2024-10-23T10:46:13-05:00 2023-12-31 410746749 CLIFTONLARSONALLEN LLP 8390 EAST CRESCENT PARKWAY SUITE 300 GREENWOOD VILLAGE CO 80111 990 2023-01-01 830279242 WYOMING MEDICAL CENTER INC WYOM 6027474000 2901 NORTH CENTRAL AVENUE 160 PHOENIX AZ 85012 STACI DICKERSON EVP, CFO 6027474000 2024-10-22 1 1 KURT BENNION CPA P01469618 3037795710 2024-10-22 2023 2024-10-15 13:58:12Z AMY PERRY 2901 NORTH CENTRAL AVENUE 160 PHOENIX AZ 85012 260071920 0 X SEE SCHEDULE O X 1986 WY ASSIST BANNER HEALTH COMPLETE ITS MISSION TO MAKE HEALTH CARE EASIER, SO LIFE CAN BE BETTER BY PROVIDING INTEGRATED AND COORDINATED CARE AND POPULATION HEALTH MANAGEMENT. 3 0 0 59 866540 802129 3714216 6219597 232416952 252838295 79831 -69898 544226 1047093 236755225 260035087 25835 30500 0 0 91843210 89425506 0 0 0 140473292 169551705 232342337 259007711 4412888 1027376 250080113 243925960 63082634 63299077 186997479 180626883 X ASSIST BANNER HEALTH COMPLETE ITS MISSION TO MAKE HEALTH CARE EASIER, SO LIFE CAN BE BETTER BY PROVIDING INTEGRATED AND COORDINATED CARE AND POPULATION HEALTH MANAGEMENT. 0 0 180204466 30500 251971755 GUIDED BY AND DEEPLY DEVOTED TO THE NONPROFIT MISSION: "MAKING HEALTH CARE EASIER, SO LIFE CAN BE BETTER," WYOMING MEDICAL CENTER, IS COMMITTED TO PROVIDING A WIDE RANGE OF QUALITY CARE, BASED ON THE NEEDS OF THE COMMUNITY. LOCATED IN THE COUNTY SEAT OF CASPER WYOMING, THE SECOND MOST POPULOUS CITY IN WYOMING, THE LEVEL TWO TRAUMA CENTER SERVES AS A REGIONAL REFERRAL CENTER AND PRIMARY FACILITY FOR NATRONA COUNTY RESIDENTS. WYOMING MEDICAL CENTER PROVIDES A WIDE RANGE OF QUALITY CARE SERVICES INCLUDING CARDIOLOGY, WOMEN AND INFANTS' SERVICES, PEDIATRICS, BARIATRICS, SURGERY, IMAGING, NEUROLOGY, ONCOLOGY, REHABILITATION, AND ENDOCRINOLOGY. (CONTINUED IN SCHEDULE O)WYOMING MEDICAL CENTER HAS A STRONG HISTORY OF DEDICATION TO ITS COMMUNITY AND PROVIDING CARE TO UNDERSERVED POPULATIONS AND CONTINUES TO HELP IDENTIFY ADDITIONAL OPPORTUNITIES TO BETTER CARE FOR POPULATIONS WITHIN THE COMMUNITY WHO HAVE SPECIAL OR UNMET NEEDS.WYOMING MEDICAL CENTER IS DEDICATED TO STRENGTHENING PATIENT CARE THROUGH A CONTINUOUS FOCUS ON IMPROVING PATIENT OUTCOMES AND SERVICE, DEVELOPMENT AND TRAINING OF AN ENGAGED WORKFORCE, USE OF INNOVATIVE TECHNOLOGIES, AND EXPANSION OF SERVICES TO MEET COMMUNITY NEEDS. PEOPLE HAVE ALWAYS COME FIRST AND WHETHER WELCOMING NEWBORNS, OR PROVIDING CARE FOR THRIVING IN LATER YEARS, OUR PATIENTS PROVIDE THE MOTIVATION THAT KEEPS US MOVING FORWARD. AT ALL STAGES IN LIFE, WYOMING MEDICAL CENTER MEETS THE HEALTH AND MEDICAL NEEDS OF ITS PATIENTS THROUGH COMPASSIONATE PROFESSIONALS AND OUTSTANDING SERVICE. WYOMING MEDICAL CENTER'S REACH PROVIDES PATIENTS WITH ACCESS TO THESE SERVICES BE IT FROM A HOSPITAL BED, MOBILE WEB SITE, VIRTUAL TELEHEALTH SPACE, OR PHYSICAL PRESENCE IN A CLINIC OR PHYSICIAN'S OFFICE. WYOMING MEDICAL CENTER MEETS THE PATIENT WHERE THEY ARE AND AT THEIR DESIRED LOCALE. WYOMING MEDICAL CENTER'S MISSION IS "MAKING HEALTH CARE EASIER, SO LIFE CAN BE BETTER. AND AS A NONPROFIT ORGANIZATION, WE EXIST TO SUPPORT OUR CHARITABLE MISSION OF PROVIDING EXCELLENT HEALTH CARE SERVICES TO THE COMMUNITIES WE SERVE, RATHER THAN GENERATING INCOME FOR INVESTORS OR STOCKHOLDERS. EVERY DOLLAR WE EARN IS REINVESTED INTO NEW EQUIPMENT, NEW OR EXPANDING PATIENT CARE SERVICES, NEW PHYSICIAN SERVICES, MODERN TECHNOLOGIES, MAINTAINING EXISTING EQUIPMENT AND FACILITIES, AND EMPLOYEES. WYOMING MEDICAL CENTER PRESERVES THE DIGNITY OF EVERYONE REGARDLESS OF RACE, CREED, SEX, SEXUAL ORIENTATION, GENDER IDENTITY, AGE, SOCIAL STATUS, OR ABILITY TO PAY FOR SERVICES RENDERED AND OPERATES IN A COST-EFFECTIVE AND FINANCIALLY RESPONSIBLE MANNER TO ENSURE THAT ALL RECEIVE THE EXCELLENT PATIENT CARE THEY DESERVE. FULFILLMENT OF THE WYOMING MEDICAL CENTER MISSION AND EXEMPT PURPOSE IS ACCOMPLISHED IN PART BY PROVIDING PATIENTS FINANCIAL ASSISTANCE AND CHARITY CARE, AS WELL AS COMMUNITY BENEFIT PROGRAMS AND SERVICES (SEE SCHEDULE H). NOTABLE 2023 COMMUNITY BENEFIT ACTIVITIES INCLUDE:COMMUNITY EDUCATION - WYOMING MEDICAL CENTER HAS SET ITS SIGHTS ON IMPROVING THE HEALTH OF THE COMMUNITIES IT SERVES AND FOCUSES ON PROVIDING THE BEST POSSIBLE CARE TO PATIENTS. IN THIS PROCESS, WYOMING MEDICAL CENTER RECOGNIZES DELIVERING EXCELLENT CARE IS MORE THAN CLINICAL TREATMENT. WYOMING MEDICAL CENTER IS COMMITTED TO PROVIDING EDUCATION IN ALL THE COMMUNITIES IT SERVES AND DOING ITS PART TO KEEP WYOMING MEDICAL CENTER COMMUNITIES STRONG AND HEALTHY. AREA RESIDENTS AND COMMUNITY MEMBERS HAVE ACCESS TO IN-PERSON AND ONLINE EDUCATIONAL OPPORTUNITIES INCLUDING CLASSES, SYMPOSIUMS, PRESENTATIONS, AND FORUMS AIMED AT COMMUNITY HEALTH AWARENESS. TOPICS INCLUDED DISCUSSIONS SPECIFIC TO VARIOUS DISEASES AND DISEASE PREVENTION TECHNIQUES, HOLISTIC THERAPIES, WELLNESS, CAREGIVER SUPPORT AND SAFETY. COVID 19 - WYOMING MEDICAL CENTER FOCUSES ON EMERGENCY PREPAREDNESS YEAR-ROUND TO BE ABLE TO RESPOND TO ANY PUBLIC HEALTH CRISIS AND THE ARRIVAL OF THE COVID-19 PANDEMIC TO THE U.S. PUT THOSE PLANS INTO IMMEDIATE ACTION. SINCE THEN, WYOMING MEDICAL CENTER HAS BEEN EVER PRESENT, PROVIDING QUALITY-CARE AND ACCESS AND LEADING THE WAY IN OUR COMMUNITIES. PROFOUNDLY ALTERED BY THE GLOBAL PANDEMIC AND AMID THE COVID-19 CHALLENGES, THE IMPORTANCE OF HIGH-QUALITY, ACCESSIBLE HEALTH CARE WAS NEVER MORE EVIDENT AND IN THE PANDEMIC ERA, WYOMING MEDICAL CENTER CONTINUES TO STEADFASTLY FOCUS ON CARING FOR OUR DIVERSE COMMUNITIES INCLUDING SAFE TESTING, VACCINATIONS, EDUCATION, PROTECTION, AND CARE. WYOMING MEDICAL CENTER HEALTH CONTINUALLY WORKS TO DEVELOP AND IMPLEMENT PRACTICES TO ENSURE THE SAFETY OF PATIENTS AND HEALTH CARE WORKERS ACROSS ITS WYOMING SERVICE AREA; CONSTANTLY REVIEWING AND ENHANCING MEASURES. THE IMPORTANCE OF HEALTH CARE WORKER AND PATIENT SAFETY IS PARAMOUNT WITH AN OVERARCHING MESSAGE - WYOMING MEDICAL CENTER IS A SAFE PLACE - FOR CARE AND WORK.SAFETY EDUCATION - AT WYOMING MEDICAL CENTER WE ARE COMMITTED TO PROMOTING A CULTURE OF SAFETY AND EMBRACING HIGH RELIABILITY PRINCIPLES AND HELPING TO KEEP OUR PATIENTS AND FAMILIES SAFE AT HOME, REST, OR PLAY AND SAFETY IS THE FOREMOST PRIORITY AT OUR FACILITIES. AS PART OF OUR EFFORTS, WE OFFER SAFETY EDUCATION RELATED TO HANDWASHING, FARM, RECREATION, WATER, HOLIDAY, POISON PREVENTION, AND SUMMER SAFETY ALONG WITH FREE GUIDES TO HELP INDIVIDUALS AND FAMILIES PREPARE FOR ANY KIND OF EMERGENCY. HEALTH CARE SUPPORT SERVICES - PUBLIC AHCCCS/MEDICAID PROGRAM ENROLLMENT ASSISTANCE AND CARE COORDINATION VALUED AT $143,000 PROVIDED TO INDIVIDUALS IN NEED. PATIENT WELLNESS - AT WYOMING MEDICAL CENTER HEALTH, WE ARE COMMITTED TO HELPING PERSONS BE THE HEALTHIEST THEY CAN BE, AND WE OFFER MANY WAYS TO LEARN HOW TO MAINTAIN OR IMPROVE YOUR HEALTH. IN 2023 COMMUNITY EDUCATION AND WELLNESS ACTIVITIES WERE VALUED AT $310,000 . PHARMACY EDUCATION - AS PART OF COMMUNITY SERVICE, WYOMING MEDICAL CENTER PROVIDED APPROXIMATELY $380,000 FOR THE TRAINING OF FUTURE PHARMACISTS.FUNDED DISCHARGE PROGRAM - INITIATIVE TO PROVIDE POST-DISCHARGE SERVICES TO THE VULNERABLE AND UNDERSERVED. IMPROVES THE HEALTH OF THE COMMUNITY BY PROVIDING ACCESS TO AND RESOURCES FOR POST-DISCHARGE CARE WHICH LEVERAGES' THE PATIENT'S RECOVERY OPTIONS, HELPS MINIMIZE RETURN VISITS, AND ADDRESSES ACCESS TO CARE. APPROXIMATELY $88,000 PROVIDED TO NEEDY COMMUNITY RESIDENTS FOR POST DISCHARGE CARE. FINANCIAL CONTRIBUTIONS AND IN-KIND DONATIONS - WYOMING MEDICAL CENTER IS COMMITTED TO ASSISTING FINANCIALLY AND THROUGH IN-KIND CONTRIBUTIONS TO INDIVIDUALS AND THE COMMUNITY AT LARGE. APPROXIMATELY $28,000 IN-KIND WAS PROVIDED TO SUPPORT COMMUNITY EFFORTS. 180204466 1 1 0 1 0 0 0 0 0 0 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 1 0 0 0 0 0 1 1 0 0 0 1 0 0 0 1 1 0 0 0 0 0 0 0 0 0 0 0 X 3 0 0 1 0 0 1 1 1 1 0 0 1 1 0 1 1 1 1 1 1 1 1 1 X BANNER HEALTH 6027474000 2901 NORTH CENTRAL AVENUE 160 PHOENIX AZ 85012 MARGO KARSTEN DIVISION PRESIDENT 2.00 40.00 X X 0 1075459 314142 LANCE PORTER CEO, LARGE FACILITY 2.00 40.00 X X 0 443342 114457 DAN WEINMAN VP. STRATEGY & PLANNING 2.00 40.00 X X 0 855506 223561 AMY PERRY PRESIDENT & COO 2.00 42.00 X 0 3808609 1828722 JEAN LANCE SECRETARY EVP CHIEF LEGAL OFF. & GEN. COUNSEL 2.00 42.00 X 0 1087861 604280 BRENDA SCHAEFER TREASURER VP, CHIEF INVESTMENT OFFICER 2.00 40.00 X 0 678427 155292 DONALD NORDLUND EVP CHIEF STRATEGY & GROWTH OFFICER 2.00 40.00 X 0 1817866 873358 ELIZABETH AVANT DIR LEGAL OPERATIONS & ASSISTANT SECRETARY 2.00 40.00 X 0 153045 12837 0 9920115 4126649 0 0 1 0 0 6209076 10521 6219597 NET PATIENT REVENUE 621110 245853687 245853687 JV INVESTMENT INCOME 901101 5922696 5093067 829629 CAFETERIA SALES 722514 879172 842261 36911 NON-PATIENT/OPERATING 900099 182740 182740 252838295 -33065 -33065 1046693 0 1046693 1046693 1046693 36833 -36833 -36833 -36833 OTHER NONOPERATING 900099 400 400 400 260035087 251971755 866540 977195 X 30500 30500 76602691 62030714 14571977 1562915 1265605 297310 6682702 5411465 1271237 4577198 3706487 870711 28145874 28145874 295952 295952 8407 8407 36773382 25457745 11315637 1599 1599 1320337 769391 550946 4000906 56067 3944839 19028689 3016720 16011969 259980 76013 183967 5238498 5238498 16900708 16900708 1056314 1056314 DRUG & MEDICAL SUPPLIES 42321000 42321000 BAD DEBT EXPENSE 9408385 9408385 PHYSICIAN RECRUITMENT 2303787 1553720 750067 FOOD 1363084 1169540 193544 1124803 735594 389209 259007711 180204466 78803245 0 13014036 9246410 1153 43593529 42402409 499814 1432049 7620694 7761143 936797 333209 466680636 314842374 149122230 151838262 6419044 8100438 2278571 1335715 26595398 21475172 250080113 243925960 18491961 15880527 72417 38507 44518256 47380043 63082634 63299077 X 173705384 170519058 13292095 10107825 186997479 180626883 250080113 243925960 X 1027376 -7397972 X X 0 1 X 1 0 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 0 0 0 0 0 0 0 0 0 0 1 36960 0 1 15230 52190 0 PART II-B, LINE 1: WYOMING MEDICAL CENTER SPENT $36,960 IN REIMBURSED EXPENSES RELATED TO DIRECT COMMUNICATIONS WITH LEGISLATORS. WYOMING MEDICAL CENTER ALSO CONTRIBUTED $15,230 IN LOBBYING COSTS THROUGH ITS PAYMENT OF DUES TO THE WYOMING HOSPITAL ASSOCIATION. 13344402 13344402 146018961 105285290 40733671 4757381 4757381 0 276691245 191497876 85193369 25868647 13301827 12566820 151838262 RIGHT OF USE ASSET 21475172 21475172 ESTIMATED THIRD-PARTY PAYOR SETTLEMENTS 619146 DUE TO RELATED ORGANIZATIONS 16389840 OPERATING LEASE LIABILITY 23348392 ASSET RETIREMENT OBILIGATION 7022665 47380043 1 1 X 1 X 1 X 1 1 1 0 1 1 17367216 17367216 0.06780 25004044 15609187 9394857 0.03670 42371260 15609187 26762073 0.10450 452163 452163 0.00180 379595 379595 0.00150 88079 88079 0.00030 27607 27607 0.00010 947444 947444 0.00370 43318704 15609187 27709517 0.10820 1446 1446 0.00000 400978 400978 0.00160 402424 402424 0.00160 1 3010683 451602 75603722 75791600 -187878 X 1 1 1 OUTPATIENT RADIOLOGY LLC IMAGING SERVICES 0.50000 0.00000 0.50000 2 CENTRAL WYOMING OUTPATIENT SURGERY CENTER LLC SURGICAL CENTER 0.50000 0.25000 0.25000 3 NORTH PLATTE PATHOLOGY LLC PATHOLOGY SERVICES 0.50000 0.00000 0.50000 1 1 WYOMING MEDICAL CENTER 1233 EAST 2ND STREET CASPER WY 82601 SEE SCHEDULE O 15341 X X X WYOMING MEDICAL CENTER 1 0 0 1 X X X X X X X X X X 22 1 0 1 1 X SEE LINE 7D X X 1 22 1 SEE LINE 7D 0 1 X 200.000000000000 400.000000000000 X X X 1 1 X X X X 1 X SEE LINE 16J X SEE LINE 16J X SEE LINE 16J X X X X X X X 1 X 0 X X X X 1 X 0 0 WYOMING MEDICAL CENTER PART V, SECTION B, LINE 5: IN ADDITION TO THE NOTED COMMUNITY OUTREACH AND IN COMPLIANCE WITH FEDERAL REQUIREMENTS, WYOMING MEDICAL CENTER, AND THE BANNER HEALTH CHNA STEERING COMMITTEE PARTNERED WITH PUBLIC HEALTH EXPERTS AS WELL AS KEY INFORMANTS, RESIDENTS, REPRESENTATIVES, OR LEADERS OF LOW-INCOME, MINORITY, AND MEDICALLY UNDERSERVED POPULATIONS TO COLLECT AND REVIEW DATA AND FINDINGS. WYOMING MEDICAL CENTER PART V, SECTION B, LINE 6B: THE COMMUNITY HEALTH NEEDS ASSESSMENT WAS CONDUCTED IN COLLABORATION WITH THE CASPER-NATRONA COUNTY HEALTH DEPARTMENT. WYOMING MEDICAL CENTER PART V, SECTION B, LINE 7D: THE 2022 CHNA REPORT IS AVAILABLE ONLINE AT WWW.BANNERHEALTH.COM/STAYING-WELL/COMMUNITY/HEALTH-NEEDS-ASSESSMENTS-REPORT AND THE IMPLEMENTATION STRATEGY IS AVAILABLE ONLINE AT WWW.BANNERHEALTH.COM/-/MEDIA/FILES/PROJECT/BH/CHNA-REPORTS/2022/IMPLEMENTATION-STRATEGIES-FOR-POSTING.ASHX. WYOMING MEDICAL CENTER PART V, SECTION B, LINE 11: ACTIONS SINCE PRECEEDING CHNA/BANNER HEALTH IMPLEMENTATION STRATEGIES:TO ADDRESS THE SIGNIFICANT HEALTH NEEDS IDENTIFIED DURING THE CHNA PROCESS, BANNER HEALTH DEVELOPED SYSTEMWIDE IMPLEMENTATION STRATEGIES TO ADDRESS THE SIGNIFICANT HEALTH NEEDS. THE STRATEGIES, TACTICS, AND ANTICIPATED OUTCOMES OF THOSE STRATEGIES FOLLOW.SIGNIFICANT HEALTH NEED: IMPROVING THE HEALTH OF THE COMMUNITIES WE SERVE:STRATEGY: INCREASED UTILIZATION OF BANNER HEALTH'S CARE CONTINUUM THROUGH OUR CLINICS, HOSPITALS, AMBULATORY SETTINGS, AND POST-ACUTE SETTINGS OF CARE.ANTICIPATED OUTCOME: IMPROVE OUR COMMUNITIES EASE AND ACCESS TO THE CARE CONTINUUM FOR ALL THEIR HEALTH CARE NEEDS.TACTIC 1: INCREASE ACCESS TO AMBULATORY SERVICES.TACTIC 2: INCREASE UTILIZATION OF ONLINE SCHEDULING FOR EASE OF APPOINTMENT.TACTIC 3: INCREASE COMMUNITY CARE COMMUNICATION WITH BANNER HEALTH TO SUPPORT THE PATIENT IN ACCESSING THE CARE THEY NEED, NAVIGATE THE CARE CONTINUUM, AND INFORM THEIR PCP OF THEIR ONGOING HEALTHCARE STATUS.COVID TACTIC: CONTINUE TO PROVIDE LONG-COVID CARE.REHAB TACTIC: CONTINUE TO PROMOTE ACCESS TO BANNER PHYSICAL THERAPY AND BANNER HOME CARE FOLLOWING DISCHARGE FROM BANNER REHABILITATION HOSPITAL.STRATEGY: SUPPORTING OUR TEAM MEMBERS THROUGH INTERNAL WELLNESS PROGRAMS AND EMPLOYEE BENEFITS.ANTICIPATED OUTCOME: INSPIRE A HEALTHY AND PRODUCTIVE WORK FORCE.TACTIC 1: OFFER AND PROMOTE EMPLOYEE WELLNESS PROGRAMS TO REDUCE BURNOUT AND TURNOVER.TACTIC 2: PROMOTE EMPLOYEE SATISFACTION AND EMPLOYMENT EXPERIENCE.TACTIC 3: EXPAND UTILIZATION OF MYWELL-BEING TO ENCOURAGE DAILY WELLNESS AT BANNER HEALTH.COVID TACTIC: CONTINUE TO PROVIDE COMMUNICATION WITH BANNER HEALTH EMPLOYEES ON COVID.STRATEGY: ALIGN BANNER HEALTH'S STRATEGIES AND PROCESSES WITH SOCIAL DETERMINANTS OF HEALTH PRACTICES.ANTICIPATED OUTCOME: EDUCATE BANNER HEALTH TEAM MEMBERS AND PARTNERS ON INCORPORATING SOCIAL DETERMINANTS OF HEALTH INTO OUR HEALTH CARE STRATEGIES.TACTIC 1: IDENTIFY AND SUPPORT COMMUNITY-BASED ORGANIZATIONS TO FURTHER ALIGN BANNER HEALTH'S SDOH AGENDA.TACTIC 2: PROMOTE IN-SCHOOL CLINICS AND MOBILE HEALTH CLINICS FOR LOW-INCOME PEDIATRIC PATIENTS.TACTIC 3: PROVIDE NON-CLINICAL SUPPORT TO ADDRESS SOCIAL DETERMINANTS OF HEALTH FOR SENIORS TO IMPROVE THEIR HEALTH AND WELL-BEING THROUGH THE CARE CONTINUUM.SIGNIFICANT HEALTH NEED: CHRONIC DISEASE MANAGEMENTSTRATEGY: INCREASE ACCESS TO PRIMARY CARE.ANTICIPATED OUTCOME: IMPROVE EASE OF PRIMARY CARE UTILIZATION.TACTIC 1: IMPROVE EASE OF SCHEDULING PRIMARY CARE VISITS BY INCREASING ACCESS TO PROVIDERS AND ONLINE SCHEDULING.TACTIC 2: CREATE A PROCESS TO BETTER LEVERAGE TELEHEALTH IN THE MANAGEMENT OF CHRONIC CARE CONDITIONS.TACTIC 3: PROVIDE ADDITIONAL RESOURCES TO HELP OUR COMMUNITIES MANAGE THEIR HEALTH.COVID TACTIC: SUPPORT PATIENTS WITH CHRONIC DISEASES RECOVERING FROM COVID-19.STRATEGY: SUPPORT BANNER HEALTH COMMUNITIES IN MANAGING CHRONIC DISEASES.ANTICIPATED OUTCOME: IMPROVE CHRONIC DISEASE MANAGEMENT THROUGH CLINICAL SUPPORT AND PATIENT EDUCATION.TACTIC 1: SUPPORT PATIENTS WITH OR AT RISK FOR HYPERTENSION WITH MANAGING THEIR BLOOD PRESSURE CONTROL.TACTIC 2: SUPPORT PATIENTS WITH OR AT RISK FOR DIABETES WITH MANAGING THEIR HBA1C LEVELS.TACTIC 3: PROVIDE EDUCATION OR DEMENTIA CAPABILITY TO PROFESSIONALS AND FAMILIES IN THE COMMUNITIES WE SERVE (DEMENTIA ECHO AND COMMUNITY EDUCATION PROGRAMS)REHAB TACTIC: PROVIDE EDUCATION AND SUPPORT IN MANAGING LONG TERM CHRONIC DISEASE CARE.STRATEGY: INCREASE AWARENESS OF AND ACCESS TO CANCER SCREENINGS.ANTICIPATED OUTCOME: INCREASE PREVENTATIVE CANCER CARE.TACTIC 1: PROVIDE EDUCATIONAL RESOURCES TO THE COMMUNITY FOR CANCER AWARENESS AND PREVENTION.TACTIC 2: INCREASE PATIENT COMPLIANCE ON ROUTINE COLON SCREENINGS.TACTIC 3: INCREASE PATIENT COMPLIANCE ON ROUTINE BREAST CANCER SCREENINGSIGNIFICANT HEALTH NEED: BEHAVIORAL HEALTHSTRATEGY: PROVIDE AWARENESS AND ACCESS TO MENTAL HEALTH RESOURCES.ANTICIPATED OUTCOME: REDUCE VOLUME OF ACUTE MENTAL HEALTH EPISODES THROUGH EARLY INTERVENTIONS OF EDUCATION AND ACCESS TO PREVENTATIVE CARE.TACTIC 1: CONTINUE TO PROVIDE VIRTUAL EDUCATION WITH BANNER AND THEIR PARTNERS FOR MENTAL HEALTH AWARENESS.TACTIC 2: IMPROVE PROVIDER ACCESS TO MENTAL HEALTH RESOURCES TO LEVERAGE WITH BEHAVIORAL PATIENTS UTILIZING TELE-BEHAVIORAL.TACTIC 3: ENCOURAGE CLINICIAN UTILIZATION OF BANNER HEALTH PROVIDED MENTAL HEALTH RESOURCES.STRATEGY: SUPPORT COMMUNITIES IN ACCESSING SUBSTANCE PREVENTION AND INTERVENTION SERVICES.ANTICIPATED OUTCOME: IMPROVE UTILIZATION OF PREVENTION AND INTERVENTION SERVICES FOR SUBSTANCE USE.TACTIC 1: PROMOTE CLINICIAN AND PHARMACISTS' PREVENTION AND INTERVENTION WORK FOR SUBSTANCE ABUSE AND MISUSE.TACTIC 2: CONTINUE TO OFFER MULTI-INTERVENTIONAL TOBACCO CESSATION SUPPORT AT BANNER HEALTH FACILITIES.TACTIC 3: CONTINUE TO PROVIDE INPATIENT DETOX AND INTENSIVE OUTPATIENT SERVICES AT ALL ACUTE BEHAVIORAL HEALTH SITES. WYOMING MEDICAL CENTER PART V, SECTION B, LINE 16J: THE FINANCIAL ASSISTANCE POLICY, PLAIN LANGUAGE SUMMARY AND APPLICATION ARE AVAILABLE ONLINE AT WWW.BANNERHEALTH.COM/PATIENTS/BILLING/FINANCIAL-ASSISTANCE. PART V, SECTION B, LINE 3J: LINE 3A:WYOMING MEDICAL CENTER, A REGIONAL REFERRAL CENTER IS IN NATRONA COUNTY, WYOMING AND INCLUDES A CENTRAL AND EAST CAMPUS. THE CENTRAL CAMPUS IS THE PRIMARY FACILITY FOR NATRONA COUNTY RESIDENTS AND A LEVEL 2 TRAUMA CENTER. THE DEMOGRAPHIC AREA FOR THIS COMMUNITY HEALTH NEEDS ASSESSMENT (CHNA) IS NATRONA COUNTY. NATRONA COUNTY IS IN THE CENTER OF WYOMING AND IS THE SECOND MOST POPULOUS COUNTY IN WYOMING. WYOMING MEDICAL CENTER IS POSITIONED IN THE COUNTY SEAT OF CASPER. THE PRIMARY SERVICE AREA (PSA) INFORMATION FOR WYOMING MEDICAL CENTER INCLUDES ALL RESIDENTS IN A DEFINED GEOGRAPHIC AREA SURROUNDING THE HOSPITAL AND DOES NOT EXCLUDE LOW-INCOME OR UNDERSERVED POPULATIONS. LINE 3C: IN COMPLIANCE WITH FEDERAL REQUIREMENTS, WYOMING MEDICAL CENTER, AND THE BANNER HEALTH CHNA STEERING COMMITTEE PARTNERED WITH PUBLIC HEALTH EXPERTS AS WELL AS RESIDENTS, REPRESENTATIVES, OR LEADERS OF LOW-INCOME, MINORITY, AND MEDICALLY UNDERSERVED POPULATIONS. WORKING COLLABORATIVELY THE HEALTH NEEDS OF RESIDENTS IN NATRONA COUNTY, WYOMING INCLUDING THE PRIMARY SERVICES AREA FOR WYOMING MEDICAL CENTER WERE ASSESSED. LINE 3D: WYOMING MEDICAL CENTER EMPLOYS AN EIGHT-STEP CHNA PROCESS BASED ON BANNER HEALTH'S EXPERIENCE FROM PREVIOUS CHNA CYCLES. THE EIGHT-STEP PROCESS CONSISTS OF THE FOLLOWING:1. REVIEW AND EVALUATE PRIOR CHNA REPORT AND ACTION PLANS, REVIEW DATA2. PARTNER WITH COMMUNITY AGENCIES, INCLUDING COUNTY PUBLIC HEALTH DEPARTMENTS 3. CONDUCT FOCUS GROUP WITH COMMUNITY STAKEHOLDERS AND CONFIRM COMMUNITY PRIORITIES 4. RESEARCH ADDITIONAL HEALTH NEEDS IDENTIFIED 5. PREPARE CHNA REPORT 6. DEVELOP STRATEGIES FOR THE NEXT THREE YEARS7. OBTAIN BANNER HEALTH LEADERSHIP AND BOARD OF DIRECTOR APPROVAL 8. POST TO WWW.BANNERHEALTH.COM AND OBTAIN ONGOING COMMUNITY FEEDBACKORGANIZATIONAL STRUCTURE:- EXTERNAL STAKEHOLDERS - A TEAM OF EXTERNAL STAKEHOLDERS IS MADE UP OF INDIVIDUALS AND ORGANIZATIONS EXTERNAL TO WYOMING MEDICAL CENTER, AND REPRESENT THE UNDERSERVED, UNINSURED, AND MINORITY POPULATIONS IN NATRONA COUNTY AND THE SURROUNDING AREAS. BASED ON THEIR ROLE IN THE PUBLIC HEALTH REALM OF THE HOSPITAL'S SURROUNDING COMMUNITY, THESE STAKEHOLDERS ARE INSTRUMENTAL IN COLLABORATING AROUND IMPROVING OUR COMMUNITIES. EACH STAKEHOLDER IS VESTED IN THE OVERALL HEALTH OF THE COMMUNITY AND BRINGS FORTH A UNIQUE PERSPECTIVE WITH REGARDS TO THE POPULATION'S HEALTH NEEDS.- BANNER HEALTH'S CHNA STEERING COMMITTEE - COMPRISED OF LEADERS FROM THROUGHOUT BANNER HEALTH, THESE LEADERS REPRESENT OUR ARIZONA COMMUNITY DELIVERY, WESTER DIVISION, AND RURAL FACILITIES, AS WELL AS OUR ACADEMIC MEDICAL CENTERS. IN COLLABORATION WITH WYOMING MEDICAL CENTER'S LEADERSHIP TEAM AND BANNER HEALTH'S STRATEGY PLANNING DEPARTMENT, THE STEERING COMMITTEE IS INSTRUMENTAL IN BOTH THE DEVELOPMENT OF THE CHNA PROCESS AND THE CONTINUATION OF WYOMING MEDICAL CENTER'S AND BANNER HEALTH'S COMMITMENT TO PROVIDING SERVICES THAT MEET COMMUNITY HEALTH NEEDS. - CHNA CHAMPIONS - A WORKING TEAM FROM EACH OF BANNER HEALTH'S HOSPITALS MEETS MONTHLY TO REVIEW THE ONGOING PROCESS OF COMMUNITY STAKEHOLDER MEETINGS, REPORT CREATION, AND ACTION PLAN IMPLEMENTATION. THIS GROUP CONSISTS OF MEMBERSHIP MADE UP OF CEOS, CNOS, COOS, FACILITY DIRECTORS, QUALITY MANAGEMENT PERSONNEL, VOLUNTEER SERVICES LEADERS, AND OTHER CLINICAL STAKEHOLDERS. PRIMARY DATA:1. CONSISTS OF NEW DATA THAT IS OBTAINED VIA DIRECT MEANS. FOR BANNER HEALTH, PRIMARY DATA IS CREATED BY RENDERING HEALTHCARE SERVICES TO PATIENTS; THE DATA INCLUDES INPATIENT, OR OUTPATIENT COUNTS, VISITS, PAYER, ETC. FOR THE CHNA REPORT, PRIMARY DATA WAS ALSO COLLECTED DIRECTLY FROM THE COMMUNITY THROUGH SURVEYS, FOCUS GROUPS, AND KEY INFORMANT INTERVIEWS. THE PRIMARY DATA FOR THE CHNA ORIGINATED FROM CERNER (BANNER HEALTH'S ELECTRONIC MEDICAL RECORD) AND MCKESSON (BANNER HEALTH'S COST ACCOUNTING/DECISION SUPPORT TOOL). THESE DATA SOURCES WERE USED TO IDENTIFY THE HEALTH SERVICES CURRENTLY BEING ACCESSED BY THE COMMUNITY AND PROVIDES INDICATORS FOR DIAGNOSIS-BASED HEALTH NEEDS OF THE COMMUNITY. THIS DATA WAS ALSO USED TO IDENTIFY THE PRIMARY SERVICE AREAS (PSA = 75%), INFORM THE STEERING COMMITTEE, AND FACILITY CHAMPIONS ON WHAT THE NEXT STEPS OF RESEARCH AND FOCUS GROUP FACILITATION NEEDED TO ENTAIL. 2. COMMUNITY SURVEY - TO IDENTIFY AND UNDERSTAND COMMUNITY HEALTH NEEDS, A COMMUNITY HEALTH ASSESSMENT SURVEY WAS ADMINISTERED TO COMMUNITY MEMBERS IN WESTERN DIVISION BETWEEN MAY-JULY 2022. SURVEYS WERE INTENDED TO PROVIDE INFORMATION ABOUT PROMINENT HEALTH PROBLEMS FACING THE COMMUNITY. THE SURVEY HAD A TOTAL OF 15 QUESTIONS TO IDENTIFY FACTORS WHICH CONTRIBUTED TO OVERALL QUALITY OF LIFE, MORE IMPORTANT HEALTH ISSUES AND BEHAVIORS, RATING SCALES, AND IMPACT COVID-19 HAD IN THEIR LIFE AND IN THE COMMUNITY. A TOTAL OF 234 SURVEYS WERE COLLECTED FROM OUR WESTERN DIVISION COMMUNITY PARTNERS, 88 FROM OUR WYOMING PARTNERS, AND 58 FROM NATRONA COUNTY. 3. KEY INFORMANT INTERVIEWS - BANNER HEALTH CONDUCTED A SERIES OF KEY INFORMANT INTERVIEWS WITH COMMUNITY MEMBERS IDENTIFIED BY FACILITY CHAMPIONS. KEY INFORMANTS REPRESENTED LOCAL HEALTH DEPARTMENTS, FIRE DEPARTMENTS, BEHAVIORAL HEALTH CENTERS, LOCAL COMMUNITY COLLEGES, AND SOCIAL SERVICE DEPARTMENTS. THROUGH A SERIES OF QUESTIONS, KEY INFORMANTS DEFINED THEIR OPINION OF HEALTH AND WHAT QUALITY OF LIFE MEANT, THEY IDENTIFIED TOP COMMUNITY NEEDS, AND DISCUSSED THE IMPACT COVID-19 CONTINUES TO HAVE IN THEIR COMMUNITY. WHILE THE DEFINITION OF HEALTH VARIED PERSON BY PERSON, THE PRIMARY THEME WAS THE ABILITY TO LIVE A SAFE AND PRODUCTIVE LIFE.SECONDARY DATA:WYOMING MEDICAL CENTER'S PROCESS FOR CONDUCTING THEIR CHNA LEVERAGED A MULTI-PHASED APPROACH TO UNDERSTANDING GAPS IN SERVICES PROVIDED TO THE COMMUNITY, AS WELL AS EXISTING COMMUNITY RESOURCES. THE CHNA UTILIZED A MIXED-METHODS APPROACH THAT INCLUDED THE COLLECTION OF SECONDARY OR QUANTITATIVE DATA WITH REVIEW AND INPUT FROM KEY INFORMANTS, AND MEETINGS WITH INTERNAL LEADERSHIP. SECONDARY DATA INCLUDES PUBLICLY AVAILABLE HEALTH STATISTICS AND DEMOGRAPHIC DATA. WITH INPUT FROM STAKEHOLDERS, CHAMPIONS, AND THE STEERING COMMITTEE, ADDITIONAL HEALTH INDICATORS OF SPECIAL INTEREST WERE INVESTIGATED. COMPARISONS OF DATA SOURCES WERE MADE TO THE COUNTY, STATE, AND PSA IF POSSIBLE. DATA ANALYTICS WERE EMPLOYED TO IDENTIFY DEMOGRAPHICS, SOCIOECONOMIC FACTORS, AND HEALTH TRENDS IN THE PSA, COUNTY, AND STATE. DATA REVIEWED INCLUDED INFORMATION AROUND DEMOGRAPHICS, POPULATION GROWTH, HEALTH INSURANCE COVERAGE, HOSPITAL SERVICES UTILIZATION, PRIMARY AND CHRONIC HEALTH CONCERNS, RISK FACTORS, AND EXISTING COMMUNITY RESOURCES. SEVERAL SERVICES OF DATA WERE CONSULTED TO PRESENT THE MOST COMPREHENSIVE PICTURE OF WYOMING MEDICAL CENTER'S PSA'S HEALTH STATUS AND OUTCOMES. LINE 3E AND 3G: BUILDING ON BANNER HEALTH'S PAST THREE CHNA REPORTS, THE STEERING COMMITTEE AND FACILITY CHAMPIONS WORKED WITH BANNER HEALTH CORPORATE PLANNERS TO PRIORITIZE HEALTH NEEDS FOR CYCLE 4 OF THE CHNA. FACILITY STAKEHOLDERS, COMMUNITY MEMBERS, AND PUBLIC HEALTH PROFESSIONALS WERE AMONG MAJOR EXTERNAL ENTITIES INVOLVED IN IDENTIFYING HEALTH NEEDS, WHICH WERE THEN BROUGHT TO THE STEERING COMMITTEE. BOTH BANNER HEALTH INTERNAL MEMBERS, AND EXTERNAL ENTITIES WERE STRATEGICALLY SELECTED FOR THEIR RESPECTIVE UNDERSTANDING OF COMMUNITY PERSPECTIVES, COMMUNITY-BASED HEALTH ENGAGEMENT, AND HEALTH CARE EXPERTISE. TO BE CONSIDERED A HEALTH NEED THE FOLLOWING CRITERIA WAS TAKEN INTO CONSIDERATION: -THE PSA HAD A HEALTH OUTCOME OR FACTOR RATE WORSE THAN THE AVERAGE COUNTY/STATE RATE. -THE PSA DEMONSTRATED A WORSENING TREND WHEN COMPARED TO COUNTY/STATE DATA IN RECENT YEARS. -THE PSA INDICATED AN APPARENT HEALTH DISPARITY. -THE HEALTH OUTCOME OR FACTOR WAS MENTIONED IN THE FOCUS GROUP. -THE HEALTH NEED ALIGNED WITH BANNER HEALTH'S MISSION AND STRATEGIC PRIORITIES. USING THE PREVIOUS CHNAS AS A TOOL, THE STEERING COMMITTEE REVIEWED AND COMPARED THE HEALTH NEEDS IDENTIFIED IN 2022 TO THE PREVIOUS HEALTH NEEDS. THE GROUP NARROWED THE COMMUNITY HEALTH NEEDS TO THREE. IT WAS DETERMINED THAT BANNER HEALTH, AS A HEALTH SYSTEM WOULD CONTINUE TO ADDRESS THE SAME HEALTH NEEDS FROM CYCLE 3, THE 2019 CHNA, DUE TO THE CONTINUED IMPACT THESE HEALTH NEEDS HAVE ON THE OVERALL HEALTH OF THE COMMUNITY. THESE NEEDS AND THE STRATEGIES TO ADDRESS THE NEEDS ALIGN WITH THE SHORT AND LONG-TERM GOALS THE HEALTH SYSTEM HAS, SPECIFIC STRATEGIES CAN BE TAILORED TO THE REGIONS BANNER HEALTH SERVES, AND THE HEALTH NEEDS CAN ADDRESS MANY HEALTH AREAS WITHIN EACH OF THEM. WHILE PRIORITIZING NEEDS, COVID-19 WAS A CONSISTENT THEME THAT AROSE IN ALL FORMS OF PRIMARY DATA COLLECTION. COVID-19 HAS HAD AN IMPACT ON THE MEASUREMENT OF HEALTH NEEDS, SOCIOECONOMIC FACTORS, FACILITY VOLUMES, AND HEALTH BEHAVIORS TO NAME A FEW. BANNER STEERING COMMITTEE AND FACILITY LEADERSHIP DETERMINED THAT FOR BANNER HEALTH'S CHNA PROCESS, RATHER THAN ADDING A FOURTH COMMUNITY HEALTH NEED, BANNER WOULD INCORPORATE COVID-19 INTO EACH OF THE THREE COMMUNITY HEALTH NEEDS. BANNER HEALTH WILL CONTINUE TO PROVIDE ONGOING CARE FOR THOSE AFFECTED PHYSICALLY AND MENTALLY BY COVID-19 THROUGHOUT CYCLE 4 OF THE CHNA PROCESS. BASED ON DATA AND INFORMATION GATHERED THROUGH THE CHNA PROCESS, THE FOLLOWING REPRESENT THE THREE 2022 PRIORITIZE HEALTH NEEDS: 1. IMPROVING THE HEALTH OF THE COMMUNITIES WE SERVE -ACCESS TO AND NAVIGATING HEALTHCARE SERVICES -ACCESS TO SUPPORTIVE CARE AFTER HOSPITAL DISCHARGE -ACCESS TO CARE POST-COVID -EMPLOYEE WELLNESS -INTEGRATING SOCIAL DETERMINANTS OF HEALTH WITH BANNER 2. CHRONIC DISEASE MANAGEMENT -HEALTH LITERACY -HEALTH MANAGEMENT -DIABETES AND HEART DISEASE MANAGEMENT -DIAGNOSING AND MANAGING DEMENTIA -ONGOING CARE FOR THOSE WITH LONG-COVID -PREVENTATIVE CANCER EDUCATION -CANCER SCREENINGS3. BEHAVIORAL HEALTH -ACCESS TO MENTAL HEALTH RESOURCES -MENTAL HEALTH CARE FOR THOSE AFFECTED BY COVID RELATED EXPERIENCES (INCLUDING PTSD AND OTHER BEHAVIORAL HEALTH PROBLEMS) -SUBSTANCE AND ALCOHOL ABUSE AND MISUSE PREVENTION LINE 3H: INPUT WAS COLLECTED FROM INDIVIDUALS IN THE COMMUNITY, INCLUDING PUBLIC HEALTH EXPERTS AS WELL AS RESIDENTS, REPRESENTATIVES, OR LEADERS OF LOW-INCOME, MINORITY, AND MEDICALLY UNDERSERVED POPULATIONS. AS NOTED ABOVE SURVEYS AND FOCUS GROUPS WERE CONDUCTED THROUGHOUT 2022 AND RESULTS INCORPORATED INTO THE CHNA. 17 1 - CENTRAL WY OUTPATIENT SURGERY CENTER 1201 E 3RD STREET CASPER WY 82601 SURGICAL CENTER 2 - OUTPATIENT RADIOLOGY 419 S WASHINGTON STREET SUITE 100 CASPER WY 82601 IMAGING SERVICES 3 - WY HEALTH MED GROUP MULTISPECIALTY 419 S WASHINGTON STREET CASPER WY 82601 PHYSICIAN PRACTICE 4 - WY HEALTH MED GROUP MULTISPECIALTY 6650 E 2ND STREET CASPER WY 82609 PHYSICIAN PRACTICE 5 - NORTH PLATTE PATHOLOGY 111 S JEFFERSON STREET CASPER WY 82601 PATHOLOGY SERVICES 6 - BANNER HEALTH CLINIC 1020 S CONWELL STREET CASPER WY 82601 PRIMARY CARE CLINIC 7 - BANNER HEALTH CLINIC 3632 AMERICAN WAY CASPER WY 82604 PRIMARY CARE CLINIC 8 - BANNER HEALTH WALK-IN CLINIC 3632 AMERICAN WAY CASPER WY 82604 QUICK-CARE CLINIC 9 - RESPIRATORY SYMPTOMS SCREENING CLINIC 245 S FENWAY STREET CASPER WY 82601 QUICK-CARE CLINIC 10 - WOUND CARE CENTER 1201 E 3RD STREET CASPER WY 82601 WOUND CARE 11 - WYOMING NEUROSURGERY & SPINE 1020 E 2ND STREET SUITE 201 CASPER WY 82601 NEUROSURGICAL CLINIC 12 - BANNER HEALTH CLINIC 6600 E 2ND STREET CASPER WY 82601 PRIMARY CARE CLINIC 13 - WYOMING PAIN CENTER 6600 E 2ND STREET CASPER WY 82601 PAIN MANAGEMENT CLINIC 14 - WYOMING ENDOCRINE & DIABETES CLINIC 419 S WASHINGTON STREET SUITE 201 CASPER WY 82601 ENDOCRINE & DIABETES CLINIC 15 - BANNER NERD WELLNESS CENTER 1233 E SECOND STREET CASPER WY 82601 WELLNESS CENTER 16 - BANNER WY MEDICAL CENTER SLEEP CENTER 6500 E SECOND STREET CASPER WY 82601 SLEEP TREATMENT CLINIC 17 - BANNER HOME MEDICAL EQUIPMENT 1255 EAST C STREET CASPER WY 82601 MEDICAL EQUIPMENT PART I, LINE 3C: BANNER HEALTH USES FPG. DEDICATED TO PROVIDING QUALITY, NON-DISCRIMINATING HEALTHCARE TO ALL PATIENTS REGARDLESS OF AGE, SEX, SEXUAL ORIENTATION, GENDER PREFERENCE, RACE, RELIGION, DISABILITY, VETERAN STATUS, NATIONAL ORIGIN AND/OR ABILITY TO PAY, DETERMINATIONS ARE MADE BASED UPON BANNER HEALTH'S FINANCIAL ASSISTANCE POLICY FOR HOSPITAL PATIENTS. THIS POLICY ESTABLISHES:1) GENERAL - BANNER HEALTH FINANCIAL ASSISTANCE PROGRAMS WHICH, BASED ON HOUSEHOLD INCOME AND THE LEVEL OF MEDICAL EXPENSES, DETERMINE A PATIENT'S QUALIFICATION FOR CHARITY CARE OR DISCOUNTED COVERED SERVICES. ELIGIBILITY FOR FINANCIAL ASSISTANCE WILL BE PROVIDED FOR THOSE INDIVIDUALS WHO ARE UNINSURED OR UNDERINSURED AND WHO MEET THE HOUSEHOLD INCOME GUIDELINES AS OUTLINED IN THIS POLICY, OR ARE MEMBERS OF A MEDICALLY INDIGENT HOUSEHOLD.2) FINANCIAL ASSISTANCE FOR UNINSURED PATIENTS - UNINSURED PATIENTS WILL QUALIFY FOR BANNER HEALTH FINANCIAL ASSISTANCE IF: (A) THEIR HOUSEHOLD INCOME IS LESS THAN 400% OF FPL, (B) THEY CANNOT QUALIFY FOR MEDICAID/AHCCCS OR OTHER GOVERNMENT PROGRAM, OR ARE UNABLE TO REASONABLY COMPLETE THE APPLICATION PROCESS FOR SUCH GOVERNMENTAL PROGRAMS, AND (C) THEY COMPLETE AN APPLICATION FOR FINANCIAL ASSISTANCE (UNLESS DETERMINED TO BE PRESUMPTIVELY ELIGIBLE, AS PROVIDED BELOW), IN ACCORDANCE WITH THE FOLLOWING: FINANCIAL ASSISTANCE-UNINSURED PATIENTS: HOUSEHOLD INCOME --> AMOUNTS CHARGED< 200% OF FPL --> FULL CHARITY, 100% DISCOUNT, WRITE-OFF ENTIRE PATIENT ACCOUNT> 201%-300% FPL --> 75% DISCOUNT OFF AGB (I.E., PATIENT OWES 25% OF AGB)> 301%-400% FPL --> 50% DISCOUNT OFF AGB (I.E., PATIENT OWES 50% OF AGB)3) FINANCIAL ASSISTANCE FOR MEMBERS OF MEDICALLY INDIGENT HOUSEHOLDS. PATIENTS WHO ARE MEMBERS OF MEDICALLY INDIGENT HOUSEHOLDS WILL QUALIFY FOR BANNER HEALTH FINANCIAL ASSISTANCE, SUBJECT TO APPLICATION FOR FINANCIAL ASSISTANCE, AS FOLLOWS: A) IF AN UNINSURED PATIENT, THE PATIENT IS RESPONSIBLE FOR 25% OF THE PATIENT LIABILITY (INCLUDING ANY ADJUSTMENT OF THE PATIENT LIABILITY AMOUNT PURSUANT TO APPLICATION OF THE BANNER HEALTH FINANCIAL ASSISTANCE POLICY FOR UNINSURED PATIENTS, I.E., IF THE UNINSURED PATIENT IS A MEMBER OF A MEDICALLY INDIGENT HOUSEHOLD WHICH HAS A HOUSEHOLD INCOME OF 400% OF FPL, THE PATIENT WOULD OWE 25% OF THE BAI (WITHOUT REGARD TO THE AMOUNT OF THE BAI). B) IF AN UNDERINSURED PATIENT, THE PATIENT IS RESPONSIBLE FOR 25% OF THE BAI (WITHOUT REGARD TO THE AMOUNT OF THE BAI). PART I, LINE 7: 1) FINANCIAL ASSISTANCE AT COST, MEDICAID AND OTHER MEANS -TESTED GOVERNMENT PROGRAMS - USING THE COST-TO CHARGE METHODOLOGY DETERMINED BY THE COST ACCOUNTING SYSTEM, THE RATIO OF PATIENT CARE COST TO CHARGES OR RELATIVE VALUE UNITS IS APPLIED TO PATIENT ACCOUNTS TO CALCULATE THEESTIMATED COST OF FINANCIAL ASSISTANCE. THE COST ACCOUNT SYSTEM ADDRESSES ALL PATIENT SEGMENTS AT THE ACUTE CARE FACILITIES. THE COST ACCOUNTING APPLICATION IS NOT IMPLEMENTED AT THE HEALTH CENTERS, PHYSICIAN PRACTICES, HOME CARE, SURGICAL CENTERS, OR OCCUPATIONAL HEALTH.2) COMMUNITY HEALTH IMPROVEMENT - BANNER HEALTH USES THE CBISA, COMMUNITY BENEFIT INVENTORY TOOL TO COORDINATE AND ESTIMATE THE COSTS ASSOCIATED WITH COMMUNITY HEALTH IMPROVEMENT INITIATIVES.3) HEALTH PROFESSIONS EDUCATION, SUBSIDIZED HEALTH SERVICES, AND RESEARCH - ACTUAL COST LESS REIMBURSEMENTS AS REPORTED IN THE GENERAL LEDGER ARE USED TO VALUE THESE ACTIVITIES, WHICH OPERATED AT A LOSS PROVIDE INVALUABLE SERVICES TO BANNER HEALTH COMMUNITIES. 4) CASH AND IN-KIND CONTRIBUTIONS - ACTUAL OR FAIR MARKET VALUE IS USED TO VALUE THESE CONTRIBUTIONS OR ACTIVITIES. PART I, LINE 7G: SUBSIDIZED HEALTH SERVICES INCLUDE THE WYOMING BEHAVIORAL INSTITUTE AND ENDOCRINE & DIABETES SERVICES. 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 $ 3,010,683. PART II, COMMUNITY BUILDING ACTIVITIES: THE COMMUNITY BUILDING ACTIVITIES PROMOTE THE HEALTH OF THE COMMUNITY BY PROVIDING NEEDED SPECIALISTS AND PHYSICIANS AS WELL AS DETERMINING WHAT IS NEEDED BY THE RESIDENTS IN THE LOCAL COMMUNITY AND SURROUNDING AREA. WYOMING MEDICAL CENTER SPENT $400,978 IN RECRUITING PHYSICIANS FOR PEDIATRICS, OB/GYN, PRIMARY CARE, RADIOLOGY SERVICES, AND EMERGENCY CARE. PART III, LINE 2: ACCOUNTS ARE DISCOUNTED TO ESTIMATED AMOUNTS EXPECTED TO BE RECEIVED. THOSE AMOUNTS ARE SUBJECT TO BAD DEBT POLICES. DISCOUNTS AND PAYMENTS ON PATIENT ACCOUNT ARE RECORDED AS AN ADJUSTMENT TO REVENUE, NOT BAD DEBT EXPENSE. PART III, LINE 3: BANNER HEALTH/WYOMING MEDICAL CENTER RUN A PRESUMPTIVE CHARITY ANALYSIS ON ALL ACCOUNTS TO MINIMIZE QUALIFYING PATIENTS BEING CLASSIFIED AS BAD DEBT. BANNER HEALTH ESTIMATES THAT LESS THAN 15% OF THE PATIENT ACCOUNTS COMPRISING THE ORGANIZATION'S BAD DEBT MAY HAVE BEEN ELIGIBLE FOR FINANCIAL ASSISTANCE UNDER BANNER HEALTH POLICIES. PART III, LINE 4: FOOTNOTE PER AUDITED FINANCIAL STATEMENTS (PAGE 14): NET PATIENT ACCOUNTS RECEIVABLE FOOTNOTE: NET PATIENT ACCOUNTS RECEIVABLE AND NET PATIENT SERVICES REVENUES HAVE BEEN ADJUSTED TO THE ESTIMATED AMOUNTS EXPECTED TO BE RECEIVED BASED ON CONTRACTUAL RATES FOR SERVICES RENDERED INCLUSIVE OF THE ESTIMATED PRICE CONCESSION. PART III, LINE 8: THE MEDICARE COST REPORTS THAT HOSPITALS ARE REQUIRED TO FILE DO NOT INCLUDE ALL OF THE COSTS REQUIRED TO TREAT MEDICARE PATIENTS. USING A FINANCIAL STATEMENT COST-TO-CHARGE RATIO METHODOLOGY, THE 2023 RESULTS IN A MEDICARE SHORTFALL OF $188 THOUSAND. MEDICARE SHORTFALLS SHOULD BE TREATED AS A COMMUNITY BENEFIT BECAUSE ABSENT THIS PROGRAM, MANY INDIVIDUALS WOULD QUALIFY FOR FINANCIAL ASSISTANCE AND OTHER NEEDS BASED PROGRAMS, BY ACCEPTING PAYMENT BELOW COST TO TREAT THESE INDIVIDUALS, THE BURDENS OF THE GOVERNMENT ARE RELIEVED AND THE AMOUNT SPENT TO COVER THE MEDICARE SHORTFALL IS MONEY NOT AVAILABLE TO COVER FINANCIAL ASSISTANCE AND OTHER COMMUNITY BENEFIT NEEDS. PART III, LINE 9B: BANNER HEALTH'S FINANCIAL ASSISTANCE POLICIES REQUIRE THAT THE ACCOUNTS OF PATIENTS WHO ARE KNOWN TO QUALIFY FOR FINANCIAL ASSISTANCE BE WRITTEN OFF EITHER IN FULL OR IN PART, DEPENDING UPON THE LEVEL OF THE FINANCIAL ASSISTANCE FOR WHICH THE PATIENT HAS QUALIFIED. IF THE ACCOUNT IS NOT WRITTEN OFF COMPLETELY, THE REDUCED BALANCE IS TREATED IN THE SAME MANNER AS ACCOUNTS FOR PATIENTS WITHOUT INSURANCE WHO DO NOT QUALIFY FOR FINANCIAL ASSISTANCE. FOR THOSE PATIENTS WHO DO NOT QUALIFY FOR FINANCIAL ASSISTANCE AND FOR THE PORTION OF THE ACCOUNTS REMAINING AFTER APPLICATION OF THE FINANCIAL ASSISTANCE POLICIES FOR PATIENTS WHO QUALIFY FOR SUCH ASSISTANCE, ACCOUNT COLLECTION PROCESS IS AS FOLLOWS:1) THE PATIENT OR GUARANTOR WILL RECEIVE NO LESS THAN 3 STATEMENTS PRIOR TO THE ACCOUNT BEING PLACED WITH AN OUTSIDE AGENCY. THE PROCESS TAKES 120 DAYS TO COMPLETE. THE ACCOUNT IS OUTSOURCED TO A THIRD-PARTY COLLECTION AGENCY AFTER THE FINAL STATEMENT CYCLE AND RETURNED TO BANNER HEALTH AFTER A REASONABLE COLLECTION ATTEMPT. 2) ATTEMPTS ARE MADE TO VERIFY PHYSICAL LOCATION OF PATIENT AND TO DETERMINE IF THE PATIENT MAY BE ELIGIBLE FOR AHCCCS/MEDICAID COVERAGE. 3) ONCE ASSIGNED TO AN OUTSIDE COLLECTION AGENCY, APPROPRIATE DEBT COLLECTION PRACTICES ARE UTILIZED IN DIFFERENT STATES, DEPENDING UPON LOCAL REGULATIONS. THE COLLECTION AGENCY ATTEMPTS TO OBTAIN PAYMENT FROM THE PATIENT BY MEANS OF DIRECT TELEPHONE CONTACT. IF THIS IS UNSUCCESSFUL, FAILURE TO MAKE PAYMENT MAY RESULT IN A REPORT TO A CREDIT AGENCY. PART VI, LINE 2: BANNER HEALTH UTILIZES ITS STRATEGY AND PLANNING TEAM TO CONTINUALLY IDENTIFY AREAS IN THE COMMUNITIES BANNER HEALTH SERVES WHERE INSTITUTIONAL CLINICAL NEEDS ARE NOT BEING SATISFIED ESPECIALLY FOR THOSE WITHIN UNDERSERVED, UNINSURED AND MINORITY POPULATIONS. IT ALSO LEVERAGES A MULTI-PHASED APPROACH TO UNDERSTANDING GAPS IN SERVICES PROVIDED TO COMMUNITIES SERVED BY HOSPITALS WITHIN THE SYSTEM AS WELL AS COMMUNITY RESOURCES THROUGH A COMBINATION OF POPULATION GROWTH AND CHANGING DEMOGRAPHICS ANALYSIS, DETAILED ANALYSIS OF NATIONAL, STATE AND COUNTY DATA SOURCES, HEALTHCARE SERVICES AVAILABLE THROUGH OTHER HOSPITAL PROVIDERS, PHYSICIAN SUPPLY IN THE BANNER HEALTH SERVICE AREAS, NEW AND MORE EFFECTIVE HEALTHCARE SERVICES THAT ARE BECOMING AVAILABLE THAT WOULD ELEVATE THE QUALITY OF HEALTHCARE SERVICES PROVIDED TO BANNER HEALTH COMMUNITIES, AND DEMAND PRESSURES EXPERIENCED BY EXISTING BANNER HEALTH FACILITIES AND PHYSICIANS.ON A LOCAL BASIS, HOSPITAL MANAGEMENT TEAMS REGULARLY CONSULT WITH COMMUNITY LEADERS AND PARTNERS, LOCAL COMMUNITY-BASED ADVISORY BOARDS, OTHER SERVICE PROVIDERS (INCLUDING FEDERALLY QUALIFIED HEALTH CLINICS) AND BUSINESSES TO IDENTIFY UNMET PHYSICIAN AND HOSPITAL NEEDS. THESE FINDINGS ARE THEN PRIORITIZED BASED ON SYSTEM CAPITAL AND OPERATING RESOURCE AVAILABILITY, FEASIBILITY, AVAILABILITY OF PHYSICIANS TO BE RECRUITED TO THE SERVICE AREA, AND SUSTAINABILITY. BASED UPON THIS PRIORITIZATION, CAPITAL AND OPERATING RESOURCES ARE THEN INTEGRATED INTO THE FACILITY AND SYSTEM BUDGETS AND PLANS. PART VI, LINE 3: POLICIES AND PROCEDURES EXIST TO EDUCATE OUR PATIENTS ON FINANCIAL ASSISTANCE ELIGIBILITY, AND THEY ARE PROVIDED NUMEROUS OPPORTUNITIES FOR EDUCATION ON BANNER HEALTH FINANCIAL ASSISTANCE POLICIES. THE FOLLOWING ARE EXAMPLES OF COMMUNICATION/EDUCATION AVAILABLE TO BANNER HEALTH PATIENTS:A. SIGNAGE AND COLLATERAL IN BOTH ENGLISH AND SPANISH ARE POSTED PROMINENTLY IN-PATIENT WAITING LOBBIES, INCLUDING THE EMERGENCY DEPARTMENTS, STATING THAT BANNER HEALTH HAS FINANCIAL ASSISTANCE PROGRAMS FOR THOSE WHO DO NOT HAVE INSURANCE OR MAY BE UNABLE TO PAY FOR THEIR SHARE OF THE COST OF SERVICES.B. A TOLL-FREE NUMBER IS PROVIDED FOR THE PATIENT'S/FAMILY'S CONVENIENCE.C. AFTER MEDICAL SCREENING, SELF PAY PATIENTS ARE VISITED BY STAFF AND INFORMED OF THE FINANCIAL POLICY. STAFF ALSO ASSISTS POTENTIALLY ELIGIBLE PATIENTS TO APPLY FOR ENROLLMENT FOR MEDICAID/AHCCCS.D. AN INSERT IS INCLUDED IN ALL OF OUR BILLING STATEMENT TO PATIENTS. THE INSERT AGAIN INFORMS PATIENTS OF THE AVAILABILITY OF FINANCIAL ASSISTANCE IN BOTH ENGLISH AND SPANISH AND PROVIDES TOLL-FREE ACCESS.E. DEPARTMENT REPRESENTATIVES AGAIN INFORM PATIENTS OF THE FINANCIAL ASSISTANCE POLICIES DURING THE SELF-PAY COLLECTION PROCESS.F. BANNER HEALTH WEBSITE PROVIDES INFORMATION IN BOTH ENGLISH AND SPANISH OF THE AVAILABILITY OF FINANCIAL ASSISTANCE.THROUGHOUT THE PROCESS, STAFF CONTINUES TO ADVISE POTENTIALLY ELIGIBLE PATIENTS OF THE POSSIBILITY OF ENROLLMENT IN MEDICAID/AHCCCS AND OFFER TO ASSIST IN SUCH ENROLLMENT. PART VI, LINE 4: BANNER HEALTH'S 33 HOSPITALS, INCLUDING WYOMING MEDICAL CENTER, OPERATE OR LEASE NURSING HOMES, PHYSICIAN CLINICS, HOME HEALTH AGENCIES, AMBULATORY FACILITIES, AND DURABLE MEDICAL EQUIPMENT SERVICES IN SIX WESTERN STATES WHICH INCLUDE DEMOGRAPHIC AREAS THAT RANGE FROM METROPOLITAN TO REMOTE RURAL AREAS. THE FOLLOWING SETS FORTH PERTINENT DEMOGRAPHIC INFORMATION WITH RESPECT TO THE COMMUNITIES AND AREAS SERVED BY BANNER HEALTH FACILITIES:WYOMING:I) ESTIMATED POPULATION: 584,057II) MEDIAN HOUSEHOLD INCOME: $72,495III) PERCENT OF POPULATION IN POVERTY: 11.80%IV) PERCENT OF UNINSURED PERSONS UNDER AGE 65: 14.00%V) PER CAPITA HEALTHCARE EXPENSE: $10,989VI) TOTAL PERCENT OF UNINSURED IN POPULATION: 11.60%VII) PERCENT OF UNINSURED ADULTS 19-64 LIVING IN POVERTY: 20.30%VIII) PERCENT OF UNINSURED NONELDERLY W INCOME BELOW 100% OF FPL: 39.00%IX) PERCENT OF UNINSURED NONELDERLY W INCOME UP TO 200% OF FPL: 29.00%X) PERCENT OF POPULATION BELOW 400% OF FPL: 61.40%XI) PERCENT OF ADULTS REPORTING FAIR OR POOR HEALTH: 14.80%XII) PERCENT OF ADULTS DIAGNOSED WITH DIABETES: 7.60%XIII) PERCENT OF ADULTS DIAGNOSED WITH CARDIOVASCULAR DISEASE: 7.10%XIV) PERCENT OF ADULTS WHO ARE OVERWEIGHT OR OBESE: 33.50%XV) PERCENT OF ADULTS REPORTING MENTAL ILLNESS IN PAST YEAR: 53.10%XVI) PERCENT OF ADULTS REPORTING NOT SEEING A DOCTOR BECAUSE OF COST IN THE PAST YEAR: 9.80%NATRONA COUNTY, WYOMING:I) ESTIMATED POPULATION: 79,941II) MEDIAN HOUSEHOLD INCOME: $69,104III) PERCENT OF POPULATION IN POVERTY: 10.80%IV) PERCENT OF UNINSURED PERSONS UNDER AGE 65: 13.20%BANNER HEALTH:I) ESTIMATED POPULATION: 9,671,793II) MEDIAN HOUSEHOLD INCOME: $77,991III) PERCENT OF POPULATION IN POVERTY: 11.60%IV) PERCENT OF UNINSURED PERSONS UNDER AGE 65: 10.55%V) PER CAPITA HEALTHCARE EXPENSE: $9,582VI) TOTAL PERCENT OF UNINSURED IN POPULATION: 8.88%VII) PERCENT OF UNINSURED ADULTS 19-64 LIVING IN POVERTY: 22.13%VIII) PERCENT OF UNINSURED NONELDERLY W INCOME BELOW 100% OF FPL: 22.53%IX) PERCENT OF UNINSURED NONELDERLY W INCOME UP TO 200% OF FPL: 22.77%X) PERCENT OF POPULATION BELOW 400% OF FPL: 58.35%XI) PERCENT OF ADULTS REPORTING FAIR OR POOR HEALTH: 17.30%XII) PERCENT OF ADULTS DIAGNOSED WITH DIABETES: 8.92%XIII) PERCENT OF ADULTS DIAGNOSED WITH CARDIOVASCULAR DISEASE: 7.75%XIV) PERCENT OF ADULTS WHO ARE OVERWEIGHT OR OBESE: 31.18%XV) PERCENT OF ADULTS REPORTING MENTAL ILLNESS IN PAST YEAR: 41.05%XVI) PERCENT OF ADULTS REPORTING NOT SEEING A DOCTOR BECAUSE OF COST IN THE PAST YEAR 9.98 PART VI, LINE 5: BANNER HEALTH IS GOVERNED BY A COMMUNITY BOARD, DRAWN PRIMARILY FROM THE COMMUNITIES SERVED BY BANNER HEALTH. THIS BOARD ESTABLISHES BANNER HEALTH'S PRIORITIES AND ENSURES THAT IT OPERATES IN A MANNER THAT WILL FURTHER ITS CHARITABLE, NONPROFIT PURPOSE TO IMPROVE THE HEALTH OF THE COMMUNITIES IT SERVES. AS A NONPROFIT ENTITY, BANNER HEALTH EXISTS TO PROVIDE HEALTH CARE SERVICES TO THE COMMUNITIES WE SERVE, NOT TO GENERATE PROFITS. TO THAT END, EVERY DOLLAR EARNED IS REINVESTED IN NEW EQUIPMENT, NEW OR EXPANDED PATIENT CARE SERVICES, NEW TECHNOLOGIES, MAINTAINING EXISTING EQUIPMENT AND FACILITIES AND NEW FACILITIES TO MEET MARKET NEEDS OR TO ENSURE THE LONGTERM SUCCESS OF THE ORGANIZATION.IN PARTICULAR, BANNER HEALTH'S HEAVY REINVESTMENT IN CLINICAL SYSTEMS AND HEALTH INFORMATION TECHNOLOGY ENABLES BANNER HEALTH TO PROVIDE A UNIFORMLY HIGH QUALITY OF CARE THROUGHOUT THE SYSTEM, INCLUDING BANNER HEALTH'S SMALL, RURAL, CRITICAL ACCESS HOSPITALS. PHYSICIANS AND STAFF PRACTICING IN THESE SOLE COMMUNITY PROVIDERS HAVE THE SAME ELECTRONIC HEALTH RECORD SYSTEMS AND COMPUTERIZED PHYSICIAN ORDER ENTRY AND DECISION SUPPORT TOOLS AS ARE UTILIZED IN BANNER HEALTH'S LARGEST TEACHING HOSPITAL. IN ADDITION, BY MEANS OF REMOTE MONITORING AND TELEMEDICINE TECHNOLOGIES, THESE SMALL RURAL HOSPITALS HAVE ACCESS TO THE CLINICAL AND OPERATIONAL SUPPORT OF THE ENTIRE SYSTEM, THEREBY BRINGING A LEVEL OF SOPHISTICATED HEALTH CARE TO THESE COMMUNITIES THAT WOULD NOT OTHERWISE BE POSSIBLE.EXCEPT IN LIMITED CIRCUMSTANCES WHERE NECESSARY TO ENSURE THE AVAILABILITY OF CONSISTENT AND EFFICIENT PHYSICIAN SERVICES, BANNER HEALTH UTILIZES AN OPEN MEDICAL STAFF MODEL, THEREBY MAKING THE FACILITIES AVAILABLE TO LOCAL PHYSICIANS TO PROVIDE HIGH QUALITY HOSPITAL SERVICES TO OUR COMMUNITIES. IN ADDITION, BANNER HEALTH IS AGGRESSIVELY PURSUING AN INTEGRATION STRATEGY INVOLVING NETWORKS OF EMPLOYED AND INDEPENDENT PHYSICIANS CAPABLE OF PROVIDING EFFICIENT, EVIDENCEBASED AND HIGH-QUALITY CLINICAL CARE WITHIN AN INTEGRATED SYSTEM COVERING THE FULL CONTINUUM OF CARE. THIS WILL ENABLE BANNER HEALTH TO IMPROVE THE HEALTH OF THE COMMUNITIES IT SERVES WHILE LIMITING THE COSTS OF PROVIDING SUCH CARE. PART VI, LINE 7, REPORTS FILED WITH STATES WY 1 EASTERN WYOMING COLLEGE 3200 WEST C STREET TORRINGTON WY 82240 237061112 501(C)(3) 25000 0 N/A N/A ENDOWED SCHOLARSHIP SPUDS BASEBALL CLUB LLC 4251 GRAMIN DR CASPER WY 82609 853927706 5500 0 N/A N/A SPONSORSHIP 1 1 PART I, LINE 2: PRIOR TO MAKING A CONTRIBUTION TO ANOTHER ORGANIZATION, WYOMING MEDICAL CENTER'S STAFF CONFIRM THAT THE RECIPIENT IS A QUALIFIED CHARITY OR GOVERNMENT AGENCY OR THAT THE FUNDS WILL BE USED FOR A CHARITABLE PURPOSE. ALL CONTRIBUTIONS ARE FOR GENERAL OPERATING SUPPORT, SO NO FURTHER FOLLOW-UP REGARDING THE USE OF FUNDS IS CONDUCTED. X 1 1 X X X 0 1 0 0 0 1 1 1 0 AMY PERRY PRESIDENT & COO 0 1157323 0 2623884 0 27402 0 1796410 0 32312 0 5637331 0 594039 DONALD NORDLUND EVP CHIEF STRATEGY & GROWTH OFFICER 0 701412 0 1005991 0 110463 0 854057 0 19301 0 2691224 0 667766 JEAN LANCE SECRETARY EVP CHIEF LEGAL OFF. & GEN. COUNSEL 0 547860 0 490970 0 49031 0 580820 0 23460 0 1692141 0 216927 MARGO KARSTEN DIVISION PRESIDENT 0 509679 0 483703 0 82077 0 289998 0 24144 0 1389601 0 267715 DAN WEINMAN VP. STRATEGY & PLANNING 0 516812 0 290279 0 48415 0 195967 0 27594 0 1079067 0 109418 BRENDA SCHAEFER TREASURER VP, CHIEF INVESTMENT OFFICER 0 381762 0 256713 0 39952 0 143378 0 11914 0 833719 0 111642 LANCE PORTER CEO, LARGE FACILITY 0 253008 0 167251 0 23083 0 90474 0 23983 0 557799 0 47327 ELIZABETH AVANT DIR LEGAL OPERATIONS & ASSISTANT SECRETARY 0 133465 0 18981 0 599 0 5251 0 7586 0 165882 0 0 PART I, LINE 1A FIRST CLASS AND BUSINESS CLASS TRAVEL ARE NOT REIMBURSABLE EXCEPT AS FOLLOWS: (A) AS SET FORTH IN A WRITTEN AGREEMENT APPROVED BY THE BANNER HEALTH BOARD COMPENSATION COMMITTEE; OR (B) UPON PRIOR WRITTEN APPROVAL OF THE BANNER HEALTH CEO BASED ON BUSINESS NEED. FIRST CLASS OR BUSINESS CLASS UPGRADES OR COUPON BOOKS ARE NOT REIMBURSABLE, UNLESS: (A) AS SET FORTH IN A WRITTEN AGREEMENT APPROVED BY THE BANNER HEALTH BOARD COMPENSATION COMMITTEE; OR (B) UPON PRIOR WRITTEN APPROVAL OF THE BANNER HEALTH CEO BASED ON BUSINESS NEED. PART I, LINE 4B EXEC 457(F) - COVERED APPROXIMATELY 100 FORMER AND CURRENT EXECUTIVES. THIS NONQUALIFIED PLAN IS HELD AT FIDELITY INVESTMENTS. VESTING OCCURS UPON MEETING VESTING REQUIREMENTS (SUBJECT TO A SUBSTANTIAL RISK OF FORFEITURE). - AWARDS ARE SUBJECT TO A ROLLING THREE-YEAR VESTING SCHEDULE-OR A TEAM MEMBER REACHES THE AGE OF 65, 3 YEARS FROM THE DATE OF DEPOSIT. TAXATION OCCURS UPON DISTRIBUTION (IF VESTED). THE ONLY CONTRIBUTIONS ALLOWED ARE EMPLOYER CONTRIBUTIONS. PAYOUT AMOUNTS ARE TAXABLE AND INCLUDED IN SCHEDULE J, PART II, COLUMN (B)(III). DEPOSIT AMOUNTS ARE INCLUDED IN SCHEDULE J, PART II, COLUMN (C). 2023 457(F) ACCRUALS: AMY PERRY - $175,294 MARGO KARSTEN - $44,064 JEAN LANCE - $38,826 LANCE PORTER - $435 BRENDA SCHAEFER - $11,465 DAN WEINMAN - $17,501 2023 457(F) DISTRIBUTIONS: MARGO KARSTEN - $55,854 BRENDA SCHAEFER - $14,782 DAN WEINMAN - $22,927 JEAN LANCE - $22,510 PART I, LINE 6 CERTAIN INDIVIDUALS PARTICIPATE IN A LONG-TERM INCENTIVE PLAN (LTIP) COVERING THREE-YEAR CYCLES FROM 2020-2022, 2021-2023, 2022-2024 AND 2023-2025. THE LTIP WAS DESIGNED AT THE INITIATIVE OF BANNER HEALTH BOARD OF DIRECTORS WITH THE ASSISTANCE OF WILLIS TOWERS WATSON AND ALL COMPONENTS WERE APPROVED BY THE BOARD. THE PLANS' AREAS OF PERFORMANCE TARGETS INCLUDE: STARTS RATING IMPROVEMENT, TRANSFORM REVENUE CYCLE ($ IMPROVEMENT), AND BUILD OUR BENCH TO REFLECT COMMUNITIES (VOICE, MINORITY %, SUCCESSION), AND OTHER KEY LONG-TERM INITIATIVES. AWARDS ARE CALCULATED AS A PERCENTAGE OF BASE SALARY ON THE LAST DAY OF THE THREE-YEAR CYCLE, AND OPPORTUNITY VARIES BY POSITION LEVEL. THE PLAN REQUIRES A THRESHOLD LEVEL OF FINANCIAL PERFORMANCE BEFORE ANY AWARDS CAN BE MADE, AND THE AMOUNT OF THE AWARDS VARIES WITH THE DEGREE OF ACHIEVEMENT OF THE TARGETS. THE MAXIMUM LTIP PAYOUT OPPORTUNITY RANGES FROM 30% TO 255% OF THE BASE SALARY AS OF DECEMBER 31 IN THE LAST YEAR OF THE THREE-YEAR PLAN. AWARDS HAVE BEEN ACCRUED UNDER THE LTIP, BUT NO PAYMENTS ARE MADE UNTIL AFTER YEAR-END AND ACHIEVEMENT IS VERIFIED BY THE BANNER HEALTH BOARD COMPENSATION COMMITTEE AND APPROVED BY THE FULL BOARD OF DIRECTORS OF BANNER HEALTH . ALL LTIP COMPENSATION PAYMENTS ARE REPORTED IN THE INCENTIVE AND BONUS COMPENSATION SHOWN IN SCHEDULE J, PART II, COLUMN (B)(II). AMOUNTS PAID FOR THE 2020-2022 CYCLE ARE REPORTED IN SCHEDULE J, PART II, COLUMN (B) AS BONUS & INCENTIVE COMPENSATION. AMOUNTS ACCRUED FOR 2023 FOR THE 2021-2023, 2022-2024, AND 2023-2025 CYCLES (TO BE PAID OUT IN 2024, 2025 AND 2026 RESPECTIVELY) ARE REPORTED IN SCHEDULE J, PART II, COLUMN (C) AS DEFERRED COMPENSATION. BANNER HEALTH HAS A MANAGEMENT INCENTIVE PLAN (MIP) WHICH IS BASED ON COMPANY ACHIEVEMENT OF SEVERAL FINANCIAL AND NON-FINANCIAL/CLINICAL QUALITY METRICS THAT ARE ESTABLISHED ANNUALLY BY THE BANNER HEALTH BOARD OF DIRECTORS. AWARDS ARE GRANTED AS A PERCENTAGE OF THE PARTICIPANT'S BASE SALARY AND VARY WITH THE POSITION LEVEL OF THE PARTICIPATING EMPLOYEE, RANGING FROM 7% TO 110% OF BASE SALARY. IN 2023, THERE WERE 1,440 MIP PARTICIPANTS. THE MIP WAS ACCRUED IN 2022 FOR THE 2023 MIP PAYOUT. MIP COMPENSATION IS INCLUDED IN SCHEDULE J, PART II, COLUMN (B)(II). ROCKY MOUNTAIN INFECTIOUS DISEASES DR. MARK DOWELL, FORMER BOARD MEMBER, OWNS 51% 37204 INFECTIOUS DISEASE MEDICAL SERVICES 0 FORM 990, PART VI, SECTION A, LINE 3 THE ORGANIZATION DELEGATED MANAGEMENT DUTIES TO BANNER HEALTH AND WERE PAID A TOTAL $110,888,678 FOR CALENDAR YEAR 2023. FORM 990, PART VI, SECTION A, LINE 6 BANNER HEALTH, AN ARIZONA NONPROFIT CORPORATION EXEMPT FROM TAX AS AN ENTITY DESCRIBED UNDER SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE, IS THE SOLE MEMBER. FORM 990, PART VI, SECTION A, LINE 7A THE SOLE MEMBER ELECTS THE BOARD OF DIRECTORS. FORM 990, PART VI, SECTION A, LINE 7B THE SOLE MEMBER RESERVES THE AUTHORITY TO APPROVE DECISIONS REGARDING THE FOLLOWING MATTERS: STRATEGIC PLAN, OPERATING AND CAPITAL BUDGETS, INSURANCE AND RISK MANAGEMENT, STAFFING, COMPENSATION, BENEFIT PLANS, AND ANY OTHER MATERIAL ACTION TAKEN OUTSIDE OF THE NORMAL COURSE OF BUSINESS. FORM 990, PART VI, SECTION A, LINE 8B THERE ARE NO COMMITTEES WITH AUTHORITY TO ACT ON BEHALF OF THE BOARD OF DIRECTORS. FORM 990, PART VI, SECTION B, LINE 11B BANNER HEALTH'S TAX DEPARTMENT (BH TAX) IS RESPONSIBLE FOR OVERSEEING THE PROCESSES FOR PREPARING THE FORM 990. BH TAX TAKES THE LEAD ROLE IN THE PROCESS AND IS CHARGED WITH THE DUTY TO COLLECT THE FINANCIAL AND OTHER INFORMATION NEEDED TO COMPLETE THE FORM 990. THIS INCLUDES COORDINATING WITH OTHER BANNER HEALTH DEPARTMENTS, SUCH AS THE LEGAL, PAYROLL, GOVERNMENT RELATIONS, LICENSING, COMMUNITY BENEFIT, COMPENSATION AND BENEFITS, ACCOUNTS PAYABLE, BUSINESS RISK, ETHICS AND COMPLIANCE, CERTIFICATION, CREDENTIALING, FINANCIAL SERVICES AND TREASURY MANAGEMENT IN ORDER TO ENSURE THAT THE EXPERTISE OF EACH DEPARTMENT IS UTILIZED IN THE INFORMATION-GATHERING PROCESS. ONCE THE INFORMATION IS GATHERED, IT IS ORGANIZED AND ASSEMBLED INTO AN ORGANIZER BY AN OUTSIDE ACCOUNTING FIRM TO PREPARE THE FORM 990. THE ACCOUNTING FIRM HAS EXPERTISE IN NON-PROFIT HOSPITAL SYSTEMS AND HAS SPECIFIC KNOWLEDGE OF WYOMING MEDICAL CENTER'S OPERATIONS AND RETURN COMPLEXITY. ONCE THE INFORMATION GATHERING PROCESS IS COMPLETE, A FIRST DRAFT OF THE FORM 990 IS PREPARED BY THE OUTSIDE ACCOUNTING FIRM AND READIED FOR REVIEW. THE REVIEW PROCESS BEGINS WITH AN INITIAL REVIEW DONE BY BH TAX. DURING THIS REVIEW, A LIST OF QUESTIONS, ISSUES AND ADDITIONAL TASKS IS COMPILED. THIS LIST IS THEN DISSEMINATED TO THE APPROPRIATE BANNER HEALTH DEPARTMENTS FOR FURTHER ACTION. ONCE ALL QUESTIONS, ISSUES AND TASKS HAVE BEEN COMPLETED, A SECOND REVIEW BY BH TAX IS AND THE ACCOUNTING FIRM IS DONE. AGAIN, IF APPLICABLE, A LIST OF QUESTIONS, ISSUES AND ADDITIONAL TASKS IS COMPILED. THIS LIST IS THEN DISSEMINATED TO THE APPROPRIATE BANNER HEALTH DEPARTMENTS FOR FURTHER ACTION. ONCE THIS SECOND REVIEW PROCESS IS COMPLETED, A FINAL DRAFT OF THE FORM 990 IS PRESENTED TO THE CHIEF LEGAL OFFICER & GENERAL COUNSEL AND CHIEF FINANCIAL OFFICER FOR REVIEW AND APPROVAL. CHANGES TO THE FORM 990 ARE MADE IF NECESSARY AND APPROVAL IS GRANTED TO SEND THE FORM 990 TO THE BOARD MEMBERS. EACH MEMBER OF THE BOARD IS THEN SENT THE DRAFT FORM 990 ALONG WITH AN EXECUTIVE SUMMARY OF KEY ITEMS REPORTED IN THE FORM 990. ANY ISSUES ARE ADDRESSED AND RESOLVED AND THE FINAL VERSION OF THE FORM 990 IS SIGNED BY THE CFO OR ANOTHER OFFICER IF REQUIRED TO MEET TIMELY FILING REQUIREMENTS. FORM 990, PART VI, SECTION B, LINE 12C PURSUANT TO BANNER HEALTH CONFLICT OF INTEREST POLICY, ALL BOARD MEMBERS, OFFICERS, AND KEY EMPLOYEES MUST DISCLOSE THE EXISTENCE OF ANY FINANCIAL INTEREST THAT MAY GIVE RISE TO A CONFLICT OF INTEREST PROMPTLY TO THE BOARD AUDIT COMMITTEE. THE COMMITTEE MUST THEN CONSIDER THE DISCLOSED INTEREST AND EITHER AUTHORIZE THE CONTINUATION OF THE POTENTIAL FINANCIAL INTEREST AND ANY RELATED TRANSACTION WITH APPROPRIATE PROTECTIONS, OR DISAPPROVE OF IT. OTHER BANNER HEALTH EMPLOYEES MUST GO THROUGH A SIMILAR PROCESS OF DISCLOSURE TO THEIR RESPECTIVE SUPERVISOR AND TO THE DIRECTOR OF ETHICS AND COMPLIANCE, WHO MAINTAINS ALL OF THE DISCLOSED FINANCIAL INTERESTS/CONFLICTS. IN ADDITION, ALL BOARD MEMBERS, OFFICERS, VICE PRESIDENTS, AND OTHER SELECTED MEMBERS OF MANAGEMENT, KEY EMPLOYEES AND EMPLOYED PHYSICIANS MUST COMPLETE AN ANNUAL SURVEY THAT IS DISTRIBUTED ELECTRONICALLY UNDER THE SUPERVISION OF THE DIRECTOR OF ETHICS AND COMPLIANCE. THE SURVEY INCLUDES A QUESTIONNAIRE THAT IS DESIGNED TO IDENTIFY ACTUAL OR POTENTIAL CONFLICTS OF INTEREST, AS WELL AS OTHER TRANSACTIONS AND RELATIONSHIPS REQUIRED TO BE DISCLOSED IN THE FORM 990 AND SCHEDULE L. MEMBERS OF EXECUTIVE MANAGEMENT ARE ALSO REQUIRED TO COMPLETE A QUARTERLY QUESTIONNAIRE MANAGED UNDER THE SUPERVISION OF THE DIRECTOR OF INTERNAL ASSUANCE. THIS QUESTIONNAIRE IS PRIMARILY DESIGNED TO IDENTIFY WEAKNESSES IN INTERNAL CONTROLS OR ACCOUNTING, BUT ALSO REQUIRES DISCLOSURE OF ANY KNOWLEDGE BY THE RESPONDING MANAGER OF ANY VIOLATIONS OF BANNER HEALTH'S CONFLICT OF INTEREST POLICY. THE DIRECTOR OF ETHICS AND COMPLIANCE COMPILES A SUMMARY OF THE CONFLICT OF INTEREST DISCLOSURES OBTAINED THROUGH THE ANNUAL SURVEY PROCESS INVOLVING BOARD MEMBERS OR OFFICERS. THIS SUMMARY IS REVIEWED WITH BANNER HEALTH'S GENERAL COUNSEL TO DETERMINE THE APPROPRIATE ACTION TO BE TAKEN UNDER CONFLICT OF INTEREST POLICY. IN ADDITION, THE DIRECTOR REVIEWS THE SUMMARY ANNUALLY WITH THE BOARD AUDIT COMMITTEE IN ORDER TO ENSURE THAT ALL DISCLOSED ACTUAL OR POTENTIAL CONFLICTS HAVE BEEN REVIEWED AND PROCESSED APPROPRIATELY UNDER THE CONFLICT OF INTEREST POLICY. FORM 990, PART VI, SECTION B, LINE 15 BANNER HEALTH UTILIZES A COMPENSATION COMMITTEE COMPRISED OF INDEPENDENT DIRECTORS THAT EXERCISES OVERSIGHT OVER ALL ASPECTS OF THE COMPENSATION PAID TO OR FOR THE BENEFIT OF THE CEO AND ALL OTHER SENIOR EXECUTIVES OF BANNER HEALTH AND ANY OF ITS AFFILIATES AND ALL OTHER PERSONS WHO CONSTITUTE "DISQUALIFIED PERSONS" WITH RESPECT TO BANNER HEALTH UNDER CODE SECTION 4958. THE COMMITTEE: - ASSESSES ANNUALLY THE PERFORMANCE OF THE CEO. - EXERCISES OVERSIGHT OVER ALL ASPECTS OF COMPENSATION FOR THE CEO. - REVIEWS AND DETERMINES THE EXECUTIVE TOTAL COMPENSATION PHILOSOPHY OF BANNER HEALTH. - ESTABLISHES THE PERMISSIBLE RANGES OF COMPENSATION FOR SENIOR EXECUTIVES AND DISQUALIFIED PERSONS. - REVIEWS AND APPROVES THE DESIGN OF THE COMPONENTS OF COMPENSATION FOR SENIOR EXECUTIVES AND ANY OTHER DISQUALIFIED PERSONS AND MONITORS COMPLIANCE OF BANNER HEALTH WITH THE PHILOSOPHY AND DESIGN COMPONENTS OF EXECUTIVE COMPENSATION. - RECEIVES THE CEO'S REPORT CONCERNING THE OVERALL PERFORMANCE AND DEVELOPMENT ASSESSMENT OF THE SENIOR EXECUTIVES. - ACTS FOR THE BOARD IN THE ENGAGEMENT AND DIRECT OVERSIGHT OF EXTERNAL INDEPENDENT COMPENSATION CONSULTANTS ENGAGED TO PROVIDE ADVICE AND INFORMATION WITH RESPECT TO THE REASONABLENESS AND COMPETITIVENESS OF THE COMPENSATION PAID TO THE CEO, SENIOR EXECUTIVES AND ANY OTHER DISQUALIFIED PERSONS, WHICH CONSULTANT REPORTS DIRECTLY TO THE COMMITTEE. IN ADDITION, THE COMMITTEE HAS ADOPTED THE FOLLOWING BEST PRACTICES WITH RESPECT TO ITS EXECUTIVE COMPENSATION OVERSIGHT FUNCTION: - REVIEWS ALL INCENTIVE PLANS, BENEFIT PLANS AND PROGRAMS THAT APPLY TO EMPLOYEES AND PHYSICIANS. - APPROVES CEO'S RECOMMENDATIONS AS TO THE COMPENSATION OF SENIOR EXECUTIVES. - USES TALLY SHEETS SUMMARIZING ALL COMPONENTS OF THE CEO'S AND SENIOR EXECUTIVES' COMPENSATION, INCLUDING A THREE-YEAR EARNINGS HISTORY AND THE COST OF ALL COMPENSATION (INCLUDING SPECIFICALLY DEFERRED COMPENSATION) AT THE TIME THAT ANY ACTION IS TAKEN WITH RESPECT TO THE CEO'S OR SENIOR EXECUTIVES' COMPENSATION IN ORDER TO ENSURE THAT THE COMMITTEE IS FULLY INFORMED OF THE COMPLETE COMPENSATION PACKAGE BEFORE TAKING ANY SUCH ACTION. - REVIEWS THE ANNUAL FORM 990 DISCLOSURES RELATING TO EXECUTIVE COMPENSATION TO ENSURE THE DISCLOSURES ACCURATELY RECONCILE TO THE COMPENSATION PACKAGES APPROVED BY THE COMMITTEE. THE COMPENSATION COMMITTEE RETAINS AN EXTERNAL INDEPENDENT COMPENSATION CONSULTING FIRM TO ASSIST THE COMMITTEE. THE COMMITTEE ENGAGES A NATIONALLY RECOGNIZED COMPENSATION CONSULTING FIRM WITH SUBSTANTIAL HEALTHCARE EXPERIENCE. THIS FIRM REVIEWED AND OPINED AS TO THE REASONABLENESS OF THE TOTAL COMPENSATION PACKAGE OF THE CEO, SENIOR EXECUTIVE MANAGEMENT, AND OTHER EXECUTIVE MANAGEMENT IDENTIFIED BY THE COMMITTEE AS POTENTIAL DISQUALIFIED PERSONS. THE COMMITTEE ANNUALLY REVIEWS THE RELATIONSHIP BETWEEN BANNER HEALTH AND EACH CONSULTANT TO ENSURE THE CONSULTANT'S INDEPENDENCE. IN CONNECTION WITH EACH SUCH EVALUATION, THE COMMITTEE REQUESTS A WRITTEN CERTIFICATION FROM EACH CONSULTANT THAT: - INCLUDES AN INDEPENDENCE ATTESTATION AFFIRMING THAT THE CONSULTANT HAS CONDUCTED ITS OWN INTERNAL ASSESSMENT AND BASED ON SUCH ASSESSMENT AND ITS INTERNAL CONTROLS, CONCLUDED THAT IT HAS PERFORMED ITS SERVICES FOR THE COMMITTEE IN AN INDEPENDENT MANNER AND IS INDEPENDENT AS DEFINED IN THE INTERMEDIATE SANCTION REGULATIONS UNDER CODE SECTION 4958. - CONFIRMS THAT THE CONSULTANT REPORTS TO THE COMMITTEE THROUGH THE CHAIR OF THE COMMITTEE AND THAT ALL CONSULTING ACTIVITY FOR BANNER HEALTH CONDUCTED BY SUCH CONSULTANT DURING THE PRECEDING YEAR WAS CONDUCTED WITH THE KNOWLEDGE AND CONSENT OF THE CHAIR OF THE COMMITTEE. - DETAILS THE AMOUNTS PAID BY BANNER HEALTH TO THE CONSULTANT IN ITS CAPACITY AS AN EXTERNAL COMPENSATION CONSULTANT TO THE COMMITTEE, AND THE AMOUNTS PAID BY BANNER HEALTH, IF ANY, TO THE CONSULTANT AND ITS AFFILIATES FOR ANY OTHER ENGAGEMENTS. WITH THE ASSISTANCE OF THE INDEPENDENT COMPENSATION CONSULTANT, THE COMPENSATION COMMITTEE ANNUALLY REVIEWS THE PERFORMANCE OF THE CEO AND RECOMMENDS ADJUSTMENTS TO THEIR BASE SALARY AS DEEMED APPROPRIATE BASED UPON THE REVIEW, SUBJECT TO CONFIRMATION FROM THE CONSULTANT (WHO ATTENDS SUCH MEETING) THAT THE RECOMMENDATION IS APPROPRIATE AND WILL NOT RESULT IN THE OVERALL COMPENSATION OF THE CEO BECOMING UNREASONABLE. IN ORDER TO ENSURE THAT THE COMPENSATION DECISION IS SUBJECT TO THE ACTION OF INDEPENDENT DIRECTORS, THE BOARD MAY NOT APPROVE A SALARY ACTION DIFFERENT FROM THAT RECOMMENDED BY THE COMPENSATION COMMITTEE WITHOUT THE CONCURRENCE OF THE COMMITTEE. THE CEO ESTABLISHES THE BASE SALARY OF THE EXECUTIVES WHO DIRECTLY REPORT TO HIM/HER, AND THOSE EXECUTIVES IN TURN ESTABLISH THE BASE SALARY OF THOSE INDIVIDUALS WHO REPORT TO THEM. ALL BASE SALARIES ARE, HOWEVER, BASED UPON POSITION-SPECIFIC MARKET DATA PROVIDED BY BANNER HEALTH'S EXECUTIVE COMPENSATION DEPARTMENT. THESE RANGES ARE ESTABLISHED IN ACCORDANCE WITH AN EXECUTIVE COMPENSATION PHILOSOPHY THAT IS ESTABLISHED, AND ANNUALLY REVIEWED, BY THE COMPENSATION COMMITTEE. ANNUAL EQUITY ADJUSTMENTS MAY BE MADE UPON APPROVAL OF THE CEO AND BASED UPON SPECIFIC MARKET DATA. THE COMPENSATION COMMITTEE RECEIVES AN ANNUAL REPORT FROM THE EXECUTIVE COMPENSATION DEPARTMENT SHOWING THAT BASE SALARIES ARE BEING MAINTAINED CONSISTENT WITH THE EXECUTIVE COMPENSATION PHILOSOPHY APPROVED BY THE COMMITTEE. AS STATED IN THE RESPONSE TO SCHEDULE J, PART I, LINE 7, THE SIGNIFICANT NON-FIXED COMPONENTS OF THE COMPENSATION OF THE CEO AND OTHER SENIOR MANAGEMENT ARE ESTABLISHED AND MONITORED BY THE COMPENSATION COMMITTEE WITH THE ASSISTANCE OF THE INDEPENDENT COMPENSATION CONSULTANT AND ARE INCLUDED IN THE ANNUAL REASONABLENESS OPINION RENDERED BY THE INDEPENDENT COMPENSATION CONSULTANT. CONTEMPORANEOUS MINUTES ARE KEPT OF ALL MEETINGS OF THE COMPENSATION COMMITTEE AND OF THE ACTIONS OF THE BOARD OF DIRECTORS IN APPROVING THE COMPENSATION OF CEO AND REVIEWING AND MONITORING THE COMPENSATION FOR ALL OTHER SENIOR EXECUTIVES AND TOP MANAGEMENT. THE COMPENSATION REVIEW PROCESS WAS LAST COMPLETED IN 2023. FORM 990, PART VI, SECTION C, LINE 19 THE ORGANIZATION'S AUDITED FINANCIAL STATEMENTS, CONFLICT OF INTEREST POLICY, AND TAX RETURNS ARE AVAILABLE UPON REQUEST. COPIES ARE MAINTAINED AT EACH ADMINISTRATIVE OFFICE AND IN THE LEGAL AND TAX DEPARTMENTS. THE ORGANIZATION'S GOVERNING DOCUMENTS ARE NOT REQUIRED TO BE MADE AVAILABLE TO THE PUBLIC AND THEREFORE THEY ARE NOT MADE PUBLIC. FORM 990, PART IX, LINE 11G OTHER FEES: PROGRAM SERVICE EXPENSES 25,457,745. MANAGEMENT AND GENERAL EXPENSES 11,315,637. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 36,773,382. FORM 990, PART XI, LINE 9: NET ASSET ADJUSTMENT WITH COMPANY TRANSFERS -7,397,972. FORM 990, PART XII, LINE 2C: WYOMING MEDICAL CENTER IS INCLUDED IN BANNER HEALTH'S AUDITED FINANCIAL STATEMENTS. BANNER HEALTH'S BOARD OF DIRECTORS IS RESPONSIBLE FOR OVERSIGHT OF THE FINANCIAL STATEMENT AUDIT. 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