2024-09-09T09:53:28-05:00 2023-12-31 390758449 WIPFLI LLP 105 E PINE ST UPPER FLOOR MISSOULA MT 59802 990 2023-01-01 820226453 ST MARY'S HOSPITAL INC STMA 2089623251 PO BOX 137 COTTONWOOD ID 83522 JYL RULAND CFO 2089623251 2024-08-13 1 1 SAM BRUNSON CPA P01696998 4067281800 2024-08-13 2023 2024-08-08 14:25:15Z ST MARY'S HEALTH LENNE BONNER PO BOX 137 COTTONWOOD ID 83522 27360657 0 0928 X SMH-CVH.ORG X 1958 ID WE IMPROVE HEALTHCARE ONE PATIENT AT A TIME IN A FRIENDLY AND PROFESSIONAL CULTURE COMMITTED TO SUPERIOR QUALITY AND SAFETY. 12 11 257 10 0 0 1043398 780076 24907804 25868248 179870 391741 307176 171139 26438248 27211204 7807 4336 0 0 16636310 16712708 0 0 9096 8684959 8562348 25329076 25279392 1109172 1931812 29199175 30784173 7532890 6863256 21666285 23920917 X WE IMPROVE HEALTHCARE ONE PATIENT AT A TIME IN A FRIENDLY AND PROFESSIONAL CULTURE COMMITTED TO SUPERIOR QUALITY AND SAFETY. 0 0 18970724 4336 25868248 ST MARY'S HOSPITAL (SMH) IS CREATED AND ORGANIZED TO OWN, MAINTAIN, OPERATE AND CONDUCT, DIRECTLY OR INDIRECTLY, AND TO ASSIST AND COORDINATE ACTIVITIES OF FACILITIES FOR HEALTH CARE, EDUCATION, CARE FOR THE AGED AND SOCIAL SERVICES IN ACCORDANCE WITH THE CHARITABLE WORKS TRADITION OF THE ROMAN CATHOLIC CHURCH. IN KEEPING WITH THIS SPECIFIC PURPOSE, ALL WORKS SHALL BE CARRIED OUT IN ACCORDANCE WITH THE CHARISM OF THE BENEDICTINE SISTERS OF ST. SCHOLASTICA MONASTERY. SMH OPERATES A 25-BED CRITICAL ACCESS HOSPITAL AND PRIMARY CARE CLINICS THAT PROVIDE GENERAL MEDICAL AND SURGICAL CARE FOR INPATIENT, OUTPATIENT, AND EMERGENCY ROOM PATIENTS IN COTTONWOOD AND THE SURROUNDING AREAS OF KAMIAH, GRANGEVILLE, NEZPERCE, CRAIGMONT AND ELK CITY.THE HOSPITAL PROVIDED 971 HOSPITAL PATIENT DAYS, 22,709 OUTPATIENT VISITS, 2,010 ER VISITS, AND 27,431 CLINIC ENCOUNTERS DURING THE YEAR. THE HOSPITAL PROVIDES CARE TO PERSONS COVERED BY GOVERNMENTAL PROGRAMS AT BELOW COST AND TO INDIVIDUALS WHO ARE UNABLE TO PAY. THE UNREIMBURSED VALUE OF PROVIDING CARE TO THESE PATIENTS WAS $27,372 FOR CHARITY CARE, $4,013,507 FOR MEDICARE, $2,420,890 FOR MEDICAID, AND $1,986,166 FOR OTHER THIRD PARTY PAYORS FOR THE YEAR. 18970724 1 1 0 1 0 0 0 0 0 0 1 1 0 0 1 0 0 1 0 0 0 0 0 0 0 0 1 1 1 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 1 140 0 1 257 1 0 0 0 0 0 0 0 0 0 0 0 0 X 12 11 0 0 0 0 1 1 1 1 1 0 0 1 1 1 1 1 1 1 1 0 X JYL RULAND 2089623251 301 CEDAR OROFINO ID 83544 CINDY O'BRIEN CHAIR 1.00 1.00 X X 0 0 0 KIM INGRAM VICE CHAIR 1.00 1.00 X X 0 0 0 CHRISTINA ULMER SECRETARY 1.00 1.00 X X 0 0 0 KELLY MCGRATH DIRECTOR/CMO 20.00 20.00 X 0 328919 21637 MATT SARTINI DIRECTOR 1.00 1.00 X 0 0 0 PAUL NUSSER DIRECTOR 1.00 1.00 X 0 0 0 SISTER LISA MAURER DIRECTOR 1.00 1.00 X 0 0 0 RENE FORSMAN DIRECTOR 1.00 1.00 X 0 0 0 JEREMY EVANS DIRECTOR 1.00 1.00 X 0 0 0 SISTER BARBARA JEAN GLODOWSKI DIRECTOR 1.00 1.00 X 0 0 0 MARK IMUS DIRECTOR 1.00 1.00 X 0 0 0 CHRISTOPHER RIGGERS DIRECTOR 1.00 1.00 X 0 0 0 LENNE BONNER CEO 30.00 30.00 X 0 281018 23757 JYL RULAND CFO 30.00 30.00 X 0 161779 15867 THOMAS WONDERLICH PHYSICIAN 40.00 0.00 X 435341 0 16170 JUSTIN JONES PHYSICIAN 40.00 0.00 X 434684 0 21925 TEMA JESSUP PHYSICIAN 40.00 0.00 X 382833 0 21251 JACK BRUNER II PHYSICIAN 40.00 0.00 X 380054 0 21696 JOHN TRUEBLOOD PHYSICIAN 40.00 0.00 X 270105 0 19315 1903017 771716 161618 26 0 1 0 PALOUSE IMAGING CONSULTANTS PLLC PO BOX 9583 MOSCOW ID 83843 RADIOLOGY READS 336068 DMS IMAGING PO BOX 670747 DALLAS TX 752670747 MRI RADIOLOGY READS 334385 AXON ANESTHESIA INC PO BOX 310 GRANGEVILLE ID 83530 ANESTHESIA 219980 NEWPORT HEALTH SERVICES 4 CORPORATE PLAZA SUITE 150 NEWPORT BEACH CA 92660 SLEEP LAB MANAGEMENT 176550 QUALVIS LLC 5930 CORNORSTONE COURT WEST SUITE 3 SAN DIEGO CA 92121 RN COVERAGE 155762 5 5082 654902 120092 780076 PATIENT SERVICE REVENUE 621110 25497095 25497095 PHARMACY 340B REVENUE 456110 371153 371153 25868248 381194 381194 640 0 640 640 640 160000 149453 10547 10547 10547 34050 0 34050 34050 MEDICARE SHARED SAVINGS 900099 116654 116654 MISCELLANEOUS REVENUE 900099 19795 19795 136449 27211204 25868248 0 562880 X 4336 4336 14674029 10733320 3933536 7173 431344 315506 115627 211 693092 506962 185791 339 914243 668723 245073 447 27304 27304 1191 1191 1412 1412 2808051 2173288 634763 71094 71094 313869 125548 188164 157 145406 112690 32629 87 296096 180293 115744 59 100181 68422 31759 152411 152411 840006 603344 236547 115 131097 54059 77038 PHARMACEUTICALS 1028615 1028615 MEDICAL SUPPLIES 928536 928536 DUES & SUBSCRIPTIONS 688558 504517 183703 338 REPAIRS & MAINTENANCE 364378 247925 116453 664143 562229 101744 170 25279392 18970724 6299572 9096 1516620 1093230 3184258 4692842 65422 75474 3005188 3350057 25500 215 230711 174160 316525 179929 25621556 12367483 13343143 13254073 6829382 7442581 682426 521612 29199175 30784173 1917618 2303841 185688 337 3873644 3647665 1555940 911413 7532890 6863256 X 21666285 23920917 21666285 23920917 29199175 30784173 X 1931812 331571 -8751 X X 0 1 X 1 0 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 0 0 0 0 0 0 0 0 1 1191 1191 0 PART II-B, LINE 1: THE HOSPITAL DOES NOT DIRECTLY PERFORM ANY LOBBYING ACTIVITIES. THE HOSPITAL PAYS MEMBERSHIP DUES TO NATIONAL AND STATE HOSPITAL ASSOCIATIONS. THE ASSOCIATIONS USE A PORTION OF SUCH DUES TO CARRY OUT LOBBYING ACTIVITIES. 195511 195511 15072344 3568406 11503938 10290453 8784891 1505562 63248 14186 49062 13254073 POOLED INVESTMENT FUND 7442581 F 7442581 DUE TO RELATED ORGANIZATION 775196 CAPITAL LEASE LIABILITY 136217 911413 1 1 X 1 X 175.000000000000 1 X 250.000000000000 1 1 0 1 1 19012 19012 0.00080 2613987 1342474 1271513 0.05030 2632999 1342474 1290525 0.05110 19 1037 7955 60 7895 0.00030 4852707 3099344 1753363 0.06940 8 1301 3985 3985 0.00020 27 2338 4864647 3099404 1765243 0.06990 27 2338 7497646 4441878 3055768 0.12100 1 240708 0 12135529 12220056 -84527 X 1 1 1 1 ST MARY'S HOSPITAL INC 701 LEWISTON STREET COTTONWOOD ID 83522 WWW.SMH-CVH.ORG X X X X X ST MARY'S HEALTH 1 0 0 1 X X X X X X X X X 23 1 1 1 1 X WWW.SMH-CVH.ORG X 1 23 1 WWW.SMH-CVH.ORG 0 1 X 175.000000000000 250.000000000000 X X X X X 1 1 X X X X 1 X WWW.SMH-CVH.ORG X WWW.SMH-CVH.ORG X WWW.SMH-CVH.ORG X X X X X 1 X 0 X X X X 1 X 0 0 ST. MARY'S HEALTH PART V, SECTION B, LINE 5: DURING 2022 AND EARLY 2023, ST. MARY'S HEALTH ANALYZED DATA, CONVENED PUBLIC MEETINGS WITH COMMUNITY PARTNERS, SOUGHT INPUT ON HEALTH PRIORITIES FROM COMMUNITY MEMBERS, AND LED A PROCESS TO IDENTIFY THE PRIORITY AREAS FOR THE 2023 - 2025 COMMUNITY HEALTH NEEDS ASSESSMENT. THE PARTNERS REPRESENTED THE PUBLIC HEALTH PERSPECTIVE AND THE INTERESTS OF MEMBERS OF MEDICALLY UNDERSERVED, LOW-INCOME, AND MINORITY POPULATIONS, OR INDIVIDUALS. OTHER ORGANIZATIONS REPRESENTED ON THE STEERING COMMITTEE INCLUDED: BOARD OF EDUCATION MEMBERS, CLEARWATER ECONOMIC DEVELOPMENT COUNCIL, IDA-LEW ECONOMIC DEVELOPMENT COUNCIL, SMH AMBULANCE, NORTH IDAHO CORRECTIONAL CENTER, COTTONWOOD SENIOR CENTER, LOCAL BUSINESS LEADERS, COTTONWOOD CHAMBER OF COMMERCE, COTTONWOOD POLICE DEPARTMENT, AND FAITH-BASED ORGANIZATIONS. ST. MARY'S HEALTH PART V, SECTION B, LINE 6A: THE CHNA WAS CONDUCTED IN COLLABORATION WITH CLEARWATER VALLEY HOSPITAL AND CLINICS, INC., A RELATED ORGANIZATION, IN ORDER TO ALIGN RESOURCES AND STRENGTHS TO BETTER SERVE OUR COMMUNITY. ST. MARY'S HEALTH PART V, SECTION B, LINE 6B: ST. MARY'S HEALTH WORKED IN CONJUNCTION WITH THE UNIVERSITY OF WASHINGTON - "RURAL HEALTH LAB", AND THE INSTITUTE OF TRANSLATIONAL HEALTH SCIENCES TO CONDUCT OUR COMMUNITY HEALTH NEEDS ASSESSMENT AND IDAHO PUBLIC HEALTH, NORTH CENTRAL REGION, TO CONDUCT OUR NEEDS ASSESSMENT. ST. MARY'S HEALTH PART V, SECTION B, LINE 11: THE SIGNIFICANT NEEDS IDENTIFIED IN THE MOST RECENT ASSESSMENT ARE DEATHS OF DESPAIR (SUICIDE), OBESITY/HEALTHY LIFESTYLE, HEALTHCARE ACCESS, AND CANCER SCREENINGS. WITH FEW EXCEPTIONS, ST. MARY'S HEALTH PLAYS A PRIMARY ROLE IN ESTABLISHING THE FRAMEWORK FOR PROGRESS IN EACH OF THESE AREAS. PRIORITY AREA #1: DEATHS OF DESPAIRST. MARY'S HEALTH WILL CONTINUE TO OFFER SUICIDE PREVENTION TRAINING FOR THE COMMUNITY, DISTRIBUTE GUNLOCKS FOR THOSE THAT WANT THEM, INCREASE STAFF & COMMUNITY TRAINING AROUND SUICIDE PREVENTION, AWARENESS, AND DE-ESCALATION, AND EXPAND BEHAVIORAL HEALTH AND COUNSELING SERVICES.PRIORITY AREA #2: OBESITY/HEALTHY LIFESTYLEOUR AREA OFFERS A ROBUST OUTDOOR LIFESTYLE FOR ITS CITIZENS AND GUESTS. FISHING, HUNTING, SWIMMING, AND HIKING ARE ALL AVAILABLE RIGHT OUTSIDE YOUR DOOR. STRONG YOUTH PROGRAMS SUCH AS BASEBALL AND SOCCER ARE ALSO AVAILABLE TO THE AREA'S CHILDREN, AND A SKATE PARK AND A PUBLIC SWIMMING POOL ARE IN PROCESS OF BEING BUILT TO ADD TO THE COMMUNITIES ALREADY RICH RESOURCES. ST. MARY'S HEALTH WILL CONTINUE TO BUILD UPON THESE AVAILABLE RESOURCES TO OFFER COMMUNITY WALKS, VIRTUAL HEALTH CHALLENGES, EXPAND NUTRITIONAL COUNSELING AND DIABETES EDUCATION, AND SUPPORT THE COMMUNITY PARK EXPANSION AND OTHER RELATED HEALTHY LIFESTYLE INITIATIVES.PRIORITY AREA #3: HEALTHCARE ACCESS40.3% OF POPULATION IN CLEARWATER, IDAHO, AND LEWIS COUNTIES LIVE IN AN AREA AFFECTED BY HEALTH PROFESSIONAL SHORTAGES AS COMPARED TO 23% OF U.S. RESIDENTS. THE ISSUE INCREASED DURING THE COVID-19 PANDEMIC, WITH PEOPLE MOVING INTO OUR RURAL COMMUNITIES.AREAS OF SPECIFIC FOCUS INCLUDE:1. GROW ALREADY SUCCESSFUL PARTNERSHIPS WITH LOCAL AND REGIONAL TRAINING PROGRAMS (AREA HIGH SCHOOLS, HOSA PROGRAMS, WWAMI, ETC.) TO DEVELOP A LOCAL HEALTHCARE WORKFORCE FOR NOW AND IN THE FUTURE.2. EXPAND TELEHEALTH (VIRTUAL CARE) TO INCLUDE PRIMARY CARE, SPECIALTY CARE, AND BEHAVIORAL HEALTH.3. ADD NEW SERVICE LINES LOCALLY, INCLUDING SLEEP LAB, ORTHOPEDIC SERVICES, AND CHEMOTHERAPY INFUSIONS.PRIORITY AREA #4: CANCER SCREENINGSIDAHO PUBLIC HEALTH DISTRICT 2 HAS A BREAST CANCER INCIDENCE RATE HIGHER THAN OTHER IDAHO HEALTH DISTRICTS, AND SIGNIFICANTLY HIGHER THAN THE U.S. "AVERAGE". ADDITIONALLY, BREAST CANCER IS MORE LIKELY TO BE DIAGNOSED AT A LATE STAGE, COMPARED TO OTHER AREAS OF THE U.S. IDAHO RANKS 49TH OUT OF 53 U.S. STATES, TERRITORIES, AND THE DISTRICT OF COLUMBIA FOR BREAST CANCER SCREENINGS. COLORECTAL CANCER AND LUNG CANCER ALSO HAVE POOR SCREENING RATES.1. CLEARWATER VALLEY HEALTH & ST. MARY'S HEALTH HAVE PURCHASED A NEW MAMMOGRAPHY TRUCK THAT WILL SIGNIFICANTLY INCREASE OUR ABILITY TO OFFER ACCESS TO SCREENINGS FOR OUR PATIENTS AND COMMUNITIES. 2. ADDING NEW SERVICE LINES TO INCLUDE LOW DOSE CT SCANS FOR LUNG CANCER SCREENING AND INCREASE CANCER SCREENING BY UTILIZING OUR QUALITY METRICS AND COMMUNITY EDUCATION. 9 1 - ST MARY'S COTTONWOOD MEDICAL CLINIC 701 LEWISTON STREET COTTONWOOD ID 83522 OUTPATIENT CLINIC 2 - ST MARY'S KAMIAH MEDICAL CLINIC 518 OAK STREET KAMIAH ID 83536 OUTPATIENT CLINIC 3 - ST MARY'S KAMIAH PHYSICAL THERAPY 518 OAK STREET KAMIAH ID 83536 OUTPATIENT CLINIC 4 - ST MARY'S GRANGEVILLE MEDICAL CLINIC 617 W 2ND STE 2 GRANGEVILLE ID 83530 OUTPATIENT CLINIC 5 - ST MARY'S COTTONWOOD PHYSICAL THERAPY 701 LEWISTON STREET COTTONWOOD ID 83522 OUTPATIENT CLINIC 6 - ST MARY'S GRANGEVILLE PHYSICAL THERAPY 617 W 2ND STE 2 GRANGEVILLE ID 83530 OUTPATIENT CLINIC 7 - ST MARY'S CRAIGMONT MEDICAL CLINIC 320 N DIVISION CRAIGMONT ID 83523 OUTPATIENT CLINIC 8 - ST MARY'S NEZPERCE MEDICAL CLINIC 501 OAK NEZPERCE ID 83543 OUTPATIENT CLINIC 9 - ST MARY'S ELK CITY MEDICAL CLINIC 131 MAIN STREET ELK CITY ID 83525 OUTPATIENT CLINIC PART I, LINE 3C: ASSETS WILL BE CONSIDERED ALONG WITH THE PATIENT'S INCOME TO DETERMINE ELIGIBILITY FOR THE FINANCIAL ASSISTANCE PROGRAM. ASSETS MAY INCLUDE, BUT ARE NOT LIMITED TO, SUCH ITEMS AS CHECKING AND SAVINGS ACCOUNTS, IRAS, 401(K)S, 403(B)S, PENSIONS, HEALTH SAVINGS ACCOUNTS, ADDITIONAL PROPERTY, AND ANY OTHER RETIREMENT FUNDING. PART I, LINE 7: THE HOSPITAL APPLIES THE RATIO OF PATIENT CARE COST-TO-CHARGES (WORKSHEET 2) FOR FIGURES REPORTED IN THE TABLE RELATED TO CHARITY CARE AND UNREIMBURSED MEDICAID (TOTAL OPERATING EXPENSES LESS NON-PATIENT CARE ACTIVITIES, TOTAL COMMUNITY BENEFIT, AND TOTAL COMMUNITY BUILDING EXPENSES). ACTUAL COSTS WERE USED FOR THE REMAINDER OF THE COMMUNITY BENEFITS REPORTED. PART III, LINE 2: THE HOSPITAL REPORTS PATIENT ACCOUNTS RECEIVABLE FOR SERVICES RENDERED AT NET REALIZABLE AMOUNTS FROM THIRD-PARTY PAYERS, PATIENTS AND OTHERS. THE HOSPITAL PROVIDES AN ALLOWANCE FOR UNCOLLECTIBLE ACCOUNTS BASED UPON A REVIEW OF OUTSTANDING RECEIVABLES, HISTORICAL COLLECTION INFORMATION AND EXISTING ECONOMIC CONDITIONS. IF, DURING THE COLLECTION PROCESS, IT BECOMES KNOWN THAT THE PATIENT QUALIFIES FOR CHARITY CARE, THE AMOUNTS INCLUDED WITHIN BAD DEBT EXPENSE WOULD BE RECLASSIFIED TO CHARITY CARE. PART III, LINE 3: IF, DURING THE COLLECTION PROCESS, IT BECOMES KNOWN THAT A PATIENT QUALIFIES FOR CHARITY CARE, THE AMOUNTS INCLUDED WITHIN BAD DEBT EXPENSE WOULD BE RECLASSIFIED TO CHARITY CARE. THEREFORE, NO AMOUNTS RECORDED AS BAD DEBT EXPENSE ARE ATTRIBUTABLE TO PATIENTS ELIGIBLE FOR FINANCIAL ASSISTANCE. THE HOSPITAL INCORPORATES THE COST OF BAD DEBT AS A COMMUNITY BENEFIT. AS A TAX-EXEMPT HOSPITAL, WE MUST PROVIDE THE NECESSARY SERVICES REGARDLESS OF THE PATIENT'S ABILITY TO PAY FOR THAT CARE. IN DOING SO, WE MAKE QUALITY PATIENT CARE AVAILABLE TO ALL IN OUR COMMUNITY, REGARDLESS OF THEIR ECONOMIC MEANS. PART III, LINE 4: PAGES 20 AND 28 OF THE ATTACHED AUDITED FINANCIAL STATEMENTS CONTAIN THE FOOTNOTES DESCRIBING BAD DEBT EXPENSE. PART III, LINE 8: THESE ALLOWABLE COSTS ARE OBTAINED FROM THE MEDICARE COST REPORT FOR THE YEAR. THE REPORTED MEDICARE ALLOWABLE COSTS ARE OBTAINED FROM THE HOSPITAL'S GENERAL LEDGER AND THEN ADJUSTED AND REPORTED IN ACCORDANCE WITH CENTERS FOR MEDICARE SERVICES (CMS) "COST FINDING" GUIDELINES AS PUBLISHED IN THEIR PROVIDER REIMBURSEMENT MANUAL. ONCE THE MEDICARE ALLOWABLE COSTS ARE DETERMINED FROM THE HOSPITAL'S COST REPORT, ANY COSTS ATTRIBUTED TO SUBSIDIZED HEALTH SERVICES, AND MEDICAL EDUCATION, ARE REMOVED AND REPORTED SEPARATELY. EXPLANATION FOR ANY PRIOR YEAR SETTLEMENTS FOR MEDICARE-RELATED SERVICES IN THE CURRENT TAX YEAR: THE HOSPITAL IS REQUIRED TO FILE A MEDICARE COST REPORT 5 MONTHS AFTER THE CLOSE OF THEIR FISCAL YEAR. THE COST REPORT PROVIDES MEDICARE WITH INFORMATION THAT IS USED TO DETERMINE UTILIZATION AND SPENDING TRENDS BUT ALSO IS USED TO SET FUTURE PAYMENT RATES FOR MOST MEDICARE SERVICES. IF THE INTERIM PAYMENTS PAID TO A HOSPITAL ARE HIGHER OR LOWER THAN THE FILED COST REPORT ALLOWABLE REIMBURSEMENT THERE WILL BE A SETTLEMENT FOR THAT FISCAL YEAR. THIS CAN BE DUE TO CHANGES IN UTILIZATION OR COST OF PROVIDING SERVICES FOR CRITICAL ACCESS HOSPITALS (CAH) OR DIFFERENCES BETWEEN INTERIM AND FINAL PAYMENT FACTORS FOR DISPROPORTIONATE SHARE, BAD DEBTS, OR INDIRECT MEDICAL EDUCATION FOR NON-CAH HOSPITALS. AN ESTIMATE FOR THESE SETTLEMENTS IS RECORDED AT THE CLOSE OF THE FISCAL YEAR. IF THE ESTIMATE VARIES FROM THE FINAL SETTLEMENT RECEIVED 6-7 MONTHS AFTER THE FISCAL YEAR ENDS, THEN THESE AMOUNTS ARE RECORDED AS PRIOR YEAR MEDICARE REVENUE.ANY MEDICARE ALLOWABLE COSTS OF PATIENT CARE SHORTFALLS REPORTED IN PART III, LINE 7 ARE TREATED AS COMMUNITY BENEFIT. THE RATIONALE FOR THE HOSPITAL'S OPINION IS PROVIDING CARE FOR THE ELDERLY AND SERVING MEDICARE PATIENTS IS AN ESSENTIAL PART OF THE COMMUNITY BENEFIT STANDARD. MEDICARE, LIKE MEDICAID, DOES NOT PAY THE FULL COST OF CARE AND IT IS LIKELY TO GET WORSE. MANY MEDICARE BENEFICIARIES ARE POOR AND ARE ELIGIBLE FOR MEDICAID IN ADDITION TO MEDICARE. MEDICARE UNDERPAYMENT MUST BE SHOULDERED BY THE HOSPITAL IN ORDER TO CONTINUE TREATING THE COMMUNITY'S ELDERLY AND POOR. THESE UNDERPAYMENTS REPRESENT A REAL COST OF SERVING THE COMMUNITY. PART III, LINE 9B: THE POLICIES AND PROCEDURES FOR INTERNAL AND EXTERNAL COLLECTION PRACTICES TAKE INTO ACCOUNT THE EXTENT TO WHICH THE PATIENT QUALIFIES FOR THE FINANCIAL ASSISTANCE POLICY (FAP) AND FINANCIAL ASSISTANCE, A PATIENT'S GOOD FAITH EFFORT TO APPLY FOR A GOVERNMENTAL PROGRAM OR FOR FINANCIAL ASSISTANCE, AND THE PATIENT'S GOOD FAITH EFFORT TO COMPLY WITH HIS/HER PAYMENT AGREEMENTS. THE HOSPITAL OFFERS EXTENDED PAYMENT PLANS TO ELIGIBLE PATIENTS AND WILL NOT CHARGE A PATIENT THE GROSS AMOUNT OF CHARGES FOR ANY UNINSURED TREATMENT. UNINSURED DISCOUNTS WILL BE APPLIED TO THE GROSS CHARGES PRIOR TO ANY FINANCIAL ASSISTANCE OR OTHER DISCOUNTS. IF AT ANY TIME THE HOSPITAL RECOGNIZES THAT A PATIENT MAY BE ELIGIBLE FOR STATE OR FEDERAL PROGRAMS, A REPRESENTATIVE WILL ASSIST THE PATIENT IN OBTAINING INFORMATION ABOUT THESE PROGRAMS OR PROVIDE CONTACT INFORMATION FOR THESE PROGRAMS. THE HOSPITAL CONTRACTS WITH AN OUTSIDE PATIENT ADVOCACY AGENCY, WHICH MAY PROVIDE ASSISTANCE TO THE UNINSURED PATIENT IN APPLYING TO CERTAIN STATE AND FEDERAL PROGRAMS. AT ANY STAGE OF THE PATIENT EXPERIENCE AND UP THROUGH THE COLLECTION PROCESS, THE PATIENT MAY EXPRESS A CONCERN THAT THEY ARE UNABLE TO PAY THEIR BILL IN FULL OR MEET THE PAYMENT PLAN REQUIREMENTS. AT THAT TIME, THE PATIENT WILL BE GIVEN EVERY OPPORTUNITY TO COMPLETE AND SUBMIT AN APPLICATION FOR FINANCIAL ASSISTANCE. THE HOSPITAL TRAINS ITS OUTSIDE DEBT COLLECTION AGENCIES AND ATTORNEYS ABOUT THE FAP AND HOW A PATIENT MAY OBTAIN MORE INFORMATION ABOUT THE FAP OR SUBMIT AN APPLICATION FOR FINANCIAL ASSISTANCE. THE HOSPITAL REQUIRES IT'S OUTSIDE COLLECTION AGENCIES AND ATTORNEYS TO REFER PATIENTS WHO MAY BE ELIGIBLE FOR FINANCIAL ASSISTANCE BACK TO THE HOSPITAL. IF A PATIENT HAS SUBMITTED AN APPLICATION FOR FINANCIAL ASSISTANCE AFTER AN ACCOUNT HAS BEEN REFERRED FOR COLLECTION ACTIVITY, THE HOSPITAL SUSPENDS ALL COLLECTION ACTIVITY UNTIL THE PATIENT'S FINANCIAL ASSISTANCE APPLICATION HAS BEEN PROCESSED AND THE HOSPITAL HAS NOTIFIED THE PATIENT OF ITS DECISION. PATIENTS ARE ADVISED AT THAT TIME TO NOTIFY THE COLLECTION AGENCY TO HOLD THEIR ACCOUNT. THE OUTSIDE DEBT COLLECTION AGENCIES ARE NOTIFIED BY THE HOSPITAL ONCE AN ACCOUNT ADJUSTMENT HAS BEEN MADE. PART VI, LINE 2: WE ASSESS AND RESPOND TO THE HEALTH CARE NEEDS OF THE COMMUNITIES WE SERVE THROUGH MANY WAYS INCLUDING THE FOLLOWING:MARKETING RESEARCH - CLEARWATER VALLEY HEALTH AND ST. MARY'S HEALTH REVIEW INTERNAL DATA TO BETTER UNDERSTAND THE NEEDS AND USE(S) OF OUR SERVICES. THIS INCLUDES ACCESS TO SERVICE AREAS (I.E. PRIMARY CARE), PAYOR INFORMATION, AND OVERALL GAPS IN SERVICES. ASSESSMENTS HAVE RESULTED IN STRATEGIC PLANS FOR GROWING SERVICES, AS WELL AS, CHANGES TO INTERNAL PROCESSES FOR HEALTH CARE ACCESS.POPULATION CARE MANAGEMENT - WE REGULARLY COMPARE OUR HEALTH RANKINGS AND RATINGS TO STATE AND NATIONAL DATA TO IDENTIFY GREATEST AREAS OF HEALTH CARE NEEDS. WE PREPARE INTERVENTIONS TARGETED TO AREAS OF GREATEST NEED, SUCH AS UNCONTROLLED DIABETES OR PRE-DIABETES. WE THEN MEASURE THE EFFECT OF INTERVENTIONS COMPARED TO OVERALL COUNTY RANKINGS. WE USE THIS DATA TO ASSESS THE IMPLICATIONS OF EXPANDING PILOT PROGRAMS.PLANNED INTERACTION WITH VARIOUS COMMUNITY HEALTH, HEALTHCARE, AND SOCIAL WELFARE GROUPS - AN UMBRELLA COALITION OF COMMUNITY HEALTH, HEALTHCARE, AND SOCIAL WELFARE GROUPS MEETS REGULARLY TO SHARE PERSPECTIVES ON COMMUNITY NEEDS AND THE ROLE THE HOSPITAL CAN PLAY IN ADDRESSING THOSE NEEDS AS A COLLABORATIVE PARTNER. INTERACTIONS HAVE RESULTED IN SUCCESSFUL PROGRAMS FOR NURSE CASE MANAGEMENT, COMMUNITY REFERRAL COORDINATOR, COMMUNITY HEALTH WORKER, AND BENEFITS COUNSELOR POSITIONS.INTERNAL QUALITY INDICATORS - WE TRACK DATA THAT LEAD TO THE IMPROVED CARE AND TREATMENT OF PATIENTS WITH CHRONIC DISEASES, TOBACCO USE, AND MENTAL HEALTH CONDITIONS. THIS INCLUDES PATIENT ACTIVITY AND OUTCOMES, ALLOWING FOR THE HOSPITAL TO BETTER IDENTIFY THE NEEDS OF THE PATIENTS, WHICH CAN BE UTILIZED TO ASSESS THE OVERALL HEALTH OF THE COMMUNITIES WE SERVE. HEALTH DATA PROVIDED BY PAYOR ORGANIZATIONS, NAMELY GOVERNMENT AND COMMERCIAL HEALTH INSURERS - THIS HEALTH DATA TYPICALLY INVOLVES MEDICAL TREATMENT AND OUTCOMES THAT REFLECT TRENDS OF UNHEALTHY LIFESTYLES AND BEHAVIORS. OUR OBJECTIVE IS TO UNDERSTAND THESE RELATIONSHIPS AND TO DEVELOP ACTION STEPS TO INTERVENE ON THE FRONT END TO PREVENT SUCH MEDICAL SITUATIONS FROM OCCURRING. EXAMPLES INCLUDE MANAGEMENT OF DIABETES, INCREASE ACCESS TO CANCER SCREENINGS, AND EXPANDED BEHAVIORAL HEALTH.THE CHNA CAN BE FOUND ON THE HOSPITAL WEBSITE AT THE FOLLOWING URL: HTTPS://SMH-CVH.ORG/COMMUNITY-HEALTH-NEEDS-ASSESSMENT/ PART VI, LINE 3: THE HOSPITAL MAKES INFORMATION ON ITS FINANCIAL ASSISTANCE POLICY (FAP) READILY AVAILABLE TO PATIENTS. INFORMATION ABOUT FINANCIALS ASSISTANCE PROGRAMS IS AVAILABLE ON THE HOSPITAL WEBSITE (SMH-CVH.ORG) WHERE THE INFORMATION AND APPLICATION IS EASILY ACCESSIBLE TO BE VIEWED, DOWNLOADED, AND PRINTED AT NO CHARGE TO THE PATIENT. NOTICES ON THE AVAILABILITY OF FINANCIAL ASSISTANCE ARE CONSPICUOUSLY POSTED IN EMERGENCY ROOM DEPARTMENTS. FINANCIAL ASSISTANCE INFORMATION IS AVAILABLE DURING THE PRE-ADMISSION FINANCIAL SCREENING, AT THE TIME OF REGISTRATION, AND PRIOR TO A HOSPITAL DISCHARGE. INFORMATION ABOUT THE FAP IS IN COLLECTION LETTERS AND PATIENT STATEMENTS.FAP INFORMATION AND/OR APPLICATIONS ARE MADE AVAILABLE TO APPROPRIATE COMMUNITY HEALTH SERVICES AGENCIES AND OTHER ORGANIZATIONS THAT ASSIST PEOPLE IN NEED. THE HOSPITAL EDUCATES STAFF MEMBERS WHO WORK CLOSELY WITH PATIENTS PROVIDING DIRECT PATIENT TREATMENT AND WHO WORK IN ADMISSIONS, BILLING, AND COLLECTIONS ABOUT THE EXISTENCE OF THE FAP AND HOW A PATIENT MAY OBTAIN MORE INFORMATION. ANNUAL EDUCATION/AWARENESS OF THE FAP IS PROVIDED TO ENSURE ALL EMPLOYEES WITH PATIENT CONTACT ARE AWARE OF THE PROGRAM AND HOW PATIENTS CAN OBTAIN ADDITIONAL INFORMATION.CLINICAL AND HOSPITAL STAFF WHO PROVIDE DIRECT PATIENT CARE HAVE KNOWLEDGE OF THE FAP AND KNOW TO DIRECT PATIENTS TO A REGISTRATION INTERVIEWER OR BUSINESS OFFICE REPRESENTATIVE. REGISTRATION STAFF HAVE AN UNDERSTANDING OF THE POLICY, KNOWLEDGE OF WHERE THE RELATED DOCUMENTS ARE LOCATED, AND WHERE TO DIRECT THE PATIENT FOR MORE INFORMATION ON THE FAP. DESIGNATED EMPLOYEES (FINANCIAL COUNSELORS & PATIENT ACCOUNTS REPRESENTATIVES) HAVE A THOROUGH UNDERSTANDING OF THE FAP AND OFFER THE INFORMATION ON THE FAP TO THOSE PATIENTS WHO MAKE AN INQUIRY ABOUT THE PROGRAM OR ARE DETERMINED THROUGH A FINANCIAL SCREENING TO BE ELIGIBLE FOR THIS PROGRAM. PATIENT ADVOCACY SERVICES ALSO INFORM THE PATIENT ABOUT THE AVAILABILITY OF ASSISTANCE. A REQUEST FOR FINANCIAL ASSISTANCE MAY BE MADE BY THE PATIENT, A PATIENT'S GUARANTOR, A FAMILY MEMBER, CLOSE FRIEND, OR ASSOCIATE OF THE PATIENT, SUBJECT TO APPLICABLE PRIVACY LAWS. THE ORGANIZATION RESPONDS TO ANY ORAL OR WRITTEN REQUESTS FOR MORE GENERAL INFORMATION ON THE FAP MADE BY A PATIENT OR ANY INTERESTED PARTY.DUE TO THE SMALL SIZES OF THE LIMITED ENGLISH PROFICIENCY (LEP) POPULATIONS OF THE COMMUNITIES SERVED BY THE HOSPITAL, SMH WAS NOT REQUIRED TO TRANSLATE THE FINANCIAL ASSISTANCE POLICY (FAP), THE FAP APPLICATION FORM, OR THE PLAIN LANGUAGE SUMMARY OF THE FAP TO OTHER LANGUAGE.THE FAP, FAP APPLICATION AND FAP PLAIN LANGUAGE SUMMARY CAN BE FOUND ON THE HOSPITAL WEBSITE AT THE FOLLOWING URL: HTTPS://APPS.PARA- HCFS.COM/PTT/FINALLINKS/STMARYS_V2.ASPX PART VI, LINE 4: THE HOSPITAL IS LOCATED IN COTTONWOOD, IDAHO AND OPERATES A CRITICAL ACCESS HOSPITAL AND 6 CLINICS THAT SERVE THE COMMUNITIES OF CLEARWATER, LEWIS, AND IDAHO COUNTIES COVERING 2,400 SQUARE MILES. THE OVERALL COMMUNITY IS DESIGNATED NOT ONLY AS RURAL, BUT ALSO AS FRONTIER. FRONTIER REGIONS ARE DEFINED AS THE MOST GEOGRAPHICALLY REMOTE, SPARSELY POPULATED, AND UNDEVELOPED TERRAIN IN THE UNITED STATES.THE SERVICE AREA IS APPROXIMATELY 30,300 PEOPLE WITH AN AGE DISTRIBUTION OF 26% UNDER THE AGE OF 18; 51% BETWEEN THE AGES OF 18 AND 65; AND 27% OVER THE AGE OF 65. THE RACIAL MAKEUP OF THE SERVICE AREA IS 91% CAUCASIAN; 3% HISPANIC, AND 6% OTHER. THE GENDER SPLIT RATIO IS 48% WOMEN AND 52% MEN. THE AVERAGE INCOME FOR THE SERVICE AREA IS APPROXIMATELY $52,300. THE HOSPITAL IS COMMITTED TO SERVE PATIENTS REGARDLESS OF THEIR ABILITY TO PAY. APPROXIMATELY 3.6% GROSS REVENUE DOLLARS WERE FROM SELF-PAY PATIENTS AND 14.6% FROM MEDICAID RECIPIENTS. IDAHO AND LEWIS COUNTIES ARE CURRENTLY DESIGNATED AS MEDICALLY UNDERSERVED AREAS. THERE ARE 2 OTHER HOSPITALS THAT SERVE THE COMMUNITIES. PART VI, LINE 5: THE HOSPITAL BOARD OF DIRECTORS IS COMPOSED MAINLY OF VOLUNTEER REPRESENTATIVES FROM THE PRIMARY SERVICE AREA AND DEDICATE TIME TO ENSURING THEY UNDERSTAND THE HEALTH AND WELFARE NEEDS OF OUR COMMUNITY. THE HOSPITAL EXTENDS MEDICAL STAFF PRIVILEGES TO ALL QUALIFIED PHYSICIANS IN THE COMMUNITY WHO ARE PROPERLY SCREENED. ALL APPLICANTS THAT APPLY MUST MEET THE CREDENTIALING STANDARDS AND BE APPROVED BY THE GOVERNING BOARD IN ORDER TO PROVIDE SERVICES AT THE HOSPITAL. IN ADDITION, THE HOSPITAL SERVES AS A CLINICAL PRACTICE SITE FOR MANY STUDENTS IN X-RAY TECHNOLOGY, NURSING, PHYSICIAN ASSISTANT, NURSE PRACTITIONER, AND MEDICAL RESIDENCY PROGRAMS. THIS IS ESPECIALLY IMPORTANT BECAUSE IDAHO HAS ONE OF THE LOWEST PHYSICIAN PER CAPITAL RATES IN THE NATION. ANY SURPLUS FUNDS ARE REINVESTED INTO THE FACILITY, EQUIPMENT, AND EMPLOYEE EDUCATION. WE REGULARLY REVIEW FACILITIES AND EQUIPMENT AND DEVELOP AN ATTRITION PROCESS TO REPLACE AGING PLANT OPERATIONS AND EQUIPMENT. WE ALSO LOOK FOR OPPORTUNITIES TO BRING NEW SERVICES TO THE COMMUNITIES VIA INVESTING IN NEW SKILLS AND TECHNOLOGY WHERE APPROPRIATE.THE HOSPITAL ENGAGED COMMUNITIES IN COMING TOGETHER AND CREATING SOCIAL CONNECTIVITY THROUGH SUPPORT OF LOCAL EVENTS AND COMMUNITY PROGRAMS. THESE INCLUDE THE FORMATION OF COMMUNITY AND SCHOOL GARDENS, HEALTH TALKS, SPONSORSHIP OF RACES, AND PARTICIPATION IN COUNTY FAIR ACTIVITIES.WE PROMOTE BETTER MENTAL HEALTH BY BRINGING CHILD AND ADULT PSYCHIATRISTS TO OUR FRONTIER COMMUNITIES USING TELEMEDICINE. THIS MODEL HAS WON STATE AND NATIONAL AWARDS FOR INNOVATION IN REACHING THE MEDICALLY UNDERSERVED. WE ARE ALSO ACTIVE PARTICIPANTS IN NATIONAL DEMONSTRATION PROJECTS AND OTHER COLLABORATIONS TO PROVIDE AN EVIDENCE BASE FOR EFFECTIVE PROCESSES TO PROMOTE RURAL HEALTH.IN ADDITION TO THE ACTIVITIES LISTED IN PART I, LINE 7 AS WELL AS PART V, SECTION B, LINE 11, SOME OTHER PROJECTS UNDERTAKEN BY SMH INCLUDE THE FOLLOWING:MOST MONTHS WE HAVE AN OVERALL THEME TARGETING A CHRONIC DISEASE STATE WITH SPECIAL PROGRAMS AND OUTREACH TO OUR COMMUNITIES (I.E. FEBRUARY IS HEART MONTH, OCTOBER IS BREAST CANCER AWARENESS, NOVEMBER IS DIABETES AWARENESS, ETC.). DOC TALKS ARE GEARED TO THE MONTHLY THEME WITH SCREENINGS AND INFORMATION PROVIDED AT THE EVENTS. OUR CARE MANAGERS, REFERRAL COORDINATORS, AND QUALITY DIRECTORS ARE ESPECIALLY ACTIVE IN COORDINATING THESE ACTIVITIES AND REACHING OUT TO PATIENTS WHO MAY NOT BE AWARE OF THE SERVICES OFFERED. COMMUNITY HEALTH WORKERS ARE HOSTING CHRONIC DISEASE SELF-MANAGEMENT AND CHRONIC PAIN SELF-MANAGEMENT CLASSES THROUGHOUT OUR SERVICE AREA. COLON CANCER AWARENESS AND SCREENING HAS BEEN A MAJOR OUTREACH EFFORT AT HEALTH FAIRS, LOCAL BAZAARS, SOME OF THE FARMER'S MARKET DAYS, AND WITHIN ALL OF THE CLINICS OVER THE PAST YEAR.THE HOSPITAL IS AN ACTIVE PARTICIPANT IN ATTENDING AND SITTING ON THE BOARDS OF THE LOCAL HUMAN NEED COUNCILS WITHIN THE SERVICE AREAS. WE HAVE A PRESENCE ON MULTIPLE COALITIONS THROUGHOUT THE NORTHERN AND NORTH CENTRAL IDAHO. THIS IS OFTEN ACCOMPLISHED BY PHONE CONFERENCING IN ORDER TO PARTICIPATE IN THE DISCUSSIONS AND GROWTH WITHOUT INCURRING TRAVEL EXPENSE. WE ARE ALSO ACTIVELY ENGAGED IN STATE COALITIONS ON CHRONIC DISEASE AND COMMUNITY HEALTH WORKER PROGRAMS (OFTEN SEEN AS MENTORS WITHIN THESE GROUPS FOR THE ACCOMPLISHMENTS ACHIEVED OVER THE PAST FEW YEARS). FUNDRAISERS AND VOLUNTEER EFFORTS ARE ESTABLISHED AND ONGOING WITH LOCAL FOOD BANKS, CLOTHING DISTRIBUTION DRIVES, AND OTHER VOLUNTEERS THAT ARE GEARED AROUND NATURAL DISASTERS AND OTHER NEEDS WITHIN OUR AREA. EFFORTS ARE BEING MADE TO BRING SAFE WALKING AND BIKE TRAILS TO COMMUNITIES WITHIN OUR SERVICE AREAS. A RESULT OF ALMOST EVERY SURVEY AND CONVERSATION IS THAT THE COMMUNITIES WANT MORE WAYS TO ENGAGE SAFELY IN PHYSICAL ACTIVITY AT LITTLE OR NO EXPENSE. COMMUNITY HEALTH WORKERS HAVE WORKED WITH COMMUNITY PARTNERS TO HOST WEEKLY WALKS THROUGHOUT THE REGION PROVIDING BOTH AN EDUCATION COMPONENT AND A SAFE WALKING PATH FOR THE DAY. COMMUNITY HEALTH WORKERS COORDINATE AND HOST SCREENING EVENTS IN VARIOUS LOCATIONS THROUGHOUT THE SERVICE AREA TO HELP SCREEN FOR DIABETES, DEPRESSIONS, SDOH ISSUES, AND COLON CANCER. SOME OF THE SCREENING EVENTS ARE HELD IN CONJUNCTION WITH A FOOD BANK DISTRIBUTION SITE.THE HOSPITAL IS PART OF KOOTENAI HOSPITAL DISTRICT DBA KOOTENAI HEALTH, A FULLY INTEGRATED HEALTH SYSTEM WITH FACILITIES IN IDAHO. KOOTENAI HEALTH REINVESTS SURPLUS REVENUES INTO TECHNOLOGY, INFRASTRUCTURE AND CLINICAL PROGRAMS TO INCREASE THE HEALTH AND VITALITY OF THE COMMUNITIES WE SERVE. KOOTENAI HEALTH PROVIDES SERVICES IN RURAL COMMUNITIES AND IS COMMITTED TO ELIMINATING GEOGRAPHIC BARRIERS TO CARE. WE INVEST IN FACILITY UPGRADES, TECHNOLOGY, AND STAFFING THAT ENHANCE CARE IN THESE COMMUNITIES TO ENSURE PATIENTS CAN RECEIVE AS MUCH CARE AS POSSIBLE CLOSE TO HOME. TELEHEALTH ALLOWS PATIENTS TO RECEIVE CARE FROM A PROVIDER IN THEIR HOME. TELEHEALTH APPOINTMENTS TAKE PLACE IN LOCAL CLINICS OR HOSPITALS THROUGH SECURE INTERACTIVE VIDEOCONFERENCING. PATIENTS FEEL LIKE THEY ARE IN THE SAME ROOM WITH THEIR DOCTOR. THIS EXPERIENCE OFFERS THE SAME HIGH-QUALITY CARE THAT PATIENTS EXPECT DURING AN IN-PERSON VISIT.ON MAY 26, 2015, THE DISTRICT BOARD VOTED TO DEVELOP A CLINICAL INTEGRATION NETWORK CALLED KOOTENAI CARE NETWORK, LLC, (KCN) A NON-PROFIT, WHOLLY-OWNED SUBSIDIARY. THE GOAL OF THE NETWORK IS TO IMPROVE THE OVERALL HEALTH OF THE COMMUNITY THROUGH THE DELIVERY OF EFFICIENT, HIGH QUALITY CARE THROUGH THE INTEGRATION OF INDEPENDENT AND EMPLOYED PHYSICIANS, HOSPITALS, POST-ACUTE CARE PROVIDERS AND PAYERS. AS OF DECEMBER 31, 2023, THERE WERE OVER 600 PARTICIPATING PROVIDERS AND 61,500 COVERED LIVES IN THE NETWORK. KOOTENAI ACCOUNTABLE CARE, LLC WAS FORMED IN 2017 WITH KCN AS ITS SOLE MEMBER, FOR PURPOSES OF PARTICIPATING AS A MEDICARE SHARED SAVINGS PROGRAM. IN ADDITION, KOOTENAI VALUE CARE, LLC WAS FORMED IN 2021 WITH KCN AS ITS SOLE MEMBER, FOR PURPOSES OF PARTICIPATING IN THE IDAHO MEDICAID VALUE CARE PROGRAM.KCN HAS A TEAM OF CARE MANAGERS TO HELP PATIENTS WITH CHRONIC CONDITIONS TO MANAGE THEIR CARE. THESE CHRONIC CONDITIONS INCLUDE CHRONIC OBSTRUCTIVE PULMONARY DISEASE, HEART FAILURE, DEPRESSION, AND ANXIETY. THE CARE MANAGERS WORK WITH A VARIETY OF PATIENTS, CAREGIVERS, AND HEALTHCARE EXPERTS WITHIN KCH TO PROVIDE EFFICIENT, HIGH QUALITY CARE FOR THE COMMUNITY.EACH YEAR KOOTENAI HEALTH MAKES SUBSTANTIAL FINANCIAL AND IN-KIND DONATIONS THAT BENEFIT THE COMMUNITY. THESE INCLUDE DONATIONS TO GROUPS SUCH AS THE SUICIDE PREVENTION ACTION NETWORK AND THE COMMUNITY CANCER FUND. KOOTENAI HEALTH PROVIDES FREE AND LOW COST HEALTH SCREENINGS AND SUPPORT GROUPS FOR PATIENTS WITH DIABETES, CANCER, MENDED HEARTS, PARKINSON'S, AND PULMONARY DISEASE. KOOTENAI HEALTH PROVIDES TRAINING OPPORTUNITIES FOR PHYSICIANS, NURSES, AND OTHER HEALTHCARE WORKERS. TOGETHER, THESE SERVICES ARE IMPROVING HOW PEOPLE ARE CARED FOR IN THE GEOGRAPHICALLY DIVERSE COMMUNITIES WE SERVE. PART VI, LINE 6: ST. MARY'S HEALTH IS PART OF KOOTENAI HOSPITAL DISTRICT (THE DISTRICT). THE DISTRICT IS ORGANIZED AND EXISTS AS A POLITICAL SUBDIVISION UNDER THE LAWS OF THE STATE OF IDAHO TO PROVIDE HEALTH CARE SERVICES WITHIN THE DISTRICT WHICH INCLUDES ALL OF KOOTENAI COUNTY AS WELL AS ADDITIONAL COUNTIES WITHIN IDAHO. THE DISTRICT IS INVOLVED IN SEVERAL JOINT RELATIONSHIPS TO PROVIDE NEEDED HEALTH SERVICES TO NORTH IDAHO RESIDENTS. THESE RELATIONSHIPS ARE IN THE AREAS OF IMAGING SERVICES, MAGNETIC RESONANCE IMAGING SERVICES, REHABILITATION SERVICES, AMBULATORY SURGICAL SERVICES, AND RADIATION THERAPY SERVICES.WE ALSO SUPPORT COMMUNITY HEALTH THROUGH THE KOOTENAI HEALTH FOUNDATION AND THROUGH CONTRIBUTIONS THAT FOCUS ON PROGRAMS AND SERVICES THAT BENEFIT THE OVERALL HEALTH OF THE COMMUNITIES WE SERVE. 1 KOOTENAI HEALTH FOUNDATION 2271 W IRONWOOD CENTER DR COEUR DALENE ID 83814 820380784 501(C)(3) 7173 0 FINANCIAL SUPPORT CLEARWATER VALLEY HEALTH 301 CEDAR AVE OROFINO ID 83544 820497771 501(C)(3) 8830 0 PASS THRU GRANT 2 0 PART I, LINE 2: THE HOSPITAL'S MANAGEMENT REVIEWS THE GRANT ACTIVITY BY REVIEWING AND DOCUMENTING EACH EXPENDITURE REQUEST AND APPROVING THE EXPENSE. X X X X 0 0 0 0 0 0 0 0 0 JUSTIN JONES PHYSICIAN 310216 0 123200 0 1268 0 12147 0 9778 0 456609 0 0 0 THOMAS WONDERLICH PHYSICIAN 330795 0 104546 0 0 0 6774 0 9396 0 451511 0 0 0 TEMA JESSUP PHYSICIAN 318836 0 60789 0 3208 0 11891 0 9360 0 404084 0 0 0 JACK BRUNER II PHYSICIAN 311570 0 68484 0 0 0 12300 0 9396 0 401750 0 0 0 KELLY MCGRATH DIRECTOR/CMO 0 316206 0 1765 0 10948 0 12241 0 9396 0 350556 0 0 LENNE BONNER CEO 0 281018 0 0 0 0 0 13657 0 10100 0 304775 0 0 JOHN TRUEBLOOD PHYSICIAN 172935 0 90580 0 6590 0 10749 0 8566 0 289420 0 0 0 JYL RULAND CFO 0 161779 0 0 0 0 0 6471 0 9396 0 177646 0 0 FORM 990, PART VI, SECTION A, LINE 6 KOOTENAI HOSPITAL DISTRICT DBA KOOTENAI HEALTH IS THE SOLE MEMBER OF ST. MARY'S HOSPITAL AND CLINICS, INC. AND MAY ELECT ONE OR MORE MEMBERS OF THE GOVERNING BODY AS DESCRIBED IN SCHEDULE O, PART VI, LINE 7. KOOTENAI HEALTH AND BENEDICTINE SISTERS OF SCHOLASTICA MONASTERY HAVE RESERVED POWERS WITH RESPECT TO ST. MARY'S HOSPITAL, INC. AS DESCRIBED IN SCHEDULE O, PART VI. LINE 7B. FORM 990, PART VI, SECTION A, LINE 7A KOOTENAI HOSPITAL DISTRICT APPOINTS AND REMOVES ST. MARY'S HOSPITAL, INC. GOVERNING BODY. FORM 990, PART VI, SECTION A, LINE 7B KOOTENAI HOSPITAL DISTRICT HAS RESERVED POWERS AS FOLLOWS: STRATEGIC AND BUSINESS PLANS - AUTHORITY TO CREATE AND TO APPROVE SMH'S STRATEGIC AND BUSINESS PLANS. MISSION - AUTHORITY TO CREATE AND TO APPROVE THE MISSION PURPOSE AND VISION STATEMENT FOR SMH. DEBT - APPROVAL OF THE INCURRENCE OF DEBT BY AND THE CREATION OF ALL MORTGAGES, LIENS, SECURITY INTERESTS, OR OTHER ENCUMBRANCES ON THE ASSETS OF SMH IN EXCESS OF THE SINGLE OR ANNUAL AGGREGATE DOLLAR LIMITS PRESCRIBED IN WRITING BY THE KH BOARD OF DIRECTORS. GOVERNING INSTRUMENTS - AUTHORITY TO CAUSE AND APPROVE AMENDMENTS OF THE ARTICLES OF INCORPORATION AND BYLAWS OF SMH. MERGERS AND ACQUISITIONS - AUTHORITY TO CAUSE AND TO APPROVE ALL MERGERS, CONSOLIDATIONS, AND DISSOLUTIONS OF SMH. AFFILIATIONS AND JOINT VENTURES - AUTHORITY TO CAUSE AND APPROVE ALL AFFILIATIONS, JOINT VENTURES AND OTHER ALLIANCES BETWEEN THIRD PARTIES AND SMH. TRANSFER OF ASSETS - AUTHORITY TO CAUSE AND TO APPROVE THE SALE, LEASE, OR OTHER TRANSFER OF SMH ASSETS WHEN THE ASSET'S VALUE EXCEEDS THE SINGLE OR AGGREGATE DOLLAR LIMIT PRESCRIBED IN WRITING BY THE KH BOARD OF DIRECTORS. SERVICES - AUTHORITY TO CAUSE AND TO APPROVE THE DISCONTINUANCE OF SERVICES AND SERVICE LOCATIONS OF SMH. BUDGETS - APPROVAL OF CAPITAL AND OPERATING BUDGETS OF SMH. PROFESSIONAL SERVICES - SELECTION OF THE GENERAL LEGAL COUNSEL AND EXTERNAL AUDITORS OF SMH. ACQUISITIONS - AUTHORITY TO CAUSE AND TO APPROVE ALL ACQUISITIONS BY AND FORMATIONS OF ENTITIES BY SMH. MARKETING AND BRANDING - AUTHORITY TO IMPLEMENT SMH MARKETING, BRANDING, AND PROMOTIONAL ACTIVITIES. COMPLIANCE PLANS - AUTHORITY TO CREATE AND TO APPROVE CORPORATE COMPLIANCE, SAFETY AND RISK MANAGEMENT PLANS FOR SMH. QUALITY PLAN - AUTHORITY TO CREATE TO APPROVE SMH'S QUALITY PLAN. NON-BUDGETED PURCHASES - APPROVAL OF NON-BUDGETED CAPITAL PURCHASES, OPERATING EXPENSES, AND LEASES IN EXCESS OF THE SINGLE OR ANNUAL AGGREGATE DOLLAR LIMITS PRESCRIBED IN WRITING BY KH FOR SMH. HUMAN RESOURCES - AUTHORITY TO CREATE HUMAN RESOURCE POLICIES AND PROCEDURES FOR SMH. RESERVED POWERS - AUTHORITY TO CREATE ADDITIONAL KH RESERVED POWERS BY THE AFFIRMATIVE VOTE OF AT LEAST 75% OF THE KH BOARD OF DIRECTORS (EXCLUDING THE KH PRESIDENT); PROVIDED, HOWEVER THAT ANY ADDITIONAL KH RESERVED POWERS SHALL NOT CONTRAVENE OR HINDER THE SSM RESERVED POWERS. AS A SPONSOR TO SMH, THE SISTERS OF ST. SCHOLASTICA MONASTERY (SSM) ALSO HAS CERTAIN RESERVED POWERS OVER SMH. SSM'S RESERVED POWERS ARE AS FOLLOWS: MISSION - AUTHORITY TO APPROVE THE MISSION AND PURPOSE STATEMENTS FOR SMH. ADHERENCE TO ERDS - AUTHORITY TO REVIEW AND APPROVE THE METHODS, POLICIES AND PROCEDURES PERTAINING TO ADHERENCE OF SMH TO THE ETHICAL AND RELIGIOUS DIRECTIVES FOR CATHOLIC HEALTH CARE SERVICES (ERDS). OFFICIAL CATHOLIC DIRECTOR - AUTHORITY TO OVERSEE THE LISTING OF SMH IN THE OFFICIAL CATHOLIC DIRECTORY, SUBJECT TO THE APPROVAL OF APPLICABLE CATHOLIC AUTHORITIES. CATHOLIC HEALTH ASSOCIATION - AUTHORITY TO REQUIRE SMH TO JOIN THE MEMBERSHIP OF THE CATHOLIC HEALTH ASSOCIATION OF THE UNITED STATES IF SMH QUALIFIES AND SUCH MEMBERSHIP DOES NOT IMPOSE AN UNREASONABLE BURDEN ON SMH AS DETERMINED BY KOOTENAI HEALTH. ALIENATION OF STABLE PATRIMONY OR ECCLESIASTICAL GOODS - AUTHORITY TO APPROVE ALIENATION OF EITHER STABLE PATRIMONY OR OTHER ECCLESIASTICAL GOODS AT SMH HAVING A DOLLAR VALUE EQUAL TO OR GREATER THAN 70% OF THE AMOUNT ESTABLISHED FROM TIME TO TIME THAT REQUIRES APPROVAL FROM THE HOLY SEE; PROVIDED, HOWEVER, THAT IT IS THE INTENT OF THE PARTIES THAT THIS PROVISION NOT BE APPLIED TO RESTRICT OR TO IMPEDE SMH FROM ACTING AND MAKING DECISIONS IN THE ORDINARY COURSE OF BUSINESS; INSTEAD IT IS INTENDED TO PREVENT THE TRANSFER OF SUBSTANTIAL ASSETS OF SMH TO SUPPORT THE SECULAR ENTITIES OF KOOTENAI HEALTH WITHOUT THE PRIOR APPROVAL OF SSM. MISSION EFFECTIVENESS -AUTHORITY TO APPROVE ANNUAL PLANS AND EVALUATIONS RELATING TO MISSION EFFECTIVENESS AND CHAPLAINCY FOR SMH INCLUDING THE USE OF RELIGIOUS SYMBOLS AND PRAYERS. AMENDMENTS - AUTHORITY TO APPROVE ANY AMENDMENTS TO THE GOVERNING DOCUMENTS OF SMH WHICH COULD MATERIALLY AFFECT SSM'S SERVED POWERS, INCLUDING WITHOUT LIMITATION ANY AMENDMENT THAT WOULD ALTER THE NUMBER OF DULUTH BENEDICTINES OR SSM BOARD OF DIRECTOR MEMBERS OR OTHER APPOINTEES OF DULUTH BENEDICTINES SERVING AS MEMBERS OF SMH'S BOARD OF DIRECTORS. SSM RESERVED POWERS - AUTHORITY TO TRANSFER OR TERMINATE THE SSM RESERVED POWERS APPLICABLE TO SMH. FORM 990, PART VI, SECTION B, LINE 11B A COPY OF THE 990 IS PROVIDED TO THE CEO AND CFO WHO REVIEW THE FORM, SCHEDULES AND RELATED ATTACHMENTS. ANY COMMENTS OR QUESTIONS ARE ADDRESSED WITH THE PREPARER AND A FINAL DRAFT IS PROVIDED TO THE BOARD OF DIRECTORS. ONCE MANAGEMENT IS SATISFIED WITH THE 990, THE CFO SIGNS THE FORM 8879-TE AUTHORIZING THE PREPARER TO E-FILE THE RETURN. FORM 990, PART VI, SECTION B, LINE 12C THE HOSPITAL REQUIRES BOARD MEMBERS AND OFFICERS OF THE ORGANIZATION TO ANNUALLY DISCLOSE POTENTIAL CONFLICTS. IF A POTENTIAL CONFLICT EXISTS, THEY ARE REVIEWED BY THE BOARD AND THE INDIVIDUAL WITH THE POTENTIAL CONFLICT ABSTAINS FROM VOTING ON THE ISSUE. FORM 990, PART VI, SECTION B, LINE 15 THE INDEPENDENT EXECUTIVE COMPENSATION COMMITTEE OF THE BOARD OF DIRECTORS IS AUTHORIZED TO FULFILL THE BOARD'S RESPONSIBILITIES REGARDING EXECUTIVE COMPENSATION. THE EXECUTIVE COMPENSATION COMMITTEE RESPONSIBILITIES INCLUDE, BUT ARE NOT LIMITED TO, ESTABLISHING, REVIEWING AND MODIFYING, AS APPROPRIATE, REASONABLE COMPENSATION AND BENEFITS FOR DESIGNATED EXECUTIVES WHO ARE OFFICERS OR KEY EMPLOYEES WHICH MAY BE PAID BY RELATED ORGANIZATIONS. THE EXECUTIVE COMPENSATION COMMITTEE ENGAGES QUALIFIED INDEPENDENT COMPENSATION ADVISORS TO PROVIDE OBJECTIVE AND IMPARTIAL COMPARATIVE DATA AND TO EXPRESS OPINION ON TOTAL COMPENSATION REASONABLENESS. THE EXECUTIVE COMPENSATION COMMITTEE MAY REQUEST ITS INDEPENDENT ADVISORS TO MONITOR COMPARABILITY DATA AND MARKETPLACE TRENDS, MAKE APPROPRIATE RECOMMENDATIONS REGARDING SALARY RANGES, AND PERIODICALLY REVIEW THE MARKET COMPETITIVENESS OF EXECUTIVE COMPENSATION PACKAGES PRIOR TO ESTABLISHING OR ADJUSTING EXECUTIVE COMPENSATION. THE EXECUTIVE COMPENSATION COMMITTEE WILL OBTAIN AND RELY UPON APPROPRIATE DATA AS TO COMPARABILITY OF THE PROPOSED COMPENSATION OR ADJUSTMENTS. THE EXECUTIVE COMPENSATION COMMITTEE WILL ADEQUATELY DOCUMENT THE BASIS FOR ITS DETERMINATION CONCURRENTLY WITH MAKING THOSE DETERMINATIONS. THE EXECUTIVE COMPENSATION COMMITTEE MINUTES WILL INCLUDE THE TERMS OF THE APPROVED COMPENSATION AND THE DATE APPROVED. THE EXECUTIVE COMPENSATION COMMITTEE MEMBERS PRESENT DURING THE REVIEW, DISCUSSION AND APPROVAL OF THE PROPOSED COMPENSATION AND THOSE WHO VOTED ON THE PROPOSED COMPENSATION IDENTIFICATION OF THE COMPARABILITY DATA OBTAINED AND RELIED UPON BY THE EXECUTIVE COMPENSATION COMMITTEE AND HOW THE DATA WAS OBTAINED, ANY ACTIONS BY A MEMBER OF THE EXECUTIVE COMPENSATION COMMITTEE HAVING CONFLICT OF INTEREST, AND DOCUMENTATION OF THE BASIS FOR DETERMINATION THE YEAR THIS PROCESS WAS LAST UNDERTAKEN. FORM 990, PART VI, SECTION C, LINE 19 THE GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND AUDITED FINANCIAL STATEMENTS ARE AVAILABLE TO THE PUBLIC UPON REQUEST. FORM 990, PART IX, LINE 11G PURCHASED SERVICES: PROGRAM SERVICE EXPENSES 1,215,164. MANAGEMENT AND GENERAL EXPENSES 354,919. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 1,570,083. PROFESSIONAL FEES: PROGRAM SERVICE EXPENSES 958,124. MANAGEMENT AND GENERAL EXPENSES 279,844. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 1,237,968. FORM 990, PART XI, LINE 9: TRANSFER OF NET POSITION -8,751. FORM 990, PART XII, LINE 2C: THE PROCESS HAS NOT CHANGED SINCE THE PRIOR YEAR. CLEARWATER VALLEY HOSPITAL & CLINIC 301 CEDAR OROFINO ID 83544 820497771 HOSPITAL ID 501(C)(3) LINE 3 KOOTENAI HEALTH 1 KOOTENAI HEALTH FOUNDATION INC 2003 KOOTENAI HEALTH WAY COEUR DALENE ID 83814 820380784 FOUNDATION ID 501(C)(3) LINE 7 KOOTENAI HEALTH 1 KOOTENAI HEALTH 2003 KOOTENAI HEALTH WAY COEUR DALENE ID 83814 HOSPITAL ID GOV N/A 0 KOOTENAI URGENT CARE LLC 700 IRONWOOD DR SUITE 120E COEUR DALENE ID 83814 MEDICAL ID N/A 0 0 KOOTENAI OUTPATIENT SURGERY 707 IRONWOOD DR COEUR DALENE ID 83814 SURGERY ID N/A 0 0 KOOTENAI OUTPATIENT IMAGING 700 W IRONWOOD DR SUITE 175 COEUR DALENE ID 83814 IMAGING ID N/A 0 0 0 1 1 0 1 0 0 0 0 0 0 0 1 0 1 1 1 0 0