2013-11-14T15:49:36-06:00 2012-12-31 ERNST & YOUNG US LLP 178 S RIO GRANDE STREET SUITE 400 SALT LAKE CITY UT 84101 990 2012-01-01 810231792 HOLY ROSARY HEALTHCARE % SHARON OWENS VP OF FINANCE HOLY 4062373318 2600 WILSON STREET Suite MILES CITY MT 59301 Calvin Carey 2013-11-14 8013503300 2012 2016-02-25 16:41:14Z CALVIN CAREY 2600 WILSON STREET MILES CITY MT 59301 43390560 false 0928 X WWW.HRH-MT.ORG X 1997 MT WE WILL, IN THE SPIRIT OF THE SISTERS OF CHARITY, REVEAL GOD'S HEALING LOVE BY IMPROVING THE HEALTH OF THE INDIVIDUALS AND COMMUNITIES WE SERVE, ESPECIALLY THOSE WHO ARE POOR OR VULNERABLE. 13 11 427 69 115326 -15951 180948 35258 39089244 42952231 -17832 4377 459813 398694 39712173 43390560 46193 32740 0 0 20522665 20977711 0 0 0 19642049 19704959 40210907 40715410 -498734 2675150 21832173 22726122 3406568 1621772 18425605 21104350 X We reveal and foster God's healing love by improving the health of the people and communities we serve, especially those who are poor and vulnerable. false false 28801533 0 36162861 HOLY ROSARY HEALTHCARE PROVIDES INPATIENT AND OUTPATIENT HOSPITAL SERVICES TO THE POPULATIONS OF EASTERN MONTANA. THESE SERVICES INCLUDE SURGICAL, ONCOLOGY, AND MATERNITY SERVICES, AS WELL AS 24- HOUR EMERGENCY ROOM AND DIAGNOSTIC AND THERAPEUTIC SERVICES. 3117174 0 3787365 HOLY ROSARY HEALTHCARE'S EXTENDED CARE UNIT PROVIDES SHORT-TERM TRANSITIONAL CARE AFTER ILLNESS, INJURY, OR SURGERY, AS WELL AS, LONG-TERM CARE FOR THOSE UNABLE TO LIVE INDEPENDENTLY. 3507296 0 3443929 HOLY ROSARY HEALTHCARE CLINIC PROVIDES PRIMARY CARE SERVICES. THE CLINIC ALSO MAKES AVAILABLE VARIOUS SPECIALTY SERVICES OFFERED BY VISITING PROVIDERS. 32740 32740 0 35458743 true true false true false false false false false true true false false true false false false true false false false false false false false false true true true false true false false false false false false false false false false false false false true true true false false true 83 0 true 427 true true true false false false false false false false false false X 13 11 false true false false true true true true true false false true true true true true true false false false X SHARON OWENS VP OF FINANCE 3038135280 2480 W 26TH AVE SUITE 200 DENVER CO 80211 SISTER JUDITH JACKSON 1.0 0.0 X TRACI SCHELL 1.0 0.0 X PAUL LEWIS 36.0 1.0 X X 202899 40725 BILL OFTEDAL 1.0 0.0 X X RACHEL ARMSTRONG 1.0 0.0 X X SISTER KATHERINE FRANCHETT 1.0 0.0 X STEFANI HICSWA MD 1.0 0.0 X JASON BARKER 36.0 1.0 X X 588371 0 67245 RONALD HATHAWAY 1.0 0.0 X TAMMIE MCFARLAND 1.0 0.0 X ROGER MUGGLI 1.0 0.0 X POLLY PETERSEN 1.0 0.0 X DONOVAN MCCOMB 1.0 0.0 X CALVIN CAREY 36.0 1.0 X 168656 0 15367 JAMES MACMILLIAN 40.0 0.0 X 255691 0 1001 JEFF WILLIAMS 40.0 0.0 X 294481 0 24435 DORTHY BRADBURY 40.0 0.0 X 311722 0 11505 CHRISTOPHER LIEB 40.0 0.0 X 264077 0 34197 TRAVIS WALKER 40.0 0.0 X 218982 0 12373 2304879 0 206848 8 false true false MEDEFIS INC 10826 OLD MILL ROAD SUITE 101 OMAHA NE 68154 TEMPORARY STAFFING 811635 ROCKY MOUNTAIN HEALTH NETWORK 315 NORTH 25TH STREET BILLINGS MT 59101 PATIENT BILLING SERV 152940 Synaptic Healthcare LLC 1006 S COTTAGE MILES CITY MT 59301 TEMPORARY STAFFING 1154273 CHG Companies Inc PO BOX 972651 DALLAS TX 753972651 TEMPORARY STAFFING 177405 Yellowstone Pathology Inst Inc 2900 12TH AVE N STE 295W BILLINGS MT 59101 LAB SERVICES 139000 6 35258 35258 NET PATIENT SERVICE 900099 42838991 42838991 PROGRAM SERVICE RENTAL INCOME 532000 113240 113240 42952231 4377 7972 0 0 0 0 0 0 0 0 0 NON-PATIENT FOOD SERVICES 722320 342021 339935 2086 DEPARTMENT OTHER OPERATING REVENUE 900099 50457 50457 MANAGEMENT FEES 900099 6000 6000 216 216 398694 43390560 43235599 115326 7972 32740 32740 0 0 0 1083263 1083263 0 15971547 15635789 335758 642500 642500 2180232 2180232 1100169 986852 113317 4361023 2529394 1831629 290284 290284 0 438 438 0 0 3408801 2829305 579496 88928 88928 1155454 935918 219536 0 0 638978 587860 51118 185024 85111 99913 0 0 0 0 1910361 1910361 361990 361990 BAD DEBTS 2776144 2776144 MEDICAID PROVIDER TAXES 385633 385633 RECRUITING EXPENSES 166927 46740 120187 MEDICAL EXPENSES 3898605 3898605 76369 19202 57167 40715410 35458743 5256667 0 -754125 1615576 219612 111242 0 0 4565306 5767375 0 0 0 0 22783 9051 902468 885693 436985 602795 40796378 28656289 13442182 12140089 0 178820 0 0 662381 0 0 0 2334581 1415481 21832173 22726122 3406568 1621772 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3406568 1621772 X 18425605 21104350 0 0 0 0 18425605 21104350 21832173 22726122 2675150 3595 X false true X true false X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED false false false false false false true 438 false false 438 false Schedule C, Part II-B Lobbying Activity Explanation Holy Rosary Healthcare pays dues to the Montana Hospital Association, of which $438 is charged for lobbying. 157436 2655 13771 2500 529 170833 152032 8504 2500 600 157436 170256 -15721 2500 3 152032 126507 46785 3000 36 170256 152571 -23564 2500 126507 1.00000 false true true 135511 135511 13634903 7003867 6631036 9473977 7016786 2457191 15749499 13250317 2499182 1802488 1385319 417169 12140089 OTHER RECEIVABLES 1415481 1415481 X SCH. D, PART V, LINE 4 ENDOWMENT FUNDS THE INTENDED USE FOR THE KENNETH HOM TRUST ENDOWMENT FUND IS TO PROVIDE NURSING SCHOLARSHIPS. EACH YEAR A SCHOLARSHIP IS AWARDED TO AN INDIVIDUAL WITH EASTERN MONTANA TIES WHO IS PURSUING HIS OR HER NURSING EDUCATION. IN 2012, ONE SCHOLARSHIP WAS AWARDED. Endowment funds are held by the Holy Rosary Healthcare Foundation. true true true X true X true true false true true 1022838 1022838 0.02700 950362 950362 0.02500 1973200 1973200 0.05200 19 2548 192184 28791 163393 0.00430 11 288 189163 189163 0.00500 3 1876188 1876188 0.04950 8 1408 19431 19431 0.00050 41 4244 2276966 28791 2248175 0.05930 41 4244 4250166 28791 4221375 0.11130 3 151 3213 3213 1 3 183 183 1 2 245 245 1 1 194407 194407 0.00050 2 220 4666 4666 0.00010 8 377 202714 202714 0.00060 false 1517440 9216284 16083681 -6867397 X true true 1 1 HOLY ROSARY HEALTHCARE

2600 WILSON STREET MILES CITY MT 59301

X X X HOLY ROSARY HEALTHCARE 1 true true 200. true 400. true X X X X X X true true X X X X X X true false X X X X true X false false 1 POWDER RIVER MEDICAL CLINIC

507 NORTH LINCOLN AVENUE BROADUS MT 59317

AMBULATORY CARE CLINIC SCHEDULE H, PART VI SUPPLEMENTAL INFORMATION PART I, LINE 3C ELIGIBILITY IS BASED ON FEDERAL POVERTY GUIDELINES. PART I, LINE 6A THE ANNUAL COMMUNITY BENEFIT REPORT IS INCLUDED IN THE SISTERS OF CHARITY OF LEAVENWORTH HEALTH SYSTEM REPORT TO THE COMMUNITY. WE SUBMIT COMMUNITY BENEFIT ACTIVITIES AS NEWS TO LOCAL MEDIA AND REPORT THEM ON OUR WEBSITE AS THEY OCCUR. A SEPARATE PUBLICATION SPECIFICALLY DEDICATED TO COMMUNITY BENEFIT WAS NOT RELEASED IN 2011. PART I, LINE 7G PHYSICIAN CLINICS ACCOUNT FOR $31,649 OF TOTAL SUBSIDIZED SERVICE EXPENSE; THIS IS A CLINIC IN A REMOTE RURAL AREA WITH NO OTHER ACCESS TO HEALTHCARE WITHIN AN 80 MILE RADIUS. PART I, LINE 7, COLUMN F THE AMOUNT OF BAD DEBT EXPENSE DELETED FROM THE DENOMINATOR BEFORE CALCULATING PERCENTAGES IN COLUMN (F) IS $2,776,144. PART I, LINE 7 COST TO CHARGE RATIO IS USED FOR ALL REMAINING CATEGORIES OF COMMUNITY BENEFIT. THE COST TO CHARGE RATIO USED WAS DERIVED FROM WORKSHEET 2. PART II Community Building Activities, those that enhance existing efforts or support gaps of community need, include programs that support those in the community who are living at or below poverty. Holy Rosary Healthcare ("Holy Rosary") leadership and its employees performed civic activities in which the health of the community was advocated as a priority by the hospital. In 2012, Holy Rosary performed the following activities: -Participating in "Meals on Wheels" program delivering noon meals to those in our community. -Healthcare talks to community members and or members of local communities by Clinic physicians, hospice team and physical therapy team. -Taxi vouchers for seniors to get to their physician and lab appointments. -Medicaid Waiver team provides education to patients and prepares them for admission to state program. -Financial assistance is provided by hospital staff to assist those needing help registering for public programs, such as Medicaid. -Pastoral care outreach on behalf of Holy Rosary is provided to local community emergency medical responders.-Mission Department provides funding for hotels, gas, food, and prescriptions to assist patients in their release from the hospital. -Membership in civic groups such as Kiwanis and Rotary where we represent the health of our community and our hospital. We provide lectures, trainings and will organize events that relate to needs of the community. In 2012, we provided manpower to improve a local park specifically to building a restroom facility PART III, LINE 4 DISCOUNTS AND PAYMENTS APPLIED TO ACCOUNTS REDUCE BAD DEBT EXPENSE. NO METHOD IS USED TO DETERMINE THE AMOUNT THAT REASONABLY COULD BE ATTRIBUTABLE TO PATIENTS WHO WOULD LIKELY QUALIFY FOR FINANCIAL ASSISTANCE, HOWEVER, THE ORGANIZATION'S FINANCIAL ASSISTANCE POLICY ALLOWS FINANCIAL ASSISTANCE AWARDS TO BE MADE PRESUMPTIVELY TO INDIVIDUALS WHO HAVE NOT ADEQUATELY COMPLETED THE APPLICATION PROCESS IF THE INDIVIDUAL IS HOMELESS OR IF THE INDIVIDUAL IS NON-RESPONSIVE AND HAS A CREDIT SCORE LESS THAN 600. BAD DEBT EXPENSES INCLUDE ACTUAL WRITE OFFS AND ANY ASSOCIATED ACCRUAL BASED ON ACCOUNTS RECEIVABLE. THE COSTING METHODOLOGY USED TO CALCULATE THE COST OF BAD DEBT INCLUDED ON PART III LINE 2 WAS THE COST TO CHARGE RATIO DERIVED USING THE METHODOLOGY FROM WORKSHEET 2. PART III, LINE 8 THE ORGANIZATION DOES NOT BELIEVE THAT MEDICARE SHORTFALLS SHOULD BE INCLUDED AS COMMUNITY BENEFIT. MEDICARE ALLOWABLE COSTS WERE DERIVED FROM THE MEDICARE COST REPORT'S SCHEDULE D PART V, PART VI AND SCHEDULE D-1. PART III, 9B AN INTEGRAL COMPONENT OF OUR MISSION IS TO BE GOOD FINANCIAL STEWARDS. THIS REQUIRES US TO DETERMINE WHICH PATIENTS ARE IN NEED OF CHARITY CARE AND WHICH ARE ABLE TO CONTRIBUTE SOME PAYMENT FOR CARE RECEIVED. WE MAINTAIN A BALANCE THAT ENABLES US TO CONTINUE TO PROVIDE CHARITY CARE TO THOSE WHO NEED IT MOST, AND TO ENSURE THAT WE MANAGE OUR RESOURCES SO THAT WE CAN CONTINUE TO BE HERE WHEN PEOPLE NEED US MOST. HOLY ROSARY HEALTHCARE NOTIFIES PATIENTS OF FINANCIAL ASSISTANCE POLICY UPON ADMISSION, DISCHARGE AND IN COMMUNICATION REGARDING PATIENT BILLS. PATIENTS ARE CONTACTED MULTIPLE TIMES ABOUT UNPAID BALANCES PRIOR TO INITIATING ANY COLLECTION ACTION. IF A PATIENT IS DETERMINED TO BE ELIGIBLE FOR FINANCIAL ASSISTANCE AT ANY TIME DURING THE COLLECTION PROCESS, THE ACCOUNT IS RECLASSIFIED AS FINANCIAL ASSISTANCE AND DEBT COLLECTION EFFORTS ARE CEASED. PART VI, Supplemental Information, Question 2: NEEDS ASSESSMENT - AS PART OF OUR ORGANIZATIONAL MISSION TO RESPOND TO THE HEALTH NEEDS OF THE PEOPLE AND COMMUNITIES SERVED, WE TAKE STEPS TO DETERMINE WHERE THERE IS THE MOST NEED IN ORDER TO PROVIDE THE GREATEST GOOD. HOLY ROSARY HAS REGULARLY PARTICIPATED IN COMMUNITY HEALTH NEEDS ASSESSMENT SURVEYS TO IDENTIFY THE ONGOING AND CHANGING NEEDS OF THE COMMUNITY. THE MOST RECENT SURVEY WAS CONDUCTED IN 2011. THIS ASSESSMENT STUDIED MILES CITY, MONTANA, AND THE NINE-COUNTY SURROUNDING AREA SERVED BY HOLY ROSARY. THE ASSESSMENT, COMPLETED BY A THIRD-PARTY FIRM SPECIALIZING IN RURAL COMMUNITY RESEARCH, INCLUDED COLLABORATIVE PARTNERSHIPS WITH LOCAL GOVERNMENT AND SOCIAL AGENCIES AND THE CUSTER COUNTY PUBLIC HEALTH NURSING OFFICE; COMBINING EFFORTS WITH OTHER LOCAL HOSPITALS AND HEALTH CARE ORGANIZATIONS; AND CONDUCTING SURVEYS, FOCUS GROUPS, AND ASSESSMENTS WITH THE ASSISTANCE OF THE Montana OFFICE OF RURAL HEALTH and the National Rural Health Resource Center. COMMUNITY EDUCATION WAS COMPLETED UTILIZING THE MEDIA, INTERNET, AND MAILINGS TO BUILD AWARENESS AND ENCOURAGE PARTICIPATION IN THIS PROJECT. RESULTS WERE RECEIVED IN EARLY 2012, INFORMATION WAS SHARED WITH KEY STAKEHOLDER GROUPS IN THE COMMUNITY AND REGION, RESPECTIVE PRIORITIES WERE IDENTIFIED AND ACTION PLANS WERE PURSUED. To obtain input from the community, Holy Rosary provided the National Rural Health Resource Health Center with a list of inpatient and outpatient admissions. Zip codes with the greatest number of admissions were selected to be included in the survey. A random list of 575 residents was selected from Prime Net Data Source. Residence was stratified in the initial sample selection so that each area would be represented in proportion to the overall service population and the proportion of past admissions. In addition another 300 surveys were hand-distributed in the community to boost the response rate. Thus a total of 875 surveys were distributed amongst the Holy Rosary service area. Two focus groups were held to identify the motives of local residents when selecting health care providers and discover reasons why people may leave the service area to seek health care services. It was intended that this information would help determine gaps in service, increase awareness of local programs and services, and improve satisfaction with local services providers and facilities, which relates to understanding the health needs of the community. The Community Benefit Committee ("CBC") of the Holy Rosary Board of Directors was charged with addressing the top needs discovered in the CHNA. The top community needs and priorities were: Alcohol abuse, overweight/obesity, cancer, drug abuse (including prescription) and lack of exercise. A grant program available to community organizations was established to specifically address the top needs. The CBC held quarterly meetings to review and approve or deny the grant applications received from the southeastern Montana communities within the Holy Rosary primary and secondary service areas. Notification was placed in the local newspaper announcing grant funds were available. A total of seven grants totaling $5,000 were awarded to Eastern Montana Veterans Stand Down, Custer County Family Treatment Court, Sacred Heart School, Ashland Community Health Center, Miles City Fire Rescue, Global Health Equity Foundation and First United Methodist Church. Holy Rosary provided funding for community programs to deal with four of the top concerns/needs: Alcohol/drug abuse, obesity, cancer and mental health issues. These needs were addressed by Holy Rosary's support of a student lunch program for high school students that provide a healthy-approach balanced noon meal; a food, clothing and supplies donation program for the Eastern Montana Veterans Stand Down project; "Let's Talk Miles City" suicide prevention program; and a reward incentive program for the Custer County Family Treatment Court program. Holy Rosary provided office space for an oncologist and an infusion center at the hospital which is available to any community patient, regardless of insurance or hospital affiliation. As a small rural community, not all needs can be addressed by Holy Rosary. Of those, cancer was not specifically addressed due to the lack of resources in people and funding. A local non-profit group not related to our hospital or health system will address personal needs (fuel, food, and hotel) of individuals and their families in Eastern Montana who are undergoing cancer treatment. Holy Rosary is part of the Diabetes Prevention Program grant as funded by the Centers for true HOLY ROSARY FOUNDATION 2600 WILSON MILES CITY MT 59301 202270238 501(C)(3) 31239 ASSIST IN CHARITY EXEMPT PURPOSES 1 Description of Organization's Procedures for Monitoring the Use of Grants Form 990, Schedule I, Part I, Line 2 GRANTS ARE MONITORED THROUGH THE HOLY ROSARY HEALTHCARE FOUNDATION. THE FOUNDATION FOLLOWS A TWO-STEP PROCESS IN PREPARING THE SCHEDULE OF EXPENDITURES OF FEDERAL AWARDS (SEFA). THE GRANT PROJECT DIRECTOR IS RESPONSIBLE TO SUBMIT THE INVOICES FOR EACH MONTH'S ACTIVITY TO THE FOUNDATION DIRECTOR. THESE ARE THEN REVIEWED FOR COMPLIANCE WITH FEDERAL STANDARDS AND GUIDELINES AND ARE SUBMITTED TO THE FEDERAL GOVERNMENT FOR REIMBURSEMENT OR APPLIED TO GRANT IF AWARDED UPFRONT. THE AMOUNTS ARE THEN DRAWN DOWN BY THE FOUNDATION ADMINISTRATOR AND THE MONEY IS WIRED TO THE FOUNDATION'S BANK ACCOUNT OR REIMBURSED TO THE HOSPITAL IF THE EXPENDITURES WERE PAID BY THE HOSPITAL AND THE FUNDS MADE AVAILABLE TO THE FOUNDATION IN ADVANCE. THIS INFORMATION IS COMPILED QUARTERLY BY THE DIRECTOR OF FINANCE AND IS TRACKED BY GRANT NAME AND CEDA NUMBER. THE FOUNDATION DIRECTOR ALSO PROVIDES THE FINANCE DIRECTOR WITH THE AWARD LETTER AND ANY COMMUNICATIONS RELATED TO THE GRANT AS WELL AS SUPPORTING INVOICES AND EXPENDITURES. AT THE END OF THE YEAR, QUARTERLY WORKSHEETS ARE USED TO PREPARE THE SEFA. THE SEFA IS PREPARED BY THE DIRECTOR OF FINANCE, REVIEWED BY THE GRANTS ADMINISTRATOR AND FORWARDED TO THE SYSTEM OFFICE AND ERNST AND YOUNG CPA FIRM. false true false false false false false true false PAUL LEWIS 170291 20700 11908 24317 16408 243624 JASON BARKER 428530 0 147000 0 12841 0 54384 0 12861 0 655616 0 0 0 JAMES MACMILLIAN 110301 0 0 0 145390 0 0 0 1001 0 256692 0 0 0 JEFF WILLIAMS 293224 0 0 0 1257 0 17946 0 6489 0 318916 0 0 0 DORTHY BRADBURY 239435 0 68880 0 3407 0 4984 0 6521 0 323227 0 0 0 CHRISTOPHER LIEB 199828 0 62885 0 1364 0 18195 0 16002 0 298274 0 0 0 CALVIN CAREY 136047 0 0 0 32609 0 7000 0 8367 0 184023 0 0 0 TRAVIS WALKER 218188 0 0 0 794 0 6545 0 5828 0 231355 0 0 0 FORM 990, SCHEDULE J, PART I, LINE 3 SEE FORM 990, SCHEDULE O DISCLOSURE FOR FORM 990, PART VI, LINES 15A & B REGARDING THE PROCESS USED BY SCLHS TO DETERMINE EXECUTIVE COMPENSATION WHICH IS RELIED UPON BY THIS ORGANIZATION. FORM 990, SCHEDULE J, PART I, LINE 4B PAYMENTS FROM NONQUALIFIED RETIREMENT PLAN OTHER REPORTABLE COMPENSATION SHOWN IN SCHEDULE J PART II COLUMN (B) (III) CONTAINS AN ANNUAL REPORTING ADJUSTMENT FOR CERTAIN EMPLOYEES WHO PARTICIPATE IN THE SUPPLEMENTAL NONQUALIFIED RETIREMENT PLANS. SCLHS PROVIDES NONQUALIFIED RETIREMENT PLANS FOR EXECUTIVES TO COMPENSATE FOR IRS IMPOSED LIMITATIONS IN QUALIFIED RETIREMENT PLANS AND TO PROVIDE A BENEFIT CONSISTENT WITH OTHER NOT FOR PROFIT HEALTH SYSTEMS. THESE PLANS ENABLE THE EXECUTIVE TO EARN BENEFITS DURING EACH YEAR THAT THEY PARTICIPATE. ON THE ADVICE OF COUNSEL, SCLHS HAS DETERMINED THAT THESE BENEFITS SHOULD BE SUBJECT TO TAXATION AS THEY ARE EARNED AND VESTED RATHER THAN WHEN THEY ARE RECEIVED. AS A RESULT, THE TOTAL NONQUALIFIED RETIREMENT PLAN BENEFITS, WHICH WERE ACCRUED AND VESTED IN THE CURRENT YEAR, ARE NOW CONSIDERED TAXABLE AND THUS WERE TAXED TO THE PARTICIPANTS. AN AMOUNT EQUAL TO THE PARTICIPANT'S EXPECTED INCOME TAX LIABILITY WAS WITHDRAWN FROM THE PARTICIPANT'S ACCOUNT AND REMITTED TO THE IRS AS WITHHOLDING ON THE TAXABLE BENEFIT. FOR 2012, THIS WAS ZERO. FORM 990, SCHEDULE J, PART I, LINE 7 (NON-FIXED PAYMENTS) SCLHS HAS MANAGEMENT INCENTIVE PLANS WHICH ARE BASED ON A COMBINATION OF MEASURES. MANAGEMENT AND SENIOR LEADERSHIP ARE ELIGIBLE FOR THE INCENTIVE COMPENSATION. PERFORMANCE CATEGORIES ARE MADE UP OF A COMBINATION OF CLINICAL QUALITY MEASURES AND OPERATING INCOME. THE OPERATING INCOME CATEGORY IS GENERALLY RELATED TO THE NET EARNINGS OF THE CARE SITE IN WHICH THE INDIVIDUAL WORKS, OR IN THE CASE OF SCLHS SENIOR MANAGEMENT, THE NET EARNINGS OF SCLHS. FORM 990 SCHEDULE J, PART II AND FORM 990 PART VII THE SISTERS OF CHARITY OF LEAVENWORTH HEALTH SYSTEM, INC. (SCLHS) CONSISTS OF ELEVEN HOSPITALS AND FOUR CLINICS (AFFILIATES) IN FOUR STATES INCLUDING HOLY ROSARY HEALTHCARE (HOLY ROSARY) IN MILES CITY, MONTANA. SCLHS AND ITS AFFILIATES ADHERE TO GOVERNANCE EXCELLENCE STANDARDS INCLUDING TRANSPARENCY AND ACCOUNTABILITY. JASON L. BARKER IS PRESIDENT AND CHIEF EXECUTIVE OFFICER FOR ST. VINCENT HEALTHCARE. HE FORMERLY SERVED AS A MEMBER OF HOLY ROSARY HEALTHCARE'S BOARD. HE ALSO SERVE AS A MEMBER OF HOLY ROSARY HEALTHCARE'S BOARD. THE COMPENSATION REFLECTED IS THAT OF MR. BARKER'S POSITION AS A ST. VINCENT HEALTHCARE EXECUTIVE AND IS NOT RELATED TO HOLY ROSARY HEALTHCARE. IN KEEPING WITH SCLHS' CORE VALUE OF STEWARDSHIP, NO BOARD MEMBER SERVING ON SCLHS OR AFFILIATE BOARDS IS COMPENSATED FOR THAT SERVICE. DISCLOSURES FORM 990, PART III, LINE 4D PROGRAM SERVICE ACCOMPLISHMENTS HOLY ROSARY HEALTHCARE (HOSPITAL) PROVIDES QUALITY MEDICAL HEALTHCARE REGARDLESS OF RACE, CREED, SEX, NATIONAL ORIGIN, HANDICAP, OR ABILITY TO PAY. THE HOSPITAL PROVIDES CARE TO INDIVIDUALS COVERED BY GOVERNMENTAL PROGRAMS, OTHER BENEFITS, AND ACCOMPLISHMENTS INCLUDE: -ASSISTING EDUCATORS BY WORKING WITH HEALTHCARE INTERNS -PRESENT SPEAKING ENGAGEMENTS TO THE COMMUNITY COVERING HEALTHCARE ISSUES SUCH AS TELEMEDICINE, ARTHRITIS, HOSPICE PROGRAM, SLEEP DISORDERS, ETHICS, JOINT SEMINARS, EAR, NOSE, AND THROAT ISSUES, PSYCHOLOGY, AND DIABETES -PARTICIPATED IN HEALTH FAIRS TO PROMOTE HEALTH EDUCATION AND FOSTER PREVENTION TECHNIQUES -PROVIDE HOSPICE PROGRAM TO COMMUNITY -PROVIDE DENTAL CARE FOR CHILDREN THROUGH SMILE SAVERS -PROVIDE HEALTH RELATED ARTICLES TO LOCAL PRESS TO EDUCATE PUBLIC ON VARIOUS TOPICS -PROVIDE WELLNESS SCREENS TO SCHOOL DISTRICT AT DISCOUNTED RATE -PROVIDE FREE TOURS TO AREA SCHOOL CHILDREN AND OTHER COMMUNITY GROUPS TO TEACH THEM ABOUT THE HOSPITAL -PROVIDE MEDICAL EXPLORERS PROGRAM TO PROMOTE CAREERS IN HEALTHCARE -SPONSOR AFFORDABLE ACCESS ADVANTAGE FOR OUR EMPLOYEES -SPONSOR BLOOD DRIVES, CHARITY WALKS, 55 ALIVE, SCHOOL NURSE PROGRAM, AND OTHER GROUPS EXPENSES - $32,740 GRANTS - $32,740 REVENUE - $0 FORM 990 PART VI, SEC A, LINE 3 MANAGEMENT COMPANIES MANAGEMENT DUTIES DELEGATED BY HOLY ROSARY HEALTHCARE TO MANAGEMENT COMPANIES WERE IN THE FOLLOWING AREAS: (1) ARAMARK CORPORATION: FOOD SERVICES (2) BROADLANE: SUPPLY CHAIN MANAGEMENT FORM 990 PART VI, SEC A, LINES 6, 7A & 7B CLASS OF MEMBER, NATURE OF RIGHTS, ELECTION OF BOARD MEMBERS, DECISIONS SUBJECT TO APPROVAL THE SOLE MEMBER AND CONTROLLING MEMBER OF THE HOLY ROSARY HEALTHCARE (HRH) CORPORATION IS THE SISTERS OF CHARITY OF LEAVENWORTH HEALTH SYSTEM, INC (SCLHS), A KANSAS NON-FOR-PROFIT CORPORATION. SOME OF THE EXCLUSIVE POWERS OF SCLHS INCLUDE: - TO APPOINT, AFTER CONSULTATION WITH THE HRH CORPORATE BOARD, THE BOARD OF DIRECTORS OF HRH AND APPOINT MEMBERS OF SCLHS TO THE HRH BOARD OF DIRECTORS; - TO REMOVE, WITH OR WITHOUT CAUSE, AFTER CONSULTATION WITH THE HRH CORPORATE BOARD, ANY MEMBER OF THE HRH BOARD OF DIRECTORS; - TO APPOINT OR REMOVE, WITH OR WITHOUT CAUSE, THE CHIEF EXECUTIVE OFFICER AND THE CHIEF ADMINISTRATIVE OFFICER OF HRH; - TO IMPLEMENT CORPORATE GOALS, POLICIES, AND PROCEDURES OF HRH; - TO APPROVE FOR HRH THE ACQUISITION OF ASSETS, THE INCURRENCE OF INDEBTEDNESS, OR THE LEASE, SALE, TRANSFER, ASSUMPTION, OR ENCUMBERING OF HRH ASSETS; - TO APPROVE THE MERGER, DISSOLUTION, OR CORPORATE RESTRUCTURING OF HRH; AND - TO APPROVE HRH ANNUAL STRATEGIC PLANS AND OPERATING AND CAPITAL BUDGETS. THE HRH BOARD OF DIRECTORS HAVE THE POWERS TO EXERCISE GENERAL MANAGEMENT AND CONTROL OF THE BUSINESS AFFAIRS OF HRH WITH DUE REGARD FOR THE POWERS RESERVED BY SCLHS. THE POWERS OF THE HRH BOARD OF DIRECTORS INCLUDE NOMINATION OF BOARD MEMBERS FOR APPOINTMENT BY SCLHS. FORM 990 PART VI, SEC B, LINE 11B PROCESS THE ORGANIZATION USES TO REVIEW FORM 990 THE 990 FOR HOLY ROSARY HEALTHCARE WILL BE REVIEWED AT SISTERS OF CHARITY OF LEAVENWORTH HEALTH SYSTEM AND THE HOLY ROSARY HEALTHCARE BOARD MEETINGS BEFORE THE RETURN IS FILED WITH THE IRS. THE 990 TAX RETURN IS REVIEWED BY AN INDEPENDENT ACCOUNTING FIRM. FORM 990, PART VI, SEC B, LINE 12C DESCRIPTION OF PROCESS TO MONITOR TRANSACTIONS FOR CONFLICTS OF INTEREST ALL HOLY ROSARY HEALTHCARE EXECUTIVES, DIRECTORS, AND MANAGERS, BOARD MEMBERS AND BOARD COMMITTEE MEMBERS, MEDICAL EXECUTIVE COMMITTEE (MEC) MEMBERS AND OTHER PHYSICIANS IN DECISION MAKING ROLES OR SERVING ON HRH COMMITTEES, COMPLETE A NEW CONFLICT OF INTEREST (COI) DISCLOSURE FORM ANNUALLY. A COPY OF THE POLICY IS DISTRIBUTED ALONG WITH THE COI FORMS. IN THE EVENT OF A CHANGE OF CIRCUMSTANCE, EACH INDIVIDUAL WHO HAS ALREADY SIGNED A COI IS EXPECTED TO NOTIFY THE ORGANIZATION OF THE CHANGE AND UPDATE THE CONFLICT OF INTEREST INFORMATION. THE STATEMENTS ARE REVIEWED AND COI ISSUES ARE ADDRESSED BY THE ORGANIZATION RESPONSIBILITY OFFICER (ORO) AND LEADERSHIP AT THE APPROPRIATE LEVEL: - BOARD BY BOARD CHAIR - PHYSICIANS BY THE MEC PRESIDENT - HRH DIRECTORS AND MANAGERS BY THE HRH ADMINISTRATION - HRH EXECUTIVES BY THE SISTERS OF CHARITY OF LEAVENWORTH HEALTH SYSTEM THE SIGNED COI FORMS ARE MAINTAINED IN HRH ADMISTRATION. THE CONFLICT OF INTEREST DISCLOSURE STATEMENTS FOR HRH EXECUTIVES ARE MAINTAINED AT SISTERS OF CHARITY OF LEAVENWORTH HEALTH SYSTEM, INC. AT THE BEGINNING OF BOARD AND BOARD COMMITTEE MEETINGS, THE QUESTION OF COI IS ASKED OF THOSE IN ATTENDANCE. WHEN AN ACTUAL CONFLICT IS IDENTIFIED, THE INDIVIDUAL ASKS TO BE EXCUSED FROM PARTICIPATING IN THE DISCUSSIONS AND DECISION-MAKING. FORM 990, PART VI, LINES 15A & B SCLHS EMPLOYS THE EXECUTIVE TEAM AT EACH OF ITS HOSPITAL AFFILIATES. AS PART OF ITS ANNUAL REVIEW PROCESS, SCLHS USES THE FOLLOWING IN ESTABLISHING THE COMPENSATION OF THOSE IN THESE POSITIONS: -COMPENSATION COMMITTEE -INDEPENDENT COMPENSATION CONSULTANT -FORM 990 OF OTHER ORGANIZATIONS -WRITTEN EMPLOYMENT CONTRACTS -COMPENSATION SURVEYS AND STUDIES -APPROVAL BY THE BOARD OR COMPENSATION COMMITTEE THE ABOVE SUPPORT THE COMPENSATION COMMITTEE'S EFFORTS TO ENSURE THAT THE LEVEL OF COMPENSATION PROVIDED TO ITS EXECUTIVES (OFFICERS, KEY EMPLOYEES, ETC.) IS CONSISTENT WITH MARKET VALUE AND THE PAY PHILOSOPHY SET BY THE BOARD. THE PAY PHILOSOPHY SET BY THE BOARD IS TO PAY AT THE MIDDLE OF THE MARKET FOR EXECUTIVES OF SIMILAR SIZED ORGANIZATIONS OVERALL. SCLHS' EXECUTIVE COMPENSATION IS COMPARABLE TO THAT PROVIDED IN SIMILAR, NOT-FOR-PROFIT HEALTHCARE SYSTEMS AND HOSPITALS. FORM 990 PART VI, SEC C, LINE 19 AVAIL OF GOV DOCS, CONFLICT OF INTEREST POLICY, & FIN STMTS TO GEN PUBLIC THE CONFLICT OF INTEREST POLICY AND GOVERNING DOCUMENTS ARE AVAILABLE AT HOSPITAL ADMINISTRATION UPON REQUEST. THE SISTERS OF CHARITY CONSOLIDATED AUDITED FINANCIAL STATEMENTS ARE AVAILABLE ON THE SISTERS OF CHARITY WEBSITE WWW.SCLHEALTHSYSTEM.ORG. 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