2026-04-01T17:54:27-05:00 2025-06-30 410746749 CLIFTONLARSONALLEN LLP 600 WASHINGTON AVENUE SUITE 1800 ST LOUIS MO 63101 990 2024-07-01 300975387 IVINSON MEMORIAL HOSPITAL IVIN 3077422141 255 NORTH 30TH STREET LARAMIE WY 82072 DOUG FAUS PRESIDENT & CEO 3077422141 2026-03-31 1 1 STEPHANIE MCCARTHY P01805699 3149254300 2026-03-31 2024 2025-03-06 01:10:19Z DOUG FAUS 255 NORTH 30TH STREET LARAMIE WY 82072 315981082 0 X WWW.IVINSONHOSPITAL.ORG X 2017 WY TRUSTED PARTNERS IN WORLD-CLASS HEALTHCARE. 14 13 797 45 0 0 5110136 7221296 146585633 165961723 8623229 15958664 1289370 1410668 161608368 190552351 1642924 3837405 0 0 59738731 62922006 0 0 330778 71283276 78165037 132664931 144924448 28943437 45627903 417938891 468345646 24818893 25322886 393119998 443022760 X TRUSTED PARTNERS IN WORLD-CLASS HEALTHCARE. BUILDING TRUST WITH OUR PATIENTS AND WITH EACH OTHER. 0 0 122420835 3837405 166587931 IVINSON MEMORIAL HOSPITAL SERVES THE RESIDENTS OF ALBANY COUNTY, WYOMING AND THE SURROUNDING AREA. LARAMIE IS THE LARGEST CITY IN THE SERVICE AREA WITH A POPULATION OF APPROXIMATELY 32,000. THE SERVICES PROVIDED TO THE COMMUNITY ARE BEHAVIORAL HEALTH (INPATIENT), CARDIAC REHAB, CARDIOPULMONARY, CHAPLAIN, DIALYSIS, DISCHARGE PLANNING / SOCIAL SERVICES, EMERGENCY SERVICES, INFECTION CONTROL, INPATIENT ACUTE CARE, INTENSIVE CARE UNIT, IVINSON MEDICAL GROUP, LAB (ANATOMIC / CLINICAL), NUTRITIONAL COUNSELING, OB/GYN, ONCOLOGY, PEDIATRICS, PHARMACY, RADIATION THERAPY, RADIOLOGY / DIAGNOSTIC IMAGING, RADIOLOGY - MRI, RADIOLOGY - CT, RADIOLOGY - NUCLEAR MEDICINE, RADIOLOGY - MAMMOGRAPHY, REHAB - PHYSICAL / OCCUPATIONAL THERAPY, SLEEP LAB, SPEECH PATHOLOGY - INPATIENT (INCLUDING SWING BEDS)/ OUTPATIENT, SURGERY SERVICES, AND ULTRASOUND.FOR THE YEAR ENDED JUNE 30, 2025, IMH HAD THE FOLLOWING STATISTICS:ADMISSIONS - 2,098EMERGENCY VISITS - 12,686URGENT CARE - 7,305OUTPATIENT VISITS - 96,396CLINIC VISITS - 58,198IMH ALSO PROVIDED $3,837,405.00 IN CHARITY CARE FOR THE YEAR ENDED JUNE 30, 2025.IVINSON MEMORIAL HOSPITAL RECEIVED MULTIPLE AWARDS AND RECOGNITIONS DEMONSTRATING ITS COMMITMENT TO QUALITY CARE, OPERATIONAL EXCELLENCE AND COMMUNITY TRUST. NATIONALLY, THE HOSPITAL WAS NAMED ONE OF THE 313 QUIETEST HOSPITALS BY BECKER'S HOSPITAL REVIEW, BASED ON STANDARDIZED PATIENT SURVEY RESULTS REFLECTING SUPERIOR INPATIENT EXPERIENCE IN HOSPITAL QUIETNESS. IVINSON ALSO EARNED THE SUPPLY CHAINS OF DISTINCTION AWARD FROM GLOBAL HEALTHCARE EXCHANGE, RECOGNIZING OUTSTANDING PERFORMANCE AND INNOVATION IN HEALTHCARE SUPPLY CHAIN MANAGEMENT ACROSS NORTH AMERICA. IN ADDITION, THE HOSPITAL RECEIVED LABORATORY ACCREDITATION FROM THE JOINT COMMISSION, EARNING THE GOLD SEAL OF APPROVAL FOR MEETING RIGOROUS NATIONAL STANDARDS FOR QUALITY AND PATIENT SAFETY IN LABORATORY SERVICES, AND WAS RECOGNIZED AS A TOP 100 RURAL AND COMMUNITY HOSPITAL BY THE CHARTIS CENTER FOR RURAL HEALTH, HIGHLIGHTING EXCELLENCE IN CLINICAL AND OPERATIONAL PERFORMANCE. LOCALLY, IVINSON RECEIVED 2024 LARAMIE'S BEST OF THE BEST AWARDS IN THE FOLLOWING CATEGORIES: BEST AUDIOLOGY/HEARING CLINIC, BEST FAMILY PRACTICE, AND BEST WOMEN'S HEALTH SERVICES, AND IN 2025, IVINSON WAS NAMED BUSINESS OF THE YEAR BY THE LARAMIE CHAMBER BUSINESS ALLIANCE, CELEBRATING EXCELLENCE IN ENTREPRENEURSHIP, INNOVATION, AND COMMUNITY IMPACT. 122420835 1 1 0 1 0 0 0 0 0 0 1 1 0 1 1 1 0 1 0 0 0 0 0 0 0 0 1 1 0 1 1 0 0 0 0 0 0 0 0 0 0 0 0 0 1 1 1 0 0 1 100 0 1 797 1 0 0 0 0 0 0 0 0 0 0 0 0 X 14 13 0 1 0 0 0 0 1 1 1 0 0 1 1 1 1 1 1 1 1 0 X JAMES BANDS 3077554603 255 NORTH 30TH STREET LARAMIE WY 82072 BURK YOUNG MD PHYSICIAN 40.00 0.00 X 969207 0 59134 BAILEY JOHNSON MD PHYSICIAN 40.00 0.00 X 709223 0 37460 JOHN ULLRICH MD PHYSICIAN 40.00 0.00 X 519977 0 60986 GARY GRAHAM MD PHYSICIAN 40.00 0.00 X 491196 0 53078 ERIC UHLMAN MD PHYSICIAN 40.00 0.00 X 498591 0 29257 TERRY MOSS COO 40.00 0.00 X 310422 0 39243 JAMES BANDS CFO 23.00 1.00 X 213556 0 38432 SAGAN WHEELER CHRO 40.00 0.00 X 204538 0 43456 MARY PONCE CNO 40.00 0.00 X 144057 0 33889 DOUG FAUS CEO 40.00 0.00 X X 0 0 0 GARY CRUM CHAIR 3.00 0.00 X X 0 0 0 SHARON WEBER VICE CHAIR 3.00 0.00 X X 0 0 0 BRAD JACKSON - VICE CHAIR THEN DIRECTOR (AS OF JAN. 2025) 2.00 0.00 X X 0 0 0 PAM DUNNUCK TREASURER 3.00 0.00 X X 0 0 0 JACKIE GONZALES SECRETARY 3.00 0.00 X X 0 0 0 JOSEPH STEINER PAST CHAIR 3.00 0.00 X X 0 0 0 CATIE BALLARD DIRECTOR 2.00 0.00 X 0 0 0 STAN GUNSTREAM MD DIRECTOR 2.00 0.00 X 0 0 0 KEM KRUEGER DIRECTOR 2.00 0.00 X 0 0 0 RICK MELONE DIRECTOR 2.00 0.00 X 0 0 0 ROLF PETERSON DIRECTOR 2.00 0.00 X 0 0 0 JENNA SCOZZAFAVA DIRECTOR 2.00 0.00 X 0 0 0 SHERRILL SMITH DIRECTOR 2.00 0.00 X 0 0 0 4060767 0 394935 112 0 1 0 NCAP 3702 AUTOMATION WAY STE 103 FORT COLLINS CO 80525 ANESTHESIOLOGISTS 3817407 SUMMIT MEDICAL GROUP LLC 700 CENTRAL EXPRESSWAY S STE 400 ALLEN TX 75035 ED PHYSICIANS 959369 MBS LOCUMS 100 WEST CYPRESS CREEK RD STE 960 FORT LAUDERDALE FL 33309 TEMPORARY STAFFING 789594 WYOMING ONCOLOGY PROFESSIONALS 3773 SE WYOMING BLVD CASPER WY 82601 ONCOLOGY PHYSICIANS 389600 GEM CITY BONE & JOINT 1909 VISTA DR LARAMIE WY 82070 ORTHOPEDIC SURGEONS 330000 20 159140 7062156 7221296 PATIENT SERVICE REVENUES 621110 165961723 165961723 165961723 10141041 10141041 599488 0 599488 599488 599488 131186179 125368556 5817623 5817623 5817623 86895 60175 26720 26720 CAFETERIA 722310 654413 654413 MISCELLANEOUS INCOME 900099 130047 130047 784460 190552351 166587931 0 16743124 X 3837405 3837405 1609926 44486 1565440 48859944 43612247 4983513 264184 1683631 1513963 160505 9163 7410228 6563714 806737 39777 3358277 2916851 423772 17654 133012 133012 99881 99881 16960 16960 688751 688751 16461071 15704383 756688 549970 26386 523584 1933241 797385 1135856 2934069 1591649 1342420 2108607 129143 1979464 211141 115764 95377 3777 3777 6433998 3420328 3013670 1184169 1184169 MEDICAL SUPPLIES 32088117 29777737 2310380 BAD DEBT EXPENSE 11729764 11729764 FOOD 766836 352548 414288 REPAIRS & MAINTENANCE 472668 193428 279240 349005 93654 255351 144924448 122420835 22172835 330778 5686356 14149655 7007663 10107701 12467593 11088308 1661143 1718810 1452738 1466967 125137427 43690453 80472329 81446974 227287470 274722084 40386371 34915434 41517228 38729713 417938891 468345646 12130473 12213180 12282875 11677589 405545 1432117 24818893 25322886 X 325440100 380589570 67679898 62433190 393119998 443022760 417938891 468345646 X 45627903 8371079 -4096220 X X 0 1 X 1 1 1 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 0 0 0 0 0 0 0 0 0 0 0 0 1 16960 16960 0 PART II-B, LINE 1: IVINSON MEMORIAL HOSPITAL PAYS MEMBERSHIP DUES TO THE WYOMING HOSPITAL ASSOCIATION AND THE AMERICAN HOSPITAL ASSOCIATION. A PORTION OF THOSE DUES ARE USED BY THE ASSOCIATIONS TO LOBBY ON BEHALF OF THEIR MEMBERS FOR HEALTH-RELATED ISSUES, INCLUDING IVINSON MEMORIAL HOSPITAL. 45159000 8467313 36691687 43142539 8400222 34742317 36751840 26822918 9928922 84048 84048 81446974 REAL ESTATE AND HEDGE FUNDS 34915434 C 34915434 DUE FROM RELATED ORGANIZATION 12053000 BENEFICIAL INTEREST IN FOUNDATION 24962463 RIGHT-OF-USE ASSETS 1432117 DUE FROM THIRD PARTY PAYORS 282133 38729713 RIGHT-OF-USE LEASE LIABILITIES 1432117 1432117 X 178720728 8371079 1128975 295269 9795323 168925405 21626946 21626946 190552351 129536812 1128975 1014115 2143090 127393722 17530726 17530726 144924448 PART X, LINE 2: THE HOSPITAL IS ORGANIZED AS WYOMING NONPROFIT CORPORATIONS AND HAVE BEEN RECOGNIZED BY THE INTERNAL REVENUE SERVICE (IRS) AS EXEMPT FROM FEDERAL INCOME TAXES UNDER INTERNAL REVENUE CODE (IRC) SECTION 501(C)(3). THE HOSPITAL IS ANNUALLY REQUIRED TO FILE A RETURN OF ORGANIZATION EXEMPT FROM INCOME TAX (FORM 990) WITH THE IRS. IN ADDITION, THE HOSPITAL IS SUBJECT TO INCOME TAX ON NET INCOME THAT IS DERIVED FROM BUSINESS ACTIVITIES THAT ARE UNRELATED TO THEIR EXEMPT PURPOSE. THE HOSPITAL BELIEVES THAT THEY HAVE APPROPRIATE SUPPORT FOR ANY TAX POSITIONS TAKEN AFFECTING THEIR ANNUAL FILING REQUIREMENTS, AND AS SUCH, DO NOT HAVE ANY UNCERTAIN TAX POSITIONS THAT ARE MATERIAL TO THE CONSOLIDATED FINANCIAL STATEMENTS. THE HOSPITAL WOULD RECOGNIZE FUTURE ACCRUED INTEREST AND PENALTIES RELATED TO UNRECOGNIZED TAX BENEFITS AND LIABILITIES IN INCOME TAX EXPENSE IF SUCH INTEREST AND PENALTIES ARE INCURRED. PART XI, LINE 2D - OTHER ADJUSTMENTS: RELATED ORGANIZATION REVENUE 235,094. GIFT SHOP COST OF GOODS SOLD 60,175. PART XI, LINE 4B - OTHER ADJUSTMENTS: ELIMINATING ENTRIES 834,582. PROVISION FOR BAD DEBTS 11,729,764. CHARITY CARE REPORTED AS GRANTS 3,837,405. CHANGE IN BENEFICIAL INTEREST IN FOUNDATION 4,096,220. AMORTIZATION ON DONATED USE OF BUILDING 1,128,975. PART XII, LINE 2D - OTHER ADJUSTMENTS: GIFT SHOP COST OF GOODS SOLD 60,175. RELATED ORGANIZATION EXPENSES 953,940. PART XII, LINE 4B - OTHER ADJUSTMENTS: PROVISION FOR BAD DEBTS 11,729,764. CHARITY CARE REPORTED AS GRANTS 3,837,405. ELIMNATING ENTRIES 834,582. AMORTIZATION ON DONATED USE OF BUILDING 1,128,975. 1 1 X 1 X 1 X 1 1 1 0 0 1712110 1712110 0.01290 7412665 3322332 4090333 0.03070 9124775 3322332 5802443 0.04360 128686 128686 0.00100 1047978 1047978 0.00790 81456 81456 0.00060 1258120 1258120 0.00950 10382895 3322332 7060563 0.05310 0 12619 12619 0.00010 29072 29072 0.00020 0 12682 12682 0.00010 3103 3103 0.00000 0 246187 246187 0.00180 303663 303663 0.00220 1 11729764 1865032 34615778 115803290 -81187512 X 1 1 1 1 IVINSON MEMORIAL HOSPITAL 255 NORTH 30TH STREET LARAMIE WY 82072 WWW.IVINSONHOSPITAL.ORG 15271 X X X IVINSON MEMORIAL HOSPITAL 1 0 0 1 X X X X X X X X X 22 1 0 0 1 X HTTPS://WWW.IVINSONHOSPITAL.ORG/CHNA X X 1 22 1 HTTPS://WWW.IVINSONHOSPITAL.ORG/CHNA 0 1 X 150.000000000000 300.000000000000 X X X X X 1 1 X X X X 1 X WWW.IVINSONHOSPITAL.ORG/FINANCIAL-ASSISTANCE X WWW.IVINSONHOSPITAL.ORG/FINANCIAL-ASSISTANCE X WWW.IVINSONHOSPITAL.ORG/FINANCIAL-ASSISTANCE X X X X X X 1 X 0 X X X X 1 X 0 0 IVINSON MEMORIAL HOSPITAL PART V, SECTION B, LINE 5: IVINSON MEMORIAL HOSPITAL ENGAGED SUPPORT FROM UCHEALTH COMMUNITY HEALTH IMPROVEMENT TO ASSIST WITH THE DEVELOPMENT OF THE CHNA. A MULTI-PHASED APPROACH WAS USED TO IDENTIFY THE TOP HEALTH PRIORITIES FOR FUTURE IMPACT. BETWEEN NOVEMBER 2022 AND APRIL 2023, IVINSON CONDUCTED THE CHNA WHICH PROVIDED AN OPPORTUNITY FOR THE HOSPITAL TO ENGAGE PUBLIC HEALTH EXPERTS, MEDICAL PROVIDERS AND COMMUNITY STAKEHOLDERS IN A FORMAL PROCESS TO ENSURE THAT COMMUNITY BENEFIT PROGRAMS AND RESOURCES ARE FOCUSED ON SIGNIFICANT HEALTH NEEDS IDENTIFIED WITHIN THE COMMUNITY. THE PROCESS INCLUDED:1. A COMPREHENSIVE ANALYSIS OF LOCAL, STATE AND, WHERE AVAILABLE, NATIONAL POPULATION HEALTH INDICATORS.2. REQUISITION OF COMMUNITY INPUT ON LOCAL HEALTH ISSUES THROUGH A PUBLIC MEETING AND A WEB-BASED SURVEY.3. A WEB-BASED SURVEY DISTRIBUTED TO HEALTHCARE PROVIDERS AT IVINSON TO GATHER INPUT ON COMMUNITY HEALTH NEEDS. IVINSON MEMORIAL HOSPITAL PART V, SECTION B, LINE 7D: IVINSON OFFICIALS HAVE GONE TO MULTIPLE COMMUNITY MEETINGS, MEETING WITH LAW ENFORCEMENT, NONPROFITS AND OTHER LOCAL ORGANIZATIONS TO TALK ABOUT AND DISTRIBUTE IVINSON'S CHNA AND IMPLEMENTATION PLAN. IVINSON'S CHNA HAS ALSO BEEN PUBLICLY DISCUSSED IN LOCAL MEDIA WHEN TALKING ABOUT MENTAL HEALTH AND HAS BEEN LEVERAGED BY COMMUNITY PARTNERS TO DISCUSS COMMUNITY HEALTH NEEDS OF ALBANY COUNTY. IVINSON MEMORIAL HOSPITAL PART V, SECTION B, LINE 11: IVINSON CONTINUES TO ADDRESS THE SOCIAL AND ECONOMIC CONDITIONS THAT CONTRIBUTE TO HEALTH DISPARITIES IN ALBANY COUNTY. THROUGH COMMUNITY PARTNERSHIPS, CHNA-FUNDED PROGRAMS, AND DIRECT ENGAGEMENT BY HOSPITAL STAFF, IVINSON WORKED THROUGHOUT THE IMPLEMENTATION PERIOD TO IMPROVE ACCESS TO FOOD, HOUSING, TRANSPORTATION, CHILDCARE, AND OTHER BASIC NEEDS.FOOD INSECURITY AND ACCESS TO HEALTHY FOODS1. PARTICIPATED IN LOCAL FAIR TO FORK EFFORTS, PURCHASING ONE COW AND ONE PIG AT A COST OF $13,750 FROM THE ALBANY COUNTY JUNIOR FAIR AUCTION FOR COMMUNITY FOOD DISTRIBUTION. MEAT PROCESSING WAS COVERED BY THE WYOMING HUNGER INITIATIVE, AND IVINSON LEADERSHIP DELIVERED THE PROCESSED MEAT TO THE LARAMIE SOUP KITCHEN AND LARAMIE INTERFAITH.2. HOSTED A COMMUNITY MEAL-PACKING EVENT, PARTNERING WITH LOCAL ORGANIZATIONS AND USING LEADERSHIP VOLUNTEER TIME TO PACK 10,000 SHELF-STABLE MEALS.3. DONATED 25 TURKEYS AND ADDITIONAL HOLIDAY FOOD ITEMS TO THE LARAMIE SOUP KITCHEN FOR DISTRIBUTION.4. PROVIDED A $2,000 DONATION TO THE LARAMIE SOUP KITCHEN DURING ITS ANNUAL FUNDRAISING EVENT.5. DONATED 960 POUNDS OF SURPLUS FOOD FROM THE IVINSON KITCHEN TO LOCAL FOOD BANKS TO INCREASE ACCESS TO HEALTHY FOODS.6. PARTNERED WITH THE WYOMING HUNGER INITIATIVE AND ALBANY COUNTY SCHOOL DISTRICT TO SUPPORT PROVIDING FREE BREAKFAST AND LUNCH TO ALL STUDENTS.7. PROVIDED CHNA FUNDING TO LARAMIE INTERFAITH TO SUPPORT FOOD INSECURITY PROGRAMMING, HOUSING ASSISTANCE, AND CASE MANAGEMENT.8. HOSTED THE FEEDING LARAMIE VALLEY MOBILE MARKET WEEKLY AT THE HOSPITAL TO INCREASE ACCESS TO FRESH FRUITS AND VEGETABLES ON A SLIDING-SCALE BASIS.TRANSPORTATION INITIATIVES1. PROVIDED $15,000 IN CHNA-RESTRICTED FINANCIAL SUPPORT TO THE EPPSON CENTER FOR ITS SENIOR ASSISTED TRANSPORTATION SERVICES (SATS), REDUCING TRANSPORTATION BARRIERS FOR OLDER ADULTS.2. CONTINUED PARTNERSHIP WITH ANOTHER LOCAL NONPROFIT TO SUPPORT FREE TRANSPORTATION FOR ALBANY COUNTY RESIDENTS OF ALL AGES THROUGH CHNA FUNDING.CHILDCARE AND YOUTH SUPPORT1. PROVIDED CHNA FUNDING TO BIG BROTHERS BIG SISTERS TO SUPPORT AFTER-SCHOOL PROGRAMMING AND MENTORSHIP FOR SCHOOL-AGED CHILDREN.HOUSING INITIATIVES1. PARTICIPATED IN A LOCAL HOUSING COALITION WITH NONPROFITS, EDUCATION INSTITUTIONS AND CITY OFFICIALS TO IDENTIFY COMMUNITY HOUSING NEEDS AND SUPPORT EFFORTS TO EXPAND AFFORDABLE HOUSING OPTIONS.OTHER SOCIAL AND ECONOMIC INITIATIVES1. PARTNERED WITH THE DOWNTOWN CLINIC AND IVINSON PROVIDERS TO DELIVER $737,175 IN DONATED CARE TO UNINSURED AND UNDERINSURED PATIENTS.2. HOSTED AN ANNUAL PSA DAY, A FREE PROSTATE CANCER SCREENING EVENT IN PARTNERSHIP WITH WWAMI AND IVINSON CANCER CENTER STAFF. SIXTY-FIVE MEN RECEIVED SCREENING, AND FIVE ABNORMAL RESULTS WERE REFERRED FOR FOLLOW-UP CARE.3. PARTNERED WITH ALBANY COUNTY SCHOOL DISTRICT TO PROVIDE WATER BOTTLES TO 500 MIDDLE-SCHOOL STUDENTS AND OTHERS THROUGHOUT THE DISTRICT TO INCREASE AWARENESS OF HYDRATION AND ITS LINK TO HEALTH, LEARNING AND PERFORMANCE.4. SUPPORTED THE UNITED WAY OF ALBANY COUNTY AND 16 ASSOCIATED NONPROFIT ORGANIZATIONS BY HOSTING THE COMMUNITY CAMPAIGN KICK-OFF AND PLEDGING A $10,000 CONTRIBUTION. FUNDS SUPPORT PROGRAMS THAT ADDRESS HOUSING, FOOD SECURITY, ACCESS TO CARE, TRANSPORTATION, MENTAL HEALTH SERVICES, CHILDCARE, EDUCATION AND RELATED COMMUNITY RESOURCES.ADDRESSING BEHAVIORAL HEALTHIVINSON CONTINUES TO PRIORITIZE BEHAVIORAL HEALTH THROUGH PARTNERSHIPS, EDUCATION, CRISIS RESPONSE TRAINING, AND EXPANDED ACCESS TO MENTAL HEALTH RESOURCES.1. PARTNERED WITH ROBBIE'S HOUSE, A MENTAL-HEALTH CLUBHOUSE OFFERING COMMUNITY SUPPORT AND RESOURCES. CHNA FUNDING SUPPORTED EXPANSION OF THEIR SERVICES.2. PROVIDED CHNA FUNDING FOR A MENTAL-HEALTH WORKSHOP DESIGNED FOR FIRST RESPONDERS IN ALBANY COUNTY.3. PROVIDED $10,000 TO CATHEDRAL HOME TO SUPPORT ITS RESOURCE CENTER, OFFERING LOW-COST COUNSELING AND MENTAL-HEALTH SERVICES FOR YOUTH AND FAMILIES.4. PARTNERED WITH COMMUNITY ORGANIZATIONS AND LOCAL SCHOOLS TO IMPLEMENT THE JAE BOOTS FOR SENIORS' INITIATIVE, WHICH PROVIDES MENTAL-HEALTH AWARENESS AND SUICIDE-PREVENTION TOOLS TO HIGH SCHOOL SENIORS.5. HOSTED MULTIPLE WEEK-LONG CRISIS INTERVENTION TRAININGS (CITS) FOR LAW ENFORCEMENT. STAFF FROM THE EMERGENCY DEPARTMENT AND BEHAVIORAL HEALTH PARTICIPATED IN COURSE FACILITATION.6. OFFERED FREE QUESTION, PERSUADE, REFER (QPR) SUICIDE-PREVENTION TRAINING AT IVINSON, INCLUDING CLASSES CONDUCTED AT THE UNIVERSITY OF WYOMING AND WYOTECH. LAST FISCAL YEAR, 147 INDIVIDUALS COMPLETED QPR TRAINING.7. PARTNERED WITH UCHEALTH TO PROVIDE MENTAL-HEALTH TELEHEALTH EVALUATIONS FOR PATIENTS IN THE EMERGENCY DEPARTMENT; 91 PATIENTS WERE SEEN.8. COLLABORATED WITH ALBANY COUNTY ATTORNEY'S OFFICE, MENTAL HEALTH BOARD, LAW ENFORCEMENT AGENCIES, THE VOA AND UW PSYCHOLOGY DEPARTMENT ON EMERGENCY DETENTIONS, MENTAL-HEALTH RESPONSE AND COMMUNITY SAFETY EFFORTS. PART I, LINE 3C: TO QUALIFY FOR ASSISTANCE UNDER IVINSON MEMORIAL HOSPITAL'S FINANCIAL ASSISTANCE POLICY, AN INDIVIDUAL MUST BE UNINSURED, UNDERINSURED, INELIGIBLE FOR ANY GOVERNMENT HEALTH CARE BENEFIT PROGRAM, AND UNABLE TO PAY FOR EMERGENCY TREATMENT OR MEDICALLY NECESSARY CARE. THE FOLLOWING FACTORS ARE CONSIDERED IN DETERMINING THE AMOUNT OF FINANCIAL ASSISTANCE GRANTED:1. INDIVIDUAL OR FAMILY INCOME AND NET WORTH;2. EMPLOYMENT STATUS AND EARNING CAPACITY;3. FAMILY SIZE;4. OTHER FINANCIAL OBLIGATIONS; AND5. OTHER SOURCES OF PAYMENT FOR THE SERVICES RENDERED. PART I, LINE 7: THE FINANCIAL ASSISTANCE AND MEANS-TESTED GOVERNMENT PROGRAM EXPENSES WERE CALCULATED USING THE SCHEDULE H INSTRUCTIONS' WORKSHEETS TO CALCULATE A COST-TO-CHARGE RATIO, WHICH WAS THEN APPLIED TO TOTAL EXPENSES. COMMUNITY BENEFIT EXPENSE IS TRACKED BY PROGRAM THROUGHOUT THE YEAR AND APPLIES DIRECT COSTS INCLUDING SALARIES AND BENEFITS OF PAID STAFF PROVIDING COMMUNITY BENEFIT, AS WELL AS SUPPLIES AND EXPENSES EXPENDED BY IVINSON TO PROVIDE COMMUNITY BENEFIT. NEARLY ALL COMMUNITY BENEFIT PROGRAMS IN LINE 7 ARE PROVIDED AS A COMMUNITY BENEFIT AND DO NOT GENERATE A PATIENT BILL OR RECEIVE ANY GRANT FUNDING TO GENERATE ANY REVENUE. FOR SUBSIDIZED HEALTH SERVICES, THIS IS ACCOUNTED FOR USING SCHEDULE H INSTRUCTIONS FROM WORKSHEET 6. SUBSIDIZED SERVICE EXPENSES ARE BASED ON DIRECT REVENUES AND EXPENSES ONLY, AND DO NOT INCLUDE AN ALLOCATION OF ANY SUPPORT EXPENSES, SUCH AS ENVIRONMENTAL SERVICES, REVENUE CYCLE, UTILITIES OR OTHER FACILITY COSTS, THAT WOULD BE PART OF WHAT A STAND-ALONE PRACTICE WOULD HAVE TO BEAR. 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 $ 11,729,764. PART II, COMMUNITY BUILDING ACTIVITIES: IVINSON PROMOTES THE HEALTH OF THE COMMUNITY BY MAINTAINING AN OPEN MEDICAL STAFF, A GOVERNING BOARD THAT INCLUDES COMMUNITY REPRESENTATION AND EMERGENCY AND INPATIENT SERVICES AVAILABLE TO ALL REGARDLESS OF ABILITY TO PAY. THE ORGANIZATION REINVESTS SURPLUS FUNDS INTO PATIENT CARE, FACILITY IMPROVEMENTS AND COMMUNITY HEALTH PROGRAMS AND SUPPORTS ACCESS TO CARE THROUGH PARTNERSHIPS, FINANCIAL ASSISTANCE AND COMMUNITY BENEFIT INITIATIVES. PART III, LINE 2: IN EVALUATING THE COLLECTIBILITY OF ACCOUNTS RECEIVABLE, THE HOSPITAL ANALYZES ITS PAST HISTORY AND IDENTIFIES TRENDS FOR EACH OF ITS MAJOR PAYOR SOURCES OF REVENUE TO ESTIMATE THE APPROPRIATE ALLOWANCE FOR DOUBTFUL ACCOUNTS AND PROVISION FOR BAD DEBTS. FOR RECEIVABLES ASSOCIATED WITH SERVICES PROVIDED TO PATIENTS WHO HAVE THIRD-PARTY COVERAGE, THE HOSPITAL ANALYZES CONTRACTUALLY DUE AMOUNTS AND PROVIDES AN ALLOWANCE FOR DOUBTFUL ACCOUNTS AND A PROVISION FOR BAD DEBTS, IF NECESSARY. FOR RECEIVABLES ASSOCIATED WITH SELF-PAY PATIENTS (WHICH INCLUDES BOTH PATIENTS WITHOUT INSURANCE AND PATIENTS WITH DEDUCTIBLE AND COPAYMENT BALANCES DUE FOR WHICH THIRD-PARTY COVERAGE EXISTS FOR PART OF THE BILL), THE HOSPITAL RECORDS A PROVISION FOR BAD DEBTS IN THE PERIOD OF SERVICE ON THE BASIS OF ITS PAST EXPERIENCE, WHICH INDICATES THAT MANY PATIENTS ARE UNABLE OR UNWILLING TO PAY THE PORTION OF THEIR BILL FOR WHICH THEY ARE FINANCIALLY RESPONSIBLE. PART III, LINE 3: A. PART III, LINE 3: THE PORTION OF BAD DEBT EXPENSE ATTRIBUTABLE TO PATIENTS WHO ARE ELIGIBLE FOR FINANCIAL ASSISTANCE WAS ESTIMATED USING THE PERCENTAGE OF THE SERVICE AREA IDENTIFIED AS LIVING BELOW THE FEDERAL POVERTY LEVEL BASED ON THE MOST RECENT U.S. CENSUS DATA. ACCORDING TO THE U.S. CENSUS BUREAU, 15.9% OF ALBANY COUNTY RESIDENTS LIVED BELOW THE FEDERAL POVERTY LEVEL AS OF JULY 1, 2024. PART III, LINE 4: SEE THE "PATIENT ACCOUNTS RECEIVABLES" PARAGRAPH ON PAGE 8 OF THE ATTACHED AUDITED FINANCIAL STATEMENTS FOR AN EXPLANATION OF IVINSON MEMORIAL HOSPITAL'S BAD DEBT EXPENSE. PART III, LINE 8: THE MEDICARE REVENUES AND ALLOWABLE COSTS OF CARE WERE CALCULATED USING THE JUNE 30, 2025 MEDICARE COST REPORT. THE SHORTFALL SHOULD BE CONSIDERED A COMMUNITY BENEFIT SINCE IVINSON MEMORIAL HOSPITAL PROVIDES THESE SERVICES TO THE ELDERLY INDIVIDUALS IN OUR COMMUNITY WHO WOULD LIKELY HAVE DIFFICULTY OBTAINING SUFFICIENT MEDICAL CARE WITHOUT THE MEDICARE PROGRAM. PART III, LINE 9B: IVINSON MEMORIAL HOSPITAL BILLS OUT ANY INSURANCE PRIOR TO BILLING THE PATIENT. THESE BILLS NORMALLY GO OUT WITHIN 7 DAYS OF THE SERVICE DATE. AFTER THE INSURANCE COMPANY HAS PAID ITS SHARE OF THE MEDICAL BILL, THE ACCOUNT IS POSTED FOR PAYMENTS AND ADJUSTMENTS AND THEN THE FIRST BILL IS SUBMITTED TO THE PATIENT. THREE STATEMENT CYCLES (MONTHLY) ARE SENT TO THE GUARANTOR FOR UNPAID ACCOUNTS BEFORE ANY REFERRAL TO AN OUTSIDE COLLECTION AGENCY IS MADE. EACH ACCOUNT IS INDIVIDUALLY REVIEWED PRIOR TO BEING SENT TO COLLECTION. IF THE PATIENT REQUESTS FINANCIAL ASSISTANCE, ALL BILLING/COLLECTION ACTIVITY IS SUSPENDED UNTIL A DETERMINATION IS MADE REGARDING THE PATIENT'S REQUEST FOR ASSISTANCE. EACH REQUEST IS REVIEWED BY THE BUSINESS OFFICE STAFF FOR COMPLETENESS AND QUALIFICATION AND THEN FURTHER REVIEWED BY THE PATIENT FINANCIAL SERVICES DIRECTOR AND CFO. THE PATIENT THEN RECEIVES A CALL AND A LETTER EXPLAINING THE DETERMINATION. PART VI, LINE 2: BETWEEN NOVEMBER 2022 AND APRIL 2023, IVINSON CONDUCTED OUR COMMUNITY HEALTH NEEDS ASSESSMENT, WITH FEEDBACK FROM PUBLIC HEALTH EXPERTS, MEDICAL PROVIDERS AND COMMUNITY STAKEHOLDERS IN A FORMAL PROCESS TO IDENTIFY SIGNIFICANT HEALTH NEEDS. IVINSON ENGAGED SUPPORT FROM UCHEALTH TO ASSIST IN THE RESEARCH AND DEVELOPMENT OF THE CHNA WHICH INCLUDED DATA ANALYSIS ON THE LOCAL, STATE AND NATIONAL LEVELS REGARDING HEALTH INDICATORS, A PUBLIC MEETING TO REQUEST FEEDBACK AND A WEB BASED SURVEY TO GATHER INPUT ON COMMUNITUY HEALTH NEEDS. THIS CULMINATION OF THIS DATA IS REVIEWED BY IVINSON LEADERSHIP TO IDENTIFY RECCOMENDED HEALTH NEEDS AREA OF FOCUS. THEIR REPORT IS PRESENTED TO THE IVINSON BOARD OF DIRECTORS FOR REVIEW AND APPROVAL. OUR 2023-2025 CHNA WAS APPROVED IN APRIL OF 2023. PART VI, LINE 3: IVINSON MEMORIAL HOSPITAL EDUCATES THE PUBLIC ABOUT THE AVAILABILITY OF FINANCIAL ASSISTANCE THROUGH THE FOLLOWING PROCESSES:1. INFORMATION ON BILLING STATEMENTS AND PATIENT CONSENT FORMS;2. INFORMATION POSTED IN EMERGENCY ROOMS, ADMITTING LOCATIONS, WAITING ROOMS, THE BUSINESS OFFICE, AND OTHER PUBLIC PLACES;3. PUBLICATION ON THE HOSPITAL'S WEBSITE;4. PUBLICATION ON BROCHURES AVAILABLE IN PATIENT ACCESS SITES AND OTHER LOCATIONS IN THE COMMUNITY; AND5. REFERRALS GIVEN TO SPECIFIC PATIENTS BY HOSPITAL STAFF. PART VI, LINE 4: ALBANY COUNTY, WYOMING, IS A LARGE AND RURAL COUNTY COVERING ROUGHLY 4,300 SQUARE MILES WITH A POPULATION OF ABOUT 39,000. THE COMMUNITY IS DEFINED BY LOW POPULATION DENSITY, A SIGNIFICANT AMOUNT OF FEDERAL LAND, AND A HIGH DEGREE OF RESIDENTIAL MOBILITY. LARAMIE IS THE COUNTY SEAT AND THE PRIMARY POPULATION CENTER.THE COUNTY'S DEMOGRAPHIC PROFILE IS STRONGLY INFLUENCED BY THE UNIVERSITY OF WYOMING, RESULTING IN A YOUNGER POPULATION THAN STATE AND NATIONAL AVERAGES. THE MEDIAN AGE IS ABOUT 28 YEARS, AND YOUNG ADULTS AGES 18 TO 24 MAKE UP MORE THAN ONE-QUARTER OF THE POPULATION. THE COUNTY IS PREDOMINANTLY WHITE, WITH GROWING RACIAL AND ETHNIC DIVERSITY AND A FOREIGN-BORN POPULATION HIGHER THAN THE STATE AVERAGE.ALBANY COUNTY HAS HIGH LEVELS OF EDUCATIONAL ATTAINMENT, WITH MORE THAN HALF OF ADULTS HOLDING A BACHELOR'S DEGREE OR HIGHER. DESPITE THIS, MEDIAN HOUSEHOLD INCOME IS LOWER THAN THE STATE AVERAGE, AND APPROXIMATELY 16 PERCENT OF RESIDENTS LIVE BELOW THE FEDERAL POVERTY LEVEL. THE COMMUNITY EXPERIENCES HIGH GEOGRAPHIC MOBILITY, SHORT COMMUTE TIMES AND A WORKFORCE CONCENTRATED IN GOVERNMENT, EDUCATION, HEALTH CARE AND RETAIL.HOUSING IS SPLIT NEARLY EVENLY BETWEEN RENTERS AND HOMEOWNERS, AND HOUSING AFFORDABILITY CONTINUES TO BE A CHALLENGE FOR MANY RESIDENTS. THE SECONDARY SERVICE AREA INCLUDES SEVERAL ADDITIONAL COUNTIES IN WYOMING AND PARTS OF NORTHERN COLORADO. PART VI, LINE 6: IVINSON MEMORIAL HOSPITAL AFFILIATED WITH UCH AS THEY PROVIDE IVINSON MEMORIAL HOSPITAL A CEO BUT IVINSON MEMORIAL HOSPITAL IS INDEPENDENT AND IS OPERATED BY A FULLY INDEPENDENT BOARD OF DIRECTORS. PART VI, LINE 7, REPORTS FILED WITH STATES WY 1 CHARITY CARE 603 0 3837405 COST FINANCIAL ASSISTANCE AT ACOST PART I, LINE 2: IVINSON MEMORIAL HOSPITAL DOES NOT PROVIDE CASH ASSISTANCE TO INDIVIDUALS. RATHER THAN GIVING CASH OR NON-CASH TO INDIVIDUALS, IVINSON PROVIDES FREE OR DISCOUNTED CARE ON ITS SERVICES, IN THE FORM OF CHARITY CARE, TO INDIVIDUALS WHO MEET SPECIFIED CRITERIA. IVINSON USES THE FPG TO DETERMINE FREE OR DISCOUNTED CARE. INDIVIDUALS WHO ARE BELOW 150% OF THE FPG QUALIFY FOR FREE CARE. INDIVIDUALS BETWEEN 150% AND 300% OF THE FEDERAL POVERTY LIMITS ARE GRANTED CHARITY ON A SLIDING SCALE. IMH DOES NOT CONSIDER FINANCIAL ASSISTANCE TO BE A SUBSTITUTE FOR PERSONAL RESPONSIBILITY. PATIENTS ARE EXPECTED TO FOLLOW IMH'S PROCEDURES FOR OBTAINING FINANCIAL ASSISTANCE OR OTHER FORMS OF PAYMENT, AND TO CONTRIBUTE TO THE COST OF THEIR CARE BASED ON THEIR ABILITY TO PAY. PERSONS WITH THE FINANCIAL CAPACITY TO PURCHASE HEALTH INSURANCE ARE ENCOURAGED TO DO SO, FOR THEIR OVERALL PERSONAL HEALTH, PROTECTION OF THEIR INDIVIDUAL ASSETS AND ACCESS TO HEALTH CARE SERVICES. X X X X 0 0 0 0 0 0 0 0 0 BURK YOUNG MD PHYSICIAN 964951 0 0 0 4256 0 28648 0 30486 0 1028341 0 0 0 BAILEY JOHNSON MD PHYSICIAN 708629 0 0 0 594 0 4071 0 33389 0 746683 0 0 0 JOHN ULLRICH MD PHYSICIAN 518459 0 0 0 1518 0 30500 0 30486 0 580963 0 0 0 GARY GRAHAM MD PHYSICIAN 489678 0 0 0 1518 0 19689 0 33389 0 544274 0 0 0 ERIC UHLMAN MD PHYSICIAN 494235 0 0 0 4356 0 13583 0 15674 0 527848 0 0 0 TERRY MOSS COO 269358 0 38442 0 2622 0 8757 0 30486 0 349665 0 0 0 JAMES BANDS CFO 169202 0 44354 0 0 0 8992 0 29440 0 251988 0 0 0 SAGAN WHEELER CHRO 173765 0 30000 0 773 0 9567 0 33889 0 247994 0 0 0 MARY PONCE CNO 133416 0 10000 0 641 0 0 0 33889 0 177946 0 0 0 FORM 990, PART VI, SECTION A, LINE 1A THE COMMITTEES OF THE BOARD SHALL HAVE AND EXERCISE AUTHORITY OF THE BOARD OF DIRECTORS IN THE MANAGEMENT OF THE CORPORATION. HOWEVER, NO SUCH COMMITTEE SHALL HAVE THE AUTHORITY OF THE BOARD OF DIRECTORS IN REFERENCE TO AUTHORIZING DISTRIBUTIONS, ELECTING, APPOINTING OR REMOVING ANY DIRECTOR, AMENDING THE ARTICLES OF INCORPORATION, AMENDING, ALTERING OR REPEALING THE BYLAWS; APPROVING A PLAN OF MERGER, OR APPROVING A SALE, LEASE, EXCHANGE OR OTHER DISPOSITION OF ALL, OR SUBSTANTIALLY ALL OF THE CORPORATION'S PROPERTY, WITH OR WITHOUT GOODWILL, OTHERWISE THAN IN THE USUAL AND REGULAR COURSE OF BUSINESS, OR VOLUNTARILY DISSOLVING OR REVOKING A VOLUNTARY DISSOLUTION OF THE CORPORATION. FORM 990, PART VI, SECTION A, LINE 3 THE CEO IS PROVIDED THROUGH AN AFFILIATION AGREEMENT WITH UCHEALTH. THE CEO'S COMPENSATION IS REVIEWED AND DETERMINED BY IVINSON MEMORIAL HOSPITAL'S BOARD OF DIRECTORS. THE CEO'S EMPLOYMENT WITH UCHEALTH IS CONTINGENT UPON HIM SERVING AS THE CEO OF IVINSON MEMORIAL HOSPITAL AND THEIR CONTINUED ENGAGEMENT WITH IVINSON MEMORIAL HOSPITAL. DOUG FAUS RECEIVED THE FOLLOWING COMPENSATION IN CALENDAR YEAR 2024 FOR HIS SERVICES AS PRESIDENT & CEO: TAXABLE COMPENSATION: BASE: $449,790 TAXABLE BONUS COMPENSATION: $69,107 OTHER TAXABLE COMPENSATION: $2,436 NONTAXABLE DEFERRED COMPENSATION: $32,134 OTHER NONTAXABLE BENEFITS: $28,866 FORM 990, PART VI, SECTION A, LINE 7B SUBJECT TO ANY CONSENTS OF THE DISTRICT AS REQUIRED UNDER THE LEASE AND IMH'S BYLAWS, THE BOARD OF DIRECTORS SHALL HAVE THE POWER TO ALTER, AMEND, OR REPEAL THE BYLAWS OR ADOPT NEW BYLAWS. HOWEVER, THE BOARD OF DIRECTORS MAY NOT AMEND THE BYLAWS, WITHOUT THE DISTRICT'S PREVIOUS APPROVAL, TO (A) APPOINT THE INITIAL ELECTED DIRECTORS PROVIDED IN SECTION 4.4 OR (B) REMOVE OR MODIFY SECTION 14.7 REGARDING CONFLICTS BETWEEN THE LEASE AND THE BYLAWS. FORM 990, PART VI, SECTION B, LINE 11B THE FORM 990 WAS PREPARED BY AN INDEPENDENT CPA FIRM WITH INFORMATION PROVIDED BY MANAGEMENT. THE 990 WAS REVIEWED IN ITS ENTIRETY BY THE FINANCE COMMITTEE OF THE BOARD PRIOR TO FILING. IN ADDITION, THE ENTIRE BOARD WAS GIVEN THE OPPORTUNITY TO REVIEW PRIOR TO ITS FILING. FORM 990, PART VI, SECTION B, LINE 12C IVINSON MEMORIAL HOSPITAL HAS A CONFLICT OF INTEREST POLICY THAT COVERS ALL BOARD MEMBERS, OFFICERS, DIRECTORS, MANAGERS, SUPERVISORS AND HIGHLY COMPENSATED EMPLOYEES. ALL COVERED INDIVIDUALS COMPLETE A CONFLICT OF INTEREST DISCLOSURE STATEMENT UPON JOINING IVINSON MEMORIAL HOSPITAL AND ANNUALLY THEREAFTER. ALL COVERED INDIVIDUALS HAVE AN OBLIGATION TO DISCLOSE ALL INTERESTS, ACTIONS OR RELATIONSHIPS THAT CREATE AN ACTUAL OR POTENTIAL CONFLICT OF INTEREST OR THAT COULD CREATE SUCH. AFTER SUCH DISCLOSURE, THE INDIVIDUAL LEAVES THE MEETING WHILE THE BOARD, COMMITTEE OR SUPERVISOR DETERMINES WHETHER A CONFLICT EXISTS. IF A CONFLICT IS DEEMED TO EXIST, THE RELEVANT BODY EVALUATES WHETHER A MORE BENEFICIAL TRANSACTION IS AVAILABLE TO IVINSON MEMORIAL HOSPITAL. IF A MORE BENEFICIAL TRANSACTION IS NOT IDENTIFIED, THE RELEVANT BODY VOTES WHETHER TO ENTER THE TRANSACTION THAT INVOLVES THE CONFLICT OF INTEREST. THE INDIVIDUAL WITH THE CONFLICT DOES NOT PARTICIPATE IN THE VOTE. RECORDS ARE KEPT OF ALL SITUATIONS THAT INVOLVE AN ACTUAL OR POTENTIAL CONFLICT OF INTEREST. IF AN INDIVIDUAL FAILS TO DISCLOSE A CONFLICT OF INTEREST, THE INDIVIDUAL IS GIVEN THE OPPORTUNITY TO EXPLAIN, AFTER WHICH THE RELEVANT BODY DETERMINES APPROPRIATE DISCIPLINARY ACTION, IF ANY. FORM 990, PART VI, SECTION B, LINE 15 THE BOARD'S COMPENSATION COMMITTEE REVIEWS THE CEO'S COMPENSATION ANNUALLY. THIS COMMITTEE UTILIZES DATA FROM AN INDEPENDENT COMPENSATION CONSULTANT. THE DATA IS CREATED BASED ON COMPARABLE FACILITIES IN THE GEOGRAPHIC REGION. THE COMMITTEES DECISION IS DOCUMENTED IN THE BOARD MINUTES. THE CEO REVIEWS THE COMPENSATION OF OTHER KEY EMPLOYEES. THE CEO UTILIZES DATA FROM AN INDEPENDENT COMPENSATION CONSULTANT WHO PREPARE THE DATA FROM LIKE-SIZED HOSPITALS WITHIN THE GEOGRAPHIC REGION. THIS INFORMATION IS REVIEWED AND APPROVED BY THE BOARD'S COMPENSATION COMMITTEE ANNUALLY AS WELL. COMPENSATION REVIEWS WERE LAST CONDUCTED IN 2025. FORM 990, PART VI, SECTION C, LINE 19 IVINSON MEMORIAL HOSPITAL'S GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY AND FINANCIAL STATEMENTS ARE AVAILABLE UPON REQUEST. FINANCIAL AND OPERATIONAL DATA IS ALSO PROVIDED SEMI-ANNUALLY TO THE ALBANY COUNTY HOSPITAL DISTRICT AND THE ALBANY COUNTY BOARD OF COMMISSIONERS, WHICH PRESENTATION IS OPEN TO THE PUBLIC. FORM 990, PART IX, LINE 11G PURCHASE SERVICES: PROGRAM SERVICE EXPENSES 15,704,383. MANAGEMENT AND GENERAL EXPENSES 756,688. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 16,461,071. FORM 990, PART XI, LINE 9: CHANGE IN BENEFICIAL INTEREST IN FOUNDATION -4,096,220. FORM 990, PART XII, LINE 2C: THE PROCESS FOR OVERSIGHT AND SELECTION OF AN INDEPENDENT ACCOUNTANT HAS NOT CHANGED FROM THE PRIOR YEAR. IMH QALICB 255 NORTH 30TH STREET LARAMIE WY 82072 843157045 SUPPORT IVINSON MEMORIAL HOSPITAL WY 501(C)(3) LINE 12B, II IMH 1 MEDICINE BOW TECHNOLOGIES INC 3821 BEECH STREET LARAMIE WY 82072 721620736 INFORMATION SERVICES WY IVINSON MEMORIAL HOSPITAL C 1.00000 0 1 0 0 1 1 0 0 0 0 0 1 1 0 1 1 0 0 0 0 IMH QALICB A 599488 FAIR MARKET VALUE IMH QALICB L 235094 COST