Answer:  They are created and operated to pursue different missions and use their profits in different ways. Both try to earn more than they spend to continue to pursue their missions.

Answer:  "For-profit" hospitals (as well as other for-profit companies) are founded and owned by investors who buy stock in that hospital as a means of making money. Such a hospital is accountable to those owners and has as its purpose to earn a growing profit and maximize the rate of return to the stockholders.

Answer:  "Not-for-profit" hospitals (as well as other not-for-profit companies) are founded to serve the community. They are operated to serve the community and consider community benefit as integral to their missions.

Answer:  The primary question when decisions are made in an investor owned hospital is: What return will this bring to the stockholders? There may be concern for quality but the primary motive is the effect on over-all profits. For this reason, "for-profit" hospitals have a powerful incentive to avoid the uninsured and low density rural areas populated by those most vulnerable and challenging-to-serve.

St. Joseph Health System hospitals and services, as "not-for-profit" and religious-based organizations, evaluate their decisions with a different set of questions:

The St. Joseph Health System hospitals were founded to meet community needs which include the vulnerable and underserved populations. The Sisters of St. Francis who are the sponsors of SJHS have as their mission "to commit themselves to works that reverence human dignity and embrace the poor and marginalized." SJHS hospitals extend that mission of the Sisters in the Brazos Valley.

Answer:  All successful hospitals, both "for-profit" and "not-for-profit" have money left over when all their expenses are paid. Most re-invest a certain portion into new programs and services.

At "not-for-profit" hospitals, excess revenues are re-invested into the communities served -- improving existing facilities and programs, offering new programs to meet community need, purchasing new and updated equipment, paying off debts, and caring for people with no health care coverage and no means of paying on their own.

In its 1998 Annual Report to State and Local authorities of Community Benefit activities, SJRHC reported over $11.5 million dollars in unreimbursed cost of care provided to the financially and medically indigent. Included in this number is $1.9 million dollars in unreimbursed cost providing government sponsored indigent health care, and over $500,000 support to its rural hospital affiliates in Burleson and Madison counties.

Additionally, SJRHC reported in excess of $7.8 million dollars in unreimbursed cost of care provided to Medicare and Champus patients.

During the same period, SJRHC reported more than $2.7 million dollars for miscellaneous community benefit activities. These activities include staff and patient education, support to the Brazos Valley Family Practice Residency Program, and numerous donations/support to health related and non-health related organizations.

In 1998, SJHS added capital investments of more than $25 million to renew facilities and add new services and equipment. In 1997, SJRHC issued $65 million in tax exempt bonds. Of this debt, $20 million was used for the construction of St. Joseph Regional Rehabilitation Center. The balance of the funds will be used as follows: $4 million for O/P Rehabilitation, $16 million for a Long Term Care Facility, and $25 million for capital improvements and equipment acquisitions.

During 1998, SJRHC repaid $1.5 million of long term debt.

Answer:  The Sisters of St. Francis believe that health care involves care of body, mind, and spirit and is different from commodities, such as computers and machines. Therefore, health care providers cannot be motivated primarily by economic concerns. A not-for-profit, mission-driven faith- and value-based institution is better aligned with the goals of health care -- to heal, to comfort, to give patients reason to hope, to care for the whole person.