Attach to Form 990 or Form 990-EZ.
Go to
www.irs.gov/Form990 for the latest information.
| (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 |
||||||
Calendar year (or fiscal year beginning in) ![]() |
(a) 2014 | (b) 2015 | (c) 2016 | (d) 2017 | (e) 2018 | (f) Total | |
|---|---|---|---|---|---|---|---|
| 1 | Gifts, grants, contributions, and membership fees received. (Do not include any "unusual grant.") .. | ||||||
| 2 | Tax revenues levied for the organization's benefit and either paid to or expended on its behalf.... | ||||||
| 3 | The value of services or facilities furnished by a governmental unit to the organization without charge.. | ||||||
| 4 | Total. Add lines 1 through 3 | ||||||
| 5 | The portion of total contributions by each person (other than a governmental unit or publicly supported organization) included on line 1 that exceeds 2% of the amount shown on line 11, column (f).. | ||||||
| 6 | Public support. Subtract line 5 from line 4. | ||||||
Calendar year
(or fiscal year beginning in) ![]() |
(a) 2014 | (b) 2015 | (c) 2016 | (d) 2017 | (e) 2018 | (f) Total | |
|---|---|---|---|---|---|---|---|
| 7 | Amounts from line 4.. | ||||||
| 8 | Gross income from interest, dividends, payments received on securities loans, rents, royalties and income from similar sources... | ||||||
| 9 | Net income from unrelated business activities, whether or not the business is regularly carried on.. | ||||||
| 10 | Other income. Do not include gain or loss from the sale of capital assets (Explain in Part VI.).. | ||||||
| 11 | Total support. Add lines 7 through 10 | ||||||
Calendar year (or fiscal year beginning in) ![]() |
(a) 2014 | (b) 2015 | (c) 2016 | (d) 2017 | (e) 2018 | (f) Total | |
|---|---|---|---|---|---|---|---|
| 1 | Gifts, grants, contributions, and membership fees received. (Do not include any "unusual grants.") . | 2,874,402 | 3,372,802 | 4,351,540 | 5,016,951 | 3,177,760 | 18,793,455 |
| 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 | 0 | |||||
| 3 | Gross receipts from activities that are not an unrelated trade or business under section 513 ..... | 0 | |||||
| 4 | Tax revenues levied for the organization's benefit and either paid to or expended on its behalf... | 0 | |||||
| 5 | The value of services or facilities furnished by a governmental unit to the organization without charge | 0 | |||||
| 6 | Total. Add lines 1 through 5 | 2,874,402 | 3,372,802 | 4,351,540 | 5,016,951 | 3,177,760 | 18,793,455 |
| 7a | Amounts included on lines 1, 2, and 3 received from disqualified persons | 0 | 136,634 | 260,758 | 450,241 | 563,006 | 1,410,639 |
| 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. | 0 | 0 | 0 | 0 | 0 | 0 |
| c | Add lines 7a and 7b.. | 0 | 136,634 | 260,758 | 450,241 | 563,006 | 1,410,639 |
| 8 | Public support. (Subtract line 7c from line 6.) | 17,382,816 | |||||
Calendar year (or fiscal year beginning in) ![]() |
(a) 2014 | (b) 2015 | (c) 2016 | (d) 2017 | (e) 2018 | (f) Total | |
|---|---|---|---|---|---|---|---|
| 9 | Amounts from line 6... | 2,874,402 | 3,372,802 | 4,351,540 | 5,016,951 | 3,177,760 | 18,793,455 |
| 10a | Gross income from interest, dividends, payments received on securities loans, rents, royalties and income from similar sources.. | 440,433 | 460,236 | 462,979 | 483,069 | 437,107 | 2,283,824 |
| b | Unrelated business taxable income (less section 511 taxes) from businesses acquired after June 30, 1975. | 0 | |||||
| c | Add lines 10a and 10b. | 440,433 | 460,236 | 462,979 | 483,069 | 437,107 | 2,283,824 |
| 11 | Net income from unrelated business activities not included in line 10b, whether or not the business is regularly carried on. | 332 | 2,930 | 2,534 | 5,796 | ||
| 12 | Other income. Do not include gain or loss from the sale of capital assets (Explain in Part VI.) .. | 603,857 | 466,665 | 95,798 | 28,778 | 73,066 | 1,268,164 |
| 13 | Total support. (Add lines 9, 10c, 11, and 12.).. | 3,918,692 | 4,299,703 | 4,910,649 | 5,531,728 | 3,690,467 | 22,351,239 |
| 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 | ||||
| Section D - Distributions | Current Year | |
|---|---|---|
| 1 Amounts paid to supported organizations to accomplish exempt purposes | ||
|
2
Amounts paid to perform activity that directly furthers exempt purposes of supported organizations, in excess of income from activity |
||
| 3 Administrative expenses paid to accomplish exempt purposes of supported organizations | ||
| 4 Amounts paid to acquire exempt-use assets | ||
| 5 Qualified set-aside amounts (prior IRS approval required) | ||
| 6 Other distributions (describe in Part VI). See instructions | ||
| 7Total annual distributions. Add lines 1 through 6. | ||
|
8
Distributions to attentive supported organizations to which the organization is responsive (provide details in Part VI). See instructions |
||
| 9 Distributable amount for 2018 from Section C, line 6 | ||
| 10 Line 8 amount divided by Line 9 amount | ||
| Section E - Distribution Allocations (see instructions) |
(i) Excess Distributions |
(ii) Underdistributions Pre-2018 |
(iii) Distributable Amount for 2018 |
|
|---|---|---|---|---|
|
1
Distributable amount for 2018 from Section C, line 6 |
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|
2
Underdistributions, if any, for years prior to 2018 (reasonable cause required-- explain in Part VI). See instructions. |
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| 3 Excess distributions carryover, if any, to 2018: | ||||
| a From 2013....... | ||||
| b From 2014....... | ||||
| c From 2015....... | ||||
| d From 2016....... | ||||
| e From 2017....... | ||||
| fTotal of lines 3a through e | ||||
| g Applied to underdistributions of prior years | ||||
| h Applied to 2018 distributable amount | ||||
|
i
Carryover from 2013 not applied (see instructions) |
||||
| j Remainder. Subtract lines 3g, 3h, and 3i from 3f. | ||||
| 4Distributions for 2018 from Section D, line 7: | ||||
| $ | ||||
| a Applied to underdistributions of prior years | ||||
| b Applied to 2018 distributable amount | ||||
| c Remainder. Subtract lines 4a and 4b from 4. | ||||
|
5
Remaining underdistributions for years prior to 2018, if any. Subtract lines 3g and 4a from line 2. If the amount is greater than zero, explain in Part VI. See instructions. |
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|
6
Remaining underdistributions for 2018. Subtract lines 3h and 4b from line 1. If the amount is greater than zero, explain in Part VI. See instructions. |
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|
7 Excess distributions carryover to 2019. Add lines 3j and 4c. |
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| 8 Breakdown of line 7: | ||||
| a Excess from 2014...... | ||||
| b Excess from 2015..... | ||||
| c Excess from 2016..... | ||||
| d Excess from 2017..... | ||||
| e Excess from 2018..... | ||||
| Facts And Circumstances Test |
|---|
| Return Reference | Explanation |
|---|---|
| Schedule A, Part III, Line 12 Other Income | DESCRIPTION - GROSS INCOME FROM FUNDRAISING EVENTS & GAMING, COLUMN A - 603857.0, COLUMN B - 466665.0, COLUMN C - 95798.0, COLUMN D - 28778.0, COLUMN E - 73066.0, COLUMN F - 1268164.0; |
| Software ID: | 18007697 |
| Software Version: | 2018v3.1 |
Attach to Form 990 or 990-EZ.
Go to www.irs.gov/Form990 for the latest information.
| Return Reference | Explanation |
|---|---|
| Form 990, Part III, Line 4a Program Description | I. Introduction - Mission and Vision The Franciscan Foundation was incorporated as a 501(3), tax-exempt, charitable foundation in 1986 to serve as the official gift-receiving and gift-administration agency for two CHI Franciscan hospitals in neighboring Western Washington communities, St. Joseph Medical Center of Tacoma and St. Francis Hospital of Federal Way. Although health care foundations serving multiple hospitals are a fairly common way of reducing health care costs today, the Franciscan Foundation was Washington's first regional health care foundation serving more than one hospital. In subsequent years, the Franciscan Foundation also assumed fund development and gift management responsibilities for St. Clare Hospital of Lakewood, St. Anthony Hospital of Gig Harbor, St. Elizabeth Hospital of Enumclaw, Franciscan Hospice and Palliative Care and a growing number of Franciscan Medical Group clinics in the South Puget Sound area. The Franciscan Foundation's 6-member staff and 14-member Board of Trustees raise funds through annual giving, major gifts, planned giving, special events, corporate/foundation grants and capital campaigns to help fund virtually every health care program, project and community outreach service offered by the hospitals, and clinics of CHI Franciscan. In FY 2019, the Franciscan Foundation raised $2,192,509 for these purposes through 23,319 gifts and pledges from 2,414 donors. At the same time, it disbursed $2,746,617 back to facilities and the community through its support of CHI Franciscan's nonprofit health care services. Over the past 34 years, the Foundation has generated over $110 million and disbursed $109.9 million back into the community, and it currently maintains reserve assets of about $22.4 million. B. Community Benefit Providing quality health care for all who need it, regardless of ability to pay, is an important part of the CHI Franciscan's mission as well as that of the Foundation. The Franciscan Foundation assists CHI Franciscan in providing care for the poor by encouraging its donors to contribute gifts for charity care and making their gifts available to CHI Franciscan for use in assisting the poor in paying for their care. C. Financial Assistance Policies and Programs In addition to providing funding for uncompensated patient care, the Franciscan Foundation raised funds to provide financial assistance for comfort therapies programs not covered by insurance, the CHI Franciscan Low-Income mammogram program, and community health screenings. Patient Assistance funds support diagnostic and treatment costs, the purchase of clothing for the Franciscan Clothing Closets, canes, crutches, prostheses and wheel chairs and to pay for transportation home from the hospital for patients who don't have money to pay for these things themselves. The Foundation funds two popular physician lecture series which help the community's physicians stay current on the latest health care research developments and medical techniques. Last year the Foundation awarded $62,750 in academic scholarship funding to 28 nurses, technicians and other health care providers to help them improve themselves professionally and provide the best possible care for their patients. The Franciscan Employee Giving program distributed $107,000 in emergency assistance and small grants to employees in need. Finally, the Foundation's FY 2019 fund-raising events for CHI Franciscan hospitals included the Franciscan Hospice and Palliative Care "Angels on Earth" Luncheon, Francsican Foundation's A Night at the Museum, St. Clare Hospital Golf Tournament, St. Francis Hospital Auxiliary Spring Event, Bras for a Cause, and the St. Anthony Hospital Auxiliary Luncheon. II. Qualitative Description of Community Benefit A. Community outreach for those in need The Franciscan Foundation Board of Trustees utilizes unrestricted earnings on the Foundation's gift assets to provide financial support for a wide range of other non-profit agencies in the community whose mission and goals are consistent with the healthy- community-building goals of CHI Franciscan. In FY19 the Franciscan Foundation distributed $423,125 in Community Grants and sponsorships to 53 organizations. In the past 33 years, the Franciscan Foundation Trustees have awarded 437 charitable contributions totaling $4,677,885 to a variety of other charitable organizations, including the American Cancer Society, the American Heart Association, Emergency Food Network, University of Washington Tacoma's Nursing Scholarship Fund, Cascade Regional Blood Services, Pierce County Domestic Violence Prevention Helpline, Goodwill, Tacoma/Pierce County Economic Development Board, ARK Learning Institute, Reach Ministries, Special Olympics, Communities in Schools, New Phoebe House, Renton Technical College, YWCA, Pierce Housing Authority, Tacoma Pierce County Chaplaincy, Greater MetroParks Foundation, Tacoma Children's Museum, Pierce County Project Access, South Sound Dream Center, South Sound Outreach, Habitat for Humanity, WA Healthcare Week, Liberia Medical Assistance Foundation, Carol Milgard Breast Center, Catherine Place, Gloria's Angels, Broadway for the Performing Arts, Pierce County AIDS Foundation, Step by Step, Safe Streets, NW Furniture Bank, Centerforce, South Kitsap Helpline, Tacoma Community House, Trinity Outreach Clinic, Nourish Pierce County Fish Bank, Coffee Oasis, Palmer Scholars, and University of Puget Sound. |
| Form 990, Part VI, Line 14 DOCUMENT RETENTION & DESTRUCTION POLICY | THE ORGANIZATION'S BOARD HAS NOT FORMALLY ADOPTED A WRITTEN DOCUMENT RETENTION & DESTRUCTION POLICY. THE ORGANIZATION FOLLOWS THE POLICY AND PROCEDURES OF FRANCISCAN HEALTH SYSTEM, IT'S SOLE CORPORATE MEMBER, BUT THE FRANCISCAN FOUNDATION BOARD HAS NOT OFFICIALLY ADOPTED THE POLICY. |
| Form 990, Part VI, Line 15b COMPENSATION OF OTHER OFFICERS | During the tax year ended 6/30/2019, no officers, directors or trustees received compensation from the organization. Any executive compensation paid to officers, directors or trustees by related organizations was set by the related organization's compensation committee utilizing both an independent consultant and comparability studies to determine compensation. Therefore, these questions are more appropriately answered as N/A. |
| Form 990, Part VI, Line 15a PROCESS FOR DETERMINING CEO COMPENSATION | THE ORGANIZATION'S PRESIDENT'S COMPENSATION IS PAID BY FHS, A RELATED ORGANIZATION. FHS USES AN EXTERNAL COMPENSATION FIRM WHO UTILIZES ACTUAL MARKET DATA COMPENSATION FROM SIMILAR INSTITUTIONS WITH COMPARABLE POSITIONS AND COMPENSATION LEVELS AND CONSIDERING THE ORGANIZATION'S GEOGRAPHIC LOCATION. THE EXECUTIVE COMMITTEE OF THE BOARD ANNUALLY EVALUATES AND APPROVES THE EXECUTIVE COMPENSATION ARRANGEMENT FOR EACH EXECUTIVE FOR FAIR MARKET VALUE ALONG WITH OTHER APPLICABLE FACTORS RELIED ON BY THE BOARD'S DETERMINATION. THE SUPPORTING DOCUMENTATION BECOMES PART OF THE MINUTES OF THE MEETING. THIS PROCESS IS COMPLETED YEARLY. |
| Form 990, Part VI, Line 12c Conflict of Interest Policy | c) Board evaluation of non-transactional conflicts - I. The board carefully reviews and scrutinizes any non-transactional conflict of interest (e.g., disclosure of nonpublic information, competition with CHI or a CHI entity, failure to disclose a corporate opportunity, excessive gifts or entertainment, etc.). II. In such circumstances, by a majority vote of the disinterested trustees, the board takes whatever action is deemed appropriate with respect to the trustee or corporate officer under the circumstances (including possible disciplinary or corrective action) to best protect the interests of CHI or the CHI entity. The board is encouraged to consult with the general counsel of CHI or his or her designee when considering disciplinary or corrective action. III. The conflicted trustee or corporate officer is not permitted to use his or her personal influence with respect to the conflict matter. However, if requested, such trustee or corporate officer is not prevented from briefly stating his or her position in the matter, nor from answering pertinent questions from trustees, as his or her knowledge may be relevant. The trustee or corporate officer is excused from the meeting during discussion and vote on the conflict of interest. d) Record of proceedings - with respect to board member and officer conflicts of interest, minutes of the board are expected to reflect the identity of the individual making the disclosure, the nature of the disclosure, discussion regarding any proposed transaction, the decision made by the board, and that the interested trustee or corporate officer was excused during the discussion, and that the interested trustee abstained from voting. D. Conflicts reporting: All conflicts of interest are reported by CHI as required by law, regulations, and policy. |
| Form 990, Part VI, Line 1a Delegate broad authority to a committee | THE EXECUTIVE COMMITTEE CONSISTS ONLY OF DIRECTORS OF THE CORPORATION AND IS COMPOSED OF THE CHAIRPERSON OF THE BOARD, THE VICE CHAIRPERSON OF THE BOARD, AND THE PRESIDENT AND CHIEF EXECUTIVE OFFICER OF THE CORPORATION, EACH OF WHOM SERVE AS EX OFFICIO VOTING MEMBERS OF THE EXECUTIVE COMMITTEE. THE EXECUTIVE COMMITTEE HAS THE POWER TO TRANSACT THE ROUTINE BUSINESS OF THE CORPORATION IN THE INTERIM PERIODS BETWEEN REGULARLY SCHEDULED MEETINGS OF THE BOARD OF DIRECTORS, PROVIDED THAT THEIR ACTIONS ARE CONSISTENT WITH ANY ACTIONS OR POLICIES OF THE BOARD OR THE CORPORATE MEMBER. ALL ACTIONS TAKEN ARE CONTEMPORANEOUSLY DOCUMENTED AND REPORTED TO THE BOARD AT THE EARLIEST MEETING. |
| Form 990, Part VI, Line 6 Classes of members or stockholders | According to the organization's bylaws, the entity's SOLE MEMBER IS FRANCISCAN HEALTH SYSTEM, A WASHINGTON NONPROFIT CORPORATION. |
| Form 990, Part VI, Line 7a Members or stockholders electing members of governing body | According to the organization's bylaws, directors shall be appointed or refused by the corporate member. The corporate member may appoint one or more individuals to the board of directors, and may at any time remove, with or without cause, any member of the board of directors. According to the organization's bylaws, directors of the corporation shall be appointed by the corporate member no later than June 30 of each year. The names and qualifications of each individual accepted by the board of directors shall be submitted to the corporate member, who shall appoint or refuse each nominee in accordance with the corporate member's bylaws and with endorsement of the senior vice president of operations. The corporate member may unilaterally appoint one or more individuals to the board of directors should the board fail to furnish the corporate member with a list of individuals qualified to serve on the board of directors of the corporation. (CHCF Reserved Rights) Except as otherwise provided in the Corporation's Articles of Incorporation or the laws of the State of organization, Catholic Health Care Federation ("CHCF") shall have such rights as are reserved to the Corporate Member, acting in its capacity as the membership body of CHCF, under the Governance Matrix. |
| Form 990, Part VI, Line 7b Decisions requiring approval by members or stockholders | The organization's corporate member is Franciscan Health System (FHS). Pursuant to Section 5.4 of the organization's bylaws, both FHS and CommonSpirit Health (FHS's sole corporate member) have reserved powers as outlined in the CommonSpirit Health governance matrix. Pursuant to the governance matrix the following rights are held by the FHS Board: *Approve members of the Franciscan Foundation board *Amendment of the corporate documents of the Franciscan Foundation *Approve removal of a member of the governing body of Franciscan Foundation *Adoption of long range and strategic plans for Franciscan Foundation The following rights are reserved to the CommonSpirit Health Board directly or through powers delegated to the CommonSpirit Health Chief Executive Officer: *Substantial change in the mission or philosophy of Franciscan Foundation *Removal of a member of the governing body of Franciscan Foundation *Approval of issuance of debt by Franciscan Foundation *Approval of participation of Franciscan Foundation in a joint venture *Approval of formation of a new corporation by Franciscan Foundation *Approval of a merger involving Franciscan Foundation *Approval of the sale of all or substantially all of the assets of Franciscan Foundation *To require the transfer of assets by the Franciscan Foundation to CommonSpirit Health to accomplish CommonSpirit Health's goals and objectives, and to satisfy CommonSpirit Health debts. Pursuant to Section 5.5 of the organization's bylaws, Franciscan Health System or CommonSpirit Health may, in exercise of their approval powers, grant or withhold approval in whole or in part, or may, in its complete discretion, after consultation with the Board and its President and the Chief Executive Officer of the organization, recommend such other or different actions as it deems appropriate. (CHCF Reserved Rights) Except as otherwise provided in the Corporation's Articles of Incorporation or the laws of the State of organization, Catholic Health Care Federation ("CHCF") shall have such rights as are reserved to the Corporate Member, acting in its capacity as the membership body of CHCF, under the Governance Matrix. |
| Form 990, Part VI, Line 11b Review of form 990 by governing body | THE CFO REVIEWS THE FORM 990 AND ANY NECESSARY CHANGES ARE INCLUDED IN THE FINAL VERSION THAT IS APPROVED FOR FILING WITH THE IRS. THE CFO ALSO PROVIDES THE RETURN TO THE BOARD VIA ELECTRONIC MEANS PRIOR TO FILING. SUBSEQUENT TO REVIEW, THE TAX DEPARTMENT FILES THE RETURN WITH THE APPROPRIATE FEDERAL AGENCIES, MAKING ANY NON-SUBSTANTIVE CHANGES NECESSARY TO EFFECT E-FILING. ANY SUCH CHANGES ARE NOT RESUBMITTED TO THE BOARD. |
| Form 990, Part VI, Line 12c Conflict of interest policy | The organization has a conflicts of interest ("COI") policy (the "policy") in place to maintain the integrity of its activities. Through February 7, 2019, conflicts were administered solely through Catholic Health Initiatives' ("CHI") Governance Policy No. 1 (described below). On February 8, 2019, in connection with the alignment of the Catholic Health Ministries of CHI and Dignity Health, the CommonSpirit Health Board of Stewardship Trustees approved CommonSpirit Health Corporate Responsibility Policy No. G-001, a CommonSpirit Health conflicts of interest policy. This policy stipulates that, at minimum, the pre-closing CHI COI policies and pre-closing Dignity Health COI policies identify the individuals that are covered under the new policy. In addition, subject to certain exceptions, pre-closing CHI COI policies shall continue to apply to the CHI entities and the individuals who were subject to the Pre-Closing CHI COI policies; and the Pre-Closing Dignity Health COI policies shall continue to apply to the Dignity Health entities and the individuals who were subject to the Pre-Closing Dignity Health COI policies. Until CommonSpirit Health adopts a single process for identifying and managing conflicts of interest for all system entities, the following individuals shall be subject to the Pre-Closing CHI COI policies from and after the effective date of Corporate Responsibility Policy No. G-001: 1. Members of the CommonSpirit Health Board of Stewardship Trustees and members of the committees of the Board of Stewardship Trustees; 2. Corporate officers of CommonSpirit Health; 3. Members of the Board of Directors of Dignity Health and members of the committees of the Board of Directors of Dignity Health. CHI Governance Policy No. 1: The policy applies to the following persons: members of the CHI board of stewardship trustees and its committees; members of any CHI direct affiliate or subsidiary (each a CHI entity) board and their committees; employees of CHI entities, and all CHI researchers (as defined in the policy). Disclosure, review and management of perceived, potential or actual conflicts of interest are accomplished through a defined COI disclosure review process. A. Disclosure obligations: 1. Ongoing: Each person is required to promptly and fully disclose to his/her direct manager, supervisor, medical staff office, board or board committee chair any situation or circumstance that may create a conflict of interest. The person must disclose the actual or potential conflict as soon as she/he becomes aware of it. In any situation in which the person is in doubt it is expected that full disclosure be made to permit an impartial and objective determination as to the existence of a conflict. 2. Periodic written: In addition to the ongoing disclosure obligation, periodic written conflict of interest disclosure forms must be completed as follows: a) Initially: 1) Upon hiring (employees), 2) Appointment (board / committee members), 3) Upon consideration of affiliation with research sponsor (researchers). b) Annually: 1) Board / committee members, 2) Employees at the level vice president or above, 3) Researchers, 4) Supply chain employees at the level of vice president and above and those employees involved in contracting regardless of employment level, 5) Other employees as determined by CommonSpirit Health leadership. 3. Failure to disclose - an individual who fails to disclose a perceived, potential, or actual conflict of interest, or all material facts surrounding an actual or potential conflict or fails to abide by the final decision regarding the conflict may be subject to disciplinary or corrective actions such as termination of employment, removal from a board or committee, loss or restriction of clinical privileges, or restrictions on research activities in accordance with applicable laws, regulations, rules, contracts, and bylaws. B. Conflicts review: 1. No disclosed conflicts: In the absence of perceived, potential or actual conflicts of interest, no follow-up conflicts review is required or performed. 2. Disclosure of perceived, potential or actual conflicts: a) Are initially reviewed by national or regional legal or corporate responsibility team members (depending upon the role of the individual disclosing the actual or potential conflict) to determine whether an actual or potential for a conflict may exist. b) If it is determined that a potential or actual conflict may exist, I. In the case of board or committee members or officers, issues are elevated to the executive committee of the board or board chair. II. In the case of other persons, conflicts issues are elevated to the conflicts of interest review committee ("C-CIRC"). C. Conflicts determination and management: 1. Matters elevated to C-CIRC: a) The C-CIRC determines whether a disclosed or otherwise identified interest is a conflict of interest. If the C-CIRC determines that a COI exists, and adequate controls are not in place to mitigate the conflict, the C-CIRC facilitates development of a COI management plan designed to mitigate the conflict. Designated entity staff are responsible for monitoring the COI management plan and for documenting monitoring activities. Notwithstanding the foregoing, at its sole discretion, an entity may reject a person's request to enter into the relationship in question, or require the relationship be sufficiently altered to avoid a potential conflict of interest. b) Appeal - if a person does not agree with a determination made by the C-CIRC, its interpretation of the COI policy, still seeks an exemption or exception, or seeks further clarification of the C-CIRC 's decision, the individual may appeal the decision through his or her manager for reconsideration by the C-CIRC, and the C-CIRC will review and issue a final determination based upon any new or additional information presented. 2. Matters elevated to the executive committee or board chair: a) Determination of existence of conflict - the board chair or his or her designee performs any further investigation of any conflict of interest disclosures as he or she may deem appropriate. If the conflict involves the board chair, the vice chair assumes the chair's role outlined in the COI policy. Based on review and evaluation of the relevant facts and circumstances, the board chair makes an initial determination as to whether a conflict of interest exists and whether, pursuant to the COI policy, review and approval or other action by the board is required. A written record of the board chair's determination, including relevant facts and circumstances, is made. The board chair then makes an appropriate report to the executive committee of the board concerning the COI review, evaluation and determination. If a difference of opinion exists between the board chair and another trustee as to whether the facts and circumstances of a given situation constitute a conflict of interest or whether board review and approval or other action is required under the COI policy, the matter is submitted to the board's executive committee, which makes a final determination as to the matter presented. That determination, including relevant facts and circumstances, is reflected in the executive committee minutes and is reported to the board. b) Board evaluation of transactions involving an officer / board member conflict of interest - I. The board carefully scrutinizes and must in good faith approve or disapprove any transaction in which CHI or a CHI entity is a party and in which the trustee or a corporate officer either: 1. Has a material financial interest; or 2. Is a trustee or corporate officer of the other party (other than a CHI affiliated organization). II. The board must approve the transaction by a majority of the trustees on the board (not counting any interested trustee). In reviewing such transactions between CHI or CHI entities and vendors or other contractors who are, or are affiliated with, trustees or corporate officers, the board acts no more or less favorably than it would in reviewing transactions with unrelated third parties. The transaction is not approved unless the board determines that the transaction is fair to CHI or the CHI entity. III. A conflicted trustee or corporate officer is not permitted to use his or her personal influence with respect to the approval or disapproval of the conflicted transaction. However, if requested, such trustee or corporate officer is not prevented from briefly stating his or her position in the matter, nor from answering pertinent questions from trustees, as his or her knowledge may be relevant. The trustee or corporate officer is excused from the meeting during discussion and vote on the conflict of interest. (Continued on Schedule O) |
| Form 990, Part VI, Line 19 Required documents available to the public | The organization's financial statements, conflict of interest policy and governing documents are available to the public upon request. The organization's financial statements are included in CommonSpirit Health's consolidated audited financial statements that are available at www.catholichealthinitiatives.org. |
| Form 990, Part IX, Line 11g Other Fees | Purchased Services - Total Expense: 618917, Program Service Expense: 0, Management and General Expenses: 340404, Fundraising Expenses: 278513; Contract Labor - Total Expense: 19561, Program Service Expense: 0, Management and General Expenses: 10759, Fundraising Expenses: 8802; |
| Form 990, Part XI, Line 9 Other changes in net assets or fund balances | Other Changes in Net Assets - -40000; |
| Software ID: | 18007697 |
| Software Version: | 2018v3.1 |