2025-11-03T10:48:13-06:00 2024-12-31 990 2024-01-01 237001007 ST MARY'S HOSPITAL FOUNDATION STMA 8018427851 2635 N 7TH STREET GRAND JUNCTION CO 81501 CARMEN SHIPLEY EXECUTIVE DIRECTOR 8018427851 2025-11-03 0 2024 2025-03-06 01:10:19Z CARMEN SHIPLEY 2635 N 7TH STREET GRAND JUNCTION CO 81501 8842644 0 0928 X SEE SCHEDULE "O" FOR WEBSITE ADDRESS X 1967 CO 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.ST. MARY'S HOSPITAL FOUNDATION WEBSITE ADDRESS:HTTPS://INTERMOUNTAINHEALTHCARE.ORG/GIVE/ST-MARYS-FOUNDATION 23 20 0 68 0 0 5257463 4417846 0 0 462353 4330569 -53852 -54879 5665964 8693536 4137128 2843029 0 0 589252 533494 0 0 321287 555977 477332 5282357 3853855 383607 4839681 22081535 24141044 985066 694946 21096469 23446098 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 2975454 2843029 0 THE PROMISE OF HEALTHCARE PHILANTHROPY IS THE ABILITY TO CHANGE LIVES AND THE POWER TO SAVE LIVES. THE ST. MARY'S HOSPITAL FOUNDATION DEVELOPS THE RESOURCES THAT HELP KEEP AND EXPAND THIS PROMISE TO THE PEOPLE WHO TRUST ST. MARY'S REGIONAL HOSPITAL TO CARE FOR THEM. IT IS COMMITTED TO ADVANCING THE PROMISE OF LIFE THROUGH PHILANTHROPY. THE FOUNDATION'S FUNDRAISING EFFORTS ENSURE THAT THE HOSPITAL IS ABLE TO MEET THE COMMUNITY'S HEALTHCARE NEEDS NOW AND IN THE FUTURE. ST. MARY'S HOSPITAL FOUNDATION WAS PART OF THE SISTERS OF CHARITY OF LEAVENWORTH HEALTH SYSTEM. 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, AND WYOMING. THE ORGANIZATION EMPLOYS MORE THAN 68,000 CAREGIVERS, OPERATES 33 HOSPITALS (INCLUDING ONE VIRTUAL HOSPITAL), AND RUNS HUNDREDS OF CLINICS, WHILE PROVIDING HEALTH INSURANCE TO OVER ONE MILLION PEOPLE IN UTAH AND IDAHO.AS PART OF INTERMOUNTAIN HEALTHCARE, ST. MARY'S HOSPITAL FOUNDATION HAS DIRECT ACCESS TO BEST PRACTICES, RESOURCES, TECHNOLOGY, TALENT AND STRATEGIC CAPITAL.MAJOR AREAS OF SUPPORT DURING THE YEAR INCLUDED:ROSE HILL HOSPITALITY HOUSE ROSE HILL HOUSE REFLECTS THE COMPASSION AND GENEROSITY OF OUR COMMUNITY BY PROVIDING A FREE, COMFORTABLE, HOME-LIKE SETTING WHERE FAMILIES CAN HAVE A REST FROM THE OFTEN CRITICAL CONCERNS ASSOCIATED WITH THE HEALTH OF A LOVED ONE. PATIENTS COME TO ST. MARY'S FROM MANY DISTANT PLACES TO RECEIVE MEDICAL ASSISTANCE OFTEN NOT AVAILABLE OUTSIDE OF GRAND JUNCTION. ST. MARY'S HOSPITAL FOUNDATION RECOGNIZES THE IMPORTANCE OF MEETING THE NEEDS OF FAMILY AND FRIENDS SUPPORTING A LOVED ONE IN THE HEALING PROCESS. CANCER ASSISTANCE FUND THE ST. MARY'S HOSPITAL FOUNDATION ALSO FINANCIALLY SUPPORTS ST. MARY'S CANCER PROGRAMS. ST. MARY'S IS PROUD TO OFFER A COMPREHENSIVE CANCER PROGRAM FOR PATIENTS FROM DIAGNOSIS, THROUGH TREATMENT, AND BEYOND. AS HEALTHCARE CHANGES, WE HAVE IDENTIFIED THE NEED FOR NOT ONLY PREVENTATIVE MEDICINE, BUT TO PROVIDE HOLISTIC CARE TO OUR PATIENTS. THE CANCER ASSISTANCE FUND PROVIDES RESOURCES TO EDUCATE, SUPPORT, AND EMPOWER THOSE AFFECTED BY CANCER TO TAKE CHARGE OF THEIR HEALTH SO THEY CAN TRULY THRIVE AND SUPPORTS THE PHYSICAL, EMOTIONAL, SOCIAL, SPIRITUAL, AND ECONOMIC ASPECTS OF THEIR CANCER JOURNEY. MEALS ON WHEELS OF MESA COUNTYST. MARY'S HOSPITAL FOUNDATION IS PROUD TO SPONSOR THE MEALS ON WHEELS PROGRAM OF MESA COUNTY. THE ST. MARY'S FOUNDATION RAISES FUNDS TO SUPPORT MEALS ON WHEELS MESA COUNTY, A HOSPITAL AND GOVERNMENT SPONSORED PROGRAM TO PROVIDE NOURISHING MEALS TO THE HOMEBOUND AND TO OTHERS THAT ARE IN NEED. PROGRAM REVENUE ASSOCIATED WITH THE PROGRAM REPRESENTS A VOLUNTARY CO-PAYMENT FOR THE MEALS AND IS NOT A REQUIREMENT FOR RECEIVING A MEAL.CARING FOR THE CAREGIVERAT ST. MARY'S REGIONAL HOSPITAL, OUR CAREGIVERS ARE OUR MOST VALUABLE ASSET. THE FOUNDATION RAISES FUNDS THROUGH THE CARING FOR THE CAREGIVER FUND THAT SUPPORTS THE WELL-BEING OF OUR CAREGIVERS THROUGH EUDCATION, SOCIAL SUPPORT, SELF-CARE ACTIVITIES, AND MEANINGFUL RECOGNITION AND IS AN IMPORTANT FOCUS OF ST. MARY'S FOUNDATION. TO ENHANCE AND SUSTAIN THE HEALTH AND WELL-BEING OF OUR CLINICAL WORKFORCE, THE FOUNDATION CREATED THIS FUND AS A RESOURCE FOR CLINICAL LEADERS TO DEVELOP CREATIVE SOLUTIONS TO PROMOTE CAREGIVER RELISIENCE AND REPLENISHMENT. K9 SECURITY PROGRAMST. MARY'S REGIONAL HOSPITAL, LIKE MANY OTHER HOSPITALS, HAS EXPERIENCED A SIGNIFICANT INCREASE IN VERBAL AND PHYSICAL WORKPLACE VIOLENCE INCIDENCES DIRECTED AGAINST HEALTH CARE WORKERS. THE ST. MARY'S HOSPITAL FOUNDATION SUPPORTS AN INNOVATIVE K-9 PROGRAM. THE K-9'S ARE TRAINED NOT ONLY TO PROTECT IN THREATENING SITUATIONS, BUT ALSO TO PROVIDE COMFORT AND EMOTIONAL SUPPORT FOR HEALTHCARE WORKERS, PATIENTS, THEIR FAMILIES, AND VISITORS. 2975454 1 1 0 0 0 0 0 0 0 1 0 0 0 0 1 0 0 1 0 0 0 0 0 0 1 1 0 1 1 1 0 0 0 0 0 0 0 0 1 0 0 0 0 1 1 1 0 0 1 X 0 0 0 0 0 0 0 0 1 1 0 0 0 0 0 0 X 23 20 1 0 0 0 1 1 1 1 1 0 0 1 1 1 1 1 1 0 0 0 X COLIN QUINCY 8014423491 36 SOUTH STATE STREET SUITE 1600 SALT LAKE CITY UT 84111 X BRYAN JOHNSON TRUSTEE/SMHMC CEO 1.00 57.00 X 0 789764 295366 ASHLEY THUROW TRUSTEE/SMHMC VP FINANCE (PARTIAL) 1.00 52.00 X 0 262401 29357 CARMEN SHIPLEY EXECUTIVE DIRECTOR 50.00 0.00 X X 0 165870 69606 VINCENT DONOHUE TRUSTEE/SMHMC VP FINANCE (PARTIAL) 1.00 50.00 X 0 44997 22365 KIM ALEXANDER TRUSTEE 1.00 0.00 X 0 0 0 MIKE BLACKBURN TRUSTEE 1.00 0.00 X 0 0 0 JOE BREMAN CHAIR 1.00 3.00 X X 0 0 0 CLARA BROWN SHAFFER VICE CHAIR 1.00 0.00 X X 0 0 0 NANCY CUMMINGS TRUSTEE 1.00 0.00 X 0 0 0 TYLER DAHL TRUSTEE 1.00 0.00 X 0 0 0 FRANK DESANTIS TRUSTEE 1.00 0.00 X 0 0 0 JEFF FUNDERBURK TRUSTEE 1.00 0.00 X 0 0 0 DAKOTA GRETT TRUSTEE 1.00 0.00 X 0 0 0 DAVE HUERKAMP TRUSTEE 1.00 0.00 X 0 0 0 SANDRA LEGG TRUSTEE 1.00 0.00 X 0 0 0 MARC MCATLIN TRUSTEE 1.00 0.00 X 0 0 0 KENDRA MCDANIEL SECRETARY 1.00 0.00 X X 0 0 0 JEN PEDERSON TRUSTEE 1.00 0.00 X 0 0 0 KERRY PHILLIPS TRUSTEE 1.00 0.00 X 0 0 0 ANTHONY RESTIVO TRUSTEE 1.00 0.00 X 0 0 0 MONIQUE SERRA TRUSTEE 1.00 0.00 X 0 0 0 JOSH SMITH TREASURER 1.00 0.00 X X 0 0 0 DUKE WORTMANN TRUSTEE 1.00 0.00 X 0 0 0 LEANN ZETMEIR TRUSTEE 1.00 0.00 X 0 0 0 0 1263032 416694 0 0 1 0 0 11614 143927 1090984 1349049 1822272 84057 4417846 407501 407501 3923068 0 3923068 3923068 3923068 74571 143927 137471 -62900 -62900 19658 11637 8021 8021 8693536 0 0 4275690 2828868 2828868 14161 14161 235478 23548 94191 117739 242772 24277 97109 121386 25166 2517 10066 12583 30078 3008 12031 15039 2258 2258 30690 30690 22421 9965 12456 174916 174916 13010 5782 7228 SHARED SERVICES - OTHER 88839 88839 BANK CHARGES 41659 33327 4166 4166 SHARED SVCS - RISK MGMT 35453 35453 FOOD - MEALS ON WHEELS 23700 23700 44386 22048 22338 3853855 2975454 557114 321287 1228400 948555 1929385 1889987 18923750 21302502 22081535 24141044 985066 694946 985066 694946 X 3463378 4586771 17633091 18859327 21096469 23446098 22081535 24141044 X 4839681 -2492080 7142 -5114 X 0 1 X 1 1 1 X X 1 ST MARY'S HOSPITAL & MEDICAL CENTER INC 840425720 3 1 2680400 0 1 2680400 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 17633091 3404255 958737 3136756 18859327 16103536 4419818 1051305 3941568 17633091 18258279 3651938 -1788101 4018580 16103536 17128359 3258508 1437882 3566470 18258279 16284424 3108968 1375860 3640893 17128359 0.00000 0.58400 0.41600 0 0 0 GIFT ANNUITIES 554566 INTERCOMPANY PAYABLES 140380 694946 PART V, LINE 4: THE FOUNDATION'S TEMPORARY ENDOWMENT FUNDS AND EARNINGS FROM THE PERMANENT ENDOWMENT FUNDS SUPPORT THE ST. MARY'S HOSPITAL IN AREAS INCLUDING ASSOCIATE EDUCATION, GREATEST NEED, MOM/BABY & PEDIATRICS, PATIENT EXPERIENCE, RESPIRATORY, AND OTHER SERVICES AND PROGRAMS. HIGHBALLS & HANDBAGS 26241 8324 17917 25 1610 7392 29 16645 ST. MARY'S BALL 192257 135603 56654 1572 13777 29281 4629 62511 218498 143927 74571 1597 15387 36673 4658 79156 137471 -62900 19658 1175 10239 223 1 1.00000 19658 1175 10239 223 11637 8021 CO 1 0 1 0 0.00000 1.00000 KITTY DEXTER 2635 N 7TH ST GRAND JUNCTION CO 81501 0 DEANNA COLAIZZI 0 MAKE SURE WE FOLLOW THE RAFFLE PROCEDURES DESIGNATED BY THE STATE X 1 8021 1 ST MARY'S HOSPITAL & MEDICAL CENTER INC 2635 N 7TH STREET GRAND JUNCTION CO 81501 840425720 501(C)(3) 2660971 0 SUPPORT MISSION SCL HEALTH RESEARCH INSTITUTE INC 500 ELDORADO BLVD SUITE 4300 BROOMFIELD CO 80021 852014794 501(C)(3) 134636 0 SUPPORT MISSION SISTERS OF CHARITY OF LEAVENWORTH HEALTH SYSTEM INC 500 ELDORADO BLVD SUITE 4300 BROOMFIELD CO 80021 237379161 501(C)(3) 8646 0 SUPPORT MISSION CAREFLIGHT OF THE ROCKIES LLC 500 ELDORADO BLVD SUITE 4300 BROOMFIELD CO 80021 473525381 LIMITED LIABILITY CO 19429 0 SUPPORT MISSION 3 1 HUMANITARIAN GRANT 5 3661 0 SCHOLARSHIPS 7 10500 0 PART I, LINE 2: UPON APPROVAL OF THE TRANSFER OF FUNDS FROM THE ST. MARY'S HOSPITAL FOUNDATION TO ST. MARY'S HOSPITAL & MEDICAL CENTER, INC., THE ST. MARY'S HOSPITAL FINANCE DEPARTMENT RECORDS THE FUNDS TO THE PROPER DEPARTMENT WITHIN THE HOSPITAL FOR USE AS AN OFFSET TO THE EXPENSES THAT HAVE BEEN INCURRED, OR TO CAPITAL. THE TRANSFERS ARE RECONCILED BETWEEN THE HOSPITAL AND THE FOUNDATION QUARTERLY. THE RECONCILIATIONS ARE REVIEWED BY MANAGERS AT THE HOSPITAL AND SYSTEM OFFICE. 0 1 0 0 0 0 0 0 0 BRYAN JOHNSON TRUSTEE/SMHMC CEO 0 554316 0 175097 0 60351 0 265522 0 29844 0 1085130 0 228386 ASHLEY THUROW TRUSTEE/SMHMC VP FINANCE (PARTIAL) 0 216179 0 45519 0 703 0 11067 0 18290 0 291758 0 45519 CARMEN SHIPLEY EXECUTIVE DIRECTOR 0 147288 0 16668 0 1914 0 37243 0 32363 0 235476 0 16668 PART I, LINE 3 COMPENSATION OF THE ORGANIZATION'S CEO/EXECUTIVE DIRECTOR THE FILING ORGANIZATION IS AN AFFILIATE OF INTERMOUNTAIN HEALTH, AN INTEGRATED HEALTH SYSTEM THAT IS NATIONALLY RECOGNIZED FOR PROVIDING QUALITY MEDICAL CARE THAT RANKS AMONG THE HIGHEST IN THE NATION WITH CHARGES THAT ARE AMONG THE LOWEST IN THE NATION. INTERMOUNTAIN HEALTH'S POLICY IS TO COMPENSATE ITS EMPLOYEES, INCLUDING SENIOR MANAGEMENT, AT MARKET COMPETITIVE RATES. THE ORGANIZATION'S OFFICERS AND SENIOR MANAGEMENT ARE PAID BY A RELATED ORGANIZATION, ST. MARY'S HOSPITAL & MEDICAL CENTER, INC. COMPENSATION FOR THE OFFICERS AND SENIOR MANAGEMENT IS MANAGED BY THE INTERMOUNTAIN HEALTH CARE, INC. BOARD COMPENSATION COMMITTEE (COMMITTEE) ON BEHALF OF SISTERS OF CHARITY OF LEAVENWORTH HEALTHY SYSYTEM, INC. AND ALL OF ITS AFFILIATES. THE COMPENSATION COMMITTEE OF THE BOARD OF INTERMOUNTAIN HEALTH CARE, INC. (PARENT ORGANIZATION) RETAINS OUTSIDE CONSULTANTS TO PROVIDE OBJECTIVE DATA ON COMPENSATION LEVELS AND PRACTICES. THE COMMITTEE ANNUALLY ANALYZES THIS DATA AND MAKES COMPENSATION DECISIONS, WHICH ARE REVIEWED BY THE FULL BOARD OF TRUSTEES. THE BOARD PLACES A HIGH PRIORITY ON THE NEED TO RECRUIT AND RETAIN A STRONG LEADERSHIP TEAM AND TO CREATE A HIGHLY MOTIVATED AND ENGAGED WORKFORCE TO DRIVE SUPERIOR ORGANIZATIONAL PERFORMANCE TO BECOME A TOP-TIER INTEGRATED HEALTHCARE DELIVERY SYSTEM. COMPENSATION LEVELS FOLLOW IRS GUIDELINES AND ARE SUBJECT TO IRS OVERSIGHT. A PORTION OF THE COMPENSATION REPORTED ON THIS FORM REFLECTS DEFERRED AMOUNTS THAT ARE NOT VESTED, ARE SUBJECT TO A SUBSTANTIAL RISK OF FORFEITURE, AND MAY OR MAY NOT BE PAID IN THE FUTURE. THE REPORTABLE COMPENSATION ON SCHEDULE J INCLUDES CERTAIN AMOUNTS THAT HAVE BEEN OR WILL BE REPORTED TWICE, BOTH IN THE YEAR ACCRUED AND AGAIN IN THE YEAR PAID, AS REQUIRED IN THE REPORTING SCHEDULE INSTRUCTIONS. PART I, LINE 4B PAYMENTS FROM A SUPPLEMENTAL NONQUALIFIED RETIREMENT PLAN A RELATED ORGANIZATION PROVIDES A NONQUALIFIED DEFERRED COMPENSATION PLAN (NQDC) KNOWN AS THE SUPPLEMENTAL EXECUTIVE RETIREMENT PROGRAM (SERP) FOR EXECUTIVES (SENIOR MANAGEMENT) TO COMPENSATE FOR REGULATORY IMPOSED LIMITATIONS IN QUALIFIED RETIREMENT PLANS AND TO PROVIDE A BENEFIT CONSISTENT WITH OTHER NONPROFIT HEALTH SYSTEMS. THIS PLAN ENABLES THE EXECUTIVE TO EARN BENEFITS DURING EACH YEAR OF PARTICIPATION. 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 PLAN 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 A 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 2024. 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 PARTICIPANTS' W-2. THE AMOUNTS WITHDRAWN FROM THE NQDC SERP PLANS IN 2024 WERE: BRYAN JOHNSON - $56,888. ADDITIONAL OFFICER AND BOARD DISCLOSURES: THE SISTERS WHO SERVE AS OFFICERS AND/OR BOARD MEMBERS ARE MEMBERS OF THE SISTERS OF CHARITY OF LEAVENWORTH (A RELIGIOUS ORDER OF WOMEN). THE SISTERS HAVE TAKEN VOWS OF POVERTY AND RECEIVE NO COMPENSATION, EXPENSE ACCOUNT ALLOWANCE, OR CONTRIBUTIONS TO BENEFIT PLANS FOR THEIR SERVICES TO THE HEALTH SYSTEM. HOWEVER, A PAYMENT IS MADE DIRECTLY TO THE SISTERS OF CHARITY OF LEAVENWORTH FOR THE SERVICES OF THOSE WHO PERFORM PROFESSIONAL, ADMINISTRATIVE, AND OTHER SUCH SERVICES. X 1 50375 STOCK QUOTE X EVENT ITEMS 163 33682 FMV 0 1 0 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 V, LINE 2A EXPLANATION FOR NUMBER REPORTED ON FORM W-3: THE ORGANIZATION LEASES EMPLOYEES FROM A RELATED 501(C)(3) TAX-EXEMPT ORGANIZATION. THE RELATED ORGANIZATION FILES THE REQUIRED W-3 AND RELATED W-2 TAX FORMS FOR THESE INDIVIDUALS. ACCORDING TO THE FORM 990 INSTRUCTIONS FOR PART IX, WE REFLECT THE LEASED EMPLOYEE'S COMPENSATION ON THE FORM 990, PART IX AS IF THE ORGANIZATION COMPENSATES THESE INDIVIDUALS. FORM 990, PART VI, SECTION A, LINE 2 ASHELY THUROW / BRYAN JOHNSON / CARMEN SHIPLEY - BUSINESS RELATIONSHIP (EMPLOYER/EMPLOYEE RELATIONSHIP IN ST. MARY'S HOSPITAL AND MEDICAL CENTER, INC., A RELATED TAX-EXEMPT ORGANIZATION). ANTHONY RESTIVO / CARMEN SHIPLEY - BUSINESS RELATIONSHIP. FORM 990, PART VI, SECTION A, LINE 6 MEMBERS OR STOCKHOLDERS ST. MARY'S HOSPITAL & MEDICAL CENTER, INC., (SMHMC) IS THE SOLE MEMBER OF ST. MARY'S HOSPITAL FOUNDATION. FORM 990, PART VI, SECTION A, LINE 7A POWER TO ELECT OR APPOINT MEMBERS ST. MARY'S HOSPITAL & MEDICAL CENTER, INC., THE SOLE MEMBER OF ST. MARY'S HOSPITAL FOUNDATION, APPROVES TRUSTEES OF ST. MARY'S HOSPITAL FOUNDATION BOARD OF TRUSTEES. FORM 990, PART VI, SECTION A, LINE 7B DECISIONS RESERVED TO MEMBERS OR STOCKHOLDERS ST. MARY'S HOSPITAL & MEDICAL CENTER, INC. HAS CERTAIN RESERVE POWERS TO APPROVE CHANGES TO THE ARTICLES OF INCORPORATION AND THE BYLAWS INCLUDING THE APPOINTMENT OR REMOVAL OF TRUSTEES AND THE PRESIDENT/CEO. SISTERS OF CHARITY OF LEAVENWORTH HEALTH SYSTEM, INC. ALSO HAS CERTAIN RESERVE POWERS OVER ANY CHANGE IN OWNERSHIP OF THE CORPORATION, CHANGE IN MISSION, ACQUISITION OF ASSETS, DISPOSAL OF ASSETS, LEASING OF ASSETS, INCURRENCE OF DEBT, MERGER OR DISSOLUTION, APPROVAL OF STRATEGIC PLANS AND BUDGETS, APPOINTMENT OF AUDITORS AND OVERSIGHT AND APPROVAL OF COMPENSATION AND BENEFITS FOR TRUSTEES, OFFICERS, KEY EMPLOYEES AND PHYSICIANS. FORM 990, PART VI, SECTION B, LINE 11B PROCESS USED TO REVIEW THE FORM 990 THE FORM 990 IS PREPARED BY THE TAX DEPARTMENT OF INTERMOUNTAIN HEALTH CARE, INC. AND SUBSIDIARIES. THE DRAFT FORM 990 IS REVIEWED BY CERTAIN MEMBERS OF SENIOR MANAGEMENT. A COPY OF THE FINAL FORM 990 IS PROVIDED TO THE BOARD OF DIRECTORS PRIOR TO THE FILING WITH THE INTERNAL REVENUE SERVICE. FORM 990, PART VI, SECTION B, LINE 12C 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 COMPENSATION COMMITTEE ("COMPENSATION COMMITTEE"), A SUBSET OF INTERMOUNTAIN HEALTH CARE, INC.'S GOVERNING BODY (A RELATED NONPROFIT ORGANIZATION), IS RESPONSIBLE FOR THE PROCESS OF ANNUALLY DETERMINING THE TOTAL COMPENSATION PACKAGES (INCLUDING CASH AND NONCASH BENEFITS) FOR THE FOLLOWING OFFICERS: - CHIEF EXECUTIVE OFFICER - EXECUTIVE DIRECTOR THE COMPENSATION COMMITTEE ANNUALLY RETAINS AN INDEPENDENT, EXTERNAL CONSULTING FIRM TO PROVIDE AN ANALYSIS OF COMPARABLE MARKET DATA. THE CONSULTANTS REVIEW THE VARIOUS TYPES OF DIRECT COMPENSATION, INCLUDING BASE SALARY, TOTAL CASH, AND ANNUAL AND LONG-TERM INCENTIVES. INFORMATION FROM A SELECTED GROUP OF COMPARABLE NONPROFIT ORGANIZATIONS IS USED TO SUPPLEMENT PUBLISHED SURVEY DATA. THE CONSULTANTS ALSO CONDUCT AN IN-DEPTH ANALYSIS OF THE ASSOCIATED BENEFITS AND PERQUISITES. INFORMATION PROVIDED BY THE EXTERNAL CONSULTANTS IS REVIEWED BY THE COMPENSATION COMMITTEE ALONG WITH THE PERFORMANCE DATA FOR EACH OFFICER LISTED ABOVE. DECISIONS BY THE COMPENSATION COMMITTEE ARE CONTEMPORANEOUSLY DOCUMENTED. THE COMPENSATION COMMITTEE PRESENTS THE COLLECTED INFORMATION AND THE ASSOCIATED COMPENSATION DECISIONS TO THE ENTIRE BOARD OF TRUSTEES. THE PHILOSOPHY IS TO PAY COMPENSATION AT MARKET COMPETITIVE RATES. THE DETERMINATION OF EXECUTIVE COMPENSATION IS ALSO DESIGNED TO MEET THE "REBUTTABLE PRESUMPTION OF REASONABLENESS" STANDARD AS OUTLINED IN THE TREASURY REGULATIONS. FORM 990, PART VI, SECTION C, LINE 19 AVAILABILITY OF GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS AVAILABLE TO THE PUBLIC ST. MARY'S HOSPITAL FOUNDATION DOES NOT CURRENTLY ALLOW PUBLIC INSPECTION OF ITS GOVERNING DOCUMENTS OR CONFLICT OF INTEREST POLICY. THE CONSOLIDATED FINANCIAL STATEMENTS ARE AVAILABLE TO THE PUBLIC ON THE ELECTRONIC MUNICIPAL MARKET ACCESS WEBSITE (HTTPS://EMMA.MSRB.ORG/P11734936-P11333642-P11768080.PDF), A SERVICE PROVIDED BY THE MUNICIPAL SECURITIES RULEMAKING BOARD. FORM 990, PART VII, SECTION B INDEPENDENT CONTRACTORS: THE ORGANIZATION'S EXPENSES ARE PAID BY A RELATED 501(C)(3) TAX-EXEMPT ORGANIZATION. THE RELATED ORGANIZATION FILES THE REQUIRED FORM 1096 AND RELATED 1099 TAX FORMS FOR ANY EXPENDITURE THAT REQUIRES A FORM 1099 TO BE FILED. FORM 990, PART XI, LINE 9: CHANGE IN VALUE SPLIT - INT AGREEMENT 2,127. PV CONTRIBUTION ADJUSTMENT -7,241. 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