TY 2023 Form 990

(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)	(E) Reportable compensation from related organizations (W-2/1099-MISC/1099-NEC)	(F) Estimated amount of other compensation from the organization and related organizations
(1) KEVIN D LEAHY...................................................................... PRESIDENT AND TRUSTEE	40.0 ................. 25.0	X	X			2,467,456	197,552
(2) JAMES T CALLAGHAN MD...................................................................... VP/COO	40.0 ................. 0.0			X		1,437,978	488,554
(3) JENNIFER P MARION...................................................................... SENIOR VP FINANCE, CFO	40.0 ................. 0.0			X		1,383,554	421,189
(4) YAMEEN RASHID DO...................................................................... PHYSICIAN	40.0 ................. 0.0				X	1,419,918	50,614
(5) AMIT KUMAR...................................................................... PHYSICIAN	40.0 ................. 0.0				X	1,390,861	32,814
(6) ALBERT P TOMCHANEY...................................................................... SR VP/CHIEF MEDICAL OFFICER	40.0 ................. 0.0			X		999,840	284,406
(7) FAHEEM AHMAD...................................................................... PHYSICIAN	40.0 ................. 0.0				X	1,164,518	48,414
(8) SUEYI LAI...................................................................... PHYSICIAN	40.0 ................. 0.0				X	1,188,609	19,800
(9) ZOHAIR AHMED...................................................................... PHYSICIAN	40.0 ................. 0.0				X	1,129,748	24,319
(10) RANDALL S MOORE MD...................................................................... SR VP HEALTH & CARE/COO AMB	40.0 ................. 0.0			X		1,066,109	41,252
(11) SISTER M ALINE SHULTZ...................................................................... TRUSTEE/VP/CHAIRPERSON	40.0 ................. 10.0	X	X			0	0
(12) SISTER M ANGELA MELLADY...................................................................... TRUSTEE (THRU 06/2023)	5.0 ................. 0.0	X				0	0
(13) SISTER M ANN KATHLEEN MAGIERA...................................................................... TREAS/TRUSTEE/VP MISSION	40.0 ................. 20.0	X	X			0	0
(14) SISTER M CLARE REUILLE...................................................................... TRUSTEE (THRU 08/2023)	5.0 ................. 0.0	X				0	0
(15) SISTER M MADONNA ROUGEAU...................................................................... TRUSTEE	40.0 ................. 15.0	X				0	0
(16) SISTER M MARLENE SHAPLEY...................................................................... TRUSTEE/VP MISSION INTEGRATION	40.0 ................. 0.0	X				0	0
(17) SISTER M PETRA NIELSEN...................................................................... TRUSTEE	40.0 ................. 0.0	X				0	0

(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)	(E) Reportable compensation from related organizations (W-2/1099-MISC/1099-NEC)
(18) SISTER MARILYN OLIVER........................................................................ TRUSTEE/DIRECTOR DEVELOPMENT	30.0 .......................5.0	X		0	0	0
(19) ERNEST IANNOTTA........................................................................ TRUSTEE	5.0 .......................5.0	X		0	0	0
(20) KATHLEEN GOEPPINGER PHD........................................................................ TRUSTEE	5.0 .......................0.0	X		0	0	0
(21) KENNETH HERLIN........................................................................ TRUSTEE	5.0 .......................0.0	X		0	0	0
(22) SISTER LETHIA MARIE LEVEILLE........................................................................ SECRETARY AND TRUSTEE	40.0 .......................25.0	X	X	0	0	0
(23) ALLAN GILLESPIE MD........................................................................ TRUSTEE	5.0 .......................5.0	X		0	0	0
(24) HILTON HUDSON II MD........................................................................ TRUSTEE	5.0 .......................0.0	X		0	0	0
(25) SISTER M MARGARET MARY MITCHEL........................................................................ TRUSTEE (AS OF 06/2023)	5.0 .......................0.0	X		0	0	0
(26) SISTER M LISSETTA GETTINGER........................................................................ TRUSTEE (AS OF 08/2023)	5.0 .......................0.0	X		0	0	0
(27) SISTER M KAROL ANN HOEFER........................................................................ TRUSTEE (AS OF 08/2023)	5.0 .......................0.0	X		0	0	0
(28) SISTER M MARIE MORGAN........................................................................ TRUSTEE (AS OF 08/2023)	40.0 .......................0.0	X		0	0	0
(29) SISTER JANE MARIE KLEIN........................................................................ CHAIRPERSON/TRUSTEE THRU 8/23	40.0 .......................25.0	X	X	0	0	0

(A) Name and business address	(B) Description of services	(C) Compensation
HEALTHTRUST WORKFORCE SOLUTIONS LLC, PO BOX 742697 ATLANTA,GA30374	CONTRACT LABOR	114,922,993
INDIANA INTERNAL MEDICINE CONSULTAN, 701 E COUNTY LINE RD STE 101 GREENWOOD,IN46143	PHYSICIAN SERVICES	53,620,200
LAKESHORE BONE AND JOINT INSTITUTE, 601 GATEWAY BLVD N CHESTERTON,IN46303	PHYSICIAN SERVICES	15,206,973
NORTHSTAR ANESTHESIA OF INDIANA LLC, 6225 NORTH STATE HWY 161 STE 200 IRVING,TX75038	PHYSICIAN SERVICES	9,791,737
CARDIAC SURGERY ASSOCIATES SC, 2650 WARRENVILLE RD STE 280 DOWNERS GROVE,IL60515	PHYSICIAN SERVICES	9,060,557
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 243

- TIN:

SCHEDULE A
(Form 990)

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

2023

Open to Public
Inspection

Name of the organization

FRANCISCAN ALLIANCE INC

Employer identification number

35-1330472

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.)

A church, convention of churches, or association of churches described in section 170(b)(1)(A)(i).

A school described in section 170(b)(1)(A)(ii). (Attach Schedule E (Form 990).)

A hospital or a cooperative hospital service organization described in section 170(b)(1)(A)(iii).

A medical research organization operated in conjunction with a hospital described in section 170(b)(1)(A)(iii). Enter the hospital's name, city, and state:

An organization operated for the benefit of a college or university owned or operated by a governmental unit described in section 170(b)(1)(A)(iv). (Complete Part II.)

A federal, state, or local government or governmental unit described in section 170(b)(1)(A)(v).

An organization that normally receives a substantial part of its support from a governmental unit or from the general public described in section 170(b)(1)(A)(vi). (Complete Part II.)

A community trust described in section 170(b)(1)(A)(vi). (Complete Part II.)

An agricultural research organization described in 170(b)(1)(A)(ix) operated in conjunction with a land-grant college or university or a non-land grant college of agriculture. See instructions. Enter the name, city, and state of the college or university:

An organization that normally receives: (1) more than 33 1/3% of its support from contributions, membership fees, and gross receipts from activities related to its exempt functions—subject to certain exceptions, and (2) no more than 33 1/3% of its support from gross investment income and unrelated business taxable income (less section 511 tax) from businesses acquired by the organization after June 30, 1975. See section 509(a)(2). (Complete Part III.)

An organization organized and operated exclusively to test for public safety. See section 509(a)(4).

An organization organized and operated exclusively for the benefit of, to perform the functions of, or to carry out the purposes of one or more publicly supported organizations described in section 509(a)(1) or section 509(a)(2). See section 509(a)(3). Check the box on lines 12a through 12d that describes the type of supporting organization and complete lines 12e, 12f, and 12g.

Type I. A supporting organization operated, supervised, or controlled by its supported organization(s), typically by giving the supported organization(s) the power to regularly appoint or elect a majority of the directors or trustees of the supporting organization. You must complete Part IV, Sections A and B.

Type II. A supporting organization supervised or controlled in connection with its supported organization(s), by having control or management of the supporting organization vested in the same persons that control or manage the supported organization(s). You must complete Part IV, Sections A and C.

Type III functionally integrated. A supporting organization operated in connection with, and functionally integrated with, its supported organization(s) (see instructions). You must complete Part IV, Sections A, D, and E.

Type III non-functionally integrated. A supporting organization operated in connection with its supported organization(s) that is not functionally integrated. The organization generally must satisfy a distribution requirement and an attentiveness requirement (see instructions). You must complete Part IV, Sections A and D, and Part V.

Check this box if the organization received a written determination from the IRS that it is a Type I, Type II, Type III functionally integrated, or Type III non-functionally integrated supporting organization.

Enter the number of supported organizations ...............................

Provide the following information about the supported organization(s).

(i) Name of supported organization	(ii) EIN	(iv) Is the organization listed in your governing document?		(v) Amount of monetary support (see instructions)	(vi) Amount of other support (see instructions)
(i) Name of supported organization	(ii) EIN	Yes	No	(v) Amount of monetary support (see instructions)	(vi) Amount of other support (see instructions)


Total

For Paperwork Reduction Act Notice, see the Instructions for
Form 990 or 990-EZ.

Cat. No. 11285F

Schedule A (Form 990) 2023

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)		(a) 2019	(b) 2020	(c) 2021	(d) 2022	(e) 2023	(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)		(a) 2019	(b) 2020	(c) 2021	(d) 2022	(e) 2023	(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

Gross receipts from related activities, etc. (see instructions) ..................

First 5 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

Public support percentage for 2023 (line 6, column (f) divided by line 11, column (f)) .........

Public support percentage for 2022 Schedule A, Part II, line 14 ...............

16a

33 1/3% support test—2023. If the organization did not check the box on line 13, and line 14 is 33 1/3% or more, check this box
and stop here. The organization qualifies as a publicly supported organization ....................... right arrow

33 1/3% support test—2022. If the organization did not check a box on line 13 or 16a, and line 15 is 33 1/3% or more, check this
box and stop here. The organization qualifies as a publicly supported organization ..................... right arrow

17a

10%-facts-and-circumstances test—2023. If the organization did not check a box on line 13, 16a, or 16b, and line 14 is 10% or more, and if the organization meets the "facts-and-circumstances" test, check this box and stop here. Explain in Part VI how the organization meets the "facts-and-circumstances" test. The organization qualifies as a publicly supported organization ............ right arrow

10%-facts-and-circumstances test—2022. If the organization did not check a box on line 13, 16a, 16b, or 17a, and line 15 is 10% or more, and if the organization meets the "facts-and-circumstances" test, check this box and stop here. Explain in Part VI how the organization meets the "facts-and-circumstances" test. The organization qualifies as a publicly supported organization ............ right arrow

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) 2023

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)		(a) 2019	(b) 2020	(c) 2021	(d) 2022	(e) 2023	(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)		(a) 2019	(b) 2020	(c) 2021	(d) 2022	(e) 2023	(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 on 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.)..

First 5 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

Public support percentage for 2023 (line 8, column (f) divided by line 13, column (f)) .........

Public support percentage from 2022 Schedule A, Part III, line 15 ...............

Section D. Computation of Investment Income Percentage

Investment income percentage for 2023 (line 10c, column (f) divided by line 13, column (f)) ......

Investment income percentage from 2022 Schedule A, Part III, line 17 .............

19a

33 1/3% support tests-2023. If the organization did not check the box on line 14, and line 15 is more than 33 1/3%, and line 17 is not more than 33 1/3%, check this box and stop here. The organization qualifies as a publicly supported organization ....... right arrow

33 1/3 % support tests—2022. If the organization did not check a box on line 14 or line 19a, and line 16 is more than 33 1/3% and line 18 is not more than 33 1/3%, check this box and stop here. The organization qualifies as a publicly supported organization ..... right arrow

Private foundation. If the organization did not check a box on line 14, 19a, or 19b, check this box and see instructions .... right arrow

Schedule A (Form 990) 2023

Page 4

Part IV

Supporting Organizations

(Complete only if you checked a box on line 12 of Part I. If you checked box 12a, of Part I, complete Sections A and B. If you checked box 12b, of Part I, complete Sections A and C. If you checked box 12c, of Part I, complete Sections A, D, and E. If you checked box12d, of Part I, complete Sections A and D, and complete Part V.)

Section A. All Supporting Organizations

Yes

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.

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).

Did the organization have a supported organization described in section 501(c)(4), (5), or (6)? If "Yes," answer lines 3b and 3c below.

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.

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.

Was any supported organization not organized in the United States ("foreign supported organization")? If “Yes” and if you checked box 12a or 12b in Part I, answer lines 4b and 4c below.

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.

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.

Did the organization add, substitute, or remove any supported organizations during the tax year? If “Yes,” answer lines 5b and 5c 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).

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?

Substitutions only. Was the substitution the result of an event beyond the organization's control?

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.

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) .

Did the organization make a loan to a disqualified person (as defined in section 4958) not described on line 7? If “Yes,” complete Part I of Schedule L (Form 990).

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.

Did one or more disqualified persons (as defined on line 9a) hold a controlling interest in any entity in which the supporting organization had an interest? If “Yes,” provide detail in Part VI.

Did a disqualified person (as defined on 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.

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

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) 2023

Page 5

Part IV

Supporting Organizations (continued)

Yes

Has the organization accepted a gift or contribution from any of the following persons?

A person who directly or indirectly controls, either alone or together with persons described on lines 11b and 11c below, the governing body of a supported organization?

11a

A family member of a person described on 11a above?

11b

A 35% controlled entity of a person described on line 11a or 11b above? If “Yes” to 11a, 11b, or 11c, provide detail in Part VI.

11c

Section B. Type I Supporting Organizations

Yes

Did the officers, 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.

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.

Section C. Type II Supporting Organizations

Yes

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).

Section D. All Type III Supporting Organizations

Yes

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?

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).

By reason of the relationship described in line 2 above, 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.

Section E. Type III Functionally-Integrated Supporting Organizations

Check the box next to the method that the organization used to satisfy the Integral Part Test during the year (see instructions):

The organization satisfied the Activities Test. Complete line 2 below.

The organization is the parent of each of its supported organizations. Complete line 3 below.

The organization supported a governmental entity. Describe in Part VI how you supported a government entity (see instructions)

Activities Test. Answer lines 2a and 2b below.

Yes

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.

Did the activities described on line 2a, above 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.

Parent of Supported Organizations. Answer lines 3a and 3b below.

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?If "Yes" or "No", provide details in Part VI.

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.

Schedule A (Form 990) 2023

Page 6

Part V

Type III Non-Functionally Integrated 509(a)(3) Supporting Organizations

Check here if the organization satisfied the Integral Part Test as a qualifying trust on Nov. 20, 1970 (explain in Part VI). See instructions. All other Type III non-functionally integrated supporting organizations must complete Sections A through E.

	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 0.015 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 0.035	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

Check here if the current year is the organization's first as a non-functionally-integrated Type III supporting organization (see instructions)

Schedule A (Form 990) 2023

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	1
2 Amounts paid to perform activity that directly furthers exempt purposes of supported organizations, in excess of income from activity	2
3 Administrative expenses paid to accomplish exempt purposes of supported organizations	3
4 Amounts paid to acquire exempt-use assets	4
5 Qualified set-aside amounts (prior IRS approval required - provide details in Part VI)	5
6 Other distributions (describe in Part VI). See instructions	6
7Total annual distributions. Add lines 1 through 6.	7
8 Distributions to attentive supported organizations to which the organization is responsive (provide details in Part VI). See instructions	8
9 Distributable amount for 2023 from Section C, line 6	9
10 Line 8 amount divided by Line 9 amount	10

Section E - Distribution Allocations (see instructions)		(i) Excess Distributions	(ii) Underdistributions Pre-2023	(iii) Distributable Amount for 2023
1 Distributable amount for 2023 from Section C, line 6
2 Underdistributions, if any, for years prior to 2023 (reasonable cause required-- explain in Part VI). See instructions.
3 Excess distributions carryover, if any, to 2023:
a From 2018.......
b From 2019.......
c From 2020.......
d From 2021.......
e From 2022.......
fTotal of lines 3a through e
g Applied to underdistributions of prior years
h Applied to 2023 distributable amount
i Carryover from 2018 not applied (see instructions)
j Remainder. Subtract lines 3g, 3h, and 3i from line 3f.
4Distributions for 2023 from Section D, line 7:
$
a Applied to underdistributions of prior years
b Applied to 2023 distributable amount
c Remainder. Subtract lines 4a and 4b from line 4.
5 Remaining underdistributions for years prior to 2023, 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 2023. 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 2024. Add lines 3j and 4c.
8 Breakdown of line 7:
a Excess from 2019.....
b Excess from 2020.....
c Excess from 2021.....
d Excess from 2022.....
e Excess from 2023.....

Schedule A (Form 990) (2023)

Schedule A (Form 990) 2023

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) 2023

Additional Data

Software ID:
Software Version:

- TIN:

Schedule B
(Form 990)

Department of the Treasury
Internal Revenue Service

Schedule of Contributors

Attach to Form 990, 990-EZ, or 990-PF.

Go to www.irs.gov/Form990 for the latest information.

OMB No. 1545-0047

2023

Name of the organization

FRANCISCAN ALLIANCE INC

Employer identification number

35-1330472

Organization type (check one):

Filers of:

Section:

Form 990 or 990-EZ

501(c)( ) (enter number) organization

4947(a)(1) nonexempt charitable trust not treated as a private foundation

527 political organization

Form 990-PF

501(c)(3) exempt private foundation

4947(a)(1) nonexempt charitable trust treated as a private foundation

501(c)(3) taxable private foundation

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

For an organization filing Form 990, 990-EZ, or 990-PF that received, during the year, contributions totaling $5,000 or more (in money or other property) from any one contributor. Complete Parts I and II. See instructions for determining a contributor's total contributions.

Special Rules

For an organization described in section 501(c)(3) filing Form 990 or 990-EZ that met the 33¹/3% support test of the regulations
under sections 509(a)(1) and 170(b)(1)(A)(vi), that checked Schedule A (Form 990 or 990-EZ), Part II, line 13, 16a, or 16b, and that received from any one contributor, during the year, total contributions of the greater of (1) $5,000 or (2) 2% of the amount on (i) Form 990, Part VIII, line 1h, or (ii) Form 990-EZ, line 1. Complete Parts I and II.

For an organization described in section 501(c)(7), (8), or (10) filing Form 990 or 990-EZ that received from any one contributor,
during the year, total contributions of more than $1,000 exclusively for religious, charitable, scientific, literary, or educational purposes, or for the prevention of cruelty to children or animals. Complete Parts I, II, and III.

For an organization described in section 501(c)(7), (8), or (10) filing Form 990 or 990-EZ that received from any one contributor,
during the year, contributions exclusively for religious, charitable, etc., purposes, but no such contributions totaled more than $1,000. If this box is checked, enter here the total contributions that were received during the year for an exclusively religious, charitable, etc., purpose. Don't complete any of the parts unless the General Rule applies to this organization because it received nonexclusively religious, charitable, etc., contributions totaling $5,000 or more during the year ......... 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) (2023)

Schedule B (Form 990) (2023) Page 2

Name of organization FRANCISCAN ALLIANCE INC

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	Person Payroll Noncash (Complete Part II for noncash contributions.)
(a) No.	(b) Name, address, and ZIP + 4	(c) Total contributions	(d) Type of contribution
		$	Person Payroll Noncash (Complete Part II for noncash contributions.)
(a) No.	(b) Name, address, and ZIP + 4	(c) Total contributions	(d) Type of contribution
		$	Person Payroll Noncash (Complete Part II for noncash contributions.)
(a) No.	(b) Name, address, and ZIP + 4	(c) Total contributions	(d) Type of contribution
		$	Person Payroll Noncash (Complete Part II for noncash contributions.)
(a) No.	(b) Name, address, and ZIP + 4	(c) Total contributions	(d) Type of contribution
		$	Person Payroll Noncash (Complete Part II for noncash contributions.)
(a) No.	(b) Name, address, and ZIP + 4	(c) Total contributions	(d) Type of contribution
		$	Person Payroll Noncash (Complete Part II for noncash contributions.)
Schedule B (Form 990) (2023)

Schedule B (Form 990) (2023)

Page 3

Name of organization FRANCISCAN ALLIANCE INC		Employer identification number 35-1330472

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) (2023)

Schedule B (Form 990) (2023)

Page 4


Name of organization FRANCISCAN ALLIANCE INC			Employer identification number 35-1330472
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.) $ Use duplicate copies of Part III if additional space is needed.

(a)
No. from Part I

(b) Purpose 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

(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

(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

(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) (2023)

Additional Data

Software ID:
Software Version:

- TIN:

SCHEDULE C
(Form 990)

Department of the Treasury
Internal Revenue Service

Political Campaign and Lobbying Activities

For Organizations Exempt From Income Tax Under section 501(c) and section 527

right arrow

Complete if the organization is described below. 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

2022

Open to Public
Inspection

If the organization answered "Yes" on Form 990, Part IV, Line 3, or Form 990-EZ, Part V, line 46 (Political Campaign Activities), then
Round Bullet

Section 501(c)(3) organizations: Complete Parts I-A and B. Do not complete Part I-C.
Round Bullet

Section 501(c) (other than section 501(c)(3)) organizations: Complete Parts I-A and C below. Do not complete Part I-B.
Round Bullet

Section 527 organizations: Complete Part I-A only.
If the organization answered "Yes" on Form 990, Part IV, Line 4, or Form 990-EZ, Part VI, line 47 (Lobbying Activities), then
Round Bullet

Section 501(c)(3) organizations that have filed Form 5768 (election under section 501(h)): Complete Part II-A. Do not complete Part II-B.
Round Bullet

Section 501(c)(3) organizations that have NOT filed Form 5768 (election under section 501(h)): Complete Part II-B. Do not complete Part II-A.
If the organization answered "Yes" on Form 990, Part IV, Line 5 (Proxy Tax) (see separate instructions) or Form 990-EZ, Part V, line 35c (Proxy Tax) (see separate instructions), then
Round Bullet

Section 501(c)(4), (5), or (6) organizations: Complete Part III.

Name of the organization

FRANCISCAN ALLIANCE INC

Employer identification number

35-1330472

Part I-A

Complete if the organization is exempt under section 501(c) or is a section 527 organization.

Provide a description of the organization’s direct and indirect political campaign activities in Part IV. See instructions for definition of “political campaign activities."

Political campaign activity expenditures. See instructions .................................................................... right arrow

Volunteer hours for political campaign activities. See instructions ..................................................................

Part I-B

Complete if the organization is exempt under section 501(c)(3).

Enter the amount of any excise tax incurred by the organization under section 4955 ................................ right arrow

Enter the amount of any excise tax incurred by organization managers under section 4955 ....................... right arrow

If the organization incurred a section 4955 tax, did it file Form 4720 for this year? .........................................

Yes No

Was a correction made? ......................................................................................................................

Yes No

If "Yes," describe in Part IV.

Part I-C

Complete if the organization is exempt under section 501(c), except section 501(c)(3).

Enter the amount directly expended by the filing organization for section 527 exempt function activities ..... right arrow

Enter the amount of the filing organization's funds contributed to other organizations for section 527 exempt function activities ............................................................................................................................ right arrow

Total exempt function expenditures. Add lines 1 and 2. Enter here and on Form 1120-POL, line 17b........... right arrow

Did the filing organization file Form 1120-POL for this year? ...................................................................

Yes No

Enter the names, addresses and employer identification number (EIN) of all section 527 political organizations to which the filing
organization made payments. For each organization listed, enter the amount paid from the filing organization’s funds. Also enter the amount of political contributions received that were promptly and directly delivered to a separate political organization, such as a separate segregated fund or a political action committee (PAC). If additional space is needed, provide information in Part IV.

(a) Name	(b) Address	(c) EIN	(d) Amount paid from filing organization's funds. If none, enter -0-.	(e) Amount of political contributions received and promptly and directly delivered to a separate political organization. If none, enter -0-.
1
2
3
4
5
6

For Paperwork Reduction Act Notice, see the instructions for Form 990.

Cat. No. 50084S

Schedule C (Form 990) 2022

Page 2

Part II-A

Complete if the organization is exempt under section 501(c)(3) and filed Form 5768 (election under section 501(h)).

A Check right arrow

if the filing organization belongs to an affiliated group (and list in Part IV each affiliated group member's name, address, EIN, expenses, and share of excess lobbying expenditures).
B Check right arrow

if the filing organization checked box A and "limited control" provisions apply.

Limits on Lobbying Expenditures (The term "expenditures" means amounts paid or incurred.)		(b) Affiliated group totals
1a	Total lobbying expenditures to influence public opinion (grass roots lobbying) ......................
b	Total lobbying expenditures to influence a legislative body (direct lobbying) ........................
c	Total lobbying expenditures (add lines 1a and 1b) ............................................................
d	Other exempt purpose expenditures ...............................................................................
e	Total exempt purpose expenditures (add lines 1c and 1d) ..................................................
f	Lobbying nontaxable amount. Enter the amount from the following table in both columns.
	If the amount on line 1e, column (a) or (b) is:The lobbying nontaxable amount is:
	Not over $500,00020% of the amount on line 1e.
	Over $500,000 but not over $1,000,000$100,000 plus 15% of the excess over $500,000.
	Over $1,000,000 but not over $1,500,000$175,000 plus 10% of the excess over $1,000,000.
	Over $1,500,000 but not over $17,000,000$225,000 plus 5% of the excess over $1,500,000.
	Over $17,000,000$1,000,000.

g	Grassroots nontaxable amount (enter 25% of line 1f) .................................................
h	Subtract line 1g from line 1a. If zero or less, enter -0-. ................................................
i	Subtract line 1f from line 1c. If zero or less, enter -0-. ................................................
j	If there is an amount other than zero on either line 1h or line 1i, did the organization file Form 4720 reporting section 4911 tax for this year? ...................................................................................................................	Yes No

4-Year Averaging Period Under Section 501(h) (Some organizations that made a section 501(h) election do not have to complete all of the five columns below. See the separate instructions for lines 2a through 2f.)
Lobbying Expenditures During 4-Year Averaging Period
	Calendar year (or fiscal year beginning in)	(a) 2019	(b) 2020	(c) 2021	(d) 2022	(e) Total

2a	Lobbying nontaxable amount

b	Lobbying ceiling amount (150% of line 2a, column(e))

c	Total lobbying expenditures

d	Grassroots nontaxable amount

e	Grassroots ceiling amount (150% of line 2d, column (e))

f	Grassroots lobbying expenditures

Schedule C (Form 990) 2022

Page 3

Part II-B

Complete if the organization is exempt under section 501(c)(3) and has NOT filed Form 5768 (election under section 501(h)).

For each "Yes" response on lines 1a through 1i below, provide in Part IV a detailed description of the lobbying activity.

(a)

Yes|No

(b)

Amount

During the year, did the filing organization attempt to influence foreign, national, state or local legislation, including any attempt to influence public opinion on a legislative matter or referendum, through the use of:

Volunteers? ...........................................................................................................

Paid staff or management (include compensation in expenses reported on lines 1c through 1i)? ........

Media advertisements? ...................................................................................................

Mailings to members, legislators, or the public? .............................................................................

Publications, or published or broadcast statements? ...........................................................

Grants to other organizations for lobbying purposes? ..........................................................

Direct contact with legislators, their staffs, government officials, or a legislative body? .......................

Rallies, demonstrations, seminars, conventions, speeches, lectures, or any similar means? ..................

Other activities? ...................................................................................................................

Yes

386,962

Total. Add lines 1c through 1i ....................................................................................................

386,962

Did the activities in line 1 cause the organization to be not described in section 501(c)(3)? .....

If "Yes," enter the amount of any tax incurred under section 4912 ...........................................

If "Yes," enter the amount of any tax incurred by organization managers under section 4912 ...................

If the filing organization incurred a section 4912 tax, did it file Form 4720 for this year? ........................

Part III-A

Complete if the organization is exempt under section 501(c)(4), section 501(c)(5), or section 501(c)(6).

Yes

Were substantially all (90% or more) dues received nondeductible by members? ...............................................

Did the organization make only in-house lobbying expenditures of $2,000 or less? ............................................

Did the organization agree to carry over lobbying and political expenditures from the prior year? .................................

Part III-B

Complete if the organization is exempt under section 501(c)(4), section 501(c)(5), or section 501(c)(6) and if either (a) BOTH Part III-A, lines 1 and 2, are answered "No" OR (b) Part III-A, line 3, is answered “Yes."

Dues, assessments and similar amounts from members ......................................................................

Section 162(e) nondeductible lobbying and political expenditures (do not include amounts of political expenses for which the section 527(f) tax was paid).

Current year .............................................................................................................................

Carryover from last year ............................................................................................................

Total ...........................................................................................................................................

Aggregate amount reported in section 6033(e)(1)(A) notices of nondeductible section 162(e) dues .

If notices were sent and the amount on line 2c exceeds the amount on line 3, what portion of the excess does the organization agree to carryover to the reasonable estimate of nondeductible lobbying and political expenditure next year? ......................................................................................................................

Taxable amount of lobbying and political expenditures. See Instructions .........................................

Part IV

Supplemental Information

Provide the descriptions required for Part l-A, line 1; Part l-B, line 4; Part l-C, line 5; Part II-A (affiliated group list); Part II-A, lines 1 and 2 (see instructions), and Part ll-B, line 1. Also, complete this part for any additional information.

Return Reference	Explanation
SCHEDULE C, PART II-B, LINE 1	DESCRIPTION OF LOBBYING ACTIVITIES FRANCISCAN ALLIANCE, INC. ("FRANCISCAN") ENGAGES IN INSUBSTANTIAL AMOUNTS OF LOBBYING ACTIVITIES. FRANCISCAN MAKES GRANTS TO OTHER ORGANIZATIONS THAT LOBBY ON ITS BEHALF INCLUDING VARIOUS HEALTH AND HOSPITAL ASSOCIATIONS. FRANCISCAN ALSO ENGAGES IN DIRECT CONTACT WITH LEGISLATORS AND THEIR STAFFS ON TOPICS RELATED TO FRANCISCAN'S HEALTHCARE MISSION.

Schedule C (Form 990) 2022

Additional Data

Software ID:
Software Version:

- TIN:

SCHEDULE D
(Form 990)

Department of the Treasury
Internal Revenue Service

Supplemental Financial Statements

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.
right arrow

Attach to Form 990.
right arrow

Go to www.irs.gov/Form990 for instructions and the latest information.

OMB No. 1545-0047

2022

Open to Public Inspection

Name of the organization

FRANCISCAN ALLIANCE INC

Employer identification number

35-1330472

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 ........

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? ............

Yes No

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? ...................................

Yes No

Part II

Conservation Easements.
Complete if the organization answered "Yes" on Form 990, Part IV, line 7.

Purpose(s) of conservation easements held by the organization (check all that apply).

Preservation of land for public use (e.g., recreation or education) Preservation of an historically important land area

Protection of natural habitat Preservation of a certified historic structure

Preservation of open space

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.


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 July 25, 2006, and not on a historic structure listed in the National Register ...	2d

Number of conservation easements modified, transferred, released, extinguished, or terminated by the organization during the
tax year right arrow

Number of states where property subject to conservation easement is located right arrow

Does the organization have a written policy regarding the periodic monitoring, inspection, handling of violations, and enforcement of the conservation easements it holds? ............

Yes No

Staff and volunteer hours devoted to monitoring, inspecting, handling of violations, and enforcing conservation easements during the year
right arrow

Amount of expenses incurred in monitoring, inspecting, handling of violations, and enforcing conservation easements during the year
right arrow

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)? .............................

Yes No

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.

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.

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 ......................... right arrow

(ii)

Assets included in Form 990, Part X ............................... right arrow

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:

Revenue included on Form 990, Part VIII, line 1 .......................... right arrow

Assets included in Form 990, Part X ............................... right arrow

For Paperwork Reduction Act Notice, see the Instructions for Form 990.

Cat. No. 52283D

Schedule D (Form 990) 2022

Page 2

Part III

Organizations Maintaining Collections of Art, Historical Treasures, or Other Similar Assets (continued)

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):

Public exhibition

Loan or exchange programs

Scholarly research

Other

Preservation for future generations

Provide a description of the organization’s collections and explain how they further the organization’s exempt purpose in
Part XIII.

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?...

Yes No

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.

Is the organization an agent, trustee, custodian or other intermediary for contributions or other assets not
included on Form 990, Part X? ....................................

Yes No


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

Did the organization include an amount on Form 990, Part X, line 21, for escrow or custodial account liability? ...

Yes No

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 ....	1,942,713	1,880,787	1,878,415	3,600,017	3,584,807
b	Contributions ...
c	Net investment earnings, gains, and losses		61,926	2,372		39,000
d	Grants or scholarships ...
e	Other expenditures for facilities and programs ...				1,721,602	23,790
f	Administrative expenses ....
g	End of year balance ......	1,942,713	1,942,713	1,880,787	1,878,415	3,600,017

Provide the estimated percentage of the current year end balance (line 1g, column (a)) held as:

Board designated or quasi-endowment right arrow

Permanent endowment right arrow

100.000 %

Term endowment right arrow

The percentages on lines 2a, 2b, and 2c should equal 100%.

Are there endowment funds not in the possession of the organization that are held and administered for the
organization by:

Yes

(i) Unrelated organizations .................

3a(i)

Yes

(ii) Related organizations .................

3a(ii)

Yes

If "Yes" on 3a(ii), are the related organizations listed as required on Schedule R? .........

Yes

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 .....	72,953,798		72,953,798
b	Buildings ....	2,387,013,858	1,134,057,061	1,252,956,797
c	Leasehold improvements	58,691,700	43,980,618	14,711,081
d	Equipment ....	845,309,413	606,711,723	238,597,690
e	Other .....	558,011,483	159,071,902	398,939,581
Total. Add lines 1a through 1e. (Column (d) must equal Form 990, Part X, column (B), line 10(c).)..				1,978,158,947

Schedule D (Form 990) 2022

Page 3

Part VII

Investments - Other Securities.
Complete if the organization answered "Yes" on Form 990, Part IV, line 11b. See Form 990, Part X, line 12.

(a) Description of security or category (including name of security)	(b) Book value	(c) Method of valuation: Cost or end-of-year market value
(1) Financial derivatives.........
(2) Closely-held equity interests........
(3)Other
(A)
(B)
(C)
(D)
(E)
(F)
(G)
(H)
Total. (Column (b) must equal Form 990, Part X, col. (B) line 12.)

Part VIII

Investments - Program Related. Complete if the organization answered 'Yes' on Form 990, Part IV, line 11c. See Form 990, Part X, line 13.

(a) Description of investment	(b) Book value	(c) Method of valuation: Cost or end-of-year market value

(1)
(2)
(3)
(4)
(5)
(6)
(7)
(8)
(9)
Total. (Column (b) must equal Form 990, Part X, col.(B) line 13.)

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)OTHER ASSETS				357,985,857
(2)OTHER CURRENT ASSETS				148,338,794
(3)RIGHT TO USE LEASED ASSETS				104,632,405
(3)
(4)
(5)
(6)
(7)
(8)
(9)
Total. (Column (b) must equal Form 990, Part X, col.(B) line 15.)...........				610,957,056

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	0
ACCRUED PAYROLL	146,647,102
LEASE LIABILITIES	129,731,527
SWAP VALUATION	19,227,125
DUE TO THIRD PARTY PAYORS	34,317,081
ACCRUED PROF & GEN'L LIABILITY	26,993,196
ACCRUED INTEREST PAYABLE	6,049,780
OTHER SHORT & LONG TERM LIABILITY	143,024,952


Total. (Column (b) must equal Form 990, Part X, col.(B) line 25.)	505,990,763
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) 2022

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	4,006,953,162
2	Amounts included on line 1 but not on Form 990, Part VIII, line 12:
a	Net unrealized gains (losses) on investments ....	2a	294,370,167
b	Donated services and use of facilities .........	2b
c	Recoveries of prior year grants ...........	2c
d	Other (Describe in Part XIII.) ...........	2d	176,864,601
e	Add lines 2a through 2d .....................			2e	471,234,768
3	Subtract line 2e from line 1..................			3	3,535,718,394
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	3,607,311
c	Add lines 4a and 4b....................			4c	3,607,311
5	Total revenue. Add lines 3 and 4c. (This must equal Form 990, Part I, line 12.) ......			5	3,539,325,705

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	3,601,315,687
2	Amounts included on line 1 but not on Form 990, Part IX, line 25:
a	Donated services and use of facilities .........	2a
b	Prior year adjustments ............	2b
c	Other losses ................	2c
d	Other (Describe in Part XIII.) ...........	2d	-3,607,311
e	Add lines 2a through 2d....................			2e	-3,607,311
3	Subtract line 2e from line 1...................			3	3,604,922,998
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	3,604,922,998

Part XIII

Supplemental Information

Provide the descriptions required for Part II, lines 3, 5, and 9; Part III, lines 1a and 4; Part lV, lines 1b and 2b; Part V, line 4; Part X, line 2; Part XI, lines 2d and 4b; and Part XII, lines 2d and 4b. Also complete this part to provide any additional information.

Return Reference	Explanation
SCHEDULE D, PART V, LINE 4	FRANCISCAN ALLIANCE, INC. USES ITS ENDOWMENT FUNDS FOR CAPITAL EXPENDITURES FOR EQUIPMENT, CAPITAL PROJECTS, OR OTHER CAPITAL NEEDS; MEDICAL EDUCATION PROGRAMS; AND HEALTH CARE PROGRAMS FOR MEDICAL AND PATIENT SERVICES IN ACCORDANCE WITH ANY STIPULATED DONOR RESTRICTIONS.
SCHEDULE D, PART XI, LINE 2D	EQUITY IN EARNINGS OF AFFILIATES $ 61,569,393 OTHER COMPONENTS OF NET PERIODIC PENSION COST $ 6,390,981 OTHER COMPREHENSIVE INCOME $ 93,011,001 DIVIDENDS RECEIVED FROM AFFILIATES $ 3,106,680 EQUITY TRANSFER (TO)/FROM AFFILIATES $ (3,509,604) CHANGES IN NET UNREALIZED GAINS/LOSSES - HILLS $ 24,540,430 CHANGES IN NET UNREALIZED GAINS/LOSSES - SWAP $ 943,721 CHANGE IN NONCONTROLLING INTEREST IN SUBS $ 84,972 CHANGE DONOR RESTRICTED NET ASSETS $ (245,308) DISTRIBUTIONS TO AFFILIATES $ (5,351,105) DONATION OF PPE $ (900,859) OTHER CHANGES IN NET ASSETS $ (2,775,700) -------------- TOTAL OTHER CHANGES IN NET ASSETS $ 176,864,601
SCHEDULE D, PART XI, LINE 4B	RENT EXPENSE AND COST OF GOODS SOLD $ 3,607,311 ----------- TOTAL EXPENSE ON RETURN NOT ON BOOKS $ 3,607,311
SCHEDULE D, PART XII, LNE 2D	RENT EXPENSE AND COST OF GOODS SOLD $ (3,607,311) ----------- TOTAL EXPENSE ON RETURN NOT ON BOOKS $ (3,607,311)

Schedule D (Form 990) 2022

Additional Data

Software ID:
Software Version:

- TIN:

SCHEDULE F(Form 990)

Department of the Treasury
Internal Revenue Service

Statement of Activities Outside the United States

Complete if the organization answered "Yes" to Form 990, Part IV, line 14b, 15, or 16. Right arrow

Attach to Form 990. Right arrow

Go to www.irs.gov/Form990 for instructions and the latest information.

OMB No. 1545-0047

2023

Open to Public Inspection

Name of the organization
FRANCISCAN ALLIANCE INC

Employer identification number

35-1330472

Part I

General Information on Activities Outside the United States. Complete if the organization answered "Yes" on Form 990, Part IV, line 14b.

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? . . . . . . . . . . . . . . . . . . . . . . . . .

Yes

For grantmakers. Describe in Part V the organization’s procedures for monitoring the use of its grants and other assistance outside the United States.

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)	(f) Total expenditures for and investments in the region
	Central America and the Caribbean	0	0	Investments	138,521,555
	Europe (Including Iceland and Greenland)	0	0	Investments	2,314,694
	North America	0	0	Investments	1,954,409














3a	Sub-total ....	0	0		142,790,658
b	Total from continuation sheets to Part I ...
c	Totals (add lines 3a and 3b)	0	0		142,790,658

For Paperwork Reduction Act Notice, see the Instructions for Form 990.Cat. No. 50082W Schedule F (Form 990) 2023

Schedule F (Form 990) 2023

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 .......
3	Enter total number of other organizations or entities .......................

Schedule F (Form 990) 2023

Schedule F (Form 990) 2023Page 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) 2023

Page 4

Part IV

Foreign Forms

Schedule F (Form 990) 2023

Page 5

Part V

Supplemental Information
Provide the information required by Part I, line 2 (monitoring of funds); Part I, line 3, column (f) (accounting method; amounts of investments vs. expenditures per region); Part II, line 1 (accounting method); Part III (accounting method); and Part III, column (c) (estimated number of recipients), as applicable. Also complete this part to provide any additional information. See instructions.

ReturnReference	Explanation

Schedule F (Form 990) 2023

Additional Data

Software ID:
Software Version:

- TIN:

SCHEDULE H
(Form 990)

Department of the Treasury
Internal Revenue Service

Hospitals

Complete if the organization answered "Yes" on Form 990, Part IV, question 20a.
Medium right arrow

Attach to Form 990.
Medium right arrow

Go to www.irs.gov/Form990EZ for instructions and the latest information.

OMB No. 1545-0047

2023

Open to Public Inspection

Name of the organization

FRANCISCAN ALLIANCE INC

Employer identification number

35-1330472

Part I

Financial Assistance and Certain Other Community Benefits at Cost

Yes

Did the organization have a financial assistance policy during the tax year? If "No," skip to question 6a . . . .

Yes

If "Yes," was it a written policy? ......................

Yes

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.

Applied uniformly to all hospital facilities Applied uniformly to most hospital facilities Generally tailored to individual hospital facilities

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.

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:

Yes

100% 150% 200% Other %

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: . . . . . . . .

Yes

200% 250% 300% 350% 400% Other %

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.

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"? . . . . . . . . . . . . .

Yes

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

Yes

If "Yes," did the organization's financial assistance expenses exceed the budgeted amount? . . . . . .

Yes

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? . . . . . . . . . . . . .

Did the organization prepare a community benefit report during the tax year? . . . . . . . . .

Yes

If "Yes," did the organization make it available to the public? . . . . . . . . . . . . .

Yes

Complete the following table using the worksheets provided in the Schedule H instructions. Do not submit these worksheets with the Schedule H.

Financial Assistance and Certain Other Community Benefits at Cost

Financial Assistance and Means-Tested Government Programs		(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) . . .	66,102,319	0	66,102,319	1.830 %
b	Medicaid (from Worksheet 3, column a) . . . . .	626,469,246	439,822,893	186,646,353	5.180 %
c	Costs of other means-tested government programs (from Worksheet 3, column b) . .	187,552	0	187,552	0.010 %
d	Total Financial Assistance and Means-Tested Government Programs . . . . .	692,759,117	439,822,893	252,936,224	7.020 %
Other Benefits
e	Community health improvement services and community benefit operations (from Worksheet 4).	5,597,070	60,429	5,536,641	0.150 %
f	Health professions education (from Worksheet 5) . . .	23,035,417	8,150,260	14,885,157	0.410 %
g	Subsidized health services (from Worksheet 6) . . . .	107,831,588	71,026,158	36,805,430	1.020 %
h	Research (from Worksheet 7) .	1,842,272	0	1,842,272	0.050 %
i	Cash and in-kind contributions for community benefit (from Worksheet 8) . . . .	618,368	619	617,749	0.020 %
j	Total. Other Benefits . .	138,924,715	79,237,466	59,687,249	1.650 %
k	Total. Add lines 7d and 7j .	831,683,832	519,060,359	312,623,473	8.670 %

For Paperwork Reduction Act Notice, see the Instructions for Form 990. Cat. No. 50192T Schedule H (Form 990) 2023

Schedule H (Form 990) 2023

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			0	0	0	0 %
4	Environmental improvements
5	Leadership development and training for community members
6	Coalition building
7	Community health improvement advocacy
8	Workforce development
9	Other			0	0	0	0 %
10	Total			0	0	0	0 %

Part III

Bad Debt, Medicare, & Collection Practices

Section A. Bad Debt Expense

Yes

Did the organization report bad debt expense in accordance with Healthcare Financial Management Association Statement No. 15? ..........................

Yes

Enter the amount of the organization's bad debt expense. Explain in Part VI the methodology used by the organization to estimate this amount. ......

9,628,450

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. ......

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

Enter total revenue received from Medicare (including DSH and IME).....

1,010,485,783

Enter Medicare allowable costs of care relating to payments on line 5.....

1,533,922,437

Subtract line 6 from line 5. This is the surplus (or shortfall)........

-523,436,654

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:

Cost accounting system Cost to charge ratio Other

Section C. Collection Practices

Did the organization have a written debt collection policy during the tax year? ..........

Yes

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 .........................

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 %
1SEE PART VI
2
3
4
5
6
7
8
9
10
11
12
13

Schedule H (Form 990) 2023

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?9Name, 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)								Facility reporting group
1	FRANCISCAN HEALTH INDIANAPOLIS 8111 SOUTH EMERSON AVENUE INDIANAPOLIS,IN46217 WWW.FRANCISCANALLIANCE.ORG/HOSPITALS 11-004972-1	X	X	X	X	X		A
2	FRANCISCAN HEALTH LAFAYETTE 1701 S CREASY LANE LAFAYETTE,IN47905 WWW.FRANCISCANALLIANCE.ORG/HOSPITALS 15-005096-1	X	X	X		X		A
3	FRANCISCAN HEALTH OLYMPIA FIELDS 20201 SOUTH CRAWFORD AVE OLYMPIA FIELDS,IL60461 WWW.FRANCISCANALLIANCE.ORG/HOSPITALS 0005074	X	X	X		X		A
4	FRANCISCAN HEALTH MICHIGAN CITY 3500 FRANCISCAN WAY MICHIGAN CITY,IN46360 WWW.FRANCISCANALLIANCE.ORG/HOSPITALS 15-005015-1	X	X			X	X	A
5	FRANCISCAN HEALTH CROWN POINT 1201 SOUTH MAIN STREET CROWN POINT,IN46307 WWW.FRANCISCANALLIANCE.ORG/HOSPITALS 15-005107-1	X	X	X		X		A
6	FRANCISCAN HEALTH DYER 24 JOLIET STREET DYER,IN46311 WWW.FRANCISCANALLIANCE.ORG/HOSPITALS 15-005080-1	X	X	X		X		A
7	FRANCISCAN HEALTH MUNSTER 701 SUPERIOR STREET MUNSTER,IN46321 WWW.FRANCISCANALLIANCE.ORG/HOSPITALS 15-005615-1	X	X	X		X		A
8	FRANCISCAN HEALTH MOORESVILLE 1201 HADLEY ROAD MOORESVILLE,IN46158 WWW.FRANCISCANALLIANCE.ORG/HOSPITALS 14-005052-1	X	X	X	X	X		A
9	FRANCISCAN HEALTH CRAWFORDSVILLE 1710 LAFAYETTE ROAD CRAWFORDSVILLE,IN47933 WWW.FRANCISCANALLIANCE.ORG/HOSPITALS 15-005021-1	X	X			X		A

Schedule H (Form 990) 2023

Page 4

Part VFacility Information (continued)

Section B. Facility Policies and Practices

(Complete a separate Section B for each of the hospital facilities or facility reporting groups listed in Part V, Section A)

	A
Name of hospital facility or letter of facility reporting group

Line number of hospital facility, or line numbers of hospital facilities in a facility
reporting group (from Part V, Section A):

Yes

Community Health Needs Assessment

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?........................

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...............

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......................

Yes

If "Yes," indicate what the CHNA report describes (check all that apply):

A definition of the community served by the hospital facility

Demographics of the community

Existing health care facilities and resources within the community that are available to respond to the health needs of the community

How data was obtained

The significant health needs of the community

Primary and chronic disease needs and other health issues of uninsured persons, low-income persons, and minority groups

The process for identifying and prioritizing community health needs and services to meet the community health needs

The process for consulting with persons representing the community’s interests

The impact of any actions taken to address the significant health needs identified in the hospital facility's prior CHNA(s)

Other (describe in Section C)

Indicate the tax year the hospital facility last conducted a CHNA: 20 22

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 .................

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..................................

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. ............................

Did the hospital facility make its CHNA report widely available to the public?..............

Yes

If "Yes," indicate how the CHNA report was made widely available (check all that apply):

Hospital facility’s website (list url): SEE PART V-C

Other website (list url):

Made a paper copy available for public inspection without charge at the hospital facility

Other (describe in Section C)

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. ..............

Yes

Indicate the tax year the hospital facility last adopted an implementation strategy: 20 22

Is the hospital facility's most recently adopted implementation strategy posted on a website?.........

Yes

If "Yes" (list url): SEE PART V-C

If "No," is the hospital facility’s most recently adopted implementation strategy attached to this return? ......

10b

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

If "Yes" on line 12a, did the organization file Form 4720 to report the section 4959 excise tax?........

12b

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) 2023

Page 5

Part VFacility Information (continued)

Financial Assistance Policy (FAP)

	A
Name of hospital facility or letter of facility reporting group

Yes

Did the hospital facility have in place during the tax year a written financial assistance policy that:

Explained eligibility criteria for financial assistance, and whether such assistance included free or discounted care?

If “Yes,” indicate the eligibility criteria explained in the FAP:

Federal poverty guidelines (FPG), with FPG family income limit for eligibility for free care of 200.%
and FPG family income limit for eligibility for discounted care of 400.%

Income level other than FPG (describe in Section C)

Asset level

Medical indigency

Insurance status

Underinsurance discount

Residency

Other (describe in Section C)

Explained the basis for calculating amounts charged to patients?.................

Yes

Explained the method for applying for financial assistance?...................

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):

Described the information the hospital facility may require an individual to provide as part of his or her application

Described the supporting documentation the hospital facility may require an individual to submit as part of his or
her application

Provided the contact information of hospital facility staff who can provide an individual with information about the
FAP and FAP application process

Provided the contact information of nonprofit organizations or government agencies that may be sources of
assistance with FAP applications

Other (describe in Section C)

Was widely publicized within the community served by the hospital facility?........

Yes

If "Yes," indicate how the hospital facility publicized the policy (check all that apply):

The FAP was widely available on a website (list url):

SEE SECTION C

The FAP application form was widely available on a website (list url):

SEE SECTION C

A plain language summary of the FAP was widely available on a website (list url):
SEE SECTION C

The FAP was available upon request and without charge (in public locations in the hospital facility and by mail)

The FAP application form was available upon request and without charge (in public locations in the hospital facility
and by mail)

A plain language summary of the FAP was available upon request and without charge (in public locations in the
hospital facility and by mail)

Individuals were notified about the FAP by being offered a paper copy of the plain language summary of the FAP, by
receiving a conspicuous written notice about the FAP on their billing statements, and via conspicuous public displays or
other measures reasonably calculated to attract patients' attention

Notified members of the community who are most likely to require financial assistance about availability of the FAP

The FAP, FAP application form, and plain language summary of the FAP were translated into the primary language(s)
spoken by LEP populations

Other (describe in Section C)

Schedule H (Form 990) 2023

Page 6

Part VFacility Information (continued)

Billing and Collections

	A
Name of hospital facility or letter of facility reporting group

Yes

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?..................................

Yes

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:

Reporting to credit agency(ies)

Selling an individual’s debt to another party

Deferring, denying, or requiring a payment before providing medically necessary care due to nonpayment of a previous
bill for care covered under the hospital facility's FAP

Actions that require a legal or judicial process

Other similar actions (describe in Section C)

None of these actions or other similar actions were permitted

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?............

If "Yes," check all actions in which the hospital facility or a third party engaged:

Reporting to credit agency(ies)

Selling an individual’s debt to another party

Deferring , denying, or requiring a payment before providing medically necessary care due to nonpayment of a previous
bill for care covered under the hospital facility's FAP

Actions that require a legal or judicial process

Other similar actions (describe in Section C)

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):

Provided a written notice about upcoming ECAs (Extraordinary Collection Action) and a plain language summary of the
FAP at least 30 days before initiating those ECAs (if not, describe in Section C)

Made a reasonable effort to orally notify individuals about the FAP and FAP application process (if not, describe in
Section C)

Processed incomplete and complete FAP applications (if not, describe in Section C)

Made presumptive eligibility determinations (if not, describe in Section C)

Other (describe in Section C)

None of these efforts were made

Policy Relating to Emergency Medical Care

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?..................

Yes

If "No," indicate why:

The hospital facility did not provide care for any emergency medical conditions

The hospital facility’s policy was not in writing

The hospital facility limited who was eligible to receive care for emergency medical conditions (describe in Section C)

Other (describe in Section C)

Schedule H (Form 990) 2023

Page 7

Part VFacility Information (continued)

Charges to Individuals Eligible for Assistance Under the FAP (FAP-Eligible Individuals)

	A
Name of hospital facility or letter of facility reporting group

Yes

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.

The hospital facility used a look-back method based on claims allowed by Medicare fee-for-service during a prior 12-month period

The hospital facility used a look-back method based on claims allowed by Medicare fee-for-service and all private health insurers that pay claims to the hospital facility during a prior 12-month period

The hospital facility used a look-back method based on claims allowed by Medicaid, either alone or in combination with
Medicare fee-for-service and all private health insurers that pay claims to the hospital facility during a prior 12-month
period

The hospital facility used a prospective Medicare or Medicaid method

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? ...............................

If "Yes," explain in Section C.

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? ...........................

If "Yes," explain in Section C.

Schedule H (Form 990) 2023

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
SCHEDULE H, PART V, SECTION B - SUPPLEMENTAL INFORMATION	LINE 3E: PLEASE SEE THE RESPONSE TO SCHEDULE H, PART V, LINE 11 BELOW FOR AN EXPLANATION OF HOW THE HEALTH NEEDS IDENTIFIED IN THE CHNA WERE PRIORITIZED.
LINE 5: INPUT FROM INDIVIDUALS IN THE COMMUNITY	THE 2022-2024 CHNA USED THE SAME SURVEY AS THE 2018-2021 CHNA DUE TO THE SCIENTIFIC RIGOR OF THE SURVEY. THE SURVEY FOR THE 2022-2024 CHNA WAS SENT TO RESIDENTS USING CONVENIENCE SAMPLING TO VERIFY THAT THE RESULTS OF THE SURVEY WERE ACCURATE. ADDITIONAL QUESTIONS WERE ADDED RELATED TO COVID TO ASSIST IN UNDERSTANDING ANY DIFFERENCE DUE TO THE PANDEMIC. FOR THE 2018-2021 CHNA, AN EXTENSIVE SURVEY WAS DEPLOYED FOLLOWING THIS PROCESS AND METHODOLOGY: TO COLLECT PRIMARY DATA FROM THE HOSPITAL'S SERVICE AREA POPULATION, A SURVEY WAS DESIGNED, FIELDED, AND ANALYZED TO ENSURE THAT THE PERSPECTIVES OF THE RESIDENTS OF THE SERVICE AREA WERE INCLUDED IN THIS ASSESSMENT, THE HOSPITAL USED A RIGOROUS POPULATION-BASED METHODOLOGICAL APPROACH TO COVER THE SERVICE AREA. TO DEVELOP THE SURVEY USED FOR THE CHNA, THE HOSPITAL PARTNERED WITH FACULTY FROM INDIANA-BASED UNIVERSITIES WHO HAD PARTICULAR EXPERTISE IN COMMUNITY-BASED SURVEY RESEARCH. DR. WILLIAM MCCONNELL OF THE UNIVERSITY OF EVANSVILLE SERVED AS THE LEAD RESEARCHER ON THE PROJECT, IN PARTNERSHIP WITH DR. MICHAEL REECE AND DR. CATHERINE SHERWOOD-LAUGHLIN (BOTH OF THE INDIANA UNIVERSITY SCHOOL OF PUBLIC HEALTH). THE UNIVERSITY OF EVANSVILLE CONTRACTED WITH THE CENTER FOR SURVEY RESEARCH (CSR) AT INDIANA UNIVERSITY TO ADMINISTER THIS SURVEY IN TWO PHASES: PHASE I WAS CONDUCTED AS A PAPER SURVEY MAILED TO A RANDOM ADDRESS-BASED SAMPLE AND PHASE II WAS CONDUCTED AS A PAPER SURVEY ADMINISTERED BY THE HOSPITALS TO A CONVENIENCE SAMPLE OF THEIR CHOOSING. THE SURVEY WAS CONDUCTED WITH APPROVAL OF THE INSTITUTIONAL REVIEW BOARD (IRB) OF THE UNIVERSITY OF EVANSVILLE. PLANNING AND DEVELOPMENT FOR THE SURVEY BEGAN IN THE WINTER OF 2017. USING A CONSTRUCT-BASED APPROACH THAT IDENTIFIED THE LEADING AREAS TO BE INCLUDED ON THE SURVEY, THE HOSPITALS AND FACULTY DEVELOPED A SURVEY. THE SURVEY INCLUDED MEASURES THAT HAD BEEN VALIDATED FOR USE IN SIMILAR PROJECTS BY OTHER RESEARCHERS AND ADDITIONAL MEASURES THAT WERE DEVELOPED BY THE PARTNERS FOR SPECIFIC NEEDS OF THIS CHNA. THE SURVEY COVERED TEN MAJOR AREAS. TWO WEIGHTING ADJUSTMENTS WERE MADE TO ENHANCE CONSISTENCY BETWEEN THE SURVEY SAMPLE AND THE CHARACTERISTICS OF THE HOSPITAL'S SERVICE POPULATION. THE FIRST WAS A BASE WEIGHT ADJUSTMENT TO ACCOUNT FOR UNEQUAL PROBABILITIES OF SELECTION WITHIN HOUSEHOLD. THE SECOND WAS A POSTSTRATIFICATION ADJUSTMENT TO THE U.S. CENSUS BUREAU 2012-2016 AMERICAN COMMUNITY SURVEY FIVE-YEAR POPULATION ESTIMATES. THE TWO WEIGHTING ADJUSTMENTS WERE MULTIPLIED TO CALCULATE A PRELIMINARY FINAL WEIGHT FOR EACH HOSPITAL'S CATCHMENT AREA. THESE PRELIMINARY WEIGHTS WERE THEN TRIMMED AND SCALED SO THAT THE FINAL WEIGHTS SUMMED TO THE NUMBER OF RESPONDENTS IN EACH CATCHMENT AREA. BECAUSE DATA COLLECTION OCCURRED DURING THE PANDEMIC, FOCUS GROUPS WERE UNABLE TO BE HELD. TO GAIN A FURTHER UNDERSTANDING OF COMMUNITY NEEDS, A SURVEY TO COMMUNITY PARTNERS, SUCH AS THE ONES LISTED BELOW, WAS ADMINISTERED. THE SURVEY MIRRORED THE RESIDENT SURVEY, WITH THE INCLUSION OF QUESTIONS RELATED TO COVID AND RECOVERY. SAMPLE OF PARTICIPATING ORGANIZATIONS - YOUTH SERVICES BUREAU - CRAWFORDSVILLE COMMUNITY SCHOOL CORPORATION - CRAWFORDSVILLE FIRE DEPARTMENT - NURSE FAMILY PARTNERSHIP - WABASH COLLEGE - CRAWFORDSVILLE PARKS DEPARTMENT - CRAWFORDSVILLE PUBLIC LIBRARY - MONTGOMERY COUNTY HEALTH DEPARTMENT - FRANCISCAN HEALTH - WABASH VALLEY ALLIANCE - COMMUNITY HEALTHNET - COVERING KIDS AND FAMILIES - METHODIST HOSPITALS - COMMUNITY HEALTH CARE - PURDUE UNIVERSITY NORTHWEST - NORTHWEST INDIANA COMMUNITY ACTION - NURSE FAMILY PARTNERSHIP - CROWN POINT SCHOOLS - DEAN AND BARBARA WHITE SOUTHLAKE YMCA - HEALTHY START - MUNSTER PARKS AND RECREATION - PURDUE EXTENSION - THE INTREPID PHOENIX - FOOD BANK OF NORTHWEST INDIANA - AREA HEALTH EDUCATION CENTER - INDIANA UNIVERSITY NORTHWEST - GIRLS ON THE RUN - HOPE CHRISTIAN CHURCH - INDIANA PARENTING INITIATIVE - COMMUNITY HEALTH NETWORK - ANTHEM - NURSE FAMILY PARTNERSHIP - WINDROSE HEALTH - INDY SOUTHSIDE QUALITY OF LIFE - BARBARA B. JORDAN YMCA - ARTHUR R. BAXTER YMCA - CITY OF GREENWOOD - INDIANA YOUTH INSTITUTE - AREA HEALTH EDUCATION CENTER - GREATER SOUTHSIDE BUSINESS ALLIANCE - NURSE FAMILY PARTNERSHIP - THE VILLAGES - PURDUE UNIVERSITY SCHOOL OF NURSING - AREA IV AGENCY - BOY SCOUTS - NORTH CENTRAL HEALTH SERVICES - RIGGS COMMUNITY HEALTH CENTER - INDIANA UNIVERSITY HEALTH- YWCA - BAUER SERVICES - LOCAL WOMEN INFANT CHILDREN'S ("WIC") AGENCY - HEALTHY COMMUNITIES OF CLINTON COUNTY/COVERING KIDS AND FAMILIES - INDIANA YOUTH INSTITUTE - PURDUE EXTENSION-4-H - FOOD FINDERS - LTHC HOMELESS SERVICES - UNITED WAY OF LAPORTE COUNTY - DUNEBROOK - OPEN DOOR - SOUTH CENTRAL SCHOOL DISTRICT - SWANSON CENTER - IVY TECH - BOYS AND GIRLS CLUB - DUNELAND FAMILY YMCA - HAMMOND FAMILY YMCA - FRONTLINE FOUNDATION - WALKER MEDICAL - AREA HEALTH EDUCATION CENTER - UNITY FOUNDATION - LAPORTE COUNTY HEALTH DEPARTMENT - HEALTHIER MORGAN COUNTY INITIATIVE - PURDUE GLOBAL - BRIDGES OF HOPE - IVY TECH - LIFE SMART YOUTH - UNITED WAY - MDWISE - BOYS AND GIRLS CLUB - MOORESVILLE PARKS DEPARTMENT - MOORESVILLE SCHOOLS YMCA - MORGAN COUNTY SUBSTANCE ABUSE COUNCIL - MORGAN COUNTY HEALTH DEPARTMENT - PEACE RESTORED - JACKSON CENTER - MOORESVILLE CHAMBER OF COMMERCE - REACH FOR YOUTH - GIRL SCOUTS - BLOOM TOWNSHIP HIGH SCHOOL - GOVENORS STATE UNIVERSITY - PARK FOREST POLICE - PRAIRIE STATE COLLEGE - SOUTH SUBURBAN FAMILY SHELTER - DISTRICT 163 SCHOOLS - DISTRICT 227 SCHOOLS - PREVENT CHILD ABUSE - SOUTH SUBURBAN PADS - RESPOND NOW - DISTRICT 227 SCHOOLS - JONES CENTER
LINE 7: ALL FACILITIES	ALL CHNA REPORTS ARE AVAILABLE ON FRANCISCAN ALLIANCE'S WEBSITE AT HTTPS://WWW.FRANCISCANHEALTH.ORG/COMMUNITYHEALTH. IN ADDITION, A PRINT COPY IS AVAILABLE FREE OF CHARGE IN EACH HOSPITAL'S ADMINISTRATIVE OFFICE.
LINE 10: ALL FACILITIES	ALL IMPLEMENTATION PLANS ARE CONTAINED IN THE CHNA AS 'CHAPTER 6: CALL TO ACTION.' THE REPORTS ARE AVAILABLE ON FRANCISCAN ALLIANCE'S WEBSITE AT HTTPS://WWW.FRANCISCANHEALTH.ORG/COMMUNITYHEALTH
LINE 11: COMMUNITY HEALTH NEEDS ASSESSMENT	THE TOP HEALTH NEEDS IN A COMMUNITY IS A DIFFICULT PROCESS. MANY POOR HEALTH OUTCOMES, HEALTH DISPARITIES, AND POOR SOCIAL DETERMINANTS OF HEALTH WEIGH HEAVILY ON SEGMENTS OF OUR COMMUNITY. WE ALSO ACKNOWLEDGE THAT THERE ARE MANY STRENGTHS AND POSITIVE GROWTH THAT BALANCE SOME OF THESE CHALLENGES. FRANCISCAN HEALTH DETERMINED THE TOP HEALTH NEEDS BY REVIEWING SECONDARY DATA, SURVEY RESPONSES, AND FEEDBACK FROM INPUT MEETINGS. A CORE TEAM OF SIX STAFF MEMBERS WITH EDUCATION AND EXPERIENCE IN PUBLIC HEALTH WORKED WITH STAFF IN EACH COMMUNITY TO COME TO A CONSENSUS ON THE TOP ISSUES. A COMBINATION OF MULTIVOTE RANKING AND THE HANLON METHOD WERE USED. ONCE A REFINED LIST OF THE TOP TEN ISSUES WAS BROUGHT TO CONSENSUS, EACH STAFF MEMBER RANKED HEALTH ISSUES BASED ON SIZE, SERIOUSNESS, EQUITY, TYPES OF INTERVENTION, AND URGENCY. TO ASSIST WITH INTERVENTION PLANNING, A SECOND SCORE ON THE POTENTIAL FOR FRANCISCAN HEALTH TO PRIORITIZE THE HEALTH ISSUE WAS DETERMINED. SCORING CRITERIA INCLUDED INTERNAL CAPACITY, COMMUNITY ACCEPTABILITY, SUSTAINABILITY, AND LONG-TERM IMPACT. USING A MIX OF HANLON AND PEARL TECHNIQUES, THE FRANCISCAN HEALTH COMMUNITY HEALTH TEAM SCORED THE SECONDARY DATA, FEEDBACK MEETING COMMENTS, AND SURVEY DATA TO PRODUCE THE LIST OF TOP HEALTH NEEDS IN THE COMMUNITY. IN DETERMINING COMMUNITY HEALTH INTERVENTIONS FOR THE SELECTED PRIORITY HEALTH NEEDS, HEALTH EQUITY, SUSTAINABILITY, AND AN EMPHASIS ON SOCIAL DETERMINANTS OF HEALTH WERE HEAVILY WEIGHTED. WHILE MOST INTERVENTIONS FOCUS ON INDIVIDUAL LIFESTYLE FACTORS, KNOWLEDGE, SKILLS, AND BEHAVIORS, CONSIDERATION OF THE CULTURAL AND ENVIRONMENTAL CONTEXTS ARE JUST AS IMPORTANT. FRANCISCAN ALLIANCE ACKNOWLEDGES THAT TRUE CHANGE COMES WITH MAJOR SHIFTS IN ALL AREAS. THE FIRST CRITERIA USED TO DETERMINE IMPLEMENTATION STRATEGIES IS THE CONNECTION TO THE SOCIO-ECOLOGICAL MODEL AND SOCIAL DETERMINENTS OF HEALTH. INTERVENTIONS IMPLEMENTED BY FRANCISCAN ALLIANCE ARE PERSON-CENTERED AND DESIGNED TO CREATE LASTING CHANGE. MALCOLM KNOWLES' PRINCIPLES OF ANDRAGOGY PROVIDED THE FRAMEWORK. WHILE THIS MODEL IS BASED ON EDUCATIONAL PROGRAMMING, IT APPLIES TO ALL TYPES OF INTERVENTIONS. FOR EXAMPLE, IN THE PROVISION OF CLINICAL CARE OR MEDICATION ASSISTANCE, PARTICIPANTS NOT ONLY RECEIVE THE CARE OR MEDICATION, THEY ALSO LEARN TO BETTER MANAGE THEIR OWN HEALTH OR ACCESS COMPONENTS OF THE HEALTH SYSTEM OR ASSISTANCE PROGRAM. REFLECTION, TEACH-BACK, AND COMMUNICATION TECHNIQUES ARE UTILIZED TO EMPOWER THE PARTICIPANT TO MOVE BEYOND A ONE-TIME INTERACTION OR ASSISTANCE. FRANCISCAN ALLIANCE USES EVIDENCE-BASED PRACTICES IN PLANNING INTERVENTIONS WHENEVER POSSIBLE, AS THESE PROGRAMS HAVE BEEN THOROUGHLY TESTED AND HAVE PROVEN EFFICACY. WHEN EVIDENCE-BASED PROGRAMS ARE NOT AVAILABLE, BEST PRACTICES AND DOCUMENTED RESEARCH GUIDES THE DEVELOPMENT AND IMPLEMENTATION OF THE INTERVENTION. IMPLEMENTATION ACTIVITIES WILL BE EVALUATED TO THE FULLEST EXTENT. USING THE KIRKPATRICK MODEL (A STANDARDIZED EVALUATION SYSTEM BASED ON REACTION, LEARNING, BEHAVIOR, AND RESULTS) AS A GUIDE, EVALUATION OF NOT ONLY THE PROGRAM, BUT ITS IMPACT AND RESULTS WILL BE REVIEWED. THIS PROCESS ALLOWS FOR CHANGES TO BE MADE TO IMPROVE THE PROGRAM ON AN ONGOING BASIS. WHILE IT CAN BE DIFFICULT TO DETERMINE THE EXACT CAUSE OF INDIVIDUAL BEHAVIORAL CHANGE, BIOMETRICS, POST-FOLLOW UP SURVEYS, AND OTHER METHODS WERE USED TO CAPTURE QUALITATIVE AND QUANTITATIVE DATA.
LINE 11: COMMUNITY HEALTH NEEDS ASSESSMENT CON'T	THE FOLLOWING SHOWS THE TOP HEALTH NEEDS IN THREE CATEGORIES: SOCIAL NEED, POOR HEALTH BEHAVIORS, AND POOR HEALTH OUTCOMES. THIS TAKES INTO ACCOUNT THE COMPLEXITY OF SOCIAL DETERMINANTS OF HEALTH AND THE MANY FACTORS THAT MAKE UP INDIVIDUAL HEALTH. IN SOME CASES, ONE WILL NOTICE A CLEAR PATH BETWEEN SOCIAL NEED, POOR BEHAVIORS, AND THE RESULTING OUTCOME. MANY NEEDS ARE SELF-EXPLANATORY OR BASED ON COMMONLY UNDERSTOOD DEFINITIONS. HOWEVER, SOME ISSUES ARE A BIT NUANCED OR EMERGING COMMUNITY TRENDS. THE DEPARTMENT OFFERS THESE DEFINITIONS TO AID IN UNDERSTANDING IDENTIFIED ISSUES: SOCIAL COHESION - INCLUDES OVERALL SENSE OF COMMUNITY, SOCIAL BONDING, BRIDGING, CONNECTEDNESS, SUPPORT NETWORKS, FAMILY BUILDING, "WARM HAND-OFF" FOR RESOURCES, UNDERSTANDING OF OTHERS, COMMUNICATION AND CONFLICT SKILL DEVELOPMENT - HOW WE KNOW: VICTIMIZATION RATES, BEHAVIORAL HEALTH ISSUES, SOCIAL SERVICE AGENCIES REPORT/SURVEY, SERVICE PROVIDER RATES (PATIENT:PROVIDER RATIO), PUBLIC SURVEY DATA, PROFESSIONAL SURVEY DATA VICTIMS OF VIOLENCE - INCLUDES DOMESTIC AND INTERPERSONAL VIOLENCE, CHILD ABUSE/NEGLECT, HUMAN TRAFFICKING, VIOLENT CRIME, ELDER ABUSE/NEGLECT - HOW WE KNOW: MORTALITY RATES, PUBLIC SURVEY DATA, PROFESSIONAL SURVEY DATE, LACK OF SERVICE PROVIDER CAPACITY; CHILD IN NEED OF SERVICES CASES, DEPARTMENT OF CHILD SERVICES AND DEPARTMENT OF CHILDREN AND FAMILIES SUBSTANTIATED ABUSE CASES, VIOLENT CRIME RATES, EMERGENCY DEPARTMENT DATA, HATE CRIME RATES BEHAVIORAL HEALTH - INCLUDES DIAGNOSED AND UNDIAGNOSED MENTAL HEALTH ISSUES, SUICIDE, SELF-HARM, DEPRESSION, ANXIETY - HOW WE KNOW: SERVICE PROVIDER RATES (PATIENT:PROVIDER RATIO), SUICIDE RATES, SELF-HARM RATES, POOR MENTAL HEALTH DAYS, PROFESSIONAL SURVEY DATA, PUBLIC SURVEY DATA, LACK OF RESOURCES SUBSTANCE ABUSE - INCLUDES ILLEGAL DRUGS, PRESCRIPTION ABUSE, ALCOHOL - HOW WE KNOW: MORTALITY RATES, OVERDOSE RATES, DUI, ED/PATIENT DATA, PUBLIC SURVEY DATA, PROFESSIONAL SURVEY DATA ACCESS TO HEALTH CARE - INCLUDES BARRIERS THAT PREVENT OR LIMIT ACCESS TO NEEDED HEALTH CARE SERVICES, NO TRANSPORTATION, LACK OF INSURANCE, UNDERINSURED, TRANSPORTATION, AVAILABILITY OF PROVIDERS AND SERVICES - HOW WE KNOW: PUBLIC SURVEY DATA, PROFESSIONAL SURVEY DATA, INSURANCE RATES, SERVICE PROVIDER RATES (PATIENT:PROVIDER RATIO) FRANCISCAN ALLIANCE HOSPITALS MADE THE FOLLOWING PROGRESS DURING 2023 IN ADDRESSING THE IDENTIFIED COMMUNITY HEALTH NEEDS FROM ITS MOST RECENT CHNA: FRANCISCAN HEALTH CRAWFORDSVILLE TOP HEALTH NEEDS INCLUDE (TOP NEEDS FIRST): - BEHAVIORAL HEALTH - INFANT AND MATERNAL CARE - SOCIAL COHESION - HOUSING - ACCESS TO HEALTHY FOOD - VIOLENCE - ACCESS TO PHYSICAL ACTIVITY - TOBACCO CESSATION - SUBSTANCE ABUSE - TRAUMA FROM VIOLENCE - INFANT AND CHILD MORTALITY - INJURY - DIABETES - CARDIOVASCULAR DISEASE USING A THEME OF 'HEALTHY BODIES, HEALTHY MINDS, AND HEALTHY CONNECTIONS' TO DESCRIBE A COMPREHENSIVE APPROACH TO THESE TOP HEALTH NEEDS, THE FOLLOWING INTERVENTIONS WERE PROVIDED: -FREE PHYSICAL ACTIVITY PROGRAMMING, INCLUDING 'WALK WITH A DOC' -EDUCATION ON HEALTHY FOOD/NUTRITION, INCLUDING COOKING MATTERS AND HEALTHY CHOICES -SUICIDE PREVENTION COURSES, INCLUDING QPR (QUESTION, PERSUADE, REFER - SUICIDE PREVENTION TRAINING) -FACILITATION OF A COMMUNITY WIDE RESILIENCE COALITION FOCUSED ON RESOLVING SYSTEMIC ISSUES LEADING TO POOR HEALTH CONDITIONS -PROFESSIONAL TRAINING ON TRAUMA INFORMED CARE, RESILIENCE AND MINDFULNESS FOR NON-PROFITS - COMMUNITY BABY SHOWER FOR UNDER-RESOURCED FAMILIES FRANCISCAN HEALTH CROWN POINT (SOUTH LAKE COUNTY): TOP HEALTH NEEDS INCLUDE (TOP NEEDS FIRST): - BEHAVIORAL HEALTH - ACCESS TO PRIMARY CARE - SOCIAL COHESION - FOOD INSECURITY - SELF-HARM/VIOLENCE - SUBSTANCE ABUSE - UNSAFE SEX - HOMICIDES - NUTRITION - PHYSICAL ACTIVITY - TOBACCO USAGE - INFANT AND CHILD MORTALITY - DIABETES - ASTHMA USING A THEME OF 'HEALTHY BODIES, HEALTHY MINDS, AND HEALTHY CONNECTIONS' TO DESCRIBE A COMPREHENSIVE APPROACH TO THESE TOP HEALTH NEEDS, THE FOLLOWING INTERVENTIONS WERE PROVIDED: -FREE PHYSICAL ACTIVITY PROGRAMMING, INCLUDING 'FIT TOGETHER' FOR FAMILIES AND 'WALK WITH A DOC' -EDUCATION ON HEALTHY FOOD/NUTRITION, INCLUDING 'COOKING MATTERS' -SUICIDE PREVENTION COURSES, INCLUDING QPR AND ASIST -FACILITATION OF A COMMUNITY WIDE RESILIENCE COALITION -PROFESSIONAL TRAINING ON MENTAL HEALTH FIRST AID -ADOPTION OF THE NATIONAL 'REACH OUT AND READ' PROGRAM -OPERATION OF A FOOD PANTRY IN CROWN POINT AND MOBILE FOOD MARKETS -OPERATION OF A DIAPER PANTRY -HOME VISITING PRENATAL CARE AND INFANT CARE PROGRAM -PRENATAL ASSISTANCE PROGRAM -LEAD AGENCY FOR TOBACCO PREVENTION AND CESSATION FOR THE STATE OF INDIANA INDIANA
LINE 11: COMMUNITY HEALTH NEEDS ASSESSMENT CON'T	FRANCISCAN HEALTH HAMMOND, FRANCISCAN HEALTH MUNSTER, AND FRANCISCAN HEALTH DYER (NORTH LAKE COUNTY) TOP HEALTH NEEDS INCLUDE (TOP NEEDS FIRST): - BEHAVIORAL HEALTH - SOCIAL COHESION - FOOD INSECURITY - ACCESS TO PRIMARY CARE - SELF-HARM/VIOLENCE - TOBACCO USAGE - SUBSTANCE USE - INFANT AND CHILD MORTALITY - VICTIMS OF CRIME TRAUMA - OBESITY - DIABETES - ASTHMA USING A THEME OF 'HEALTHY BODIES, HEALTHY MINDS, AND HEALTHY CONNECTIONS' TO DESCRIBE A COMPREHENSIVE APPROACH TO THESE TOP HEALTH NEEDS, THE FOLLOWING INTERVENTIONS WERE PROVIDED: -FREE PHYSICAL ACTIVITY PROGRAMMING, INCLUDING 'FIT TOGETHER' FOR FAMILIES AND 'WALK WITH A DOC' -EDUCATION ON HEALTHY FOOD/NUTRITION, INCLUDING 'COOKING MATTERS' -SUICIDE PREVENTION COURSES, INCLUDING QPR AND ASIST -FACILITATION OF A COMMUNITY WIDE RESILIENCE COALITION -PROFESSIONAL TRAINING ON MENTAL HEALTH FIRST AID -ADOPTION OF THE NATIONAL 'REACH OUT AND READ' PROGRAM -OPERATION OF A FOOD PANTRY IN HAMMOND AND MOBILE MARKETS -OPERATION OF A DIAPER PANTRY -HOME VISITING PRENATAL CARE AND INFANT CARE PROGRAM -PRENATAL ASSISTANCE PROGRAM -LEAD AGENCY FOR TOBACCO PREVENTION AND CESSATION FOR THE STATE OF INDIANA FRANCSICAN HEALTH INDIANAPOLIS TOP HEALTH NEEDS INCLUDE (TOP NEEDS FIRST): -POVERTY -ACCESS TO HEALTH CARE -BEHAVIORAL HEALTH -SUBSTANCE ABUSE -FOOD INSECURITY -SOCIAL COHESION -VIOLENCE -INJURY -INFANT AND CHILD MORTALITY -CARDIOVASCULAR DISEASES -DIABETES USING A THEME OF 'HEALTHY BODIES, HEALTHY MINDS, AND HEALTHY CONNECTIONS' TO DESCRIBE A COMPREHENSIVE APPROACH TO THESE TOP HEALTH NEEDS, THE FOLLOWING INTERVENTIONS WERE PROVIDED: -FREE PHYSICAL ACTIVITY PROGRAMMING, INCLUDING YOGA -EDUCATION ON HEALTHY FOOD/NUTRITION, INCLUDING 'COOKING MATTERS' -SUICIDE PREVENTION COURSES, INCLUDING QPR AND ASIST -FACILITATION OF A COMMUNITY WIDE RESILIENCE COALITION -PROFESSIONAL TRAINING ON TRAUMA INFORMED CARE, RESILIENCE AND MINDFULNESS FOR NON-PROFITS -ADOPTION OF THE NATIONAL 'REACH OUT AND READ' PROGRAM -OPENING OF A FOOD PANTRY AND OPERATION OF MOBILE FOOD PANTRIES -FAITH NURSING PROGRAM -BURMESE REFUGE SPECIFIC PROGRAMMING AND NAVIGATION PROGRAM FRANCSICAN HEALTH LAFAYETTE TOP HEALTH NEEDS INCLUDE (TOP NEEDS FIRST): - HOUSING - ACCESS TO HEALTH CARE - SOCIAL COHESION - FOOD INSECURITY - UNSAFE SEX - NUTRITION - SUBSTANCE ABUSE - TOBACCO USE - PHYSICAL ACTIVITY - INFANT MORTALITY - CARDIOVASCULAR DISEASE - OBESITY - INJURY USING A THEME OF 'HEALTHY BODIES, HEALTHY MINDS, AND HEALTHY CONNECTIONS' TO DESCRIBE A COMPREHENSIVE APPROACH TO THESE TOP HEALTH NEEDS, THE FOLLOWING INTERVENTIONS WERE PROVIDED: -EDUCATION ON HEALTHY FOOD/NUTRITION, 'EAT SMART, MOVE MORE'COOKING MATTERS' -SUICIDE PREVENTION COURSES, INCLUDING QPR AND ASIST -SAFE KIDS LEAD AGENCY -CAR SEAT AND CHILD SAFETY PROGRAMMING -OFFERING OF YOUTH MENTAL HEALTH FIRST AID COURSE FRANCISCAN HEALTH MICHIGAN CITY TOP HEALTH NEEDS INCLUDE (TOP NEEDS FIRST): -FOOD INSECURITY -POVERTY -BEHAVIORAL HEALTH -SOCIAL COHESION -NUTRITION -SUBSTANCE ABUSE -PHYSICAL ACTIVITY -CANCER -CARDIOVASCULAR DISEASES -DIABETES -INFANT MORTALITY -TEEN PREGNANCY USING A THEME OF 'HEALTHY BODIES, HEALTHY MINDS, AND HEALTHY CONNECTIONS' TO DESCRIBE A COMPREHENSIVE APPROACH TO THESE TOP HEALTH NEEDS, THE FOLLOWING INTERVENTIONS WERE PROVIDED: -FREE PHYSICAL ACTIVITY PROGRAMMING, INCLUDING 'FIT TOGETHER' FOR FAMILIES AND 'WELLNESS WEDNESDAYS' -EDUCATION ON HEALTHY FOOD/NUTRITION, 'EAT SMART, MOVE MORE' 'COOKING MATTERS' -SUICIDE PREVENTION COURSES, INCLUDING QPR -FACILITATION OF A HEALTH EQUITY COMMITTEE -ADOPTION OF THE NATIONAL 'REACH OUT AND READ' PROGRAM -OPERATION OF A DIAPER PANTRY -PRENATAL ASSISTANCE PROGRAM
LINE 11: COMMUNITY HEALTH NEEDS ASSESSMENT CON'T	FRANCISCAN HEALTH MOORESVILLE TOP HEALTH NEEDS INCLUDE (TOP NEEDS FIRST): - ACCESS TO PRIMARY CARE - BEHAVIORAL HEALTH - SOCIAL COHESION - HOUSING - VIOLENCE - TOBACCO USE - PHYSICAL ACTIVITY - MOTOR VEHICLE DEATHS - CARDIOVASCULAR DISEASE - RESPIRATORY DISEASE - DIABETES USING A THEME OF 'HEALTHY BODIES, HEALTHY MINDS, AND HEALTHY CONNECTIONS' TO DESCRIBE A COMPREHENSIVE APPROACH TO THESE TOP HEALTH NEEDS, THE FOLLOWING INTERVENTIONS WERE PROVIDED: -EDUCATION ON HEALTHY FOOD/NUTRITION, 'COOKING MATTERS' -SUICIDE PREVENTION COURSES, INCLUDING QPR AND ASIST -FACILITATION OF A COMMUNITY WIDE RESILIENCE COALITION -PROFESSIONAL TRAINING ON TRAUMA INFORMED CARE, RESILIENCE AND MINDFULNESS FOR NON-PROFITS -ADOPTION OF THE NATIONAL 'REACH OUT AND READ' PROGRAM -OFFERING OF YOUTH MENTAL HEALTH FIRST AID COURSE -FAITH NURSING PROGRAM FRANCISCAN HEALTH OLYMPIA FIELDS TOP HEALTH NEEDS INCLUDE (TOP NEEDS FIRST): - POVERTY - ACCESS TO HEALTH CARE - PRENATAL CARE - SOCIAL COHESION - PHYSICAL ACTIVITY - NUTRITION - SUBSTANCE ABUSE - CANCER - CARDIOVASCULAR DISEASE - ASTHMA - DIABETES USING A THEME OF 'HEALTHY BODIES, HEALTHY MINDS, AND HEALTHY CONNECTIONS' TO DESCRIBE A COMPREHENSIVE APPROACH TO THESE TOP HEALTH NEEDS, THE FOLLOWING INTERVENTIONS WERE PROVIDED: -SUICIDE PREVENTION COURSES, INCLUDING QPR AND ASIST -FACILITATION OF A COMMUNITY WIDE RESILIENCE COALITION -BACK TO SCHOOL READINESS EVENT WITH VACCINATIONS AND FAMILY RESOURCES -FREE FITNESS CLASSES QUARTERLY -HEALTH EDUCATION ON CANCER AND HEART DISEASE PREVENTION
LINE 15 AND 16: ALL FACILITIES	THROUGH FRANCISCAN ALLIANCE, INC. ("FRANCISCAN"), WE CONTINUE THE HEALING MINISTRY OF CHRIST IN A CATHOLIC HEALTH CARE SYSTEM THAT UPHOLDS THE MORAL VALUES AND TEACHINGS OF THE CATHOLIC CHURCH. CENTRAL CONCERNS OF THIS CORPORATE MINISTRY INCLUDE COMPASSION FOR THOSE IN NEED, RESPECT FOR LIFE AND THE DIGNITY OF PERSONS. FRANCISCAN BELIEVES IN THE DIGNITY, UNIQUENESS, AND WORTH OF EACH INDIVIDUAL AND, WITHIN THE LIMITS OF OUR RESOURCES, FRANCISCAN OFFERS A COMPREHENSIVE RANGE OF HEALTH CARE SERVICES TO ALL REGARDLESS OF RACE, CREED, COLOR, SEX, NATIONAL ORIGIN, HANDICAP OR AN INDIVIDUAL'S FINANCIAL CAPABILITY. IN LIGHT OF THIS BELIEF, WE CONSIDER OUR HEALTH CARE SERVICES TO BE REACHING OUT AND RESPONDING, IN A CHRIST-LIKE MANNER, TO THOSE WHO ARE PHYSICALLY, MATERIALLY, OR SPIRITUALLY IN NEED. FRANCISCAN IS COMMITTED TO PROVIDING FINANCIAL ASSISTANCE, IN THE FORM OF CHARITY CARE OR UNINSURED DISCOUNTS, TO PERSONS WHO ARE UNINSURED OR UNDERINSURED, WHO ARE INELIGIBLE FOR GOVERNMENTAL OR SOCIAL SERVICE PROGRAMS, AND WHO OTHERWISE ARE UNABLE TO PAY FOR EMERGENCY SERVICES OR MEDICALLY NECESSARY CARE BASED ON THEIR INDIVIDUAL FINANCIAL SITUATION. CONSISTENT WITH OUR MISSION TO DELIVER COMPASSIONATE, HIGH QUALITY, AFFORDABLE HEALTH CARE AND TO ADVOCATE FOR THOSE WHO ARE POOR AND DISENFRANCHISED, FRANCISCAN STRIVES TO ENSURE THE FINANCIAL CAPACITY OF PEOPLE WHO NEED MEDICALLY NECESSARY HEALTH CARE SERVICES DOES NOT PREVENT THEM FROM SEEKING OR RECEIVING THAT CARE. FRANCISCAN'S FINANCIAL ASSISTANCE POLICY IS DESIGNED TO ALLOW RELIEF FROM ALL OR PART OF THE CHARGES RELATED TO EMERGENCY OR MEDICALLY NECESSARY HEALTH CARE SERVICES THAT EXCEED A PATIENT'S REASONABLE ABILITY TO PAY. IN ORDER TO ENSURE TRANSPARENCY, CONSISTENCY AND FAIRNESS, WE ASK PATIENTS TO COOPERATE BY PROVIDING NECESSARY INFORMATION TO DETERMINE THEIR ELIGIBILITY FOR FINANCIAL ASSISTANCE. FOR PATIENTS NOT INITIALLY IDENTIFIED AS QUALIFYING FOR FINANCIAL ASSISTANCE, FRANCISCAN COMMUNICATES THE AVAILABILITY OF CHARITY CARE AND FINANCIAL ASSISTANCE IN THE APPLICABLE LANGUAGES OF THE HOSPITAL COMMUNITY THROUGH THE FOLLOWING MEANS: 1. FRANCISCAN COMMUNICATES THE AVAILABILITY OF FINANCIAL ASSISTANCE IN APPROPRIATE CARE SETTINGS SUCH AS EMERGENCY DEPARTMENTS, ADMITTING/REGISTRATION AREAS, BILLING OFFICES, OUTPATIENT SERVICE SETTINGS, AND ON OUR HOSPITALS' WEBSITES. SIGNS/POSTINGS INFORM PATIENTS THAT FREE OR REDUCED COST CARE MAY BE AVAILABLE TO QUALIFYING PATIENTS WHO COMPLETE A FINANCIAL ASSISTANCE APPLICATION. 2. BROCHURES SUMMARIZING OUR FINANCIAL ASSISTANCE PROGRAMS ARE AVAILABLE THROUGHOUT EACH FRANCISCAN HOSPITAL. 3. FINANCIAL COUNSELORS AND BUSINESS OFFICE PERSONNEL ARE AVAILABLE TO HELP PATIENTS UNDERSTAND AND APPLY FOR LOCAL, STATE, FEDERAL HEALTH CARE, AND HEALTH INSURANCE EXCHANGE PROGRAMS AND FRANCISCAN'S FINANCIAL ASSISTANCE PROGRAMS. 4. ALL BILLS AND STATEMENTS FOR SERVICES INFORM UNINSURED PATIENTS THAT FINANCIAL ASSISTANCE IS AVAILABLE. 5. PATIENTS/GUARANTORS MAY REQUEST A COPY OF THE FINANCIAL ASSISTANCE APPLICATION BY CALLING THE FRANCISCAN BILLING OFFICE OR DOWNLOADING A COPY AT NO COST FROM FRANCISCAN HOSPITAL'S WEBSITES. 6. PATIENTS/GUARANTORS CAN REQUEST FINANCIAL ASSISTANCE INFORMATION BY CALLING FRANCISCAN'S BILLING OFFICE PHONE LINE ON A 24-HOUR BASIS. 7. INDIVIDUALS OTHER THAN THE PATIENT, SUCH AS THE PATIENT'S PHYSICIAN, FAMILY MEMBERS, COMMUNITY OR RELIGIOUS GROUPS, SOCIAL SERVICES, OR HOSPITAL PERSONNEL MAY MAKE REQUESTS FOR FINANCIAL ASSISTANCE ON THE PATIENT'S BEHALF, SUBJECT TO APPLICABLE PRIVACY LAWS. 8. PRIOR TO TRANSFER TO A COLLECTION AGENCY, FRANCISCAN SENDS A MINIMUM OF 4 STATEMENTS AND MAKES 6 PHONE CALL ATTEMPTS TO CONTACT THE PATIENT/GUARANTOR AT THE ADDRESS AND PHONE NUMBER PROVIDED BY THE PATIENT/GUARANTOR. STATEMENTS AND COMMUNICATIONS INFORM THE PATIENT OF THE AMOUNT DUE AND IF THEY CANNOT PAY THEIR BALANCE THE AVAILABILITY OF FINANCIAL ASSISTANCE. A PATIENT'S QUALIFICATION FOR CHARITY CARE IS DETERMINED THROUGH A FINANCIAL ASSISTANCE APPLICATION AND SCREENING PROCESS. PATIENTS WHO MAY QUALIFY FOR MEDICAID OR ANY OTHER GOVERNMENTAL ASSISTANCE MUST BE DENIED COVERAGE OR ASSISTANCE FROM THOSE GOVERNMENTAL PROGRAMS PRIOR TO RECEIVING APPROVAL FOR CHARITY CARE. AS SUCH, FRANCISCAN OFFERS PATIENTS ASSISTANCE IN APPLYING OR ENROLLING IN SUCH PROGRAMS. A PATIENT WILL NEED TO FILL OUT, SIGN, AND SUBMIT THE FINANCIAL ASSISTANCE APPLICATION ALONG WITH ALL REQUESTED DOCUMENTATION OF INCOME, EXPENSES, ASSETS, AND LIABILITIES. FRANCISCAN'S BILLING OFFICE WILL PLACE THE PATIENT'S ACCOUNT ON HOLD ONCE A FINANCIAL ASSISTANCE APPLICATION HAS BEEN REQUESTED AND UNTIL A FINANCIAL ASSISTANCE DETERMINATION IS MADE. APPLICANTS ARE TREATED WITH DIGNITY AND RESPECT THROUGHOUT THE FINANCIAL ASSISTANCE PROCESS AND ALL INFORMATION/MATERIALS RECEIVED ARE CONFIDENTIALLY MAINTAINED. FRANCISCAN ALSO UTILIZES AN EXTERNAL VENDOR, SERVICE, OR DATA SOURCE THAT PROVIDES INFORMATION ON A PATIENT'S OR GUARANTOR'S ABILITY TO PAY (I.E. CREDIT SCORING). ELIGIBILITY FOR CHARITY CARE MAY BE DETERMINED AT ANY POINT IN THE COLLECTIONS CYCLE (I.E. PRIOR TO THE PROVISION OF SERVICES, DURING THE NORMAL COLLECTIONS CYCLE, OR MAY BE USED TO RE-CLASSIFY ACCOUNTS AFTER THEY HAVE BEEN DEEMED UNCOLLECTIBLE AND SUBSEQUENTLY RETURNED FROM A THIRD PARTY COLLECTION AGENCY). ONCE APPROVED, THE PATIENT WILL REMAIN ELIGIBLE FOR CHARITY CARE FOR A MAXIMUM OF FOUR MONTHS. THE ELIGIBILITY PERIOD WILL BEGIN FROM THE DATE OF THE PATIENT'S APPROVAL OF CHARITY CARE. CHARITY CARE DISCOUNTS WILL BE GIVEN FOR CURRENT OPEN ACCOUNTS AND THE FOLLOWING FOUR MONTHS OF EMERGENCY SERVICES OR MEDICALLY NECESSARY CARE. AFTER THE ELIGIBILITY PERIOD HAS ELAPSED, THE PATIENT MUST REAPPLY FOR FINANCIAL ASSISTANCE.
LINES 16A, 16B, AND 16C: ALL FACILITIES	THE FINANCIAL ASSISTANCE POLICY ("FAP"), FAP APPLICATION FORM, AND PLAIN LANGUAGE SUMMARY OF THE FAP ARE AVAILABLE AT THE FOLLOWING ADDRESS: HTTPS://STATEMENTS.FRANCISCANALLIANCE.ORG/INFO/FINANCIALASSISTANCE.ASPX
LINE 22: FRANCISCAN HEALTH OLYMPIA FIELDS	FRANCISCAN HEALTH OLYMPIA FIELDS COMPUTES THE MAXIMUM AMOUNTS CHARGED TO FINANCIAL ASSISTANCE POLICY-ELIGIBLE INDIVIDUALS BASED ON THE ILLINOIS UNINSURED DISCOUNT ACT. UNDER THIS ACT, ILLINOIS FACILITIES CANNOT CHARGE GREATER THAN 135% OF COST. THIS METHOD RESULTS IN A LARGER DISCOUNT THAN THAT DETERMINED BY THE FEDERAL CALCULATION.

Schedule H (Form 990) 2023

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?131
Name and address		Type of Facility (describe)
1	FRANCISCAN HEALTH 5255 MED BLDG 5255 E STOP 11 RD INDIANAPOLIS,IN46237	PHYSICIAN PRACTICE
2	INDIANA HEART PHYSICIANS 5330 E STOP 11 RD INDIANAPOLIS,IN46237	CARDIOVASCULAR
3	FPN LAFAYETTE 3920 ST FRANCIS WAY LAFAYETTE,IN47905	PHYSICIAN PRACTICE
4	FPN FRANCISCAN MEDICAL PAVILION 3500 FRANCISCAN WAY MICHIGAN CITY,IN46360	MEDICAL PAVILION
5	FRANCISCAN HAMMOND CLINIC 7905 CALUMET AVE MUNSTER,IN46321	FAMILY WELLNESS CENTER
6	FPN LAFAYETTE EAST 1701 S CREASY LN LAFAYETTE,IN47905	PHYSICIAN PRACTICE
7	FPN CROWN POINT SPECIALTY CTR 1205 S MAIN ST CROWN POINT,IN46307	PHYSICIAN PRACTICE
8	FRANCISCAN MEDICAL PAVILLION 3700 W 203RD ST OLYMPIA FIELDS,IL60461	PHYSICIAN PRACTICE
9	FPN MEDICAL PAVILION SOUTH 2150 GETTLER ST DYER,IN46311	MEDICAL PAVILION
10	FRANCISCAN HEALTH SPECIALITY CLINIC 8111 S EMERSON AVE INDIANAPOLIS,IN46237	PHYSICIAN PRACTICE
11	FRANCISCAN HEALTH 5230 MEDICAL BLDG 5230 E STOP 11 RD INDIANAPOLIS,IN46237	PHYSICIAN PRACTICE
12	WOODLAND HEALTH CTR 8865 W 400 N MICHIGAN CITY,IN46360	PHYSICIAN PRACTICE
13	MICHIGAN CITY COOLSPRING HEALTH CTR 1225 E COOLSPRING AVE MICHIGAN CITY,IN46360	PHYSICIAN PRACTICE
14	FRANCISCAN HEALTH MUNSTER BLDG 701 SUPERIOR AVE MUNSTER,IN46321	PHYSICIAN PRACTICE
15	FRANCISCAN MUNSTER 761 MEDICAL BLDG 761 45TH AVE MUNSTER,IN46321	PHYSICIAN PRACTICE
16	SPI - CRAWFORD AVE MEDICAL 20201 CRAWFORD AVE OLYMPIA FIELDS,IL60461	PHYSICIAN PRACTICE
17	FPN INDIANAPOLIS 8051 S EMERSON AVE INDIANAPOLIS,IN46237	PHYSICIAN PRACTICE
18	DYER OUT PATIENT REHAB 24 JOLIET ST DYER,IN46311	PHYSICIAN PRACTICE
19	FPN JOINT REPLACEMENT SURGEONS 1199 HADLEY RD MOORESVILLE,IN46158	PHYSICIAN PRACTICE
20	FPN FAMILY WELLNESS CTR 9800 VALPARAISO DR MUNSTER,IN46321	PHYSICIAN PRACTICE
21	FPN STONES CROSSING 1703 W STONES CROSSING RD GREENWOOD,IN46143	PHYSICIAN PRACTICE
22	COLUMBUS PRIMARY & SPECIALTY CARE 123 2ND ST COLUMBUS,IN47201	PHYSICIAN PRACTICE
23	FRANCISCAN HEALTH CROWN POINT MEDICAL OF 1201 S Main St CROWN POINT,IN46307	EXPRESS CARE CLINIC
24	FRANCISCAN POINT 12800 MISSISSIPPI PKWY CROWN POINT,IN46307	PHYSICIAN PRACTICE
25	ST FRANCIS WAY MEDICAL BLDG LAFAYETTE 3900 ST FRANCIS WAY LAFAYETTE,IN47905	PHYSICIAN PRACTICE
26	FPN EXPRESS CARE & IMAGING CTR 909 SAGAMORE PKWY W WEST LAFAYETTE,IN47906	EXPRESS CARE CLINIC/IMAGING
27	FPN WEST LAFAYETTE 915 SAGAMORE PKWY WEST WEST LAFAYETTE,IN47906	PHYSICIAN PRACTICE
28	FPN COUNTY LINE MEDICAL 747 E COUNTY LINE RD GREENWOOD,IN46143	PHYSICIAN PRACTICE
29	HEART AND VASCULAR INSTITUTE 3800 W 203RD ST OLYMPIA FIELDS,IL60461	CARDIOVASCULAR
30	FRANCISCAN MEDICAL SPECIALISTS - DYER 919 MAIN ST DYER,IN46311	PHYSICIAN PRACTICE
31	FRANCISCAN HEALTH CTR FOR WOMEN MOORESVI 1205 HADLEY RD MOORESVILLE,IN46158	PHYSICIAN PRACTICE
32	FPN CROWN POINT PEDIATRIC HEALTH CTR 1141 S INDIANA AVE CROWN POINT,IN46307	PHYSICIAN PRACTICE
33	FPN VALPARAISO HEALTH CTR 2421 LAPORTE AVE VALPARAISO,IN46383	PHYSICIAN PRACTICE
34	FRANCISCAN HEALTH MOORESVILLE PROFESSION 1215 HADLEY RD MOORESVILLE,IN46158	SURGERY/ENDOSCOPY CENTER
35	PHYSICIAN OFFICE WINFIELD HEALTH CTR 11161 RANDOLPH ST CROWN POINT,IN46307	PHYSICIAN PRACTICE
36	FRANCISCAN HEALTH MOORESVILLE PAVILLON 1001 HADLEY RD MOORESVILLE,IN46158	PHYSICIAN PRACTICE
37	PEDIATRIC ASSOCIATES OF GREENWOOD 900 AVERITT RD GREENWOOD,IN46143	PHYSICIAN PRACTICE
38	FRANCISCAN EXPRESSCARE THOMPSON COMMONS 5210 E THOMPSON RD INDIANAPOLIS,IN46237	EXPRESS CARE CLINIC
39	FRANCISCAN COMMUNITY CARE 1400 OTTO BLVD CHICAGO HEIGHTS,IL60411	PHYSICIAN PRACTICE
40	FPN CHESTERTON MEDICAL OFFICE BLDG 770 INDIAN BOUNDARY RD CHESTERTON,IN46304	PHYSICIAN PRACTICE
41	FPN CARMEL 12188B N MERIDIAN CARMEL,IN46032	EXPRESS CARE CLINIC
42	FPN 1630 CRAWFORDSVILLE 1630 LAFAYETTE RD CRAWFORDSVILLE,IN47933	PHYSICIAN PRACTICE
43	FPN BRDWAY HEALTH CTR 9470 BRDWAY CROWN POINT,IN46307	PHYSICIAN PRACTICE
44	INDIANAPOLIS MADISON AVE FRANCISCAN EXPR 1001 N MADISON AVE GREENWOOD,IN46142	EXPRESS CARE CLINIC
45	FRANKLIN TOWNSHIP FAMILY MEDICINE 8325 E SOUTHPORT RD INDIANAPOLIS,IN46259	PHYSICIAN PRACTICE
46	FPN HP MC EXPRESSCARE 4111 FRANKLIN ST MICHIGAN CITY,IN46360	EXPRESS CARE CLINIC
47	SOUTHEAST FAMILY MEDICINE 965 EMERSON PKWY GREENWOOD,IN46143	PHYSICIAN PRACTICE
48	FPN SOUTHSIDE FAMILY PRACTICE CRAWFORDSV 1640 CRAWFORDSVILLE SQ DR CRAWFORDSVILLE,IN47933	PHYSICIAN PRACTICE
49	LAFAYETTE FRANCISCAN HEALTHY LIVING CLIN 1116 N 16TH ST LAFAYETTE,IN47904	PHYSICIAN PRACTICE
50	PLAINFIELD MEDICAL CTR 315 N DAN JONES RD PLAINFIELD,IN46168	PHYSICIAN PRACTICE
51	FPN MICHIGAN CITY 3723 FRANKLIN ST MICHIGAN CITY,IN46360	PHYSICIAN PRACTICE
52	ST JOHN FAMILY SERVICES 10860 MAPLE LANE SAINT JOHN,IN46373	PHYSICIAN PRACTICE
53	FPN 400 NORTH HEALTH CTR 8733 W 400 N MICHIGAN CITY,IN46360	PHYSICIAN PRACTICE
54	BEECH GROVE FAMILY MEDICINE 2030 CHURCHMAN AVE BEECH GROVE,IN46107	PHYSICIAN PRACTICE
55	FPN SCHERERVILLE HEALTH CTR 7310 W LINCOLN HWY CROWN POINT,IN46307	PHYSICIAN PRACTICE
56	HEARTLAND INTERNAL MEDICINE 10701 ALLIANCE DR CAMBY,IN46113	CARDIOVASCULAR
57	FPN MICHIGAN CITY 8955 W 400 NORTH MICHIGAN CITY,IN46360	PHYSICIAN PRACTICE
58	FPN SOUTH 31 FAMILY CARE 610 E SOUTHPORT RD INDIANAPOLIS,IN46227	PHYSICIAN PRACTICE
59	CROWN POINT MEDICAL ARTS CTR 297 W FRANCISCAN DR CROWN POINT,IN46307	PHYSICIAN PRACTICE
60	SOUTHPORT FP AND SPORTS MEDICINE 7825 MCFARLAND LN INDIANAPOLIS,IN46237	PHYSICIAN PRACTICE
61	GREENWOOD PARKE FAMILY MEDICINE 701 E COUNTYLINE RD GREENWOOD,IN46143	SLEEP CENTER
62	FRANCISCAN HEALTH CITYWAY 426 S ALABAMA ST INDIANAPOLIS,IN46225	PHYSICIAN PRACTICE
63	FPN OMNI FAMILY HEALTH CTR 221 US HWY 41 SCHERERVILLE,IN46375	PHYSICIAN PRACTICE
64	FPN RENSSELAER MED CTR - FM & GEN SURGER 118 W DREXEL PKWY RENSSELAER,IN47978	PHYSICIAN PRACTICE
65	FPN DYER FAMILY HEALTH CTR 840 RICHARD RD DYER,IN46311	PHYSICIAN PRACTICE
66	INDIANA HEART PHYSICIANS MOORESVILLE 1201 HADLEY RD MOORESVILLE,IN46158	CARDIOVASCULAR
67	LAFAYETTE FERRY ST MEDICAL BLDG 2708 FERRY ST LAFAYETTE,IN47904	PHYSICIAN PRACTICE
68	FPN 1710 CRAWFORDSVILLE 1710 LAFAYETTE RD CRAWFORDSVILLE,IN47933	PHYSICIAN PRACTICE
69	FPN CEDAR LAKE HEALTH CTR 6831 133RD AVE CEDAR LAKE,IN46303	PHYSICIAN PRACTICE
70	OLYMPIA FIELDS COMPREHENSIVE CANCER INST 3900 W 203RD ST OLYMPIA FIELDS,IL60461	PHYSICIAN PRACTICE
71	FPN LOWELL HEALTH CTR 4500 WEST 181ST AVE LOWELL,IN46356	PHYSICIAN PRACTICE
72	FPN LAFAYETTE YMCA 3001 S CREASY LN LAFAYETTE,IN47905	PHYSICIAN PRACTICE
73	GREENWOOD MERIDIAN PARKE MEDICAL BLDG 362 MERIDIAN PARKE LN GREENWOOD,IN46142	PHYSICIAN PRACTICE
74	MATTESON HEALTH CTR 20939 S CICERO AVE MATTESON,IL60443	PHYSICIAN PRACTICE
75	HOBART EXPRESS CARE & WORKING WELL 101 W 61ST AVE HOBART,IN46342	EXPRESS CARE CLINIC/WORKING WELL
76	DUNELAND HEALTH AND WELLNESS 810 MICHAEL DR CHESTERTON,IN46304	PHYSICIAN PRACTICE
77	FPN INDY SOUTHSIDE FAMILY MEDICINE 4018 EAST SOUTHPORT RD INDIANAPOLIS,IN46237	PHYSICIAN PRACTICE
78	FRANCISCAN EXPRESSCARE RENSSELAER 919 E GRACE ST RENSSELAER,IN47978	EXPRESS CARE CLINIC
79	INDIANA HEART PHYSICIANS SHELBYVILLE 2451 INTELLIPLEX DR SHELBYVILLE,IN46176	CARDIOVASCULAR
80	FRANCISCAN BEHAVIORAL HEALTH NORTHPOINT 2050 N MAIN ST CROWN POINT,IN46307	PHYSICIAN PRACTICE
81	CRAWFORDSVILLE EAST SIDE FAMILY MEDICINE 2056 LEBANON RD CRAWFORDSVILLE,IN47933	PHYSICIAN PRACTICE
82	FRANCISCAN MUNSTER 759 MEDICAL BLDG 759 45TH AVE MUNSTER,IN46321	PHYSICIAN PRACTICE
83	FPN COLUMBUS SPECIALTY CTR 4035 Mimosa Dr COLUMBUS,IN47201	PHYSICIAN PRACTICE
84	CRAWFORDSVILLE FRANCISCAN HEALTH LIVING 1704 LAFAYETTE RD CRAWFORDSVILLE,IN47933	PHYSICIAN PRACTICE
85	TINLEY PARK WALK-IN CLINIC 16650 HARLEM AVE TINLEY PARK,IL60477	PHYSICIAN PRACTICE
86	WHITE OAK PROFESSIONAL BLDG 1644 45TH ST MUNSTER,IN46321	PHYSICIAN PRACTICE
87	VALPARAISO EXPRESSCARE & WORKING WELL 2307 LAPORTE AVE VALPARAISO,IN46383	EXPRESS CARE CLINIC/WORKING WE WORKING WELL
88	FRANCISCAN MEDICAL SPECIALISTS - HAMMOND 5529 HOHMAN AVE HAMMOND,IN46320	PHYSICIAN PRACTICE
89	FPN ST CLARE CLINIC 1121 S INDIANA AVE CROWN POINT,IN46307	PHYSICIAN PRACTICE
90	INDIANAPOLIS WORKING WELL ALABAMA ST 325 S ALABAMA ST INDIANAPOLIS,IN46204	PHYSICIAN PRACTICE
91	GREENWOOD SPRINGS MEDICAL BLDG 1040 GREENWOOD SPRINGS BLVD GREENWOOD,IN46143	PHYSICIAN PRACTICE
92	CONFIDENTIAL CARE LTD 720 45TH ST MUNSTER,IN46321	PHYSICIAN PRACTICE
93	FRANCISCAN EXPRESSCARE CARMEL 10767 ILLINOIS ST CARMEL,IN46032	EXPRESS CARE CLINIC
94	LAPORTE MEDICAL GROUP SURGICAL CTR 900 I ST LAPORTE,IN46350	PHYSICIAN PRACTICE
95	FRANCISCAN EXPRESSCARE PORTAGE 3283 WILLOWCREEK RD PORTAGE,IN46368	EXPRESS CARE CLINIC
96	HOMEWOOD HEALTH CTR 18636 DIXIE HWY HOMEWOOD,IL60430	PHYSICIAN PRACTICE
97	FPN GREENCASTLE 1542 S BLOOMINGTON ST GREENCASTLE,IN46135	PHYSICIAN PRACTICE
98	SPI OLYMPIA FIELDS CRAWFORD AVE 20303 CRAWFORD AVE OLYMPIA FIELDS,IL60461	PHYSICIAN PRACTICE
99	FRANCISCAN HEALTH HAMMOND 5454 HOHMAN AVE HAMMOND,IN46320	PHYSICIAN PRACTICE
100	FPN CARDIOLOGY - LOGANSPORT 1201 MICHIGAN AVE LOGANSPORT,IN46947	PHYSICIAN PRACTICE
101	FPN INDY SOUTH 7855 S EMERSON AV INDIANAPOLIS,IN46237	PHYSICIAN PRACTICE
102	MARIE CANINE CANCER CTR 1706 LAFAYETTE RD CRAWFORDSVILLE,IN47933	PHYSICIAN PRACTICE
103	FPN VALPARAISO SPECIALTY HEALTH CTR 2590 MORTHLAND DR VALPARAISO,IN46385	PHYSICIAN PRACTICE
104	INDIANA HEART PHYSICIANS GREENSBURG 720 N LINCOLN ST GREENSBURG,IN47240	CARDIOVASCULAR
105	INDIANA PACKERS EMPLOYEE HEALTH CLINIC 1165 NORTH US 421 DELPHI,IN46923	PHYSICIAN PRACTICE
106	HAMMOND FAMILY HEALTH CTR 5530 HOHMAN AVE HAMMOND,IN46320	PHYSICIAN PRACTICE
107	CHICAGO HEIGHTS PROFESSIONAL BLDG 30 E 15TH ST CHICAGO HEIGHTS,IL60411	RESIDENCY CLINIC
108	OLYMPIA FIELDS PAVILION 20121 CRAWFORD AVE OLYMPIA FIELDS,IL60461	MEDICAL PAVILION
109	LAPORTE LEGACY HILLS HEALTH CTR 309 W JOHNSON RD LA PORTE,IN46350	PHYSICIAN PRACTICE
110	FRANKLIN JEFFERSON ST MEDICAL BLDG 1300 W JEFFERSON ST FRANKLIN,IN46131	PHYSICIAN PRACTICE
111	WORKING WELL MADISON AVE 300 S MADISON AVE GREENWOOD,IN46142	PHYSICIAN PRACTICE
112	PURDUE UNIVERSITY SPORTS MEDICINE 900 N JOHN R WOODEN DR WEST LAFAYETTE,IN47907	PHYSICIAN PRACTICE
113	HEALTH & WELLNESS - UNIVERSITY OF SAINT 1516 LEESBURG RD FORT WAYNE,IN46808	PHYSICIAN PRACTICE
114	FPN INDY SOUTHSIDE SURGICAL 1203 HADLEY RD MOORESVILLE,IN46158	PHYSICIAN PRACTICE
115	CRAWFORDSVILLE ATHENS OUTPATIENT CTR 1660 LAFAYETTE RD CRAWFORDSVILLE,IN47933	PHYSICIAN PRACTICE
116	BUTLER UNIVERSITY SPORTS MEDICINE 510 W 49TH ST INDIANAPOLIS,IN46208	PHYSICIAN PRACTICE
117	FRANCISCAN BROOK HEALTH CTR 420 E MAIN ST BROOK,IN47922	PHYSICIAN PRACTICE
118	DEFRIES CHIROPRACTIC CTR 492 S BIERMA ST WHEATFIELD,IN46392	PHYSICIAN PRACTICE
119	FPN HAMMOND FAMILY HEALTH CTR 5500 HOHMAN AVE HAMMOND,IN46320	PHYSICIAN PRACTICE
120	LAFAYETTE HUNTERS PLAZA BLDG 3218 DAUGHERTY DR LAFAYETTE,IN47909	PHYSICIAN PRACTICE
121	FPN OF ILLINOIS EXPRESSCARE 20180 S LAGRANGE RD FRANKFORT,IL60423	EXPRESS CARE CLINIC
122	IBMT OUTREACH CLINIC 5340 HOLY CROSS PKWY MISHAWAKA,IN46545	PHYSICIAN PRACTICE
123	FPN MONTICELLO MEDICAL CTR 826 N 6TH ST MONTICELLO,IN47960	MEDICAL PRACTICE
124	FRANCISCAN HEALTH ST JOHN 8345 WICKER AVE SAINT JOHN,IN46373	PHYSICIAN PRACTICE
125	FPN DEMOTTE HEALTH CTR 200 3RD COURT SE DEMOTTE,IN46310	PHYSICIAN PRACTICE
126	FPN ILLINOIS 333 DIXIE HWY CHICAGO HEIGHTS,IL60411	PHYSICIAN PRACTICE
127	PREFERRED PEDIATRICS OF LAFAYETTE 3774 BAYLEY DR LAFAYETTE,IN47905	PHYSICIAN PRACTICE
128	SPI - PARK FOREST 344 VICTORY DR PARK FOREST,IL60466	PHYSICIAN PRACTICE
129	FPN LAKE RIDGE FAMILY HEALTH CTR 1573 N CLINE AVE GRIFFITH,IN46319	PHYSICIAN PRACTICE
130	CRAWFORDSVILLE FAMILY CARE 308 W MARKET ST CRAWFORDSVILLE,IN47933	PHYSICIAN PRACTICE
131	HONEY GROVE FAMILY MEDICINE 1711 S STATE RD 135 GREENWOOD,IN46143	PHYSICIAN PRACTICE

Schedule H (Form 990) 2023

Page 10

Part VI

Supplemental Information

Provide the following information.

1	Required descriptions. Provide the descriptions required for Part I, lines 3c, 6a, and 7; Part II and Part III, lines 2, 3, 4, 8 and 9b.
2	Needs assessment. Describe how the organization assesses the health care needs of the communities it serves, in addition to any CHNAs reported in Part V, Section B.
3	Patient education of eligibility for assistance. Describe how the organization informs and educates patients and persons who may be billed for patient care about their eligibility for assistance under federal, state, or local government programs or under the organization’s financial assistance policy.
4	Community information. Describe the community the organization serves, taking into account the geographic area and demographic constituents it serves.
5	Promotion of community health. Provide any other information important to describing how the organization’s hospital facilities or other health care facilities further its exempt purpose by promoting the health of the community (e.g., open medical staff, community board, use of surplus funds, etc.).
6	Affiliated health care system. If the organization is part of an affiliated health care system, describe the respective roles of the organization and its affiliates in promoting the health of the communities served.
7	State filing of community benefit report. If applicable, identify all states with which the organization, or a related organization, files a community benefit report.

Form and Line Reference	Explanation
SCHEDULE H, PART VI, ITEM 2	NEEDS ASSESSMENT FRANCISCAN ALLIANCE, INC. ("FRANCISCAN") HOSPITALS ASSESS THE HEALTH CARE NEEDS OF THE COMMUNITIES WE SERVE BY COLLABORATING WITH PUBLIC AND PRIVATE AGENCIES TO DETERMINE COMMUNITY HEALTH NEEDS AND HOW BEST TO ADDRESS THEM. FRANCISCAN'S SYSTEM-WIDE COMMUNITY BENEFIT COMMITTEE, AS WELL AS COMMITTEES IN THE LOCAL FACILITIES, COMMITTED TO AN ONGOING ASSESSMENT OF COMMUNITY HEALTH NEEDS AND PRIORITIES BASED UPON HEALTH INITIATIVES OF THE MUNICIPAL, COUNTY, AND STATE HEALTH DEPARTMENTS, COMMUNITY-BASED ASSESSMENTS BY OTHER PUBLIC SECTOR PARTNERS, PROFESSIONAL RESEARCH CONSULTANT REPORTS, AND FAITH-BASED PARTNERS WITHIN THE COMMUNITIES SERVED. IN ADDITION, OUR HOSPITALS ADDRESS PUBLIC AGENCY AND COMMUNITY GROUP REQUESTS TO PROVIDE COMMUNITY BENEFIT ACTIVITIES AND PROGRAMS THAT MEET CERTAIN SPECIALTY OR HYBRID NEEDS OR POPULATIONS. THE DETAILED CHNA ACTIVITIES FOR EACH OF FRANCISCAN'S HOSPITALS CAN BE FOUND IN PART V OF THIS SCHEDULE H. ------------------------------------------------------------------- SCHEDULE H, PART VI, ITEM 3 FINANCIAL ASSISTANCE POLICY FRANCISCAN'S HOSPITALS INFORM AND EDUCATE PATIENTS AND PERSONS WHO MAY BE BILLED FOR PATIENT CARE ABOUT THEIR ELIGIBILITY FOR ASSISTANCE UNDER FEDERAL, STATE, OR LOCAL GOVERNMENT PROGRAMS OR UNDER FRANCISCAN'S FINANCIAL ASSISTANCE AND CHARITY CARE POLICY. FOR PATIENTS NOT INITIALLY IDENTIFIED AS QUALIFYING FOR FINANCIAL ASSISTANCE, FRANCISCAN COMMUNICATES THE AVAILABILITY OF CHARITY CARE AND FINANCIAL ASSISTANCE IN THE APPLICABLE LANGUAGES OF THE HOSPITAL COMMUNITY THROUGH THE FOLLOWING MEANS: 1. FRANCISCAN COMMUNICATES THE AVAILABILITY OF FINANCIAL ASSISTANCE IN APPROPRIATE CARE SETTINGS SUCH AS EMERGENCY DEPARTMENTS, ADMITTING/REGISTRATION AREAS, BILLING OFFICES, OUTPATIENT SERVICE SETTINGS, AND ON OUR HOSPITALS' WEBSITES. SIGNS/POSTINGS INFORM PATIENTS THAT FREE OR REDUCED COST CARE MAY BE AVAILABLE TO QUALIFYING PATIENTS WHO COMPLETE A FINANCIAL ASSISTANCE APPLICATION. 2. BROCHURES SUMMARIZING OUR FINANCIAL ASSISTANCE PROGRAMS ARE AVAILABLE THROUGHOUT EACH FRANCISCAN HOSPITAL. 3. FINANCIAL COUNSELORS AND BUSINESS OFFICE PERSONNEL ARE AVAILABLE TO HELP PATIENTS UNDERSTAND AND APPLY FOR LOCAL, STATE, FEDERAL HEALTH CARE PROGRAMS; HEALTH INSURANCE EXCHANGES; AND FRANCISCAN'S FINANCIAL ASSISTANCE PROGRAMS. 4. ALL BILLS AND STATEMENTS FOR SERVICES INFORM UNINSURED PATIENTS THAT FINANCIAL ASSISTANCE IS AVAILABLE. 5. PATIENTS/GUARANTORS MAY REQUEST A COPY OF THE FINANCIAL ASSISTANCE APPLICATION BY CALLING THE FRANCISCAN BILLING OFFICE OR DOWNLOADING A COPY AT NO COST FROM FRANCISCAN HOSPITAL'S WEBSITES. 6. PATIENTS/GUARANTORS CAN REQUEST FINANCIAL ASSISTANCE INFORMATION BY CALLING FRANCISCAN'S BILLING OFFICE PHONE LINE ON A 24-HOUR BASIS. 7. INDIVIDUALS OTHER THAN THE PATIENT, SUCH AS THE PATIENT'S PHYSICIAN, FAMILY MEMBERS, COMMUNITY OR RELIGIOUS GROUPS, SOCIAL SERVICES, OR HOSPITAL PERSONNEL MAY MAKE REQUESTS FOR FINANCIAL ASSISTANCE ON THE PATIENT'S BEHALF, SUBJECT TO APPLICABLE PRIVACY LAWS. 8. FRANCISCAN SENDS 4 STATEMENTS AND MAKES 6 PHONE CALL ATTEMPTS TO CONTACT THE PATIENT/GUARANTOR AT THE ADDRESS AND PHONE NUMBER PROVIDED BY THE PATIENT/GUARANTOR. STATEMENTS AND COMMUNICATIONS INFORM THE PATIENT OF THE AMOUNT DUE AND IF THEY CANNOT PAY THEIR BALANCE THE AVAILABILITY OF FINANCIAL ASSISTANCE. ------------------------------------------------ SCHEDULE H, PART VI, ITEM 4 COMMUNITY INFORMATION THE FRANCISCAN ALLIANCE SERVES A LARGE GEOGRAPHIC AREA WHICH INCLUDES 18 COUNTIES IN INDIANA (BENTON, CARROLL, FOUNTAIN, HAMILTON, JASPER, JOHNSON, LAKE, LAPORTE, MARION, MONTGOMERY, MORGAN, NEWTON, PORTER, SHELBY, STARKE, TIPPECANOE, WARREN, AND WHITE) AND 3 COUNTIES IN ILLINOIS (COOK, KANKAKEE, AND WILL). THE POPULATION OF THE COMMUNITIES THAT WE SERVE WAS ESTIMATED CLOSE TO 3.96 MILLION PEOPLE WITH AN AVERAGE HOUSEHOLD INCOME JUST ABOVE $74,100 IN 2024. FOR THESE COMMUNITIES, THE PERCENTAGE OF RESIDENTS BELOW THE FEDERAL POVERTY LEVEL WAS ESTIMATED AT 12.9%. THE PERCENTAGE OF INPATIENTS FROM THESE COMMUNITIES WHO WERE SERVED BY MEDICAID WAS 24.6% AND THE PERCENTAGE OF INPATIENTS FROM THESE COMMUNITIES WHO WERE UNINSURED WAS APPROXIMATELY 3.4%. FOR PURPOSES OF THE COMMUNITY HEALTH NEEDS ASSESSMENTS AND COMMUNITY HEALTH IMPROVEMENT PLANS, THE 'COMMUNITY' HAS MORE RESTRICTIVE BOUNDARIES THAN LISTED ABOVE. BECAUSE MOST HOSPITALS ARE IN AREAS OF THE MOST VULNERABLE OF THE POPULATION. BY BEING MORE STRATEGIC ABOUT SPECIFIC CITIES, TOWNS, ZIP CODES, COUNTIES, OR VILLAGES, THE INTENT OF THE COMMUNITY BENEFIT REGULATION IS HONORED, CONCENTRATING SERVICES AND RESOURCES IN THE MOST CHALLENGED AREAS. ------------------------------------------------ SCHEDULE H, PART VI, ITEM 5 & PART I, LINE 6A OTHER INFORMATION PLEASE VIEW WWW.FRANCISCANHEALTH.ORG/ABOUT/WHO-WE-ARE WHICH REFLECTS OUR MISSION OF "CONTINUING CHRIST'S MINISTRY IN OUR FRANCISCAN TRADITION." AS WELL AS WWW.FRANCISCANHEALTH.ORG/COMMUNITYHEALTH FOR FRANCISCAN'S COMMUNITY BENEFIT AND COMMUNITY HEALTH ASSESMENTS. ALTHOUGH IT IS NOT ALL INCLUSIVE OF THE MANY BENEFITS PROVIDED BY FRANCISCAN IT DOES PORTRAY THE SIGNIFICANT BENEFITS THAT REFLECT OUR COMMITMENT TO HEALTHCARE AND THE COMMUNITIES WE ARE PRIVILEGED TO SERVE. THE FOLLOWING IS A SUBSET OF THE MANY CLINICAL SERVICES AS WELL AS POPULATION HEALTH IMPROVEMENT AND COMMUNITY OUTREACH ACTIVITIES OFFERED BY ONE OR MORE OF FRANCISCAN'S HEALTHCARE FACILITIES: - INPATIENT HOSPITAL SERVICES INCLUDING: MEDICAL SERVICES, SURGICAL SERVICES, INTENSIVE CARE SERVICES, TELEMETRY SERVICES, OBSTETRICS SERVICES, PEDIATRICS SERVICES, NEONATAL INTENSIVE CARE SERVICES, ACUTE REHABILITATION SERVICES, ONCOLOGY SERVICES, BONE MARROW TRANSPLANT SERVICES, GENERAL SURGERY SERVICES, CARDIAC SURGERY SERVICES, VASCULAR SERVICES, PULMONARY SERVICES, INTERVENTIONAL RADIOLOGY, ORTHOPEDICS, JOINT AND SPINE CARE, GASTROINTESTINAL CARE, NEUROSCIENCES SERVICES, COLON AND RECTAL SERVICES, ANESTHESIA SERVICES, HOSPICE SERVICES, INPATIENT PSYCHIATRIC CARE, RESIDENTIAL TREATMENT PROGRAM FOR ADOLESCENTS, ETC. - EMERGENCY SERVICES INCLUDING: 24 HOUR EMERGENCY ROOM SERVICES, AMBULANCE SERVICES, IMMEDIATE CARE SERVICES, ADVANCED LIFE SUPPORT SERVICES, BASIC LIFE SUPPORT SERVICES, BEHAVIORAL HEALTH EMERGENCY CONSULTATION SERVICES, 24-HOUR CRISIS AND REFERRAL HOTLINE, TRAUMA SERVICES, ETC. - OUTPATIENT SERVICES INCLUDING: LABORATORY SERVICES, PHYSICAL THERAPY SERVICES, OCCUPATIONAL THERAPY SERVICES, SPEECH THERAPY SERVICES, GENERAL RADIOLOGY SERVICES, COMPUTED TOMOGRAPHY SERVICES, MAGNETIC RESONANCE IMAGING (MRI), NUCLEAR MEDICINE SERVICES, MAMMOGRAPHY SERVICES, ANGIOGRAPHY SERVICES, NEURODIAGNOSTICS SERVICES, GASTRO/INTESTINAL SERVICES, SLEEP LABORATORY, PULMONARY SERVICES, OUTPATIENT SURGERY, CARDIAC TESTING, ELECTROCARDIOGRAM (EKG) SERVICES, MEDICAL ONCOLOGY SERVICES, RADIATION ONCOLOGY SERVICES, PHARMACY, OCCUPATIONAL MEDICINE SERVICES, CARDIAC/PULMONARY REHABILITATION SERVICES, CONGESTIVE HEART FAILURE CLINIC, WOUND HEALING AND PREVENTION, NUTRITIONAL COUNSELING, DIABETES MANAGEMENT, BARIATRIC SERVICES, PAIN MANAGEMENT, SOCIAL SERVICES, PALLIATIVE CARE, SPORTS MEDICINE, BEHAVIORAL HEALTH, STROKE SERVICES, HOME HEALTH SERVICES, SKILLED NURSING SERVICES, SOCIAL SERVICES, DURABLE MEDICAL EQUIPMENT. - FRANCISCAN SENIOR HEALTH & WELLNESS IS A COMPREHENSIVE AND COORDINATED HEALTH CARE SOLUTION FOR SENIORS WHO WANT TO REMAIN AT HOME. OUR PROGRAM ENABLES SENIORS TO LIVE AS INDEPENDENTLY AS POSSIBLE BY PROVIDING TRULY ALL-INCLUSIVE SERVICES. FRANCISCAN SENIOR HEALTH & WELLNESS IS A PROGRAM OF ALL-INCLUSIVE CARE FOR THE ELDERLY (PACE), A COMMUNITY-BASED HEALTHCARE PROGRAM CREATED FOR PEOPLE 55 OR OLDER WHO ARE ELIGIBLE FOR NURSING-HOME LEVEL CARE BUT PREFER TO RECEIVE THEIR CARE IN THEIR OWN FAMILIAR SURROUNDINGS. FRANCISCAN SAVED MEDICARE AND MEDICAID OVER $3 MILLION IN 2023 AND 2022 AND ALLOWED SENIORS THE ABILITY TO CONTINUE TO LIVE AT HOME WHILE HAVING THEIR HEALTH MANAGED. THE FRANCISCAN SENIOR HEALTH & WELLNESS - PACE PROGRAM PROVIDES ALL MEDICARE AND MEDICAID COVERED SERVICES AS WELL AS ALL SERVICES DETERMINED NECESSARY BY OUR INTERDISCIPLINARY TEAM TO MAINTAIN EACH PARTICIPANT'S OVERALL MEDICAL, PHYSICAL, EMOTIONAL, AND SOCIAL HEALTH. WE EXPANDED OPERATIONS TO FOUR PACE CENTERS ACCROSS INDIANA FOR SUPPORT OF HOOSIERRS IN NEED OF SERVICES TO REMAIN HEALTHY, SAFE, AND COMFORTABLE IN THE PLACE THEY CALL HOME. COVERED BENEFITS INCLUDE: - PRIMARY MEDICAL AND NURSING CARE - OCCUPATIONAL, PHYSICAL, AND SPEECH THERAPY - MEDICATIONS AND DURABLE MEDICAL EQUIPMENT - LABORATORY AND DIAGNOSTIC SERVICES - ALL NECESSARY PRESCRIPTION DRUGS - SKILLED HOME CARE AND PERSONAL CARE AIDES - HOSPITALIZATION AND SKILLED NURSING FACILITY CARE - CARE FROM MEDICAL SPECIALISTS IN CARDIOLOGY, NEPHROLOGY, OPHTHALMOLOGY, DERMATOLOGY, ORTHOPEDICS, SURGERY, PODIATRY AND MORE - MEDICALLY NECESSARY TRANSPORTATION OUR BROAD RANGE OF SERVICE PROVIDERS, INCLUDING DOCTORS, ADVANCED PRACTICE PROVIDERS, NURSES, PHARMACISTS, THERAPISTS, SOCIAL WORKERS, DIETI
SCHEDULE H, PART VI, ITEM 5 & PART I, LINE 6A CON'T	- BEHAVIORAL HEALTH SERVICES AT FRANCISCAN HEALTH DYER TOUCHES ALL FACETS OF EMOTIONAL, MENTAL HEALTH, BEHAVIORAL HEALTH AND CHEMICAL DEPENDENCY PROBLEMS. WE OFFER TREATMENTS IN PSYCHIATRIC DISORDERS, SUBSTANCE ABUSE AND ADDICTION, FAMILY CONFLICTS, AND EMOTIONAL DISORDERS, INCLUDING TESTING FOR PSYCHOLOGICAL DISORDERS AND CONSULTATIONS. OUR BEHAVIORAL HEALTH SERVICES AND PROGRAMS ARE TAILORED TO MEET THE NEEDS OF ADULTS, ADOLESCENTS AND CHILDREN WITH BOTH INDIVIDUAL AND GROUP BEHAVIORAL THERAPY AND COUNSELING OPTIONS. AFTERCARE AND LONG-TERM RECOVERY PROGRAMS ARE ADDITIONAL, CRITICAL ASPECTS OF OUR BEHAVIORAL HEALTH SERVICES. - THE ST. FRANCIS CENTER RESIDENTIAL TREATMENT PROGRAM FOR ADOLESCENTS BASED AT FRANCISCAN HEALTH DYER, IS AN ADOLESCENT RESIDENTIAL TREATMENT PROGRAM FOR MALE AND FEMALE YOUTHS, AGES 12 THROUGH 18, WHO WOULD BE UNSUCCESSFUL WITHOUT A HIGHLY STRUCTURED AND CONTROLLED ENVIRONMENT. THE ST. FRANCIS CENTER OFFERS TWO LEVELS OF CARE IN A NURTURING, THERAPEUTIC AND SECURE ENVIRONMENT. THE PROGRAM IS DESIGNED TO ASSIST ADOLESCENTS IN DEVELOPING THE NECESSARY SKILLS TO FUNCTION AGE-APPROPRIATELY AND SUCCESSFULLY ON A DAILY BASIS SO THEY CAN REINTEGRATE WITH THE COMMUNITY AND THEIR FAMILIES. IT IS OUR BELIEF THAT SUCCESS IS OFTEN DEPENDENT ON FAMILY INVOLVEMENT. THEREFORE, FAMILIES ARE ENCOURAGED TO TAKE AN ACTIVE ROLE IN THE TREATMENT WITH FAMILY SESSIONS ROUTINELY SCHEDULED. - FRANCISCAN MICHIGAN CITY ALSO HAS A 14-BED INPATIENT BEHAVIORAL HEALTH UNIT AT THE FRANCISCAN HEALTH MICHIGAN CITY NORTH CAMPUS. - THE EMPATH UNIT AT FRANCISCAN HEALTH LAFAYETTE EAST IS FOCUSED ON TREATING AND STABILIZING PATIENTS EXPERIENCING A PSYCHIATRIC CRISIS. THIS TRAUMA-INFORMED TEAM COLLABORATES WITH COMMUNITY RESOURCES TO CONNECT PATIENTS WITH THE BEHAVIORAL HEALTH CARE THAT IS RIGHT FOR THEM. - LOCATED AT FRANCISCAN HEALTH CRAWFORDSVILLE, THE GENERATIONS PROGRAM SERVES SENIORS 55 AND OLDER THROUGHOUT INDIANA AND EASTERN ILLINOIS WHO ARE EXPERIENCING DEMENTIA OR ALZHEIMER'S DISEASE OR EXHIBITING INCONSISTENT, DISRUPTIVE, UNPREDICTABLE OR EVEN SUICIDAL BEHAVIOR. - FRANCISCAN HAS VARIOUS PRENATAL ASSISTANCE PROGRAMS THROUGHOUT INDIANA AND ILLINOIS AS PART OF OUR INITIATIVE TO REDUCE INFANT MORTALITY RATES. FRANCISCAN PROVIDES SUPPORT FOR MOMS IN NEED, INCLUDING CONNECTING THEM WITH PRENATAL CARE, CASE MANAGEMENT, CONNECTING THEM WITH RESOURCES IN THE COMMUNITY, AND PROVIDING CONTINUED SUPPORT AFTER THE BIRTH OF THEIR BABY. WE ALSO OFFER DIAPER DEPOTS THROUGHOUT OUR COMMUNITIES PROVIDING FREE DIAPERS AND WIPES TO FAMILIES IN NEED ON SET DAYS EACH MONTH. AS PART OF OUR EFFORTS, WE HAVE SEEN INFANT MORTALITY DECREASE IN NORTHWEST INDIANA FROM 10.5 PER 1,000 LIVE BIRTHS IN 2017 TO 8.0 PER 1,000 LIVE BIRTHS IN 2021 AND WE ARE COMMITTED TO THESE EFFORTS. - NEONATAL INTENSIVE CARE SERVICES OFFERS ADVANCED PROCEDURES, TECHNOLOGY AND EXPERTISE TO GIVE VERY SMALL OR VERY ILL NEWBORNS THE BEST CHANCE FOR A HEALTHY START IN LIFE. OUR TEAM OF DOCTORS, NURSES AND OTHER HEALTH PROFESSIONALS DEMONSTRATES THE GENUINE CARING, WARMTH AND SINCERITY THAT BRING OUR MISSION OF SERVICE TO LIFE AND OFFER REASSURANCE AND CONFIDENCE TO PARENTS AND REFERRING PHYSICIANS ALIKE. - PALLIATIVE CARE SERVICES ASSIST PATIENTS AND FAMILIES IN MAKING COMPLEX MEDICAL DECISIONS BY PROVIDING A GOOD UNDERSTANDING OF THE PATIENT'S PRESENT CONDITION, COORDINATING AND COMMUNICATING CARE WITH PHYSICIANS, ADVOCATING FOR PATIENTS' WISHES, AND HELPING THEM TO ACHIEVE A SENSE OF CONTROL OVER THEIR MEDICAL CARE. PALLIATIVE CARE IS OFFERED REGARDLESS OF THE STAGE OF DISEASE OR THE NEED FOR OTHER THERAPIES AND CAN BE PROVIDED CONCURRENTLY WITH LIFE-PROLONGING CARE OR AS THE MAIN FOCUS OF CARE. - CLINICS FOR THE UNINSURED INCLUDE THE ST. CLARE HEALTH CLINIC AND DR. JOHN LANMAN CLINIC. THESE CLINICS PROVIDE PRIMARY CARE FOR NON-EMERGENCY SERVICES WITH AN EMPHASIS ON PREVENTION, EARLY DETECTION, PATIENT EDUCATION, PHYSICAL EXAMS AND HEALTH SCREENINGS. THESE CLINICS ALSO SERVES THOSE WHO ENDURE HARDSHIP TO ACCESS QUALITY HEALTH CARE. - EMERGENCY SERVICES PROVIDE OUR COMMUNITIES WITH STATE-OF-THE-ART EMERGENCY FACILITIES, OPEN 24-HOURS A DAY, SEVEN DAYS A WEEK. EQUIPPED WITH ADVANCED MEDICAL TECHNOLOGY, OUR EMERGENCY TEAM OF SPECIALLY TRAINED PHYSICIANS AND NURSES TREAT THEIR PATIENTS FOR TRAUMA, STROKE, CARDIAC, AND OTHER LIFE-THREATENING CONDITIONS IN ADULTS AND CHILDREN. - AT THE FRANCISCAN HOSPICE HOUSE LOCATED IN INDIANAPOLIS, INDIANA, PATIENTS RECEIVE SPECIALIZED CARE AND RESPITE SERVICES FOR FAMILIES IN A HOME LIKE SETTING. FROM ROOMS THAT ARE LARGE, PRIVATE AND PET-FRIENDLY TO A GARDEN THAT'S JUST RIGHT FOR PRAYER, CONTEMPLATION OR QUIET CONVERSATION, THE SERVICES AND AMENITIES AT THE FRANCISCAN HOSPICE HOUSE WERE DESIGNED WITH PATIENT COMFORT IN MIND. FRANCISCAN HOSPICE HOUSE WAS ENVISIONED AS A COMPLEMENT TO THE EXCEPTIONAL HOME HEALTH, HOSPICE, AND PALLIATIVE CARE SERVICES THAT FRANCISCAN HEALTH HAS PROVIDED TO PATIENTS AND FAMILIES IN SOUTH-CENTRAL INDIANA FOR MORE THAN TWO DECADES. FRANCISCAN HOSPICE HOUSE OFFERS 16 PRIVATE ROOMS FOR PATIENTS AND FAMILIES, A LARGE COMMON AREA FOR FAMILIES, A WELL-EQUIPPED KITCHEN WITH DINING ROOM, A CHAPEL AND PRAYER GARDEN, AND HIGH-QUALITY, HOLISTIC INDIVIDUALIZED PATIENT CENTRIC MEDICAL CARE FOR ALL PATIENTS-REGARDLESS OF THEIR ABILITY TO PAY. FRANCISCAN HOSPICE HOUSE IS STAFFED WITH A COMPASSIONATE AND EXPERIENCED TEAM OF PHYSICIANS, NURSES, SOCIAL WORKERS, THERAPISTS, CHAPLAINS AND ASSISTIVE PERSONNEL WHOSE MISSION IS TO PROVIDE EXCEPTIONAL AND DIGNIFIED END OF LIFE CARE FOR PATIENTS AND SUPPORT FOR THE FAMILITIES AT ALL TIMES. - HEALTH AND WELLNESS CENTERS AND HEALTHY LIVING EDUCATION CENTERS. THE HEALTHY LIVING CENTER BRINGS TOGETHER MEDICAL PROFESSIONALS DEDICATED TO THE PREVENTION AND TREATMENT OF CHRONIC HEALTH CONDITIONS. OUR GOAL IS TO PROVIDE EVIDENCE-BASED CARE AND EDUCATION TO ASSIST WITH IMPROVING OVERALL QUALITY OF LIFE AND REDUCING CARE COMPLICATIONS AT ALL PHASES OF CARE AS A PARTNER WITH OTHER CARE TEAM MEMBERS. WE CURRENTLY OFFER THE FOLLOWING PROGRAMS: 1. NURSE PRACTITIONER LED PROGRAM FOR HEART FAILURE, CHRONIC OBSTRUCTIVE PULMONARY DISEASE, AND ASTHMA MANAGEMENT WHICH TARGETS GUIDELINE DIRECTED MEDICAL THERAPY AND EDUCATION. THIS TEAM WILL ALSO PROVIDE TRANSITIONAL MANAGEMENT VISITS FOR PATIENTS DISCHARGING FROM THE HOSPITAL AND UNABLE TO BE SEEN BY PRIMARY CARE PROVIDERS TIMELY. THE TEAM WORKS IN COLLABORATION WITH PRIMARY AND SPECIALTY CARE PROVIDERS FOR OPTIMIZED TREATMENT PLANS AND READMISSION REDUCTION. THE PROGRAM IS MULTI-DISCIPLINARY IN NATURE AND INCLUDES A PHARMACIST, DIETITIAN, RESPIRATORY THERAPIST, AND SOCIAL WORKER. 2. BETTER WEIGH OF LIFE PROGRAM IS AN INTENSIVE WEIGHT LOSS PROGRAM THAT FOCUSES ON LIFESTYLE CHANGE, BEHAVIORAL MODIFICATIONS AND MAY INCLUDE MEDICATION MANAGEMENT. THE TEAM INCLUDES A NURSE PRACTITIONER, DIETITIAN, ATHLETIC TRAINER, AND PHARMACIST. 3. DIABETES EDUCATION AND SUPPORT WORKS WITH PATIENTS AT ALL POINTS OF THE DIABETES JOURNEY TO TEACH SELF-MANAGEMENT SKILLS AND IMPROVE OVERALL DIABETES CONTROL. THE TEAM INCLUDES CERTIFIED DIABETES EDUCATORS THAT ARE NURSE PRACTITIONERS, NURSES, DIETITIANS, AND LIFESTYLE COACHES. 4. DIABETES PREVENTION PROGRAM IS A YEARLONG SMALL GROUP PROGRAM THAT MEETS ROUTINELY TO WORK ON WEIGHT MANAGEMENT AND HEALTHY LIFESTYLE TO PREVENT OR DELAY TYPE 2 DIABETES. THIS PROGRAM CAN BE OFFERED AT OFF-SITE LOCATIONS TO MEET THE NEEDS OF PATIENTS. 5. ASPIRE TOBACCO CESSATION PROGRAM SUPPORTS PATIENTS WITH QUIT ATTEMPTS TO IMPROVE THEIR OVERALL HEALTH. THE TEAM INCLUDES A NURSE PRACTITIONER AND SPECIALLY TRAINED TOBACCO TREATMENT SPECIALISTS TO COACH, EDUCATION AND PROVIDE MEDICATION MANAGEMENT. 6. PRO-EXERCISE IS A SUPERVISED EXERCISE PROGRAM FOR INDIVIDUALS THAT HAVE LIMITED MOBILITY OR OTHER HEALTH CONCERNS THAT MAKE OTHER LOCATIONS CHALLENGING. THIS SUPERVISED EXERCISE PROGRAM IS AVAILABLE BY PROVIDER REFERRAL ONLY. - COMMUNITY OUTREACH, COMMUNITY HEALTH IMPROVEMENT, AND EDUCATION PROGRAMS INCLUDING: HEALTH FAIRS, FREE HEALTH SCREENINGS, FREE IMMUNIZATIONS, FREE BREAST HEALTH SCREENING SERVICES, FREE PROSTRATE SCREENINGS, FREE SKIN CANCER SCREENINGS, FREE CERVICAL CANCER SCREENINGS, FREE GLUCOSE SCREENINGS, FREE CHOLESTEROL SCREENINGS, FREE BONE DENSITY SCREENINGS, FREE LUNG SCREENINGS, FREE SPA SERVICES FOR CANCER PATIENTS, ONLINE HEALTH CONDITION ASSESSMENT TOOLS, COLORECTAL SCREENINGS, CANCER PREVENTION ACTIVITIES, CANCER SURVIVOR PROGRAMS AND RETREATS, ORTHOPEDIC, CANCER & HEART CARE CLINICAL SYMPOSIUMS, HEALTH CARE DECISION-MAKING SESSIONS, SENIOR HEALTH EDUCATION, DIABETES MANAGEMENT EDUCATION AND ACTIVITIES, PAIN MANAGEMENT SEMINARS AND ACTIVITIES, CARDIAC RISK FACTORS EDUCATIONAL SESSIONS AND ONLINE TOOLS, HOSPICE AND PALLIATIVE CARE COUNSELING AND EDUCATION SERVICES, ALZHEIMER SUPPORT SERVICES, BEHAVIORAL HEALTH COMMUNITY EDUCATION, SMOKING CESSATION PROGRAMS, MOBILE DENTAL CLINICS, BASIC LIFE-SAVING SKILLS PROGRAMS, CHILDREN'S HEALTH NEEDS ACTIVITIES, C
SCHEDULE H, PART VI, ITEM 5 & PART I, LINE 6A CON'T	- SENIOR PROMISE IS A COMMUNITY BENEFIT PROGRAM FOR THOSE OVER THE AGE OF 55. THIS PROGRAM PROVIDES EDUCATION, SUPPORT, AND RESOURCES TO ASSIST MEMBERS OF OUR COMMUNITY ALONG THEIR PATH OF AGING. THE SENIOR PROMISE PROGRAM HAS A KEY EMPHASIS ON THE SOCIAL DETERMINANTS OF HEALTH. COLLABORATING WITH OTHER NON-PROFIT ORGANIZATIONS, SENIOR PROMISE DELIVERS EDUCATIONAL OPPORTUNITIES FOCUSED ON PROMOTING ACCESS TO CARE, IMPROVING HEALTH LITERACY, MINIMIZING SOCIAL ISOLATION, AND REDUCING FOOD INSECURITIES. SINCE 1987, SENIOR PROMISE HAS PRODUCED A QUARTERLY NEWSLETTER WHICH HIGHLIGHTS BOTH FRANCISCAN SERVICES AND COMMUNITY BENEFITS. ARTICLES IN OUR NEWSLETTER REGULARLY INFORM OUR MEMBERS OF SUCH PROGRAMS AS THE PROGRAM FOR ALL-INCLUSIVE CARE (PACE), THE ACCOUNTABLE CARE ORGANIZATION (ACO), AND FEATURE MEDICARE UPDATES, LOCAL HEALTH SCREENING OPPORTUNITIES, AND MYRIAD OF PLANNED COMMUNITY EVENTS. OTHER BENEFITS PROVIDED BY THE SENIOR PROMISE PROGRAM INCLUDE MEDICARE ASSISTANCE, CAREGIVER RESOURCES, GROUP TRAVEL OPPORTUNITIES, LOCAL BUSINESS DISCOUNTS, AND ASSISTANCE WITH BILLING QUESTIONS. - SOCIAL SERVICES INCLUDING: PASTORAL CARE, EUCHARISTIC MINISTRY PROGRAM, NO ONE DIES ALONE PROGRAMS, GRIEVANCE SUPPORT PROGRAMS FOR CHILDREN, LANGUAGE INTERPRETER SERVICES, DEAF INTERPRETER SERVICES, TRANSPORTATION FOR THE INDIGENT, ENROLLMENT ASSISTANCE IN MEDICAID AND HEALTH INSURANCE EXCHANGES, CHRISTIAN LEGAL CLINIC, TRANSPORTATION SERVICE FOR INDIGENT PATIENTS, ETC. - MEDICAL EDUCATION INCLUDING: PHYSICIAN RESIDENCY PROGRAMS, FAMILY MEDICINE RESIDENCY PROGRAM, EMERGENCY ROOM PHYSICIAN RESIDENCY PROGRAM, PHARMACY RESIDENCY PROGRAM, MEDICAL STUDENT TRAINING PROGRAM, ST. ELIZABETH SCHOOL OF NURSING PROGRAM, ADVANCE NURSING CONTINUING EDUCATION, NURSING CLINICAL ROTATIONS, PHLEBOTOMY TRAINING PROGRAM, RESPIRATORY THERAPY TRAINING, REHABILATIVE TRAINING, MEDICAL ASSISTANCE TRAINING, MEDICAL TECHNOLOGY TRAINING PROGRAMS, HIGH SCHOOL CAREER DAYS, SCHOOL OF ECHOCARDIOGRAPHY, SURGICAL TECHNICIAN EXTERNSHIPS, SOCIAL WORKER INTERNSHIPS, SEXUAL ASSAULT TRAINING PROGRAMS, AMBULANCE/PARAMEDIC TRAINING PROGRAMS, HOME HEALTH STUDENT TRAINING, INTERN & RESIDENT TRAINING FOR MIDWESTERN UNIVERSITY, OPERATING ROOM TECHNOLOGY TRAINING, ETC. INTERN, RESIDENT AND FELLOWSHIP TRAINING PRIMARILY FROM MIDWESTERN UNIVERSITY AND OTHER MEDICAL SCHOOLS IN INTERNAL MEDICINE, FAMILY MEDICINE, CRITICAL CARE, EMERGENCY MEDICINE, GASTROENTEROLOGY, GENERAL SURGERY, RHEUMATOLOGY, UROLOGY, DIAGNOSTIC RADIOLOGY, AND ORTHOPEDICS. IN 2022, FRANCISCAN HEALTH INITIATED THE FRANCISCAN STUDENT NURSE INTERN PROGRAM, A STRATEGIC INITIATIVE AIMED AT PROVIDING CRUCIAL SUPPORT TO NURSING STUDENTS IN MANAGING THEIR EDUCATIONAL EXPENSES WHILE FACILITATING A SEAMLESS TRANSITION INTO THE ROLE OF A FRANCISCAN NURSE. THIS PROGRAM HAS PROVEN INSTRUMENTAL IN OUR COMMITMENT TO FOSTERING THE GROWTH AND DEVELOPMENT OF THE HEALTHCARE WORKFORCE. THE PROGRAM IS STRUCTURED TO EXTEND ITS BENEFITS TO ELIGIBLE STUDENTS DURING THE FINAL THREE SEMESTERS OF THEIR NURSING EDUCATION. UPON ENROLLMENT, STUDENTS BECOME ELIGIBLE FOR $9,600 IN RETURN FOR A TWO-YEAR SERVICE COMMITMENT WITHIN THE FRANCISCAN HEALTH SYSTEM. DURING 2023, WE ACCEPTED 51 STUDENTS, WITH THE VAST MAJORITY OF STUDENTS COMING FROM IVY TECH COMMUNITY COLLEGE. PURDUE NORTHWEST AND THE UNIVERSITY OF ST. FRANCIS CONTRIBUTED THE MOST CANDIDATES AFTER IVY TECH. IN 2023, FRANCISCAN HEALTH DISBURSED A TOTAL OF $341,510 TO SUPPORT STUDENTS. AS OF DECEMBER 31, 2023, 24 STUDENTS HAVE SUCCESSFULLY GRADUATED AND ARE ACTIVELY FULFILLING THEIR SERVICE COMMITMENT. - RESEARCH PROGRAMS INCLUDING: ONCOLOGY RESEARCH, CARDIOVASCULAR RESEARCH, CARDIO-ONCOLOGY RESEARCH, BLOOD AND MARROW TRANSPLANTATION RESEARCH, INFECTIOUS DISEASE RESEARCH, INTERNAL MEDICINE RESEARCH, ORTHOPEDICS RESEARCH, CARDIOTHORACIC SURGERY RESEARCH, PAIN MANAGEMENT RESEARCH, COLON AND RECTAL SURGERY RESEARCH, INVESTIGATOR INITIATED RESEARCH, NURSING RESEARCH, QI/EBP PROJECTS, NCI SPONSORED CLINICAL TRIALS, PHARMACEUTICAL SPONSORED CLINICAL TRIALS, PHASE I-IV CLINICAL TRIALS, HUMANITARIAN USE DEVICES, CMS RECOGNIZED CAROTID ARTERY STENTING FACILITY. THE FRANCISCAN PROJECT GRACE PROGRAM ASSISTS FAMILIES AFFECTED BY THE OPIATE CRISIS AND HAS ONE PURPOSE - DELIBERATE ACTS OF KINDNESS. GIFTS TO THE PROJECT GRACE PROGRAM PROVIDE FAMILIES BABY FORMULA AND DIAPERS, HELP WITH PAYING BILLS, AND HELP FUND PARENTING CLASSES. EXTENDING GRACE MOTIVATES PARENTS TO STAY EMPLOYED, PROGRESS IN THEIR RECOVERY, AND GIVE THEIR BABY THE BEST POSSIBLE START IN LIFE. AGAIN, PLEASE VIEW WWW.FRANCISCANHEALTH.ORG/ABOUT/WHO-WE-ARE WHICH REFLECTS OUR MISSION OF "CONTINUING CHRIST'S MINISTRY IN OUR FRANCISCAN TRADITION" AS WELL AS WWW.FRANCISCANHEALTH.ORG/COMMUNITYHEALTH FOR FRANCISCAN'S COMMUNITY BENEFIT AND COMMUNITY HEALTH ASSESMENTS. FRANCISCAN CONTINUES TO PROVIDE ACCESS TO HEALTH CARE SERVICES AND A WIDE VARIETY OF COMMUNITY EDUCATION/HEALTH AND WELLNESS PROGRAMS. ALL OF OUR FACILITIES REACH OUT TO THEIR COMMUNITIES BY PROVIDING ACCESS TO FREE, PUBLIC WEB SITES AND ONLINE RESOURCES. EACH WEB SITE PROVIDES THE LATEST MEDICAL INFORMATION TO VISITORS, IN A BI-LINGUAL FORMAT, THROUGH THE USE OF INTERACTIVE A TO Z HEALTH LIBRARIES. THERE ARE ONLINE CENTERS THAT FOCUS ON INFORMATION RELATED TO MEDICAL CONDITIONS IN SPECIALTY AREAS SUCH AS THE HEART, BONES, KIDNEYS AND NERVES. THEY FURTHER OFFER CONDITION AND DISEASE-SPECIFIC INFORMATION ON TOPICS LIKE CANCER, PREGNANCY, AND GERIATRICS THAT PROVIDE ILLUSTRATIONS, GRAPHICS AND NARRATED VIDEOS. THE WEB SITES ALSO PROVIDE UNLIMITED FREE ACCESS TO ONLINE HEALTH RISK ASSESSMENT TOOLS SUCH AS THE HEART RISK ASSESSMENT THAT USES AN ESTABLISHED ALGORITHM TO CALCULATE RISK FACTORS FOR HEART ATTACK BASED UPON USER-ENTERED PARAMETERS. THE SITES ALSO OFFER CONDITION-SPECIFIC RECOMMENDATIONS FOR MANAGING CHRONIC ILLNESSES AND CONDITIONS SUCH AS DIABETES, HIGH BLOOD PRESSURE AND ASTHMA, AMONG OTHERS. FINALLY, THE WEB SITES HAVE HEALTHY LIVING SECTIONS THAT OFFER TIPS AND SUGGESTIONS ON BEGINNING AND MAINTAINING DIET AND EXERCISE REGIMENTS TO OPTIMIZE HEALTHY LIFESTYLES. FRANCISCAN HAS NUMEROUS URGENT CARE CLINICS WITHIN THE COMMUNITIES THEY SERVE TO HELP MINIMIZE THE COST OF NON-CRITICAL, EMERGENT MEDICAL CARE. THESE CLINICS ARE ALL SUBSIDIZED BY FRANCISCAN. MOREOVER, THERE ARE OTHER FACTORS THAT DEMONSTRATE THAT FRANCISCAN IS OPERATED FOR A PUBLIC RATHER THAN A PRIVATE INTEREST. FRANCISCAN'S GOVERNING BODY IS COMPOSED OF INDEPENDENT MEMBERS REPRESENTING THE BROAD COMMUNITY SERVED BY FRANCISCAN. MEDICAL STAFF PRIVILEGES ARE AVAILABLE TO QUALIFIED PHYSICIANS. FRANCISCAN USES ANY SURPLUS OF REVENUES OVER EXPENSES FOR IMPROVEMENTS IN PATIENT CARE, TO EXPAND AND REPLACE FACILITIES AND EQUIPMENT, FOR THE AMORTIZATION OF INDEBTEDNESS, AND FOR MEDICAL TRAINING, EDUCATION, AND RESEARCH. IN 2023 AND 2022, FRANCISCAN INVESTED APPROXIMATELY $277.3 MILLION AND $252.8 MILLION IN CAPITAL WITHIN THE COMMUNITIES IT SERVES. FRANCISCAN ALLIANCE, INC. AND ITS ACCOUNTABLE CARE ORGANIZATION ("ACO") WAS THE FIRST AND ONLY PIONEER ACO IN INDIANA AND AMONG THE FIRST IN THE COUNTRY TO PARTNER WITH MEDICARE AS AN ACO. FRANCISCAN ALSO PARTICIPATES IN VARIOUS MEDICARE SHARED SAVINGS ACO PROGRAMS AND NONGOVERNMENTAL ACO PROGRAMS AND HAS CONTRACTS TO COORDINATE THE HEALTH CARE NEEDS OF MEDICARE ADVANTAGE BENEFICIARIES. THROUGH THE MEDICARE SHARED SAVINGS PROGRAM, FRANCISCAN SAVED CENTERS FOR MEDICARE AND MEDICAID SERVICES OVER $32.2 MILLION RELATED TO MSSP AND MILLIONS OF DOLLARS FOR COMMERCIAL PATIENTS ALONG WITH IMPROVING OUTCOMES AND QUICKER RECOVERY TIMES. FORMED IN 2011, FRANCISCAN ACO PROVIDES COORDINATED, COMPREHENSIVE CARE ACROSS HOSPITALS, PHYSICIAN PRACTICES, AND OTHER HEALTHCARE PROVIDERS, WITH THE AIM OF BRINGING DOWN THE OVERALL COSTS OF MEDICAL CARE AND IMPROVING THE HEALTH OF PATIENTS ATTRIBUTED TO THE ACO. UNDER THE ACO MODEL, ATTRIBUTED MEDICARE BENEFICIARIES MAINTAIN THE ABILITY TO SEE ANY DOCTOR OR HEALTHCARE PROVIDER, AS WELL AS THE FULL BENEFITS ASSOCIATED WITH TRADITIONAL MEDICARE, BUT WITH THE ADDED BENEFIT OF A MORE COORDINATED CARE EXPERIENCE. THIS INCLUDES COORDINATION OF PREVENTIVE HEALTH SERVICES AND PHARMACY NEEDS, THE ASSIGNMENT OF CLINICAL CARE MANAGERS, THE PROVISION OF SOCIAL SUPPORT SERVICES, AND SUPPORT FOR PERSONS WITH CHRONIC HEALTH CONDITIONS, SUCH AS DIABETES AND CONGESTIVE HEART FAILURE. FRANCISCAN ACO SERVES APPROXIMATELY 76,000 MEDICARE BENEFICIARIES AND APPROXIMATELY 81,000 NONGOVERNMENTAL ACO BENEFICIARIES. FRANCISCAN'S ACO EFFORTS INCLUDE IMPROVED CLINICAL COMMUNICATION AND INFORMATION SHARING AMONG AFFILIATED AND NONAFFILIATED HEALTHCARE PROVIDERS REGARDING ACO PATIENTS, ALONG WITH THE EXPANSION OF ACO CASE MANAGEMENT RESOURCES, THE ASSIGNMENT OF DEDICATED CHRONIC DISEASE CASE ADVOCATES TO PATIENTS, EVALUATING THE QUALITY AND CAPABILITIES OF LONG-TERM CARE FACILITIES THAT ACO PATIENTS MAY TRANSITION TO, AND WORKING WITH POST-ACUTE CARE PROVIDERS TO IMPROVE THEIR CONTINUING CARE
SCHEDULE H, PART VI, ITEM 6	ROLE OF AFFILIATES EVERY HOSPITAL WITHIN OUR SYSTEM HAS THE DEGREE OF AUTONOMY AND FLEXIBILITY TO MEET THE NEEDS OF THE COMMUNITIES IT SERVES. THE SYSTEM COMMUNITY HEALTH IMPROVEMENT DIRECTOR PROVIDES COMMUNITY HEALTH DATA, INCLUDING INFORMATION RELATED TO SOCIAL DETERMINANTS OF HEALTH AND EMERGING PUBLIC HEALTH NEEDS TO LOCAL FACILITY STAFF ON A REGULAR BASIS FOR CONSIDERATION OF LOCAL ACTIVITY. THE SYSTEM DIRECTOR ALSO ORGANIZES A THOROUGH COMMUNITY HEALTH NEEDS ASSESSMENT AND PROVIDES CONSULTATION TO LOCAL STAFF ON THE IMPLEMENTATION PLAN. THE INDIVIDUAL AND REGIONAL COMMUNITY BENEFIT PLANS ARE DESIGNED TO BE PART OF AN OVERALL FRANCISCAN SYSTEM VISION TO PROVIDE FOR THE ONGOING HEALTHCARE NEEDS OF THE COMMUNITIES WE ARE PRIVILEGED TO SERVE.
SCHEDULE H, PART I, LINE 3B	IN ADDITION TO USING FEDERAL POVERTY GUIDELINES AS A FACTOR IN DETERMINING ELIGIBILITY FOR DISCOUNTED CARE, FOR UNINSURED PATIENTS, FRANCISCAN PROVIDES AN UNINSURED PATIENT DISCOUNT FOR EMERGENCY SERVICES OR MEDICALLY NECESSARY SERVICES PERFORMED AT ITS HOSPITAL LOCATIONS ALONG WITH ITS MEDICAL GROUP PHYSICIAN PRACTICES. THE UNINSURED PATIENT DISCOUNT IS BASED ON THE AVERAGE RATE OF THE RESPECTIVE FRANCISCAN HOSPITAL FACILITY'S AVERAGE RATES FOR PRIVATE HEALTH PAYERS, INCLUDING MEDICARE. FRANCISCAN FACILITIES MAY OFFER ADDITIONAL DISCOUNTS BASED ON THE FACTS AND CIRCUMSTANCES UNIQUE TO THEIR LOCAL MARKETS. THIS DISCOUNT SHALL NOT BE COMBINED WITH OTHER FACILITY DISCOUNTS, EXCEPT FOR A PROMPT PAY DISCOUNT, IF AVAILABLE. NO DISCOUNT SHALL BE PROVIDED THAT VIOLATES ANY LAWS OR GOVERNMENT REGULATIONS. FRANCISCAN WILL IDENTIFY UNINSURED PATIENTS DURING THE REGISTRATION AND/OR ADMISSIONS PROCESS. THE UNINSURED DISCOUNT IS APPLIED AUTOMATICALLY BY THE RECEIVABLE SYSTEM AT THE TIME OF INITIAL BILL. ALL STATEMENTS TO PATIENTS WILL INDICATE THE ADJUSTMENT AND THE REVISED PATIENT BALANCE. THE UNINSURED DISCOUNT IS A CONTRACTUAL DISCOUNT AND IS NOT CONSIDERED A CHARITY CARE WRITE OFF UNLESS THE PATIENT ALSO QUALIFIES FOR CHARITY CARE. UNINSURED PATIENT DISCOUNTS WILL NOT BE REVERSED DUE TO NONPAYMENT OF AN ACCOUNT. IF, AT ANY TIME, FRANCISCAN BECOMES AWARE THAT A PREVIOUSLY IDENTIFIED UNINSURED PATIENT WAS IN FACT COVERED BY INSURANCE AT THE TIME OF SERVICE, FRANCISCAN WILL REVOKE THE UNINSURED DISCOUNT AND ISSUE A REVISED STATEMENT TO THE PATIENT AND THE ASSOCIATED INSURANCE PROVIDER. PATIENTS THAT ARE STILL NOT ABLE TO PAY THE BALANCE AFTER THE UNINSURED DISCOUNT ARE ABLE TO APPLY FOR A CHARITY CARE WRITE OFF OR A MEDICAL FINANCIAL HARDSHIP ADJUSTMENT.
SCHEDULE H, PART II	COMMUNITY BUILDING ACTIVITIES FOLLOWING NATIONAL GUIDANCE ON COMMUNITY BUILDING, ACTIVITIES RELATED TO SOCIAL DETERMINANTS ARE REPRESENTED IN OTHER CATEGORIES. FRANCISCAN ALLIANCE DOES ENGAGE IN COMMUNITY BUILDING THROUGH VARIOUS PARTNERSHIP EFFORTS. FRANCISCAN ALLIANCE DOES ENGAGE IN REDUCING BARRIERS TO HEALTH CARE ACCESS. MOST ACTIVITIES IN THIS AREA ARE INCLUDED IN THE FINANCIAL ASSISTANCE AND OTHER COMMUNITY BENEFIT CATEGORIES. EXAMPLES INCLUDE: FREE OR LOW-COST HEALTH SCREENING IN SPECIFIC NEIGHBORHOODS, IMMUNIZATION SERVICES, PRESCRIPTION MEDICATION ASSISTANCE PROGRAMS, ENROLLMENT ASSISTANCE IN MEDICAID, FOOD ASSISTANCE, TRANSPORTATION ASSISTANCE, AND REFERRAL ASSISTANCE. ADDITIONALLY, SEVERAL OF OUR HOSPITALS HAVE BEEN IDENTIFIED BY THE FEDERAL GOVERNMENT AS DESIGNATED REGIONAL MEDICATION DISTRIBUTION SITES IN THE EVENT OF A NATIONAL DISASTER OR EPIDEMIC/PANDEMIC. RESPONDING TO FEDERAL, STATE, AND LOCAL NEEDS IN THE EVENT OF NATIONAL OR LOCAL DISASTERS OR EPIDEMIC/PANDEMICS, WE COLLABORATE AND COORDINATE OUR EFFORTS WITH MANY CIVIC AND OTHER AGENCIES TO ENSURE THAT THOSE NEEDS WILL BE MET SHOULD DISASTER STRIKE.
SCHEDULE H, PART III, LINE 2	THROUGHOUT THE YEAR, FRANCISCAN ESTIMATES THIS ALLOWANCE BASED ON THE AGING OF ITS PATIENT ACCOUNTS RECEIVABLE, HISTORICAL COLLECTION EXPERIENCE, AND OTHER RELEVANT FACTORS. THESE FACTORS INCLUDE CHANGES IN THE ECONOMY AND UNEMPLOYMENT RATES, WHICH HAS AN IMPACT ON THE NUMBER OF UNINSURED AND UNDERINSURED PATIENTS, AS WELL AS TRENDS IN HEALTH CARE COVERAGE, SUCH AS THE INCREASED BURDEN OF DEDUCTIBLES, COPAYMENTS, AND COINSURANCE PAYMENTS TO BE MADE BY PATIENTS WITH INSURANCE. AFTER SATISFACTION OF AMOUNTS DUE FROM INSURANCE AND REASONABLE EFFORTS TO COLLECT FROM THE PATIENT HAVE BEEN EXHAUSTED, FRANCISCAN FOLLOWS ESTABLISHED PROCEDURES FOR PLACING CERTAIN PAST DUE PATIENT BALANCES WITH COLLECTION AGENCIES, SUBJECT TO THE TERMS AND CERTAIN RESTRICTIONS ON COLLECTION EFFORTS AS DETERMINED BY FRANCISCAN. ----------------------------------------- SCHEDULE H, PART III, LINE 3 FRANCISCAN HAS A SYSTEM-WIDE CHARITY CARE AND UNINSURED DISCOUNT POLICY; HAS DETAILED ADMINISTRATIVE PROCEDURES ESTABLISHED FOR QUALIFYING AND ENROLLING PATIENTS FOR CHARITY CARE OR UNINSURED/UNDERINSURED DISCOUNTS; USES VARIOUS ANALYTICAL PROGRAMS INCLUDING SOFT CREDIT INQUIRIES THAT DO NOT AFFECT CREDIT SCORES TO HELP ASSESS A PATIENT'S ABILITY TO PAY; AND UTILIZES NUMEROUS MECHANISMS TO INFORM AND EDUCATE PATIENTS ABOUT THEIR ELIGIBILITY FOR ASSISTANCE WHICH ARE DETAILED UNDER SCHEDULE H, PART VI, ITEM 3. DESPITE THESE RIGOROUS EFFORTS, PATIENTS WHO NEED SUBSIDIZED CARE MAY NOT SEEK THIS ASSISTANCE NOR CHOOSE TO ENROLL IN THE STATE'S MEDICAID PROGRAM. ALSO, AS FURTHER DESCRIBED IN HFMA STATEMENT NO. 15, THE APPROPRIATE CLASSIFICATION OF CHARITY CARE AND BAD DEBT IS OFTEN DIFFICULT. THE URGENCY OF SOME TREATMENTS, AS WELL AS CERTAIN FEDERAL REGULATIONS, OFTEN REQUIRES THE PROVISION OF SERVICE WITHOUT CONSIDERATION OF THE PATIENT'S ABILITY TO PAY. SOME PATIENTS HAVE COMPLEX MEDICAL CONDITIONS WITH UNPREDICTABLE TREATMENT NEEDS. FOR THESE AND OTHER REASONS, FRANCISCAN BELIEVES, A PORTION OF ITS BAD DEBT EXPENSE AS REPORTED ON LINE 2 OF PART III REPRESENTS CHARITY CARE DELIVERED TO INDIVIDUALS IN THE COMMUNITIES IT SERVES CONSISTENT WITH ITS CHARITABLE HEALTHCARE MISSION. AS AN INTEGRAL PART OF ITS MISSION, FRANCISCAN PROVIDES CARE TO PATIENTS WHO MEET CERTAIN CRITERIA UNDER ITS CHARITY CARE AND UNINSURED PATIENT DISCOUNT POLICY WITHOUT CHARGE OR AT AMOUNTS LESS THAN ITS ESTABLISHED RATES. THE COST OF CHARITY CARE, AS ESTIMATED BELOW, IS DETERMINED BASED ON EACH HEALTH CENTER'S TOTAL COST AS A PERCENTAGE OF TOTAL CHARGES AND THAT RATIO IS APPLIED TO THE CHARGES INCURRED BY PATIENTS QUALIFYING FOR CHARITY CARE UNDER FRANCISCAN'S POLICY. THE CHARGES ASSOCIATED WITH THE PROVISION OF SUCH CARE ARE NOT INCLUDED IN PATIENT SERVICE REVENUE IN THE CONSOLIDATED STATEMENTS OF OPERATIONS AND CHANGES IN NET ASSETS. THE ESTIMATED COST OF CHARITY CARE PROVIDED APPROXIMATED $66.1 MILLION AND $79.3 MILLION FOR THE YEARS ENDED DECEMBER 31, 2023 AND 2022, RESPECTIVELY. FRANCISCAN MAINTAINS RECORDS TO IDENTIFY AND MONITOR THE LEVEL OF CHARITY IT PROVIDES. -------------------------------------- SCHEDULE H, PART III, LINE 4 FRANCISCAN'S UNCOLLECTIBLE AMOUNTS DUE FROM PATIENTS FOOTNOTE FROM ITS AUDITED FINANCIAL STATEMENTS IS AS FOLLOWS: FRANCISCAN ALSO PROVIDES A SIGNIFICANT AMOUNT OF UNCOMPENSATED CARE TO PATIENTS WHICH IS NOT REPORTED IN THE SUMMARY OF QUANTIFIABLE COMMUNITY BENEFITS. IN ACCORDANCE WITH FINANCIAL ACCOUNTING STANDARDS BOARD ("FASB") ACCOUNTING STANDARD UPDATE ("ASU") 2014-9, REVENUE FROM CONTRACTS WITH CUSTOMERS (TOPIC 606), FRANCISCAN RECOGNIZES REVENUE IN AN AMOUNT THAT REFLECTS THE CONSIDERATION THE ENTITY EXPECTS TO BE ENTITLED TO IN AN EXCHANGE FOR GOODS OR SERVICES. ADOPTION OF THIS ASU DOES NOT ALLOW THE SEPARATE REPORTING OF THE UNCOLLECTIBLE AMOUNTS DUE FROM PATIENTS; HOWEVER, THE IDENTIFICATION OF THIS AMOUNT IS NEEDED FOR OTHER PURPOSES INCLUDING GOVERNMENTAL REPORTING AND REIMBURSEMENT CALCULATIONS. FRANCISCAN HAS A SYSTEM-WIDE CHARITY CARE AND UNINSURED DISCOUNT POLICY THAT INCLUDES ADMINISTRATIVE PROCEDURES FOR QUALIFYING AND ENROLLING PATIENTS FOR CHARITY CARE OR UNINSURED/UNDERINSURED DISCOUNTS. FRANCISCAN ALSO USES VARIOUS ANALYTICAL PROGRAMS TO ASSESS A PATIENT'S ABILITY TO PAY AND IT UTILIZES NUMEROUS MECHANISMS TO INFORM AND EDUCATE PATIENTS ABOUT FINANCIAL ASSISTANCE. DESPITE THESE RIGOROUS EFFORTS, PATIENTS WHO NEED SUBSIDIZED CARE MAY NOT SEEK THIS ASSISTANCE NOR CHOOSE TO ENROLL IN MEDICAID OR OTHER FINANCIAL ASSISTANCE PROGRAMS. FOR THESE AND OTHER REASONS, FRANCISCAN BELIEVES A PORTION OF ITS UNCOLLECTIBLE AMOUNTS DUE FROM PATIENTS REPRESENTS CHARITY CARE DELIVERED TO INDIVIDUALS IN THE COMMUNITIES IT SERVES CONSISTENT WITH ITS CHARITABLE HEALTH CARE MISSION. DURING THE YEARS ENDED DECEMBER 31, 2023 AND 2022, FRANCISCAN INCURRED APPROXIMATELY $32.4 MILLION AND $7.8 MILLION, RESPECTIVELY, AS UNCOLLECTIBLE AMOUNTS DUE FROM PATIENTS BASED ON ACCUMULATED CHARGES. FRANCISCAN'S CHARITY CARE FOOTNOTE FROM ITS AUDITED FINANCIAL STATEMENTS IS AS FOLLOWS: AS AN INTEGRAL PART OF ITS MISSION, FRANCISCAN PROVIDES CARE TO PATIENTS WHO MEET CERTAIN CRITERIA UNDER ITS CHARITY CARE AND UNINSURED PATIENT DISCOUNT POLICY WITHOUT CHARGE OR AT AMOUNTS LESS THAN ITS ESTABLISHED RATES. THE COST OF CHARITY CARE, AS ESTIMATED BELOW, IS DETERMINED BASED ON EACH HEALTH CENTER'S TOTAL COST AS A PERCENTAGE OF TOTAL CHARGES AND THAT RATIO IS APPLIED TO THE CHARGES INCURRED BY PATIENTS QUALIFYING FOR CHARITY CARE UNDER FRANCISCAN'S POLICY. THE CHARGES ASSOCIATED WITH THE PROVISION OF SUCH CARE ARE NOT INCLUDED IN PATIENT SERVICE REVENUE IN THE CONSOLIDATED STATEMENTS OF OPERATIONS AND CHANGES IN NET ASSETS. THE ESTIMATED COST OF CHARITY CARE PROVIDED APPROXIMATED $66.3 MILLION AND $80.4 MILLION FOR THE YEARS ENDED DECEMBER 31, 2023 AND 2022, RESPECTIVELY. FRANCISCAN MAINTAINS RECORDS TO IDENTIFY AND MONITOR THE LEVEL OF CHARITY IT PROVIDES. ------------------------------------------------ SCHEDULE H, PART III, LINE 8 CONSISTENT WITH THE CHARITABLE HEALTHCARE MISSION OF FRANCISCAN AND THE COMMUNITY BENEFIT STANDARD SET FORTH IN IRS REVENUE RULING 69-545 AND THE REQUIREMENTS OF IRC SECTION 501(R), FRANCISCAN PROVIDES CARE FOR ALL PATIENTS COVERED BY MEDICARE SEEKING MEDICAL CARE AT FRANCISCAN. SUCH CARE IS PROVIDED REGARDLESS OF WHETHER THE REIMBURSEMENT PROVIDED FOR SUCH SERVICES MEETS OR EXCEEDS THE COSTS INCURRED BY FRANCISCAN TO PROVIDE SUCH SERVICES. LIKE MEDICAID, PAYMENT RATES FOR MEDICARE ARE SET BY LAW RATHER THAN THROUGH A NEGOTIATION PROCESS. THESE PAYMENT RATES ARE CURRENTLY SET BELOW THE COSTS OF PROVIDING CARE RESULTING IN UNDERPAYMENTS. MEDICARE RATES ARE DETERMINED WITHIN THE CONTEXT OF ALL THE BUDGETARY NEEDS OF THE FEDERAL GOVERNMENT AND MEDICARE PAYMENTS HAVE HISTORICALLY BEEN SET BELOW THE COSTS OF PROVIDING CARE TO MEDICARE PATIENTS THOUGH HOW FAR BELOW VARIES OVER TIME AND BY SERVICE. EACH YEAR MEDICARE IS SUPPOSED TO PROVIDE HOSPITALS AN INCREASE IN BOTH INPATIENT AND OUTPATIENT PAYMENTS TO ACCOUNT FOR INFLATION IN THE PRICES FOR GOODS AND SERVICES HOSPITALS MUST PURCHASE IN ORDER TO PROVIDE PATIENT CARE. HOWEVER INPATIENT UPDATES HAVE BEEN SET BELOW THE RATE OF INFLATION AND ACTUALLY NEGATIVE IN RECENT YEARS RESULTING IN A SHORTFALL THAT HAS GROWN OVER TIME. THE COMPOUNDING ISSUE THAT OCCURS IS THAT THIS SHORTFALL JEOPARDIZES HOSPITALS' ABILITY TO SERVE THEIR COMMUNITIES BECAUSE THEY ARE NOT REIMBURSED THEIR INCURRED COSTS. PROVIDERS MAKE THE DECISION TO ELIMINATE OR SIGNIFICANTLY REDUCE NECESSARY CLINICAL SERVICES WITHIN THE MARKETPLACE PLACING THE MEDICARE SHORTFALL BURDEN ON OTHERS THAT DO, SUCH AS FRANCISCAN. GIVEN THAT FRANCISCAN PROVIDES SUCH SERVICES TO MEDICARE PATIENTS KNOWING THAT THEY WILL RESULT IN A LOSS AND GIVEN THAT FRANCISCAN BELIEVES THAT IT PROVIDES THESE SERVICES IN AN EFFICIENT AND COST EFFECTIVE MANNER, THE SHORTFALL REPORTED ON LINE 7 OF PART III SHOULD BE VIEWED AS COMMUNITY BENEFIT PROVIDED BY FRANCISCAN. ------------------------------------------------ SCHEDULE H, PART III, LINE 9B FRANCISCAN ALLIANCE, INC.'S WRITTEN CHARITY CARE AND UNINSURED PATIENT DISCOUNT POLICY AND PATIENT COLLECTION PROCEDURE INCLUDE VARIOUS PROVISIONS ON THE COLLECTION PRACTICES TO BE FOLLOWED FOR PATIENTS WHO ARE KNOWN TO QUALIFY FOR CHARITY OR FINANCIAL ASSISTANCE. IF A PATIENT QUALIFIES FOR CHARITY OR FINANCIAL ASSISTANCE CERTAIN COLLECTION PRACTICES DO NOT APPLY.
SCHEDULE H, PART IV	NAME OF ENTITY: MOORESVILLE ENDOSCOPY CENTER LLC DESCRIPTION OF PRIMARY ACTIVITY OF ENTITY: ENDOSCOPY SERVICES ORGANIZATION'S PROFIT % OR STOCK OWNERSHIP %: 50.00000 OFFICERS, DIRECTORS, TRUSTEES. ETC. PROFIT % OR STOCK OWNERSHIP %: 0 PHYSICIANS' PROFIT % OR STOCK OWNERSHIP %: 50.00000 NAME OF ENTITY: INDIANA SLEEP CENTER LLC DESCRIPTION OF PRIMARY ACTIVITY OF ENTITY: SLEEP CENTER ORGANIZATION'S PROFIT % OR STOCK OWNERSHIP %: 50.00000 OFFICERS, DIRECTORS, TRUSTEES. ETC. PROFIT % OR STOCK OWNERSHIP %: 0 PHYSICIANS' PROFIT % OR STOCK OWNERSHIP %: 50.00000 NAME OF ENTITY: FRANCISCAN SURGERY CENTER LLC DESCRIPTION OF PRIMARY ACTIVITY OF ENTITY: SURGICAL SERVICES ORGANIZATION'S PROFIT % OR STOCK OWNERSHIP %: 52.9412 OFFICERS, DIRECTORS, TRUSTEES. ETC. PROFIT % OR STOCK OWNERSHIP %: 0 PHYSICIANS' PROFIT % OR STOCK OWNERSHIP %: 47.0588 NAME OF ENTITY: SOUTH EMERSON SURGERY CENTER LLC DESCRIPTION OF PRIMARY ACTIVITY OF ENTITY: SURGICAL SERVICES ORGANIZATION'S PROFIT % OR STOCK OWNERSHIP %: 50.00000 OFFICERS, DIRECTORS, TRUSTEES. ETC. PROFIT % OR STOCK OWNERSHIP %: 0 PHYSICIANS' PROFIT % OR STOCK OWNERSHIP %: 50.00000 NAME OF ENTITY: ST FRANCIS MOORESVILLE SURGERY CENTER LLC DESCRIPTION OF PRIMARY ACTIVITY OF ENTITY: SURGICAL SERVICES ORGANIZATION'S PROFIT % OR STOCK OWNERSHIP %: 50.00000 OFFICERS, DIRECTORS, TRUSTEES. ETC. PROFIT % OR STOCK OWNERSHIP %: 0 PHYSICIANS' PROFIT % OR STOCK OWNERSHIP %: 50.00000 NAME OF ENTITY: ST FRANCIS RADIATION THERAPY CENTERS LLC DESCRIPTION OF PRIMARY ACTIVITY OF ENTITY: RADIATION THERAPY SERVICES ORGANIZATION'S PROFIT % OR STOCK OWNERSHIP %: 84.53000 OFFICERS, DIRECTORS, TRUSTEES. ETC. PROFIT % OR STOCK OWNERSHIP %: 0 PHYSICIANS' PROFIT % OR STOCK OWNERSHIP %: 15.47000 NAME OF ENTITY: SOUTH INDY MRI & REHAB SERVICES LLC DESCRIPTION OF PRIMARY ACTIVITY OF ENTITY: MRI SERVICES ORGANIZATION'S PROFIT % OR STOCK OWNERSHIP %: 50.00000 OFFICERS, DIRECTORS, TRUSTEES. ETC. PROFIT % OR STOCK OWNERSHIP %: 0 PHYSICIANS' PROFIT % OR STOCK OWNERSHIP %: 50.00000 NAME OF ENTITY: ST FRANCIS IMAGING CENTER (GREENWOOD) LLC DESCRIPTION OF PRIMARY ACTIVITY OF ENTITY: IMAGING SERVICES ORGANIZATION'S PROFIT % OR STOCK OWNERSHIP %: 60.00000 OFFICERS, DIRECTORS, TRUSTEES. ETC. PROFIT % OR STOCK OWNERSHIP %: 0 PHYSICIANS' PROFIT % OR STOCK OWNERSHIP %: 40.00000 NAME OF ENTITY: THE ENDOSCOPY CENTER AT ST FRANCIS LLC DESCRIPTION OF PRIMARY ACTIVITY OF ENTITY: ENDOSCOPY SERVICES ORGANIZATION'S PROFIT % OR STOCK OWNERSHIP %: 50.00000 OFFICERS, DIRECTORS, TRUSTEES. ETC. PROFIT % OR STOCK OWNERSHIP %: 0 PHYSICIANS' PROFIT % OR STOCK OWNERSHIP %: 50.00000 NAME OF ENTITY: INDIANA INTERNAL MEDICINE CONSULTANTS LLC DESCRIPTION OF PRIMARY ACTIVITY OF ENTITY: INTERNAL MEDICINE SERVICES ORGANIZATION'S PROFIT % OR STOCK OWNERSHIP %: 49.000000 OFFICERS, DIRECTORS, TRUSTEES. ETC. PROFIT % OR STOCK OWNERSHIP %: 0 PHYSICIANS' PROFIT % OR STOCK OWNERSHIP %: 51.000000 FILING OF COMMUNITY BENEFIT REPORT IL, IN

Schedule H (Form 990) 2023

Additional Data

Software ID:
Software Version:

- TIN:

Note: To capture the full content of this document, please select landscape mode (11" x 8.5") when printing.

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

2023

Open to Public
Inspection

Name of the organization
FRANCISCAN ALLIANCE INC

Employer identification number
35-1330472

Part I

General Information on Grants and Assistance

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? ........................

Yes No

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) FRANCISCAN HEALTH FOUNDATION INC 1515 DRAGOON TRAIL MISHAWAKA,IN46544	35-1955283	501(C)(3)	694,819		N/A	N/A	FRANCISCAN MISSION ENHANCEMENT PILGRIMAGE

Enter total number of section 501(c)(3) and government organizations listed in the line 1 table ................. Bullet Image

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) 2023

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)
(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
SCHEDULE I, PART I, LINE 2	CONTRIBUTIONS ARE GIVEN TO TAX-EXEMPT ORGANIZATIONS WHICH USE THE FUNDS FOR CHARITABLE PURPOSES IN FURTHERANCE OF MEDICAL RESEARCH, MEDICAL INITIATIVES, EDUCATION, AND/ OR COMMUNITY ACTIVITIES.

Schedule I (Form 990) 2023

Additional Data

Software ID:
Software Version:

- TIN:

Schedule J
(Form 990)

Department of the Treasury
Internal Revenue Service

Compensation Information

For certain Officers, Directors, Trustees, Key Employees, and Highest
Compensated Employees
medium right arrow graphic

Complete if the organization answered "Yes" on Form 990, Part IV, line 23.
medium right arrow graphic

Attach to Form 990.
medium right arrow graphic

Go to www.irs.gov/Form990 for instructions and the latest information.

OMB No. 1545-0047

2023

Open to Public Inspection

Name of the organization

FRANCISCAN ALLIANCE INC

Employer identification number

35-1330472

Part I

Questions Regarding Compensation

Yes

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.

First-class or charter travel Housing allowance or residence for personal use

Travel for companions Payments for business use of personal residence

Tax idemnification and gross-up payments Health or social club dues or initiation fees

Discretionary spending account Personal services (e.g., maid, chauffeur, chef)

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 .....

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? ....

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.

Compensation committee Written employment contract

Independent compensation consultant Compensation survey or study

Form 990 of other organizations Approval by the board or compensation committee

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:

Receive a severance payment or change-of-control payment? .............

Participate in, or receive payment from, a supplemental nonqualified retirement plan? .........

Participate in, or receive payment from, an equity-based compensation arrangement? .........

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.

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:

The organization? ....................

Any related organization? .......................

If "Yes," on line 5a or 5b, describe in Part III.

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:

The organization? ..................

Any related organization? ......................

If "Yes," on line 6a or 6b, describe in Part III.

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 ............

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 ..........................

If "Yes" on line 8, did the organization also follow the rebuttable presumption procedure described in Regulations section 53.4958-6(c)? .........................

For Paperwork Reduction Act Notice, see the Instructions for Form 990.

Cat. No. 50053T

Schedule J (Form 990) 2023

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, 1099-MISC compensation, and/or 1099-NEC			(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
(A) Name and Title		(i) Base compensation	(ii) Bonus & incentive compensation	(iii) Other reportable compensation	(C) Retirement and other deferred compensation	(D) Nontaxable benefits	(E) Total of columns (B)(i)-(D)
1KEVIN D LEAHY PRESIDENT AND TRUSTEE	(i) (ii)	2,383,652 ------------- 0	0 ------------- 0	83,804 ------------- 0	182,568 ------------- 0	14,984 ------------- 0	2,665,008 ------------- 0	0 ------------- 0
2JENNIFER P MARION SENIOR VP FINANCE, CFO	(i) (ii)	1,319,122 ------------- 0	0 ------------- 0	64,432 ------------- 0	393,575 ------------- 0	27,614 ------------- 0	1,804,743 ------------- 0	0 ------------- 0
3ALBERT P TOMCHANEY SR VP/CHIEF MEDICAL OFFICER	(i) (ii)	926,672 ------------- 0	0 ------------- 0	73,168 ------------- 0	261,272 ------------- 0	23,134 ------------- 0	1,284,246 ------------- 0	0 ------------- 0
4RANDALL S MOORE MD SR VP HEALTH & CARE/COO AMB	(i) (ii)	992,941 ------------- 0	0 ------------- 0	73,168 ------------- 0	19,800 ------------- 0	21,452 ------------- 0	1,107,361 ------------- 0	0 ------------- 0
5YAMEEN RASHID DO PHYSICIAN	(i) (ii)	1,396,662 ------------- 0	0 ------------- 0	23,256 ------------- 0	29,922 ------------- 0	20,692 ------------- 0	1,470,532 ------------- 0	0 ------------- 0
6JAMES T CALLAGHAN MD VP/COO	(i) (ii)	1,371,866 ------------- 0	0 ------------- 0	66,112 ------------- 0	467,862 ------------- 0	20,692 ------------- 0	1,926,532 ------------- 0	0 ------------- 0
7AMIT KUMAR PHYSICIAN	(i) (ii)	1,367,147 ------------- 0	0 ------------- 0	23,714 ------------- 0	19,800 ------------- 0	13,014 ------------- 0	1,423,675 ------------- 0	0 ------------- 0
8SUEYI LAI PHYSICIAN	(i) (ii)	1,165,459 ------------- 0	0 ------------- 0	23,150 ------------- 0	19,800 ------------- 0	0 ------------- 0	1,208,409 ------------- 0	0 ------------- 0
9FAHEEM AHMAD PHYSICIAN	(i) (ii)	1,131,055 ------------- 0	0 ------------- 0	33,463 ------------- 0	19,800 ------------- 0	28,614 ------------- 0	1,212,932 ------------- 0	0 ------------- 0
10ZOHAIR AHMED PHYSICIAN	(i) (ii)	1,106,581 ------------- 0	0 ------------- 0	23,167 ------------- 0	19,800 ------------- 0	4,519 ------------- 0	1,154,067 ------------- 0	0 ------------- 0

Schedule J (Form 990) 2023

Page 3

Part III

Supplemental Information

Provide the information, explanation, or descriptions required for Part I, lines 1a, 1b, 3, 4a, 4b, 4c, 5a, 5b, 6a, 6b, 7, and 8, and for Part II. Also complete this part for any additional information.

Return Reference

Explanation

SCHEDULE J, PART II, COLUMN (C)

CERTAIN INDIVIDUALS ARE ELIGIBLE FOR A QUALIFIED DEFERRED BENEFIT PLAN WHERE THERE WAS A INCREASE IN PRESENT VALUE AT DECEMBER 31, 2023. THE INCREASE IN PRESENT VALUE IS DUE TO THE DECREASE IN THE DISCOUNT RATE FROM 6.81 % AS OF DECEMBER 31, 2022 TO 5.99 % AS OF DECEMBER 31, 2023. THE INCREASE IN NET PRESENT VALUE ASSOCIATED WITH THE LISTED INDIVIDUALS IS INCLUDED IN COLUMN C OF SCHEDULE J, PART II.

Schedule J (Form 990) 2023

Additional Data

Software ID:
Software Version:

- TIN:

Note: To capture the full content of this document, please select landscape mode (11" x 8.5") when printing.

Schedule K
(Form 990)

Department of the Treasury
Internal Revenue Service

Supplemental Information on Tax-Exempt Bonds

Complete if the organization answered "Yes" to Form 990, Part Ⅵ, line 24a. Provide descriptions,
explanations, and any additional information in Part Ⅵ.
Attach to Form 990.
Go to www.irs.gov/Form990 for instructions and the latest information.

OMB No. 1545-0047

2023

Open to Public
Inspection

Name of the organization
FRANCISCAN ALLIANCE INC

Employer identification number
35-1330472

Part Ⅰ

Bond Issues

(a) Issuer name		(b) Issuer EIN	(c) CUSIP #	(d) Date issued	(e) Issue price	(f) Description of purpose	(g) Defeased		(h) On behalf of issuer		(i) Pool financing
(a) Issuer name		(b) Issuer EIN	(c) CUSIP #	(d) Date issued	(e) Issue price	(f) Description of purpose	Yes	No	Yes	No	Yes	No
A	INDIANA FINANCE AUTHORITY (08F)	35-1602316	45470YBE0	10-10-2008	279,345,000	REFUND PRIOR ISSUE DATED 11/20/03		X		X		X
B	INDIANA FINANCE AUTHORITY (O8IJ)	35-1602316	45470YLB4	11-20-2008	81,850,000	REFUND PRIOR ISSUE DATED 5/16/06		X		X		X
C	INDIANA FINANCE AUTHORITY (12AB)	35-1602316		05-25-2012	82,620,000	REFUND PRIOR ISSUES DATED '01&'08		X		X		X
D	INDIANA FINANCE AUTHORITY (16AB)	35-1602316	45470YCJ8	02-04-2016	295,426,956	REFUNDING AND NEW PROJECTS		X		X		X
	INDIANA FINANCE AUTHORITY (16CE)	35-1602316		10-19-2016	223,085,000	REFUNDING PRIOR ISSUE		X		X		X
	INDIANA FINANCE AUTHORITY (17A)	35-1602316		09-19-2018	45,250,000	REFUND 2008G BONDS		X		X		X
	INDIANA FINANCE AUTHORITY (17BC)	35-1602316	45470YET4	12-28-2017	385,659,962	REFUND 2009A AND NEW PROJECTS		X		X		X
	INDIANA FINANCE AUTHORITY (23A)	35-1602316		01-19-2023	69,145,000	REFUNDING 2016(D) BONDS		X		X		X
	INDIANA FINANCE AUTHORITY 23(B)	35-1602316		12-14-2023	50,000,000	REFUNDING 2014(A) BONDS		X		X		X

Part Ⅱ

Proceeds

	A		B		C		D
	1 Amount of bonds retired ..................	234,145,000		27,590,000		9,670,000		8,250,000
2 Amount of bonds legally defeased ..............	0		0		0		0
3 Total proceeds of issue ..................	278,919,324		81,693,875		82,620,000		295,426,956
4 Gross proceeds in reserve funds .............	0		0		0		0
5 Capitalized interest from proceeds .............	0		0		0		0
6 Proceeds in refunding escrows ...............	0		0		0		0
7 Issuance costs from proceeds ...............	503,876		1,120,800		0		2,444,202
8 Credit enhancement from proceeds .............	0		0		0		0
9 Working capital expenditures from proceeds .............	0		0		0		0
10 Capital expenditures from proceeds .............	124,873,123		0		0		199,269,999
11 Other spent proceeds .............	151,542,325		80,573,075		82,620,000		93,712,755
12 Other unspent proceeds .............	0		0		0		0
13 Year of substantial completion .............	2011		2012
	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 2020, a current refunding issue)? ........	X		X		X			X
15 Were the bonds issued as part of an advance refunding issue of taxable bonds (or, if issued prior to 2020, an advance refunding issue)? ........		X		X		X	X
16 Has the final allocation of proceeds been made? ..........	X		X		X			X
17 Does the organization maintain adequate books and records to support the final allocation of proceeds? ..................	X		X		X		X

For Paperwork Reduction Act Notice, see the Instructions for Form 990.

Cat. No. 50193E

Schedule K (Form 990) 2023

Page 2

Part Ⅲ

Private Business Use

	A		B		C		D
	Yes	No	Yes	No	Yes	No	Yes	No
1 Was the organization a partner in a partnership, or a member of an LLC, which owned property financed by tax-exempt bonds? .............		X		X		X		X
2 Are there any lease arrangements that may result in private business use of bond-financed property? ...............	X		X		X		X
3a Are there any management or service contracts that may result in private business use of bond-financed property? .............	X		X		X		X
b If "Yes" to line 3a, does the organization routinely engage bond counsel or other outside counsel to review any management or service contracts relating to the financed property?	X		X		X		X
c Are there any research agreements that may result in private business use of bond-financed property? .............	X		X		X		X
d If "Yes" to line 3c, does the organization routinely engage bond counsel or other outside counsel to review any research agreements relating to the financed property?	X		X		X		X
4 Enter the percentage of financed property used in a private business use by entities other than a section 501(c)(3) organization or a state or local government ....	0.800 %		0.040 %		0.800 %		0.760 %
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 .........	0.010 %		0 %		0.010 %		0.010 %
6 Total of lines 4 and 5 .............	0.810 %		0.040 %		0.810 %		0.770 %
7 Does the bond issue meet the private security or payment test? ...		X		X		X		X
8a Has there been a sale or disposition of any of the bond-financed property to a nongovernmental person other than a 501(c)(3) organization since the bonds were issued?.............	X		X		X			X
b If "Yes" to line 8a, enter the percentage of bond-financed property sold or disposed of. ..
c If "Yes" to line 8a, was any remedial action taken pursuant to Regulations sections 1.141-12 and 1.145-2? .............		X		X		X		X
9 Has the organization established written procedures to ensure that all nonqualified bonds of the issue are remediated in accordance with the requirements under Regulations sections 1.141-12 and 1.145-2? ........	X		X		X		X

Part Ⅳ

Arbitrage

	A		B		C		D
	Yes	No	Yes	No	Yes	No	Yes	No
1 Has the issuer filed Form 8038-T, Arbitrage Rebate, Yield Reduction and Penalty in Lieu of Arbitrage Rebate? ...		X		X		X		X
2 If "No" to line 1, did the following apply? ....
a Rebate not due yet? .......		X		X	X		X
b Exception to rebate? ........	X			X		X		X
c No rebate due? .........		X	X			X		X
If "Yes" to line 2c, provide in Part Ⅵ the date the rebate computation was performed ......
3 Is the bond issue a variable rate issue? .....	X		X			X		X

Schedule K (Form 990) 2023

Page 3

Part Ⅳ

Arbitrage (Continued)

	A		B		C		D
	Yes	No	Yes	No	Yes	No	Yes	No
4a Has the organization or the governmental issuer entered into a qualified hedge with respect to the bond issue?		X		X		X		X
b Name of provider ..........	0		0		0		0
c Term of hedge .........
d Was the hedge superintegrated? ......
e Was the hedge terminated? ........
5a Were gross proceeds invested in a guaranteed investment contract (GIC)?		X		X		X		X
b Name of provider ..........	0		0		0		0
c Term of GIC .........
d Was the regulatory safe harbor for establishing the fair market value of the GIC satisfied? ........
6 Were any gross proceeds invested beyond an available temporary period?		X	X			X		X
7 Has the organization established written procedures to monitor the requirements of section 148? ...	X		X		X		X

Part Ⅴ

Procedures To Undertake Corrective Action

	A		B		C		D
	Yes	No	Yes	No	Yes	No	Yes	No
Has the organization established written procedures to ensure that violations of federal tax requirements are timely identified and corrected through the voluntary closing agreement program if self-remediation is not available under applicable regulations?	X		X		X		X

Part Ⅵ

Supplemental Information. Provide additional information for responses to questions on Schedule K. (See instructions).

Return Reference	Explanation
SCHEDULE K, PART II, LINE 3	DIFFERENCES IN AMOUNTS ENTERED IN PART I, COLUMN (E) AND PART II, LINE 3 REPRESENT INVESTMENT EARNINGS.
SCHEDULE K, PART II, LINE 13	FOR THE INDIANA FINANCE AUTHORITY 2012A/B, INDIANA FINANCE AUTHORITY 2016C/E, INDIANA FINANCE AUTHORITY 2017A, INDIANA FINANCE AUTHORITY 2023A, AND INDIANA FINANCE AUTHORITY 2023B BONDS, THESE BONDS SOLELY REFUNDED PRIOR ISSUES, SO THE YEAR OF SUBSTANTIAL COMPLETION HAS NOT BEEN ENTERED.
SCHEDULE K, PART III, LINE 8B	FOR THE INDIANA FINANCE AUTHORITY 2008F, 2008I/J, AND 2012A/B BONDS, DURING 2012, THE DISPOSITION PROCEEDS FOR THE DISPOSED OF BOND-FINANCED PROPERTY WAS $1.00, WHICH WAS WELL BELOW A TENTH OF A PERCENT OF EACH ISSUE.
SCHEDULE K, PART III, LINE 8C	FRANCISCAN ALLIANCE, THE INDIANA FINANCE AUTHORITY, AND THE IRS ENTERED INTO A CLOSING AGREEMENT TO ADDRESS THE REQUIRED REMEDIAL ACTION UNDER REGULATIONS SECTION 1.142-12 AND 1.145-2.
SCHEDULE K, PART IV, LINE 2C	FOR THE SERIES 2008I/J BOND, THE REBATE COMPUTATION WAS PERFORMED FEBRUARY 2011. FOR THE SERIES 2017B/C BOND, THE REBATE COMPUTATION WAS PERFORMED JANUARY 2020.
SCHEDULE K, PART IV, LINE 5	FOR THE INDIANA FINANCE AUTHORITY 2008I/J ISSUE, ONLY SMALL AMOUNTS OF PROCEEDS RELATED TO THE COST OF ISSUANCE WERE NOT EXPENDED AT THE END OF THE TEMPORARY PERIODS.

Schedule K (Form 990) 2023

Additional Data

Software ID:
Software Version:

- TIN:

Note: To capture the full content of this document, please select landscape mode (11" x 8.5") when printing.

Schedule K
(Form 990)

Department of the Treasury
Internal Revenue Service

Supplemental Information on Tax-Exempt Bonds

OMB No. 1545-0047

2023

Open to Public
Inspection

Name of the organization
FRANCISCAN ALLIANCE INC

Employer identification number
35-1330472

Part Ⅰ

Bond Issues

(a) Issuer name		(b) Issuer EIN	(c) CUSIP #	(d) Date issued	(e) Issue price	(f) Description of purpose	(g) Defeased		(h) On behalf of issuer		(i) Pool financing
(a) Issuer name		(b) Issuer EIN	(c) CUSIP #	(d) Date issued	(e) Issue price	(f) Description of purpose	Yes	No	Yes	No	Yes	No
A	INDIANA FINANCE AUTHORITY (08F)	35-1602316	45470YBE0	10-10-2008	279,345,000	REFUND PRIOR ISSUE DATED 11/20/03		X		X		X
B	INDIANA FINANCE AUTHORITY (O8IJ)	35-1602316	45470YLB4	11-20-2008	81,850,000	REFUND PRIOR ISSUE DATED 5/16/06		X		X		X
C	INDIANA FINANCE AUTHORITY (12AB)	35-1602316		05-25-2012	82,620,000	REFUND PRIOR ISSUES DATED '01&'08		X		X		X
D	INDIANA FINANCE AUTHORITY (16AB)	35-1602316	45470YCJ8	02-04-2016	295,426,956	REFUNDING AND NEW PROJECTS		X		X		X
	INDIANA FINANCE AUTHORITY (16CE)	35-1602316		10-19-2016	223,085,000	REFUNDING PRIOR ISSUE		X		X		X
	INDIANA FINANCE AUTHORITY (17A)	35-1602316		09-19-2018	45,250,000	REFUND 2008G BONDS		X		X		X
	INDIANA FINANCE AUTHORITY (17BC)	35-1602316	45470YET4	12-28-2017	385,659,962	REFUND 2009A AND NEW PROJECTS		X		X		X
	INDIANA FINANCE AUTHORITY (23A)	35-1602316		01-19-2023	69,145,000	REFUNDING 2016(D) BONDS		X		X		X
	INDIANA FINANCE AUTHORITY 23(B)	35-1602316		12-14-2023	50,000,000	REFUNDING 2014(A) BONDS		X		X		X

Part Ⅱ

Proceeds

	A		B		C		D
	1 Amount of bonds retired ..................	234,145,000		27,590,000		9,670,000		8,250,000
2 Amount of bonds legally defeased ..............	0		0		0		0
3 Total proceeds of issue ..................	278,919,324		81,693,875		82,620,000		295,426,956
4 Gross proceeds in reserve funds .............	0		0		0		0
5 Capitalized interest from proceeds .............	0		0		0		0
6 Proceeds in refunding escrows ...............	0		0		0		0
7 Issuance costs from proceeds ...............	503,876		1,120,800		0		2,444,202
8 Credit enhancement from proceeds .............	0		0		0		0
9 Working capital expenditures from proceeds .............	0		0		0		0
10 Capital expenditures from proceeds .............	124,873,123		0		0		199,269,999
11 Other spent proceeds .............	151,542,325		80,573,075		82,620,000		93,712,755
12 Other unspent proceeds .............	0		0		0		0
13 Year of substantial completion .............	2011		2012
	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 2020, a current refunding issue)? ........	X		X		X			X
15 Were the bonds issued as part of an advance refunding issue of taxable bonds (or, if issued prior to 2020, an advance refunding issue)? ........		X		X		X	X
16 Has the final allocation of proceeds been made? ..........	X		X		X			X
17 Does the organization maintain adequate books and records to support the final allocation of proceeds? ..................	X		X		X		X

For Paperwork Reduction Act Notice, see the Instructions for Form 990.

Cat. No. 50193E

Schedule K (Form 990) 2023

Page 2

Part Ⅲ

Private Business Use

	A		B		C		D
	Yes	No	Yes	No	Yes	No	Yes	No
1 Was the organization a partner in a partnership, or a member of an LLC, which owned property financed by tax-exempt bonds? .............		X		X		X		X
2 Are there any lease arrangements that may result in private business use of bond-financed property? ...............	X		X		X		X
3a Are there any management or service contracts that may result in private business use of bond-financed property? .............	X		X		X		X
b If "Yes" to line 3a, does the organization routinely engage bond counsel or other outside counsel to review any management or service contracts relating to the financed property?	X		X		X		X
c Are there any research agreements that may result in private business use of bond-financed property? .............	X		X		X		X
d If "Yes" to line 3c, does the organization routinely engage bond counsel or other outside counsel to review any research agreements relating to the financed property?	X		X		X		X
4 Enter the percentage of financed property used in a private business use by entities other than a section 501(c)(3) organization or a state or local government ....	0.800 %		0.040 %		0.800 %		0.760 %
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 .........	0.010 %		0 %		0.010 %		0.010 %
6 Total of lines 4 and 5 .............	0.810 %		0.040 %		0.810 %		0.770 %
7 Does the bond issue meet the private security or payment test? ...		X		X		X		X
8a Has there been a sale or disposition of any of the bond-financed property to a nongovernmental person other than a 501(c)(3) organization since the bonds were issued?.............	X		X		X			X
b If "Yes" to line 8a, enter the percentage of bond-financed property sold or disposed of. ..
c If "Yes" to line 8a, was any remedial action taken pursuant to Regulations sections 1.141-12 and 1.145-2? .............		X		X		X		X
9 Has the organization established written procedures to ensure that all nonqualified bonds of the issue are remediated in accordance with the requirements under Regulations sections 1.141-12 and 1.145-2? ........	X		X		X		X

Part Ⅳ

Arbitrage

	A		B		C		D
	Yes	No	Yes	No	Yes	No	Yes	No
1 Has the issuer filed Form 8038-T, Arbitrage Rebate, Yield Reduction and Penalty in Lieu of Arbitrage Rebate? ...		X		X		X		X
2 If "No" to line 1, did the following apply? ....
a Rebate not due yet? .......		X		X	X		X
b Exception to rebate? ........	X			X		X		X
c No rebate due? .........		X	X			X		X
If "Yes" to line 2c, provide in Part Ⅵ the date the rebate computation was performed ......
3 Is the bond issue a variable rate issue? .....	X		X			X		X

Schedule K (Form 990) 2023

Page 3

Part Ⅳ

Arbitrage (Continued)

	A		B		C		D
	Yes	No	Yes	No	Yes	No	Yes	No
4a Has the organization or the governmental issuer entered into a qualified hedge with respect to the bond issue?		X		X		X		X
b Name of provider ..........	0		0		0		0
c Term of hedge .........
d Was the hedge superintegrated? ......
e Was the hedge terminated? ........
5a Were gross proceeds invested in a guaranteed investment contract (GIC)?		X		X		X		X
b Name of provider ..........	0		0		0		0
c Term of GIC .........
d Was the regulatory safe harbor for establishing the fair market value of the GIC satisfied? ........
6 Were any gross proceeds invested beyond an available temporary period?		X	X			X		X
7 Has the organization established written procedures to monitor the requirements of section 148? ...	X		X		X		X

Part Ⅴ

Procedures To Undertake Corrective Action

	A		B		C		D
	Yes	No	Yes	No	Yes	No	Yes	No
Has the organization established written procedures to ensure that violations of federal tax requirements are timely identified and corrected through the voluntary closing agreement program if self-remediation is not available under applicable regulations?	X		X		X		X

Part Ⅵ

Supplemental Information. Provide additional information for responses to questions on Schedule K. (See instructions).

Return Reference	Explanation
SCHEDULE K, PART II, LINE 3	DIFFERENCES IN AMOUNTS ENTERED IN PART I, COLUMN (E) AND PART II, LINE 3 REPRESENT INVESTMENT EARNINGS.
SCHEDULE K, PART II, LINE 13	FOR THE INDIANA FINANCE AUTHORITY 2012A/B, INDIANA FINANCE AUTHORITY 2016C/E, INDIANA FINANCE AUTHORITY 2017A, INDIANA FINANCE AUTHORITY 2023A, AND INDIANA FINANCE AUTHORITY 2023B BONDS, THESE BONDS SOLELY REFUNDED PRIOR ISSUES, SO THE YEAR OF SUBSTANTIAL COMPLETION HAS NOT BEEN ENTERED.
SCHEDULE K, PART III, LINE 8B	FOR THE INDIANA FINANCE AUTHORITY 2008F, 2008I/J, AND 2012A/B BONDS, DURING 2012, THE DISPOSITION PROCEEDS FOR THE DISPOSED OF BOND-FINANCED PROPERTY WAS $1.00, WHICH WAS WELL BELOW A TENTH OF A PERCENT OF EACH ISSUE.
SCHEDULE K, PART III, LINE 8C	FRANCISCAN ALLIANCE, THE INDIANA FINANCE AUTHORITY, AND THE IRS ENTERED INTO A CLOSING AGREEMENT TO ADDRESS THE REQUIRED REMEDIAL ACTION UNDER REGULATIONS SECTION 1.142-12 AND 1.145-2.
SCHEDULE K, PART IV, LINE 2C	FOR THE SERIES 2008I/J BOND, THE REBATE COMPUTATION WAS PERFORMED FEBRUARY 2011. FOR THE SERIES 2017B/C BOND, THE REBATE COMPUTATION WAS PERFORMED JANUARY 2020.
SCHEDULE K, PART IV, LINE 5	FOR THE INDIANA FINANCE AUTHORITY 2008I/J ISSUE, ONLY SMALL AMOUNTS OF PROCEEDS RELATED TO THE COST OF ISSUANCE WERE NOT EXPENDED AT THE END OF THE TEMPORARY PERIODS.

Schedule K (Form 990) 2023

Additional Data

Software ID:
Software Version:

- TIN:

Note: To capture the full content of this document, please select landscape mode (11" x 8.5") when printing.

Schedule K
(Form 990)

Department of the Treasury
Internal Revenue Service

Supplemental Information on Tax-Exempt Bonds

OMB No. 1545-0047

2023

Open to Public
Inspection

Name of the organization
FRANCISCAN ALLIANCE INC

Employer identification number
35-1330472

Part Ⅰ

Bond Issues

(a) Issuer name		(b) Issuer EIN	(c) CUSIP #	(d) Date issued	(e) Issue price	(f) Description of purpose	(g) Defeased		(h) On behalf of issuer		(i) Pool financing
(a) Issuer name		(b) Issuer EIN	(c) CUSIP #	(d) Date issued	(e) Issue price	(f) Description of purpose	Yes	No	Yes	No	Yes	No
A	INDIANA FINANCE AUTHORITY (08F)	35-1602316	45470YBE0	10-10-2008	279,345,000	REFUND PRIOR ISSUE DATED 11/20/03		X		X		X
B	INDIANA FINANCE AUTHORITY (O8IJ)	35-1602316	45470YLB4	11-20-2008	81,850,000	REFUND PRIOR ISSUE DATED 5/16/06		X		X		X
C	INDIANA FINANCE AUTHORITY (12AB)	35-1602316		05-25-2012	82,620,000	REFUND PRIOR ISSUES DATED '01&'08		X		X		X
D	INDIANA FINANCE AUTHORITY (16AB)	35-1602316	45470YCJ8	02-04-2016	295,426,956	REFUNDING AND NEW PROJECTS		X		X		X
	INDIANA FINANCE AUTHORITY (16CE)	35-1602316		10-19-2016	223,085,000	REFUNDING PRIOR ISSUE		X		X		X
	INDIANA FINANCE AUTHORITY (17A)	35-1602316		09-19-2018	45,250,000	REFUND 2008G BONDS		X		X		X
	INDIANA FINANCE AUTHORITY (17BC)	35-1602316	45470YET4	12-28-2017	385,659,962	REFUND 2009A AND NEW PROJECTS		X		X		X
	INDIANA FINANCE AUTHORITY (23A)	35-1602316		01-19-2023	69,145,000	REFUNDING 2016(D) BONDS		X		X		X
	INDIANA FINANCE AUTHORITY 23(B)	35-1602316		12-14-2023	50,000,000	REFUNDING 2014(A) BONDS		X		X		X

Part Ⅱ

Proceeds

	A		B		C		D
	1 Amount of bonds retired ..................	234,145,000		27,590,000		9,670,000		8,250,000
2 Amount of bonds legally defeased ..............	0		0		0		0
3 Total proceeds of issue ..................	278,919,324		81,693,875		82,620,000		295,426,956
4 Gross proceeds in reserve funds .............	0		0		0		0
5 Capitalized interest from proceeds .............	0		0		0		0
6 Proceeds in refunding escrows ...............	0		0		0		0
7 Issuance costs from proceeds ...............	503,876		1,120,800		0		2,444,202
8 Credit enhancement from proceeds .............	0		0		0		0
9 Working capital expenditures from proceeds .............	0		0		0		0
10 Capital expenditures from proceeds .............	124,873,123		0		0		199,269,999
11 Other spent proceeds .............	151,542,325		80,573,075		82,620,000		93,712,755
12 Other unspent proceeds .............	0		0		0		0
13 Year of substantial completion .............	2011		2012
	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 2020, a current refunding issue)? ........	X		X		X			X
15 Were the bonds issued as part of an advance refunding issue of taxable bonds (or, if issued prior to 2020, an advance refunding issue)? ........		X		X		X	X
16 Has the final allocation of proceeds been made? ..........	X		X		X			X
17 Does the organization maintain adequate books and records to support the final allocation of proceeds? ..................	X		X		X		X

For Paperwork Reduction Act Notice, see the Instructions for Form 990.

Cat. No. 50193E

Schedule K (Form 990) 2023

Page 2

Part Ⅲ

Private Business Use

	A		B		C		D
	Yes	No	Yes	No	Yes	No	Yes	No
1 Was the organization a partner in a partnership, or a member of an LLC, which owned property financed by tax-exempt bonds? .............		X		X		X		X
2 Are there any lease arrangements that may result in private business use of bond-financed property? ...............	X		X		X		X
3a Are there any management or service contracts that may result in private business use of bond-financed property? .............	X		X		X		X
b If "Yes" to line 3a, does the organization routinely engage bond counsel or other outside counsel to review any management or service contracts relating to the financed property?	X		X		X		X
c Are there any research agreements that may result in private business use of bond-financed property? .............	X		X		X		X
d If "Yes" to line 3c, does the organization routinely engage bond counsel or other outside counsel to review any research agreements relating to the financed property?	X		X		X		X
4 Enter the percentage of financed property used in a private business use by entities other than a section 501(c)(3) organization or a state or local government ....	0.800 %		0.040 %		0.800 %		0.760 %
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 .........	0.010 %		0 %		0.010 %		0.010 %
6 Total of lines 4 and 5 .............	0.810 %		0.040 %		0.810 %		0.770 %
7 Does the bond issue meet the private security or payment test? ...		X		X		X		X
8a Has there been a sale or disposition of any of the bond-financed property to a nongovernmental person other than a 501(c)(3) organization since the bonds were issued?.............	X		X		X			X
b If "Yes" to line 8a, enter the percentage of bond-financed property sold or disposed of. ..
c If "Yes" to line 8a, was any remedial action taken pursuant to Regulations sections 1.141-12 and 1.145-2? .............		X		X		X		X
9 Has the organization established written procedures to ensure that all nonqualified bonds of the issue are remediated in accordance with the requirements under Regulations sections 1.141-12 and 1.145-2? ........	X		X		X		X

Part Ⅳ

Arbitrage

	A		B		C		D
	Yes	No	Yes	No	Yes	No	Yes	No
1 Has the issuer filed Form 8038-T, Arbitrage Rebate, Yield Reduction and Penalty in Lieu of Arbitrage Rebate? ...		X		X		X		X
2 If "No" to line 1, did the following apply? ....
a Rebate not due yet? .......		X		X	X		X
b Exception to rebate? ........	X			X		X		X
c No rebate due? .........		X	X			X		X
If "Yes" to line 2c, provide in Part Ⅵ the date the rebate computation was performed ......
3 Is the bond issue a variable rate issue? .....	X		X			X		X

Schedule K (Form 990) 2023

Page 3

Part Ⅳ

Arbitrage (Continued)

	A		B		C		D
	Yes	No	Yes	No	Yes	No	Yes	No
4a Has the organization or the governmental issuer entered into a qualified hedge with respect to the bond issue?		X		X		X		X
b Name of provider ..........	0		0		0		0
c Term of hedge .........
d Was the hedge superintegrated? ......
e Was the hedge terminated? ........
5a Were gross proceeds invested in a guaranteed investment contract (GIC)?		X		X		X		X
b Name of provider ..........	0		0		0		0
c Term of GIC .........
d Was the regulatory safe harbor for establishing the fair market value of the GIC satisfied? ........
6 Were any gross proceeds invested beyond an available temporary period?		X	X			X		X
7 Has the organization established written procedures to monitor the requirements of section 148? ...	X		X		X		X

Part Ⅴ

Procedures To Undertake Corrective Action

	A		B		C		D
	Yes	No	Yes	No	Yes	No	Yes	No
Has the organization established written procedures to ensure that violations of federal tax requirements are timely identified and corrected through the voluntary closing agreement program if self-remediation is not available under applicable regulations?	X		X		X		X

Part Ⅵ

Supplemental Information. Provide additional information for responses to questions on Schedule K. (See instructions).

Return Reference	Explanation
SCHEDULE K, PART II, LINE 3	DIFFERENCES IN AMOUNTS ENTERED IN PART I, COLUMN (E) AND PART II, LINE 3 REPRESENT INVESTMENT EARNINGS.
SCHEDULE K, PART II, LINE 13	FOR THE INDIANA FINANCE AUTHORITY 2012A/B, INDIANA FINANCE AUTHORITY 2016C/E, INDIANA FINANCE AUTHORITY 2017A, INDIANA FINANCE AUTHORITY 2023A, AND INDIANA FINANCE AUTHORITY 2023B BONDS, THESE BONDS SOLELY REFUNDED PRIOR ISSUES, SO THE YEAR OF SUBSTANTIAL COMPLETION HAS NOT BEEN ENTERED.
SCHEDULE K, PART III, LINE 8B	FOR THE INDIANA FINANCE AUTHORITY 2008F, 2008I/J, AND 2012A/B BONDS, DURING 2012, THE DISPOSITION PROCEEDS FOR THE DISPOSED OF BOND-FINANCED PROPERTY WAS $1.00, WHICH WAS WELL BELOW A TENTH OF A PERCENT OF EACH ISSUE.
SCHEDULE K, PART III, LINE 8C	FRANCISCAN ALLIANCE, THE INDIANA FINANCE AUTHORITY, AND THE IRS ENTERED INTO A CLOSING AGREEMENT TO ADDRESS THE REQUIRED REMEDIAL ACTION UNDER REGULATIONS SECTION 1.142-12 AND 1.145-2.
SCHEDULE K, PART IV, LINE 2C	FOR THE SERIES 2008I/J BOND, THE REBATE COMPUTATION WAS PERFORMED FEBRUARY 2011. FOR THE SERIES 2017B/C BOND, THE REBATE COMPUTATION WAS PERFORMED JANUARY 2020.
SCHEDULE K, PART IV, LINE 5	FOR THE INDIANA FINANCE AUTHORITY 2008I/J ISSUE, ONLY SMALL AMOUNTS OF PROCEEDS RELATED TO THE COST OF ISSUANCE WERE NOT EXPENDED AT THE END OF THE TEMPORARY PERIODS.

Schedule K (Form 990) 2023

Additional Data

Software ID:
Software Version:

- TIN:

Schedule L
(Form 990)

Department of the Treasury
Internal Revenue Service

Transactions with Interested Persons

Complete if the organization answered "Yes" on Form 990, Part IV, lines 25a, 25b, 26, 27, 28a, 28b, or 28c, or Form 990-EZ, Part V, line 38a or 40b.
Attach to Form 990 or Form 990-EZ.
Go to www.irs.gov/Form990 for instructions and the latest information.

OMB No. 1545-0047

2023

Open to Public Inspection

Name of the organization

FRANCISCAN ALLIANCE INC

Employer identification number

35-1330472

Part I

Excess Benefit Transactions (section 501(c)(3), section 501(c)(4), and section 501(c)(29) organizations only).
Complete if the organization answered "Yes" on Form 990, Part IV, line 25a or 25b, or Form 990-EZ, Part V, line 40b.

1(a) Name of disqualified person	(c) Description of transaction	(d) Corrected?
1(a) Name of disqualified person	(c) Description of transaction	Yes	No

Enter the amount of tax incurred by the organization managers or disqualified persons during the year under section 4958. ........................... $

Enter the amount of tax, if any, on line 2, above, reimbursed by the organization ........ $

Part II

Loans to and/or From Interested Persons.
Complete if the organization answered "Yes" on Form 990-EZ, Part V, line 38a, or Form 990, Part IV, line 26; or if the organization reported an amount on Form 990, Part X, line 5, 6, or 22

(a) Name of interested person	(b) Relationship with organization	(c) Purpose of loan	(d) Loan to or from the organization?		(e) Original principal amount	(f) Balance due	(g) In default?		(h) Approved by board or committee?		(i) Written agreement?
(a) Name of interested person	(b) Relationship with organization	(c) Purpose of loan	To	From	(e) Original principal amount	(f) Balance due	Yes	No	Yes	No	Yes	No




Total ............... $

Part III

Grants or Assistance Benefiting Interested Persons.
Complete if the organization answered "Yes" on Form 990, Part IV, line 27.

(a) Name of interested person	(b) Relationship between interested person and the organization	(c) Amount of assistance	(d) Type of assistance	(e) Purpose of assistance

For Paperwork Reduction Act Notice, see the Instructions for Form 990 or 990-EZ.

Cat. No. 50056A

Schedule L (Form 990) 2023

Page 2

Part IV

Business Transactions Involving Interested Persons.
Complete if the organization answered "Yes" on Form 990, Part IV, line 28a, 28b, or 28c.

(a) Name of interested person	(b) Relationship between interested person and the organization	(c) Amount of transaction	(d) Description of transaction	(e) Sharing of organization's revenues?
(a) Name of interested person		(c) Amount of transaction	(d) Description of transaction	Yes	No
(1) HPC INTERNATIONAL INC	Entity > 35% owned by Hilton Hudson, Trustee	145,043	BUSINESS TRANSACTION		No
(2) HPC SURGICAL PLLC	Entity > 35% owned by Hilton Hudson, Trustee	3,380,842	BUSINESS TRANSACTION		No

Part V

Supplemental Information
Provide additional information for responses to questions on Schedule L (see instructions).

Return Reference	Explanation

Schedule L (Form 990) 2023

Additional Data

Software ID:
Software Version:

- TIN:

SCHEDULE O
(Form 990)

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.
Attach to Form 990 or 990-EZ.
Go to www.irs.gov/Form990 for the latest information.

OMB No. 1545-0047

2023

Open to Public
Inspection

Name of the organization

FRANCISCAN ALLIANCE INC

Employer identification number

35-1330472

Return Reference	Explanation
FORM 990, PART I, LINE 1	FRANCISCAN ALLIANCE, INC.'S ("FRANCISCAN") PURPOSE IS TO CONTINUE THE HEALING MINISTRY OF CHRIST IN ACCORDANCE WITH THE TEACHINGS OF THE ROMAN CATHOLIC CHURCH AND IN PARTNERSHIP WITH OTHERS TO PROVIDE A FULL CONTINUUM OF HEALTH CARE SERVICES; TO CARRY ON EDUCATIONAL ACTIVITIES RELATED TO THE PROMOTION OF HEALTH; TO PROMOTE AND CARRY ON SCIENTIFIC RESEARCH RELATED TO HEALTH CARE; AND TO PARTICIPATE IN ACTIVITIES DESIGNED AND CONDUCTED TO PROMOTE THE GENERAL HEALTH OF THOSE SERVED BY FRANCISCAN. PLEASE VIEW WWW.FRANCISCANHEALTH.ORG/ABOUT/WHO-WE-ARE WHICH REFLECTS OUR MISSION OF "CONTINUING CHRIST'S MINISTRY IN OUR FRANCISCAN TRADITION" AS WELL AS WWW.FRANCISCANHEALTH.ORG/COMMUNITYHEALTH FOR FRANCISCAN'S COMMUNITY BENEFIT AND COMMUNITY HEALTH ASSESMENTS.
FORM 990, PART III, LINE 1	THE PURPOSES FOR WHICH FRANCISCAN ALLIANCE, INC. ("FRANCISCAN") IS FORMED ARE: TO CONTINUE THE HEALING MINISTRY OF CHRIST IN ACCORDANCE WITH THE TEACHINGS OF THE ROMAN CATHOLIC CHURCH AND, IN PARTNERSHIP WITH OTHERS, TO PROVIDE A FULL CONTINUUM OF HEALTH CARE SERVICES; TO CARRY ON EDUCATIONAL ACTIVITIES RELATED TO THE PROMOTION OF HEALTH; TO PROMOTE AND CARRY ON SCIENTIFIC RESEARCH RELATED TO HEALTH CARE; AND TO PARTICIPATE IN ANY ACTIVITY DESIGNED AND CONDUCTED TO PROMOTE THE GENERAL HEALTH OF THOSE SERVED BY FRANCISCAN. THE REVENUES OF FRANCISCAN ALLOW FOR THE OPERATION OF HEALTH CARE FACILITIES WHERE THE PURPOSE IS TO RESPECT LIFE AND TO PRESERVE HEALTH AS WELL AS TREAT ILLNESS AND INJURY. THIS ALLOWS FOR THE ACCOMPLISHMENT OF FRANCISCAN'S MINISTRY WHICH HAS THE FOLLOWING CENTRAL CONCERNS: COMPASSION FOR THOSE IN NEED, RESPECT FOR LIFE AND THE DIGNITY OF PERSONS, WELLNESS AND THE PREVENTION OF ILLNESS, RESTORATION TO HEALTH, AND THE ACCEPTANCE OF DEATH AS THE FINAL STEP TOWARDS WHOLENESS. PLEASE VIEW WWW.FRANCISCANHEALTH.ORG/ABOUT/WHO-WE-ARE WHICH REFLECTS OUR MISSION OF "CONTINUING CHRIST'S MINISTRY IN OUR FRANCISCAN TRADITION" AS WELL AS WWW.FRANCISCANHEALTH.ORG/COMMUNITYHEALTH FOR FRANCISCAN'S COMMUNITY BENEFIT AND COMMUNITY HEALTH ASSESMENTS.
FORM 990, PART III, LINE 4A	FOR OVER 145 YEARS, FRANCISCAN ALLIANCE, INC. ("FRANCISCAN") HAS ENDEAVORED TO STAY TRUE TO OUR FOUNDING MISSION OF CARING FOR PATIENTS WHO COME THROUGH OUR DOORS AND WE CONTINUE TO LOOK FOR OPPORTUNITIES TO SERVE OUR COMMUNITIES THROUGH THE VERY BEST IN MEDICAL CARE AND SERVICE TO THE LESS FORTUNATE AMONG US. FRANCISCAN'S PURPOSE IS TO CONTINUE THE HEALING MINISTRY OF CHRIST IN ACCORDANCE WITH THE TEACHINGS OF THE ROMAN CATHOLIC CHURCH AND IN PARTNERSHIP WITH OTHERS TO PROVIDE A FULL CONTINUUM OF HEALTH CARE SERVICES; TO CARRY ON EDUCATIONAL ACTIVITIES RELATED TO THE PROMOTION OF HEALTH; TO PROMOTE AND CARRY ON SCIENTIFIC RESEARCH RELATED TO HEALTH CARE; AND TO PARTICIPATE IN ACTIVITIES DESIGNED AND CONDUCTED TO PROMOTE THE GENERAL HEALTH OF THOSE SERVED BY FRANCISCAN. FRANCISCAN DIRECTLY OR INDIRECTLY OPERATES 12 HOSPITAL CAMPUSES (ONE IN ILLINOIS AND 11 IN INDIANA) ALONG WITH NUMEROUS PHYSICIAN CLINICS AND ANCILLARY SERVICES CENTERS AND OFFERS NUMEROUS COMMUNITY HEALTH IMPROVEMENT PROGRAMS THAT ARE FURTHER DESCRIBED IN SCHEDULE H, PART VI, ITEM 5 AND SCHEDULE H, PART I, LINE 6A. IN 2023, FRANCISCAN SERVED ABOUT 2 MILLION PERSONS AND PROVIDED OVER $836 MILLION IN CHARITY CARE AND OTHER COMMUNITY BENEFITS. FRANCISCAN PROVIDES SIGNIFICANT BENEFITS THAT REFLECT THE ORGANIZATION'S COMMITMENT TO HEALTHCARE AND THE COMMUNITIES IT IS PRIVILEGED TO SERVE. IN 2023, FRANCISCAN PROVIDED COMMUNITY BENEFITS WHICH INCLUDED: UNREIMBURSED COSTS OF MEDICAID AND OTHER INDIGENT CARE PROGRAMS $186,833,905 COST OF CHARITY CARE PROVIDED $ 66,102,319 OTHER BENEFITS FOR THE POOR AND UNDERSERVED $ 3,086,533 SUBSIDIZED HEALTH SERVICES $ 35,311,714 HEALTH PROFESSIONS EDUCATION $ 14,885,157 COMMUNITY HEALTH IMPROVEMENT SERVICES $ 3,886,846 FINANCIAL AND IN-KIND CONTRIBUTIONS $ 486,313 RESEARCH $ 1,842,272 COMMUNITY BENEFIT OPERATIONS $ 188,414 UNREIMBURSED COSTS OF MEDICARE $523,436,654 _______________ TOTAL $836,060,127 PLEASE VIEW WWW.FRANCISCANHEALTH.ORG/ABOUT/WHO-WE-ARE WHICH REFLECTS OUR MISSION OF "CONTINUING CHRIST'S MINISTRY IN OUR FRANCISCAN TRADITION" AS WELL AS WWW.FRANCISCANHEALTH.ORG/COMMUNITYHEALTH FOR FRANCISCAN'S COMMUNITY BENEFIT AND COMMUNITY HEALTH ASSESMENTS. ALTHOUGH IT IS NOT ALL INCLUSIVE OF THE MANY BENEFITS PROVIDED BY FRANCISCAN IT DOES PORTRAY THE SIGNIFICANT BENEFITS THAT REFLECT OUR COMMITMENT TO HEALTHCARE AND THE COMMUNITIES WE ARE PRIVILEGED TO SERVE. PLEASE SEE THE RESPONSE TO SCHEDULE H, PART VI, ITEM 5 AND SCHEDULE H, PART I, LINE 6A FOR A DETAILED DESCRIPTION OF THE MANY CLINICAL SERVICES AS WELL AS POPULATION HEALTH IMPROVEMENT AND COMMUNITY OUTREACH ACTIVITIES OFFERED BY ONE OR MORE OF FRANCISCAN'S HEALTHCARE FACILITIES.
FORM 990, PART V, LINE 4B	EUROPEAN UNION, FINLAND, FRANCE, GERMANY, HONG KONG, INDONESIA, ISRAEL, ITALY, JAPAN, REPUBLIC OF KOREA (SOUTH), MALAYSIA, MEXICO, NETHERLANDS, NEW ZEALAND, NORWAY, PORTUGAL, RUSSIAN FEDERATION, SINGAPORE, SOUTH AFRICA, SPAIN, SWEDEN, SWITZERLAND, TAIWAN, THAILAND, UNITED ARAB EMIRATES, UNITED KINGDOM.
FORM 990, PART VI, SECTION A, LINE 7A	THE ENTIRE BOARD OF TRUSTEES SHALL CONSIST OF NO MORE THAN TWENTY (20), AND NO FEWER THAN NINE (9), SEVEN (7) OF WHOM SHALL BE SISTERS OF THE EASTERN PROVINCE ("PROVINCE") OF THE SISTERS OF ST. FRANCIS OF PERPETUAL ADORATION, A RELIGIOUS CONGREGATION OF WOMEN OF THE ROMAN CATHOLIC CHURCH ("CONGREGATION"). THE TRUSTEES OF THE BOARD SHALL INCLUDE THE FOLLOWING PERSONS: (A) THREE TRUSTEES SHALL BE MEMBERS OF THE PROVINCIAL LEADERSHIP OF THE PROVINCE, ONE OF WHOM SHALL BE THE PROVINCIAL, OR HER DESIGNEE, AND THE REMAINING TWO SHALL BE APPOINTED BY THE PROVINCIAL LEADERSHIP;(B) THE MEMBER OF THE CORPORATION SERVING AS TREASURER OF THE PROVINCE WHO MAY ALSO BE ONE OF THE PROVINCIAL LEADERSHIP REPRESENTATIVES AS DESCRIBED IN (A); (C) THE MEMBER OF THE CORPORATION SERVING AS SPONSOR LIAISON FOR HEALTHCARE OF THE PROVINCE WHO MAY ALSO BE ONE OF THE PROVINCIAL LEADERSHIP REPRESENTATIVES AS DESCRIBED IN (A); (D) THE PRESIDENT/CHIEF EXECUTIVE OFFICER OF THE CORPORATION; AND (E) THE TRUSTEES ELECTED BY THE MEMBERS TO FILL THE REMAINING POSITIONS.
FORM 990, PART VI, SECTION A, LINE 7B	NO ACTION ON THE PART OF THE BOARD OF TRUSTEES IN RESPECT OF ANY OF THE FOLLOWING MATTERS SHALL BE EFFECTIVE UNLESS THE ACTION HAS BEEN APPROVED BY A MAJORITY OF THE MEMBERS; NAMELY: (A) CORPORATE MISSION AND PHILOSOPHY; (B) APPOINTMENT OR REMOVAL OF THE CHAIRPERSON, PRESIDENT, SECRETARY, OR TREASURER OF THE CORPORATION; (C) ALIENATION OF PROPERTY AS DEFINED IN CANON LAW; OR (D) ENCUMBRANCE OF DEBT AS DEFINED BY CANON LAW.
FORM 990, PART VI, SECTION B, LINE 11B	THE INFORMATION TO PREPARE THE FORM 990 OF FRANCISCAN ALLIANCE, INC. ("FRANCISCAN") IS GATHERED BY FINANCE AND BY COMMUNITY BENEFIT AND MISSION REPRESENTATIVES AND PROVIDED TO ITS ACCOUNTING FIRM WHO PREPARES THE RETURN. SENIOR MANAGEMENT THEN REVIEWS THE RETURN PRIOR TO FILING. THE FORM 990 IS ALSO MADE AVAILABLE TO FRANCISCAN'S BOARD OF TRUSTEES AND BOARD FINANCE COMMITTEE PRIOR TO FILING.
FORM 990, PART VI, SECTION B, LINE 12C	FRANCISCAN REQUIRES ANNUAL CONFLICT OF INTEREST STATEMENTS FROM EACH DIRECTOR, PRINCIPAL OFFICER, MEMBERS OF COMMITTEES WITH BOARD DESIGNATED POWERS, KEY EMPLOYEES, AND EXECUTIVE LEADERSHIP COMMITTEE MEMBERS WHICH AFFIRMS THAT THEY HAVE RECEIVED, READ, AND UNDERSTAND THE CONFLICT OF INTEREST POLICY AND HAVE AGREED TO COMPLY WITH THE POLICY. IN CONNECTION WITH ANY ACTUAL OR POSSIBLE CONFLICT OF INTEREST, A DIRECTOR, PRINCIPAL OFFICER OR MEMBER OF A COMMITTEE WITH BOARD DESIGNATED POWERS MUST DISCLOSE THE EXISTENCE AND NATURE OF THE FINANCIAL INTEREST TO THE DIRECTORS AND MEMBERS OF COMMITTEES WITH BOARD DELEGATED POWERS CONSIDERING THE PROPOSED TRANSACTION OR ARRANGEMENTS. AFTER DISCLOSURE OF THE FINANCIAL INTEREST, THE DIRECTOR, PRINCIPAL OR COMMITTEE MEMBER SHALL LEAVE THE BOARD OR COMMITTEE MEETING WHILE THE FINANCIAL INTEREST IS DISCUSSED AND VOTE TAKEN. IN ADDITION, ONGOING REVIEWS AND ASSESSMENTS ARE MADE TO MAKE CERTAIN FRANCISCAN OPERATES IN A MANNER CONSISTENT WITH ITS CHARITABLE PURPOSES. IN CONDUCTING THE ONGOING REVIEWS AND ASSESSMENTS, FRANCISCAN USES INTERNAL AND EXTERNAL ADVISORS. REVIEWS INCLUDE COMPENSATION ARRANGEMENTS, ACQUISITIONS, PARTNERSHIPS, JOINT VENTURE ARRANGEMENTS, AND AGREEMENTS TO PROVIDE HEALTH CARE PRODUCTS/SERVICES, ETC.
FORM 990, PART VI, SECTION B, LINE 15	FRANCISCAN ALLIANCE, INC.'S ("FRANCISCAN") PROCESS FOR DETERMINING COMPENSATION FOR THE ORGANIZATION'S PRESIDENT/CEO, OFFICERS AND KEY EMPLOYEES CONSISTS OF PERIODIC EXTERNAL REVIEWS COMPLETED BY NATIONAL INDEPENDENT COMPENSATION CONSULTANTS. THE EXECUTIVE COMMITTEE OF THE BOARD OF TRUSTEES APPROVES THE PROPOSED COMPENSATION AND BENEFITS AT AN ANNUAL COMPENSATION REVIEW MEETING HELD EACH YEAR. THE ORGANIZATION'S PRESIDENT/CEO RECUSES HIMSELF FROM THE VOTE ON EXECUTIVE COMPENSATION EXECUTIVE COMPENSATION.
FORM 990, PART VI, SECTION C, LINE 19	FRANCISCAN ALLIANCE, INC.'S ARTICLES OF INCORPORATION ARE AVAILABLE ON THE INDIANA SECRETARY OF STATE WEBSITE. THE BYLAWS AND CONFLICTS OF INTEREST POLICY ARE AVAILABLE UPON WRITTEN REQUEST. THE AUDITED FINANCIAL STATEMENTS ARE AVAILABLE ON THE ELECTRONIC MUNICIPAL MARKET ACCESS (EMMA) WEBSITE.
FORM 990, PART XI, LINE 9	EQUITY IN EARNINGS OF AFFILIATES $ 61,569,393 OTHER COMPONENTS OF NET PERIODIC PENSION COST $ 6,390,981 OTHER COMPREHENSIVE INCOME $ 93,011,001 DIVIDENDS RECEIVED FROM AFFILIATES $ 3,106,680 EQUITY TRANSFER (TO)/FROM AFFILIATES $ (3,509,604) CHANGES IN NET UNREALIZED GAINS/LOSSES - HILLS $ 24,540,430 CHANGES IN NET UNREALIZED GAINS/LOSSES - SWAP $ 943,721 CHANGE IN NONCONTROLLING INTEREST IN SUBS $ 84,972 CHANGE DONOR RESTRICTED NET ASSETS $ (245,308) DISTRIBUTIONS TO AFFILIATES $ (5,351,105) DONATION OF PPE $ (900,859) OTHER CHANGES IN NET ASSETS $ (2,775,700) -------------- TOTAL OTHER CHANGES IN NET ASSETS $ 176,864,601

For Paperwork Reduction Act Notice, see the Instructions for Form 990 or 990-EZ.

Cat. No. 51056K

Schedule O (Form 990) 2023

Additional Data

Software ID:
Software Version:

- TIN:

SCHEDULE R
(Form 990)

Department of the Treasury
Internal Revenue Service

Related Organizations and Unrelated Partnerships

Complete if the organization answered "Yes" on Form 990, Part IV, line 33, 34, 35b, 36, or 37.
Attach to Form 990.
Go to www.irs.gov/Form990 for instructions and the latest information.

OMB No. 1545-0047

2023

Open to Public Inspection

Name of the organization

FRANCISCAN ALLIANCE INC

Employer identification number

35-1330472

Part I

Identification of Disregarded Entities. Complete if the organization answered "Yes" on Form 990, Part IV, line 33.

(a) Name, address, and EIN (if applicable) of disregarded entity	(b) Primary activity	(c) Legal domicile (state or foreign country)	(d) Total income	(e) End-of-year assets	(f) Direct controlling entity
(1) ST FRANCIS INSURANCE SERVICES LLC 1600 ALBANY STREET BEECH GROVE,IN46107 20-0048077	INSURANCE	IN	2,153,953	0	FRANCISCAN
(2) SPECIALTY PHYSICIANS OF ILLINOIS LLC 333 DIXIE HIGHWAY CHICAGO HEIGHTS,IL60411 05-0540914	PHYSICIAN	IL	38,397,851	7,962,960	FRANCISCAN
(3) FAITH HOPE AND LOVE CANCER CENTER LLC 1250 SOUTH CREASY LN STE A LAFAYETTE,IN47905 68-0612977	MEDICAL SRVCS	IN	3,664,418	0	FRANCISCAN
(4) ST FRANCIS MEDICAL GROUP LLC 5330 E STOP 11 RD INDIANAPOLIS,IN46237 26-3877295	MEDICAL SRVCS	IN	28,706,657	0	FRANCISCAN
(5) FRANCISCAN PHO CENTRAL INDIANA LLC 1515 DRAGOON TRAIL MISHAWAKA,IN46544 82-2534628	ACCOUNT. CARE	IN	-8,225	238,531	FRANCISCAN
(6) FRANCISCAN PHO NORTHERN INDIANA LLC 1515 DRAGOON TRAIL MISHAWAKA,IN46544 82-2537889	ACCOUNT. CARE	IN	8,935,241	3,168,998	FRANCISCAN
(7) FRANCISCAN SURGERY CENTER LAPORTE 900 I ST LA PORTE,IN46350 26-0505795	SURGERY CTR.	IN	642,109	987,767	FRANCISCAN

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?
(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	Yes	No
(1)HILLS INSURANCE COMPANY INC 1515 DRAGOON TRAIL MISHAWAKA,IN46544 03-0372512	CAPTIVE INS	VT	501(C)(3)	12-TYPE 1	FRANCISCAN	Yes
(2)SISTERS OF ST FRANCIS OF PERPETUAL ADOR PO BOX 766 MISHAWAKA,IN46546 35-1328145	RELIGIOUS	IN	501(C)(3)	1	NA		No
(3)ST ALEXIS HOSPITAL ASSOCIATION PO BOX 1290 MISHAWAKA,IN46546 34-0714485	SUPPORT ALEXA	OH	501(C)(3)	3	FRANCISCAN	Yes
(4)FRANCISCAN HEALTH FOUNDATION INC 1515 DRAGOON TRAIL MISHAWAKA,IN46544 35-1955283	FUNDRAISING	IN	501(C)(3)	7	FRANCISCAN	Yes
(5)FRANCISCAN VNS HOME CARE INC 4701 N KEYSTONE AVE S418 INDIANAPOLIS,IN46205 35-0868199	HOME HEALTH	IN	501(C)(3)	10	FRANCISCAN	Yes
(6)FRANCISCAN HEALTH RENSSELAER INC 1104 E GRACE ST RENSSELAER,IN47978 47-3825106	HEALTH SRVCS	IN	501(C)(3)	3	FRANCISCAN	Yes
(7)FRANCISCAN ACO INC 700 E SOUTHPORT ROAD INDIANAPOLIS,IN46227 35-1904455	HEALTHCARE	IN	501(C)(3)	12-TYPE 1	FRANCISCAN	Yes

For Paperwork Reduction Act Notice, see the Instructions for Form 990.

Cat. No. 50135Y

Schedule R (Form 990) 2023

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
(a) Name, address, and EIN of related organization	(b) Primary activity	(c) Legal domicile (state or foreign country)	(d) Direct controlling entity		(f) Share of total income	(g) Share of end-of-year assets	Yes	No	(i) Code V-UBI amount in box 20 of Schedule K-1 (Form 1065)	Yes	No	(k) Percentage ownership
(1) FRANCISCAN SURGERY CENTER LLC 421 N EMERSON AVE BEECH GROVE,IN46143 35-2128334	MEDICAL SERVICES	IN	FRANCISCAN	RELATED	10,598,754	2,617,858		No	0		No	52.941 %
(2) ST FRANCIS RADIATION THERAPY CENTERS LLC 421 N EMERSON AVE GREENWOOD,IN46143 77-0663631	MEDICAL SERVICES	IN	FRANCISCAN	RELATED	4,881,296	1,949,119		No	0		No	84.530 %
(3) ST FRANCIS IMAGING CTR (GREENWOOD) LLC 421 N EMERSON AVE GREENWOOD,IN46143 20-4607426	IMAGING SERVICES	IN	FRANCISCAN	RELATED	729,576	364,116		No	0		No	60.000 %
(4) TONN & BLANK CONSTRUCTION LLC 1623 GREENWOOD AVENUE MICHIGAN CITY,IN46360 26-3919039	CONSTRUCTION	IN	FHC	RELATED	7,894,033	50,614,724		No	187,698	Yes		60.721 %
(5) MAJOR HOSP CARDIAC DIAGNOSTICS LLC 2451 INTELLIPLEX DR SHELBYVILLE,IN46176 20-8715441	MEDICAL SERVICES	IN	FRANCISCAN	RELATED	572,681	262,065		No	0		No	53.604 %
(6) ST FRANCIS MOORESVILLE SURGERY CENTER 1215 HADLEY ROAD SUITE 100 MOORESVILLE,IN46158 20-2256900	MEDICAL SERVICES	IN	FRANCISCAN	RELATED	2,304,615	192,393		No	0	Yes		50.000 %
(7) FRANCISCAN ORTHOPEDIC HOSPITAL CENTER 10777 ILLINOIS ST STE H300H400 CARMEL,IN460328972 84-5101253	MEDICAL SERVICES	IN	FRANCISCAN	RELATED	15,307,746	26,283,038		No	0	Yes		51.000 %
(8) MOORESVILLE ENDOSCOPY CENTER LLC 1215 HADLEY ROAD SUITE 101 MOORESVILLE,IN46158 41-2116930	MEDICAL SERVICES	IN	FRANCISCAN	RELATED	2,418,294	154,376		No	0	Yes		50.000 %

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?
(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	Yes	No
(1) FRANCISCAN HOLDING CORPORATION 1515 DRAGOON TRAIL MISHAWAKA,IN46544 36-3593505	HOLDING CO.	IN	FRANCISCAN	C CORP	5,842,195	117,674,200	100.000 %	Yes
(2) SAGAMORE SURGICAL SERVICES INC 2320 CONCORD ROAD SUITE B LAFAYETTE,IN479092708 35-1850819	MEDICAL SERVICES	IN	FRANCISCAN	S CORP	-18,339	131,815	60.000 %	Yes

Schedule R (Form 990) 2023

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

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 .....................

b Gift, grant, or capital contribution to related organization(s) ............................

Yes

c Gift, grant, or capital contribution from related organization(s) ............................

Yes

d Loans or loan guarantees to or for related organization(s) ............................

Yes

e Loans or loan guarantees by related organization(s) ............................

f Dividends from related organization(s) ............................

g Sale of assets to related organization(s) ............................

h Purchase of assets from related organization(s) ............................

i Exchange of assets with related organization(s) ............................

j Lease of facilities, equipment, or other assets to related organization(s) .......................

k Lease of facilities, equipment, or other assets from related organization(s) ......................

Yes

l Performance of services or membership or fundraising solicitations for related organization(s) .....................

m Performance of services or membership or fundraising solicitations by related organization(s) .................

Yes

n Sharing of facilities, equipment, mailing lists, or other assets with related organization(s) ...................

o Sharing of paid employees with related organization(s) ............................

p Reimbursement paid to related organization(s) for expenses ............................

Yes

q Reimbursement paid by related organization(s) for expenses ............................

Yes

r Other transfer of cash or property to related organization(s) ............................

s Other transfer of cash or property from related organization(s) ............................

If the answer to any of the above is "Yes," see the instructions for information on who must complete this line, including covered relationships and transaction thresholds.

(a) Name of related organization	(b) Transaction type (a-s)	(c) Amount involved	(d) Method of determining amount involved
(1) FRANCISCAN HEALTH FOUNDATION INC	C	6,427,187	FMV
(2) FRANCISCAN HEALTH FOUNDATION INC	B	694,819	FMV
(3) ST FRANCIS RADIATION THERAPY CENTERS LLC	C	5,642,293	FMV
(4) ST FRANCIS IMAGING CENTER (GREENWOOD) LLC	C	856,920	FMV
(5) TONN AND BLANK CONSTRUCTION LLC	C	3,621,680	FMV
(6) MAJOR HOSPITAL CARDIAC DIAGNOSTICS	C	600,000	FMV
(7) FRANCISCAN SURGERY CENTER LLC	C	11,136,152	FMV
(8) ST FRANCIS MOORESVILLE SURGERY CENTER LLC	C	2,630,794	FMV
(9) MOORESVILLE ENDOSCOPY CENTER LLC	C	2,361,000	FMV
(10) FRANCISCAN ORTHOPEDIC HOSPITAL CENTER LLC	C	12,257,034	FMV

Schedule R (Form 990) 2023

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)	(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
(a) Name, address, and EIN of entity	(b) Primary activity	(c) Legal domicile (state or foreign country)	Yes	No	(f) Share of total income	(g) Share of end-of-year assets	Yes	No	(i) Code V-UBI amount in box 20 of Schedule K-1 (Form 1065)	Yes	No	(k) Percentage ownership

Schedule R (Form 990) 2023

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) 2023

Additional Data

Software ID:
Software Version:

1	Briefly describe the organization’s mission or most significant activities: SEE SCHEDULE O
2	Check this box
3	Number of voting members of the governing body (Part VI, line 1a) ........	3	17
4	Number of independent voting members of the governing body (Part VI, line 1b) .....	4	15
5	Total number of individuals employed in calendar year 2023 (Part V, line 2a) ......	5	23,141
6	Total number of volunteers (estimate if necessary) .............	6	493
7a	Total unrelated business revenue from Part VIII, column (C), line 12 ........	7a	5,142,161
b	Net unrelated business taxable income from Form 990-T, Part I, line 11 .........	7b	975,132

		Prior Year	Current Year
8	Contributions and grants (Part VIII, line 1h) .........	15,237,290	20,396,439
9	Program service revenue (Part VIII, line 2g) .........	3,199,875,561	3,482,152,285
10	Investment income (Part VIII, column (A), lines 3, 4, and 7d ) ....	70,572,770	25,118,858
11	Other revenue (Part VIII, column (A), lines 5, 6d, 8c, 9c, 10c, and 11e)	4,384,200	11,658,123
12	Total revenue—add lines 8 through 11 (must equal Part VIII, column (A), line 12)	3,290,069,821	3,539,325,705
13	Grants and similar amounts paid (Part IX, column (A), lines 1–3 )...	0	694,819
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)	1,659,664,555	1,673,844,183
16a	Professional fundraising fees (Part IX, column (A), line 11e) .....	0	0
b	Total fundraising expenses (Part IX, column (D), line 25) 0
17	Other expenses (Part IX, column (A), lines 11a–11d, 11f–24e)....	1,850,058,194	1,930,383,996
18	Total expenses. Add lines 13–17 (must equal Part IX, column (A), line 25)	3,509,722,749	3,604,922,998
19	Revenue less expenses. Subtract line 18 from line 12.......	-219,652,928	-65,597,293
		Beginning of Current Year	End of Year
20	Total assets (Part X, line 16).............	5,633,003,402	6,045,200,354
21	Total liabilities (Part X, line 26).............	1,957,018,636	1,963,578,113
22	Net assets or fund balances. Subtract line 21 from line 20.....	3,675,984,766	4,081,622,241

Sign Here

	Signature of officer	Date

	Type or print name and title


4a	(Code: ) (Expenses $ 3,034,815,899 including grants of $ 694,819 ) (Revenue $ 3,473,379,443 )
	SEE SCHEDULE O

4b	(Code: ) (Expenses $ including grants of $ ) (Revenue $ )












4c	(Code: ) (Expenses $ including grants of $ ) (Revenue $ )












4d	Other program services (Describe in Schedule O.)
	(Expenses $ including grants of $ ) (Revenue $ )
4e	Total program service expenses3,034,815,899

1b	Sub-Total..............
c	Total from continuation sheets to Part VII, Section A..
d	Total (add lines 1b and 1c).........	13,648,591	0	1,608,914

1a	Federated campaigns..		1a
b	Membership dues..		1b
c	Fundraising events..		1c
d	Related organizations		1d	6,427,187
e	Government grants (contributions)		1e	13,969,252

f	All other contributions, gifts, grants, and similar amounts not included above		1f	0

g	Noncash contributions included in lines 1a - 1f:$		1g

h Total. Add lines 1a-1f.......		20,396,439

		Business Code
2a	PATIENT SERVICE AND OTHER REVENUES	900099	3,460,363,300	3,458,467,463	1,895,837	0
b	PREMIUM REVENUE	900099	14,911,980	14,911,980	0	0
c	CAFETERIA/FOOD SERVICES	722310	6,874,305	0	24,526	6,849,779
d	LAUNDRY	812332	2,700	0	2,700	0
e
f	All other program service revenue.
g	Total. Add lines 2a–2f .....		3,482,152,285

3 Investment income (including dividends, interest, and othersimilar amounts) ......			27,483,647		1,045,685	26,437,962
4 Income from investment of tax-exempt bond proceeds			0
5 Royalties...........			0
			(i) Real	(ii) Personal
6a	Gross rents	6a	9,259,657
b	Less: rental expenses	6b	0
c	Rental income or (loss)	6c	9,259,657	0
d	Net rental income or (loss).......			9,259,657			9,259,657
			(i) Securities	(ii) Other
7a	Gross amount from sales of assets other than inventory	7a		160,515
b	Less: cost or other basis and sales expenses	7b		2,525,304
c	Gain or (loss)	7c		-2,364,789
d	Net gain or (loss).........			-2,364,789			-2,364,789
8a	Gross income from fundraising events (not including $ of contributions reported on line 1c). See Part IV, line 18 ....
			8a	0
b	Less: direct expenses ...		8b	0
c	Net income or (loss) from fundraising events..			0
9a	Gross income from gaming activities. See Part IV, line 19 ...
			9a	0
b	Less: direct expenses ...		9b	0
c	Net income or (loss) from gaming activities..			0
10a	Gross sales of inventory, less returns and allowances ..
			10a	1,307,059
b	Less: cost of goods sold ..		10b	1,082,007
c	Net income or (loss) from sales of inventory..			225,053			225,053

Business Code
11a	OTHER REVENUE		900099	2,173,413	0	2,173,413	0
b
c
d	All other revenue ....
e	Total. Add lines 11a–11d ......			2,173,413
12	Total revenue. See instructions.....			3,539,325,705	3,473,379,443	5,142,161	40,407,662

1	Grants and other assistance to domestic organizations and domestic governments. See Part IV, line 21 ....	694,819	694,819
2	Grants and other assistance to domestic individuals. See Part IV, line 22 ...........	0
3	Grants and other assistance to foreign organizations, foreign governments, and foreign individuals. See Part IV, lines 15 and 16. .............	0
4	Benefits paid to or for members .......	0
5	Compensation of current officers, directors, trustees, and key employees ...........	6,861,359		6,861,359
6	Compensation not included above, to disqualified persons (as defined under section 4958(f)(1)) and persons described in section 4958(c)(3)(B) .........	0
7	Other salaries and wages........	1,352,812,317	1,091,146,859	261,665,458
8	Pension plan accruals and contributions (include section 401(k) and 403(b) employer contributions) ....	76,265,479	61,203,537	15,061,942
9	Other employee benefits .......	146,385,774	117,475,524	28,910,250
10	Payroll taxes ...........	91,519,254	73,444,789	18,074,465
11	Fees for services (non-employees):
a	Management ......	93,012,572	86,912,661	6,099,911
b	Legal .........	2,965,705	78,047	2,887,658
c	Accounting ...........	1,543,864		1,543,864
d	Lobbying ...........	386,962		386,962
e	Professional fundraising services. See Part IV, line 17	0
f	Investment management fees ......	0
g	Other (If line 11g amount exceeds 10% of line 25, column (A) amount, list line 11g expenses on Schedule O)	127,821,490	91,799,193	36,022,297
12	Advertising and promotion ....	13,570,574	1,263,943	12,306,631
13	Office expenses .......	2,658,401	2,259,538	398,863
14	Information technology ......	35,444,626	35,444,626
15	Royalties ..	0
16	Occupancy ...........	39,321,246	36,686,086	2,635,160
17	Travel ............	2,969,607	1,864,186	1,105,421
18	Payments of travel or entertainment expenses for any federal, state, or local public officials .	0
19	Conferences, conventions, and meetings ....	660,797	166,436	494,361
20	Interest ...........	38,241,124	38,241,124
21	Payments to affiliates .......	0
22	Depreciation, depletion, and amortization ..	173,376,019	151,736,585	21,639,434
23	Insurance ...	46,286,149	45,389,932	896,217
24	Other expenses. Itemize expenses not covered above (List miscellaneous expenses in line 24e. If line 24e amount exceeds 10% of line 25, column (A) amount, list line 24e expenses on Schedule O.)
a	MEDICAL SUPPLIES/DRUGS	539,632,716	539,632,716	0
b	PURCHASED SERVICES	454,647,922	362,881,924	91,765,998
c	HAF	155,158,796	155,158,796	0
d	UTILITIES	49,815,105	47,823,879	1,991,226
e	All other expenses	152,870,321	93,510,699	59,359,622
25	Total functional expenses. Add lines 1 through 24e	3,604,922,998	3,034,815,899	570,107,099	0
26	Joint costs. Complete this line only if the organization reported in column (B) joint costs from a combined educational campaign and fundraising solicitation. Check here if following SOP 98-2 (ASC 958-720).

1	Cash–non-interest-bearing ........			0	1	0
2	Savings and temporary cash investments .........			166,371,270	2	92,818,653
3	Pledges and grants receivable, net ......			0	3	0
4	Accounts receivable, net .............			366,314,095	4	446,440,086
5	Loans and other receivables from 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 .......
				0	5	0
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) ...
				0	6	0
7	Notes and loans receivable, net ...........			44,844,903	7	47,541,534
8	Inventories for sale or use ............			61,885,238	8	61,012,200
9	Prepaid expenses and deferred charges ......			0	9	0
10a	Land, buildings, and equipment: cost or other basis. Complete Part VI of Schedule D	10a	3,870,367,736
b	Less: accumulated depreciation	10b	1,892,208,789	1,919,999,681	10c	1,978,158,947
11	Investments—publicly traded securities .			2,320,219,303	11	2,519,690,392
12	Investments—other securities. See Part IV, line 11 .....			234,302,464	12	273,767,396
13	Investments—program-related. See Part IV, line 11 ..			0	13	0
14	Intangible assets ...............			13,894,895	14	14,814,090
15	Other assets. See Part IV, line 11 ...........			505,171,553	15	610,957,056
16	Total assets. Add lines 1 through 15 (must equal line 33)...			5,633,003,402	16	6,045,200,354

17	Accounts payable and accrued expenses .....	261,153,477	17	288,103,080
18	Grants payable ...	0	18	0
19	Deferred revenue .........	0	19	0
20	Tax-exempt bond liabilities .........	1,104,094,668	20	1,077,209,758
21	Escrow or custodial account liability. Complete Part IV of Schedule D	0	21	0
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 .........
		0	22	0
23	Secured mortgages and notes payable to unrelated third parties ..	92,274,512	23	92,274,512
24	Unsecured notes and loans payable to unrelated third parties ..	0	24	0
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	499,495,979	25	505,990,763
26	Total liabilities. Add lines 17 through 25..	1,957,018,636	26	1,963,578,113

	Organizations that follow FASB ASC 958, check here and complete lines 27, 28, 32, and 33.
27	Net assets without donor restrictions ..........	3,673,331,641	27	4,079,214,424
28	Net assets with donor restrictions ...........	2,653,125	28	2,407,817
	Organizations that do not follow FASB ASC 958, check here 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 ...........	3,675,984,766	32	4,081,622,241
33	Total liabilities and net assets/fund balances ........	5,633,003,402	33	6,045,200,354

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). . . . . . . . . . . . . . . . . . . . . . . . . . . . . .	Yes	No
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). . . . . . . . . . . . . . . . . . . . . . . .	Yes	No
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). . . . . . . . . . . . . . . . . . . . . . . . . . . .	Yes	No
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) .	Yes	No
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). . . . . . . . . . . . . . . . . . . . . . . . . . . . . .	Yes	No
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).. . . . . . . . . . . . . . . . . . . . . . . . . . . .	Yes	No