2023-05-11T14:59:39-05:00 2022-06-30 470617373 COMMONSPIRIT HEALTH 198 INVERNESS DRIVE WEST ENGLEWOOD CO 80112 990 2021-07-01 450226711 ST ALEXIUS MEDICAL CENTER STAL 7015307000 900 EAST BROADWAY AVENUE BISMARCK ND 58501 TERRI DONOVAN INTERIM SVP FINANCE 7015307000 2023-05-11 1 TERRI DONOVAN MARK STOCKI P00642127 3032989100 3 AAL1 IAL1 2021 2023-04-26 12:10:37Z CHI ST ALEXIUS HEALTH REED REYMAN 900 EAST BROADWAY AVENUE BISMARCK ND 585014520 274518439 0 0928 X HTTP://WWW.CHISTALEXIUSHEALTH.ORG X 1905 ND ST. ALEXUS IS PROUD OF ITS STELLAR REPUTATION AS A CARING, HIGH QUALITY MEDICAL CENTER AND OF ITS AWARDS FOR CLINICAL EXCELLENCE, CUSTOMER SATISFACTION AND COMMUNITY SERVICE. 12 7 1869 80 5322777 1422281 2446641 3925994 242726863 255616036 354346 375068 12294656 14600503 257822506 274517601 821011 602183 0 0 132472953 137439010 0 0 1374342 218195117 182324869 351489081 320366062 -93666575 -45848461 236912530 233655230 289935315 336434262 -53022785 -102779032 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. 0 0 279284331 602183 255616036 CHI ST. ALEXIUS HEALTH BISMARCK IS AN ACUTE CARE MEDICAL CENTER OFFERING A FULL LINE OF INPATIENT AND OUTPATIENT MEDICAL SERVICES, INCLUDING PRIMARY AND SPECIALTY PHYSICIAN CLINICS, HOME HEALTH AND HOSPICE SERVICES, DURABLE MEDICAL EQUIPMENT SERVICES, AND A FITNESS AND HUMAN PERFORMANCE CENTER.SINCE OUR FOUNDING IN 1885, CHI ST. ALEXIUS HEALTH BISMARCK HAS BEEN DEDICATED TO SERVING THE RESIDENTS OF CENTRAL AND WESTERN NORTH DAKOTA, NORTHERN SOUTH DAKOTA AND EASTERN MONTANA. WE ARE A ROMAN CATHOLIC ORGANIZATION WHOSE SPONSORS ARE THE SISTERS OF ST. BENEDICT OF THE ANNUNCIATION MONASTERY, BISMARCK, ND AND AS AN ORGANIZATION WE FOLLOW THE ETHICAL AND RELIGIOUS DIRECTIVES FOR CATHOLIC HEALTH CARE SERVICES AS PROMULGATED BY THE UNITED STATES CONFERENCE OF CATHOLIC BISHOPS.WE ARE COMPRISED OF AN INTERVENTIONAL RADIOLOGIST, CARDIOLOGISTS, HEART AND VASCULAR SURGEONS AS WELL AS OTHER HIGHLY TRAINED SUPPORT PERSONNEL.SPECIALTY CLINICS: OUR SPECIALTY CLINICS ARE A UNIQUE MULTI-SPECIALTY GROUP PRACTICE LOCATED MAINLY INSIDE ST. ALEXIUS MEDICAL CENTER. PROVIDERS IN DIFFERENT SPECIALTIES WORK TOGETHER TO CARE FOR PATIENTS. SPECIALISTS MUST COMPLETE SEVEN OR MORE YEARS OF MEDICAL SCHOOL AND POST-GRADUATE TRAINING AND THEN COMPLETE FELLOWSHIPS IN THEIR CHOSEN SPECIALTIES. ALL PHYSICIANS ARE BOARD ELIGIBLE OR BOARD CERTIFIED IN ONE OR MORE SPECIALTIES. WE PROVIDE CLINIC SERVICES IN MANY OFF SITE SATELLITE CLINICS AND BRING SPECIALTY SERVICES TO THE REGION. ST. ALEXIUS OPERATES AN OUTPATIENT FAMILY SERVICE PROGRAM CALLED ARCHWAY MENTAL HEALTH SERVICES. THIS PROGRAM OFFERS SENSITIVE AND RESPONSIVE SERVICES FOR INDIVIDUAL, MARITAL AND FAMILY PROBLEMS. THIS PROGRAM IS KEEPING WITH ST. ALEXIUS MEDICAL CENTER'S PHILOSOPHY OF BEING A LEADER IN PROGRESSIVE AND QUALITY SERVICES TO THE PEOPLE OF NORTH DAKOTA. ARCHWAY SERVICES ARE ALSO PROVIDED IN HAZEN, GARRISON, AND LINTON, ND. GREAT PLAINS REHABILITATION SERVICES IS A DIVISION OF ST. ALEXIUS MEDICAL CENTER THAT PROVIDES HOME MEDICAL EQUIPMENT, ORTHOTIC & PROSTHETIC, HOME RESPIRATORY CARE, ADA ENVIRONMENTAL AND REHABILITATION TECHNOLOGY SERVICES.GREAT PLAINS PROVIDES NEEDED MEDICAL EQUIPMENT AND SUPPLIES TO HELP INDIVIDUAL LEAD ACTIVE AND INDEPENDENT LIVES. GREAT PLAINS SERVICES ALL OF NORTH DAKOTA, CENTER AND EASTERN MONTANA, AND NORTHERN SOUTH DAKOTA. OTHER:ST. ALEXIUS MEDICAL CENTER PROVIDED COMMUNITY ACTIVITIES AND SERVICES AT REDUCED OR NO COST. THOSE INCLUDED:1. EMPLOYEE ASSISTANCE PROGRAM (EAP)- ST. ALEXIUS SERVICES EMPLOYER CONTRACTS THROUGH ITS EAP WITH EMPLOYEES BY PROVIDING PROBLEM ASSESSMENT, SHORT TERM COUNSELING AND REFERRAL TO APPROPRIATE RESOURCES FOR FOLLOW-UP CARE. EAP SERVICES ARE ONLY OPEN TO EMPLOYEES OF A PARTICIPATING COMPANY. THE SERVICE IS FREE IF YOUR EMPLOYER PAYS TO PARTICIPATE.2. EMPLOYEE ACTIVITIES - IN KEEPING WITH THE MEDICAL CENTER COMMITMENT TO ITS EMPLOYEES:A. ACTIVELY PARTICIPATED IN THE UNITED WAY FUND CAMPAIGN.B. JOURNEY BEYOND EXCELLENCE PROGRAM - WE HAVE SEVERAL TEAMS THAT ASSIST WITH OUR JOURNEY-REWARDS AND RECOGNITION, PATIENT SATISFACTION, PHYSICIAN SATISFACTION.THESE TEAMS WORK TOGETHER WITH OUR LEADERSHIP TO RESOLVE CHALLENGES AND ENGAGE ALL IN OUR MISSION.C. THE VACATION DONATION PROGRAM ASSISTED EMPLOYEES WHO HAVE AN ILLNESS OR AN ILLNESS IN THE FAMILY ALLOWING OTHER EMPLOYEES TO DONATE VACATION HOURS TO ALLOW THE AFFECTED EMPLOYEE TIME TO HEAL OR TIME WITH A FAMILY MEMBER DURING THEIR HEALING PROCESS.D. THE EMPLOYEE EMERGENCY FUND IS FOR ANY ST. ALEXIUS EMPLOYEE WHO EXPERIENCES A CRISIS OR IS DIRECTLY AFFECTED BY A CRISIS INVOLVING A FAMILY MEMBER. THE FUNDS ARE AVAILABLE TO EMPLOYEES WHO ARE FACING PERSONAL TRAGEDIES OR HARDSHIPS FOR REASON SUCH AS A LOSS OF A SPOUSE OR CHILD, CATASTROPHIC ILLNESS, LOSS OF HOME BY FIRE OR FLOOD, OR OTHER CALAMITIES.3. ACUTE CARE FACILITY - ST. ALEXIUS IS A PARTNER WITH ANOTHER ACUTE CARE FACILITY IN BISMARCK FOR THE OPERATION OF A RADIATION THERAPY FACILITY KNOWN AS THE BISMARCK CANCER CENTER. THE BISMARCK CANCER CENTER HELPS TO ENSURE THAT PATIENTS WITH CANCER RECEIVE QUALITY CARE AND MANAGEMENT OF THEIR DISEASE WITHOUT HAVING TO DRIVE A LONG DISTANCE TO RECEIVE NECESSARY CARE.CHI ST. ALEXIUS HEALTH TURTLE LAKE IS A 25 BED CRITICAL ACCESS HOSPITAL (CAH) WITH A LEVEL V EMERGENCY DEPARTMENT THAT IS AVAILABLE 24 HOURS A DAY. THE HOSPITAL HAS BEEN COMMITTED TO PROVIDING PATIENTS QUALITY MEDICAL TREATMENT IN THE TURTLE LAKE AREA AND SURROUNDING COMMUNITIES SINCE 1952. THROUGH THE YEARS, THE HOSPITAL HAS SOUGHT TO CONTINUALLY UPGRADE THE QUALITY AND NUMBERS OF SERVICES IT PROVIDES. THE HOSPITAL'S AFFILIATION WITH MAJOR MEDICAL CENTERS AND HEALTHCARE AGENCIES HAS ALLOWED IT TO EXPAND ITS HEALTHCARE SERVICES THROUGH A NETWORK THAT BEGINS AT THE LOCAL LEVEL. CHI ST. ALEXIUS HEALTH TURTLE LAKE IS EQUIPPED WITH 2 EMERGENCY ROOMS, ON-SITE LAB, RADIOLOGY, CT, AND PHYSICAL THERAPY SERVICES. PATIENTS HAVE ACCESS TO 24/7 EMERGENCY CARE, SWING-BED PROGRAM, AND ACUTE CARE SERVICES.CHI ST ALEXIUS HEALTH-TURTLE LAKE HOSTED A VARIETY OF COVID VACCINE CLINICS THROUGHOUT SURROUNDING COMMUNITIES AND BUSINESSES. OUR DON AND ADDITIONAL RN STAFF HELD THESE SERVICES THROUGHOUT THE YEAR. CLINIC RN STAFF CONTINUE TO HOLD ANNUAL FLU VACCINE CLINICS AS WELL AS BLOOD PRESSURE SCREENINGS. CLINIC STAFF IS ALSO RESPONSIBLE FOR OUR ADULT PREVENTATIVE PROGRAMS (DIABETES, WOMEN'S AND MEN'S HEALTH) BY TRACKING THESE PROGRAM SERVICES AND SENDING REMINDERS TO PATIENTS TO SCHEDULE FOLLOW-UP VISITS. CHI ST ALEXIUS HEALTH-TURTLE LAKE CONTINUES TO PARTICIPATE IN THE DAKOTA NURSING PROGRAM OFFERED THROUGH BISMARCK STATE COLLEGE. A NURSING INSTRUCTOR IS SHARED BETWEEN CHI ST ALEXIUS HEALTH TURTLE LAKE AND GARRISON. THERE IS AN 11-MONTH LPN PROGRAM AND IF STUDENTS WANT THEY CONTINUE INTO THE ASSOCIATE DEGREE RN PROGRAM, WHICH IS 9 MONTHS. THIS PROGRAM ALLOWS INDIVIDUALS IN OUR SMALLER COMMUNITIES TO EARN THEIR NURSING DEGREES THROUGH A NON-TRADITIONAL MEANS WITHOUT TRAVELING. NURSING POSITIONS ARE HARD TO FILL ESPECIALLY IN RURAL AREAS. BY OFFERING THIS PROGRAM IT'S A GREAT WAY TO RECRUIT AND RETAIN THESE INDIVIDUALS. 279284331 1 1 0 1 0 0 0 0 0 1 1 0 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 1 0 0 0 0 0 0 1 1 1 0 0 1 231 0 1 1869 1 1 1 0 0 0 0 1 1 0 0 0 0 0 0 X 12 7 0 0 0 0 1 1 1 1 1 0 0 1 1 1 1 1 1 0 1 1 1 X STEPHANIE KAUL 7015308899 900 EAST BROADWAY AVE BISMARCK ND 58501 DR STEVEN KRALJIC NEUROSURGEON 40.00 0.00 X 2064052 0 37584 JEANETTE WOJTALEWICZ DIRECTOR/CSH SVP DIVISION OFFICER 1.00 59.00 X 0 1233421 51903 CAMERON CHARCHENKO MD - UROLOGY 40.00 0.00 X 1047697 0 131272 KURT SCHLEY DIRECTOR & CEO (THROUGH 2/17/22) 5.00 40.00 X X 0 902586 47442 JOHN HOYT PHYSICIAN 40.00 0.00 X 868315 0 59912 NICHOLAS BRADBURY MD - INTERVENTIONAL RADIOLOGY 40.00 0.00 X 812543 0 27525 PATRICK GRACE PHYSICIAN 40.00 0.00 X 725377 0 25362 KEVIN DAHMEN MD SECRETARY/TREASURER/PSYCHIATRIST 40.00 5.00 X X 594990 0 55933 TODD PRESZLER MD DIRECTOR/ANESTHESIOLOGIST 40.00 1.00 X 595016 0 40487 SHIRAZ HYDER DIRECTOR/NEUROLOGIST 40.00 1.00 X 411815 0 58783 J'PATRICK FAHN INTERIM CHIEF MEDICAL OFFICER 40.00 0.00 X 392678 0 36742 DR ELISA LAURENT CMO (THROUGH 10/6/21) 40.00 0.00 X 286923 0 15607 KEITH HORNER DIRECTOR OF PHARMACY & CLINICAL INFORMATICS 40.00 0.00 X 237784 0 37866 ELLEN HOLT DIRECTOR HUMAN RESOURCES 40.00 0.00 X 206603 0 15136 TERRI DONOVAN CHIEF FINANCIAL OFFICER (THROUGH 10/7/21) 40.00 0.00 X 199484 0 8939 RAUMI KUDRNA VP PATIENT CARE SERVICES 40.00 0.00 X 174020 0 10672 DEBRA MOHESKY MARKET PRESIDENT/CEO 40.00 5.00 X X 79570 0 0 TIMOTHY BOPP MD DIRECTOR 1.00 1.00 X 0 0 0 JOHN GIESE CHAIR 1.00 1.00 X X 0 0 0 SR NICOLE KUNZE DIRECTOR 1.00 1.00 X 0 0 0 MICHAEL LEFOR DIRECTOR 1.00 1.00 X 0 0 0 SR NANCY MILLER OSB VICE CHAIR 1.00 1.00 X X 0 0 0 JOHN MONGEON DIRECTOR 1.00 1.00 X 0 0 0 MIKE WEISBECK DIRECTOR 1.00 1.00 X 0 0 0 JAMES SMITH VICE PRESIDENT OF OPERATIONAL FINANCE 40.00 5.00 X 0 0 0 EVERT KUIPER EX-OFFICIO BOARD MEMBER/CSH SVP DIVISION OFFICER 1.00 59.00 X 0 0 0 8696867 2136007 661165 212 1 1 0 MEDEFIS CONSOLIDATED PO BOX 5068 NEW YORK NY 10087 TRAVELING NURSE SERVICE 15854403 BISMARCK RADIOLOGY ASSOCIATES 1310 EAST MAIN AVE BISMARCK ND 58501 RADIOLOGY SERVICES 4009198 WEATHERBY LOCUM INC PO BOX 972633 DALLAS TX 75397 LOCUM SERVICES 3513163 COMPHEALTH PO BOX 972651 DALLAS TX 75397 LOCUM SERVICES 3261199 HEALTH CAROUSEL LLC PO BOX 714216 CINCINNATI OH 45271 TRAVELING NURSE SERVICE 1987221 35 3703445 222549 3925994 NET PATIENT SERVICES 900099 255277922 255277922 TUITION 611600 288921 288921 CAFETERIA 722514 49193 49193 255616036 102976 102976 822486 0 822486 822486 822486 256701 15391 0 0 256701 15391 272092 272092 3656 838 2818 2818 PHARMACY SERVICES 446110 5156211 597507 4558704 LABORATORY SERVICES 621500 2891978 2891978 REHAB SERVICES REVENUE 621400 1833292 1833292 3893718 3893718 13775199 274517601 255616036 5322777 9652794 X 602183 602183 3060019 3060019 110371152 105392459 3845441 1133252 4358975 3923077 392308 43590 12522640 10986871 1409483 126286 7126224 6769913 356311 544617 544617 12065 12065 73796733 50189982 23606751 47009 23505 23504 5337337 3736136 1547828 53373 7696117 3848059 3848058 6496508 5716927 779581 1784110 1552176 214093 17841 3550029 3550029 7593012 7593012 16340596 16177190 163406 778313 770530 7783 MEDICAL SUPPLIES 51254800 51254800 REPAIRS & MAINTENANCE 4315210 4315210 RECRUITMENT AND RELOCAT 994368 994368 UNRELATED BUSINESS TAXE -103859 -103859 1887904 1887904 320366062 279284331 39707389 1374342 7770 13424 9440600 13063602 3500 0 30012465 32047857 1219337 1247243 10246287 11971985 1387743 1495068 122493092 91796614 41121225 30696478 1187223 1277963 5502345 5173186 136784035 136668424 236912530 233655230 171803131 231564333 264016 274594 249146 154249 117619022 104441086 289935315 336434262 X -59715500 -109230181 6692715 6451149 -53022785 -102779032 236912530 233655230 X -45848461 -509803 -6258509 2860526 X 0 1 X 1 1 1 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 0 0 0 0 0 1 12065 0 0 0 12065 0 PART II-B, LINE 1: THE PORTION OF ORGANIZATION DUES THAT ARE RELATED TO LOBBYING ARE AS FOLLOWS: AMERICAN HOSPITAL ASSOCIATION - $4,845 CATHOLIC HEALTH ASSOCIATION - $3,195 NORTH DAKOTA HOSPITAL ASSOCIATION - $4,025 5502345 15000 -199233 146201 3725 5168186 4512979 5000 1142302 147527 10409 5502345 4455209 15000 134210 3000 76009 12431 4512979 4175493 35000 264476 19760 4455209 4916916 80000 303577 1799 1109542 13659 4175493 0.82000 0.18000 0 1 1 7511629 7511629 6933778 6933778 0 104556727 83448304 21108423 3490958 1414532 2076426 30696478 INTERCOMPANY RECEIVABLES 134820195 RENTAL PROPERTY LAND 929181 RIGHT OF USE ASSETS 591918 DEPOSITS 95268 OTHER ASSETS 231862 136668424 INTERCOMPANY PAYABLE 77293984 LEASE LIABILITY 26941081 OTHER LIABILITIES 206021 104441086 X PART V, LINE 4: THE ENDOWMENT IS UTILIZED TO PROVIDE FUNDING TO CONTINUE TO ADVANCE MEDICAL SERVICES AND PROGRAMS FOR THE REGION AT ST. ALEXIUS MEDICAL CENTER SET FORTH IN OUR MISSION, "LET ALL BE RECEIVED AS CHRIST." PART X, LINE 2: ST. ALEXIUS MEDICAL CENTER'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 2629327 2629327 0.00820 15108585 13878676 1229909 0.00380 17737912 13878676 3859236 0.01200 91710 91710 0.00030 285558 285558 0.00090 14172100 2996551 11175549 0.03490 180481 180481 0.00060 188634 188634 0.00060 14918483 2996551 11921932 0.03730 32656395 16875227 15781168 0.04930 1 5559263 70814491 85738817 -14924326 X 1 1 1 NORTHERN PLAINS LAB LABORATORY SERVICES 0.50000 0.50000 2 1 ST ALEXIUS MEDICAL CENTER 900 EAST BROADWAY BISMARCK ND 58506 WWW.CHISTALEXIUSHEALTH.ORG 5004 X X X X 2 TURTLE LAKE COMMUNITY MEMORIAL HOSPITAL 220 5TH AVE TURTLE LAKE ND 58575 WWW.CHISTALEXIUSHEALTH.ORG/TURTLELAKE 5059 X X X X ST ALEXIUS MEDICAL CENTER 1 0 0 1 X X X X X X X X X 21 1 1 1 1 X SEE SCH H, PART V, PAGE 8 X 1 22 1 HTTPS://WWW.CHISTALEXIUSHEALTH.ORG/ABOUT-US/COMMUNITY-HEALTH-ASSESSMENTS 0 1 X 200.000000000000 400.000000000000 X X X X X X 1 1 X X X 1 X SEE SCH H, PART V, PAGE 8 X SEE SCH H, PART V, PAGE 8 X SEE SCH H, PART V, PAGE 8 X X X X X X 1 X 0 X X X X 1 X 0 0 TURTLE LAKE COMMUNITY MEMORIAL HOSPITAL 2 0 0 1 X X X X X X X X X 21 1 0 1 1 X SEE SCH H, PART V, PAGE 8 X 1 21 1 HTTPS://WWW.CHISTALEXIUSHEALTH.ORG/ABOUT-US/COMMUNITY-HEALTH-ASSESSMENTS 0 1 X 200.000000000000 400.000000000000 X X X X X X 1 1 X X X 1 X SEE SCH H, PART V, PAGE 8 X SEE SCH H, PART V, PAGE 8 X SEE SCH H, PART V, PAGE 8 X X X X X X 1 X 0 X X X X 1 X 0 0 ST. ALEXIUS MEDICAL CENTER PART V, SECTION B, LINE 5: IN CONDUCTING ITS MOST RECENT CHNA, THE CHI ST. ALEXIUS HEALTH BISMARCK 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. CHI ST. ALEXIUS HEALTH COLLABORATED WITH BISMARCK-BURLEIGH PUBLIC HEALTH, CUSTER HEALTH AND SANFORD HEALTH TO COMPLETE A COMMUNITY HEALTH NEEDS ASSESSMENT IN 2021 FOR THE BURLEIGH-MORTON COUNTY AREA. WITH ASSISTANCE FROM NDSU CENTER FOR SOCIAL RESEARCH, A COMMUNITY SURVEY WAS DISTRIBUTED TO BURLEIGH AND MORTON COUNTY. THE SURVEY STRUCTURE ALIGNED WITH THE SOCIAL DETERMINANTS OF HEALTH AND CONTAINED A COMBINATION OF SCORED RESPONSES AND OPEN-ENDED QUESTIONS. SURVEY RESPONSES WERE COLLECTED BETWEEN DECEMBER 2020 AND FEBRUARY 2021. A TOTAL OF 933 OF RESPONDENTS COMPLETED THE SURVEY. MEMBERS OF THE COMMUNITY WERE ASKED A SERIES OF QUESTIONS THROUGH AN ONLINE SURVEY DESIGNED IN PARTNERSHIP WITH HEALTH EXPERTS AND PUBLIC HEALTH OFFICIALS TO UNDERSTAND THE NEEDS OF THE COMMUNITY. RESPONDENTS WERE ASKED A SERIES OF QUESTIONS SPECIFIC TO THEIR HEALTH CARE ACCESS, HEALTH CARE QUALITY, BARRIERS TO CARE, TRAVEL TO CARE, AND INSURANCE. THE SURVEY WAS SENT TO A SAMPLE OF BURLEIGH AND MORTON COUNTY POPULATIONS SECURED THROUGH QUALTRICS, A QUALIFIED VENDOR. TO FURTHER PROMOTE COMMUNITY INVOLVEMENT THE SURVEY WAS ALSO SENT TO COMMUNITY STAKEHOLDERS AND ELECTED OFFICIALS WITH KNOWLEDGE AND CONNECTIONS AMONGST MEDICALLY UNDERSERVED, LOW INCOME, OR MINORITY POPULATIONS.SEVEN HEALTH NEEDS WERE IDENTIFIED BY SURVEY RESPONSES AND COUNTY HEALTH RANKINGS: - HEALTHY LIVING - ACCESS TO AFFORDABLE HEALTH CARE - ACCESS TO HEALTH CARE PROVIDERS - MENTAL HEALTH - LONG-TERM CARE - PUBLIC TRANSPORTATION - AFFORDABLE HOUSING COMMUNITY STAKEHOLDERS WERE INVITED TO ATTEND A PRESENTATION OF THE FINDINGS OF THE CHNA. ON WEDNESDAY, MAY 26, 2021 COMMUNITY HEALTH STAKEHOLDERS MET VIRTUALLY TO VIEW SURVEY FINDINGS. FACILITATED DISCUSSION TOOK PLACE IN SMALL GROUPS. TOPICS DISCUSSED WERE THE SURVEY RESULTS AND FEEDBACK ON PRIORITIZATION OF NEEDS. TURTLE LAKE COMMUNITY MEMORIAL HOSPITAL PART V, SECTION B, LINE 5: IN CONDUCTING ITS MOST RECENT CHNA, THE CHI ST. ALEXIUS HEALTH TURTLE LAKE 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 MCLEAN COUNTY, SHERIDAN COUNTY, AND OLIVER COUNTY WHICH ARE ALL INCLUDED IN THE CHI ST. ALEXIUS HEALTH TURTLE LAKE SERVICE AREA. IN ADDITION TO TURTLE LAKE, LOCATED IN THE SERVICE AREA ARE THE COMMUNITIES OF MERCER, MCCLUSKY, GOODRICH, UNDERWOOD, WASHBURN, WILTON, AND CENTER. CRH, IN PARTNERSHIP WITH CHI ST. ALEXIUS HEALTH TURTLE LAKE AND FIRST DISTRICT PUBLIC HEALTH, 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 ST. ALEXIUS HEALTH TURTLE LAKE. A SMALL STEERING COMMITTEE (SEE FIGURE 2) WAS FORMED THAT WAS RESPONSIBLE FOR PLANNING AND IMPLEMENTING THE PROCESS LOCALLY. REPRESENTATIVES FROM CRH MET AND CORRESPONDED REGULARLY BY VIDEOCONFERENCE 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. THIRTEEN PEOPLE, REPRESENTING A CROSS SECTION DEMOGRAPHICALLY, ATTENDED THE FOCUS GROUP MEETING. THE MEETING WAS HIGHLY INTERACTIVE WITH GOOD PARTICIPATION. CHI ST. ALEXIUS HEALTH TURTLE LAKE STAFF AND BOARD MEMBERS WERE IN ATTENDANCE, AS WELL, BUT LARGELY PLAYED A ROLE OF LISTENING AND LEARNING.THE ORIGINAL SURVEY TOOL WAS DEVELOPED AND USED BY CRH. IN ORDER TO REVISE THE ORIGINAL SURVEY TOOL TO ENSURE THE DATA GATHERED MET THE NEEDS OF HOSPITALS AND PUBLIC HEALTH, CRH WORKED WITH THE NORTH DAKOTA DEPARTMENT OF HEALTH'S PUBLIC HEALTH LIAISON. CRH REPRESENTATIVES ALSO PARTICIPATED IN A SERIES OF MEETINGS THAT GARNERED INPUT FROM THE STATE'S HEALTH OFFICER, LOCAL NORTH DAKOTA PUBLIC HEALTH UNIT PROFESSIONALS, AND REPRESENTATIVES FROM NORTH DAKOTA STATE UNIVERSITY.AS PART OF THE ASSESSMENT'S OVERALL COLLABORATIVE PROCESS, CRH SPEARHEADED EFFORTS TO COLLECT DATA FOR THE ASSESSMENT IN A VARIETY OF WAYS: 1. A SURVEY SOLICITED FEEDBACK FROM AREA RESIDENTS; 2. COMMUNITY LEADERS REPRESENTING THE BROAD INTERESTS OF THE COMMUNITY TOOK PART IN ONE-ON-ONE KEY INFORMANT INTERVIEWS; 3. THE COMMUNITY GROUP, COMPRISED OF COMMUNITY LEADERS AND AREA RESIDENTS, CONVENED TO DISCUSS AREA HEALTH NEEDS AND INFORM THE ASSESSMENT PROCESS; AND 4. 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 INFORMANTS REPRESENTED THE BROAD INTERESTS OF THE COMMUNITY SERVED BY CHI ST. ALEXIUS HEALTH TURTLE LAKE AND FDHU. THEY INCLUDED REPRESENTATIVES OF THE HEALTH COMMUNITY, BUSINESS COMMUNITY, POLITICAL BODIES, AND LAW ENFORCEMENT. NOT ALL MEMBERS OF THE GROUP WERE PRESENT AT BOTH MEETINGS. ST. ALEXIUS MEDICAL CENTER PART V, SECTION B, LINE 6A: SANFORD HEALTH ST. ALEXIUS MEDICAL CENTER PART V, SECTION B, LINE 6B: BISMARCK-BURLEIGH PUBLIC HEALTHCUSTER HEALTHCENTER FOR SOCIAL RESEARCH - NDSUQUALTRICS TURTLE LAKE COMMUNITY MEMORIAL HOSPITAL PART V, SECTION B, LINE 6B: CENTER FOR RURAL HEALTH UNIVERSITY OF NORTH DAKOTA SCHOOL OF MEDICINE & HEALTH SCIENCESTURTLE LAKE HOSPITAL ASSOCIATIONFIRST DISTRICT HEALTH UNIT- MCLEAN COUNTY ST. ALEXIUS MEDICAL CENTER PART V, SECTION B, LINE 11: THE MOST RECENT CHNA AND CORRESPONDING IMPLEMENTATION PLAN WAS COMPLETED IN THE TAX REPORTING YEAR 2022. THE FOLLOWING OUTLINES THE CURRENT IMPLEMENTATION PLAN PRIORITIES AND STRATEGIES. THIS PLAN WAS POSTED PUBLICLY ON HTTPS://WWW.CHISTALEXIUSHEALTH.ORG/COMMUNITY-HEALTH-NEED-ASSESSMENTS THE COMMUNITY IDENTIFIED THE FOLLOWING PRIORITIES AS TOP HEALTH NEEDS THROUGH PRIMARY DATA GATHERED THROUGH A COMMUNITY HEALTH SURVEY AND KEY INFORMANT INTERVIEWS AS WELL AS REVIEW OF SECONDARY DATA.TOP HEALTH NEEDS (FROM 2022 CHNA): 1. MENTAL HEALTH2. HEALTHY LIVING (CHRONIC HEALTH ISSUES/ACCESS TO HEALTHY FOOD)3. ACCESS TO AFFORDABLE HEALTH CARE4. AFFORDABLE HOUSING5. ACCESS TO HEALTH CARE PROVIDERS6. PUBLIC TRANSPORTATION7. LONG-TERM CAREFOR THIS PLAN THE HOSPITAL PRIORITIZED THE FOLLOWING HEALTH NEEDS:PRIORITY HEALTH NEED #1: HEALTHY LIVING AND MENTAL HEALTHTO ADDRESS THIS NEED THE HOSPITAL WILL IMPLEMENT THE FOLLOWING STRATEGIES IN FISCAL YEARS 2023- 2025:1. EAT/SLEEP/CONSOLE- PROVIDE EDUCATION FOR FAMILIES- DEMONSTRATE CARE- PROMOTE NON-PHARMACEUTICALS2. LITTLE FREE PANTRY- PROVIDE FOOD FOR THE HOMELESS- COLLABORATE WITH AGENCIES WITHIN THE CITY- REGULAR INVOLVEMENT IN THE "BANQUET" PRIORITY HEALTH NEED #2: ACCESS TO HEALTHCARE PROVIDERS AND ACCESS TO AFFORDABLE HEALTH CARETO ADDRESS THIS NEED THE HOSPITAL WILL IMPLEMENT THE FOLLOWING STRATEGIES IN FISCAL YEARS 2023- 2025:1. MEDICAL RESPITE CARE- SHORT-TERM RESIDENTIAL CARE THAT ALLOWS PEOPLE AN OPPORTUNITY TO REST, RECOVER AND HEAL IN A SAFE ENVIRONMENT WHILE ALSO ACCESSING CLINICAL CARE AND SUPPORT SERVICES.2. SCREENINGS FOR CHRONIC ILLNESSES- WITH OUR CLINICS AND GRANT SOURCES, PROVIDE HEALTH AWARENESS AND HEALTH CARE PROVIDERS TO THOSE WHO MAY TYPICALLY NOT PURSUE THIS CARE FOR VARIOUS REASONS INCLUDING FINANCIAL.SIGNIFICANT NEEDS THE HOSPITAL DOES NOT INTEND TO ADDRESS1. AFFORDABLE HOUSING - THE ESSENTIAL NEED FOR AFFORDABLE HOUSING INVOLVES A MORE COMMUNITY WIDE EFFORT. WE WILL COLLABORATE WITH OTHER AGENCIES AS REQUESTED AND ABLE. 2. PUBLIC TRANSPORTATION - THIS IMPORTANT NEED IS BEING ADDRESSED BY OTHER ORGANIZATIONS IN THE COMMUNITY. 3. LONG-TERM CARE - OUR FOCUS WILL BE ON SHORT-TERM CARE, ESPECIALLY FOR OUR HOMELESS POPULATION THAT NEED MINIMUM CARE AND OBSERVATION UNTIL STABLE ENOUGH TO BE ON THEIR OWN. THE FOLLOWING TOP HEALTH NEEDS WERE IDENTIFIED AND PRIORITIZED AS PART OF THE CHNA AND IMPLEMENTATION STRATEGY PLAN APPROVED IN 2019. ALTHOUGH A MORE RECENT CHNA WAS COMPLETED IN 2022, THE RELATED IMPLEMENTATION PLAN WAS NOT APPROVED UNTIL OCTOBER 2022. THEREFORE, THE WORK DESCRIBED BELOW IS TIED TO THE 2019 ASSESSMENT AND PLANS AND REPRESENTS WORK CARRIED OUT BY THE HOSPITAL DURING FISCAL YEAR 2022. THE COMMUNITY IDENTIFIED THE FOLLOWING PRIORITIES AS TOP HEALTH NEEDS THROUGH PRIMARY DATA OBTAINED THROUGH THE COMMUNITY HEALTH SURVEY AND KEY INFORMANT SURVEY, AS WELL AS A REVIEW OF SECONDARY DATA ON A VARIETY OF HEALTH INDICATORS. TOP HEALTH NEEDS (FROM 2019 CHNA): SOURCE FROM SIGNIFICANT HEALTH NEEDS OR FINDINGS SECTION OF THE CHNA1. HOUSING FOR THE HOMELESS, FOR PEOPLE WITH CHEMICAL DEPENDENCY, MENTAL HEALTH, CRIMINAL HISTORY AND DOMESTIC ABUSE VICTIMS.2. SERVICES FOR AT-RISK YOUTH INCLUDING OBESITY, SUBSTANCE ABUSE, AVAILABILITY OF CHILD CARE.3. COST OF LONG-TERM, IN-HOME AND MEMORY SERVICES.4. SAFETY CONCERNS INCLUDING PRESCRIPTION DRUGS, BINGE DRINKING, ACCESSIBLE HEALTH CARE.5. ACCESS TO AFFORDABLE HEALTH CARE FOR BEHAVIORAL AND MENTAL HEALTH NEEDS.6. WELLNESS ISSUES, SUCH AS OBESITY, DIABETES, HIGH CHOLESTEROL.7. MENTAL HEALTH AND SUBSTANCE ABUSE.FOR THIS PLAN THE HOSPITAL PRIORITIZED THE FOLLOWING HEALTH NEEDS:PRIORITY HEALTH NEED #1: OPIOID MISUSETO ADDRESS THIS NEED THE HOSPITAL IMPLEMENTED THE FOLLOWING STRATEGIES IN 2019-2021:1. REDUCE OPIOID ABUSE AND MISUSE IN THE BISMARCK/MANDAN AREA.- REVIEW CURRENT TAKE-BACK POLICY- ASSESS PRESCRIPTION USAGE- REVIEW LITERATURE ON OTHER PROGRAMS- PLAN PROVIDER EDUCATION PROGRAMS- EDUCATE PATIENTSFY2022 ACTIONS AND IMPACT: - MONITORED OPIOID PRESCRIPTIONS- EDUCATED PROVIDERS- COLLABORATED WITH ST. ALEXIUS OPIOID COMMITTEE- FOCUSED ON THREE SETTINGS: CLINICS, IN-PATIENT, EMERGENCY DEPARTMENTSMEASURES:- OPIOID PRESCRIPTIONS WERE REDUCED IN THE THREE AREAS: CLINIC, IN-PATIENT, EMERGENCY DEPARTMENT- PARTNERED WITH THE STATE OF NORTH DAKOTA'S TAKE BACK PROGRAM PRIORITY HEALTH NEED #2: FOOD INSECURITY TO ADDRESS THIS NEED THE HOSPITAL IMPLEMENTED THE FOLLOWING STRATEGIES IN 2019-2021:1. FOCUSED ON EDUCATING DIALYSIS PATIENTS, WHO LIVE IN THEIR OWN HOME, ABOUT HEALTHY NUTRITION/DIET2. IMPROVE HEALTH OF DIALYSIS PATIENTS, IMPROVE QUALITY OF FOODS CONSUMED, INCREASE ACCESS TO AND CONSUMPTION OF HEATH FOODS AMONG DIALYSIS PATIENTS/PATIENTS WITH KIDNEY DISEASE AND SHORTEN DIALYSIS TIME.- ASSESS FOOD HUNGER AMONG DIALYSIS PATIENTS- EDUCATE NURSES AND PHYSICIANS ON ASSESSMENT OF FOOD INSECURITY- WORK WITH DIETARY, FOOD PANTRIES AND FAMILIES TO SIMPLIFY THE PROCESS OF OBTAINING APPROPRIATE FOODS FY2022 ACTIONS AND IMPACT:- PROVIDED FRUITS AND VEGETABLES FOR PATIENTS WHO FIND IT DIFFICULT TO SHOP OR THOSE ON A LIMITED BUDGET- EDUCATE RENAL PATIENTS AND FAMILIES ABOUT THE ADVANTAGES OF CONSUMING FRESH FRUITS AND VEGETABLES- PROVIDED RECIPES TO STIMULATE RENAL DIALYSIS PATIENTS TO PREPARE FRESH VEGETABLES- CONTINUED THE GIVING GARDEN - GREW VEGETABLES, HARVESTED VEGETABLES AND GAVE TO PATIENTS EACH WEEKMEASURES:- SELF-REPORT OF VEGETABLE USAGE- BLOOD WORK RESULTS- DURATION OF TIME FOR DIALYSIS PRIORITY HEALTH NEED #3: DOMESTIC VIOLENCETO ADDRESS THIS NEED THE HOSPITAL IMPLEMENTED THE FOLLOWING STRATEGIES IN 2019-2021:1. HEIGHTEN AWARENESS AMONG HEALTHCARE PROVIDERS IN THE AREA OF DOMESTIC VIOLENCE AND CREATE A PLAN BY WHICH A PERSON CAN SEEK HELP WITHIN OUR CLINICS- EDUCATE NURSES ON MEANS OF IDENTIFYING SIGNS OF INTIMATE PARTNER VIOLENCE- CREATE A SYSTEM IN WHICH AN INDIVIDUAL CAN INDICATE THAT THEY ARE IN AN ABUSIVE SITUATION- CREATE A WORKFLOW TO INCLUDE A PROCESS BY WHICH THE WOMAN CAN BE SEPARATED AND REMOVED FROM THE SITUATION OR GIVEN INFORMATION WHICH SHE CAN USE WHEN READY. FY2022 ACTIONS AND IMPACT:- CREATED A WORK FLOW TO GUIDE NURSES TO GUIDE TO GUIDE NURSES TO ASSIST PATIENTS WHEN THEY SUSPECT ABUSE- UPDATED POLICY TO SUPPORT PRACTICE I.E.; PARTNER MUST LEAVE THE ROOM DURING ASSESSMENT- CREATED A PLAN BY WHICH THE ABUSED PERSON CAN LEAVE THE ROOM DURING ASSESSMENT- IDENTIFY COMMUNITY SUPPORTMEASURES:- CONTINUED INCREASE PARTICIPATION IN PREVENTION SUMMITS- EXCEEDED GOALS IN TRAINING ADDITIONAL COMMUNITY OUTREACH LEADERS AND HEALTHY RELATIONSHIP FACILITATORS- DEEPENED RELATIONSHIPS WITH LOCAL AGENCIES- CONTINUED TO PROMOTE EDUCATION/WORKSHOPS FOR OUR ASSOCIATES TO ATTEND TURTLE LAKE COMMUNITY MEMORIAL HOSPITAL PART V, SECTION B, LINE 11: THE MOST RECENT CHNA AND CORRESPONDING IMPLEMENTATION PLAN WAS COMPLETED IN THE TAX REPORTING YEAR 2022. THE FOLLOWING OUTLINES THE CURRENT IMPLEMENTATION PLAN PRIORITIES AND STRATEGIES. THIS PLAN WAS POSTED PUBLICLY ON HTTPS://WWW.CHISTALEXIUSHEALTH.ORG/COMMUNITY-HEALTH-NEED-ASSESSMENTS THE COMMUNITY IDENTIFIED THE FOLLOWING PRIORITIES AS TOP HEALTH NEEDS THROUGH PRIMARY DATA GATHERED THROUGH A COMMUNITY HEALTH SURVEY FOCUS GROUP AND KEY INFORMANT INTERVIEWS AS WELL AS REVIEW OF SECONDARY DATA.TOP HEALTH NEEDS (FROM 2022 CHNA): 1. ATTRACTING AND RETAINING YOUNG FAMILIES2. AVAILABILITY OF RESOURCES TO HELP THE ELDERLY STAY IN THEIR HOMES3. HAVING ENOUGH CHILD DAYCARE SERVICES4. NOT ENOUGH PLACES FOR EXERCISE/WELLNESS ACTIVITIESFOR THIS PLAN THE HOSPITAL PRIORITIZED THE FOLLOWING HEALTH NEEDS:PRIORITY HEALTH NEED #1: AVAILABILITY OF RESOURCES TO HELP ELDERLY STAY IN THEIR HOMETO ADDRESS THIS NEED THE HOSPITAL WILL IMPLEMENT THE FOLLOWING STRATEGIES IN FISCAL YEARS 2023- 2025:- INVESTIGATE EXISTING RESOURCES AVAILABLE WITHIN THE COUNTY THAT PROVIDE ASSISTANCE TO THE ELDERLY POPULATION.- BECOME AN ADVOCATE TO OUR ELDERLY POPULATION BY MAKING INFORMATION ABOUT AVAILABILITY OF RESOURCES EITHER WITHIN THE COUNTY OR OUR OWN HOSPITAL SERVICES. - INVESTIGATING QSP SERVICES AND COMPILE A LIST OF QSP PROVIDERS WITHIN OUR REGION TO OFFER RESPITE AND ADULT CAREGIVER SERVICES.PRIORITY HEALTH NEED #2: NOT HAVING ENOUGH PLACES FOR EXERCISE AND WELLNESS ACTIVITIESTO ADDRESS THIS NEED THE HOSPITAL WILL IMPLEMENT THE FOLLOWING STRATEGIES IN FISCAL YEARS 2023- 2025:- WORK WITH SUPPORTING HOSPITAL BOARDS TO PROVIDE ACTIVITIES THAT ENCOURAGE WELLNESS AND EXERCISE OPPORTUNITIES. - WORK WITH THE TURTLE LAKE AMBULANCE. THE AMBULANCE IS PUTTING IN AN EXERCISE FACILITY WITHIN THEIR BUILDING. WE WILL DISCUSS THE OPTIONS OF OPENING IT TO THE PUBLIC FOR EXERCISE AND WELLNESS ACTIVITIES.PRIORITY HEALTH NEED #3: NOT HAVING ENOUGH CHILD DAYCARE SERVICESTO ADDRESS THIS NEED THE HOSPITAL WILL IMPLEMENT THE FOLLOWING STRATEGIES IN FISCAL YEARS 2023- 2025:- INCREASE AVAILABLE DAYCARE SERVICES FOR WORKING FAMILIES. - WORK WITH THE PUBLIC HEALTH, CITY BOARD, ECONOMIC DEVELOPMENT, TO LOOK INTO OPTIONS FOR A COMMUNITY DAYCARESIGNIFICANT NEEDS THE HOSPITAL DOES NOT INTEND TO ADDRESSATTRACTING AND RETAINING YOUNG FAMILIES- OUR FACILITY CURRENTLY OFFERS JOBS WITH LIVABLE WAGES BASED ON PREVAILING MARKET WAGES WITH HOPES OF ATTRACTING YOUNG FAMILIES TO OUR AREA. CHI ST ALEXIUS HEALTH-TURTLE LAKE ALSO PARTICIPATES IN THE DAKOTA NURSING PROGRAM WHICH ALLOWS STUDENT TO FURTHER THEIR EDUCATION IN THE NURSING FIELD AT LOCAL LOCATION WHILE MAINTAINING THEIR EMPLOYMENTTHE FOLLOWING TOP HEALTH NEEDS WERE IDENTIFIED AND PRIORITIZED AS PART OF THE CHNA AND IMPLEMENTATION STRATEGY PLAN APPROVED IN 2019. ALTHOUGH A MORE RECENT CHNA WAS COMPLETED IN 2022, THE RELATED IMPLEMENTATION PLAN WAS NOT APPROVED UNTIL FEBRUARY 2022. THEREFORE THE WORK DESCRIBED BELOW IS TIED TO THE 2019 ASSESSMENT AND PLANS AND REPRESENTS WORK CARRIED OUT BY THE HOSPITAL DURING FISCAL YEAR 2022.THE COMMUNITY IDENTIFIED THE FOLLOWING PRIORITIES AS TOP HEALTH NEEDS THROUGH PRIMARY DATA OBTAINED THROUGH THE COMMUNITY HEALTH SURVEY AND KEY INFORMANT SURVEY, AS WELL AS A REVIEW OF SECONDARY DATA ON A VARIETY OF HEALTH INDICATORS.TOP HEALTH NEEDS (FROM 2019 CHNA): SOURCE FROM SIGNIFICANT HEALTH NEEDS OR FINDINGS SECTION OF THE CHNA1. ABILITY TO RETAIN PRIMARY CARE PROVIDERS (MD, DO, NP, PA) AND NURSES2. AVAILABILITY OF RESOURCES TO HELP THE ELDERLY STAY IN THEIR HOMES3. NOT HAVING JOBS WITH LIVABLE WAGES4. NOT HAVING ENOUGH PLACES FOR EXERCISE/ WELLNESS ACTIVITIESFOR THIS PLAN THE HOSPITAL PRIORITIZED THE FOLLOWING HEALTH NEEDS:PRIORITY HEALTH NEED #1: ABILITY TO RECRUIT AND RETAIN PRIMARY CARE PROVIDERSTO ADDRESS THIS NEED THE HOSPITAL IMPLEMENTED THE FOLLOWING STRATEGIES IN 2019-2021:FY2022 ACTIONS AND IMPACT: - CHI ST ALEXIUS HEALTH TURTLE LAKE MET WITH THE TURTLE LAKE COMMUNITY ASSOCIATION (TLCHA) IN REGARDS TO THIS MATTER. - THE TLCHA MAINTAINS THE HOSPITAL BUILDING AND GROUNDS SO IT IS IMPORTANT TO THEM TO HAVE LONG LASTING PROVIDERS WITHIN THE COMMUNITY. - THE TLCHA MATCHED SLRP FUNDS WHICH IS A STUDENT LOAN REPAYMENT PROGRAM. MEASURES:- IN ORDER TO QUALIFY FOR THIS, THE ADVANCED PRACTITIONERS NEEDED A COMMUNITY MATCH. - THIS ASSURES COMMITMENT ON THE PROVIDER'S PART TO REMAIN IN THE COMMUNITY.PRIORITY HEALTH NEED #2: AVAILABILITY OF RESOURCES TO HELP THE ELDERLY STAY IN THEIR HOMESFY2022 ACTIONS AND IMPACT: - THE ELDERLY HAVE THE CAPABILITY TO DO TELEHEALTH VISITS IN THEIR HOME DUE TO THE PANDEMIC. - HEALTH AT HOME CAME TO THE MEDICAL STAFF MEETING TO INFORM MEDICAL PROVIDERS OF THE SERVICES THEY PROVIDE TO KEEP PATIENTS IN THEIR HOMES. - WITH THE OPENING OF THE RHC CLINIC IN THE TURTLE LAKE HOSPITAL THEY ARE BEGINNING TO CONSIDER IMPLEMENTING CHRONIC CARE MANAGEMENT (CCM) THROUGH THEIR RHC. PRIORITY HEALTH NEED #3: NOT HAVING JOBS WITH LIVABLE WAGESFY2022 ACTIONS AND IMPACT: - CHI ST. ALEXIUS HEALTH TURTLE LAKE RECENTLY DID A MARKETING WAGE ADJUSTMENT FOR NONPROFESSIONAL POSITIONS. - THEY ARE CURRENTLY IN THE PROCESS OF REVIEWING OTHER POSITIONS, AS WELL. PRIORITY HEALTH NEED #4: NOT HAVING ENOUGH PLACES FOR EXERCISE/WELLNESS ACTIVITIESFY2022 ACTIONS AND IMPACT: - CHI ST. ALEXIUS HEALTH TURTLE LAKE HAS OFFERED "FITNESS" CHALLENGES WITH INCENTIVES FOR COMMUNITY MEMBERS. THESE CHALLENGES ARE USUALLY OFFERED ONCE OR TWICE A YEAR. WITH COVID-19, THEY WERE UNABLE TO DO SO IN 2020. CHI ST. ALEXIUS HEALTH TURTLE LAKE DID OFFER A FITNESS CHALLENGE FOR THEIR EMPLOYEES THAT WENT OVER VERY WELL. THERE WAS A TOTAL OF 20 PARTICIPANTS. CHI ST. ALEXIUS HEALTH TURTLE LAKE HAS ALSO PARTICIPATED IN A VARIETY OF HEALTH FAIRS. IN 2019, A PA ATTENDED A HEALTH FAIR FOR 7-12 GRADE STUDENTS IN MCLEAN COUNTY. DURING THIS HEALTH FAIR, SHE DEMONSTRATED HOW TO GIVE STITCHES WHICH WAS A HANDS-ON DEMONSTRATION. MEASURES:- THERE WAS A TOTAL OF 20 PARTICIPANTS. CHI ST. ALEXIUS HEALTH TURTLE LAKE HAS ALSO PARTICIPATED IN A VARIETY OF HEALTH FAIRS. IN 2019, A PA ATTENDED A HEALTH FAIR FOR 7-12 GRADE STUDENTS IN MCLEAN COUNTY. DURING THIS HEALTH FAIR, SHE DEMONSTRATED HOW TO GIVE STITCHES WHICH WAS A HANDS-ON DEMONSTRATION. ST. ALEXIUS MEDICAL CENTER 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. TURTLE LAKE COMMUNITY MEMORIAL HOSPITAL 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. SCHEDULE H, 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. SCHEDULE H, PART V, SECTION B, LINE 7A CHNA REPORTS FOR BOTH FACILITIES CAN BE FOUND HERE:HTTPS://WWW.CHISTALEXIUSHEALTH.ORG/COMMUNITY-HEALTH-NEED-ASSESSMENTS SCHEDULE H, PART V, SECTION B, LINE 16A HTTPS://WWW.CHISTALEXIUSHEALTH.ORG/PATIENTS-VISITORS/OUR-PATIENTS/FINANCIAL-ASSISTANCE SCHEDULE H, PART V, SECTION B, LINE 16B HTTPS://WWW.CHISTALEXIUSHEALTH.ORG/PATIENTS-VISITORS/OUR-PATIENTS/FINANCIAL-ASSISTANCE SCHEDULE H, PART V, SECTION B, LINE 16C HTTPS://WWW.CHISTALEXIUSHEALTH.ORG/PATIENTS-VISITORS/OUR-PATIENTS/FINANCIAL-ASSISTANCE 21 1 - ST ALEXIUS HEART & LUNG CLINIC 310 NORTH 10TH STREET BISMARCK ND 58501 HEART, LUNG & PERIPHERAL VASCULAR DISEASE CLINIC 2 - GREAT PLAINS REHABILITATION SERVICES 1212 EAST MAIN BISMARCK ND 58501 HOME MEDICAL PRODUCTS 3 - ST ALEXIUS MINOT CLINIC 2111 LANDMARK CIRCLE MINOT ND 58703 FAMILY MEDICINE CLINIC 4 - THE PAIN CLINIC AT CHI ST ALEXIUS HEALTH 810 E ROSSER AVE BISMARCK ND 58501 PAIN MANAGEMENT CLINIC 5 - NEUROSURGERY CLINIC AT CHI ST ALEXIUS 810 E ROSSER AVE BISMARCK ND 58501 BRAIN, NERVE, AND SPINAL CORD DISEASE CLINIC 6 - THE INFUSION CLINIC AT CHI ST ALEXIUS 310 NORTH 9TH STREET BISMARCK ND 58501 INFUSION CLINIC 7 - ARCHWAY MENTAL HEALTH SERVICES 310 NORTH 10TH STREET BISMARCK ND 58501 MENTAL HEALTH SERVICES 8 - URGENT CARE ON MAIN 807 E MAIN SUITE A BISMARCK ND 58501 URGENT CARE 9 - URGENT CARE ON 43RD 4315 OTTAWA STREET BISMARCK ND 58503 URGENT CARE 10 - THE NEUROLOGY CLINIC AT CHI ST ALEXIUS 810 E ROSSER AVE BISMARCK ND 58501 NERVOUS SYSTEM, NEUROMUSCULAR JUNCTION AND MUSCLE DISORDERS CLINIC 11 - ST ALEXIUS MANDAN CLINIC NORTH 2500 SUNSET DR NW MANDAN ND 58554 FAMILY MEDICINE CLINIC 12 - THE ARTHRITIS CLINIC AT CHI ST ALEXIUS 310 NORTH 10TH STREET BISMARCK ND 58501 JOINT, MUSCLE AND IMMUNE RHEUMATIC DISEASE CLINIC 13 - THE NEPHROLOGY CLINIC AT CHI ST ALEXIUS 310 NORTH 10TH STREET BISMARCK ND 58501 KIDNEY DISEASE CLINIC 14 - PINEHURST FAMILY MEDICAL CLINIC 921 W INTERSTATE AVE BISMARCK ND 58503 FAMILY MEDICINE CLINIC 15 - CENTURY FAMILY CLINIC 300 W CENTURY AVE BISMARCK ND 58503 FAMILY MEDICINE CLINIC 16 - OCCUPATIONAL MEDICINE CLINIC - BISMARCK 310 NORTH 9TH STREET BISMARCK ND 58501 OCCUPATIONAL MEDICINE CLINIC 17 - WASHBURN FAMILY CLINIC 1177 BORDER LANE WASHBURN ND 58577 FAMILY MEDICINE CLINIC 18 - SUPPORTIVEPALLIATIVE CARE CLINIC 810 E ROSSER AVE BISMARCK ND 58501 PALLIATIVE MEDICINE CLINIC 19 - CHI ST ALEXIUS HEALTH HEMATOLOGY & ONCOLOG 810 E ROSSER AVE BISMARCK ND 58501 ONCOLOGY CLINIC 20 - CHI ST ALEXIUS HEALTH TURTLE LAKE CLINIC 220 5TH AVE WEST PO BOX 280 TURTLE LAKE ND 58575 RURAL HEALTH CLINIC 21 - UNIVERSITY OF MARY CLINIC 7500 UNIVERSITY DR BISMARCK ND 58504 UNIVERSITY OF MARY HEALTH SERVICES 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 I, LINE 7G: SUBSIDIZED HEALTH SERVICES INCLUDES $14,172,100 IN COSTS ATTRIBUTABLE TO PHYSICIAN CLINICS. 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 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 PROMPT PAY DISCOUNTS, AND 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: ST. ALEXIUS MEDICAL CENTER MAKES EVERY EFFORT TO DETERMINE IF A PATIENT QUALIFIES FOR FINANCIAL ASSISTANCE UPON ADMISSION. ST. ALEXIUS MEDICAL CENTER'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. ST. ALEXIUS MEDICAL CENTER ALSO UTILIZES A PAYMENT ASSISTANCE RANK ORDERING (PARO) SCORING SYSTEM TO ASSIST IN DETERMINING IF AN UNINSURED PATIENT MAY QUALIFY FOR PAYMENT ASSISTANCE EVEN THOUGH THEY HAVE NOT APPLIED FOR IT. PARO IS A METHODOLOGY THAT APPLIES CONSISTENT SCREENING AND APPLICATION STANDARDS TO ALL UNINSURED 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, ST. ALEXIUS MEDICAL CENTER 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: ST. ALEXIUS MEDICAL CENTER 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, 2022, RELATED TO PATIENT ACCOUNTS RECEIVABLE AND NET PATIENT REVENUE. THE ENTIRE FOOTNOTE CAN BE VIEWED IN THE ATTACHED COMMONSPIRIT CONSOLIDATED FINANCIAL STATEMENTS ON PAGES 12-13."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. ST ALEXIUS MEDICAL CENTER'S SHORTFALL, AS REPORTED ON PART III, SECTION B, LINE 7, OF $14,924,326 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: FACILITY: ST ALEXIUS MEDICAL CENTERWE WORK IN COLLABORATION WITH SEVERAL COMMUNITY PARTNERS. HOMELESSNESS: CHI ST. ALEXIUS HEALTH WORKS COLLABORATIVELY WITH INSTITUTIONS WHO ARE PROVIDING HOUSING FOR HOMELESS INDIVIDUALS AND FAMILIES AS WELL AS INDIVIDUALS THAT ARE IMPAIRED. VIOLENCE PREVENTION: CHI ST. ALEXIUS HEALTH BISMARCK PARTICIPATES IN THE ND VIOLENCE PREVENTION PROGRAM. WE WORK CLOSELY WITH THIS PROGRAM AS IT IS A PART OF CHI. WELLNESS: WE WORK WITH CLINICS TO PREVENT OPIOID MISUSE AND PARTICIPATE IN ALL "TAKE BACK" DRUG PROGRAMS.FACILITY: TURTLE LAKE COMMUNITY MEMORIAL HOSPITALWE WORK IN COLLABORATION WITH SEVERAL COMMUNITY PARTNERS. THEY INCLUDE NATIONAL HEALTH SERVICE CORPS, CHI ST. ALEXIUS HEALTH AT HOME, MEALS ON WHEELS, MEDICALERT SYSTEMS, VETERAN SERVICES, HOSPITAL AUXILIARY, TURTLE LAKE CHAMBER OF PROGRESS, HOSPITAL ASSOCIATION BOARD, TURTLE LAKE AMBULANCE SERVICES 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: FACILITY: ST ALEXIUS MEDICAL CENTERTHE RESIDENTS OF THE CITIES OF BISMARCK AND MANDAN AND THEIR SURROUNDING AREAS ARE THE PRIMARY SOURCES OF PATIENTS SERVED BY CHI ST. ALEXIUS HEALTH BISMARCK. BISMARCK IS THE CAPITAL OF NORTH DAKOTA AND THE COUNTY SEAT OF BURLEIGH COUNTY. THE U.S. CENSUS POPULATION ESTIMATE FOR BISMARCK IN 2020 WAS 73,622 PEOPLE AND 98,458 FOR BURLEIGH COUNTY. BISMARCK IS THE SECOND MOST POPULOUS CITY IN THE STATE OF NORTH DAKOTA. THE CITY OF MANDAN IS DIRECTLY ACROSS THE MISSOURI RIVER FROM BISMARCK. THE U.S. CENSUS POPULATION ESTIMATE FOR MANDAN IN 2020 WAS 24,206 PEOPLE. MORTON COUNTY HAS A POPULATION ESTIMATE OF 33,291 PEOPLE. BISMARCK AND MANDAN MAKE UP THE CORE OF THE BISMARCK-MANDAN STATISTICAL AREA.ADDITIONAL DEMOGRAPHICS:POPULATION PER SQUARE MILEBISMARCK 1986.5 BURLEIGH COUNTY 49.8 MORTON COUNTY 14.3 NORTH DAKOTA 9.7PERSONS 65 YEARS OR OLDERBISMARCK 17.3% BURLEIGH COUNTY 16.6% MORTON COUNTY 17.0% NORTH DAKOTA 15.7%PERSONS UNDER 18 YEARSBISMARCK 22.2% BURLEIGH COUNTY 23.3% MORTON COUNTY 23.1% NORTH DAKOTA 23.6%GENDER (% FEMALE)BISMARCK 50.8% BURLEIGH COUNTY 49.9% MORTON COUNTY 49.5% NORTH DAKOTA 48.8%RACE (%)WHITE ALONEBISMARCK 87.9% BURLEIGH COUNTY 90.4% MORTON COUNTY 92.2% NORTH DAKOTA 86.9%BLACK OR AFRICAN AMERICAN ALONEBISMARCK 2.8% BURLEIGH COUNTY 2.4% MORTON COUNTY 1.3% NORTH DAKOTA 3.4%AMERICAN INDIAN OR ALASKAN NATIVE ALONEBISMARCK 4.4% BURLEIGH COUNTY 4.3% MORTON COUNTY 3.8% NORTH DAKOTA 5.6%HISPANIC OR LATINOBISMARCK 2.4% BURLEIGH COUNTY 2.8% MORTON COUNTY 4.1% NORTH DAKOTA 4.1%MEDIAN HOUSEHOLD INCOMEBISMARCK $67,629 BURLEIGH COUNTY $72,974 MORTON COUNTY $72,778 NORTH DAKOTA $65,315PERSONS IN POVERTYBISMARCK 8.4% BURLEIGH COUNTY 8.6% MORTON COUNTY 8.3% NORTH DAKOTA 10.2%CHILDREN IN POVERTYBURLEIGH COUNTY 6.76% MORTON COUNTY 6.66% NORTH DAKOTA 11.12%UNEMPLOYMENT RATEBURLEIGH COUNTY 2.8% MORTON COUNTY 3.7% NORTH DAKOTA 3.3%% OF PERSON WITHOUT HEALTH INSURANCE (UNDER 65)BISMARCK 6.5% BURLEIGH COUNTY 5.6% MORTON COUNTY 6.3% NORTH DAKOTA 8.1%% OF UNINSURED CHILDREN (UNDER 18)BURLEIGH COUNTY 5.0% MORTON COUNTY 3.2% NORTH DAKOTA 7.3%HIGH SCHOOL GRADUATION RATEBURLEIGH COUNTY 90.7% MORTON COUNTY 84.6% NORTH DAKOTA 86.3%% OF POPULATION AGE 25+ WITH BACHELOR'S DEGREE OR HIGHERBISMARCK 36.9% BURLEIGH COUNTY 36.5% MORTON COUNTY 27.3% NORTH DAKOTA 30.7%FACILITY: TURTLE LAKE COMMUNITY MEMORIAL HOSPITALTHE INPUT FROM THE RESIDENTS, WHO PRIMARILY RESIDE IN MCLEAN COUNTY, REPRESENTED THE BROAD INTERESTS OF THE COMMUNITIES IN THE SERVICE AREA. TOGETHER WITH SECONDARY DATA GATHERED FROM A WIDE RANGE OF SOURCES, THE SURVEY PRESENTS A SNAPSHOT OF THE HEALTH NEEDS AND CONCERNS IN THE COMMUNITY. DEMOGRAPHICS:WITH REGARD TO DEMOGRAPHICS, MCLEAN COUNTY'S POPULATION FROM 2010 TO 2019 INCREASED BY 5.4%. THE AVERAGE NUMBER OF RESIDENTS UNDER AGE 18 (22%) FOR MCLEAN COUNTY COMES IN 1.6 PERCENTAGE POINTS LOWER THAN THE NORTH DAKOTA AVERAGE (23.6%). THE PERCENTAGE OF RESIDENTS AGES 65 AND OLDER, IS 8.5% HIGHER FOR MCLEAN COUNTY (24.2%) THAN THE NORTH DAKOTA AVERAGE (15.7%), AND THE RATE OF EDUCATION FOR MCLEAN COUNTY (92.4%) IS REFLECTIVE TO THE NORTH DAKOTA AVERAGE (92.6%). THE MEDIAN HOUSEHOLD INCOME IN MCLEAN COUNTY ($68,529) IS HIGHER THAN THE STATE AVERAGE FOR NORTH DAKOTA ($64,894). ADDITIONAL DEMOGRAPHICS:POPULATION PER SQUARE MILEMCLEAN COUNTY 4.2 NORTH DAKOTA 9.7PERSONS 65 YEARS OR OLDERMCLEAN COUNTY 24.2% NORTH DAKOTA 15.7%PERSONS UNDER 18 YEARSMCLEAN COUNTY 22% NORTH DAKOTA 23.6%GENDER (% FEMALE)MCLEAN COUNTY 51.7% NORTH DAKOTA 48.8%RACE (%)WHITE ALONEMCLEAN COUNTY 89.6% NORTH DAKOTA 86.9%MEDIAN HOUSEHOLD INCOMEMCLEAN COUNTY $68,529 NORTH DAKOTA $65,315PERSONS IN POVERTYMCLEAN COUNTY 9.4% NORTH DAKOTA 10.2%% OF PERSON WITHOUT HEALTH INSURANCE (UNDER 65)MCLEAN COUNTY 9.1% NORTH DAKOTA 8.1%HIGH SCHOOL GRADUATION RATEMCLEAN COUNTY 92.4% NORTH DAKOTA 86.3%% OF POPULATION AGE 25+ WITH BACHELOR'S DEGREE OR HIGHERMCLEAN COUNTY 20.8% NORTH DAKOTA 30.7% 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 21 STATES AND IS THE SOLE CORPORATE MEMBER (PARENT CORPORATION) OF OTHER PRIMARILY NONPROFIT CORPORATIONS THAT ARE EXEMPT FROM FEDERAL AND STATE INCOME TAXES. AS OF JUNE 30, 2022, COMMONSPIRIT HEALTH IS COMPRISED OF APPROXIMATELY 2,200 CARE SITES, CONSISTING OF 142 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. IN FISCAL YEAR 2022, COMMONSPIRIT HEALTH PROVIDED MORE THAN $3.16 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 $4.89 BILLION WITH THE INCLUSION OF THE UNPAID COSTS OF MEDICARE. THE HEALTH SYSTEM, WHICH GENERATED OPERATING REVENUES OF $33.9 BILLION IN FISCAL YEAR 2022, HAS TOTAL ASSETS OF APPROXIMATELY $50.31 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. PART VI, LINE 7, REPORTS FILED WITH STATES ND 1 BENEDICTINE SISTERS OF THE ANNUNCIATION 7520 UNIVERSITY DR BISMARCK ND 58504 450261530 501(C)(3) 530450 0 PROGRAM SUPPORT LIGHT OF CHRIST SCHOOLS 1025 N 2ND ST BISMARCK ND 58501 460581758 501(C)(3) 52083 0 PROGRAM SUPPORT BISMARCK MARATHON PO BOX 7023 BISMARCK ND 58507 208441757 501(C)(3) 6205 0 PROGRAM SUPPORT 3 0 PART I, LINE 2: ST. ALEXIUS MEDICAL CENTER MAKES DONATIONS TO ENTITIES WITH CHARITABLE MISSIONS TO ENSURE THAT OUR DONATIONS ARE USED FOR THE PURPOSES INTENDED. 0 1 0 0 0 0 0 0 0 DR STEVEN KRALJIC NEUROSURGEON 1276246 0 786546 0 1260 0 10150 0 27434 0 2101636 0 0 0 JEANETTE WOJTALEWICZ DIRECTOR/CSH SVP DIVISION OFFICER 0 646728 0 527651 0 59042 0 17100 0 34803 0 1285324 0 0 CAMERON CHARCHENKO MD - UROLOGY 629384 0 363642 0 54671 0 118875 0 12397 0 1178969 0 0 0 KURT SCHLEY DIRECTOR & CEO (THROUGH 2/17/22) 0 459470 0 337184 0 105932 0 17100 0 30342 0 950028 0 78652 JOHN HOYT PHYSICIAN 564298 0 303177 0 840 0 27248 0 32664 0 928227 0 0 0 NICHOLAS BRADBURY MD - INTERVENTIONAL RADIOLOGY 0 0 812543 0 0 0 27525 0 0 0 840068 0 0 0 PATRICK GRACE PHYSICIAN 527208 0 167212 0 30957 0 2881 0 22481 0 750739 0 0 0 KEVIN DAHMEN MD SECRETARY/TREASURER/PSYCHIATRIST 268860 0 324198 0 1932 0 25750 0 30183 0 650923 0 0 0 TODD PRESZLER MD DIRECTOR/ANESTHESIOLOGIST 501642 0 73913 0 19461 0 10304 0 30183 0 635503 0 0 0 SHIRAZ HYDER DIRECTOR/NEUROLOGIST 331241 0 75030 0 5544 0 28600 0 30183 0 470598 0 0 0 J'PATRICK FAHN INTERIM CHIEF MEDICAL OFFICER 351107 0 40328 0 1243 0 9750 0 26992 0 429420 0 0 0 DR ELISA LAURENT CMO (THROUGH 10/6/21) 282859 0 0 0 4064 0 0 0 15607 0 302530 0 0 0 KEITH HORNER DIRECTOR OF PHARMACY & CLINICAL INFO 202452 0 34250 0 1082 0 8609 0 29256 0 275649 0 0 0 ELLEN HOLT DIRECTOR HUMAN RESOURCES 176552 0 28012 0 2039 0 5688 0 9448 0 221739 0 0 0 TERRI DONOVAN CHIEF FINANCIAL OFFICER (THROUGH 10/ 188987 0 9430 0 1067 0 0 0 8939 0 208423 0 0 0 RAUMI KUDRNA VP PATIENT CARE SERVICES 143333 0 30396 0 291 0 6163 0 4509 0 184692 0 0 0 PART I, LINE 3 DURING THE CALENDAR YEAR 2021, COMPENSATION FOR THE TOP MANAGEMENT OFFICIAL WAS ESTABLISHED AND PAID BY COMMONSPIRIT HEALTH, A RELATED ORGANIZATION. COMMONSPIRIT HEALTH USED THE FOLLOWING TO ESTABLISH THE TOP MANAGEMENT OFFICIAL'S COMPENSATION: (1) COMPENSATION COMMITTEE; (2) INDEPENDENT COMPENSATION CONSULTANT; (3) COMPENSATION SURVEY OR STUDY; (4) APPROVAL BY THE BOARD OR COMPENSATION COMMITTEE. SCHEDULE J, PART I, 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. NO REPORTABLE INDIVIDUALS RECEIVED SEVERANCE PAYMENTS DURING THE 2021 CALENDAR YEAR. SCHEDULE J, PART I, LINE 4B DURING THE 2021 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. DURING 2021 THE FOLLOWING DISTRIBUTIONS WERE MADE BY COMMONSPIRIT FROM THE DEFERRED COMPENSATION PLAN: KURT SCHLEY, $79,433 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 2021 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 2021, THE FOLLOWING PAYMENTS WERE MADE PURSUANT TO THE SUPER VESTING RULES: KURT SCHLEY, $22,888; JEANETTE WOJTALEWICZ, $55,430 KARI EMERY FAMILY MEMBER OF A BOARD MEMBER 259746 EMPLOYEE PAYROLL WAGES 0 HOLLI SCHOCK FAMILY MEMBER OF A KEY EMPLOYEE 62980 EMPLOYEE PAYROLL WAGES 0 AUSTIN SCHOCK FAMILY MEMBER OF A KEY EMPLOYEE 76185 EMPLOYEE PAYROLL WAGES 0 KRISTEN FAHN FAMILY MEMBER OF A KEY EMPLOYEE 16747 EMPLOYEE PAYROLL WAGES 0 FORM 990, PART VI, SECTION A, LINE 1A PURSUANT TO SECTION 8.6 OF THE BYLAWS OF ST. ALEXIUS MEDICAL CENTER, THE EXECUTIVE COMMITTEE IS COMPOSED OF ONLY DIRECTORS OF THE CORPORATION AND SHALL BE COMPOSED OF THE CHAIRPERSON OF THE BOARD, THE VICE CHAIRPERSON OF THE BOARD, AND THE PRESIDENT, EACH OF WHOM SHALL SERVE AS AN EX OFFICIO VOTING MEMBER OF THE EXECUTIVE COMMITTEE. EACH INDIVIDUAL APPOINTED TO THE EXECUTIVE COMMITTEE SHALL SERVE FOR A TERM OF ONE (1) YEAR OR UNTIL HIS OR HER SUCCESSOR IS DULY APPOINTED BY THE BOARD OF DIRECTORS. PURSUANT TO SECTION 8.1 OF THE CORPORATION'S BYLAWS, COMMITTEES, SUCH AS THE EXECUTIVE COMMITTEE, THAT ARE GRANTED THE AUTHORITY TO ACT ON BEHALF OF THE BOARD OF DIRECTORS MAY INCLUDE ONLY DIRECTORS OF THE CORPORATION. FURTHER, PURSUANT TO SECTION 8.6 OF THE CORPORATION'S BYLAWS, THE EXECUTIVE COMMITTEE HAS AND MAY EXERCISE SUCH POWERS AS MAY BE DELEGATED TO IT BY THE BOARD OF DIRECTORS. THE EXECUTIVE COMMITTEE ALSO POSSESSES THE POWER TO TRANSACT ROUTINE BUSINESS OF THE CORPORATION IN THE INTERIM PERIOD BETWEEN REGULARLY SCHEDULED MEETINGS OF THE BOARD OF DIRECTORS. FORM 990, PART VI, SECTION A, LINE 6 ACCORDING TO THE BYLAWS OF ST. ALEXIUS MEDICAL CENTER, 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, COMMONSPIRIT HEALTH 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: * APPROVE MEMBERS OF THE ORGANIZATION'S BOARD * AMENDMENT OF THE CORPORATE DOCUMENTS OF THE ORGANIZATION * ADOPTION OF LONG RANGE AND STRATEGIC PLANS FOR THE ORGANIZATION * SUBSTANTIAL CHANGE IN THE MISSION OR PHILOSOPHY OF THE ORGANIZATION * REMOVAL OF A MEMBER OF THE GOVERNING BODY OF THE ORGANIZATION * APPROVAL OF ISSUANCE OF DEBT BY ORGANIZATION * APPROVAL OF PARTICIPATION OF ORGANIZATION IN A JOINT VENTURE * APPROVAL OF FORMATION OF A NEW CORPORATION BY ORGANIZATION * APPROVAL OF A MERGER INVOLVING THE ORGANIZATION * APPROVAL OF THE SALE OF ALL OR SUBSTANTIALLY ALL OF THE ASSETS OF THE ORGANIZATION * TO REQUIRE THE TRANSFER OF ASSETS BY THE ORGANIZATION TO COMMONSPIRIT HEALTH TO ACCOMPLISH COMMONSPIRIT HEALTH'S GOALS AND OBJECTIVES, AND TO SATISFY COMMONSPIRIT HEALTH DEBTS. PURSUANT TO SECTION 5.5 OF THE ORGANIZATION'S BYLAWS, COMMONSPIRIT HEALTH MAY, IN EXERCISE OF THEIR APPROVAL POWERS, GRANT OR WITHHOLD APPROVAL IN WHOLE OR IN PART, OR MAY, IN ITS COMPLETE DISCRETION, AFTER CONSULTATION WITH THE BOARD AND ITS PRESIDENT AND THE CHIEF EXECUTIVE OFFICER OF THE ORGANIZATION, RECOMMEND SUCH OTHER OR DIFFERENT ACTIONS AS IT DEEMS APPROPRIATE. (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 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 - 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 LINE 15A THE ORGANIZATION'S TOP MANAGEMENT OFFICIAL'S COMPENSATION WAS PAID BY COMMONSPIRIT HEALTH, A RELATED ORGANIZATION. THE BOARD OF STEWARDSHIP TRUSTEES APPOINTS A HUMAN RESOURCES AND COMPENSATION COMMITTEE, COMPRISED EXCLUSIVELY OF INDEPENDENT DIRECTORS, WHO ARE ACCOUNTABLE FOR APPROVING REASONABLE COMPENSATION PACKAGES FOR EACH OFFICER AND CERTAIN KEY EMPLOYEES (INCLUDING THE PRESIDENT/CEO). THE HUMAN RESOURCES AND COMPENSATION COMMITTEE APPROVES, CONSISTENT WITH THE ORGANIZATION'S PHILOSOPHY AND PRINCIPLES, THE ANNUAL PERFORMANCE GOALS AND CRITERIA TO BE USED IN DETERMINING MERIT INCREASES AND VARIABLE COMPENSATION CRITERIA FOR OFFICERS AND KEY EXECUTIVES. THE HUMAN RESOURCES AND COMPENSATION COMMITTEE ALSO ENGAGES AN INDEPENDENT CONSULTANT AS NECESSARY AND QUALIFIED INDEPENDENT COMPENSATION AND BENEFITS SPECIALISTS (INDEPENDENT EXPERTS) TO REVIEW, ANALYZE AND PROVIDE BENCHMARKING DATA FOR THE TOTAL COMPENSATION AND BENEFITS PACKAGES OF OFFICERS AND KEY EXECUTIVES. APPROPRIATE COMPARABLE DATA IS OBTAINED FROM THE INDEPENDENT EXPERTS, (E.G., TOTAL ECONOMIC BENEFITS PAID BY SIMILARLY SITUATED ORGANIZATIONS, BOTH TAXABLE AND TAX-EXEMPT, FOR SIMILAR JOB RESPONSIBILITIES). KEY DELIBERATIONS OF THE COMMITTEE ARE DOCUMENTED IN MEETING MINUTES WHICH ARE APPROVED AT THE NEXT COMMITTEE MEETING AND PROVIDED TO THE BOARD OF STEWARDSHIP TRUSTEES. THE DOCUMENTATION OF THE DELIBERATIONS INCLUDES (A) THE TERMS OF THE AGREEMENT APPROVED AND THE DATE APPROVED; (B) THE MEMBERS OF THE COMMITTEE WHO WERE PRESENT DURING DISCUSSION OF THE APPROVED AGREEMENT AND THOSE WHO VOTED ON IT; AND (C) THE COMPARABILITY DATA OBTAINED AND RELIED UPON BY THE COMMITTEE AND HOW THE DATA WAS OBTAINED. COMPENSATION FOR THE PRESIDENT/CEO WAS PAID BY ST ALEXIUS MEDICAL CENTER. ST ALEXIUS' EXECUTIVE COMMITTEE ENGAGES WITH AN INDEPENDENT CONSULTANT AS NECESSARY AND QUALIFIED INDEPENDENT COMPENSATION AND BENEFITS SPECIALISTS (INDEPENDENT EXPERTS) TO REVIEW, ANALYZE AND PROVIDE BENCHMARKING DATA. APPROPRIATE COMPARABLE DATA IS OBTAINED FROM THE INDEPENDENT EXPERTS, BOTH TAXABLE AND TAX-EXEMPT, FOR SIMILAR JOB RESPONSIBILITIES). KEY DELIBERATIONS AND APPROVALS OF THE COMMITTEE ARE DOCUMENTED IN COMMITTEE MEETING MINUTES. LINE 15B COMPENSATION IS REVIEWED ANNUALLY BY AN INDEPENDENT GROUP USING COMPARABILITY DATA AND RECOMMENDATIONS ARE PRESENTED TO THE PRESIDENT AND/OR EXECUTIVE COMMITTEE FOR APPROVAL. 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.COMMONSPIRIT.ORG. FORM 990, PART IX, LINE 11G CONTRACT SERVICES: PROGRAM SERVICE EXPENSES 21,794,403. MANAGEMENT AND GENERAL EXPENSES 10,256,190. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 32,050,593. CONTRACT LABOR: PROGRAM SERVICE EXPENSES 13,645,657. MANAGEMENT AND GENERAL EXPENSES 6,421,486. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 20,067,143. PURCHASED SERVICES: PROGRAM SERVICE EXPENSES 9,339,995. MANAGEMENT AND GENERAL EXPENSES 4,383,227. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 13,723,222. OTHER FEES FOR SERVICES: PROGRAM SERVICE EXPENSES 5,364,663. MANAGEMENT AND GENERAL EXPENSES 2,524,547. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 7,889,210. CONSULTING FEES: PROGRAM SERVICE EXPENSES 45,264. MANAGEMENT AND GENERAL EXPENSES 21,301. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 66,565. FORM 990, PART XI, LINE 9: ANNUAL GIFT ANNUITY -1,500. EQUITY CHANGES IN UNCONSOLIDATED ORGS 2,862,026. 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