2025-05-14T10:22:38-05:00 2024-06-30 470617373 COMMONSPIRIT HEALTH 198 INVERNESS DRIVE WEST ENGLEWOOD CO 80112 990 2023-07-01 450226553 MERCY HOSPITAL OF VALLEY CITY MERC 7018456489 570 CHAUTAUQUA BLVD VALLEY CITY ND 58072 NICK O'TOOL MARKET CFO 7018456489 2025-05-14 1 1 MARK STOCKI P00642127 3032989100 2023 2025-03-06 01:10:19Z CHI MERCY HEALTH D RYAN FOWLER 570 CHAUTAUQUA BLVD VALLEY CITY ND 58072 15365225 0 0928 X WWW.MERCYHOSPITALVALLEYCITY.ORG/ X 1928 ND MERCY HOSPITAL OF VALLEY CITY IS A CRITICAL ACCESS HOSPITAL SERVING A LARGE GEOGRAPHICAL AREA. COMMUNITY BENEFITS INCLUDE: UNCOMPENSATED CARE, MEDICAL EDUCATION AND AWARENESS, SUPPORT SERVICES, AND COMMUNITY OUTREACH. 5 3 82 30 0 0 83946 68239 13217559 13169013 663740 1195187 83626 932786 14048871 15365225 28725 71245 0 0 4851077 5414650 0 0 0 8405984 8492427 13285786 13978322 763085 1386903 47658626 50641207 6062448 5750492 41596178 44890715 X AS AN AFFILIATE OF COMMONSPIRIT HEALTH, WE MAKE THE HEALING PRESENCE OF GOD KNOWN IN OUR WORLD BY IMPROVING THE HEALTH OF THE PEOPLE WE SERVE, ESPECIALLY THOSE WHO ARE VULNERABLE, WHILE WE ADVANCE SOCIAL JUSTICE FOR ALL. TO FULFILL THIS MISSION, THE CORPORATION, AS A VALUES-BASED ORGANIZATION, WILL ASSURE THE INTEGRITY OF THE MINISTRY IN BOTH CURRENT AND DEVELOPING ORGANIZATIONS AND ACTIVITIES; RESEARCH AND DEVELOP NEW MINISTRIES THAT INTEGRATE HEALTH, EDUCATION, PASTORAL, AND SOCIAL SERVICES; PROMOTE LEADERSHIP DEVELOPMENT AND FORMATION FOR MINISTRY THROUGHOUT THE ENTIRE ORGANIZATION; ADVOCATE FOR SYSTEMIC CHANGES WITH SPECIFIC CONCERN FOR PERSONS WHO ARE POOR, ALIENATED, AND UNDERSERVED; AND STEWARD RESOURCES BY GENERAL OVERSIGHT OF THE ENTIRE ORGANIZATION. 0 0 13023365 71245 13169013 SEE SCHEDULE H 13023365 1 1 0 1 0 0 0 0 0 1 1 1 0 1 1 1 0 1 0 0 0 0 0 0 0 0 1 1 1 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 1 1 1 0 0 1 X 0 0 82 1 0 0 0 0 0 0 0 0 0 0 0 0 X 5 3 0 0 0 0 1 1 1 1 1 0 0 1 1 1 1 1 0 0 1 0 ND X AMBER STOWMAN 7012378022 570 CHAUTAUQUA BLVD VALLEY CITY ND 58072 JULIE GOEBEL BOARD MEMBER/DIVISION SVP COO (PARTIAL YEAR) 1.00 49.00 X 0 964934 55466 DAVID JONES BOARD MEMBER/MARKET PRESIDENT, CENTRAL REGION 1.00 49.00 X 0 460692 53617 TIM SCHNACK MARKET CFO 1.00 49.00 X 0 369715 48053 NICK O'TOOL MARKET CFO (PARTIAL YEAR) 4.00 46.00 X 0 349020 50949 REBECCA THOMPSON FORMER INTERIM PRESIDENT 0.00 40.00 X 0 343425 24380 D RYAN FOWLER BOARD MEMBER/PRESIDENT 40.00 0.00 X X 0 272205 44714 CLARK KRUTA CRNA 40.00 0.00 X 234019 0 54215 AMBER STOMAN TREASURER/VP FINANCE 1.00 39.00 X 0 221301 44587 BETH SMITH TREASURER (PARTIAL YEAR) 1.00 39.00 X 0 158338 41138 ALANA MCCLELLAN MANAGER, EMERGENCY SERVICES 40.00 0.00 X 147582 0 28521 COLLEEN JONES VP, PATIENT CARE SERVICES 40.00 0.00 X 153772 0 20644 AMY NOESKE PHARMACY MANAGER 40.00 0.00 X 135203 0 35590 CAMILLE SETTELMEYER FORMER OFFICER 0.00 40.00 X 0 147170 20013 CARLA MORRISON MANAGER PHARMACY 40.00 0.00 X 20388 120505 4580 KAYLA BEILKE BOARD SECRETARY 40.00 0.00 X 48624 0 12618 ALAN LAFAVE BOARD MEMBER 1.00 0.00 X 0 0 0 CASEY STOUDT CHAIR 1.00 0.00 X X 0 0 0 TIM OST BOARD MEMBER (PARTIAL YEAR) 1.00 0.00 X 0 0 0 FREDRICK MITZEL MD VICE CHAIR (PARTIAL YEAR) 1.00 0.00 X X 0 0 0 TYLER MARTHALER BOARD MEMBER 1.00 0.00 X 0 0 0 739588 3407305 539085 12 1 1 0 NATIONAL MEDICAL RESOURCES INC 2900 E BROADWAY AVE BISMARCK ND 58540 LOCUM PROVIDERS 1143370 MEDEFIS INC 2121 N 117TH AVE STE 200 OMAHA NE 68164 VENDOR MANAGEMENT/STAFFING 729976 CONVERDIA HEALTH STAFFING 301 SHEYENNE ST WEST FARGO ND 58078 STAFFING SERVICES 270188 ALLIANCE HEALTHCARE SERVICES 18202 VON KARMAN AVE SUITE 600 IRVINE CA 92612 PATIENT CARE SERVICES 137387 4 55889 12350 68239 NET PATIENT SERVICES 900099 13167113 13167113 0 0 RENTAL INCOME 900099 1900 1900 0 0 13169013 369088 369088 826099 0 826099 826099 826099 INTERCOMPANY TRANSACTI 900099 801070 0 0 801070 INSURANCE RECOVERIES 900099 124542 0 0 124542 MEDICAL SERVICES 621300 3277 0 0 3277 3897 3897 932786 15365225 13169013 0 2127973 X 71245 71245 65859 65859 4339548 4085114 254434 209866 191725 18141 475880 451542 24338 323497 297617 25880 18675 18675 1055 1055 4559374 4103436 455938 34021 34021 149493 125574 23919 539253 539253 203006 203006 7875 7560 315 6558 6558 940 940 541573 541573 776783 761247 15536 81081 81081 MEDICAL SUPPLIES 1123708 1123708 0 0 REPAIRS AND MAINTENANCE 308826 308826 0 0 DUES & SUBSCRIPTIONS 60079 60079 0 0 INTERCOMPANY ALLOCATION 21729 20643 1086 0 58398 50136 8262 13978322 13023365 954957 0 500 501 9034224 9658575 0 2557244 2088599 0 0 0 221535 271188 0 15916295 14167469 2291590 1748826 0 29393927 32465005 0 0 4159606 4408513 47658626 50641207 1759326 1180105 0 0 0 0 0 0 0 4303122 4570387 6062448 5750492 X 41582424 44876961 13754 13754 41596178 44890715 47658626 50641207 X 1386903 1875890 31744 X 0 1 X 1 1 1 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 0 0 0 0 0 1 1055 0 0 0 1055 0 PART II-B, LINE 1: THE PORTION OF ORGANIZATION DUES THAT ARE RELATED TO LOBBYING ARE AS FOLLOWS: CATHOLIC HEALTH ASSOCIATION - $76 AMERICAN HOSPITAL ASSOCIATION - $177 340B - $67 NORTH DAKOTA HEALTH ASSOCIATION - $735 122479 12810 6950 331 128008 118220 4495 236 122479 122801 -4281 300 118220 97450 25351 122801 94878 2885 313 97450 0.37040 0.62960 0 1 1 19382 19382 6955588 6325545 630043 8490595 7727747 762848 450730 114177 336553 1748826 CSH OPERATING INVESTMENT POOL 32465005 F 32465005 INTERCOMPANY RECEIVABLES 4260094 INVESTMENT IN UNCONSOLIDATED ORGS 48168 RIGHT OF USE ASSETS 100251 4408513 INTERCOMPANY PAYABLES 4377730 LEASE LIABILITIES 89793 SERVICE FEE LIABILITY 359 PHYSICIAN RECRUIT AND GUARANTEE PAYABLE 102505 4570387 X PART V, LINE 4: WE HAVE TWO ENDOWMENT FUNDS, ONE IS FOR SCHOLARSHIPS AND THE OTHER ONE IS AN EMPLOYEE ENDOWMENT FUND THAT WAS CREATED FOR REMODEL PURPOSES. THE BALANCE OF THE SCHOLARSHIP FUND IS $35,571, AND THE EMPLOYEE ENDOWMENT FUND IS $92,437. PART X, LINE 2: MERCY HOSPITAL OF VALLEY CITY'S FINANCIAL INFORMATION IS INCLUDED IN COMMONSPIRIT HEALTH'S CONSOLIDATED AUDITED FINANCIAL STATEMENTS, WHICH INCLUDES THE FOLLOWING DISCLOSURE: COMMONSPIRIT REVIEWS ITS TAX POSITIONS QUARTERLY AND HAS DETERMINED THAT THERE ARE NO MATERIAL UNCERTAIN TAX POSITIONS THAT REQUIRE RECOGNITION IN THE ACCOMPANYING CONSOLIDATED FINANCIAL STATEMENTS. 1 1 X 1 X 1 X 1 1 0 1 1 342 223414 223414 0.01600 1703 1261103 1349039 0 0.00000 2045 1484517 1349039 223414 0.01600 2 173 16294 16294 0.00120 2 12 370 370 0.00000 2 1 6167 6167 0.00040 6 186 22831 22831 0.00160 6 2231 1507348 1349039 246245 0.01760 2 0 1211 1211 0.00010 1 10 33 33 0.00000 3 10 1244 1244 0.00010 1 526825 0 5044052 4647370 396682 X 1 1 1 1 MERCY HOSPITAL OF VALLEY CITY 570 CHAUTAUQUA BLVD VALLLEY CITY ND 58072 HTTP://WWW.MERCYHOSPITALVALLEYCITY.ORG 5050A X X X X MERCY HOSPITAL OF VALLEY CITY 1 0 0 1 X X X X X X X X X 21 1 0 1 1 X HTTPS://WWW.MERCYHOSPITALVALLEYCITY.ORG/COMMUNITY-BENEFITS/ X 1 22 1 HTTPS://WWW.MERCYHOSPITALVALLEYCITY.ORG/COMMUNITY-BENEFITS/ 0 1 X 200.000000000000 400.000000000000 X X X X X X 1 1 X X X 1 X HTTPS://WWW.MERCYHOSPITALVALLEYCITY.ORG/FINANCIAL-INFORMATION-DOCUMENTS/ X HTTPS://WWW.MERCYHOSPITALVALLEYCITY.ORG/FINANCIAL-INFORMATION-DOCUMENTS/ X HTTPS://WWW.MERCYHOSPITALVALLEYCITY.ORG/FINANCIAL-INFORMATION-DOCUMENTS/ X X X X X X 1 X 0 X X X X 1 X 0 0 PART V, SECTION B, LINE 3E: THE SIGNIFICANT HEALTH NEEDS ARE A PRIORITIZED DESCRIPTION OF THE SIGNIFICANT HEALTH NEEDS OF THE COMMUNITY AND IDENTIFIED THROUGH THE CHNA. PART V, SECTION B, LINE 5: IN CONDUCTING ITS MOST RECENT CHNA, CHI MERCY HEALTH VALLEY CITY TOOK INTO ACCOUNT INPUT FROM PERSONS WHO REPRESENT THE BROAD INTERESTS OF THE COMMUNITY SERVED BY THE HOSPITAL FACILITY, INCLUDING THOSE WITH SPECIAL KNOWLEDGE OF OR EXPERTISE IN PUBLIC HEALTH. THIS ASSESSMENT EXAMINES HEALTH NEEDS AND CONCERNS IN BARNES COUNTY. IN ADDITION TO VALLEY CITY, LOCATED IN THE COUNTY ARE THE COMMUNITIES OF DAZEY, FINGAL, KATHRYN, LEAL, LITCHVILLE, NOME, ORISKA, PILLSBURY, ROGERS, SANBORN, SIBLEY, TOWER CITY, AND WIMBLEDON.CENTER FOR RURAL HEALTH (CRH), IN PARTNERSHIP WITH CHI MERCY HEALTH AND CITY-COUNTY HEALTH DISTRICT, FACILITATED THE CHNA PROCESS. COMMUNITY REPRESENTATIVES MET REGULARLY IN-PERSON, BY TELEPHONE CONFERENCE, AND EMAIL. A CHNA LIAISON WAS SELECTED LOCALLY, WHO SERVED AS THE MAIN POINT OF CONTACT BETWEEN CRH AND CHI MERCY HEALTH. A SMALL STEERING COMMITTEE WAS FORMED THAT WAS RESPONSIBLE FOR PLANNING AND IMPLEMENTING THE PROCESS LOCALLY. REPRESENTATIVES FROM THE CRH MET AND CORRESPONDED REGULARLY BY TELECONFERENCE AND/OR VIA THE ETOOLKIT WITH THE CHNA LIAISON. THE COMMUNITY GROUP (DESCRIBED IN MORE DETAIL BELOW) PROVIDED IN-DEPTH INFORMATION AND INFORMED THE ASSESSMENT PROCESS IN TERMS OF COMMUNITY PERCEPTIONS, COMMUNITY RESOURCES, COMMUNITY NEEDS, AND IDEAS FOR IMPROVING THE HEALTH OF THE POPULATION, AND HEALTHCARE SERVICES. EIGHT PEOPLE, REPRESENTING A CROSS SECTION DEMOGRAPHICALLY, ATTENDED THE FOCUS GROUP MEETING.AS PART OF THE ASSESSMENT'S OVERALL COLLABORATIVE PROCESS, CRH SPEARHEADED EFFORTS TO COLLECT DATA FOR THE ASSESSMENT IN A VARIETY OF WAYS:A SURVEY SOLICITED FEEDBACK FROM AREA RESIDENTS;* COMMUNITY LEADERS, REPRESENTING THE BROAD INTERESTS OF THE COMMUNITY, TOOK PART IN ONE-ON-ONE KEY INFORMANT INTERVIEWS;* THE COMMUNITY GROUP, COMPRISED OF COMMUNITY LEADERS AND AREA RESIDENTS, WAS CONVENED TO DISCUSS AREA HEALTH NEEDS AND INFORM THE ASSESSMENT PROCESS; AND* A WIDE RANGE OF SECONDARY SOURCES OF DATA WERE EXAMINED, PROVIDING INFORMATION ON A MULTITUDE OF MEASURES, INCLUDING DEMOGRAPHICS, HEALTH CONDITIONS, INDICATORS, OUTCOMES, RATES OF PREVENTIVE MEASURES; RATES OF DISEASE; AND AT-RISK BEHAVIOR.MEMBERS OF THE COMMUNITY GROUP AND KEY INFORMANT INTERVIEWS REPRESENTED THE BROAD INTERESTS OF THE COMMUNITY AND SERVED BY CHI MERCY HEALTH AND CITY-COUNTY HEALTH DISTRICT. THEY INCLUDED REPRESENTATIVES OF THE HEALTH COMMUNITY, BUSINESS COMMUNITY, POLITICAL BODIES, LAW ENFORCEMENT, EDUCATION, FAITH COMMUNITY, AND SOCIAL SERVICE AGENCIES. PART V, SECTION B, LINE 6B: CENTER FOR RURAL HEALTHCITY-COUNTY HEALTH DISTRICTOUR SAVIOR'S LUTHERAN CHURCHSOUTH CENTRAL HUMAN SERVICE CENTERVALLEY CITY STATE UNIVERSITYVALLEY CITY CHAMBER OF COMMERCE PART V, SECTION B, LINE 11: THE COMMUNITY IDENTIFIED THE FOLLOWING PRIORITIES AS TOP HEALTH NEEDS THROUGH PRIMARY DATA GATHERED THROUGH A COMMUNITY HEALTH SURVEY AND KEY INFORMANT INTERVIEW, AS WELL AS REVIEW OF SECONDARY DATA. TOP HEALTH NEEDS (FROM 2022 CHNA): 1. AVAILABILITY OF MENTAL HEALTH SERVICES2. NOT ENOUGH JOBS WITH LIVABLE WAGES3. DEPRESSION/ANXIETY - YOUTH4. ALCOHOL AND DRUG USE AND ABUSE - YOUTH5. AVAILABILITY OF RESOURCES TO HELP THE ELDERLY STAY IN THEIR HOMES6. ALCOHOL USE AND ABUSE - ADULTS7. ATTRACTING AND RETAINING YOUNG FAMILIES8. COST OF LONG-TERM/NURSING HOME CARE 9. DRUG USE AND ABUSE - ADULT10. DEPRESSION/ANXIETY - ADULTFOR THIS PLAN THE HOSPITAL PRIORITIZED THE FOLLOWING HEALTH NEEDS:PRIORITY HEALTH NEED #1: HEALTH NEED: AVAILABILITY OF MENTAL HEALTH SERVICESTO ADDRESS THIS NEED THE HOSPITAL WILL IMPLEMENT THE FOLLOWING STRATEGIES IN FISCAL YEARS 2023- 2025:1.1 VIRTUAL BEHAVIORAL HEALTH SERVICE ASSESSMENTS1.1.1 PROVIDE A VIRTUAL PROVIDER-PATIENT ASSESSMENT TOOL FOR ASSESSING BEHAVIORAL HEALTH ISSUES. - FY24 ACTIONS AND IMPACT: STRATEGY BEING DISCONTINUED DUE TO LACK OF RESOURCES. - MEASURES: THERE ARE NO MEASURES TO REPORT.1.2 NORTH DAKOTA HOSPITAL ASSOCIATION (NDHA) BEHAVIORAL HEALTH WORKGROUP1.2.1 PARTICIPATE IN NDHA WORKGROUP TO ADDRESS BEHAVIORAL HEALTH CARE IN ND CAHS. - FY24 ACTIONS AND IMPACT: STRATEGY BEING DISCONTINUED AS IT IS BEING CAPTURED IN OTHER STRATEGIES WITHIN THIS PRIORITY NEED. - MEASURES: THERE ARE NO MEASURES TO REPORT.1.3 SCREENING PROCESS AT CRITICAL ACCESS HOSPITAL (CAH)1.3.1 EVALUATE SCREENINGS FOR PEOPLE IN CRISIS WHO MAY NEED REFERRAL TO OTHER FACILITIES. - FY24 ACTIONS AND IMPACT: SCREENINGS CURRENTLY IMPLEMENTED FOR PATIENTS PRESENTING TO THE ER - MEASURES: 60 PATIENTS SCREENED AND REFERRED FOR FURTHER TREATMENT TO OTHER FACILITIES 1.3.2 DEFINE PROCESS FOR TRANSPORTING INDIVIDUALS IN NEED OF BEHAVIORAL HEALTH SERVICES. - FY24 ACTIONS AND IMPACT: RESPONSIBILITY FOR THIS PROCESS ASSUMED BY LOCAL LAW ENFORCEMENT AND IS IN PLACE. STRATEGY TO BE DISCONTINUED TO BETTER UTILIZE RESOURCES - MEASURES: THERE ARE NO MEASURES TO REPORT.1.4 SCREENING AND COMMUNICATION PROCESSES WITH SCHOOLS1.4.1 ASSIST IN DEVELOPING SCREENING AND COMMUNICATION PROCESSES TO IDENTIFY BEHAVIORAL HEALTH ISSUES IN YOUTH AND COMMUNICATE WITH APPROPRIATE RESOURCES. - FY24 ACTIONS AND IMPACT: COMMUNITY HEALTH IMPROVEMENT GRANT ($6,124) AWARDED TO VALLEY CITY EDUCATION FOUNDATION. THE FUNDS WERE USED TO SPONSOR ACCESS FOR ALL PROGRAMMING FOR MENTAL HEALTH SERVICES FOR PUBLIC SCHOOL STUDENTS. - MEASURES: GRANT FUNDING COVERED ONE MONTH OF BEHAVIORAL HEALTH SUPPORT FOR OVER 50 STUDENTS IN KINDERGARTEN THROUGH 12TH GRADE IN VALLEY CITY. 1.5 EDUCATION ON AVAILABLE BEHAVIORAL HEALTH SERVICES 1.5.1 PARTNER WITH CITY-COUNTY HEALTH DISTRICT TO PROVIDE MENTAL HEALTH FIRST AID TRAINING TO EDUCATE THE COMMUNITY AND EMERGENCY ROOM PROVIDERS ON THE CURRENT AVAILABLE TREATMENT OPTIONS AND WORK TOWARDS DEVELOPING AND IMPLEMENTING NEW TREATMENT OPTIONS FOR PEOPLE IN CRISIS. - FY24 ACTIONS AND IMPACT: NO TRAININGS PROVIDED IN FY24 DUE TO STAFFING TURNOVER AT CITY-COUNTY HEALTH DISTRICT AND STAFFING SHORTAGES AT CHI MERCY HOSPITAL. CONVERSATIONS CONTINUING TO PROVIDE TRAININGS IN FY25 - MEASURES: NO MEASURES TO REPORT AT THIS TIME.1.5.2 NORTH DAKOTA VIOLENCE PREVENTION "COACHING BOYS INTO MEN" PROGRAM THAT ADDRESSES MENTAL HEALTH ISSUES TIED TO VIOLENCE IN YOUTH AS YOUNG AS 12 YEARS OF AGE. - FY24 ACTIONS AND IMPACT: NO TRAINING PROVIDED IN FY24 DUE TO TURNOVER IN COACHING STAFF AND INABILITY TO FIND NEW COACH TO PROVIDE TRAININGS. ACTIVITY ON HOLD UNTIL NEW COACH IS FOUND TO PROVIDE TRAININGS, OR DIFFERENT STRATEGY CAN BE EMPLOYED TO PROVIDE TRAININGS TO OTHER COMMUNITY MEMBERS. - MEASURES: NO MEASURES TO REPORT AT THIS TIME.1.6.1 PARTNERED WITH SOUTH CENTRAL HUMAN SERVICES AND CITY-COUNTY HEALTH DISTRICT TO DISTRIBUTE GRANT FUNDING FOR BEHAVIORAL HEALTH AND HOUSING NEEDS.- FY24 ACTION AND IMPACT: AWARDED $25,000 SPARK GRANT. SET UP SCREENING AND FUND DISTRIBUTION PROCESSES FOR TRANSITIONAL HOUSING NEEDS RELATED TO BEHAVIORAL HEALTH.- MEASURES: DISTRIBUTED $25,000 TO 34 INDIVIDUALS IN NEED.PRIORITY HEALTH NEED #2: : NOT ENOUGH JOBS WITH LIVABLE WAGESTO ADDRESS THIS NEED THE HOSPITAL WILL IMPLEMENT THE FOLLOWING STRATEGIES IN FISCAL YEARS 2023- 2025:2.1 GROW YOUR OWN HEALTHCARE WORKFORCE2.1.1 HOSPITAL WILL CREATE A JOB SHADOW PROGRAM FOR HIGH SCHOOL-AGED YOUTH TO LEARN ABOUT HEALTHCARE OCCUPATIONS. - FY24 ACTION AND IMPACT: SHADOW PROGRAM UTILIZED FOR HIGH SCHOOL STUDENTS INTERESTED IN HEALTHCARE OCCUPATIONS - MEASURES: 9 STUDENTS SHADOWED HEALTHCARE PROFESSIONALS IN FY242.1.2 THE HOSPITAL WILL PARTICIPATE IN OR HOST A LOCAL JOB FAIR. - FY24 ACTION AND IMPACT: STRATEGY DISCONTINUED IN FY23 DUE TO LESS THAN OPTIMAL SUCCESS AND STAFFING RESTRUCTURE; PLAN TO BETTER UTILIZE RESOURCES. - MEASURES: THERE ARE NO MEASURES TO REPORT.2.1.3 CHI MERCY HEALTH VALLEY CITY TO PROVIDE CLASSES TO THE COMMUNITY FOR CERTIFIED NURSING ASSISTANT CERTIFICATION BEYOND EXISTING HIGH SCHOOL PROGRAMS - FY24 ACTION AND IMPACT: HOSPITAL ACCEPTED CLINICAL STUDENTS IN NURSING, LAB, AND PHARMACY DURING FY24. - MEASURES: THERE ARE NO MEASURES TO REPORT.2.1.4 CHI MERCY HEALTH VALLEY CITY WILL PROVIDE CLINICAL ROTATIONS FOR STUDENTS IN HEALTHCARE CAREER FIELDS TO PROMOTE HEALTHCARE PROFESSIONS- FY24 ACTION AND IMPACT: HOSPITAL ACCEPTED CLINICAL STUDENTS IN NURSING, LAB, AND PHARMACY DURING FY24.- MEASURES: 12 STUDENTS TOTAL SERVED IN CLINICAL ROTATIONS2.1.5 CHI MERCY HEALTH TO DEVELOP HEALTHCARE CAREERS THROUGH SCHOLARSHIPS TO GRADUATING HIGH SCHOOL STUDENTS ENTERING EDUCATIONAL PROGRAMS IN HEALTHCARE FIELDS.- FY24 ACTION AND IMPACT: SCHOLARSHIPS PROVIDED TO GRADUATING HIGH SCHOOL STUDENTS ENTERING HEALTHCARE CAREER FIELDS- MEASURES: THREE $500 SCHOLARSHIPS AWARDED TO THREE GRADUATING HIGH SCHOOL SENIORS2.2 PARTNER WITH VALLEY CITY ECONOMIC DEVELOPMENT GROUP AND CHAMBER OF COMMERCE2.2.1 IN SUPPORT OF LOCAL BUSINESSES, BUILD AWARENESS OF JOBS AND THE AVAILABILITY OF COMPETITIVE LIVABLE WAGES AND BENEFITS WITHIN THE COMMUNITY. - FY24 ACTION AND IMPACT: COMMUNITY COMPLETED THIS PROGRAM IN FY23 AND HAS DISCONTINUED THESE EFFORTS. RESOURCES BEING UTILIZED ON OTHER RECRUITMENT PROGRAMS. - MEASURES: NO ACTIVITIES TO REPORT AT THIS TIME.2.3 WORKFORCE HEALTH EDUCATION2.3.1 INCREASE AWARENESS AMONG EMPLOYERS AND ENCOURAGE EDUCATION IN UNDERSTANDING WORKPLACE MENTAL HEALTH STRUGGLES TO MAINTAIN/RECRUIT WORKFORCE. - FY24 ACTION AND IMPACT: STRATEGY BEING DISCONTINUED AS IT IS BEING REPORTED IN STRATEGY 1.5.1. - MEASURES: THERE ARE NO MEASURES TO REPORT. PART V, SECTION B, LINE 11 (CONTINUED): PRIORITY HEALTH NEED #3: HEALTH NEED: DEPRESSION/ANXIETY YOUTHTO ADDRESS THIS NEED THE HOSPITAL WILL IMPLEMENT THE FOLLOWING STRATEGIES IN FISCAL YEARS 2023- 2025:3.1 EDUCATION FOR FRONTLINE WORKERS3.1.1 THE HOSPITAL WILL WORK WITH LOCAL SCHOOLS, EMERGENCY SERVICES AND AGENCIES TO PROVIDE BEHAVIORAL HEALTH EDUCATION TO WORKERS WHO ARE DIRECTLY IMPACTED BY YOUTH WITH BEHAVIORAL HEALTH PROBLEMS. - FY24 ACTION AND IMPACT: STRATEGY ON HOLD DUE TO TURNOVER IN THE LOCAL PUBLIC HEALTH DEPARTMENT AND FEWER RESOURCES AVAILABLE WITHIN CHI MERCY HEALTH. LOOKING TO ADDRESS IN FY25. - MEASURES: THERE ARE NO MEASURES TO REPORT.3.2 EXPLORE EVIDENCE-BASED PREVENTION PROGRAMS3.2.1 WORK WITH LOCAL AGENCIES TO DEVELOP OR IMPLEMENT A PREVENTION PROGRAM THAT CAN BE USED BY ALL MEMBERS OF THE BEHAVIORAL HEALTH COALITION TO WORK TOWARDS REDUCING THE NUMBER OF YOUTH SUFFERING FROM DEPRESSION AND ANXIETY. - FY24 ACTION AND IMPACT: STRATEGY BEING DISCONTINUED AS IT IS BEING REPORTED IN STRATEGIES 3.1.1 AND 3.1.3. - MEASURES: THERE ARE NO MEASURES TO REPORT.3.3 SOUTH CENTRAL HUMAN SERVICE CENTER RESOURCES3.3.1 PARTNER WITH SOUTH CENTRAL HUMAN SERVICE CENTER TO EDUCATE THE COMMUNITY ON THE CURRENT AVAILABLE TREATMENT OPTIONS AND WORK TOWARDS DEVELOPING AND IMPLEMENTING NEW TREATMENT OPTIONS. - FY24 ACTION AND IMPACT: COLLABORATED WITH SOUTH CENTRAL HUMAN SERVICE CENTER AND CITY-COUNTY HEALTH DISTRICT TO CREATE ONE GRANT FUNDED BEHAVIORAL HEALTH POSITION AT LOCAL PRISON. THIS POSITION WILL SCREEN RESIDENTS AND ESTABLISH CONNECTIONS TO BEHAVIORAL HEALTH RESOURCES. ESTABLISHED MEMORY CAFE WHICH IS A MONTHLY MEETING FOR CAREGIVERS, FAMILY, AND PATIENTS WITH DEMENTIA. - MEASURES: ONE BEHAVIORAL HEALTH POSITION CREATED, ON HOLD AS PROCESSES AND LOGISTICS ARE REFINED. MEMORY CAFE MEETS MONTHLY AND HAS 10 ATTENDANTS ON AVERAGE.PRIORITY HEALTH NEED #4: HEALTH NEED: ALCOHOL AND DRUG USE AND ABUSE YOUTHTO ADDRESS THIS NEED THE HOSPITAL WILL IMPLEMENT THE FOLLOWING STRATEGIES IN FISCAL YEARS 2023- 2025:4.1 COMMUNITY HEALTH PARTNERS AT VALLEY CITY SCHOOLS4.1.1 PROVIDE SCHOOL-BASED HEALTH CARE EDUCATION ABOUT ALCOHOL AND DRUG ABUSE TO CHILDREN AND FAMILIES. - FY24 ACTION AND IMPACT: STRATEGY WAS PUT ON HOLD IN FY23 DUE TO LIMITED RESOURCES. FOCUS ON OTHER PRIORITIES DUE TO STAFFING CONSTRAINTS. - MEASURES: THERE ARE NO MEASURES TO REPORT.4.1.2 TRAIN STAFF IN IDENTIFYING AND ASSESSING YOUTH WHO MAY BE STRUGGLING WITH ADDICTION PROBLEMS. - FY 24 ACTION AND IMPACT: THIS STRATEGY IS BEING DISCONTINUED AS IT IS BEING REPORTED IN STRATEGY 3.1.1. - MEASURES: THERE ARE NO MEASURES TO REPORT.4.2 IDENTIFY PREVENTIVE PROGRAMS FOR ALCOHOL AND DRUG ABUSE.4.2.1 WORK WITH LOCAL FAITH LEADERS, SCHOOLS AND PARENT GROUPS TO DEVELOP PEER SUPPORT RESOURCES FOR YOUTH STRUGGLING WITH ADDICTION. - FY 24 ACTION AND IMPACT: STRATEGY BEING DISCONTINUED AS IT IS BEING REPORTED IN STRATEGY 3.1.1. - MEASURES: THERE ARE NO MEASURES TO REPORT.4.3 IDENTIFY CURRENT AND NEW TREATMENT RESOURCES4.3.1 PARTNER WITH SOUTH CENTRAL HUMAN SERVICE CENTER TO EDUCATE THE COMMUNITY ON THE CURRENTLY AVAILABLE TREATMENT OPTIONS AND WORK TOWARDS DEVELOPING AND IMPLEMENTING NEW TREATMENT OPTIONS. - FY 24 ACTION AND IMPACT: STRATEGY BEING DISCONTINUED AS IT IS BEING REPORTED IN STRATEGY 3.3.1. - MEASURES: THERE ARE NO MEASURES TO REPORT.THE HOSPITAL HAS CHOSEN NOT TO ADDRESS THE FOLLOWING IDENTIFIED NEEDS SPECIFICALLY WITHIN OUR INITIATIVES. THESE HEALTH CONCERNS ARE EITHER BEYOND ARE CAPACITY, BEING ADDRESSED BY OTHER ORGANIZATIONS AND PROGRAMS, OR ARE CURRENTLY ADDRESSED THROUGH EXISTING HOSPITAL PROGRAMS. FOR EACH ISSUE, HOWEVER, WE WILL CONTINUE TO DIALOGUE WITH COMMUNITY PARTNERS.1. AVAILABILITY OF RESOURCES TO HELP THE ELDERLY STAY IN THEIR HOMES2. ALCOHOL USE AND ABUSE - ADULTS3. ATTRACTING AND RETAINING YOUNG FAMILIES4. COST OF LONG-TERM/NURSING HOME CARE 5. DRUG USE AND ABUSE - ADULT6. DEPRESSION/ANXIETY - ADULT PART V, SECTION B, LINE 13H: THE PATIENT MUST HAVE A MINIMUM ACCOUNT BALANCE OF TEN DOLLARS ($10.00) WITH THE COMMONSPIRIT HOSPITAL ORGANIZATION. MULTIPLE ACCOUNT BALANCES MAY BE COMBINED TO REACH THIS AMOUNT. PATIENTS/GUARANTORS WITH BALANCES BELOW TEN DOLLARS ($10.00) MAY CONTACT A FINANCIAL COUNSELOR TO MAKE MONTHLY INSTALLMENT PAYMENT ARRANGEMENTS. THE PATIENT MUST SUBMIT A COMPLETED FINANCIAL ASSISTANCE APPLICATION. PATIENT COOPERATION STANDARDS - A PATIENT MUST COOPERATE WITH THE HOSPITAL FACILITY IN PROVIDING THE INFORMATION AND DOCUMENTATION NECESSARY TO DETERMINE ELIGIBILITY. SUCH COOPERATION INCLUDES COMPLETING ANY REQUIRED APPLICATIONS OR FORMS. THE PATIENT IS RESPONSIBLE FOR NOTIFYING THE HOSPITAL FACILITY OF ANY CHANGE IN FINANCIAL SITUATION THAT WOULD IMPACT THE ASSESSMENT OF ELIGIBILITY. A PATIENT MUST EXHAUST ALL OTHER PAYMENT OPTIONS, INCLUDING PRIVATE COVERAGE, FEDERAL, STATE AND LOCAL MEDICAL ASSISTANCE PROGRAMS, AND OTHER FORMS OF ASSISTANCE PROVIDED BY THIRD PARTIES PRIOR TO BEING APPROVED. AN APPLICANT FOR FINANCIAL ASSISTANCE IS RESPONSIBLE FOR APPLYING TO PUBLIC PROGRAMS FOR AVAILABLE COVERAGE. HE OR SHE IS ALSO EXPECTED TO PURSUE PUBLIC OR PRIVATE HEALTH INSURANCE PAYMENT OPTIONS FOR CARE PROVIDED BY A COMMONSPIRIT HOSPITAL ORGANIZATION WITHIN A HOSPITAL FACILITY. A PATIENT'S AND, IF APPLICABLE, ANY GUARANTOR'S COOPERATION IN APPLYING FOR APPLICABLE PROGRAMS AND IDENTIFIABLE FUNDING SOURCES, INCLUDING COBRA COVERAGE (A FEDERAL LAW ALLOWING FOR A TIME-LIMITED EXTENSION OF EMPLOYEE HEALTHCARE BENEFITS), SHALL BE REQUIRED. IF A HOSPITAL FACILITY DETERMINES THAT COBRA COVERAGE IS POTENTIALLY AVAILABLE, AND THAT A PATIENT IS NOT A MEDICARE OR MEDICAID BENEFICIARY, THE PATIENT OR GUARANTOR SHALL PROVIDE THE HOSPITAL FACILITY WITH INFORMATION NECESSARY TO DETERMINE THE MONTHLY COBRA PREMIUM FOR SUCH PATIENT, AND SHALL COOPERATE WITH HOSPITAL FACILITY STAFF TO DETERMINE WHETHER HE OR SHE QUALIFIES FOR HOSPITAL FACILITY COBRA PREMIUM ASSISTANCE, WHICH MAY BE OFFERED FOR A LIMITED TIME TO ASSIST IN SECURING INSURANCE COVERAGE. A HOSPITAL FACILITY SHALL MAKE AFFIRMATIVE EFFORTS TO HELP A PATIENT OR PATIENT'S GUARANTOR APPLY FOR PUBLIC AND PRIVATE PROGRAMS. PART I, LINE 3C: UNLESS ELIGIBLE FOR PRESUMPTIVE FINANCIAL ASSISTANCE, THE FOLLOWING ELIGIBILITY CRITERIA MUST BE MET IN ORDER FOR A PATIENT TO QUALIFY FOR FINANCIAL ASSISTANCE:* THE PATIENT MUST HAVE A MINIMUM ACCOUNT BALANCE OF TEN DOLLARS ($10.00) WITH THE COMMONSPIRIT HOSPITAL ORGANIZATION. MULTIPLE ACCOUNT BALANCES MAY BE COMBINED TO REACH THIS AMOUNT. PATIENTS/GUARANTORS WITH BALANCES BELOW TEN DOLLARS ($10.00) MAY CONTACT A FINANCIAL COUNSELOR TO MAKE MONTHLY INSTALLMENT PAYMENT ARRANGEMENTS.* THE PATIENT MUST COMPLY WITH PATIENT COOPERATION STANDARDS.* THE PATIENT MUST SUBMIT A COMPLETED FINANCIAL ASSISTANCE APPLICATION (FAA).FOR PATIENTS AND GUARANTORS WHO ARE UNABLE TO PROVIDE REQUIRED DOCUMENTATION, A HOSPITAL FACILITY MAY GRANT PRESUMPTIVE FINANCIAL ASSISTANCE BASED ON INFORMATION OBTAINED FROM OTHER RESOURCES. IN PARTICULAR, PRESUMPTIVE ELIGIBILITY MAY BE DETERMINED ON THE BASIS OF INDIVIDUAL LIFE CIRCUMSTANCES THAT MAY INCLUDE:* RECIPIENT OF STATE-FUNDED PRESCRIPTION PROGRAMS;* HOMELESS OR ONE WHO RECEIVED CARE FROM A HOMELESS OR FREE CARE CLINIC;* PARTICIPATION IN WOMEN, INFANTS AND CHILDREN PROGRAMS (WIC);* FOOD STAMP ELIGIBILITY;* ELIGIBILITY OR REFERRALS FOR OTHER STATE OR LOCAL ASSISTANCE PROGRAMS (E.G., MEDICAID);* LOW INCOME/SUBSIDIZED HOUSING IS PROVIDED AS A VALID ADDRESS; OR* PATIENT IS DECEASED WITH NO KNOWN SPOUSE OR KNOWN ESTATE. PART I, LINE 7: COMMONSPIRIT HEALTH HOSPITALS USE A COST ACCOUNTING SYSTEM OR AN ADJUSTED COST TO CHARGE RATIO CALCULATED IN A MANNER CONSISTENT WITH WORKSHEET 2 FOR EACH REPORTING FACILITY, TO DERIVE THE REPORTED COSTS OF FINANCIAL ASSISTANCE, MEDICAID AND OTHER MEANS-TESTED PROGRAMS. WORKSHEET 3 OR THE EQUIVALENT IN THE COMMUNITY BENEFIT INVENTORY FOR SOCIAL ACCOUNTABILITY ("CBISA") SOFTWARE ARE USED TO CALCULATE EXPENSE AND REVENUE, INCLUDING WHERE APPLICABLE MEDICAID PROVIDER FEES AND PAYMENTS FROM UNCOMPENSATED CARE PROGRAMS. ACTUAL OR ESTIMATED COST AND ANY DIRECT OFFSETTING REVENUE IS REPORTED, AND SCHEDULE H WORKSHEETS OR THEIR EQUIVALENTS ARE USED, FOR OTHER COMMUNITY BENEFIT ACTIVITIES SUCH AS COMMUNITY HEALTH IMPROVEMENT SERVICES, COMMUNITY BENEFIT OPERATIONS, HEALTH PROFESSIONS EDUCATION, SUBSIDIZED HEALTH SERVICES, RESEARCH, AND CASH AND IN-KIND DONATIONS. PART II, COMMUNITY BUILDING ACTIVITIES: CHI HEALTH HAS A HISTORY OF CENTRALIZED COMMUNITY BENEFIT INVESTMENTS, AS WELL AS HOSPITAL SPECIFIC INVESTMENTS THAT ADDRESS COMMUNITY HEALTH NEEDS WHICH INCLUDE SUPPORT OF LOCAL HEALTH COALITIONS, INVESTMENTS IN PARTNERSHIPS AND PROGRAMS THAT ADDRESS TOP COMMUNITY HEALTH NEEDS, PARTICIPATION IN LOCAL COMMITTEES AND BOARDS TIED TO TOP HEALTH NEEDS, AND INVESTMENTS IN MANY OTHER WAYS AS DESCRIBED IN OTHER AREAS OF THE SCHEDULE H NARRATIVE.BELOW ARE SPECIFIC EXAMPLES OF WORK THAT FALLS WITHIN THE DEFINITION OF COMMUNITY BUILDING ACTIVITIES. THESE ACTIVITIES ARE CRITICAL IN HELPING BUILD SOCIAL, HEALTH, AND ECONOMIC OPPORTUNITIES IN OUR COMMUNITY THAT ULTIMATELY DRIVE HEALTH STATUS AND QUALITY OF LIFE FOR OUR RESIDENTS: * DONATE AND PARTICIPATE IN ANNUAL TRICK OR TREAT EVENTS FOR 500 CHILDREN OF THE COMMUNITY TO PROVIDE A SAFE AND JOYFUL HOLIDAY EXPERIENCE.* COLLECT AND SAFELY DISPOSE OF RED SHARPS CONTAINERS FROM COMMUNITY MEMBERS. PART III, LINE 2: THE AMOUNT OF THE ORGANIZATION'S BAD DEBT AT COST IS DETERMINED BY APPLYING THE COST TO CHARGE RATIO TO PATIENT CHARGES THAT ARE DEEMED TO BE UNCOLLECTIBLE. THIS AMOUNT REPRESENTS THE COST OF SERVICES PROVIDED TO PATIENTS WHO ARE UNABLE OR REFUSE TO PAY THEIR BILLS AND DO NOT QUALIFY FOR FREE OR ADDITIONAL DISCOUNTED CARE, GOVERNMENT SPONSORED PROGRAMS OR OTHER PAYMENT ASSISTANCE, AND ARE OTHERWISE UNINSURED.THE FILING ORGANIZATION PROVIDES FREE CARE TO ANY PATIENT WHOSE FAMILY INCOME IS AT OR BELOW 200% OF THE FEDERAL POVERTY LEVEL, OR DISCOUNTED CARE TO UNINSURED OR UNDER-INSURED INDIVIDUALS WHOSE FAMILY INCOME IS ABOVE 201% BUT LOWER THAN 400% OF THE FEDERAL POVERTY LEVEL. THE FILING ORGANIZATION ALSO PROVIDES OPTIONS FOR INTEREST-FREE EXTENDED PAYMENT PLANS FOR PATIENTS WHO HAVE DEMONSTRATED GOOD FAITH AND ARE COOPERATING IN RESOLVING THEIR HOSPITAL BILLS. ALL ACCOUNTS FOR ELIGIBLE UNINSURED PATIENTS AT ALL FACILITIES RECEIVE AN AUTOMATIC UNINSURED DISCOUNT. THE EXPECTED PATIENT PAYMENT AMOUNT ON THE PATIENT'S BILL REFLECTS THIS DISCOUNT. DISCOUNTS ARE ACCOUNTED FOR AS DEDUCTIONS FROM REVENUE, NOT AS BAD DEBT EXPENSE. PART III, LINE 3: MERCY HOSPITAL OF VALLEY CITY MAKES EVERY EFFORT TO DETERMINE IF A PATIENT QUALIFIES FOR FINANCIAL ASSISTANCE UPON ADMISSION. MERCY HOSPITAL OF VALLEY CITY'S FINANCIAL ASSISTANCE POLICY IS COMMUNICATED TO PATIENTS UPON ADMISSION AND IS AVAILABLE IN THE LANGUAGES PRIMARILY SPOKEN IN THE COMMUNITY. IT IS ALSO POSTED IN VARIOUS COMMON AREAS OF THE HOSPITAL, SUCH AS EMERGENCY ROOMS, URGENT CARE CENTERS, ADMITTING AND REGISTRATION DEPARTMENTS, HOSPITAL BUSINESS OFFICES LOCATED ON FACILITY CAMPUSES, AND OTHER PUBLIC PLACES, AND IS PROVIDED UPON BILLING IF ELIGIBILITY IS NOT PREVIOUSLY DETERMINED. ELIGIBILITY IS REEVALUATED AS NEEDED AND AMOUNTS ARE CLASSIFIED AS CHARITY AS SOON AS ELIGIBILITY IS KNOWN. MERCY HOSPITAL OF VALLEY CITY ALSO UTILIZES A WAYSTAR SCORING SYSTEM TO ASSIST IN DETERMINING IF A PATIENT MAY QUALIFY FOR PAYMENT ASSISTANCE EVEN THOUGH THEY HAVE NOT APPLIED FOR IT. WAYSTAR USES A METHODOLOGY THAT APPLIES CONSISTENT SCREENING AND APPLICATION STANDARDS TO ALL PATIENTS UTILIZING HISTORICAL DATA TO DEVELOP A PREDICTIVE MODEL FOR HEALTHCARE PAYMENT ASSISTANCE. IN ITS DEVELOPMENT, SPECIAL ATTENTION WAS PAID TO THOSE SOCIOECONOMIC FACTORS THAT MIGHT ADVERSELY AFFECT THOSE PATIENTS DESERVING THE MOST ATTENTION. OTHER CRITERIA ARE ALSO UTILIZED TO ENSURE THAT SERVICES THAT HAVE QUALIFIED AS FINANCIAL ASSISTANCE ARE NOT REPORTED AS BAD DEBT. AS SUCH, MERCY HOSPITAL OF VALLEY CITY DOES NOT BELIEVE THAT ANY AMOUNTS INCLUDED IN PART III, LINE 2, ARE ATTRIBUTABLE TO PATIENTS ELIGIBLE UNDER THE ORGANIZATION'S PAYMENT ASSISTANCE POLICY, AND THEREFORE, NO PORTION OF BAD DEBT EXPENSE IS INCLUDED AS COMMUNITY BENEFIT EXPENSE. PART III, LINE 4: MERCY HOSPITAL OF VALLEY CITY DOES NOT ISSUE SEPARATE COMPANY AUDITED FINANCIAL STATEMENTS. HOWEVER, THE ORGANIZATION IS INCLUDED IN THE CONSOLIDATED FINANCIAL STATEMENTS OF COMMONSPIRIT HEALTH. THE FOLLOWING IS AN EXCERPT FROM COMMONSPIRIT'S CONSOLIDATED ANNUAL AUDITED FINANCIAL STATEMENTS FOR THE YEAR ENDED JUNE 30, 2024, RELATED TO PATIENT ACCOUNTS RECEIVABLE AND NET PATIENT REVENUE. THE ENTIRE FOOTNOTE CAN BE VIEWED IN THE ATTACHED COMMONSPIRIT CONSOLIDATED FINANCIAL STATEMENTS ON PAGES 11-12."PATIENT SERVICE REVENUE IS REPORTED AT THE AMOUNTS THAT REFLECT THE CONSIDERATION COMMONSPIRIT EXPECTS TO BE PAID IN EXCHANGE FOR PROVIDING PATIENT CARE. THESE AMOUNTS ARE DUE FROM PATIENTS, THIRD-PARTY PAYORS (INCLUDING HEALTH INSURERS AND GOVERNMENT PROGRAMS), AND OTHERS, AND INCLUDE CONSIDERATION FOR RETROACTIVE REVENUE ADJUSTMENTS DUE TO SETTLEMENT OF AUDITS AND REVIEWS. GENERALLY, PERFORMANCE OBLIGATIONS FOR PATIENTS RECEIVING INPATIENT ACUTE CARE SERVICES AND OUTPATIENT SERVICES ARE RECOGNIZED OVER TIME AS SERVICES ARE PROVIDED. NET PATIENT REVENUE IS PRIMARILY COMPRISED OF HOSPITAL AND PHYSICIAN SERVICES." PART III, LINE 8: COMMONSPIRIT HEALTH HOSPITALS PREPARE MEDICARE COST REPORTS IN A MANNER THAT COMPORTS WITH PROVIDER REIMBURSEMENT MANUAL (PRM) 15-1 AND PRM 15-2 CHAPTER 40 (TRANSMITTAL 13). AS SUCH, THE FOLLOWING LANGUAGE PER PRM 15-1 DESCRIBES THE COMPUTATION OF COSTS PER THE MEDICARE COST REPORT: TOTAL ALLOWABLE COSTS OF A PROVIDER ARE APPORTIONED BETWEEN PROGRAM BENEFICIARIES AND OTHER PATIENTS SO THAT THE SHARE BORNE BY THE PROGRAM IS BASED UPON ACTUAL SERVICES RECEIVED BY PROGRAM BENEFICIARIES. THE RATIO OF COVERED BENEFICIARY CHARGES TO TOTAL PATIENT CHARGES FOR THE SERVICES OF EACH ANCILLARY DEPARTMENT IS APPLIED TO THE COST OF THE DEPARTMENT. ADDED TO THIS AMOUNT IS THE COST OF ROUTINE SERVICES FOR PROGRAM BENEFICIARIES, DETERMINED ON THE BASIS OF A SEPARATE AVERAGE COST PER DIEM FOR ALL PATIENTS FOR GENERAL ROUTINE PATIENT CARE AREAS. ANOTHER FACTOR CONSIDERED IS A SEPARATE AVERAGE COST PER DIEM FOR EACH INTENSIVE CARE UNIT, CORONARY CARE UNIT, AND OTHER SPECIAL CARE INPATIENT HOSPITAL UNITS. COMMONSPIRIT HEALTH AND ITS SUBORDINATE CORPORATIONS BELIEVE THAT THE ENTIRE MEDICARE SHORTFALL FOR THE CONSOLIDATED ENTITIES CONSTITUTES COMMUNITY BENEFIT. THE IRS COMMUNITY BENEFIT STANDARD INCLUDES THE PROVISION OF CARE TO THE ELDERLY AND MEDICARE PATIENTS. MEDICARE SHORTFALLS MUST BE ABSORBED BY COMMONSPIRIT HEALTH HOSPITALS IN ORDER TO CONTINUE TREATING THE ELDERLY IN OUR COMMUNITIES. THE HOSPITALS PROVIDE CARE REGARDLESS OF THIS SHORTFALL AND THEREBY RELIEVE THE FEDERAL GOVERNMENT OF THE BURDEN OF PAYING THE FULL COST FOR MEDICARE BENEFICIARIES. MERCY HOSPITAL OF VALLEY CITY'S SURPLUS, AS REPORTED ON PART III, SECTION B, LINE 7, OF $396,682 REPRESENTS THE FILING ORGANIZATION'S MEDICARE COST REPORTS. PART III, LINE 9B: COMMONSPIRIT HEALTH ENSURES THAT PATIENT ACCOUNTS ARE PROCESSED FAIRLY AND CONSISTENTLY. COMMONSPIRIT HEALTH'S BILLING AND COLLECTION POLICY CONTAINS PROVISIONS THAT PROHIBIT THE COLLECTION OF AMOUNTS DUE FROM PATIENTS WHO THE ORGANIZATION KNOWS QUALIFY FOR FINANCIAL ASSISTANCE. ACCOUNTS WITH INCORRECT OR INCOMPLETE DEMOGRAPHIC INFORMATION ARE ASSIGNED TO A COLLECTION AGENCY IF THE COMMONSPIRIT HEALTH FACILITY, OR BILLING COMPANY RETAINED BY COMMONSPIRIT HEALTH, IS UNABLE TO OBTAIN AN UPDATED ADDRESS THROUGH SKIP TRACING OR OTHER MEANS. FOR PATIENTS WHO HAVE AN APPLICATION PENDING FOR EITHER GOVERNMENT-SPONSORED ASSISTANCE OR FOR ASSISTANCE UNDER COMMONSPIRIT HEALTH'S FINANCIAL ASSISTANCE POLICY, OR WHERE THE PATIENT IS ATTEMPTING IN GOOD FAITH TO SETTLE AN OUTSTANDING BILL WITH THE FACILITY VIA PAYMENT PLANS, COMMONSPIRIT HEALTH WILL NOT KNOWINGLY SEND THAT PATIENT'S BILL TO AN OUTSIDE COLLECTION AGENCY. ON SELF-PAY ACCOUNTS THAT DO NOT MEET THE CRITERIA NOTED ABOVE, THE INITIAL DETERMINATION OF ASSIGNMENT TO A COLLECTION AGENCY WILL VARY DEPENDING ON THE NATURE OF THE ACCOUNT WITH THE FINAL DECISION BEING AT THE DISCRETION OF THE BILLING COMPANY RETAINED BY COMMONSPIRIT HEALTH. UPON ASSIGNMENT OF SUCH A PATIENT ACCOUNT TO A COLLECTION AGENCY, COMMONSPIRIT HEALTH REQUIRES THE AGENCY TO COMPLY WITH THE FAIR DEBT COLLECTION PRACTICES ACT. PART VI, LINE 2: BARNES COUNTY BEHAVIORAL HEALTH COALITION, HOSTED BY CHI MERCY HEALTH WITH PARTNERSHIP FROM CITY COUNTY PUBLIC HEALTH, CONSISTS OF A VARIED GROUP OF LEADERS IN BARNES COUNTY. THESE LEADERS INCLUDE CHI MERCY HEALTH, CITY-COUNTY HOME HEALTH, ECONOMIC DEVELOPMENT, LOCAL AND STATE REPRESENTATIVES, STATE AGENCIES, SCHOOLS, BUSINESS OWNERS, LAW ENFORCEMENT, SOCIAL SERVICES, STATES ATTORNEY, DISTRICT 24 REPRESENTATIVES, PHYSICIANS, CLINICS, SCHSC, AND LOCAL BEHAVIORAL HEALTH PROVIDERS. THE COALITION MEETS QUARTERLY AND IS OPEN TO ALL WHO WISH TO ATTEND. THE COALITION WORKS ON THE GOALS, CAPTURED FROM THE CHNA, OPIOID GRANT, ALCOHOL PREVENTION GROUP, AND SERVICES AND SUPPORTS NEEDED FOR OUR COMMUNITY MEMBERS. CORE COALITION MEMBERS WERE MEETING MONTHLY BEFORE PANDEMIC TO COMPLETE THE "WORK". PART VI, LINE 3: INFORMATION ABOUT COMMONSPIRIT HEALTH'S FINANCIAL ASSISTANCE PROGRAM AND A CONTACT NUMBER ARE MADE AVAILABLE TO PATIENTS AND THE PUBLIC. PATIENTS ARE INFORMED OF COMMONSPIRIT HEALTH'S FINANCIAL ASSISTANCE PROGRAM VIA SIGNAGE IN ALL ADMITTING AREAS AND IN VARIOUS COMMON AREAS OF THE HOSPITAL. FINANCIAL ASSISTANCE PROGRAM INFORMATION NOTICES ARE POSTED IN THE EMERGENCY AND ADMITTING DEPARTMENTS AND AT OTHER PUBLIC PLACES AS EACH FACILITY MAY ELECT. SUCH INFORMATION IS PROVIDED IN THE PRIMARY LANGUAGES SPOKEN IN THE COMMUNITIES COMMONSPIRIT HEALTH SERVES. THE SIGNAGE INCLUDES NOTIFICATION THAT FURTHER DISCOUNTS MAY BE PROVIDED UPON THE COMPLETION AND SUBMISSION OF A FINANCIAL ASSISTANCE APPLICATION AND HOW TO REACH STAFF THAT CAN ASSIST WITH ANSWERING QUESTIONS AND GUIDE PATIENTS THROUGH THE APPLICATION PROCESS. INFORMATION CAN ALSO BE FOUND ON THE FACILITY WEBSITES. IF FINANCIAL ASSISTANCE ELIGIBILITY IS NOT DETERMINED PRIOR TO BILLING, INITIAL BILLING STATEMENTS TO PATIENTS INCLUDE A REQUEST TO THE PATIENT TO PROVIDE ANY INSURANCE INFORMATION THAT WAS VALID FOR THE DATES OF SERVICE BILLED AND A STATEMENT INFORMING PATIENTS HOW TO CONTACT US REGARDING FINANCIAL ASSISTANCE. ADDITIONALLY, CONTRACT TERMS WITH COLLECTION VENDORS WORKING ON BEHALF OF COMMONSPIRIT HEALTH REQUIRE THEY FOLLOW COMMONSPIRIT HEALTH FINANCIAL ASSISTANCE POLICY. ALSO, REFERRAL OF PATIENTS FOR FINANCIAL ASSISTANCE MAY BE MADE BY ANY MEMBER OF THE COMMONSPIRIT HOSPITAL ORGANIZATION NON-MEDICAL OR MEDICAL STAFF, INCLUDING PHYSICIANS, NURSES, FINANCIAL COUNSELORS, SOCIAL WORKERS, CASE MANAGERS, CHAPLAINS, AND RELIGIOUS SPONSORS. A REQUEST FOR ASSISTANCE MAY BE MADE BY THE PATIENT OR A FAMILY MEMBER, CLOSE FRIEND OR ASSOCIATE OF THE PATIENT, SUBJECT TO APPLICABLE PRIVACY LAWS. PART VI, LINE 4: BARNES COUNTY IS LOCATED IN SOUTHEASTERN NORTH DAKOTA. THE COUNTY SEAT IS VALLEY CITY, WHICH LIES IN THE CENTER OF THE COUNTY. THE STATE CAPITAL, BISMARCK, IS LOCATED TWO HOURS TO THE WEST OF VALLEY CITY. THE 2019 ESTIMATED POPULATION OF BARNES COUNTY WAS 10,415, WHICH IS A 5.9% DECREASE FROM 2010. VALLEY CITY'S ESTIMATED POPULATION IN 2019 WAS 6,323 (A 4.9% DECREASE FROM 2010). RURAL BARNES COUNTY HAS SEVERAL INCORPORATED CITIES, INCLUDING WIMBLEDON, SANBORN, LITCHVILLE, ORISKA, AND DAZEY. BEYOND CITY-COUNTY HEALTH DISTRICT AND CHI MERCY HEALTH, ADDITIONAL AGENCIES WHO PROVIDE HEALTH SERVICES IN BARNES COUNTY INCLUDE ESSENTIA HEALTH VALLEY CITY CLINIC AND SANFORD HEALTH VALLEY CITY CLINIC. IN ADDITION TO SEEKING HEALTHCARE IN BARNES COUNTY, RESIDENTS MOST FREQUENTLY ACCESS HEALTHCARE SERVICES IN CASS COUNTY AND STUTSMAN COUNTY. THE VALLEY CITY AREA HAS A NUMBER OF COMMUNITY ASSETS AND RESOURCES THAT ARE POTENTIALLY AVAILABLE TO ADDRESS SIGNIFICANT HEALTH NEEDS. WITH REGARD TO DEMOGRAPHICS, BARNES COUNTY'S POPULATION FROM 2010 TO 2019 DECREASED BY 5.9%. THE AVERAGE NUMBER OF RESIDENTS UNDER AGE 18 (19.6%) FOR BARNES COUNTY COMES IN 3.9 PERCENTAGE POINTS LOWER THAN THE NORTH DAKOTA AVERAGE (23.5%). THE PERCENTAGE OF RESIDENTS, AGES 65 AND OLDER, IS MUCH HIGHER FOR BARNES COUNTY (23.2%) THAN THE NORTH DAKOTA AVERAGE (15.3%), AND THE RATE OF HIGH SCHOOL GRADUATES IS VERY SIMILAR FOR BARNES COUNTY (92.3%) TO THE NORTH DAKOTA AVERAGE (92.5%). THE MEDIAN HOUSEHOLD INCOME IN BARNES COUNTY ($64,894) IS SLIGHTLY HIGHER THAN THE STATE AVERAGE FOR NORTH DAKOTA ($63,843). VALLEY CITY IS NESTLED ON THE BANKS OF THE BEAUTIFUL SHEYENNE RIVER. THE 11 BRIDGES IN VALLEY CITY HELP TELL ITS HISTORY. INTERPRETIVE PANELS HAVE BEEN PLACED AT SEVEN BRIDGES IN TOWN AND ONE NORTH OF VALLEY CITY, GIVING THE DETAILS ABOUT HOW THE VALLEY WAS DEVELOPED. VALLEY CITY IS ALSO KNOWN FOR SPECIALTY SHOPS WHETHER ANTIQUING, LOOKING FOR LOCAL ART OR QUILTING VALLEY CITY HAS IT COVERED! HISTORY BUFFS WILL ENJOY THE ROSEBUD VISITOR CENTER, HOME TO AN 1881 NORTHERN PACIFIC SUPERINTENDENT'S RAILCAR WITH THE ORIGINAL FURNISHINGS, AND THE OUTDOOR RAILROAD DISPLAY. DON'T MISS THE BARNES COUNTY MUSEUM RIGHT IN THE MIDDLE OF DOWNTOWN. THEY HAVE A SPECIAL GUEST - GUNDY THE TRICERATOPS. REMAINING ON THE HISTORIC REGISTER, OLD MAIN AND THE CLOCK TOWER ARE VALLEY CITY STATE UNIVERSITY'S CAMPUS ICONS. ALSO, ON CAMPUS VISITORS WILL FIND THE PLANETARIUM. UP THE HILL, SOUTH OF THE CAMPUS ON WINTER SHOW ROAD IS HOME TO MEDICINE WHEEL PARK. A REPLICA OF A NATIVE AMERICAN SOLAR CALENDAR, A MERIDIAN CALENDAR, BURIAL MOUNDS, AND A WALK AMONG THE PLANTS WITH INTERPRETATION ARE ALL PART OF THE PARK. FOR THOSE WHO LOVE THE OUTDOORS, THERE ARE TWO BEAUTIFUL GOLF COURSES ALONG THE RIVER. HIKERS ENJOY THE NORTH COUNTRY SCENIC TRAIL AS WELL AS SEVERAL WALKWAYS AROUND VALLEY CITY. ENJOY A BEAUTIFUL DRIVE ON THE SHEYENNE RIVER VALLEY NATIONAL SCENIC BYWAY, LOCATED NORTH AND SOUTH OF VALLEY CITY. A 2016 COMMUNITY ADDITION, THE GAUKLER WELLNESS CENTER IS A STATE OF THE ART, 65,000 SQUARE FOOT CENTER, WHICH OFFERS FITNESS CLASSES, A THREE LANE TRACK, MATRIX AND OCTANE CARDIO EQUIPMENT, NAUTILUS WEIGHT MACHINES, FREE WEIGHTS, TWO BASKETBALL COURTS, AN INDOOR PLAYGROUND, AND A SWIMMING POOL, FEATURING FOUR LANES, A ZERO DEPTH AREA, AND HOT TUB. PART VI, LINE 5: FINANCIAL ASSISTANCE: IT IS THE POLICY OF COMMONSPIRIT HEALTH TO PROVIDE, WITHOUT DISCRIMINATION, EMERGENCY MEDICAL CARE AND MEDICALLY NECESSARY CARE IN COMMONSPIRIT HOSPITAL FACILITIES TO ALL PATIENTS, WITHOUT REGARD TO A PATIENT'S FINANCIAL ABILITY TO PAY. THIS HOSPITAL HAS A FINANCIAL ASSISTANCE POLICY THAT DESCRIBES THE ASSISTANCE PROVIDED TO PATIENTS FOR WHOM IT WOULD BE A FINANCIAL HARDSHIP TO FULLY PAY THE EXPECTED OUT-OF-POCKET EXPENSES FOR SUCH CARE, AND WHO MEET THE ELIGIBILITY CRITERIA FOR SUCH ASSISTANCE. THE FINANCIAL ASSISTANCE POLICY, A PLAIN LANGUAGE SUMMARY AND RELATED MATERIALS ARE AVAILABLE IN MULTIPLE LANGUAGES ON THE HOSPITAL'S WEBSITE.USE OF SURPLUS FUNDS: AS A NOT-FOR-PROFIT HOSPITAL ORGANIZATION DEDICATED TO IMPROVING THE QUALITY OF LIFE, THE HOSPITAL REINVESTS ALL OF ITS SURPLUS FUNDS FROM OPERATING AND INVESTMENT ACTIVITIES TO IMPROVE THE QUALITY OF PATIENT CARE, EXPAND AND REPLACE EXISTING FACILITIES AND EQUIPMENT, INVEST IN TECHNOLOGICAL ADVANCEMENTS, SUPPORT COMMUNITY HEALTH PROGRAMS, AND ADVANCE MEDICAL TRAINING, EDUCATION, AND RESEARCH. THIS ACTIVE REINVESTMENT OF FUNDS MAKES IT POSSIBLE FOR THE HOSPITAL TO DELIVER ON ITS MISSION, INCLUDING HELPING TO ENSURE THAT EVERYONE IN THE COMMUNITIES SERVED HAS ACCESS TO HEALTH CARE.OPEN MEDICAL STAFF: MEDICAL STAFF PRIVILEGES ARE OPEN TO PHYSICIANS WHOSE EXPERIENCE AND TRAINING ARE VERIFIED THROUGH A CREDENTIALING PROCESS. THE PROCESS INCLUDES GATHERING AND VERIFYING CREDENTIALS, ALLOWING THE MEDICAL STAFF TO EVALUATE AN APPLICANT'S QUALIFICATIONS, PREVIOUS EXPERIENCE, AND COMPETENCE, AND ULTIMATELY MAKING A DECISION TO GRANT OR DENY MEDICAL STAFF MEMBERSHIP AND CLINICAL PRIVILEGES ON THE BASIS OF AUTHENTIC AND VALID CREDENTIALS.ROLE OF THE BOARD: THE COMMONSPIRIT HEALTH BOARD AND SPECIFIC COMMITTEES HAVE ORGANIZATIONAL, POLICY-BASED ROLES TO OVERSEE COMMUNITY BENEFIT AND COMMUNITY HEALTH PROGRAMS, AND THEY RECEIVE REGULAR REPORTS ON ACTIVITIES AND PERFORMANCE. HOSPITAL COMMUNITY BOARDS (OR THEIR DESIGNATED COMMUNITY HEALTH OR COMMUNITY BENEFIT COMMITTEES) ARE RESPONSIBLE FOR ENSURING THAT THE HOSPITALS CONDUCT AND ADOPT COMMUNITY HEALTH NEEDS ASSESSMENTS AND IMPLEMENTATION STRATEGIES, TAKE ACTIONS TO HELP ADDRESS IDENTIFIED SIGNIFICANT HEALTH NEEDS WITH AN EMPHASIS ON POOR AND VULNERABLE POPULATIONS AND HEALTH EQUITY, AND MONITORING ACTIONS AND PROGRESS TOWARD IDENTIFIED GOALS. PART VI, LINE 6: THE ORGANIZATION IS AFFILIATED WITH COMMONSPIRIT HEALTH. COMMONSPIRIT HEALTH WAS CREATED BY THE ALIGNMENT OF CATHOLIC HEALTH INITIATIVES AND DIGNITY HEALTH IN EARLY 2019. COMMONSPIRIT HEALTH, A NONPROFIT, FAITH-BASED HEALTH SYSTEM IS COMMITTED TO BUILDING HEALTHIER COMMUNITIES, ADVOCATING FOR THOSE WHO ARE POOR AND VULNERABLE, AND INNOVATING HOW AND WHERE HEALING CAN HAPPEN BOTH INSIDE ITS HOSPITALS AND OUT IN THE COMMUNITY. COMMONSPIRIT HEALTH OWNS AND OPERATES HEALTH CARE FACILITIES IN 24 STATES AND IS THE SOLE CORPORATE MEMBER (PARENT CORPORATION) OF OTHER PRIMARILY NONPROFIT CORPORATIONS. COMMONSPIRIT HEALTH AND SUBSTANTIALLY ALL OF ITS DIRECT AFFILIATES AND SUBSIDIARIES HAVE BEEN GRANTED EXEMPTIONS FROM FEDERAL INCOME TAX AS CHARITABLE ORGANIZATIONS UNDER SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE. AS OF SEPTEMBER 25, 2024, COMMONSPIRIT HEALTH IS COMPRISED OF APPROXIMATELY 2,300 CARE SITES, CONSISTING OF 137 HOSPITALS, INCLUDING ACADEMIC HEALTH CENTERS, MAJOR TEACHING HOSPITALS, AND CRITICAL ACCESS FACILITIES, COMMUNITY HEALTH SERVICES ORGANIZATIONS, ACCREDITED NURSING COLLEGES, HOME HEALTH AGENCIES, LIVING COMMUNITIES, A MEDICAL FOUNDATION AND OTHER AFFILIATED MEDICAL GROUPS, AND OTHER FACILITIES AND SERVICES THAT SPAN THE INPATIENT AND OUTPATIENT CONTINUUM OF CARE. AN ADDITIONAL 21 HOSPITALS ARE OPERATED THROUGH UNCONSOLIDATED JOINT VENTURES. IN FISCAL YEAR 2024, COMMONSPIRIT HEALTH PROVIDED MORE THAN $2.574 BILLION IN FINANCIAL ASSISTANCE AND COMMUNITY BENEFIT FOR PROGRAMS AND SERVICES FOR THE POOR, FREE CLINICS, EDUCATION AND RESEARCH. FINANCIAL ASSISTANCE AND COMMUNITY BENEFIT TOTALED MORE THAN $4.22 BILLION WITH THE INCLUSION OF THE UNPAID COSTS OF MEDICARE. THE HEALTH SYSTEM, WHICH GENERATED OPERATING REVENUES OF $37.5 BILLION IN FISCAL YEAR 2024, HAS TOTAL ASSETS OF APPROXIMATELY $54.73 BILLION.COMMONSPIRIT HEALTH PROVIDES STRATEGIC PLANNING AND MANAGEMENT SERVICES AS WELL AS CENTRALIZED SERVICES FOR ITS DIVISIONS. THE PROVISION OF CENTRALIZED MANAGEMENT AND SHARED SERVICES INCLUDING AREAS SUCH AS ACCOUNTING, HUMAN RESOURCES, PAYROLL AND SUPPLY CHAIN PROVIDES ECONOMIES OF SCALE AND PURCHASING POWER TO THE DIVISIONS. THE COST SAVINGS ACHIEVED THROUGH COMMONSPIRIT HEALTH'S CENTRALIZATION ENABLE DIVISIONS TO DEDICATE ADDITIONAL RESOURCES TO HIGH-QUALITY HEALTH CARE AND COMMUNITY OUTREACH SERVICES TO THE MOST VULNERABLE MEMBERS OF OUR SOCIETY. 1 VALLEY CITY PARKS AND RECREATION FOUNDATION 733 8TH AVE SW VALLEY CITY ND 58072 933677660 501C3 20000 0 HOUSING DISBURSEMENT NEEDS EDUCATION FOUNDATION FOR VALLEY CITY PUBLIC SCHOOLS 460 CENTRAL AVE N VALLEY CITY ND 58072 450453648 501C3 6124 0 BEHAVIORAL HEALTHCARE FOR STUDENTS MERCY HOSPITAL FOUNDATION 570 CHAUTAUQUA BLVD VALLEY CITY ND 58072 450435338 501C3 44544 0 PROGRAM SUPPORT 3 0 PART I, LINE 2: ONCE A GRANT HAS BEEN AWARDED, THE GRANT DIRECTOR PRESENTS TO THE EXECUTIVE TEAM TO REVIEW OBJECTIVES AND REQUIREMENTS. IF EXECUTIVE TEAM AGREES EXPECTATIONS CAN BE MET, THE GRANT IS FORMALLY ACCEPTED BY THE MARKET PRESIDENT WHO IS THE AUTHORIZED REPRESENTATIVE. THE GRANT DIRECTOR, WHO HAS COORDINATED THE ORIGINAL PROPOSAL, DISSEMINATES THE SIGNED CONTRACTS AND BUDGETS TO THE APPLICABLE DEPARTMENT HEAD(S), MARKET PRESIDENT, PURCHASING MANAGER, AND FINANCE DIRECTOR. THE FINANCE DIRECTOR WORKS WITH NATIONAL GRANTS-PHILANTHROPY ACCOUNTING TO SET THE GRANT UP IN THE GRANTS MANAGEMENT SYSTEM FOR TRACKING AND REPORTING AND THEN CONTINUES TO MONITOR EXPENSES AND BUDGET STATUS JOINTLY WITH THE GRANT DIRECTOR. THE GRANT DIRECTOR OVERSEES THE GRANT IMPLEMENTATION, COORDINATION OF BUDGETS, AND PROGRESS REPORTING. SUPPORTING DOCUMENTATION IS RETAINED PER GRANT TERMS AND THE GRANTS MANAGEMENT MODULE PROVIDES A DETAILED SUMMARY OF EXPENSES. THE GRANT DIRECTOR ENSURES ACCOUNTABILITY TO THE FUNDER BY HELPING COORDINATE PROGRAMMATIC OUTCOME OBJECTIVES AND MONITORING COMPLIANCE WITH FEDERAL AND STATE REGULATIONS. 0 1 0 0 0 0 0 0 0 JULIE GOEBEL BOARD MEMBER/DIVISION SVP COO (PARTI 0 515562 0 448209 0 1163 0 19175 0 36291 0 1020400 0 0 DAVID JONES BOARD MEMBER/MARKET PRESIDENT, CENTR 0 303052 0 156175 0 1465 0 19175 0 34442 0 514309 0 0 TIM SCHNACK MARKET CFO 0 290959 0 74901 0 3855 0 19529 0 28524 0 417768 0 0 NICK O'TOOL MARKET CFO (PARTIAL YEAR) 0 252554 0 96047 0 419 0 16660 0 34289 0 399969 0 0 REBECCA THOMPSON FORMER INTERIM PRESIDENT 0 214193 0 117547 0 11685 0 13784 0 10596 0 367805 0 0 D RYAN FOWLER BOARD MEMBER/PRESIDENT 0 180296 0 91368 0 541 0 12159 0 32555 0 316919 0 0 CLARK KRUTA CRNA 229311 0 800 0 3908 0 14795 0 39420 0 288234 0 0 0 AMBER STOMAN TREASURER/VP FINANCE 0 195050 0 25800 0 451 0 14252 0 30335 0 265888 0 0 BETH SMITH TREASURER (PARTIAL YEAR) 0 126334 0 31251 0 753 0 9253 0 31885 0 199476 0 0 ALANA MCCLELLAN MANAGER, EMERGENCY SERVICES 131530 0 15259 0 793 0 8188 0 20333 0 176103 0 0 0 COLLEEN JONES VP, PATIENT CARE SERVICES 121798 0 30585 0 1389 0 8305 0 12339 0 174416 0 0 0 AMY NOESKE PHARMACY MANAGER 119088 0 15375 0 740 0 6656 0 28934 0 170793 0 0 0 CAMILLE SETTELMEYER FORMER OFFICER 0 109171 0 36832 0 1167 0 10545 0 9468 0 167183 0 0 PART I, LINE 3 DURING THE CALENDAR YEAR 2023, COMPENSATION FOR THE TOP MANAGEMENT OFFICIAL WAS ESTABLISHED AND PAID BY COMMONSPIRIT HEALTH, A RELATED ORGANIZATION. COMMONSPIRIT HEALTH USED ONE OR MORE OF THE METHODS DESCRIBED IN SCHEDULE J, PART I, LINE 3 TO ESTABLISH THE TOP MANAGEMENT OFFICIAL'S COMPENSATION: (1) COMPENSATION SURVEY OR STUDY; (2) APPROVAL BY THE BOARD OR COMPENSATION COMMITTEE; (3) COMPENSATION SURVEY OR STUDY; (4) APPROVAL BY THE BOARD OR COMPENSATION COMMITTEE. SEE SCHEDULE O DISCLOSURE FOR FORM 990, PART VI, SECTION B, LINE 15 FOR ADDITIONAL INFORMATION. PART 1, LINE 4A: CERTAIN REPORTABLE INDIVIDUALS ARE COVERED BY AN EXECUTIVE SEVERANCE POLICY THAT PROVIDES MARKET-STANDARD COMPENSATION, RANGING FROM PAYMENTS OF 9 MONTHS TO 2 YEARS OF BASE COMPENSATION, DEPENDING ON THE EXECUTIVE'S POSITION, IN THE EVENT OF A POSITION ELIMINATION OR OTHER INVOLUNTARY TERMINATION, IN ACCORDANCE WITH THE GUIDELINES OF THE POLICY. CERTAIN REPORTABLE INDIVIDUALS ARE COVERED BY A NON-EXECUTIVE SEVERANCE POLICY THAT PROVIDES MARKET-STANDARD COMPENSATION, RANGING FROM PAYMENTS OF 2 WEEKS TO 52 WEEKS OF BASE COMPENSATION, DEPENDING ON THE EMPLOYEE'S POSITION AND TENURE, IN THE EVENT OF A POSITION ELIMINATION OR OTHER INVOLUNTARY TERMINATION, IN ACCORDANCE WITH THE GUIDELINES OF THE POLICY. PART 1, LINE 4B: DURING THE 2023 CALENDAR YEAR, COMMONSPIRIT HEALTH ("COMMONSPIRIT") MAINTAINED A SUPPLEMENTAL NON-QUALIFIED DEFERRED COMPENSATION PLAN FOR DIVISION CEOS/PRESIDENTS AND OTHER DESIGNATED COMMONSPIRIT EXECUTIVES AT THE LEVEL OF SENIOR VICE PRESIDENT AND ABOVE. DUE TO THE "SUPER" VESTING RULES UNDER COMMONSPIRIT'S DEFERRED COMPENSATION PLAN, PARTICIPANTS WHO HAVE MET CERTAIN REQUIREMENTS SUCH AS INVOLUNTARY TERMINATION WITHOUT CAUSE, AGE, AGE AND YEARS OF SERVICE, OR MORE THAN 5 YEARS OF PLAN PARTICIPATION ARE ELIGIBLE TO RECEIVE THEIR 2023 CONTRIBUTIONS IN CASH. THESE CASH PAYOUTS ARE INCLUDED IN THE PARTICIPANT'S REPORTABLE COMPENSATION IN COLUMN (III) OTHER REPORTABLE COMPENSATION ON SCHEDULE J PART II. DURING 2023, THE FOLLOWING PAYMENTS WERE MADE PURSUANT TO THE SUPER VESTING RULES: REBECCA LYNN THOMPSON $9,808. PART II: MERCY HOSPITAL OF VALLEY CITY FOLLOWS COMMONSPIRIT'S EXECUTIVE COMPENSATION PHILOSOPHY. COMMONSPIRIT'S EXECUTIVE COMPENSATION PHILOSOPHY IS DESIGNED TO ASSIST COMMONSPIRIT IN ATTRACTING AND RETAINING THE CALIBER OF EXECUTIVES REQUIRED TO ENABLE COMMONSPIRIT TO FULFILL ITS MISSION OF PROVIDING HIGH QUALITY HEALTHCARE FOR ALL PERSONS REGARDLESS OF THEIR ABILITY TO PAY FOR SERVICES, IMPROVING THE QUALITY OF LIFE IN THE COMMUNITIES COMMONSPIRIT SERVES, PROMOTING PATIENT AND EMPLOYEE SATISFACTION, AND ENSURING FINANCIAL STABILITY. A SUBSTANTIAL PORTION OF EXECUTIVE COMPENSATION IS PERFORMANCE BASED AND IS LINKED TO ORGANIZATIONAL GOALS APPROVED IN ADVANCE BY THE HUMAN RESOURCES AND COMPENSATION COMMITTEE. THESE GOALS INCLUDE ATTAINMENT OF ANNUAL AND LONG-TERM FINANCIAL PERFORMANCE, CERTAIN HEALTHCARE QUALITY STANDARDS AND COMMONSPIRIT'S COMMITMENT TO SERVING THE POOR AND DISENFRANCHISED IN THE COMMUNITIES IT SERVES. TOTAL COMPENSATION, WHICH INCLUDES BASE SALARY, ANNUAL, AND LONG-TERM INCENTIVE COMPENSATION, IS ESTABLISHED TO APPROXIMATE THE PREVAILING MARKET CONDITIONS FOR EXECUTIVES OF COMPANIES OF SIMILAR SIZE, REVENUES AND COMPLEXITY. PAYMENTS PURSUANT TO A LONG-TERM FINANCIAL PERFORMANCE GOAL WERE PAID IN CALENDAR YEAR 2023. FORM 990, PART V, LINE 1C: PAYMENTS TO VENDORS FOR ENTITIES THAT ARE PART OF COMMONSPIRIT HEALTH ARE MADE BY COMMONSPIRIT HEALTH. THEREFORE, NO FORMS 1099 ARE ISSUED BY MERCY HOSPITAL OF VALLEY CITY. COMMONSPIRIT HEALTH FILES THE FORMS 1099 AND COMPLIES WITH THE BACKUP WITHHOLDING RULES FOR REPORTABLE PAYMENTS TO VENDORS AND GAME WINNINGS. THE FORMS 1099 ISSUED ON BEHALF OF MERCY HOSPITAL OF VALLEY CITY ARE REPORTED TO THE IRS. FORM 990, PART VI, SECTION A, LINE 1A PURSUANT TO SECTION 8.6 OF THE BYLAWS OF MERCY HOSPITAL OF VALLEY CITY, THE EXECUTIVE COMMITTEE SHALL CONSIST OF ONLY DIRECTORS OF THE CORPORATION. THE EXECUTIVE COMMITTEE HAS THE POWER TO TRANSACT THE ROUTINE BUSINESS OF THE CORPORATION IN THE INTERIM PERIODS BETWEEN REGULARLY SCHEDULED MEETINGS OF THE BOARD OF DIRECTORS, PROVIDED THAT THEIR ACTIONS ARE CONSISTENT WITH ANY ACTIONS OR POLICIES OF THE BOARD OR THE CORPORATE MEMBER. ALL ACTIONS TAKEN ARE CONTEMPORANEOUSLY DOCUMENTED AND REPORTED TO THE BOARD AT THE EARLIEST MEETING. FORM 990, PART VI, SECTION A, LINE 6 ACCORDING TO THE BYLAWS OF MERCY HOSPITAL OF VALLEY CITY, THE ENTITY'S SOLE MEMBER IS COMMONSPIRIT HEALTH, A COLORADO NONPROFIT ORGANIZATION. FORM 990, PART VI, SECTION A, LINE 7A ACCORDING TO THE ORGANIZATION'S BYLAWS, DIRECTORS SHALL BE APPOINTED OR REFUSED BY THE CORPORATE MEMBER. THE CORPORATE MEMBER MAY APPOINT ONE OR MORE INDIVIDUALS TO THE BOARD OF DIRECTORS, AND MAY AT ANY TIME REMOVE, WITH OR WITHOUT CAUSE, ANY MEMBER OF THE BOARD OF DIRECTORS. ACCORDING TO THE ORGANIZATION'S BYLAWS, DIRECTORS OF THE CORPORATION SHALL BE APPOINTED BY THE CORPORATE MEMBER NO LATER THAN JUNE 30 OF EACH YEAR. THE NAMES AND QUALIFICATIONS OF EACH INDIVIDUAL ACCEPTED BY THE BOARD OF DIRECTORS SHALL BE SUBMITTED TO THE CORPORATE MEMBER, WHO SHALL APPOINT OR REFUSE EACH NOMINEE IN ACCORDANCE WITH THE CORPORATE MEMBER'S BYLAWS AND WITH ENDORSEMENT OF THE SENIOR VICE PRESIDENT OF OPERATIONS. THE CORPORATE MEMBER MAY UNILATERALLY APPOINT ONE OR MORE INDIVIDUALS TO THE BOARD OF DIRECTORS SHOULD THE BOARD FAIL TO FURNISH THE CORPORATE MEMBER WITH A LIST OF INDIVIDUALS QUALIFIED TO SERVE ON THE BOARD OF DIRECTORS OF THE CORPORATION. (CHCF RESERVED RIGHTS) EXCEPT AS OTHERWISE PROVIDED IN THE CORPORATION'S ARTICLES OF INCORPORATION OR THE LAWS OF THE STATE OF ORGANIZATION, CATHOLIC HEALTH CARE FEDERATION ("CHCF") SHALL HAVE SUCH RIGHTS AS ARE RESERVED TO THE CORPORATE MEMBER, ACTING IN ITS CAPACITY AS THE MEMBERSHIP BODY OF CHCF, UNDER THE GOVERNANCE MATRIX. FORM 990, PART VI, SECTION A, LINE 7B THE ORGANIZATION'S CORPORATE MEMBER IS COMMONSPIRIT HEALTH. PURSUANT TO SECTION 5.4 OF THE ORGANIZATION'S BYLAWS, THE CORPORATE MEMBER SHALL HAVE THE SPECIFIC RIGHTS SET FORTH IN THE GOVERNANCE MATRIX. PURSUANT TO THE GOVERNANCE MATRIX THE FOLLOWING RIGHTS ARE RESERVED TO THE COMMONSPIRIT HEALTH BOARD DIRECTLY OR THROUGH POWERS DELEGATED TO THE COMMONSPIRIT HEALTH CHIEF EXECUTIVE OFFICER: * SUBSTANTIAL CHANGE IN THE MISSION OR PHILOSOPHY OF MERCY HOSPITAL OF VALLEY CITY * AMENDMENT OF THE CORPORATE DOCUMENTS OF MERCY HOSPITAL OF VALLEY CITY * APPROVE MEMBERS OF MERCY HOSPITAL OF VALLEY CITY'S BOARD * REMOVAL OF A MEMBER OF THE GOVERNING BODY OF MERCY HOSPITAL OF VALLEY CITY * APPROVAL OF ISSUANCE OF DEBT BY MERCY HOSPITAL OF VALLEY CITY * APPROVAL OF PARTICIPATION OF MERCY HOSPITAL OF VALLEY CITY IN A JOINT VENTURE * APPROVAL OF FORMATION OF A NEW CORPORATION BY MERCY HOSPITAL OF VALLEY CITY * APPROVAL OF A MERGER INVOLVING MERCY HOSPITAL OF VALLEY CITY * APPROVAL OF THE SALE OF ALL OR SUBSTANTIALLY ALL OF THE ASSETS OF MERCY HOSPITAL OF VALLEY CITY * TO REQUIRE THE TRANSFER OF ASSETS BY MERCY HOSPITAL OF VALLEY CITY TO COMMONSPIRIT HEALTH TO ACCOMPLISH COMMONSPIRIT HEALTH'S GOALS AND OBJECTIVES, AND TO SATISFY COMMONSPIRIT HEALTH DEBTS. * ADOPTION OF LONG RANGE AND STRATEGIC PLANS FOR MERCY HOSPITAL OF VALLEY CITY PURSUANT TO SECTION 5.5 OF THE ORGANIZATION'S BYLAWS, COMMONSPIRIT HEALTH MAY, IN EXERCISE OF ITS APPROVAL POWERS, GRANT OR WITHHOLD APPROVAL IN WHOLE OR IN PART, OR MAY, IN ITS COMPLETE DISCRETION, AFTER CONSULTATION WITH THE BOARD AND THE PRESIDENT AND CHIEF EXECUTIVE OFFICER OF THE ORGANIZATION, RECOMMEND SUCH OTHER OR DIFFERENT ACTIONS AS IT DEEMS APPROPRIATE." EXCEPT AS OTHERWISE PROVIDED IN THE CORPORATION'S ARTICLES OF INCORPORATION OR THE LAWS OF THE STATE OF ORGANIZATION, CATHOLIC HEALTH CARE FEDERATION ("CHCF") SHALL HAVE SUCH RIGHTS AS ARE RESERVED TO THE CORPORATE MEMBER, ACTING IN ITS CAPACITY AS THE MEMBERSHIP BODY OF CHCF, UNDER THE GOVERNANCE MATRIX. FORM 990, PART VI, SECTION B, LINE 11B FOLLOWING THE PREPARATION OF THE FORM 990 BY TAX ANALYSTS OF COMMONSPIRIT HEALTH, A RELATED ORGANIZATION, THE RETURN IS REVIEWED BY THE COMMONSPIRIT HEALTH TAX DIRECTOR AND THE LOCAL VP OF OPERATIONAL FINANCE. ADDITIONALLY, THE BOARD OF DIRECTORS ARE PROVIDED THE FINAL FORM 990 AND RELATED SCHEDULES TO REVIEW VIA EMAIL AND ARE ABLE TO ASK THE VP OF OPERATIONAL FINANCE AND TAX DIRECTOR QUESTIONS PRIOR TO FILING WITH THE IRS. UPON VP OF OPERATIONAL FINANCE APPROVAL AND SIGNATURE, THE TAX ANALYST FILES THE FINAL FORM 990 AS PRESENTED TO THE BOARD, MAKING ANY NON-SUBSTANTIVE CHANGES NECESSARY IN ORDER TO EFFECT E-FILING. ANY SUCH CHANGES ARE NOT RE-SUBMITTED TO THE BOARD. FORM 990, PART VI, SECTION B, LINE 12C THE ORGANIZATION HAS A CONFLICTS OF INTEREST ("COI") POLICY (THE "POLICY") IN PLACE TO PROTECT THE INTERESTS OF COMMONSPIRIT HEALTH ("COMMONSPIRIT") IN CIRCUMSTANCES THAT MAY RESULT IN A CONFLICT BETWEEN PERSONAL INTERESTS OF A PERSON AND THE INTERESTS OF THE ORGANIZATION AND THOSE IT SERVES. COMMONSPIRIT'S COI POLICY APPLIES TO COMMONSPIRIT, ITS DIRECT AFFILIATES AND SUBSIDIARIES AND ANY RELATED ENTITY THE GOVERNING DOCUMENTS OF WHICH REQUIRE THE ENTITY TO COMPLY WITH COMMONSPIRIT POLICY (COLLECTIVELY THE "SYSTEM ENTITIES"). THE FOLLOWING PERSONS ARE REQUIRED TO DISCLOSE ACTUAL OR POTENTIAL CONFLICTS OF INTEREST AT LEAST ANNUALLY (VIA A FORMAL SYSTEM-ADMINISTERED SURVEY) IF THE PERSON'S AFFILIATION WITH COMMONSPIRIT CONTINUES: - MEMBERS OF CORPORATE AND COMMUNITY BOARDS OF SYSTEM ENTITIES - MEMBERS OF COMMITTEES OF CORPORATE AND COMMUNITY BOARDS OF SYSTEM ENTITIES - MEMBERS OF THE EXECUTIVE LEADERSHIP TEAM ("ELT") OF COMMONSPIRIT - CORPORATE OFFICERS OF SYSTEM ENTITIES - EMPLOYED PHYSICIANS AND ADVANCED PRACTICE PROVIDERS - KEY EMPLOYEES AND HIGHEST COMPENSATED EMPLOYEES AS SPECIFIED BY THE INTERNAL REVENUE SERVICE FOR FORM 990 PURPOSES WHO ARE NOT OTHERWISE INCLUDED IN THE CATEGORIES ABOVE - EMPLOYEES OF SYSTEM ENTITIES AT THE VICE PRESIDENT LEVEL AND ABOVE - ALL INDIVIDUALS ENGAGED IN RESEARCH AT INSTITUTIONS OWNED OR OPERATED BY A SYSTEM ENTITY - SELECT EMPLOYEES AS DETERMINED FROM TIME TO TIME BY LEADERSHIP DISCLOSURE, REVIEW, AND MANAGEMENT OF PERCEIVED, POTENTIAL, OR ACTUAL CONFLICTS OF INTEREST ARE ACCOMPLISHED THROUGH A DEFINED COI DISCLOSURE REVIEW PROCESS. EACH PERSON IS REQUIRED TO PROMPTLY AND FULLY DISCLOSE ANY SITUATION OR CIRCUMSTANCE THAT MAY CREATE A CONFLICT OF INTEREST AS SOON AS SHE/HE BECOMES AWARE OF IT. IN ADDITION, AT THE INCEPTION OF AN INDIVIDUAL'S RELATIONSHIP WITH COMMONSPIRIT (E.G. HIRING, BOARD APPOINTMENT), AND FOR CERTAIN POSITIONS, ANNUALLY THEREAFTER, WRITTEN CONFLICT OF INTEREST DISCLOSURE FORMS MUST BE COMPLETED. A FAILURE TO DISCLOSE MAY RESULT IN DISCIPLINARY OR CORRECTIVE ACTIONS. REPORTED POTENTIAL OR ACTUAL CONFLICTS OF INTEREST ARE INITIALLY REVIEWED BY LEGAL, CORPORATE RESPONSIBILITY OR RESEARCH INTEGRITY STAFF. IF NECESSARY, A CONFLICT OF INTEREST MANAGEMENT PLAN IS DEVELOPED, WHICH PLAN SHALL BE SUBJECT TO ACCEPTANCE BY THE APPROPRIATE DIRECT MANAGER, SUPERVISOR, MEDICAL STAFF OFFICE, BOARD OR BOARD COMMITTEE (FOR BOARD, BOARD COMMITTEE, ELT OR CORPORATE OFFICER CONFLICTS), OR OTHER APPROPRIATE INDIVIDUAL OR BODY. ONCE ACCEPTED, THE CONFLICT OF INTEREST MANAGEMENT PLAN IS COMMUNICATED TO THE PERSON WITH THE ACTUAL OR POTENTIAL CONFLICT AND THE INDIVIDUAL MUST CONDUCT THEMSELVES IN CONFORMITY WITH THE PLAN. IN THE EVENT THAT A TRANSACTIONAL CONFLICT INTEREST ARISES IN CONNECTION WITH A SYSTEM ENTITY BOARD MEETING, THE CONFLICTED INDIVIDUAL MUST DISCLOSE THAT CONFLICT PRIOR TO OR AT THE BEGINNING OF THE MEETING IN WHICH THE MATTER IS TO BE CONSIDERED. THE CONFLICTED INDIVIDUAL IS EXCLUDED FROM VOTING ON THE TRANSACTION AND IS PROHIBITED FROM USING PERSONAL INFLUENCE WITH RESPECT TO THE MATTER, BUT IS NOT PROHIBITED FROM PROVIDING INPUT IF REQUESTED TO DO SO. FORM 990, PART VI, SECTION B, LINE 15B COMMONSPIRIT'S BOARD OF STEWARDSHIP TRUSTEES APPOINTS A HUMAN RESOURCES AND COMPENSATION COMMITTEE, COMPRISED EXCLUSIVELY OF INDEPENDENT DIRECTORS, WHO ARE ACCOUNTABLE FOR SETTING REASONABLE COMPENSATION PRACTICES FOR CERTAIN EXECUTIVES WITHIN ORGANIZATION. THE HUMAN RESOURCES AND COMPENSATION COMMITTEE APPROVES, CONSISTENT WITH THE ORGANIZATION'S PHILOSOPHY AND PRINCIPLES, THE ANNUAL PERFORMANCE GOALS AND CRITERIA TO BE IN DETERMINING VARIABLE COMPENSATION. THE HUMAN RESOURCES AND COMPENSATION COMMITTEE ALSO ENGAGES AN INDEPENDENT CONSULTANT AND FINANCIAL LEGAL COUNSEL TO VALIDATE THE ORGANIZATION'S BENCHMARKING APPROACH AND REASONABLENESS OF THE TOTAL COMPENSATION AND BENEFITS PACKAGES FOR CERTAIN EXECUTIVES. APPROPRIATE COMPARABLE DATA IS OBTAINED BY THE COMMONSPIRIT HEALTH COMPENSATION DEPARTMENT FROM INDEPENDENT THIRD-PARTY SALARY SURVEYS, (E.G., TOTAL ECONOMIC BENEFITS PAID BY SIMILARLY SITUATED ORGANIZATIONS, BOTH TAXABLE AND TAX-EXEMPT, FOR SIMILAR JOB RESPONSIBILITIES) FOR ALL OTHER STAFF AND LEADERSHIP ROLES. FORM 990, PART VI, SECTION C, LINE 19 THE ORGANIZATION'S FINANCIAL STATEMENTS, CONFLICT OF INTEREST POLICY AND GOVERNING DOCUMENTS ARE AVAILABLE TO THE PUBLIC UPON REQUEST. THE ORGANIZATION'S FINANCIAL STATEMENTS ARE INCLUDED IN COMMONSPIRIT HEALTH'S CONSOLIDATED AUDITED FINANCIAL STATEMENTS THAT ARE AVAILABLE AT WWW.COMMONSPIRITHEALTH.ORG. FORM 990, PART VI, LINE 14: THE DOCUMENT RETENTION AND DESTRUCTION POLICY IS MORE OF AN OPERATIONAL POLICY. THESE TYPES OF POLICIES USUALLY DO NOT GO TO THE BOARD OF DIRECTORS. THIS HAS NOT BEEN ADOPTED BY THE BOARD OF DIRECTORS. FORM 990, PART IX, LINE 11G OTHER FEES: PROGRAM SERVICE EXPENSES 1,755,287. MANAGEMENT AND GENERAL EXPENSES 195,032. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 1,950,319. CONTRACT SERVICES: PROGRAM SERVICE EXPENSES 537,082. MANAGEMENT AND GENERAL EXPENSES 59,676. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 596,758. CONTRACT LABOR: PROGRAM SERVICE EXPENSES 1,157,437. MANAGEMENT AND GENERAL EXPENSES 128,604. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 1,286,041. PURCHASED SERVICES: PROGRAM SERVICE EXPENSES 653,630. MANAGEMENT AND GENERAL EXPENSES 72,626. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 726,256. FORM 990, PART XI, LINE 9: EQUITY CHANGES OF UNCONSOLIDATED ORGS 31,744. ALEGENT CREIGHTON CLINIC 12809 W DODGE RD OMAHA NE 68154 470765154 HOSPITAL NE 501(C)(3) LINE 3 ACH 0 ALEGENT CREIGHTON HEALTH 12809 W DODGE RD OMAHA NE 68154 470757164 HOSPITAL NE 501(C)(3) LINE 3 CHI NEBRASKA 0 ALEGENT HEALTH - BERGAN MERCY HEALTH SYSTEM 7500 MERCY RD OMAHA NE 68124 470484764 HOSPITAL NE 501(C)(3) LINE 3 CHI NEBRASKA 0 ALEGENT HEALTH - COMM MEM HOSPITAL OF MO VALLEY IA 631 N 8TH ST MISSOURI VALLEY IA 51555 420776568 HOSPITAL IA 501(C)(3) LINE 3 CHI NEBRASKA 0 ALEGENT HEALTH - IMMANUEL MEDICAL CENTER 6901 N 72ND ST OMAHA NE 68122 470376615 HOSPITAL NE 501(C)(3) LINE 3 CHI NEBRASKA 0 ALEGENT HEALTH - MEMORIAL HOSPITAL SCHUYLER 104 W 17TH ST SCHUYLER NE 68661 470399853 HOSPITAL NE 501(C)(3) LINE 3 CHI NEBRASKA 0 ALEGENT HEALTH - MERCY HOSPITAL CORNING IOWA PO BOX 368 CORNING IA 50841 420782518 HOSPITAL IA 501(C)(3) LINE 3 CHI NEBRASKA 0 ALVERNA APARTMENTS 300 SE 8TH AVE LITTLE FALLS MN 56345 411351177 LTERM CARE MN 501(C)(3) LINE 10 CSH 0 APPLETREE COURT 601 OAK ST BRECKENRIDGE MN 56520 411850500 SENIOR LIVING MN 501(C)(3) LINE 10 SFH 0 ARROYO GRANDE COMMUNITY HOSPITAL FOUNDATION 345 S HALCYON RD ARROYO GRANDE CA 93420 203256066 FUNDRAISING FOUNDATION CA 501(C)(3) LINE 12A, I DH 0 BAKERSFIELD MEMORIAL HOSPITAL 420 34TH STREET BAKERSFIELD CA 93301 951802779 HOSPITAL CA 501(C)(3) LINE 3 DCC 0 BAYLOR ST LUKE'S HEALTH VENTURES 17200 ST LUKES WAY STE 170 THE WOODLANDS TX 77384 274499340 PHYSICIANS TX 501(C)(3) LINE 12A, I SLHS 0 BAYLOR ST LUKE'S MEDICAL GROUP 6624 FANNIN ST STE 1100 HOUSTON TX 77030 760458535 PHYSICIANS TX 501(C)(3) LINE 3 BSLHV 0 BORNEMANN HEALTHCARE CORPORATION 198 INVERNESS DRIVE WEST ENGLEWOOD CO 80112 232187242 INACTIVE PA 501(C)(3) LINE 12A, I CSH 0 BRAZOSPORT REGIONAL PHYSICIAN SERVICES 100 MEDICAL DRIVE LAKE JACKSON TX 77566 800240261 PHYSICIANS TX 501(C)(3) LINE 3 TCHB 0 BURLESON ST JOSEPH HEALTH CENTER 2801 FRANCISCAN DRIVE BRYAN TX 77802 742759890 HOSPITAL TX 501(C)(3) LINE 3 SLH-CO 0 BURLESON ST JOSEPH MANOR 2801 FRANCISCAN DRIVE BRYAN TX 77802 742913931 REHABILITATION TX 501(C)(3) LINE 10 SJSC 0 CALIFORNIA HOSPITAL MEDICAL CENTER FOUNDATION 1401 SOUTH GRAND AVENUE LOS ANGELES CA 90015 954000909 FUNDRAISING FOUNDATION CA 501(C)(3) LINE 12A, I DCC 0 CARRINGTON HEALTH CENTER 800 N 4TH ST CARRINGTON ND 58421 450227311 HOSPITAL ND 501(C)(3) LINE 3 CSH 0 CATHOLIC HEALTH INITIATIVES - COLORADO 9100 EAST MINERAL CIRCLE CENTENNIAL CO 80112 840405257 HOSPITAL CO 501(C)(3) LINE 3 CSH 0 CATHOLIC HEALTH INITIATIVES COLORADO FOUNDATION 9100 EAST MINERAL AVE CENTENNIAL CO 80112 840902211 FUNDRAISING FOUNDATION CO 501(C)(3) LINE 7 CHIC 0 CATHOLIC HEALTH INITIATIVES NATIONAL FOUNDATION 1150 KELLY JOHNSON BLVD 204 COLORADO SPRINGS CO 80920 270930004 FUNDRAISING FOUNDATION CO 501(C)(3) LINE 12A, I CSH 0 CATHOLIC HEALTH INITIATIVES VIRTUAL HEALTH SERVICES 198 INVERNESS DRIVE WEST ENGLEWOOD CO 80112 460992796 TELEHEALTH CO 501(C)(3) LINE 12A, I CSH 0 CENTENNIAL MEDICAL GROUP INC 2700 STEWART PKWY ROSEBURG OR 97471 263946191 SURGERY CENTER OR 501(C)(3) LINE 10 MMC - ROSEBURG 0 CENTRAL CALIFORNIA HEALTH CENTERS 300 OLD RIVER ROAD STE 200 BAKERSFIELD CA 93311 844171789 CLINIC CA 501(C)(3) LINE 3 DCC 0 CENTRAL KANSAS MEDICAL CENTER 9100 E MINERAL CIRCLE CENTENNIAL CO 80112 480543724 INACTIVE KS 501(C)(3) LINE 3 CSH 0 CHI HEALTH CONNECT AT HOME - FARGO 4816 AMBER VALLEY PKWY S FARGO ND 58104 271966847 SENIOR LIVING MN 501(C)(3) LINE 10 CSH 0 CHI HEALTH FOUNDATION 12809 W DODGE RD OMAHA NE 68154 470648586 FUNDRAISING FOUNDATION NE 501(C)(3) LINE 7 ACH 0 CHI KENTUCKY INC 3900 OLYMPIC BLVD STE 400 ERLANGER KY 41018 202741651 INVESTMENTS KY 501(C)(3) LINE 12A, I CSH 0 CHI LIVING COMMUNITIES 930 S WYNN ROAD OREGON OH 43616 341892096 SENIOR LIVING OH 501(C)(3) LINE 12A, I SFH-OH 0 CHI MEMORIAL HOSPITAL - GEORGIA 100 GROSS CRESCENT CIRCLE FORT OGLETHORPE GA 30742 822748395 HOSPITAL GA 501(C)(3) LINE 3 MHCS 0 CHI NEBRASKA 12809 WEST DODGE ROAD OMAHA NE 68510 363233121 HOLDING CO NE 501(C)(3) LINE 12A, I CSH 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