2023-05-11T13:14:41-05:00 2022-06-30 861065772 DELOITTE TAX LLP 111 S WACKER DRIVE CHICAGO IL 60606 990 2021-07-01 411865315 CENTRACARE HEALTH SYSTEM - MELROSE CENT 3202564231 525 MAIN STREET WEST MELROSE MN 56352 JOSEPH KALKMAN EVP, CAO & CHRO 3202564231 2023-05-10 1 JOSEPH KALKMAN 999009999 MONIKA YADAV P01473820 3124861000 3 AAL1 IAL1 2021 2023-04-26 12:10:37Z CENTRACARE HEALTH - MELROSE DR KENNETH HOLMEN 525 MAIN STREET WEST MELROSE MN 56352 59045986 0 X WWW.CENTRACARE.COM X 1997 MN WE'RE HERE FOR YOUR WHOLE LIFE TO LISTEN, THEN SERVE, TO GUIDE AND HEAL BECAUSE HEALTH MEANS EVERYTHING. 14 9 0 13 0 0 -1486197 975418 44220605 52124182 2377738 5625162 631236 250213 45743382 58974975 696289 879917 0 0 24867558 28799079 0 0 0 21381837 21301189 46945684 50980185 -1202302 7994790 87022550 80850643 34228169 29133899 52794381 51716744 WE'RE HERE FOR YOUR WHOLE LIFE TO LISTEN, THEN SERVE, TO GUIDE AND HEAL BECAUSE HEALTH MEANS EVERYTHING. 0 0 19871813 879917 40784054 CCH - MELROSE IS PART OF A LARGER INTEGRATED HEALTH CARE DELIVERY SYSTEM KNOWN AS CENTRACARE HEALTH, A SYSTEM RECOGNIZED FOR BEING A LEADER IN PROVIDING HIGH-QUALITY, COMPREHENSIVE CARE THROUGHOUT THE REGION. CCH - MELROSE IS A 14 BED CRITICAL ACCESS HOSPITAL THAT PROVIDES ACUTE CARE SERVICES IN THE AREAS OF MEDICAL, SURGICAL, DIAGNOSTIC AND OBSTETRICS ALONG WITH OTHER SERVICES OF 24 HOUR EMERGENCY ROOM, IMAGING, LABORATORY, REHABILITATION, AND CHEMOTHERAPY TO THE COMMUNITY OF STEARNS COUNTY. THERE WERE 506 INPATIENT VISITS, 2,051 INPATIENT DAYS WITH 50,806 OUTPATIENT VISITS IN FISCAL YEAR 2022. 7899866 6808182 CCH - MELROSE OPERATES MELROSE PARK VIEW PLACE AND CENTRACARE - MELROSE CARE CENTER, WHICH ARE CONVENIENTLY CONNECTED TO THE MELROSE HOSPITAL FOR THE HEALTH NEEDS OF THE COMMUNITY. MELROSE PARK VIEW PLACE IS A 60-UNIT INDEPENDENT LIVING SENIOR HOUSING APARTMENT BUILDING THAT OFFERS RETIREMENT LIVING AT ITS FINEST. MELROSE PINE VILLA CARE CENTER IS A 75 BED SKILLED NURSING FACILITY THAT PROVIDES QUALITY, COMPASSIONATE CARE WITH AN EMPHASIS ON ENHANCING EACH RESIDENT'S PHYSICAL, SPIRITUAL, EMOTIONAL AND SOCIAL WELL BEING. THERE WERE 23,244 RESIDENT DAYS DURING FISCAL YEAR 2022. 10683442 4531946 CCH - MELROSE OPERATES THE MELROSE CLINIC, WHICH IS CONVENIENTLY CONNECTED TO THE MELROSE HOSPITAL FOR THE HEALTH NEEDS OF THE COMMUNITY. MELROSE CLINIC PROVIDES SERVICES OF GENERAL SURGERY, NEUROLOGY, OBSTETRICS/GYNECOLOGY, ONCOLOGY, ORTHOPEDICS, AND UROLOGY. THERE WERE 29,036 CLINIC VISITS DURING FISCAL YEAR 2022. 38455121 1 1 0 1 0 0 0 0 0 0 1 1 0 0 1 0 0 1 0 0 0 0 0 0 0 0 1 1 0 1 1 0 0 0 0 0 0 0 0 0 0 0 0 0 1 1 1 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 X 14 9 0 0 0 0 1 1 1 1 1 0 0 1 1 1 1 1 1 0 0 0 MN X ADAM PAULSON 3202564231 525 MAIN STREET WEST MELROSE MN 56352 KENNETH HOLMEN MD PRESIDENT/CEO 6.50 33.50 X X 0 1690800 45185 CHRISTIAN SCHMIDT MD DIRECTOR 1.00 39.00 X 0 508558 47990 BRYAN ROLPH MD DIRECTOR 1.00 39.00 X 0 456324 2687 RICHARD WEHSELER MD DIRECTOR 1.00 39.00 X 0 361850 51695 BOBBIE BERTRAM APRN DIRECTOR (BEG 9/16/21) 1.00 39.00 X 0 160634 48657 DAVID ANFINSON VICE CHAIR 0.25 1.75 X X 0 3667 0 STEVE LARAWAY BOARD CHAIR 0.25 1.75 X X 0 3500 0 BOB THUERINGER DIRECTOR 0.20 1.80 X 0 1000 0 JAMES HEBL MD DIRECTOR 0.25 1.75 X 0 1000 0 JEFF GAU DIRECTOR 0.25 1.75 X 0 1000 0 JOE UPHUS DIRECTOR 0.25 1.75 X 0 1000 0 MICHELLE JOHNSON DIRECTOR 0.25 1.75 X 0 1000 0 TIM WENSMAN DIRECTOR 0.25 1.75 X 0 1000 0 FATHER TOM KNOBLACH DIRECTOR 0.25 1.75 X 0 0 0 CRAIG BROMAN CHIEF OPERATING OFFICER/EVP 6.50 33.50 X 0 1157044 17026 MICHAEL BLAIR CHIEF FINANCIAL OFFC/SR VP/TREASURER 1.00 39.00 X 0 696579 54992 SANTO CRUZ CHIEF LEGAL OFFICER/SR VP/SECRETARY 1.00 39.00 X 0 495979 45247 CINDY FIRKINS SMITH MD VICE PRESIDENT 10.00 30.00 X 0 911392 54651 AMY PORWOLL CHIEF INFORMATION SYSTEM OFFCR/SR VP 6.50 33.50 X 0 581153 52457 ANTHONY GARDNER CHIEF MARKETING & COMM OFFICER/SR VP 6.50 33.50 X 0 447036 36652 PATRICK HELLER PHYSICIAN 40.00 0.00 X 0 486824 43903 MICHAEL BESTE PHYSICIAN 40.00 0.00 X 0 383047 50142 LINDSEY CHMIELEWSKI PHYSICIAN 40.00 0.00 X 0 356803 47005 LEANNE ANDERSON PHYSICIAN 40.00 0.00 X 0 348964 27237 BRYAN BAUCK EXECUTIVE DIRECTOR 40.00 0.00 X 0 329530 38320 0 9385684 663846 0 0 1 0 AYA HEALTHCARE INC PO BOX 123519 DALLAS TX 75312 TRAVEL NURSES 1281542 WEST CENTRAL ANESTHESIA PC 10382 AUGUSTA DRIVE SAUK CENTRE MN 56378 ANESTHESIA SERVICES 700888 CONVERDIA HEALTH STAFFING 2108 SOUTH UNIVERSITY DR STE 106B FARGO ND 58103 STAFFING AGENCY 401740 3 20581 931005 23832 975418 PATIENT & RESIDENT REV 622110 50540796 50540796 SENIOR HOUSING REVENUE 623311 1107545 1107545 OTHER PROGRAM REVENUE 622110 475841 475841 52124182 5625162 5625162 321224 71011 250213 250213 58974975 52124182 0 5875375 X 856508 856508 23409 23409 8727729 6545797 2181932 14456564 10842423 3614141 696599 522449 174150 3924504 2943378 981126 993683 745262 248421 5222864 3917148 1305716 7125 5344 1781 46265 34699 11566 2115805 1586854 528951 952133 714100 238033 28373 21280 7093 70760 53070 17690 783651 587738 195913 3291767 2468825 822942 201791 151343 50448 DRUGS/MEDICAL SUPPLIES 4690399 3517799 1172600 EQUIPMENT RENT & MAINT. 1484757 1113568 371189 IMPLICIT PRICE CONCES. 1363508 1022631 340877 MEDICAID AND MNCARE 852219 639164 213055 189772 142332 47440 50980185 38455121 12525064 0 10883087 1305 82605 11282585 6518190 6757287 381812 245137 130052 317497 64916716 33884976 33754757 31031740 33187006 29716473 620212 2085041 878407 87022550 80850643 7156525 5201650 141521 20055885 291596 7015759 23499132 34228169 29133899 X 52787892 51710255 6489 6489 52794381 51716744 87022550 80850643 7994790 -9072427 0 X 0 1 X 1 1 1 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 0 0 0 0 0 0 0 0 1 771 771 0 PART II-B, LINE 1: CENTRACARE - MELROSE PAID $771 TO STATE AND NATIONAL ASSOCIATIONS TO CONDUCT LOBBYING ACTIVITIES ON ITS BEHALF, AS A MEMBER OF THE ASSOCIATIONS. 517250 517250 47842118 21151919 26690199 179626 155907 23719 16377722 12577150 3800572 31031740 INVESTMENTS HELD BY CENTRACARE IN POOLED INVESTMENTS 29716473 F 29716473 DUE TO AFFILIATES 21070161 THIRD PARTY PAYOR SETTLEMENTS 1265697 LEASE LIABILITIES 707165 ASSET RETIREMENT OBLIGATION 456109 23499132 1 1 X 1 X 175.000000000000 1 X 1 1 1 0 1 1 119168 119168 0.00240 12514482 8814687 3699795 0.07460 12633650 8814687 3818963 0.07700 4442 4442 0.00010 28121 28121 0.00060 32563 32563 0.00070 12666213 8814687 3851526 0.07770 400 400 0.00000 400 400 0.00000 1 1363508 6769233 6638880 130353 X 1 1 1 1 CENTRACARE HEALTH - MELROSE 525 MAIN STREET WEST MELROSE MN 56352 WWW.CENTRACARE.COM/LOCATIONS/MELROSE/ 347139 X X X X RURAL HEALTH CLINIC, NURSING HOME CENTRACARE HEALTH - MELROSE 1 0 0 1 X X X X X X X X X X 19 1 1 1 1 X SEE SECTION C SUPPLEMENTAL INFORMATION X 1 19 1 SEE SECTION C SUPPLEMENTAL INFORMATION 0 1 X 175.000000000000 250.000000000000 X X 1 1 X X X 1 X CENTRACARE.COM/PRICING-FINANCIAL-ASSISTANCE X CENTRACARE.COM/PRICING-FINANCIAL-ASSISTANCE X CENTRACARE.COM/PRICING-FINANCIAL-ASSISTANCE X X X X X X X 1 X 0 X X X X X 1 X 0 0 CENTRACARE HEALTH - MELROSE PART V, SECTION B, LINE 3J: CENTRACARE UTILIZED THE MAPP (MOBILIZING FOR ACTION THROUGH PLANNING AND PARTNERSHIPS) PROCESS TO CONDUCT THE CHNA AND PREPARE THE IMPLEMENTATION STRATEGY WHICH WE CALLED THE COMMUNITY HEALTH IMPROVEMENT PLAN (CHIP). THE MAPP PROCESS INCLUDES A LOCAL PUBLIC HEALTH SYSTEM ASSESSMENT, STAKEHOLDER INTERVIEWS, COMMUNITY HEALTH SURVEY JOINTLY FUNDED AND MANAGED WITH THREE COUNTY PUBLIC HEALTH DEPARTMENTS, AND SEVERAL COMMUNITY MEETINGS TO GATHER INFORMATION ON FORCES THAT CREATE HEALTH, TRENDS, FACTORS AND EVENTS AFFECTING HEALTH, AND STRATEGIES TO OVERCOME BARRIERS TO HEALTHY LIVING. THE CHNA INCLUDED A HEALTH EQUITY ASSESSMENT AND INFORMATION ON NATIONAL, STATE, AND OTHER LOCAL PLANNING PROCESSES RELATED TO HEALTH.AS A FOLLOW UP TO THE PRIOR CHNA PROCESS WHERE PUBLIC HEALTH DATA WAS A SIGNIFICANT GAP, THIS CHNA AND SUBSEQUENT CHIP WAS A COLLABORATIVE EFFORT EXECUTED WITH BENTON COUNTY PUBLIC HEALTH, SHERBURNE COUNTY PUBLIC HEALTH, AND STEARNS COUNTY PUBLIC HEALTH. THE RESULT WAS A JOINT CHNA AND CHIP. CENTRACARE HEALTH - MELROSE PART V, SECTION B, LINE 5: CENTRACARE POPULATION HEALTH CONDUCTED SPECIFIC AND COMPREHENSIVE EVALUATION OF ZIP CODE 56304 THAT HAS THE WORST HEALTH OUTCOMES IN THE THREE COUNTIES INCLUDED IN THE CHNA AND CHIP. THIS EVALUATION INCLUDED DATA EVALUATION, KEY INFORMANT INTERVIEWS, AND HEALTH INDICATORS FOR MINORITY GROUPS. THE CENTRAL MN ALLIANCE ALSO COMPLETED SEVERAL SURVEYS AND ASSESSMENTS TO GET INPUT FROM MULTIPLE SECTORS OF EACH COMMUNITY REPRESENTING DIFFERENT POPULATIONS IN ORDER TO COMPILE A LIST OF TOP PRIORITIES IN THE REGION:THE COMMUNITY HEALTH STATUS ASSESSMENT (CHSA) WAS DATA COLLECTED FROM THE COMMUNITY HEALTH ASSESSMENT COMPLETED IN 2016, CENTRACARE PATIENT DATA, MINNESOTA STUDENT SURVEY DATA, AND MINNESOTA PUBLIC HEALTH VITAL STATISTICS. THIS DATA WAS COMPARED TO DOCUMENTS AND DATASETS FROM THE MN STATEWIDE HEALTH ASSESSMENT (SHA), CENTRAL MN COMMUNITY HEALTH SURVEY DATA, PREVIOUS PLANNING PROCESS PRIORITY LISTS, HEALTH EQUITY DATA ANALYSES (HEDA) FROM EACH COUNTY, TYPES OF DATA REQUESTS OUR AGENCIES WERE GETTING FROM THE PUBLIC, AND THE MN DEPARTMENT OF HEALTH DATA INDICATOR LIST. A "COMMUNITY PRIORITY CATEGORY" WAS ASSIGNED TO EACH DATA POINT TO IDENTIFY A LIST OF COMMUNITY PRIORITIES.THE COMMUNITY THEMES AND STRENGTHS ASSESSMENT (CTSA) WAS CONDUCTED IN THE FORM OF KEY STAKEHOLDER INTERVIEWS VIA PHONE WITH A WIDE VARIETY OF COMMUNITY PARTNERS THROUGHOUT THE THREE COUNTIES. A TOTAL OF 50 STAKEHOLDERS WERE INTERVIEWED FROM 20 DIFFERENT SECTORS INCLUDING: 1. YOUTH, PARENT, SMALL BUSINESS OWNER, CORPORATE BUSINESS OWNER, MEDIA, SCHOOL/EDUCATION, YOUTH-SERVING ORGANIZATION, LAW ENFORCEMENT, RELIGIOUS OR FAITH-BASED ORGANIZATION, PRIMARY HEALTHCARE, BEHAVIORAL HEALTH, HOSPITAL-BASED HEALTHCARE, STATE/LOCAL GOVERNMENT- ELECTED, STATE/LOCAL GOVERNMENT- NON-ELECTED, NON-PROFIT, CIVIC/VOLUNTEER GROUP, VETERANS INTEREST GROUP, AGING POPULATION INTEREST GROUP, ENVIRONMENTAL INTEREST GROUP, MINORITY INTEREST GROUP.FOR THE LOCAL PUBLIC HEALTH SYSTEM ASSESSMENT (LPHSA) BENTON, SHERBURNE, AND STEARNS COUNTY LPH AGENCIES PARTICIPATED IN A CAPACITY ASSESSMENT TO HELP DETERMINE THE EXTENT TO WHICH REQUIRED LOCAL PUBLIC HEALTH ACTIVITIES ARE IN PLACE STATEWIDE. THE ASSESSMENT QUESTIONS WERE THEN UTILIZED TO FORMULATE A SURVEY FOR THREE SECTORS OF THE LOCAL PUBLIC HEALTH SYSTEM: EMERGENCY PREPAREDNESS, ENVIRONMENTAL HEALTH, AND HEALTHCARE ACCESS/INFECTIOUS DISEASE. COMMUNITY PARTNERS WERE INVITED TO PARTICIPATE IN THE SURVEY VIA EMAIL. AFTER ANALYZING THE RESULTS, THE LPHSA SUBGROUP DEVELOPED A LIST OF THEIR TOP 10 RECOMMENDATIONS FROM ALL 3 SECTORS TO SUPPORT THE DEVELOPMENT OF THE COMMUNITY COMMUNITY HEALTH IMPROVEMENT PLAN.THE FORCES OF CHANGE (FOC) ASSESSMENT WAS COMPLETED IN THE FORM OF A COMUNITY MEETING IN AUGUST OF 2018 TO IDENTIFY FORCES THAT MAY AFFECT A COMMUNITY AND OPPORTUNITIES AND THREATS ASSOCIATED WITH THOSE FORCES. THE AGENDA INCLUDED A BRAINSTORMING ACTIVITY AND TIME IN SMALL GROUP AND LARGE GROUP DISCUSSION. A FLIER ADVERTISING THE MEETING WAS DISTRIBUTED TO COMMUNITY MEMBERS VIA EMAIL. THERE WERE 68 PEOPLE THAT ATTENDED REPRESENTING 27 ORGANIZATIONS AND TWO THAT IDENTIFIED THEIR AFFILIATION AS 'COMMUNITY MEMBER'. AS A FOLLOW UP TO THE FORCES OF CHANGE COMMUNITY MEETING, A WORLD CAFE WAS HELD IN JANUARY 2019 FOR MEMBERS OF THE COMMUNITY TO COME AND TALK ABOUT THEIR PERCEPTION OF NEEDS IN THE SURROUNDING COMMUNITIES. THERE WERE 94 PEOPLE THAT ATTENDED THE MEETING REPRESENTING 32 ORGANIZATIONS AND THREE THAT IDENTIFIED THEIR AFFILIATION AS 'COMMUNITY MEMBER'. ORGANIZATIONS THAT WERE REPRESENTED AT BOTH COMMUNITY MEETINGS INCLUDED LOCAL GOVERNMENT, HEALTHCARE, LOCAL NONPROFITS, EDUCATION, UNDERREPRESENTED COMMUNITIES, FAITH COMMUNITY, AND OTHERS.IN ORDER TO BETTER ENGAGE INDIVIDUALS OR ORGANIZATIONS WITH A PERSPECTIVE OF AT-RISK POPULATIONS, A HEALTH EQUITY ASSESSMENT WAS ALSO COMPLETED. FOCUS-GROUP MEETINGS WERE HELD ON THREE SEPARATE OCCASIONS AT THE GREAT RIVER REGIONAL LIBRARY IN ST. CLOUD, AND COMMUNITY INPUT WAS GATHERED AT THE BENTON, SHERBURNE, AND STEARNS COUNTY FAIRS TO REACH OUT TO A VARIETY OF COMMUNITIES. IN TOTAL, THERE WERE 30 SOMALI ADULTS WHO DISCUSSED POSITIVES, NEGATIVES, AND AREAS-TO-IMPROVE-ON WITHIN THE COMMUNITY. AT THE COUNTY FAIRS, INFORMATION WAS GATHERED FROM RESPONDENTS FROM THE 56304-ZIP CODE. CENTRACARE HEALTH - MELROSE PART V, SECTION B, LINE 6A: CENTRACARE HEALTH SYSTEMC - MELROSE CONDUCTED THE CHNA WITH CENTRACARE- PAYNESVILLE, CENTRACARE- SAUK CENTRE, AND ST. CLOUD HOSPITAL. CENTRACARE HEALTH - MELROSE PART V, SECTION B, LINE 6B: CENTRACARE HEALTH SYSTEMC - MELROSE CONDUCTED THE CHNA WITH BENTON COUNTRY PUBLIC HEALTH, SHERBURNE COUNTRY PUBLIC HEALTH AND STEARNS COUNTRY PUBLIC HEALTH. CENTRACARE HEALTH - MELROSE PART V, SECTION B, LINE 11: THE PRIORITIZATION PROCESS TOOK PLACE WHILE UTILIZING THE MAPP PROCESS. THE WORK OF EACH OF THE FOUR MAPP ASSESSMENT SUB-GROUPS RESULTED IN FOUR LISTS OF 10 COMMUNITY PRIORITIES. AS A REMINDER, THE FOUR ASSESSMENTS INCLUDE: COMMUNITY HEALTH STATUS ASSESSMENT, COMMUNITY THEMES AND STRENGTHS ASSESSMENT, LOCAL PUBLIC HEALTH STATUS ASSESSMENT, AND FORCES OF CHANGE ASSESSMENT. THOSE FOUR LISTS OF 10 ARE INCLUDED IN THE NARRATIVE EARLIER IN THIS DOCUMENT.THE CORE SUPPORT TEAM WAS PROVIDED THOSE FOUR LISTS OF TEN PRIORITIES. THEY TOOK THOSE LISTS AND TALKED WITH THEIR AGENCY STAFF TO IDENTIFY ANY THEMES OR COMMONALITIES AMONGST THE FOUR LISTS. THE CORE SUPPORT TEAM THEN CAME TOGETHER IN A MEETING AND WENT THROUGH A FACILITATED PROCESS USING THE CENTRAL MN ALLIANCE VISION AS A GUIDE TO COME UP WITH A TOP 10 LIST TO SEND ON TO THE DELEGATED AUTHORITIES.THE DELEGATED AUTHORITIES MET AND CONTINUED THE DISCUSSION ABOUT THE PRIORITY LIST. THE PRIORITIES PASSED ON BY THE CORE SUPPORT TEAM WERE RUN THROUGH TWO PRIORITIZATION EXERCISES. THE FIRST WAS A RANKING DISCUSSION WITH POINTS ASSIGNED FOR CERTAIN CRITERIA. RANKS INCLUDED 3 FOR HIGH, 2 FOR MEDIUM, AND 1 FOR LOW. THE CRITERIA INCLUDED:URGENCY: IS THIS A PRIORITY ISSUE THAT NEEDS TO BE ADDRESSED IN THE NEXT 1-3 YEARS?POTENTIAL IMPACT: IS IT LIKELY THAT ADDRESSING THIS CRITICAL ISSUE WILL HAVE A SIGNIFICANT IMPACT ON ONE OR MORE SPECIFIC POPULATIONS? DO YOU HAVE REASON TO BELIEVE YOU CAN BE SUCCESSFUL ON THIS ISSUE?ACTIONABLE/FEASIBLE: ARE THERE OPPORTUNITIES FOR ACTION TO ADDRESS THE CRITICAL ISSUE? IS THERE ROOM TO MAKE MEANINGFUL IMPROVEMENT ON THE ISSUE?RESOURCES: ARE RESOURCES (FUNDS, STAFF, & EXPERTISE) EITHER READILY AVAILABLE OR LIKELY RESOURCES CAN BE OBTAINED TO ADDRESS THE CRITICAL ISSUE? ARE THERE RESOURCES THROUGH THE STATE AND COMMUNITY MEMBERS TO WORK ON THE ISSUE? IF NOT, CAN RESOURCES BE ACQUIRED?COMMUNITY READINESS: IS THIS A CRITICAL ISSUE IDENTIFIED AS IMPORTANT BY THE COMMUNITY? ARE PEOPLE IN THE COMMUNITY INTERESTED IN THE ISSUE? IS THERE COMMUNITY MOMENTUM TO MOVE THIS INITIATIVE FORWARD?INTEGRATION: IS THERE OPPORTUNITY FOR COLLABORATION? IS THERE OPPORTUNITY TO BUILD ON EXISTING INITIATIVES? WILL THIS DUPLICATE EFFORTS? FINALLY, THE PRIORITIES WERE PLACED ON A CONTROL/INFLUENCE GRID.THE PRIORITIES IDENTIFIED WERE AS FOLLOWS IN COMMUNITY INFORMED RANKING: 1) BUILDING FAMILIES, 2) MENTAL HEALTH, 3) ENCOURAGING SOCIAL CONNECTION, 4) ADVERSE CHILDHOOD EXPERIENCES (ACES), 5) TOBACCO/NICOTINE USE, 6) HEALTH CARE, 7) RISKY YOUTH BEHAVIOR, 8) FINANCIAL STRESS, 9) TRAUMA, AND 10) EDUCATING POLICY MAKERS AND KEY COMMUNITY STAKEHOLDERS. DUE TO THE NEWNESS OF THE COLLABORATION ON THIS WORK, A DECISION WAS MADE TO FOCUS ON THE TOP TWO PRIORITIES (BUILDING FAMILIES AND MENTAL HEALTH) FOR THE COMMUNITY HEALTH IMPROVEMENT PLAN. THE PRIORITIES ENCOURAGING SOCIAL CONNECTION, ADVERSE CHILDHOOD EXPERIENCES (ACES), TOBACCO/NICOTINE USE, HEALTH CARE, RISKY YOUTH BEHAVIOR, FINANCIAL STRESS, TRAUMA, AND EDUCATING POLICY MAKERS AND KEY COMMUNITY STAKEHOLDERS WILL NOT SPECIFICALLY BE ADDRESSED THROUGH ACTION PLANNING OR MEASUREMENT DUE TO FINANCIAL AND STAFFING RESTRAINTS, HOWEVER, THERE ARE WAYS MANY OF THESE PRIORITIES ARE BEING ADDRESSED EITHER WITHIN THE TOP TWO PRIORITIES OR THE COMMUNITY. IN THE FUTURE, THE GROUP WILL ASSESS THE CAPACITY TO EXPAND THE NUMBER OF PRIORITIES BEING ADDRESSED AND MEASURED. ALTHOUGH NOT DIRECTLY ADDRESSED IN THE PLAN, CENTRACARE DOES ACTIVELY SUPPORT OTHER ORGANIZATIONS WITHIN THE COMMUNITY WHO ARE WORKING ON DETERMINANTS OF HEALTH IDENTIFIED DURING THE CHNA PROCESS LIKE ACES, TOBACCO, TRAUMA, EDUCATING POLICYMAKERS, ETC.THE COMMUNITY HEALTH IMPROVEMENT PLAN (CHIP) IS THE ACTION PLAN THAT USES GUIDING PRINCIPLES AND STRATEGIES TO ADDRESS THE COMMUNITY PRIORITIES IDENTIFIED IN THE COMMUNITY HEALTH NEEDS ASSESSMENT (CHNA) PROCESS. THE TOP PRIORITIES ARE BUILDING FAMILIES AND MENTAL HEALTH. WE WILL USE THE GUIDING PRINCIPLES OF COMMUNITY COLLABORATION, AWARENESS, RESILIENCE, EQUITY, EDUCATION, AND HEALTH ORGANIZATIONS TO DRIVE OUR STRATEGIES.THE ST. CLOUD HOSPITAL, CENTRACARE- MELROSE HOSPITAL, CENTRACARE- SAUK CENTRE, AND CENTRACARE- PAYNESVILLE WILL MAINTAIN THEIR ENGAGEMENTS WITH THE CENTRAL MN ALLIANCE AND FOLLOW THE MAPP LEADERSHIP STRUCTURE TO CARRY OUT THE STRATEGIES OUTLINED IN THE CHIP. THERE WILL BE MEETINGS AS OUTLINED IN THE CHIP UNDER LEADERSHIP SYSTEM & PROCESS FOR MONITORING AND REVISION. TO SEE THE FULL CHIP GO TO THE CENTRACARE WEBSITE AT HTTPS://WWW.CENTRACARE.COM/ABOUT-US/COMMUNITY-HEALTH-NEEDS-ASSESSMENT/. CENTRACARE HEALTH - MELROSE PART V, SECTION B, LINE 13H: A NON-CITIZEN CAN BE DENIED CARE IF THEY CAME TO THE US SPECIFICALLY TO RECEIVE FREE CARE.PRESUMPTIVE ELIGIBILITY - IF PATIENTS FAIL TO SUPPLY SUFFICIENT INFORMATION TO SUPPORT FINANCIAL ASSISTANCE ELIGIBILITY, CENTRACARE HEALTH MAY REFER TO OR RELY ON EXTERNAL SOURCES AND/OR OTHER PROGRAM ENROLLMENT RESOURCES TO DETERMINE ELIGIBILITY WHEN:(A) PATIENT IS HOMELESS(B) PATIENT IS ELIGIBLE FOR OTHER STATE OR LOCAL ASSISTANCE PROGRAMS(C) PATIENT IS ELIGIBLE FOR FOOD STAMPS OR SUBSIDIZED SCHOOL LUNCH PROGRAM(D) PATIENT IS ELIGIBLE FOR A STATE-FUNDED PRESCRIPTION MEDICATION PROGRAM(E) PATIENT'S VALID ADDRESS IS CONSIDERED LOW-INCOME OR SUBSIDIZED HOUSING(F) PATIENT RECEIVES FREE CARE FROM A COMMUNITY CLINIC AND IS REFERRED TO HOSPITAL FOR FURTHER TREATMENT CENTRACARE HEALTH - MELROSE PART V, SECTION B, LINE 16J: PATIENTS WHO ARE AT A SELF PAY STATUS RECEIVE FINANCIAL ASSISTANCE INFORMATION EITHER VIA A TELEPHONE CALL OR ON BILLING STATEMENTS. CENTRACARE HEALTH - MELROSE PART V, SECTION B, LINE 20E: OUR CREDIT COLLECTION AGENCIES ARE REQUIRED TO PROVIDE CHARITY INFORMATION AS PART OF THEIR COLLECTION PROCESS PRIOR TO ANY CONSIDERATION OF LEGAL ACTION AGAINST THE PATIENT. PART V, SECTION B, LINE 7A: THE HOSPITAL'S CHNA AND STRATEGY AND IMPLEMENTATION PLAN CAN BE FOUND ON ITS WEBSITE AT HTTPS://WWW.CENTRACARE.COM/DOCUMENTS/ABOUT/CENTRAL-MN-ALLIANCE-CHIP_CHNA-2019-2022-VERSION-2-UPDATED-02.20.PDF PART V, SECTION B, LINE 10A: THE HOSPITAL'S CHNA AND STRATEGY AND IMPLEMENTATION PLAN CAN BE FOUND ON ITS WEBSITE AT HTTPS://WWW.CENTRACARE.COM/DOCUMENTS/ABOUT/CENTRAL-MN-ALLIANCE-CHIP_CHNA-2019-2022-VERSION-2-UPDATED-02.20.PDF PART V, SECTION B, LINE 22B: THE FOLLOWING DISCLOSURE IS IN ACCORDANCE WITH REV. PROC. 2015-21 SECTION 7 IN REGARDS TO SCHEDULE H, PART V, SECTION B, LINE 22B. DURING THE TAX PERIOD ENDED JUNE 30, 2022, THE FINANCIAL ASSISTANCE POLICY DID NOT INCLUDE THE PERCENTAGE CALCULATED FOR THE "AMOUNTS GENERALLY BILLED" USING THE LOOK BACK METHOD. CENTRACARE IDENTIFIED THIS ERROR IN MARCH 2022 DURING THE PREPARATION OF THE FORM 990 FOR THE TAX PERIOD ENDED JUNE 30, 2021 AND CORRECTED THIS ERROR IN APRIL 2022. THIS ERROR WAS MINOR AND INADVERTENT AND CORRECTIVE ACTIONS WERE TAKEN AFTER THE DISCOVERY OF THE ERROR. 3 1 - MELROSE PINE RILLA CARE CENTER 525 MAIN STREET WEST MELROSE MN 56382 SKILLED CARE AND MEMORY ASSISTANCE LIVING FACILITY 2 - MELROSE PARK VIEW PLACE 125 5TH AVE NW MELROSE MN 56352 ASSISTED LIVING FACILITY 3 - MELROSE CLINIC 525 MAIN STREET WEST MELROSE MN 56352 CLINIC PART I, LINE 6A: CENTRACARE HEALTH SYSTEM PREPARES AN ANNUAL COMMUNITY BENEFIT REPORT THAT INCLUDES ALL RELATED ORGANIZATIONS. PART I, LINE 7: THE ORGANIZATIONS TOTAL EXPENSES WERE REDUCED BY THEIR NON-OPERATING REVENUE, MEDICAID SURCHARGE AND MN CARE TAX. THE NET TOTAL EXPENSES WERE THEN DIVIDED BY GROSS CHARGES TO DETERMINE THE COST TO CHARGE RATIO. THE COST TO CHARGE RATIO WAS THEN APPLIED TO THE FINANCIAL ASSISTANCE ON LINE 7A. MEDICAID COMMUNITY BENEFIT EXPENSE AND DIRECT OFFSETTING REVENUES ON LINE 7B ARE REPORTED AT COST. COMMUNITY HEALTH IMPROVEMENT SERVICES AND COMMUNITY BENEFIT OPERATIONS ON LINE 7E ARE REPORTED AT COST. HEALTH PROFESSIONALS EDUCATION AND DIRECT OFFSETING REVENUES ON LINE 7F ARE REPORTED AT COST. PART I, LINE 7, COLUMN (F): THE BAD DEBT EXPENSE INCLUDED ON FORM 990, PART IX, LINE 25, COLUMN (A), BUT SUBTRACTED FOR PURPOSES OF CALCULATING THE PERCENTAGE IN THIS COLUMN IS $ 1,363,508. PART II, COMMUNITY BUILDING ACTIVITIES: CENTRACARE - MELROSE PARTICIPATED IN NUMEROUS MEETINGS THROUGHOUT THE YEAR WITH SURROUNDING LIONS/JAYCEES AND ALSO COMPLETED BIOMETRIC SCREENINGS WHICH HELPED PROMOTE IMPROVED HEALTH IN THE COMMUNITY.THE HEALTH SYSTEM PROVIDED DRIVE THROUGH TEST SITES, FREE VACCINATION CLINICS, MANDATED EMPLOYEE VACCINATION, TRAINING, SCREENING, PRODUCTS TO ENSURE SAFE ENVIRONMENTS, AND OTHER VARIOUS SERVICES/PRODUCTS. PART III, LINE 2: THE PROVISION FOR UNCOLLECTIBLE ACCOUNTS IS BASED UPON MANAGEMENT'S ASSESSMENT OF HISTORICAL AND EXPECTED NET COLLECTIONS CONSIDERING HISTORICAL BUSINESS AND ECONOMIC CONDITIONS, TRENDS IN HEALTHCARE COVERAGE, AND OTHER COLLECTION INDICATORS. PART III, LINE 4: THE FOLLOWING IS FROM THE "ACCOUNTS RECEIVABLE" PARAGRAPH INCLUDED IN NOTE 2 ON PAGE 10 OF THE ORGANIZATION'S AUDITED FINANCIALS."THE SYSTEM REPORTS PATIENT AND RESIDENT SERVICE REVENUE AT THE AMOUNT THAT REFLECTS THE CONSIDERATION TO WHICH THE SYSTEM EXPECTS TO BE ENTITLED TO IN EXCHANGE FOR PROVIDING PATIENT CARE. THESE AMOUNTS ARE DUE FROM PATIENTS AND THIRD-PARTY PAYORS (INCLUDING MEDICARE, MEDICAID, BLUE CROSS AND OTHER THIRD-PARTY PAYORS). CERTAIN REIMBURSEMENT ARRANGEMENTS INCLUDE VARIABLE CONSIDERATION FOR AMOUNTS SUBJECT TO RETROACTIVE AUDIT AND ADJUSTMENT. DIFFERENCES BETWEEN AMOUNTS ORIGINALLY RECORDED AND FINALLY SETTLED ARE INCLUDED IN OPERATIONS IN THE YEAR IN WHICH THE DIFFERENCES ARE KNOWN. REVENUE IS RECOGNIZED AS PERFORMANCE OBLIGATIONS ARE SATISFIED." PART III, LINE 8: THE AMOUNT ON LINE 7 OF PART III WAS DETERMINED BY UTILIZING KEY SECTIONS OF THE MEDICARE COST REPORT, PRIMARILY THE D SERIES AND E SERIES. PART III, LINE 9B: THE COLLECTION POLICIES AT THE ORGANIZATION REQUIRE COLLECTION STAFF TO OFFER CHARITY TO PATIENTS WHO INDICATE THAT PAYMENT MAY BE AN ISSUE. IF A PATIENT DOES QUALIFY FOR FULL CHARITY, ALL OTHER COLLECTION EFFORTS MUST CEASE. IF A PATIENT QUALIFIES FOR PARTIAL CHARITY, COLLECTION EFFORTS WILL CONTINUE ON THE BALANCE OF THE ACCOUNT. THESE PROVISIONS APPLY TO BOTH HOSPITAL EMPLOYED COLLECTION STAFF AND COLLECTION AGENCY STAFF. NO PATIENTS, WHETHER THEY QUALIFY FOR CHARITY OR NOT, ARE REPORTED TO CREDIT REPORTING AGENCIES. PART VI, LINE 2: THE ORGANIZATIONS' STRATEGIC PLANNING ASSESSES THE NEEDS OF THE COMMUNITY AND PATIENTS THROUGH PATIENT SATISFACTION SURVEYS, COMMENT CARDS, COMMUNITY ASSESSMENTS AND A DIVERSE OPERATING COMMITTEE THAT REPRESENTS THE COMMUNITY AND BRINGS TO THE TABLE ISSUES, CONCERNS AND RECOMMENDATIONS FOR HEALTH CARE SERVICES. PART VI, LINE 3: INPATIENTS WHO ARE SELF PAY ARE IDENTIFIED, AND A REPRESENTATIVE OF THE ORGANIZATION'S BILLING DEPARTMENT EXPLAINS THE CHARITY CARE POLICY TO PATIENTS. THEY ALSO EXPLAIN THE SELF PAY DISCOUNT AND SCREENS THE PATIENT FOR ELIGIBILITY FOR ANY STATE OR FEDERAL PROGRAMS. THEY ALSO ASSIST THE PATIENT WITH ANY PAPERWORK REQUIRED TO APPLY FOR SUCH PROGRAMS. OUTPATIENTS WHO ARE SELF PAY RECEIVE AN AUTOMATIC SELF PAY DISCOUNT. IF THE PATIENT DOES NOT REMIT PAYMENT, COLLECTION STAFF ATTEMPT TO REACH THE PATIENT BY PHONE. PATIENTS ARE TOLD ABOUT THE CHARITY PROGRAM. FOR BOTH INPATIENTS AND OUTPATIENTS, ALL STATEMENTS CONTAIN A LETTER REGARDING THE AVAILABILITY OF CHARITY CARE. ALSO ALL PRECOLLECTION LETTERS HAVE THIS SAME LANGUAGE INDICATING THE AVAILABILITY AND PROCESS OF OBTAINING CHARITY CARE. PART VI, LINE 4: MELROSE IS PREDOMINANTLY AN AGRICULTURAL COMMUNITY LOCATED IN STEARNS COUNTY, MINNESOTA IN WHICH THERE IS 1 HOSPITAL. THE ESTIMATED 2023 POPULATION SHOWS 6,152 RESIDENTS WITH AN ESTIMATED DECREASE TO 6,142 BY 2028. THIS AREA HAS SEEN AN DECREASE IN ITS POPULATION AND PROJECTIONS INDICATE THAT WILL CONTINUE. THE PROJECTED CHANGE BY AGE BRACKET FROM 2023 TO 2028 IS AS FOLLOWS: 0-17: 1.10%, 18-44: 3.35%, 45-64: -10.91%, 65+: 4.49%. THE ESTIMATED 2023 ETHNIC MIX IS AS FOLLOWS: CAUCASIAN: 77.63%, AFRICAN AMERICAN: .41%, ASIAN: .16%, HISPANIC: 20.29%, OTHER: 1.51%. THE ESTIMATED 2023 AVERAGE INCOME IS $85,356. THE ESTIMATED MEDICAL UNDERSERVICE SCORE IS 59.60. PART VI, LINE 5: THE ORGANIZATION HAS A COMMUNITY BASED OPERATING COMMITTEE THAT MEETS ON A MONTHLY BASIS TO REVIEW VARIOUS ASPECTS OF THE FACILITY AND PROVIDE INPUT ON THOSE ASPECTS FROM A COMMUNITY PERSPECTIVE. A MAJORITY OF THE COMMITTEE IS COMPRISED OF PERSONS WHO RESIDE IN THE ORGANIZATION'S PRIMARY SERVICE AREA THAT ARE NOT EMPLOYEES OR INDEPENDENT CONTRACTORS OF THE ORGANIZATION AND ARE NOT FAMILY MEMBERS THEREOF. THE ORGANIZATION PARTICIPATES IN THE COMMUNITY BLOOD DRIVES BY PROVIDING FOOD AND SUPPLIES FOR BOTH THE WORKERS AND BLOOD DONORS. THE FACILITY ALSO SPONSORS A HEALTH FAIR ON AN ANNUAL BASIS FOR THE LOCAL AND SURROUNDING COMMUNITIES. THE ORGANIZATION EXTENDS MEDICAL STAFF PRIVILEGES TO ALL QUALIFIED PHYSICIANS IN ITS COMMUNITY FOR SOME OR ALL OF ITS DEPARTMENTS OR SPECIALTIES AND FACILITIES AND EQUIPMENT, PATIENT CARE, MEDICAL TRAINING, EDUCATION AND RESEARCH. PART VI, LINE 6: THE ORGANIZATION IS PART OF CENTRACARE HEALTH SYSTEM (CCHS) WHICH PROVIDES A BROAD RANGE OF HEALTH CARE SERVICES TO THE PATIENTS OF CENTRAL MINNESOTA. CCHS IS DEDICATED TO IMPROVING THE HEALTH OF PEOPLE LIVING AND WORKING IN THE COMMUNITIES IT SERVES. TO ACCOMPLISH ITS GOALS IT WORKS ACTIVELY WITH ITS AFFILIATE HEALTH CARE ORGANIZATIONS. CCHS CONTINUES TO FOCUS ON PROVIDING THE BEST CARE POSSIBLE AND IN REINVESTING INTO THE COMMUNITY. CCHS ALSO PROMOTES WELLNESS BY SPONSORING PROGRAMS AND EVENTS IN LOCAL COMMUNITIES THAT FOCUS ON HEALTHY EATING AND EXERCISE, AND BY CONDUCTING SCREENINGS FOR CONDITIONS SUCH AS HIGH BLOOD PRESSURE. PART VI, LINE 7, REPORTS FILED WITH STATES MN 1 SCHOLARSHIPS FOR ADVANCING EDUCATION 33 23409 PART I, LINE 2: THE CLASSES ARE POSTED AS "POSITIONS" ON THE WEBSITE THAT PEOPLE CAN APPLY TO. THE APPLICATIONS ARE SCREENED BY RECRUITMENT AND IF SELECTED, SET UP FOR AN INTERVIEW WITH THE HIRING MANGER AT THE SITE. IF THE HIRING MANAGER WISHES TO PROCEED, THEY ARE OFFERED A POSITION BY THE RECRUITER TO TAKE THE CNA CLASS BUT THEN ALSO TO TAKE A PART TIME OR FULL TIMES POSITION AS A CNA IN ONE OF OUR ENTITIES ONCE THEY COMPLETE THE CLASS, SKILLS, AND TEST. ANYONE THAT APPLIES AND IS NOT SELECTED, THE RECRUITMENT TEAM WOULD HAVE NOTES AND TRACKING ITEMS FOR THIS IN ORACLE. 0 1 0 0 0 0 0 1 0 KENNETH HOLMEN MD PRESIDENT/CEO 0 1098562 0 309744 0 282494 0 16908 0 28277 0 1735985 0 272575 CRAIG BROMAN CHIEF OPERATING OFFICER/EVP 0 663125 0 53304 0 440615 0 0 0 17026 0 1174070 0 342108 CINDY FIRKINS SMITH MD VICE PRESIDENT 0 593203 0 123492 0 194697 0 26000 0 28651 0 966043 0 184809 MICHAEL BLAIR CHIEF FINANCIAL OFFC/SR VP/TREASURER 0 544317 0 123288 0 28974 0 26000 0 28992 0 751571 0 0 AMY PORWOLL CHIEF INFORMATION SYSTEM OFFCR/SR VP 0 404042 0 100553 0 76558 0 26000 0 26457 0 633610 0 67084 CHRISTIAN SCHMIDT MD DIRECTOR 0 455593 0 24203 0 28762 0 26000 0 21990 0 556548 0 0 SANTO CRUZ CHIEF LEGAL OFFICER/SR VP/SECRETARY 0 395624 0 91475 0 8880 0 19500 0 25747 0 541226 0 0 PATRICK HELLER PHYSICIAN 0 449146 0 28564 0 9114 0 21874 0 22029 0 530727 0 0 ANTHONY GARDNER CHIEF MARKETING & COMM OFFICER/SR VP 0 278597 0 74758 0 93681 0 26000 0 10652 0 483688 0 84642 BRYAN ROLPH MD DIRECTOR 0 426393 0 22775 0 7156 0 0 0 2687 0 459011 0 0 MICHAEL BESTE PHYSICIAN 0 356133 0 21638 0 5276 0 19500 0 30642 0 433189 0 0 RICHARD WEHSELER MD DIRECTOR 0 333495 0 21258 0 7097 0 26000 0 25695 0 413545 0 0 LINDSEY CHMIELEWSKI PHYSICIAN 0 308019 0 23106 0 25678 0 19500 0 27505 0 403808 0 0 LEANNE ANDERSON PHYSICIAN 0 334946 0 6301 0 7717 0 5147 0 22090 0 376201 0 0 BRYAN BAUCK EXECUTIVE DIRECTOR 0 258433 0 35758 0 35339 0 6911 0 31409 0 367850 0 26012 BOBBIE BERTRAM APRN DIRECTOR (BEG 9/16/21) 0 150966 0 6086 0 3582 0 19500 0 29157 0 209291 0 0 PART I, LINE 3 THE COMPENSATION PAID TO THE PRESIDENT AND VICE PRESIDENTS (NON-MEDICAL PROVIDERS) IS DETERMINED BY CENTRACARE HEALTH SYSTEM, A RELATED ORGANIZATION. CENTRACARE HEALTH SYSTEM USES THE FOLLOWING METHODS TO DETERMINE COMPENSATION: - COMPENSATION COMMITTEE - INDEPENDENT COMPENSATION CONSULTANT - FORM 990 OF OTHER ORGANIZATIONS - COMPENSATION SURVEY OR STUDY - APPROVAL BY THE BOARD OR COMPENSATION COMMITTEE PART I, LINE 4B THE CORPORATIONS' EXECUTIVES ARE ELIGIBLE TO PARTICIPATE IN BENEFIT PLANS WHICH INCLUDE TAX DEFERRED NON-QUALIFIED INVESTMENT ACCOUNTS. THESE PLANS MAY PROVIDE, BUT ARE NOT CERTAIN TO PROVIDE, FOR PAYMENT OF TAX DEFERRED COMPENSATION TO THESE EXECUTIVES AT SOME TIME IN THE FUTURE. THE EXECUTIVE HAS NO LEGAL RIGHT TO THESE DOLLARS UNTIL, AND UNLESS, CERTAIN FUTURE EVENTS OCCUR. IN ACCORDANCE WITH THE INSTRUCTIONS TO FORM 990, THE AMOUNTS LISTED IN PART VII AND SCHEDULE J, PART II, COLUMN C, REFLECT TAX DEFERRED COMPENSATION. THIS COMPENSATION IS POTENTIALLY REPORTED TWICE ON FORM 990 - ONCE WHEN THE COMPENSATION IS DEFERRED OR ACCRUED AND AGAIN IF AND WHEN IT IS PAID TO THE EXECUTIVE. THE FOLLOWING INDIVIDUALS PARTICIPATED IN THE NON-QUALIFIED PLAN: CRAIG BROMAN - PAID $342,108 AMY PORWOLL - PAID $67,084 ANTHONY GARDNER - PAID $84,642 BRYAN BAUCK - PAID $26,012 CINDY FIRKINS SMITH - PAID $184,809 KENNETH HOLMEN - PAID $272,575 PART I, LINE 7 THE ORGANIZATION PROVIDES INCENTIVE COMPENSATION TO DESIGNATED INDIVIDUALS BASED ON FOUR DISCRETE AREAS: STEWARDSHIP, THROUGH A COMPARISON BETWEEN BUDGETED AND ACTUAL NET OPERATING INCOME FOR SAINT CLOUD HOSPITAL AND/OR CENTRACARE HEALTH SYSTEM AS WELL THROUGH ACHIEVING METRICS FOR AN IDENTIFIED COST REDUCTION PROGRAM; QUALITY, THROUGH ACHIEVING SAINT CLOUD HOSPITAL AND SYSTEM QUALITY METRICS; PATIENT EXPERIENCE, THROUGH ACHIEVEMENT OF PATIENT SATISFACTION GOALS AS COMPARED TO NATIONAL AND BASELINE RANKINGS; AND PEOPLE/EMPLOYEES, THROUGH ACHIEVEMENT OF SPECIFIED EMPLOYMENT SATISFACTION GOALS AND HIRING AND/OR RETENTION GOALS. THE INCENTIVE COMPENSATION PAID OUT IS NOT A PORTION OR PERCENTAGE OF ACTUAL NET EARNINGS OF ANY CENTRACARE HEALTH SYSTEM AFFILIATE, HOWEVER NET EARNINGS GOALS ARE REQUIRED TO BE MET BEFORE THE INCENTIVE COMPENSATION IS PAID. FORM 990, PART VI, SECTION A, LINE 6 THE SOLE MEMBER IS CENTRACARE HEALTH SYSTEM, A MINNESOTA NONPROFIT ORGANIZATION. FORM 990, PART VI, SECTION A, LINE 7A ALL BOARD MEMBERS ARE APPOINTED BY CENTRACARE HEALTH SYSTEM, THE SOLE CORPORATE MEMBER. FORM 990, PART VI, SECTION A, LINE 7B THE FOLLOWING MATTERS ARE RESERVED FOR ACTION BY CENTRACARE HEALTH SYSTEM, THE SOLE MEMBER: 1. ADOPTION OF AMENDMENTS TO THE ARTICLES OF INCORPORATION OR BYLAWS. 2. APPOINTMENT OF DIRECTORS AND OFFICERS. 3. APPROVAL OF THE CORPORATION'S ANNUAL OPERATING AND CAPITAL BUDGETS AND ANY DEBTS TO BE INCURRED. 4. APPROVAL OF ALL STRATEGIC PLANS. 5. DETERMINATION OF THE DISSOLUTION OF OR THE DISCONTINUATION OF THE BUSINESS OF THE CORPORATION. 6. APPROVAL OF ANY TRANSACTION WHICH MAY AFFECT THE CORPORATION'S STATUS AS AN ORGANIZATION EXEMPT FROM FEDERAL INCOME TAXATION. FORM 990, PART VI, SECTION B, LINE 11B THE BOARD OF DIRECTORS HAS DELEGATED THE APPROVAL AUTHORITY OF THE FORM 990 TO THE AUDIT COMMITTEE. ANNUALLY, AT THE AUDIT COMMITTEE MEETING, PRIOR TO FILING WITH THE IRS, THE AUDIT COMMITTEE REVIEWS AND APPROVES FORM 990. A COPY OF FORM 990 IS THEN PROVIDED FOR THE FULL BOARD TO REVIEW PRIOR TO FILING WITH THE IRS. FORM 990, PART VI, SECTION B, LINE 12C THE BOARD MEMBERS ARE REQUIRED TO REVIEW AND SIGN A CONFLICT OF INTEREST QUESTIONNAIRE TWICE A YEAR. ALL STAFF SIGN CONFLICTS OF INTEREST FORMS ON AN ANNUAL BASIS. THE QUESTIONNAIRES ARE REVIEWED BY THE CORPORATE COMPLIANCE OFFICER AS WELL AS THE CORPORATE COMPLIANCE GROUP (A COMPLIANCE COMMITTEE WHICH INCLUDES INTERNAL MEMBERS AND OUTSIDE COUNSEL). THE RESPONSES TO THE QUESTIONNAIRES ARE THEN REVIEWED WITH THE EXECUTIVE COMMITTEE OF THE BOARD. THE CORPORATE COMPLIANCE OFFICER IS RESPONSIBLE FOR MONITORING CONFLICTS OF INTERESTS RELATED TO BOARD AND STAFF AND TO ALERT AFFECTED PARTIES WHEN A CONFLICT ARISES. WHEN AN ACTUAL CONFLICT ARISES, THE AFFECTED PARTY IS ASKED TO RECUSE HIM/HER SELF FROM THE DECISION MAKING PROCESS. THE CORPORATE COMPLIANCE OFFICER ATTENDS BOARD MEETINGS AND SPECIFIED BOARD COMMITTEE MEETINGS WHERE CONFLICT ISSUES MAY ARISE. FORM 990, PART VI, SECTION B, LINE 15 THE COMPENSATION AND BENEFITS OF THE PRESIDENT ARE SUBJECT TO FULL COMPENSATION AND BENEFITS COMPARABILITY STUDIES CONDUCTED BIENNIALLY BY A THIRD PARTY INDEPENDENT COMPENSATION CONSULTANT. HOWEVER, THE COMPENSATION PORTION OF THE STUDY IS REVIEWED ANNUALLY BY THE CONSULTANT AND UPDATED FOR COMPENSATION COMMITTEE AND BOARD OF DIRECTORS REVIEW AND APPROVAL. THE MOST RECENT FULL REVIEW WAS DONE JUNE 2022. THE THIRD PARTY INDEPENDENT COMPENSATION CONSULTANT IS RETAINED BY ST. COULD HOSPITAL TO PERFORM SERVICES. THE COMPENSATION AND BENEFITS OF THE VICE PRESIDENTS (NON-MEDICAL PROVIDERS) ARE SUBJECT TO FULL COMPENSATION AND BENEFITS COMPARABILITY STUDIES CONDUCTED BIENNIALLY BY A THIRD PARTY INDEPENDENT COMPENSATION CONSULTANT. HOWEVER, THE COMPENSATION PORTION OF THE STUDY IS REVIEWED ANNUALLY BY THE CONSULTANT AND UPDATED FOR COMPENSATION COMMITTEE AND BOARD OF DIRECTORS REVIEW AND APPROVAL. THE MOST RECENT FULL REVIEW WAS COMPLETED IN JUNE 2022. THE THIRD PARTY INDEPENDENT COMPENSATION CONSULTANT IS RETAINED BY ST. CLOUD HOSPITAL TO PERFORM THESE SERVICES. FORM 990, PART VI, SECTION C, LINE 19 THE HOSPITAL/CENTRACARE HEALTH SYSTEM DOES NOT GENERALLY MAKE ITS GOVERNING DOCUMENTS OR CONFLICT OF INTEREST POLICY AVAILABLE TO THE PUBLIC. THE HOSPITAL/CENTRACARE HEALTH SYSTEM DOES DO AN ANNUAL REPORT TO THE COMMUNITY IN WHICH FINANCIAL RESULTS ARE REPORTED TO AND DISCUSSED WITH THE PUBLIC. THIS REPORT IS AVAILABLE TO THE PUBLIC ON THE ORGANIZATION'S WEBSITE. FORM 990, PART IX, LINE 11G MEDICAL FEES: PROGRAM SERVICE EXPENSES 969,943. MANAGEMENT AND GENERAL EXPENSES 323,314. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 1,293,257. PROFESSIONAL FEES: PROGRAM SERVICE EXPENSES 962. MANAGEMENT AND GENERAL EXPENSES 321. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 1,283. LABORATORY FEES: PROGRAM SERVICE EXPENSES 1,219,194. MANAGEMENT AND GENERAL EXPENSES 406,398. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 1,625,592. PURCHASED SERVICES: PROGRAM SERVICE EXPENSES 1,325,703. MANAGEMENT AND GENERAL EXPENSES 441,901. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 1,767,604. CONTRACTED SERVICES: PROGRAM SERVICE EXPENSES 1,988,200. MANAGEMENT AND GENERAL EXPENSES 662,733. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 2,650,933. RECLASS INFORMATION TECHNOLOGY: PROGRAM SERVICE EXPENSES -1,586,854. MANAGEMENT AND GENERAL EXPENSES -528,951. FUNDRAISING EXPENSES 0. TOTAL EXPENSES -2,115,805. COMMUNITY BENEFIT - COVID-19 ACTIVITIES: WHERE APPLICABLE, THE IMPACT RESULTING FROM THE COVID-19 PANDEMIC DURING THE PERIODS ENDED DECEMBER 31, 2022, JUNE 30, 2022, AND DECEMBER 31, 2021, HAS BEEN CONSIDERED. SOURCES OF RELIEF INCLUDED THE CORONAVIRUS AID, RELIEF AND ECONOMIC SECURITY ACT (THE "CARES ACT"), WHICH WAS ENACTED ON MARCH 27, 2020, AND THE PAYCHECK PROTECTION PROGRAM AND HEALTH CARE ENHANCEMENT ACT (THE "PPPHCE ACT"), WHICH WAS ENACTED ON APRIL 24, 2020. TOGETHER, THE CARES ACT AND THE PPPHCE ACT INCLUDED $178 BILLION IN FUNDING TO BE DISTRIBUTED TO ELIGIBLE PROVIDERS THROUGH THE PUBLIC HEALTH AND SOCIAL SERVICES EMERGENCY FUND (THE "PHSSEF"). IN ADDITION, THE CARES ACT PROVIDED FOR AN EXPANSION OF THE MEDICARE ACCELERATED AND ADVANCE PAYMENT PROGRAM WHEREBY INPATIENT ACUTE CARE HOSPITALS AND OTHER ELIGIBLE PROVIDERS MAY REQUEST ACCELERATED PAYMENT OF UP TO 100 PERCENT OF THEIR MEDICARE PAYMENT AMOUNT FOR A SIX-MONTH PERIOD TO BE REPAID THROUGH WITHHOLDING OF FUTURE MEDICARE FEE-FOR-SERVICE PAYMENTS BEGINNING 365 DAYS AFTER RECEIPT. CENTRACARE WAS THE BENEFICIARY OF THESE STIMULUS MEASURES. DURING THE YEAR ENDED JUNE 30, 2022, CENTRACARE HAS SERVED OVER 5,300 COMMUNITY MEMBERS BY HOSTING VARIOUS EVENTS AND ACTIVITIES. SOME OF THE EVENTS AND ACTIVITIES HOSTED INCLUDED: BOUNCE BACK PROJECT, DENTAL ACCESS WORKGROUPS, LEADERSHIP MEETINGS, HEALTH & ENERGY INTEGRATION MEETINGS, AGE FRIENDLY TASK FORCE, SAFE SPACE TRAINING, DIABETES MANAGEMENT, COMMUNITY STATUS ASSESSMENTS AND MANY OTHERS. CENTRACARE ALSO HOSTED MANY COVID-19 AND INFLUENZA VACCINATION CLINICS FOR THE COMMUNITY. CENTRACARE HEALTH SYSTEM 1406 6TH AVENUE NORTH ST CLOUD MN 56303 411813221 INTEGRATED HEALTH SYSTEM MN 501(C)(3) 3 N/A 0 ST CLOUD HOSPITAL 1406 6TH AVENUE NORTH ST CLOUD MN 56303 410695596 ACUTE / LT CARE MN 501(C)(3) 3 CENTRACARE HEALTH SYSTEM 0 CENTRACARE HEALTH - LONG PRAIRIE 50 CENTRACARE DRIVE LONG PRAIRIE MN 56347 411924645 ACUTE / LT CARE MN 501(C)(3) 3 CENTRACARE HEALTH SYSTEM 1 CENTRACARE HEALTH - SAUK CENTRE 425 NORTH ELM STREET SAUK CENTRE MN 56378 452438973 ACUTE / LT CARE MN 501(C)(3) 3 CENTRACARE HEALTH SYSTEM 1 CENTRACARE CLINIC 1200 6TH AVENUE NORTH ST CLOUD MN 56303 411806657 MULTI-SPECIALTY MN 501(C)(3) 3 CENTRACARE HEALTH SYSTEM 1 CENTRACARE HEALTH FOUNDATION 1406 6TH AVENUE NORTH ST CLOUD MN 56303 411855173 FUNDRAISING MN 501(C)(3) 7 CENTRACARE HEALTH SYSTEM 0 CUSHMAN ALBERT RICE TRUST 1100 WEST ST GERMAIN STREET ST CLOUD MN 56303 416019335 SUPPORT FOR CARRIS HEALTH MN 501(C)(3) 12A, I CARRIS HEALTH 0 CARRIS HEALTH FOUNDATION 301 BECKER AVENUE SOUTHWEST WILLMAR MN 56303 411611555 SUPPORT FOR CARRIS HEALTH MN 501(C)(3) 7 CENTRACARE HEALTH FOUNDATION 0 MONTICELLO CANCER CENTER 1001 HART BOULEVARD SUITE 50 MONTICELLO MN 55362 261909519 RADIATION & ONCOLOGY SERVICES MN N/A 0 0 CENTRAL IMAGING LLC 1406 6TH AVENUE NORTH ST CLOUD MN 56303 852580688 IMAGING SERVICES MN N/A 0 0 CENTRACARE HOLDINGS INC 1406 6TH AVENUE NORTH ST CLOUD MN 56303 472688595 HOLDING COMPANY / PHARMACY MN N/A C 0 AFFILIATED COMMUNITY MEDICAL CENTERS PA 301 BECKER AVENUE SOUTHWEST WILLMAR MN 56201 410850702 HEALTHCARE SYSTEM MN N/A C 0 0 0 1 0 0 0 0 0 0 0 0 0 0 1 1 1 0 0 0 CENTRACARE HEALTH FOUNDATION C 20581 FMV CENTRACARE HEALTH SYSTEM N 3572636 FMV CENTRACARE HEALTH SYSTEM O 5573642 FMV CENTRACARE HEALTH SYSTEM P 41326506 FMV