2024-05-09T12:03:46+00:00 2023-06-30 346565596 ERNST & YOUNG US LLP 2323 VICTORY AVENUE DALLAS TX 75219 990 2022-07-01 741109665 Christus Santa Rosa Health Care Corporation CHRI 2103218000 333 N SANTA ROSA STREET SAN ANTONIO TX 78207 DEAN ALEXANDER PRESIDENT & CEO & BOARD DIRECTOR 2024-05-09 true STEVE CHEN 999009999 true Stephanie Lew P01080011 2149698000 2022 2023-04-26 12:10:37Z SEE SCHEDULE O Stephanie Parker 333 N SANTA ROSA STREET SAN ANTONIO TX 78207 1076133157 false 0928 X HTTPS://WWW.CHRISTUSHEALTH.ORG/SANTA-ROSA X 1985 TX SUPPORTING THE HEALTH CARE MINISTRIES OF THE SPONSORING CONGREGATIONS IN EXTENDING THE HEALTH MINISTRY OF JESUS CHRIST IN CONFORMITY WITH THE ROMAN CATHOLIC CHURCH. 16 13 5512 346 1453170 1305333 9309498 12888960 1033980187 1061171115 -1025914 40651 1406713 2032431 1043670484 1076133157 7419 5973 0 0 389304402 386366754 0 2011835 690277872 727972719 1079589693 1114345446 -35919209 -38212289 891277182 903010144 123560104 108332873 767717078 794677271 X See Schedule O false false 348450769 0 265459369 See Schedule O 305180089 0 227136538 See Schedule O 275499115 0 570446258 See Schedule O 5893816 0 0 COMMUNITY SERVICES FOR THE BROADER COMMUNITY THE GREATEST SHARE OF THESE EXPENSES IS USED FOR EDUCATING HEALTH PROFESSIONALS. HELPING TO PREPARE FUTURE HEALTH CARE PROFESSIONALS IS A DISTINGUISHING CHARACTERISTIC OF NOT-FOR-PROFIT HEALTH CARE, AND CONSTITUTES A SIGNIFICANT COMMUNITY BENEFIT. CHRISTUS SANTA ROSA HEALTH CARE CORPORATION ALSO USED CASH DONATIONS AS A VEHICLE TO HELP OUR COMMUNITIES. WE MADE CASH DONATIONS, IN ADDITION TO GRANTS AWARDED THROUGH THE CHRISTUS FUND, TO INCREASE ACCESS TO HEALTH CARE, SUPPORT CAUSES LIKE THE FIGHT AGAINST CANCER, HEART DISEASE, DIABETES, AND FOR MANY OTHER EQUALLY WORTHY PURPOSES. DURING FY 2023, CHRISTUS SANTA ROSA ADVOCATED FOR IMPROVING PUBLIC POLICIES, WORKING TO ESTABLISH, AND IN SOME INSTANCES AUGMENT, GRASSROOTS ADVOCACY AND GREATER ACCESS TO HEALTHCARE SERVICES FOR THE CONSTITUENTS WE SERVE. 2443391 5973 0 COMMUNITY SERVICES FOR THE POOR AND UNDERSERVED ROOTED IN OUR MISSION AND TRADITION, THE FOUNDERS AND SPONSORS OF CHRISTUS HEALTH AND THOSE WHO CO-MINISTER WITH THEM SEEK NEW AND INNOVATIVE WAYS OF DELIVERING QUALITY HEALTH CARE THAT IS BOTH AFFORDABLE AND ACCESSIBLE TO ALL. TODAY, MORE THAN EVER, WE MUST AIM TO IMPROVE THE TOTAL HEALTH STATUS OF THE COMMUNITY THROUGH PROGRAMS THAT PLACE OUR SERVICES WHERE THEY ARE NEEDED MOST, WITH SPECIAL ATTENTION AND PREFERENCE GIVEN TO PROGRAMS THAT SUPPORT AND BENEFIT THE HEALTH AND WELFARE OF THE POOR AND UNDERSERVED. COMMUNITY SERVICES FOR THE POOR AND UNDERSERVED REPRESENT THE UNPAID COST OF SERVICES PROVIDED FOR WHICH A PATIENT IS NOT BILLED, OR FOR WHICH A FEE HAS BEEN ASSESSED THAT RECOVERS ONLY A PORTION OF THE COST OF THE RENDERED SERVICE. THIS CATEGORY INCLUDES INITIATIVES THAT REACH OUT TO THOSE IN NEED THROUGH COMMUNITY HEALTH AND SOCIAL PROGRAMS. THESE PROGRAMS SEEK JUSTICE FOR THE VULNERABLE AND WORK TO BRING ABOUT CHANGES IN OUR POLITICAL AND ECONOMIC SYSTEMS. THE PROGRAMS COVER A BROAD SPECTRUM OF SERVICES FROM COMMUNITY CLINICS, OUTREACH PROGRAMS FOR CHILDREN AND SENIORS, HEALTH EDUCATION, AIR AMBULANCE AND A VARIETY OF OTHER SOCIAL SERVICES. ONE EXAMPLE OF CHRISTUS SANTA ROSA HEALTH CARE CORPORATION'S COMMUNITY BENEFITS ACCOUNTED FOR UNDER COMMUNITY SERVICES FOR THE POOR AND UNDERSERVED INCLUDE THE CHRISTUS HEALTH COMMUNITY DIRECT INVESTMENT PROGRAM (CDI). THE CHRISTUS HEALTH BOARD OF DIRECTORS APPROVED THE FUNDING OF THE CDI LOAN PROGRAM TO ENSURE THAT THE WORK OF SOCIAL ACCOUNTABILITY AND MORAL AND ETHICAL STEWARDSHIP CONTINUES IN SPITE OF CHALLENGING FISCAL CONDITIONS FACED BY LOCAL OPERATING ENTITIES. THE PURPOSE OF THE CDI PROGRAM IS TO SUPPORT COMMUNITY-DRIVEN INITIATIVES PRIMARILY FOR AFFORDABLE HOUSING AND ECONOMIC DEVELOPMENT BY PROVIDING FINANCING AT BELOW-MARKET INTEREST RATES TO NOT-FOR-PROFIT ORGANIZATIONS AT TERMS NOT EXCEEDING MORE THAN FIVE YEARS. THE INCOME THAT IS LOST FROM THE MARKET RATE LESS OUR LOAN RATE (FOREGONE INCOME) IS CONSIDERED A COMMUNITY BENEFIT FOR REPORTING PURPOSES. THE COST OF THESE INVESTMENTS IS NOT INCLUDED IN THE PROGRAM SERVICE EXPENSES OF CHRISTUS SANTA ROSA HEALTH CARE CORPORATION. CHRISTUS HEALTH HAS ESTABLISHED THE CHRISTUS FUND TO PROVIDE RESOURCES TO NOT FOR-PROFIT AGENCIES AND GROUPS WHOSE MISSION, VISION AND GOALS ARE CONSISTENT WITH CHRISTUS HEALTH'S MISSION, VALUES AND PHILOSOPHY OF A HEALTHY COMMUNITY. WE BELIEVE THAT BY WORKING TOGETHER, WE CAN MAKE A PROFOUND DIFFERENCE IN THE QUALITY OF PEOPLES' LIVES AND CREATE SUSTAINABLE HEALTH IN OUR COMMUNITIES. DURING FY 2022, THE TOTAL GRANT MONEY DISTRIBUTED BY CHRISTUS HEALTH TO THE CHRISTUS SANTA ROSA HEALTH CARE CORPORATION REGION WAS $343,000. THE COST OF THESE GRANTS IS NOT INCLUDED IN THE PROGRAM SERVICE EXPENSES FOR CHRISTUS SANTA ROSA HEALTH CARE CORPORATION. SEVERAL CHRISTUS REGIONS PROVIDE INDIGENT FUNDING DONATIONS OR "GRANTS" TO AID THE COUNTIES IN WHICH THEY, OR ANOTHER CHRISTUS REGION, SERVE. SUCH GRANTS MAY BE PAID TO THE COUNTY DIRECTLY OR VIA ANOTHER HOSPITAL OR HEALTHCARE ORGANIZATION IN THE AREA. THIS CHARITABLE DONATION HELPS RELIEVE THE ADDITIONAL EXPENSE OF HEALTHCARE FOR THE INDIGENT POPULATION WITHIN OUR COMMUNITIES THAT CHRISTUS MAY NOT DIRECTLY SERVE IN ONE OF OUR HOSPITALS. THIS IS A RESULT OF OUR MISSION TO EXTEND THE HEALING MINISTRY OF JESUS CHRIST, ESPECIALLY TO THE POOR AND UNDERSERVED. 8337207 5973 937467180 true true false true false false false false false true false false true true true false true false false false false false false false false true true false false true false false false false false false false false false false false false false true true true false false true 0 0 5512 true true true false false false false false false false false false false false X 16 13 true false false false true true true true true false false true true true true true true true true true true X LEE SONNE 4692822000 5101 N OConnor Blvd IRVING TX 75039 Charles Hankins MD CMO & BOARD DIRECTOR, QUALITY COMMITTEE OF THE BOARD (TERM 12/22) 40.0 0.0 X X 0 1127525 44347 Charlie Amato DIRECTOR/VICE CHAIR 1.0 0.0 X X 0 0 0 Cris Daskevich CEO OF CHOSA & BOARD DIRECTOR 40.0 0.0 X X 0 1162364 208160 Dr James Chris Henderson MEDICAL STAFF PRESIDENT & DIRECTOR 40.0 0.0 X X 0 354479 21471 J Michael Belz Chairperson 1.0 0.0 X X 0 0 0 Stephanie A Parker CEO & BOARD DIRECTOR 40.0 0.0 X X 0 730317 122369 Varshi Broumand MD CSR Medical Staff President 40.0 0.0 X X 0 0 0 Christiane Perkins-Garcia Board Director 1.0 0.0 X 0 0 0 Gary Arthur Board Director 1.0 0.0 X 0 0 0 Jelynne LeBlanc-Burley Board Director (Term 12/22) 1.0 0.0 X 0 0 0 Lisa Campos Board Director 1.0 0.0 X 0 0 0 Pat Frost Board Director 1.0 0.0 X 0 0 0 Pilar Oates Board Director 1.0 0.0 X 0 0 0 Sandra Chavarria-Salinas Board Director 1.0 0.0 X 0 0 0 Sister Mary Cecilia Henry Mentee 1.0 0.0 X 0 0 0 Sr Cindy Stacy Board Director 1.0 0.0 X 0 0 0 Sr Hanna Paradowska Board Director 1.0 0.0 X 0 0 0 Wendy Gramm Board Director 1.0 0.0 X 0 0 0 Steve Chen CFO & Treasurer 40.0 0.0 X 0 660891 65005 Tammy Rivers CORPORATE SECRETARY (TERM 1/2022) 40.0 0.0 X 99796 0 4867 Alexis Arel VP Finance Admin Office 40.0 0.0 X 0 297972 8756 Barbara Vazquez CNO Childrens Hospital 40.0 0.0 X 0 297986 16416 Bonifacio Benitez Vp Clinical Operations 40.0 0.0 X 0 275903 28279 Cara Ansaldo President Santa Rosa Medical Center 40.0 0.0 X 0 408062 30047 Carla Moreno VP, Patient Placement 40.0 0.0 X 0 301709 22506 Christine Keating VP AMB SVS-Network of care 40.0 0.0 X 0 336286 33866 Debasish Dasgupta CMO Westover Hills 40.0 0.0 X 0 452415 46849 Dominic Dominguez Regional CEO 20.0 20.0 X 0 1441660 430569 Genifer Rucker President New Braunfels 40.0 0.0 X 0 344602 23977 Ian Thompson Pres. & VP Market Oncology 40.0 0.0 X 0 563808 68118 Karen Bryant VP-Strategy-Bus Development 40.0 0.0 X 0 435643 85604 Nikki Rivers CNO New Braunfels 40.0 0.0 X 0 307197 51202 Norman Christopher CMO Childrens Hospital 40.0 0.0 X 0 673080 92183 Patricia Burns President 40.0 0.0 X 0 514752 20481 Sarah Hill VP MISSION INTEGRATION 40.0 0.0 X 0 252704 38623 Sherry Fraser President Alamo Heights 40.0 0.0 X 0 277478 27386 Steven Martin Associate CIO 40.0 0.0 X 0 239214 24099 Terry Kyle Chief Development Officer 40.0 0.0 X 0 401169 38939 Thomas Mckinney President 40.0 0.0 X 0 462885 104147 William M Johnson Chief Nursing Officer 40.0 0.0 X 0 259672 11036 DUSTYN D TYSDAL Dir Pharmacy 40.0 0.0 X 275609 0 23939 EDWARD R ALANIZ RN Lead 40.0 0.0 X 245362 0 14306 GIANG P DINH Clinical Pharmacist 40.0 0.0 X 240888 0 12106 KENNETH DAVIS MD CHIEF MEDICAL OFFICER (Thru 12/2022) 0.0 0.0 X 0 261772 0 Travis Krug VP Human Resources 40.0 0.0 X 0 235620 21637 Dean Alexander President & CEO & Board Director (Term 12/21) 0.0 0.0 X 0 925611 473259 EILEEN HUSS CHIEF NURSING OFFICER 0.0 0.0 X 0 53736 127920 861655 14056512 2342469 487 true true false 0 109642 9727846 2178103 873369 12888960 Net Patient Service Revenue 621100 1051998650 1050561819 1436831 Rent Related to Exempt Purpose 531120 2572649 2572649 Support Services Revenue 900099 1009547 1009547 Research Revenue 900099 639597 639597 OTHER PROGRAM SERVICES 900099 4950672 4950672 0 0 0 0 1061171115 1072 1072 111 111 0 0 39579 0 39579 39579 39579 Clinical Research 900099 1878724 1878724 Parking Service 900099 125478 125478 Misc Revenue 900099 19453 19453 8665 -7674 16339 0 2032320 1076133157 1061605334 1453170 185693 X 5973 5973 0 0 326497856 311807131 13088200 1602525 6171489 5787483 346287 37719 32022958 29223142 2579524 220292 21674451 20772065 790680 111706 704200 17433 686767 4037 4037 262424797 136043032 126379463 2302 1755807 1712617 42681 509 78486951 75115492 3343369 28090 33328184 32767903 560281 546023 322214 217604 6205 669672 501095 167120 1457 16546612 16567728 -21116 45420212 45496893 -76681 11594462 6957132 4637330 Medical Supplies 167746525 167313503 432699 323 Provision for uncollectible accts 42371229 42371229 Dues/Membership & Sponsorship 915676 419944 495582 150 LPPF Tax Expense 27905951 27905951 37552381 16359220 21192604 557 1114345446 937467180 174866431 2011835 368199 257174 146237596 130657652 0 0 0 0 42152072 39581523 29717511 29842981 20874534 26736364 1032370600 542574125 470758914 489796475 0 7004094 7968892 3143190 0 171021072 178169083 891277182 903010144 53004642 60931448 13815039 9884535 50714 54245 0 0 56689709 37462645 123560104 108332873 X 652637183 661949184 115079895 132728087 767717078 794677271 891277182 903010144 X -38212289 65172482 X false true X true true true X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED false false false false false false true 4037 false false 4037 Schedule C, Part II-B, Line 1g LOBBYING DESCRIPTION AT THE FEDERAL LEVEL, CHRISTUS HEALTH TEXAS LEADERSHIP HAD DIRECT CONTACT WITH MEMBERS OF THE CONGRESS AND ADMINISTRATION OFFICIALS THROUGH EMAILS, LETTERS, TELEPHONE CALLS AND MEETINGS TO DISCUSS ISSUES IMPORTANT TO OUR MINISTRY. THESE ISSUES INCLUDE, BUT ARE NOT LIMITED TO ISSUES RELATED TO SAFETY-NET PROVIDERS, ACCESS TO CARE, HEALTH CARE REFORM PROPOSALS, QUALITY PROGRAM IMPLEMENTATION, RURAL HOSPITALS, REMOTE MEDICAL TECHNOLOGY, 340B DRUG PRICING PROGRAM, SITE NEUTRAL PAYMENTS, COMMUNITY PROJECT FUNDING, FREESTANDING EMERGENCY DEPARTMENTS, MEDICARE ADVANCED PAYMENTS, VALUE-BASED PAYMENT MODELS, FOREIGN HEALTH CARE WORKERS, CHILDREN'S HEALTH ISSUES, CHGME, MEDICAID, SUPPLEMENTAL PAYMENT PROGRAMS, RURAL HEALTH PROGRAM REAUTHORIZATION, AND HEALTH CARE FOR VETERANS. AT THE STATE LEVEL, CHRISTUS HEALTH TEXAS LEADERSHIP HAD DIRECT CONTACT WITH MEMBERS OF THE TEXAS LEGISLATURE AND ADMINISTRATION OFFICIALS THROUGH EMAILS, LETTERS, TELEPHONE CALLS AND MEETINGS TO DISCUSS ISSUES IMPORTANT TO OUR MINISTRY. THESE ISSUES INCLUDE, BUT ARE NOT LIMITED TO ISSUES RELATED TO MEDICAID REIMBURSEMENT, ACCESS TO HEALTH CARE AND STATE FUNDING FOR SAFETY NET PROVIDERS, EMERGENCY PREPAREDNESS, WORKPLACE VIOLENCE, COVID-19 RESPONSE, GRADUATE MEDICAL EDUCATION, TRAUMA NETWORK AND SERVICES, LOCAL PROVIDER PARTICIPATION FUNDS, MATERNAL HEALTH, CHILDREN'S HEALTH ISSUES, BEHAVIORAL HEALTH, MEDICAID MANAGED CARE, PRESCRIPTION DRUGS COSTS, PHARMACY AND PRESCRIBING AUTHORITY, RURAL HOSPITALS, PHYSICIAN RELATIONS, ITEMIZED BILLING, FOSTER CARE REFORM, MEDICAID DIRECTED PAYMENT PROGRAMS, HEALTH CARE STAFFING, PRICE TRANSPARENCY, AND THE 1115 WAIVER PROGRAM. 15 EXECUTIVE HOURS. CHRISTUS SANTA ROSA HEALTH CARE CORPORATION DID NOT SUBSTANTIALLY LOBBY DURING THE FISCAL YEAR ENDING 6-30-23. 27198740 27198740 607223970 211055425 396168545 11158314 7801665 3356649 332190971 306403261 25787710 54598605 17313774 37284831 489796475 INTEREST IN SUPPORTING ORGS ROU TRANSACTIONS DEFERRED RENT DEFERRED LEASE INCENTIVE ASSET OTHERS BENEFICIAL INTEREST SUB ORG 125961612 ROU TRANSACTIONS 32712209 OTHERS 8163586 DEFERRED RENTS 6708133 FIN 45 ASSETS 2787627 DEPOSITS 1020710 INTERCOMPANY ACCOUNTS PAYABLE 815206 178169083 339226 LT PORTION-CAPITAL LEASE BLDG DEFERRED MEDICARE PAYABLE CP LEASE LIABILITY OTHER LT PORTION CAPITAL LEASE BLDG/HOSP CP LEASE LIABILITY OTHER NOTES PAYABLE LT PORTION CAPITAL LEASE BLDG/HOSP 28200623 CP LEASE LIABILITY 7896006 OTHER 982176 NOTES PAYABLE 43150 STATE SALES TAX PAYABLE 1464 37462645 X Schedule D, Part X, Line 2 FIN 48 (ASC 740) footnote PER FOOTNOTE 3 IN THE CONSOLIDATED FINANCIAL STATEMENTS, THERE ARE NO MATERIAL UNRECORDED TAX LIABILITIES AS OF JUNE 30, 2023 AND 2022 . true true X true X 300 true X true true true false true true 0 0 67153517 0 67153517 0.0626 0 0 305180089 227136538 78043551 0.0728 0 0 0 0 0 0.0 0 0 372333606 227136538 145197068 0.1354 16 77760 3386150 0 3386150 0.0032 2 303 717073 0 717073 0.0007 2 0 4186843 0 4186843 0.0039 0 0 0 0 0 0.0 4 0 16093705 0 16093705 0.0150 24 78063 24383771 0 24383771 0.0227 24 78063 396717377 227136538 169580839 0.1582 0 0 0 0 0 0.0 0 0 0 0 0 0.0 0 0 0 0 0 0.0 0 0 0 0 0 0.0 0 0 0 0 0 0.0 0 0 0 0 0 0.0 1 0 47141 0 47141 0.0000 0 0 0 0 0 0.0 0 0 0 0 0 0.0 1 0 47141 0 47141 0.0000 true 42371229 316042 133577907 144170109 -10592202 X true true CH SN RSA OTPT SGY OUTPATIENT SURGERY CENTER 0.524 0.476 CR SN RS PH AB SG CT SURGERY CENTER 0.5781 0.2796 7 1 CHRISTUS SANTA ROSA NEW BRAUNFELS 600 N UNION AVENUE NEW BRAUNFELS TX 78130 WWW.CHRISTUSHEALTH.ORG/SANTA-ROSA 000339 X X X A 2 CHRISTUS SANTA ROSA WESTOVER HILLS 11212 STATE HIGHWAY 151 SAN ANTONIO TX 78251 WWW.CHRISTUSHEALTH.ORG/SANTA-ROSA 100165 X X X A 3 CHRISTUS SANTA ROSA MEDICAL CENTER 2827 BABCOCK ROAD SAN ANTONIO TX 78229 WWW.CHRISTUSHEALTH.ORG/SANTA-ROSA 000339 X X X A 4 CHRISTUS SANTA ROSA ALAMO HEIGHTS 403 TREELINE PARK SAN ANTONIO TX 78209 WWW.CHRISTUSHEALTH.ORG/SANTA-ROSA 000339 X X X A 5 CHRISTUS CHILDREN'S 333 N SANTA ROSA STREET SAN ANTONIO TX 78207 WWW.CHOFSA.ORG 100166 X X X X X X A 6 CHRISTUS SANTA ROSA SAN MARCOS 1301 WONDER WORLD DRIVE SAN MARCOS TX 78666 WWW.CHRISTUSHEALTH.ORG 100514 X X X A A false false true X X X X X X X X X 22 true true true true X HTTPS://WWW.CHRISTUSHEALTH.ORG/CONNECT/COMMUNITY/COMMUNITY-NEEDS X true 22 true HTTPS://WWW.CHRISTUSHEALTH.ORG/CONNECT/COMMUNITY/COMMUNITY-NEEDS false true X 300.0 400.0 X X X X X true true X X X X X true X SEE SUPPLEMENTAL INFO X SEE SUPPLEMENTAL INFO X SEE SUPPLEMENTAL INFO X X X X X X X true X false X X X X X true X false false Schedule H, Part V, Section B, Line 3E CHRISTUS Santa Rosa Health System and CHRISTUS Children's, CHRISTUS Santa Rosa Hospital - New Braunfels and CHRISTUS Santa Rosa Hospital - San Marcos The CHNAs identified many priorities to be addressed. However, given the large population of uninsured patients with chronic illness who seek care at CHRISTUS Santa Rosa Health System, CSRHS chooses to implement programs specifically at this population. To that end, the major community benefit activities enacted by CSRHS are focused on Advancing Health & Wellbeing (Specialty Care & Chronic Illness, Behavioral Health) and Build Resilient Communities & Improving Social Determinants (Improving Food Access and Reducing smoking and vaping). CSRHS anticipates meeting all the needs identified. Schedule H, Part V, Section B, Line 5 Facility A, 1 Facility A, 1 - CHRISTUS Santa Rosa Health System and CHRISTUS Children's. Input from persons who represent the community health needs assessment process included synthesizing existing quantitative data on Social, Economic, and Health indicators for the County. Quantitative data was compiled and analyzed from a number of sources, including the U.S. Census, Centers for Disease Control and Prevention, County Health Rankings, Texas Department of State Health Services, San Antonio Metropolitan Health District, and Nowdata. Types of data included public health disease surveillance data, hospitalization records, vital statistics based on birth and death data, and self-reports for health behaviors from large, population-based surveys, such as the behavioral risk factor surveillance survey and youth risk behavior survey. When possible, data was provided down to the subsector level to provide relevant information for more granular geographic areas within Bexar County. To compliment these quantitative data, qualitative information was collected and analyzed based on five focus groups and key informant interviews and discussion groups comprised from community members, including community health workers, people over 65, young adults 15 to 18, and Mayor Ron Nirenberg. The focus groups and key informant interviews were moderated by staff at The Health Collaborative and qualitatively analyzed by Community Information Now (CI:Now). Using a grounded theory framework and the software Dedoose CI:Now performed open coding as an initial way of identifying general themes, axial coding as a way of connecting the themes into categories and subcategories, and selective coding to identify themes. Schedule H, Part V, Section B, Line 5 Facility A, 2 Facility A, 2 - CHRISTUS Santa Rosa Hospital - New Braunfels and CHRISTUS Santa Rosa Hospital - San Marcos. Community Focus Groups and Key Informant Interviews and discussions were a critical part of a robust, primary data collection for the CHNA. It involved speaking directly to community members, partners and leaders that live in and/or work in the CHRISTUS Santa Rosa Hospital - New Braunfels PSA and CHRISTUS Santa Rosa Hospital - San Marcos PSA. All focus groups were coordinated by hospital site and the CHRISTUS Health system office and facilitated by Metopio. Focus groups included a broad range of individuals from underrepresented, and priority populations in the respective hospital sites. Focus groups were conducted virtually, lasted 90 minutes and had up to 10 community members participate in each group. Schedule H, Part V, Section B, Line 6a Facility A, 1 Facility A, 1 - CHRISTUS Santa Rosa Health System and CHRISTUS Children's. The hospitals' CHNAs were a collaboration with other hospital facilities in the area. In Bexar County, CHRISTUS Santa Rosa Health System, Addition Studio, The State of Texas County of Bexar, Community First Health Plans, Methodist Healthcare Ministries of South Texas Inc., Methodist Healthcare, City of San Antonio Metropolitan Health District, University Health, UIW - School of Osteopathic Medicine and UT Health San Antonio worked together to conduct the CHNA. In addition, community focus groups and key informant interviews were conducted. Schedule H, Part V, Section B, Line 6a Facility A, 2 Facility A, 2 - CHRISTUS Santa Rosa Hospital - New Braunfels and CHRISTUS Santa Rosa Hospital - San Marcos. The hospitals' CHNAs were not a collaboration with any other hospital facility in the area. Spoke directly to community members, partners and leaders that live in and/or work in the PSA. This was done through focus groups and key informant interviews representing the public and not-for-profit community-based organizations. In CSRHS - New Braunfels, participants included Hill County Community Mental Health Center, Recovery Werks, McKenna Foundation, New Braunfels Christian Ministry, NB Food Bank, NB Housing Partners, Volunteers in Medicine, and 10 Community members representing underrepresented and priority populations. In CSRHS - San Marcos, participants included the SM Housing Authority, Hays-Caldwell Women's Center, Hays County Food Bank, Southside Community Center, Community Action Inc. of Hays, Caldwell & Blanco, Central Texas Children's Home and 10 community members representing underrepresented and priority populations. Schedule H, Part V, Section B, Line 6b Facility A, 1 Facility A, 1 - CHRISTUS Santa Rosa Health System and CHRISTUS Children's. The hospitals' CHNAs were a collaboration with other hospital facilities in the area. In Bexar County, CHRISTUS Santa Rosa Health System, Addition Studio, The State of Texas County of Bexar, Community First Health Plans, Methodist Healthcare Ministries of South Texas Inc., Methodist Healthcare, City of San Antonio Metropolitan Health District, University Health, UIW - School of Osteopathic Medicine and UT Health San Antonio worked together to conduct the CHNA. In addition, community focus groups and key informant interviews were conducted. Schedule H, Part V, Section B, Line 6b Facility A, 2 Facility A, 2 - CHRISTUS Santa Rosa Hospital - New Braunfels and CHRISTUS Santa Rosa Hospital - San Marcos. The hospitals' CHNAs were not a collaboration with any other hospital facility in the area. Spoke directly to community members, partners and leaders that live in and/or work in the PSA. This was done through focus groups and key informant interviews representing the public and not-for-profit community-based organizations. In CSRHS - New Braunfels, participants included Hill County Community Mental Health Center, Recovery Werks, McKenna Foundation, New Braunfels Christian Ministry, NB Food Bank, NB Housing Partners, Volunteers in Medicine, and 10 Community members representing underrepresented and priority populations. In CSRHS - San Marcos, participants included the SM Housing Authority, Hays-Caldwell Women's Center, Hays County Food Bank, Southside Community Center, Community Action Inc. of Hays, Caldwell & Blanco, Central Texas Children's Home and 10 community members representing underrepresented and priority populations. Schedule H, Part V, Section B, Line 11 Facility A, 1 Facility A, 1 - CHRISTUS SRHS and CHRISTUS Children's CHRISTUS Santa Rosa Hospital - New Braunfels and CHRISTUS SRH - San Marcos. The CHNAs identified many priorities to be addressed. However, given the large population of uninsured patients with chronic illness who seek care at CHRISTUS Santa Rosa Health System, CHSRHS chooses to implement programs targeted specifically at this population. To that end, the major community benefit activities enacted by CSRHS are focused on Advancing Health & Wellbeing (Specialty Care & Chronic Illness, Behavioral Health) and Build Resilient Communities & Improving Social Determinants (Improving Food Access and Reducing smoking and vaping). CSRHS anticipates meeting all the needs identified. Schedule H, Part V, Section B, Line 13 Facility A, 1 Facility A, 1 - See Schedule, H, Part V, Section A. UNDER THE HOSPITAL'S POLICY, PATIENTS WHO WERE UNINSURED AND MET CERTAIN FINANCIAL CRITERIA WERE ELIGIBLE FOR FINANCIAL ASSISTANCE. THE POLICY ALSO PROVIDED FOR ASSISTANCE FOR MEDICALLY INDIGENT PATIENTS. IN GENERAL, PATIENTS WHO WERE BELOW 300% OF FEDERAL POVERTY GUIDELINES RECEIVED FREE CARE. PATIENTS WHO WERE UNINSURED AND ABOVE 300% OF THE FEDERAL POVERTY GUIDELINE WERE BILLED RATES CONSISTENT WITH AMOUNTS GENERALLY BILLED TO COMMERCIAL PAYERS. PATIENTS WHO WERE UNINSURED AND BETWEEN 300% TO 400% OF FEDERAL POVERTY GUIDELINES COULD APPLY FOR ADDITIONAL ASSISTANCE TO PAY AMOUNTS LESS THAN AGB. Schedule H, Part V, Section B, Line 15 Facility A, 1 Facility A, 1 - See Schedule, H, Part V, Section A. IN ADDITION TO REGULAR APPLICATIONS, THE HOSPITAL ALSO ASSESSED PATIENTS FOR PRESUMPTIVE ELIGIBILITY TO FACILITATE GIVING ASSISTANCE TO NEEDY PATIENTS. THE HOSPITAL IMPLEMENTED ELECTRONIC ELIGIBILITY TOOLS THAT USED PATIENT DEMOGRAPHIC DATA, CREDIT REPORTS, AND OTHER PUBLICLY AVAILABLE INFORMATION TO ESTIMATE A PATIENT'S INCOME, ASSETS, AND LIQUIDITY. PATIENTS WERE SCREENED AS PART OF THE COLLECTION ATTEMPT PROCESS. WHEN ELECTRONIC SCREENING WAS USED AS THE BASIS FOR PRESUMPTIVE ELIGIBILITY, THE HIGHEST DISCOUNT OF FULL FREE CARE WAS GRANTED FOR ELIGIBLE SERVICES FOR RETROSPECTIVE DATES OF SERVICE ONLY. IF A PATIENT DID NOT QUALIFY UNDER THE ELECTRONIC ENROLLMENT PROCESS, THE PATIENT COULD STILL BE CONSIDERED UNDER THE TRADITIONAL FINANCIAL ASSISTANCE APPLICATION PROCESS. Schedule H, Part V, Section B, Line 16 Facility A, 1 Facility A, 1 - See Schedule, H, Part V, Section A. HOW THE HOSPITAL FACILITY PUBLICIZES THE FINANCIAL ASSISTANCE POLICY THE HOSPITAL POSTED SIGNS TO INFORM PATIENTS ABOUT THE AVAILABILITY OF CHARITY CARE IN THE EMERGENCY DEPARTMENT, LOBBY, AND ADMISSIONS AREAS. IN ADDITION, A SUMMARY OF THE POLICY AND DOCUMENTS NEEDED TO APPLY FOR ASSISTANCE WAS WIDELY AVAILABLE AT WWW.CHRISTUSHEALTH.ORG/CHARITYCARE. (THIS WEBSITE WAS THE FIRST RESULT IN GOOGLE WHEN PATIENTS SEARCHED FOR THE HOSPITAL NAME AND CHARITY CARE OR FINANCIAL ASSISTANCE.) EFFECTIVE JULY 1, 2016, THE INDIVIDUAL HOSPITAL'S HOMEPAGE HAD A CONSPICUOUS FINANCIAL ASSISTANCE LINK DIRECTING PATIENTS TO THE CHARITY CARE HOMEPAGE. COUNSELORS ALSO PUBLICIZED THE AVAILABILITY OF FINANCIAL ASSISTANCE DURING ONE-ON-ONE VISITS WITH PATIENTS. THE HOSPITAL ATTEMPTED TO PROVIDE ALL UNINSURED PATIENTS WITH FINANCIAL COUNSELING. SPENDING TIME FACE-TO-FACE WITH PATIENTS ALLOWED COUNSELORS TO FACILITATE THE APPLICATION PROCESS FOR PATIENTS WHO OTHERWISE MIGHT NOT HAVE SOUGHT ASSISTANCE. COUNSELORS HELPED COMPLETE FINANCIAL ASSISTANCE APPLICATIONS AND EVALUATE PAYMENT PLANS FOR OUTSTANDING BALANCES. UNINSURED PATIENTS WERE SCREENED FOR MEDICAID ELIGIBILITY, AND COUNSELORS ALSO ASSISTED ELIGIBLE PATIENTS IN COMPLETING THOSE APPLICATIONS. Schedule H, Part V, Section B, Line 20 Facility A, 1 Facility A, 1 - See Schedule, H, Part V, Section A. WHEN COLLECTION CALLS RESULTED IN PATIENT CONTACT, BUSINESS AGENTS PERFORMED A VERBAL SCREENING TO SEE IF THE PATIENT MIGHT BE ELIGIBLE FOR CHARITY CARE. IN ADDITION, BILLING STATEMENTS CONTAINED THE FOLLOWING NOTICE: (YOU MAY QUALIFY FOR FINANCIAL ASSISTANCE BASED UPON YOUR INCOME LEVEL. IF YOU DO NOT QUALIFY AND CANNOT MAKE PAYMENT IN FULL, WE WILL WORK WITH YOU TO SET UP AN ACCEPTABLE PAYMENT PLAN.) 7 CHRISTUS SR PHYS AMB SURG CENTER SA 502 MADISON OAK SAN ANTONIO TX 78258 SURGERY CENTER CHRISTUS SR PHYS AMB SURG CENTER SA 423 TREELINE PARK STE 202 SAN ANTONIO TX 78209 SURGERY CENTER CHRISTUS SR PHYS AMB SURG CENTER NB 1738 E COMMON ST NEW BRAUNFELS TX 78130 SURGERY CENTER CHRISTUS SR PHYS AMB SURG CENTER NB 1305 WONDER WORLD DR 105 SAN MARCOS TX 78666 SURGERY CENTER CHRISTUS SR EMERGENCY CENTER - CREEKSIDE 244 CREEKSIDE CROSSING NEW BRAUNFELS TX 78130 EMERGENCY CENTER CHRISTUS SANTA ROSA - ALON 11503 NW MILITARY HIGHWAY SUITE 12 SAN ANTONIO TX 78231 EMERGENCY CENTER The CHRISTUS Childrens Emergency Center Stone Oak 1434 E Sonterra Blvd San Antonio TX 78258 Emergency Center Schedule H, Part I, Line 5a BUDGETED CHARITY CARE THE ORGANIZATION BUDGETS CHARITY CARE FOR INTERNAL FINANCIAL REVIEW PURPOSES ONLY. THE PROVISION OF CHARITY CARE IS NOT LIMITED TO AMOUNTS ESTABLISHED FOR BUDGETARY PURPOSES. Schedule H, Part I, Line 6a ANNUAL COMMUNITY BENEFIT REPORT A REPORT OF COMMUNITY BENEFIT IS INCLUDED IN A WRITTEN ANNUAL REPORT FOR CHRISTUS HEALTH, THE ORGANIZATION'S PARENT COMPANY. CHRISTUS HEALTH IS AN INTERNATIONAL, CATHOLIC, FAITH BASED, NONPROFIT HEALTH SYSTEM FORMED IN 1999 WITH A MISSION TO EXTEND THE HEALING MINISTRY OF JESUS CHRIST. THE ANNUAL COMMUNITY BENEFIT REPORT SUMMARIZES ACTIVITIES AND PROGRAMS CONDUCTED DURING THE PAST YEAR TO IMPROVE HEALTH INCLUDING PROACTIVE COMMUNITY HEALTH SERVICES. HOWEVER, THE ANNUAL REPORT IS ONLY A SNAPSHOT OF HOW THE ORGANIZATION DISTINGUISHES ITSELF IN ITS VISION TO BE A LEADER, A PARTNER, AND AN ADVOCATE IN CREATING INNOVATIVE HEALTH AND WELLNESS SOLUTIONS THAT IMPROVE THE LIVES OF INDIVIDUALS AND COMMUNITIES. Schedule H, Part III, Line 1 BAD DEBT REPORTING IN ACCORDANCE WITH HFMA STATEMENT 15 CHRISTUS HEALTH FOLLOWS IN PRINCIPLE HEALTHCARE FINANCIAL MANAGEMENT ASSOCIATION STATEMENT NO. 15. THE SYSTEM HAS ADOPTED AN UNCOMPENSATED CARE POLICY WHERE REVENUE FROM SERVICES PROVIDED TO THE UNINSURED IS RECOGNIZED AT THE TIME OF PAYMENT, RATHER THAN AT THE TIME OF SERVICE. THIS POLICY IS THE RESULT OF A LACK OF REASONABLE ASSURANCE OF COLLECTION FOR SERVICES PROVIDED TO THE UNINSURED DUE TO THE SYSTEM'S HISTORICALLY LOW COLLECTION RATE. MANAGEMENT HAS ESTIMATED THAT THE DIFFERENCE BETWEEN RECORDING REVENUE FROM THE UNINSURED ON A CASH BASIS, RATHER THAN THE ACCRUAL BASIS, IS IMMATERIAL. ACCORDINGLY, ALL ACCOUNTS RECEIVABLE FROM THE UNINSURED HAVE BEEN FULLY RESERVED IN THE ALLOWANCE FOR UNCOMPENSATED CARE. Schedule H, Part VI, Line 7 COMMUNITY BENEFIT REPORT A COMMUNITY BENEFIT REPORT IS FILED FOR THE STATE OF TEXAS IN THE FORM OF THE ANNUAL STATEMENT OF COMMUNITY BENEFITS STANDARD (ASCBS) FORM AS REQUIRED BY THE HEALTH AND SAFETY CODE, SECTIONS 311.045 AND 311.046. THE CODE REQUIRES NONPROFIT HOSPITALS TO FILE THE ASCBS FORM AND ANNUAL REPORT OF THE COMMUNITY BENEFITS PLAN WITH THE TEXAS DEPARTMENT OF STATE HEALTH SERVICES (DSHS). THE 2012 ASCBS FORM IS EXPANDED TO COLLECT THE INFORMATION ON CHARITY CARE POLICIES AND COMMUNITY BENEFITS IN A STANDARDIZED FORMAT. ALL CHRISTUS HEALTH ENTITIES INCLUDING FACILITIES LOCATED IN STATES THAT DO NOT REQUIRE ANNUAL COMMUNITY BENEFIT REPORTING (I.E., LOUISIANA, AND NEW MEXICO), FOLLOW THE SAME REPORTING RULES AS OUTLINED IN THE CATHOLIC HEALTH ASSOCIATION GUIDE TO PLANNING AND REPORTING COMMUNITY BENEFIT, COPYRIGHT 2008. TOTAL COMMUNITY BENEFIT FOR CHRISTUS HEALTH IS ALSO REPORTED IN THE ANNUAL REPORT PREPARED AND DISTRIBUTED BY THE SYSTEM OFFICE. Schedule H, Part I, Line 7b UNREIMBURSED MEDICAID CHRISTUS SANTA ROSA HEALTH CARE CORPORATION REINVESTS ALL SURPLUS FUNDS BACK INTO THE COMMUNITIES WE SERVE THROUGH EXPANDED HEALTH SERVICES, NEW TECHNOLOGIES, AND BETTER FACILITIES. Schedule H, Part I, Line 7f PERCENT OF TOTAL EXPENSE TOTAL EXPENSE FROM FORM 990, PART IX, LINE 25, COLUMN(A) IS $1,114,345,446. THE BAD DEBT EXPENSE INCLUDED IN THIS AMOUNT IS $42,371,229. THIS LEAVES A TOTAL EXPENSE OF $ 1,071,973,136 FOR PURPOSES OF CALCULATING LINES 7, COLUMN(F). Schedule H, Part I, Line 7f FIN ASSISTANCE/OTHER BENEFITS AS PERCENTAGE OF COST THE ORGANIZATION'S TOTAL COMMUNITY BENEFIT EXPENSE AS REPORTED ON PART I, LINE 7K, COLUMN(C) AS A PERCENTAGE OF TOTAL EXPENSE IS 37.01%, WHICH EXCEEDS THE AMOUNT REPORTED ON PART I, LINE 7K COLUMN(F) WHICH IS COMPUTED USING NET COMMUNITY BENEFIT EXPENSE. Schedule H, Part I, Line 7i CASH AND IN-KIND CONTRIBUTIONS CHRISTUS SANTA ROSA HEALTH CARE CORPORATION MADE OVER $16,093,705 IN CASH AND IN-KIND CONTRIBUTIONS DURING FISCAL YEAR 2023. THE AFOREMENTIONED AMOUNT IS DETERMINED IN ACCORDANCE WITH REPORTING RULES FOR SCHEDULE H, WORKSHEET 8. AS SUCH THIS AMOUNT DIFFERS FROM GRANTS REPORTED AT FORM 990, SCHEDULE I, GRANTS AND OTHER ASSISTANCE TO ORGANIZATIONS, GOVERNMENTS, AND INDIVIDUALS AND PART IX, LINES 1 THROUGH 3 GRANTS AND OTHER ASSISTANCE. CHRISTUS HEALTH ESTABLISHED THE CHRISTUS FUND, A GRANT FUND TO PROVIDE RESOURCES TO NONPROFIT AGENCIES AND GROUPS WHOSE VISION, MISSION, AND GOALS ARE CONSISTENT WITH CHRISTUS HEALTH'S MISSION, VALUES AND PHILOSOPHY OF A HEALTHY COMMUNITY. CHRISTUS FUND GRANTS TOTALING $300,000 WERE DONATED BY CHRISTUS HEALTH TO NONPROFIT ORGANIZATIONS LOCATED IN THE COMMUNITY SERVED BY CHRISTUS SANTA ROSA HEALTH CARE CORPORATION. THE GRANT DOLLARS WERE USED TO SUPPORT PROGRAMS THAT PROMOTE THE HEALTH OF THE COMMUNITIES THAT CHRISTUS SANTA ROSA HEALTH CARE CORPORATION SERVES. ALL GRANTS MADE TO OUTSIDE ORGANIZATIONS THROUGH THE CHRISTUS FUND ARE MADE TO NONPROFIT ORGANIZATIONS THAT SUPPORT THE COMMUNITY. INDIGENT FUNDING EXPENSE OF $78,043,551 IS INCLUDED IN SCHEDULE H, PART I, LINE 7(I). Schedule H, Part V, Section B, Line 13 ITEM A DETERMINATION OF ELIGIBILITY FOR DISCOUNTED CARE UNDER THE HOSPITAL'S POLICY, PATIENTS WHO WERE UNINSURED AND MET CERTAIN FINANCIAL CRITERIA WERE ELIGIBLE FOR FINANCIAL ASSISTANCE. THE POLICY ALSO PROVIDED FOR ASSISTANCE FOR MEDICALLY INDIGENT PATIENTS. IN GENERAL, PATIENTS WHO WERE BELOW 300% OF FEDERAL POVERTY GUIDELINES RECEIVED FREE CARE. PATIENTS WHO WERE UNINSURED AND ABOVE 300% OF THE FEDERAL POVERTY GUIDELINES WERE BILLED RATES CONSISTENT WITH AMOUNTS GENERALLY BILLED TO COMMERCIAL PAYERS. PATIENTS WHO WERE UNINSURED AND BETWEEN 300% AND 400% OF FEDERAL POVERTY GUIDELINES COULD APPLY FOR ADDITIONAL ASSISTANCE TO PAY AMOUNTS LESS THAN AGB. Schedule H, Part V, Section B, Line 17 THE HOSPITAL DID NOT ENGAGE IN ANY EXTRAORDINARY COLLECTION ACTIONS DURING THE TAX YEAR. THE POLICY STRICTLY PROHIBITED TAKING LEGAL ACTION AGAINST PATIENTS AND ALSO FORBADE PLACING A LIEN ON THE PATIENT'S HOME. IN THE EVENT OF NONPAYMENT, THE HOSPITAL AND ITS COLLECTIONS GROUPS WOULD SEND STATEMENTS AND MAKE PHONE CALLS. Schedule H, Part V, Section B, Line 18 ITEM F THE HOSPITAL DID NOT ENGAGE IN ANY EXTRAORDINARY COLLECTION ACTIONS DURING THE TAX YEAR. THE POLICY STRICTLY PROHIBITED TAKING LEGAL ACTION AGAINST PATIENTS AND ALSO FORBADE PLACING A LIEN ON THE PATIENT'S HOME. IN THE EVENT OF NONPAYMENT, THE HOSPITAL AND ITS COLLECTIONS GROUPS WOULD SEND STATEMENTS AND MAKE PHONE CALLS. Schedule H, Part V, Section B, Line 22 ITEM B THE HOSPITAL USED THE AVERAGE COMMERCIAL INSURANCE REIMBURSEMENT RATE FROM FISCAL YEAR ENDING 6/30/23 TO DETERMINE AMOUNTS GENERALLY BILLED TO PATIENTS WITH INSURANCE. THIS AVERAGE RATE WAS THE AVERAGE REIMBURSEMENT RECEIVED FOR CATEGORIES OF SERVICES FROM ALL PRIVATE INSURERS THAT REIMBURSE HOSPITALS ACROSS THE CHRISTUS HEALTH SYSTEM, EXCEPT FOR ST. VINCENT AND LONG-TERM HOSPITALS, AND EXCLUDING IMPLANT AND DRUG CONTRIBUTION DOLLARS. ALL UNINSURED PATIENTS WERE CHARGED NO MORE THAN 45% OF CHARGES FOR THE RELEVANT SERVICE LINE. PATIENTS ELIGIBLE FOR ADDITIONAL FINANCIAL ASSISTANCE WERE CHARGED NO MORE THAN THE AVERAGE RATE (FOR INCOME LEVELS FROM 301% TO 400% OF THE FPL) OR RECEIVED FREE CARE (FOR INCOMES AT OR BELOW 300% OF THE FPL). FOR LAB SERVICES, ELIGIBLE PATIENTS WERE CHARGED A PERCENTAGE OF THE MEDICARE RATE. Schedule H, Part V, Section B, Line 16b FAP APPLICATION FORM WEBSITE https://www.christushealth.org/-/media/christus-health/plan-care/files/bill-pay/financial-assistance/financial-language-documents/v2financial-assistance-application.ashx Schedule H, Part V, Section B, Line 16c PLAIN LANGUAGE FAP SUMMARY WEBSITE https://www.christushealth.org/-/media/christus-health/plan-care/files/bill-pay/financial-assistance/financial-language-documents/2021plainlanguagesummaryhospitalenglish.ashx Schedule H, Part V, Section B, Line 16a FAP AVAILABLE HERE https://www.christushealth.org/-/media/christus-health/plan-care/files/bill-pay/financial-assistance/financial-language-documents/financial-assistance-policy-english.ashx Schedule H, Part I, Line 7 Bad Debt Expense excluded from financial assistance calculation 42371229 Schedule H, Part I, Line 7 Costing Methodology used to calculate financial assistance LINE 7A: RATIO OF PATIENT CARE COST TO CHARGES BASED ON SCHEDULE H, WORKSHEET 2 LINE 7B: RATIO OF PATIENT CARE COST TO CHARGES BASED ON SCHEDULE H, WORKSHEET 2 LINE 7E: ACTUAL EXPENSES LESS ANY DIRECT OFFSETTING REVENUE LINE 7F: ACTUAL EXPENSES LESS ANY DIRECT OFFSETTING REVENUE LINE 7I: ACTUAL EXPENSE OF THE CONTRIBUTIONS Schedule H, Part II Community Building Activities THE CHRISTUS HEALTH BOARD OF DIRECTORS APPROVED FUNDING OF A COMMUNITY DIRECT INVESTMENT (CDI) LOAN PROGRAM TO ENSURE THAT THE WORK OF SOCIAL ACCOUNTABILITY AND MORAL AND ETHICAL STEWARDSHIP CONTINUE IN SPITE OF CHALLENGING FISCAL CONDITIONS FACED BY LOCAL OPERATING ENTITIES. THE PURPOSE OF THE CDI PROGRAM IS TO SUPPORT COMMUNITY DRIVEN INITIATIVES, PRIMARILY FOR AFFORDABLE HOUSING AND ECONOMIC DEVELOPMENT BY PROVIDING FINANCING AT BELOW MARKET INTEREST RATES TO NONPROFIT ORGANIZATIONS AT TERMS NOT EXCEEDING MORE THAN FIVE YEARS. THE INCOME EARNED AT THE MARKET RATE LESS OUR LOAN RATE (FOREGONE INCOME) IS CONSIDERED A COMMUNITY BENEFIT FOR REPORTING PURPOSES. THE FOREGONE INTEREST FOR THE CHRISTUS SANTA ROSA REGION IN FISCAL YEAR ENDING JUNE 30, 2023 WAS $0. IN AN EFFORT TO MEET AND ADDRESS THE IDENTIFIED HEALTH CARE NEEDS IN THE COMMUNITIES IT SERVES, CHRISTUS SANTA ROSA HEALTH CARE CORPORATION PROVIDES ACCESS TO HEALTH CARE SERVICES THROUGH PROGRAMS AND LOCAL COMMUNITY PARTNERS AND SERVICE ORGANIZATIONS. THE CHRISTUS HEALTH ADVOCACY DEPARTMENT IS WORKING IN PARTNERSHIP WITH LOCAL, STATE AND FEDERAL POLICY MAKERS TO ENSURE ACTIVITIES AND PROGRAMSARE IN PLACE THAT WILL ENHANCE PUBLIC HEALTH AND ADVANCE GENERAL KNOWLEDGE THROUGH IMPROVED ACCESS TO HEALTH SERVICES AND ADVANCE GENERAL KNOWLEDGE. DURING FY 2023, CHRISTUS HEALTH ADVOCATED FOR IMPROVING PUBLIC POLICIES BY WORKING TO ESTABLISH, AND IN SOME INSTANCES AUGMENT, GRASSROOTS ADVOCACY AND GREATER ACCESS TO HEALTHCARE SERVICES FOR THE CONSTITUENTS WE SERVE. THESE ARE SOME OF THE MAIN COMMUNITY BUILDING ACTIVITIES THAT ARE IMPROVING ACCESS TO HEALTH SERVICES, ENHANCING PUBLIC HEALTH, AND ADVANCING KNOWLEDGE. Schedule H, Part III, Line 2 Bad debt expense - methodology used to estimate amount THE ORGANIZATION'S TOTAL BAD DEBT EXPENSE (TOTAL OF ALL HOSPITAL FACILITIES) IS IN ACCORDANCE WITH THE ORGANIZATION'S FINANCIAL STATEMENTS, WHICH IS COMPUTED AS BAD DEBT NET OF CONTRACTUAL ALLOWANCE, PAYMENTS RECEIVED AND RECOVERIES OF BAD DEBT PREVIOUSLY WRITTEN OFF. Schedule H, Part III, Line 3 Bad Debt Expense Methodology THE FILING ORGANIZATION RECOGNIZES THAT SOME PATIENTS ARE UNABLE OR UNWILLING TO SEEK FINANCIAL ASSISTANCE DUE TO BARRIERS SUCH AS EDUCATIONAL LEVEL, LITERACY, DOCUMENTATION REQUIREMENTS, OR BEING INTIMIDATED BY THE APPLICATION PROCESS. IN ORDER TO ESTIMATE THE AMOUNT OF THE ORGANIZATION'S BAD DEBT EXPENSE ATTRIBUTABLE TO PATIENTS WHO MAY BE ELIGIBLE FOR FINANCIAL ASSISTANCE BUT HAVE NOT SUBMITTED AN APPLICATION, THE ORGANIZATION ENGAGED PARO DECISION SUPPORT, LLC. PARO CHARITY SCORE IS DESIGNED TO IDENTIFY PATIENTS THAT LIKELY QUALIFY FOR FINANCIAL ASSISTANCE BASED ON A PREDICTIVE MODEL AND OTHER FINANCIAL AND ASSET ESTIMATES FOR THE PATIENT DERIVED FROM PUBLIC RECORD SOURCES. IN ORDER TO ASSESS THE BAD DEBT ACCOUNTS THAT WOULD LIKELY QUALIFY FOR CHARITY CARE, THE FOLLOWING CRITERIA WERE ESTABLISHED BASED ON AN ANALYSIS OF HISTORICAL DATA OF CHRISTUS HEALTH AND ITS RELATED ORGANIZATIONS: 1. PARO SCORE OF LESS THAN OR EQUAL TO 586, WHICH IS A PREDICTOR DEFINING THE LIKELY SOCIOECONOMIC CONDITIONS FOR THE PATIENT; 2. ESTIMATED FEDERAL POVERTY LEVEL OF LESS THAN OR EQUAL TO 226%, WHICH IS BASED ON ESTIMATED HOUSEHOLD SIZE AND HOUSEHOLD ESTIMATED INCOME; AND 3. THIRD PARTY DATA AVAILABLE ON PATIENT ACCOUNTS WHICH INDICATE THAT THE PATIENT IS NOT A HOMEOWNER OR A PROBABLE HOMEOWNER. FOR THE FISCAL YEAR ENDING JUNE 30, 2011, THE ORGANIZATION REPORTED THAT 30% OF BAD DEBT EXPENSES WERE ATTRIBUTABLE TO PATIENTS WHO MAY HAVE BEEN ELIGIBLE FOR FINANCIAL ASSISTANCE BUT WERE NOT RESPONSIVE TO THE APPLICATION PROCESS EXISTING AT THAT TIME. THIS FIGURE WAS BASED ON THE PARO ANALYSIS AND ESTIMATES OF PATIENTS' FINANCIAL NEEDS THAT EXAMINED WHETHER PATIENTS WERE CHARACTERISTIC OF OTHERS WHO HISTORICALLY QUALIFIED FOR ASSISTANCE UNDER THE TRADITIONAL APPLICATION PROCESS. THE PRESUMPTIVE CHARITY CARE ANALYSIS PERFORMED FOR THE PRIOR FISCAL YEAR DETERMINED A BENCHMARK OF BAD DEBT ACCOUNTS IN THE CHRISTUS HEALTH SYSTEM THAT LACKED THE INFORMATION TO QUALIFY FOR CHARITY CARE UNDER THE FILING ORGANIZATION'S CUSTOMARY PROCESS BUT WOULD HAVE LIKELY QUALIFIED FOR ASSISTANCE. DURING THE FISCAL YEAR ENDING JUNE 30, 2023, THE ORGANIZATION UTILIZED THE PARO SCORE TO IDENTIFY THE ACCOUNTS OF INDIVIDUAL PATIENTS THAT WERE LIKELY ELIGIBLE FOR FINANCIAL ASSISTANCE DESPITE HAVING NOT COMPLETED AN APPLICATION, AND SUCH ANALYSIS DETERMINED THAT 3.73% OF SUCH ACCOUNTS WERE LIKELY ELIGIBLE FOR FINANCIAL ASSISTANCE. THE ORGANIZATION GRANTED PRESUMPTIVE ELIGIBILITY FOR THESE ACCOUNTS AND THEY WERE RECLASSIFIED UNDER OUR FINANCIAL ASSISTANCE POLICY. THESE AMOUNTS WERE NOT REPORTED AS BAD DEBT. THE AMOUNT REPORTED ON SCHEDULE H, PART III, LINE 3 IS THE DIFFERENCE BETWEEN THE PRESUMPTIVE CHARITY CARE BENCHMARK ESTABLISHED IN THE FISCAL YEAR ENDING JUNE 30, 2011 AND THE AGGREGATE OF INDIVIDUAL ACCOUNTS FOR WHICH THE ORGANIZATION GRANTED PRESUMPTIVE ELIGIBILITY IN THE FISCAL YEAR ENDING JUNE 30, 2023. THUS, THE ORGANIZATION ESTIMATES THAT ONLY 0.75% OF THE BAD DEBT EXPENSES IN FISCAL YEAR ENDING JUNE 30, 2023 ARE ATTRIBUTABLE TO PATIENTS WHO WOULD LIKELY HAVE QUALIFIED FOR FINANCIAL ASSISTANCE. IT IS IMPORTANT TO NOTE THAT THE FIGURE CALCULATED FOR FISCAL YEAR ENDING JUNE 30, 2011 WAS ESTIMATED AND NOT EXACT, AND THEREFORE THE DIFFERENCE BETWEEN THE AMOUNTS QUALIFIED AS PRESUMPTIVE CHARITY CARE IN ANY FISCAL YEAR MAY VARY FROM THE BENCHMARK ESTABLISHED IN FISCAL YEAR ENDING JUNE 30, 2011. Schedule H, Part III, Line 4 Bad debt expense - financial statement footnote THE FOOTNOTE TO THE CHRISTUS HEALTH CONSOLIDATED FINANCIAL STATEMENTS SAYS, "THE PREPARATION OF THE ACCOMPANYING CONSOLIDATED FINANCIAL STATEMENTS IN CONFORMITY WITH ACCOUNTING PRINCIPLES GENERALLY ACCEPTED IN THE UNITED STATES (U.S. GAAP) REQUIRES MANAGEMENT OF THE SYSTEM TO MAKE ASSUMPTIONS, ESTIMATES, AND JUDGMENTS THAT AFFECT THE AMOUNTS REPORTED IN THE FINANCIAL STATEMENTS, INCLUDING THE NOTES THERETO, AND RELATED DISCLOSURES OF COMMITMENTS AND CONTINGENCIES, IF ANY AT THE DATE OF THE CONSOLIDATED FINANCIAL STATEMENTS. MANAGEMENT RELIES ON HISTORICAL EXPERIENCE AND ON OTHER ASSUMPTIONS BELIEVED TO BE REASONABLE UNDER THE CIRCUMSTANCES IN MAKING ITS JUDGMENT AND ESTIMATES. ACTUAL RESULTS COULD DIFFER MATERIALLY FROM THESE ESTIMATES." Schedule H, Part III, Line 8 Community benefit & methodology for determining medicare costs THE SHORTFALL ON PART III, LINE 7 IS NOT COUNTED AS A COMMUNITY BENEFIT. THE AMOUNT ON SCHEDULE H, PART III, LINE 6 IS DETERMINED BY CALCULATING MEDICARE ALLOWABLE COSTS USING WORKSHEET A OF THE MEDICARE COST REPORT. WORKSHEET A OF THE MEDICARE COST REPORT REQUIRES THE ORGANIZATION TO REMOVE NON-ALLOWABLE EXPENSES FROM TOTAL EXPENSES VIA THE ADJUSTMENTS TO EXPENSES WORKSHEETS WITHIN THE MEDICARE COST REPORT. THE AMOUNT REPORTED ON SCHEDULE H, PART III, LINE 6 DOES NOT TAKE INTO ACCOUNT ALL COSTS INCURRED BY THE FILING ORGANIZATION ASSOCIATED WITH THE FILING ORGANIZATION'S PROVISIONS OF SERVICES TO MEDICARE PATIENTS. SCHEDULE H, PART III, LINE 7 WOULD EQUAL A SHORTFALL OF (10,592,202) IF TOTAL EXPENSES ALLOCABLE TO MEDICARE SERVICES WERE SUBSTITUTED ON SCHEDULE H, PART III, LINE 6. Schedule H, Part III, Line 9b Collection practices for patients eligible for financial assistance IT IS THE POLICY OF THE ORGANIZATION TO PURSUE COLLECTIONS OF PATIENT BALANCES FROM PATIENTS WHO HAVE THE ABILITY TO PAY FOR THESE SERVICES. CHRISTUS HEALTH APPLIES ITS COLLECTION EFFORTS CONSISTENTLY AND FAIRLY TO ALL PATIENTS REGARDLESS OF INSURANCE. IF A PATIENT DOES NOT HAVE THE FINANCIAL RESOURCES TO PAY THEIR OUTSTANDING BALANCES, THE GOAL OF THE ORGANIZATION IS TO QUALIFY THESE PATIENTS THROUGH THE ORGANIZATION'S CHARITY POLICY OR SCREEN THE PATIENTS THROUGH ORGANIZATION'S PRESUMPTIVE CHARITY TESTS. IF THE PATIENT QUALIFIES UNDER EITHER POLICY THE ACCOUNT WILL BE WRITTEN OFF BASED UPON LEVEL OF QUALIFICATION. THESE POLICIES SUPPORT THE MISSION AND VISION OF THE ORGANIZATION AND ARE APPROVED BY SENIOR LEADERSHIP. Schedule H, Part V, Section B, Line 16a FAP website A - CHRISTUS SANTA ROSA NEW BRAUNFELS: Line 16a URL: SEE SUPPLEMENTAL INFO; Schedule H, Part V, Section B, Line 16b FAP Application website A - CHRISTUS SANTA ROSA NEW BRAUNFELS: Line 16b URL: SEE SUPPLEMENTAL INFO; Schedule H, Part V, Section B, Line 16c FAP plain language summary website A - CHRISTUS SANTA ROSA NEW BRAUNFELS: Line 16c URL: SEE SUPPLEMENTAL INFO; Schedule H, Part VI, Line 2 Needs assessment Over the Last 25 years, The Health Collaborative has had the privilege to work in partnership with community stakeholders, leaders and community members to ensure that this comprehensive report is produced and shared. The report is the result of a formal community assessment that reflects over 18 months of collaborative work with agency partners and community stakeholders to establish a shared vision, select relevant indicators, and prepare a document that addresses the important drivers of health in our community. In keeping with the national movement in public heath to focus more sharply on the root causes of health outcomes, the report devotes significant space to describing social, economic, and environmental conditions. The framework used to organize the report developed by the Bay Area Regional Health Inequities Initiatives, moves from population characteristics to living conditions, to health behaviors and risk factors, and finally to prevalence of specific disease and causes of death. Recognizing that COVID-19 has placed additional stress on our community families on the already fragile eco-system of care, this report highlights key access issues of concern and public health threats that we need to continue to learn about and act upon for years to come. As is customary, the community's voice has been integrated into the narrative of the CHNA. This strengthens and validates the 2022 CHNA by providing on going community commentary and reinforces the idea that we are more than just collective data points on page but rather individuals that experience health outcomes in our daily lives. The Report reveals numerous health disparities along a number of dimensions, e.g., age, race and ethnicity, education. A guiding principle for the pro-active approach through an equity lens is to remember that equity and disparity are related: in communities where resources are not equitably distributed, health disparities tend to predominate. Through the leadership and guidance of the The Health Collaborative Board of Directors, Steering Committee, Research partner CI:NOW The Report was developed. With the support of the sponsors and in-kind partners it was possible for the report to be available to the community. Most importantly, the contribution from the greater community, for providing feedback and ongoing support to the people and places reflected in The Report. CHRISTUS Santa Rosa Hospital - New Braunfels and CHRISTUS Santa Rosa Hospital - San Marcos The CHNA is a systematic, data-driven approach to determine the health needs in the service area of the hospitals. In the process, the hospitals directly engaged community members and stakeholders to identify issues of greatest need, as well as the largest impediments to health. With this information, the hospitals can better allocate resources towards efforts to improve community health and wellness. Directing resources toward the greatest needs in the community is critical to CSRHS' work as a nonprofit hospital. The important work of a CHNA was codified in the Patient Protection and Affordable Care Act added Section 501(r) to the Internal Revenue Service Code, which requires nonprofit hospitals to conduct a CHNA every three years. The process used was designed to meet federal requirements and guidelines in Section 501(r): including: - Clearly defining the community served by the hospital, and ensuring that defined community does not exclude low-income, medically underserved, or minority populations in proximity to the hospital; - Providing a clear description of the CHNA process and methods; community health needs: collaboration, including with public health experts; and description of existing facilities and resources in the community; - Receiving input from persons representing the broad needs of the community; - Documenting community comments on the CHNA and health needs in the community; and - Documenting the CHNA in a written report and making it widely available to the public. When assessing the health needs of the entire CSRHS-New Braunfels and -San Marcos service areas, the CHNA data is presented by zip code and county depending on the available data. Providing localized data brings to light the differences and similarities within the communities. The hospitals worked with Metopio, a software and services company that is grounded in the philosophy that communities are connected through places and people. Metopio's tools and visualizations use data to reveal valuable, interconnected factors that influence outcome in different locations. The health system's partners and stakeholder groups provided insight and expertise around the indicators to be assessed, types of focus group questions to be asked, interpretation of results and prioritization of areas of highest need. Primary date for the CHNA was collected through four channels: - Community resident surveys - Community resident focus groups - Health care and social services provider focus groups - Key informant interviews Secondary data for the CHNA were aggregated on Metopio's data platform and included: - Hospital utilization data - Secondary sources including, but not limited to, the American Community Survey, the Decennial Census, the Centers for Disease Control, the Environmental Protection Agency, Housing and Urban Development, and the Texas department of State Health Services Community Resident Surveys were conducted in both service areas to provide input to the CHNA. The survey was available online and in paper form in English and Spanish. Survey dissemination happened through multiple channels led by our hospitals and community partners. The survey sought input from priority populations typically underrepresented in assessment processes, including communities of color, immigrants, persons with disabilities, and low-income residents. The survey was designed to collect information regarding: - Demographics of respondents - Health needs of the community for different age groups - Perception of community strengths - Utilization and perception of local health services The survey was based on a design used extensively for CHNAs and by public health agencies across the country. The final survey included 26 questions. Two focus groups were conducted in an effort to speak directly to community members, partners and leaders that live in and/or work in the hospitals PSA. Schedule H, Part VI, Line 3 Patient education of eligibility for assistance CHRISTUS SANTA ROSA HEALTH CARE CORPORATION MAKES EVERY EFFORT TO EDUCATE PATIENTS ON ITS CHARITY AND DISCOUNT POLICY AND ABOUT THEIR ELIGIBILITY FOR ASSISTANCE UNDER FEDERAL, STATE, OR LOCAL GOVERNMENT PROGRAMS DURING REGISTRATION, PRE REGISTRATION (FOR SCHEDULED TESTS AND SURGERIES), POST REGISTRATION (DURING THEIR HOSPITALIZATION) AND FOLLOWING DISCHARGE (TELEPHONE OR WRITTEN INQUIRY) IN LANGUAGES APPROPRIATE FOR THE POPULATION BEING SERVED. PATIENTS ARE GIVEN INFORMATION AND FORMS BY A FINANCIAL COUNSELOR WHO HELPS THEM COMPLETE THE FORMS DURING THEIR INPATIENT AND OUTPATIENT VISITS. PATIENTS ARE ASKED TO BRING OR MAIL SUPPORTING DOCUMENTATION TO DETERMINE INCOME, ASSETS AND HOUSEHOLD EXPENSES. THE BUSINESS OFFICE REVIEWS THE APPLICATION BASED ON THE INFORMATION PROVIDED BY THE PATIENT. IF THE PATIENT QUALIFIES FOR CHARITY CARE OR A DISCOUNT, A NEW BILL IS GENERATED. PATIENTS WHO DO NOT PROVIDE THE REQUIRED DOCUMENTATION ARE CONSIDERED INELIGIBLE AND ARE BILLED ACCORDINGLY. IF THE DOCUMENTATION IS PROVIDED AT A LATER TIME, THE PATIENT MAY THEN BE DETERMINED TO BE ELIGIBLE FOR CHARITY CARE OR A DISCOUNT. DOCUMENTATION IS RETAINED BY THE BILLING OFFICE FOR SEVEN YEARS. A PUBLIC NOTICE REGARDING THE CHARITY CARE POLICY IS POSTED IN PROMINENT PLACES THROUGHOUT THE HOSPITALS, INCLUDING BUT NOT LIMITED TO THE EMERGENCY ROOM WAITING AREAS AND THE ADMISSIONS OFFICE WAITING AREAS, AS REQUIRED BY BOTH THE STATE OF TEXAS COMMUNITY BENEFIT STANDARD (WHICH ADDRESSES THE DUTIES AND RESPONSIBILITIES OF NONPROFIT HOSPITALS) AND CHRISTUS HEALTH COMMUNITY BENEFIT GUIDELINES #050. IN ADDITION, A PUBLIC NOTICE REGARDING THE CHARITY CARE POLICY AND INFORMATION ON FINANCIAL ASSISTANCE ARE ALSO POSTED ON THE CHRISTUS HEALTH WEBSITE. THE INFORMATION ON FINANCIAL ASSISTANCE INCLUDES EXPLANATIONS ON THE AVAILABILITY OF FINANCIAL ASSISTANCE, WHO QUALIFIES, AND HOW TO APPLY FOR FINANCIAL ASSISTANCE. Schedule H, Part VI, Line 4 Community information CHRISTUS Santa Rosa Health Care Corporation is headquartered in San Antonio, Texas in the South-Central Area of the State. It has six hospital campuses (Medical Center, Westover Hills, Alamo Heights, New Braunfels, San Marcos and CHRISTUS Children's. It serves the southwestern border of Texas and into the Central Texas Hill Country. The area comprises a population of more than 2.3 million individuals. The population consists of 63.20% Hispanic and 36.80% non-Hispanic. Schedule H, Part VI, Line 5 Promotion of community health CHRISTUS Santa Rosa Health Care Corporation provides a full range of inpatient and outpatient services to the communities it serves. It conducts its activities and its health care purpose without regard to race, color, creed, religion, gender, orientation, disability, age, or national origin. One of the top health care organizations in South Texas, CHRISTUS Health Care Corporation has six hospital campuses: 1. CHRISTUS Santa Rosa Hospital - Medical Center, located in the South Texas Medical Center of San Antonio 2. CHRISTUS Children's, located in downtown San Antonio 3. CHRISTUS Santa Rosa Hospital - Westover Hills, located in the Westover Hills area of San Antonio 4. CHRISTUS Santa Rosa Hospital - Alamo Heights, located in the Alamo Heights area of San Antonio 5. CHRISTUS Santa Rosa Hospital - New Braunfels, located in New Braunfels, Texas 6. CHRISTUS Santa Rosa Hospital - San Marcos, located in San Marcos, Texas Each of the facilities of CHRISTUS Santa Rosa share one objective - To lead the way to a healthier community. Each of the six hospitals within CHRISTUS Santa Rosa Health Care Corporation provides a 24-hour emergency room that is open to serve all those in need of emergency care, regardless of ability to pay. CHRISTUS Santa Rosa Health Care Corporation works to facilitate and strengthen access to quality comprehensive health care services for all, particularly the vulnerable and underserved populations. CHRISTUS Santa Rosa Health Care Corporation also supports many local community health services, offering convenient locations for adult and pediatric primary care through family health clinics and mobile health clinics. CHRISTUS Santa Rosa Health Care Corporation offers services such as: Comprehensive Pediatric Care, Intensive and Intermediate care to critically ill infants requiring medical and/or surgical interventions such as the neonatal ECMO Program that provides Veno-Venous or Veno-Arterial Extracorporeal Life support for up to three infants in the NICU; a centralized Level IV NICU and a Wound Care and Hyperbaric Center. In addition, our adult hospitals offer the following; Cardiac Care that is nationally certified by the American Association of Cardiovascular and Pulmonary Rehabilitation (AACVPR) and accredited as a Chest Pain Center with Percutaneous Coronary Intervention (PCI) designation from the Society of Chest Pain Centers (SCPC); a comprehensive cancer program; complete obstetrical and newborn services; surgical units; a diabetes care program; and state-of-the-art medical care for children with an array of specialty services and orthopedic services. We also offer rehabilitation treatment for those who have experienced a stroke, a spinal cord injury, closed head injury and more. CHRISTUS Santa Rosa Health Care Corporation collaborates with communities, churches, and other health care organizations to provide comprehensive and accessible health care services and proactive healthcare programs. The Health Collaborative's (as defined in schedule H, Part VI, Question 2) existing priorities of Risk Behaviors, Health Care and Disease and Injury, as they relate to diabetes, obesity, and heart disease, will continue to be addressed through the chronic care management for children and adults as well as preventative care and health education through the collaborative relationships with school districts. The CHRISTUS Santa Rosa Health Care Corporation Community Benefit Plan ("The Plan") supports the CHNAs priority areas. The Plan's focus is on the community initiatives that can impact family members of all ages with diabetes, obesity, and heart disease. These initiatives are provided through a pediatric mobile clinic, school-based health centers, community health worker program and chronic illness education programs. The Plan includes the work performed at The Center for Miracles which is dedicated to providing free services for abused/neglected children and their affected family members. Other efforts are to provide application assistance to Medicaid/CHIP patients to ensure health care opportunities are offered to women and children. Women, Infant and Children (WIC) services provide nutrition/breastfeeding education and food vouchers to help decrease the incidence of low-birth-weight infants and improve infant mortality rates in Bexar County. CHRISTUS Health reinvests all surplus funds back into the communities it serves through expanded health services, new technologies, and better facilities. As a not-for-profit health system and as part of CHRISTUS Health, a regional governing board comprised largely of independent community members representing the makeup of the area we serve guides CHRISTUS Santa Rosa Health Care Corporation. We are privileged to have an open medical staff comprised of qualified physicians who work with us to provide care to our communities. All qualified physicians who are granted privileges to serve with us in our hospitals must undergo a thorough and comprehensive credentialing and orientation process. ICAL experience and other education for all persons employed and affiliated with CHRISTUS Santa Rosa Health Care Corporation are required to complete annual conflict of interest statements. Individuals employed and affiliated with CHRISTUS Santa Rosa Health Care Corporation are required to complete annual conflict of interest survey. Schedule H, Part VI, Line 6 Affiliated health care system CHRISTUS SANTA ROSA HEALTH CARE CORPORATION IS PART OF CHRISTUS HEALTH, AN INTERNATIONAL, CATHOLIC, FAITH BASED, NONPROFIT HEALTH SYSTEM COMPRISED OF ALMOST 350 SERVICES AND FACILITIES INCLUDING MORE THAN 60 HOSPITALS AND LONG TERM CARE FACILITIES, 175 CLINICS AND OUTPATIENT CENTERS, AND OTHER COMMUNITY HEALTH MINISTRIES AND COMMUNITY DEVELOPMENT VENTURES. CHRISTUS SERVICES CAN BE FOUND IN: ARKANSAS, LOUISIANA, NEW MEXICO, TEXAS, AND INTERNATIONALLY IN THE COUNTRIES OF MEXICO, CHILE AND COLOMBIA. A COMMON MISSION, CORE VALUES, AND VISION UNITE THE HEALTH SYSTEM. EACH REGION, INCLUDING CHRISTUS SANTA ROSA HEALTH CARE CORPORATION, DEVELOPS FIVE-YEAR AND TEN-YEAR STRATEGIC PLANS THAT HELP SET THE YEARLY OPERATIONAL PLANS AND BUDGETS. REGIONAL STRATEGIC GOALS ARE SET IN COLLABORATION WITH CHRISTUS HEALTH AND INCLUDE METRICS THAT WILL BE USED TO MEASURE COMMUNITY BENEFIT, CLINICAL OUTCOMES, PATIENT SATISFACTION, AND ASSOCIATE ENGAGEMENT. CHRISTUS HEALTH PROVIDES UPDATED MARKET, DEMOGRAPHICS, AND HEALTH INDICATOR DATA ON AN ANNUAL BASIS. THE DATA SUPPLIED FROM CHRISTUS HEALTH ALONG WITH THE SYSTEM WIDE STRATEGIC INITIATIVES ARE CONSISTENT WITH THE COMMUNITY NEEDS ASSESSMENT OF THE REGION. CHRISTUS SANTA ROSA HEALTH CARE CORPORATION, IN TURN, PARTNERS WITH OTHER NONPROFIT GROUPS (CHURCHES, HEALTH CARE PROVIDERS, AND GOVERNMENT AGENCIES) TO CREATE COLLABORATIONS WHERE HEALTH NEEDS CAN BE ADDRESSED AND THE GENERAL HEALTH OF INDIVIDUALS AND THE COMMUNITY IS IMPROVED. Schedule H, Part VI, Line 7 State filing of community benefit report TX X true true true true false false false false false false false Cris Daskevich CEO OF CHOSA & BOARD DIRECTOR 0 602236 0 350501 0 209627 0 187002 0 21158 0 1370524 0 0 Charles Hankins MD CMO & BOARD DIRECTOR, QUALITY COMMITTEE OF THE BOARD (TERM 12/22) 0 601022 0 357683 0 168820 0 32700 0 11647 0 1171872 0 0 Stephanie A Parker CEO & BOARD DIRECTOR 0 479509 0 236844 0 13964 0 107086 0 15283 0 852686 0 0 Dr James Chris Henderson MEDICAL STAFF PRESIDENT & DIRECTOR 0 309572 0 42932 0 1975 0 13789 0 7682 0 375950 0 0 Steve Chen CFO & Treasurer 0 299359 0 207000 0 154532 0 56616 0 8389 0 725896 0 0 Dominic Dominguez Regional CEO 0 971617 0 425136 0 44907 0 420603 0 9966 0 1872229 0 0 Norman Christopher CMO Childrens Hospital 0 455417 0 162959 0 54704 0 88616 0 3567 0 765263 0 0 Ian Thompson Pres. & VP Market Oncology 0 377411 0 133093 0 53304 0 57480 0 10638 0 631926 0 0 Thomas Mckinney President 0 335909 0 113725 0 13251 0 87823 0 16324 0 567032 0 0 Patricia Burns President 0 377233 0 137519 0 0 0 12200 0 8281 0 535233 0 0 Karen Bryant VP-Strategy-Bus Development 0 281037 0 100221 0 54385 0 53648 0 31956 0 521247 0 0 Debasish Dasgupta CMO Westover Hills 0 291806 0 79391 0 81218 0 36220 0 10629 0 499264 0 0 Terry Kyle Chief Development Officer 0 294191 0 106328 0 650 0 32700 0 6239 0 440108 0 0 Cara Ansaldo President Santa Rosa Medical Center 0 296563 0 111499 0 0 0 20500 0 9547 0 438109 0 0 Christine Keating VP AMB SVS-Network of care 0 247461 0 88825 0 0 0 31397 0 2469 0 370152 0 0 Genifer Rucker President New Braunfels 0 230548 0 114054 0 0 0 12200 0 11777 0 368579 0 0 Nikki Rivers CNO New Braunfels 0 237692 0 69505 0 0 0 49938 0 1264 0 358399 0 0 Carla Moreno VP, Patient Placement 0 218655 0 82619 0 435 0 12200 0 10306 0 324215 0 0 Barbara Vazquez CNO Childrens Hospital 0 196451 0 15000 0 86535 0 8664 0 7752 0 314402 0 0 Alexis Arel VP Finance Admin Office 0 218065 0 79907 0 0 0 7245 0 1511 0 306728 0 0 Sherry Fraser President Alamo Heights 0 213393 0 63985 0 100 0 11327 0 16059 0 304864 0 0 Bonifacio Benitez Vp Clinical Operations 0 198067 0 76361 0 1475 0 11605 0 16674 0 304182 0 0 Sarah Hill VP MISSION INTEGRATION 0 172662 0 79932 0 110 0 32673 0 5950 0 291327 0 0 William M Johnson Chief Nursing Officer 0 186742 0 72031 0 899 0 10830 0 206 0 270708 0 0 Steven Martin Associate CIO 0 181015 0 57234 0 965 0 6606 0 17493 0 263313 0 0 KENNETH DAVIS MD CHIEF MEDICAL OFFICER (Thru 12/2022) 0 0 0 0 0 261772 0 0 0 0 0 261772 0 0 DUSTYN D TYSDAL Dir Pharmacy 245394 0 29282 0 933 0 12823 0 11116 0 299548 0 0 0 EDWARD R ALANIZ RN Lead 93568 0 16500 0 135294 0 694 0 13612 0 259668 0 0 0 Travis Krug VP Human Resources 0 180070 0 55550 0 0 0 9975 0 11662 0 257257 0 0 GIANG P DINH Clinical Pharmacist 138830 0 500 0 101558 0 9724 0 2382 0 252994 0 0 0 EILEEN HUSS CHIEF NURSING OFFICER 0 53736 0 0 0 0 0 44216 0 83704 0 181656 0 0 Dean Alexander President & CEO & Board Director (Term 12/21) 0 383286 0 0 0 542325 0 378016 0 95243 0 1398870 0 0 Schedule J, Part I, Line 1a Travel for companions TAXABLE COMPENSATION WAS REPORTED TO VARIOUS OFFICERS AND BOARD MEMBERS RELATED TO COMPANION TRAVEL TO CHRISTUS MEETINGS. Schedule J, Part I, Line 3 Arrangement used to establish the top management official's compensation THE FILING ORGANIZATION'S CEO/EXECUTIVE DIRECTOR IS AN EMPLOYEE OF CHRISTUS HEALTH, A RELATED ORGANIZATION. AS A RESULT, COMPENSATION IS ESTABLISHED AT THE CHRISTUS HEALTH LEVEL AND THE FILING ORGANIZATION DOES NOT HAVE A ROLE IN IMPLEMENTING THE METHODS USED TO ESTABLISH COMPENSATION OR IN DETERMINING CEO/EXECUTIVE DIRECTOR COMPENSATION. CHRISTUS HEALTH USES AN EXECUTIVE COMPENSATION COMMITTEE TO ESTABLISH AND APPROVE THE COMPENSATION OF THE FILING ORGANIZATION'S CEO/EXECUTIVE DIRECTOR. THIS COMMITTEE USES AN INDEPENDENT COMPENSATION CONSULTANT WHO PERFORMS BI-ANNUAL COMPENSATION SURVEY. Schedule J, Part I, Line 4a Severance or change-of-control payment KENNETH DAVIS RECEIVED $249,704 IN SEVERANCE DURING CALENDAR YEAR 2022. DEAN ALEXANDER RECEIVED $520,400 IN SEVERANCE DURING CALENDAR YEAR 2022. Schedule J, Part I, Line 4b Supplemental nonqualified retirement plan KAREN BRYANT RECEIVED $53,735 DURING CALENDAR YEAR 2022 UNDER A SUPPLEMENTAL NON QUALIFIED RETIREMENT PLAN. CRIS DASKEVICH RECEIVED $209,627 DURING CALENDAR YEAR 2022 UNDER A SUPPLEMENTAL NON QUALIFIED RETIREMENT PLAN. CHARLES HANKINS RECEIVED $168,820 DURING CALENDAR YEAR 2022 UNDER A SUPPLEMENTAL NON QUALIFIED RETIREMENT PLAN. STEPHANIE PARKER RECEIVED $12,564 DURING CALENDAR YEAR 2022 UNDER A SUPPLEMENTAL NON QUALIFIED RETIREMENT PLAN. IAN THOMPSON RECEIVED $53,304 DURING CALENDAR YEAR 2022 UNDER A SUPPLEMENTAL NON QUALIFIED RETIREMENT PLAN. NORMAN CHRISTOPHER RECEIVED $47,305 DURING CALENDAR YEAR 2022 UNDER A SUPPLEMENTAL NON QUALIFIED RETIREMENT PLAN. Schedule J, Part II SUPPLEMENTAL COMPENSATION INFORMATION DIRECTORS AND EX-OFFICIO DIRECTORS PROVIDE THEIR SERVICES AS MEMBERS OF THE BOARD WITHOUT COMPENSATION OR BENEFITS. ANY COMPENSATION AND BENEFITS DISCLOSED FOR SUCH PERSONS IS EARNED IN THE RESPECTIVE INDIVIDUAL'S ROLE AS AN OFFICER OR EMPLOYEE OF THE ORGANIZATION, NOT FOR THE INDIVIDUAL'S ROLE AS A BOARD MEMBER OR DIRECTOR. BOARD MEMBERS SPEND TIME AS NEEDED FOR BOARD MEETINGS AND FUNCTIONS. Schedule J, Part II SUPPLEMENTAL COMPENSATION INFORMATION W-2 COMPENSATION MAY INCLUDE PAYMENTS RELATED TO COMPENSATION DEFERRED IN PRIOR YEARS. DEFERRED COMPENSATION MAY INCLUDE DEFERRALS OF CURRENT YEAR COMPENSATION UNDER EXECUTIVE DEFERRED INCOME ACCOUNT, SUPPLEMENTAL EXECUTIVE RETIREMENT AND RETENTION PLAN AND PENSION RESTORATION PLAN. Schedule J, Part II, Column (B)(ii) BONUS AND INCENTIVE COMPENSATION BONUS AND INCENTIVE COMPENSATION MAY INCLUDE AMOUNTS THAT WERE DEFERRED IN A PRIOR YEAR BUT PAID OUT IN CALENDAR YEAR 2022. Schedule J, Part II, Column (C) DEFERRED COMPENSATION DEFERRED COMPENSATION INCLUDES EXECUTIVE DEFERRED INCOME ACCOUNT, SUPPLEMENTAL EXECUTIVE RETIREMENT AND RETENTION PLAN, EMPLOYER CONTRIBUTION TO 403(B) MATCHED SAVINGS PLAN, PENSION RESTORATION PLAN AND ESTIMATED PENSION BENEFITS UNDER CHRISTUS HEALTH CASH BALANCE PLAN. ESTIMATED PENSION BENEFITS WERE CALCULATED BASED ON THE PROVISIONS OF THE CURRENT CASH BALANCE PLAN AT 6% OF PENSIONABLE EARNINGS. SOME ASSOCIATES ARE GRANDFATHERED UNDER AN EARLIER PENSION PLAN. THESE GRANDFATHERED PARTICIPANTS, BASED ON COMPUTATION AT THE TIME OF THEIR RETIREMENT, WILL RECEIVE THE LARGER OF THE RETIREMENT BENEFIT COMPUTED UNDER THE CASH BALANCE PLAN COMPARED TO THE PREVIOUS PENSION PLAN. DUE TO THE COMPLEXITY OF CALCULATING AN ACCURATE BENEFIT COST FOR GRANDFATHERED PARTICIPANTS, THE FORM 990 REPORTS AS PENSION BENEFITS THEIR ANNUAL ESTIMATED CASH BALANCE PLAN ACCRUAL. THE FORM 990 REPORTS AS PENSION BENEFITS THEIR ANNUAL ESTIMATED CASH BALANCE PLAN ACCRUAL. Form 990, Part III, Line 1 ORGANIZATION'S MISSION THE CORPORATION IS ORGANIZED AND SHALL BE OPERATED EXCLUSIVELY FOR CHARITABLE, SCIENTIFIC, EDUCATIONAL AND RELIGIOUS PURPOSES OF ADVANCING, PROMOTING AND SUPPORTING THE HEALTH CARE MINISTRIES OF THE SPONSORING CONGREGATIONS WHICH OPERATE AND ARE CONTROLLED IN CONFORMITY WITH THE ETHICAL AND MORAL TEACHINGS OF THE ROMAN CATHOLIC CHURCH, AND PROMOTING EFFICIENT GOVERNANCE AND MANAGEMENT, COOPERATIVE PLANNING AND THE SHARING OF RESOURCES AMONG SUCH HEALTH CARE MINISTRIES. WITHOUT LIMITING THE GENERALITY OF THE FOREGOING, THE CORPORATION'S MISSION SHALL BE TO EXTEND THE HEALING MINISTRY OF JESUS CHRIST, AND CONSISTENT THEREWITH, SHALL OPERATE ACCORDING TO THE DOCTRINES, RESOLUTIONS, DECREES AND ETHICAL PRINCIPLES OF THE SPONSORING CONGREGATIONS, AND THE ETHICAL AND RELIGIOUS DIRECTORS FOR CATHOLIC HEALTH CARE SERVICES AS PROMULGATED OR AMENDED FROM TIME TO TIME BY THE UNITED STATES CONFERENCE OF CATHOLIC BISHOPS. IT IS ALSO A PURPOSE OF THE CORPORATION TO AID, LEND FINANCIAL SUPPORT AND ASSISTANCE TO, AND TO INVEST, TRANSFER AND/OR DISPOSE OF FUNDS OF THE CORPORATION AND THE SYSTEM PARTICIPANTS FOR THE USE AND BENEFIT OF, AND IN FURTHERANCE OF THE PURPOSES OF, THE SYSTEM, THE CORPORATION, THE SYSTEM PARTICIPANTS, AND THE LOCAL ENTITIES. THE CORPORATION'S PURPOSES SHALL ALSO INCLUDE THE MAKING OF GIFTS, GRANTS AND CONTRIBUTIONS TO OTHER QUALIFYING TAX-EXEMPT ORGANIZATIONS, PARTICULARLY THOSE DESIGNED TO SUPPORT AND BENEFIT THE HEALTH AND WELFARE OF THE POOR AND UNDERSERVED. THE CORPORATION SHALL ALSO BE AUTHORIZED TO ENGAGE IN SUCH PURSUITS AS MAY BE NECESSARY OR INCIDENTAL, OR WHICH MAY AID AND ASSIST, IN CARRYING OUT THE CORPORATION'S MISSION AND PURPOSES. THE CORPORATION IS ORGANIZED AND SHALL BE OPERATED EXCLUSIVELY FOR THE BENEFIT OF THESE PURPOSES, AS WELL AS THOSE SYSTEM ENTITIES THAT ARE DESCRIBED IN SECTION 501(C)(3), AND SECTION 509(A)(1) OR SECTION 509(A)(2) OF THE INTERNAL REVENUE CODE OF 1986, AS AMENDED, OR CORRESPONDING PROVISIONS OF ANY SUBSEQUENT LAW. PROVISIONS OF ANY SUBSEQUENT LAW. Form 990, Part III, Line 4c PROGRAM SERVICE, LINE 4C COMMITMENT TO BENEFITING OUR COMMUNITIES - PATIENT CARE SERVICES CHRISTUS SANTA ROSA HEALTH CARE CORPORATION, FOUNDED IN 1869 BY THE SISTERS OF CHARITY OF THE INCARNATE WORD, IS THE ONLY CATHOLIC FAITH-BASED, NON-PROFIT HEALTH CARE SYSTEM IN SAN ANTONIO, NEW BRAUNFELS, and san marcos. WITH THE MISSION TO EXTEND THE HEALING MINISTRY OF JESUS CHRIST, CHRISTUS HEALTH IS CHALLENGED TO REACH OUT TO, AND BEYOND, MORE THAN 18 COMMUNITIES WE SERVE TO HELP THOSE IN NEED. THE VISION OF CHRISTUS HEALTH, AS A CATHOLIC, FAITH-BASED MINISTRY, IS TO BE A LEADER, A PARTNER AND AN ADVOCATE IN THE CREATION OF INNOVATIVE HEALTH AND WELLNESS SOLUTIONS THAT IMPROVE THE LIVES OF INDIVIDUALS AND COMMUNITIES SO THAT ALL MAY EXPERIENCE GOD'S HEALING PRESENCE AND LOVE. ONE OF THE TOP HEALTH CARE ORGANIZATIONS IN SOUTH TEXAS, CHRISTUS SANTA ROSA HEALTH CARE CORPORATION IS HEADQUARTERED IN SAN ANTONIO, TEXAS, IN THE SOUTH CENTRAL AREA OF THE STATE. IT HAS SIX HOSPITAL CAMPUSES. IT SERVICES THE SOUTHWESTERN BORDER OF TEXAS AND INTO THE CENTRAL TEXAS HILL COUNTRY. THE AREA COMPRISES A POPULATION OF MORE THAN 3.1 MILLION INDIVIDUALS. THE POPULATION CONSISTS OF 55.20% HISPANIC AND 44.80% NON-HISPANIC. THE MEDIAN INCOME FOR THE CITY OF SAN ANTONIO IS $63,480, AND HIGH SCHOOL GRADUATES REPRESENT 82.5% OF THE POPULATION. CHRISTUS SANTA ROSA HEALTH CARE CORPORATION HAS SIX HOSPITAL CAMPUSES: (1) CHRISTUS SANTA ROSA MEDICAL CENTER, LOCATED IN THE SOUTH TEXAS MEDICAL CENTER, located in SAN Antonio; (2) CHILDREN'S HOSPITAL OF SAN ANTONIO, LOCATED IN DOWNTOWN SAN ANTONIO; (3) CHRISTUS SANTA ROSA -WESTOVER HILLS IN THE WESTOVER HILLS AREA OF SAN ANTONIO; (4) CHRISTUS SANTA ROSA ALAMO HEIGHTS, located in san antonio; (5) CHRISTUS SANTA ROSA NEW BRAUNFELS, LOCATED IN NEW BRAUNFELS, TEXAS; and (6) CHRISTUS SANTA ROSA SAN MARCOS, LOCATED IN SAN MARCOS, TEXAS CHRISTUS SANTA ROSA HEALTH CARE CORPORATION'S OTHER HEALTH FACILITIES INCLUDE CHRISTUS SANTA ROSA FAMILY HEALTH CENTER, A CERTIFIED 162.001(B) NON-PROFIT HEALTH ORGANIZATION THAT PROVIDES THE COMMUNITY WITH A FAMILY MEDICINE RESIDENCY PROGRAM, SPORTS MEDICINE FELLOWSHIP, AND A PATIENT CENTERED MEDICAL HOME WITH A TOTAL OF 29 RESIDENTS. IN ADDITION, THE ORGANIZATION OWNS A MAJORITY INTEREST IN TWO JOINT VENTURES - CHRISTUS SANTA ROSA OUTPATIENT SURGERY CENTER - NEW BRAUNFELS AND CHRISTUS SANTA ROSA PHYSICIAN AMBULATORY SURGERY CENTER - SAN ANTONIO. BOTH AMBULATORY SURGERY CENTERS HAVE 2 LOCATIONS FOR A TOTAL OF 4 IN THE CHRISTUS SANTA ROSA AREA. THERE ARE OVER 200 SURGEONS WHO UTILIZE THE PHYSICIAN AMBULATORY SURGERY CENTER. CHRISTUS SANTA ROSA HEALTH CARE CORPORATION IS ALSO ONE OF THE COLLABORATING PARTNERS IN BEXAR COUNTY CLINICAL SERVICES, INC. WHICH PROVIDES PHYSICIAN AND OTHER CLINICAL HEALTH CARE SERVICES TO MEDICAID AND INDIGENT PATIENTS. EACH OF THE FACILITIES OF CHRISTUS SANTA ROSA SHARES ONE OBJECTIVE -- WHICH IS TO LEAD THE WAY TO A HEALTHIER COMMUNITY. CHRISTUS SANTA ROSA HEALTH CARE CORPORATION IS HEADQUARTERED IN SAN ANTONIO, TEXAS, IN THE SOUTH CENTRAL AREA OF THE STATE. ITS SERVICE TO THE SOUTHERN AND WESTERN BORDERS OF TEXAS AND INTO THE CENTRAL TEXAS HILL COUNTRY AREA COVERS A POPULATION OF MORE THAN 3.2 MILLION INDIVIDUALS. IN FISCAL YEAR 2023 ALONE, WE WERE PRIVILEGED TO SERVE HUNDREDS OF THOUSANDS OF INDIVIDUALS IN VARIOUS WAYS INCLUDING 151,096 VISITS TO OUR EMERGENCY DEPARTMENT; 5,635 INPATIENT SURGERY PROCEDURES; 43,402 OUTPATIENT SURGERY VISITS; 27,809 PATIENTS WHO WERE ADMITTED TO OUR HOSPITALS FOR CARE; AND XXX PATIENTS WHO RECEIVED OUTPATIENT CARE AT OUR FACILITIES. TOUCHING THE LIVES OF THE PEOPLE AROUND US IS WHAT MAKES CHRISTUS SANTA ROSA HEALTH CARE CORPORATION STAND APART. ALLOWING OTHERS TO TOUCH US GIVES US A VISION FOR THE MEDICALLY NEEDY IN EACH OF THE COMMUNITIES WE SERVE. WHETHER IT IS THE LIFE OF A CHILD EXPECTING A FUTURE FILLED WITH MIRACLES, THE LIFE OF A MAN IN NEED OF A CRITICAL HEART SURGERY, OR THE LIFE OF A WOMAN ABOUT TO GIVE BIRTH TO HER FIRST CHILD, CHRISTUS SANTA ROSA HEALTH CARE CORPORATION WORKS TO PROVIDE THE BEST CARE POSSIBLE REGARDLESS OF AN INDIVIDUAL'S ABILITY TO PAY. BY COLLABORATING WITH COMMUNITIES, CHURCHES, BUSINESSES, AND OTHER HEALTH CARE ORGANIZATIONS, CHRISTUS SANTA ROSA HEALTH CARE CORPORATION'S VARIOUS ENTITIES HAVE STRENGTHENED THEIR ROLES AS MAJOR PROVIDERS OF COMPREHENSIVE AND ACCESSIBLE HEALTH CARE SERVICES. THESE PARTNERSHIPS WITH THE COMMUNITY HAVE BEEN A BLESSING BY HELPING CHRISTUS SANTA ROSA HEALTH CARE CORPORATION EXTEND SERVICES TO THOSE IN NEED. FURTHERMORE, INVESTMENT IN COMMUNITY SERVICES WOULD NOT BE POSSIBLE WITHOUT DEDICATED EMPLOYEES AND VOLUNTEERS. THEY HELP TO BUILD STRONG RELATIONSHIPS BETWEEN THE HOSPITALS, OTHER HEALTH CARE MINISTRIES AND THE COMMUNITIES WHICH NURTURE CHRISTUS HEALTH'S MISSION TO EXTEND THE HEALING MINISTRY OF JESUS CHRIST. OUR EMPLOYEES WORK BOTH INSIDE THE WALLS OF OUR HEALTH CARE FACILITIES AND IN THE COMMUNITY AND ARE COMMITTED TO REACHING BEYOND THE TRADITIONAL HOSPITAL WALLS TO HELP OUR COMMUNITIES MAINTAIN GOOD HEALTH. UNDERSTANDING THE NEED TO PROVIDE ACCESS TO HEALTH CARE TO AS MUCH OF THE PUBLIC AS POSSIBLE, CHRISTUS SANTA ROSA HEALTH CARE CORPORATION PARTICIPATES IN GOVERNMENT-SPONSORED HEALTH CARE PROGRAMS, INCLUDING MEDICAID, MEDICARE, CHAMPUS, TRICARE AND OTHERS. IN ADDITION, WE OFFER SPECIFIC PROGRAMS TO PROVIDE DISCOUNTED SERVICES TO THOSE IN NEED WHO DO NOT HAVE MEDICAL INSURANCE OR WHO DO NOT PARTICIPATE IN GOVERNMENT-SPONSORED PROGRAMS. CHRISTUS SANTA ROSA HEALTH CARE CORPORATION PROVIDES A FULL RANGE OF INPATIENT AND OUTPATIENT SERVICES TO THE PEOPLE FROM THE COMMUNITIES IT SERVES, INCLUDING FOUR AMBULATORY SURGICAL CENTERS THAT OFFER AN ARRAY OF SERVICES. IT CONDUCTS ITS ACTIVITIES AND SERVES ITS PURPOSE WITHOUT REGARD TO RACE, COLOR, CREED, RELIGION, GENDER, ORIENTATION, DISABILITY, AGE OR NATIONAL ORIGIN. CHRISTUS Santa Rosa Health Care Corporation also supports many local community health services, offering convenient locations for adult and pediatric primary care through family health clinics and mobile health clinics. CHRISTUS Santa Rosa Health Care Corporation offers services such as: Comprehensive Pediatric Care, Intensive and Intermediate care to critically ill infants requiring medical and/or surgical interventions such as the neonatal ECMO Program that provides Veno-Venous or Veno-Arterial Extracorporeal Life support for up to three infants in the NICU; a centralized Level IV NICU and a Wound Care and Hyperbaric Center. In addition, our adult hospitals offer the following; Cardiac Care that is nationally certified by the American Association of Cardiovascular and Pulmonary Rehabilitation (AACVPR) and accredited as a Chest Pain Center with Percutaneous Coronary Intervention (PCI) designation from the Society of Chest Pain Centers (SCPC); a comprehensive cancer program; complete obstetrical and newborn services; surgical units; a diabetes care program; and state-of-the-art medical care for children with an array of specialty services and orthopedic services. We also offer rehabilitation treatment for those who have experienced a stroke, a spinal cord injury, closed head injury and more. EACH CAMPUS OF CHRISTUS SANTA ROSA HEALTH CARE CORPORATION PROVIDES A 24-HOUR EMERGENCY ROOM THAT IS OPEN TO SERVE ALL THOSE IN NEED OF EMERGENT CARE, REGARDLESS OF THEIR ABILITY TO PAY. AS A NOT-FOR-PROFIT ORGANIZATION AND AS PART OF CHRISTUS HEALTH, A REGIONAL GOVERNING BOARD COMPRISED LARGELY OF INDEPENDENT COMMUNITY MEMBERS REPRESENTING THE AREA WE SERVE GUIDES CHRISTUS SANTA ROSA HEALTH CARE CORPORATION. WE HAVE AN OPEN MEDICAL STAFF COMPRISED OF QUALIFIED PHYSICIANS WHO WORK WITH US TO PROVIDE CARE TO OUR COMMUNITIES. ALL QUALIFIED PHYSICIANS GRANTED PRIVILEGES TO SERVE WITH US IN OUR HOSPITALS MUST UNDERGO A THOROUGH AND COMPREHENSIVE CREDENTIALING PROCESS. THE PHYSICIANS ASSIST OUR CONTINUOUS EFFORTS TO IMPROVE SERVICE TO OUR PATIENTS, QUALITY OF CARE, AND HOSPITAL EFFICIENCY. Form 990, Part III, Line 4b PROGRAM SERVICE, LINE 4B COMMUNITY BENEFIT REPORTING - CHARITY CARE AND MEDICAID CHRISTUS ADHERES TO THE CATHOLIC HEALTH ASSOCIATION'S A GUIDE FOR PLANNING AND REPORTING COMMUNITY BENEFIT (2012), AND COMPLIES WITH THE STATE OF TEXAS REQUIREMENTS FOR REPORTING. COMMUNITY BENEFIT, REPORTED AS UNPAID COSTS, INCLUDES BOTH CHARITY CARE AND COMMUNITY SERVICES. TO THE LIMITS OF ITS RESOURCES, CHRISTUS SANTA ROSA HEALTH CARE CORPORATION IS AN INSTITUTION OF PURELY PUBLIC CHARITY; THUS, THE MOST TANGIBLE EXPRESSION OF CHARITABLE PURPOSE IS THE PROVISION OF HEALTH CARE SERVICES TO THOSE PERSONS WHO ARE UNABLE TO PAY. THIS FALLS INTO TWO CATEGORIES: CHARITY CARE AND UNPAID GOVERNMENT INDIGENT CARE. IN KEEPING WITH THE MISSION, VALUES, AND VISION OF CHRISTUS HEALTH, CHRISTUS SANTA ROSA HEALTH CARE CORPORATION PROVIDES CHARITY CARE SERVICES IN A MANNER THAT RESPECTS THE DIGNITY OF THE PATIENTS AND THEIR FAMILIES. CHARITY CARE IS PROVIDED WITHOUT CHARGE OR AT A CHARGE THAT IS LESS THAN THE USUAL CHARGE FOR SUCH SERVICES. THE DETERMINATION AS TO THE AMOUNT TO BE CHARGED, IF ANY, IS MADE ACCORDING TO A PATIENT'S ABILITY TO PAY AS DETERMINED BY ESTABLISHED ELIGIBILITY CRITERIA. FOR UNINSURED PATIENTS WHOSE ECONOMIC CIRCUMSTANCES PLACE THEM AT OR UNDER 300 PERCENT OF THE FEDERAL POVERTY LEVEL (FPL), SERVICES ARE PROVIDED WITHOUT ANY EXPECTATION OF PAYMENT. UNINSURED PATIENTS WHOSE ECONOMIC CIRCUMSTANCES PLACE THEM BETWEEN 300 AND 400 PERCENT OF FPL ARE CHARGED BASED ON A SLIDING SCALE, AND THOSE ABOVE 400 PERCENT RECEIVE DISCOUNTS BASED ON THE UNINSURED FEE SCHEDULE. NO PATIENT IS REFUSED NECESSARY MEDICAL CARE BASED ON THE INABILITY TO PAY. CHRISTUS SANTA ROSA HEALTH CARE CORPORATION IS AN ACTIVE PARTICIPANT IN THE STATE OF TEXAS MEDICAID PROGRAMS AND WORKS WITH OTHER STATE MEDICAID PROGRAMS TO ENSURE PATIENTS HAVE FULL ACCESS TO THEIR BENEFITS. THOSE PROGRAMS SEEK TO PROVIDE PAYMENT FOR HEALTH CARE SERVICES TO INDIVIDUALS WHO MEET CERTAIN FINANCIAL AND OTHER REQUIREMENTS. FINANCIAL REQUIREMENTS INCLUDE EVALUATION OF BOTH ASSETS AND INCOME. Form 990, Part III, Line 4a PROGRAM SERVICE, LINE 4A OTHER GOVERNMENT SPONSORED SERVICES IN ADDITION TO THE PROVISION OF CHARITY CARE AND OTHER COMMUNITY SERVICES, CHRISTUS HEALTH PROVIDES SERVICES TO PERSONS COVERED UNDER GOVERNMENT-SPONSORED PROGRAMS, INCLUDING MEDICARE AND TRICARE. THE COSTS NOT REIMBURSED FOR THESE SERVICES ARE REPORTED TO THE STATE OF TEXAS. THEY ARE NOT INCLUDED IN REPORTS PREPARED FOLLOWING CATHOLIC HEALTH ASSOCIATION GUIDELINES. CHRISTUS SANTA ROSA HEALTH CARE CORPORATION PROVIDES SERVICES TO PERSONS COVERED UNDER THE FEDERAL MEDICARE PROGRAM, AND IN FACT, THIS IS THE LARGEST SINGLE PAYOR CLASSIFICATION OF PATIENTS SERVED BY THIS HOSPITAL. THE PAYMENT RATE FOR INPATIENT SERVICES IS ON A PER-CASE RATE, CALCULATED BASED ON THE DIAGNOSTIC-RELATED GROUP (DRG) INTO WHICH THE PATIENT IS CATEGORIZED. MEDICARE REIMBURSES OUTPATIENT SERVICES BASED ON ITS FEE SCHEDULE. Form 990, Part III, Line 4d Description of other program services (Expenses $ 5,893,816 including grants of $ 0)(Revenue $ 0) COMMUNITY SERVICES FOR THE BROADER COMMUNITY THE GREATEST SHARE OF THESE EXPENSES IS USED FOR EDUCATING HEALTH PROFESSIONALS. HELPING TO PREPARE FUTURE HEALTH CARE PROFESSIONALS IS A DISTINGUISHING CHARACTERISTIC OF NOT-FOR-PROFIT HEALTH CARE, AND CONSTITUTES A SIGNIFICANT COMMUNITY BENEFIT. CHRISTUS SANTA ROSA HEALTH CARE CORPORATION ALSO USED CASH DONATIONS AS A VEHICLE TO HELP OUR COMMUNITIES. WE MADE CASH DONATIONS, IN ADDITION TO GRANTS AWARDED THROUGH THE CHRISTUS FUND, TO INCREASE ACCESS TO HEALTH CARE, SUPPORT CAUSES LIKE THE FIGHT AGAINST CANCER, HEART DISEASE, DIABETES, AND FOR MANY OTHER EQUALLY WORTHY PURPOSES. DURING FY 2023, CHRISTUS SANTA ROSA ADVOCATED FOR IMPROVING PUBLIC POLICIES, WORKING TO ESTABLISH, AND IN SOME INSTANCES AUGMENT, GRASSROOTS ADVOCACY AND GREATER ACCESS TO HEALTHCARE SERVICES FOR THE CONSTITUENTS WE SERVE. Form 990, Part III, Line 4d Description of other program services (Expenses $ 2,443,391 including grants of $ 5,973)(Revenue $ 0) COMMUNITY SERVICES FOR THE POOR AND UNDERSERVED ROOTED IN OUR MISSION AND TRADITION, THE FOUNDERS AND SPONSORS OF CHRISTUS HEALTH AND THOSE WHO CO-MINISTER WITH THEM SEEK NEW AND INNOVATIVE WAYS OF DELIVERING QUALITY HEALTH CARE THAT IS BOTH AFFORDABLE AND ACCESSIBLE TO ALL. TODAY, MORE THAN EVER, WE MUST AIM TO IMPROVE THE TOTAL HEALTH STATUS OF THE COMMUNITY THROUGH PROGRAMS THAT PLACE OUR SERVICES WHERE THEY ARE NEEDED MOST, WITH SPECIAL ATTENTION AND PREFERENCE GIVEN TO PROGRAMS THAT SUPPORT AND BENEFIT THE HEALTH AND WELFARE OF THE POOR AND UNDERSERVED. COMMUNITY SERVICES FOR THE POOR AND UNDERSERVED REPRESENT THE UNPAID COST OF SERVICES PROVIDED FOR WHICH A PATIENT IS NOT BILLED, OR FOR WHICH A FEE HAS BEEN ASSESSED THAT RECOVERS ONLY A PORTION OF THE COST OF THE RENDERED SERVICE. THIS CATEGORY INCLUDES INITIATIVES THAT REACH OUT TO THOSE IN NEED THROUGH COMMUNITY HEALTH AND SOCIAL PROGRAMS. THESE PROGRAMS SEEK JUSTICE FOR THE VULNERABLE AND WORK TO BRING ABOUT CHANGES IN OUR POLITICAL AND ECONOMIC SYSTEMS. THE PROGRAMS COVER A BROAD SPECTRUM OF SERVICES FROM COMMUNITY CLINICS, OUTREACH PROGRAMS FOR CHILDREN AND SENIORS, HEALTH EDUCATION, AIR AMBULANCE AND A VARIETY OF OTHER SOCIAL SERVICES. ONE EXAMPLE OF CHRISTUS SANTA ROSA HEALTH CARE CORPORATION'S COMMUNITY BENEFITS ACCOUNTED FOR UNDER COMMUNITY SERVICES FOR THE POOR AND UNDERSERVED INCLUDE THE CHRISTUS HEALTH COMMUNITY DIRECT INVESTMENT PROGRAM (CDI). THE CHRISTUS HEALTH BOARD OF DIRECTORS APPROVED THE FUNDING OF THE CDI LOAN PROGRAM TO ENSURE THAT THE WORK OF SOCIAL ACCOUNTABILITY AND MORAL AND ETHICAL STEWARDSHIP CONTINUES IN SPITE OF CHALLENGING FISCAL CONDITIONS FACED BY LOCAL OPERATING ENTITIES. THE PURPOSE OF THE CDI PROGRAM IS TO SUPPORT COMMUNITY-DRIVEN INITIATIVES PRIMARILY FOR AFFORDABLE HOUSING AND ECONOMIC DEVELOPMENT BY PROVIDING FINANCING AT BELOW-MARKET INTEREST RATES TO NOT-FOR-PROFIT ORGANIZATIONS AT TERMS NOT EXCEEDING MORE THAN FIVE YEARS. THE INCOME THAT IS LOST FROM THE MARKET RATE LESS OUR LOAN RATE (FOREGONE INCOME) IS CONSIDERED A COMMUNITY BENEFIT FOR REPORTING PURPOSES. THE COST OF THESE INVESTMENTS IS NOT INCLUDED IN THE PROGRAM SERVICE EXPENSES OF CHRISTUS SANTA ROSA HEALTH CARE CORPORATION. CHRISTUS HEALTH HAS ESTABLISHED THE CHRISTUS FUND TO PROVIDE RESOURCES TO NOT FOR-PROFIT AGENCIES AND GROUPS WHOSE MISSION, VISION AND GOALS ARE CONSISTENT WITH CHRISTUS HEALTH'S MISSION, VALUES AND PHILOSOPHY OF A HEALTHY COMMUNITY. WE BELIEVE THAT BY WORKING TOGETHER, WE CAN MAKE A PROFOUND DIFFERENCE IN THE QUALITY OF PEOPLES' LIVES AND CREATE SUSTAINABLE HEALTH IN OUR COMMUNITIES. DURING FY 2022, THE TOTAL GRANT MONEY DISTRIBUTED BY CHRISTUS HEALTH TO THE CHRISTUS SANTA ROSA HEALTH CARE CORPORATION REGION WAS $343,000. THE COST OF THESE GRANTS IS NOT INCLUDED IN THE PROGRAM SERVICE EXPENSES FOR CHRISTUS SANTA ROSA HEALTH CARE CORPORATION. SEVERAL CHRISTUS REGIONS PROVIDE INDIGENT FUNDING DONATIONS OR "GRANTS" TO AID THE COUNTIES IN WHICH THEY, OR ANOTHER CHRISTUS REGION, SERVE. SUCH GRANTS MAY BE PAID TO THE COUNTY DIRECTLY OR VIA ANOTHER HOSPITAL OR HEALTHCARE ORGANIZATION IN THE AREA. THIS CHARITABLE DONATION HELPS RELIEVE THE ADDITIONAL EXPENSE OF HEALTHCARE FOR THE INDIGENT POPULATION WITHIN OUR COMMUNITIES THAT CHRISTUS MAY NOT DIRECTLY SERVE IN ONE OF OUR HOSPITALS. THIS IS A RESULT OF OUR MISSION TO EXTEND THE HEALING MINISTRY OF JESUS CHRIST, ESPECIALLY TO THE POOR AND UNDERSERVED. Form 990, Part VI, Line 18 PUBLIC DISCLOSURE OF 1023 AND FORMS 990 & 990-T CHRISTUS HEALTH AND MOST OF ITS AFFILIATED ENTITIES DO NOT HAVE FORMS 1023 BECAUSE OF THEIR INCLUSION IN THE IRS GROUP RULING WITH THE UNITED STATES CONFERENCE OF CATHOLIC BISHOPS, WHICH COVERS THE ORGANIZATIONS LISTED IN THE ANNUAL OFFICIAL CATHOLIC DIRECTORY. CHRISTUS HEALTH'S WEBSITE DISPLAYS THE IRS GROUP RULING AND RELEVANT ANNUAL OFFICIAL CATHOLIC DIRECTORY PAGES FOR THE ORGANIZATIONS RELATED TO CHRISTUS HEALTH. FORMS 990 AND 990-T ARE MADE AVAILABLE UPON REQUEST. Form 990, Part VI, Line 2 FAMILY/BUSINESS RELATIONSHIPS AMONGST INTERESTED PERSONS OFFICER AND DIRECTOR DEAN ALEXANDER AND KEY EMPLOYEE KENNETH DAVIS HAVE A BUSINESS RELATIONSHIP BECAUSE THEY SERVE AS MEMBERS OF THE MANAGING BOARD OF CHRISTUS SANTA ROSA PHYSICIANS AMBULATORY SURGERY CENTER-SAN ANTONIO, LLC. Form 990, Part VI, Line 6 Classes of members or stockholders CHRISTUS HEALTH IS THE SOLE CORPORATE MEMBER OF THE FILING ORGANIZATION. Form 990, Part VI, Line 7a Members or stockholders electing members of governing body CHRISTUS HEALTH, THE SOLE CORPORATE MEMBER OF THE FILING ORGANIZATION, HAS THE POWER TO APPOINT ALL MEMBERS OF THE FILING ORGANIZATION'S GOVERNING BODY. Form 990, Part VI, Line 7b Decisions requiring approval by members or stockholders CHRISTUS HEALTH'S BOARD OF DIRECTORS HAS THE FOLLOWING POWERS: APPROVE, CHANGE AND/OR INTERPRET THE FILING ORGANIZATION'S PHILOSOPHY, MISSION AND VISION; APPROVE THE ADOPTION OR AMENDMENT OF THE FILING ORGANIZATION'S CERTIFICATE OF FORMATION/ ARTICLES OF INCORPORATION AND BYLAWS; APPOINT AND REMOVE MEMBERS OF THE FILING ORGANIZATION'S BOARD OF DIRECTORS; APPOINT AND REMOVE THE FILING ORGANIZATION'S CHAIR OF THE BOARD OF DIRECTORS; APPROVE INCURRENCE OF DEBT THAT EXCEEDS $20 MILLION PER INCURRENCE; APPROVE ANY MERGER, CONSOLIDATION, ACQUISITION, DISSOLUTION OR LIQUIDATION BY THE FILING ORGANIZATION; APPROVE SYSTEM WIDE CONSOLIDATED BUDGET AND PERFORMANCE INDICATORS FOR THE FILING ORGANIZATION; APPROVE THE INDEPENDENT AUDIT REPORTS OF THE FILING ORGANIZATION; APPROVE CAPITAL PROJECTS GREATER THAN $20 MILLION FOR THE FILING ORGANIZATION; APPROVE ANY TRANSACTION BY THE FILING ORGANIZATION THE EFFECT OF WHICH IS TO CREATE A NEW LEGAL ENTITY OR JOINT VENTURE, ANY TRANSACTION INVOLVING A SYSTEM ENTITY WHICH CREATES A NEW LEGAL ENTITY OR JOINT VENTURE, OR CHANGES IN BUSINESS PURPOSE OR RELATIONSHIP OF ANY SYSTEM ENTITY; AND APPROVE AND AUTHORIZE ACTIONS RESERVED TO CHRISTUS HEALTH IN ORGANIZATION DOCUMENTS OR SIMILAR GOVERNANCE DOCUMENTS. THE CHRISTUS HEALTH CEO HAS THE FOLLOWING POWERS: POWER TO APPOINT AND REMOVE THE PRESIDENT OF THE FILING ORGANIZATION; APPROVE THE SALE, LEASE, MORTGAGE, TRANSFER, EASEMENT OR ENCUMBRANCE OF THE FILING ORGANIZATION'S REAL PROPERTY DESIGNATED AS NON DESIGNATED MINISTRY PROPERTY UNDER $1 MILLION BUT MORE THAN $20 MILLION; APPROVE THE INCURRENCE OF DEBT UP TO A $20 PER INCURRENCE BY THE FILING ORGANIZATION; APPROVE STRATEGIC PLANS OF THE FILING ORGANIZATION; APPROVE THE FILING ORGANIZATION'S BUDGET; APPROVE THE IMPLEMENTATION OF SYSTEM-WIDE POLICIES FOR THE FILING ORGANIZATION; SET THE THRESHOLD OF CAPITAL PROJECTS LESS THAN $20 MILLION BY THE FILING ORGANIZATION; AND APPROVE MANAGEMENT DIRECTIVES FOR THE FILING ORGANIZATION. THE CHRISTUS HEALTH MEMBERS ARE TWO SISTERS APPOINTED BY EACH OF THE FOUNDING SPONSORING CONGREGATIONS OF CHRISTUS HEALTH, THE CONGREGATION OF THE SISTERS OF CHARITY OF THE INCARNATE WORD, HOUSTON, TEXAS, AND THE CONGREGATION OF SISTERS OF CHARITY OF THE INCARNATE WORD OF SAN ANTONIO, AND ONE SISTER APPOINTED BY THE SISTERS OF THE HOLY FAMILY OF NAZARETH. THE CHRISTUS HEALTH MEMBERS HAVE THE FOLLOWING POWERS: APPROVE THE ADOPTION AND AMENDMENT OF CERTIFICATES OF FORMATION/ ARTICLES OF INCORPORATION AND BYLAWS OF THE FILING ORGANIZATION IF THE CHANGE IS RELATED TO MEMBER RESERVED POWERS; APPROVE THE SALE, LEASE, MORTGAGE, TRANSFER, EASEMENT OR ENCUMBRANCE OF REAL PROPERTY IN EXCESS OF A THRESHOLD DOLLAR AMOUNT REQUIRED BY CANON LAW; APPROVE THE SALE, LEASE, MORTGAGE, TRANSFER, EASEMENT, OR ENCUMBRANCE OF REAL PROPERTY DESIGNATED AS DESIGNATED MINISTRY PROPERTY; APPROVE THE CHANGE OF OWNERSHIP, MANAGEMENT OR CONTROL OF DESIGNATED MINISTRY PROPERTY (EXCEPT IN THE ORDINARY COURSE OF BUSINESS) OR THE FUNDAMENTAL USE OF DESIGNATED MINISTRY PROPERTY BY CHANGE IN LICENSE THAT WOULD SIGNIFICANTLY CHANGE THE NATURE OF A FACILITY, OR THE ELIMINATION OF OB, PED, PSYCH OR EMERGENCY SERVICES ON REAL PROPERTY PROVIDED IN CONNECTION WITH DESIGNATED MINISTRY PROPERTY OWNED BY THE FILING ORGANIZATION; AND APPROVE THE MERGER, CONSOLIDATION, ACQUISITION, DISSOLUTION OR LIQUIDATION OF THE FILING ORGANIZATION IF IT OWNS DESIGNATED MINISTRY PROPERTY. Form 990, Part VI, Line 11b Review of form 990 by governing body THE FORM 990 IS PREPARED AND REVIEWED BY THE ORGANIZATION'S EXTERNAL INDEPENDENT ACCOUNTANTS. THE CHRISTUS HEALTH ACCOUNTING DEPARTMENT WORKS WITH AN EXTERNAL ACCOUNTING FIRM IN PREPARATION AND REVIEW OF THE FORM 990. THE FILING ORGANIZATION'S CFO, OR OTHER DESIGNEE, REVIEWS THE FORM 990. THE FINAL FORM 990 THAT WILL BE FILED WITH THE IRS IS POSTED TO A SECURE INTERNET PORTAL FOR ALL MEMBERS OF THE BOARD OF DIRECTORS TO VIEW. REVIEW OF THE FINAL FORM 990 OCCURS PRIOR TO FILING WITH THE IRS IN THE SPRING OF 2024 VIA A WEB PORTAL POLLING TOOL BY THE RESPECTIVE CHRISTUS ORGANIZATION'S BOARD, BASED ON A SET OF SUGGESTED REVIEW PROCESSES DEVELOPED BY CHRISTUS HEALTH. Form 990, Part VI, Line 12c Conflict of interest policy AT THE END OF EACH CALENDAR YEAR, THE CHRISTUS HEALTH CORPORATE SECRETARY DISTRIBUTES A CONFLICT OF INTEREST QUESTIONNAIRE TO ALL OF THE ORGANIZATION'S BOARD AND COMMITTEE MEMBERS FOR COMPLETION PRIOR TO THE 1ST OF JANUARY IN THE NEXT YEAR. THE CORPORATE SECRETARY THOROUGHLY REVIEWS ALL COMPLETED AND EXECUTED CONFLICT OF INTEREST QUESTIONNAIRE FORMS TO ENSURE ACCURACY AND THAT NO POTENTIAL OR IDENTIFIED CONFLICT IS DISCLOSED OR EXISTS. THE ORGANIZATION'S BOARD OF DIRECTORS IS RESPONSIBLE FOR ENFORCEMENT OF THE CONFLICT OF INTEREST POLICY OF THE ORGANIZATION. Form 990, Part VI, Line 15a Process to establish compensation of top management official THE EXECUTIVE COMPENSATION COMMITTEE OF CHRISTUS HEALTH DETERMINES THE COMPENSATION OF THE CEO (OR EXECUTIVE DIRECTOR, AS APPLICABLE), OFFICERS AND KEY EMPLOYEES OF CHRISTUS HEALTH AND CERTAIN OTHER OFFICERS AND KEY EMPLOYEES OF RELATED ORGANIZATIONS INCLUDING CHRISTUS SANTA ROSA HEALTH CARE CORPORATION. THE EXECUTIVE COMPENSATION COMMITTEE IS COMPOSED OF INDIVIDUALS WHO HAVE NO CONFLICT OF INTEREST WITH THE COMPENSATION ARRANGEMENTS AT HAND. THE EXECUTIVE COMPENSATION COMMITTEE OF THE CHRISTUS HEALTH BOARD SELECTS AN INDEPENDENT EXTERNAL FIRM TO PERFORM AN INDEPENDENT COMPENSATION REVIEW, TO ENSURE THAT ALL COMPENSATION IS REASONABLE AND COMPARABLE TO OTHER SIMILARLY SITUATED ORGANIZATIONS, FOR SIMILARLY QUALIFIED PERSONS IN FUNCTIONALLY COMPARABLE POSITIONS, AND TO PROVIDE SUPPORTING INFORMATION OF COMPENSATION DECISIONS. ON AN ANNUAL BASIS THE EXTERNAL CONSULTANT: 1. DEVELOPS THE MERIT INCREASE RECOMMENDATIONS FOR ALL DESIGNATED SYSTEM EXECUTIVES BASED ON MARKET COMPARABILITY. 2. RECOMMENDS THE CHANGES IN THE COMPENSATION STRUCTURE (GRADES) BASED ON THE MARKET CHANGES. 3. COMPLETES A REVIEW AND EVALUATION OF NEWLY CREATED POSITIONS TO RECOMMEND A GRADE PLACEMENT TO THE COMMITTEE FOR ITS DISCUSSION AND APPROVAL. ON A BI-ANNUAL BASIS, THE EXTERNAL CONSULTANT COMPLETES A DETAILED REVIEW OF ALL OTHER DESIGNATED SYSTEM EXECUTIVES' COMPENSATION AND BENEFITS. THIS GROUP INCLUDES ALL TOP MANAGEMENT OFFICIALS, OTHER OFFICERS AND KEY LEADERS OF THE ORGANIZATION. THE REVIEW INCLUDES RECOMMENDATIONS TO THE COMMITTEE ON ANY CHANGES NECESSARY IN EITHER SPECIFIC COMPENSATION OR COMPENSATION STRUCTURE TO ENSURE MARKET COMPETITIVENESS, REASONABLENESS AND INTERNAL EQUITY. UPON RECOMMENDATIONS FROM THE INDEPENDENT EXTERNAL FIRM, THE EXECUTIVE COMPENSATION COMMITTEE MAKES FINAL COMPENSATION DECISIONS. ADDITIONALLY, THE EXECUTIVE COMPENSATION COMMITTEE REVIEWS ALL COMPENSATION PAYMENTS FOR EXCESS BENEFIT TRANSACTIONS. THE DISCUSSION AND DECISIONS OF THE COMMITTEE ARE DOCUMENTED AND FORMALIZED IN THE COMMITTEE MINUTES AND MAINTAINED ON RECORD. THE FILING ORGANIZATION DETERMINES THE COMPENSATION OF THE SECRETARY BY USE OF AN INDEPENDENT AND EXTERNAL CONSULTANT. THE CONSULTANT HELPS DETERMINE PAY RATES FOR THE ASSOCIATES OF THE FILING ORGANIZATION, TAKING INTO ACCOUNT MARKET DATA AND SHIFT DIFFERENTIAL. THE COMPENSATION RATES ARE APPROVED BY THE FILING ORGANIZATION. BASED ON THE AFOREMENTIONED PROCEDURE, THE SECRETARY'S COMPENSATION IS NOT REVIEWED BY A COMPENSATION COMMITTEE. Form 990, Part VI, Line 15b Process to establish compensation of other employees THE EXECUTIVE COMPENSATION COMMITTEE OF CHRISTUS HEALTH DETERMINES THE COMPENSATION OF THE CEO (OR EXECUTIVE DIRECTOR, AS APPLICABLE), OFFICERS AND KEY EMPLOYEES OF CHRISTUS HEALTH AND CERTAIN OTHER OFFICERS AND KEY EMPLOYEES OF RELATED ORGANIZATIONS INCLUDING CHRISTUS SANTA ROSA HEALTH CARE CORPORATION. THE EXECUTIVE COMPENSATION COMMITTEE IS COMPOSED OF INDIVIDUALS WHO HAVE NO CONFLICT OF INTEREST WITH THE COMPENSATION ARRANGEMENTS AT HAND. THE EXECUTIVE COMPENSATION COMMITTEE OF THE CHRISTUS HEALTH BOARD SELECTS AN INDEPENDENT EXTERNAL FIRM TO PERFORM AN INDEPENDENT COMPENSATION REVIEW, TO ENSURE THAT ALL COMPENSATION IS REASONABLE AND COMPARABLE TO OTHER SIMILARLY SITUATED ORGANIZATIONS, FOR SIMILARLY QUALIFIED PERSONS IN FUNCTIONALLY COMPARABLE POSITIONS, AND TO PROVIDE SUPPORTING INFORMATION OF COMPENSATION DECISIONS. ON AN ANNUAL BASIS THE EXTERNAL CONSULTANT: 1. DEVELOPS THE MERIT INCREASE RECOMMENDATIONS FOR ALL DESIGNATED SYSTEM EXECUTIVES BASED ON MARKET COMPARABILITY. 2. RECOMMENDS THE CHANGES IN THE COMPENSATION STRUCTURE (GRADES) BASED ON THE MARKET CHANGES. 3. COMPLETES A REVIEW AND EVALUATION OF NEWLY CREATED POSITIONS TO RECOMMEND A GRADE PLACEMENT TO THE COMMITTEE FOR ITS DISCUSSION AND APPROVAL. ON A BI-ANNUAL BASIS, THE EXTERNAL CONSULTANT COMPLETES A DETAILED REVIEW OF ALL OTHER DESIGNATED SYSTEM EXECUTIVES' COMPENSATION AND BENEFITS. THIS GROUP INCLUDES ALL TOP MANAGEMENT OFFICIALS, OTHER OFFICERS AND KEY LEADERS OF THE ORGANIZATION. THE REVIEW INCLUDES RECOMMENDATIONS TO THE COMMITTEE ON ANY CHANGES NECESSARY IN EITHER SPECIFIC COMPENSATION OR COMPENSATION STRUCTURE TO ENSURE MARKET COMPETITIVENESS, REASONABLENESS AND INTERNAL EQUITY. UPON RECOMMENDATIONS FROM THE INDEPENDENT EXTERNAL FIRM, THE EXECUTIVE COMPENSATION COMMITTEE MAKES FINAL COMPENSATION DECISIONS. ADDITIONALLY, THE EXECUTIVE COMPENSATION COMMITTEE REVIEWS ALL COMPENSATION PAYMENTS FOR EXCESS BENEFIT TRANSACTIONS. THE DISCUSSION AND DECISIONS OF THE COMMITTEE ARE DOCUMENTED AND FORMALIZED IN THE COMMITTEE MINUTES AND MAINTAINED ON RECORD. THE FILING ORGANIZATION DETERMINES THE COMPENSATION OF THE SECRETARY BY USE OF AN INDEPENDENT AND EXTERNAL CONSULTANT. THE CONSULTANT HELPS DETERMINE PAY RATES FOR THE ASSOCIATES OF THE FILING ORGANIZATION, TAKING INTO ACCOUNT MARKET DATA AND SHIFT DIFFERENTIAL. THE COMPENSATION RATES ARE APPROVED BY THE FILING ORGANIZATION. BASED ON THE AFOREMENTIONED PROCEDURE, THE SECRETARY'S COMPENSATION IS NOT REVIEWED BY A COMPENSATION COMMITTEE. Form 990, Part VI, Line 19 Required documents available to the public THE CONSOLIDATED AUDITED FINANCIAL STATEMENTS OF CHRISTUS HEALTH ARE MADE AVAILABLE TO THE PUBLIC VIA THE CHRISTUS HEALTH WEBSITE. THE ORGANIZATION'S GOVERNING DOCUMENTS AND CONFLICT OF INTEREST POLICY ARE NOT MADE AVAILABLE TO THE PUBLIC. Form 990, Part VIII, Line 11d Other Miscellaneous Revenue Other revenue - Total Revenue: 8665, Related or Exempt Function Revenue: -7674, Unrelated Business Revenue: 16339, Revenue Excluded from Tax Under Sections 512, 513, or 514: ; Form 990, Part IX, Line 11g Other Fees PHYSICIAN FEES - Total Expense: 98242042, Program Service Expense: 97757078, Management and General Expenses: 484964, Fundraising Expenses: ; OCCUPANCY - Total Expense: 633741, Program Service Expense: 624087, Management and General Expenses: 9654, Fundraising Expenses: ; CONSULTING SERVICES - Total Expense: 1930517, Program Service Expense: 1081512, Management and General Expenses: 849005, Fundraising Expenses: ; MEDICAL SERVICES - Total Expense: 573962, Program Service Expense: 457675, Management and General Expenses: 116287, Fundraising Expenses: ; BILLING AND COLLECTIONS FEES - Total Expense: 6104594, Program Service Expense: 6085084, Management and General Expenses: 19510, Fundraising Expenses: ; REPAIR AND MAINTENANCE - Total Expense: 16676016, Program Service Expense: 16301943, Management and General Expenses: 371906, Fundraising Expenses: 2167; MARKETING - Total Expense: 363272, Program Service Expense: 361872, Management and General Expenses: 1400, Fundraising Expenses: ; OTHER SERVICES - Total Expense: XXX-XX-XXXX, Program Service Expense: 13373781, Management and General Expenses: XXX-XX-XXXX, Fundraising Expenses: 135; - Total Expense: , Program Service Expense: , Management and General Expenses: , Fundraising Expenses: ; - Total Expense: , Program Service Expense: , Management and General Expenses: , Fundraising Expenses: ; - Total Expense: , Program Service Expense: , Management and General Expenses: , Fundraising Expenses: ; - Total Expense: , Program Service Expense: , Management and General Expenses: , Fundraising Expenses: ; - Total Expense: , Program Service Expense: , Management and General Expenses: , Fundraising Expenses: ; - Total Expense: , Program Service Expense: , Management and General Expenses: , Fundraising Expenses: ; - Total Expense: , Program Service Expense: , Management and General Expenses: , Fundraising Expenses: ; - Total Expense: , Program Service Expense: , Management and General Expenses: , Fundraising Expenses: ; - Total Expense: , Program Service Expense: , Management and General Expenses: , Fundraising Expenses: ; - Total Expense: , Program Service Expense: , Management and General Expenses: , Fundraising Expenses: ; - Total Expense: , Program Service Expense: , Management and General Expenses: , Fundraising Expenses: ; - Total Expense: , Program Service Expense: , Management and General Expenses: , Fundraising Expenses: ; Form 990, Part X, Line 1 CASH - NON-BEARING INTEREST CHRISTUS HEALTH SYSTEM MAINTAINS A CENTRALIZED CASH MANAGEMENT SYSTEM. THIS CASH MANAGEMENT SYSTEM (CMS) INCLUDES A CONCENTRATION ACCOUNT WHEREIN DEPOSITS AND DISBURSEMENTS FOR RELATED CHRISTUS EXEMPT ORGANIZATIONS FLOW THROUGH THIS ACCOUNT AND OVER TO THE MANAGED INVESTMENT ACCOUNTS. EACH PARTICIPATING ORGANIZATION REPORTS A BALANCE IN THE CMS REFLECTIVE OF ITS CUMULATIVE CASH ACTIVITY. CASH BALANCES FOR EACH CHRISTUS ORGANIZATION ARE REPORTED ON FORM 990 IN ACCORDANCE WITH FINANCIAL STATEMENT REPORTING. CMS OWNERSHIP IS MAINTAINED BY CHRISTUS HEALTH (EIN 76-0590551) AND ALL ASSOCIATED INVESTMENT INCOME IS PROPERLY REPORTED ON THE CHRISTUS HEALTH FORM 990. Form 990, Part XI, Line 9 Other changes in net assets or fund balances INTERCOMPANY - 43729482; CHANGE IN RESTRICTED NET ASSETS - 17648192; NA RELEASED FROM RESTRICTIONS FOR CAPITAL - 3140801; OTHER TAX ADJUSTMENTS - 654002; ROUNDING - 5; FORM 990, BOX C DOING BUSINESS AS CHRISTUS HEALTH SANTA ROSA HEALTH CARE CORPORATION OPERATES UNDER THE FOLLOWING NAMES: CHRISTUS Cardiovascular CHRISTUS Cardiovascular Medical Center CHRISTUS Cardiovascular New Braunfels CHRISTUS Cardiovascular Westover Hills CHRISTUS Children's CHRISTUS Hospice - Central Texas CHRISTUS Neuroscience Institute - Alamo Heights CHRISTUS Neuroscience Institute - Medical Center CHRISTUS Neuroscience Institute - Westover Hills CHRISTUS Oncology CHRISTUS Oncology - Medical Center CHRISTUS Oncology - New Braunfels CHRISTUS Oncology - Westover Hills CHRISTUS Santa Rosa Cardiothoracic Center CHRISTUS Santa Rosa Children's Hospital CHRISTUS Santa Rosa Diagnostic Services - San Marcos CHRISTUS Santa Rosa Emergence Center - Creekside CHRISTUS Santa Rosa Emergency - Bandera CHRISTUS Santa Rosa Emergency Center CHRISTUS Santa Rosa Emergency Center - Alon CHRISTUS Santa Rosa Emergency Center - Bandera CHRISTUS Santa Rosa Emergency Center - Bitters CHRISTUS Santa Rosa Emergency Center - Creekside CHRISTUS Santa Rosa Health System CHRISTUS Santa Rosa Heart and Vascular Clinic CHRISTUS Santa Rosa Hospice - San Marcos CHRISTUS Santa Rosa Hospital CHRISTUS Santa Rosa Hospital - Alamo Heights CHRISTUS Santa Rosa Hospital - Medical Center CHRISTUS Santa Rosa Hospital - New Braunfels CHRISTUS Santa Rosa Hospital - San Marcos CHRISTUS Santa Rosa Hospital - San Marcos Hospice CHRISTUS Santa Rosa Hospital - Westover Hills CHRISTUS Santa Rosa Hospital Alamo Heights Outpatient Surgery Center CHRISTUS Santa Rosa Imaging Center-Alamo Heights CHRISTUS Santa Rosa Medical Center CHRISTUS Santa Rosa Neurosurgical Spine CHRISTUS Santa Rosa Orthopaedic & Sports Medicine - New Braunfels CHRISTUS Santa Rosa Orthopaedics & Sports Medicine CHRISTUS Santa Rosa Physicians Ambulatory Surgery Center Alamo Heights CHRISTUS SANTA ROSA Quality Care Alliance CHRISTUS Santa Rosa Rehabilitation Services CHRISTUS Santa Rosa Sleep Lab - San Marcos CHRISTUS Santa Rosa Specialty Care Clinic - San Marcos CHRISTUS Santa Rosa Specialty Clinic New Braunfels CHRISTUS Santa Rosa Spine Center CHRISTUS Santa Rosa Sports Medicine CHRISTUS Santa Rosa Surgical Solutions - Westover Hills CHRISTUS Santa Rosa Urology Clinic CHRISTUS Santa Rosa Urology Clinic - Medical Center CHRISTUS Santa Rosa Wound Care and Hyperbaric Center CHRISTUS Weight Loss Institute - San Marcos CHRISTUS Weight Loss Institute - Westover Hills CHRISTUS Women's Pavilion - Alamo Heights PT Solutions - CHRISTUS Santa Rosa Health System Spinal and Thoracic Treatment and Research Center (STTAR Center) The Children's Hospital of San Antonio The Children's Hospital of San Antonio - Multispecialty Center The Children's Hospital of San Antonio CHRISTUS Health - Health Pavilion Stone Oak The Children's Hospital of San Antonio Emergency Center - Bandera The Children's Hospital of San Antonio Specialty Care Center CHRISTUS HEALTH CENTRAL LOUISIANA 3330 MASONIC DRIVE ALEXANDRIA LA 71301 720408984 HLTHCARE SVCS LA 501(c)(3) 3 CH true CHRISTUS HEALTH GULF COAST PO BOX 922037 HOUSTON TX 77292 760591592 HLTHCARE SVCS TX 501(c)(3) 7 CH true CHRISTUS HEALTH NORTHERN LOUISIANA ONE SAINT MARY PLACE SHREVEPORT LA 71101 720408982 HLTHCARE SVCS LA 501(c)(3) 3 CH true CHRISTUS SPOHN HEALTH SYSTEM CORPORATION 600 ELIZABETH STREET CORPUS CHRISTI TX 78404 741109836 HLTHCARE SVCS TX 501(c)(3) 3 CH true CHRISTUS HEALTH SOUTHEAST TEXAS 2830 CALDER STREET BEAUMONT TX 77726 760591590 HLTHCARE SVCS TX 501(c)(3) 3 CH true CHRISTUS HEALTH SOUTHWESTERN LOUISIANA 524 DR MICHAEL DEBAKEY DR LAKE CHARLES LA 70601 720411322 HLTHCARE SVCS LA 501(c)(3) 3 CH true CHRISTUS HEALTH 5101 N OConnor Blvd IRVING TX 75039 760590551 SPT HLTH SVCS TX 501(c)(3) 10 NA false CHRISTUS CONTINUING CARE 1700 W LOOP SOUTH SUITE 1100 HOUSTON TX 77027 742898615 HLTHCARE SVCS TX 501(c)(3) 3 CH true CH WILKINSON PHYSICIAN NETWORK 1700 WEST LOOP SOUTH STE 400B HOUSTON TX 77027 760422435 HLTHCARE SVCS TX 501(c)(3) Type I CH true CHRISTUS HEALTH FOUNDATION 5101 N OConnor Blvd IRVING TX 75039 611500100 SPT HLTH SVCS TX 501(c)(3) Type I CH true FRIENDS OF SANTA ROSA FOUNDATION 333 N SANTA ROSA STREET SAN ANTONIO TX 78207 742723391 SPT HLTH SVCS TX 501(c)(3) Type I CSRHCC true SANTA ROSA FAMILY HEALTH CENTER 333 N SANTA ROSA STREET SAN ANTONIO TX 78207 742806531 HLTHCARE SVCS TX 501(c)(3) 10 CSRHCC true CHRISTUS SANTA ROSA MED CTR AUXILIARY 2827 BABOCK ROAD SAN ANTONIO TX 78229 731655493 SPT HLTH SVCS TX 501(c)(3) 10 CSRHCC true CHRISTUS HEALTH STRATEGIC GROWTH 5101 N OConnor Blvd IRVING TX 75039 462798043 SPT HLTH SVCS TX 501(c)(3) Type I CH true CHRISTUS HEALTH PLAN LOUISIANA 5101 N OConnor Blvd IRVING TX 75039 464617988 MEDICAID HMO LA 501(c)(4) CH true CHRISTUS PEDIATRIC PHYSICIAN GROUP 5101 N OConnor Blvd IRVING TX 75039 465203505 HLTHCARE SVCS TX 501(c)(3) 3 CH true SANTA ROSA CHILDREN'S HOSPITAL FND 1 INTL CTR 100 NE LP 410 706 SAN ANTONIO TX 78216 741224362 FUNDRAISING TX 501(c)(3) 7 CSRHCC true CHRISTUS FOUNDATION FOR HEALTHCARE PO BOX 1919 HOUSTON TX 77251 746074210 SUPP HTH SVCS TX 501(c)(3) 7 CH true CHRISTUS NORTHEAST TX HEALTH SYSTEM CORP 1315 DOCTORS DRIVE TYLER TX 75701 752616975 HLTHCARE SVCS TX 501(c)(3) Type II CH true CHRISTUS HEALTH PLAN 600 ELIZABETH STREET CORPUS CHRISTI TX 78404 452106295 MEDICAID HMO TX 501(c)(4) CSHSC true CHRISTUS CONNECTED CARE NETWORK 5101 N OConnor Blvd IRVING TX 75039 473403356 SPT HLTH SVCS TX 501(c)(4) CH true SPECIALTY PHYSICIANS OF CENTRAL TEXAS 1301 WONDER WORLD DRIVE SAN MARCOS TX 78666 208814408 HLTHCARE SVCS TX 501(c)(3) 3 CTHC true Christus TRINITY CLINIC 1315 DOCTORS DRIVE TYLER TX 75701 752616977 HEALTHCARE TX 501(c)(3) 3 CNTHSC true Christus Santa Rosa - San Marcos Foundation PO Box 912 San Marcos TX 78667 742259907 SUPPORT TX 501(c)(3) 7 SRHCC true CSR PASC SA LLC 333 SN ROS SAN ANTONIO TX 78207 412092141 HEALTHCARE SVCS TX CSRHCC Related false false 0.5434 CSR OUTPT SRG NB LP 333 SN ROS SAN ANTONIO TX 78207 810571409 HEALTHCARE SVCS TX CSRHCC Related false false 0.5265 CHRISTUS MUGUERZA SAPI DE CV HIDALGO PTE 2525 G40G0 COL OBISPADO MONTERREY MX 64060 HEALTHCARE SV MX CH C Corporation true EMERALD ASSURANCE CAYMAN LTD PO BOX 1051 GRAND CAYMAN CJ KY11102 980407545 INSURANCE CJ CH C Corporation true CHRISTUS LOUISIANA QUALITY ALLIANCE 5101 N OConnor Blvd IRVING TX 75039 474618648 ACO LA CH C Corporation true CENTRAL TEXAS MEDICAL ASSOCIATE 1301 WONDER WORLD DRIVE SAN MARCOS TX 78666 742729873 INACTIVE TX CTHC C Corporation true CENTRAL TEXAS PROVIDERS NETWORK 1301 WONDER WORLD DRIVE SAN MARCOS TX 78666 742827652 HEALTHCARE SV TX CTHC C Corporation true SAN MARCOS REGIONAL MRI 1301 WONDER WORLD DRIVE SAN MARCOS TX 78666 770597968 HOLDING COMPANY TX CTHC C Corporation true CENTRAL TEXAS HEALTHCARE COLLABORATIVE 1301 WONDER WORLD DRIVE SAN MARCOS TX 78666 453739929 SUPPORT TX CSRHCC C Corporation 1 true true false true false false false false false false true true true true false true true true true true CHRISTUS CHILDREN'S L 540326 ACCRUAL CHRISTUS CHILDREN'S O 1252660 ACCRUAL CHRISTUS CHILDREN'S P 2621094 ACCRUAL CHRISTUS CHILDREN'S Q 4131668 ACCRUAL CHRISTUS HEALTH SOUTHEAST TEXAS P 300262 ACCRUAL CHRISTUS PEDIATRIC PHYSICIAN GROUP A 117554 ACCRUAL CHRISTUS PEDIATRIC PHYSICIAN GROUP J 117554 ACCRUAL CHRISTUS PEDIATRIC PHYSICIAN GROUP K 93326 ACCRUAL CHRISTUS PEDIATRIC PHYSICIAN GROUP P 93326 ACCRUAL CHRISTUS SANTA ROSA FAMILY HEALTH CENTER J 140103 ACCRUAL CHRISTUS SANTA ROSA FAMILY HEALTH CENTER K 140103 ACCRUAL CHRISTUS SANTA ROSA OUTPATIENT SURGERY NEW BRAUNFELS LP J 57795 ACCRUAL CHRISTUS SPOHN HEALTH SYSTEM CORPORATION M 781421 ACCRUAL DEDICATED SYSTEM SUPPORT INC O 116796 ACCRUAL DEDICATED SYSTEM SUPPORT INC Q 134992 ACCRUAL FRIENDS OF SANTA ROSA FOUNDATION B 108851 ACCRUAL FRIENDS OF SANTA ROSA FOUNDATION C 225659 ACCRUAL SANTA ROSA CHILDREN'S HOSPITAL FOUNDATION C 9727846 ACCRUAL TRINITY CLINIC A 399587 ACCRUAL TRINITY CLINIC J 477715 ACCRUAL TRINITY CLINIC L 31231197 ACCRUAL TRINITY CLINIC M 5434620 ACCRUAL