2023-11-06T14:56:18-06:00 2022-12-31 346565596 ERNST & YOUNG US LLP 2005 MARKET ST STE 700 PHILADELPHIA PA 19103 990 2022-01-01 237379161 SISTERS OF CHARITY OF LEAVENWORTH HEALTH SYSTEM INC SIST 8018427851 500 ELDORADO BLVD SUITE 4300 BROOMFIELD CO 80021 SEAN FADDEN REGIONAL VP, FINANCE 8018427851 2023-11-06 0 SEAN FADDEN 999009999 0 LAUREN E BENNETT P01787029 2154485000 2 AAL1 IAL1 2022 2023-04-26 12:10:37Z MARK KORTH 500 ELDORADO BLVD SUITE 4300 BROOMFIELD CO 80021 875764861 0 X WWW.SCLHEALTH.ORG X 1972 KS WE REVEAL AND FOSTER GOD'S HEALING LOVE BY IMPROVING THE HEALTH OF THE PEOPLE (SEE SCHEDULE O) AND COMMUNITIES WE SERVE, ESPECIALLY THOSE WHO ARE POOR AND VULNERABLE. 16 14 4645 0 1699533 0 27621970 24895959 662550827 773189629 230222738 56470107 8524380 6666614 928919915 861222309 6781746 10155110 0 0 380009532 443815003 0 0 0 423572419 480642703 810363697 934612816 118556218 -73390507 3670085821 2693225086 3112789706 1313307153 557296115 1379917933 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. 0 0 866413189 10155110 779996194 ON APRIL 1, 2022, SISTERS OF CHARITY OF LEAVENWORTH HEALTH SYSTEM, INC. AFFLIATED WITH INTERMOUNTAIN HEALTH CARE, INC., CREATING A MODEL HEALTH SYSTEM THAT PROVIDES HIGH-QUALITY, ACCESSIBLE, AND AFFORDABLE HEALTHCARE TO COMMUNITIES IN UTAH, IDAHO, NEVADA, COLORADO, MONTANA, WYOMING, AND KANSAS. THE ORGANIZATION EMPLOYS NEARLY 60,000 CAREGIVERS, OPERATES 33 HOSPITALS (INCLUDING ONE VIRTUAL HOSPITAL), AND RUNS HUNDREDS OF CLINICS, WHILE PROVIDING HEALTH INSURANCE TO OVER ONE MILLION PEOPLE IN UTAH, IDAHO AND NEVADA.SCLHS WAS FOUNDED BY THE SISTERS OF CHARITY OF LEAVENWORTH (SCL), WHO TRACE THEIR ORIGIN AS A RELIGIOUS COMMUNITY TO THE 1600S IN FRANCE, WHERE VINCENT DE PAUL AND LOUISE DE MARILLAC (SEE SCHEDULE O) ESTABLISHED THE DAUGHTERS OF CHARITY. THESE WOMEN WERE DEDICATED TO SERVING THE SICK AND POOR THROUGH AN ACTIVE MINISTRY.IN 1857, A SMALL CONGREGATION OF SISTERS FROM NASHVILLE, TENN., LED BY MOTHER XAVIER ROSS, VENTURED TO THE EDGE OF AN EXPANDING FRONTIER IN THE THEN INDIAN TERRITORY OF KANSAS. THEY OPENED THE FIRST PRIVATE HOSPITAL IN THE STATE IN 1864, WITH THE FIRST TRAINED NURSE IN THE STATE AND SURELY THE FIRST WOMAN IN THE WESTERN TERRITORY TO RUN A HOSPITAL. IN 1873, THE SISTERS FOUNDED WHAT IS NOW SAINT JOSEPH HOSPITAL IN DENVER, THE OLDEST PRIVATE TEACHING HOSPITAL IN COLORADO, AND ONE OF THE FIVE COLORADO HOSPITALS OF THE HEALTHCARE SYSTEM.SCLHS WAS FORMED IN 1972 TO STRENGTHEN AND UNIFY THE HEALTHCARE FACILITIES SPONSORED BY SCLHS. IN 2011, THE SISTERS TRANSFERRED SPONSORSHIP OF SCLHS TO LEAVEN MINISTRIES. SCLHS' RICH HERITAGE AND ENDURING LEGACY SERVE AS THE FOUNDATION FOR ITS HEALTH MINISTRY TODAY, AND ITS MISSION, VISION AND VALUES SERVE AS THE FRAMEWORK FOR ITS SUCCESS. SCLHS IS THE MANAGEMENT COMPANY PROVIDING CENTRALIZED SERVICES FOR ALL SCLHS SUBSIDIARIES. SCLHS PERFORMS NUMEROUS COORDINATED AND CENTRALIZED SERVICES FOR THE ENTITIES AND CARE SITES THAT COMPRISE ITS SYSTEM, SUCH AS ADMINISTERING FINANCING AND CAPITAL FORMATION PROGRAMS; ETHICAL AND RELIGIOUS DIRECTION; FINANCIAL REPORTING; TAX SERVICES; HUMAN RESOURCES FUNCTIONS, INCLUDING EXECUTIVE RECRUITING AND ADMINISTERING AND MAINTAINING WELFARE; BENEFIT AND RETIREMENT PLANS; INFORMATION TECHNOLOGY SERVICES, INCLUDING ELECTRONIC MEDICAL RECORD SYSTEMS; BUSINESS MANAGEMENT SYSTEMS; EQUIPMENT AND CONNECTIVITY; INTERNAL AUDIT FUNCTIONS; LEGAL SERVICES; PHYSICIAN NETWORK DEVELOPMENT; PROCUREMENT AND SUPPLY CHAIN MANAGEMENT, INCLUDING MEDICAL DEVICES; SUPPLIES AND EQUIPMENT; PROFESSIONAL LIABILITY INSURANCE THROUGH A CAPTIVE PROVIDER, INCLUDING GROUP EXCESS COVERAGE AND REINSURANCE AND LITIGATION MANAGEMENT; PUBLIC RELATIONS; COMMUNICATIONS AND LEGISLATIVE AFFAIRS; REAL ESTATE MANAGEMENT SERVICES, INCLUDING LEASING AND CONSTRUCTION; PURCHASE AND SALE; REGULATORY COMPLIANCE SERVICES; REVENUE CYCLE MANAGEMENT SERVICES, INCLUDING BILLING AND COLLECTIONS; RISK MANAGEMENT SERVICES INCLUDING SELF-INSURANCE; GROUP EXCESS COVERAGE AND REINSURANCE; LITIGATION MANAGEMENT; INSPECTION AND CONTROLS. THE CENTRALIZATION OF MANAGEMENT SERVICES PROVIDES FOR HIGH QUALITY, COST EFFECTIVE AND COMPASSIONATE HEALTHCARE MANAGEMENT AND MEDICAL SERVICES FOR THE COMMUNITIES WE SERVE. THEREFORE, THESE MANAGEMENT SERVICES RELATE DIRECTLY TO THE EXEMPT PURPOSE OF OWNING AND MANAGING PUBLIC HOSPITALS AND A HEALTHCARE SYSTEM. OUR MISSION, VISION AND VALUES ARE LISTED BELOW.MISSION, VISION, & VALUES MISSION: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.VISION:INSPIRED BY OUR FAITH, WE WILL PARTNER WITH OUR PATIENTS ANDCOMMUNITIES TO EXCEED THEIR EXPECTATIONS FOR HEALTH.VALUES:CARING SPIRIT - WE HONOR THE SACRED DIGNITY OF EACH PERSON.EXCELLENCE - WE SET AND SURPASS HIGH STANDARDS.GOOD HUMOR - WE CREATE JOYFUL AND WELCOMING ENVIRONMENTS.INTEGRITY - WE DO THE RIGHT THING WITH OPENNESS AND PRIDE.SAFETY - WE DELIVER CARE THAT SEEKS TO ELIMINATE ALL HARM FOR PATIENTS AND ASSOCIATES.STEWARDSHIP - WE ARE ACCOUNTABLE FOR THE RESOURCES ENTRUSTED TO US. 866413189 1 1 0 1 0 0 0 0 0 1 1 1 1 0 1 0 0 1 0 0 1 0 0 0 0 0 1 1 1 0 1 0 0 0 0 0 0 0 0 0 0 0 0 1 1 1 1 0 0 1 X 1154 0 1 4645 1 1 1 1 CJ EI LU ID PO RS KS 0 0 0 0 0 0 0 0 1 0 X 16 14 1 0 1 0 1 1 1 1 1 0 1 1 1 1 1 1 1 1 1 1 1 0 X COLIN QUINCY 8014423491 36 SOUTH STATE STREET SUITE 1600 SALT LAKE CITY UT 84111 ALBERT ZIMMERLI TREASURER 12/14-12/31 2.00 63.00 X 0 4298891 1390538 LYDIA JUMONVILLE PRES & CEO 1/1-4/1/22, CEO/DIRECTOR 4/1-12/31 50.00 6.00 X X 3193207 0 695330 JANIE WADE TREAS 1/1-12/14/22 / EVP CFO 50.00 15.00 X 2254921 0 321825 ROSLAND MCLEOD SEC 1/1-4/1 / CHIEF LEGAL 1/1-6/3 50.00 3.00 X 2102345 0 190295 JAMES VALIN MD VICE PRES 1/1-12/14 / CHIEF CLINICAL OFFICER 50.00 2.00 X 1799242 0 335906 MARK KORTH EVP COO 1/1-4/1, PRES 4/1-12/31 50.00 5.00 X X 1741709 0 320302 GREG MATIS SEC 12/14-12/31 3.00 50.00 X 0 1380583 561819 GREGORY M JOHNSON VP, FINANCE SERVICES 12/14-12/31 3.00 56.00 X 0 1607457 281279 TAJQUAH HUDSON EVP CHIEF STRATEGY & GROWTH OFFICER 50.00 2.00 X 1416515 0 292209 ANTHONY RUSSO MD MG PHYSICIAN 50.00 0.00 X 1587314 0 53121 J GRANT WICKLUND PRESIDENT REGIONAL WESTERN CO & LMC 1.00 51.00 X 1113263 0 468497 CLAY M ASHDOWN SVP, FINANCE OPS 12/14-12/31 3.00 50.00 X 0 1012822 436297 SHAWN DUFFORD MD SVP, CHIEF MEDICAL OFFICER 1/1-4/15 25.00 27.00 X 1250773 0 108966 CRAIG RICHARDVILLE SVP, CHIEF INFO AND DIGITAL OFFICER 50.00 0.00 X 1089369 0 201411 JENNIFER ALDERFER MONTANA MARKET PRESIDENT 3.00 50.00 X 948294 0 253601 LOUIS ROSS MD PHYSICIAN CLINIC 50.00 0.00 X 1082718 0 46412 MEGAN MAHNCKE PRESIDENT SCL HLTH FOUNDATIONS & SVP MKTG COMMS 1/ 50.00 7.00 X 896080 0 170062 TAMARA SAUNAITIS SVP CHIEF HR OFFICER 1/1-4/1 50.00 1.00 X 940376 0 89684 SUZANNE DRAPER VP, ETHICS & COMPLIANCE 12/14-12/31 3.00 56.00 X 0 585787 439552 STUART GOODMAN MD PHYSICIAN ANESTHESIA 50.00 0.00 X 925976 0 40580 STACY JENNINGS VP, CHIEF INVEST OFFICER 12/14-12/31 3.00 56.00 X 0 638012 322933 JOHN BRAXTON MD PHYSICIAN CLINIC 50.00 0.00 X 921284 0 33784 THOMAS DONOHOE VP GENERAL COUNSEL OPERATIONS 50.00 12.00 X 762392 0 172741 DAVID PRINGLE CHIEF CATHOLIC MISSION OFFICER 50.00 0.00 X 769726 0 140202 CHRISTOPHER AWTREY MD CHIEF MEDICAL OFFICER, MEDICAL GROUP 50.00 1.00 X 683030 0 194188 HEIDI WALD VP CHIEF QUALITY & SAFETY OFFICER 50.00 0.00 X 678113 0 172567 BRYAN JOHNSON WESTERN CO MKT PRESIDENT 3.00 54.00 X 635785 0 207161 ALAN BAKER CHIEF OPERATING OFFICER, MEDICAL GROUP 50.00 0.00 X 617365 0 191429 SIMON PAYNE MD CMO, ACUTE CARE 50.00 0.00 X 616325 0 160835 BARBARA JAHN CHIEF OPERATING OFFICER 50.00 0.00 X 618352 0 149179 AMY CHURCH VP FINANCE OPERATIONS 50.00 0.00 X 622413 0 132004 LAURA WIGHTMAN SVP CHIEF NURSING OFFICER SYS 1/1-5/2/22 50.00 3.00 X 678322 0 55730 TROY SPRING VP REVENUE CYCLE 50.00 0.00 X 571481 0 153633 MARK WILKINSON VP TREASURER 50.00 0.00 X 483047 0 120950 SEAN FADDEN VP, STR FIN PLAN 1/1-4/13, REG VP, FIN 4/14-12/31 50.00 1.00 X 472817 0 127656 TROY HOLMES VP PAYER CONTRACTING 50.00 0.00 X 456186 0 117694 DINA BUSH CHIEF NURSING OFFICER 50.00 0.00 X 407774 0 161014 JAMES RITCHEY VP HUMAN RESOURCES OPERATIONS 50.00 0.00 X 384285 0 116111 SUSAN SCHAUB VP HR OPERATIONS 50.00 0.00 X 321852 0 109416 STEVEN CHYUNG SVP SUPPLY CHAIN & REAL ESTATE 1/1- 4/8/22 50.00 0.00 X 332535 0 75556 TERENCE MOLOUGHNEY ASST SECRETARY 12/14-12/31/22 50.00 0.00 X 254970 0 49043 KHADIJA MOHAMED ASST SECRETARY / BOARD GOV PROG MGR 1/1-12/14/22 50.00 0.00 X 135627 0 17480 PAMELA FEDERBUSCH DIRECTOR 1.00 0.00 X 7349 0 0 BETH BECKMAN DIRECTOR 1.00 0.00 X 5349 0 0 DOUGLAS ADEN DIRECTOR, SECRETARY 3.00 0.00 X X 5000 0 0 KATHRYN PAUL VICE CHAIR 3.00 0.00 X X 4849 0 0 ROBERT E WILSON DIRECTOR 1.00 0.00 X 4849 0 0 C GORDON HOWIE DIRECTOR 1.00 1.00 X 4349 0 0 MARIO CARRERA DIRECTOR 1/1-2/28/22 1.00 0.00 X 3849 0 0 NGUYEN-VU PHAM DIRECTOR 1.00 3.00 X 2500 0 0 MICHAEL FORDYCE CHAIR 3.00 0.00 X X 2000 0 0 SISTER MAUREEN HALL SCL DIRECTOR 1.00 0.00 X 699 0 0 MARY BETH MIKOLS DIRECTOR 1.00 0.00 X 699 0 0 ALAN YORDY DIRECTOR 1.00 0.00 X 699 0 0 SHERYL MANNING DIRECTOR 1/1-6/13/22 1.00 0.00 X 0 0 0 MICHAEL SALEM MD DIRECTOR 1.00 3.00 X 0 0 0 RITA TURLEY DIRECTOR 1.00 0.00 X 0 0 0 BARTH WHITHAM DIRECTOR 1.00 0.00 X 0 0 0 33807974 9523552 9678992 774 0 1 0 BARTON MALOW-HASELDEN 26500 AMERICAN DRIVE SOUTHFIELD MI 48034 CONSTRUCTION SERVICES 192754907 RIGHTSOURCING INC 999 STEWART AVENUE SUITE 100 BETHPAGE NY 11714 CONTRACT LABOR 162636947 SAUNDERS EXPRESS LLC 86 INVERNESS PLACE NORTH ENGLEWOOD CO 80112 CONSTRUCTION SERVICES 20331943 MIDTOWN INPATIENT MEDICINE LLC 835 E 18TH AVE STE 110 DENVER CO 80218 MEDICAL SERVICES 19026308 ROCKY MOUNTAIN PRIMARY CARE 7625 W 92ND AVE WESTMINSTER CO 80021 MEDICAL SERVICES 18577169 286 24890959 5000 24895959 MANAGEMENT SERVICES 560000 481215832 481125832 90000 PATIENT SERVICE 440000 290008976 288579727 1429249 JOINT VENTURES-MEDICAL 620000 995438 995438 PROGRAM RELATED INVEST 620000 969383 969383 773189629 61118095 180284 60937811 40333 0 40333 40333 40333 9894564 4825330 9717222 -4825330 177342 -4647988 -4647988 VENDOR ADMINISTRATION 900000 6626281 6626281 6626281 861222309 778296661 1699533 56330156 10155110 10155110 31612910 1044309 30568601 342524032 324233652 18290380 14667489 11972561 2694928 32349219 31895571 453648 22661353 22443254 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HEALTHCARE 810231785 3 0 0 0 SAINT JOSEPH HOSPITAL INC 840417134 3 0 0 0 SCL HEALTH - FRONT RANGE INC 841103606 3 0 247517 0 ST MARY'S HOSPITAL AND MEDICAL CENTER INC 840425720 3 0 0 0 SCL HEALTH - MONTANA 810232124 3 0 8900000 0 HOLY ROSARY HEALTHCARE 810231792 3 0 0 0 CARITAS CLINICS INC 481009910 3 0 419184 0 MOUNT ST VINCENT HOME 840405260 10 0 500000 0 BRIGHTON COMMUNITY HOSPITAL ASSOCIATION 840482695 3 0 0 0 SCL HEALTH RESEARCH INSTITUTE INC 852014794 3 0 0 0 MARIAN CLINIC INC 481046905 3 0 47568 0 11 10114269 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 SCHEDULE A, PART IV, SECTION A, LINE 1 SISTERS OF CHARITY OF LEAVENWORTH HEALTH SYSTEM, INC. (SCLHS) IS THE PARENT OF EACH OF ITS SUPPORTED ORGANIZATIONS AND CONTROLS THEM AS PART OF AN INTEGRATED HEALTH SYSTEM. EACH SUPPORTED ORGANIZATION IS CONTROLLED BY SCLHS. A CLOSE AND HISTORIC ORGANIZATIONAL RELATIONSHIP ENSURES THAT SCLHS AND ITS SUPPORTED ORGANIZATIONS SHARE A SUBSTANTIAL IDENTITY OF INTERESTS. THE SUPPORTED CLASS ALSO INCLUDES GOVERNMENT ORGANIZATIONS AND OTHER QUALIFIED NON-PROFIT ORGANIZATIONS UNDER 501(C)(3) THAT SHARE A SIMILAR MISSION OF IMPROVING THE HEALTH OF PEOPLE AND COMMUNITIES SERVED. SCHEDULE A, PART IV, SECTION A, LINE 6 SUPPORT WAS PROVIDED TO MEDICAL AND OTHER CHARITABLE ORGANIZATIONS NOT CONSIDERED SUPPORTED ORGANIZATIONS. HOWEVER, THESE INSTITUTIONS ARE SUPPORTING MEDICAL AND OTHER ACTIVITIES BENEFITING THE COMMUNITIES SERVED BY SUPPORTED ORGANIZATIONS. AMOUNTS GRANTED ARE INSIGNIFICANT TO THE OVERALL OPERATIONS OF SCLHS. SCHEDULE A, PART IV, SECTION C, LINE 1 EACH OF THE SUPPORTED ORGANIZATIONS IS PART OF AN INTEGRATED HEALTH SYSTEM. SCLHS' MEMBERS, INTERMOUNTAIN HEALTH CARE, INC. AND THE MEMBERS OF LEAVEN MINISTRIES, DIRECTLY CONTROL SCLHS AND INDIRECTLY CONTROL ALL OF THE SCLHS SUBSIDIARIES. RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 0 0 0 0 0 0 0 0 1 480978 480978 0 PART II-B, LINE 1: LOBBYING EXPENSES OF $81,715 WERE DERIVED AS A PERCENTAGE OF DUES PAID TO THE AMERICAN HOSPITAL ASSOCIATION. ADDITIONAL LOBBYING EXPENSES OF $399,263 WERE DERIVED FROM FEES FOR ADVOCACY SERVICES RELATED TO COLORADO AND MONTANA LEGISLATIVE ACTIVITIES. 2000000 2000000 2000000 2000000 2000000 2000000 2000000 2000000 2000000 2000000 0.00000 1.00000 0.00000 0 0 15159976 15159976 27067515 3969481 23098034 89100528 33156125 55944403 18691604 1602434 17089170 111291583 HEDGE FUNDS 127158474 F JOINT VENTURE - NORTHERN ROCKIES HEALTHCARE ALLIANCE, LLC 4773 F JOINT VENTURE - DENVER WEST ENDOSCOPY CTR, LLC 249331 F JOINT VENTURE - E + PET IMAGING X, LP -7179 F JOINT VENTURE - LUTHERAN CAMPUS ASC, LLC 2868749 F JOINT VENTURE - SCLH-GI ENDOSCOPY CENTER HOLDINGS, LLC 588343 F JOINT VENTURE - SCLTDI JV, LLC 13403303 F JOINT VENTURE - THE REHABILITATION HOSPITAL OF MONTANA, LLC 1872786 F JOINT VENTURE - RED ROCKS RADIATION ONCOLOGY MANAGEMENT, LLC -28204 F JOINT VENTURE - SCL HEALTH PARTNERS, LLC 388373 F JOINT VENTURE - SJ EAST CAMPUS ASC, LLC 615573 F OPPORTUNISTIC INVESTMENTS 171998798 F REAL RETURN INVESTMENTS 236647303 F SWEEP ACCOUNTS 360730266 F VHA STOCK INVESTMENT 646857 F 917137546 NOTES REC - INTERCOMPANY 195617113 C 195617113 INTERCOMPANY PAYABLE 950740769 DEFERRED COMPENSATION PLAN PAYABLE 40519310 INTEREST RATE SWAP PAYABLE 9971 BROKER PAYABLE 67308243 ACCRUED LIABILITY - OPERATING LEASE 30948155 ACCRUED LIABILITY - FINANCING LEASE 3588218 GUARANTEE FEE PAYABLE 2610168 1095724834 PART V, LINE 4: SCLHS HAS A PERMANENT ENDOWMENT IN THE AMOUNT OF $2,000,000. THE EARNINGS FROM THE PERMANENT ENDOWMENT ARE TO BE USED FOR EDUCATIONAL PURPOSES AS DETERMINED BY SCLHS MANAGEMENT. CENTRAL AMERICA/CARIBBEAN 0 0 PROGRAM SERVICES CAPTIVE INSURANCE PREMIUM 18749869 EUROPE/CARIBBEAN 0 0 INVESTMENTS, PROGRAM-RELATED 7347032 0 0 0 0 0 0 26096901 0 26096901 1 0 1 1 1 0 PART III ACCOUNTING METHOD: SCHEDULE F, PART I, LINE 3 INVESTMENTS REPORTED IN SCHEDULE F ARE ACCOUNTED FOR ON THE ACCRUAL BASIS OF ACCOUNTING. SCLHS' EXPENDITURES (PREMIUMS PAID) FOR ITS CAPTIVE INSURANCE PREMIUMS WERE $18,749,869 NET OF PREMIUM DISCOUNTS. 1 1 X 1 X 250.000000000000 1 X 1 1 0 1 1 2469809 1436121 1033688 0.00110 38862804 37388199 1474605 0.00160 41332613 38824320 2508293 0.00270 316000 316000 0.00030 7610452 3268178 4342274 0.00460 7926452 3268178 4658274 0.00490 49259065 42092498 7166567 0.00760 1 1782255 32139328 76526395 -44387067 X 1 1 1 DENVER WEST ENDOSCOPY CENTER LLC OUTPATIENT ENDOSCOPY SERVICES 0.51000 0.00000 0.49000 2 LUTHERAN CAMPUS ASC LLC OUTPATIENT SURGERY 0.30780 0.00000 0.37190 3 SCLH-GI ENDOSCOPY CENTER HOLDINGS LLC ENDOSCOPY SERVICES 0.51000 0.00000 0.49000 4 NORTHGLENN ENDOSCOPY CENTER LLC ENDOSCOPY SERVICES 0.51000 0.00000 0.49000 5 SJ EAST CAMPUS ASC LLC AMBULATORY SURGICAL 0.24990 0.00000 0.49000 6 GALLATIN VALLEY SURGERY CENTER LLC AMBULATORY SURGICAL 0.51000 0.00000 0.49000 1 1 THE REHABILITATION HOSPITAL OF MONTANA LLC 3572 HESPER ROAD BILLINGS MT 59102 WWW.REHABHOSPITALOFMONTANA.COM LICENSE# 13564 X X REHABILITATION HOSPITAL OF MONTANA LLC 1 0 0 1 X X X X X X X X 21 1 1 1 1 X SEE PART V, SECTION C X 1 22 1 SEE PART V, SECTION C 0 1 X 250.000000000000 400.000000000000 X X 1 1 X X X X 1 X SEE PART V, SECTION C X SEE PART V, SECTION C X SEE PART V, SECTION C X X X X X X 1 X 0 X X X X 1 X 0 0 REHABILITATION HOSPITAL OF MONTANA, LLC PART V, SECTION B, LINE 5: A SURVEY WAS CONDUCTED WITH KEY INFORMANTS AT THE END OF JULY 2021. SURVEYS WERE EMAILED TO 29 KEY STAKEHOLDERS REPRESENTING HEALTHCARE, PUBLIC HEALTH, STATE HEALTH AGENCIES, AND STATEWIDE NON-PROFIT ORGANIZATIONS. THE SURVEY INSTRUMENT INCLUDED 8 QUESTIONS FOCUSED ON GENERAL HEALTH STATUS, SERIOUS HEALTH CONCERNS, NEEDS FOR A HEALTHY COMMUNITY INCLUDING SOCIAL DETERMINANTS OF HEALTH, SERVICES OF THE REHABILITATION HOSPITAL OF MONTANA, LLC, BARRIERS TO HEALTH FOR PATIENTS, AND OPPORTUNITIES TO ADDRESS HEALTH NEEDS. 15 KEY STAKEHOLDERS COMPLETED THE SURVEY, A 51% RESPONSE RATE. REHABILITATION HOSPITAL OF MONTANA, LLC PART V, SECTION B, LINE 6A: THE CHNA WAS CONDUCTED WITH PARTNERING HOSPITAL FACILITIES BILLINGS CLINIC, KINDRED HEALTHCARE, AND SCL HEALTH - MONTANA D/B/A ST. VINCENT HEALTHCARE. REHABILITATION HOSPITAL OF MONTANA, LLC PART V, SECTION B, LINE 6B: RIVERSTONE HEALTH (YELLOWSTONE COUNTY PUBLIC HEALTH DEPARTMENT) AND THE HEALTHY BY DESIGN COMMUNITY HEALTH IMPROVEMENT MANAGER ASSISTED WITH CONDUCTING THE 2021 CHNA.PART V, SECTION B, LINE 7A: WEBSITEHTTPS://WWW.REHABHOSPITALOFMONTANA.COM/PATIENT-EXPERIENCE/COMMUNITY-HEALTH-NEEDS-ASSESSMENTPART V, SECTION B, LINE 10A: WEBSITEHTTPS://WWW.REHABHOSPITALOFMONTANA.COM/PATIENT-EXPERIENCE/COMMUNITY-HEALTH-NEEDS-ASSESSMENT REHABILITATION HOSPITAL OF MONTANA, LLC PART V, SECTION B, LINE 11: NINE AREAS OF NEED WERE IDENTIFIED IN THE CHNA THROUGH REVIEW OF THE PRIMARY DATA, SECONDARY DATA, AND KEY INFORMANT RESPONSES. THE NINE NEEDS IDENTIFIED INCLUDED: ACCESS TO HEALTHCARE SERVICES, BRAIN INJURY, HEALTHY BEHAVIORS AND LIFESTYLE (PHYSICAL ACTIVITY, NUTRITION, WEIGHT), INJURIES INCLUDING FALLS AND TRAUMA, MENTAL HEALTH, TOBACCO USE, SOCIOECONOMIC BARRIERS, STROKE, AND SUBSTANCE USE. A GROUP OF STAKEHOLDERS REPRESENTING THE REHABILITATION HOSPITAL OF MONTANA, LLC, BILLINGS CLINIC, KINDRED HEALTH, AND SCL HEALTH - MONTANA MET TO EVALUATE AND PRIORITIZE NEEDS ALONG TWO CRITERIA: SCOPE AND SEVERITY AND ABILITY TO IMPACT. FROM THIS PROCESS, THREE HEALTH NEED PRIORITIES EMERGED: ACCESS TO HEALTHCARE SERVICES, STROKE AND BRAIN INJURY, AND FALLS PREVENTION.ACCESS TO HEALTHCARE SERVICES: EFFORTS FOCUS ON INCREASING PROVIDER AWARENESS OF SERVICES THROUGH CLINICAL LIAISON AND MEDICAL DIRECTOR OUTREACH AND INCREASING WORKFORCE CAPACITY THROUGH HEALTHCARE STUDENT ROTATIONS FOR THERAPY STUDENTS, CERTIFIED NURSING ASSISTANTS, AND NURSING STUDENTS. IN 2022, THIRTEEN OUTREACH SESSIONS WERE PROVIDED TO TEN DIFFERENT COMMUNITIES THAT REACHED AN ESTIMATED 358 PROVIDERS, THERAPISTS, AND CASE MANAGERS. THE REHABILITATION HOSPITAL OF MONTANA, LLC PROVIDED A SUBJECT MATTER EXPERT TO SPEAK AT THE POST-ACUTE STROKE CONFERENCE. ONE THERAPY STUDENT COMPLETED CLINICAL ROTATIONS IN 2022. BRAIN INJURY AND STROKE: EFFORTS FOCUS ON PROVIDING COMMUNITY EDUCATION TO INCREASE AWARENESS OF SIGNS OF STROKE AND COMMUNITY EDUCATION ON BRAIN INJURY. STROKE AWARENESS INCLUDED SOCIAL MEDIA FACEBOOK POSTS AND A COMMUNITY AND MEDIA EVENT. THE REHABILITATION HOSPITAL OF MONTANA, LLC HOSTED A MONTHLY TRAUMATIC BRAIN INJURY SUPPORT GROUP IN PARTNERSHIP WITH THE MONTANA BRAIN ALLIANCE. THE SUPPORT GROUPS BEGAN IN NOVEMBER 2022. STAFF FROM THE REHABILITATION HOSPITAL OF MONTANA, LLC SERVE AS SUBJECT MATTER EXPERTS FOR THE SUPPORT GROUP. BRAIN INJURY AWARENESS INCLUDED SOCIAL MEDIA FACEBOOK POSTS. FALLS PREVENTION: EFFORTS FOCUS ON PROVIDING COMMUNITY HEALTH EDUCATION, IMPLEMENTING A FALL SCALE DESIGNED FOR THE REHABILITATION POPULATION, AND COLLABORATING WITH COMMUNITY EFFORTS FOR FALLS PREVENTION. SOCIAL MEDIA POSTS INCLUDED TIPS TO PREVENT FALLS WHILE AT HOME AND IN THE COMMUNITY.THE REHABILITATION HOSPITAL OF MONTANA, LLC RECOGNIZES THAT THE OTHER HEALTH NEEDS AND INDICATORS IDENTIFIED IN THE SJH COMMUNITY HEALTH NEEDS ASSESSMENT PROCESS ARE IMPORTANT FOR THE HOSPITAL AND THE COMMUNITIES IT SERVES. NUMEROUS OTHER ORGANIZATIONS ARE CONCURRENTLY ADDRESSING MANY OF THESE REMAINING NEEDS. THEREFORE, DUE TO LIMITED EXPERTISE AND RESOURCES THE REHABILITATION HOSPITAL OF MONTANA, LLC HAS NARROWED ITS TOP PRIORITIES TO THE FOCUS AREAS LISTED ABOVE. PART V, SECTION B, LINES 16A, 16B, 16C, FAP APPLICATION WEBSITE: HTTPS://WWW.REHABHOSPITALOFMONTANA.COM/PATIENT-EXPERIENCE/FINANCIAL-ASSISTANCE 143 1 - CANCER CENTERS OF COLORADO LLC 500 ELDORADO BLVD SUITE 4300 BROOMFIELD CO 80021 CANCER CENTER 2 - GS CAMPUS ASC LLC 500 ELDORADO BLVD SUITE 4300 BROOMFIELD CO 80021 SURGERY CENTER 3 - RED ROCKS RADIATION ONCOLOGY MANAGEMENT 400 INDIANA ST SUITE 220 GOLDEN CO 80401 CANCER CENTER 4 - LUTHERAN CAMPUS ASC LLC 3455 LUTHERAN PKWY STE 150 WHEATRIDGE CO 80033 OUTPATIENT SURGERY 5 - SJ EAST CAMPUS ASC LLC 1830 FRANKLIN ST SUITE 200 DENVER CO 80218 SURGERY CENTER 6 - DENVER WEST ENDOSCOPY CENTER LLC 382 S ARTHUR AVENUE LOUISVILLE CO 80027 OUTPATIENT ENDOSCOPY 7 - NORTHGLENN ENDOSCOPY CENTER LLC 11900 GRANT STREET NORTHGLENN CO 80233 ENDOSCOPY SERVICES 8 - TOUCHSTONE MEDICAL IMAGING - AURORA 3055 SOUTH PARKER RD BLDG A SUITE 103 AURORA CO 80014 RADIOLOGY SERVICES 9 - TOUCHSTONE MEDICAL IMAGING - CASTLE ROCK 3911 AMBROSIA ST CASTLE ROCK CO 80109 RADIOLOGY SERVICES 10 - TOUCHSTONE MEDICAL IMAGING - DRY CREEK 125 INVERNESS DR EAST SUITE 140 ENGLEWOOD CO 80112 RADIOLOGY SERVICES 11 - TOUCHSTONE MEDICAL IMAGING - LAFAYETTE 390 EMPIRE ROAD SUITE 102 LAFAYETTE CO 80026 RADIOLOGY SERVICES 12 - TOUCHSTONE MEDICAL IMAGING - LAKEWOOD 14062 DENVER WEST PKWY BLDG 52 SUITE 1 LAKEWOOD CO 80401 RADIOLOGY SERVICES 13 - TOUCHSTONE MEDICAL IMAGING - MAMMOGRAPHY 7615 W 38TH AVENUE SUITE B-107 WHEAT RIDGE CO 80033 RADIOLOGY SERVICES 14 - TOUCHSTONE MEDICAL IMAGING - RED ROCKS 400 INDIANA ST SUITE 210 GOLDEN CO 80401 RADIOLOGY SERVICES 15 - TOUCHSTONE MEDICAL IMAGING - SUPERIOR 3 SUPERIOR WAY SUITE 150 SUPERIOR CO 80027 RADIOLOGY SERVICES 16 - TOUCHSTONE MEDICAL IMAGING - THORNTON 12021 PENNSYLVANIA ST SUITE 106 THORNTON CO 80241 RADIOLOGY SERVICES 17 - TOUCHSTONE MEDICAL IMAGING - UPTOWN 1007 E COLFAX AVE CO CO 80218 RADIOLOGY SERVICES 18 - TOUCHSTONE MEDICAL IMAGING - WHEAT RIDGE 7615 WEST 38TH AVENUE SUITE B115 WHEAT RIDGE CO 80033 RADIOLOGY SERVICES 19 - TOUCHSTONE MEDICAL IMAGING - BILLINGS 1739 SPRING CREEK LANE BILLINGS MT 59106 RADIOLOGY SERVICES 20 - SCL FRONT RANGE HOME HEALTH LLC 8300 W 38TH AVENUE WHEAT RIDGE CO 80033 HOME HEALTH 21 - SCL HEALTH HEART & VASCULAR INSTITUTE - BI 2900 12TH AVE N BILLINGS MT 59101 OUTPATIENT PHYSICIAN CLINIC 22 - SCL HEALTH MEDICAL GROUP - DOWNTOWN INTERN 2900 12TH AVE N BILLINGS MT 591017588 OUTPATIENT PHYSICIAN CLINIC 23 - SCL HEALTH ST VINCENT EMERGENCY MEDICINE 1233 N 30TH ST BILLINGS MT 591010127 OUTPATIENT PHYSICIAN CLINIC 24 - SCL HEALTH MEDICAL GROUP - MONTANA ORTHOPE 435 S CRYSTAL ST BUTTE MT 597011506 OUTPATIENT PHYSICIAN CLINIC 25 - CANCER CENTERS OF COLORADO - SLOAN'S LAKE 1601 LOWELL BLVD STE 150 DENVER CO 802041545 OUTPATIENT PHYSICIAN CLINIC 26 - SCL HEALTH MEDICAL GROUP - BROADWATER 2019 BROADWATER AVE BILLINGS MT 591024810 OUTPATIENT PHYSICIAN CLINIC 27 - SCL HEALTH MEDICAL GROUP - BROADWATER WALK 2019 BROADWATER AVE BILLINGS MT 591024810 OUTPATIENT PHYSICIAN CLINIC 28 - SCL HEALTH MEDICAL GROUP - HEIGHTS 32 WICKS LN BILLINGS MT 591053810 OUTPATIENT PHYSICIAN CLINIC 29 - SCL HEALTH MEDICAL GROUP - BUTTE 435 S CRYSTAL ST BUTTE MT 59701 OUTPATIENT PHYSICIAN CLINIC 30 - SCL HEALTH HEART & VASCULAR INSTITUTE - BI 2900 12TH AVE N BILLINGS MT 591017504 OUTPATIENT PHYSICIAN CLINIC 31 - SCL HEALTH MEDICAL GROUP - BILLINGS GASTRO 1144 N BROADWAY BILLINGS MT 591010110 OUTPATIENT PHYSICIAN CLINIC 32 - SCL HEALTH MEDICAL GROUP - LAUREL 1035 1ST AVE LAUREL MT 590442119 OUTPATIENT PHYSICIAN CLINIC 33 - SCL HEALTH MEDICAL GROUP - N 27TH WALK-IN 1027 N 27TH STREET BILLINGS MT 591010701 OUTPATIENT PHYSICIAN CLINIC 34 - SCL HEALTH MEDICAL GROUP - BILLINGS UROLOG 2900 12TH AVE N BILLINGS MT 591017502 OUTPATIENT PHYSICIAN CLINIC 35 - SCL HEALTH MEDICAL GROUP - NORTH SHILOH 2223 MISSION WAY BILLINGS MT 591020160 OUTPATIENT PHYSICIAN CLINIC 36 - SCL HEALTH ST JAMES EMERGENCY PHYSICIANS 400 S CLARK ST BUTTE MT 59701 OUTPATIENT PHYSICIAN CLINIC 37 - SCL HEALTH MEDICAL GROUP - BILLINGS SLEEP 2900 12TH AVE N BILLINGS MT 591010127 OUTPATIENT PHYSICIAN CLINIC 38 - SCL HEALTH MEDICAL GROUP - WEST GRAND 2750 GRAND AVE BILLINGS MT 591022629 OUTPATIENT PHYSICIAN CLINIC 39 - SCL HEALTH MEDICAL GROUP - BILLINGS DIABET 2900 12TH AVE N BILLINGS MT 591017588 OUTPATIENT PHYSICIAN CLINIC 40 - SCL HEALTH MEDICAL GROUP - BILLINGS PAIN C 2900 12TH AVE N BILLINGS MT 591017506 OUTPATIENT PHYSICIAN CLINIC 41 - SCL HEALTH MEDICAL GROUP - BILLINGS MIDWIF 2900 12TH AVE N BILLINGS MT 591017506 OUTPATIENT PHYSICIAN CLINIC 42 - SCL HEALTH MEDICAL GROUP - HEIGHTS WALK-IN 32 WICKS LN BILLINGS MT 591053810 OUTPATIENT PHYSICIAN CLINIC 43 - SCL HEALTH MEDICAL GROUP - BILLINGS DERMAT 2900 12TH AVE N BILLINGS MT 591017513 OUTPATIENT PHYSICIAN CLINIC 44 - SCL HEALTH ST VINCENT INTENSIVISTS 1233 N 30TH ST BILLINGS MT 591010127 OUTPATIENT PHYSICIAN CLINIC 45 - SCL HEALTH MEDICAL GROUP - BILLINGS NEPHRO 2900 12TH AVE N BILLINGS MT 591017508 OUTPATIENT PHYSICIAN CLINIC 46 - SCL HEALTH ST VINCENT NEONATOLOGY 1233 N 30TH ST BILLINGS MT 591010127 OUTPATIENT PHYSICIAN CLINIC 47 - SCL HEALTH MEDICAL GROUP - BUTTE OB-GYN 305 W PORPHYRY BUTTE MT 59701 OUTPATIENT PHYSICIAN CLINIC 48 - SCL HEALTH MEDICAL GROUP - BUTTE UROLOGY 305 W PORPHYRY BUTTE MT 59701 OUTPATIENT PHYSICIAN CLINIC 49 - SCL HEALTH MEDICAL GROUP - BUTTE DOWNTOWN 3636 HARRISON AVE BUTTE MT 59701 OUTPATIENT PHYSICIAN CLINIC 50 - SCL HEALTH MEDICAL GROUP - BILLINGS TRANSI 2223 MISSION WAY BILLINGS MT 59102 OUTPATIENT PHYSICIAN CLINIC 51 - SCL HEALTH MEDICAL GROUP - HARDIN 16 N MILES HARDIN MT 590342356 OUTPATIENT PHYSICIAN CLINIC 52 - SCL HEALTH MEDICAL GROUP BUTTE EXPRESS CAR 435 S CRYSTAL ST BUTTE MT 59701 OUTPATIENT PHYSICIAN CLINIC 53 - SCL HEALTH MEDICAL GROUP - RED LODGE 10 ROBINSON LN RED LODGE MT 590680070 OUTPATIENT PHYSICIAN CLINIC 54 - SCL HEALTH MEDICAL GROUP - BOZEMAN 711 W MAIN ST BOZEMAN MT 597153356 OUTPATIENT PHYSICIAN CLINIC 55 - SCL HEALTH MEDICAL GROUP - BILLINGS BEHAVI 2900 12TH AVE N BILLINGS MT 591017516 OUTPATIENT PHYSICIAN CLINIC 56 - SCL HEALTH MEDICAL GROUP - BILLINGS PEDIAT 1232 N 30TH BILLINGS MT 591010128 OUTPATIENT PHYSICIAN CLINIC 57 - SCL HEALTH MEDICAL GROUP - BUTTE SURGICAL 435 S CRYSTAL ST BUTTE MT 59701 OUTPATIENT PHYSICIAN CLINIC 58 - SCL HEALTH MEDICAL GROUP - BILLINGS MATERN 2900 12TH AVE N BILLINGS MT 591017504 OUTPATIENT PHYSICIAN CLINIC 59 - SCL HEALTH MEDICAL GROUP - LEWISTOWN 70 CATTAIL DR LEWISTOWN MT 594574123 OUTPATIENT PHYSICIAN CLINIC 60 - SCL HEALTH MEDICAL GROUP - LAUREL WALK-IN 331 S WASHINGTON ST LAUREL MT 59044 OUTPATIENT PHYSICIAN CLINIC 61 - SCLHBI WOUND CARE 2900 12TH AVE N BILLINGS MT 59101 OUTPATIENT PHYSICIAN CLINIC 62 - SCL HEALTH MEDICAL GROUP - MONTANA ORTHOPE 435 S CRYSTAL ST BUTTE MT 597011506 OUTPATIENT PHYSICIAN CLINIC 63 - ST JAMES HEALTHCARE - CANCER CENTERS OF MO 400 S CLARK ST BUTTE MT 59701 OUTPATIENT PHYSICIAN CLINIC 64 - SCL HEALTH MEDICAL GROUP - BILLINGS WEIGHT 2900 12TH AVE N BILLINGS MT 591017588 OUTPATIENT PHYSICIAN CLINIC 65 - SCL HEALTH MEDICAL GROUP - BUTTE ENT 435 S CRYSTAL ST BUTTE MT 59701 OUTPATIENT PHYSICIAN CLINIC 66 - SCL HEALTH MEDICAL GROUP - BILLINGS OCCUPA 2019 BROADWATER AVE BILLINGS MT 591024810 OUTPATIENT PHYSICIAN CLINIC 67 - SCL HEALTH MEDICAL GROUP - BUTTE DOWNTOWN 3636 HARRISON AVE BUTTE MT 59701 OUTPATIENT PHYSICIAN CLINIC 68 - ST JAMES HEALTHCARE - CANCER CENTERS OF MO 400 S CLARK ST BUTTE MT 59701 OUTPATIENT PHYSICIAN CLINIC 69 - SCL HEALTH MEDICAL GROUP - CODY 720 LINDSAY LN CODY WY 824144103 OUTPATIENT PHYSICIAN CLINIC 70 - SCL HEALTH HEART & VASCULAR INSTITUTE - BU 435 S CRYSTAL ST BUTTE MT 59701 OUTPATIENT PHYSICIAN CLINIC 71 - SCL HEALTH MEDICAL GROUP - BOULDER 214 S MAIN ST BOULDER MT 59632 OUTPATIENT PHYSICIAN CLINIC 72 - SCL HEALTH MEDICAL GROUP - LOCKWOOD 2054 HWY 87 EAST BILLINGS MT 591016699 OUTPATIENT PHYSICIAN CLINIC 73 - SCL HEALTH ST VINCENT PEDIATRIC HOSPITALIS 1233 N 30TH ST BILLINGS MT 591075200 OUTPATIENT PHYSICIAN CLINIC 74 - SCL HEALTH MEDICAL GROUP - PEDIATRIC SPECI 1232 N 30TH BILLINGS MT 59101 OUTPATIENT PHYSICIAN CLINIC 75 - SCL HEALTH MEDICAL GROUP WHITEHALL PHYSICA 309 EAST LEGION WHITEHALL MT 59759 OUTPATIENT PHYSICIAN CLINIC 76 - SCL HEALTH MEDICAL GROUP - ABSAROKEE 55 N MONTANA ABSAROKEE MT 590010425 OUTPATIENT PHYSICIAN CLINIC 77 - SCL HEALTH ST VINCENT PALLIATIVE CARE 1233 N 30TH ST BILLINGS MT 59101 OUTPATIENT PHYSICIAN CLINIC 78 - SCL HEALTH ST VINCENT NEUROLOGY 2600 WILSON ST MILES CITY MT 59301 OUTPATIENT PHYSICIAN CLINIC 79 - SCL HEALTH MEDICAL GROUP BUTTE NEUROLOGY 435 S CRYSTAL ST BUTTE MT 59701 OUTPATIENT PHYSICIAN CLINIC 80 - SCL HEALTH MEDICAL GROUP - PEDIATRIC SPECI 1232 N 30TH BILLINGS MT 591010128 OUTPATIENT PHYSICIAN CLINIC 81 - SCL HEALTH MEDICAL GROUP - BILLINGS PHYSIA 2900 12TH AVE N BILLINGS MT 591010136 OUTPATIENT PHYSICIAN CLINIC 82 - SCL HEALTH- ST VINCENT NEUROSURGERY 2600 WILSON MILES CITY MT 59301 OUTPATIENT PHYSICIAN CLINIC 83 - SCL HEALTH ST VINCENT NEUROLOGY 621 3RD ST S GLASGOW MT 59230 OUTPATIENT PHYSICIAN CLINIC 84 - SCL HEALTH MEDICAL GROUP -MILES CITY 2600 WILSON ST MILES CITY MT 59301 OUTPATIENT PHYSICIAN CLINIC 85 - SCL HEALTH HEART & VASCULAR INSTITUTE - MI 2600 WILSON ST MILES CITY MT 59301 OUTPATIENT PHYSICIAN CLINIC 86 - SCL HEALTH ST VINCENT NEUROLOGY 711 W MAIN ST BOZEMAN MT 59715 OUTPATIENT PHYSICIAN CLINIC 87 - SCL HEALTH MEDICAL GROUP - BOULDER 214 S MAIN BOULDER MT 59632 OUTPATIENT PHYSICIAN CLINIC 88 - SCL HEALTH HEART & VASCULAR INSTITUTE - BI 711 W MAIN ST BOZEMAN MT 597153356 OUTPATIENT PHYSICIAN CLINIC 89 - SCL HEALTH MEDICAL GROUP - BILLINGS UROLOG 181 12TH AVE SW SIDNEY MT 59270 OUTPATIENT PHYSICIAN CLINIC 90 - SCL HEALTH ST VINCENT NEUROSURGERY 621 3RD STREET SOUTH GLASGOW MT 59230 OUTPATIENT PHYSICIAN CLINIC 91 - SCL HEALTH HEART & VASCULAR INSTITUTE - SI 216 14TH AVE SW SIDNEY MT 59270 OUTPATIENT PHYSICIAN CLINIC 92 - SCL HEALTH MEDICAL GROUP - MILES CITY SLEE 2600 WILSON ST MILES CITY MT 59301 OUTPATIENT PHYSICIAN CLINIC 93 - SCLHBI WOUND MILES CITY 2600 WILSON ST MILES CITY MT 59301 OUTPATIENT PHYSICIAN CLINIC 94 - SCL HEALTH HEART & VASCULAR INSTITUTE - CO 424 YELLOWSTONE AVE CODY WY 824144103 OUTPATIENT PHYSICIAN CLINIC 95 - SCL HEALTH ST VINCENT NEUROLOGY 181 12TH AVE SW SIDNEY MT 59270 OUTPATIENT PHYSICIAN CLINIC 96 - SCL HEALTH MEDICAL GROUP - SIDNEY MATERNAL 216 14TH AVE SW SIDNEY MT 59270 OUTPATIENT PHYSICIAN CLINIC 97 - SCL HEALTH HEART & VASCULAR INSTITUTE - BO 711 W MAIN ST BOZEMAN MT 59715 OUTPATIENT PHYSICIAN CLINIC 98 - SCL HEALTH HEART & VASCULAR INSTITUTE - LE 70 CATTAIL DR LEWISTOWN MT 59457 OUTPATIENT PHYSICIAN CLINIC 99 - SCL HEALTH MEDICAL GROUP - BILLINGS UROLOG 720 LINDSAY LN CODY WY 82414 OUTPATIENT PHYSICIAN CLINIC 100 - SCL HEALTH MEDICAL GROUP - CODY NEPH 720 LINDSAY LN CODY WY 824144103 OUTPATIENT PHYSICIAN CLINIC 101 - SCL HEALTH MEDICAL GROUP - SHERIDAN SHERIDAN MEMORIAL HOSPITAL WOMENS CLINIC SHERIDAN WY 82801 OUTPATIENT PHYSICIAN CLINIC 102 - SCL HEALTH ST VINCENT HOSPITALISTS 1233 N 30TH ST BILLINGS MT 591010127 OUTPATIENT PHYSICIAN CLINIC 103 - SCL HEALTH HEART & VASCULAR INSTITUTE - RE 10 ROBINSON LANE RED LODGE MT 590689010 OUTPATIENT PHYSICIAN CLINIC 104 - SCL HEALTH MEDICAL GROUP - BOULDER OBGYN 214 S MAIN ST BOULDER MT 59701 OUTPATIENT PHYSICIAN CLINIC 105 - SCL HEALTH MEDICAL GROUP - BILLINGS UROLOG 202 PROSPECT GLENDIVE MT 59330 OUTPATIENT PHYSICIAN CLINIC 106 - SCL HEALTH MEDICAL GROUP - HARDIN SLEEP AN 16 N MILES AVE HARDIN MT 59034 OUTPATIENT PHYSICIAN CLINIC 107 - SCL HEALTH ST VINCENT NEUROSURGERY 711 W MAIN ST BOZEMAN MT 59715 OUTPATIENT PHYSICIAN CLINIC 108 - SCL HEALTH MEDICAL GROUP - MONTANA ORTHOPE 2442 WINNE AVE HELENA MT 596014921 OUTPATIENT PHYSICIAN CLINIC 109 - SCL HEALTH MEDICAL GROUP - BOZEMAN ENT 711 W MAIN ST BOZEMAN MT 597153356 OUTPATIENT PHYSICIAN CLINIC 110 - SCL HEALTH MEDICAL GROUP - BILLINGS MIDWIF 16 N MILES AVE HARDIN MT 59034 OUTPATIENT PHYSICIAN CLINIC 111 - SCL HEALTH ST VINCENT NEUROLOGY 70 CATTAIL DRIVE LEWISTOWN MT 59457 OUTPATIENT PHYSICIAN CLINIC 112 - SCL HEALTH MEDICAL GROUP - DEER LODGE OB 1100 HOLLENBECK LANE DEER LODGE MT 59722 OUTPATIENT PHYSICIAN CLINIC 113 - SCL HEALTH MEDICAL GROUP - LEWISTOWN 70 CATTAIL DR LEWISTOWN MT 59457 OUTPATIENT PHYSICIAN CLINIC 114 - SCL HEALTH MEDICAL GROUP - BILLINGS UROLOG 1106 BIGHORN AVE WORLAND WY 82401 OUTPATIENT PHYSICIAN CLINIC 115 - SCL HEALTH MEDICAL GROUP - BOZEMAN 711 W MAIN ST BOZEMAN MT 59715 OUTPATIENT PHYSICIAN CLINIC 116 - SCL HEALTH HEART & VASCULAR INSTITUTE - MI 2600 WILSON ST MILES CITY MT 59301 OUTPATIENT PHYSICIAN CLINIC 117 - SCL HEALTH MEDICAL GROUP - BILLINGS UROLOG 2600 WILSON ST MILES CITY MT 59301 OUTPATIENT PHYSICIAN CLINIC 118 - SCL HEALTH MEDICAL GROUP - WORLAND 1106 BIG HORN AVE WORLAND WY 824012803 OUTPATIENT PHYSICIAN CLINIC 119 - SCL HEALTH ST VINCENT NEUROSURGERY 181 12TH AVE SW SIDNEY MT 59270 OUTPATIENT PHYSICIAN CLINIC 120 - SCL HEALTH MEDICAL GROUP - CODY PEDS 720 LINDSAY LANE CODY WY 82414 OUTPATIENT PHYSICIAN CLINIC 121 - SCL HEALTH MEDICAL GROUP - MILES CITY MATE 2600 WILSON ST MILES CITY MT 59301 OUTPATIENT PHYSICIAN CLINIC 122 - SCL HEALTH ST VINCENT NEUROSURGERY 401 15TH AVE SOUTH GREAT FALLS MT 59405 OUTPATIENT PHYSICIAN CLINIC 123 - SCL HEALTH HEARTVASCULAR CODY CARDIOVASCU 720 LINDSEY LANE CODY WY 824144103 OUTPATIENT PHYSICIAN CLINIC 124 - SCL HEALTH ST VINCENT NEUROSURGERY 720 LINDSAY LN CODY WY 82414 OUTPATIENT PHYSICIAN CLINIC 125 - SCL HEALTH MEDICAL GROUP - SIDNEY PEDS 216 14TH AVENUE SW SIDNEY MT 592703521 OUTPATIENT PHYSICIAN CLINIC 126 - SCL HEALTH ST VINCENT NEUROSURGERY THE FOOT CARE CENTER SHERIDAN WY 828010000 OUTPATIENT PHYSICIAN CLINIC 127 - SCL HEALTH MEDICAL GROUP - BILLINGS UROLOG 70 CATTAIL DR LEWISTOWN MT 59457 OUTPATIENT PHYSICIAN CLINIC 128 - SCL HEALTH MEDICAL GROUP - BUTTE PEDS 435 S CRYSTAL ST BUTTE MT 59701 OUTPATIENT PHYSICIAN CLINIC 129 - SCL HEALTH MEDICAL GROUP - BOZEMAN 711 W MAIN ST BOZEMAN MT 59715 OUTPATIENT PHYSICIAN CLINIC 130 - SCLHBI MW WMNS HEIGHTS 32 WICKS LANE BILLINGS MT 591058310 OUTPATIENT PHYSICIAN CLINIC 131 - SCL HEALTH MEDICAL GROUP - MILES CITY MATE 2600 WILSON ST MILES CITY MT 593010014 OUTPATIENT PHYSICIAN CLINIC 132 - SCL HEALTH MEDICAL GROUP - SIDNEY PEDS 216 14TH AVENUE SW SIDNEY MT 592703521 OUTPATIENT PHYSICIAN CLINIC 133 - SCL HEALTH HEART & VASCULAR INSTITUTE - BI 70 CATTAIL DR LEWISTOWN MT 594570000 OUTPATIENT PHYSICIAN CLINIC 134 - SCL HEALTH MEDICAL GROUP - HARDIN NEPHROLO 16 N MILES AVE HARDIN MT 59034 OUTPATIENT PHYSICIAN CLINIC 135 - SCLHBI UROLOGY BOZEMAN 711 W MAIN ST BOZEMAN MT 59715 OUTPATIENT PHYSICIAN CLINIC 136 - SCL HEALTH MEDICAL GROUP - CODY PEDS 720 LINDSAY LANE CODY WY 82414 OUTPATIENT PHYSICIAN CLINIC 137 - SCL HEALTH MEDICAL GROUP - BOULDER 214 S MAIN ST BOULDER MT 59701 OUTPATIENT PHYSICIAN CLINIC 138 - SCL HEALTH MEDICAL GROUP - BUTTE PEDS 435 S CRYSTAL ST BUTTE MT 59701 OUTPATIENT PHYSICIAN CLINIC 139 - SCL HEALTH MEDICAL GROUP - RMAP OBGYN 435 S CRYSTAL STREET BUTTE MT 59701 OUTPATIENT PHYSICIAN CLINIC 140 - SCL HEALTH MEDICAL GROUP -BUTTE ST JAMES HEALTHCARE BUTTE MT 59701 OUTPATIENT PHYSICIAN CLINIC 141 - SCL HEALTH MEDICAL GROUP- RUBY VALLEY OBGY 321 MADISON SHERIDAN MT 59749 OUTPATIENT PHYSICIAN CLINIC 142 - SCL HEALTH MEDICAL GROUP - BOZEMAN 711 W MAIN ST BOZEMAN MT 59715 OUTPATIENT PHYSICIAN CLINIC 143 - SCL HEALTH MEDICAL GROUP -BUTTE OBGYN 445 CENTENNIAL AVE BUTTE MT 597012870 OUTPATIENT PHYSICIAN CLINIC PART I, LINE 3C: SCLHS'S SLIDING SCALE FOR FREE AND DISCOUNTED CARE IS 0 TO 400% FEDERAL POVERTY LEVEL (FPL) IN ACCORDANCE WITH THE FEDERAL POVERTY GUIDELINES. PATIENTS BETWEEN 0-250% FPL WILL RECEIVE 100% DISCOUNT ON THEIR BALANCES WHILE PATIENTS BETWEEN 251-400% WILL RECEIVE PARTIAL DISCOUNT BASED ON WHERE THEY FALL. THE DETERMINATION IS BASED ON HOUSEHOLD INCOME AND THE HOUSEHOLD SIZE. PATIENTS ARE REQUIRED TO FILL OUT A SIMPLE ONE-PAGE APPLICATION AND SUPPLY SUPPORTING DOCUMENTATION. THE APPLICATION ASKS FOR INFORMATION ABOUT THE APPLICANT AND HOUSEHOLD MEMBERS. SUPPORTING DOCUMENTATION IS THE MOST RECENT PAYSTUB, OR SOME OTHER FORM FOR PROOF OF INCOME. IF THERE IS MORE THAN ONE FAMILY MEMBER WORKING AND COUNTED IN THE HOUSEHOLD DETERMINATION, THEY WOULD ALSO BE REQUIRED TO PROVIDE PROOF OF INCOME. PART I, LINE 6A: SCLHS IS PART OF THE INTERMOUNTAIN HEALTH CARE, INC. SYSTEM, WHICH PREPARES AN ANNUAL REPORT TO THE COMMUNITY ON A CONSOLIDATED BASIS. THE REPORT IS PREPARED BY THE PARENT COMPANY, INTERMOUNTAIN HEALTH CARE, INC. PART I, LINE 7: THE AMOUNTS REPORTED ON FORM 990, SCHEDULE H, PART I, LINE 7A, 7B AND 7C WERE DETERMINED USING THE COST TO CHARGE RATIO DERIVED FROM WORKSHEET 2, IN THE SCHEDULE H, FORM 990 INSTRUCTIONS. FORM 990, SCHEDULE H, PART I, LINES 7E, 7F, 7G, 7H AND 7I ARE REPORTED AT COST AS REPORTED IN SCLHS' FINANCIAL STATEMENTS. AMOUNTS REPORTED IN LINE 7G FOR COSTS INCURRED TO PROVIDE SUBSIDIZED HEALTH SERVICES AT PHYSICIAN CLINICS WERE $7,610,452.PART I, LINE 7, COLUMN (F):BAD DEBT EXPENSE INCLUDED ON FORM 990,PART IX, LINE 25, COLUMN (A), BUT SUBTRACTED FOR PURPOSES OF CALCULATING THE PERCENTAGE ON SCHEDULE H, PART I, LINE 7 COLUMN (F), IS $1,782,255. PART II, COMMUNITY BUILDING ACTIVITIES: PART III, LINE 1:SCLHS REPORTS BAD DEBT IN ACCORDANCE WITH HEALTHCARE FINANCIAL MANAGEMENT ASSOCIATION (HFMA) STATEMENT NO. 15 TO THE EXTENT THAT HFMA STATEMENT NO. 15 FOLLOWS THE GENERALLY ACCEPTED ACCOUNTING PRINCIPLES (GAAP) FOR THE REPORTING OF BAD DEBT. PART III, LINE 2: THE BAD DEBT EXPENSE REPORTED ON PART III, LINE 2 IS AT CHARGES AS RECORDED IN SCLHS' FINANCIAL STATEMENTS. THE ALLOWANCE FOR BAD DEBT IS BASED UPON MANAGEMENT'S ASSESSMENT OF HISTORICAL AND EXPECTED NET COLLECTIONS CONSIDERING THE BUSINESS AND GENERAL ECONOMIC CONDITIONS IN ITS SERVICE AREA, TRENDS IN HEALTH CARE COVERAGE, AND OTHER COLLECTION INDICATORS.THE BAD DEBT ALLOWANCE IS CALCULATED AS A PERCENTAGE OF PATIENT RECEIVABLES AFTER DEDUCTIONS FOR ESTIMATED PROVISIONS FOR CONTRACTUAL ADJUSTMENTS (DISCOUNTS) ON SERVICES PROVIDED TO ENROLLEES OF MEDICARE, MEDICAID, AND THIRD-PARTY PAYOR PROGRAMS; CHARITY CARE; UNINSURED DISCOUNTS; AND OTHER ADMINISTRATIVE ADJUSTMENTS. PART III, LINE 4: THE ALLOWANCE FOR BAD DEBT IS BASED UPON MANAGEMENT'S ASSESSMENT OF HISTORICAL AND EXPECTED NET COLLECTIONS CONSIDERING THE BUSINESS AND GENERAL ECONOMIC CONDITIONS IN ITS SERVICE AREA, TRENDS IN HEALTH CARE COVERAGE, AND OTHER COLLECTION INDICATORS.THE BAD DEBT ALLOWANCE IS CALCULATED AS A PERCENTAGE OF PATIENT RECEIVABLES AFTER DEDUCTIONS FOR ESTIMATED PROVISIONS FOR CONTRACTUAL ADJUSTMENTS (DISCOUNTS) ON SERVICES PROVIDED TO ENROLLEES OF MEDICARE, MEDICAID, AND THIRD-PARTY PAYOR PROGRAMS; CHARITY CARE; UNINSURED DISCOUNTS; AND OTHER ADMINISTRATIVE ADJUSTMENTS.SCLHS HAS A FINANCIAL ASSISTANCE PROGRAM THAT PROVIDES PATIENTS OPPORTUNITIES TO APPLY FOR FREE OR DISCOUNTED CARE AND/OR TO BE ENROLLED IN A GOVERNMENT-SPONSORED MEDICAL CARE PROGRAM. THE PROCESS INCLUDES IDENTIFYING PATIENTS WITH A FINANCIAL CONCERN AND PROVIDING FINANCIAL COUNSELING AND ASSISTANCE IN APPLYING FOR THE SCLHS' CHARITY CARE AND OTHER FINANCIAL ASSISTANCE PROGRAMS.CERTAIN PATIENT ACCOUNTS ARE WRITTEN OFF TO BAD DEBT BECAUSE SCLHS DOES NOT HAVE SUFFICIENT INFORMATION TO DETERMINE IF THE PATIENT WOULD QUALIFY FOR FREE CARE OR FINANCIAL AID. THEREFORE, IT IS POSSIBLE THAT SOME BAD DEBT IS ACTUALLY CHARITY CARE. HOWEVER, IF A PATIENT ACCOUNT IS WRITTEN OFF TO BAD DEBT AND THE COLLECTION AGENCY LATER DETERMINES THAT THE PATIENT WOULD HAVE QUALIFIED FOR FREE CARE OR FINANCIAL AID, THEN THE BAD DEBT EXPENSE IS RECLASSIFIED TO CHARITY CARE. THE PATIENT SERVICE REVENUE FOOTNOTE THAT DESCRIBES BAD DEBT EXPENSE AND ALLOWANCE FOR UNCOLLECTIBLE ACCOUNTS IS ON PAGES 13 AND 14 OF THE AUDITED CONSOLIDATED FINANCIAL STATEMENTS. PART III, LINE 8: SCLHS BELIEVES THAT AT LEAST SOME PORTION OF THE COSTS IT INCURS IN EXCESS OF PAYMENTS RECEIVED FROM THE FEDERAL GOVERNMENT FOR PROVIDING MEDICAL SERVICES TO MEDICARE ENROLLEES AND BENEFICIARIES UNDER THE FEDERAL MEDICARE PROGRAM (SHORTFALL OR MEDICARE SHORTFALL) CONSTITUTES A COMMUNITY BENEFIT. PROVIDING THESE SERVICES LESSENS THE BURDENS OF THE GOVERNMENT BY ALLEVIATING THE FEDERAL GOVERNMENT FROM HAVING TO DIRECTLY PROVIDE THESE MEDICAL SERVICES. AS DEMONSTRATED AND CALCULATED ON FORM 990, SCHEDULE H, PART III, LINES 5, 6 AND 7, THE MEDICARE "ALLOWABLE COSTS" EXCEED THE PAYMENTS WE RECEIVE FOR PROVIDING THESE MEDICAL SERVICES UNDER THE MEDICARE PROGRAM. BY ABSORBING THE MEDICARE SHORTFALL COSTS, SCLHS IS PROVIDING A COMMUNITY BENEFIT AS WELL AS EASING THE BURDEN OF THE FEDERAL GOVERNMENT HAVING TO COVER THESE COSTS.TO ARRIVE AT THE FORM 990, SCHEDULE H, PART III, LINE 6 AMOUNT, SCLHS USED ACTUAL MEDICARE CHARGES FROM INTERNAL RECORDS AND APPLIED AN ESTIMATED COST TO CHARGE RATIO TO DETERMINE THE MEDICARE ALLOWABLE COSTS. THE ESTIMATED MEDICARE COST TO CHARGE RATIO IS THE PRIOR PERIOD MEDICARE COST REPORT COST TO CHARGE RATIO. PART III, LINE 9B: AN INTEGRAL COMPONENT OF SCLHS' MISSION IS TO BE GOOD FINANCIAL STEWARDS. THIS REQUIRES SCLHS TO DETERMINE WHICH PATIENTS ARE IN NEED OF CHARITY CARE AND WHICH ARE ABLE TO CONTRIBUTE SOME PAYMENT FOR CARE RECEIVED. SCLHS MAINTAINS A BALANCE THAT ENABLES SCLHS TO CONTINUE TO PROVIDE CHARITY CARE TO THOSE WHO NEED IT MOST AND ENSURE THAT SCLHS MANAGES OUR RESOURCES SO SCLHS CAN CONTINUE TO BE HERE WHEN PEOPLE NEED SCLHS MOST. SCLHS NOTIFIES PATIENTS OF FINANCIAL ASSISTANCE POLICY UPON ADMISSION AND DISCHARGE. IN ADDITION, THE PATIENTS RECEIVE INFORMATION ABOUT THE FINANCIAL ASSISTANCE POLICY WITH THEIR 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, LINE 2: THE REHABILITATION HOSPITAL OF MONTANA, LLC IS A PARTNERSHIP BETWEEN SCL HEALTH - MONTANA, SCL HEALTH MEDICAL GROUP - BILLINGS CLINIC AND KINDRED HEALTHCARE, INC. OPENED IN AUGUST OF 2019, THE REHABILITATION HOSPITAL OF MONTANA, LLC PROVIDES A 34-BED INPATIENT REHABILITATION HOSPITAL TO TREAT PATIENTS RECOVERING FROM CONDITIONS SUCH AS STROKE, TRAUMATIC BRAIN INJURY AND SPINAL CORD INJURY. PARTNERING ORGANIZATIONS, SCL HEALTH MEDICAL GROUP - BILLINGS CLINIC AND SCL HEALTH - MONTANA CONDUCTED A COMMUNITY HEALTH NEEDS ASSESSMENT (CHNA) IN 2021 WITH THE PARTICIPATION OF REHABILITATION HOSPITAL OF MONTANA STAFF. THIS COMPREHENSIVE CHNA FOCUSED ON YELLOWSTONE COUNTY, MONTANA, WHICH SERVES AS THE PRIMARY SERVICE AREA FOR BOTH SCL HEALTH MEDICAL GROUP - BILLINGS CLINIC AND SCL HEALTH - MONTANA, REPRESENTING APPROXIMATELY 60% AND 64% OF HOSPITAL AND EMERGENCY ADMISSIONS, RESPECTIVELY. THIS COMPREHENSIVE CHNA PROVIDED AN IN-DEPTH VIEW OF COMMUNITY HEALTH NEEDS AND CAN BE ACCESSED ONLINE: HTTPS://WWW.HEALTHYBYDESIGNYELLOWSTONE.ORG/WP-CONTENT/UPLOADS/2021/09/2020-PRC-CHNA-REPORT-YELLOWSTONE-COUNTY-MT-FINAL-2020.02.07-1.PDFIN 2021, THE REHABILITATION HOSPITAL OF MONTANA, LLC CONDUCTED A CHNA TO INCLUDE ADDITIONAL STATEWIDE DATA RELATED TO APPLICABLE HEALTH CONDITIONS. THIS CHNA INCLUDES SECONDARY DATA FROM STATEWIDE SOURCES, DATA FROM THE YELLOWSTONE COUNTY CHNA, AND PRIMARY DATA FROM A KEY STAKEHOLDER SURVEY. STATEWIDE SECONDARY DATA FOR THE REHABILITATION HOSPITAL OF MONTANA, LLC COMMUNITY HEALTH NEEDS ASSESSMENT HAVE BEEN QUERIED FROM THE MONTANA PUBLIC HEALTH INFORMATION SYSTEM AND INCLUDE DATA FROM THE BEHAVIORAL HEALTH RISK FACTOR SURVEILLANCE SYSTEM (BRFSS) AND DATA FROM THE MONTANA HOSPITAL DISCHARGE DATA SYSTEM. A SURVEY WAS CONDUCTED WITH KEY INFORMANTS IN JULY 2021. SURVEYS WERE EMAILED TO 29 KEY STAKEHOLDERS. THE SURVEY INSTRUMENT INCLUDED 8 QUESTIONS FOCUSED ON GENERAL HEALTH STATUS, SERIOUS HEALTH CONCERNS, NEEDS FOR A HEALTHY COMMUNITY INCLUDING SOCIAL DETERMINANTS OF HEALTH, SERVICES OF THE MONTANA REHABILITATION HOSPITAL, LLC, BARRIERS TO HEALTH FOR PATIENTS, AND OPPORTUNITIES TO ADDRESS HEALTH NEEDS. 15 KEY STAKEHOLDERS COMPLETED THE SURVEY, A 51% RESPONSE RATE. PART VI, LINE 3: THE ORGANIZATION NOTIFIES PATIENTS ABOUT THE FINANCIAL ASSISTANCE POLICY UPON ADMISSION AND PRIOR TO DISCHARGE. NOTICES ABOUT THE FINANCIAL ASSISTANCE POLICY ARE DISPLAYED THROUGHOUT THE HOSPITAL. IN ADDITION, PATIENTS RECEIVE INFORMATION ABOUT THE FINANCIAL ASSISTANCE POLICY WITH THEIR PATIENT BILLS AND THROUGH THE PATIENT PORTAL, MYCHART. THE FINANCIAL ASSISTANCE POLICY AND APPLICATION ARE POSTED ON THE HOSPITAL'S WEBSITE. THE POLICY AND APPLICATION ARE ALSO AVAILABLE UPON REQUEST. THE ORGANIZATION HAS A FINANCIAL ASSISTANCE PROGRAM THAT PROVIDES PATIENTS OPPORTUNITIES TO APPLY FOR FREE OR DISCOUNTED CARE AND/OR TO BE ENROLLED IN A GOVERNMENT-SPONSORED MEDICAL CARE PROGRAM. THE PROCESS INCLUDES IDENTIFYING PATIENTS WITH A FINANCIAL CONCERN, PROVIDING FINANCIAL COUNSELING AND ASSISTANCE IN APPLYING FOR THE ORGANIZATION'S CHARITY CARE AND OTHER FINANCIAL ASSISTANCE PROGRAMS. PART VI, LINE 4: THE REHABILITATION HOSPITAL OF MONTANA, LLC SERVES PATIENTS FROM ACROSS THE STATE OF MONTANA AND THE SURROUNDING STATES. APPROXIMATELY 88% OF PATIENTS COME FROM MONTANA AND 53% OF PATIENTS ARE LOCATED IN YELLOWSTONE COUNTY. THE REHABILITATION HOSPITAL OF MONTANA, LLC IS A STATE-OF-THE-ART, 34-BED INPATIENT ACUTE REHABILITATION HOSPITAL DEDICATED TO THE TREATMENT AND RECOVERY OF INDIVIDUALS WHO HAVE EXPERIENCED A LOSS OF FUNCTION DUE TO AN INJURY OR ILLNESS. POPULATION AND GEOGRAPHY: THE STATE OF MONTANA HAS A POPULATION OF 1,084,225. BETWEEN THE 2010 AND 2020 CENSUS, THE STATEWIDE POPULATION INCREASED BY 9.5%. MONTANA HAS A TOTAL LAND AREA OF 145,545.42 SQUARE MILES AND A POPULATION DENSITY OF 7.44 PEOPLE PER SQUARE MILE. (CENSUS.GOV/QUICKFACTS)DEMOGRAPHICS: MOST RESIDENTS OF MONTANA (88.9%) ARE WHITE. APPROXIMATELY 6.7% OF RESIDENTS ARE NATIVE AMERICAN/ALASKA NATIVE, 4.1% ARE HISPANIC OR LATINO, AND 2.8% REPORT TWO OR MORE RACES. LESS THAN 1% OF THE POPULATION ARE BLACK, ASIAN, OR NATIVE HAWAIIAN/OTHER PACIFIC ISLANDER. (CENSUS.GOV/QUICKFACTS)DATA FROM THE U.S. CENSUS BUREAU REPORTS 86,787 VETERANS IN THE STATE, APPROXIMATELY 10.6% OF THE TOTAL POPULATION. APPROXIMATELY 93.6% OF MONTANA RESIDENTS HAVE A HIGH SCHOOL DIPLOMA, WITH 32% OF RESIDENTS HAVING A BACHELOR'S DEGREE OR HIGHER. AN ADDITIONAL 9.2% OF RESIDENTS UNDER AGE 65 HAVE A DISABILITY. POVERTY AND ECONOMICS: THE MEDIAN HOUSEHOLD INCOME (IN 2019 DOLLARS) FROM 2015-2019 WAS $54,970. APPROXIMATELY 12.6% OF RESIDENTS LIVE IN POVERTY. HEALTH STATUS: MOST RESIDENTS IN MONTANA HAVE HEALTHCARE COVERAGE, BUT 10.3% REPORT NO HEALTHCARE COVERAGE (BRFSS, 2018). A SIMILAR PERCENTAGE OF RESIDENTS (10.1%) REPORTED BEING UNABLE TO GET NEEDED MEDICAL CARE DUE TO COST IN 2018. NEARLY A THIRD OF RESIDENTS (27.2%) HAD NO PRIMARY CARE PROVIDER. MOST RESIDENTS (73%) REPORTED A ROUTINE HEALTH VISIT IN THE LAST YEAR. THE MAJORITY OF MONTANA RESIDENTS (84.5%) REPORT EXCELLENT TO GOOD OVERALL HEALTH, BUT 15.5% OF RESIDENTS REPORT FAIR TO POOR OVERALL HEALTH. RESIDENTS WITH LOWER INCOMES WERE MORE LIKELY TO REPORT FAIR/POOR OVERALL HEALTH THAN RESIDENTS OF HIGHER INCOMES. AN ADDITIONAL 9.2% OF RESIDENTS UNDER AGE 65 HAVE A DISABILITY. (BRFSS, 2015-2018). PART VI, LINE 5: THE REHABILITATION HOSPITAL OF MONTANA, LLC. PARTICIPATES IN COLLABORATIVE COMMUNITY HEALTH IMPROVEMENT EFFORTS AS PART OF THE HEALTHY BY DESIGN COALITION, A COLLABORATIVE SPONSORED BY JOINT VENTURE PARTNERS SCL HEALTH MEDICAL GROUP - BILLINGS CLINIC AND SCL HEALTH - MONTANA IN CONJUNCTION WITH RIVERSTONE HEALTH AND COMMITS IN-KIND RESOURCES TO FULFILL GOALS OUTLINED IN THE COLLABORATIVE COMMUNITY HEALTH IMPROVEMENT PLAN FOR YELLOWSTONE COUNTY. PART VI, LINE 6: THE FILING ORGANIZATION IS AN AFFILIATE OF INTERMOUNTAIN HEALTH CARE, INC. (INTERMOUNTAIN), AN INTEGRATED HEALTH SYSTEM WHOSE VISION IS TO "BE A MODEL HEALTH SYSTEM BY PROVIDING EXTRAORDINARY CARE AND SUPERIOR SERVICES AT AN AFFORDABLE COST." INTERMOUNTAIN STRIVES TO FULFILL THAT MISSION THROUGH ACCOMPLISHING ITS STATED MISSION OF "HELPING PEOPLE LIVE THE HEALTHIEST LIVES POSSIBLE." INTERMOUNTAIN HEALTH CARE, INC., IS A NONPROFIT CORPORATION EXEMPT UNDER IRC SECTION 501(C)(3). AFFILIATES WITHIN THE HEALTH SYSTEM NETWORK INCLUDE NONPROFIT CORPORATIONS EXEMPT UNDER IRC SECTIONS 501(C)(3) AND 501(C)(4), TAXABLE CORPORATIONS, PARTNERSHIPS WITH PHYSICIANS, STRATEGIC INVESTMENTS, AND JOINT VENTURES.HEADQUARTERED IN SALT LAKE CITY, UTAH, INTERMOUNTAIN CONSISTS OF A TEAM OF NEARLY 60,000 CAREGIVERS WHO SERVE THE HEALTHCARE NEEDS OF PEOPLE ACROSS THE INTERMOUNTAIN WEST, INCLUDING UTAH, IDAHO, NEVADA, COLORADO, MONTANA, WYOMING, AND KANSAS. INTERMOUNTAIN PROVIDES SERVICES TO AND PROMOTES THE HEALTH OF THESE COMMUNITIES THROUGH 33 HOSPITALS, HUNDREDS OF CLINICS, A MEDICAL GROUP, AFFILIATE NETWORKS, HOMECARE, TELEHEALTH, INSURANCE PLANS, MEDICAL AIR TRANSPORT, AND OTHER SERVICES. INTERMOUNTAIN IS WIDELY RECOGNIZED AS A LEADER IN TRANSFORMING HEALTHCARE BY USING EVIDENCE-BASED BEST PRACTICES TO CONSISTENTLY DELIVER HIGH-QUALITY OUTCOMES AT SUSTAINABLE COSTS.INTERMOUNTAIN IS WORKING TO IMPROVE THE HEALTH AND WELL-BEING BY IMPROVING MENTAL WELL-BEING, PREVENTING AVOIDABLE DISEASE, IMPROVING AIR QUALITY, ADDRESSING SOCIAL DETERMINANTS OF HEALTH, AND OTHER COMMUNITY HEALTH INITIATIVES.THROUGH MULTIPLE CHARITABLE FOUNDATIONS, INTERMOUNTAIN ALSO DEVELOPS FINANCIAL AND CHARITABLE SUPPORT FOR ITS PATIENTS WHILE ALSO SUPPORTING OTHER NONPROFIT ORGANIZATIONS THAT PROVIDE DIRECT MEDICAL, DENTAL, AND MENTAL SERVICES FOR LOW-INCOME, UNINSURED, OR MEDICALLY UNDERSERVED POPULATIONS.PART VI, LINE 7:STATE FILING OF COMMUNITY BENEFIT REPORT - NOT APPLICABLE. 1 SCL HEALTH - MONTANA 1233 NORTH 30TH STREET BILLINGS MT 59101 810232124 501(C)(3) 8900000 0 SUPPORT MISSION MOUNT ST VINCENT HOME INC 4159 LOWELL BOULEVARD DENVER CO 80211 840405260 501(C)(3) 500000 0 SUPPORT MISSION CARITAS CLINICS INC 818 NORTH 7TH STREET LEAVENWORTH KS 66048 481009910 501(C)(3) 419184 0 SUPPORT MISSION SCL HEALTH - FRONT RANGE INC 500 ELDORADO BLVD SUITE 4300 BROOMFIELD CO 80021 841103606 501(C)(3) 247517 0 SUPPORT MISSION MARIAN CLINIC INC 3164 SE SIXTH AVENUE TOPEKA KS 66607 481046905 501(C)(3) 47569 0 SUPPORT MISSION FREDRICK - FIRESTONE FIRE PROTECTION DISTRICT 8426 KOSMERL PLACE FREDRICK CO 80504 840949589 COUNTY DISTRICT 0 5290 FMV LAND LAND FOR FIRE STATION 6 0 PART I, LINE 2: SCLHS' MISSION DEPARTMENT REQUIRES WRITTEN STATEMENTS THREE TIMES A YEAR REGARDING THE PROGRESS AND STATUS OF THE GRANT. X 0 1 X X X X X X 1 1 0 0 0 0 0 1 0 ALBERT ZIMMERLI TREASURER 12/14-12/31 0 1206132 0 888226 0 2204533 0 1380079 0 10459 0 5689429 0 759188 LYDIA JUMONVILLE PRES & CEO 1/1-4/1/22, CEO/DIRECTOR 1457019 0 1300392 0 435796 0 675533 0 19797 0 3888537 0 382586 0 JANIE WADE TREAS 1/1-12/14/22 / EVP CFO 911292 0 757353 0 586276 0 296475 0 25350 0 2576746 0 581138 0 ROSLAND MCLEOD SEC 1/1-4/1 / CHIEF LEGAL 1/1-6/3 281361 0 817358 0 1003626 0 159680 0 30615 0 2292640 0 580472 0 JAMES VALIN MD VICE PRES 1/1-12/14 / CHIEF CLINICAL 1018982 0 675622 0 104638 0 305673 0 30233 0 2135148 0 98880 0 MARK KORTH EVP COO 1/1-4/1, PRES 4/1-12/31 889240 0 847403 0 5066 0 294602 0 25700 0 2062011 0 0 0 GREG MATIS SEC 12/14-12/31 0 672534 0 398107 0 309942 0 551190 0 10629 0 1942402 0 0 GREGORY M JOHNSON VP, FINANCE SERVICES 12/14-12/31 0 546031 0 305661 0 755765 0 260012 0 21267 0 1888736 0 655717 TAJQUAH HUDSON EVP CHIEF STRATEGY & GROWTH OFFICER 647801 0 591630 0 177084 0 282369 0 9840 0 1708724 0 164654 0 ANTHONY RUSSO MD MG PHYSICIAN 1149418 0 434640 0 3256 0 16773 0 36348 0 1640435 0 0 0 J GRANT WICKLUND PRESIDENT REGIONAL WESTERN CO & LMC 604937 0 198354 0 309972 0 447555 0 20942 0 1581760 0 0 0 CLAY M ASHDOWN SVP, FINANCE OPS 12/14-12/31 0 584531 0 306360 0 121931 0 418066 0 18231 0 1449119 0 0 SHAWN DUFFORD MD SVP, CHIEF MEDICAL OFFICER 1/1-4/15 213503 0 188445 0 848825 0 92388 0 16578 0 1359739 0 324506 0 CRAIG RICHARDVILLE SVP, CHIEF INFO AND DIGITAL OFFICER 591087 0 485833 0 12449 0 179164 0 22247 0 1290780 0 0 0 JENNIFER ALDERFER MONTANA MARKET PRESIDENT 570549 0 174139 0 203606 0 225368 0 28233 0 1201895 0 72010 0 LOUIS ROSS MD PHYSICIAN CLINIC 804715 0 275659 0 2344 0 18300 0 28112 0 1129130 0 0 0 MEGAN MAHNCKE PRESIDENT SCL HLTH FOUNDATIONS & SVP 473771 0 391051 0 31258 0 141612 0 28450 0 1066142 0 29019 0 TAMARA SAUNAITIS SVP CHIEF HR OFFICER 1/1-4/1 284696 0 420855 0 234825 0 75296 0 14388 0 1030060 0 227610 0 SUZANNE DRAPER VP, ETHICS & COMPLIANCE 12/14-12/31 0 329217 0 193297 0 63273 0 413722 0 25830 0 1025339 0 0 STUART GOODMAN MD PHYSICIAN ANESTHESIA 737403 0 178795 0 9778 0 14372 0 26208 0 966556 0 0 0 STACY JENNINGS VP, CHIEF INVEST OFFICER 12/14-12/31 0 494818 0 142904 0 290 0 300529 0 22404 0 960945 0 133242 JOHN BRAXTON MD PHYSICIAN CLINIC 898487 0 14640 0 8157 0 15227 0 18557 0 955068 0 0 0 THOMAS DONOHOE VP GENERAL COUNSEL OPERATIONS 439403 0 237988 0 85001 0 144291 0 28450 0 935133 0 83350 0 DAVID PRINGLE CHIEF CATHOLIC MISSION OFFICER 374613 0 340026 0 55087 0 117345 0 22857 0 909928 0 0 0 CHRISTOPHER AWTREY MD CHIEF MEDICAL OFFICER, MEDICAL GROUP 398324 0 124751 0 159955 0 165955 0 28233 0 877218 0 0 0 HEIDI WALD VP CHIEF QUALITY & SAFETY OFFICER 439844 0 159492 0 78777 0 144566 0 28001 0 850680 0 73757 0 BRYAN JOHNSON WESTERN CO MKT PRESIDENT 457894 0 141306 0 36585 0 181461 0 25700 0 842946 0 32319 0 ALAN BAKER CHIEF OPERATING OFFICER, MEDICAL GRO 372211 0 201674 0 43480 0 164579 0 26850 0 808794 0 40758 0 SIMON PAYNE MD CMO, ACUTE CARE 414072 0 149703 0 52550 0 134947 0 25888 0 777160 0 49613 0 BARBARA JAHN CHIEF OPERATING OFFICER 416100 0 149850 0 52402 0 129072 0 20107 0 767531 0 45450 0 AMY CHURCH VP FINANCE OPERATIONS 481761 0 117839 0 22813 0 130189 0 1815 0 754417 0 22099 0 LAURA WIGHTMAN SVP CHIEF NURSING OFFICER SYS 1/1-5/ 138276 0 117216 0 422830 0 47583 0 8147 0 734052 0 115968 0 TROY SPRING VP REVENUE CYCLE 411119 0 121675 0 38687 0 123900 0 29733 0 725114 0 35719 0 MARK WILKINSON VP TREASURER 314752 0 134216 0 34079 0 99930 0 21020 0 603997 0 31683 0 SEAN FADDEN VP, STR FIN PLAN 1/1-4/13, REG VP, F 340253 0 111907 0 20657 0 102280 0 25376 0 600473 0 19816 0 TROY HOLMES VP PAYER CONTRACTING 306761 0 111901 0 37524 0 97587 0 20107 0 573880 0 32247 0 DINA BUSH CHIEF NURSING OFFICER 338548 0 64160 0 5066 0 133114 0 27900 0 568788 0 0 0 JAMES RITCHEY VP HUMAN RESOURCES OPERATIONS 288560 0 57646 0 38079 0 87911 0 28200 0 500396 0 36276 0 SUSAN SCHAUB VP HR OPERATIONS 288632 0 31757 0 1463 0 99071 0 10345 0 431268 0 0 0 STEVEN CHYUNG SVP SUPPLY CHAIN & REAL ESTATE 1/1- 127114 0 146930 0 58491 0 64775 0 10781 0 408091 0 56057 0 TERENCE MOLOUGHNEY ASST SECRETARY 12/14-12/31/22 239255 0 14752 0 963 0 28284 0 20759 0 304013 0 0 0 KHADIJA MOHAMED ASST SECRETARY / BOARD GOV PROG MGR 122820 0 12286 0 521 0 7300 0 10180 0 153107 0 0 0 PART I, LINE 1A TAX INDEMNIFICATION AND GROSS-UP PAYMENTS SCLHS AND RELATED ORGANIZATIONS ALLOW FOR CERTAIN TAX INDEMNIFICATION AND GROSS-UP PAYMENTS IN THE INSTANCES OF RELOCATION. THESE AMOUNTS ARE TREATED AS TAXABLE COMPENSATION. THE INDIVIDUALS THAT RECEIVED TAX GROSS-UP PAYMENTS IN 2022 WERE: JENNIFER ALDERFER - $30,036, CHRISTOPHER AWTREY, MD - $45,433 PART I, LINE 1B SCLHS AND RELATED ORGANIZATIONS DO NOT HAVE A FORMAL WRITTEN POLICY FOR TAX INDEMNIFICATION AND GROSS-UP PAYMENTS. HOWEVER, BEFORE ANY TAX INDEMNIFICATION AND GROSS-UP PAYMENTS ARE MADE, PROPER APPROVAL FROM THE EMPLOYEE'S MANAGER IS REQUIRED. IN ADDITION, APPROVAL IS ALSO REQUIRED FROM HUMAN RESOURCES. PART I, LINE 3 COMPENSATION OF THE ORGANIZATION'S CEO/EXECUTIVE DIRECTOR SCLHS' OFFICERS AND SENIOR MANAGEMENT ARE PAID BY SCLHS. COMPENSATION FOR THE OFFICERS AND SENIOR MANAGEMENT IS MANAGED BY THE INTERMOUNTAIN HEALTH CARE, INC. BOARD COMPENSATION COMMITTEE (COMMITTEE) ON BEHALF OF SCLHS AND ALL OF ITS AFFILIATES. THE COMMITTEE REVIEWS AND APPROVES COMPENSATION ARRANGEMENTS OF THE OFFICERS AND SENIOR MANAGEMENT AND MAKES RECOMMENDATIONS TO INTERMOUNTAIN HEALTH CARE, INC.'S BOARD FOR APPROVAL OF ANY CHANGES TO COMPENSATION FOR THE OFFICERS AND SENIOR MANAGEMENT. THE COMMITTEE'S REVIEW IS CONDUCTED IN A MANNER THAT IS INTENDED TO QUALIFY FOR THE REBUTTABLE PRESUMPTION OF REASONABLENESS UNDER THE INTERMEDIATE SANCTIONS RULES OF INTERNAL REVENUE CODE SECTION 4958. THE COMMITTEE CONDUCTS THE REVIEW WITH THE ASSISTANCE OF AN EXPERIENCED AND INDEPENDENT COMPENSATION CONSULTING FIRM THAT HAS DEEP NATIONAL EXPERTISE IN HEALTH SYSTEMS' EXECUTIVE COMPENSATION PROGRAMS AND LEVELS. THE COMMITTEE OBTAINS AND RELIES UPON CURRENT, COMPARABLE MARKET DATA FOR PEER ORGANIZATIONS PRIOR TO MAKING COMPENSATION RELATED DECISIONS. THE INFORMATION REVIEWED INCLUDES COMPENSATION LEVELS PAID BY SIMILARLY SITUATED ORGANIZATIONS FOR FUNCTIONALLY COMPARABLE POSITIONS, THE AVAILABILITY OF SIMILAR SERVICES IN THE GEOGRAPHIC AREA SERVED BY INTERMOUNTAIN HEALTH CARE, INC. AND CURRENT COMPENSATION SURVEYS COMPILED BY AN INDEPENDENT FIRM. CONSISTENT WITH THE PAY PHILOSOPHY SET BY INTERMOUNTAIN HEALTH CARE INC.'S BOARD, THE COMMITTEE EMPHASIZES THE IMPORTANCE OF ENSURING TOTAL REMUNERATION IS REASONABLE AND APPROPRIATE WHEN REVIEWING AND MAKING RECOMMENDATIONS WITH RESPECT TO COMPENSATION PACKAGES FOR THE OFFICERS AND SENIOR MANAGEMENT. AS PART OF THE REVIEW PROCESS, INTERMOUNTAIN HEALTH CARE, INC. USES THE FOLLOWING IN ESTABLISHING THE COMPENSATION OF OFFICERS AND SENIOR MANAGEMENT. 1) COMPENSATION COMMITTEE 2) INDEPENDENT COMPENSATION CONSULTANT 3) FORM 990 OF OTHER ORGANIZATIONS 4) WRITTEN EMPLOYMENT CONTRACTS 5) COMPENSATION SURVEYS AND STUDIES 6) APPROVAL BY THE BOARD OR COMPENSATION COMMITTEE THE ITEMS LISTED ABOVE SUPPORT THE COMPENSATION COMMITTEE'S EFFORTS TO ENSURE THAT THE LEVEL OF COMPENSATION PROVIDED TO ITS OFFICERS AND SENIOR MANAGEMENT IS REASONABLE, APPROPRIATE AND CONSISTENT WITH THE PAY PHILOSOPHY SET BY THE BOARD. PART I, LINES 4A-B SCHEDULE J, PART I, LINE 4A SEVERANCE PAYMENTS SCLHS AND RELATED ORGANIZATIONS PERIODICALLY INCUR SEVERANCE PAYMENTS TO FORMER EMPLOYEES. THE INDIVIDUALS AND THE AMOUNTS PAID FOR SEVERANCE IN 2022 WERE: ROSLAND MCLEOD - $322,805, SHAWN DUFFORD - $400,522, LAURA WIGHTMAN - $233,910 SCHEDULE J, PART I, LINE 4B A RELATED ORGANIZATION PROVIDES NONQUALIFIED DEFERRED COMPENSATION PLANS (NQDC) KNOWN AS SUPPLEMENTAL EXECUTIVE RETIREMENT PROGRAM (SERP) FOR EXECUTIVES (SENIOR MANAGEMENT) TO COMPENSATE FOR REGULATORY IMPOSED LIMITATIONS IN QUALIFIED RETIREMENT PLANS AND TO PROVIDE A BENEFIT CONSISTENT WITH OTHER NONPROFIT HEALTH SYSTEMS. THESE PLANS ENABLE THE EXECUTIVE TO EARN BENEFITS DURING EACH YEAR THAT THEY PARTICIPATE. IN 2014, IN AN EFFORT TO REDUCE LONG-TERM COST AND HAVE GREATER CONTROL OVER FINANCIAL RISK, THE SERP WAS CONVERTED FROM A DEFINED BENEFIT (DB) TO A DEFINED CONTRIBUTION (DC) DESIGN. CERTAIN MEMBERS OF SENIOR MANAGEMENT WHOSE BENEFITS WERE CONVERTED FROM DB TO DC WOULD HAVE BEEN DISPROPORTIONATELY AND NEGATIVELY AFFECTED BY THE CHANGE, SO THE COMMITTEE DETERMINED IT WOULD BE APPROPRIATE TO GRANT "TRANSITION CREDITS" IN ORDER TO MITIGATE THE NEGATIVE IMPACT OF THE CHANGE ON THEIR RETIREMENT BENEFITS. THIS IS A COMMON APPROACH EMPLOYED BY OTHER ORGANIZATIONS UNDERGOING A SIMILAR TRANSITION. THE TRANSITION CREDITS VEST IN ACCORDANCE WITH THE TERMS OF THE DC SERP (I.E., AFTER THREE YEARS) AND ARE PAID TO THE EXECUTIVE UPON VESTING. NQDC SERP PLANS PRIOR TO 2014 PRIOR TO 2014, THE RELATED ORGANIZATION'S NQDC SERP PLAN PROVIDED A BENEFIT TO ELIGIBLE PARTICIPANTS BASED ON A PERCENTAGE OF THEIR BASE COMPENSATION. THE VESTING PERIOD IS 5 YEARS OR WHEN THE PARTICIPANT IS AGE 65 OR OLDER. THERE WERE NO CONTRIBUTIONS TO THIS PLAN AFTER DECEMBER 31, 2013. FOR AMOUNTS CONTRIBUTED TO THE NQDC SERP PLAN PRIOR TO 2014, VESTED AMOUNTS ARE PAYABLE UPON THE END OF EMPLOYMENT. THE VESTED AMOUNTS WITHDRAWN INCLUDE AMOUNTS PREVIOUSLY TAXED TO THE RECIPIENT AND AMOUNTS TAXABLE TO THE RECIPIENT IN THE CURRENT YEAR. THE TAXABLE AMOUNTS ARE INCLUDED ON THE RECIPIENT'S W-2. ANY DISTRIBUTIONS FROM THIS PLAN ARE REPORTED BELOW. IN 2019, THE RELATED ORGANIZATION CONSOLIDATED FOUR NONQUALIFED DEFERRED COMPENSATION PLANS INTO ONE PLAN. AS PART OF THIS EFFORT, ALL VESTED BALANCES FROM THE SERP PLANS PRIOR TO 2014 WERE PAID TO THE PARTICIPANTS IN 2020. THERE ARE NO REMAINING PARTICIPANTS IN THE LEGACY PLANS. NQDC SERP PLANS STARTING IN 2014 STARTING IN 2014, THE RELATED ORGANIZATION'S NQDC SERP PLAN PROVIDED A BENEFIT TO ELIGIBLE PARTICIPANTS BASED ON A PERCENTAGE OF THEIR BASE COMPENSATION. THE VESTING PERIOD IS ROLLING 3 YEARS OR WHEN THE PARTICIPANT IS AGE 65 OR OLDER. THERE WERE NO CONTRIBUTIONS TO THIS PLAN BEFORE JANUARY 1, 2014. ANY DISTRIBUTIONS FROM THIS PLAN ARE REPORTED BELOW. STARTING IN 2014, FOR CONTRIBUTIONS TO THE NQDC SERP PLAN, CERTAIN PARTICIPANTS ARE VESTED OR BECAME VESTED IN THE PLAN DURING 2022. VESTED AMOUNTS ARE PAYABLE TO THE RECIPIENT. THE VESTED AMOUNTS ARE TAXABLE TO THE RECIPIENT IN THE CURRENT YEAR. THE TAXABLE AMOUNTS ARE INCLUDED ON THE RECIPIENT'S W-2. THE AMOUNTS WITHDRAWN FROM THE NQDC SERP PLANS IN 2022 WERE: LYDIA JUMONVILLE - $382,586; ROSLAND MCLEOD - $580,472; JAMES VALIN - $98,880; JANIE WADE - $581,138; ALAN BAKER - $40,758; SEAN FADDEN - $19,816; DAVID PRINGLE - $42,516; BRYAN JOHNSON - $32,319; JENNIFER ALDERFER - $72,010; SIMON PAYNE - $49,613; BARBARA JAHN - $45,450; STEVEN CHYUNG - $56,057; SHAWN DUFFORD - $324,506; TAJQUAH HUDSON - $164,654; MEGAN MAHNCKE - $29,019; TAMARA SAUNAITIS - $227,610; TROY SPRING - $35,719; LAURA WIGHTMAN - $115,968; THOMAS DONOHOE - $83,350; HEIDI WALD - $73,757; AMY CHURCH - $22,099; TROY HOLMES - $32,247; JAMES RITCHEY - $36,276; MARK WILKINSON - $31,633; ALBERT ZIMMERLI - $360,375; GREG JOHNSON - $655,717. IN ACCORDANCE WITH THE REQUIREMENTS OF SCHEDULE J, DEFERRED COMPENSATION EARNED OVER THE VESTING PERIOD IS REPORTED IN COLUMN C AND ANY AMOUNTS VESTED/PAID FROM A DEFERRED COMPENSATION PLAN ARE REPORTED IN COLUMN B(III). THUS, THE SAME AMOUNT WOULD BE REPORTED TWICE (FIRST WHEN IT ACCRUED DURING THE VESTING PERIOD AND AGAIN WHEN IT IS VESTED/PAID). THIS RESULTS IN THE APPEARANCE OF CERTAIN EXECUTIVES RECEIVING MORE THAN THEY ARE ACTUALLY PAID FROM THE DEFERRED COMPENSATION PLANS. COLUMN F IS INTENDED TO RECONCILE THIS DUPLICATION (BY REPORTING AMOUNTS INCLUDED IN COLUMN B(III) THAT HAD BEEN REPORTED AS DEFERRED COMPENSATION ON A SCHEDULE J FOR A PREVIOUS YEAR). HOWEVER, THE SIGNIFICANCE OF THE AMOUNTS LISTED IN COLUMN F IS OFTEN OVERLOOKED AND GIVEN THE COMPLEXITY OF THE SCHEDULE J REPORTING REQUIREMENTS, THE AMOUNTS SHOWN ARE EASILY MISUNDERSTOOD. TO DETERMINE TOTAL AMOUNT EARNED (RATHER THAN THE AMOUNT VESTED/PAID OUT) DURING THE YEAR, SUBTRACT THE AMOUNT IN COLUMN F FROM COLUMN E. PART I, LINE 7 OTHER NON-FIXED PAYMENTS THE AT-RISK COMPENSATION (ARC) PLAN WAS ESTABLISHED TO ENABLE SCLHS TO ATTRACT AND ENGAGE QUALIFIED LEADERS AND TO PROVIDE SUCH LEADERS WITH AN ADDITIONAL PERFORMANCE COMPENSATION OPPORTUNITY TO PROMOTE AND FURTHER ITS CHARITABLE MISSION AND STRATEGIC IMPERATIVES. THE PLAN OPERATES ON A CALENDAR-YEAR BASIS AND AWARD OPPORTUNITIES ARE A PERCENTAGE OF LEADERS' BASE PAY AS DETERMINED BY THEIR MANAGEMENT LEVEL AT SCLHS. ACTUAL AWARDS WILL BE PAID OUT BASED ON ATTAINMENT OF SELECTED SCLHS BOARD-APPROVED GOALS, INCLUDING EBIDA (EARNINGS BEFORE INTEREST, DEPRECIATION AND AMORTIZATION), STEWARDSHIP, QUALITY, PATIENT AND ASSOCIATE SAFETY, AND PATIENT EXPERIENCE AND FULFILLMENT OF OUR MISSION. AWARDS ARE BASED ON THE BOARD'S DETERMINATION ON HOW WELL THE HEALTH SYSTEM PERFORMS RELATIVE TO THE PLAN'S STATED PERFORMANCE STANDARDS AND THE WEIGHT GIVEN TO EACH OF THE PERFORMANCE MEASURES AS DEFINED FOR THAT PLAN YEAR. THE AT-RISK COMPENSATION PLAN SHALL BE INTERPRETED, APPLIED AND ADMINISTERED AT ALL TIMES IN ACCORDANCE WITH CODE SECTION 409A AND GUIDANCE ISSUED THEREUNDER. THE HEALTH SYSTEM RESERVES THE RIGHT TO AMEND OR TERMINATE THIS PLAN AT ANY TIME FOR ANY REASON. ADDITIONAL OFFICER AND BOARD DISCLOSURES: ON APRIL 1, 2022, SISTERS OF CHARITY OF LEAVENWORTH HEALTH SYSTEM, INC. AFFLIATED WITH INTERMOUNTAIN HEALTH CARE, INC., CREATING A MODEL HEALTH SYSTEM THAT PROVIDES HIGH-QUALITY, ACCESSIBLE, AND AFFORDABLE HEALTHCARE TO COMMUNITIES IN UTAH, IDAHO, NEVADA, COLORADO, MONTANA, WYOMING, AND KANSAS. THE ORGANIZATION EMPLOYS NEARLY 60,000 CAREGIVERS, OPERATES 33 HOSPITALS (INCLUDING ONE VIRTUAL HOSPITAL), AND RUNS HUNDREDS OF CLINICS, WHILE PROVIDING HEALTH INSURANCE TO OVER ONE MILLION PEOPLE IN UTAH, IDAHO AND NEVADA. INTERMOUNTAIN HEALTH CARE, INC. AND RELATED TAX-EXEMPT ORGANIZATIONS ADHERE TO GOVERNANCE EXCELLENCE STANDARDS INCLUDING ACCOUNTABILITY. IN KEEPING WITH INTERMOUNTAIN HEALTH CARE, INC.'S CORE VALUE OF STEWARDSHIP, INTERMOUNTAIN HEALTH CARE, INC.'S BOARD COMPENSATION COMMITTEE (COMMITTEE) HAS RETAINED THE SERVICES OF AN INDEPENDENT COMPENSATION ADVISOR. THE COMPENSATION ADVISOR IS RESPONSIBLE FOR ADVISING THE COMMITTEE ON ALL MATTERS RELATING TO EXECUTIVE COMPENSATION INCLUDING SUPPORTING THE COMMITTEE'S EFFORTS TO ENSURE THAT THE LEVEL OF COMPENSATION PROVIDED OFFICERS AND SENIOR MANAGEMENT IS REASONABLE, APPROPRIATE AND CONSISTENT WITH THE PAY PHILOSOPHY SET BY THE BOARD. THE SISTERS WHO SERVE AS OFFICERS AND/OR BOARD MEMBERS ARE MEMBERS OF THE SISTERS OF CHARITY OF LEAVENWORTH (A RELIGIOUS ORDER OF WOMEN). THE SISTERS HAVE TAKEN VOWS OF POVERTY AND RECEIVE NO COMPENSATION, EXPENSE ACCOUNT ALLOWANCE, OR CONTRIBUTIONS TO BENEFIT PLANS FOR THEIR SERVICES TO THE HEALTH SYSTEM. HOWEVER, A PAYMENT IS MADE DIRECTLY TO THE SISTERS OF CHARITY OF LEAVENWORTH FOR THE SERVICES OF THOSE WHO PERFORM PROFESSIONAL, ADMINISTRATIVE, AND OTHER SUCH SERVICES. FORM 990, PART VI, SECTION A, LINE 2 CLAY M. ASHDOWN / SUZANNE DRAPER / STACY JENNINGS / GREGORY M. JOHNSON / GREG J. MATIS / ALBERT R. ZIMMERLI- BUSINESS RELATIONSHIP (EMPLOYER/EMPLOYEE RELATIONSHIPS IN IHC HEALTH SERVICES, INC., A RELATED TAX-EXEMPT ORGANIZATION) JAMES P. VALIN, MD / ALBERT R. ZIMMERLI- BUSINESS RELATIONSHIP (TRUSTEES AND/OR OFFICERS OF SELECTHEALTH BENEFIT ASSURANCE COMPANY, INC., A RELATED TAXABLE ENTITY) CLAY M. ASHDOWN / ALBERT R. ZIMMERLI- BUSINESS RELATIONSHIP (TRUSTEES OF NAVICAN GENOMICS, INC., A RELATED TAXABLE ENTITY) FORM 990, PART VI, SECTION A, LINE 4 SIGNIFICANT CHANGES TO ITS GOVERNING DOCUMENTS SINCE THE PRIOR FORM 990: ON APRIL 1, 2022, SISTERS OF CHARITY OF LEAVENWORTH HEALTH SYSTEM, INC. AFFLIATED WITH INTERMOUNTAIN HEALTH CARE, INC. (INTERMOUNTAIN). AS A RESULT, THE GOVERNING DOCUMENTS OF SCLHS WERE UPDATED TO REFLECT THE NEW PARENT ORGANIZATION, INTERMOUNTAIN AS A MEMBER OF SCLHS. AS A RESULT OF THE AFFILIATION BETWEEN SCLHS AND INTERMOUNTAIN, RESERVED POWERS ARE HELD BY BOTH SCLHS AND INTERMOUNTAIN. SCLHS HAS THE POWER TO APPOINT TRUSTEES TO THE BOARD OF DIRECTORS, SUBJECT TO RATIFICATION BY INTERMOUNTAIN. RESERVED POWERS HELD BY INTERMOUNTAIN INCLUDE THE FOLLOWING: - ESTABLISH THE MISSION, VISION, AND VALUES FOR THE CORPORATION; - DEVELOP, ADOPT, AND OVERSEE STRATEGY, GOALS, OBJECTIVES, POLICIES, STANDARDS, AND GUIDELINES FOR THE CORPORATION; - ADOPT, AMEND, OR REPEAL THE GOVERNING DOCUMENTS OF THE CORPORATION; - FIX THE NUMBER OF TRUSTEES OF THE BOARD AND APPOINT AND REMOVE TRUSTEES TO AND FROM THE BOARD; - APPOINT AND REMOVE THE TRUSTEES, DIRECTORS, MANAGERS, OR BOARD OFFICERS OF THE CORPORATION; - PROVIDE FOR THE OVERALL MANAGEMENT OF THE CORPORATION, INCLUDING APPOINTING, OVERSEEING, AND REMOVING THE PRESIDENT AND CHIEF EXECUTIVE OFFICER OF THE CORPORATION; - OVERSEE AUDIT AND COMPLIANCE, CLINICAL EXCELLENCE, COMPENSATION, FINANCE, INVESTMENT, NOMINATING AND GOVERNANCE, AND ANY OTHER NEEDED FUNCTIONS FOR THE PROPER OPERATION OF THE CORPORATION; - OVERSEE THE MEDICAL GROUPS OF THE SYSTEM IN A MANNER TO ENCOURAGE THE DELIVERY OF COST-EFFECTIVE PROFESSIONAL SERVICES TO PATIENTS SERVED AND, IN ACCORDANCE WITH APPLICABLE STATE LAW, OVERSEE CLINICAL PRACTICE AND EVIDENCED-BASED MEDICINE; - APPROVE THE ACQUISITION OF ASSETS, INCURRENCE OF INDEBTEDNESS, SALE, LEASE, TRANSFER, ASSIGNMENT, OR ENCUMBRANCE OF ALL OR SUBSTANTIALLY ALL OF THE ASSETS OF THE CORPORATION; - APPROVE ANY MERGER, CHANGE OF CONTROL, DISSOLUTION, OR CORPORATE RESTRUCTURING OF THE CORPORATION; - OVERSEE THE ACQUISITION OR FORMATION OF ANY NEW SUBSIDIARY OF THE CORPORATION; AND - DIRECT FINANCES AND INVESTMENTS OF THE CORPORATION, INCLUDING CONTROLS, OPERATING AND CAPITAL BUDGETS, INTERCOMPANY TRANSFERS OR LOANS, AND SELECTION AND REMOVAL OF EXTERNAL AUDITORS. AS PART OF THE AFFILIATION, CERTAIN PROTECTIONS WERE INCLUDED IN THE BYLAWS TO ENSURE THE SCLHS CATHOLIC ENTITIES WERE ABLE TO RETAIN THEIR CATHOLICITY, WHICH MAY NOT BE NEGATED, RESTRICTED, RESCINDED, REVOKED, SUSPENDED, TERMINATED, ALTERED OR AMENDED WITHOUT THE APPROVAL OF LEAVEN MINISTRIES. THE CATHOLIC PROTECTIONS INCLUDE EACH SCLHS CATHOLIC ENTITY RETAINING ITS CATHOLIC MISSION AND ALL CATHOLIC MORAL PRINCIPLES, POLICIES, AND PRACTICES THAT ARE REQUIRED BY THE CATHOLIC CHURCH, CONTINUING TO BE SUBJECT TO THE ETHICAL AND RELIGIOUS DIRECTIVES FOR CATHOLIC HEALTHCARE SERVICES AS ADOPTED AND AMENDED BY THE UNITED STATES CONFERENCE OF CATHOLIC BISHOPS, RETAINING THE CATHOLIC REFERENCES IN EACH SCLHS ENTITY NAME, NOT PERFORMING ANY MEDICAL PROCEDURE, CLINICAL INTERVENTION, OR USE ANY DEVICE OR PRODUCT THAT HAS BEEN DEEMED MORALLY OBJECTIONABLE BY THE CHURCH'S TEACHINGS. RESERVED POWERS GRANTED TO LEAVEN MINISTRIES INCLUDE THE FOLLOWING: - TO APPROVE THE ADOPTION, AMENDMENT OR REPEAL OF THE CIVIL ARTICLES OF INCORPORATION OR BYLAWS OF SCLHS, OF ANY CIVIL CORPORATION OF WHICH SCLHS IS THE CONTROLLING MEMBER, AND OF ANY SUBSIDIARY CORPORATION OF SCLHS; - TO FIX THE NUMBER AND APPOINT THE MEMBERS OF THE BOARD OF TRUSTEES OF SCLHS; - TO REMOVE, WITH OR WITHOUT CAUSE, ANY MEMBER OF THE BOARD OF TRUSTEES OF SCLHS; - TO APPROVE FOR SCLHS, ANY CORPORATION OF WHICH SCLHS IS THE CONTROLLING MEMBER, OR ANY SUBSIDIARY CORPORATION OF SCLHS, THE INCURRENCE OF INDEBTEDNESS OR THE SALE, TRANSFER, ASSIGNMENT, OR ENCUMBERING OF THE ASSETS, PURSUANT TO POLICIES ESTABLISHED FROM TIME TO TIME BY THE MEMBERS OF LEAVEN MINISTRIES; - TO APPROVE ANY OTHER ACTION WHICH, IN ACCORDANCE WITH THE CIVIL CORPORATE DOCUMENTS GOVERNING SCLHS IS RESERVED TO THE MEMBERS OF LEAVEN MINISTRIES; - TO APPROVE ANY ALIENATION, SALE, GIFT OR OTHER TRANSFER OF THE REAL PROPERTY HELD BY ANY SCLHS CATHOLIC ENTITY THAT CONSTITUTES ECCLESIASTICAL GOODS; - TO APPROVE ANY DISSOLUTION, FILING OF A BANKRUPTCY PETITION, MERGER, CONSOLIDATION OR CHANGE OF MAJORITY CONTROL OF ANY SCLHS CATHOLIC ENTITY; - TO APPROVE ANY MORTGAGE OR OTHER SECURITY INSTRUMENT THAT DIRECTLY ENCUMBERS THE REAL PROPERTY OF ANY SCLHS CATHOLIC ENTITY THAT CONSTITUTES ECCLESIASTICAL GOODS; - TO MONITOR, OVERSEE AND ENFORCE THE CATHOLIC PROTECTIONS INCLUDING THOSE ON-GOING OBLIGATIONS OF SCLHS AND INTERMOUNTAIN SET FORTH IN THE AFFILIATION AGREEMENT THAT ARE FOR THE BENEFIT OF LEAVEN MINISTRIES; AND - TO APPROVE ANY ALTERATION, REVOCATION, SUSPENSION, OR OTHER TERMINATION OR MODIFICATION OF THE RESERVED POWERS SET FORTH HEREIN. IN THE EVENT ANY CONFLICTS ARISE BETWEEN THE ENTITY BYLAWS AND EITHER THE CATHOLIC PROTECTIONS OR LEAVEN RESERVED POWERS, THE CATHOLIC PROTECTIONS AND LEAVEN RESERVED POWERS WILL CONTROL. THE TAX-EXEMPT PURPOSE OF SCLHS WAS UPDATED TO INCLUDE THE FURTHERANCE OF THE TAX-EXEMPT PURPOSES OF INTERMOUNTAIN. THE MAXIMUM NUMBER OF BOARD MEMBERS WAS INCREASED FROM 17 TO 22 TO PROVIDE ADDITIONAL FLEXIBILITY MOVING FORWARD. THE TERM THE BOARD CHAIR MAY SERVE WAS EXTENDED FROM 2 YEARS TO 3 YEARS. THE DISSOLUTION CLAUSE WAS UPDATED TO THE NEW ORGANIZATIONAL PARENT, INTERMOUNTAIN, WHO REPLACED SCLHS. CHANGES TO THE GOVERNING DOCUMENTS MAY BE PROPOSED BY THE MEMBER, BUT NEED TO BE APPROVED BY THE IHC BOARD, PRIOR TO ADOPTION. FORM 990, PART VI, SECTION A, LINE 6 THE MEMBERS OF THE CORPORATION ARE INTERMOUNTAIN HEALTH CARE, INC., A UTAH NONPROFIT CORPORATION, AND THE MEMBERS OF LEAVEN MINISTRIES. EACH MEMBER OF LEAVEN MINISTRIES SHALL SERVE AS A MEMBER OF THE CORPORATION DURING THE MEMBER'S TERM OF OFFICE AS A MEMBER OF LEAVEN MINISTRIES, WHICH IS AN UNINCORPORATED PUBLIC JURIDIC PERSON AUTHORIZED BY THE CATHOLIC CHURCH. FORM 990, PART VI, SECTION A, LINE 7A POWER TO ELECT OR APPOINT MEMBERS THE PRESIDENT/CHIEF EXECUTIVE OFFICER OF THE CORPORATION AND THE CHAIR OF LEAVEN MINISTRIES, OR HIS/HER DESIGNEE, SHALL BE TRUSTEES OF THE BOARD WITH FULL VOTING RIGHTS. THE CHAIR OF LEAVEN MINISTRIES SHALL APPOINT AN ADDITIONAL MEMBER OF LEAVEN MINISTRIES TO SERVE ON THE BOARD OF DIRECTORS OF SCLHS. LEAVEN MINISTRIES AND INTERMOUNTAIN WILL EACH HAVE THE POWER TO REMOVE A TRUSTEE AT ANY TIME WITH OR WITHOUT CAUSE IMMEDIATELY UPON GIVING NOTICE TO THE TRUSTEE AND TO THE OTHER MEMBER. AT THE ANNUAL MEETING OF THE BOARD OF TRUSTEES OF INTERMOUNTAIN, SUBJECT TO THE LEAVEN MINISTRIES APPOINTMENT AND REMOVAL RIGHTS, INTERMOUNTAIN WILL APPOINT TRUSTEES, ELECT BOARD OFFICERS, AND TRANSACT SUCH OTHER BUSINESS AS IT CONSIDERS APPROPRIATE. TRUSTEES AND BOARD OFFICERS MAY BE NOMINATED FOR APPOINTMENT BY THE BOARD OF SISTERS OF CHARITY OF LEAVENWORTH HEALTH SYSTEM, INC. WHILE THE BOARD OF INTERMOUNTAIN HEALTH CARE, INC. WILL MAINTAIN A SET OF COMPETENCIES AND QUALIFICATIONS FOR BOARD APPOINTMENT THAT MAY BE UPDATED FROM TIME TO TIME. FORM 990, PART VI, SECTION A, LINE 7B DECISIONS RESERVED TO MEMBERS OR STOCKHOLDERS RESERVED POWERS ARE HELD BY BOTH MEMBERS OF SCLHS. THE MEMBERS ARE INTERMOUNTAIN AND LEAVEN MINISTRIES. RESERVED POWERS HELD BY INTERMOUNTAIN INCLUDE: - ESTABLISH THE MISSION, VISION, AND VALUES FOR THE CORPORATION; - DEVELOP, ADOPT, AND OVERSEE STRATEGY, GOALS, OBJECTIVES, POLICIES, STANDARDS, AND GUIDELINES FOR THE CORPORATION; - ADOPT, AMEND, OR REPEAL THE GOVERNING DOCUMENTS OF THE CORPORATION; - FIX THE NUMBER OF TRUSTEES OF THE BOARD AND APPOINT AND REMOVE TRUSTEES TO AND FROM THE BOARD; - APPOINT AND REMOVE THE TRUSTEES, DIRECTORS, MANAGERS, OR BOARD OFFICERS OF THE CORPORATION; - PROVIDE FOR THE OVERALL MANAGEMENT OF THE CORPORATION, INCLUDING APPOINTING, OVERSEEING, AND REMOVING THE PRESIDENT AND CHIEF EXECUTIVE OFFICER OF THE CORPORATION; - OVERSEE AUDIT AND COMPLIANCE, CLINICAL EXCELLENCE, COMPENSATION, FINANCE, INVESTMENT, NOMINATING AND GOVERNANCE, AND ANY OTHER NEEDED FUNCTIONS FOR THE PROPER OPERATION OF THE CORPORATION; - OVERSEE THE MEDICAL GROUPS OF THE SYSTEM IN A MANNER TO ENCOURAGE THE DELIVERY OF COST-EFFECTIVE PROFESSIONAL SERVICES TO PATIENTS SERVED AND, IN ACCORDANCE WITH APPLICABLE STATE LAW, OVERSEE CLINICAL PRACTICE AND EVIDENCED-BASED MEDICINE; - APPROVE THE ACQUISITION OF ASSETS, INCURRENCE OF INDEBTEDNESS, SALE, LEASE, TRANSFER, ASSIGNMENT, OR ENCUMBRANCE OF ALL OR SUBSTANTIALLY ALL OF THE ASSETS OF THE CORPORATION; - APPROVE ANY MERGER, CHANGE OF CONTROL, DISSOLUTION, OR CORPORATE RESTRUCTURING OF THE CORPORATION; - OVERSEE THE ACQUISITION OR FORMATION OF ANY NEW SUBSIDIARY OF THE CORPORATION; AND - DIRECT FINANCES AND INVESTMENTS OF THE CORPORATION, INCLUDING CONTROLS, OPERATING AND CAPITAL BUDGETS, INTERCOMPANY TRANSFERS OR LOANS, AND SELECTION AND REMOVAL OF EXTERNAL AUDITORS. RESERVED POWERS HELD BY LEAVEN MINISTRIES INCLUDE: - TO APPROVE THE ADOPTION, AMENDMENT OR REPEAL OF THE CIVIL ARTICLES OF INCORPORATION OR BYLAWS OF SCLHS, OF ANY CIVIL CORPORATION OF WHICH SCLHS IS THE CONTROLLING MEMBER, AND OF ANY SUBSIDIARY CORPORATION OF SCLHS; - TO FIX THE NUMBER AND APPOINT THE MEMBERS OF THE BOARD OF TRUSTEES OF SCLHS; - TO REMOVE, WITH OR WITHOUT CAUSE, ANY MEMBER OF THE BOARD OF TRUSTEES OF SCLHS; - TO APPROVE FOR SCLHS, ANY CORPORATION OF WHICH SCLHS IS THE CONTROLLING MEMBER, OR ANY SUBSIDIARY CORPORATION OF SCLHS, THE INCURRENCE OF INDEBTEDNESS OR THE SALE, TRANSFER, ASSIGNMENT, OR ENCUMBERING OF THE ASSETS, PURSUANT TO POLICIES ESTABLISHED FROM TIME TO TIME BY THE MEMBERS OF LEAVEN MINISTRIES; - TO APPROVE ANY OTHER ACTION WHICH, IN ACCORDANCE WITH THE CIVIL CORPORATE DOCUMENTS GOVERNING SCLHS IS RESERVED TO THE MEMBERS OF LEAVEN MINISTRIES; - TO APPROVE ANY ALIENATION, SALE, GIFT OR OTHER TRANSFER OF THE REAL PROPERTY HELD BYANY SCLHS CATHOLIC ENTITY THAT CONSTITUTES ECCLESIASTICAL GOODS; - TO APPROVE ANY DISSOLUTION, FILING OF A BANKRUPTCY PETITION, MERGER, CONSOLIDATION OR CHANGE OF MAJORITY CONTROL OF ANY SCLHS CATHOLIC ENTITY; - TO APPROVE ANY MORTGAGE OR OTHER SECURITY INSTRUMENT THAT DIRECTLY ENCUMBERS THE REAL PROPERTY OF ANY SCLHS CATHOLIC ENTITY THAT CONSTITUTES ECCLESIASTICAL GOODS; - TO MONITOR, OVERSEE AND ENFORCE THE CATHOLIC PROTECTIONS INCLUDING THOSE ON-GOING OBLIGATIONS OF BOTH SCLHS AND INTERMOUNTAIN FORTH IN THE AFFILIATION AGREEMENT THAT ARE FOR THE BENEFIT OF LEAVEN MINISTRIES; AND - TO APPROVE ANY ALTERATION, REVOCATION, SUSPENSION, OR OTHER TERMINATION OR MODIFICATION OF THE RESERVED POWERS SET FORTH HEREIN. IN THE EVENT ANY CONFLICTS ARISE BETWEEN THE RESERVED POWERS GRANTED TO LEAVEN MINISTRIES AND THOSE OF INTERMOUNTAIN, THE LEAVEN RESERVED POWERS WILL CONTROL. FORM 990, PART VI, SECTION B, LINE 11B THE FORM 990 IS PREPARED BY THE TAX DEPARTMENT. THE FORM 990 IS REVIEWED BY CERTAIN MEMBERS OF SENIOR MANAGEMENT. A COPY OF THE FORM 990 IS PROVIDED TO THE BOARD OF DIRECTORS PRIOR TO THE FILING OF THE FORM 990 WITH THE INTERNAL REVENUE SERVICE. FORM 990, PART VI, SECTION B, LINE 12C MONITORING AND ENFORCEMENT OF COMPLIANCE WITH CONFLICT OF INTEREST POLICY SISTERS OF CHARITY OF LEAVENWORTH HEALTH SYSTEM, INC. REGULARLY AND CONSISTENTLY MONITORS AND ENFORCES ITS CONFLICT OF INTEREST POLICY BY PROVIDING EDUCATION AND TRAINING FOR ITS EMPLOYEES, OFFICERS AND DIRECTORS. PERSONS CONSIDERED TO BE IN AN INFLUENTIAL POSITION, SUCH AS BOARD MEMBERS, OFFICERS, PHYSICIANS, EXECUTIVES AND DIRECTOR LEVEL MANAGERS ARE ALL REQUIRED TO COMPLETE A CONFLICT OF INTEREST STATEMENT UPON HIRE/APPOINTMENT AND ON AN ANNUAL BASIS TO DISCLOSE ANY POTENTIAL CONFLICT ISSUES. THESE STATEMENTS ARE CAREFULLY REVIEWED BY THE SCLHS INTEGRITY AND COMPLIANCE DEPARTMENT AND APPROPRIATE LEADERSHIP. THE BUSINESS AND AFFAIRS OF SCLHS WILL AT ALL TIMES BE CONDUCTED IN A MANNER THAT IS SOLELY IN THE BEST INTERESTS OF SCLHS AND NOT BE INFLUENCED BY CONFLICTING INTERESTS OF PERSONS RESPONSIBLE FOR ADMINISTERING THOSE AFFAIRS. THE EXISTENCE OF ANY CONFLICTS OF INTEREST WILL BE DISCLOSED AND THE PROCEDURES SET FORTH HEREIN WILL BE FOLLOWED. CERTAIN TRANSACTIONS DETERMINED TO CONSTITUTE A CONFLICT OF INTEREST ARE PROHIBITED. ANY PERSON IN A POSITION TO EXERCISE SUBSTANTIAL INFLUENCE OVER SCLHS IS CONSIDERED AN INTERESTED PERSON. THIS TERM INCLUDES, BUT IS NOT LIMITED TO THE FOLLOWING: - BOARD MEMBERS, BOARD COMMITTEE MEMBERS, OFFICERS AND DIRECTORS; - SENIOR LEADERS AND EXECUTIVES (CEO, PRESIDENT, SVP, VP, EXECUTIVE DIRECTORS); - EMPLOYED PHYSICIANS AND PHYSICIANS IN MEDICAL STAFF LEADERSHIP ROLES (E.G., DEPARTMENT CHAIRS, MEMBERS OF MEDICAL STAFF COMMITTEES); - MEDICAL DIRECTORS OF CLINICAL PROGRAMS THAT ASSESS, REVIEW, RECOMMEND OR REQUEST PURCHASE OF ANY SPECIFIC PHARMACEUTICAL PRODUCTS, MEDICAL DEVICES, SUPPLIES AND/OR EQUIPMENT; - DEPARTMENT DIRECTORS; AND - OTHER SELECT INDIVIDUALS IDENTIFIED BY LEADERSHIP WHICH MAY INCLUDE, BUT IS NOT LIMITED TO, SUPPLY CHAIN AND FINANCE. UPON BECOMING AN INTERESTED PERSON AND ON AN ANNUAL BASIS, INTERESTED PERSONS ARE REQUIRED TO DISCLOSE ANY RELATIONSHIPS THAT CONSTITUTE OR MIGHT LEAD TO A CONFLICT OF INTEREST BY COMPLETING THE CURRENT CONFLICT OF INTEREST AND GIFT DISCLOSURE STATEMENT ("STATEMENT") AS APPROVED BY THE CHIEF INTEGRITY AND COMPLIANCE OFFICER. THE CHIEF INTEGRITY AND COMPLIANCE OFFICER WILL OVERSEE THE REVIEW OF THE STATEMENTS AND THE RESOLUTION OF ANY IDENTIFIED CONFLICTS OF INTEREST AND ALERT THE SUPERVISOR AND/OR BOARD CHAIR. WHEN AN INTERESTED PERSON BECOMES AWARE OF A CONFLICT OF INTEREST WHICH HAS NOT BEEN DISCLOSED ON A STATEMENT, HE OR SHE SHALL CONTACT THE LOCAL COMPLIANCE AND PRIVACY OFFICER OR THE CHIEF INTEGRITY AND COMPLIANCE OFFICER, COMPLETE A DISCLOSURE, AND RETURN IT TO THE SCLHS INTEGRITY AND COMPLIANCE DEPARTMENT. WHENEVER AN INTERESTED PERSON BECOMES AWARE THAT AN ARRANGEMENT WITH RESPECT TO WHICH HE OR SHE HAS A CONFLICT OF INTEREST IS BEING CONSIDERED, THE INTERESTED PERSON MUST DISCLOSE ALL MATERIAL FACTS CONCERNING THE EXISTENCE AND NATURE OF THE CONFLICT OF INTEREST TO HIS OR HER SUPERVISOR OR TO THE APPLICABLE BOARD OR COMMITTEE CHAIR, EVEN IF THE CONFLICT OF INTEREST HAS BEEN PREVIOUSLY DISCLOSED. THE INTERESTED PERSON'S LOCAL COMPLIANCE AND PRIVACY OFFICER, SUPERVISOR, AND/OR BOARD OR COMMITTEE CHAIR WILL DETERMINE WHETHER A CONFLICT OF INTEREST EXISTS. PERSON(S) RESPONSIBLE FOR THE DETERMINATION SHOULD OBTAIN FURTHER GUIDANCE FROM THE SCLHS INTEGRITY AND COMPLIANCE OR LEGAL DEPARTMENTS. UPON MAKING HIS OR HER DISCLOSURE, THE INTERESTED PERSON WILL LEAVE THE MEETING OR OTHERWISE REMOVE HIM OR HERSELF FROM THE DELIBERATIONS OR OTHER DECISION-MAKING PROCESS UNTIL SUCH TIME AS A DETERMINATION IS REACHED. IF A DETERMINATION HAS BEEN MADE THAT NO CONFLICT OF INTEREST EXISTS, THE INTERESTED PERSON MAY BE PRESENT AND PARTICIPATE IN THE DELIBERATION REGARDING THE TRANSACTION OR ARRANGEMENT. HOWEVER, IF AN INTERESTED PERSON HAS BEEN DETERMINED TO HAVE A CONFLICT OF INTEREST, HE OR SHE MAY NOT PARTICIPATE IN THE DELIBERATION OR DECISION REGARDING THE TRANSACTION OR ARRANGEMENT; BE PRESENT DURING THE DELIBERATION OR DECISION-MAKING; OR BE ALLOWED TO MAKE A PRESENTATION PRIOR TO THE DELIBERATION AND DECISION-MAKING ACTIVITIES. WHEN AN INTERESTED PERSON HAS A CONFLICT OF INTEREST, THE DECISION-MAKER/DECISION-MAKING BODY CONSIDERING THE TRANSACTION OR ARRANGEMENT WILL TAKE REASONABLE MEASURES, PRIOR TO APPROVING OR ENTERING INTO THE TRANSACTION OR ARRANGEMENT, TO ENSURE THAT THE PROPOSAL IS IN SCLHS' BEST INTERESTS. THE PROPOSED TRANSACTION OR ARRANGEMENT MAY PROCEED IF THE DECISION-MAKER/DECISION-MAKING BODY, AFTER HAVING BEEN FULLY INFORMED OF THE MATERIAL FACTS ESTABLISHING THE CONFLICT OF INTEREST, DETERMINES THAT THE TRANSACTION OR ARRANGEMENT IS IN SCLHS' BEST INTERESTS AND IS FAIR AND REASONABLE. A MAJORITY VOTE OF THE DISINTERESTED DECISION-MAKERS IS REQUIRED WHEN A DETERMINATION IS MADE BY A BOARD, COMMITTEE OR OTHER DECISION-MAKING BODY. MANAGEMENT OF POTENTIAL CONFLICTS IS DONE BY THE CHIEF INTEGRITY AND COMPLIANCE OFFICER AND/OR CARE SITE COMPLIANCE AND PRIVACY OFFICERS AND REPORTED ANNUALLY TO THE CARE SITE LEADERSHIP COMMITTEES AND/OR AUDIT AND COMPLIANCE COMMITTEES. ANY REPORTED CONFLICTS OR POTENTIAL CONFLICTS WILL ALSO BE REPORTED TO AND REVIEWED BY INTERMOUNTAIN'S TAX DEPARTMENT FOR COMPLIANCE WITH THE FORM 990 TAX RETURN. FORM 990, PART VI, SECTION B, LINE 15 SISTERS OF CHARITY OF LEAVENWORTH HEALTH SYSTEM, INC.'S PROCESS FOR DETERMINING COMPENSATION FOR THE OFFICERS AND SENIOR MANAGEMENT IS THE RESPONSIBILITY OF THE COMPENSATION COMMITTEE. COMPENSATION FOR THE OFFICERS AND SENIOR MANAGEMENT IS MANAGED BY THE INTERMOUNTAIN HEALTH CARE, INC. BOARD COMPENSATION COMMITTEE (COMMITTEE) ON BEHALF OF SCLHS AND ALL OF ITS AFFILIATES. THE COMMITTEE REVIEWS AND APPROVES COMPENSATION ARRANGEMENTS OF THE OFFICERS AND SENIOR MANAGEMENT AND MAKES RECOMMENDATIONS TO INTERMOUNTAIN HEALTH CARE, INC.'S BOARD FOR APPROVAL OF ANY CHANGES TO COMPENSATION FOR THE OFFICERS AND SENIOR MANAGEMENT. THE COMMITTEE'S REVIEW IS CONDUCTED IN A MANNER THAT IS INTENDED TO QUALIFY FOR THE REBUTTABLE PRESUMPTION OF REASONABLENESS UNDER THE INTERMEDIATE SANCTIONS RULES OF INTERNAL REVENUE CODE SECTION 4958. THE COMMITTEE CONDUCTS THE REVIEW WITH THE ASSISTANCE OF AN EXPERIENCED AND INDEPENDENT COMPENSATION CONSULTING FIRM THAT HAS DEEP NATIONAL EXPERTISE IN HEALTH SYSTEMS' EXECUTIVE COMPENSATION PROGRAMS AND LEVELS. THE COMMITTEE OBTAINS AND RELIES UPON CURRENT, COMPARABLE MARKET DATA FOR PEER ORGANIZATIONS PRIOR TO MAKING COMPENSATION RELATED DECISIONS. THE INFORMATION REVIEWED INCLUDES COMPENSATION LEVELS PAID BY SIMILARLY SITUATED ORGANIZATIONS FOR FUNCTIONALLY COMPARABLE POSITIONS, THE AVAILABILITY OF SIMILAR SERVICES IN THE GEOGRAPHIC AREA SERVED BY INTERMOUNTAIN HEALTH CARE, INC. AND CURRENT COMPENSATION SURVEYS COMPILED BY AN INDEPENDENT FIRM. CONSISTENT WITH THE PAY PHILOSOPHY SET BY INTERMOUNTAIN HEALTH CARE, INC.'S BOARD, THE COMMITTEE EMPHASIZES THE IMPORTANCE OF ENSURING TOTAL REMUNERATION IS REASONABLE AND APPROPRIATE WHEN REVIEWING AND MAKING RECOMMENDATIONS WITH RESPECT TO COMPENSATION PACKAGES FOR THE OFFICERS AND SENIOR MANAGEMENT. AS PART OF THE REVIEW PROCESS, INTERMOUNTAIN HEALTH CARE, INC. USES THE FOLLOWING IN ESTABLISHING THE COMPENSATION OF OFFICERS AND SENIOR MANAGEMENT. 1) COMPENSATION COMMITTEE 2) INDEPENDENT COMPENSATION CONSULTANT 3) FORM 990 OF OTHER ORGANIZATIONS 4) WRITTEN EMPLOYMENT CONTRACTS 5) COMPENSATION SURVEYS AND STUDIES 6) APPROVAL BY THE BOARD OR COMPENSATION COMMITTEE THE ITEMS LISTED ABOVE SUPPORT THE COMPENSATION COMMITTEE'S EFFORTS TO ENSURE THAT THE LEVEL OF COMPENSATION PROVIDED TO ITS OFFICERS AND SENIOR MANAGEMENT IS REASONABLE, APPROPRIATE AND CONSISTENT WITH THE PAY PHILOSOPHY SET BY THE BOARD. FORM 990, PART VI, SECTION C, LINE 19 THE ORGANIZATION MAKES ITS CONFLICT OF INTEREST POLICY, FINANCIAL STATEMENTS, AND GOVERNING DOCUMENTS AVAILABLE UPON REQUEST. FORM 990, PART XI, LINE 9: CHANGE IN SELF INSURED LIABILITY 849,829. FAIR VALUE ACQUISITION ADJUSTMENT -91,330,121. TRANSFERS TO SUBSIDIARIES 958,601. TRANSFER OF DEBT TO AFFILIATE 1,087,728,935. TRANSFER OF BOND PROCEEDS FROM AFFILIATE 257,541,778. OTHER TRANSFERS TO/FROM AFFILIATE -1,098,041. 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