2019
Page 2
Part II
Support Schedule for Organizations Described in Sections 170(b)(1)(A)(iv) and 170(b)(1)(A)(vi)
(Complete only if you checked the box on line 5, 7, or 8 of Part I or if the organization failed to qualify under Part III. If the organization failed 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) 2015 (b) 2016 (c) 2017 (d) 2018 (e) 2019 (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) 2015 (b) 2016 (c) 2017 (d) 2018 (e) 2019 (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) 2019

Schedule A (Form 990 or 990-EZ) 2019
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) 2015 (b) 2016 (c) 2017 (d) 2018 (e) 2019 (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) 2015 (b) 2016 (c) 2017 (d) 2018 (e) 2019 (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) 2019

Schedule A (Form 990 or 990-EZ) 2019
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) 2019

Schedule A (Form 990 or 990-EZ) 2019
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) 2019

Schedule A (Form 990 or 990-EZ) 2019
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) 2019

Schedule A (Form 990 or 990-EZ) 2019
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 2019 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-2019
(iii)
Distributable
Amount for 2019
1 Distributable amount for 2019 from Section C, line 6  
2 Underdistributions, if any, for years prior to 2019 (reasonable cause required-- explain in Part VI).
See instructions.
 
3 Excess distributions carryover, if any, to 2019:
a From 2014.......  
b From 2015.......  
c From 2016.......  
d From 2017.......  
e From 2018.......  
fTotal of lines 3a through e  
g Applied to underdistributions of prior years  
h Applied to 2019 distributable amount  
i Carryover from 2014 not applied (see
instructions)
 
j Remainder. Subtract lines 3g, 3h, and 3i from 3f.  
4Distributions for 2019 from Section D, line 7:
$  
a Applied to underdistributions of prior years  
b Applied to 2019 distributable amount  
c Remainder. Subtract lines 4a and 4b from 4.  
5 Remaining underdistributions for years prior to
2019, 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 2019. 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 2020. Add lines
3j and 4c.
 
8 Breakdown of line 7:
a Excess from 2015.....  
b Excess from 2016.....  
c Excess from 2017.....  
d Excess from 2018.....  
e Excess from 2019.....  
Schedule A (Form 990 or 990-EZ) (2019)

Schedule A (Form 990 or 990-EZ) 2019
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) 2019


Additional Data


Software ID:  
Software Version:  
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
2019
Name of the organization
ST FRANCIS REGIONAL MEDICAL CENTER
 
Employer identification number

41-0907986
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) (2019)
Schedule B (Form 990, 990-EZ, or 990-PF) (2019) Page 2
Name of organization
ST FRANCIS REGIONAL MEDICAL CENTER
 
Employer identification number
41-0907986
Part I
Contributors
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) (2019)
Schedule B (Form 990, 990-EZ, or 990-PF) (2019)
Page 3
Name of organization
ST FRANCIS REGIONAL MEDICAL CENTER
 
Employer identification number

41-0907986
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) (2019)
Schedule B (Form 990, 990-EZ, or 990-PF) (2019)
Page 4
Name of organization
ST FRANCIS REGIONAL MEDICAL CENTER
 
Employer identification number

41-0907986
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) (2019)

Additional Data


Software ID:  
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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 instructions and the latest information.
OMB No. 1545-0047
2019
Open to Public Inspection
Name of the organization
ST FRANCIS REGIONAL MEDICAL CENTER
 
Employer identification number

41-0907986
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 FASB 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 FASB ASC 958, to report in its revenue statement and balance sheet works of art, historical treasures, or other similar assets held for public exhibition, education, or research in furtherance of public service, provide the following amounts relating to these items:
(i)
Revenue included on Form 990, Part VIII, line 1 .........................SchDMd Bullet $  
(ii)
Assets included in Form 990, Part X ...............................SchDMd Bullet $  
2
If the organization received or held works of art, historical treasures, or other similar assets for financial gain, provide the
following amounts required to be reported under FASB 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) 2019

Schedule D (Form 990) 2019
Page 2
Part III
Organizations Maintaining Collections of Art, Historical Treasures, or Other Similar Assets (continued)
3
Using the organization’s acquisition, accession, and other records, check any of the following that are a significant use of its collection items (check all that apply):
a
d
b
e
 
c
4
Provide a description of the organization’s collections and explain how they further the organization’s exempt purpose in
Part XIII.
5
During the year, did the organization solicit or receive donations of art, historical treasures or other similar
assets to be sold to raise funds rather than to be maintained as part of the organization’s collection?...
Part IV
Escrow and Custodial Arrangements. Complete if the organization answered "Yes" on Form 990, Part IV, line 9, or reported an amount on Form 990, Part X, line 21.
1a
Is the organization an agent, trustee, custodian or other intermediary for contributions or other assets not
included on Form 990, Part X? ....................................
b If "Yes," explain the arrangement in Part XIII and complete the following table: Amount
c Beginning balance ............................. 1c  
d Additions during the year ............................ 1d  
e Distributions during the year .......................... 1e  
f Ending balance ................................ 1f  
2a
Did the organization include an amount on Form 990, Part X, line 21, for escrow or custodial account liability? ...
b
If "Yes," explain the arrangement in Part XIII. Check here if the explanation has been provided in Part XIII ....
Part V
Endowment Funds.
Complete if the organization answered "Yes" on Form 990, Part IV, line 10.
(a) Current year (b) Prior year (c) Two years back (d) Three years back (e) Four years back
1a Beginning of year balance ....          
b Contributions ...          
c Net investment earnings, gains, and losses          
d Grants or scholarships ...          
e Other expenditures for facilities
and programs ...
         
f Administrative expenses ....          
g End of year balance ......          
2
Provide the estimated percentage of the current year end balance (line 1g, column (a)) held as:
a
Board designated or quasi-endowment SchDMd Bullet  
b
Permanent endowment SchDMd Bullet  
c
Term 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 .....   220,940 220,940
b Buildings ....   103,271,727 50,543,455 52,728,272
c Leasehold improvements   6,188,688 5,047,054 1,141,634
d Equipment ....   48,810,100 39,994,578 8,815,522
e Other .....   4,731,372 2,774,560 1,956,812
Total. Add lines 1a through 1e. (Column (d) must equal Form 990, Part X, column (B), line 10(c).)..SchDMdBullet 64,863,180
Schedule D (Form 990) 2019

Schedule D (Form 990) 2019
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) TRUST SHORT-TERM FIXED INCOME
12,000 F

(B) TRUST MONEY MARKET
14,537,056 F

(C) TRUST CORE FIXED INCOME
27,937,107 F

(D) TRUST EQUITY SECURITIES
19,745,075 F

(E) TRUST GLOBAL BOND FUNDS
4,891,955 F

(F) COMMODITIES & OTHER
3,618,425 F

(G) TRUST GLOBAL EQUITY FUND
3,326,669 F

(H) TRUST EMERGING MARKETS EQUITY FUND
3,218,888 F

(I) EMERGING MARKETS DEBT FUND
1,583,503 F

(J) OPPORTUNISTIC FIXED INCOME HEDGE FUND
3,392,076 F

(K) EQUITY LONG/SHORT HEDGE FUNDS
5,696,636 F

(L) DONOR RESTRICTED INVESTMENTS
1,564,047 F

(M) FUNDS RESTRICTED BY TRUSTEE
912 F
Total. (Column (b) must equal Form 990, Part X, col. (B) line 12.)Small Bullet 89,524,349
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
(2)
(3)
(4)
(5)
(6)
(7)
(8)
(9)
(10)
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)OPERATING LEASE RIGHT OF USE ASSETS, NET 9,952,436
(2)DUE FROM ALLINA HEALTH SYSTEM 1,961,224
(3)CASH SURRENDER VALUE OF LIFE INSURANCE 216,319
(4)OTHER ASSETS 258,322
(5)
(6)
(7)
(8)
(9)
(10)
Total. (Column (b) must equal Form 990, Part X, col.(B) line 15.)...........Small Bullet 12,388,301
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  
(4)
(5)
(6)
(7)
(8)
(9)
Total. (Column (b) must equal Form 990, Part X, col.(B) line 25.)Small Bullet 12,264,491
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) 2019

Schedule D (Form 990) 2019
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
PART X, LINE 2: THE FOLLOWING IS FROM NOTE 2(L) TO THE AUDITED FINANCIAL STATEMENTS: "THE MEDICAL CENTER ANALYZES INCOME TAX POSITIONS TAKEN FOR FILING WITH THE INTERNAL REVENUE SERVICE AND THE STATE OF MINNESOTA. THE MEDICAL CENTER BELIEVES THAT INCOME TAX FILING POSITIONS WILL BE SUSTAINED UPON EXAMINATION AND DOES NOT ANTICIPATE ANY ADJUSTMENTS THAT WOULD RESULT IN A MATERIAL ADVERSE EFFECT ON THE MEDICAL CENTER'S CONSOLIDATED FINANCIAL STATEMENTS. AS OF DECEMBER 31, 2019 AND 2018, THE MEDICAL CENTER DOES NOT HAVE A LIABILITY FOR UNRECOGNIZED TAX BENEFITS. ACCORDINGLY, THE MEDICAL CENTER HAS NOT RECORDED ANY RESERVES OR RELATED ACCRUALS FOR INTEREST AND PENALTIES FOR UNCERTAIN INCOME TAX POSITIONS. THE FILINGS FOR THE YEARS 2015 TO 2018 ARE OPEN TO EXAMINATION BY FEDERAL AND STATE AUTHORITIES."
Schedule D (Form 990) 2019


Additional Data


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Software Version:  




SCHEDULE F(Form 990)
Department of the Treasury
Internal Revenue Service
Statement of Activities Outside the United States
Right pointing arrow large image Complete if the organization answered "Yes" to Form 990, Part IV, line 14b, 15, or 16.Right pointing arrow large image Attach to Form 990.Right pointing arrow large image Go to www.irs.gov/Form990 for instructions and the latest information.
OMB No. 1545-0047
2019
Open to Public Inspection
Name of the organization
ST FRANCIS REGIONAL MEDICAL CENTER
 
Employer identification number

41-0907986
Part I
General Information on Activities Outside the United States. Complete if the organization answered "Yes" on Form 990, Part IV, line 14b.
1
For grantmakers. Does the organization maintain records to substantiate the amount of its grants and
other assistance, the grantees’ eligibility for the grants or assistance, and the selection criteria used
to award the grants or assistance? . . . . . . . . . . . . . . . . . . . . . . . . .
2
For grantmakers. Describe in Part V the organization’s procedures for monitoring the use of its grants and other assistance outside the United States.
3
Activites per Region. (The following Part I, line 3 table can be duplicated if additional space is needed.)
(a) Region (b) Number of offices in the region (c) Number of employees, agents, and independent contractors in the region (d) Activities conducted in region (by type) (such as, fundraising, program services, investments, grants to recipients located in the region) (e) If activity listed in (d) is a program service, describe specific type of
service(s) in the region
(f) Total expenditures
for and investments
in the region
CENTRAL AMERICA AND THE CARIBBEAN - ANTIGUA & BARBUDA, ARUBA, BAHAMAS,         12,039,604
EUROPE (INCLUDING ICELAND & GREENLAND) - ALBANIA, ANDORRA, AUSTRIA, BELGIUM         1,003,396
           
           
           
           
           
           
           
           
           
           
           
           
           
           
           
3a Sub-total .... 0 0 13,043,000
b Total from continuation sheets to Part I ... 0 0 0
c Totals (add lines 3a and 3b) 0 0 13,043,000
For Paperwork Reduction Act Notice, see the Instructions for Form 990.Cat. No. 50082W Schedule F (Form 990) 2019
Schedule F (Form 990) 2019
Page 2
Part II
Grants and Other Assistance to Organizations or Entities Outside the United States. Complete if the organization answered "Yes" on Form 990, Part IV, line 15, for any recipient who received more than $5,000. Part II can be duplicated if additional space is needed.
1 (a) Name of organization (b) IRS code section
and EIN (if applicable)
(c) Region (d) Purpose of
grant
(e) Amount of
cash grant
(f) Manner of
cash
disbursement
(g) Amount
of noncash
assistance
(h) Description
of noncash
assistance
(i) Method of
valuation
(book, FMV,
appraisal, other)
             
             
             
             
             
             
             
             
             
             
             
             
             
             
             
             
2 Enter total number of recipient organizations listed above that are recognized as charities by the foreign country, recognized as tax-exempt by the IRS, or for which the grantee or counsel has provided a section 501(c)(3) equivalency letter .......MediumBullet
 
3 Enter total number of other organizations or entities .......................MediumBullet
 
Schedule F (Form 990) 2019
Schedule F (Form 990) 2019Page 3
Part III
Grants and Other Assistance to Individuals Outside the United States. Complete if the organization answered "Yes" on Form 990, Part IV, line 16.
Part III can be duplicated if additional space is needed.
(a) Type of grant or assistance (b) Region (c) Number of recipients (d) Amount of
cash grant
(e) Manner of cash
disbursement
(f) Amount of
noncash
assistance
(g) Description
of noncash
assistance
(h) Method of
valuation
(book, FMV,
appraisal, other)
               
               
               
               
               
               
               
               
               
               
               
               
               
               
               
               
               
               
Schedule F (Form 990) 2019
Schedule F (Form 990) 2019
Page 4
Part IV
Foreign Forms
1 Was the organization a U.S. transferor of property to a foreign corporation during the tax year? If "Yes," the organization may be required to file Form 926, Return by a U.S. Transferor of Property to a Foreign Corporation (see Instructions for Form 926). . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
2 Did the organization have an interest in a foreign trust during the tax year? If "Yes," the organization may be required to separately file Form 3520, Annual Return to Report Transactions with Foreign Trusts and Receipt of Certain Foreign Gifts, and/or Form 3520-A, Annual Information Return of Foreign Trust With a U.S. Owner (see Instructions for Forms 3520 and 3520-A; don't file with Form 990). . . . . . . . . . . . . . . . . . . . . . . .
3 Did the organization have an ownership interest in a foreign corporation during the tax year? If "Yes," the organization may be required to file Form 5471, Information Return of U.S. Persons with Respect to Certain Foreign Corporations. (see Instructions for Form 5471). . . . . . . . . . . . . . . . . . . . . . . . . . . .
4 Was the organization a direct or indirect shareholder of a passive foreign investment company or a qualified electing fund during the tax year? If “Yes,” the organization may be required to file Form 8621, Information Return by a Shareholder of a Passive Foreign Investment Company or Qualified Electing Fund. (see Instructions for Form 8621) .
5 Did the organization have an ownership interest in a foreign partnership during the tax year? If "Yes," the organization may be required to file Form 8865, Return of U.S. Persons with Respect to Certain Foreign Partnerships (see Instructions for Form 8865). . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
6 Did the organization have any operations in or related to any boycotting countries during the tax year? If "Yes," the organization may be required to separately file Form 5713, International Boycott Report (see Instructions for Form 5713; don't file with Form 990).. . . . . . . . . . . . . . . . . . . . . . . . . . . .
Schedule F (Form 990) 2019
Schedule F (Form 990) 2019
Page 5
Part V
Supplemental Information
Provide the information required by Part I, line 2 (monitoring of funds); Part I, line 3, column (f) (accounting method; amounts of investments vs. expenditures per region); Part II, line 1 (accounting method); Part III (accounting method); and Part III, column (c) (estimated number of recipients), as applicable. Also complete this part to provide any additional information. See instructions.
ReturnReference Explanation
PART III ACCOUNTING METHOD:  
FORM 990 SCHEDULE F PART IV 3 ST. FRANCIS REGIONAL MEDICAL CENTER'S INVESTMENTS, INCLUDING THOSE OUTSIDE THE U.S., ARE POOLED WITH THOSE OF OTHER ALLINA HEALTH ENTITIES UNDER A TRUST AGREEMENT, WITH THE CUSTODIAN /TRUSTEE BANK HANDLING THE INVESTMENT ACCOUNTING. INVESTMENTS ARE STATED AT FAIR VALUE. THE MEDICAL CENTER HAS CLASSIFIED INVESTMENTS, OTHER THAN THOSE LIMITED AS TO USE, AS TRADING AND RECORDS ADJUSTMENTS TO MARKET VALUE AS A COMPONENT OF NONOPERATING GAINS(LOSSES). THE DETAILS OF THE SALES AND PURCHASES ARE MAINTAINED BY THE CUSTODIAN/TRUSTEE BANK. DUE TO THE UNITIZED STRUCTURE OF THE INVESTMENTS AT ALLINA HEALTH, THE MEDICAL CENTER IS ALLOCATED AN EQUITABLE PORTION OF SALES AND PURCHASES OF INVESTMENTS EXECUTED FOR ALLINA HEALTH. THE MEDICAL CENTER'S EQUITABLE PORTION IS INCLUDED IN SCHEDULE F PART I LINE 3 AND ALLINA HEALTH SYSTEM MASTER TRUST, EIN 36-3261413, FILES THE FORM 5471 ON BEHALF OF THE OTHER ALLINA HEALTH ENTITIES, INCLUDING THE MEDICAL CENTER.
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
Schedule F (Form 990) 2019
Additional Data


Software ID:  
Software Version:  



SCHEDULE G (Form 990 or 990-EZ)
Department of the Treasury
Internal Revenue Service
Supplemental Information Regarding
Fundraising or Gaming Activities
Complete if the organization answered "Yes" on Form 990, Part IV, lines 17, 18, or 19, or if the organization entered more than $15,000 on Form 990-EZ, line 6a. right arrowAttach to Form 990 or Form 990-EZ.
right arrowGo to www.irs.gov/Form990 for instructions and the latest information.
OMB No. 1545-0047
2019
Open to Public Inspection
Name of the organization
ST FRANCIS REGIONAL MEDICAL CENTER
 
Employer identification number

41-0907986
Part I
Fundraising Activities.Complete if the organization answered "Yes" on Form 990, Part IV, line 17.
Form 990-EZ filers are not required to complete this part.
1
Indicate whether the organization raised funds through any of the following activities. Check all that apply.
a e
b f
c g
d
2a
Did the organization have a written or oral agreement with any individual (including officers, directors, trustees
or key employees listed in Form 990, Part VII) or entity in connection with professional fundraising services?
b
If "Yes," list the 10 highest paid individuals or entities (fundraisers) pursuant to agreements under which the fundraiser is
to be compensated at least $5,000 by the organization.


(i) Name and address of individual
or entity (fundraiser)
(ii) Activity (iii) Did fundraiser have custody or control of contributions? (iv) Gross receipts
from activity
(v) Amount paid to
(or retained by)
fundraiser listed in
col. (i)
(vi) Amount paid to
(or retained by)
organization
Yes No
             
             
             
             
             
             
             
             
             
             
Total . . . . . . . . . . . . . . . . . . . . right arrow      
3
List all states in which the organization is registered or licensed to solicit contributions or has been notified it is exempt from registration or licensing.
For Paperwork Reduction Act Notice, see the Instructions for Form 990 or 990-EZ.
Cat. No. 50083H
Schedule G (Form 990 or 990-EZ) 2019
Schedule G (Form 990 or 990-EZ) 2019
Page 2
Part II
Fundraising Events. Complete if the organization answered "Yes" on Form 990, Part IV, line 18, or reported more than $15,000 of fundraising event contributions and gross income on Form 990-EZ, lines 1 and 6b. List events with gross receipts greater than $5,000.









VerticalRevenue
(a) Event #1

FOUNDATION GALA
(event type)
(b) Event #2

GOLF TOURNAMENT
(event type)
(c) Other events

1
(total number)
(d) Total events
(add col. (a) through col. (c))

1

Gross receipts . . . . .

262,506

57,587

16,947

337,040

2

Less: Contributions . . . .

133,961

29,248

6,850

170,059
3 Gross income (line 1 minus
line 2) . . . . . .

128,545

28,339

10,097

166,981



VerticalDirectExpenses
4 Cash prizes . . . . . 0 1,390 480 1,870
5 Noncash prizes . . . . 11,990 4,128 696 16,814
6 Rent/facility costs . . . . 16,888 0 0 16,888
7 Food and beverages . . . 71,561 7,484 3,412 82,457
8 Entertainment . . . . 22,650 12,144 0 34,794
9 Other direct expenses . . . 32,519 779 10,507 43,805
10 Direct expense summary. Add lines 4 through 9 in column (d) . . . . . . . . . . right arrow 196,628
11 Net income summary. Subtract line 10 from line 3, column (d). . . . . . . . . . right arrow -29,647
Part III
Gaming. Complete if the organization answered "Yes" on Form 990, Part IV, line 19, or reported more than $15,000 on Form 990-EZ, line 6a.
VerticalRevenue
(a) Bingo (b) Pull tabs/Instant
bingo/progressive bingo
(c) Other gaming (d) Total gaming (add col.(a) through col.(c))

1

Gross revenue . . . . .

 

 

 

 
VerticalDirectExpenses

2

Cash prizes . . . . .

 

 

 

 

3

Noncash prizes . . . .

 

 

 

 

4

Rent/facility costs . . . .

 

 

 

 

5

Other direct expenses . . .

 

 

 

 


6


Volunteer labor . . . .
%
%
%


7

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

 

8

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

 

9
Enter the state(s) in which the organization conducts gaming activities:
a
Is the organization licensed to conduct gaming activities in each of these states? . . . . . . . .
b
If "No," explain:
 
10a
Were any of the organization's gaming licenses revoked, suspended or terminated during the tax year? . . .
b
If "Yes," explain:
 
Schedule G (Form 990 or 990-EZ) 2019
Schedule G (Form 990 or 990-EZ) 2019
Page 3
11
Does the organization conduct gaming activities with nonmembers? . . . . . . . . . . .
12
Is the organization a grantor, beneficiary or trustee of a trust or a member of a partnership or other entity
formed to administer charitable gaming? . . . . . . . . . . . . . . . . .
13
Indicate the percentage of gaming activity conducted in:
a
The organization's facility . . . . . . . . . . . . . . . . . .
13a
%
b
An outside facility . . . . . . . . . . . . . . . . . . . .
13b
%
14
Enter the name and address of the person who prepares the organization's gaming/special events books and records:
Name right arrow
Address right arrow
15a
Does the organization have a contract with a third party from whom the organization receives gaming
revenue? . . . . . . . . . . . . . . . . . . . . . . . .
b
If "Yes," enter the amount of gaming revenue received by the organization right arrow $   and the
amount of gaming revenue retained by the third party right arrow $   .
c
If "Yes," enter name and address of the third party:
Name right arrow
Address right arrow
16
Gaming manager information:
Name right arrow
Gaming manager compensation right arrow $  
Description of services provided right arrow
 
17
Mandatory distributions:
a
Is the organization required under state law to make charitable distributions from the gaming proceeds to
retain the state gaming license? . . . . . . . . . . . . . . . . . . .
b
Enter the amount of distributions required under state law distributed to other exempt organizations or spent
in the organization's own exempt activities during the tax year right arrow$  
Part IV
Supplemental Information. Provide the explanations required by Part I, line 2b, columns (iii) and (v); and Part III, lines 9, 9b, 10b, 15b, 15c, 16, and 17b, as applicable. Also provide any additional information. See instructions.
Return Reference Explanation
Schedule G (Form 990 or 990-EZ) 2019
Additional Data


Software ID:  
Software Version:  
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
2019
Open to Public Inspection
Name of the organization
ST FRANCIS REGIONAL MEDICAL CENTER
 
Employer identification number

41-0907986
Part I
Financial Assistance and Certain Other Community Benefits at Cost
Yes
No
1a
Did the organization have a financial assistance policy during the tax year? If "No," skip to question 6a . . . .
1a
Yes
 
b
If "Yes," was it a written policy? ......................
1b
Yes
 
2
If the organization had multiple hospital facilities, indicate which of the following best describes application of the financial assistance policy to its various hospital facilities during the tax year.
3
Answer the following based on the financial assistance eligibility criteria that applied to the largest number of the organization's patients during the tax year.
a
Did the organization use Federal Poverty Guidelines (FPG) as a factor in determining eligibility for providing free care?
If "Yes," indicate which of the following was the FPG family income limit for eligibility for free care:
3a
Yes
 
b
Did the organization use FPG as a factor in determining eligibility for providing discounted care? If "Yes," indicate
which of the following was the family income limit for eligibility for discounted care: . . . . . . . .
3b
 
No
%
c
If the organization used factors other than FPG in determining eligibility, describe in Part VI the criteria used for determining eligibility for free or discounted care. Include in the description whether the organization used an asset test or other threshold, regardless of income, as a factor in determining eligibility for free or discounted care.
4
Did the organization's financial assistance policy that applied to the largest number of its patients during the tax year provide for free or discounted care to the "medically indigent"? . . . . . . . . . . . . .

4

Yes

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

5a

Yes

 
b
If "Yes," did the organization's financial assistance expenses exceed the budgeted amount? . . . . . .
5b
Yes
 
c
If "Yes" to line 5b, as a result of budget considerations, was the organization unable to provide free or discountedcare to a patient who was eligibile for free or discounted care? . . . . . . . . . . . . .
5c
 
No
6a
Did the organization prepare a community benefit report during the tax year? . . . . . . . . .
6a
Yes
 
b
If "Yes," did the organization make it available to the public? . . . . . . . . . . . . .
6b
Yes
 
Complete the following table using the worksheets provided in the Schedule H instructions. Do not submit these worksheets with the Schedule H.
7
Financial Assistance and Certain Other Community Benefits at Cost
Financial Assistance and
Means-Tested
Government Programs
(a) Number of activities or programs (optional) (b) Persons served (optional) (c) Total community benefit expense (d) Direct offsetting revenue (e) Net community benefit expense (f) Percent of total expense
a Financial Assistance at cost
(from Worksheet 1) . . .
    1,226,033   1,226,033 0.760 %
b Medicaid (from Worksheet 3, column a) . . . . .     3,203,880   3,203,880 1.980 %
c Costs of other means-tested government programs (from Worksheet 3, column b) . .     2,374,891   2,374,891 1.470 %
d Total Financial Assistance and Means-Tested Government Programs . . . . .     6,804,804   6,804,804 4.210 %
Other Benefits
e Community health improvement services and community benefit operations (from Worksheet 4). 9 2,949 623,489   623,489 0.380 %
f Health professions education (from Worksheet 5) . . . 4 123 548,983   548,983 0.340 %
g Subsidized health services (from Worksheet 6) . . . . 1 75 12,210   12,210 0.010 %
h Research (from Worksheet 7) . 1 0 140,376   140,376 0.090 %
i Cash and in-kind contributions for community benefit (from Worksheet 8) . . . . 6 305 365,450 12,400 353,050 0.220 %
j Total. Other Benefits . . 21 3,452 1,690,508 12,400 1,678,108 1.040 %
k Total. Add lines 7d and 7j . 21 3,452 8,495,312 12,400 8,482,912 5.250 %
For Paperwork Reduction Act Notice, see the Instructions for Form 990. Cat. No. 50192T Schedule H (Form 990) 2019
Schedule H (Form 990) 2019
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            
2 Economic development            
3 Community support            
4 Environmental improvements            
5 Leadership development and
training for community members
           
6 Coalition building 2 0 2,134   2,134 0 %
7 Community health improvement advocacy            
8 Workforce development 1 28 922   922 0 %
9 Other            
10 Total 3 28 3,056   3,056 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 Healthcare 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
2,950,753
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
 
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
23,659,923
6
Enter Medicare allowable costs of care relating to payments on line 5.....
6
28,778,083
7
Subtract line 6 from line 5. This is the surplus (or shortfall)........
7
-5,118,160
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) 2019
Schedule H (Form 990) 2019
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 FRANCIS REGIONAL MEDICAL CENTER
1455 ST FRANCIS AVENUE
SHAKOPEE,MN55379
WWW.STFRANCIS-SHAKOPEE.COM
380437
X X       X X      
Schedule H (Form 990) 2019
Schedule H (Form 990) 2019
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 FRANCIS REGIONAL MEDICAL CENTER
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 19
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   No
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 19
10 Is the hospital facility's most recently adopted implementation strategy posted on a website?......... 10 Yes  
a If "Yes" (list url): SEE WEBSITE PART V,SECTION C, LINE 7D
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) 2019
Schedule H (Form 990) 2019
Page 5
Part VFacility Information (continued)

Financial Assistance Policy (FAP)
ST FRANCIS REGIONAL MEDICAL CENTER
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
WWW.STFRANCIS-SHAKOPEE.COM
b
WWW.STFRANCIS-SHAKOPEE.COM
c
d
e
f
g
h
i
j
Schedule H (Form 990) 2019
Schedule H (Form 990) 2019
Page 6
Part VFacility Information (continued)

Billing and Collections
ST FRANCIS REGIONAL MEDICAL CENTER
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) 2019
Schedule H (Form 990) 2019
Page 7
Part VFacility Information (continued)

Charges to Individuals Eligible for Assistance Under the FAP (FAP-Eligible Individuals)
ST FRANCIS REGIONAL MEDICAL CENTER
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 Yes  
If "Yes," explain in Section C.
Schedule H (Form 990) 2019
Schedule H (Form 990) 2019
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, 20a, 20b, 20c, 20d, 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
ST FRANCIS REGIONAL MEDICAL CENTER PART V, SECTION B, LINE 5: IN 2019, EACH ALLINA HOSPITAL CONDUCTED ITS 2020-2022 CHNA INDEPENDENTLY. EACH HOSPITAL WORKED CLOSELY WITH LOCAL PUBLIC HEALTH TO COMPLETE ITS CHNA. THESE INCLUDE REPRESENTATIVES FROM THESE COUNTIES: ANOKA COUNTY, BROWN COUNTY, CARVER COUNTY, DAKOTA COUNTY, HENNEPIN COUNTY, ISANTI COUNTY, RAMSEY COUNTY, STEELE COUNTY, SCOTT COUNTY, WASHINGTON COUNTY, WRIGHT COUNTY, AND PIERCE COUNTY. AT A MINIMUM, LOCAL PUBLIC HEALTH WORKED WITH ALLINA HEALTH TO REVIEW HOSPITAL, STATE AND LOCAL DATA AND HELP DEFINE 2020-2022 CHNA PRIORITIES. ADDITIONALLY, TO INCREASE THEIR UNDERSTANDING OF COMMUNITY MEMBERS' PERSPECTIVES ON IDENTIFIED HEALTH ISSUES AND IDEAS FOR ADDRESSING THEM, STAFF SOLICITED INPUT FROM INDIVIDUALS REPRESENTING THE BROAD INTERESTS OF THE COMMUNITY SUCH AS STAFF FROM SOCIAL SERVICE AND PUBLIC HEALTH ORGANIZATIONS AND RESIDENTS. STAFF COLLECTED FEEDBACK THROUGH A RANGE OF METHODS, INCLUDING FOCUS GROUPS AND INTERVIEWS. COMMUNITY INPUT CAME FROM DIVERSE GROUPS IN TERMS OF AGE, RACE/ETHNICITY, CULTURAL GROUP, AND OTHER DEMOGRAPHICS. A SPECIAL EFFORT WAS MADE TO REACH HISTORICALLY UNDERSERVED COMMUNITIES INCLUDING, BUT NOT LIMITED TO: WEST AFRICAN, SOMALI, LATINX, LGBTQ, FARMING, AFRICAN AMERICAN, PEOPLE EXPERIENCING MENTAL HEALTH CONDITIONS, PEOPLE LIVING ON LESS AND LOW-INCOME HOUSING RESIDENTS. WHERE POSSIBLE, THE HOSPITAL ALIGNED THEIR PROCESS WITH ASSESSMENTS BEING CONDUCTED BY LOCAL PUBLIC HEALTH AND OTHER COMMUNITY AGENCIES. IN MANY CASES, THE HOSPITALS CONDUCTED THE CHNA JOINTLY WITH PARTNERS, WITH SHARED LEADERSHIP THROUGHOUT.THE ST. FRANCIS MEDICAL CENTER APPROACH:ST. FRANCIS DEVELOPED ITS CHNA IN PARTNERSHIP WITH SCOTT COUNTY PUBLIC HEALTH, WHICH WAS SIMULTANEOUSLY LEADING ITS COMMUNITY HEALTH IMPROVEMENT PLANNING (CHIP) PROCESS. THE PROCESS WAS ALSO INFLUENCED BY STAFF'S PARTICIPATION IN THE SCOTT COUNTY HEALTH CARE SYSTEM COLLABORATIVE, SCOTT COUNTY HEALTH IMPROVEMENT PARTNERSHIP'S COMMUNITY LEADERSHIP TEAM, THE CARVER COUNTY PUBLIC HEALTH CHIP PROCESS AND OTHER COMMUNITY EFFORTS. THESE GROUPS INCLUDED COMMUNITY MEMBERS AND REPRESENTATIVES FROM 19 AGENCIES AND ORGANIZATIONS. AS PART OF THIS PROCESS, THE SCOTT COUNTY HEALTH CARE COLLABORATIVE HOSTED A PRIMARY DATA COLLECTION EVENT IN OCTOBER 2017 THAT WAS HEAVILY PROMOTED TO ENSURE ATTENDANCE BY A BROAD CROSS-SECTION OF COMMUNITY. APPROXIMATELY 140 RESIDENTS PARTICIPATED. HALF OF PARTICIPANTS IDENTIFIED AS INDIGENOUS OR PEOPLE OF COLOR. A WIDE RANGE OF AGES WERE REPRESENTED: ALMOST 25 PERCENT OF PARTICIPANTS WERE YOUTH UNDER AGE 24 YEARS, AND 39 PERCENT OF PARTICIPANTS IDENTIFIED AND GENERATION X. THE EVENT INCLUDED AN ENGAGEMENT PROCESS CALLED INTENTIONAL SOCIAL INTERACTION, WHICH CONSISTS OF FOCUSED CONVERSATIONS ABOUT SCOTT COUNTY ASSETS, CULTURAL WELLNESS TRADITIONS AND GAPS IN CARE. AS PART OF THE PRIORITIZATION PROCESS CONDUCTED BY SCOTT COUNTY PUBLIC HEALTH CARE SYSTEM COLLABORATIVE AND SCOTT COUNTY HEALTH IMPROVEMENT PARTNERSHIP'S COMMUNITY LEADERSHIP TEAM TO REVIEW STATE AND LOCAL SECONDARY DATA RESOURCES, SUCH AS HEALTH ISSUE BROCHURES PREPARED BY SCOTT COUNTY PUBLIC HEALTH, SCOTT COUNTY RESPONSES ON THE MINNESOTA STUDENT SURVEY, SCOTT COUNTY CHRONIC DISEASE DASHBOARD AND SCOTT COUNTY 10-YEAR DEATH DATA. ADDITIONALLY, THE SCOTT COUNTY PRIORITIZATION GROUP REVIEWED SELECT ALLINA HEALTH PATIENT DATA, CHOSEN BASED ON PRIORITIES DEFINED BY THE CENTER FOR COMMUNITY HEALTH AND ALLINA HEALTH EQUITY PRIORITIES. ADDITIONALLY, SCOTT COUNTY PUBLIC HEALTH CONDUCTED A COMMUNITY INPUT SURVEY, CREATED IN PARTNERSHIP WITH ST. FRANCIS AND HEALTH PARTNERS/PARK NICOLLET FOUNDATION. IN THE SUMMER OF 2018, STAFF DISTRIBUTED ENGLISH AND SPANISH VERSIONS OF THE SURVEY AT EVENTS, SUCH AS THE SHAKOPEE INTERNATIONAL FESTIVAL, SCOTT COUNTY FAIR, VISION 2040 POP-UPS AND COMMUNITY AREAS LIKE LAUNDRY MATS, ETHNIC GROCERY STORES AND THE DEPARTMENT OF MOTOR VEHICLES. THE SURVEY ASKED COMMUNITY RESIDENTS TO LIST THEIR TOP THREE COMMUNITY HEALTH CONCERNS FROM A LIST THAT INCLUDED EXPERIENCES WITH TRAUMA AND HEALTH CONDITIONS, BEHAVIORS AND PERCEPTIONS. A TOTAL OF 1,125 COMMUNITY MEMBERS COMPLETED THE SURVEY. STAFF ANALYZED THE SURVEY RESULTS BY COMMUNITY AND DEMOGRAPHIC INDICATORS, INCLUDING GENDER, RACE, ETHNICITY, AGE AND INCOME.BASED ON THE DATA REVIEW AND COMMUNITY FEEDBACK, SCOTT COUNTY PUBLIC HEALTH CHIP PARTICIPANTS GENERATED A LIST OF 16 HEALTH ISSUES FOR FINAL REVIEW. IN NOVEMBER 2018, SCOTT COUNTY PUBLIC HEALTH HOSTED A PRIORITIZATION MEETING IN WHICH PARTICIPANTS VOTED ON THEIR TOP THREE LOCAL HEALTH PRIORITIES. THIS VOTING PROCESS RESULTED IN THE FOLLOWING NEEDS BEING IDENTIFIED FOR SCOTT COUNTY: - ALCOHOL AND DRUG USE BY YOUTH- OBESITY- MENTAL HEALTH CONCERNSTO BUILD ON PREVIOUS WORK AND DUE TO THE OVERLAP IN PRIORITIES IDENTIFIED THROUGH THE SCOTT COUNTY PUBLIC HEALTH ASSESSMENT PROCESS WITH THOSE IDENTIFIED FOR ST. FRANCIS' 2016 CHNA, ST. FRANCIS CHOSE TO CONTINUE ITS EXISTING PRIORITIES FOR ACTION IN 2020-2022: - MENTAL WELLNESS AND SUBSTANCE ABUSE - HEALTHY WEIGHT- ACCESS TO CARE
ST FRANCIS REGIONAL MEDICAL CENTER PART V, SECTION B, LINE 6B: PUBLIC HEALTH AGENCY STAFF WERE VERY INVOLVED IN MEETING TO REVIEW DATA AND PLAN THE FOCUS GROUP AND COMMUNITY DIALOGUE. COUNTIES INVOLVED IN THE ST. FRANCIS CHNA INCLUDE: CARVER COUNTY, DAKOTA COUNTY, AND SCOTT COUNTY.
ST FRANCIS REGIONAL MEDICAL CENTER PART V, SECTION B, LINE 7D: UPON REQUESTSCHEDULE H PART V, LINE 7A AND 10A: WWW.STFRANCIS-SHAKOPEE.COM/MEDIA/14831/STFRANCIS-CHNA.PDFSCHEDULE H PART V, LINE 7B: HTTP://WWW.ALLINAHEALTH.ORG/ABOUT-US/COMMUNITY-INVOLVEMENT/COMMUNITY-HEALTH-NEEDS-ASSESSMENTS
ST FRANCIS REGIONAL MEDICAL CENTER PART V, SECTION B, LINE 11: ACROSS THE ALLINA HEALTH SYSTEM, TWO PRIMARY NEEDS, IDENTIFIED VIA THE 2016 CHNA, WERE ADDRESSED IN 2017-2019: HEALTHY WEIGHT (NUTRITION AND PHYSICAL ACTIVITY) AND MENTAL HEALTH/WELLNESS. AT THE END OF 2019, ALLINA HEALTH COMPLETED A NEW COMMUNITY HEALTH NEEDS ASSESSMENT. THE 2019 ASSESSMENT IDENTIFIED HEALTHY EATING/ACTIVE LIVING, MENTAL HEALTH AND SUBSTANCE USE AND SOCIAL DETERMINANTS OF HEALTH AS PRIORITY NEEDS FOR 2020-2022 ACROSS ALL ALLINA HEALTH GEOGRAPHIES. EXAMPLES OF SYSTEM-WIDE INITIATIVES IN THESE AREAS INCLUDE: CHANGE TO CHILL (CTC) - A FREE, ONLINE RESOURCE THAT PROVIDES STRESS REDUCTION TIPS, LIFE BALANCE TECHNIQUES AND HEALTH EDUCATION SERVICES FOR TEENS. IN ADDITION TO THE EXISTING RESOURCES, CHANGE TO CHILL ADDED A MENTAL HEALTH AND VAPING SECTION TO THE WEBSITE IN 2019 IN RESPONSE TO THE RISING VAPING EPIDEMIC. FROM MINNESOTA ALONE, MORE THAN 30,000 USERS VISITED THE CHANGE TO CHILL WEBSITE IN 2019. SOME OF THE USERS ARE TEACHERS WHO USE IT IN THEIR CLASSROOMS, TEENS WHO USE IT IN SOCIAL GROUPS AND PARENTS LOOKING FOR WAYS TO HELP THEIR CHILD STRESS LESS. ALSO IN 2019, CTC CONTINUED ITS CHANGE TO CHILL SCHOOL PARTNERSHIP (CTCSP) THAT WAS LAUNCHED IN 2018. THE GOAL OF CTCSP IS TO PROMOTE AND SUPPORT A CULTURE OF MENTAL WELL-BEING IN LOCAL HIGH SCHOOLS. DURING THE 2019-2020 SCHOOL YEAR, ST. FRANCIS PARTNERED WITH SIXTEEN HIGH SCHOOLS THROUGH CTCSP. COMPONENTS OF CTCSP INCLUDE STAFF TRAINING ON CTC, CTC MESSAGING FOR PARENTS, A PAID STUDENT INTERNSHIP AND FUNDING FOR A "CHILL ZONE" - A DESIGNATED SPACE FOR STUDENTS AND STAFF TO PRACTICE SELF-CARE. MORE THAN 1,100 HEALTH AND EDUCATION PROFESSIONALS WERE TRAINED ON HOW TO USE THE CHANGE TO CHILL RESOURCES AND CURRICULUMS AS PART OF CTCSP. THIRTY-FOUR CHILL CHAMPION INTERNS LED STRESS REDUCTION ACTIVITIES WITHIN THEIR SCHOOL PARTNERSHIP SCHOOL. INITIAL EVALUATIONS OF CTCSP HAVE SHOWN INCREASES IN CONFIDENCE IN ABILITY TO COPE WITH STRESS AMONG STUDENTS WHO PARTICIPATE IN PROGRAM COMPONENTS.BE THE CHANGE - ALLINA HEALTH HAS BEEN A LEADER IN ELIMINATING STIGMA AROUND MENTAL HEALTH AND ADDICTION CONDITIONS WITHIN THE HEALTHCARE INDUSTRY. BE THE CHANGE, IS AN EFFORT TO ELIMINATE STIGMA AROUND MENTAL HEALTH AND ADDICTION CONDITIONS AT ALLINA HEALTH AND ENSURE ALL PATIENTS RECEIVE THE SAME CONSISTENT, EXCEPTIONAL CARE. AT THE CAMPAIGN'S LAUNCH, 500 ALLINA HEALTH EMPLOYEES VOLUNTEERED TO LEAD THE EFFORT AS TRAINED BE THE CHANGE CHAMPIONS AND HELP EDUCATE AND GENERATE AWARENESS AMONG THEIR COLLEAGUES ABOUT MENTAL HEALTH AND ADDICTION CONDITIONS. IN 2019, BE THE CHANGE CONTINUED TO SUPPORTED ANTI-STIGMA WORK IN THE COMMUNITY BY SPONSORING AND PROMOTING THE NAMI WALK AND WALK FOR RECOVERY. ADDITIONALLY, CHAMPIONS RECEIVED ANTI-STIGMA EDUCATION AND MATERIALS TO SHARE WITH THEIR COLLEAGUES THROUGH QUARTERLY COMMUNICATIONS, WITH ADDITIONAL RESOURCES SHARED IN MAY FOR MENTAL HEALTH AWARENESS MONTH AND IN SEPTEMBER FOR RECOVERY MONTH. THROUGH PRESENTATIONS AND EDUCATION EVENTS, BE THE CHANGE CHAMPIONS HAVE REACHED MORE THAN 18,140 EMPLOYEES SINCE THE INITIATIVE'S LAUNCH, OR APPROXIMATELY TWO-THIRDS OF EMPLOYEES. THE EFFORT IS ONGOING AND THE CAMPAIGN'S GOAL IS TO REACH ALL ALLINA HEALTH EMPLOYEES. AN INITIAL AND FOLLOW-UP EMPLOYEE SURVEY IN 2017 REVEALED THAT THE CAMPAIGN IMPROVED EMPLOYEE'S PERCEPTION OF ALLINA HEALTH'S SUPPORT OF PEOPLE WITH MENTAL HEALTH OR ADDICTION CONDITIONS, COMFORT WORKING WITH OR INTERACTING WITH PEOPLE WITH MENTAL HEALTH OR ADDICTION CONDITIONS, AND KNOWLEDGE OF MENTAL HEALTH RESOURCES.IN ADDITION, ST FRANCIS IS ADDRESSING NEEDS IDENTIFIED THROUGH THE CHNA; GOAL 1: SUPPORT THE MENTAL HEALTH AND WELLNESS OF TEENS IN OUR COMMUNITY. ST. FRANCIS CONTINUES TO PROMOTE THE MENTAL HEALTH AND WELLNESS OF TEENS THROUGH LOCAL PROMOTION OF THE CHANGE TO CHILL PROGRAM AND SUPPORTING LOCAL SCHOOLS VIA THE CHANGE TO CHILL SCHOOL PARTNERSHIP. IN AN EFFORT TO ELIMINATE STIGMA ASSOCIATED WITH MENTAL HEALTH AND ADDICTION CONDITIONS, ST. FRANCIS REGIONAL MEDICAL CENTER STAFF CONTINUE TO PROMOTE AND PARTICIPATE IN ALLINA HEALTH'S BE THE CHANGE INITIATIVE. ADDITIONALLY, MEDICAL STAFF WORKED CLOSELY WITH NUMEROUS COMMUNITY PARTNERS TO IMPROVE MENTAL WELLNESS AND SUPPORT IN SCOTT COUNTY. THESE PARTNERSHIPS INCLUDED SUPPORTING SCOTT COUNTY PUBLIC HEALTH EFFORTS TO RECEIVE A DRUG FREE COMMUNITY GRANT, PARTICIPATING IN THE SCOTT COUNTY ATOD CHIC ACTION TEAM AND PROVIDING CHARITABLE SUPPORT TO CHOOSE NOT TO USE. ADDITIONALLY, TO SUPPORT OPPORTUNITIES TO EDUCATE AND BUILD THE REFUSAL SKILLS OF ADOLESCENTS WITH RESPECT TO SUBSTANCE USE, ST. FRANCIS CONTRIBUTED $2,500 TO TREEHOUSE'S TEEN MONITORING PROGRAM. TREEHOUSE WORKS TO MEET THE NEEDS OF AT-RISK YOUTH TO HELP THEM OVERCOME THE CHALLENGES RELATED TO POVERTY, PARENTAL ADDICTION, NEGLECT AND ABUSE. AN EVALUATION OF THE MENTORING PROGRAM, SPECIFICALLY, INDICATES THE PROGRAM REDUCES TEENS LIKELIHOOD OF UTILIZING NEGATIVE COPING STRATEGIES SUCH AS SELF-HARM, SUICIDE, AND SUBSTANCE USE.TO IMPROVE MENTAL HEALTH SERVICES OFFERED TO ITS PATIENTS, THE ST. FRANCIS MENTAL HEALTH COMMITTEE CONTINUED TO PARTNER WITH LOCAL ORGANIZATIONS, SUCH AS GUILD INC., TO CREATE EFFECTIVE COMMUNICATIONS AND INFORMATION SHARING ACROSS SECTORS. THE MEDICAL CENTER ALSO BROUGHT LICENSED ALCOHOL AND DRUG COUNSELORS TO THE CAMPUS TO SCREEN PATIENTS FOR MENTAL HEALTH AND SUBSTANCE USE NEEDS. ST. FRANCIS ALSO IMPLEMENTED TELEHEALTH IN THE MENTAL HEALTH EMERGENCY DEPARTMENT AND INPATIENT SETTINGS, CONTRIBUTING TO ST. FRANCIS' DESIGNATION OF HAVING THE HIGHEST TELEHEALTH UTILIZATION WITHIN THE ALLINA HEALTH SYSTEM. ST. FRANCIS MADE A $100,000 CHARITABLE CONTRIBUTION IN SUPPORT OF THE DEVELOPMENT AND OPERATION OF A 16 BED INTENSIVE RESIDENTIAL TREATMENT SERVICES (IRTS) AND RESIDENTIAL CRISIS FACILITY IN SAVAGE, MN. THUS CREATING A LESS RESTRICTIVE OPTION FOR PEOPLE EXPERIENCING A MENTAL HEALTH CRISIS.GOAL 2: IMPROVE THE HEALTH OF PEOPLE LIVING IN OUR COMMUNITY BY ENCOURAGING PHYSICAL ACTIVITY, PROMOTING NUTRITION AND REDUCING BARRIERS TO HEALTHY LIVING. ST. FRANCIS WORKED TO SUPPORT LOCAL FOOD SHELVES IN PROVIDING HEALTHY FOOD TO SCOTT AND CARVER COUNTY RESIDENTS WHO EXPERIENCE FOOD INSECURITY VIA A HEALTHY FOOD DRIVE AND $6,000 IN CHARITABLE CONTRIBUTIONS TO LOCAL FOOD SHELVES.TO INCREASE OPPORTUNITIES FOR COMMUNITY MEMBERS TO INCREASE PHYSICAL ACTIVITY AND IMPROVE NUTRITION, ST. FRANCIS PROMOTED HEALTH POWERED KIDS TO LOCAL SCHOOLS - A FREE COMMUNITY EDUCATION PROGRAM DESIGNED TO EMPOWER CHILDREN AGES 3 TO 14 YEARS TO MAKE HEALTHIER CHOICES ABOUT EATING, EXERCISE, KEEPING CLEAN AND MANAGING STRESS. THE MEDICAL CENTER ALSO AWARDED $3,000 IN GRANTS TO SEVEN LOCAL COMMUNITY ORGANIZATIONS THROUGH ALLINA HEALTH'S NEIGHBORHOOD CONNECTION PROGRAM. NEIGHBORHOOD HEALTH CONNECTION (NHC) IS A COMMUNITY GRANTS PROGRAM THAT AIMS TO IMPROVE THE HEALTH OF COMMUNITIES BY BUILDING SOCIAL CONNECTIONS THROUGH HEALTHY EATING AND PHYSICAL ACTIVITY. EACH YEAR, ALLINA HEALTH AWARDS OVER 50 NEIGHBORHOOD HEALTH CONNECTION GRANTS, RANGING IN SIZE FROM $500-$10,000, TO LOCAL NONPROFITS AND GOVERNMENT AGENCIES IN MINNESOTA AND WESTERN WISCONSIN. EVALUATIONS OF THE NHC PROGRAM FOUND THAT MOST PARTICIPANTS INCREASED THEIR SOCIAL CONNECTIONS, MADE POSITIVE CHANGES IN PHYSICAL ACTIVITY AND HEALTHY EATING AND MAINTAINED THESE CHANGES FOR AT LEAST SIX MONTHS. GOAL 3: MEETING COMMUNITY HEALTH CARE NEEDS BY INCREASING CAPACITY AND IMPROVING COLLABORATION AMONG COMMUNITY SAFETY NET PROVIDERS. THE MEDICAL CENTER HAS BEEN A LONG TIME PARTNER AND MAJOR FUNDER OF ST. MARY'S HEALTH CLINIC IN SHAKOPEE AND THE RIVER VALLEY NURSING CENTER (RVNC), WHICH TOGETHER SERVE OVER 1,000 UNINSURED OR UNDERINSURED PEOPLE EACH YEAR. ST. FRANCIS PROVIDED CLINIC SPACE, SUPPLIES AND EMPLOYEE VOLUNTEERS (VALUED AT $79,422 WEEKLY), AND MADE A $25,000 CHARITABLE CONTRIBUTION TO ST. MARY'S HEALTH CLINIC. ST. FRANCIS MEDICAL CENTER'S CFO, CINDY VINCENT, ALSO SERVES ON THE ST. MARY'S HEALTH CENTER'S BOARD OF DIRECTORS. A $40,000 CHARITABLE CONTRIBUTION WAS PROVIDED TO RVNC AND THE MEDICAL CENTER'S DIRECTOR OF PATIENT CARE, SARAH AMENDOLA, SERVES ON THE RVNC BOARD OF DIRECTORS. IN 2019, ST. FRANCIS ALSO CONTRIBUTED $100,000 TO THE SCOTT COUNTY CDA FOR AN IRTS FACILITY, WHICH OPENED IN SPRING 2020. TO ENSURE LOCAL SAFETY NET ORGANIZATIONS ARE AWARE OF ITS CHARITY CARE PROGRAMS AND DISCOUNTS, ST. FRANCIS PROMOTED ALLINA HEALTH PARTNERS CARE PROGRAM'S DISCOUNTS TO THE SCOTT COUNTY HEALTH CARE SYSTEM COLLABORATIVE AND A LOCAL HISPANIC/LATINO LEADERSHIP GROUP.
ST FRANCIS REGIONAL MEDICAL CENTER PART V, SECTION B, LINE 13B: SEE RESPONSE TO FORM 990, SCHEDULE H, PART I, LINE 3C INCLUDED IN FORM 990, SCHEDULE H , PART VI FOR EXPLANATION OF CRITERIA.
ST FRANCIS REGIONAL MEDICAL CENTER PART V, SECTION B, LINE 24: NON-MEDICAL NECESSARY OR RETAIL/COSMETIC PROCEDURES WOULD NOT QUALIFY FOR THE UNINSURED DISCOUNT.
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
Schedule H (Form 990) 2019
Schedule H (Form 990) 2019
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?  
Name and address Type of Facility (describe)
1
2
3
4
5
6
7
8
9
10
Schedule H (Form 990) 2019
Schedule H (Form 990) 2019
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
PART I, LINE 3C: CHARITY CARE PROGRAM - ALLINA PARTNER'S CARE PROGRAM:A KEY COMPONENT OF ST. FRANCIS REGIONAL MEDICAL CENTER'S (ST. FRANCIS) MISSION IS TO DELIVER COMPASSIONATE, HIGH QUALITY, AFFORDABLE HEALTH CARE SERVICES AND TO ADVOCATE FOR THOSE WITH LIMITED FINANCIAL MEANS. ST FRANCIS STRIVES TO ENSURE THAT THE FINANCIAL CAPACITY OF PEOPLE WHO NEED HEALTH CARE SERVICES DOES NOT PREVENT THEM FROM SEEKING OR RECEIVING MEDICAL CARE. THEREFORE, ST. FRANCIS HAS SEVERAL FINANCIAL ASSISTANCE PROGRAMS INCLUDING A ROBUST CHARITY CARE PROGRAM KNOWN AS ALLINA PARTNER'S CARE PROGRAM, WHICH PROVIDES FREE CARE TO ALL PERSONS AT OR BELOW 275 PERCENT OF THE FEDERAL POVERTY GUIDELINES AS PUBLISHED ANNUALLY IN THE FEDERAL REGISTRAR.THE CHARITY CARE PROGRAM ALSO PROVIDES FOR THE CONSIDERATION OF SPECIAL CIRCUMSTANCES FOR THE "MEDICALLY INDIGENT". ST. FRANCIS EXTENDS THE CHARITY CARE PROGRAM IN INSTANCES THAT ST. FRANCIS DETERMINES THE PATIENT IS UNABLE TO PAY SOME OR ALL OF THEIR MEDICAL BILLS DUE TO CATASTROPHIC CIRCUMSTANCES EVEN THOUGH THEY HAVE INCOME OR ASSETS THAT OTHERWISE EXCEED THE GENERALLY APPLICABLE ELIGIBILITY CRITERIA FOR THE FREE CARE PROGRAM OR THE DISCOUNTED CARE PROGRAM (DESCRIBED BELOW) UNDER ST. FRANCIS' FINANCIAL ASSISTANCE PROGRAM GUIDELINES. DISCOUNTED CARE PROGRAM - UNINSURED DISCOUNT PROGRAM ST. FRANCIS ALSO HAS A FINANCIAL ASSISTANCE PROGRAM KNOWN AS THE UNINSURED DISCOUNT PROGRAM THAT PROVIDES A DISCOUNT ON BILLED CHARGES TO UNINSURED PATIENTS, AND INSURED PATIENTS WHO RECEIVE UNINSURED TREATMENT, FOR MEDICALLY NECESSARY CARE RECEIVED. THE UNINSURED DISCOUNT PROGRAM DOES NOT USE FEDERAL POVERTY GUIDELINES TO DETERMINE ELIGIBILITY. INSTEAD, UNINSURED PATIENTS AND INSURED PATIENTS WHO RECEIVE UNINSURED TREATMENT ARE ELIGIBLE FOR A DISCOUNT BASED UPON THEIR INCOME LEVEL. ALL PATIENTS WITH AN ANNUAL INCOME AT OR BELOW $125,000 ARE ELIGIBLE FOR A DISCOUNT. THE DISCOUNT IS ALSO GENERALLY EXTENDED TO PATIENTS WITH AN ANNUAL INCOME ABOVE $125,000. ST. FRANCIS' UNINSURED DISCOUNT PROGRAM PROVIDES A SUBSTANTIAL DISCOUNT TO BILLED CHARGES FOR UNINSURED PATIENTS. THE DISCOUNT IS UPDATED ANNUALLY AND IS BASED ON THE REIMBURSEMENT RATE OF THE NON-GOVERNMENTAL THIRD PARTY PAYER WHICH PROVIDED ST. FRANCIS THE MOST REVENUE DURING THE PREVIOUS YEAR.
PART I, LINE 6A: ST. FRANCIS' ANNUAL COMMUNITY BENEFIT REPORT IS AVAILABLE UPON REQUEST. SEE CONTACT INFORMATION CONTAINED IN SCHEDULE O TO OBTAIN A COPY.
PART I, LINE 7: WHERE APPROPRIATE, ST. FRANCIS USES A RATIO OF PATIENT CARE COSTS TO CHARGES (COST TO CHARGE RATIO) TO CALCULATE THE AMOUNTS REPORTED FOR PART I, LINE 7 (THE TABLE).
PART I, LINE 7G: THE AMOUNT REPORTED AS SUBSIDIZED HEALTH SERVICES DOES NOT INCLUDE ANY COSTS ATTRIBUTABLE TO A PHYSICIAN CLINIC.
PART I, LN 7 COL(F): BAD DEBT EXPENSE HAS NOT BEEN INCLUDED IN FORM 990, PART IX, LINE 25 AND HAS NOT BEEN USED FOR THE PURPOSE OF CALCULATING THE AMOUNTS REPORTED IN COLUMN 7F. IT HAS BEEN REPORTED AS A REDUCTION TO PATIENT SERVICE REVENUE ON FORM 990, PART VIII LINE 2B.
PART II, COMMUNITY BUILDING ACTIVITIES: COMMUNITY-BUILDING ACTIVITIESUNDERSTANDING THAT GOOD HEALTH IS DEPENDENT ON SOCIETAL, COMMUNITY, AND FAMILY ENVIRONMENTS AS WELL AS INDIVIDUAL CHOICES, AND IS BIGGER THAN THE PROVISION OF HEALTH CARE, ST. FRANCIS ENGAGES IN COMMUNITY ACTIVITIES THAT ADDRESS THE ROOT CAUSES OF HEALTH PROBLEMS SUCH AS POVERTY AND HOMELESSNESS. RESEARCH SHOWS THAT MANY OF THESE ROOT CAUSES ARE DIRECTLY TIED TO POOR HEALTH IF IGNORED, PARTICULARLY AMONG LOW-INCOME, MINORITY POPULATIONS. BELOW ARE A FEW EXAMPLES OF WAYS THAT ST. FRANCIS PARTICIPATED IN COMMUNITY-BUILDING ACTIVITIES IN 2019:COMMUNITY COALITIONSST. FRANCIS PARTICIPATES ON LOCAL COMMUNITY COALITIONS, SUCH AS THE SCOTT COUNTY HEALTHCARE SYSTEM COLLABORATIVE, AND LOCAL SHIP(STATEWIDE HEALTH IMPROVEMENT PROGRAM), COMMUNITY ADVISORY TEAMS IN ORDER TO RESPOND TO COMMUNITY NEEDS THROUGH COLLABORATION AND PARTNERSHIP. THESE COALITIONS PROVIDE ST FRANCIS THE OPPORTUNITY TO BUILD RELATIONSHIPS TO DETERMINE HOW BEST TO LEVERAGE LOCAL RESOURCES TO ADDRESS COMMUNITY NEEDS THAT EXIST OUTSIDE THE TRADITIONAL REALM OF HEALTH CARE. IN ADDITION, ST. FRANCIS PARTICIPATES ON THE SCOTT-DAKOTA COUNTY WORKFORCE INVESTMENT BOARD AND THE SCOTT COUNTY LOCAL ADVISORY COMMITTEE FOR MENTAL HEALTH.DISASTER PREPAREDNESSIN ADDITION TO COMMUNITY-BUILDING ACTIVITIES THAT RELATED TO ROOT CAUSES OF HEALTH, ST. FRANCIS ENGAGED IN AND LED DISASTER PREPAREDNESS PLANNING TO ENSURE SAFETY, EFFICIENCY AND EXCELLENT HEALTH CARE DURING TIMES OF TRAGEDY AND/OR UPSET. THIS INCLUDED PLANNING MEETINGS AND COMMUNITY MEETINGS/TRAININGS, AMONG OTHER THINGS. THESE PROGRAMS AND SERVICES, AMONG OTHERS, GIVE ST. FRANCIS THE OPPORTUNITY TO IMPACT COMMUNITY HEALTH BEFORE IT BECOMES PROBLEMATIC AND EXPENSIVE. IN ADDITION, THIS IMPORTANT WORK IS SUPPORTED BY THE MISSION OF OUR ORGANIZATION AND IS OUR RESPONSIBILITY AS A NOT-FOR-PROFIT HEALTH CARE ORGANIZATION. ST. FRANCIS WILL CONTINUE TO CONTRIBUTE TO IMPROVING THE HEALTH OF THE COMMUNITIES IT SERVES THROUGH PROMOTION OF COMMUNITY HEALTH.
PART III, LINE 2: SCH H, PART III, SECTION A, LINES 2 & 3SEE SCHEDULE H, PART III, SECTION A, LINE 3 NARRATIVE BELOW.
PART III, LINE 4: SEE ATTACHED AUDIT, PAGE 10, 2(O).
PART III, LINE 8: ST. FRANCIS USED THE AMOUNT REPORTED IN THE MEDICARE COST REPORT AS THE SOURCE FOR THE AMOUNTS REPORTED ON PART III, LINES 5 & 6 AS OUTLINED IN THE FORM 990, SCHEDULE H INSTRUCTIONS. FOR MEDICARE COST REPORTS, ST. FRANCIS USES A RATIO OF PATIENT CARE COSTS TO CHARGES (COST TO CHARGE RATIO) TO DETERMINE MEDICARE ALLOWABLE COSTS. GENERALLY, THE RATIO IS CALCULATED AS THE TOTAL MEDICARE ALLOWABLE PATIENT COSTS OVER THE TOTAL PATIENT CHARGES. MEDICARE CHARGES MULTIPLIED BY THIS RATIO EQUALS THE MEDICARE ALLOWABLE COSTS REPORTED IN THE MEDICARE COST REPORTS. ST. FRANCIS BELIEVES THAT AT LEAST SOME PORTION OF THE COSTS IT INCURS IN EXCESS OF PAYMENTS RECEIVED FROM THE FEDERAL GOVERNMENT FOR PROVIDING MEDICAL SERVICES TO MEDICARE ENROLLEES AND BENEFICIARIES UNDER THE FEDERAL MEDICARE PROGRAM (SHORTFALL OR MEDICARE SHORTFALL) CONSTITUTES A COMMUNITY BENEFIT. ST. FRANCIS' PROVIDING OF THESE SERVICES CLEARLY LESSENS THE BURDENS OF GOVERNMENT BY ALLEVIATING THE FEDERAL GOVERNMENT FROM HAVING TO DIRECTLY PROVIDE THESE MEDICAL SERVICES. AS DEMONSTRATED AND CALCULATED ON FORM 990, SCHEDULE H, PART III, LINE 7, ST. FRANCIS' MEDICARE "ALLOWABLE COSTS" CLEARLY EXCEED THE PAYMENTS IT RECEIVES FOR PROVIDING THESE MEDICAL SERVICES UNDER THE MEDICARE PROGRAM. THE TRUE COMMUNITY BENEFIT FOR ST. FRANCIS' PARTICIPATION IN THE CURRENT MEDICARE PROGRAM IS DEPENDENT ON HOW EFFICIENTLY AND COST EFFECTIVELY THE FEDERAL GOVERNMENT COULD OPERATE A DIRECT MEDICAL CARE MEDICARE PROGRAM OR ALTERNATIVELY THE COST TO THE GOVERNMENT TO CONTRACT OUT SUCH SERVICES THROUGH A COMPETITIVE BIDDING PROCESS IN THE OPEN MARKETS FOR THE SAME OR SIMILAR SERVICES FACTORING IN ITEMS SUCH AS QUALITY OF CARE, OUTCOMES AND SIMILAR IMPORTANT FACTORS AS COMPARED TO ST. FRANCIS' ACTUAL COSTS OF PROVIDING THE MEDICAL CARE. THE MEDICARE SHORTFALL CALCULATION ON THE FORM 990, SCHEDULE H, LINE 7 SIGNIFICANTLY UNDERSTATES ST. FRANCIS' ACTUAL MEDICARE SHORTFALL FOR TWO REASONS. FIRST, ST. FRANCIS INCURS SIGNIFICANT COSTS IN EXCESS OF PAYMENTS UNDER THE MEDICARE PROGRAM FOR PROVIDING CERTAIN SERVICES THAT ARE NOT SUBJECT TO MEDICARE COST REPORTING AND THEREFORE NOT REFLECTED IN ST. FRANCIS' COST AMOUNTS ON LINE 6. SECOND, LINE 6 LIMITS ST. FRANCIS' REPORTED COSTS TO ONLY MEDICARE "ALLOWABLE COSTS" AS SOLELY DETERMINED BY THE FEDERAL GOVERNMENT MEDICARE PROGRAM. FOR THESE TWO REASONS, THE MEDICARE SHORTFALL REPORTED ON LINE 7 SIGNIFICANTLY UNDERSTATES THE ACTUAL MEDICARE SHORTFALL AND THE ACTUAL COST OF PROVIDING MEDICAL CARE TO MEDICARE PROGRAM PARTICIPANTS.ST. FRANCIS BELIEVES A DIRECT MEDICAL SERVICE MEDICARE PROGRAM OPERATED BY THE FEDERAL GOVERNMENT AND THE COST TO THE GOVERNMENT TO CONTRACT OUT THE SERVICES UNDER A COMPETITIVE BIDDING PROCESS MAY PROVE TO BE EVEN MORE EXPENSIVE TO THE FEDERAL GOVERNMENT THAN ST. FRANCIS' REPORTED MEDICARE "ALLOWABLE COSTS" ON LINE 6 GIVEN ST. FRANCIS' QUALITY OF CARE, SUCCESSFUL OUTCOMES AND THE SIGNIFICANT DIFFERENCE BETWEEN ACTUAL COSTS ST. FRANCIS INCURS AND MEDICARE "ALLOWABLE COSTS" IN PROVIDING CARE UNDER THE MEDICARE PROGRAM. THEREFORE, ST. FRANCIS FIRMLY BELIEVES THAT THERE IS A TRUE COMMUNITY BENEFIT COMPONENT TO ITS PARTICIPATION IN THE FEDERAL MEDICARE PROGRAM.
PART III, LINE 9B: ST. FRANCIS' WRITTEN DEBT COLLECTION POLICY AND COLLECTION PRACTICES APPLY UNIFORMLY TO ALL PATIENTS AND INCLUDE PROVISIONS RELATED TO ITS CHARITY CARE PROGRAM AND OTHER FINANCIAL ASSISTANCE PROGRAMS. IF A PATIENT IS KNOWN TO QUALIFY FOR A FINANCIAL ASSISTANCE PROGRAM, THEY ARE AUTOMATICALLY AFFORDED THE PROGRAM BENEFITS FOR UP TO ONE YEAR AS THEY WOULD HAVE ALREADY PROVIDED INFORMATION NECESSARY FOR ST. FRANCIS TO MAKE SUCH A DETERMINATION. FOR EXAMPLE, A PATIENT THAT QUALIFIED FOR ST. FRANCIS' CHARITY CARE PROGRAM BEFORE RECEIVING SERVICES WOULD NOT RECEIVE A BILLING STATEMENT FOR THE MEDICAL SERVICES PROVIDED. IN THE CASE OF A PATIENT QUALIFYING FOR THE CHARITY CARE PROGRAM AFTER RECEIVING SERVICES AND THE COMMENCEMENT OF CERTAIN COLLECTION ACTIVITIES, THE AMOUNTS ARE DISCHARGED AS CHARITY CARE AND ALL COLLECTION ACTIVITIES CEASE. AS DISCUSSED IN THE RESPONSE TO PART VI, LINE 3, PATIENTS ARE INFORMED AND EDUCATED ON ST. FRANCIS' FINANCIAL ASSISTANCE PROGRAMS INCLUDING ITS CHARITY CARE PROGRAM AS PART OF THE ROUTINE REGISTRATION, ADMISSION, INTAKE, BILLING AND COLLECTION PROCESSES. IF A PATIENT DESIRES TO APPLY FOR THE CHARITY CARE PROGRAM, PERSONNEL WILL SEND AN APPLICATION TO THE PATIENT. IF COLLECTION ACTIVITIES HAVE COMMENCED, THOSE ACTIVITIES WILL BE SUSPENDED FOR THIRTY (30) DAYS TO ALLOW TIME FOR THE APPLICATION PROCESS. COLLECTION ACTIVITY MAY RESUME IF, AFTER 30 DAYS, A COMPLETED APPLICATION HAS NOT BEEN RECEIVED. IN THE CASE OF AN INCOMPLETE APPLICATION, ST. FRANCIS MAY RESUME COLLECTION ACTIVITIES IF REQUESTS FOR ADDITIONAL INFORMATION ARE NOT MET WITH A TIMELY RESPONSE. IF AN APPLICANT DOES NOT MEET THE ELIGIBILITY CRITERIA AND THE APPLICATION IS DENIED, COLLECTION ACTIVITY MAY RESUME UPON DENIAL. HOWEVER, THE PATIENT MAY STILL BE ELIGIBLE FOR OTHER FINANCIAL ASSISTANCE PROGRAMS THAT ARE APPLIED AS WARRANTED BASED UPON THE INFORMATION PROVIDED. SUCH ACTIVITIES ARE FULLY EXPLAINED TO THE PATIENT DURING THE COLLECTION PROCESS.
SCH H , PART III, SECTION A, LINE 3 ST. FRANCIS HAS ADOPTED HEALTHCARE FINANCIAL MANAGEMENT ASSOCIATION [HFMA] STATEMENT NO. 15, VALUATION AND FINANCIAL STATEMENT PRESENTATION OF CHARITY CARE, IMPLICIT PRICE CONCESSIONS AND BAD DEBTS BY INSTITUTIONAL HEALTHCARE PROVIDERS (STATEMENT 15). AS DISCLOSED IN THE FOOTNOTES TO ST. FRANCIS' AUDITED FINANCIAL STATEMENTS (SEE RESPONSE TO PART III, LINE 4), THE PROVISIONS FOR BAD DEBT AND CHARITY CARE ARE BASED UPON MANAGEMENT'S ASSESSMENT OF HISTORICAL AND EXPECTED NET COLLECTIONS CONSIDERING HISTORICAL BUSINESS AND ECONOMIC CONDITIONS, TRENDS IN HEALTHCARE COVERAGE, AND OTHER COLLECTION INDICATORS. THEREFORE, THE BAD DEBT AMOUNT STATED FOR FINANCIAL REPORTING PURPOSES IS REPORTED "NET" OF ANY ANTICIPATED PATIENT DISCOUNTS OR IMPLICIT PRICE CONCESSIONS TO WHICH THE PATIENT MAY BE ELIGIBLE INCLUDING, BUT NOT LIMITED TO, THE UNINSURED DISCOUNT PROGRAM (DISCUSSED ABOVE) AND REFLECTS THE ESTIMATED AMOUNT REPORTED AS "NET PATIENT SERVICE REVENUE" DURING THE CURRENT PERIOD OR ANY PREVIOUS PERIOD. THIS DOES NOT NECESSARILY EQUAL THE "COST" TO PROVIDE THE MEDICAL SERVICES. ALSO, NOTE THAT AMOUNTS RELATED TO PATIENTS WHO HAVE QUALIFIED UNDER THE CHARITY CARE PROGRAM ARE NOT INCLUDED IN EITHER NET PATIENT REVENUE OR IN BAD DEBT EXPENSE. IN OTHER WORDS, THE BAD DEBT EXPENSE AS REPORTED IN THE REVENUE SECTION OF THE FINANCIAL STATEMENTS OF THE FORM 990 DOES NOT INCLUDE AMOUNTS RELATED TO QUALIFIED CHARITY CARE PATIENTS AND IS STATED AT THE "NET" EXPECTED OR ANTICIPATED COLLECTION AMOUNT, WHICH MAY BE SIGNIFICANTLY DIFFERENT THAN PATIENT CHARGES DUE TO THE APPLICATION OF DISCOUNTS SUCH AS THOSE PROVIDED UNDER THE UNINSURED DISCOUNT PROGRAM. THIS AMOUNT ALSO CONSTITUTES A DIFFERENT AMOUNT THAN ST. FRANCIS' ACTUAL COST TO PROVIDE THE MEDICAL SERVICES. TO ARRIVE AT THE BAD DEBT "AT COST" AS REPORTED IN FORM 990, SCHEDULE H, PART III, LINE 2, ST. FRANCIS HAS APPLIED A RATIO OF PATIENT CARE COST TO CHARGES (COST-TO-CHARGE RATIO) TO THE ESTIMATED PATIENT CHARGE AMOUNT INCLUDED IN BAD DEBT AFTER REMOVING THE ANTICIPATED DISCOUNTS. THIS PROCESS PROVIDES A VERY CONSERVATIVE ESTIMATE OF ST. FRANCIS' BAD DEBT (AT COST) REPORTED ON LINE 2.ST. FRANCIS HAS A ROBUST PROCESS FOR ADMINISTERING ITS FINANCIAL ASSISTANCE PROGRAMS INCLUDING THE CHARITY CARE AND UNINSURED DISCOUNT PROGRAM DESCRIBED IN FURTHER DETAIL IN PART VI, LINE 3. EACH PATIENT IS PROVIDED NUMEROUS OPPORTUNITIES TO APPLY TO ALLINA PARTNER'S CARE PROGRAM AND TO PARTICIPATE, IF QUALIFIED, TO RECEIVE FREE OR DISCOUNTED MEDICAL CARE OR BE ENROLLED IN A GOVERNMENT SPONSORED MEDICAL CARE PROGRAM UNDER ST. FRANCIS'S VARIOUS FINANCIAL ASSISTANCE PROGRAMS. THE ADMINISTRATIVE PROCESS INCLUDES IDENTIFYING ANY PATIENT WITH A FINANCIAL CONCERN, AS WELL AS INFORMING, COUNSELING, QUALIFYING AND ASSISTING PATIENTS TO APPLY FOR THE ST. FRANCIS' CHARITY CARE AND OTHER FINANCIAL ASSISTANCE PROGRAMS. ALTHOUGH EACH PATIENT IS PROVIDED NUMEROUS OPPORTUNITIES TO RECEIVE FINANCIAL ASSISTANCE AND INFORMED MULTIPLE TIMES OF THE CHARITY CARE PROGRAM PRIOR TO ST. FRANCIS CLASSIFYING THE AMOUNTS AS BAD DEBT, IT IS POSSIBLE THAT PATIENTS WHO WOULD QUALIFY FOR CHARITY CARE DO NOT COMPLETE THE APPLICATION. THIS AMOUNT IS NOT REASONABLY ESTIMABLE.AS A TAX-EXEMPT HOSPITAL, ST. FRANCIS IS REQUIRED TO PROVIDE NECESSARY MEDICAL CARE REGARDLESS OF THE PATIENT'S ABILITY TO PAY FOR THE SERVICES PROVIDED. DUE TO CIRCUMSTANCES BEYOND ST. FRANCIS' CONTROL, A PERSON WHO WOULD OTHERWISE QUALIFY UNDER THE CHARITY CARE PROGRAM MAY NOT PROVIDE ST. FRANCIS THE NECESSARY INFORMATION, FAIL TO QUALIFY FOR THE PROGRAM, AND FAIL TO RECEIVE FREE CARE. ULTIMATELY, THOSE AMOUNTS ARE WRITTEN-OFF AND REPORTED AS BAD DEBT EXPENSE. ANY METHODOLOGY ST. FRANCIS COULD USE TO QUANTIFY AND PROVIDE AN ESTIMATE OF HOW MUCH BAD DEBT (AT COST AND IF ANY) REPORTED ON LINE 2 REASONABLY COULD BE ATTRIBUTABLE TO PERSONS WHO LIKELY WOULD QUALIFY FOR FINANCIAL ASSISTANCE UNDER ST. FRANCIS' CHARITY CARE POLICY AND FOR ST. FRANCIS TO PROVIDE AN ESTIMATE OF WHAT PORTION OF BAD DEBT, IF ANY, ST. FRANCIS BELIEVES SHOULD CONSTITUTE COMMUNITY BENEFIT WOULD BE PURELY SPECULATIVE, IMPRECISE AND SUBJECT TO INHERENT METHODOLOGY FLAWS. WHILE ST. FRANCIS FIRMLY BELIEVES, FOR THE REASONS STATED ABOVE, THAT SOME COMPONENT OF ITS REPORTED BAD DEBT EXPENSE (AT COST) ON LINE 2 CONSTITUTES AMOUNTS RELATED TO PERSONS WHO LIKELY WOULD QUALIFY FOR FINANCIAL ASSISTANCE UNDER ST FRANCIS' CHARITY CARE PROGRAM, ST. FRANCIS CANNOT REASONABLY QUANTIFY THE AMOUNT AND RESPECTFULLY DECLINES THE OPPORTUNITY TO PROVIDE AN AMOUNT. THEREFORE, ST. FRANCIS HAS REPORTED ZERO OR NONE FOR FORM 990, SCHEDULE H, PART III, LINE 3.
PART VI, LINE 2: IN 2019, ALLINA HEALTH CONDUCTED A COMMUNITY HEALTH NEEDS ASSESSMENT FOR EACH OF THE HOSPITALS IN THE SYSTEM. THE PURPOSE WAS TO IDENTIFY LOCAL PRIORITIES FOR EACH HOSPITAL AS WELL AS OVER-ARCHING THEMES FOR THE HEALTH SYSTEM TO ADDRESS FOR FY 2020-2022.TO RESPOND TO LOCAL NEEDS AND RESOURCES, EACH ALLINA HEALTH HOSPITAL CONDUCTED ITS 2020-2022 CHNA INDEPENDENTLY. THE HOSPITALS WORKED CLOSELY WITH LOCAL PUBLIC HEALTH. THESE INCLUDE REPRESENTATIVES FROM THESE COUNTIES: ANOKA COUNTY, BROWN COUNTY, CARVER COUNTY, DAKOTA COUNTY, HENNEPIN COUNTY, ISANTI COUNTY, RAMSEY COUNTY, STEELE COUNTY, SCOTT COUNTY, WASHINGTON COUNTY, WRIGHT COUNTY, AND PIERCE COUNTY. SOME ALSO COLLABORATED WITH OTHER HEALTH SYSTEMS AND COMMUNITY ORGANIZATIONS. WHERE POSSIBLE, THE HOSPITAL ALIGNED THEIR PROCESS WITH ASSESSMENTS BEING CONDUCTED BY LOCAL PUBLIC HEALTH AND OTHER COMMUNITY AGENCIES. IN MANY CASES, THE HOSPITALS CONDUCTED THE CHNA JOINTLY WITH PARTNERS, WITH SHARED LEADERSHIP THROUGHOUT. THE CHNA PROCESS OCCURRED IN THREE STEPS: DATA REVIEW AND PRIORITIZATION, COMMUNITY INPUT AND THE DEVELOPMENT OF A THREE-YEAR IMPLEMENTATION PLAN. MOST HOSPITALS USED THE MOBILIZING FOR ACTION THROUGH PLANNING AND PARTNERSHIPS (MAPP) COMMUNITY-DRIVEN STRATEGIC PLANNING PROCESS FOR IMPROVING COMMUNITY HEALTH. THE OFFICIAL CHNA PROCESS BEGAN IN JUNE 2018 AND WAS COMPLETED IN AUGUST 2019. EACH HOSPITAL'S CHNA TEAM REVIEWED COUNTY-SPECIFIC DATA RELATED TO DEMOGRAPHICS, SOCIAL AND ECONOMIC FACOTRS, HEALTH BEHAVIORS, PREVALENCE OF HEALTH CONDITIONS AND HEALTH CARE ACCESS. SOURCES VARIED, BUT INCLUDED THE MINNESOTA STUDENT SURVEY, HEALTH SURVEYS CONDUCTED BY LOCAL PUBLIC HEALTH DEPARTMENTS, LOCAL RESEARCH STUDIES ON TOPICS SUCH AS HOUSING AND SECONDARY PUBLIC HEALTH DATA AVAILABLE THROUGH THE MINNESOTA DEPARTMENT OF HEALTH. ADDITIONALLY, TEAMS REVIEWED SELECT COUNTY-SPECIFIC ALLINA HEALTH PATIENT DATA. MANY HOSPITALS ALSO COLLECTED FEEDBACK ON PERCEIVED COMMUNITY HEALTH NEEDS FROM LOCAL STAKEHOLDERS THROUGH COMMUNITY DIALOGUES, INTERVIEWS AND SURVEYS. BASED ON THE DATA REVIEW AND COMMUNITY FEEDBACK, LOCAL CHNA TEAMS CHOSE CHNA PRIORITIES FOR THE 2020-2022 CYCLE. SPECIFIC PRIORITIZATION CRITERIA WAS DETERMINED LOCALLY, BUT SIZE AND SERIOUSNESS OF THE PROBLEM, IMPORTANCE TO THE COMMUNITY AND ORGANIZATIONAL CAPACITY TO ADDRESS THE NEED WERE ALL CONSIDERED. HOSPITAL PRIORITIES INCLUDE:- MENTAL HEALTH AND WELLNESS, INCLUDING SUBSTANCE ABUSE- OBESITY, PHYSICAL ACTIVITY AND NUTRITION- ACCESS TO CARE- SOCIAL DETERMINANTS OF HEALTH- SOCIAL ISOLATION- VIOLENCE- DENTAL CAREST. FRANCIS SPECIFIC PRIORITIES INCLUDE:- MENTAL HEALTH AND WELLNESS, INCLUDING SUBSTANCE ABUSE- HEALTHY WEIGHT- ACCESS TO CARETO INCREASE THEIR UNDERSTANDING OF COMMUNITY MEMBERS' PERSPECTIVES ON IDENTIFIED HEALTH ISSUES AND IDEAS FOR ADDRESSING THEM, STAFF SOLICITED INPUT FROM INDIVIDUALS REPRESENTING THE BROAD INTERESTS OF THE COMMUNITY SUCH AS STAFF FROM SOCIAL SERVICE AND PUBLIC HEALTH ORGANIZATIONS AND RESIDENTS. STAFF COLLECTED FEEDBACK THROUGH A RANGE OF METHODS, INCLUDING FOCUS GROUPS AND INTERVIEWS. FOCUSED OUTREACH OCCURRED TO HISTORICALLY UNDERSERVED COMMUNITIES WHO EXPERIENCE HEALTH DISPARITIES. IN FEBRUARY AND APRIL 2019, COMMUNITY ENGAGEMENT LEADERS FROM EACH OF ALLINA HEALTH'S HOSPITALS DISCUSSED THE RESULTS OF EACH HOSPITAL'S DATA REVIEW, PRIORITIZATION AND COMMUNITY INPUT PROCESSES. PRIORITIES AND COMMON THEMES FOR ACTION WERE IDENTIFIED ACROSS ALL GEOGRAPHIES. TOGETHER, THEY IDENTIFIED MENTAL HEALTH (INCLUDING SUBSTANCE ABUSE) AND OBESITY CAUSED BY PHYSICAL INACTIVITY AND POOR NUTRITION AS PRIORITY NEEDS IN ALL ALLINA HEALTH GEOGRAPHIES. THEY ALSO IDENTIFIED SOCIAL DETERMINANTS OF HEALTH, PARTICULARLY ACCESS TO HEALTHY FOOD AND STABLE HOUSING, AS KEY FACTORS CONTRIBUTING TO HEALTH. ALL ALLINA HEALTH ASSESSMENTS AND ACTION PLANS WERE APPROVED BY LOCAL FACILITIES AND THE ALLINA HEALTH BOARD OF DIRECTORS BY DECEMBER 2019. COPIES OF EACH FACILITY'S NEEDS ASSESSMENT REPORT AND ACTION PLAN, INCLUDING THE REPORT AND ACTION PLAN FOR ST. FRANCIS, CAN BE FOUND AT: HTTPS://WWW.ALLINAHEALTH.ORG/ABOUT-US/COMMUNITY-INVOLVEMENT/NEED-ASSESSMENTS/2020-2022-NEEDS-ASSESSMENTS-AND-IMPLEMENTATIONS-PLANS. ONCE IMPLEMENTATION PLANS ARE CREATED, MORE DETAILED PLANNING CONTINUES WITH STAKEHOLDER TO DEVELOP AND DELIVER SPECIFIC PROGRAMS, SERVICES AND ACTIVITIES EITHER LOCALLY OR SYSTEM-WIDE.
PART VI, LINE 3: AS A FAITH-BASED, NOT-FOR-PROFIT HOSPITAL, ST. FRANCIS DELIVERS COMPASSIONATE, HIGH QUALITY, AFFORDABLE HEALTH CARE SERVICES AND ADVOCATES FOR PEOPLE WITH LIMITED FINANCIAL MEANS. ST. FRANCIS WORKS TO ENSURE THAT THE FINANCIAL CAPACITY OF PEOPLE WHO NEED HEALTH CARE SERVICES DOES NOT PREVENT THEM FROM SEEKING OR RECEIVING CARE AT ST. FRANCIS. PROVIDING CONVENIENT ACCESS TO NECESSARY MEDICAL CARE REGARDLESS OF ONE'S ABILITY TO PAY FOR THOSE SERVICES IS IMPORTANT TO ST. FRANCIS. THROUGH ALLINA HEALTH SYSTEM, ST. FRANCIS HAS ESTABLISHED THE FOLLOWING FINANCIAL ASSISTANCE PROGRAMS: - ALLINA PARTNER'S CARE PROGRAM, PROVIDING CHARITY CARE - UNINSURED DISCOUNTS PROGRAM- SPECIAL CIRCUMSTANCES ASSISTANCE (INDIVIDUAL, CASE-BY-CASE BASIS)- MEDELIGIBLE SERVICES- MEDCREDIT FINANCIAL SERVICES ST. FRANCIS EMPLOYS FINANCIAL COUNSELORS TO ASSIST PEOPLE WHO WILL BE RECEIVING CARE IN BOTH THE INPATIENT AND OUTPATIENT SETTING. THE FINANCIAL COUNSELOR WORKS WITH INDIVIDUALS ON A CASE-BY-CASE BASIS. ST. FRANCIS ALSO EMPLOYS A FINANCIAL COUNSELOR FOR ITS EMERGENCY DEPARTMENT. THIS ALLOWS ST. FRANCIS TO ENROLL UNINSURED PATIENTS INTO PROGRAMS THE PATIENT MAY NOT OTHERWISE KNOW THEY ARE ENTITLED TO PARTICIPATE IN. IT ALSO ALLOWS ST. FRANCIS TO CONNECT THE PATIENTS WITH COMMUNITY RESOURCES LIKE THE RIVER VALLEY NURSING CENTER AND ST. MARY'S HEALTH CLINICS, BOTH OF THESE COMMUNITY PROGRAMS RECEIVE CHARITABLE CONTRIBUTIONS FROM ST. FRANCIS. ST. FRANCIS' CHARITY CARE POLICY AND UNINSURED DISCOUNT POLICY ARE AVAILABLE IN MULTIPLE LANGUAGES.FOR MORE INFORMATION ON ANY OF THE ST. FRANCIS FINANCIAL ASSISTANCE PROGRAMS, YOU MAY VISIT WWW.STFRANCIS-SHAKOPEE.COM OR WWW.ALLINAHEALTH.ORG AND CLICK ON THE FINANCIAL ASSISTANCE LINK.ST. FRANCIS PARTICIPATES IN ALL ALLINA HEALTH SYSTEM PROGRAMMING WITH RESPECT TO FINANCIAL ASSISTANCE, INCLUDING THE FOLLOWING:CHARITY CARE PROGRAM - ALLINA PARTNER'S CARE PROGRAM PROVIDES FREE MEDICALLY NECESSARY CARE TO ALL PERSONS AT OR BELOW 275 PERCENT OF THE FEDERAL POVERTY GUIDELINES AS PUBLISHED ANNUALLY IN THE FEDERAL REGISTER. THE PROGRAM WAS ESTABLISHED TO ASSIST PATIENTS WHO DO NOT QUALIFY FOR MEDICAL ASSISTANCE OR MINNESOTA CARE AND WHOSE ANNUAL INCOMES ARE AT OR BELOW 275 PERCENT OF THE FEDERAL POVERTY LEVEL. THE APPLICATION IS BRIEF AND ASKS FOR INFORMATION ON FAMILY SIZE, EMPLOYMENT, INCOME, BANKING AND INSURANCE. IF A PATIENT MEETS THE ELIGIBILITY GUIDELINES, THEIR TOTAL BALANCE WILL BE ZERO. THEY WILL RECEIVE FREE MEDICAL CARE. AN ELIGIBLE INDIVIDUAL WILL BE COVERED BY THE PROGRAM FOR UP TO ONE YEAR BARRING ANY SIGNIFICANT CHANGE IN INCOME. PATIENTS MAY BE ASKED TO APPLY FOR MEDICAL ASSISTANCE AND MINNESOTA CARE AND BE FOUND INELIGIBLE FOR THOSE PROGRAMS BEFORE THEY QUALIFY FOR ST FRANCIS' PARTNER'S CARE PROGRAM.THE UNINSURED DISCOUNT PROGRAM PROVIDES A DISCOUNT ON BILLED CHARGES TO UNINSURED PATIENTS, AND INSURED PATIENTS WHO RECEIVE UNINSURED TREATMENT, FOR MEDICALLY NECESSARY CARE RECEIVED FROM ANY ALLINA HOSPITAL, HOSPITAL BASED CLINIC AND WHOLLY-OWNED AMBULATORY SURGERY CENTERS. UNINSURED PATIENTS AND INSURED PATIENTS WHO RECEIVE UNINSURED TREATMENT ARE ELIGIBLE FOR A DISCOUNT BASED UPON THEIR INCOME LEVEL AND THE LOCATION OF THE SERVICES PROVIDED. ALL PATIENTS WITH AN ANNUAL INCOME AT OR BELOW $125,000 ARE ELIGIBLE FOR A DISCOUNT. THE DISCOUNT IS ALSO GENERALLY EXTENDED TO PATIENTS WITH AN ANNUAL INCOME ABOVE $125,000. THERE ARE THREE DISCOUNTS LEVELS ESTABLISHED, ONE FOR METRO HOSPITALS, ONE FOR REGIONAL HOSPITALS, AND ONE FOR HOSPITAL BASED CLINICS WITHIN THE ALLINA SYSTEM. SPECIAL CIRCUMSTANCES ASSISTANCE (ON INDIVIDUAL CASE BY CASE BASIS) - ST. FRANCIS PROVIDES FOR THE CONSIDERATION OF SPECIAL CIRCUMSTANCES FOR THE "MEDICALLY INDIGENT." ST. FRANCIS EXTENDS THE CHARITY CARE PROGRAM IN INSTANCES IT DETERMINES THE PATIENT IS UNABLE TO PAY SOME OR ALL OF THEIR MEDICAL BILLS DUE TO CATASTROPHIC CIRCUMSTANCES EVEN THOUGH THEY HAVE INCOME OR ASSETS THAT OTHERWISE EXCEED THE GENERALLY APPLICABLE ELIGIBILITY CRITERIA FOR THE FREE CARE PROGRAM OR THE DISCOUNTED CARE PROGRAM (DESCRIBED BELOW) UNDER ST. FRANCIS' FINANCIAL ASSISTANCE PROGRAM GUIDELINES. FINANCIAL ASSISTANCE SERVICES WILL PROVIDE AN EVALUATION OF PATIENTS WITH SPECIAL CIRCUMSTANCES. THERE MAY BE A CIRCUMSTANCE WHERE PATIENTS EXPERIENCE A CATASTROPHIC EVENT THAT PUTS THEM IN A DEVASTATING FINANCIAL POSITION WHEREBY THE PROGRAM REPRESENTATIVES WILL DETERMINE HOW TO BEST SUPPORT THEM FINANCIALLY. MEDELIGIBLE SERVICES PROVIDE ADVOCACY SUPPORT TO PATIENTS WHO HAVE DIFFICULTY PAYING THEIR MEDICAL BILLS. THEY CAN ASSIST PATIENTS WITH APPLYING FOR FEDERAL, STATE AND COUNTY BENEFIT PROGRAMS. THE MEDELIGIBLE SERVICES PERSONNEL ARE ADVOCATES WHO EDUCATE PATIENTS AND FAMILIES ABOUT THE ADVANTAGES OF PROGRAMS AND ASSIST THEM WITH GETTING HELP. PERSONNEL CAN PROVIDE ASSISTANCE WITH MEDICAID AND MEDICARE, SOCIAL SECURITY, VETERAN'S ADMINISTRATION, FOOD STAMPS, EMERGENCY FOOD, AND SHELTER. MEDCREDIT FINANCIAL SERVICES PROVIDES FINANCIAL LOANS TO PATIENTS WHO CANNOT AFFORD TO PAY THEIR MEDICAL BILLS. THE PATIENT CAN CONSOLIDATE ALL MEDICAL EXPENSES FROM PARTICIPATING PROVIDERS SUCH THAT THE PATIENT HAS ONLY ONE MONTHLY PAYMENT. THERE IS NO CREDIT APPLICATION REQUIRED AND NO ANNUAL FEES OR DUES. THE ANNUAL PERCENTAGE INTEREST RATE IS 8 PERCENT. ONCE A PATIENT HAS ESTABLISHED A MEDCREDIT ACCOUNT, AMOUNTS CAN BE ADDED ON ANY ADDITIONAL MEDICAL EXPENSES FOR THEMSELVES AND THEIR FAMILY. PAYMENT PLANS-IF A PATIENT INDICATES THEY ARE UNABLE OR UNWILLING TO PAY THE BALANCE IN FULL, ST. FRANCIS OFFERS A PAYMENT PLAN WHICH CANNOT EXCEED TWELVE MONTHS AND CANNOT BE LESS THAN THIRTY DOLLARS PER MONTH. IF THE PATIENT IS UNABLE TO MEET THESE PARAMETERS, MEDCREDIT IS OFFERED TO THEM. THE FINANCIAL ASSISTANCE SERVICES INFORMATION AND EDUCATION METHODS - ALLINA HAS ROBUST METHODS TO INFORM AND EDUCATE PATIENTS AND PERSONS WHO ARE BILLED FOR PATIENT CARE ABOUT THEIR ELIGIBILITY FOR ASSISTANCE UNDER ITS FINANCIAL ASSISTANCE PROGRAMS, INCLUDING ITS CHARITY CARE PROGRAM, AND ALSO ABOUT GOVERNMENT PROGRAMS FOR WHICH THEY MAY BE ELIGIBLE TO RECEIVE BENEFITS. EACH PATIENT BILLING STATEMENT CONTAINS INFORMATION ABOUT THE FINANCIAL ASSISTANCE PROGRAMS AND INCLUDES CONTACT INFORMATION. THE ST. FRANCIS WEBSITE HOMEPAGE AT WWW.STFRANCIS-SHAKOPEE.COM PROMINENTLY CONTAINS A LINK TO THE FINANCIAL ASSISTANCE SERVICES PAGE WHICH DESCRIBES ST FRANCIS' FINANCIAL ASSISTANCE PROGRAMS AND INCLUDES CONTACT INFORMATION. ST. FRANCIS POSTS SUMMARIES OF ITS FINANCIAL ASSISTANCE PROGRAMS IN BROCHURES IN ADMISSIONS AREAS, EMERGENCY ROOMS, AND OTHER AREAS ST. FRANCIS' FACILITIES WHERE ELIGIBLE PATIENTS ARE LIKELY TO BE PRESENT.THE BROCHURES CONTAIN SUMMARIES OF THE FINANCIAL ASSISTANCE PROGRAMS AND INCLUDE CONTACT INFORMATION FOR THE PROGRAMS. THIS INFORMATION IS ALSO AVAILABLE IN SOMALI AND SPANISH. REGISTRATION, ADMISSIONS AND INTAKE PERSONNEL ARE TRAINED TO PROVIDE FINANCIAL ASSISTANCE PROGRAM INFORMATION TO ANYONE EXPRESSING A CONCERN ABOUT THEIR ABILITY TO PAY FOR SERVICES. ALL "SELF-PAY" PATIENTS (THE PATIENT IS NOT COVERED BY INSURANCE OR A GOVERNMENT PROGRAM) THAT COMES TO ST. FRANCIS' EMERGENCY ROOM RECEIVES A PACKET OF INFORMATION CONTAINING EVERYTHING NECESSARY TO APPLY FOR ST. FRANCIS' FINANCIAL ASSISTANCE PROGRAMS AND CERTAIN GOVERNMENT PROGRAMS. THERE IS CONTACT INFORMATION AND TELEPHONE NUMBERS THEY CAN CALL WITH ANY QUESTIONS OR TO RECEIVE ASSISTANCE IN COMPLETING APPLICATIONS. FINANCIAL ASSISTANCE PROGRAM PERSONNEL ALSO MEET DIRECTLY WITH ANY SELF-PAY PATIENT ADMITTED TO THE HOSPITAL. PERSONNEL WILL MEET WITH PATIENTS WHEREVER IT IS MOST CONVENIENT FOR THE PATIENT SUCH AS THE HOSPITAL, A CLINIC, ST. FRANCIS' OFFICES OR THE PATIENT'S HOME. ST. FRANCIS HAS AN INTERPRETER SERVICES TEAM THAT PROVIDES INTERPRETERS TO PATIENTS, COMPANIONS AND FAMILIES WHO HAVE LIMITED ENGLISH PROFICIENCY (LEP) OR ARE DEAF OR HARD OF HEARING (DHH). THIS SERVICE IS PROVIDED AT NO COST TO THE PATIENT. LEP AND DHH PERSONNEL ARE TRAINED TO INFORM AND EDUCATE PATIENTS ABOUT THE FINANCIAL ASSISTANCE PROGRAMS. ALL PERSONNEL RESPONSIBLE FOR ST. FRANCIS' COLLECTION ACTIVITIES ARE EXTENSIVELY TRAINED ON ST. FRANCIS' FINANCIAL ASSISTANCE PROGRAMS. ANY TIME A PATIENT EXPRESSES A CONCERN REGARDING THEIR ABILITY TO PAY FOR SERVICES, THE PERSONNEL EXPLAIN THE FINANCIAL ASSISTANCE PROGRAMS, ASK CERTAIN QUESTIONS TO OBTAIN INFORMATION AND TO DETERMINE WHICH FINANCIAL ASSISTANCE PROGRAMS THE PATIENT MAY QUALIFY AND BEST FITS THE PATIENTS' NEEDS.
PART VI, LINE 4: ALLINA HEALTH SYSTEM (ALLINA HEALTH) IS A NOT-FOR-PROFIT SYSTEM OF CLINICS, HOSPITALS AND OTHER HEALTH CARE SERVICES. ALLINA HEALTH OWNS AND OPERATES 11 HOSPITALS, MORE THAN 90 CLINICS AND HEALTH CARE SERVICES, INCLUDING HOME CARE, HOSPICE CARE, PALLIATIVE CARE, OXYGEN AND MEDICAL EQUIPMENT, PHARMACIES AND EMERGENCY MEDICAL TRANSPORTATION IN OPERATION WITHIN MINNESOTA AND WESTERN WISCONSIN. NEARLY ALL ALLINA HOSPITAL PATIENTS COME FROM MINNESOTA AND WISCONSIN, THE MAJORITY OF WHICH COME FROM THE COUNTIES SURROUNDING ITS HOSPITALS AND CLINICS, INCLUDING THE SEVEN-COUNTY TWIN CITIES METRO AND SUBURBAN AND RURAL COMMUNITIES IN WESTERN WISCONSIN, SOUTHERN MINNESOTA AND CENTRAL MINNESOTA. COMMUNITIES SERVED BY ALLINA HEALTH ARE ASSIGNED INTO ONE OF NINE REGIONS AND EACH REGION INCLUDES AT LEAST ONE HOSPITAL WITHIN OUR SYSTEM. COMMUNITY ENGAGEMENT LEADS ARE ASSIGNED TO EACH REGION TO ENGAGE COMMUNITY IN COMMUNITY BENEFIT ACTIVITIES. ST. FRANCIS REPRESENTS THE SOUTH METRO.WEST METRO THE WEST METRO REGION INCLUDES ABBOTT NORTHWESTERN HOSPITAL AND PHILLIPS EYE INSTITUTE AND SERVES MOST COMMUNITIES WITHIN HENNEPIN COUNTY, THE LARGEST COUNTY IN MINNESOTA. THE CITY OF MINNEAPOLIS IS ITS LARGEST CITY AND THE COUNTY SEAT. THE WEST METRO REGION SERVES BOTH URBAN AND SUBURBAN COMMUNITIES AND INCLUDES A RANGE OF SOCIOECONOMIC STATUSES AS WELL AS A BROAD REPRESENTATION OF RACES AND ETHNICITIES. EAST METRO THE EAST METRO REGION INCLUDES UNITED HOSPITAL AND SERVES RAMSEY, WASHINGTON AND DAKOTA COUNTIES. THIS REGION SPANS THE EASTERN EDGE OF THE TWIN CITIES METRO, INCLUDING THE CITY OF ST. PAUL AND ITS SURROUNDING COMMUNITIES. ST. PAUL IS THE CAPITAL AND SECOND-MOST POPULOUS CITY IN THE STATE. THE EAST METRO REGION IS HIGHLY DIVERSE; GEOGRAPHICALLY, SOCIOECONOMICALLY AND RACIALLY. NORTHWEST METRO THE NORTHWEST METRO REGION INCLUDES MERCY HOSPITAL AND ITS UNITY CAMPUS AND PRIMARILY SERVES COMMUNITIES WITHIN ANOKA COUNTY, BUT ALSO INCLUDES AREAS WITHIN RAMSEY, SHERBURNE AND HENNEPIN COUNTIES. ANOKA COUNTY IS THE FOURTH-MOST POPULOUS COUNTY IN THE STATE OF MINNESOTA AND INCLUDES THE NORTHWEST METROPOLITAN AREA THAT IS PREDOMINANTLY SUBURBAN IN NATURE. SOUTH METRO THE SOUTH METRO REGION INCLUDES ST. FRANCIS REGIONAL MEDICAL CENTER, A PARTIALLY-OWNED HOSPITAL WITHIN THE ALLINA SYSTEM, AND PRIMARILY SERVES SCOTT AND EASTERN CARVER COUNTIES, BUT ALSO INCLUDES COMMUNITIES IN SIBLEY, LE SUEUR, DAKOTA AND HENNEPIN COUNTIES. THIS REGION INCLUDES BOTH SUBURBAN AND SMALL COMMUNITIES IN THE SOUTHWEST AREA OF THE MINNEAPOLIS-ST. PAUL METROPOLITAN AREA. NORTHWEST REGIONAL THE NORTHWEST REGIONAL AREA INCLUDES BUFFALO HOSPITAL AND IS LOCATED WEST OF THE METROPOLITAN AREA OF MINNEAPOLIS AND ST. PAUL. THIS REGION PRIMARILY SERVES WRIGHT COUNTY, BUT ALSO SERVES COMMUNITIES WITHIN STEARNS, MEEKER AND HENNEPIN COUNTIES. THIS REGION IS MADE UP OF BOTH SMALL AND RURAL COMMUNITIES. NORTH REGIONALTHE NORTH REGIONAL AREA INCLUDES CAMBRIDGE MEDICAL CENTER AND SERVES SMALL AND RURAL COMMUNITIES WITHIN ISANTI, CHISAGO, KANABEC AND PINE COUNTIES NORTH OF THE METROPOLITAN AREA OF MINNEAPOLIS AND ST. PAUL. SOUTHWEST REGIONALTHE SOUTHWEST REGIONAL AREA IS LOCATED IN SOUTH CENTRAL MINNESOTA AND INCLUDES NEW ULM MEDICAL CENTER. THE REGION SERVES COMMUNITIES AND RURAL AREAS IN AND AROUND BROWN COUNTY AND COMMUNITIES WITHIN SIBLEY AND NICOLLET COUNTIESSOUTH REGIONALLOCATED SOUTH OF THE TWIN CITIES METROPOLITAN AREA, THE SOUTH REGIONAL REGION PRIMARILY SERVES MID-SIZED SUBURBAN CITIES AND RICE, STEELE AND SOUTHERN DAKOTA COUNTIES AS WELL AS COMMUNITIES AND RURAL AREAS ACROSS DODGE, WASECA, AND GOODHUE COUNTIES. OWATONNA HOSPITAL AND DISTRICT ONE HOSPITALS SERVE THESE AREAS.EAST REGIONALTHE EAST REGIONAL REGION IS LOCATED IN EASTERN MINNESOTA AND WESTERN WISCONSIN. IT INCLUDES REGINA HOSPITAL AND RIVER FALLS AREA HOSPITALS, SERVING COMMUNITIES IN DAKOTA COUNTY IN MINNESOTA, AND PIERCE AND ST. CROIX COUNTIES IN WISCONSIN.
PART VI, LINE 5: GOVERNING BODY A MAJORITY OF ST. FRANCIS' GOVERNING BODY IS COMPRISED OF PERSONS WHO RESIDE IN THE ORGANIZATION'S PRIMARY SERVICE AREA WHO ARE NEITHER EMPLOYEES NOR INDEPENDENT CONTRACTORS OF THE ORGANIZATION NOR FAMILY MEMBERS THEREOF. OPEN MEDICAL STAFFTHE MEDICAL STAFF AT ST. FRANCIS IS OPEN, WITH THE EXCEPTION OF CERTAIN DEPARTMENTS (SUCH AS RADIOLOGY, PATHOLOGY, EMERGENCY MEDICINE) WITH WHICH ST. FRANCIS HAS ENTERED INTO EXCLUSIVE CONTRACTS WITH PARTICULAR MEDICAL GROUPS. THE HOSPITAL ENTERS INTO THESE CONTRACTS WHEN IT DETERMINES SUCH ARRANGEMENTS WILL IMPROVE CARE AND OPERATIONS IN THE HOSPITAL BY, FOR EXAMPLE, IMPROVING THE QUALITY OF PATIENT CARE, ASSURING THE AVAILABILITY OF SPECIFIC SERVICES, REDUCING THE COSTS OF PROVIDING HEALTH CARE, ALLOCATING HOSPITAL RESOURCES MORE EFFICIENTLY, SECURING GREATER PATIENT SATISFACTION, OR FACILITATING THE ORDERLY OPERATIONS OF THE HOSPITAL. IT DOES NOT ENTER INTO THESE ARRANGEMENTS SOLELY TO BENEFIT OR EXCLUDE SPECIFIC PROVIDERS OR TO RESTRAIN COMPETITION.ST. FRANCIS ENGAGES IN A BROAD ARRAY OF ACTIVITIES THAT PROMOTE GOOD HEALTH IN OUR COMMUNITY. SEVERAL DEPARTMENTS ENGAGE IN COMMUNITY OUTREACH ACTIVITIES INCLUDING SUPPORT GROUPS (DIABETES, CANCER, GRIEF AND LOSS), EDUCATIONAL CLASSES (CPR ANYTIME, NUTRITION), AND FREE SCREENINGS (SKIN CANCER, CERVICAL CANCER, AND DIABETES). ST. FRANCIS PARTNERS WITH SEVERAL LOCAL ORGANIZATIONS IN STRENGTHENING THE CONTINUUM OF CARE FOR PEOPLE WHO ARE UNINSURED AND UNDERINSURED. ST. FRANCIS PROVIDED FINANCIAL SUPPORT FOR RIVER VALLEY HEALTH SERVICES WHICH OFFERS FREE PUBLIC HEALTH NURSING AND SOCIAL SERVICES REFERRALS FOR THE UNINSURED AND UNDERINSURED IN SCOTT AND EASTERN CARVER COUNTY. RIVER VALLEY HEALTH SERVICES COORDINATES CARE FOR THE UNINSURED POPULATION, HELPING PEOPLE NAVIGATE THE HEALTH AND SOCIAL SERVICES SYSTEM AND CONNECT WITH THE MOST APPROPRIATE CARE PROVIDER FOR THE CLIENT'S PARTICULAR NEED. IN 2019, THEY HAD 399 CLIENT VISITS AND PROVIDED SCREENINGS FOR 257. ST. FRANCIS PROVIDES FINANCIAL SUPPORT AND IN-KIND CLINIC SPACE ON THE ST. FRANCIS CAMPUS FOR ST. MARY'S HEALTH CLINICS TO ENSURE FREE MEDICAL CARE FOR UNINSURED AT ST. MARY'S SHAKOPEE LOCATION.
PART VI, LINE 6: PURSUANT TO A JOINT MEMBERSHIP AGREEMENT, ALLINA HEALTH SYSTEM, HPI-RAMSEY, AND CRITICAL ACCESS GROUP ARE JOINT MEMBERS OF ST. FRANCIS REGIONAL MEDICAL CENTER (ST. FRANCIS).UNDER THE MEMBERSHIP AGREEMENT, ALLINA HEALTH HAS THE AUTHORITY AND RESPONSIBILITY FOR THE OPERATION AND MAINTENANCE OF ST. FRANCIS, INCLUDING PROMOTING THE HEALTH OF THE COMMUNITIES SERVED BY ST. FRANCIS. THE JOINT MEMBERS HAVE CERTAIN JOINT RESERVE POWERS. ALLINA HEALTH AND CRITICAL ACCESS GROUP HAVE CERTAIN EXCLUSIVE RESERVE POWERS RELATING TO GOVERNANCE OF ST. FRANCIS.
PART VI, LINE 7, REPORTS FILED WITH STATES MN
Schedule H (Form 990) 2019
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Schedule I
(Form 990)
Department of the Treasury
Internal Revenue Service
Grants and Other Assistance to Organizations,
Governments and Individuals in the United States
Complete if the organization answered "Yes," on Form 990, Part IV, line 21 or 22.
lBullet Attach to Form 990.
lBullet Go to www.irs.gov/Form990 for the latest information.
OMB No. 1545-0047
2019
Open to Public
Inspection
Name of the organization
ST FRANCIS REGIONAL MEDICAL CENTER
 
Employer identification number
41-0907986
Part I
General Information on Grants and Assistance
1
Does the organization maintain records to substantiate the amount of the grants or assistance, the grantees' eligibility for the grants or assistance, and
the selection criteria used to award the grants or assistance? ........................
2
Describe in Part IV the organization's procedures for monitoring the use of grant funds in the United States.
Part II
Grants and Other Assistance to Domestic Organizations and Domestic Governments. Complete if the organization answered "Yes" on Form 990, Part IV, line 21, for any recipient
that received more than $5,000. Part II can be duplicated if additional space is needed.
(a) Name and address of organization
or government
(b) EIN (c) IRC section
(if applicable)
(d) Amount of cash grant (e) Amount of non-cash
assistance
(f) Method of valuation
(book, FMV, appraisal,
other)
(g) Description of
noncash assistance
(h) Purpose of grant
or assistance
(1) SHAKOPEE AREA CHAMBER OF COMMERCE
1801 EAST COUNTY ROAD 101
SHAKOPEE,MN55379
41-1367856 501(C)(6) 15,000       CORPORATE EVENT SPONSOR
(2) GUILD INC
130 SOUTH WABASHA STREET SUITE 90
ST PAUL,MN55107
41-1669233 501(C)(3) 100,000       DONATION TOWARDS THE INTENSIVE RESIDENTIAL TREATMENT SERVICES FACILITY BEING BUILT
(3) NEW CREATION LUTHERAN CHURCH
1053 JEFFERSON STREET SOUTH
SHAKOPEE,MN55379
41-0954977 501(C)(3) 16,500       TO SUPPORT NEW CREATION LUTHERAN CHURCH WITH ONGOING OPERATIONAL COSTS AND FUNDING FOR THE SUPPLEMENTAL SOCCER PROGRAM
(4) RIVER VALLEY YMCA
3575 NORTH BERENS ROAD NW
PRIOR LAKE,MN55379
45-2563299 501(C)(3) 38,000       TO SUPPORT THE ESPERANZA DAY CAMP PROGRAM FOR UNDESERVED YOUTH FROM PRE-K THROUGH HIGH SCHOOL.
(5) RIVER VALLEY COMMUNITY PARTNERSHIP (DBA RIVER VALLEY NURSING CENTER)
303 EAST 6TH STREET
CHASKA,MN55318
20-2886410 501(C)(3) 40,000       TO SUPPORT WORKING WITH UNINSURED AND UNDERINSURED IN SCOTT AND CARVER COUNTIES CONNECTING THEM TO LOW-COST HEALTH CARE SERVICES.
(6) ST MARY'S HEALTH CLINIC
1884 RANDOLPH AVENUE
ST PAUL,MN55105
41-1760632 509(A)(2) 25,000       TO SUPPORT THE CLINIC THAT PROVIDES HEALTH SERVICES FOR UNINSURED AND LOW-INCOME FAMILIES.
2
Enter total number of section 501(c)(3) and government organizations listed in the line 1 table ................. Bullet Image
 
3
Enter total number of other organizations listed in the line 1 table ........................ . Bullet Image
 
For Paperwork Reduction Act Notice, see the Instructions for Form 990.
Cat. No. 50055P
Schedule I (Form 990) 2019

Schedule I (Form 990) 2019
Page 2
Part III
Grants and Other Assistance to Domestic Individuals. Complete if the organization answered "Yes" on Form 990, Part IV, line 22.
Part III can be duplicated if additional space is needed.
(a) Type of grant or assistance (b) Number of
recipients
(c) Amount of
cash grant
(d) Amount of
noncash assistance
(e) Method of valuation (book,
FMV, appraisal, other)
(f) Description of noncash assistance
(1) HOUSING AND LIVING 12 18,445      
(1)
(2)
(3)
(4)
(5)
(6)
(7)
Part IV
Supplemental Information. Provide the information required in Part I, line 2; Part III, column (b); and any other additional information.
Return Reference Explanation
PART I, LINE 2: ST. FRANCIS REGIONAL MEDICAL CENTER STRICTLY MONITORS GRANT FUNDS TO ENSURE THAT SUCH GRANTS ARE USED FOR PROPER AND INTENDED PURPOSES AND ARE NOT OTHERWISE DIVERTED FROM THE INTENDED USE. THE ORGANIZATION HAS PROCESS WHICH INCLUDES A WRITTEN APPLICATION WHICH REQUIRES SUPPORTING DOCUMENTATION AND SUBSTANTIATION PRIOR TO A GRANT BEING APPROVED AND DISBURSED. IN ADDITION AND DEPENDING ON THE FACTS AND CIRCUMSTANCE OF THE GRANT, THE ORGANIZATION EMPLOYS VARIOUS METHODS TO ENSURE PROPER AND INTENDED USE SUCH AS PERIODIC REPORTING TO THE ORGANIZATION, FIELD INVESTIGATIONS, CONTRACTS WITH REPAYMENT CLAUSES, REQUIRING ADDITIONAL SUBSTANTIATION AND DOCUMENTATION NOT AVAILABLE AT THE TIME OF THE GRANT, PAYING THIRD PARTIES DIRECTLY ON BEHALF OF THE GRANTEE ORGANIZATION, AND OTHER METHODS AS APPROPRIATE AND WARRANTED.
Schedule I (Form 990) 2019



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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
2019
Open to Public Inspection
Name of the organization
ST FRANCIS REGIONAL MEDICAL CENTER
 
Employer identification number

41-0907986
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 on 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
 
No
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 on Line 1a? ..
2
Yes
 
3
Indicate which, if any, of the following the filing organization used to establish the compensation of the
organization's CEO/Executive Director. Check all that apply. Do not check any boxes for methods
used by a related organization to establish compensation of the CEO/Executive Director, but explain in Part III.
4
During the year, did any person listed on Form 990, Part VII, Section A, line 1a, with respect to the filing organization or a related organization:
a
Receive a severance payment or change-of-control payment? .............
4a
 
No
b
Participate in, or receive payment from, a supplemental nonqualified retirement plan? .........
4b
Yes
 
c
Participate in, or receive payment from, an equity-based compensation arrangement? .........
4c
 
No
If "Yes" to any of lines 4a-c, list the persons and provide the applicable amounts for each item in Part III.
Only 501(c)(3), 501(c)(4), and 501(c)(29) organizations must complete lines 5-9.
5
For persons listed on Form 990, Part VII, Section A, line 1a, did the organization pay or accrue any
compensation contingent on the revenues of:
a
The organization? ....................
5a
 
No
b
Any related organization? .......................
5b
 
No
If "Yes," on line 5a or 5b, describe in Part III.
6
For persons listed on Form 990, Part VII, Section A, line 1a, did the organization pay or accrue any
compensation contingent on the net earnings of:
a
The organization? ..................
6a
Yes
 
b
Any related organization? ......................
6b
Yes
 
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
Yes
 
9
If "Yes" on line 8, did the organization also follow the rebuttable presumption procedure described in Regulations section 53.4958-6(c)? .........................
9
Yes
 
For Paperwork Reduction Act Notice, see the Instructions for Form 990.
Cat. No. 50053T
Schedule J (Form 990) 2019

Schedule J (Form 990) 2019
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
1AMY JERDEE
DIRECTOR/PRESIDENT
(i)

(ii)
138,158
-------------
0
30,000
-------------
0
53,417
-------------
0
877
-------------
0
14,092
-------------
0
236,544
-------------
0
0
-------------
0
2MONTE JOHNSON MD
DIRECTOR/INTERIM PRES.
(i)

(ii)
198,770
-------------
132,514
56,533
-------------
37,688
23,998
-------------
15,999
8,400
-------------
5,600
18,151
-------------
12,100
305,852
-------------
203,901
21,635
-------------
14,423
3MICHAEL MCMAHAN
DIR/PRES/CHIEF INTEGRATION
(i)

(ii)
0
-------------
378,261
0
-------------
91,744
0
-------------
41,008
0
-------------
15,400
0
-------------
32,880
0
-------------
559,293
0
-------------
34,301
4KEITH OLSON DO
DIRECTOR
(i)

(ii)
0
-------------
363,551
0
-------------
12,928
0
-------------
40,436
0
-------------
15,400
0
-------------
20,701
0
-------------
453,016
0
-------------
21,660
5CYNTHIA VINCENT
VP FINANCE/OPERATIONS
(i)

(ii)
178,629
-------------
0
64,013
-------------
0
50,989
-------------
0
17,394
-------------
0
37,633
-------------
0
348,658
-------------
0
22,325
-------------
0
6SUE MILLER
VP PATIENT CARE SERVICES
(i)

(ii)
188,940
-------------
0
59,540
-------------
0
17,558
-------------
0
13,250
-------------
0
22,707
-------------
0
301,995
-------------
0
9,548
-------------
0
7KARYN BARRY
CRNA
(i)

(ii)
177,881
-------------
0
0
-------------
0
5,082
-------------
0
0
-------------
0
29,881
-------------
0
212,844
-------------
0
0
-------------
0
8JAMES GRUENWALD
CRNA
(i)

(ii)
180,977
-------------
0
0
-------------
0
4,405
-------------
0
0
-------------
0
29,581
-------------
0
214,963
-------------
0
0
-------------
0
9FARAH PIEPER
CRNA
(i)

(ii)
188,822
-------------
0
0
-------------
0
3,716
-------------
0
0
-------------
0
1,084
-------------
0
193,622
-------------
0
0
-------------
0
10GREGORY SPINDLER
CRNA
(i)

(ii)
180,005
-------------
0
0
-------------
0
3,820
-------------
0
0
-------------
0
19,485
-------------
0
203,310
-------------
0
0
-------------
0
11DEAN TEBRAKE
CRNA
(i)

(ii)
184,160
-------------
0
0
-------------
0
5,474
-------------
0
0
-------------
0
18,692
-------------
0
208,326
-------------
0
0
-------------
0
12BRIAN PROKOSCH MD
FORMER VP MEDICAL AFFAIRS
(i)

(ii)
0
-------------
232,684
0
-------------
0
0
-------------
151,542
0
-------------
16,360
0
-------------
0
0
-------------
400,586
0
-------------
90,453
Schedule J (Form 990) 2019

Schedule J (Form 990) 2019
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
PART I, LINE 1A EXPLANATION: TAX INDEMNIFICATION AND GROSS-UP PAYMENTS: ST. FRANCIS REGIONAL MEDICAL CENTER PROVIDES THIS TYPE OF PAYMENT AS IT RELATES TO TAXABLE MOVING EXPENSE REIMBURSEMENTS ON CERTAIN EXECUTIVES.
PART I, LINE 4B 4(B): MONTE JOHNSON, MD - $31,880; MICHAEL MCMAHAN - $30,724; KEITH OLSON, DO - $24,599; CYNTHIA VINCENT - $22,863; SUE MILLER - $9,548; BRIAN PROKOSCH, MD - $129,595.
PART I, LINE 6 DEFERRED COMPENSATION PLANS TERMS AND CONDITIONS: SEE SCHEDULE O RELATED TO FORM 990, PART VI, SECTION B, LINE 15 FOR A STATEMENT ON ALLINA HEALTH SYSTEM (ALLINA) PROVIDING ST. FRANCIS REGIONAL MEDICAL CENTER (ST. FRANCIS) STAFFING. ALLINA INCENTIVE PLAN ALLINA PROVIDES AN ANNUAL INCENTIVE COMPENSATION OPPORTUNITY FOR EXECUTIVES, MANAGEMENT AND KEY INDIVIDUAL CONTRIBUTOR STAFF. UNDER THIS PLAN, THE TARGET AWARD IS EXPRESSED AS A FUNCTION OF THE PARTICIPANT'S SALARY PAID DURING THE CALENDAR YEAR AND REQUIRES AT LEAST FOUR MONTHS OF SERVICE IN AN ELIGIBLE POSITION DURING THE YEAR. ACTUAL AWARDS CAN RANGE FROM 0% TO 150% OF THE TARGET AWARD, BASED ON ALLINA'S FINANCIAL AND NON-FINANCIAL PERFORMANCE OVER THE CALENDAR YEAR. NON-FINANCIAL PERFORMANCE MEASURES INCLUDE PATIENT & EMPLOYEE SAFETY, QUALITY, PATIENT EXPERIENCE AND FINANCIAL HEALTH. NO AWARDS ARE PROVIDED UNLESS THRESHOLD FINANCIAL PERFORMANCE IS ACHIEVED. PARTICIPANTS WHO HAVE LEFT EMPLOYMENT PRIOR TO THE END OF THE YEAR AS THE RESULT OF VOLUNTARY TERMINATION OR TERMINATION FOR POOR PERFORMANCE ARE NOT ELIGIBLE FOR AN AWARD.
PART I, LINE 8 CERTAIN AMOUNTS REPORTED ON FORM 990, PART VII WERE PAID OR ACCRUED PURSUANT TO A CONTRACT THAT WAS SUBJECT TO THE INITIAL CONTRACT EXCEPTION DESCRIBED IN REGULATION SECTION 53.4958-4(A)(3). FROM TIME TO TIME, ST. FRANCIS REGIONAL MEDICAL CENTER ENTERS INTO CONTRACTUAL ARRANGEMENTS THAT MAY QUALIFY FOR THE INITIAL CONTRACT EXCEPTION BASED ON THE TERMS AND UNDERSTANDINGS OF THE CONTRACTUAL AGREEMENTS.
SCHEDULE J, LINE 4(A) & (B) ADDITIONAL COMPENSATION DISCLOSURE: DEFERRED COMPENSATION PLANS TERMS AND CONDITIONS: EXECUTIVE MUTUAL FUND ACCOUNT PLAN PHYSICIAN MUTUAL FUND ACCOUNT PLAN THESE ACCOUNTS GIVE THE PARTICIPANT THE OPPORTUNITY FOR CAPITAL ACCUMULATION NOT FULLY AVAILABLE TO THEM THROUGH SOCIAL SECURITY OR THE GENERAL EMPLOYEE RETIREMENT PLANS BECAUSE OF MAXIMUMS PLACED ON COMPENSATION THAT CAN BE RECOGNIZED UNDER FEDERAL LAW FOR PURPOSES OF CONTRIBUTIONS. THEY ALSO SERVE AS AN IMPORTANT NON-COMPETE INCENTIVE TO PARTICIPANTS. PRIOR TO THE YEAR IN WHICH CONTRIBUTIONS ARE MADE, THE PARTICIPANT MUST DESIGNATE A VESTING/PAYOUT DATE CONSISTENT WITH THE CONSTRAINTS OF THE PLANS AND FEDERAL DEFERRED COMPENSATION REGULATIONS. AFTER THE CONTRIBUTIONS ARE MADE, THE PARTICIPANT HAS A ONE-TIME LIMITED OPPORTUNITY TO EXTEND THE ELECTED PAYMENT DATE FOR AT LEAST FIVE YEARS. ONCE THE VESTING/PAYOUT DATE HAS BEEN REACHED, ALLINA WILL WITHHOLD THE APPROPRIATE TAXES AND THE BALANCE WILL BE PAID TO THE PARTICIPANT ON THEIR PAYCHECK AS SOON AS ADMINISTRATIVELY FEASIBLE. IF THE PARTICIPANT TERMINATES EMPLOYMENT VOLUNTARILY BEFORE AN AMOUNT IS PAID, PAYMENT WILL BE SUBJECT TO THE PARTICIPANT'S COMPLIANCE WITH A NON-COMPETE AGREEMENT WITH ALLINA FOR TWO YEARS AFTER TERMINATION. THE PARTICIPANT MAY ELECT FROM AMONG INVESTMENT ALTERNATIVES THAT ARE SIMILAR TO THOSE AVAILABLE IN THE RETIREMENT SAVINGS PLAN. UNLIKE THE RETIREMENT SAVINGS PLAN, THE PARTICIPANT HAS THE STATUS OF AN UNSECURED CREDITOR OF ALLINA AND WILL NOT HAVE A PREFERRED CLAIM TO PAYMENT IN THE CASE OF THE COMPANY'S INABILITY TO PAY. HOWEVER, THE COMPANY DOES SET ASIDE ASSETS FOR ITS OBLIGATIONS BY ACTUALLY INVESTING THE PROMISED ASSETS CONSISTENT WITH PARTICIPANT ELECTIONS. THE MUTUAL FUND PLANS TERMINATED EFFECTIVE DECEMBER 31, 2018. ALL MUTUAL FUND ACCOUNTS SHALL BE DISTRIBUTED IN A LUMP SUM NO LATER THAN JANUARY 2021, OR IF ELECTED BY THE PARTICIPANT IN DECEMBER 2018, IN THREE ANNUAL INSTALLMENTS WITH THE FIRST HAVING BEEN MADE FEBRUARY 2019 (33.33 PERCENT OF ACCOUNT BALANCE), THE SECOND MADE FEBRUARY 2020 (50 PERCENT OF REMAINING BALANCE), AND THE THIRD MADE JANUARY 2021 (REMAINING BALANCE). ALLINA DEFINED CONTRIBUTION SUPPLEMENTAL EXECUTIVE RETIREMENT PLAN THIS PLAN WAS AMENDED AND FROZEN EFFECTIVE DECEMBER 31, 2008, SUCH THAT NO FUTURE BENEFITS ACCRUE FOR SERVICE AFTER THAT DATE. THIS PLAN WAS REPLACED WITH THE EXECUTIVE RETIREMENT BENEFIT RESTORATION PLAN (ERBRP) EFFECTIVE JANUARY 1, 2009, AND IS NOW FROZEN AS OF DECEMBER 31, 2018. ELIGIBLE ALLINA EXECUTIVES PARTICIPATED IN A DEFINED CONTRIBUTION SERP. EMPLOYER CREDITS WERE MADE EACH YEAR TO THEIR DC SERP BALANCE ACCORDING TO THE FOLLOWING SCHEDULE: EXEC YRS OF SERVICE CONTRIBUTION % OF PENSIONABLE EARNINGS 0-5 2.75% 6-10 3.50% 11+ 4.75% EXECUTIVES WERE ALSO CREDITED AN AMOUNT EQUAL TO THE EXCESS AMOUNT THAT WOULD HAVE BEEN CREDITED TO THE PENSION ACCOUNT PLAN WERE IT NOT FOR THE QUALIFIED PLAN COMPENSATION LIMITS. DEPOSITS EARN THE INVESTMENT RATE OF RETURN EQUAL TO THE PENSION ACCOUNT PLAN CREDITING RATE AS DECLARED BY ALLINA. THE CURRENT RATE IS 4%. THE PARTICIPANT VESTS AFTER THREE YEARS OF EXECUTIVE SERVICE PROVIDED THAT IF THE PARTICIPANT TERMINATES EMPLOYMENT WITH ALLINA PRIOR TO AGE 65 FOR ANY REASON OTHER THAN ELIMINATION OF POSITION, THE PARTICIPANT MUST FULFILL THE TERMS OF A COVENANT NOT TO COMPETE, BENEFITS ARE PAID AS A SINGLE LUMP-SUM AMOUNT UPON AGE 65, RETIREMENT OR JOB POSITION ELIMINATION. IN THE CASE OF OTHER VOLUNTARY TERMINATIONS, PAYMENT IS DELAYED UNTIL COMPLETION OF THE TWO-YEAR NON-COMPETE PERIOD. THE DC SERP IS PAYABLE FROM ALLINA'S GENERAL ASSETS. IF ALLINA BECOMES INSOLVENT, THE PARTICIPANT WILL BE AN UNSECURED CREDITOR AND WILL HAVE NO PREFERRED CLAIM TO ANY ASSETS. ALLINA EXECUTIVE RETIREMENT BENEFIT RESTORATION PLAN (ERBRP) ELIGIBLE ALLINA EXECUTIVES PARTICIPATE IN A DEFERRED COMPENSATION RETIREMENT PLAN. EXECUTIVES ARE CREDITED AN AMOUNT EQUAL TO THE EXCESS AMOUNT THAT WOULD HAVE BEEN CREDITED TO THE ALLINA RETIREMENT SAVINGS PLAN WERE IT NOT FOR THE QUALIFIED PLAN COMPENSATION LIMITS. EMPLOYER CREDITS ARE MADE EACH YEAR TO THEIR ACCOUNT BALANCE ACCORDING TO THE FOLLOWING SCHEDULE AS OF THE END OF THE PLAN YEAR: PARTICIPANT'S YEARS OF VESTING SERVICE APPLICABLE PERCENTAGE LESS THAN 1 0% 1-5 5.0% 6-10 5.5% 11-15 6.0% 16 OR MORE 6.5% DEPOSITS EARN THE INVESTMENT RATE OF RETURN EQUAL TO THE INVESTMENT OPTIONS SELECTED BY THE PARTICIPANT WHICH ARE THE SAME OPTIONS AVAILABLE UNDER THE QUALIFIED PLAN. A PARTICIPANT WHO HAS COMPLETED AT LEAST TWO YEARS OF SERVICE BECOMES VESTED IN THE PORTION OF HIS OR HER ACCOUNT ATTRIBUTABLE TO THE ANNUAL CREDIT FOR A PARTICULAR YEAR AS OF JANUARY 15 OF THE YEAR FOLLOWING THE CALENDAR YEAR IN WHICH THE ANNUAL CREDIT IS EARNED. IN THE EVENT OF TERMINATION (OTHER THAN BECAUSE OF DEATH) PRIOR TO AGE 67, THE DISTRIBUTION DATE SHALL BE AS SOON AS ADMINISTRATIVELY POSSIBLE AFTER TERMINATION IN THE FORM OF A LUMP SUM PAYMENT. THE PLAN IS PAYABLE FROM ALLINA'S GENERAL ASSETS. IF ALLINA BECOMES INSOLVENT, THE PARTICIPANT WILL BE AN UNSECURED CREDITOR AND WILL HAVE NO PREFERRED CLAIM TO ANY ASSETS. THIS PLAN WAS EFFECTIVE JANUARY 1, 2009 AND IS NOW FROZEN AS OF DECEMBER 31, 2018. EXECUTIVE SEVERANCE PLAN ALLINA PROVIDES SALARY CONTINUATION FOR EXECUTIVES WHO'S EMPLOYMENT HAS BEEN INVOLUNTARILY TERMINATED FOR REASONS OTHER THAN CAUSE OR POOR PERFORMANCE. THE LENGTH OF THE SEVERANCE PAY PERIOD IS DEFINED BY THE PLAN AND DEPENDS ON THE LEVEL OF THE EXECUTIVE POSITION. UNDER THE PLAN THE SEVERED EXECUTIVE ALSO COULD CONTINUE CERTAIN BENEFITS FOR A LIMITED PERIOD OF TIME. IN 2009 THE PLAN WAS AMENDED TO FURTHER RESTRICT SEVERANCE BENEFITS IN THE CASE THAT THE EXECUTIVE OBTAINS OTHER EMPLOYMENT DURING THE SEVERANCE PERIOD.
Schedule J (Form 990) 2019

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Schedule K
(Form 990)
Department of the Treasury
Internal Revenue Service
Supplemental Information on Tax-Exempt Bonds
SchKMediumBullet Complete if the organization answered "Yes" to Form 990, Part , line 24a. Provide descriptions,
explanations, and any additional information in Part .
SchKMediumBullet Attach to Form 990.

SchKMediumBulletGo to www.irs.gov/Form990 for instructions and the latest information.
OMB No. 1545-0047
2019
Open to Public
Inspection
Name of the organization
ST FRANCIS REGIONAL MEDICAL CENTER
 
Employer identification number
41-0907986
Part
Bond Issues
(a) Issuer name (b) Issuer EIN (c) CUSIP # (d) Date issued (e) Issue price (f) Description of purpose (g) Defeased (h) On
behalf of
issuer
(i) Pool
financing
Yes No Yes No Yes No
A CITY OF SHAKOPEE
 
41-6005539 819175BJ8 06-18-2014 46,172,827 SEE PART VI   X   X   X
Part
Proceeds
A B C D
1 Amount of bonds retired .................. 6,700,000      
2 Amount of bonds legally defeased ..............        
3 Total proceeds of issue .................. 46,172,827      
4 Gross proceeds in reserve funds .............        
5 Capitalized interest from proceeds .............        
6 Proceeds in refunding escrows ...............        
7 Issuance costs from proceeds ............... 750,150      
8 Credit enhancement from proceeds .............        
9 Working capital expenditures from proceeds .............        
10 Capital expenditures from proceeds .............        
11 Other spent proceeds ............. 45,422,677      
12 Other unspent proceeds .............        
13 Year of substantial completion ............. 2014
Yes No Yes No Yes No Yes No
14 Were the bonds issued as part of a current refunding issue of tax-exempt
bonds (or, if issued prior to 2018, a current refunding issue)? ........
X              
15 Were the bonds issued as part of an advance refunding issue of taxable
bonds (or, if issued prior to 2018, an advance refunding issue)? ........
  X            
16 Has the final allocation of proceeds been made? .......... X              
17 Does the organization maintain adequate books and records to support the final allocation of proceeds? .................. X              
Part
Private Business Use
A B C D
Yes No Yes No Yes No Yes No
1 Was the organization a partner in a partnership, or a member of an LLC, which owned property financed by tax-exempt bonds? .............   X            
2 Are there any lease arrangements that may result in private business use of bond-financed property? ...............   X            
For Paperwork Reduction Act Notice, see the Instructions for Form 990.
Cat. No. 50193E
Schedule K (Form 990) 2019

Schedule K (Form 990) 2019
Page 2
Part
Private Business Use (Continued)
A B C D
Yes No Yes No Yes No Yes No
3a Are there any management or service contracts that may result in private business use of bond-financed property? .............   X            
b If "Yes" to line 3a, does the organization routinely engage bond counsel or other outside counsel to review any management or service contracts relating to the financed property?                
c Are there any research agreements that may result in private business use of bond-financed property? .............   X            
d If "Yes" to line 3c, does the organization routinely engage bond counsel or other outside counsel to review any research agreements relating to the financed property?                
4 Enter the percentage of financed property used in a private business use by entities other than a section 501(c)(3) organization or a state or local government ....SchKMediumBullet 0 %      
5 Enter the percentage of financed property used in a private business use as a result of unrelated trade or business activity carried on by your organization, another section 501(c)(3) organization, or a state or local government ......... SchKMediumBullet 0 %      
6 Total of lines 4 and 5 ............. 0 %      
7 Does the bond issue meet the private security or payment test? ...   X            
8a Has there been a sale or disposition of any of the bond-financed property to a nongovernmental person other than a 501(c)(3) organization since the bonds were issued?.............   X            
b If "Yes" to line 8a, enter the percentage of bond-financed property sold or disposed of. ..        
c If "Yes" to line 8a, was any remedial action taken pursuant to Regulations sections 1.141-12 and 1.145-2? .............                
9 Has the organization established written procedures to ensure that all nonqualified bonds of the issue are remediated in accordance with the requirements under
Regulations sections 1.141-12 and 1.145-2? ........
X              
Part
Arbitrage
A B C D
Yes No Yes No Yes No Yes No
1 Has the issuer filed Form 8038-T, Arbitrage Rebate, Yield Reduction and Penalty in Lieu of Arbitrage Rebate? ...   X            
2 If "No" to line 1, did the following apply? ....
a Rebate not due yet? .......   X            
b Exception to rebate? ........ X              
c No rebate due? .........   X            
If "Yes" to line 2c, provide in Part the date the rebate
computation was performed ......
3 Is the bond issue a variable rate issue? .....   X            
4a Has the organization or the governmental issuer entered into a qualified hedge with respect to the bond issue?   X            
b Name of provider ..........  
 
 
 
 
 
 
 
c Term of hedge .........        
d Was the hedge superintegrated? ......                
e Was the hedge terminated? ........                
Schedule K (Form 990) 2019

Schedule K (Form 990) 2019
Page 3
Part
Arbitrage (Continued)
A B C D
Yes No Yes No Yes No Yes No
5a Were gross proceeds invested in a guaranteed investment contract (GIC)?   X            
b Name of provider ..........  
 
 
 
 
 
 
 
c Term of GIC .........        
d Was the regulatory safe harbor for establishing the fair market value of the GIC satisfied? ........                
6 Were any gross proceeds invested beyond an available temporary period?   X            
7 Has the organization established written procedures to monitor the requirements of section 148? ... X              
Part
Procedures To Undertake Corrective Action
--------------------------------------------------------------------------------------------------------------- A B C D
Yes No Yes No Yes No Yes No
Has the organization established written procedures to ensure that violations of federal tax requirements are timely identified and corrected through the voluntary closing agreement program if self-remediation is not available under applicable regulations? X              
Part
Supplemental Information. Provide additional information for responses to questions on Schedule K. (See instructions).
Return Reference Explanation
SCHEDULE K SUPPLENTAL INFORMATION IN JUNE 2014, THE CITY OF SHAKOPEE , ON BEHALF OF ST. FRANCIS REGIONAL MEDICAL CENTER, ISSUED FIXED RATE HEALTH CARE FACILITIES REVENUE REFUNDING BONDS, SERIES 2014. THE 2014 BONDS, WHICH ARE SECURED BY PLEDGED REVENUE , WERE USED TO REDEEM THE CITY OF SHAKOPEE, MINNESOTA HEALTH CARE FACILITIES FIXED RATE REVENUE BONDS, SERIES 2004 ON SEPTEMBER 1, 2014. USED FOR THE PURPOSE OF REFUNDING OF THE 2004 DEBT WHICH INCLUDED THE REFUNDING OF THE SERIES 1998 NOTES, CONSTRUCTION OF IMPATIENT BED TOWER AND RENOVATION OF MULTIPLE EXISTING FACILITIES, ACQUISITION OF MEDICAL EQUIPMENT, INFORMATION TECHNOLOGY, AND FURNISHINGS.
Schedule K (Form 990) 2019

Additional Data


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Software Version:  

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
2019
Open to Public
Inspection
Name of the organization
ST FRANCIS REGIONAL MEDICAL CENTER
 
Employer identification number

41-0907986
Return Reference Explanation
FORM 990, PART V, LINE 1A: ST. FRANCIS REGIONAL MEDICAL CENTER DOES NOT ISSUE PAYMENTS TO VENDORS AND SUPPLIERS BUT RATHER ALLINA HEALTH SYSTEM, A JOINT MEMBER ORGANIZATION, PROVIDES PAYMENTS TO VENDORS AND SUPPLIERS. THE NUMBER REPORTED ON FORM 990, PART V, LINE 1A IS THE NUMBER REPORTED ON ALLINA HEALTH SYSTEM'S FORM 1096 BOX 3 RELATED TO PAYMENTS MADE ON BEHALF OF ST. FRANCIS REGIONAL MEDICAL CENTER BY ALLINA.
FORM 990, PART VI, SECTION A, LINE 2 BUSINESS RELATIONSHIP - DAVID DRUCKMAN M.D. IS EMPLOYED BY THE SAME ORGANIZATION THAT MARK SANNES, M.D IS AN OFFICER.
FORM 990, PART VI, SECTION A, LINE 3 ST. FRANCIS REGIONAL MEDICAL CENTER (ST. FRANCIS) HAS THREE MEMBERS, EACH OF WHICH IS A MINNESOTA NONPROFIT CORPORATION AND 501(C)(3) ORGANIZATION. PURSUANT TO A JOINT MEMBERSHIP AGREEMENT, CRITICAL ACCESS GROUP ("CAG"), ALLINA HEALTH SYSTEM, AND HPI-RAMSEY ARE JOINT MEMBERS OF ST. FRANCIS. ALLINA HEALTH SYSTEM HAS THE AUTHORITY AND RESPONSIBILITY FOR THE OPERATIONS AND MAINTENANCE OF ST. FRANCIS. THE JOINT MEMBERS HAVE CERTAIN JOINT RESERVED POWERS. ALLINA HEALTH SYSTEM AND CAG HAVE CERTAIN EXCLUSIVE RESERVED POWERS RELATING TO THE GOVERNANCE OF ST. FRANCIS. THE RESERVED AND JOINT POWERS ARE FULLY DESCRIBED IN ST. FRANCIS' GOVERNING DOCUMENTS.
FORM 990, PART VI, SECTION A, LINE 6 SEE DESCRIPTION FOR LINE 3 ABOVE.
FORM 990, PART VI, SECTION A, LINE 7A SEE DESCRIPTION FOR LINE 3 ABOVE.
FORM 990, PART VI, SECTION A, LINE 7B SEE DESCRIPTION FOR LINE 3 ABOVE.
FORM 990, PART VI, SECTION B, LINE 11B THE ST. FRANCIS REGIONAL MEDICAL CENTER ("ST. FRANCIS") FORM 990 WAS PREPARED BY THE TAX SERVICES FUNCTION OF ALLINA HEALTH SYSTEM ("ALLINA"), A JOINT MEMBER ORGANIZATION. THE FORM 990 FILING WAS SUBJECTED TO A RIGOROUS REVIEW PROCESS BY ALLINA'S TAX MANAGER AND TAX DIRECTOR. ALLINA'S CHIEF FINANCIAL OFFICER ALSO PERFORMED AN EXECUTIVE REVIEW OF THE FORM 990. AFTER THE MANAGEMENT REVIEW PROCESS DESCRIBED ABOVE WAS COMPLETED, THE FINAL FORM 990, AS ULTIMATELY FILED WITH THE INTERNAL REVENUE SERVICE ["IRS"],WAS PROVIDED TO EACH VOTING MEMBER OF ST. FRANCIS' BOARD OF DIRECTORS. THE ST. FRANCIS BOARD OF DIRECTORS REVIEWED THE FORM 990 AND AUTHORIZED AND APPROVED THE FILING OF THE FORM 990 AND THE MINNESOTA CHARITABLE TRUST ANNUAL REPORT. THE BOARD OF DIRECTORS RESOLUTION ALSO DIRECTED OFFICERS TO FILE THE FORM 990 WITH THE IRS AND THE CHARITABLE TRUST ANNUAL REPORT WITH THE CHARITIES DIVISION OF THE OFFICE OF THE MINNESOTA ATTORNEY GENERAL. THE ABOVE STATED REVIEW AND APPROVAL PROCESS OCCURRED PRIOR TO FILING THE ST. FRANCIS FORM 990 WITH THE IRS AND MINNESOTA CHARITABLE TRUST ANNUAL REPORT WITH THE MINNESOTA ATTORNEY GENERAL.
FORM 990, PART VI, SECTION B, LINE 12C THE ORGANIZATION HAS SEVERAL METHODS OF MONITORING AND ENFORCING COMPLIANCE WITH ITS CONFLICT OF INTEREST POLICY. FIRST, THE ORGANIZATION REGULARLY DISTRIBUTES CONFLICT OF INTEREST DISCLOSURE QUESTIONNAIRES TO ITS OFFICERS, DIRECTORS, TRUSTEES, AND KEY EMPLOYEES. THESE INDIVIDUALS ARE REQUIRED TO DISCLOSE ANNUALLY ANY INTEREST THAT COULD GIVE RISE TO CONFLICTS, INCLUDING ANY FAMILY OR BUSINESS RELATIONSHIP. SECOND, THE GENERAL COUNSEL'S OFFICE ANNUALLY DELIVERS A REPORT TO ALLINA'S BOARD OF DIRECTORS WHICH INCLUDES, AMONG OTHER THINGS, THE RESULTS OF THE CONFLICT OF INTEREST QUESTIONNAIRE, AN ANALYSIS OF POTENTIAL CONFLICTS, AND GUIDANCE FOR SATISFACTORILY RESOLVING CONFLICTS. THIRD, THE ORGANIZATION UNDERTAKES MANDATORY COMPLIANCE TRAINING OF ALL ITS EMPLOYEES WHICH INCLUDES TRAINING ON CONFLICTS OF INTEREST. FOURTH, ALL EMPLOYEES RECEIVE, AND ARE EXPECTED TO CONDUCT THEMSELVES IN ACCORDANCE WITH, ALLINA'S CODE OF CONDUCT. THE CODE OF CONDUCT CONTAINS EDUCATIONAL MATERIALS AND GUIDANCE TO RESOLVE POTENTIAL CONFLICTS OF INTEREST. FIFTH, ALLINA MAINTAINS A CORPORATE INTEGRITY HOTLINE, A CONFIDENTIAL 24 HOUR EXTERNAL RESOURCE TO HELP ANSWER QUESTIONS RELATED TO ETHICAL BUSINESS CONDUCT. ALL CALLS TO THE INTEGRITY LINE ARE KEPT CONFIDENTIAL.
FORM 990, PART VI, SECTION B, LINE 15 ST. FRANCIS REGIONAL MEDICAL CENTER (ST. FRANCIS) HAS NO EMPLOYEES OF ITS OWN BUT RATHER ALLINA HEALTH SYSTEM, A JOINT MEMBER ORGANIZATION, PROVIDES THE STAFFING. THEREFORE, ST.FRANCIS' COMPENSATION AND BENEFITS PROGRAMS ARE VESTED IN AND ADMINISTERED IN CONJUNCTION WITH ALLINA HEALTH SYSTEM. THE COMPENSATION COMMITTEE OF THE ALLINA HEALTH SYSTEM BOARD OF DIRECTORS IS RESPONSIBLE FOR ALL COMPENSATION AND BENEFITS PROGRAM ELEMENTS FOR NON-COLLECTIVELY BARGAINED ALLINA HEALTH SYSTEM EXECUTIVE EMPLOYEES INCLUDING THOSE AT ST. FRANCIS. ALLINA HEALTH SYSTEM USES A PROCESS FOR DETERMINING COMPENSATION FOR THE ALLINA HEALTH SYSTEM CHIEF EXECUTIVE OFFICER, AND CERTAIN OTHER OFFICERS AND KEY EMPLOYEES THAT INCLUDED ALL OF THE FOLLOWING ELEMENTS: - REVIEW AND APPROVAL BY THE HUMAN RESOURCES AND COMPENSATION COMMITTEE OF THE BOARD OF DIRECTORS, THE MEMBERS OF WHICH ARE INDEPENDENT AND WITHOUT A CONFLICT OF INTEREST AS DEFINED IN REGULATION SECTION 53.4958-6(C)(1)(III). - ENGAGEMENT OF AN INDEPENDENT COMPENSATION CONSULTANT SPECIALIZING IN EXECUTIVE COMPENSATION. - USE OF DATA AS TO COMPARABLE COMPENSATION FOR SIMILARLY QUALIFIED PERSONS IN FUNCTIONALLY COMPARABLE POSITIONS AT SIMILARLY SITUATED ORGANIZATIONS. - CONTEMPORANEOUS DOCUMENTATION, SUBSTANTIATION AND RECORDKEEPING WITH RESPECT TO DELIBERATIONS AND DECISIONS REGARDING THE COMPENSATION ARRANGEMENT. THE ABOVE DESCRIBED PROCESS AND AN ASSESSMENT IS PERFORMED AT LEAST ANNUALLY FOR THE FOLLOWING POSITIONS: CHIEF EXECUTIVE OFFICER/PRESIDENT, CHIEF FINANCIAL OFFICER, CHIEF MEDICAL OFFICER, PRESIDENT - ABBOTT NORTHWESTERN HOSPITAL, PRESIDENT - UNITED HOSPITAL, PRESIDENT - MERCY HOSPITAL, EXECUTIVE VICE PRESIDENT - NETWORK INTEGRATION, SENIOR VICE PRESIDENT - GENERAL COUNSEL, EXECUTIVE VICE PRESIDENT ALLINA HEALTH GROUP, SENIOR VICE PRESIDENT - CHIEF COMPLIANCE OFFICER, SENIOR VICE PRESIDENT ALLINA HEALTH GROUP OPERATIONS, SENIOR VICE PRESIDENT - CHIEF HUMAN RESOURCES OFFICER AND SENIOR VICE PRESIDENT - CHIEF INFORMATION OFFICER. IN ADDITION, THE COMPENSATION COMMITTEE REVIEWS AND RECOMMENDS CHANGES TO THE BOARD OF DIRECTORS FOR THE ALLINA HEALTH SYSTEM CHIEF EXECUTIVE OFFICER AND REVIEWS AND APPROVES ALL COMPENSATION CHANGES OF THE OTHER FORE MENTIONED POSITIONS LISTED IN ADVANCE OF THE CHANGE.
FORM 990, PART VI, SECTION C, LINE 19 ST. FRANCIS REGIONAL MEDICAL CENTER MAKES ITS FORM 990, FORM 1023, GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS AVAILABLE TO THE PUBLIC UPON REQUEST. TO ARRANGE AN INSPECTION OR RECEIVE A COPY, PLEASE CONTACT THE FOLLOWING: ST. FRANCIS REGIONAL MEDICAL CENTER TAX SERVICES MAIL ROUTE 10890 P.O. BOX 43 MINNEAPOLIS, MN 55407-0043 TELEPHONE: 612-262-0660 PHYSICAL ADDRESS: 2925 CHICAGO AVENUE MINNEAPOLIS, MN 55407-1321 THE FORM 990 AND FORM 1023 ARE ALSO AVAILABLE DIRECTLY FROM THE INTERNAL REVENUE SERVICE. THE FORM 990 IS ALSO AVAILABLE FROM THE CHARITIES DIVISION OF THE OFFICE OF THE MINNESOTA ATTORNEY GENERAL. THE FINANCIAL STATEMENTS ARE ALSO AVAILABLE FROM ELECTRONIC MUNICIPAL MARKET ACCESS AND ON THEIR WEBSITE AT HTTP://EMMA.MSRB.ORG.
FORM 990, PART XI, LINE 9: CONTRIBUTION, EXPENSE AND GRANT FOUNDATION TRANSFER -12,070. DISTRIBUTIONS TO MEMBERS -5,000,000. IMPACT OF ASC 842 LEASE IMPLEMENTATION -1,295,719.
FORM 990, PART XII, LINE 2C: THIS PROCESS REMAINS UNCHANGED FROM PRIOR YEAR.
For Paperwork Reduction Act Notice, see the Instructions for Form 990 or 990-EZ.
Cat. No. 51056K
Schedule O (Form 990 or 990-EZ) 2019


Additional Data


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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
2019
Open to Public Inspection
Name of the organization
ST FRANCIS REGIONAL MEDICAL CENTER
 
Employer identification number

41-0907986
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) VALLEY REHABILITATION SERVICES LLC
1455 ST FRANCIS AVENUE
SHAKOPEE,MN55379
41-1752857
MEDICAL SERVICES MN 665,030 442,803 ST FRANCIS REGIONAL MEDICAL CENTER
 










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)ALLINA HEALTH SYSTEM
PO BOX 43 MAIL ROUTE 10890

MINNEAPOLIS,MN554400043
36-3261413
HEALTHCARE SERVICES MN 501(C)(3) LINE 3 N/A
 
No
(2)CRITICAL ACCESS GROUP
503 E 3RD STREET SUITE 400

DULUTH,MN55805
26-1219624
SUPPORTING ORGANIZATION MN 501(C)(3) LINE 12C, III-FI ESSENTIA HEALTH
 
 
No
(3)HPI-RAMSEY
8170 33RD AVENUE S PO BOX 1309

MINNEAPOLIS,MN554401309
41-1793333
SUPPORTING ORGANIZATION MN 501(C)(3) LINE 12B, II HEALTHPARTNERSINC
 
 
No








For Paperwork Reduction Act Notice, see the Instructions for Form 990.
Cat. No. 50135Y
Schedule R (Form 990) 2019
Schedule R (Form 990) 2019
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












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












Schedule R (Form 990) 2019
Schedule R (Form 990) 2019
Page 3
Part V
Transactions With Related Organizations. Complete if the organization answered "Yes" on Form 990, Part IV, line 34, 35b, or 36.
Note. Complete line 1 if any entity is listed in Parts II, III, or IV of this schedule.
Yes
No
1 During the tax year, did the orgranization engage in any of the following transactions with one or more related organizations listed in Parts II-IV?
a Receipt of (i) interest, (ii) annuities, (iii) royalties, or (iv) rent from a controlled entity .....................
1a
 
No
b Gift, grant, or capital contribution to related organization(s) ............................
1b
 
No
c Gift, grant, or capital contribution from related organization(s) ............................
1c
 
No
d Loans or loan guarantees to or for related organization(s) ............................
1d
 
No
e Loans or loan guarantees by related organization(s) ............................
1e
 
No
f Dividends from related organization(s) ............................
1f
 
No
g Sale of assets to related organization(s) ............................
1g
 
No
h Purchase of assets from related organization(s) ............................
1h
 
No
i Exchange of assets with related organization(s) ............................
1i
 
No
j Lease of facilities, equipment, or other assets to related organization(s) .......................
1j
 
No
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
 
No
p Reimbursement paid to related organization(s) for expenses ............................
1p
 
No
q Reimbursement paid by related organization(s) for expenses ............................
1q
 
No
r Other transfer of cash or property to related organization(s) ............................
1r
 
No
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) 2019
Schedule R (Form 990) 2019
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) 2019
Schedule R (Form 990) 2019
Page 5
Part VII
Supplemental Information
Provide additional information for responses to questions on Schedule R. (see instructions).
Return Reference Explanation
Schedule R (Form 990) 2019

Additional Data


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