2024-05-13T06:59:00-05:00 2023-06-30 450250958 Eide Bailly LLP 800 Nicollet Mall Ste 1300 Minneapolis MN 554027033 990 2022-07-01 420733472 St Anthony Regional Hospital and Nursing Home STAN 7127945246 311 South Clark Street PO Box 628 Carroll IA 51401 Eric Salmonson CFO/Vice President 7127945246 2024-05-07 1 Eric Salmonson 999009999 1 Kim Hunwardsen CPA P00484560 6122536500 2024-04-29 0 AAL1 IAL1 2022 2023-04-26 12:10:37Z Allen Anderson 311 South Clark Street PO Box 628 Carroll IA 51401 107589425 0 0928 X www.stanthonyhospital.org X 1905 IA Consistently providing high quality healthcare services to meet patient and community needs. 10 8 884 246 0 0 4159569 1533134 82538190 88886347 5073147 4150556 229515 -175410 92000421 94394627 0 276724 0 0 44444231 47943948 0 0 0 47902230 52438541 92346461 100659213 -346040 -6264586 193905686 198229212 40040787 42900019 153864899 155329193 X St. Anthony Regional Hospital is inspired by faith and committed to excellence. We are dedicated to improving the health of the people we serve. We will lead in providing high quality, high value healthcare services responsive to the needs of our patients and the region. We are committed to the health ministry of our sponsors, St. Anthony Ministries. 0 0 97254676 276724 88922302 St. Anthony Regional Hospital and Nursing Home (the Hospital), located in Carroll, Iowa, operates an acute care hospital, a nursing care center, several medical clinics, retirement housing called Orchard View, and assisted living called Garden View. The Hospital is a 99-bed acute care facility. St. Anthony Nursing Home has 79 beds. In the year ended June 30, 2023, St. Anthony Regional Hospital and Nursing Home provided health care services to approximately 1,844 inpatients, 73,087 outpatients, and had 42,864 clinic visits. St. Anthony Regional Hospital provided services for 1,376 acute care inpatients, and provided psychiatric, swing bed, and nursing home services for the remainder of inpatients. Outpatient services were provided to patients through ancillary departments, emergency room, and clinics. Continued on Sch O. St. Anthony Hospital provides services of cardiac rehabilitation, dialysis, hospice care, laboratory, observation, chemotherapy, pathology, radiology, respiratory therapy, physical therapy, occupational therapy, speech therapy, diabetes, medical oncology, radiation therapy, and surgical services. St. Anthony's largest patient service area is physical therapy. In the year ended June 30, 2023, St. Anthony services 9,713 patients in physical therapy, 7,159 in emergency room, and 6,694 in radiology. The activities pursued by St. Anthony Regional Hospital and Nursing Home in the provision of health care services are consistent with its exempt purpose.As part of its mission, St. Anthony Regional Hospital provides medical care to individuals who are unable to pay for services, incurs costs in excess of reimbursement for services to Medicaid beneficiaries, and carries out other activities and programs free of charge to support the community in which it operates. Community benefit projects include community health education, health care support services, behavioral health services, community health improvement advocacy, and other traditional charity care.The Hospital provides care to patients who meet certain criteria under its charity care policy without charge or at amounts less than established rates. Since the Hospital does not pursue collection of amounts, they are not reported as revenue. For classification of accounts as charity care, the Hospital uses the "exhaust all possible sources" of payment standard, as referenced in the Hill Burton program. Although the Hospital no longer has a HillBurton obligation, they continue to use this standard when determining if an account is eligible for charity care. The Hospital exercises sound business practices and makes reasonable efforts to collect accounts; therefore, any unpaid balance that the Hospital has exhausted their collection efforts on is subsequently classified as charity care. The total amount of charges foregone for services provided under the Hospital's charity care policies was approximately $3,277,000 for the year ended June 30, 2023. Total estimated cost of providing these services was $1,427,000 for the year ended June 30, 2023 based on an average ratio of costs to gross charges. 97254676 1 1 0 1 0 0 0 0 0 1 1 0 0 1 1 1 1 0 0 0 0 0 0 0 0 0 1 1 1 0 1 1 0 0 0 0 0 0 0 0 1 1 0 0 0 0 0 1 0 0 0 1 179 0 1 884 1 0 0 0 0 0 0 0 0 0 0 0 0 X 10 8 0 0 0 0 1 1 1 1 0 0 0 1 1 1 1 1 1 1 1 0 X Eric Salmonson 7127945246 311 South Clark Street PO Box 628 Carroll IA 51401 Nick Badding Chairman 0.30 0.00 X X 0 0 0 Peggy White Vice Chairman 0.30 0.30 X X 0 0 0 Sr Theresa Keller Secretary 0.30 0.00 X X 0 0 0 Howard Drees Treasurer 0.30 0.00 X X 0 0 0 Deb Auen Board Member 0.30 0.30 X 0 0 0 Jeff Scharfenkamp Board Member 0.30 0.00 X 0 0 0 Karl Eischeid DDS Board Member 0.30 0.00 X 0 0 0 Sr Donna Venteicher Board Member 0.30 0.00 X 0 0 0 Sr Michelle Pettit Board Member 0.30 0.00 X 0 0 0 Sr Rose Elsbernd Board Member 0.30 0.00 X 0 0 0 Allen Anderson CEO/President 40.00 0.30 X 184185 0 18660 Eric Salmonson CFO/Vice President 40.00 0.30 X 146449 0 18564 Edward H Smith Jr CEO/President until Dec. 2022 40.00 0.30 X 362086 0 61888 Randall Hess MD Radiation Oncologist 40.00 0.00 X 528344 0 44030 Brian Boes MD Neurology 40.00 0.00 X 392723 0 28751 Amy Canuso DO Mental Health 40.00 0.00 X 413779 0 46464 Richard Goding MD Orthopedics 40.00 0.00 X 370677 0 20777 Nicole Hayworth DNP ARNP CRNA 40.00 0.00 X 338039 0 43652 John Munson Former CFO/VP 0.00 0.00 X 103243 0 13437 2839525 0 296223 75 1 1 0 Onestaff Medical LLC 10802 Farnam Dr Omaha NE 68154 Contract Labor 1140105 Medical Oncology and Hematology 1221 Pleasant St Suite 100 Des Moines IA 50309 Oncology Physician Services 1044654 Grapetree Medical Staffing LLC 2501 Boji Bend Dr Suite 100 Milford IA 513601245 Contract Labor 835224 Bruner Law Firm Trust Account 225 E 7th Street Carroll IA 51401 Legal Services 445872 Deloitte & Touche LLP PO Box 844708 Dallas TX 752844708 Accounting Services 342803 12 32000 707193 595558 198383 1533134 Patient Service Revenue 621110 83980199 83980199 Assisted Living 623000 2353647 2353647 Pharmacy Revenue 456110 586769 586769 Retirement Housing 623000 555382 555382 Cafeteria Revenue 722514 424457 424457 985893 985893 88886347 1518659 1518659 575425 786790 -211365 -211365 -211365 14774862 265043 11759294 648714 3015568 -383671 2631897 2631897 Insurance Proceeds 900099 35955 35955 35955 94394627 88922302 0 3939191 X 276724 276724 990089 990089 16578 16578 39182864 38561387 621477 959178 935827 23351 4088707 4027378 61329 2706532 2605247 101285 72537 72537 284921 15500 269421 13820 13820 11670423 10857967 812456 216092 7942 208150 1385429 1344716 40713 2054116 2039894 14222 393798 333618 60180 715345 715345 8240547 8240547 607734 607734 Medical Supplies 20238278 20238137 141 Repairs and Maintenance 4047727 3998454 49273 Tax Assessment 1211141 1211141 Food 894048 894048 392585 326492 66093 100659213 97254676 3404537 0 2832165 1784084 287236 10241127 11440582 189 1000 2759179 2847873 910980 1031764 172876054 102147438 69973059 70728616 81131772 85880112 4254372 21802843 24227945 193905686 198229212 10256390 7277400 1212090 27896801 5209052 412127 28027646 1475469 1173831 40040787 42900019 X 137522089 132799898 16342810 22529295 153864899 155329193 193905686 198229212 X -6264586 5526959 2201921 X 0 1 X 1 1 1 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 0 0 0 0 0 0 0 0 1 13820 13820 0 Part II-B, Line 1: St. Anthony Regional Hospital and Nursing Home is a member of the Iowa Hospital Association and the Catholic Health Organization. A percentage of dues are paid for lobbying activities. 21094463 362476 2538624 43550 484629 23467384 23500033 255947 -2620802 43550 -2835 21094463 19046674 868052 6253780 15900 2652573 23500033 18596647 98672 1108234 14850 742029 19046674 14742656 2531749 1454273 15000 117031 18596647 0.00000 0.04260 0.95740 0 1 1 693934 693934 118605823 64378347 54227476 45777639 34891096 10886543 7798658 2877995 4920663 70728616 Beneficial Interest in Net Asset of Foundation 22529295 Deferred compensation investments 1212090 Right to use assets 486560 24227945 Finance Lease Liability 181918 Operating Lease Liability 486560 Estimated third-party payor settlements 505353 1173831 X 101056092 5526959 5526959 95529133 -1134506 -1134506 94394627 101793719 1134506 1134506 100659213 0 100659213 Part V, Line 4: All restricted endowed funds held at the St. Anthony Foundation are used for the benefit of St. Anthony Regional Hospital and Nursing Home and for scholarships. Part X, Line 2: The Hospital believes that it has appropriate support for any tax positions taken affecting its annual filing requirements, and as such, does not have any uncertain tax positions that are material to the 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 4b - Other Adjustments: Other Gain/Loss on Sale of Assets included in expense in F/S -383,671. Gain/Loss on Insurance Proceeds included in expense in F/S 35,955. Rental expenses included in revenue for Form 990 -786,790. Part XII, Line 2d - Other Adjustments: Other Gain/Loss on Sale of Assets included in expense in F/S 383,671. Gain/Loss on Insurance Proceeds included in expense in F/S -35,955. Rental expenses inlcuded in revenue for Form 990 786,790. 1 1 X 1 X 1 X 1 1 1 0 1 1 1427000 1427000 0.01420 10784039 7281336 3502703 0.03480 12211039 7281336 4929703 0.04900 155451 4200 151251 0.00150 526580 526580 0.00520 14079019 9481345 4597674 0.04570 192656 61232 131424 0.00130 14953706 9546777 5406929 0.05370 27164745 16828113 10336632 0.10270 3720 3720 0.00000 3720 3720 0.00000 1 1137348 110323 22717106 31377761 -8660655 X 1 1 1 1 St Anthony Regional Hospital and Nursing Home 311 South Clark St Carroll IA 51401 www.stanthonyhospital.org 14009OH X X X 9 provider based clinics St Anthony Regional Hospital and Nursin 1 0 0 1 X X X X X X X X X 21 1 0 0 1 X See supplemental info. X 1 21 1 See supplemental info. 0 1 X 200.000000000000 400.000000000000 X X X X 1 1 X X X 1 X See supplemental info. X See supplemental info. X See supplemental info. X X X X X X 1 X 0 X X X X 1 X 0 0 St. Anthony Regional Hospital and Nursing Home Part V, Section B, Line 5: St. Anthony Regional Hospital conducted a CHNA assessment in fiscal year 2022. Interviews with community stakeholders throughout the region provided an understanding of the community's health needs from the organizations and agencies that have a deep understanding of the populations in the greatest need. St. Anthony provided Tripp Umbach with a list of community stakeholders to interview. Interviews were conducted with a public health expert and representatives of underserved populations. St. Anthony Regional Hospital and Nursing Home Part V, Section B, Line 11: The following significant health needs and action items were identified in the most recent CHNA. All needs will be addressed over the next 3 years. Mental Health Goal 1. Decrease depression among children, youth, and adults.Strategy 1.1: Provided depression screening in primary care settings, with systems in place to ensure accurate diagnoses, effective treatment and appropriate follow up.-PHQ- 2 implemented in the clinics. -PHQ- 9 implemented in the clinics, as indicated.-Columbia Suicide assessment implemented in the clinics.-Depression screening completed at admission.-Social Determinants of Health screening implemented at admission.Strategy 1.2 Implemented Collaborative Care for the Management of Depressive Disorders.-The Birth Place social media page was developed and now includes information promoting mental health services available in the region. Strategy 1.3 Integrate behavioral health and primary care services.-SARH Mental Health provides consultation and referral for primary care in the inpatient and outpatient setting.-SARH Mental Health provides consultation and medication management for SARH nursing home patients. Goal 2. Reduce Suicide RiskStrategy 2.1 Train healthcare providers, educators, and community volunteers in Mental Health First Aid.-Working to put together a Mental Health First Aid class for the community. Strategy 2.2 Implement the "Zero Suicide in Healthcare" framework (organizational assessment, training, consultation).-Discharged inpatients have scheduled follow-up appointment with mental health provider within 1 week of discharge 95%. CancerGoal 1. Increase Cancer Screenings. Strategy 1.1 Implement Multicomponent Interventions to Increase Cancer Screening: Increased community demand (education, incentives, reminders, media): Increased community access. Increased Provider Delivery (reminders, incentives, feedback). -Iowa Cancer Consortium (ICC) toolkit for digital media to provide screening updates- breast, colorectal, melanoma.-SARH Pulse- public E-newsletter, radio ads, digital ads, SARH website at minimum quarterly and per ICC guidelines.-Tumor Board education provided to medical staff in attendance.-Monthly screening initiatives given to SARH medical staff for posting in clinic and as guideline for provider screening plan.-SARH offers radiation therapy, genetic testing, and bone marrow biopsy- services unavailable in surrounding areas.-Medical staff provided with ICC screening guidelines and information via Nurse Navigator.-ICC screening guidelines displayed in SARH Cancer Center. -Barre community event hosted by SARH to raise community awareness and fundraise.-October Breast Cancer Awareness Month - expanded hours for mammography screenings, times and screenings promoted through social media and community web boards. Goal 2. Reduce Cancer MortalitiesStrategy 2.1 Provided anticoagulation therapy (aspirin) to prostate cancer patients.-Anticoagulation therapy is determined at time of consultation per medical provider.-Patients may receive a gel spacer prior to radiation therapy as medically indicated.Strategy 2.2 Vaccinate cancer patients against infectious diseases, including influenza and pneumonia.-Tracking of vaccination data in collaboration with Mission Cancer. Strategy 2.3 Implement risk assessment for breast cancer in primary care settings and provide tailored recommendations based on individual risk (including use of chemoprevention).-October 2023 MRI enhanced mammography screening offered. Strategy 2.4 Educate patients (and the families of adolescent patients) about the importance of the HPV vaccine.-Education provided through SARH clinic providers and medical staff. Goal 3: Increase patient access and retention through support services.Strategy 3.1 Incorporated Patient Navigators into Cancer Center care team.-Nurse Navigators incorporated into Cancer Center in 2020- role has expanded since that time to bridge the gap between referral and treatment and now includes increased financial strategies to facilitate assistance. Strategy 3.2 Provided psychosocial care for patients with cancer and their families.-A psychosocial screening tool based upon the Commission on Cancer (COC) recommendations is utilized by social work for all patients in treatment.Obesity/Live Healthy Goal 1. Increase daily physical activity among children, youth and adults.Strategy 1.1 Used Point of Decision Prompts for Physical Activity in healthcare and community settings.-Diabetes Prevention promoted through 2 cohorts annually with a year long program promoting lifestyle change both in the community setting and in-person. -Promotion of healthy living programs, diabetes prevention, and community education is supported through marketing and education information via social media, community promotion, and the SARH website.Strategy 1.2 Provide Exercise "Prescriptions" in primary care and other healthcare settings.-Promotion of healthy lifestyles and living choices promoted through SARH providers and medical staff. Strategy 1.3 Promote community-based Social Support for Physical Activity.-SARH diabetes educators engage with 4th grade students at Kuemper and Carroll schools for the Diabetes Busters program to educate about diabetes and prevention strategies with diet and exercise.-Diabetes Busters exercise program is promoted and participants engage in the gym or outside in different games/exercise. -SARH provides support and staff during the City of Carroll annual Wellness Program. Goal 2. Increase diabetes prevention and management.Strategy 2.1 Promote enrollment in community based Diabetes Intervention Programs. -The Birth Place social media page was developed and now includes information promoting diabetes management services in the region. -SARH diabetes educators engage with 4th grade students at Kuemper and Carroll schools for the Diabetes Busters program to teach about diabetes and prevention strategies with diet and exercise. -SARH hosts monthly support group for Diabetes and Pre-diabetes, held at the hospital and free of charge. -Diabetes Prevention promoted through 2 cohorts annually with a year long program promoting lifestyle change both in the community setting and in-person. -Promotion of prevention programs, diabetes prevention, and community education is supported through marketing and education information via social media, community websites, and the SARH website.Strategy 2.2 Engage community in Management of Type 2 Diabetes through virtual Touchpoint connections-Diabetes class participants are encouraged to share their glucose data digitally with SARH diabetes educators. -Diabetes class participants are encouraged to connect with SARH educators and providers via email or portal. Strategy 2.3 Implement Text Message-Based Health Interventions.-Future plans are to utilize the State of Iowa virtual program to support Diabetes Prevention Program.Substance UseGoal 1. Reduce Risky and underage alcohol use.Strategy 1.1 Implement CDC Risky Alcohol Use Screening and Brief Interventions in Primary Care Settings (for youth and adults).-Implementation pending collaboration and planning with HRSA RCORP grant coalition. Strategy 1.2 Support universal school-based alcohol prevention programs (lesson plans, prevention education, alcohol free fundraising policies, peer support, life skills training, etc.).-Implementation pending collaboration and planning with HRSA RCORP grant coalition. Goal 2. Reduce Alcohol Impaired Driving Strategy 2.1 Implement media campaign against alcohol impaired driving.-Implementation pending collaboration and planning with HRSA RCORP grant coalition. Strategy 2.2 Implement "Every 15 Minutes" program in local high schools.-Implementation pending collaboration and planning with HRSA RCORP grant coalition. Goal 3. Reduction of tobacco products Strategy. 3.1 Expand promotion of Quit Line to reach at-risk populations.-The Iowa Quit Line posters and information is posted throughout the SARH.-Iowa Quit Line information is included in discharge teaching and planning across SARH. Strategy 3.2 Implement social media and media campaigns against use of tobacco products.-Promotion of prevention programs and community education is supported through marketing and education information via social media, community websites, and the SARH website.Strategy 3.3 Promote smokefree workplaces, shared public spaces and multiunit housing.-SARH is a smoke and tobacco free campus.CHNA Continued on Part V: St. Anthony Regional Hospital and Nursing Home Part V, Section B, Line 13h: In addition to FPG, the Hospital will consider the extent to which the patient's household has assets that could be used to meet his or her financial obligation. Assets may include, but are not limited to, cash, savings and checking account, certificates of deposit, stocks and bonds, individual retirement accounts (IRAs), trust funds, real estate (excluding the patient's home) and motor vehicles. The hospital will take into account any liabilities that are the responsibility of the patient's household. To relieve stress related to financial burdens, families with a medical catastrophe with self-pay balances greater than 20 percent of their annual household income in one calendar year may be eligible for substantial discounts. St. Anthony's Regional Hospital and Nursing Home also uses asset level, medical indigency, insurance status, Medicaid/Medicare coverage, and state regulations as factors in determining eligibility for free and discounted care. Schedule H, Part V, Schedule B, Line 16a-c: FAP, FAP Application, and Plain Language Summary:https://www.stanthonyhospital.org/patients-visitors/patients/financial-assistance/ Schedule H, Part V, Section B, Line 7 and 10: CHNA and Implementation Strategy:www.stanthonyhospital.org/about-us/communityhealthneedsassessment/ Schedule H, Part V, Schedule B, Line 11: CHNA Continued:Goal 4: Reduce misuse and abuse of opioids.Strategy 4.1 Participate in the Billion Pill Pledge program.-In February of 2023, SARH engaged with Goldfinch to explore opportunities for participation in the Billion Pill Pledge program.-In May of 2023, SARH hosted a press conference attended by the Iowa State Attorney General to raise awareness and to launch the Billion Pill Pledge program at SARH.Strategy 4.2 Promote appropriate opioid prescribing practices among St. Anthony providers.-2023 first year reporting saw a 62% decrease in opioids prescribed post discharge at SARH.-Avg number of prescribed opioids by participating prescribers saw a decrease from 45 pre-program to 17.3 post initiation.-Results of year one 2023 participation was shared with the SARH Board of Directors and the SARH medical staff. Women's HealthGoal 1: Improve access to quality health services that enhance the overall maternal health for child bearing families in the service region.Strategy 1.1 Increase knowledge of services available to child bearing families within the service area. -Website updates have been made to showcase capabilities and services offered, as well as enhancements to page navigation to make it more user friendly.-Education opportunities offered by The Birth Place have been shared at community coalition meetings in each of the six identified counties.-A new, revised and updated booklet was created with information about what to expect during appointments, when to call the doctor, how to support a new mother, educational offerings, as well as information on lactation services.-Updated booklets have been translated into Spanish and are now available.-A dedicated space for community resource information has also been created in the St. Anthony Clinic exam rooms and at the Infant Feeding Support Group location.-Future plans include the addition of a link to county resource directories on the SARH website. -The Birth Place service capabilities, educational resources, and health safety trainings were promoted through a variety of communication resources including the St. Anthony Regional Hospital website, social media, local media, community events, and targeted newspaper and social media ads.Strategy 1.2 Increase facilitation of child bearing families into support services within the St. Anthony service area.-Outreach events have been held in Denison (Crawford County) and Carroll (Carroll County).-Each event highlights the topics of Infant Safety, including SIDS prevention and car seat safety, Sibling Adjustment, Infant feeding options, provider options for care of the mother and the baby, as well as a video tour of the delivery unit.-In partnership with Crawford County Public Health, a outreach event was offered to include maternal child health services as well as their Family S.T.E.P.S home visitation service.-Center of Excellence (COE) coordinator enrolled in Community Health Worker certification. Goal 2: Facilitate return to health services with local providers following medical care within St. Anthony for child bearing family.Strategy 2.1 Identify point of contact with local hospitals, providers, and public health entities within the local community of child bearing families.-Service area providers scheduled to tour and visit to SARH to see facilities and meet SARH providers. -Collaboration through Title V maternal health program with Public Health of Crawford, Sac, Calhoun, and Greene counties. -Collaboration with Carroll County Public Health department.-Through community outreach, local coalitions and community education SARH continues to facilitate relationships with Loring Hospital, Greene County Memorial Center, Crawford County Memorial Hospital and Manning Regional Health Care Center. -With input from the maternal health agency, public health, WIC, and St. Anthony social work staff, the Center of Excellence team developed a referral form for social workers to present to each obstetrical patient prior to discharge that will facilitate a referral to their local maternal health agency, WIC program, or public health department.Strategy 2.2 Develop formal process of care coordination activities to facilitate communication between Birth Place medical staff and local providers.-COE Coordinator attends community coalition meetings of 6 surrounding counties. -With input from the maternal health agency, public health, WIC, and St. Anthony social work staff, the Center of Excellence team developed a referral form for social workers to present to each obstetrical patient prior to discharge that will facilitate a referral to their local maternal health agency, WIC program, or public health department.Goal 3: Decrease the number of child abuse and unintentional injury rates within the St. Anthony service area.Strategy 3.1 Maintain efforts aimed at child abuse prevention. -SARH Outreach Coordinator is a member of Child Abuse prevention Council for Sac and Crawford counties.-Through collaboration and funding from Community Partnerships for Protecting Children, each family who delivers at The Birth Place will be given an educational packet from The Period of PURPLE Crying that includes a booklet with an overview of expected infant behavior, a reminder card with key points to remember during a crying episode, and access to a mobile application with education on ways to help soothe the baby, encourage healthy sleep, coping, and ways to prevent and protect the baby from shaken baby syndrome by ensuring all the child's needs have been met.-Education on excessive infant crying is included in prenatal teaching and group prenatal teaching. Strategy 3.2 Increase access to services for women experiencing post-partum depression.-The COE coordinator did complete the Components of Care, Maternal Mental Health provider training offered though Postpartum Support International.-COE coordinator is a sitting Board Member of the PSI- Iowa chapter.-SARH ARNP has scheduled to attend Maternal Mental Health training in March of 2024.-SARH COE coordinator scheduled to attend Maternal Mental Health training offered in March of 2024. -The Edinburgh postnatal depression scale is utilized to screen all patients for depression prior to discharge, results are shared with primary care providers.-Following discharge, nurse follow-up phone calls/assessments are conducted where mothers are encouraged to attend weekly SARH post-partum support group.-Information regarding weekly post-partum support groups has been added to discharge instructions and discharge teaching.-Questions about changes to feeding plans, assess overall mood and emotions, and encourage new mothers to attend the weekly post-partum support group held at the St. Anthony Regional Hospital.-Scheduled for agenda item for SARH clinic medical staff meeting will be the implementation of caregiver depression screening during the well child exam. Goal 4: Provide access to high quality obstetrical care to child bearing families.Strategy 4.1 Reduce primary C-section rates.-IMQCC data for SARH primary C-section rates vs state/national averages presented at SARH Family Medicine committee for consideration. Strategy 4.2 Increase additional physician providers to provide obstetrical and gynecological care with the St. Anthony service area.-OB/Gyn services are offered at Denison and Coon Rapids.Strategy 4.3 Increase training and advanced certifications for nursing staff providing care to mothers and babies within the St. Anthony service area.-The following advanced SARH certified nurse include : 2- Certified Lactation Specilaists; 3- Electronic Fetal Monitoring Certified; 16/20 Have completed Spinning Babies Course.-All Birthing Place providers have ALSO training (Advanced Life Support in Obstetrics.-SARH provider scheduled to obtain credential as ALSO instructor.Strategy 4.4 Complete infrastructure improvements to the Birth Place at St. Anthony. -Construction completed in September 2023.-Occupancy of the renovated Birthing Place in October 2023. 4 1 - St Anthony Nursing Home 311 South Clark St Carroll IA 51401 Nursing Home 4 - St Anthony Regional Home Health Agency 311 South Clark St Carroll IA 51401 Home Health Services 5 - St Anthony Regional Hospice 311 South Clark St Carroll IA 51401 Hospice Services 7 - St Anthony Clinic - Denison 1820 4th Ave South Denison IA 51442 Family Practice Clinic Part I, Line 3c: In addition to FPG, the Hospital will consider the extent to which the patient's household has assets that could be used to meet his or her financial obligation. Assets may include, but are not limited to, cash, savings and checking account, certificates of deposit, stocks and bonds, individual retirement accounts (IRAs), trust funds, real estate (excluding the patient's home) and motor vehicles. The hospital will take into account any liabilities that are the responsibility of the patient's household. To relieve stress related to financial burdens, families with a medical catastrophe with self-pay balances greater than 20 percent of their annual household income in one calendar year may be eligible for substantial discounts. St. Anthony's Regional Hospital and Nursing Home also uses asset level, medical indigency, insurance status, Medicaid/Medicare coverage, and state regulations as factors in determining eligibility for free and discounted care. Part I, Line 6a: The annual community benefit report is available upon request. Part I, Line 7: Charity care expense was converted to cost on line 7a based on an overall cost to charge ratio addressing all patient segments. Unreimbursed Medicaid on line 7b was calculated using the cost-to-charge ratio derived from worksheet 2. Cost of community health improvement services on line 7e, health professions education on line 7f, and cash and in-kind contributions for community benefit on line 7i are based on actual costs recorded in the general ledger. The cost for subsidized health services reported on line 7g was determined using the Medicare Cost Report. Part II, Community Building Activities: The Hospital CEO participates in the Carroll Area Development board that is active in economic development. The CEO is a board member of the Iowa Hospital Association Board of Directors. There are managers of the Hospital that serve on local health advisory boards. Part III, Line 2: The amount on line 2 represents implicit price concessions. The Organization determines its estimate of implicit price concession based on its historical collection experience with this class of patients. Part III, Line 3: The estimated amount of the Organization's implicit price concessions attributable to patients eligible under the Organization's charity care policy is calculated based on an approximate 9.7% of individuals living below the poverty level in the service area. Part III, Line 4: The footnote to the organization's financial statements that describes implicit price concessions is located in Note 1 on pages 13 and 14 of the attached financial statements. Part III, Line 8: The amount of Medicare shortfall on line 6 should be included as a community benefit. Providing services to Medicare patients is essential to these patients and the community and increases their access to healthcare services, which is a community benefit.Medicare allowable costs of care are based on the Medicare Cost Report. The Medicare cost report is completed based on the rules and regulations set forth by the Centers for Medicare and Medicaid Services. Part III, Line 9b: St. Anthony Regional Hospital accepts and processes financial assistance applications beginning on the date care is provided and ends on the 240th day after the first post-discharge billing statement or can also be the deadline indicated by the Hospital for the application deadline or the deadline for providing additional information. If there is an incomplete application within 240 days of the first post-discharge billing statement, St. Anthony Regional Hospital will suspend any extraordinary collection activities (ECAs) and notify the individual in writing with contact information for resources of how to complete the application and give a reasonable time to respond. If there is a complete application within 240 days of the first post-discharge billing statement, St. Anthony Regional Hospital will suspend any ECAs and notify the individual of eligibility and updated billing statements. If a financial assistance application is filed with the Hospital on or close to the deadline, the application will be processed on an expedited basis. Notification is sent to patients 30 days prior to initiating any ECAs. Part VI, Line 2: An internal working group was charged, along with Tripp Umbach, to help identify the needs of those living in the hospital's service area. The information presented in the community health needs assessment represents a comprehensive community-wide process where St. Anthony Regional Hospital continued to connect with public and private organizations, such as health-related professionals, human service organizations, non-profits, civic organizations, and childcare facilities, to evaluate the community's health and social needs. The needs assessment took a deep dive into existing resources integrating helpful information to achieve health equality in the community. An independent review of existing data, including in-depth interviews with local stakeholders, resulted in the identification and confirmation of crucial community health needs. We coordinate with local county organizations including law enforcement, ambulance service, and other providers of healthcare. We participate and host forums, feedback surveys, the Patient and Family Advisory Council, multiple support groups, and community grants. All of these things, along with our CHNA, help St. Anthony Regional Hospital to assess and ascertain the needs of the communities we serve. Part VI, Line 3: The financial counselor from the organization informs and educates patients about eligibility of federal, state, and local government programs and charity policies. The charity care policy is made available to patients in the admissions office and provided in the admission packets. If patients have questions, they can stop in the business office and discuss them with the financial counselor. Part VI, Line 4: St. Anthony Regional Hospital and Nursing Home is located in Carroll, Iowa, St. Anthony serves a predominantly rural population over a large geographic area comprising six counties in West Central Iowa. These counties include Audubon, Calhoun, Carroll, Crawford, Greene, and Sac. Carroll, IA had a population of 10,300 people with a median household income of $51,443. The 5 largest ethnic groups in Carroll, IA are White (Non-Hispanic) (93.4%), (Non-Hispanic) (1.8%), Other (Hispanic) (1.26%), (Hispanic) (0.984%), and White (Hispanic) (0.877%). The largest industries in Carroll, IA are Manufacturing, Health Care & Social Assistance, and Retail Trade. Part VI, Line 5: St. Anthony Regional Hospital and Nursing Home operates an acute care hospital, a nursing care center, several medical clinics, retirement housing called Orchard View, and assisted living called Garden View. The Hospital is a 99-bed acute care facility. St. Anthony Nursing Home has 79 beds. The Hospital has a 10 member independent board of directors. The Hospital extends medical staff privileges to all qualified physicians in the community. St. Anthony Regional Hospital and Nursing Home invests surplus funds in infrastructure and equipment improvements.St. Anthony Regional Hospital has demonstrated a commitment to promoting health care to further its exempt purpose of providing quality health care in the community and surrounding counties for more than one hundred and fifteen years. St. Anthony Regional Hospital is a regional provider and is committed to providing quality care to the community. The majority of the Hospital's board members are from local businesses and reside in the community.Community benefit projects include community health education, health care support services, behavioral health services, community health improvement advocacy, and other traditional charity care. Part VI, Line 7, Reports Filed With States IA 1 St Anthony Foundation 311 South Clark St PO Box 628 Carroll IA 51401 421419695 501(c)(3) 276724 0 Development Office Expenses 1 0 Part I, Line 2: St. Anthony Hospital and Nursing Home made a payment to a related organization, St. Anthony Foundation. The Foundation and Hospital have a close working relationship and monitor the use of the funds. X X X X 0 1 0 0 0 0 0 1 0 Randall Hess MD Radiation Oncologist 496976 0 26163 0 5205 0 15958 0 28072 0 572374 0 0 0 Amy Canuso DO Mental Health 278536 0 131472 0 3771 0 12695 0 33769 0 460243 0 0 0 Edward H Smith Jr CEO/President until Dec. 2022 219633 0 66604 0 75849 0 27619 0 34268 0 423973 0 34787 0 Brian Boes MD Neurology 347995 0 40000 0 4728 0 0 0 28751 0 421474 0 0 0 Richard Goding MD Orthopedics 370677 0 0 0 0 0 0 0 20777 0 391454 0 0 0 Nicole Hayworth DNP ARNP CRNA 275939 0 59752 0 2348 0 10487 0 33165 0 381691 0 0 0 Allen Anderson CEO/President 184156 0 0 0 29 0 0 0 18660 0 202845 0 0 0 Eric Salmonson CFO/Vice President 145997 0 0 0 452 0 3304 0 15260 0 165013 0 0 0 John Munson Former CFO/VP 102543 0 0 0 700 0 0 0 13437 0 116680 0 0 0 Part I, Line 4b St. Anthony Regional Hospital and Nursing home has a non-qualified deferred compensation plan that complies with section 457(f) of the Internal Revenue Code and the short-term deferral provisions of section 409A of the code. The plan is to be an unfunded plan maintained primarily for the purpose of providing deferred compensation benefits for a select group of management or highly compensated employees. Edward H. Smith Jr. was paid $34,787 for his 457f plan in calendar year 2022. Part I, Line 7 In their roles as executives employed by St. Anthony Regional Hospital and Nursing Home, the executives are eligible for incentive payouts. The incentive award will be a percentage of the base pay compensation for the CEO, CFO, and other executives. The ultimate payout includes a reduction/increase multiplier depending on whether the organization reached specified performance metrics identified by the Board of Directors. A Carroll County Iowa 426004323 000000000 2022-10-27 6000000 See Part VI 0 0 0 A 6000000 47500 5952500 2023 0 0 1 1 A 0 0 0 0 0.00000 0.00000 0.00000 0 0 1 A 0 0 0 0 0 0 0 0 1 A 1 Schedule K, Part I, (f), Description of Purpose: Finance a portion of the costs of constructing, renovating, equipping and furnishing the Hospital's dialysis and obstetrical departments and other improvements at the Hospital facilities. Melissa Anderson Wife of CEO/President, Allen Anderson 16578 Compensation as an employee 0 Badding Construction Entity owned more than 35% by Nick Badding, Board Chair, and family 169175 Construction Services 0 Drees Co Entity owned more than 35% by Howard J. Drees, Treasurer, and family 565546 Construction, plumbing, and heating services 0 Form 990, Part VI, Section A, line 6 The former members of the St. Anthony Regional Hospital and Nursing Home are the sisters of the religious community known as the Congregation of the Sisters of the Third Order of the St. Francis of Perpetual Adoration (FSPA). The FSPA formed St. Anthony Ministries to assume canonical sponsorship and membership of St. Anthony Regional Hospital and Nursing Home, performed previously by the FSPA. Form 990, Part VI, Section A, line 7a St. Anthony Ministries, as the sole member of St. Anthony Regional Hospital and Nursing Home has the power to appoint the Board of Directors. Form 990, Part VI, Section A, line 7b All decisions, including dissolution of the organization, made by the Board of Directors of St. Anthony Regional Hospital and Nursing Home are subject to the approval of St. Anthony Ministries. Form 990, Part VI, Section A, line 8b The organization does not have any committees with the authority to act on behalf of the governing body. Form 990, Part VI, Section B, line 11b The final version of the form 990 is given to each member of the Board of Directors prior to filing the return. The Form 990 was reviewed by the CFO and the Audit committee. Form 990, Part VI, Section B, line 12c The Officers and Board Members annually disclose in writing, "any interest which would be inconsistent with the expeditious, proper, and impartial performance of duties." Defining disclosable conflict or duality of interest as any matter in which the corporations are "interested which affects the financial interest or employment of such member, a member of his/her family by blood or marriage, or any business enterprise in which he/she or such family member is employed or has a financial interest." Officers and Board members are required to disclose the facts surrounding any possible conflict of interest throughout the year. If a conflict of interest is disclosed by an Officer or Board Member, during a board meeting the Officer or Board Member will not participate in any discussions or deliberations regarding the matter and would abstain from any voting decisions on this matter during the meeting. All conflict of interests that are disclosed will be reported in the minutes of the board meetings. Form 990, Part VI, Section B, line 15 At the direction of the Board of Directors the CEO gathers compensation information (salary and benefits) from various sources including Iowa Hospital Association and benefit consultants for like-sized organizations. The Executive Committee then determines the annual compensation for the CEO and CFO for the total board approval. The compensation process for the CEO is completed in August annually. The compensation process for the CFO is completed in March annually. The process and determination is documented in the meeting minutes and personnel files. Form 990, Part VI, Section C, line 19 St. Anthony Regional Hospital and Nursing Home's governing documents, conflict of interest policy, and financial statements are available to the public upon request. Form 990, Part IX, line 11g Contractor Labor: Program service expenses 4,510,856. Management and general expenses 0. Fundraising expenses 0. Total expenses 4,510,856. Other Fees: Program service expenses 2,611,482. Management and general expenses 720,922. Fundraising expenses 0. Total expenses 3,332,404. Consulting Services: Program service expenses 270,188. Management and general expenses 91,534. Fundraising expenses 0. Total expenses 361,722. Physicians Fees: Program service expenses 3,465,441. Management and general expenses 0. Fundraising expenses 0. Total expenses 3,465,441. Form 990, Part XI, line 9: Change in beneficial interest in net assets of St. Anthony Foundation 2,201,921. St Anthony Foundation 311 South Clark St PO Box 628 Carroll IA 51401 421419695 Support St. Anthony Regional Hospital and Nursing Home IA 501(c)(3) Line 7 St Anthony Ministries 0 St Anthony Ministries 311 South Clark St PO Box 628 Carroll IA 51401 Religious Order IA 501(c)(3) Canonical entity N/A 0 0 1 1 0 0 0 0 0 0 0 0 0 1 1 1 0 0 1 0