2024-11-07T09:57:11-06:00 2023-12-31 990 2023-01-01 810231792 HOLY ROSARY HEALTHCARE HOLY 4062332600 2600 WILSON STREET MILES CITY MT 59301 PAM PALAGI VP FINANCE & CFO 4062332600 2024-11-06 0 2023 2024-10-15 13:58:12Z KAREN COSTELLO 2600 WILSON STREET MILES CITY MT 59301 91806144 0 0928 X SEE SCHEDULE O X 1961 MT WE REVEAL AND FOSTER GOD'S HEALING LOVE BY IMPROVING THE HEALTH OF THEPEOPLE AND COMMUNITIES WE SERVE, ESPECIALLY THOSE WHO ARE POOR ANDVULNERABLE. 16 14 383 13 58747 0 85461 409167 72354598 90723397 331218 389337 469262 262715 73240539 91784616 27739 32120 0 0 25920618 29899581 0 0 0 41745243 47108141 67693600 77039842 5546939 14744774 88354527 102833838 7501073 7396238 80853454 95437600 X WE REVEAL AND FOSTER GOD'S HEALING LOVE BY IMPROVING THE HEALTH OFTHE PEOPLE AND COMMUNITIES WE SERVE, ESPECIALLY THOSE WHO ARE POORAND VULNERABLE. 0 0 63977353 32120 90927365 FOUNDED IN 1910, HOLY ROSARY HEALTHCARE IS EASTERN MONTANA'S HEALTHCARE DESTINATION. HOLY ROSARY OPERATES A COMPREHENSIVE ACUTE-CARE HOSPITAL, PHYSICIAN CLINICS, A RESIDENTIAL LIVING COMMUNITY, AND HOSPICE AND PALLIATIVE CARE SERVICES - PROVIDING A COMPLETE CONTINUUM OF CARE TO A 11-COUNTY REGION OF EASTERN MONTANA. IN AUGUST 1910, THE PRESENTATION SISTERS OF ABERDEEN, SOUTH DAKOTA, ASSUMED MANAGEMENT AND OPERATION OF THE COUNTY HOSPITAL IN MILES CITY AT THE REQUEST OF THE COMMUNITY, THE MILWAUKEE RAILROAD AND THE DOCTORS ASSOCIATED WITH THE RAILROAD. IN 1915, THE SISTERS PURCHASED THE HOSPITAL, COMMITTING TO A RELATIONSHIP WITH THE COMMUNITY THAT WOULD EXTEND FOR DECADES.IN 1995, HOLY ROSARY HEALTHCARE OPENED A NEW COST EFFECTIVE FACILITY ON A 58-ACRE CAMPUS IN MILES CITY THAT ALLOWED PHYSICIANS AND OTHER CARE FACILITIES TO LOCATE IN THE NEW HOSPITAL BUILDING. THE BUILDING OF THE NEW FACILITY AND MOVING INTO THE NEW FACILITY WAS A COMMUNITY-WIDE EFFORT, AND WAS ACCOMPLISHED THROUGH THE CONTRIBUTIONS OF THE STAFF, PHYSICIANS, BOARD MEMBERS, COMMUNITY MEMBERS AND VOLUNTEERS.IN KEEPING WITH THE NEW COVENANT PROCESS, SISTERS OF CHARITY OF LEAVENWORTH HEALTH SYSTEM, INC. (SCLHS) ASSUMED SPONSORSHIP OF HOLY ROSARY HEALTHCARE IN 1997. TODAY, THE HOSPITAL, RESIDENTIAL LIVING COMMUNITY, AND CLINICS SERVE AS A CENTRALIZED SETTING FOR COMPREHENSIVE HEALTH CARE FOR THE PEOPLE ACROSS EASTERN MONTANA. ON APRIL 1, 2022, INTERMOUNTAIN HEALTH CARE, INC. AND SISTERS OF CHARITY OF LEAVENWORTH HEALTH SYSTEM, INC. AFFILIATED, 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 MORE THAN 66,000 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.AS PART OF INTERMOUNTAIN HEALTHCARE, HOLY ROSARY HAS DIRECT ACCESS TO BEST PRACTICES, RESOURCES, TECHNOLOGY, TALENT ANDSTRATEGIC CAPITAL.TODAY, HOLY ROSARY HEALTHCARE SERVES SEVERAL EASTERN MONTANA COUNTIES, WHICH COVER OVER 20,000 SQUARE MILES. MORE THAN HALF OF THE PEOPLE RECEIVING HEALTHCARE IN MILES CITY, WHICH HAS A POPULATION OF 8,000, ARE FROM OUTSIDE CUSTER COUNTY. THEREFORE, HOLY ROSARY HEALTHCARE'S IMPACT ON THE HEALTHCARE DELIVERY SYSTEM REACHES FAR BEYOND CITY AND COUNTY LINES. AS PART OF THE MONTANA MARKET WITHIN THE PEAKS REGION OF INTERMOUNTAIN HEATLH CARE, INC., HOLY ROSARY IS AFFILIATED WITH ST. JAMES HEALTHCARE IN BUTTE AND SCL HEALTH - MONTANA (DOING BUSINESS AS ST. VINCENT HEALTHCARE) IN BILLINGS, GIVING IT ACCESS TO SOME OF THE STATE'S MOST ADVANCED MEDICAL TECHNOLOGY. HOLY ROSARY HAS A HISTORIC COMMITMENT TO SERVING THE POOR AND THOSE WITH LIMITED ACCESS TO HEALTHCARE. THE COMMITMENT IS TO THE WORTH AND DIGNITY OF THE WHOLE PERSON - SPIRITUAL, PSYCHOLOGICAL, AND MEDICAL.HOLY ROSARY IS CURRENTLY LICENSED BY THE STATE OF MONTANA AND IS ACCREDITED BY THE JOINT COMMISSION ON ACCREDITATION OF HEALTH CARE ORGANIZATIONS. HOLY ROSARY HAS 25 ACUTE CARE AND 90 EXTENDED CARE BEDS. HOLY ROSARY IS RECOGNIZED AS ONE OF THE BEST MATERNITY HOSPITALS IN THE COUNTRY BY US NEWS AND WORLD REPORT.HOLY ROSARY HEALTHCARE HAS A VARIETY OF PROGRAMS AND SERVICES TO SERVE THE COMMUNITY INCLUDING BUT NOT LIMITED TO:- CANCER CARE- EMERGENCY AND TRAUMA SERVICES- FAMILY HEALTH AND WELLNESS- HOSPICE AND PALLIATIVE CARE- LABOR AND DELIVERY, LEVEL II NEONATAL INTENSIVE CARE UNIT (NICU)- ORTHOPEDICS- RADIOLOGY, IMAGAING AND ANCILLARY SERVICES- RESIDENTIAL LIVING- SPORTS MEDICINE- SURGERY CENTER- THERAPY AND REHAB SERVICES- WALK-IN CARE 7 DAYS A WEEK- WOMEN'S HEALTH SERVICESDURING 2023, HOLY ROSARY HEALTHCARE HAD THE FOLLOWING RESULTS:ADMISSIONS 962 OUTPATIENT VISITS 36,981EMERGENCY ROOM VISITS 5,268BIRTHS - 200SURGERIES 432 LAB TESTS 86,774MISSION, VISION, AND 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 AND COMMUNITIES 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 FORPATIENTS AND ASSOCIATES.STEWARDSHIP - WE ARE ACCOUNTABLE FOR THE RESOURCES ENTRUSTED TOUS. 63977353 1 1 0 1 0 0 0 0 0 1 1 0 0 1 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 1 1 0 0 1 X 0 0 383 1 1 1 0 0 0 0 0 0 0 0 0 0 0 X 16 14 1 0 0 0 1 1 1 1 1 0 0 1 1 1 1 1 1 0 0 0 X COLIN QUINCY 8014423491 36 SOUTH STATE STREET SUITE 1600 SALT LAKE CITY UT 84111 X BRYAN JOHNSON INTERIM PRESIDENT, MT REGION (PARTIAL) 2.00 53.00 X X 0 684612 282612 JENNIFER ALDERFER PRESIDENT, MT REGION (PARTIAL) 4.00 49.00 X X 0 756683 42121 JAMES RITCHEY FORMER KEY EMPLOYEE 0.00 50.00 X 0 434421 181079 MICHAEL BUSH MD VP CHIEF MEDICAL OFFICER 50.00 0.00 X 414665 0 189929 PAMELA PALAGI VP FINANCE REGION MT 4.00 46.00 X 0 386020 148363 CRAIG THOMPSON MD PHYSICIAN 50.00 0.00 X 465086 0 43919 KAREN COSTELLO PRESIDENT HRH 50.00 1.00 X 336872 0 151230 JAY LITTLEFIELD MD PHYSICIAN 50.00 0.00 X 457773 0 17907 PHILLIP CLEMENT MD PHYSICIAN ED 50.00 0.00 X 371660 0 34360 JEANNETTE MCINTYRE MD PHYSICIAN 50.00 0.00 X 369792 0 27328 ADAM SCHAFER VP NETWORK DEVELOPMENT MT REGION 4.00 46.00 X 0 273752 122709 SUSAN PETERSEN MD DIRECTOR 1.00 52.00 X 0 330406 15404 TRACY NEARY VP MISSION INTEGRATION MT REGION 4.00 46.00 X 0 227988 111563 STEVEN GRIFFIN MD PHYSICIAN 50.00 0.00 X 291032 0 40585 BENJAMIN UHLICH VP CHIEF NURSING OFFICER/CHIEF OPEARATING OFFICER 50.00 0.00 X 208309 0 95755 CHRISTOPHER EDWARDS VICE CHAIR 1.00 2.00 X X 0 0 0 KAREN FAGG DIRECTOR 1.00 4.00 X 0 0 0 DANETTE GLEASON CHAIR 1.00 2.00 X X 0 0 0 SISTER EILEEN HURLEY DIRECTOR 1.00 2.00 X 0 0 0 SISTER JUDITH JACKSON DIRECTOR 1.00 2.00 X 0 0 0 MJ JANSSEN DIRECTOR 1.00 2.00 X 0 0 0 BERNARD MCCARTHY DIRECTOR 1.00 2.00 X 0 0 0 CHARLES NOTBOHM SECRETARY 1.00 2.00 X X 0 0 0 COLLEEN O'LEARY DIRECTOR 1.00 2.00 X 0 0 0 NGUYEN-VU PHAM DIRECTOR 1.00 4.00 X 0 0 0 BECKY RENO DIRECTOR 1.00 2.00 X 0 0 0 MAJEL RUSSELL DIRECTOR 1.00 2.00 X 0 0 0 CINDY SORICH DIRECTOR 1.00 2.00 X 0 0 0 MISTY STEADMAN DIRECTOR 1.00 2.00 X 0 0 0 2915189 3093882 1504864 57 1 1 0 0 409167 409167 PATIENT SERVICES REVEN 622110 90723397 90664650 58747 90723397 378644 378644 12776 2083 10693 10693 10693 6817 19445 -12628 -12628 CAFETERIA 722514 275343 275343 275343 91784616 90927365 58747 389337 X 32120 32120 1646169 1629751 16418 22933032 22416505 516527 1018361 1016926 1435 2672361 2339846 332515 1629658 1507201 122457 5108 5108 15035173 14926681 108492 35601 33304 2297 111303 107708 3595 4521628 4521628 1030506 882147 148359 201733 184595 17138 80883 74388 6495 576968 576968 4794819 4794819 362388 362388 MEDICAL SUPPLIES 6911949 6911949 SHARED SERVICES - OTHER 3417491 3417491 SHARED SERVICES - RSC 2697589 2697589 MAINTENANCE 1897053 1816175 80878 5427949 4363882 1064067 77039842 63977353 13062489 0 4451 9081 7540190 7904484 259064 151154 1512144 1505685 270904 269570 84099176 7913677 68363329 76185499 10404445 16808365 88354527 102833838 7244645 7155469 209847 225020 46581 15749 7501073 7396238 X 80853454 95437600 80853454 95437600 88354527 102833838 X 14744774 -160628 X 0 1 X 1 0 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 0 0 0 0 0 0 0 0 1 5108 5108 0 PART II-B, LINE 1: HOLY ROSARY PAID MEMBERSHIP DUES TO THE MONTANA HOSPITAL ASSOCIATION OF WHICH $374 IS ATTRIBUTED TO LOBBYING. HOLY ROSARY PAID $4,734 TO BROWNING, KALECZYC, BERRY & HOVEN ATTRIBUTED TO LOBBYING. 5442883 2196281 24585 372660 7291089 1405807 4162284 -39362 85846 5442883 1131090 411111 33829 170223 1405807 1111525 245891 31671 257997 1131090 1146448 266013 32899 -333835 1111525 0.03703 0.96297 0 1 1 3900000 3900000 50790362 3512278 47278084 7493354 919335 6574019 13838324 3482064 10356260 8077136 8077136 76185499 THIRD PARTY SETTLEMENTS 10108679 OTHER RECEIVABLES 48389 INTERCOMPANY RECEIVABLE 6651297 16808365 FINANCING LEASE 15749 15749 PART V, LINE 4: HOLY ROSARY HEALTHCARE FOUNDATION'S TEMPORARY ENDOWMENT FUNDS AND EARNINGS FROM THE PERMANENT ENDOWMENT FUNDS SUPPORT THE HOLY ROSARY HOSPITAL IN AREAS INCLUDING OTHER SERVICES & PROGRAMS. 1 1 X 1 X 250.000000000000 1 X 500.000000000000 1 1 1 0 1 1 1737234 0 1737234 0.02290 15131331 16658024 0 0.00000 334932 257468 77464 0.00100 17203497 16915492 1814698 0.02390 248791 5395 243396 0.00320 159179 0 159179 0.00210 7441704 3089538 4352166 0.05740 0 0 27895 0 27895 0.00040 7877569 3094933 4782636 0.06310 25081066 20010425 6597334 0.08700 0 0 672 0 672 0.00000 24741 0 24741 0.00030 0 0 0 0 0 0 0 0 0 0 0 0 25413 25413 0.00030 1 1231377 26458773 25453390 1005383 X 1 1 1 1 HOLY ROSARY HEALTHCARE 2600 WILSON STREET MILES CITY MT 59301 WEBSITE: SEE PART VI SUPP INFO 13512 X X X HOLY ROSARY HEALTHCARE 1 0 0 1 X X X X X X X X X 23 1 0 1 1 X SEE PART V, SECTION C X SEE PART V, SECTION C X 1 23 1 SEE PART V, SECTION C 0 1 X 250.000000000000 500.000000000000 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 HOLY ROSARY HEALTHCARE PART V, SECTION B, LINE 5: HOLY ROSARY HEALTHCARE (REFERRED TO HEREAFTER AS HOLY ROSARY) CONDUCTED THE 2023 CHNA IN CONJUNCTION WITH ONE HEALTH (PUBLIC HEALTH DEPARTMENT) AND THE MONTANA OFFICE OF RURAL HEALTH. A STEERING COMMITTEE WITH REPRESENTATIVES OF PUBLIC HEALTH, FAITH COMMUNITY, EDUCATION, SOCIAL SERVICES, GOVERNMENT, HEALTHCARE AND BUSINESS PROVIDED INPUT THROUGHOUT THE CHNA PROCESS INCLUDING DESIGN OF THE SURVEY INSTRUMENT AND REVIEW OF THE RESULTS AND PRIORITIZATION OF THE IDENTIFIED HEALTH NEEDS.THE CHNA STUDY AREA INCLUDED RESIDENTS IN CUSTER COUNTY AND SURROUNDING COMMUNITIES OF FORSYTH, TERRY, GLENDIVE, EKALAKA, PLEVNA, BAKER, BROADUS, JORDAN, AND VOLBORG. MAILED SURVEYS WERE SENT TO A RANDOM LIST OF 1,099 RESIDENTS THROUGH THE ASSISTANCE OF MONTANA STATE UNIVERSITY HELPS LAB. RESIDENCE WAS STRATIFIED IN THE INITIAL SAMPLE SELECTION SO THAT EACH AREA WOULD BE REPRESENTED IN PROPORTION TO THE OVERALL SERVED POPULATION AND THE PROPORTION OF PAST ADMISSIONS. THE RETURN RATE FOR SURVEYS WAS 14.47%. BASED ON SAMPLE SIZE, WE CAN BE 95% CONFIDENT THAT THE RESPONSES TO THE SURVEY QUESTIONS ARE REPRESENTATIVE OF THE SERVICE AREA POPULATION, PLUS OR MINUS 7.7%. IN ADDITION TO THE RANDOMIZED SURVEY, HOLY ROSARY AND ONE HEALTH PROMOTED AN ONLINE SURVEY WITH QUESTIONS THAT CORRESPONDED TO THE RANDOMIZED SURVEY. THIS SURVEY WAS OPEN TO THE PUBLIC VIA HOLY ROSARY'S FACEBOOK PAGE, ONE HEALTH'S FACEBOOK PAGE, AND THE MILES CITY AREA CHAMBER OF COMMERCE FACEBOOK PAGE FOR TWO WEEKS IN FEBRUARY 2023. THE ONLINE SURVEY HAD 81 SURVEY RESPONDENTS. IN ADDITION TO THE SURVEYS, THE MONTANA OFFICE OF RURAL HEALTH CONDUCTED TWO FOCUS GROUPS WITH COMMUNITY REPRESENTATIVES AND THREE KEY INFORMANT PHONE INTERVIEWS IN NOVEMBER 2022. A TOTAL OF TWENTY INDIVIDUALS DESIGNED TO REPRESENT KEY STAKEHOLDER GROUPS IN THE COMMUNITY PROVIDED INPUT FOR THE FOCUS GROUPS AND KEY INFORMANT INTERVIEWS. HOLY ROSARY HEALTHCARE PART V, SECTION B, LINE 6B: HOLY ROSARY HOSPITAL CONDUCTED THE 2023 COMMUNITY HEALTH NEEDS ASSESSMENT IN COLLABORATION WITH ONE HEALTH, CUSTER COUNTY'S PUBLIC HEALTH DEPARTMENT AND FQHC. THE SURVEY WAS CONDUCTED WITH ASSISTANCE FROM THE MONTANA OFFICE OF RURAL HEALTH. REPRESENTATIVES FROM COMMUNITY HEALTH AND SOCIAL SERVICES ORGANIZATIONS INCLUDING EASTERN MONTANA COMMUNITY MENTAL HEALTH CENTER, MILES COMMUNITY COLLEGE, MILES CITY SOUP KITCHEN, MT DPHHS CHILD FAMILY SERVICES DIVISION, AND BILLINGS CLINIC MILES CITY SERVED ON THE CHNA STEERING COMMITTEE.PART V, SECTION B, LINE 7A: HTTPS://WWW.SCLHEALTH.ORG/LOCATIONS/HOLY-ROSARY-HEALTHCARE/ABOUT/COMMUNITY-BENEFIT/COMMUNITY-HEALTH-NEEDS-ASSESSMENT/PART V, SECTION B, LINE 7B: HTTPS://WWW.ONECHC.ORG/_FILES/UGD/D0DAE5_7D0CA4F9CF1C4984B67F2690471DD3CA.PDFPART V, SECTION B, LINE 10A: HTTPS://WWW.SCLHEALTH.ORG/LOCATIONS/HOLY-ROSARY-HEALTHCARE/ABOUT/COMMUNITY-BENEFIT/COMMUNITY-HEALTH-IMPROVEMENT-PLAN/ HOLY ROSARY HEALTHCARE PART V, SECTION B, LINE 11: SEVEN AREAS OF NEED WERE IDENTIFIED IN THE 2023 CHNA THROUGH REVIEW OF THE SURVEY DATA, SECONDARY DATA, AND KEY INFORMANT RESPONSES: ACCESS TO HEALTHCARE ALCOHOL/SUBSTANCE USE AWARENESS OF HEALTH SERVICES, RESOURCES, AND EDUCATION CHRONIC DISEASE DOMESTIC VIOLENCE/SEXUAL ASSAULT/INTIMATE PARTNER VIOLENCE HOUSING AFFORDABILITY MENTAL HEALTHMEMBERS OF THE COMMUNITY AND MEMBERS OF THE HOLY ROSARY COMMUNITY BENEFIT BOARD COMMITTEE WERE PRESENTED WITH KEY FINDINGS FROM THE COMMUNITY HEALTH NEEDS ASSESSMENT BY THE MONTANA OFFICE OF RURAL HEALTH. FOLLOWING THE PRESENTATION, COMMUNITY MEMBERS WERE ASKED TO RANK THE AREAS OF OPPORTUNITY BASED ON TWO CRITERIA: ABILITY TO IMPACT AND SCOPE/SEVERITY OF THE HEALTH ISSUE. THIS PROCESS LED TO A COMMUNITY PRIORITIZATION OF: MENTAL HEALTH ALCOHOL/SUBSTANCE USE CHRONIC DISEASE AWARENESS OF HEALTH SERVICES, RESOURCES, EDUCATION ACCESS TO HEALTHCARE DOMESTIC VIOLENCE/SEXUAL ASSAULT/INTIMATE PARTNER VIOLENCE HOUSING AFFORDABILITY FOLLOWING THE COMMUNITY PRIORITIZATION, A SIMILAR PRESENTATION WAS CONDUCTED, AND HOSPITAL LEADERS WERE ASKED TO PRIORITIZE FINDINGS BASED ON THE SAME CRITERIA. HOLY ROSARY'S SENIOR LEADERSHIP TEAM MET TO DETERMINE FINAL HOSPITAL PRIORITIES CONSIDERING THE COMMUNITY'S PRIORITIZATION, HOSPITAL LEADERSHIP PRIORITIZATION, COMMUNITY RESOURCES AND CAPACITY, AND HOSPITAL RESOURCES AND CAPACITY. THIS PROCESS RESULTED IN A FINAL HOSPITAL PRIORITIZATION OF THREE AREAS WITH AWARENESS OF AVAILABLE HEALTH SERVICES AND RESOURCES INCORPORATED INTO EACH OF THESE PRIORITIES: ACCESS TO HEALTHCARE BEHAVIORAL HEALTH (MENTAL HEALTH AND SUBSTANCE USE) CHRONIC DISEASE ACCESS TO HEALTHCARE: WHILE NOT A PRIORITY FOCUS AREA FOR COMMUNITY HEALTH IMPROVEMENT UNTIL 2024, ACCESS TO HEALTHCARE IS ADDRESSED THROUGHOUT THE COMMUNITY HEALTH IMPROVEMENT PLAN INCLUDING TELEMEDICINE AND VIRTUAL HEALTH OPPORTUNITIES, ESPECIALLY FOR SPECIALTY CARE. IN 2023, HOLY ROSARY HOSPITAL OFFERED 480 VIRTUAL HEALTH VISITS. SPECIALTY OUTREACH WAS CONDUCTED TO SURROUDING COMMUNITIES FOR OB/GYN SERVICES INCLUDING BAKER, EKALAKA, AND FORSYTH. SPECIALISTS FROM ST. VINCENT REGIONAL HOSPITAL CAME TO HOLY ROSARY TO OFFER INCREASED LOCAL ACCESS TO CARDIOLOGY, HEART AND VASCULAR SERVICES, NEPHROLOGY, NEUORLOGY, NEUROSURGERY, ONCOLOGY, PEDIATRIC CARDIOLOGY, SLEEP MEDICINE, UROLOGY AND WOUND CARE. OUTPATIENT HOSPICE CARE SERVICES ARE PROVIDED FOR RESIDENTS IN A 20-MILE RADIUS. IN 2023, HOLY ROSARY HOSPITAL HELD A GROUNDBREAKING FOR A NEW CANCER CENTER WHICH WILL OFFER SERVICES INCLUDING A MEDICAL LINEAR ACCELERATOR THAT WERE PREVIOUSLY UNAVAILABLE IN EASTERN MONTANA. ROBOTIC SURGERY BECAME AVAILABLE TO RESIDENTS IN EASTERN MONTANA AT HOLY ROSARY IN 2023. AS A HEALTH PROFESSIONAL SHORTAGE AREA, HOLY ROSARY HOSPITAL HAS BEEN FOCUSED ON RECRUITING FOR PROVIDERS. IN 2023, 4 PROVIDERS WERE RECRUITED IN 4 SPECIALTIES. IN ADDITION, HOLY ROSARY INCREASED ACCESS TO HEALTHCARE THROUGH SERVING AS A CLINICAL TRAINING SITE FOR HEALTHCARE STUDENTS INCLUDING 106 NURSING STUDENT ROTATIONS, 4 PHYSICAL THERAPY STUDENTS, AND 1 LABORATORY STUDENT. IN ADDITION, HIGH SCHOOL STUDENTS WERE PROVIDED EXPOSURE TO HEALTHCARE CAREERS THROUGH AHEC'S REACH CAMP HOSTED AT HOLY ROSARY HOSPITAL.BEHAVIORAL HEALTH (MENTAL HEALTH AND SUBSTANCE USE):FAIR OR POOR MENTAL HEALTH WAS REPORTED BY 13.4% OF ADULTS AND 15.4% REPORTED CHRONIC DEPRESSION IN THE 2023 CHNA. SUICIDE DEATH RATES PER 100,000 POPULATION WERE HIGHER FOR CUSTER COUNTY (30.1) THAN THE STATE OF MONTANA OVERALL (23.9). NEARLY A QUARTER OF ADULTS (23.7%) REPORTED THEIR LIVES WERE SOMEWHAT OR GREATLY AFFECTED BY SUBSTANCE ABUSE. 25% OF ADULTS IN CUSTER COUNTY REPORTED EXCESSIVE DRINKING, HIGHER THAN THE STATE OF MONTANA RATE (22%) AND NATIONAL RATE (15%).HOLY ROSARY HOSPITAL IS WORKING TO INCREASE ACCESS TO BEHAVIORAL HEALTH SERVICES THROUGH PROVIDING INTEGRATED BEHAVIORAL HEALTH SERVICES. IN 2023, A LICENSED CLINICAL SOCIAL WORKER FROM EASTERN MONTANA MENTAL HEALTH CENTER PROVIDED MENTAL HEALTH SERVICES TO INDIVIDUALS AT HOLY ROSARY INCLUDING FACILITATING A GROUP FOR VETERANS. PRENATAL PATIENTS WERE PROVIDED SCREENING FOR MENTAL HEALTH AND SUBSTANCE USE NEEDS.COMMUNITY MEMBERS ARE EDUCATED ON RISK FACTORS FOR SUICIDE THROUGH QPR GATEKEEPER TRAININGS. IN 2023, HOLY ROSARY HOSPITAL PROMOTED TWO TRAINING OPPORTUNITIES TO COMMUNITY MEMBERS. IN ADDITION, HOLY ROSARY IS WORKING TO CONNECT COMMUNITY MEMBERS TO THE RESOURCES THEY NEED THROUGH PROMOTION OF MT211. IN 2023 THERE WERE 167 VISITS FROM MILES CITY RESIDENTS TO THE MT211 WEBSITE. TOP SEARCHES INCLUDED MENTAL HEALTH, ADDICTIONS, AND HEALTHCARE. CHRONIC DISEASE PREVENTION AND MANAGEMENT: CUSTER COUNTY HAS AN OBESITY RATE OF 30%. NEARLY A QUARTER OF ADULTS (23%) REPORT PHYSICAL INACTIVITY. RESIDENTS REPORT LOWER THAN RECOMMENDED RATES OF HEATLH SCREENINGS INCLUDING BLOOD PRESSURE CHECKS (62.9%), AND DIABETES BLOOD SUGAR CHECKS (42.1%). CANCER SCREENING RATES FOR COLORECTAL CANCER AND BREAST CANCER ARE LOWER THAN THE STATE OF MONTANA OVERALL. HOLY ROSARY HOSPITAL IS WORKING TO INCREASE THE NUMBER OF QUALIFYING PRIMARY CARE PATIENTS RECEIVING RECOMMENDED CANCER SCREENINGS. IN 2023, 68% RECEIVED BREAST CANCER SCREENINGS, AND 69% RECEIVED COLORECTAL CANCER SCREENINGS. THESE SCREENING PERCENTAGES HAVE BEEN SUPPORTED BY OUTREACH AND EDUCATIONAL EVENTS. ADDITIONALLY, 103 INDIVIDUALS RECEIVED LOW-DOSE CT SCANS FOR LUNG CANCER SCREENING. ADDITIONAL EFFORTS ARE FOCUSED ON DECREASING RESIDENTS WITH UNCONTROLLED DIABETES AND UNCONTROLLED BLOOD PRESSURE. IN 2023, 80% OF PRIMARY CARE PATIENTS HAD CONTROLLED DIABETES. BLOOD PRESSURE WAS CONTROLLED FOR 65% OF PATIENTS. HOLY ROSARY HOSPITAL OFFERS A DIABETES AND HEART DISEASE PREVENTION PROGRAM, HEALTHY LIFESTYLES, WHICH HELPS INDIVIDUALS LEARN HEALTHY EATING AND EXERCISE HABITS TO PREVENT CHRONIC DISEASE. IN 2023, 50% OF THE 42 COMMUNITY MEMBERS COMPLETING THIS PROGRAM LOST AT LEAST 5% OF THEIR BODY WEIGHT. A 2.5 MILE WALKING PATH IS MAINTAINED BY HOLY ROSARY TO ENCOURAGE ACTIVE LIFESTYLES. HOLY ROSARY HOSPITAL PROVIDED ATHLETIC TRAINERS TO SUPPORT CUSTER COUNTY HIGH SCHOOL AND MILES COMMUNITY COLLEGE. HOLY ROSARY OFFERS OUTPATIENT MEDICAL NUTRITION THERAPY FOR RESIDENTS WITH DIABETES, HEART DISEASE AND OBESITY. IN 2023, 492 RESIDENTS RECEIVED OUTPATIENT MEDICAL NUTRITION THERAPY. NUTRITION SERVICES WERE ALSO PROVIDED TO END STAGE RENAL PATIENTS IN THE COMMUNITY. THE CARDIAC REHABILITATION PROGRAM PROVIDES EXERCISE COUNSELING AND TRAINING, EDUCATION FOR HEART HEALTHY LIVING, AND SUPPORT FOR INDIVIDUALS WHO HAVE EXPERIENCED A HEART ATTACK OR HAVE A HEART CONDITION. IN 2023, 54 INDIVIDUALS WERE REFERRED TO THE CARDIAC REHABILITATION PROGRAM AND 27 WERE REFERRED TO THE PULMONARY REHABILITATION PROGRAM. HOLY ROSARY HOSPITAL REDUCES GEOGRAPHIC BARRIERS TO CARE FOR CHRONIC DISEASE THROUGH OUTREACH SERVICES AND VIRTUAL HEALTH/TELEMEDICINE ENCOUNTERS. VISITING SPECIALISTS PROVIDE CARE WITHOUT THE NEED TO TRAVEL. CARDIOLOGY OUTREACH WAS CONDUCTED TWICE PER MONTH. ADDITIONALLY, HOLY ROSARY HAS SUPPORTED THE CUSTER COUNTY TRANSIT PROGRAM TO DECREASE TRANSPORTATION BARRIERS. OTHER SIGNIFICANT NEEDS NOT PRIORITIZED: HOLY ROSARY HOSPITAL RECOGNIZES OTHER HEALTH NEEDS AND INDICATORS IDENTIFIED IN THE CHNA PROCESS ARE IMPORTANT FOR THE HOSPITAL AND COMMUNITIES IT SERVES. NUMEROUS OTHER ORGANIZATIONS ARE CONCURRENTLY ADDRESSING THE OTHER NEEDS THAT WERE NOT PRIORITIZED BY HOLY ROSARY HOSPITAL. DUE TO LIMITED EXPERTISE AND RESOURCES, HOLY ROSARY NARROWED ITS PRIORITY HEALTH NEEDS TO THE THREE HEALTH NEEDS DISCUSSED. HOLY ROSARY HOSPITAL CONTINUED TO COLLABORATE WITH COMMUNITY ORGANIZATIONS TO ADDRESS THESE HEALTH NEEDS:HEALTHY LIFESTYLES: HEALTHY LIFESTYLES ARE ADDRESSED BY STRATEGIES FOR CHRONIC DISEASE PREVENTION AND MANAGEMENT LISTED IN DETAIL ABOVE. ATHLETIC TRAINERS SUPPORT LOCAL SCHOOLS TO PREVENT INJURY FOR ATHLETES. SENIOR ISSUES/AGING: HOLY ROSARY HOSPITAL OPERATES A SKILLED NURSING FACILITY WITH 48 BEDS AND PROVIDES OUTPATIENT PALLIATIVE CARE AND HOSPICE SERVICES IN A 20 MILE RADIUS OF MILES CITY. HOLY ROSARY STAFFS DELIVERY OF MEALS ON WHEELS A FEW WEEKS EACH YEAR, PROVIDING NUTRITION FOR HOMEBOUND SENIORS.DOMESTIC VIOLENCE, SEXUAL ASSAULT, INTERPERSONAL VIOLENCE: IN 2023, HOLY ROSARY HOSPITAL PROVIDED IN-KIND SUPPORT TO CUSTER NETWORK AGAINST DOMESTIC ABUSE AND SEXUAL ASSAULT. COMMUNITY BUILDING: HOLY ROSARY HOSPITAL PROVIDES SUPPORT FOR MILES CITY ECONOMIC DEVELOPMENT AND WORKS WITH COMMUNITY PARTNERS TO ADDRESS HOUSING AFFORDABILITY. IN-KIND SUPPORT IS PROVIDED TO ORGANIZATIONS SERVING THE MOST VULNERABLE RESIDENTS INCLUDING THE SALVATION ARMY AND THE MILES CITY SOUP KITCHEN. 9 1 - HOLY ROSARY PRIMARY CARE 2600 WILSON ST MILES CITY MT 59301 OUTPATIENT PHYSICIAN CLINIC 2 - HOLY ROSARY ED 2600 WILSON ST MILES CITY MT 59301 OUTPATIENT PHYSICIAN CLINIC 3 - HOLY ROSARY HOSPITALISTS 2600 WILSON ST MILES CITY MT 59301 OUTPATIENT PHYSICIAN CLINIC 4 - HOLY ROSARY WOMEN'S HEALTH 2600 WILSON ST MILES CITY MT 59301 OUTPATIENT PHYSICIAN CLINIC 5 - HOLY ROSARY PEDIATRICS 2600 WILSON ST MILES CITY MT 59301 OUTPATIENT PHYSICIAN CLINIC 6 - HOLY ROSARY GENERAL SURGERY 2600 WILSON ST MILES CITY MT 59301 OUTPATIENT PHYSICIAN CLINIC 8 - HOLY ROSARY WOMEN'S HEALTH-BAKER 202 S 4TH ST BAKER MT 59313 OUTPATIENT PHYSICIAN CLINIC 9 - HOLY ROSARY WOMEN'S HEALTH-FORSYTH 383 N 17TH AVE FORSYTH MT 59327 OUTPATIENT PHYSICIAN CLINIC 10 - HOLY ROSARY WOMEN'S HEALTH-EKALAKA 215 SANDY ST EKALAKA MT 59324 OUTPATIENT PHYSICIAN CLINIC PART I, LINE 3C: MAXIMUM FINANCIAL ASSISTANCE IS PROVIDED TO PATIENTS AT OR BELOW 250% OF THE FEDERAL POVERTY GUIDELINES ("FPG"). APPLICANTS EQUAL TO OR BELOW THIS THRESHOLD RECEIVE A 100% WAIVER OF PATIENT FINANCIAL OBLIGATION.A SLIDING SCALE IS USED FOR PATIENTS BETWEEN 250% AND 500% OF FPG.TO DETERMINE ELIGIBILITY FOR PROVIDING FREE OR DISCOUNTED CARE, A VARIETY OF FACTORS IS USED, INCLUDING INCOME, MEDICAL INDIGENCE, INSURANCE STATUS, SOCIAL-ECONOMIC, GEOGRPAHICAL LOCATION, AND MEDICAID ELIGIBILITY.TOTAL CHARGES ARE LIMITED IN RELATION TO THE GROSS HOUSEHOLD INCOME. CHARGES ARE DISCOUNTED TO NOT EXCEED 25% OF GROSS ANNUAL HOUSEHOLD INCOME.SINCE EACH PATIENT'S CIRCUMSTANCES VARY, ALLOWANCE IS MADE FOR EXTENUATING CIRCUMSTANCES NOT DIRECTLY ADDRESSED IN THE FINANCIAL ASSISTANCE POLICIES TO BE CONSIDERED WHEN DETERMINING ELIGIBILITY FOR FINANCIAL ASSISTANCE. PART I, LINE 6A: THIS ORGANIZATION IS PART OF INTERMOUNTAIN HEALTH 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 THE ORGANIZATION'S FINANCIAL STATEMENTS. PART I, LINE 7, COLUMN (F): THE BAD DEBT EXPENSE INCLUDED ON FORM 990, PART IX, LINE 25, COLUMN (A), BUT SUBTRACTED FOR PURPOSES OF CALCULATING THE PERCENTAGE IN THIS COLUMN IS $ 1,231,377. PART II, COMMUNITY BUILDING ACTIVITIES: COMMUNITY BUILDING: HOLY ROSARY HOSPITAL RECOGNIZES THE NEED TO ADDRESS UNDERLYING FACTORS WHICH INFLUENCE HEALTH IN OUR COMMUNITY SUCH AS EDUCATION, HOUSING, EARLY CHILDHOOD DEVELOPMENT AND ECONOMIC SECURITY. WE COLLABORATE WITH COMMUNITY BASED ORGANIZATIONS TO ADDRESS THESE ISSUES. PART III, LINE 1THE ORGANIZATION REPORTS BAD DEBT IN ACCORDANCE WITH HEALTHCARE FINANCIAL MANAGEMENT ASSOCIATION (HFMA) STATEMENT NO. 15 TO THE EXTENT THAT HFMA STATEMENT NO. 15 FOLLOWS GENERALLY ACCEPTED ACCOUNTING PRINCIPLES (GAAP) FOR REPORTING BAD DEBT. PART III, LINE 2: THE BAD DEBT EXPENSE REPORTED ON PART III, LINE 2 IS AT CHARGES AS RECORDED IN THE ORGANIZATION'S 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, 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, THIRD-PARTY PAYOR PROGRAMS, CHARITY CARE, UNINSURED DISCOUNTS, AND OTHER ADMINISTRATIVE ADJUSTMENTS.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 AND PROVIDING FINANCIAL COUNSELING AND ASSISTANCE IN APPLYING FOR THE ORGANIZATION'S CHARITY CARE AND OTHER FINANCIAL ASSISTANCE PROGRAMS.CERTAIN PATIENT ACCOUNTS ARE WRITTEN OFF TO BAD DEBT BECAUSE THE ORGANIZATION 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 WHICH DESCRIBES BAD DEBT EXPENSE AND ALLOWANCE FOR UNCOLLECTIBLE ACCOUNTS IS ON PAGES 12 AND 13 OF THE AUDITED CONSOLIDATED FINANCIAL STATEMENTS. PART III, LINE 9B: AN INTEGRAL COMPONENT OF OUR MISSION IS TO BE GOOD FINANCIAL STEWARDS. THIS REQUIRES US TO DETERMINE WHICH PATIENTS ARE IN NEED OF CHARITY CARE AND WHICH ARE ABLE TO CONTRIBUTE SOME PAYMENT FOR CARE RECEIVED. WE MAINTAIN A BALANCE THAT ENABLES US TO CONTINUE TO PROVIDE CHARITY CARE TO THOSE WHO NEED IT MOST AND ENSURE THAT WE MANAGE OUR RESOURCES SOWE CAN CONTINUE TO BE HERE WHEN PEOPLE NEED US MOST. THE ORGANIZATION 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 V, SECTION A WEBSITE: HTTPS://INTERMOUNTAINHEALTHCARE.ORG/LOCATIONS/INTERMOUNTAIN-HEALTH-HOLY-ROSARY-HOSPITAL PART VI, LINE 2: HOLY ROSARY HOSPITAL CONTINUOUSLY ASSESSES THE NEEDS OF THE COMMUNITY THROUGH CLOSE WORKING RELATIONSHIPS AND PARTNERSHIPS WITH SERVICE AGENCIES IN THE COMMUNITY. HOLY ROSARY'S LEADERSHIP SERVE ON VARIOUS COMMUNITY BOARDS TO UNDERSTAND THE SPECIFIC NEEDS OF THEIR COMMUNITY.IN ADDITION TO THE CHNA DATA FOCUSED ON CUSTER COUNTY, HOLY ROSARY REVIEWS SECONDARY DATA SUCH AS COUNTY HEALTH RANKINGS AND THE BEHAVIOR RISK FACTOR SURVEILLANCE SYSTEM (BRFSS) TO DETERMINE HEALTH NEEDS FOR NEIGHBORING COUNTIES. OUTREACH AND RELATIONSHIPS WITH OTHER CRITICAL ACCESS HOSPITALS, HEALTH CENTERS, AND CLINICS IN BAKER, BROADUS, CIRCLE, FORSYTH, GLENDIVE, JORDAN, AND TERRY PROVIDE ADDITIONAL INFORMATION AND RESOURCES. THESE ADDITIONAL STEPS ENABLE HOLY ROSARY HOSPITAL TO BETTER ASSESS THE HEALTH NEEDS OF THESE COMMUNITIES. 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: POPULATION AND GEOGRAPHY: LOCATED IN SOUTHEASTERN MONTANA, HOLY ROSARY HOSPITAL IS A FEDERALLY DESIGNATED CRITICAL ACCESS HOSPITAL PROVIDING CARE TO RESIDENTS OF CUSTER COUNTY INCLUDING THE COMMUNITY OF MILES CITY, MONTANA. CUSTER COUNTY HAS A POPULATION OF 11,729 AND IS CLASSIFIED AS RURAL WITH 3.1 PEOPLE PER SQUARE MILE. HOSPITALS IN THE SERVICE AREA: THERE ARE NO OTHER ACUTE HOSPITALS IN CUSTER COUNTY.DEMOGRAPHICS: APPROXIMATELY 19.1% OF RESIDENTS ARE SENIORS (HIGHER THAN THE STATE OF MONTANA OVERALL). THE COUNTY IS 96.8% WHITE (HIGHER THAN THE STATE OF MONTANA OVERALL), FOLLOWED BY 4.5% NATIVE AMERICAN AND APPROXIMATELY 2.3% REPORTING BLACK, ASIAN, OR HISPANIC ANCESTRY. 10.1% OF CUSTER COUNTY RESIDENTS ARE VETERANS AND 18.2% OF RESIDENTS ARE DISABLED. ECONOMICS: 11.5% OF RESIDENTS ARE BELOW THE FEDERAL POVERTY LEVEL AND 10.8% OF CHILDREN ARE IN POVERTY. CUSTER COUNTY HAS A HIGHER NUMBER OF RESIDENTS WITHOUT A HIGH SCHOOL DEGREE (8.0%) THAN THE STATE OF MONTANA (6.4%). HEALTH STATUS: THE MAJORITY OF ADULTS IN HOLY ROSARY HOSPITAL'S SERVICE AREA REPORT THEIR HEALTH AS EXCELLENT, VERY GOOD, OR GOOD. HOWEVER, 15.4% OF ADULTS RATED THEIR HEALTH AS FAIR OR POOR. UNINSURED RATE: 10.7% OF PEOPLE IN CUSTER COUNTY ARE UNINSURED, WHICH IS HIGHER THAN THE U.S AVERAGE OF 9.3%. PART VI, LINE 5: HOLY ROSARY ADHERES TO COMMUNITY BENEFIT GUIDELINES OUTLINED IN THE CATHOLIC HEALTH ASSOCIATION'S PUBLICATION, "A GUIDE TO PLANNING AND REPORTING COMMUNITY BENEFIT". HOLY ROSARY HOSPITAL'S COMMUNITY BENEFIT WORK IS DRIVEN BY IDENTIFIED COMMUNITY HEALTH NEEDS AND BY WORKING WITH LOCAL ORGANIZATIONS AND THE BROADER COMMUNITY. A COMMUNITY BENEFIT REPORT TO THE COMMUNITY IS PUBLISHED ANNUALLY AND CAN BE FOUND AT: HTTPS://INTERMOUNTAINHEALTHCARE.ORG/-/MEDIA/FILES/INTERMOUNTAIN-HEALTH/CHNA-REPORTS---PEAKS/HRH_COMMUNITY-HEALTH-ANNUAL-REPORT_FINAL-2022.ASHX COMMUNITY BENEFIT STRATEGIES ARE INTEGRATED IN THE ORGANIZATIONAL STRATEGIC PLAN. PROGRAMS ARE LOCATED THROUGHOUT THE ORGANIZATION AND STAFF AND BOARD EDUCATION IS CONDUCTED. HOLY ROSARY HOSPITAL HAS DEDICATED COMMUNITY BENEFIT STAFF. HOSPITAL LEADERS, MANAGERS, AND SUPERVISORS ARE ENCOURAGED TO PARTICIPATE ANNUALLY IN COMMUNITY BENEFIT SERVICE EVENTS WITH NON-PROFIT ORGANIZATIONS TO IMPROVE THE HEALTH OF THE COMMUNITIES WE SERVE.THE MONTANA MARKET'S BOARD OF DIRECTORS IS A VOLUNTEER GOVERNING BODY WHICH INCLUDES INDEPENDENT PERSONS THAT REPRESENT THE COMMUNITY. WITHIN THE BOARD OF DIRECTORS, THERE IS A SPECIFIC LOCAL COMMUNITY BENEFIT BOARD COMMITTEE. THIS COMMITTEE IS INVOLVED IN THE COMMUNITY HEALTH NEEDS ASSESSMENT PROCESS AND PROVIDES DIRECTION TO THE DEVELOPMENT OF THE ORGANIZATION'S IMPROVEMENT PLAN IN RESPONSE TO RESULTS OF COMMUNITY HEALTH NEEDS ASSESSMENT. THE HOSPITAL'S COMMUNITY BENEFIT BOARD COMMITTEE MONITORS IMPLEMENTATION OF COMMUNITY BENEFIT PROGRAMS AND PROVIDES REPORTS BACK TO THE FULL REGIONAL BOARD. HOLY ROSARY HOSPITAL OPERATES AN EMERGENCY ROOM THAT IS OPEN TO ALL PERSONS REGARDLESS OF ABILITY TO PAY. HOLY ROSARY ENGAGES IN THE TRAINING AND EDUCATION OF HEALTHCARE PROFESSIONALS AND PARTICIPATES IN MEDICAID, MEDICARE AND OTHER GOVERNMENT SPONSORED HEALTH PROGRAMS. HOLY ROSARY HOSPITAL EMPLOYS THE STAFF OF THE HOLY ROSARY HOSPITAL FOUNDATION, A NON-PROFIT ORGANIZATION THAT PROVIDES FUNDRAISING FOR HOLY ROSARY FACILITIES AND PROGRAMS THAT REACH BOTH THE POOR AND THE BROADER COMMUNITY. OPERATIONS OF THE HOLY ROSARY HOSPITAL FOUNDATION ARE GOVERNED BY A SEPARATE FOUNDATION BOARD WITH VOLUNTARY MEMBERSHIPS FROM THE LOCAL COMMUNITY. WHEN HOLY ROSARY HOSPITAL HAS EXCESS REVENUE OVER OPERATING EXPENSES, THEY USE THOSE FUNDS TO OBTAIN CURRENT HEALTHCARE TECHNOLOGIES AND EQUIPMENT, IMPROVE PATIENT CARE, AND PROVIDE MEDICAL TRAINING EDUCATION AND TO EXPAND ACCESS TO POINTS OF CARE. THESE INVESTMENTS ENSURE THE HOSPITAL WILL BE ABLE TO CARE FOR FUTURE GENERATIONS. 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 IS A NONPROFIT CORPORATION EXEMPT UNDER INTERNAL REVENUE CODE 501(C)(3). AFFILIATES WITHIN THE HEALTH SYSTEM NETWORK INCLUDE NONPROFIT CORPORATIONS EXEMPT UNDER IRS 501(C)(3) AND 501(C)(4), TAXABLE CORPORATIONS, PARTNERSHIPS WITH PHYSICIANS, STRATEGIC INVESTMENTS, AND JOINT VENTURES.HEADQUARTERED IN UTAH WITH LOCATIONS IN SEVEN STATES AND ADDITIONAL OPERATIONS ACROSS THE WESTERN U.S., INTERMOUNTAIN HEALTH IS A NONPROFIT SYSTEM OF MORE THAN 66,000 CAREGIVERS, 33 HOSPITALS, 385 CLINICS, MEDICAL GROUP, A HEALTH PLAN DIVISION CALLED SELECT HEALTH WITH MORE THAN ONE MILLION MEMBERS, AND OTHER HEALTH SERVICES. HELPING PEOPLE LIVE THE HEALTHIEST LIVES POSSIBLE, INTERMOUNTAIN IS COMMITTED TO IMPROVING COMMUNITY HEALTH AND 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. 1 HOLY ROSARY HEALTHCARE FOUNDATION INC 2600 WILSON STREET MILES CITY MT 59301 202270238 501(C)(3) 24150 0 SUPPORT MISSION 1 PART I, LINE 2: THE ORGANIZATION KEEPS RECORDS TO SUPPORT THE AMOUNTS PROVIDED OR REASON FOR SUCH SUPPORT. FUNDING DECISIONS ARE DETERMINED ON AN INDIVIDUAL BASIS, CONSIDERING THE USE OF THE FUNDS AND HOW THE USE RELATES TO THE ORGANIZATION'S MISSION. 0 1 0 0 0 0 0 0 0 BRYAN JOHNSON INTERIM PRESIDENT, MT REGION (PARTIA 0 502548 0 109425 0 72639 0 255252 0 27360 0 967224 0 162823 JENNIFER ALDERFER PRESIDENT, MT REGION (PARTIAL) 0 549575 0 130931 0 76177 0 14518 0 27603 0 798804 0 203684 JAMES RITCHEY FORMER KEY EMPLOYEE 0 327797 0 62403 0 44221 0 150869 0 30210 0 615500 0 73082 MICHAEL BUSH MD VP CHIEF MEDICAL OFFICER 313152 0 48455 0 53058 0 165638 0 24291 0 604594 0 48455 0 PAMELA PALAGI VP FINANCE REGION MT 0 309390 0 47018 0 29612 0 137628 0 10735 0 534383 0 74294 CRAIG THOMPSON MD PHYSICIAN 412880 0 39850 0 12356 0 13793 0 30126 0 509005 0 0 0 KAREN COSTELLO PRESIDENT HRH 271248 0 58884 0 6740 0 131871 0 19359 0 488102 0 58884 0 JAY LITTLEFIELD MD PHYSICIAN 406364 0 28725 0 22684 0 14151 0 3756 0 475680 0 0 0 PHILLIP CLEMENT MD PHYSICIAN ED 362638 0 2160 0 6862 0 928 0 33432 0 406020 0 0 0 JEANNETTE MCINTYRE MD PHYSICIAN 299229 0 55000 0 15563 0 13858 0 13470 0 397120 0 0 0 ADAM SCHAFER VP NETWORK DEVELOPMENT MT REGION 0 261298 0 10565 0 1889 0 112625 0 10084 0 396461 0 10565 SUSAN PETERSEN MD DIRECTOR 0 222183 0 106353 0 1870 0 12912 0 2492 0 345810 0 0 TRACY NEARY VP MISSION INTEGRATION MT REGION 0 183426 0 28674 0 15888 0 85749 0 25814 0 339551 0 42913 STEVEN GRIFFIN MD PHYSICIAN 260740 0 6600 0 23692 0 7772 0 32813 0 331617 0 0 0 BENJAMIN UHLICH VP CHIEF NURSING OFFICER/CHIEF OPEAR 195049 0 12065 0 1195 0 94834 0 921 0 304064 0 12065 0 PART I, LINE 3 COMPENSATION OF THE ORGANIZATION'S CEO/EXECUTIVE DIRECTOR THE ORGANIZATION'S OFFICERS AND SENIOR MANAGEMENT ARE PAID BY A RELATED ORGANIZATION, SISTERS OF CHARITY OF LEAVENWORTH HEALTH SYSTEM, INC. (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) COMPENSATION SURVEYS AND STUDIES 5) 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, 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 NOT-FOR-PROFIT 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 COSTS 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 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. CERTAIN PARTICIPANTS ARE VESTED OR BECAME VESTED IN THE PLAN DURING 2023. VESTED AMOUNTS ARE PAYABLE TO THE RECIPIENT UPON THE END OF EMPLOYMENT. 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 2023 WERE: JENNIFER ALDERFER - $72,753; BRYAN JOHNSON - $53,398; PAMELA PALAGI - $27,276; MICHAEL BUSH - $46,411; TRACY NEARY - $14,239; JAMES RITCHEY - $25,482. ADDITIONAL OFFICER AND BOARD DISCLOSURES 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 CARE 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, LINE J WEBSITE: HTTPS://INTERMOUNTAINHEALTHCARE.ORG/LOCATIONS/INTERMOUNTAIN-HEALTH-HOLY- ROSARY-HOSPITAL FORM 990, PART V, LINE 1A EXPLANATION FOR NUMBER REPORTED IN BOX 3 OF FORM 1096: THE ORGANIZATION'S EXPENSES ARE PAID BY A RELATED 501(C)(3) TAX-EXEMPT ORGANIZATION. THE RELATED ORGANIZATION FILES THE REQUIRED FORM 1096 AND RELATED 1099 TAX FORMS FOR ANY EXPENDITURE THAT REQUIRES A FORM 1099 TO BE FILED. FORM 990, PART VI, SECTION A, LINE 2 PAM PALAGI / TRACY NEARY - BUSINESS RELATIONSHIP (EMPLOYER/EMPLOYEE RELATIONSHIP IN SCL HEALTH - MONTANA). JEN ALDERFER / ADAM SCHAFER / SUSAN PETERSEN - BUSINESS RELATIONSHIP (EMPLOYER/EMPLOYEE RELATIONSHIP IN SISTERS OF CHARITY OF LEAVENWORTH HEALTH SYSTEM, INC.). FORM 990, PART VI, SECTION A, LINE 6 MEMBERS OR STOCKHOLDERS SISTERS OF CHARITY OF LEAVENWORTH HEALTH SYSTEM, INC. IS THE SOLE MEMBER OF HOLARY ROSARY HEALTHCARE. FORM 990, PART VI, SECTION A, LINE 7A POWER TO ELECT OR APPOINT MEMBERS SISTERS OF CHARITY OF LEAVENWORTH HEALTH SYSTEM, INC., THE SOLE MEMBER OF HOLY ROSARY HEALTHCARE, HAS THE POWER TO APPOINT MEMBERS OF THE HOLY ROSARY HEALTHCARE BOARD OF DIRECTORS, SUBJECT TO THE RATIFICATION BY THE BOARD OF INTERMOUNTAIN HEALTH CARE, INC. FORM 990, PART VI, SECTION A, LINE 7B DECISIONS RESERVED TO MEMBERS OR STOCKHOLDERS WHILE SISTERS OF CHARITY OF LEAVENWORTH HEALTH SYSTEM, INC. (SCLHS) IS THE SOLE MEMBER OF HOLY ROSARY HEALTHCARE, RESERVED POWERS ARE PRIMARILY HELD BY INTERMOUNTAIN HEALTH CARE, INC. (INTERMOUNTAIN), WHO AS A RESULT OF AFFILIATION, IS A MEMBER OF SCLHS. SCLHS HAS THE POWER TO APPOINT TRUSTEES TO THE BOARD OF DIRECTORS, WHICH ARE SUBJECT TO RATIFICATION BY INTERMOUNTAIN. 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. THE OTHER MEMBER OF SCLHS IS LEAVEN MINISTRIES, WHO WAS GRANTED THE FOLLOWING RESERVED POWERS: - 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 THE CONSOLIDATED SYSTEM PARENT SET FORTH IN THE MERGER 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 PROCESS USED TO REVIEW THE FORM 990 THE FORM 990 IS PREPARED BY THE TAX DEPARTMENT OF INTERMOUNTAIN HEALTH CARE, INC. AND SUBSIDIARIES. THE DRAFT FORM 990 IS REVIEWED BY CERTAIN MEMBERS OF SENIOR MANAGEMENT. A COPY OF THE FINAL FORM 990 IS PROVIDED TO THE BOARD OF DIRECTORS PRIOR TO THE FILING WITH THE INTERNAL REVENUE SERVICE. FORM 990, PART VI, SECTION B, LINE 12C EACH OFFICER, DIRECTOR, TRUSTEE AND KEY EMPLOYEE IS REQUIRED TO COMPLETE A CONFLICT OF INTEREST QUESTIONNAIRE AT LEAST ANNUALLY. THESE INDIVIDUALS HAVE BEEN INSTRUCTED TO UPDATE THEIR QUESTIONNAIRE INFORMATION IF THEY BECOME AWARE OF A NEW POTENTIAL CONFLICT, OR IF ANY OF THE PREVIOUSLY REPORTED INFORMATION CHANGES. ADDITIONALLY, BOARD MEMBERS ARE ASKED AT THE BEGINNING OF EACH BOARD OR COMMITTEE MEETING IF THEY ARE AWARE OF ANY CONFLICTS. ACCORDING TO POLICY, THE QUESTIONNAIRES ARE COLLECTED AND REVIEWED BY INTERMOUNTAIN'S CHIEF COMPLIANCE OFFICER. POTENTIAL CONFLICTS OF INTEREST ARE REVIEWED WITH APPROPRIATE PERSONNEL, WHICH MAY INCLUDE (BUT IS NOT LIMITED TO) THE AUDIT AND COMPLIANCE COMMITTEE CHAIR, SENIOR MANAGEMENT AND THE LEGAL DEPARTMENT. IF AN INDIVIDUAL DISCLOSES A SITUATION THAT POSES A CONFLICT OF INTEREST, A DETERMINATION IS MADE WHETHER THE SITUATION CAN BE MANAGED (SUCH AS BY RECUSAL IN DECISION-MAKING SETTINGS) OR MUST BE ELIMINATED (SUCH AS THROUGH DIVESTITURE OF THE OUTSIDE INTEREST). FINDINGS ARE REPORTED TO THE AUDIT AND COMPLIANCE COMMITTEE OF INTERMOUNTAIN HEALTH CARE, INC. FORM 990, PART VI, SECTION B, LINE 15 THE ORGANIZATION'S OFFICERS AND SENIOR MANAGEMENT ARE PAID BY A RELATED ORGANIZATION, SISTERS OF CHARITY OF LEAVENWORTH HEALTH SYSTEM, INC. (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) COMPENSATION SURVEYS AND STUDIES 5) 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 AVAILABILITY OF GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS AVAILABLE TO THE PUBLIC THE ORGANIZATION MAKES ITS CONFLICT OF INTEREST POLICY, FINANCIAL STATEMENTS, AND GOVERNING DOCUMENTS AVAILABLE UPON REQUEST. FORM 990, PART VII, SECTION B, LINE 2 INDEPENDENT CONTRACTORS THE ORGANIZATION'S EXPENSES ARE PAID BY A RELATED 501(C)(3) TAX-EXEMPT ORGANIZATION. THE RELATED ORGANIZATION FILES THE REQUIRED FORM 1096 AND RELATED 1099 TAX FORMS FOR ANY EXPENDITURE THAT REQUIRES A FORM 1099 TO BE FILED. FORM 990, PART IX, LINE 11G CONTRACT MEDICAL SERVICES: PROGRAM SERVICE EXPENSES 11,691,104. MANAGEMENT AND GENERAL EXPENSES 84,975. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 11,776,079. PHYSICIAN SERVICES: PROGRAM SERVICE EXPENSES 2,936,804. MANAGEMENT AND GENERAL EXPENSES 21,346. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 2,958,150. LABORATORY SERVICES: PROGRAM SERVICE EXPENSES 298,773. MANAGEMENT AND GENERAL EXPENSES 2,171. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 300,944. FORM 990, PART XI, LINE 9: FAIR VALUE ACQUISITION ADJUSTMENT -160,628. 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