2023-11-06T09:14:55-06:00 2022-12-31 410746749 CLIFTONLARSONALLEN LLP 220 SOUTH 6TH STREET SUITE 300 MINNEAPOLIS MN 55402 990 2022-01-01 410713913 ASTERA HEALTH ASTE 2186313510 415 JEFFERSON STREET N WADENA MN 56482 JOEL BEISWENGER CEO 2186313510 2023-11-01 1 JOEL BEISWENGER 999009999 0 MACKENZIE MCNAUGHTON P02025805 6123764500 2023-11-01 2 AAL1 IAL1 2022 2023-04-26 12:10:37Z X SEE SCHEDULE O JOEL BEISWENGER 415 JEFFERSON STREET N WADENA MN 56482 84252515 0 X HTTPS://WWW.ASTERAHEALTH.ORG X 1974 MN ASTERA HEALTH IS COMMITTED TO IMPROVING THE HEALTH OF THE COMMUNITIES WE SERVE. 11 8 530 95 22750 0 11151202 1406727 77272654 80860669 368521 589293 1270450 1192019 90062827 84048708 57114 71282 0 0 42194458 41192976 0 0 297248 34674646 35991908 76926218 77256166 13136609 6792542 80743979 125596386 33347565 71915870 47396414 53680516 X TO IMPROVE THE HEALTH OF THE COMMUNITIES WE SERVE. 0 0 63201946 272860 80860669 ASTERA HEALTH IS A PRIVATE, NOT-FOR-PROFIT 25-BED CRITICAL ACCESS HEALTH SYSTEM COMMITTED TO PROVIDING PERSONALIZED SERVICES THAT IMPROVE THE HEALTH OF THE COMMUNITIES WE SERVE. AN 11-MEMBER VOLUNTEER GOVERNING BOARD PRESIDES OVER THE HOSPITAL, WHICH IS ACCREDITED BY THE JOINT COMMISSION. ASTERA HEALTH IS EQUIPPED WITH INTENSIVE CARE UNITS, SURGERY SUITES, LABOR AND DELIVERY SUITES, AN INPATIENT UNIT, DIAGNOSTIC X-RAY, LABORATORY, RESPIRATORY THERAPY, PHYSICAL AND OCCUPATIONAL THERAPY, CHIROPRACTIC, AND 24-HOUR EMERGENCY AND AMBULANCE CARE. ADDITIONALLY, ASTERA HEALTH OPERATES SIX CERTIFIED RURAL HEALTH CLINICS IN AREAS IDENTIFIED BY STATE AND FEDERAL AGENCIES AS HEALTH PROFESSIONAL SHORTAGE AREAS. AS ONE OF THE LARGEST EMPLOYERS IN WADENA COUNTY, OUR 369 (FTES) EMPLOYEES AND 95 VOLUNTEERS CONTRIBUTE TO OUR PATIENTS AND COMMUNITIES.ASTERA HEALTH IS COMMITTED TO IMPROVING THE HEALTH OF THE COMMUNITIES IT SERVES BY OFFERING SEVERAL CLASSES, EVENTS, AND SUPPORT GROUPS TO EDUCATE AND PROMOTE HEALTHY LIVING. EMS COURSES, INJURY PREVENTION FOR ATHLETES AND ADULT CLASSES, CPR CLASSES, PREGNANCY CLASSES, SUMMER INTERNSHIP PROGRAM, AND OUR BITE SIZE CONVERSATION MONTHLY LUNCH AND LEARN PROGRAM ARE JUST SOME OF THE FREE OFFERINGS AVAILABLE TO THE COMMUNITIES WE SERVE. THE ASTERA HEALTH FOUNDATION PROVIDES STUDENT AND STAFF SCHOLARSHIPS AS WELL AS COMMUNITY GRANTS TO IMPROVE HEALTH. OUR UNCOMPENSATED CARE (CHARITY CARE) PROGRAM PROVIDES DISCOUNTED AND FREE SERVICES TO PATIENTS WHO LACK THE RESOURCES TO BE FULLY RESPONSIBLE FOR THE HEALTHCARE THEY RECEIVE. OUR FINANCIAL ASSISTANCE PROGRAM (FAP) IS PUBLISHED ONLINE, AND OUR PATIENT FINANCIAL ADVOCATES ASSIST THOSE IN NEED OF USING THE FAP.THE COMMUNITY PARAMEDIC OUTREACH PROGRAM SERVES PATIENTS AT RISK OF USING THE ER OR INPATIENT UNIT FOR PRIMARY CARE SERVICES. THE PROGRAM HELPS THEM FIND MORE APPROPRIATE RESOURCES FOR THEIR MEDICAL NEEDS, CONDUCTING 368 VISITS DURING 2022, REDUCING THE COST OF CARE FOR THOSE INDIVIDUALS. ASTERA HEALTH SERVES AS A CLINICAL ROTATION SITE FOR NURSING STUDENTS AND FOR RADIOLOGY AND LABORATORY TECHNICIANS FROM AREA TECHNICAL COLLEGES, PARTICIPATING AS PRECEPTOR SITES FOR MEDICAL SCHOOLS INCLUDING THE RURAL PHYSICIAN ASSOCIATE PROGRAM AND SUMMER INTERNSHIP IN MEDICINE, AS WELL AS PROVIDING CAMPUS-BASED PRECEPTOR PHYSICIANS TO THE UNIVERSITY OF MINNESOTA-DULUTH AND ST. CLOUD RESIDENCY PROGRAMS. 63201946 1 1 0 1 0 0 0 0 1 0 1 0 0 0 1 1 0 1 0 0 0 0 0 1 1 1 1 1 1 1 1 1 0 0 0 0 0 1 0 0 0 1 0 0 0 0 0 0 0 0 0 1 153 0 530 1 1 1 0 0 0 0 1 1 0 0 0 0 0 0 X 11 8 1 0 1 0 0 0 0 1 1 0 0 1 1 1 1 1 1 1 1 0 MN X JOEL BEISWENGER CEO 2186317489 415 JEFFERSON STREET N WADENA MN 56482 MATTHEW VAN BRUGGEN BOARD MEMBER 4.00 X 4000 0 0 TERRY DAVIS BOARD MEMBER 4.00 X 0 0 0 RYAN ANDERSON BOARD CHAIR 4.00 X X 0 0 0 PAUL DRANGE BOARD VICE CHAIR 4.00 X X 3709 0 0 DAVE FJELDHEIM BOARD MEMBER 4.00 X 3536 0 0 JOLENE JOHANNES BOARD SECRETARY 4.00 X 0 0 0 STEVE DAVIS MD BOARD MEMBER 4.00 X 0 0 0 JACKIE OCH BOARD MEMBER 4.00 X 0 0 0 SHANEEN SCHMIDT MD BOARD MEMBER 4.00 X 21746 0 0 BOBBI ADAMS MD CMO 4.00 X X 1200 0 0 DAVID QUINCER BOARD MEMBER 4.00 X 2268 0 0 JOEL BEISWENGER CEO, PRESIDENT 40.00 X 396904 0 39289 KIM AAGARD CFO 40.00 X 223519 0 32541 JOSE ALBA CAO (TO JULY 2022) 40.00 X 122201 0 2412 THOMAS PINT CNO 40.00 X 208265 0 6157 TERESA JOHNSON CHRO 40.00 X 192034 0 34752 MEDLEY SHAMP CAO (SINCE OCTOBER 2022) 40.00 X 153479 0 41719 RACHEL REDIG MD PHYSICIAN 40.00 X 536351 0 43139 NATHANIEL RONNING MD PHYSICIAN 40.00 X 706902 0 6820 BENJAMIN ROBERTSON MD PHYSICIAN 40.00 X 1296919 0 50631 TRAVIS SWARTZ MD PHYSICIAN 40.00 X 524185 0 45530 RYAN SCOTT MD PHYSICIAN 40.00 X 503453 0 46579 TIMOTHY MONSON MD PHYSICIAN 40.00 X 447050 0 26885 5347721 0 376454 51 0 1 0 MA MORTENSON AND COMPANY 700 MEADOW LN N GOLDEN VALLEY MN 55422 BUILDING CONTRACTOR 37676608 WADENA MEDICAL CENTER LTD 4 DEERWOOD AVE WADENA MN 56482 PHYSICIAN SERVICES 4454556 REGIONAL DIAGNOSTIC RADIOLOGY PO BOX 1611 EVANSVILLE IN 47706 RADIOLOGY READING FEES 928529 BSG MAINTENANCE OF GREEN BAY INC PO BOX 165 NEWBURG MN 53060 HOUSEKEEPING AND LAUNDRY SERVICES 774429 HAMMEL GREEN AND ABRAHAMSON INC 420 5TH STREET NORTH MINNEAPOLIS MN 55401 BUILDING ARCHITECT 472436 24 127084 402561 877082 1406727 PROGRAM SERVICE REVENUE 621400 75964425 75964425 PHARMACY 456110 4503298 4503298 CMDI INCOME 561499 370196 370196 INDUSTRIAL BILLING 561000 22750 22750 80860669 467194 467194 697396 99293 598103 598103 598103 72099 50000 0 0 72099 50000 122099 122099 27049 127084 100606 -73557 -73557 18584 3908 14676 14676 MISCELLANEOUS 624100 351104 351104 CLINIC REVENUE 624100 150196 150196 EMPLOYEE/GUEST MEALS 722514 141505 141505 9992 9992 652797 84048708 80837919 22750 1781312 X 44382 44382 26900 26900 2069221 579490 1489731 29710435 25297140 4310785 102510 1071951 905966 165985 6363257 5287999 1075258 1978112 1615893 362219 113723 113723 6805 6805 14023673 12745532 1278141 332270 332270 1016465 212826 617418 186221 71310 71310 1115371 831415 283956 183441 132282 49100 2059 53640 53640 2101789 1043389 1058400 381957 381957 MEDICAL SUPPLIES 11662698 11662698 RENTAL & MAINTENANCE 3236144 2594020 642124 TAXES 762296 762296 MEDICARE SURCHARGE 402280 402280 528046 168374 353214 6458 77256166 63201946 13756972 297248 73100 197184 16829659 8613861 1111982 564067 11989307 11997191 12121 3148 655236 1645044 843687 791892 562477 502875 121102420 45023433 32518829 76078987 14572859 22808343 1574722 2393794 80743979 125596386 14320295 16383339 11267213 53171113 7760057 2361418 33347565 71915870 X 47331000 53584373 65414 96143 47396414 53680516 80743979 125596386 X 6792542 -2684133 2175693 X 0 1 X 1 1 1 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 0 0 0 0 0 0 0 0 1 6805 6805 0 PART II-B, LINE 1: A PORTION OF MEMBERSHIP DUES PAID TO AMERICAN HOSPITAL ASSOCIATION AND MINNESOTA HOSPITAL ASSOCIATION ARE USED FOR LOBBYING PURPOSES. 1 1776 35 1811 0 498225 498225 34445701 27564998 6880703 2120330 1734257 386073 19638311 15724178 3914133 64399853 64399853 76078987 ASSET RETIREMENT OBLIGATION 705514 ESTIMATED THIRD PARTY SETTLEMENTS 1655904 2361418 X 83401508 99343 99343 83302165 746544 746544 84048709 77347785 99293 99293 77248492 7674 7674 77256166 PART IV, LINE 1B: DONATIONS FROM VENDING MACHINE AND POP CAN SALVAGE IS USED FOR SCHOLARSHIPS FOR CHILDREN OF EMPLOYEES. PART X, LINE 2: THE SYSTEM FOLLOWS THE PROVISION OF THE INCOME TAX STANDARD REGARDING THE RECOGNITION AND MEASUREMENT OF UNCERTAIN TAX POSITIONS. THE APPLICATION OF THESE PROVISIONS HAS NO IMPACT ON THE SYSTEM'S CONSOLIDATED FINANCIAL STATEMENTS. PART XI, LINE 2D - OTHER ADJUSTMENTS: EXPENSES INCLUDED IN REVENUES IN THE FINANCIAL STATEMENTS -7,674. NET ASSETS RELEASED FROM RESTRICTION 107,017. PART XI, LINE 4B - OTHER ADJUSTMENTS: REALIZED LOSS ON INVESTMENTS 72,099. INTEREST INCOME 467,194. RENTAL EXPENSE -99,293. TEMPORARILY RESTRICTED CONTRIBUTIONS 137,746. CAPITAL CONTRIBUTIONS 168,798. PART XII, LINE 2D - OTHER ADJUSTMENTS: RENTAL EXPENSES 99,293. PART XII, LINE 4B - OTHER ADJUSTMENTS: EXPENSES INCLUDED IN REVENUES IN THE FINANCIAL STATEMENTS 7,674. X X X X X X X 1 BOUTS VENTURES LLC PO BOX 99 DIAMONDALE MI 48821 COMMUNITY RELATIONS COUNSELING SERVICE 0 0 45600 -45600 45600 -45600 MN GALA 93088 66065 27023 295 7326 13744 26253 4649 13798 GOLF CLASSIC 61045 61019 26 313 283 20440 4959 8546 154133 127084 27049 608 7609 34184 31212 4649 22344 100606 -73557 18584 3908 1 1.00000 18584 3908 3908 14676 MN 1 0 0 0 1.00000 RYAN DAMLO 415 JEFFERSON STREET N WADENA MN 56482 0 0 1 1 X 1 X 1 X 1 1 1 0 1 0 735132 735132 0.00950 1794376 837917 956459 0.01240 12807042 7137353 5669689 0.07340 15336550 7975270 7361280 0.09530 229701 229701 0.00300 92984 92984 0.00120 23813436 15966848 7846588 0.10160 137243 137243 0.00180 24273364 15966848 8306516 0.10760 39609914 23942118 15667796 0.20290 8198 8198 0.00010 1691 1691 0.00000 238833 238833 0.00310 248722 248722 0.00320 0 973801 0 13531543 13682919 -151376 X 1 1 1 1 ASTERA HEALTH 415 JEFFERSON STREET N WADENA MN 56482 HTTPS://ASTERAHEALTH.ORG/ 365897 X X X X ASTERA HEALTH 1 0 0 1 X X X X X X X X X 22 1 1 1 1 X SEE URL BELOW X 1 22 1 SEE URL BELOW 0 1 X 200.000000000000 200.000000000000 X X X X 1 1 X X X X 1 X HTTPS://ASTERAHEALTH.ORG/PATIENTS-AND-VISITORS/BILLING-FINANCIAL-INFORMATIO X HTTPS://ASTERAHEALTH.ORG/PATIENTS-AND-VISITORS/BILLING-FINANCIAL-INFORMATIO X HTTPS://ASTERAHEALTH.ORG/PATIENTS-AND-VISITORS/BILLING-FINANCIAL-INFORMATIO X X X X X 1 X 0 X X X X 1 X 0 0 ASTERA HEALTH PART V, SECTION B, LINE 5: ASTERA HEALTH CONDUCTED THE FOLLOWING COMMUNITY HEALTH NEEDS ASSESSMENT (CHNA) WITH THE COLLABORATION OF TODD, WADENA AND MORRISON COUNTY PUBLIC HEALTH AGENCIES; CENTRACARE HEALTH SYSTEM; CHI ST. GABRIEL'S HOSPITAL; AND LAKEWOOD HEALTH SYSTEM TO ENSURE THE MOST COMPREHENSIVE ASSESSMENT OF THE SERVICE AREA COMMUNITY. THE MAPP PROCESS (MOBILIZING FOR ACTION THROUGH PLANNING AND PARTNERSHIPS) WAS USED AS A "COMMUNITY-DRIVEN STRATEGIC PLANNING PROCESS FOR IMPROVING COMMUNITY HEALTH AND PROVIDED THE FRAMEWORK FOR DATA COLLECTION AND PRIORITIZING PUBLIC HEALTH NEEDS. DATA WAS COLLECTED FROM A VARIETY OF SOURCES, INCLUDING INFORMATION FROM QUESTIONNAIRES FOR KEY STAKEHOLDERS, A COMMUNITY HEALTH SURVEY, AND QUANTITATIVE STATISTICS FROM LOCAL, COUNTY, AND STATE PUBLIC HEALTH SOURCES. THE DATA GATHERED WAS THEN USED TO IDENTIFY SPECIFIC ISSUES AND PRIORITIZE THEM ACCORDING TO NEED. THESE PRIORITIZED ISSUES WERE USED TO DEVELOP STRATEGIES FOR THE IMPLEMENTATION OF INTERVENTIONS. ASTERA HEALTH PART V, SECTION B, LINE 6A: ASTERA HEALTH CONDUCTED THE COMMUNITY HEALTH NEEDS ASSESSMENT WITH THE COLLABORATION OF CENTRACARE HEALTH SYSTEM, CHI ST. GABRIEL'S HOSPITAL, AND LAKEWOOD HEALTH SYSTEM. ASTERA HEALTH PART V, SECTION B, LINE 6B: ASTERA HEALTH CONDUCTED THE COMMUNITY HEALTH NEEDS ASSESSMENT WITH THE COLLABORATION OF TODD, WADENA, AND MORRISON COUNTY PUBLIC HEALTH AGENCIES. ASTERA HEALTH PART V, SECTION B, LINE 7D: SEE CHNA AT THIS URL: HTTPS://ASTERAHEALTH.ORG/EDUCATION-AND-RESOURCES/COMMUNITY-HEALTH-NEEDS-ASSESSMENT ASTERA HEALTH PART V, SECTION B, LINE 11: IN 2022, ASTERA HEALTH CONDUCTED A CHNA THAT PRIORITIZED SOCIAL DETERMINANTS OF HEALTH, HEALTHY BEHAVIORS, MENTAL HEALTH/DRUG ADDICTION PAIN/PRESCRIPTION MANAGEMENT. ASTERA HEALTH HAS ADDRESSED THESE ISSUES AS FOLLOWS:1. HEALTHY BEHAVIORS AND CHRONIC DISEASE MANAGEMENT:STRATEGY 1: COMMUNITY EDUCATION AND PARTNERSHIPS - TACTIC: IHP AND ACO/CIN WORK STRATEGY 2: INCREASE PREVENTATIVE MEDICAL VISITS STRATEGY 3: EMPLOYEE WELLNESS INITIATIVES STRATEGY 4: EXPAND OCCUPATIONAL HEALTH THROUGH HEALTH FAIRS/ BIOMETRIC SCREENINGS FOR LOCAL EMPLOYERS STRATEGY 5: CONTINUE CHRONIC DISEASE MANAGEMENT EFFORTS TO IMPROVE OPTIMAL CARE OUTCOMES - TACTIC: I CAN PREVENT DIABETES CLASSES - TACTIC: ENSURE HEALTHY BEHAVIORS TO BETTER LIVE WITH DIAGNOSED CHRONIC DISEASES 1. EXPLANATION OF THE ACTIONS YOU PLAN TO TAKE: FOCUSED ATTENTION ON QUALITY IMPROVEMENTS ASSOCIATED WITH ACO, CIN, AND IHP PARTNERSHIPS, REVIEW OF PATIENTS FREQUENTLY USING THE EMERGENCY DEPARTMENT FOR CARE AND DETERMINE ALTERNATIVE CARE OPTIONS FOR THESE PATIENTS, PROVIDE EVIDENCE-BASED HEALTH EDUCATION CLASSES TO PATIENTS (I CAN PREVENT DIABETES, LIVING WELL WITH CHRONIC CONDITIONS), PROVIDE EDUCATIONAL OPPORTUNITIES TO THE SERVICE AREA 2. RESOURCES PLAN TO COMMIT: WAGES OF STAFF DEVELOPING, PLANNING, AND IMPLEMENTING EDUCATION CLASSES AND EVENTS, EDUCATION CLASSES AND EVENTS ARE PROVIDED TO PATIENTS AND SERVICE AREA AT NO COST, WAGES OF STAFF FOCUSING EFFORTS ON IMPROVEMENT OF QUALITY METRICS OF ACO, CIN AND IHP CONTRACTS 3. ANTICIPATED IMPACT OF THE ACTION: IMPROVEMENT IN PATIENT HEALTH OUTCOMES, INCREASED PATIENT ENGAGEMENT, INCREASED QUALITY METRICS 4. ANY PLANNED COLLABORATIONS: JUNIPER, CENTRAL MINNESOTA COUNCIL ON AGING, WADENA COUNTY PUBLIC HEALTH, LOCAL BUSINESSES 2. MENTAL HEALTH / OPIOID-USE DISORDER AND PRESCRIPTION MANAGEMENT: STRATEGY 1: IDENTIFICATION OF PATIENT POPULATION STRATEGY 2: MENTAL HEALTH SERVICE LINE ASSESSMENT AND STRATEGIC PLAN DEVELOPED STRATEGY 3: OPIOID PLAN EXECUTION (CARE PLAN, MORE VISITS, REHAB, MEDICATION-ASSISTED TREATMENT)1. EXPLANATION OF THE ACTIONS YOU PLAN TO TAKE: IDENTIFY PATIENTS USING OPIOIDS AND CONTROLLED SUBSTANCES ON A CONSISTENT BASIS, INCREASE CONTROLLED SUBSTANCE CARE PLANS FOR PATIENTS, DECREASE THE NUMBER OF PATIENTS CHRONICALLY USING OPIOIDS AND CONTROLLED SUBSTANCES, IDENTIFY GAPS IN MENTAL HEALTH CARE PROVIDED TO PATIENTS, PROVIDE MEDICATION-ASSISTED TREATMENT FOR PATIENTS ADDICTED TO OPIOIDS. 2. RESOURCES PLAN TO COMMIT: WAGES OF STAFF WHO PROVIDE EDUCATION AND ASSISTANCE TO PATIENTS USING OPIOIDS/CONTROLLED SUBSTANCES 3. ANTICIPATED IMPACT OF THE ACTION: DECREASED RISKS TO PATIENTS CHRONICALLY USING OPIOIDS AND CONTROLLED SUBSTANCES AND PROVIDERS WHO PRESCRIBE TO THESE PATIENTS 4. ANY PLANNED COLLABORATIONS: WADENA COUNTY CHAMP (CHEMICAL HEALTH AWARENESS AND MULTI-DRUG PREVENTION), OTTERTAIL COUNTY OPIOID TASKFORCE, LOCAL BUSINESSES, AREA HEALTH CARE AGENCIES OPIOID ECHOS 3. SOCIAL DETERMINANTS OF HEALTH: STRATEGY 1: TRACKING/SYSTEM/IDENTIFICATION STRATEGY 2: INFRASTRUCTURE IDENTIFY COMMUNITY PARTNERS/RESOURCES STRATEGY 3: INCREASE MEDICAL VISITS CAPTURE THE DATA ON OUR PATIENTS1. EXPLANATION OF THE ACTIONS YOU PLAN TO TAKE: DEVELOP AND IMPLEMENT A SYSTEM FOR THE IDENTIFICATION OF SOCIAL DETERMINANTS OF HEALTH OF PATIENTS, DETERMINE AND ESTABLISH RELATIONSHIPS WITH COMMUNITY STAKEHOLDERS AND IDENTIFY RESOURCES FOR SOCIAL NEEDS DETERMINED THROUGH A SCREENING PROCESS, UTILIZE DATA TO DETERMINE PATTERNS AND TRENDS OF SOCIAL CHALLENGES PATIENTS ARE FACING 2. RESOURCES PLAN TO COMMIT: WAGES OF STAFF MEMBERS PLANNING, DEVELOPING, AND ANALYZING SOCIAL DETERMINANTS OF HEALTH OF PATIENTS IN THE SERVICE AREA, COST OF DESIGN AND IMPLEMENTATION TO CAPTURE SOCIAL DETERMINANTS OF HEALTH IN THE ELECTRONIC HEALTH RECORD 3. ANTICIPATED IMPACT OF THE ACTION: IMPROVEMENT IN HEALTH OUTCOMES, INCREASED PATIENT SATISFACTION, INCREASED PATIENT ENGAGEMENT 4. ANY PLANNED COLLABORATIONS: WILL DETERMINE NECESSARY COLLABORATION WITH EXTERNAL STAKEHOLDERS AS PART OF STRATEGIES FOR THIS PRIORITY. ASTERA HEALTH PART V, SECTION B, LINE 20E: THE ORGANIZATION WRITES OFF SELF ADMINISTERED DRUGS FOR MEDICARE PATIENTS AS APPROVED BY THE OIG. 8 1 - ASTERA HEALTH WADENA CLINIC 421 11TH STREET NW WADENA MN 56482 RURAL HEALTH CLINIC 2 - ASTERA HEALTH BERTHA CLINIC 214 1ST STREET NW BERTHA MN 56437 RURAL HEALTH CLINIC 3 - ASTERA HEALTH HENNING CLINIC 4010 DOUGLAS AVENUE HENNING MN 56551 RURAL HEALTH CLINIC 4 - ASTERA HEALTH OTTERTAIL CLINIC 232 MINNESOTA HIGHWAY 78 N OTTERTAIL MN 56571 RURAL HEALTH CLINIC 5 - ASTERA HEALTH SEBEKA CLINIC 106 MINNESOTA AVENUE SEBEKA MN 56477 RURAL HEALTH CLINIC 6 - ASTERA HEALTH VERNDALE CLINIC 102 FARWELL STREET SOUTH VERNDALE MN 56481 RURAL HEALTH CLINIC 7 - ASTERA HENNING PHYSICAL THERAPY CLINIC 801 INMAN STREET HENNING MN 56551 PHYSICAL THERAPY CLINIC 8 - ASTERA HEALTH BAXTER CLINIC 7073 FORTHUN ROAD S BAXTER MN 56425 FREESTANDING CLINIC PART I, LINE 3C: ASTERA HEALTH DETERMINES ELIGIBILITY BASED ON AN INDIVIDUAL'S INCOME, NET ASSETS, INSURANCE COVERAGE, AND APPLICATION FOR FEDERAL AND/OR STATE-PROVIDED ASSISTANCE. SEE OUR WEBSITE, HTTPS://ASTERAHEALTH.ORG/PATIENTS-AND-VISITORS/BILLING-FINANCIAL-INFORMATION/, FOR DETAILED INFORMATION ABOUT ELIGIBILITY CRITERIA. PART I, LINE 7: IN ORDER TO DETERMINE THE AMOUNTS INCLUDED IN PART I, LINE 7, ASTERA HEALTH GENERALLY USES THE COST-TO-CHARGE RATIO DERIVED FROM WORKSHEET 2 OF THE IRS FORM 990 INSTRUCTIONS. TO CALCULATE THE COSTS OF COMMUNITY HEALTH IMPROVEMENT SERVICES AND COMMUNITY BENEFITS OPERATIONS, HEALTH PROFESSIONS EDUCATION, AND SUBSIDIZED HEALTH SERVICES, TCH USES THE COST-TO-CHARGE RATIO SPECIFIC TO THOSE SERVICES. PART I, LINE 7G: SUBSIDIZED HEALTH SERVICES INCLUDE REVENUES AND COSTS ASSOCIATED WITH ER AND THE FOLLOWING SIX PROVIDER-BASED CLINICS:- ASTERA HEALTH WADENDA CLINIC- ASTERA HEALTH BERTHA CLINIC- ASTERA HEALTH HENNING CLINIC- ASTERA HEALTH OTTERTAIL CLINIC- ASTERA HEALTH SEBEKA CLINIC- ASTERA HEALTH VERNDALE CLINICCOMMUNITY BENEFIT EXPENSES RELATED TO THESE CLINICS IS $17,481,615. PART II, COMMUNITY BUILDING ACTIVITIES: THROUGH OUR HOSPITAL AND FOUNDATION, COMMUNITY EDUCATION, COMMUNITY SUPPORT AND MANY OTHER EFFORTS, WE ARE ABLE TO SUPPORT SEVERAL HEALTH INITIATIVES THROUGHOUT THE COMMUNITIES WE SERVE SUCH AS CONTINUING HEALTH EDUCATION, HEALTH EQUIPMENT IN THE SCHOOLS, PRENATAL EDUCATION, CONTINUING COMMUNITY HEALTH EDUCATION, CAR SEAT SAFETY EDUCATION, HEALTH CARE SCHOLARSHIPS, ETC. PART III, LINE 3: IN 2014, ASTERA HEALTH ADDED THE PRESUMPTIVE UNCOMPENSATED CARE POLICY. IF AN ACCOUNT IS READY TO BE SENT TO BAD DEBT BUT HAS MEDICAID NOW OR THERE IS OTHER PROOF THAT THE PATIENT WOULD QUALIFY, THE AMOUNT IS WRITTEN OFF AS UNCOMPENSATED CARE. THEREFORE, ACCOUNTS ARE NOT BEING SENT TO COLLECTIONS THAT MEET THIS NEW UNCOMPENSATED CARE GUIDELINE. PART III, LINE 4: SEE THE 'PATIENT RECEIVABLES, NET' PARAGRAPH ON PAGE 11 OF THE ATTACHED FINANCIAL STATEMENTS FOR INFORMATION ABOUT BAD DEBT EXPENSE. PART III, LINE 8: THE TOTAL ALLOWABLE COST REPORTED TO MEDICARE WAS BASED ON THE 2022 FILED MEDICARE COST REPORT. AS A CRITICAL ACCESS HOSPITAL, ASTERA HEALTH IS REIMBUSED AT 101% (LESS SEQUESTRATION WHEN IN EFFECT) OF COST WHEN SERVING MEDICARE BENEFICIARIES. 2022'S COST REPORT RESULTED IN A DEFICIT OF $151,376. PART III, LINE 9B: IT IS THE EXPECTATION THAT ALL PATIENTS RECEIVING SERVICES ARE FINANCIALLY RESPONSIBLE FOR THE TIMELY PAYMENT OF ALL CHARGES INCURRED. HOWEVER, NO PATIENT WILL BE REFUSED NECESSARY OR EMERGENCY CARE IF UNABLE TO MEET THE FINANCIAL REQUIREMENTS. INFORMATION GATHERED AT REGISTRATION IS THE KEY TO SUCCESSFUL COLLECTION EFFORTS. ACCURATE NAME, ADDRESS, PHONE NUMBERS, EMPLOYMENT AND CONTACT NAMES ARE REQUIRED. ALL CLIENTS PROVIDE A COPY OF THEIR DRIVER'S LICENSE AS IDENTIFICATION. IF THE PATIENT IS UNABLE TO PAY THE TOTAL AMOUNT, A PAYMENT PLAN WILL BE SET UP ACCORDING TO THE ATTACHED PAYMENT SCHEDULE. OTHER MEANS TO RESOLVE THE DEBT SUCH AS ASSISTANCE WITH MEDICAID FORMS AND UNCOMPENSATED CARE WILL BE DISCUSSED WITH THE PATIENT. ACCOUNT REPRESENTATIVES ARE RESPONSIBLE FOR PATIENT AND INSURANCE CONTACTS NECESSARY TO SECURE PAYMENT FOR SERVICES. IF PAYMENT HAS NOT BEEN RECEIVED AT THE TIME OF SERVICE, THE FOLLOWING INTERNAL COLLECTION GUIDELINE WILL BEGIN. SOME STEPS IN THE POLICY COULD BE ELIMINATED, OR TIMING CHANGED, DUE TO THE STATUS OF PREVIOUS ACCOUNTS FOR GUARANTOR.- 1ST STATEMENT - AFTER ALL INSURANCE AND ADJUSTMENTS ARE PROCESSED ON AN ACCOUNT, AND THE ACCOUNT IS SELF-PAY, THE FIRST STATEMENT WILL BE PRODUCED AND SENT TO THE PATIENT.- 2ND STATEMENT - A 2ND INVOICE IS GENERATED IF THE ACCOUNT HAS NOT BEEN PAID IN FULL. THIS IS APPROXIMATELY 30 DAYS FROM THE 1ST INVOICE DATE, BUT DOES VARY BASED ON THE TIMING OF STATEMENT CYCLES. AT APPROXIMATELY THE TIME OF THE SECOND STATEMENT. PATIENT FINANCIAL REPRESENTATIVES WILL BEGIN FOLLOWING UP WITH PHONE CALLS. CALLS ARE COMPLETED MONTHLY, AT A MINIMUM. POSSIBLY MORE FREQUENTLY IF THEY ARE UNABLE TO REACH THE PATIENT TO DISCUSS PAYMENT.- 3RD STATEMENT - A 3RD INVOICE IS GENERATED IF THE ACCOUNT HAS NOT BEEN PAID IN FULL. THIS IS APPROXIMATELY 30 DAYS FROM THE 2ND INVOICE DATE.- 4TH STATEMENT - A 4TH INVOICE IS GENERATED IF THE ACCOUNT HAS NOT BEEN PAID IN FULL. THIS IS APPROXIMATELY 30 DAYS FROM THE 3RD INVOICE DATE. - 5TH STATEMENT - A 5TH INVOICE IS GENERATED IF THE ACCOUNT HAS NOT BEEN PAID IN FULL. THIS IS APPROXIMATELY 30 DAYS FROM THE 4TH INVOICE DATE. THIS STATEMENT PRESENTS A RED FINAL NOTICE NOTIFICATION WITH VERBIAGE IN THE MESSAGING THAT THE ACCOUNT WILL BE SENT TO 3RD PARTY COLLECTIONS IF ACTION IS NOT TAKEN.- 30 DAYS AFTER FINAL NOTICE HAS BEEN GIVEN, ACCOUNTS ARE REVIEWED FOR SUBMISSION TO THIRD-PARTY COLLECTION AGENCIES. PART VI, LINE 2: ASTERA HEALTH ANTICIPATES THE NEEDS OF THE COMMUNITY BY USING BOTH INTERNAL AND EXTERNAL DATA. FOR INTERNAL MEANS, ASTERA HEALTH CAN GAUGE THE NEEDS OF THE COMMUNITY BASED ON WHAT IS PRESENTING IN OUR E/R, EMS CALLS, AND IDENTIFIED HEALTH PROBLEMS FOR OUR CLINIC PATIENTS. FOR EXTERNAL SOURCES OF DATA, ASTERA HEALTH ALSO WORKS CLOSELY WITH LOCAL LAW ENFORCEMENT, SOCIAL SERVICES, AND OTHER PUBLIC AGENCIES TO ASSESS THE NEEDS OF THE COMMUNITY. ASTERA HEALTH IS INVOLVED WITH THE CHILD PROTECTION TEAM, ASTERA HEALTH LEADERSHIP IS INVOLVED WITH OTHER CIVIC GROUPS TO HELP IDENTIFY NEEDS, AND ASTERA HEALTH CLINIC ADVISORY GROUPS INCLUDE COMMUNITY LEADERS AND SCHOOL OFFICIALS TO PROVIDE INPUT TO IDENTIFY HEALTH NEEDS IN ALL SIX OF THE COMMUNITIES WHERE ASTERA HEALTH HAS A CLINIC. THE ORGANIZATION ALSO PROVIDES FREE EDUCATIONAL OPPORTUNITIES FOR COMMUNITY MEMBERS THROUGH COMMUNITY EVENTS WHICH INCLUDE FREE LAB SCREENINGS FOR ALL WHO WISH TO ATTEND. THESE EVENTS ARE NOT LIMITED TO ASTERA HEALTH PATIENTS AND LAB RESULTS ARE FORWARDED TO THE PATIENT'S DESIGNATED PROVIDER. PART VI, LINE 3: WE MAKE INFORMATION AVAILABLE REGARDING OUR UNCOMPENSATED CARE PROGRAM ON OUR WEBSITE, IN BROCHURES, AND DURING COLLECTION CONTACTS WITH PATIENTS. PART VI, LINE 4: THE ASTERA HEALTH COMMUNITY IS LOCATED IN WEST CENTRAL MINNESOTA AND INCLUDES EASTERN/CENTRAL OTTER TAIL, TODD, AND WADENA COUNTIES. THE TOTAL POPULATION OF ALL THREE COUNTIES IS ESTIMATED AT 95,839; THE PRIMARY SERVICE AREA POPULATION OF ASTERA HEALTH IS ESTIMATED AT 38,184 BECAUSE IT MORE SPECIFICALLY FOCUSES ON THE CITIES OF WADENDA, SEBEKA, NEW YORK MILLS, BERTHA, DEER CREEK, HEWITT, ALDRICH, VERNDALE, BLUFFTON, HENNING, MENAHGA AND OTTERTAIL. THE ASTERA HEALTH SERVICE AREA CONSISTS OF PRIMARILY WHITE/CAUCASIANS AT 95.7 PERCENT WITH 4.3 PERCENT MINORITY. THE STATE OF MINNESOTA IS ALSO PRIMARILY WHITE/CAUCASIANS AT 83.7 PERCENT BUT HAS A GREATER MINORITY POPULATION OF 16.3 PERCENT. PART VI, LINE 5: ASTERA HEALTH'S UNCOMPENSATED CARE (CHARITY CARE) PROGRAM PROVIDES DISCOUNTED AND FREE SERVICES TO PATIENTS WHO LACK THE RESOURCES TO BE FULLY RESPONSIBLE FOR THE HEALTH CARE THEY RECEIVE. THE UNCOMPENSATED CARE PROGRAM IS DESIGNED TO ENSURE THE ENTIRE COMMUNITY SERVED BY ASTERA HEALTH HAS ACCESS TO NEEDED HEALTHCARE SERVICES. ASTERA HEALTH OPERATES A FULL-TIME EMERGENCY ROOM AND ACCEPTS ALL PATIENTS WHO PRESENT THEMSELVES FOR EMERGENCY SERVICES AT THE FACILITY. ASTERA HEALTH ALSO PROVIDES OR PARTICIPATES IN OTHER PROGRAMS WHICH CONTRIBUTE TO ITS CHARITABLE MISSION, INCLUDING THE HIGH SCHOOL SUMMER INTERNSHIP PROGRAM AND PROVIDES A CLINICAL ROTATION SITE FOR LPN/LVN NURSING STUDENTS FROM THE LOCAL TECHNICAL COLLEGE. ASTERA HEALTH ALSO OPERATES AN ADJUNCT ORGANIZATION (TRI COUNTY HOSPITAL FOUNDATION) WHICH HAS DEVELOPED A LOCAL SCHOLARSHIP FUND AND GRANT DOLLARS FOR WORTHY CAUSES, AND PROVIDES COMMUNITY HEALTH EDUCATION PROGRAMS, WHICH ARE CONSISTENT WITH IMPROVING THE COMMUNITIES' HEALTH STATUS. ASTERA HEALTH ALSO PROVIDES ORGANIZATIONAL AND ADMINISTRATIVE SUPPORT TO VARIOUS COMMUNITY BASED GROUPS OFFERING PEER SUPPORT PROGRAMS. THESE INCLUDE AREAS SUCH AS CANCER, BREAST CANCER, ARTHRITIS, DIABETES, AND OTHERS. ASTERA HEALTH PROVIDES SEVERAL AVENUES FOR LOCAL INDIVIDUALS TO CONTRIBUTE TO THE COMMUNITY THROUGH OUR VOLUNTEER PROGRAMS. INCLUDED ARE THE HOSPITAL INPATIENT AND OUTPATIENT VOLUNTEER SUPPORT PROGRAM, VOLUNTEER PROGRAMS. HOSPICE VOLUNTEERS, VOLUNTEERS, AND VARIOUS ADVISORY COMMITTEES. WE ARE CONTINUALLY THANKED BY THESE INDIVIDUALS FOR THE OPPORTUNITY FOR THEM TO FEEL NEEDED AND OFFER A PRODUCTIVE OUTLET FOR THEIR TALENTS. PART VI, LINE 6: ASTERA HEALTH IS PART OF AN INTEGRATED HEALTH SYSTEM (TRI-COUNTY HEALTH CARE). THE SYSTEM OPERATES A 25-BED CRITICAL ACCESS HOSPITAL (ASTERA HEALTH) AND ALSO OPERATES SEVERAL CLINICS IN THE SURROUNDING AREA. PART VI, LINE 7, REPORTS FILED WITH STATES MN 1 UNITED WAY OF OTTER TAIL AND WADENA COUNTIES 120 E WASHINGTON AVE FERGUS FALLS MN 56537 410873718 501(C)(3) 6500 0 GENERAL SUPPORT WEST CENTRAL ECONOMIC DEVELOPMENT ALLIANCE 308 FRONTAGE RD SEBEKA MN 56477 275168472 501(C)(6) 7500 0 GENERAL SUPPORT 1 1 HS ENDOWMENT SCHOLARSHIP 6 6000 N/A N/A MOEN BROTHERS GRANT 1 8000 N/A N/A DAVIS SCHOLARSHIP 5 12900 N/A N/A N/A N/A PART I, LINE 2: ALL SCHOLARSHIPS HAVE SPECIFIC CRITERIA SET-UP AND ALL APPLICANTS ARE SCREENED TO MEET THAT CRITERIA. WINNERS ARE SELECTED USING A BLIND SELECTION PROCESS. X X X X X 0 0 0 0 0 0 0 1 0 BENJAMIN ROBERTSON MD PHYSICIAN 1145329 0 50 0 151540 0 10694 0 39937 0 1347550 0 0 0 NATHANIEL RONNING MD PHYSICIAN 645616 0 50 0 61236 0 6820 0 0 0 713722 0 0 0 RACHEL REDIG MD PHYSICIAN 486000 0 50 0 50301 0 6070 0 37069 0 579490 0 0 0 TRAVIS SWARTZ MD PHYSICIAN 472860 0 50 0 51275 0 12107 0 33423 0 569715 0 0 0 RYAN SCOTT MD PHYSICIAN 455170 0 50 0 48233 0 6076 0 40503 0 550032 0 0 0 TIMOTHY MONSON MD PHYSICIAN 366590 0 0 0 80460 0 6070 0 20815 0 473935 0 0 0 JOEL BEISWENGER CEO, PRESIDENT 312896 0 37763 0 46245 0 11003 0 28286 0 436193 0 0 0 KIM AAGARD CFO 165485 0 14300 0 43734 0 7499 0 25042 0 256060 0 0 0 TERESA JOHNSON CHRO 146505 0 13250 0 32279 0 6575 0 28177 0 226786 0 0 0 THOMAS PINT CNO 165113 0 23025 0 20127 0 6157 0 0 0 214422 0 0 0 MEDLEY SHAMP CAO (SINCE OCTOBER 2022) 117964 0 14363 0 21152 0 4812 0 36907 0 195198 0 0 0 PART I, LINE 7 THE ORGANIZATION'S CHIEF OFFICERS MAY RECEIVE NON-FIXED PAYMENTS DEPENDING ON VARIOUS MEASURES THAT INCLUDE 1) QUALITY AND SERVICE, 2) FINANCIAL MEASURES - EBIDA MARGIN & DEBT SERVICE RATIO W/CAPEX, AND 3) GROWTH AND VOLUME. A CITY OF BERTHA HEALTH CARE FACILITIES REVENUE NOTE SERIES 2021A 416004976 2021-05-19 42480000 FINANCE BUILDING PROJECT AND REFINANCE 2017 SERIES DEBT 0 0 0 B CITY OF DEER CREEK SERIES 2021A 410952833 2021-05-19 10000000 FINANCE BUILDING PROJECT AND REFINANCE 2017 SERIES DEBT 0 0 0 C CITY OF WADENA HEALTH CARE FACILITIES REVENUE NOTE SERIES 2021A 416005605 2021-05-19 1545600 FINANCE BUILDING PROJECT AND REFINANCE 2017 SERIES DEBT 0 0 0 D CITY OF VERNDALE HEALTH CARE FACILITIES REVENUE NOTE SERIES 2021A 416005591 2021-05-19 9700000 FINANCE CAPITAL EXPENDITURE AND BUILDING PROJECT 0 0 0 A 32437748 727601 32437748 1 0 0 1 B 10000000 294475 10000000 1 0 0 1 C 1545600 32631 1545600 1 0 0 1 D 9700000 234832 9700000 1 0 0 1 A 0 0 1 1 0 0.01450 0.00000 0.01450 0 0 1 B 0 0 1 1 0 0.01450 0.00000 0.01450 0 0 1 C 0 0 1 1 0 0.01450 0.00000 0.01450 0 0 1 D 0 0 1 1 0 0.01450 0.00000 0.01450 0 0 1 A 0 0 1 0 1 0 0 0 1 B 0 0 1 0 1 0 0 0 1 C 0 0 1 0 1 0 0 0 1 D 0 0 1 0 1 0 0 0 1 A 1 B 1 C 1 D 1 RACHEL REDIG PHYSICIAN PRIOR EMPLOYMENT BUYOUT LOAN X 52000 3148 0 1 1 3148 WADENA MEDICAL CENTER LTD DR DAVIS(BOARD MEMBER), DR SCHMIDT(BOARD MEMBER), DR ADAMS(CMO): PARTNERS 4320000 PHYSICIAN SERVICES 0 RURAL RADIOLOGY DR. MCCULLOUGH IS FORMER BOARD MEMBER AND OWNER 139000 PROFESSIONAL RADIOLOGY SERVICES 0 FORM 990, PART VI, SECTION A, LINE 1A THE RETIREMENT COMMITTEE HAS AUTHORITY TO ACT ON BEHALF OF THE BOARD BETWEEN MEETINGS OF THE BOARD. THE RETIREMENT COMMITTEE CONSISTS OF TWO BOARD MEMBERS AS WELL AS THE ORGANIZATION'S CEO, CFO AND VP OF HR. FORM 990, PART VI, SECTION A, LINE 2 ASTERA HEALTH WORKS WITH PEMBERTON LAW FIRM, MATTHEW VAN BRUGGEN FOR ATTORNEY SERVICES. DR. DAVIS, BOARD MEMBER, DR. SCHMIDT, BOARD MEMBER, AND DR. ADAMS, CMO, ARE PARTNERS OF WMC LTD. FORM 990, PART VI, SECTION A, LINE 4 ENTITY CHANGED THEIR NAME FROM TRI-COUNTY HOSPITAL TO ASTERA HEALTH IN FEBRUARY 2023. FORM 990, PART VI, SECTION B, LINE 11B THE FORM 990 WAS REVIEWED IN DETAIL BY THE OFFICERS OF ASTERA HEALTH. THE FORM 990 WAS THEN PRESENTED AT A REGULAR SCHEDULED BOARD MEETING FOR REVIEW AND APPROVAL BY THE FULL BOARD PRIOR TO FILING WITH THE IRS. FORM 990, PART VI, SECTION B, LINE 12C THE BOARD OF DIRECTORS AND MANAGEMENT PERSONNEL ARE THE INDIVIDUALS COVERED UNDER THIS POLICY. IT IS THE CONTINUING RESPONSIBILITY OF THE BOARD AND MANAGEMENT TO SCRUTINIZE TRANSACTIONS AND MAKE IMMEDIATE DISCLOSURE OF ANY POTENTIAL CONFLICTS OF INTEREST TO THE CHIEF EXECUTIVE OFFICER OR THE BOARD CHAIR. EACH POTENTIAL CONFLICT IS SCRUTINIZED BY THE BOARD (WITH THE POTENTIAL PERSON WITH A CONFLICT OF INTEREST BEING EXCLUDED) TO DETERMINE IF THE CONTEMPLATED TRANSACTION IS JUST, FAIR AND IN THE BEST INTEREST OF THE ORGANIZATION. FORM 990, PART VI, SECTION B, LINE 15 EACH YEAR DURING THE PREPARATION OF THE ANNUAL BUDGET, HUMAN RESOURCES ACCESSES TWO TO THREE REGIONAL, STATE AND NATIONAL WAGE SURVEYS DEPENDING ON THE POSITION. THIS DATA IS USED BY MANAGEMENT AND THE BOARD TO ESTABLISH FAIR AND EQUITABLE COMPENSATION FOR TOP MANAGEMENT AND OTHER KEY EMPLOYEES WITHIN THE ORGANIZATION. THE BOARD DETERMINES THE CEO'S COMPENSATION AND THE CEO DETERMINES OTHER MANAGEMENT'S COMPENSATION. THE PROCESS DESCRIBED HERE WAS LAST COMPLETED IN 2022. FORM 990, PART VI, SECTION C, LINE 19 THE GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS ARE MADE AVAILABLE TO THE PUBLIC UPON REQUEST. FORM 990, PART IX, LINE 11G OTHER SERVICES: PROGRAM SERVICE EXPENSES 12,745,532. MANAGEMENT AND GENERAL EXPENSES 1,278,141. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 14,023,673. FORM 990, PART XI, LINE 9: UNREALIZED GAIN ON INTEREST RATE SWAP AGREEMENT 2,175,693. FORM 990, BOX C ASTERA HEALTH ALSO DOES BUSINESS AS ASTERA HEALTH BAXTER CLINIC, ASTERA HEALTH BERTHA AREA WELLNESS CENTER, ASTERA HEALTH BERTHA CLINIC, ASTERA HEALTH HENNING CLINIC, ASTERA HEALTH HENNING PHYSICAL THERAPY CLINIC, ASTERA HEALTH OTTERTAIL CLINIC, ASTERA HEALTH SEBEKA CLINIC, ASTERA HEALTH VERNDALE CLINIC, ASTERA HEALTH WADENA CLINIC.