2024-11-07T09:57:11-06:00 2023-12-31 990 2023-01-01 810232124 SCL HEALTH - MONTANA SCLH 4062377000 1233 NORTH 30TH STREET BILLINGS MT 59101 PAM PALAGI VP FINANCE & CFO 4062377000 2024-11-07 0 2023 2024-10-15 13:58:12Z ST VINCENT HEALTHCARE JENNIFER ALDERFER 1233 NORTH 30TH STREET BILLINGS MT 59101 583591478 0 0928 X SEE SCHEDULE O X 1972 MT 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. 16 14 2377 114 3714577 0 18363128 10589744 488203847 546375682 28000751 22506712 1371522 1683409 535939248 581155547 24192754 19863201 0 0 146524753 160606852 0 0 0 366608856 393481404 537326363 573951457 -1387115 7204090 1015591872 1007922426 59198069 53579649 956393803 954342777 X WE REVEAL AND FOSTER GOD'S HEALING LOVE BY IMPROVING THE HEALTH OF THE PEOPLE AND COMMUNITIES WE SERVE, ESPECIALLY THOSE WHO ARE POOR AND VULNERABLE. 0 0 496257222 19863201 547779116 MOTHER XAVIER ROSS LED THE SISTERS OF CHARITY INTO THE INDIAN TERRITORY OF KANSAS IN 1858. IN 1869, THE SISTERS EXTENDED THEIR CHARITABLE WORKS INTO MONTANA TERRITORY AT THE REQUEST OF FATHER PIERRE JEAN DESMET. SAINT VINCENT HOSPITAL IN BILLINGS WAS FOUNDED BY THE SISTERS OF CHARITY OF LEAVENWORTH IN 1898. THE HOSPITAL OFFICIALLY OPENED ON FEBRUARY 1, 1899. THE CITY AND REGION GREW QUICKLY AND THE DEMAND FOR HEALTHCARE INCREASED DRAMATICALLY. BY 1915, THE SISTERS AND AREA MEDICAL PERSONNEL HAD CARED FOR MORE THAN 20,000 PATIENTS.DURING THE NEXT THIRTY YEARS, RAPID MEDICAL ADVANCEMENTS AND THE AREA'S GROWING POPULATION KEPT THE HOSPITAL IN A CONSTANT STATE OF CHANGE AND GROWTH, BUT TRUE TO ITS MISSION, COMPASSION AND CHARITY REMAINED AT THE FOREFRONT OF THE HOSPITAL'S ENDEAVORS. DURING THE GREAT DEPRESSION OF THE 1930S, THE SISTERS AT SAINT VINCENT HOSPITAL HELPED FEED THE HUNGRY. WITH THE ADVENT OF WORLD WAR II, VOLUNTEER SERVICES BECAME ESSENTIAL TO THE OPERATION OF THE HOSPITAL.ADAPTING TO THE CHANGES IN HEALTHCARE MEANT A NEW NAME FOR SAINT VINCENT HOSPITAL. IN NOVEMBER 2000, WE BECAME ST. VINCENT HEALTHCARE. FROM ITS MODEST BEGINNINGS OVER 100 YEARS AGO, ST. VINCENT HEALTHCARE HAS GROWN INTO ONE OF MONTANA'S LARGEST COMPREHENSIVE HOSPITALS, SERVING THE HEALTHCARE NEEDS OF OVER 400,000 PEOPLE IN A FOUR-STATE AREA. RENOWNED FOR A MISSION OF COMPASSIONATE CARE AND SERVICE TO THE POOR, THE ST. VINCENT HEALTHCARE TEAM IS CONTINUALLY RECOGNIZED AS A TECHNOLOGICAL LEADER IN THE HEALTHCARE INDUSTRY. THE NAME WAS AGAIN CHANGED IN 2021 TO SCL HEALTH - MONTANA. SCL HEALTH - MONTANA IS PART OF SISTERS OF CHARITY OF LEAVENWORTH HEALTH SYSTEM.SCL HEALTH - MONTANA IS RELATED TO SCL HEALTH MEDICAL GROUP -BILLINGS, LLC, A SINGLE MEMBER LIMITED LIABILITY COMPANY OWNED BY A RELATED ORGANIZATION, SISTERS OF CHARITY OF LEAVENWORTH HEALTH SYSTEM, INC. SCL HEALTH MEDICAL GROUP - BILLINGS, LLC IS A GROUP OF PHYSICIAN CLINICS THAT PROVIDE PROFESSIONAL SERVICES TO THE SCL HEALTH - MONTANA COMMUNITY AND SUPPORTS THE MISSION OF SCL HEALTH - MONTANA.ALTHOUGH SCL HEALTH MEDICAL GROUP - BILLINGS, LLC IS NOT OWNED DIRECTLY BY SCL HEALTH - MONTANA, SCL HEALTH - MONTANA IS REQUIRED TO FUND ALL OPERATING LOSSES OF SCL HEALTH MEDICAL GROUP - BILLINGS, LLC. IN 2023, THE HOSPITAL PROVIDED $37,237,082 IN SUPPORT OF THE LOSSES OF THE PHYSICIAN CLINICS.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 HEALTH (INTEGRATED HEALTH SYSTEM), SCL HEALTH - MONTANA HAS DIRECT ACCESS TO BEST PRACTICES, RESOURCES, TECHNOLOGY, TALENT AND STRATEGIC CAPITAL. SCL HEALTH - MONTANA HAS CONSISTENTLY BEEN RATED BY PRESS GANEY IN THE TOP 95TH PERCENTILE FOR PATIENT EXPERIENCE.SCL HEALTH - MONTANA HAS A VARIETY OF PROGRAMS AND SERVICES TO SERVE THE COMMUNITY INCLUDING BUT NOT LIMITED TO:- CANCER CARE- CARDIOTHORACIC AND VASCULAR MEDICINE- EMERGENCY AND TRAUMA SERVICES (LEVEL II TRAUMA CENTER)- FAMILY MEDICINE- LABOR AND DELIVERY (LEVEL III NEONATAL INTENSIVE CARE UNIT)- ORTHOPEDICS- PALLIATIVE CARE- PEDIATRIC INTENSIVE CARE UNIT- RADIOLOGY, IMAGING AND ANCILLARY SERVICES- SPORTS MEDICINE- SURGERY CENTER- THERAPY AND REHAB SERVICES- WALK-IN CARE 7 DAYS A WEEK- WOMEN'S HEALTHDURING 2023, THE FOLLOWING STATISTICAL DATA WAS GATHERED:ADMISSIONS 12,224OUTPATIENT VISTS 223,854EMERGENCY DEPARTMENT VISITS 38,728BIRTHS 1,828SURGERIES 8,719LABORATORY TESTS 1,294,815MISSION, VISION & VALUESMISSION:WE REVEAL AND FOSTER GOD'S HEALING LOVE BY IMPROVING THE HEALTH OF THEPEOPLE AND COMMUNITIES WE SERVE, ESPECIALLY THOSE WHO ARE POOR AND VULNERABLE.VISION:INSPIRED BY OUR FAITH, WE WILL PARTNER WITH OUR PATIENTS ANDCOMMUNITIES TO EXCEED THEIR EXPECTATIONS FOR HEALTH.VALUES:CARING SPIRIT - WE HONOR THE SACRED DIGNITY OF EACH PERSON.EXCELLENCE - WE SET AND SURPASS HIGH STANDARDS.GOOD HUMOR - WE CREATE JOYFUL AND WELCOMING ENVIRONMENTS.INTEGRITY - WE DO THE RIGHT THING WITH OPENNESS AND PRIDE.SAFETY - WE DELIVER CARE THAT SEEKS TO ELIMINATE ALL HARM FOR PATIENTS AND ASSOCIATES.STEWARDSHIP - WE ARE ACCOUNTABLE FOR THE RESOURCES ENTRUSTED TO US. 496257222 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 1 0 0 0 0 0 0 1 1 1 0 0 1 X 0 0 2377 1 1 1 0 0 0 0 0 0 0 0 0 0 0 X 16 14 0 0 0 0 1 1 1 1 1 0 0 1 1 1 1 1 1 0 0 1 0 X COLIN QUINCY 8014423491 36 SOUTH STATE STREET SALT LAKE CITY UT 84111 YEVGENIY AREFIEV FORMER HIGHEST COMPENSATED 0.00 50.00 X 0 1150512 50783 BRYAN JOHNSON INTERIM PRESIDENT, MT REGION (PARTIAL) 22.00 33.00 X X 0 684612 282612 JENNIFER ALDERFER PRESIDENT, MT REGION (PARTIAL) 37.00 16.00 X X 0 756683 42121 JAMES RICHARDS FORMER HIGHEST COMPENSATED 0.00 50.00 X 0 668877 38387 CHRISTOFFER SPOJA VP CHIEF MEDICAL OFF. SVB (PARTIAL) 50.00 0.00 X 425293 0 254261 JAMES RITCHEY FORMER KEY EMPLOYEE 0.00 50.00 X 0 434421 181079 MICHAEL BUSH FORMER KEY EMPLOYEE 0.00 50.00 X 0 414665 189929 RONALD SNYDER FORMER HIGHEST COMPENSATED 0.00 50.00 X 0 530303 46060 DANIEL LEWIS FORMER HIGHEST COMPENSATED 0.00 50.00 X 0 511364 44890 TRENT MIHALICK FORMER HIGHEST COMPENSATED 0.00 50.00 X 0 502689 45898 SHELDON NELSON FORMER HIGHEST COMPENSATED 0.00 50.00 X 0 494736 45373 PAMELA PALAGI VP FINANCE REGION MT 37.00 13.00 X 386020 0 148363 FRANK LAMM FORMER HIGHEST COMPENSATED 0.00 50.00 X 0 462852 48917 EDEN JONES FORMER HIGHEST COMPENSATED 0.00 50.00 X 0 471043 27916 EDWIN RODRIGUEZ FORMER HIGHEST COMPENSATED 0.00 50.00 X 0 432979 45189 RICHARD LAMMERS FORMER HIGHEST COMPENSATED 0.00 50.00 X 0 425378 46850 MELISSA FILTER VP CHIEF NURSING OFFICER SVB 50.00 0.00 X 280996 0 147837 MARJORIE TEVLIN FORMER HIGHEST COMPENSATED 0.00 50.00 X 0 357383 45399 ADAM SCHAFER VP NETWORK DEVELOPMENT REGION MT 37.00 13.00 X 0 273752 122709 SUSAN PETERSEN MD DIRECTOR 1.00 52.00 X 0 330406 15404 TRACY NEARY VP MISSION INTEGRATION REGION MT 37.00 13.00 X 227988 0 111563 KRIKOR JANSEZIAN FORMER KEY EMPLOYEE 0.00 50.00 X 0 313266 16568 DUSTIN STRANDELL DIRECTOR SENIOR SVC LINES 50.00 0.00 X 212974 0 80091 HEATHER BRENDEN SENIOR DIRECTOR HR BUSINESS PARTNER SVB 50.00 0.00 X 225102 0 62955 JACQUELINE HINES DIRECTOR SENIOR SURG AND PROCEDURAL SERVICES 50.00 0.00 X 211600 0 70885 JOELLEN MAURER DIRECTOR PHARMACY 50.00 0.00 X 224278 0 48616 HEATHER STAMEY DIRECTOR SENIOR EMERGENCY AND CRITICAL CARE SVB 50.00 0.00 X 181226 0 74957 JENNY PAULSON RN SHIFT COORDINATOR 50.00 0.00 X 209533 0 10054 BECKY RENO 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 CHRISTOPHER EDWARDS VICE CHAIR 1.00 2.00 X X 0 0 0 CINDY SORICH DIRECTOR 1.00 2.00 X 0 0 0 COLLEEN O'LEARY DIRECTOR 1.00 2.00 X 0 0 0 DANETTE GLEASON CHAIR 1.00 2.00 X X 0 0 0 KAREN FAGG DIRECTOR 1.00 4.00 X 0 0 0 MAJEL RUSSELL DIRECTOR 1.00 2.00 X 0 0 0 MISTY STEADMAN DIRECTOR 1.00 2.00 X 0 0 0 MJ JANSSEN DIRECTOR 1.00 2.00 X 0 0 0 NGUYEN-VU PHAM DIRECTOR 1.00 4.00 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 2585010 9215921 2345666 314 1 1 0 0 10589744 10589744 PATIENT SERVICES 620000 546375682 542952698 3422984 546375682 23348210 23348210 26568 38186 -11618 -11618 -11618 1556247 2397745 -841498 -841498 -841498 CAFETERIA SALES 720000 1488209 1196616 291593 PARKING LOT FEES 530000 299628 299628 LAUNDRY SERVICE - JV 810000 -93031 -93031 221 221 1695027 581155547 544356132 3714577 22495094 X 19863201 19863201 3182074 3132003 50071 125302493 123330831 1971662 5508358 5489314 19044 17079274 16867361 211913 9534653 9439342 95311 42914 42914 50045 50045 118138185 117823645 314540 138390 138390 1757481 1753690 3791 28719286 111662 28607624 10347759 10141169 206590 540746 472859 67887 278355 154981 123374 2630785 2630785 18824032 18824032 1824732 1824732 MEDICAL SUPPLIES 118937217 118937217 SHARED SERVICES - ADMIN 21024345 21024345 SHARED SERVICES BILLING 17064988 17064988 MAINTENANCE SERVICES 10417555 10390123 27432 42744589 34931885 7812704 573951457 496257222 77694235 0 8261 6758 67831692 71896153 42438 9521182 10964718 1531860 2133327 322645150 31327604 278598971 291317546 7181285 7197845 650876183 624406079 1015591872 1007922426 40382537 36255384 517619 232844 18297913 17091421 59198069 53579649 X 956393803 954342777 956393803 954342777 1015591872 1007922426 X 7204090 -9255116 X 0 1 X 1 0 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 0 0 0 0 0 0 0 0 1 50045 50045 0 PART II-B, LINE 1, LOBBYING ACTIVITIES: LOBBYING EXPENSES OF $50,045 WERE DERIVED FROM FEES FOR ADVOCACY SERVICES RELATED TO MONTANA LEGISLATIVE ACTIVITIES. 47261047 4087102 3279059 5758518 48868690 56646748 4202307 -6202412 7385596 47261047 54363477 1844356 3880208 3441293 56646748 48881586 4723259 4256990 3498358 54363477 42024169 5005363 4621764 2769710 48881586 0.28400 0.37160 0.34440 0 1 1 39082987 39082987 336380 169021295 10392541 158965134 1910243 334292 1575951 82373068 20434452 61938616 29921177 166319 29754858 291317546 INTERCOMPANY RECEIVABLE 548408530 RIGHT OF USE ASSETS 16809242 OTHER ACCT RECEIVABLE 5152053 3RD PARTY SETTLEMENTS 52969249 JOINT VENTURE RECEIVABLES 440404 DEFERRED TAXES 241838 RENT RECEIVABLES 384763 624406079 OPERATING LEASE 17060572 FINANCING LEASE 30849 17091421 PART V, LINE 4: ST. VINCENT HEALTHCARE FOUNDATION'S TEMPORARY ENDOWMENT FUNDS AND EARNINGS FROM THE PERMANENT ENDOWMENT FUNDS SUPPORT ST. VINCENT HOSPITAL IN AREAS INCLUDING ASSOCIATE EDUCATION, CARDIOVASCULAR, CHARITY CARE, COMMUNITY HEALTH & WELLNESS, GREATEST NEED, MOM/BABY & PEDIATRICS, NEUROSCIENCES, ONCOLOGY, SPIRITUAL CARE, WOMEN'S SERVICES, AND OTHER SERVICES AND PROGRAMS. THERE ARE ALSO BOARD-DESIGNATED ENDOWMENTS WHICH THE BOARD HAS THE RIGHT TO EXPEND AT ANY TIME. 1 1 X 1 X 250.000000000000 1 X 500.000000000000 1 1 1 0 1 1 6257398 0 6257398 0.01110 76182679 72793529 3389150 0.00600 1146332 1229270 0 0.00000 83586409 74022799 9646548 0.01710 640275 1367 638908 0.00110 3831289 2825859 1005430 0.00180 85648687 64593847 21054840 0.03730 447 0 447 0.00000 19235772 0 19235772 0.03410 109356470 67421073 41935397 0.07430 192942879 141443872 51581945 0.09140 379 379 0.00000 126839 126839 0.00020 28 28 0.00000 5418 5418 0.00000 132664 132664 0.00020 1 9223430 158230309 203314863 -45084554 X 1 1 1 ATHLETIC MEDICINE & PERFORMANCE LLC PHYSICAL THERAPY 0.33330 0.49580 2 ROCKY MOUNTAIN HEALTH NETWORK INC PHO - ADMINISTRATIVE SERVICES 0.50000 0.50000 1 1 ST VINCENT HEALTHCARE 1233 NORTH 30TH STREET BILLINGS MT 59101 SEE PART VI SUPP INFO 13258 X X X X ST VINCENT HEALTHCARE 1 0 0 1 X X X X X X X X X 23 1 1 1 1 X SEE PART V, SECTION C X SEE PART V, SECTION C X 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 ST. VINCENT HEALTHCARE PART V, SECTION B, LINE 5: SCL HEALTH - MONTANA (REFERRED TO AS ST. VINCENT HEREAFTER) CONDUCTED A COMMUNITY HEALTH NEEDS ASSESSMENT (CHNA) IN 2023. THE CHNA WAS IN COLLABORATION WITH BILLINGS CLINIC, A NONPROFIT HOSPITAL LOCATED IN BILLINGS, MT; RIVERSTONE HEALTH, THE CITY-COUNTY HEALTH DEPARTMENT AND OPERATOR OF A FEDERALLY QUALIFIED HEALTH CENTER; AND THE REHABILITATION HOSPITAL OF MONTANA. ADDITIONALLY, PRC, A NATIONALLY RECOGNIZED HEALTHCARE CONSULTING FIRM, WAS UTILIZED TO CONDUCT THE CHNA AND A STEERING COMMITTEE PROVIDED GUIDANCE CONSISTING OF REPRESENTATIVES FROM PUBLIC HEALTH, FAITH-BASED ORGANIZATIONS, GOVERNMENT ENTITIES, SOCIAL SERVICE AGENCIES, AND PRIVATE BUSINESS.THE CHNA INCORPORATED INPUT FROM THE FOLLOWING: PRIMARY QUANTITATIVE DATA INCLUDING TELEPHONE SURVEYS OF 400 HOUSEHOLDS AND ADDITIONAL ONLINE SURVEYS, SECONDARY QUANTITATIVE DATA INCLUDING EXISTING PUBLIC HEALTH DATA, AND PRIMARY QUALITATIVE DATA INCLUDING ONLINE KEY INFORMANT SURVEYS. THE SAMPLE FOR THE 400 HOUSEHOLD TELEPHONE SURVEY IS REPRESENTATIVE OF THE YELLOWSTONE COUNTY POPULATION IN TERMS OF DEMOGRAPHIC AND SOCIOECONOMIC CHARACTERISTICS, AS WELL AS GEOGRAPHIC LOCATION. IN ADDITION, COMMUNITY OUTREACH CONDUCTED AN ONLINE SURVEY. COMMUNITY HEALTH WORKERS CONDUCTED ADDITIONAL SURVEYS TO OVERSAMPLE KEY DEMOGRAPHIC POPULATIONS, WHICH YIELDED AN ADDITIONAL 294 RESPONSES. BASED ON THE SAMPLE SIZE OF 694 RESPONDENTS, WE CAN BE 95% CONFIDENT THAT THE RESPONSES TO THE SURVEY QUESTIONS ARE REPRESENTATIVE OF THE SERVICE AREA POPULATION, PLUS OR MINUS 3.7%. THE 2023 CHNA WAS A FOLLOW-UP TO SIMILAR SURVEYS CONDUCTED IN 2020, 2017, 2014, 2011, AND 2006 WHICH ALLOWED FOR TRENDING OVER TIME.AN ONLINE SURVEY SOLICITED INPUT FROM KEY INFORMANTS, AND A TOTAL OF 86 COMMUNITY STAKEHOLDERS TOOK PART, INCLUDING REPRESENTATIVES OF COMMUNITY-BASED ORGANIZATIONS, EDUCATION, GOVERNMENT, BUSINESS, HEALTHCARE, AND PUBLIC HEALTH. THROUGHOUT THE PROCESS, REPRESENTATIVES FROM ORGANIZATIONS THAT SERVE LOW-INCOME, MINORITY, OR OTHER MEDICALLY UNDERSERVED POPULATIONS PROVIDED INPUT. ST. VINCENT HEALTHCARE PART V, SECTION B, LINE 6A: ST. VINCENT CONDUCTED THE 2023 CHNA IN COLLABORATION WITH BILLINGS CLINIC, A HOSPITAL LOCATED IN BILLINGS, MT, AND THE REHABILITATION HOSPITAL OF MONTANA, A SPECIALTY HOSPITAL LOCATED IN BILLINGS. ST. VINCENT HEALTHCARE PART V, SECTION B, LINE 6B: ST. VINCENT CONDUCTED THE 2023 CHNA WITH RIVERSTONE HEALTH, THE CITY-COUNTY HEALTH DEPARTMENT. IN ADDITION, 93 REPRESENTATIVES FROM BUSINESS, COMMUNITY, EDUCATION, FAITH-BASED ORGANIZATIONS, SOCIAL SERVICE AGENCIES, AND GOVERNMENT ENTITIES WERE INVOLVED IN THE CHNA PROCESS AS MEMBERS OF THE CHNA ADVISORY GROUP WHICH PROVIDED GUIDANCE IN THE CHNA PROCESS.ST. VINCENT HEALTHCARE:PART V, SECTION B, LINE 7A: HTTPS://INTERMOUNTAINHEALTHCARE.ORG/-/MEDIA/FILES/INTERMOUNTAIN-HEALTH/CHNA-REPORTS---PEAKS/ST-VINCENT-CHNA-2023.ASHXST. VINCENT HEALTHCARE:PART V, SECTION B, LINE 7B: HTTPS://WWW.HEALTHYBYDESIGNYELLOWSTONE.ORG/WP-CONTENT/UPLOADS/2023/01/2023-PRC-CHNA-REPORT-YELLOWSTONE-COUNTY-MT.PDF ST. VINCENT HEALTHCARE PART V, SECTION B, LINE 7D: A PRESS CONFERENCE WAS HELD ON JANUARY 1, 2023, TO REPORT THE CHNA RESULTS AND PROVIDE A SUMMARY OF KEY FINDINGS. THE CHNA IS ALSO AVAILABLE ON THE ST. VINCENT AND HEALTHY BY DESIGN COALITION WEBSITES: HTTPS://INTERMOUNTAINHEALTHCARE.ORG/ABOUT/WHO-WE-ARE/CHNA-REPORTS HTTP://WWW.HEALTHYBYDESIGNYELLOWSTONE.ORGST. VINCENT HEALTHCARE:PART V, SECTION B, LINE 10A:HTTPS://INTERMOUNTAINHEALTHCARE.ORG/-/MEDIA/FILES/INTERMOUNTAIN-HEALTH/CHNA-REPORTS---PEAKS/CHIP-SVH-2024.ASHXHTTPS://WWW.HEALTHYBYDESIGNYELLOWSTONE.ORG/WP-CONTENT/UPLOADS/2023/06/PLAN_2023-2026YELLOWSTONECOUNTYCHIP_FINAL_2023.06.30.PDF ST. VINCENT HEALTHCARE PART V, SECTION B, LINE 11: THE 2023 CHNA IDENTIFIED 11 AREAS OF OPPORTUNITY AND WERE EVALUATED AND PRIORITIZED BY APPLYING THE FOLLOWING CRITERIA: RANKING IN COMPARISON TO NATIONAL AND STATE LEVEL BENCHMARK DATA; IDENTIFIED TRENDS; THE PREPONDERANCE OF SIGNIFICANT FINDINGS WITHIN TOPIC AREAS; MAGNITUDE IN TERMS OF NUMBER OF PERSONS AFFECTED; AND THE POTENTIAL HEALTH IMPACT OF A GIVEN ISSUE. IN ALPHABETICAL ORDER, AREAS OF OPPORTUNITY IDENTIFIED IN THE 2023 CHNA:1. ACCESS TO HEALTHCARE SERVICES2. CANCER3. DIABETES4. HEART DISEASE AND STROKE5. INJURY AND VIOLENCE6. MENTAL HEALTH7. NUTRITION, PHYSICAL ACTIVITY, AND WEIGHT8. POTENTIALLY DISABLING CONDITIONS9. RESPIRATORY DISEASES 10. SEXUAL HEALTH11. SUBSTANCE ABUSECOMMUNITY STAKEHOLDERS REPRESENTING A CROSS-SECTION OF COMMUNITY-BASED AGENCIES AND ORGANIZATIONS CONVENED TO EVALUATE, DISCUSS, AND PRIORITIZE HEALTH ISSUES FOR THE COMMUNITY. PARTICIPANTS EVALUATED EACH OF THE 11 IDENTIFIED AREAS OF OPPORTUNITY USING THE CRITERIA OF SCOPE AND SEVERITY, AND ABILITY TO IMPACT. THIS PROCESS YIELDED THE TOP PRIORITIZED COMMUNITY NEEDS, WITH THE TOP FOUR IDENTIFIED AS: 1. MENTAL HEALTH2. SUBSTANCE USE 3. ACCESS TO HEALTH CARE4. NUTRITION, PHYSICAL ACTIVITY, AND WEIGHTFOLLOWING THE COMMUNITY'S PRIORITIZATION OF THE NEEDS, ST. VINCENT'S COMMUNITY BENEFIT COMMITTEE OF THE MONTANA MARKET BOARD OF DIRECTORS AND ST. VINCENT'S LEADERSHIP TEAM REVIEWED THE DATA AND PRIORITIZED BASED ON THE FOLLOWING CRITERIA: ABILITY TO IMPACT, SCOPE AND SEVERITY OF THE ISSUE, COMMUNITY PRIORITIZATION OF ISSUES, POTENTIAL COMMUNITY COLLABORATORS, AND ALIGNMENT WITH CURRENT EFFORTS AND STRATEGIES. THEY IDENTIFIED THE TOP PRIORITY NEEDS AS:1. ACCESS TO HEALTHCARE SERVICES2. BEHAVIORAL HEALTH (MENTAL HEALTH AND SUBSTANCE USE) 3. INJURY AND VIOLENCE4. NUTRITION, PHYSICAL ACTIVITY, AND WEIGHTST. VINCENT IS ADDRESSING THESE IDENTIFIED HEALTH NEEDS THROUGH BOTH COLLABORATIVE COMMUNITY EFFORTS AND SPECIFIC HOSPITAL EFFORTS.ACCESS TO HEALTHCARE SERVICES:IN THE 2023 CHNA, 45.4% OF YELLOWSTONE COUNTY ADULTS REPORTED SOME DIFFICULTY OR DELAY IN OBTAINING HEALTHCARE SERVICES IN THE PAST YEAR. THE COUNTY HAS A RATE OF 67% OF INDIVIDUALS RECEIVING A ROUTINE CHECKUP, WHICH WAS LOWER THAN STATE AVERAGE OF 74.9%. YELLOWSTONE COUNTY RESIDENTS EXPERIENCE HEALTHCARE PROVIDER SHORTAGES BASED ON GEOGRAPHIC PROXIMITY AND LOW INCOME. TO ENHANCE ACCESS TO HEALTHCARE SERVICES, ESPECIALLY FOR RESIDENTS IN RURAL AND TRIBAL COMMUNITIES, ST. VINCENT OPENED PRIMARY CARE AND WALK-IN CLINICS IN LOCKWOOD AND WEST BILLINGS, MT, AND EXPANDED VIRTUAL HEALTH SERVICES WITH AN AVERAGE OF 1,171 VIRTUAL HEALTH VISITS EACH MONTH IN 2023. ST. VINCENT ALSO PROVIDED OUTREACH SERVICES SUCH AS MOBILE MAMMOGRAPHY AND PEDIATRIC AND SPECIALTY PROVIDERS OFFERING CLINICAL HOURS AT OUTLYING HOSPITALS. MOBILE MAMMOGRAPHY PROVIDED SCREENINGS TO 3,452 WOMEN AT 60 LOCATIONS, INCLUDING 528 SCREENINGS AT INDIAN HEALTH SERVICE SITES ON THE CROW AND NORTHERN CHEYENNE RESERVATIONS, AND OUTREACH SERVICES PROVIDED 16 OUTLYING COMMUNITIES WITH 16 AREAS OF SPECIALTY CARE. TO INCREASE WORKFORCE CAPACITY FOR HEALTHCARE SERVICES, ST. VINCENT PROVIDES CLINICAL ROTATIONS FOR PHYSICIANS, NURSING, DIETITIAN, PHYSICAL AND OCCUPATIONAL THERAPY, LABORATORY, PARAMEDIC, AND PHARMACY STUDENTS. ADDITIONALLY, ST. VINCENT OFFERS THE ONLY ACCREDITED CLINICAL PASTORAL EDUCATION (CPE) PROGRAM IN THE STATE. IN 2023 THE FOLLOWING NUMBER OF STUDENTS OR INTERNS COMPLETED ROTATIONS: 55 NURSING, 4 PHARMACY, 5 PHYSICAL THERAPY, 6 OCCUPATIONAL THERAPY, 1 SPEECH LANGUAGE PATHOLOGY, 5 DIETETICS, 29 PARAMEDICS, 3 LABORATORY, AND 11 CPE. TO SUPPORT WORKFORCE DEVELOPMENT OF PHYSICIANS, ST. VINCENT PROVIDED LEADERSHIP AND FINANCIAL SUPPORT TO THE MONTANA FAMILY PRACTICE RESIDENCY PROGRAM, WHICH TRAINED 26 RESIDENTS. IN ADDITION, ST. VINCENT OFFERS A MEDICATION ASSISTANCE PROGRAM PROVIDING ASSISTANCE TO LOW-INCOME, UNINSURED INDIVIDUALS TO OBTAIN FREE OR DISCOUNTED PRESCRIPTION MEDICATIONS DIRECTLY FROM PHARMACEUTICAL COMPANIES. BEHAVIORAL HEALTH (MENTAL HEALTH AND SUBSTANCE USE):YELLOWSTONE COUNTY ADULTS REPORTED HIGHER RATES OF DEPRESSIVE DISORDER (33.3%) THAN STATE OR NATIONAL RATE. THE PERCENTAGE OF ADULTS IN THE COUNTY REPORTING THEIR OVERALL MENTAL HEALTH AS FAIR OR POOR WAS 20.7%, WHICH HAS SIGNIFICANTLY INCREASED SINCE 2005. IN THE 2023 CHNA, 33.1% OF LOW-INCOME RESIDENTS AND 41.7% OF PEOPLE OF COLOR REPORTED CONSIDERING SUICIDE AND 43.4% OF COUNTY ADULTS REPORTED BEING NEGATIVELY IMPACTED BY SUBSTANCE USE. ST. VINCENT HAS INTEGRATED BEHAVIORAL HEALTH INTO PRIMARY CARE AND MIDWIFERY CLINICS. MENTAL HEALTH SPECIALISTS ARE EMBEDDED IN CLINICS AND PROVIDE INCREASED ACCESS TO MENTAL HEALTH SERVICES AND REDUCE BARRIERS RELATED TO STIGMA. IN 2023, ST. VINCENT BEHAVIORAL HEALTH SPECIALISTS COMPLETED 4,555 IN-PERSON, TELEPHONE, AND VIRTUAL VISITS. MIDWIFERY CLINICS ARE ADDRESSING PRENATAL BEHAVIORAL HEALTH, INCLUDING CARE COORDINATORS TO FOCUS ON SCREENINGS FOR MENTAL HEALTH NEEDS AND SUBSTANCE USE AND ADDRESSING SOCIAL NEEDS.ST. VINCENT CONTINUES TO SUPPORT THE COMMUNITY CRISIS CENTER, WHICH PROVIDES ACCESS TO INTEGRATED MENTAL HEALTH SERVICES AND ASSESSMENTS, CASE MANAGEMENT, PEER SUPPORT GROUPS, SUBSTANCE USE DISORDER COUNSELING, REFERRALS TO COMMUNITY SERVICES, AND 24/7 COMMUNITY STABILIZATION RESPONSE FOR AT-RISK INDIVIDUALS IN MENTAL DISTRESS TO PREVENT HOSPITALIZATION. IN 2023, THE CENTER HAD 11,980 RESOLVED CLIENT VISITS, AND 80-85% OF THEIR CLIENTS WERE EXPERIENCING HOMELESSNESS. THE CENTER ALSO PROVIDES CRISIS INTERVENTION TRAINING FOR LAW ENFORCEMENT.ST. VINCENT ALSO INCREASED ACCESS TO MENTAL HEALTH SERVICES BY SUPPORTING A STUDENT-RUN MENTAL HEALTH CLINIC AT WALLA WALLA UNIVERSITY-BILLINGS. IN 2023, THIS CLINIC PROVIDED 866 NO-COST MENTAL HEALTH APPOINTMENTS TO INDIVIDUALS WITHOUT INSURANCE UTILIZING THE CLINICAL HOURS FROM STUDENTS COMPLETING MSW DEGREES.ST. VINCENT CONTINUES SUPPORTING COMMUNITY COLLABORATIONS ADDRESSING SUICIDE AND MENTAL HEALTH, INCLUDING THE YELLOWSTONE VALLEY SUICIDE PREVENTION COALITION. IN 2023, 218 PEOPLE ATTENDED A SUICIDE PREVENTION CONFERENCE PROVIDED BY THE YELLOWSTONE VALLEY SUICIDE PREVENTION COALITION AND HOSTED BY ST. VINCENT. THROUGH COLLABORATION WITH THE COALITION, 1,050 COMMUNITY MEMBERS RECEIVED QPR TRAINING, WHICH PROMOTES SUICIDE PREVENTION. ST. VINCENT IS AN ACTIVE MEMBER OF THE SUBSTANCE ABUSE CONNECT COALITION, FOCUSED ON DECREASING METHAMPHETAMINE USE IN OUR COMMUNITY AND EMPLOYEES SERVE ON THE EXECUTIVE COMMITTEE. ST. VINCENT IS ALSO A MEMBER OF THE HEALTHY BY DESIGN COALITION, WHICH ADOPTED A COLLECTIVE COMMUNITY HEALTH IMPROVEMENT PLAN TO ADDRESS BEHAVIORAL HEALTH CONCERNS THROUGH AN UPSTREAM APPROACH. THESE EFFORTS INCLUDE THE CREATION OF HEALTHY NEIGHBORHOODS, HEALTHY CONNECTIONS TO DECREASE SOCIAL ISOLATION, AND HEALTHY INVESTMENTS TO IMPROVE THE QUALITY OF LIFE AND LIVABILITY OF THE COMMUNITY. INJURY AND VIOLENCE: WHILE NOT A PRIORITY FOCUS FOR COMMUNITY HEALTH IMPROVEMENT UNTIL 2024, ST. VINCENT ADDRESSED THE TRENDING ISSUE OF INJURY AND VIOLENCE IN 2023 THROUGH FALL PREVENTION AND STAYING ACTIVE AND INDEPENDENT FOR LIFE PROGRAMS AND EDUCATIONAL PRESENTATIONS ON WINTER SAFETY, HELMET SAFETY, WATER SAFETY, AND SAFE GUN STORAGE SAFETY. ADDITIONALLY, 1,626 INDIVIDUALS RECEIVED STOP THE BLEED TRAINING AND HIGH SCHOOL STUDENTS RECEIVED DISTRACTED DRIVING CLASSES. IN PARTNERSHIP WITH VITALANT, ST. VINCENT HELD BLOOD DRIVES, WHICH RESULTED IN 261 DONATIONS.NUTRITION, PHYSICAL ACTIVITY, WEIGHT: THE 2023 CHNA REPORTED THAT 73.3% OF YELLOWSTONE COUNTY ADULTS ARE OVERWEIGHT OR OBESE, 27.8% OF ADULTS DAILY CONSUMED FIVE OR MORE SERVINGS OF FRUITS OR VEGETABLES, 29.3% OF ADULTS MET PHYSICAL ACTIVITY RECOMMENDATIONS, AND 33.7% OF CHILDREN REPORTED THREE OR MORE HOURS OF SCREEN TIME DURING SCHOOL FOR ENTERTAINMENT.ST. VINCENT OFFERED EVIDENCE-BASED DIABETES AND HEART DISEASE PREVENTION PROGRAMS TWICE A YEAR AT THE BILLINGS FAMILY YMCA. IN 2023, 115 INDIVIDUALS AT RISK FOR DEVELOPING TYPE 2 DIABETES OR HEART DISEASE ENROLLED IN THE PROGRAM WHICH FOCUSED ON NUTRITION EDUCATION AND PHYSICAL ACTIVITY, SUPPORTING HEALTHY LIFESTYLE CHANGES. PARTICIPANTS WHO FINISHED THE YEAR-LONG PROGRAM HAD % WEIGHT LOSS OF 10% OR 640 POUNDS OF WEIGHT LOSS. CONTINUED IN SCHED H PART V SUPPLEMENTAL INFORMATION PART V, SECTION B, LINE 11 CONTINUED AS PRESENTING SPONSOR OF KIDS IN MOTION, ST. VINCENT COLLABORATED WITH THE CITY OF BILLINGS AND SCHOOL DISTRICT 2 TO PROVIDE BICYCLE TUNE-UP CLINICS TO EMPOWER YOUTH TO RIDE THEIR BICYCLES TO SCHOOL. IN 2023, THE PROGRAM INSPECTED A TOTAL OF 218 STUDENT BICYCLES AT NINE SCHOOLS AND PROVIDED REPAIRS AS NEEDED. AS A SPONSORING ENTITY AND MEMBER OF THE HEALTHY BY DESIGN COALITION, ST. VINCENT AIMED TO INCREASE THE PROPORTION OF YELLOWSTONE COUNTY RESIDENTS AT A HEALTHY WEIGHT THROUGH POLICY, SYSTEMS AND ENVIRONMENTAL CHANGE. THE COALITION'S EFFORTS INCLUDED A GARDENERS' MARKET HOSTED IN A FEDERALLY IDENTIFIED FOOD DESERT WITHIN A LOW-INCOME NEIGHBORHOOD. THE GARDENERS' MARKET ACCEPTED SNAP, WIC, AND SENIOR FARMERS MARKET NUTRITION PROGRAM PAYMENTS, WHICH INCREASED ACCESS TO FRESH AND AFFORDABLE PRODUCE. MARKET ATTENDEES REPORTED AN 87% INCREASE IN THEIR CONSUMPTION OF FRUITS AND VEGETABLES. ST. VINCENT ALSO PROVIDED INDIVIDUAL INTERVENTIONS FOR HEALTHY WEIGHT THROUGH THE WEIGHT MANAGEMENT CLINIC. BARIATRIC PATIENTS REDUCED THEIR BMI AT ONE YEAR POST-OPERATION FROM 44.5 TO 32.4. PEDIATRIC SPECIALITY CLINIC OFFERED PEDIATRIC WEIGHT MANAGEMENT SERVICES. OTHER SIGNIFICANT NEEDS NOT PRIORITIZED: ST. VINCENT 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 ST. VINCENT. DUE TO LIMITED EXPERTISE AND RESOURCES, ST. VINCENT NARROWED ITS PRIORITY HEALTH NEEDS TO THE FOUR HEALTH NEEDS DISCUSSED. ST. VINCENT CONTINUED TO COLLABORATE WITH COMMUNITY ORGANIZATIONS TO ADDRESS THESE HEALTH NEEDS:CANCER: IN 2023, ST. VINCENT SCREENED 524 PATIENTS FOR LUNG CANCER USING LOW-DOSE CT SCANS. THE MOBILE MAMMOGRAPHY COACH PROVIDED MAMMOGRAMS TO 3,452 WOMEN AT 60 LOCATIONS, INCLUDING 528 SCREENINGS AT INDIAN HEALTH SERVICE SITES. DIABETES: ST. VINCENT OFFERED TWO SESSIONS OF PREVENTIVE PROGRAMS FOR DIABETES AND HEART DISEASE AT THE BILLINGS FAMILY YMCA IN CORRELATION WITH OUR HEALTHY WEIGHT STATUS PRIORITY. ADDITIONALLY, ST. VINCENT PROVIDED FREE DIABETES SCREENINGS AT EVENTS THAT TARGETED AT-RISK POPULATIONS, INCLUDING THE MATE SHOW AND POWWOWS. HEART DISEASE AND STROKE: ST. VINCENT OFFERED A BROAD ARRAY OF SERVICES, INCLUDING CARDIOLOGY, INTERVENTIONAL CARDIOLOGY, ADVANCED THROMBECTOMY-CAPABLE STROKE CENTER CERTIFICATION, AND CARDIAC REHABILITATION. THE HEALTHY WEIGHT STATUS PRIORITY ALSO ADDRESSED THE PREVENTION OF HEART DISEASE.INFANT HEALTH AND SEXUAL HEALTH: ST. VINCENT OFFERED MATERNAL FETAL MEDICINE WITH OUTREACH TO RURAL COMMUNITIES, AND OUR MIDWIFERY CLINIC PROVIDED OUTREACH TO TRIBAL COMMUNITIES. BEHAVIORAL HEALTH SCREENINGS WERE PROVIDED AT PRENATAL APPOINTMENTS, AND OTHER TARGETED INTERVENTIONS WERE DEVELOPED FOR HIGH-RISK PARENTS. POTENTIAL DISABLING CONDITIONS: ST. VINCENT IS A MEMBER OF THE DEMENTIA FRIENDLY BILLINGS COALITION AND PARTICIPATED IN THE AGE FRIENDLY BILLINGS INITIATIVE. RESPIRATORY DISEASE: LOW-DOSE CT SCANS WERE OFFERED TO 524 CURRENT AND FORMER HEAVY SMOKERS TO SCREEN FOR LUNG CANCER. ST. VINCENT PROVIDED TOBACCO CESSATION INFORMATION IN CONJUNCTION WITH SCREENINGS AND PULMONARY REHABILITATION SERVICES. SOCIAL DETERMINANTS OF HEALTH: ST. VINCENT RECOGNIZED THE EMERGING NEED TO ADDRESS UNDERLYING FACTORS THAT INFLUENCE COMMUNITY HEALTH, SUCH AS EDUCATION, HOUSING, EARLY CHILDHOOD DEVELOPMENT, AND ECONOMIC SECURITY. ST. VINCENT SPONSORED THE FOSTER GRANDPARENT PROGRAM, WHICH ALLOWED LOW-INCOME SENIORS TO MENTOR AT-RISK STUDENTS AT SCHOOLS AND HEAD START CENTERS IN THREE COUNTIES AND ONE RESERVATION. THE PROGRAM VOLUNTEERS PROVIDED 9,244 HOURS OF SERVICE THAT RESULTED IN IMPROVED ACADEMIC SCORES. ST. VINCENT PARTICIPATED WITH THE CONTINUUM OF CARE COALITION TO ADDRESS HOUSING FOR INDIVIDUALS AND FAMILIES EXPERIENCING HOMELESSNESS.ST. VINCENT HEALTHCARE:PART V, SECTION B, LINE 16A, 16B, 16C: HTTPS://INTERMOUNTAINHEALTHCARE.ORG/FOR-PATIENTS/FINANCIAL-ASSISTANCE/COLORADO-MONTANA-WYOMING 13 1 - SCL HEALTH ST VINCENT MS CENTER 1041 N 29TH ST BILLINGS MT 59101 OUTPATIENT PHYSICIAN CLINIC 2 - SCL HEALTH ST VINCENT NEUROLOGY 1041 N 29TH ST BILLINGS MT 59101 OUTPATIENT PHYSICIAN CLINIC 3 - SCL HEALTH ST VINCENT NEUROSURGERY 1041 N 29TH ST BILLINGS MT 59101 OUTPATIENT PHYSICIAN CLINIC 4 - SCL HEALTH ST VINCENT ORTHOPEDICS 2900 12TH AVE N BILLINGS MT 59101 OUTPATIENT PHYSICIAN CLINIC 5 - SCL HEALTH ST VINCENT RHEUMATOLOGY 2900 12TH AVE N BILLINGS MT 59101 OUTPATIENT PHYSICIAN CLINIC 6 - CANCER CENTERS OF MONTANA 1315 GOLDEN VALLEY CIR BILLINGS MT 59102 OUTPATIENT PHYSICIAN CLINIC 7 - CANCER CENTERS OF MONTANA 1315 GOLDEN VALLEY CIR BILLINGS MT 59102 OUTPATIENT PHYSICIAN CLINIC 8 - ST VINCENT NEUROLOGY HOSPITALISTS 1233 N 30TH ST BILLINGS MT 59101 OUTPATIENT PHYSICIAN CLINIC 9 - SCL HEALTH MEDICAL GROUP - RED LODGE 810 N BROADWAY REDLODGE MT 59086 OUTPATIENT PHYSICIAN CLINIC 10 - CANCER CENTERS OF MONTANA 1315 GOLDEN VALLEY CIR BILLINGS MT 59102 OUTPATIENT PHYSICIAN CLINIC 11 - SCL CANCER CENTERS OF MONTANA 2600 WILSON STREET MILES CITY MT 59301 OUTPATIENT PHYSICIAN CLINIC 12 - ATHLETIC MEDICINE & PERFORMANCE LLC 1144 NORTH 28TH STREET BILLINGS MT 59101 PHYSICAL THERAPY 13 - FIRST FLIGHT OF WYOMING LLC 500 ELDORADO BLVD SUITE 4300 BROOMFIELD CO 80021 AIR AMBULANCE SERVICES 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 THE INTERMOUNTAIN HEALTH CARE, INC. SYSTEM WHICH PREPARES AN ANNUAL REPORT TO THE COMMUNITY ON A CONSOLIDATED BASIS. THE REPORT IS PREPARED BY THE PARENT COMPANY, INTERMOUNTAIN HEALTH CARE, INC. PART I, LINE 7: THE AMOUNTS REPORTED ON FORM 990, SCHEDULE H, PART I, LINE 7A, 7B AND 7C WERE DETERMINED USING THE COST TO CHARGE RATIO DERIVED FROM WORKSHEET 2, IN THE SCHEDULE H, FORM 990 INSTRUCTIONS. FORM 990, SCHEDULE H, PART I, LINES 7E, 7F, 7G, 7H AND 7I ARE REPORTED AT COST AS REPORTED IN 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 ON SCHEDULE H, PART I, LINE 7 COLUMN (F) IS $9,223,430. PART II, COMMUNITY BUILDING ACTIVITIES: ST. VINCENT RECOGNIZES THE NEED TO ADDRESS UNDERLYING FACTORS THAT INFLUENCE HEALTH IN OUR COMMUNITY SUCH AS EDUCATION, HOUSING, EARLY CHILDHOOD DEVELOPMENT, AND ECONOMIC SECURITY. WE SPONSOR THE FOSTER GRANDPARENT PROGRAM WITH LOW-INCOME SENIORS MENTORING STUDENTS IN NEED AT SCHOOLS, AFTER-SCHOOL PROGRAMS, AND HEAD START CENTERS IN THREE COUNTIES AND ON ONE RESERVATION, RESULTING IN IMPROVED ACADEMIC SCORES. IN 2023, FOSTER GRANDPARENT VOLUNTEERS PROVIDED 9,244 HOURS MENTORING AT-RISK YOUTH. ST. VINCENT PARTICIPATED WITH THE CONTINUUM OF CARE COALITION TO ADDRESS HOUSING FOR INDIVIDUALS AND FAMILIES EXPERIENCING HOMELESSNESS.SCHEDULE H, 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 8: THE ORGANIZATION BELIEVES THAT AT LEAST SOME PORTION OF THE COSTS WE INCUR IN EXCESS OF PAYMENTS RECEIVED FROM THE FEDERAL GOVERNMENT FOR PROVIDING MEDICAL SERVICES TO MEDICARE ENROLLEES AND BENEFICIARIES UNDER THE FEDERAL MEDICARE PROGRAM (SHORTFALL OR MEDICARE SHORTFALL) CONSTITUTES A COMMUNITY BENEFIT. PROVIDING THESE SERVICES CLEARLY LESSENS THE BURDENS OF THE GOVERNMENT BY ALLEVIATING THE FEDERAL GOVERNMENT FROM HAVING TO DIRECTLY PROVIDE THESE MEDICAL SERVICES. AS DEMONSTRATED AND CALCULATED ON FORM 990, SCHEDULE H, PART III, LINES 5, 6 AND 7, OUR MEDICARE "ALLOWABLE COSTS" CLEARLY EXCEED THE PAYMENTS WE RECEIVE FOR PROVIDING THESE MEDICAL SERVICES UNDER THE MEDICARE PROGRAM. BY ABSORBING THE MEDICARE SHORTFALL COSTS, WE ARE PROVIDING A COMMUNITY BENEFIT AS WELL AS EASING THE BURDEN OF THE FEDERAL GOVERNMENT HAVING TO COVER THESE COSTS. ABSENT THE MEDICARE PROGRAM, IT IS LIKELY MANY OF THE INDIVIDUALS WOULD QUALIFY FOR CHARITY CARE OR OTHER NEEDS-BASED GOVERNMENT PROGRAMS. BY ACCEPTING PAYMENT BELOW COST TO TREAT THESE INDIVIDUALS, BURDENS BORNE BY GOVERNMENTS ARE RELIEVED. TO ARRIVE AT THE FORM 990, SCHEDULE H, PART III, LINE 6 AMOUNT, WE USED ACTUAL MEDICARE CHARGES FROM INTERNAL RECORDS AND APPLIED AN ESTIMATED COST TO CHARGE RATIO TO DETERMINE THE MEDICARE ALLOWABLE COSTS. THE ESTIMATED MEDICARE COST TO CHARGE RATIO IS THE PRIOR PERIOD MEDICARE COST REPORT COST TO CHARGE RATIO. PART III, LINE 9B: AN INTEGRAL COMPONENT OF 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. WEMAINTAIN A BALANCE THAT ENABLES US TO CONTINUE TO PROVIDE CHARITY CARE TOTHOSE 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-ST-VINCENT-REGIONAL-HOSPITAL PART VI, LINE 2: ST. VINCENT LEADERS SERVE ON VARIOUS COMMUNITY BOARDS TO UNDERSTAND SPECIFIC NEEDS. ST. VINCENT ALSO UTILIZES OUTREACH AND RELATIONSHIPS WITH OTHER HOSPITALS AND CLINICS TO ASSESS BETTER THE HEALTHCARE NEEDS OF OUR RURAL MONTANA COMMUNITIES.IN ADDITION TO THE CHNA, ST. VINCENT USED SECONDARY DATA SUCH AS COUNTY HEALTH RANKINGS AND THE BEHAVIOR RISK FACTOR SURVEILLANCE SYSTEM (BRFSS) TO DETERMINE HEALTH NEEDS FOR COUNTIES BEYOND OUR PRIMARY SERVICE AREA. ST. VINCENT ALSO UTILIZED OTHER LOCAL NEEDS ASSESSMENTS AND REPORTS FROM COMMUNITY ORGANIZATIONS SUCH AS UNITED WAY OF YELLOWSTONE COUNTY AND HRDC. 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: ST. VINCENT'S PRIMARY SERVICE AREA INCLUDES YELLOWSTONE COUNTY, ENCOMPASSING 2,633 SQUARE MILES AND A POPULATION OF 160,390 RESIDENTS. BETWEEN THE 2000 AND 2020 US CENSUSES, THE COUNTY POPULATION INCREASED 11.3%, A GREATER PROPORTIONAL INCREASE THAN IN MONTANA AND THE NATION. YELLOWSTONE COUNTY IS PREDOMINANTLY URBAN, WITH 83.3% OF THE POPULATION LIVING IN AREAS DESIGNATED AS URBAN WITH SURROUNDING RURAL AND FRONTIER COUNTIES.HOSPITALS IN THE SERVICE AREA: THERE ARE TWO ACUTE CARE HOSPITALS IN YELLOWSTONE COUNTY: ST. VINCENT HEALTHCARE AND BILLINGS CLINIC, A NON-PROFIT HEALTH SYSTEM HOSPITAL. THERE IS ALSO AN ACUTE REHABILITATION HOSPITAL, THE REHABILITATION HOSPITAL OF MONTANA, LOCATED IN BILLINGS.AGE: IN YELLOWSTONE COUNTY, 23.4% OF THE POPULATION ARE AGE 0-17, 59.6% ARE AGE 18 TO 64, AND 17.0% ARE AGE 65 AND OLDER. RACE AND ETHNICITY: THE MAJORITY OF YELLOWSTONE COUNTY RESIDENTS OR 89.2% ARE WHITE, 4.0% ARE NATIVE AMERICAN, 2.8% ARE ANOTHER RACE, AND 4.1% MULTIPLE RACES. A TOTAL OF 5.9% OF YELLOWSTONE COUNTY RESIDENTS ARE HISPANIC OR LATINO, WHICH IS HIGHER THAN THE STATE OF MONTANA PREVALENCE. POVERTY AND ECONOMICS: THE LATEST CENSUS ESTIMATE SHOWS 9.6% OF THE YELLOWSTONE COUNTY POPULATION LIVING BELOW THE FEDERAL POVERTY LEVEL, INCLUDING 4,176 CHILDREN. IN YELLOWSTONE COUNTY, 5.2% OF ADULTS OVER AGE 25 DO NOT HAVE A HIGH SCHOOL EDUCATION. THE UNEMPLOYMENT RATE IS 2.5% AND DECREASED SINCE 2020. OTHER ECONOMIC INDICATORS INCLUDE 26.1% OF COUNTY RESIDENTS ARE WORRIED OR STRESSED ABOUT HAVING ENOUGH MONEY TO PAY THEIR RENT OR MORTGAGE AND 30.8% OF PERSONS OF COLOR REPORT HAVING LIVED WITH A FRIEND OR RELATIVE BECAUSE OF AN EMERGENCY. APPROXIMATELY 31,000 RESIDENTS HAVE LOW FOOD ACCESS, AND 21.3% OF ADULTS FIND IT DIFFICULT TO ACCESS AFFORDABLE FRESH FRUITS AND VEGETABLES. HEALTH STATUS: MOST YELLOWSTONE COUNTY RESIDENTS RATED THEIR OVERALL HEALTH FAVORABLY, WITH 84.7% RATING IT AS EXCELLENT, VERY GOOD, OR GOOD. HOWEVER, 15.3% OF ADULTS BELIEVED THEIR HEALTH WAS FAIR OR POOR. LOW-INCOME ADULTS, PERSONS OF COLOR, AND ADULTS 65 AND OLDER HAD HIGHER RATES OF IDENTIFYING THEIR HEALTH AS FAIR OR POOR.UNINSURED RATE: 9.6% OF PEOPLE IN YELLOWSTONE COUNTY ARE UNINSURED, WHICH IS HIGHER THAN THE U.S AVERAGE OF 9.3%. PART VI, LINE 5: ST. VINCENT ADHERED TO COMMUNITY BENEFIT GUIDELINES OUTLINED IN THE CATHOLIC HEALTH ASSOCIATION'S PUBLICATION, "A GUIDE TO PLANNING AND REPORTING COMMUNITY BENEFIT." ST. VINCENT'S COMMUNITY BENEFIT WORK WAS DRIVEN BY IDENTIFIED COMMUNITY HEALTH NEEDS AND DIRECTED IN COLLABORATION WITH OTHER HEALTHCARE ORGANIZATIONS AND THE BROADER COMMUNITY. A COMMUNITY BENEFIT REPORT TO THE COMMUNITY IS PUBLISHED ANNUALLY AND FOUND AT: HTTPS://INTERMOUNTAINHEALTHCARE.ORG/-/MEDIA/FILES/INTERMOUNTAIN-HEALTH/CHNA-REPORTS---PEAKS/SVH_COMMUNITY-HEALTH-ANNUAL-REPORT_FINAL-2022.ASHXST. VINCENT INTEGRATED COMMUNITY BENEFIT STRATEGIES IN THE ORGANIZATIONAL STRATEGIC PLAN INCLUDE PROGRAMS AND EDUCATION OFFERED BY VARIOUS ORGANIZATIONAL STAFF AND HAS DEDICATED STAFF COMMITTED TO COMMUNITY BENEFIT EFFORTS. HOSPITAL LEADERS, MANAGERS, AND SUPERVISORS PARTICIPATE ANNUALLY IN COMMUNITY BENEFIT SERVICE EVENTS WITH NONPROFIT ORGANIZATIONS TO IMPROVE COMMUNITY HEALTH.MONTANA MARKET'S BOARD OF DIRECTORS IS A VOLUNTEER GOVERNING BODY THAT INCLUDES INDEPENDENT PERSONS REPRESENTING THE COMMUNITY. WITHIN THE BOARD OF DIRECTORS, THERE IS A SPECIFIC COMMUNITY BENEFIT BOARD LEVEL COMMITTEE. THIS COMMITTEE WAS DEEPLY INVOLVED IN THE COMMUNITY HEALTH NEEDS ASSESSMENT PROCESS AND PROVIDED DIRECTION TO THE DEVELOPMENT OF THE ORGANIZATION'S IMPROVEMENT PLAN IN RESPONSE TO THE RESULTS OF THE COMMUNITY HEALTH NEEDS ASSESSMENT. THE HOSPITAL'S COMMUNITY BENEFIT BOARD COMMITTEE MONITORS THE IMPLEMENTATION OF COMMUNITY BENEFIT PROGRAMS AND PROVIDES REPORTS BACK TO THE FULL MARKET BOARD.ST. VINCENT OPERATES AN EMERGENCY ROOM OPEN TO ALL PERSONS REGARDLESS OF ABILITY TO PAY AND HAS AN OPEN MEDICAL STAFF WITH PRIVILEGES AVAILABLE TO ALL QUALIFIED PHYSICIANS IN THE AREA. ST. VINCENT ENGAGED IN MEDICAL AND SCIENTIFIC RESEARCH PROGRAMS, TRAINING AND EDUCATION OF HEALTHCARE PROFESSIONALS, AND PARTICIPATED IN MEDICAID, MEDICARE, AND OTHER GOVERNMENT-SPONSORED HEALTH PROGRAMS. ST. VINCENT EMPLOYS THE STAFF OF THE ST. VINCENT HEALTHCARE FOUNDATION, A NONPROFIT ORGANIZATION THAT PROVIDES FUNDRAISING FOR BOTH ST. VINCENT AND COMMUNITY PROGRAMS THAT BENEFIT BOTH THE POOR AND THE BROADER COMMUNITY. A SEPARATE FOUNDATION BOARD GOVERNS THE ST. VINCENT FOUNDATION WITH VOLUNTARY MEMBERSHIPS FROM THE LOCAL COMMUNITY. WHEN ST. VINCENT HAS EXCESS REVENUE OVER OPERATING EXPENSES, IT USES FUNDS TO OBTAIN CURRENT HEALTHCARE TECHNOLOGIES AND EQUIPMENT, IMPROVE PATIENT CARE, PROVIDE MEDICAL TRAINING EDUCATION AND RESEARCH, AND EXPAND ACCESS TO POINTS OF CARE. THESE INVESTMENTS ENSURE THEY WILL BE ABLE TO CARE FOR FUTURE GENERATIONS. ST. VINCENT CO-LEADS COMMUNITY HEALTH IMPROVEMENT EFFORTS AS PART OF THE ALLIANCE, A COLLABORATION WITH BILLINGS CLINIC AND RIVERSTONE HEALTH, AND COMMITS TIME AND FINANCIAL RESOURCES TO FULFIL GOALS OUTLINED IN THE COLLABORATIVE COMMUNITY HEALTH IMPROVEMENT PLAN FOR YELLOWSTONE COUNTY. PART VI, LINE 6: THE FILING ORGANIZATION IS AN AFFILIATE OF INTERMOUNTAIN HEALTH CARE, INC. (INTERMOUNTAIN), AN INTEGRATED HEALTH SYSTEM WHOSE VISION IS TO "BE A MODEL HEALTH SYSTEM BY PROVIDING EXTRAORDINARY CARE AND SUPERIOR SERVICES AT AN AFFORDABLE COST." INTERMOUNTAIN STRIVES TO FULFILL THAT MISSION THROUGH ACCOMPLISHING ITS STATED MISSION OF "HELPING PEOPLE LIVE THE HEALTHIEST LIVES POSSIBLE." INTERMOUNTAIN, 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 SISTERS OF CHARITY OF LEAVENWORTH HEALTH SYSTEM INC 500 ELDORADO BLVD SUITE 4300 BROOMFIELD CO 80021 237379161 501(C)(3) 17659243 0 SUPPORT MONTANA CLINICS ST VINCENT HEALTHCARE FOUNDATION 1106 NORTH 30TH STREET BILLINGS MT 59101 810468034 501(C)(3) 1868123 0 SUPPORT OPERATIONS RIVERSTONE HEALTH FOUNDATION 123 S 27TH STREET BILLINGS MT 59101 352332179 501(C)(3) 29857 0 PROGRAM SUPPORT BILLINGS PUBLIC LIBRARY FOUNDATION INC 510 NORTH BROADWAY BILLINGS MT 59101 810451892 501(C)(3) 25000 0 LIBRARY EXPRESS LOCKER PROJECT MONTANA STATE UNIVERSITY FOUNDATION PO BOX 172750 BOZEMAN MT 59717 816001649 501(C)(3) 21500 0 PROGRAM SUPPORT BILLINGS CATHOLIC SCHOOLS FOUNDATION 215 N 31ST STREET BILLINGS MT 59101 383819006 501(C)(3) 20500 0 PROGRAM SUPPORT MONTANA AMATEUR SPORTS INC PO BOX 7136 BILLINGS MT 59103 810431595 501(C)(3) 17500 0 SUPPORT COMMUNITY HEALTH ROCKY MOUNTAIN COLLEGE 1511 POLY DR BILLINGS MT 59102 810235407 501(C)(3) 13250 0 SPONSORSHIP AMERICAN CANCER SOCIETY 1903 CENTRAL AVE BILLINGS MT 59102 131788491 501(C)(3) 12500 0 PROGRAM SUPPORT BILLINGS CHAMBER OF COMMERCE 815 S 27TH ST BILLINGS MT 59101 810111570 501(C)(6) 11000 0 SPONSORSHIP BIG SKY ECONOMIC DEVELOPMENT CORPORATION 201 BROADWATER AVE BILLINGS MT 59101 223880639 501(C)(3) 10000 0 PROGRAM SUPPORT BILLINGS COMMUNITY FOUNDATION 404 N 30TH STREET BILLINGS MT 59101 204286919 501(C)(3) 10000 0 PROGRAM SUPPORT EDUCATION FOUNDATION FOR BILLINGS PUBLIC SCHOOLS 415 N 30TH STREET BILLINGS MT 59101 810452904 501(C)(3) 10000 0 SPONSORSHIP NATIONAL MULTIPLE SCLEROSIS SOCIETY 900 S BROADWAY SUITE 200 DENVER CO 80209 135661935 501(C)(3) 8000 0 SPONSORSHIP BILLINGS FAMILY YMCA INC 402 NORTH 32ND STREET BILLINGS MT 59101 810229386 501(C)(3) 7500 0 PROGRAM SUPPORT ST JOHNS FOUNDATION 3940 RIMROCK RD BILLINGS MT 59102 810459472 501(C)(3) 7500 0 PROGRAM SUPPORT GALLATIN VALLEY YOUNG MENS CHRISTIAN ASSOCIATION INC 3673 LOVE LANE BOZEMAN MT 59718 810542574 501(C)(3) 7000 0 PROGRAM SUPPORT AMERICAN FOUNDATION FOR SUICIDE PREVENTION 199 WATER STREET 11TH FLOOR NEW YORK NY 10038 133393329 501(C)(3) 6750 0 PROGRAM SUPPORT ST JAMES HEALTHCARE FOUNDATION INC 400 SOUTH CLARK ST BUTTE MT 59701 651202190 501(C)(3) 6500 0 PROGRAM SUPPORT BILLINGS SYMPHONY SOCIETY 2820 2ND AVE N BILLINGS MT 59102 237083873 501(C)(3) 6500 0 PROGRAM SUPPORT 19 1 PART I, LINE 2: MISSION FUND POLICIES ST VINCENT HEALTHCARE PROVIDES A LIMITED NUMBER OF GRANTS TO IMPROVE THE HEALTH AND WELL-BEING OF THE PEOPLE IN OUR COMMUNITY. GUIDED BY HOSPITAL POLICY, MISSION FUND AWARD PROJECTS MUST: (1) DEMONSTRATE A COMMITTMENT TO THE SCL HEALTH - MONTANA MISSION, VISION, AND VALUES; (2) MEET CRITERIA FOR INCLUSION IN THE COMMUNITY BENEFIT REPORT; AND (3) DOCUMENT MEASURABLE OUTCOMES THAT DEMONSTRATE THE SUCCESS OF THE PROJECT. PREFERENCE WILL BE GIVEN WHEN THE PROJECT CAN: (1) ADDRESS CREATIVELY THE UNMET NEEDS OF THE ECONOMICALLY DISADVANTAGED; (2) FORM COLLABORATIVE PARTNERSHIPS THAT IMPROVE THE HEALTH OF THE COMMUNITY; (3) AID A SIGNIFICANT POPULATION OF THE POOR, UNDERSERVED AND/OR UNINSURED; (4) REFLECT ST VINCENT HEALTHCARE'S ANNUAL AND STRATEGIC GOALS; AND (5) DEMONSTRATE THE POSSIBILITY FOR SUSTAINABILITY BEYOND THE GRANT PERIOD. APPLICATIONS ARE REVIEWED ON AN ANNUAL BASIS BY COMMITTEE. GRANTEES ARE REQUIRED TO PROVIDE A 6-MONTH AND 1-YEAR REPORT TO ST VINCENT HEALTHCARE AND PROVIDE FOR AN ON-SITE VISIT OF THE PROGRAM. AS NOTED IN THE MISSION FUND APPLICATION, IF FUNDS ARE USED OUTSIDE OF PROJECT GUIDELINES THE GRANTEE MAY BE ASKED TO REIMBURSE ST VINCENT HEALTHCARE FOR FUNDS ALREADY DISTRIBUTED FOR THE PROJECT. 1 1 0 0 0 0 0 0 0 YEVGENIY AREFIEV FORMER HIGHEST COMPENSATED 0 499838 0 626774 0 23900 0 13200 0 37583 0 1201295 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 RICHARDS FORMER HIGHEST COMPENSATED 0 658834 0 6652 0 3391 0 14278 0 24109 0 707264 0 0 CHRISTOFFER SPOJA VP CHIEF MEDICAL OFF. SVB (PARTIAL) 366167 0 56508 0 2618 0 224734 0 29527 0 679554 0 56508 0 JAMES RITCHEY FORMER KEY EMPLOYEE 0 327797 0 62403 0 44221 0 150869 0 30210 0 615500 0 73082 MICHAEL BUSH FORMER KEY EMPLOYEE 0 313152 0 48455 0 53058 0 165638 0 24291 0 604594 0 48455 RONALD SNYDER FORMER HIGHEST COMPENSATED 0 503094 0 20000 0 7209 0 14714 0 31346 0 576363 0 0 DANIEL LEWIS FORMER HIGHEST COMPENSATED 0 422741 0 82535 0 6088 0 14196 0 30694 0 556254 0 0 TRENT MIHALICK FORMER HIGHEST COMPENSATED 0 494027 0 0 0 8662 0 14353 0 31545 0 548587 0 0 SHELDON NELSON FORMER HIGHEST COMPENSATED 0 314402 0 175346 0 4988 0 14163 0 31210 0 540109 0 0 PAMELA PALAGI VP FINANCE REGION MT 309390 0 47018 0 29612 0 137628 0 10735 0 534383 0 74294 0 FRANK LAMM FORMER HIGHEST COMPENSATED 0 454702 0 0 0 8150 0 14353 0 34564 0 511769 0 0 EDEN JONES FORMER HIGHEST COMPENSATED 0 426113 0 20000 0 24930 0 14177 0 13739 0 498959 0 0 EDWIN RODRIGUEZ FORMER HIGHEST COMPENSATED 0 364429 0 62290 0 6260 0 14253 0 30936 0 478168 0 0 RICHARD LAMMERS FORMER HIGHEST COMPENSATED 0 342451 0 81401 0 1526 0 13909 0 32941 0 472228 0 0 MELISSA FILTER VP CHIEF NURSING OFFICER SVB 242036 0 36796 0 2164 0 128473 0 19364 0 428833 0 36796 0 MARJORIE TEVLIN FORMER HIGHEST COMPENSATED 0 350542 0 0 0 6841 0 14053 0 31346 0 402782 0 0 ADAM SCHAFER VP NETWORK DEVELOPMENT REGION MT 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 REGION MT 183426 0 28674 0 15888 0 85749 0 25814 0 339551 0 42913 0 KRIKOR JANSEZIAN FORMER KEY EMPLOYEE 0 0 0 0 0 313266 0 0 0 16568 0 329834 0 0 DUSTIN STRANDELL DIRECTOR SENIOR SVC LINES 196885 0 15178 0 911 0 60242 0 19849 0 293065 0 15178 0 HEATHER BRENDEN SENIOR DIRECTOR HR BUSINESS PARTNER 205830 0 18305 0 967 0 43727 0 19228 0 288057 0 15805 0 JACQUELINE HINES DIRECTOR SENIOR SURG AND PROCEDURAL 196784 0 13970 0 846 0 55832 0 15053 0 282485 0 13970 0 JOELLEN MAURER DIRECTOR PHARMACY 205472 0 17320 0 1486 0 34080 0 14536 0 272894 0 15820 0 HEATHER STAMEY DIRECTOR SENIOR EMERGENCY AND CRITIC 168777 0 11793 0 656 0 53091 0 21866 0 256183 0 11793 0 JENNY PAULSON RN SHIFT COORDINATOR 206548 0 2045 0 940 0 9189 0 865 0 219587 0 0 0 PART I, LINE 3 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. 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. THE BOARD PLACES A HIGH PRIORITY ON THE NEED TO RECURIT AND RETAIN A STRONG LEADERSHIP TEAM AND TO CREATE A HIGHLY MOTIVATED AND ENGAGED WORKFORCE. COMPENSATION LEVELS FOLLOW IRS GUIDELINES AND ARE SUBJECT TO IRS OVERSIGHT. 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, LINES 4A-B PART I, LINE 4A SEVERANCE PAYMENTS THE ORGANIZATION AND RELATED ORGANIZATIONS PERIODICALLY INCUR SEVERANCE PAYMENTS TO DEPARTING EMPLOYEES. THE INDIVIDUALS AND THE AMOUNTS PAID FOR SEVERANCE IN 2023 WERE: KRIKOR JANSEZIAN - $306,324. PART I, LINE 4B PAYMENTS FROM A SUPPLEMENTAL NONQUALIFIED RETIREMENT PLAN 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; TRACY NEARY - $14,239; MICHAEL BUSH - $46,411; 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. CHRISTOPHER EDWARDS BOARD SEE PART V 3324049 BUSINESS 0 SCH L, PART IV, BUSINESS TRANSACTIONS INVOLVING INTERESTED PERSONS: CHRISTOPHER EDWARDS (BOARD MEMBER) OWNS GREATER THAN 35% OF EDWARDS JET CENTER, WHOM SCH HEALTH - MONTANA DOES BUSINESS WITH. FORM 990, LINE J WEBSITE: HTTPS://INTERMOUNTAINHEALTHCARE.ORG/LOCATIONS/INTERMOUNTAIN-HEALTH- ST-VINCENT-REGIONAL-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 6 SISTERS OF CHARITY OF LEAVENWORTH HEALTH SYSTEM, INC. IS THE SOLE MEMBER OF SCL HEALTH - MONTANA. FORM 990, PART VI, SECTION A, LINE 7A SISTERS OF CHARITY OF LEAVENWORTH HEALTH SYSTEM, INC., THE SOLE MEMBER OF SCL HEALTH - MONTANA, HAS THE POWER TO APPOINT MEMBERS OF THE SCL HEALTH - MONTANA BOARD OF DIRECTORS, SUBJECT TO THE RATIFICATION BY THE BOARD OF INTERMOUNTAIN HEALTH CARE, INC. FORM 990, PART VI, SECTION A, LINE 7B WHILE SISTERS OF CHARITY OF LEAVENWORTH HEALTH SYSTEM, INC. (SCLHS) IS THE SOLE MEMEBER OF SCL HEALTH - MONTANA , 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 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 MONITORING AND ENFORCEMENT OF COMPLIANCE WITH CONFLICT OF INTEREST POLICY 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 THE ORGANIZATION MAKES ITS CONFLICT OF INTEREST POLICY, FINANCIAL STATEMENTS, AND GOVERNING DOCUMENTS AVAILABLE UPON REQUEST. FORM 990, PART IX, LINE 11G PROFESSIONAL MEDICAL SERVICES: PROGRAM SERVICE EXPENSES 36,719,148. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 36,719,148. PHYSICIAN MANAGEMENT SERVICES: PROGRAM SERVICE EXPENSES 75,774,485. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 75,774,485. OUTSIDE LABORATORY FEES: PROGRAM SERVICE EXPENSES 5,326,140. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 5,326,140. PROFESSIONAL CONSULTING SERVICES: PROGRAM SERVICE EXPENSES 3,872. MANAGEMENT AND GENERAL EXPENSES 314,540. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 318,412. FORM 990, PART XI, LINE 9: ASBESTOS LIABILITY -2,300,000. TRANSFERS TO SUBSIDIARIES -1,204,230. FAIR VALUE ACQUISITION ADJUSTMENT -5,750,886. 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